TRIAD FALL 2014
VOLUME 25 ISSUE 4
THE AWARD WINNING JOURNAL OF THE MICHIGAN OSTEOPATHIC ASSOCIATION
• Holistically holistic: An osteopathic approach to complementary and alternative medicine (cam) • Be Cybersecure: Protect Patient Records, Avoid Fines, and Safeguard Your Reputation
Congratulations to our newest PCMH practices. Blue Cross Blue Shield of Michigan and Blue Care Network proudly congratulate the 902 DO physicians designated by BCBSM as Patient-Centered Medical Homes (PCMH) in 2014. Their efforts are helping to dramatically transform health care delivery and outcomes across the state of Michigan. In this sixth year, the results continue to be impressive: • Significantly fewer emergency visits and hospital stays • More than 99% of designated practices provide medication review and management for patients with chronic conditions • The number of PCMH-designated physicians has more than tripled in the last six years There are now more than 4,000 PCMH-designated PCPs in 78 of Michigan’s 83 counties. PCMH is one of many initiatives within the nationally recognized Physician Group Incentive Program (PGIP), where more than 19,000 Michigan physicians work together to transform health care delivery for Michigan adults and children.
MOA members: To learn more about joining PGIP, contact your BCBSM provider consultant or visit valuepartnerships.com
Patient-Centered Medical Home || Hospital Collaborations || Physician Group Incentive Program
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
TABLE OF CONTENTS FEATURES 12
Holistically holistic: An osteopathic approach to
complementary and alternative medicine
18
The Doctors Company:
Be Cybersecure—Protect Patient Records, Avoid
Fines, and Safeguard Your Reputation
DEPARTMENTS 5
Editor’s Notebook
7
President’s Page
9
Physician Spotlight: David Best, D.O.
10
Intern/Resident Spotlight: Adam Hunt, D.O., MHS
11
Student Spotlight: Kevin Leikert, OMS-II
21
The Practice Manager
22
Dean’s Column
23
Advertiser Index
FALL 2014 VOLUME 25 ISSUE 4
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4 TRIAD, FALL 2014
EDITOR’S NOTEBOOK
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omplementary, alternative and integrative medicine, while hard to define, is often used to mean the array of health care approaches with a history of use or origins outside of mainstream medicine. This may include acupuncture, massage therapy, meditation, movement
therapies, tai chi, spinal manipulation and more. More Americans are turning to complementary, alternative and integrative medicine, including those who have trouble meeting
JOHN SEALEY, D.O., FACOS
the cost of conventional care. While osteopathic medicine is a form of conventional medicine, it is our hands-on techniques, such as osteopathic manipulation, that are considered – by some – as an element of complementary, alternative and integrative medicine. We have an underlying belief that all of the body’s systems work together; and, disturbances in one system may affect function elsewhere in the body. In this edition of TRIAD, we have interviewed three osteopathic physicians who will shed light on the practice of complementary, alternative and integrative medicine.
KEVIN LEIKERT, OMS-II
Edward Rosick, D.O., Wendy Page-Echols, D.O. and William Page-Echols, D.O. use their experience to discuss complementary, alternative and integrative medicine. JOHN SEALEY, D.O., FACOS, AND KEVIN LEIKERT, OMS-II, ARE EDITORS-IN-CHIEF OF TRIAD AND MEMBERS OF THE MOA BOARD OF TRUSTEES.
As always, we would like to hear from you! Did you like this issue of triad? Please send us feedback by e-mailing: kmcfatridge@mi-osteopathic.org.
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PRESIDENT’S PAGE
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ccording to the National Center for Complementary and Alternative Medicine (NCCAM), nearly 40 percent of Americans “use health care approaches developed outside of mainstream Western, or conventional, medicine for specific conditions or overall well-being.”
Osteopathic medicine, as we might remember, was once labeled as alternative medicine. As the public began to better understand osteopathic medicine, the more widely
MYRAL R. ROBBINS, D.O., FAAFP, FACOFP
accepted it became. What differentiates us as osteopathic physicians is our beliefs that all body systems are interrelated and interdependent for good health. It was Dr. Andrew Taylor Still who pioneered the concept of “wellness” and recognized the importance of treating illness within the context of the whole body. Dr. Still’s research and clinical observations led him to believe that the musculoskeletal system played a vital role in health and disease and that the body contained, when properly stimulated, all the elements needed to maintain health. Dr. Still believed that by correcting problems in the body’s structure, through the use of manual techniques known as osteopathic manipulative treatment, the body’s ability to function and heal itself could be greatly improved. He also promoted the idea of preventive medicine and endorsed the philosophy that physicians should focus on treating the whole patient, rather than just the disease. At its inception, many criticized osteopathic medicine for its tenets. Today, many similarly criticize complementary, alternative and integrative medicine. I believe we can learn from history. The humble beginnings of osteopathic medicine, ultimately, changed health care. I wonder what complementary, alternative and integrative medicine will be like in 10 years? MYRAL R. ROBBINS, D.O., FAAFP, FACOFP IS THE PRESIDENT OF THE MICHIGAN OSTEOPATHIC ASSOCIATION AND MAY BE REACHED AT MYRALROBBINSDO@AOL.COM.
“A mind is like a parachute. It doesn’t work if it is not open.” — Frank Zappa —
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8 TRIAD, FALL 2014
D.O. SPOTLIGHT DAVID BEST, D.O.
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BY CHLOE SEYMOUR
DAVID BEST, D.O.
eginning his osteopathic career, David Best, D.O. received the National Health Service Corps Scholar award, giving him the opportunity to work in a medically underserved region. With multiple opportunities in northern Michigan,
Dr. Best made the trek north and never looked back. Practicing medicine in areas that desperately need medical attention provides Dr. Best with a daily reminder of the power of his profession.
“Osteopathic medicine is great because we’re looking at the whole rather than just one area,” Dr. Best said. “It’s a rewarding profession.” A profession so rewarding that Dr. Best balances his time as both the medical director and hospice physician at Heartland Hospice, along with his own private practice, Best Medical Services. In addition to being newly inducted to the Michigan Osteopathic Association Board of Trustees, Dr. Best is the current president of the Michigan Association of Osteopathic Family Physicians. He emphasizes the immense benefits of being involved in professional organizations. “I think it’s important to know what direction healthcare reform is going and it’s a way to remain in contact with your peers,” Dr. Best said. Taking on his new role on the Board of Trustees, Dr. Best is looking forward to cultivating connections with other D.O.s, in order to continue promoting the osteopathic profession. “It’s still early in the game, but I’m looking forward to developing relationships with others on the Board,” he said. “We really learn from each other and we strive to make our profession the best it can be.”
TRIAD, FALL 2014 9
RESIDENT SPOTLIGHT ADAM HUNT, D.O.
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BY CHLOE SEYMOUR
ADAM HUNT, D.O.
or Adam Hunt, D.O., choosing to attend medical school and pursue his residency in Michigan was a no-brainer. A Troy, Michigan native, Dr. Hunt feels there is no other place to be when entering into a career in osteopathic medicine.
“Michigan is kind of a D.O. hub, with most osteopathic programs based here in Michigan,” Dr. Hunt said. “I love Michigan, it’s home for me. I’m very comfortable here and I like that it’s a D.O. stronghold.” Dr. Hunt completed his undergraduate in biology at the University of Michigan and attended the Johns Hopkins University Bloomberg School of Public Health where he received a master’s focusing on international health and disease prevention. He is a graduate of the Michigan State University College of Osteopathic Medicine and is currently in residency at McLaren Oakland Regional Medical Center in Pontiac, Michigan. With a concentration in family practice, Dr. Hunt has found that his residency, at what is considered an inner-city practice, has been mutually rewarding for both him and the patients he serves.
“Getting to see people that have gone without any kind of insurance and getting them back on track has been a rewarding experience for me,” Dr. Hunt said. “I’m going through these experiences with fellow residents and fellow D.O.s and maturing as a physician.” With his new position on the Michigan Osteopathic Association Board of Trustees, Dr. Hunt is seeking to gain further insight into his profession from other members. “I’m looking forward to making the voices of the interns and residents on the board heard, and learning from the experienced people on the board, they have a lot to offer,” He said. “MOA has already been a springboard for other great opportunities.” 10 TRIAD, FALL 2014
STUDENT SPOTLIGHT KEVIN LEIKERT, OMS-II
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BY CHLOE SEYMOUR
KEVIN LEIKERT, OMS-II
evin Leikert knew exactly where he wanted to go to medical school. “I can’t seem to leave! Michigan State has been great since day one of my undergrad and remains so now that I’m a medical
student,” Leikert explained. Though his educational track was an easy pick, his path to the Michigan Osteopathic Association Board of Trustees was a little less clear. Unknowingly nominated to serve as a student doctor trustee on the MOA Board, Kevin accepted the responsibility and has become more than grateful for the unpredicted opportunity to learn from board members.
“Medical school is known for being a lot of work - and it is - but I think what I’ve loved the most has been the D.O. community as a whole,” Leikert said. “It has a family feel and it’s given me great opportunities and taught me a lot.” Leikert, a Ludington, Michigan native and a second year student at the Michigan State University College of Osteopathic Medicine holds more than just his prestigious MOA student leader position. He also serves as the president of the MSUCOM Peer Mentor Organization and the treasurer of the MSUCOM class of 2017. A trip to the American Osteopathic Association House of Delegates in Chicago helped Leikert recognize that serving on the MOA Board as a student sets his knowledge of the profession apart from many of his peers. “With the MOA, I’m able to see what’s currently happening in the osteopathic community and how these policies will affect me in the future; as a student I would likely have a zero exposure to this,” Leikert said. Through his participation in both student groups and MOA, Leikert has come to understand the importance of staying active within the D.O. community when he begins practicing. “I’ve gained a different perspective that I wouldn’t have otherwise,” Leikert said. “It made me realize that I want to stay involved in the politics of medicine in our state once I become a practicing physician.” TRIAD, FALL 2014 11
BY VERONICA GRACIA-WING
Complementary and alternative medicine. Complementary medicine. Alternative medicine. Integrative medicine. Complementary and integrative medicine. It seems there are endless iterations and combinations in the attempt to describe a growing trend in health care.
WHAT IS THE TREND?
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he array of approaches to health care that fall outside of mainstream medicine, which by all reports, appear to be used by a growing number of patients. The National Center for Complementary and Alternative Medicine is the Federal Government’s agency for scientific research on complementary and alternative medicine, making up one of the 27 institutes and centers within the National Institutes of Health. Established in 1998, NCCAM offers the following when trying to settle on just exactly what to call this approach.
True alternative medicine is not common. Most people use non-mainstream approaches along with conventional treatments. And the boundaries between complementary and conventional medicine overlap and change with time. For example, guided imagery and massage, both once considered complementary or alternative, are used regularly in some hospitals to help with pain management.” Add to this that many consider CAM (complementary and alternative medicine) part of integrative medicine or integrative health care, and you have a cumbersome number of options from which to choose when describing the very thing that unites and underscores the osteopathic profession: the holistic approach. You’d think that for a majority of osteopathic physicians, integrating practices with origins outside of mainstream medicine would be commonplace, an answer to truly treating patients holistically. Not so, says Edward Rosick, D.O., chairperson and medical director of the Michigan State University College of Osteopathic Medicine’s family and community medicine department.
– ‘Complementary’ generally refers to using a nonmainstream approach together with conventional medicine.
“Historically, D.O. practices were thought of as complementary and alternative medicine. Just 75 years ago D.O.s were thought of as quacks, but what was once considered quackery is now standard. However, we’re finding that it’s more likely for an M.D. to practice CAM, most likely because a majority of the medical centers that offer training are in allopathic institutions,” said Dr. Rosick.
– ‘Alternative’ refers to using a non-mainstream approach in place of conventional medicine.
(Though, Dr. Rosick does wonder if the reason we see more M.D.s practicing CAM is simply because there are more of them.)
“When describing health approaches with non-mainstream roots, people often use the words ‘alternative’ and ‘complementary’ interchangeably, but the two terms refer to different concepts:
12 TRIAD, FALL 2014
If you haven’t taken the official plunge into CAM as an osteopathic professional, this is the article for you. In this issue of TRIAD, we’ll explore CAM practices and discuss some of the latest research in complementary and alternative medicine.
JUST WHAT IS IT? NCCAM very practically breaks CAM up into two subgroups: mind and body practices and natural products. Mind and body practices encompass procedures and techniques that are administered or taught by professionals. Examples from NCCAM include: • Acupuncture - the stimulation of specific points on
the body, most often by inserting thin needles through the skin. • Hypnotherapy - done with the help of a therapist
to induce a trance-like state in which focus and concentration are heightened.
Natural products encompass a diversity of products, including herbs, vitamins and minerals and probiotics. The public’s use of and interest in natural products have increased substantially in recent decades. A 2007 National Health Interview Survey indicated that 17.7 percent of American adults had used a non-vitamin/ non-mineral natural product in the past year; these products were the most popular complementary health approaches among both adults and children. What supplements are colleagues recommending most frequently? “Omega-3, vitamin D and a multivitamin,” said Dr. Rosick. “But not until we’ve talked about nutrition.” Rosick believes that nutrition is the core of patient health and that physicians do not talk about that foundational core nearly enough. Which could classify it as a CAM approach. “It does not matter what supplements you take if you eat poorly,” he said. “Our system is in dire need of a shift where nutrition fits into patient care and there is more nutrition training for physicians.”
• Massage therapy - includes different techniques
in which practitioners manually manipulate the soft tissues of the body. • Meditation - techniques, such as mindfulness
meditation or transcendental meditation, which involve ways in which a person learns to focus attention. • Movement therapies - include a broad
range of Eastern and Western movement-based approaches; examples include Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration and Trager psychophysical integration. • Relaxation techniques - includes methods
such as breathing exercises, guided imagery and progressive muscle relaxation, and are designed to produce the body’s natural relaxation response. • Spinal manipulation - hand or a device
manipulation to apply a controlled force to a joint of the spine. • Tai chi and qi gong - traditional Chinese
medicine practices that combine specific movements or postures, coordinated breathing and mental focus. • Yoga - a variety of styles used for health purposes
typically combine physical postures or movement, breathing techniques and meditation. TRIAD, FALL 2014 13
Environmental medicine is also in the CAM toolbox, according to Wendy Page-Echols, D.O and William Page-Echols, D.O., physicians and owners of Full Spectrum Family Medicine in East Lansing, Michigan. “Environmental medicine dates back to the 70s when physicians saw patients not responding to classic treatments,” said Dr. Wendy Page-Echols. “They followed up with careful allergy testing of outdoor allergens and food intolerances, and recently expanded to include investigating chemicals and toxicology levels.” Common supplements recommendations from Drs. Page-Echols include vitamin B3, B6 and B12, folic acid and even turmeric.
HOW SHOULD I START THE CONVERSATION?
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efore you have the conversation with patients about CAM, Dr. Rosick has a word of advice.
“Read the studies,” said Dr. Rosick. “It behooves us as physicians to be on the forefront of research and understanding what the data is showing.” Dr. Rosick frequents pubmed.com for intriguing CAM-related data. Drs. Page-Echols are advocates of attending CAM courses and following the research and conferences available through a variety of societies and medical groups. “We use institutions like the American Holistic Medical Association, American Academy of Medical Acupuncture, American Academy of Environmental Medicine as resources and bring back that knowledge to our patients,” they said. All three physicians believe there are misconceptions about the level of research to back up the claims in some approaches to CAM as well as misconceptions regarding the comparative strength of a prescription drug. “It’s difficult to weed through, “ Dr. Rosick admits. “There isn’t an easy answer when we look to sorting through it all to determine what is actually beneficial and what is snake oil.” 14 TRIAD, FALL 2014
But for Rosick, determining what complementary and alternative practices are effective is all part of the science behind medicine. “At one point I talked about the supplement policosanol with my patients, which was touted for lowering cholesterol. Research now shows it’s virtually worthless, so I don’t recommend it anymore. But science is about discovery and refining recommendations, whether prescription or supplemental.” Drs. Page-Echols believe in reading where a patient is at in their treatment. If a patient thinks a standard prescription is more effective or stronger than an herbal alternative, it’s on the physician to understand when and if they’ll become approachable about trying something with a comparable or higher effectiveness.
“You partly have to approach people to see where they’re at and what they’re ready to hear,” said Dr. Will Page-Echols. “Using our clinical judgment to gain that understanding is very important. Perhaps a patient you’ve known for a while has been helped by anxiety medications, but they continue to need refills. We would try in this case to figure out where it’s coming from through a mini counseling session and visualization techniques. As a result, we may recommend going to a yoga class or hypnotherapist as a way to manage anxiety. It all boils down to helping them help themselves, and CAM plays a major role in that at our practice.”
WHAT ARE THE BENEFITS? Let’s take a look at what research says about the commonly recommended supplements from Dr. Rosick and Drs. Page-Echols. Omega-3 fatty acids - Research indicates that omega-3 fatty acids reduce inflammation and may help lower risk of chronic diseases such as heart disease, cancer and arthritis and also appear to be important for cognitive and behavioral function. Vitamin D - Vitamin D is linked to decreased risk of bone fractures, increasing muscle strength, control-
ling blood pressure and preventing artery damage. Multivitamin - While multivitamin is not a cure all, it can address the fact that many people do not eat
the healthiest of diets. Multivitamins can help fill nutritional gaps caused by poor diet. Vitamin B3 - Vitamin B3 in niacin form is used to treat high cholesterol as well as diabetes and
osteoarthritis. Vitamin B6 - Vitamin B6 has been linked to alleviating several health concerns, including nausea and
vomiting in pregnant women, and has shown some promise in addressing cognitive function and cardiovascular issues, though more research is necessary. Vitamin B12 - Vitamin B12 (along with taking folic acid, thiamine and riboflavin) might help prevent cervical cancer as well as improve thinking and memory in people aged 65 and older, when used in combination with vitamin B6 and folic acid. Folic acid - Folic helps prevent major birth defects of the baby’s brain and spine. Turmeric - Preliminary research suggests turmeric may have anti-inflammatory, anticancer and antioxidant
properties, though ongoing research is necessary.
How about the mind and body practices? Acupuncture - Results from a number of studies suggest that acupuncture may help ease types of pain
that are often chronic such as low-back pain, neck pain and osteoarthritis/knee pain. Hypnotherapy - Hypnotherapy has been studied in relation to number of conditions, including anxi-
ety, headaches, smoking cessation, pain control, hot flashes in breast cancer survivors and irritable bowel syndrome. Massage therapy - There is evidence that massage helps with back pain and may improve quality of life
for people with depression, cancer and HIV/AIDS. Meditation - Meditation has been shown to address anxiety, pain, depression, stress, insomnia and physi-
cal or emotional symptoms that may be associated with chronic illnesses. Movement therapies - Movement therapies are linked to improvements in symptoms such as pain, sleep quality, depression, as well as quality of life. Relaxation techniques - Research has focused primarily on illness and conditions in which stress may
play a role either as the cause of the condition or as a factor that can make the condition worse and indicates relaxation helps anxiety, asthma, depression, fibromyalgia and headache. Spinal manipulation - Provides mild-to-moderate relief from low-back pain. Yoga - Current research suggests specific yoga poses may reduce low-back pain and improve function.
Other studies also suggest that practicing yoga might improve quality of life, reduce stress, lower heart rate and blood pressure, help relieve anxiety, depression and insomnia and improve overall physical fitness, strength and flexibility. TRIAD, FALL 2014 15
WHERE ARE WE HEADING?
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ccording to the National Health Interview Survey, conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics and released in December 2008, approximately 38 percent of U.S. adults aged 18 years and over and approximately 12 percent of children use some form of CAM.
Dr. Rosick also encourages colleagues to keep an open mind and talk to peers who are clearer on the subject of CAM, and offers himself as a resource to those interested in learning more.
A more recent NHIS study in 2012 collected information on the use of 18 complementary health approaches, which included 10 types of provider-based health therapies, but remains unpublished as of printing.
“We keep learning so much and we’ve met such fun, creative and interesting people along the way. It’s good to be inspired by the interesting and evolving work of others.”
Pair this with the so far limited and in-progress evidence with which to make informed decisions, and the charge is clear.
“The call to action here is to be honest with your patients,” said Dr. Rosick. “Good medicine involves listening to your patients and giving your opinion based on the best information possible. Those of us who practice outside the mainstream must hold ourselves to a higher standard.”
For Drs. Page-Echols, keeping up to date and on top of the latest in CAM is not only professionally fulfilling, but also fun.
For more information about CAM please visit the National Center for Alternative and Complementary medicine website: http://nccam.nih.gov/. _______________ SOURCES: http://nccam.nih.gov/ http://www.cdc.gov/ http://umm.edu/health/ http://ods.od.nih.gov/ http://www.mayoclinic.org/ http://www.hsph.harvard.edu/
Specializing in all aspects of healthcare law, including: Healthcare business transactions including contracts, corporate formations, mergers and acquisitions Stark and fraud and abuse analysis RAC, Medicare, Medicaid and other third party payor audit defense Proactive compliance programs for RAC and Medicare Audits Physician Hospital Organizations, Physicians Organizations and Accountable Care Organizations Regulatory compliance Billing and reimbursement issues Provider participation and deselection matters Licensure and staff privilege matters Defense of civil and criminal healthcare fraud issues
WACHLER & ASSOCIATES. PC 210 E. Third St., Suite 204, Royal Oak, MI 48067 P: 248-544-0888 F: 248-544-3111
www.wachler.com 16 TRIAD, FALL 2014
TRIAD, FALL 2014 17
BE CYBERSECURE
protect patient records, avoid fines, and safeguard your reputation Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.
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ybercrime costs the United States economy billions of dollars each year and causes organizations to devote substantial time and resources to keeping their information secure. This is even more important for healthcare organizations, the most frequently attacked form of business.1
if you think you may not be fully compliant with hippa privacy and security rules, consider taking the following steps:
Cybercriminals target healthcare for two main reasons: healthcare organizations fail to upgrade their cybersecurity as quickly as other businesses, an criminals find personal patient information particularly valuable to exploit.
• Policies detailing which devices are allowed to contain PHI and under what circumstances those devices may leave the office.
The repercussions of security breaches can be daunting. A business that suffers a breach of more than 500 records of unencrypted personal health information (PHI) must report the breach to the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR). This is the federal body with the power to enforce the Health Insurance Portability and Accountability Act (HIPAA) and issue fines. To date, the OCR has levied over $25 million in fines, with the largest single fine totaling $4.8 million.2 A healthcare organization’s brand and reputation are also at stake. The OCR maintains a searchable database (informally known as a “wall of shame”) that publicly lists all entities that were fined for breaches that meet the 500-record requirement.3
• Train your staff on how to protect PHI. This includes not only making sure policies and procedures are HIPAA-compliant, but also instructing staff not to openly discuss patient PHI.
18 TRIAD, FALL 2014
• Identify all areas of potential vulnerability. Develop secure office processes, such as: • Sign-in sheets that ask for only minimal information. • Procedures for the handling and destruction of paper records.
• Encrypt all devices that contain PHI (laptops, desktops, thumb drives, and centralized storage devices). Make sure that thumb drives are encrypted and that the encryption code is not inscribed on or included with the thumb drive. Encryption is the best way to prevent a breach.
• Audit and test your physical and electronic security policies and procedures regularly, including what steps to take in case of a breach. The OCR audits entities that have had a breach, as well as those that have not. The OCR will check if you have procedures in place in case of a breach. Taking the proper steps in the event of a breach may help you avoid a fine. • Insure. Make sure that your practice has insurance to assist with certain costs in case of a breach. ______________ REFERENCES: Visser S, Osinoff G, Hardin B, et al. Information security & data breach report—March 2014 update. Navigant. March 31, 2014. http://www.navigant.com/~/media/WWW/Site/Insights/Disputes%20Investigations/ Data%20Breach%20Annual%202013_Final%20Version_March%202014%20issue%202.ashx. Accessed June 17, 2014.
1
McCann E. Hospitals fined $4.8M for HIPAA violation. Government Health IT. May 9, 2014. http://www. govhealthit.com/news/hospitals-fined-48m-hipaa-violation. Accessed June 24, 2014.
2
Breaches affecting 500 or more individuals. U.S. Department of Health & Human Services. http://www.hhs. gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html. Accessed June 23, 2014.
3
KNOW THE TOP THREE WAYS A BREACH OCCURS
SOURCES: Information Security & Data Breach Report: www.ow.ly/zWdEM Healthcare Industry Lacks Adequate Cybersecurity, Says FBI: www.ow.ly/zWfxS Breaches Affecting 500 or More Individuals: www.ow.ly/zWfl4 Hospitals Fined $4.8M for HIPPA Violation: www.ow.ly/zWfEx The Doctors Company
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20 TRIAD, FALL 2014
THE PRACTICE MANAGER
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ith this issue of TRIAD focusing on complementary and alternative medicine (CAM), it’s a great time to talk about this rapidly growing area of health care. We know that nearly 40 percent of Americans use health care approaches outside of conventional medicine for their well-being.
At Michigan Obstetrics & Gynecology,
we’re seeing women turn to CAM as part of an integrative approach to their obstetric care. At Michigan Obstetrics & Gynecology, we’re seeing women turn to CAM as part of an integrative approach to their obstetric care. Since we’re an osteopathic practice, we use osteopathic manipulation regularly to help alleviate painful symptoms or to help diagnose underlying ones. Our physicians prescribe a basic foundation of prenatal vitamins, which include supplements like calcium and iron. To help women with a variety of gynecologic conditions, we can consider hormone replacement both traditional and bio-identical, pelvic floor physician therapy and, again, osteopathic manipulation. Other supplements like melatonin, vitamin B2 and B6 and ginger root are also regularly recommended to help support women while they are patients with us. We’re finding that with this desire to lean more towards natural solutions, understanding how insurance coverage of CAM is complex. Generalities are hard to make as to how insurance and CAM work with one another. The best advice we can give to our patients who are considering CAM is to contact their insurance companies to determine what they will and will not cover. We also recommend being candid with health care providers to avoid miscommunication down the line. If CAM treatments and practices are not covered by insurance, we encourage patients to continue the conversation about their treatment with their physician. As osteopathic professionals, we strive to provide the best, most holistic services possible. MONICA DUSNIK CAN BE REACHED AT MDUSNIK@YAHOO.COM
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DEAN’S COLUMN PLEASE STAY SEATED AND KEEP YOUR HANDS INSIDE THE CAR The journey to a unified graduate medical education system will be like a roller coaster ride
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n July the AOA House of Delegates passed a resolution to continue work with the
BY WILLIAM STRAMPEL, D.O.
ACGME toward a single system of graduate medical education. This is another step forward in a process that has been in the works for months and will continue on for the next several years.
It’s important for all of us to remember that there is a lot of work to be done and like the effort to this point, moving forward we’ll experience a lot of highs and lows, twists and turns – not unlike the experience of riding a roller coaster. From an osteopathic student’s perception, at first glance the unified system might sound like a great thrill like the rush downward from the roller coaster’s peak. It probably will open some doors of opportunity to students — especially those in states that don’t have a vibrant institution like our Statewide Campus System. At the same time, while the eventual outcome of this resolution will mean that there will be more residency slots available to osteopathic graduates, it will also mean that there will be competition from allopathic graduates for former AOA residencies. Maybe this causes feelings similar to the hair-raising scares as the coaster loops the loop? It’s also important to remember that the resolution is simply the next step in a long journey. The process to combine two massive systems into one will take several years to fully implement. Many of today’s students will be well into their practice years by the time all details are approved and fully implemented. This is a long, winding process and that the best track to take is one of patience and understanding. Not everything will be perfect and there will be curves, highs and lows along the way, but staying patient and positive and not spreading inaccurate or partial information will go a long way toward contributing to a smoother ride. Finally, don’t let emotion overtake you and remain seated until our ride comes to a complete stop.
WILLIAM STRAMPEL, D.O., IS DEAN OF THE MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE. HE CAN BE REACHED AT PAT.GRAUER@HC.MSU.EDU. 22 TRIAD, FALL 2014
ADVERTISER INDEX Blue Cross Blue Shield of Michigan................................. 2 TRIAD STAFF John Sealey, D.O, FACOS & Kevin Leikert, OMS-II, Editors-in-Chief William Strampel, D.O., Contributing Editor Kris T. Nicholoff, CEO and Executive Director Lisa M. Neufer, Director of Administration Kevin M. McFatridge, Manager of Communications Cyndi Earles, Director, MOA Service Corporation Shelly M. Madden, Manager of Membership Marc A. Staley, Manager of Finance Wendy Batchelor, Manager of Physician Advocacy Carl Mischka, Advertising Representative reZüberant Design, Layout and Cover Design 2014-15 BOARD OF TRUSTEES Myral R. Robbins, D.O., FAAFP, FACOFP, President Robert G.G. Piccinini, D.O., President-elect Bruce A. Wolf, D.O., Secretary/Treasurer Michael D. Weiss, D.O., Immediate Past President Edward J. Canfield, D.O., Past President Lawrence J. Abramson, D.O., MPH, & Craig Glines., D.O., MSBA, FACOOG, Department of Insurance John W. Sealey, D.O., & Kevin Leikert, Department of Public Affairs Lawrence L. Prokop, D.O. & Adam Hunt, D.O., MHS, Department of Education Jeffrey Postlewaite, D.O. & David Best, D.O., Department of Membership
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The osteopathic profession in Michigan is made up of osteopathic physicians, osteopathic hospitals and an osteopathic medical school. This TRIAD stands together to serve our patients and one another. TRIAD, the official journal of the Michigan Osteopathic Association, serves Michigan’s osteopathic community, including its osteopathic physicians, hospitals, medical school and patients. The Michigan Osteopathic Association will not accept responsibility for statements made or opinions expressed by any contributor or any article or feature published in TRIAD. The views expressed are those of the writer, and not necessarily official positions of MOA. TRIAD reserves the right to accept or reject advertising. The acceptance of an advertisement from another health institution or practitioner does not indicate an endorsement by MOA. TRIAD (ISSN 1046-4948; USPS 301-150) is published quarterly by the Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Periodical postage paid at Okemos, MI 48864 and other post offices. Subscription rate: $50 per year for non-members. All correspondence should be addressed to: Communications Department, Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Phone: 517.347.1555. Fax: 517.347.1566. Website: www.mi-osteopathic.org. Email: moa@mi-osteopathic.org. POSTMASTER: SEND ADDRESS CHANGES TO TRIAD, 2445 WOODLAKE CIRCLE, OKEMOS, MI 48864. ©2014 MICHIGAN OSTEOPATHIC ASSOCIATION
FOR ADVERTISING INQUIRIES, PLEASE CONTACT CARL MISCHKA AT 888.666.1491 OR VIA EMAIL AT CMISCHKA@MI-OSTEOPATHIC.ORG TRIAD, FALL 2014 23