The Award-Winning Journal of the Michigan Osteopathic Association S U M M E R 2019
NOT YOUR FATHER’S
PROFESSION INSIDE: The Time's Up Movement Has Hit Healthcare House of Delegates 2019 Resolutions
MICHIGAN MOA OSTEOPATHIC ASSOCIATION
w w w. D O M O A . o r g
michiganosteopathic
MichiganDOs
m i c h i g a n - o s t e o p a t h i c- a s s o c i a t i o n
lawsuits
insurance coverage concerns accountable care
financial pressures
cyber security
patient demands
patient care
EHRs
big data
shifting FDA regulations
risk of medical errors
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CONTENTS
2019 S P R I N G S C I E N T I F I C CONVENTION AT TENDEES
In Every Issue 05 President’s Page 24 Healthcare Partners
of Michigan
27 Advertiser Index
FEATURES 8
What a Difference a Generation Can Make
Contributed by Metro Health
11
Resolutions Passed at 2019 House of Delegates
14 The Time’s Up Movement Has Hit Healthcare
As published in The DO
20
Free to Members: Two AOA-Approved CME Courses
Contributed by Coverys
22
Action Needed on Bills that Would Protect Healthcare Workers from Violence
Contributed by Michigan Health and Hospital Association
23 2019 MHA Symposium
MICHIGAN MOA OSTEOPATHIC ASSOCIATION 3
Michigan Osteopathic Association
Fulford Legacy Conference ))
Michigan Osteopathic Association 2445 Woodlake Circle, Okemos, MI 48864 domoa.org | P 517-347-1555 | F 517-347-1566
BAS I C PE RC US S I O N C OUR S E
Conference Fulford Legacy Friday, Nov. 22) )- Sunday, Nov. 24, 2019
BAS I C PE RC US S IO N COUR S E
)
)
Sheraton Detroit Novi Hotel (Ballrooms A-B) November 22 - 24, 2019 21111 Haggerty Road, Novi, MI 48375
Sheraton Detroit Novi Hotel 23 AOA Category 1-A credits anticipated. This course describes the power of healing concepts which expand on the Agenda & registration at www.domoa.org/fulford
Michigan Osteopathic Association
teachings of Andrew T. Still, DO. Instructed by Richard W. Koss, DO, Michigan Osteopathic Association 2445 Woodlake Circle, Okemos, MI 48864
who first attended Dr. Fulford’s percussion course in 1987 before domoa.org | P 517-347-1555 | F 517-347-1566
23 NMM-Specific AOA Category 1-A Credits
completing his residency in Osteopathic Manipulative Medicine at A.T. Still University-Kirksville College of Osteopathic Medicine (ATSU-KCOM), Missouri.
Legacy The basic percussion “hammer”Conference course Dr. Koss worked alongside Dr. Fulford to design and teach Fulford ))
)
BA S I C on PE C U S S I& Oosteopathic N C O U R S Ethe Basic and Advanced Percussion Hammer courses for over is based theRphilosophy eight years up to his passing in 1997. Since then, Dr. Koss November 22 - 24, principles practiced by 2019 Robert C. Fulford, DO, has lead trainings internationally on Fulford’s philosophy of Sheraton Hotel authorDetroit of “TouchNovi of Life: The Healing 23 AOA Category 1-A credits anticipated. osteopathic healing and the use of the Fulford Percussor. Power of the Naturalat Life Force” and Prerequisites: Agenda & registration www.domoa.org/fulford ”Are We on the Path?”
Attendees must have completed a 40-hour introductory cranial course taught by an Osteopathic Practitioner so that they have developed the hand sensitivity and anatomical understanding necessary to successfully understand the course materials.
Early Bird registration until Nov. 1 at www.domoa.org/fulford
Credit card payment taken by phone, fax or online. Checks accepted by mail, made payable to MOA.
PREREQUISITES: By registering, I certify that I have or will have completed required courses (described on reverse) before the conference _____ Initial FRIDAY 8 AM - 6 PM
Speakers:
Name ________________________________________________________________________________ Richard W. Koss, DO, C-SPOMM, C-ACOFPAOA Number __________________________________ SATURDAY 8 AM - 6 PM (to appear on badge)
William H. Stager, DO, MS, MPH, FAAFP, FAAMA, FAAO, FACOFP dist. Phone Number _________________________________________________ Email address ____________________________________________________________ SUNDAY 7:45 AM - 3 PM
PAYMENT:
OPTION 1 - Credit card
MasterCard
Visa
Discover
OPTION 2 - Check #_____________ Made payable to MOA
Cancellation Policy: Requests for refunds by October 31, 2019 and will entitle registrant to a full refund less a $200 fee.
Name on credit card ____________________________________________________________
Early Bird registration until Nov. 1 at www.domoa.org/fulford
Credit card number _________________________________________________________________Exp. date ______ /_______ CVVpayable code _______________ Credit card payment taken by phone, fax or online. Checks accepted by mail, made to MOA. Billing Address ____________________________________________________________ City ________________________________ State________ Zip _______________
PREREQUISITES: By registering, I certify that I have or will have completed required courses (described on reverse) before the conference _____ Initial Travel & Lodging: Name ________________________________________________________________________________ AOA Number __________________________________ For out-of-state travel, closest airport: Sheraton Detroit Novi Hotel (to appear on badge) Detroit Metropolitan Wayne County Airport (DTW) 21111 Haggerty Rd, Novi, MI 48375 Phone Number _________________________________________________ address ____________________________________________________________ 18.6 miles from Sheraton, transportation not included Reservations: $139/room + tax if made by Oct. 22 - CallEmail 248-349-4000 Call hotel to coordinate special assistance (wheelchair access, accommodations, etc.)
PAYMENT:
OPTION 1 - Credit card
MasterCard
Visa
Discover
OPTION 2 - Check #_____________ Made payable to MOA
Statement of Policy: Accreditation: TheforMichigan Association is accredited by the (AOA) to provide osteopathic Cancellation Requests refundsOsteopathic by October 31, 2019 and(MOA) will entitle registrant to aAmerican full refundOsteopathic less a $200Association fee. continuing medical education for physicians. MOA designates this program for a maximum of 23 AOA Category 1-A credits and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.
Name on credit card ____________________________________________________________
Credit card number _________________________________________________________________Exp. date ______ /_______ CVV code _______________ 4
T R I A D | S U M M E R 2019
Billing Address ____________________________________________________________ City ________________________________ State________ Zip _______________
PRESIDENT'S PAGE
BE A PART OF THE CHANGE B Y C RA I G G L I N E S, D O, M OA P R E S I D E N T
T
he TRIAD 2019 Summer issue carries a theme of “Not your Father’s Profession.” This hits particularly close to home for me as my father in-law is a DO and my son is currently a resident at Beaumont Health. In my family we currently have nine DO’s. So due to my age/experience, and the number of DO’s in my family, I feel I have a great perspective on the evolution our profession has taken in the last generation.
Craig Glines, DO
“There are two kinds of fools. One says, ‘This is old, and therefore good.’ And one says, ‘This is new, and therefore better.’ The truth is, as our profession evolves, we need to be a part of the change.”
The refrain of “change” might seem overused, but it is hard to understate the amount of change I have seen in my career. From procedures to policies, the upheaval in the details of how physicians treat patients has been profound. As this tsunami of change advances, my advice for osteopathic physicians is—be involved. At whatever level you can. Health policy is changing the way you can treat patients, how payers will reimburse your work and how your patients can access your care. Be involved. Join committees, donate to PACs that represent your views and stay connected to your colleagues. The idea of “strength in numbers” has never been more applicable. Legislators are making decisions that directly affect you and your patients. The payers are certainly making their voice heard. And popular opinion can guide regulations. Unfortunately, the decision makers lack the benefit of years of graduate-level training (4), the years of residency training (3-7) and over 12,000 hours of patient care training that are required to become a DO. Our profession needs to not only make our voice heard; we need to emphatically remind those in policy-making circles of our positions come from years of education, training, experience and more education in the form of CME courses. The idea of change reminds me of an old quote: “There are two kinds of fools. One says, ‘This is old, and therefore good.’ And one says, ‘This is new, and therefore better.’ ” The truth is, as our profession evolves, we need to be a part of the change. We need to examine each issue on its own merits and lend our expertise to those who will implement the regulations and policies we will be required to follow. Let’s ensure that changes that are put upon our profession are shaped by our professionals.
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MICHIGAN OSTEOPATHIC ASSOCIATION
15th Annual Autumn
SCIENTIFIC CONVENTION
24 AOA 1-A credits November 8-10, 2019 Amway Grand Plaza, Grand Rapids w w w.domoa.org/gr2019 OBGYN Specialty Session International Medicine LARA Requirements Neurology
Scientific Research Competition Dermatology Lifestyle Medicine Risk Management
Patient Satisfaction in the ED/Hospital
Pediatrics
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WHAT A DIFFERENCE A GENERATION CAN MAKE
We often hear about generational shifts. But, can 30 years make that much difference in the medical profession? felt good about the depth of the team and getting the same level of care,” says Postlewaite. “In fact, OB data shows that group settings have better outcomes.”
Jeffery D. Postlewaite, DO, MBA
Jeffery D. Postlewaite, DO, MBA, Vice President of Medical Affairs, Metro Health - University of Michigan Health, has seen significant changes since his mid-1980s residency. For him, these changes have been positive,
Additionally, patients reported higher satisfaction and physicians felt more efficient. Today, most department teams are led by physicians with various partners that include Nurse Practitioners, Physician Assistants and Certified Nurse Midwives.
Physician Input “Passion for health care and caring for others is still pretty universal,” says Postelwaite. “But, the new generation is looking for better work-life balance.” This has resulted in a major employment shift.
leading to innovation and win-win situations for everyone involved.
“Passion for health care
Practice Changes
and caring for others is
Postlewaite’s generation of private practice physicians, especially OB/ GYNs like himself, expected long hours and being on-call consistently. He recalls one sunny weekend afternoon with a colleague while they each cared for a single patient. Their discussion turned to how shift work, at that time only seen in the emergency department, might work for their patients. Soon he and his partners developed a call arrangement using a team concept. “We were concerned about how patients might react, but our patients 8
T R I A D | S U M M E R 2019
still pretty universal but, the new generation is looking for better work-life balance.” Early in Postlewaite’s career, most physicians were in private practice— not employed by hospitals or health systems. Today, a high percentage of physicians are employed by hospitals or large health systems. Physicians also are more involved in hospital and health system leadership. “Physicians historically ‘practiced’ even
as some self-selected leadership positions,” says Postlewaite. “Practice has become so complex that physicians now arm themselves with business and leadership skills to effectively lead groups of people.”
Technological Advances Advances in technology have improved care delivery and changed physician practice. “Surgical techniques and perioperative care have improved outcomes and shortened stays,” says Postelwaite. “When I was a resident, 75% of hospital patients weren’t as sick as today’s hospitalized patients.” He credits the emphasis on pre and post-op education and therapy for this shift. Furthermore, the digital age means that radiology tests, done 24/7, can be read instantaneously by physicians anywhere. “Newer physicians don’t see film anymore and many have never seen film,” adds Postlewaite.
Patient Expectations Generational expectations, including the emphasis on transparency and outcomes, have also influenced change. “EMRs (electronic medical records) are relatively new to documentation,” says Postlewaite. “We now release lab and radiology medical records to the patient.” Although some physicians were initially uncomfortable with the idea, it’s proven to be a win-win. “Most patients really own it,” adds Postlewaite. “They ask good questions and it helps all of us to be better.”
What the Future Holds Postlewaite sees telehealth expanding in the future. “Telehealth will replace some of what we do,” says Postlewaite, “allowing physicians to focus on patients who really need their in person expertise and possibly extending careers.”
Metro Health Hospital Foundation hosts the VITALity Gala A black-tie affair benefiting the leading-edge, life-saving intervention and treatment at our certified Comprehensive Stroke Center.
SATURDAY, SEPTEMBER 21, 2019 DEVOS PLACE | STEELCASE BALLROOM 303 Monroe Ave. NW · Grand Rapids, MI 6:00 PM | Social Hour 7:00 PM | Dinner & Entertainment
The Metro Health Hospital Foundation provides support for Metro Health's innovative and compassionate health care.
Individual tickets are $250. For more information, please contact the Metro Health Hospital Foundation at 616.252.5000 or foundation@metrogr.org.
JOIN OUR COMPASSIONATE TEAM
metrohealth.net/careers Contact: Linda.Gommensen@metrogr.org | 616.252.5289
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R E S O L U T I O N S PA S S E D AT T H E
2019 HOUSE OF DELEGATES Thank you to all the delegates who served at this year’s House of Delegates, representing their component societies from all over Michigan. This process ensures that physicians remain engaged in shaping policy and the future of the osteopathic profession.
Results of the meeting held on May 16, 2019 at the Westin Southfield Detroit: Resolution Subject Name
Submitted by
Recommendation from HOD
Resolution 2019 A
Expansion of Medicaid in All States
Northern Michigan Osteopathic Assoc.
Approved as Amended
Resolution 2019 B
Prior Authorization and Utilization Management Reform
MCOMA Delegates Approved as Amended
Resolution 2019 C
Obesity Treatment Reimbursement in Primary Care
MCOMA Delegates Approved as Amended
Resolution 2019 D
Recognize Health Care as a Human Right
MCOMA Delegates Approved as Amended
Resolution 2019 E
Interoperability and its Impact on Prior Authorization
OCOMA Delegate
Resolution 2019 F
Delegate Access to Michigan MAPS via EHR integration
MCOMA Delegates Approved as Amended
Resolution 2019 G
Reimbursement for Physicians Supervised Care Management/ Care Coordination Activities
OCOMA Delegate
Resolution 2019 H
Mandating HPV Immunization for Primary Prevention of Cancer
OCOMA Delegate
Approved as Amended
Resolution 2019 J
Behavioral Health Integration and Primary Care
OCOMA Delegate
Approved as Amended
Resolution 2019 K
Behavioral Health Integration and Primary Care
OCOMA Delegate
Disapproved
Resolution 2019 L
Addressing (Alleviating) Fears and Barriers to Telemedicine Implementation and Alignment
OCOMA Delegate
Approved as Amended
Approved as Amended
Approved as Amended
2018/2019 O F F I C E R S ➤ Speaker of the House: Craig H. Bethune, DO ➤ Vice Speaker: Anthony Ognjan, DO ➤ Parliamentarian: Mary Jo Voelpel, DO ➤ Secretary: Jeffrey Postlewaite, DO
Any MOA member in good standing may author a resolution; however, introduction of resolutions to the House of Delegates is limited to delegates, alternate-seated delegates, component associations, MOA Departments, Councils, or Board of Trustees. The next deadline for Resolution submission is March 13, 2020. If you have any questions on this process please email Virginia at vbernero@domoa.org or call 517-347-1555. To see each resolution in its entirety or to learn more about the House of Delegates meeting, please go to www.domoa.org/hod.
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Michigan Osteopathic Association
120th Annual Spring
Scientific Convention
Rachel Young, DO speaks on behalf of Oakland County Osteopathic Medical Association on a Resolution during the 2019 House of Delegates.
The Base Hospital Expo drew over 100 student attendees to learn about the opportunities in the next step in their careers. President-Elect of the American Osteopathic Association, Ronald Burns, DO, FACOFP and Dean Andrea Amalfitano, DO, PhD, speak with students at the MSU College of Osteopathic Medicine Reception.
Lauren Stremers, President of the Advocates for the American Osteopathic Association addressed the 2019 House of Delegates.
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Dr. Prokop (below) fills a breakfast lecture during convention to educate his peers on the benefits of acupuncture.
Outgoing President Lawrence Prokop, DO, FAAPM&R, FAOCPMR-D, FAOASM, swears Craig Glines, DO, MSBA, FACOOG to serve as the next President of the Michigan Osteopathic Association (MOA) at the 2019 House of Delegates.
Dean Andrea Amalfitano, DO speaks on behalf of the Ingham Osteopathic Association on policy at the House of Delegates meeting.
Life Professional awardees pose with their certificate. The MOA recognizes these members who have belonged to the association for over 35 years.
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THE CLOCK HAS RUN OUT
THE TIME’S UP MOVEMENT HAS HIT HEALTH CARE Meet two DOs helping lead the charge
B Y A S H L E Y A LT U S, A S P U B L I S H E D I N T H E D O
In response to the #MeToo movement, advocates started “Time’s Up Now” last year with a goal to correct systemic inequalities in the workplace. Earlier this year, “Time’s Up Healthcare” launched as a group effort aiming to raise awareness of gender inequalities and sexual harassment in health care settings to ensure a safe and respectful workplace. The organization’s 12-person advisory board leading the strategy includes two influential osteopathic physicians, Roberta Gebhard, DO, and Barbara Ross-Lee, DO.
T
he roots of women in osteopathic medicine go back to the profession’s founding and the percentage of female DOs has doubled in the past 25 years. But recent headlines and studies indicate that there’s still work to be done to achieve gender equality in the health care professions. 14
T R I A D | S U M M E R 2019
In April, the University of Southern California’s cardiovascular disease fellowship was notified that it would lose its accreditation from the Accreditation Council for Graduate Medical Education. The fellowship’s accreditation was revoked a year after the Los Angeles Times published an article in which a fellow in the
program alleged that another physician sexually assaulted her at L.A. County-USC Medical Center. A recent survey on the topic of sexual harassment and discrimination among academic medical faculty published in JAMA found that nearly 70% of women respondents perceived gender-specific bias in the academic environment. Thirty percent of women respondents reported they had experienced harassment.
Awareness of the issues “You can’t intervene in a problem if you don’t know it exists,” says Barbara Ross-Lee, DO. “We want to influence current leadership to engage the gender resource that is being ignored.”
“You can’t intervene in a problem if you don’t know it exists. We want to influence current leadership to engage the gender resource that is being ignored.” BARBARA ROSS - LEE, DO
Dr. Ross-Lee created a legacy for women and minorities as the first African-American woman to be named dean of a U.S. medical school and first DO to become a Robert Wood Johnson Health Policy fellow. She recalls a time when there were few opportunities for women in the medical profession and opportunities were nonexistent for minority women. In 2019, women make up thirtythree percent of senior leadership positions in health care. “It has been my goal to facilitate more women in leadership positions,” Dr. Ross-Lee says. “Excellence is only achieved through every type of diversity and it’s good for the industry to have women involved in all levels of care.” One way Time’s Up Healthcare plans on improving the numbers of women in leadership roles is by helping organizations commit to diversification. Institutions can pledge their commitment to the organization’s key tenets, which include: Preventing sexual harassment Fighting against gender inequities Protecting and aiding those who are targets Tackling pay discrimination The mission of Time’s Up Healthcare aligns with the advocacy Dr. Gebhard, the first DO elected president of the American Medical Women’s Association, has led since founding AMWA’s Gender Equity Taskforce in 2005,
which published a study on workplace bullying among family physicians in the Journal of Women’s Health. In the 2019 Medscape Physician Compensation Report, full-time salaried primary care male physicians reported earning 25% more than their female counterparts. The gap among specialists is even wider, with male physicians earning 33% more. Dr. Gebhard experienced it first hand; she has left jobs over gender pay discrepancies. A male physician one year out of residency was earning $10,000 more, she says, despite her 18 years of experience. They had started their jobs within weeks of each other and Dr. Gebhard was told there was no wiggle room during negotiations because everyone was paid the same salary in the government position. “You shouldn’t have to fight or negotiate to have an equal salary,” Dr. Gebhard says. “It should be based on your education, experience and skills. Your gender is not associated with that at all.”
Calling on allies A key part of Time’s Up Healthcare is calling on male bystanders to speak up when they witness women in health care being mistreated. “The fact that men are stepping up saying ‘this isn’t fair’ is helping the system change,” Dr. Gebhard says. “You shouldn’t have to fight or negotiate to have an equal salary. It should be based on your education, experience and skills. Your gender is not associated with that at all.” ROBERTA GEBHARD, DO
The osteopathic medical profession has accepted women as equal members since A.T. Still’s first class of medical students, and today, 41 percent of DOs are women, noted AOA President William S. Mayo, DO. AOA policy supports appropriate legislation to eliminate sexual harassment and the association’s guidelines for professional conduct explicitly direct members to address violations they observe. “I’m disheartened that female physicians and medical students continue to suffer harassment and discrimination,” Dr. Mayo said. “It is incumbent on us as physicians to hold perpetrators accountable.” Students begin learning about professionalism in medical school, including the importance of reporting bias and harassment, Dr. RossLee says. “Physicians should not and can not watch someone be harassed or be a victim and not report it,” Dr. Ross-Lee says. “We all need to stand up or it never changes.”
How to get involved Donations are being used to build out the infrastructure of the organization and fund the Time’s Up Legal Defense Fund, which has received over 4,000 requests for legal assistance and raised over $24 million. The second highest number of requests for assistance came from the health care industry. “There’s a culture of sexual harassment that exists throughout the industry and Time’s Up is looking into building a structure that would provide legal support for people who want to take on these occurrences,” Dr. Ross-Lee says. You can sign up to receive updates here and learn about becoming a signatory organization here. TRIAD
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Join MOPAC Donate online: www.domoa.org/MOPAC Mail enclosed MOPAC contribution card with your payment to:
J O I N T H E PAC .
Protecting and caring for our patients and this profession
It’s what we must DO.
Corporate/business contributions are prohibited.
A M P L I F Y YO U R VO I C E .
goes beyond the office.
MOPAC Michigan Osteopathic Association 2445 Woodlake Circle Okemos, MI 48864
Symposium for Primary Care Medicine Friday and Saturday, November 1-2, 2019 The Diamond Banquet Center connected to the Hyatt Place Hotel at the Suburban Collection Showplace, Novi, Michigan For Physicians, Physician Assistants, Nurse Practitioners and Nurses 16.0 Category 1-A AOA CME Credits 16.0 AMA PRA Category 1 Credit(s)™ Featuring a Self-Guided Dermatology Virtual Workshop Sponsored by:
Register at: beaumont.cloud-cme.com/fallprimarycare2019 Direct questions to: cme@beaumont.edu or call 947-522-1839 16
T R I A D | S U M M E R 2019
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Building Stronger Communities Through Healthier Individuals Here at Lettuce, we encourage healthy lifestyles through our free community programs and by connecting people with additional resources in their area. We offer individual and group health coaching, grocery store tours, children’s programs, employee wellness programs, and more. Each community has different programs available, contact us to learn about what is offered near you!
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Benefits of Wellness Programs • More productive employees • Less sick days • More cooperation • Improved corporate image
• Michigan has the 10th highest prevalence of obesity in the United States • Cost of obesity in Michigan over 10 years is $58.8 billion (compared to normal weight/healthy population) • Employees with obesity experience 332,640 additional sick days
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EAT HEALTHY. LIVE HAPPY!
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P: 517-898-1870
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T R I A D | S U M M E R 2019
At McLaren, we’re committed to providing high-quality, effective care. By developing best practices based on clinical outcomes and the latest research on health care quality and safety, we are not only improving outcomes but also lowering costs for patients and hospitals. That’s what it means to be doing what’s best. Learn more at mclaren.org
FREE TO MEMBERS: TWO AOA-APPROVED CME COURSES Compliments of Coverys and provided through Med-IQ®, a Coverys company.
HIV Prevention for Black/African American Women: The Use of PrEP in the Primary Care Setting
Curing HCV in Treatment-Naïve Patients With Early Stage Liver Disease: Considerations for Treatment Selection, Monitoring, and Follow-Up
This activity explores the behavioral, social, and structural risk factors that contribute to the disproportionate risk of HIV in black/African American heterosexual women. It also addresses ways to incorporate HIV prevention strategies, including pre-exposure prophylaxis (PrEP), into routine care. Additionally, expert faculty offer insight into the unique challenges that contribute to the increased HIV risk in black/African American women and explain how PrEP can be a powerful tool for HIV prevention in this population. See course details.
This activity provides an overview of available therapeutic regimens for treatment-naïve patients with HCV infection and stage F2 or lower liver disease. It also addresses recommended monitoring that should occur during and after treatment, as well as the opportunity for cure among people who use injection drugs. See course details.
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T E O P AT H I C
E
E
U CO L L EG
CIN
MS
M
DI
O
OS
E
F
years 1969-2019
MOCF BALL
02.01.20 Six o’clock p.m. The Henry an Autograph Collection Hotel Dearborn, Michigan
For more information please call 517.355.9616 or visit our web site at com.msu.edu/MOCF
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ACTION NEEDED ON BILLS THAT WOULD
PROTECT HEALTHCARE WORKERS FROM VIOLENCE
T
A bipartisan group of lawmakers in Michigan’s House and Senate have introduced bills that would enhance legal protections for healthcare employees who experience violence in the workplace. The proposals seek to increase the criminal penalties for those committing assault against healthcare employees that, according to a recent statewide EPIC-MRA poll, would be supported by seventy-nine percent of Michiganders.
he Michigan Health & Hospital Association, along with the Michigan Osteopathic Association, the Michigan Academy of Family Physicians and the Michigan State Medical Society, are advocating on behalf of these bills to address the increasingly large problem of violence in hospitals and other healthcare facilities around the country. According to 2014 U.S. Bureau of Labor Statistics data cited by the Occupational Safety and Health Administration, workers in the healthcare and social assistance sector experienced violence-related injuries in the workplace at a rate more than four times higher than the rate for workers in the private sector overall. Emergency departments can be particularly dangerous for healthcare employees, with 54 percent of nurses reporting that they were physically or verbally assaulted at work in the past seven days alone. It is no coincidence that, as violent acts committed in the healthcare workplace increase, so do burnout levels among care providers, with fear of violence and emotional/psychological safety being a leading cause. Thus, ensuring a safe environment for both patients and healthcare professionals is vital for Michigan to continue delivering the highest quality care. Healthcare facilities in Michigan are actively taking steps to reduce incidents of violence in the workplace. Hospitals are working with
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consultants and other professionals on de-escalation techniques, enhanced hospital security and handto-hand violence aversion trainings. The MHA Keystone Center has launched a new collaborative to identify, develop and implement workplace safety risk-reduction strategies, while also initiating an in-depth analysis of workplace safety-related data. Together, healthcare organizations across the state are doing everything they can to protect the physical and psychological safety of all who walk through the doors of their hospitals. If passed, Michigan would join 32 other states in which it is a felony to assault a healthcare employee or emergency medical personnel while they are on the job. Healthcare workers would receive the same protections as other first responders, including police officers, firefighters and paramedics. House Bills 4327 and 4328, introduced by House Health Policy Committee Chairman Hank Vaupel (R-Fowlerville), would increase penalties for assault against all healthcare professionals or medical volunteers that provide direct patient care. This legislation is crucial in providing additional protections to healthcare workers and volunteers. A timeline for these bills has not been set, so contact your local lawmakers to let them know you support House Bills 4327 and 432. To learn more about these bills, visit www.mha.org/Issues-Advocacy.
MHA Safety & Quality Symposium Sept. 26, 2019 | Detroit Marriott Troy Providing safety and quality is not unique to one profession, one unit or one person, but requires all of us to lend expertise, be a voice and work together. Everyone has a part of caring for patients and caring for each other. Inevitably, there is resistance, with varying levels of discipline, values and teamwork; but we are responsible for creating the systems that revolutionize how we improve health and treat disease. That is why the concepts discussed and techniques used by physicians, nurses and educators here and across the country are shared at the MHA Safety and Quality Symposium — to help us learn and innovate, to ultimately protect and serve members of our family and community. Let’s maintain the determination to continually improve safety and quality. Register to attend today!
2019 Speakers Amy C. Edmondson
Eric Alberts
Keynote speaker Amy C. Edmondson headlines the list of speakers for the symposium. Edmondson, Novartis professor of leadership and management at the Harvard Business School, will outline the importance of psychological safety in creating a safe environment. Additional speakers include Eric Alberts, CEM, corporate manager, emergency preparedness, at Orlando (FL) Regional Medical Center, who will share how his team prepared for and triaged the mass casualties resulting from the Pulse nightclub tragedy. His story and the lessons learned will help attendees prepare to act in many violent circumstances. Dayna Bowen Matthew, JD, PhD, distinguished professor of law, F. Palmer Weber research professor of civil liberties and human rights, professor of public health sciences, University of Virginia, Charlottesville, will discuss the need for health equity in today’s changing healthcare landscape.
Who Should Attend
Dayna Bowen Mathew
The symposium is designed for clinical teams across the continuum of care, quality and safety professionals, healthcare executives and business leaders, and patient and family advocates. For more information on the symposium, contact Erin Steward at the MHA. Questions about registration should be directed to Janice Jones at the MHA. mha.org/Education-Events TRIAD
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domoa.org/HCPM
DON'T COUNT WOMEN OUT B Y E WA M AT U S Z E W S K I, C E O, M E D N E TO N E
It’s a man’s world, or so the saying goes. But is it? From a DO physician perspective, it is increasingly becoming a woman’s world—or perhaps I should say a shared world.
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steopathic medical schools and ultimately the osteopathic community in general have made tremendous strides in recruiting, retaining and graduating female students, thanks to the decades-long efforts of both women and men who made this a priority. This is cause for celebration as the larger medical community gets closer to gender parity in its ranks and the good old boy network gets nudged out by the good old girl network – or even better, a genderless network. So, what’s the issue? I was prompted to write this after reading a data breakdown of the MSUCOM class of 2023, which had several identifiers for students including race, ethnicity, and various categories that may be defined as family background. Not only did I learn that nearly 80 percent of the 318 students who were admitted to MSUCOM in 2019 are Michigan residents but also that two-thirds of the graduates stay in the state to practice patient-centered care in almost all of Michigan’s 81 counties, and half practice primary care. But nothing on gender. No male and female numbers. So, I was determined to get an answer.
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After doing some research, I came across several informative publications, including the AACOM Osteopathic College Information Book 2018-2019, which listed every DO school’s class composition; I also contacted the MSUCOM Dean’s Office for 2019 data. I got that data and discovered the Class of 2023 is comprised of 164 women and 154 men. While I celebrate the rising number of women, their increasing numbers are still relatively recent. That’s why we need to continue presenting data on the number of male and female graduates until it’s deemed downright old-fashioned to do so. While women are achieving their goals of both physician and mother, or physician and healthcare leader – and often all three, we must not take these and future successes for granted. We now know, unequivocally, that women count - but women must still be counted. Ewa Matuszewski, Senior Consultant for Healthcare Partners of Michigan (HCPM), will serve as a resource to provide information to members of the Michigan Osteopathic Association (MOA). Contact Ewa by phone at 844-363-6763, email hcpm@domoa.org, or visit domoa.org/hcpm
Powered by the Michigan Osteopathic Association
What is HCPM? Healthcare Partners of Michigan (HCPM) was established as a healthcare services organization in 2017 by MOA members. It was formed to support independent physician practices, to provide physicians an opportunity to participate in value-based reimbursement activities, quality improvement initiatives, and also to help reduce practice overhead costs by providing necessary infrastructure support.
Why Join? • Assist HCPM physicians transform their infrastructure by providing technology support • Guide HCPM physicians to develop quality improvement strategies focused on population health • Coach practices through the stages of becoming a Patient Centered Medical Homes (PCMH) • Provide in-office, multidisciplinary clinical care teams • Function as a liaison between physicians and payers, contract negotiations, reimbursement guidance & troubleshooting
Who can Join? Any licensed healthcare professional!
LEARN MORE: www.domoa.org/hcpm Contact 844-363-6763 | hcpm@domoa.org
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REMEMBERING MADGY A missed mentor and friend. Dr. David N Madgy, 61, of Franklin, Michigan, died on March 9, 2019. B Y B O PA N G, D O
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first met Dr. Madgy on the Amazon river in Peru while I was a second year medical student. He was the guy that got me started on otolaryngology and really took it upon himself to encourage me and believe in me along the way. Since then, I’ve followed him everywhere: to his clinic, the operating room, Peru, Guatemala, and Malawi. Through it all, he’s been a phenomenal mentor, but most importantly, a dear friend. I’ll never forget that time on the safari at 3:30 a.m. when I literally couldn’t keep my eyes open and fell asleep on his shoulder. Pretty much sums up what he’s been for me: a rock and a shoulder to lean on. No other person has had the amount of impact that you’ve had on me for my career—thank you for everything. I’ll miss you so much. I’m sure you are tearing it up up there just as much as you did here on earth. Rest in Peace.
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS The Michigan Professional Licensing User System (MiPLUS) is the Department of Licensing and Regulatory Affairs (LARA) Bureau of Professional Licensing's new online licensing and regulatory database application for health and occupational professionals in Michigan.
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Applicants can now: • apply online • track the status of their application • receive electronic notifications Licensees are able to: • renew and modify their existing licensing information • verify the status of a licensed professional • file a complaint against a licensed professional or report a change in staff privileges Video tutorials on above topics, FAQs and licensing requirements help guides can be found at: www.michigan.gov/miplus
ADVERTISERS TRIAD STAFF
Beaumont............................................................................17
Kris T. Nicholoff, CEO and Executive Director Lisa M. Neufer, Director of Administration Todd Ross, Manager of Communications Virginia Bernero, Executive Assistant & Marketing Coordinator Melissa Budd, CME Program Manager
Blue Cross Blue Shield of Michigan.....................................10
2019-2020 BOARD OF TRUSTEES
Kerr Russell...........................................................................7
Department of Business Affairs - Directors
McLaren Health Care...........................................................19
Craig Glines, DO, President Jeffrey Postlewaite, DO, President-Elect Lawrence Prokop, DO, Immediate Past President John Sealey, DO, Past President David Best, DO, Secretary/Treasurer
Coverys.................................................................................2 Fulford Legacy Conference....................................................4 Healthcare Partners of Michigan..........................................25
Metro Health.........................................................................9 MSU College of Osteopathic Medicine.................................21 MOA...................................................................................28
Department of Socio Economics - Directors
MOA Autumn Convention....................................................7
Stephen Bell, DO Emily Hurst, DO
MOPAC...............................................................................16
Department of Education - Directors Kevin Beyer, DO Adam Hunt, DO
Department of Membership - Directors Jasper Yung, DO Nathan Holmes, Student Trustee
Origami.................................................................................6 Symposium for Primary Care Medicine...............................16
For advertising inquiries, please email Todd Ross at tross@domoa.org or call 800.657.1556.
Department of Healthcare Technology & Informatics - Directors Andrew Adair, DO Miles Medina, DO 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.
COMMUNICATIONS DEPARTMENT Michigan Osteopathic Association Communications Department 2445 Woodlake Circle, Okemos, MI 48864 Phone: 517.347.1555 Fax: 517.347.1566 Website: www.domoa.org Email: moa@domoa.org Š2019 Michigan Osteopathic Association TRIAD
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