TRIAD Online Autumn 2018

The Award-Winning Journal of the Michigan Osteopathic Association A U T U M N 2018

MICHIGAN'S BEST in Medicine ALSO INSIDE Autumn Convention Highlights - 13 Credit & Debt Insight – 17 MSUCOM/GVSU Team Up - 21 The Intersection of Healthcare & Politics – 24

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

3181 Sandhill Rd. Mason MI 48854 517.336.6060 OrigamiRehab.org

Origami provides comprehensive brain injury care through residential, outpatient, and community based programs.

A Partnership Of

CONTENTS November 16-18, 2018 Amway Grand Plaza, Grand Rapids 24-26 AOA Category 1-A Credits Register for the Autumn Convention online at www.DOMOA.org/gr2018 – prices increase on-site!

Hotel reservations call 616-774-2000 or visit www.DOMOA.org/amway Learn more beginning on page 13

IN EVERY ISSUE 05 President’s Page

FEATURES 08

Michigan's Best in Medicine

22 Coverys

10

AMOA News

24 Healthcare Partners of Michigan

13

MOA Autumn Convention: Session Highlights

16

Pay Off Debt and Increase your Credit Score at the Same Time

Contributed by MSU Federal Credit Union

18

A Legacy of Excellence and Putting the Patient First

Contributed by Metro Health

21

Early Admission Program Helps Pre-Med Students Attend College of Osteopathic Medicine

Contributed by MSU College of Osteopathic Medicine

07 CEO's Message

27 Advertiser Index

3

MHA KEYSTONE CENTER. MEMBER HOSPITALS & HEALTH SYSTEMS. STATE & NATIONAL PATIENT SAFETY EXPERTS. Together, we are part of something important. We’re changing healthcare and improving patient safety and quality by implementing evidence-based, best practices that are supported by data. Our person-centered philosophy fuels our purpose and work. It drives us to continually improve and build safer and more reliable healthcare.

Michigan Health & Hospital Association (MHA) Keystone Center member hospitals are voluntarily participating in programs to improve the quality and delivery of healthcare by tackling big issues on a daily basis.

Every day, we’re exploring new and innovative ways to prevent harm, reduce healthcare costs, and improve patient safety.

TOGETHER, WE’RE MEETING THE CHALLENGES OF TODAY TO

Build a Safer Tomorrow and Beyond Read our 2017 MHA Keystone Center Annual Report and hear stories about how hospitals are improving patient safety and healthcare quality online at www.mha.org.

PRESIDENT’S PAGE

W

e are in the middle of Fall 2018 convention season. Most of the specialty colleges are having fall meetings and our Michigan Osteopathic Association Autumn Scientific Convention in Grand Rapids is a fast-approaching. I am proud of the diverse and relevant program offerings developed by the

Education Committee. Lecturers from around the state will come to share their expertise, expanding our knowledge and possibilities for our patients.

I recently attended OMED 18, the annual educational seminar from the American Lawrence L. Prokop, DO, FAAPM&R, FAOCPMR-D, FAOASM MOA President

Osteopathic Association. Dozens of lectures and labs per day were offered to DO’s from across the country, refreshing our knowledge and introducing new technology and techniques for patient evaluation and treatment. I had the honor of chairing a seminar on manual medicine, acupuncture & therapeutic exercise for TMJ syndrome and adhesive capsulitis. The international panel included Dr. Joon Sik Shin, KMD from the Korean Society of Manual Medicine and Jaseng Medical Foundation; Hollis King, DO, FAAO; Jenny Kendall-Thomas, DO, Board Certified in Physical Medicine & Rehabilitation. I’m happy to report that the seminar was well-received, expanding knowledge on a unique combination of Korean and Osteopathic Manipulative Medicine with acupuncture and therapeutic exercise.

I noticed a strong attendance of Michigan DO’s to learn and renew friendships. Our former MOA Board of Trustees member and previous Professor of Physical Medicine and Rehabilitation at Michigan State University College of Osteopathic Medicine, J. Michael Wieting, DO, was presented with the Educator of the Year Award. Andrea Amalfitano, DO, Interim Dean of MSUCOM, also gave attendees an update on the school and the excellent caliber of the students.

This time of year is busy with the meetings, CME, teaching and clinical activities of our members. Among these things, I am impressed with the additional undertakings that Michigan DO’s are contributing to our profession and our patients.

We support and expand our members’ abilities. We support and expand knowledge for our colleagues from around the country.

We have spearheaded international activities for the exchange of knowledge and professional abilities.

We as Osteopathic Physicians in the state of Michigan should be proud of our contributions to patient care locally, nationally and internationally. I believe that more of these successes at to come.

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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.

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T R I A D | A U T U M N 2018

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 Corporate/business contributions are prohibited.

CEO’S MESSAGE MICHIGAN'S BEST IN MEDICINE

I Kris Nicholoff CEO and Executive Director

n the hectic, day-to-day workings of an association it is easy to get caught up in the details. Meetings, calls, emails… But I am always amazed at the dedication of the leaders and members who work beyond their day-to-day practice to help in their areas of expertise.

Many of our members work on committees, boards and advisory positions. At last count, over 30 MOA members are active in these roles in statewide and national organizations.

These groups are making policies and impacting healthcare in so many ways. From the opioid crisis to telemedicine, the issues and policies that regulate how our physicians practice medicine are being guided and shaped by the dedication of the DOs among us.

In addition to the DO policy makers, Michigan’s Best in Medicine includes outstanding efforts in areas beyond our borders. Terrie Taylor, DO is just one example. Since 1986 Dr. Taylor, an MSU University Distinguished Professor of internal medicine and an osteopathic physician, has researched the causes and treatment of malaria. Working in the nation of Malawi, she conducts malaria research and treats patients, the majority of whom are children. The Blantyre Malaria Project, established by Dr. Taylor and Dr. Malcolm Molyneux, has carried out amazing research and patient care in the area of pediatric malaria, specifically cerebral malaria, a syndrome in which the brain is involved.

Her research and results have put her on an international stage. Dr. Taylor has received a grant from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health to build on her pioneering research that was published in the New England Journal of Medicine in 2015. And while Dr. Taylor has been honored for her work, presented at World Malaria Day and even presented at a TED Talk, her efforts don’t often make headlines. Her focus is finding new ways to save lives.

When I reflect on the leaders in osteopathic medicine and the physicians who are making a difference in healthcare, there is a common thread connecting them. Dedication.

When I reflect on the leaders in osteopathic medicine and the physicians who are making a difference in healthcare, there is a common thread connecting them. Dedication.

Whether it’s working half of the year in Africa or traveling across the state to attend a policy meeting after a long day at work, the potential to improve the quality of care is the driving force. And while this issue of the TRIAD aims to highlight Michigan’s Best in Medicine, it is impossible to recognize all of the individual doctors making a difference.

I am truly thankful for the physicians whose commitment to their profession make our communities a better place to live.

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MICHIGAN'S BEST in Medicine The Michigan Osteopathic Association is proud of the talent, strategic focus and compassion of our state’s health care providers. The following is recognition for their accomplishments in the medical industry.

While bottom lines are met in a fiercely competitive environment, quality patient care has remained a top priority to these leaders.

Congratulations and thank you for your dedication to excellence.

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Beaumont

McLaren

U.S. NEWS & WORLD REPORT RANKINGS Beaumont Hospital, Royal Oak earned national recognition by U.S. News and World Report in nine medical specialties in the 2017-2018 “America’s Best Hospitals” rankings. The Royal Oak hospital ranked No. 2 in Michigan and No. 2 in Metro Detroit.

This marks the 23rd consecutive year Beaumont, Royal Oak has been included in this national listing by U.S News. Six Beaumont hospitals, including Royal Oak, also received 'high performing' ratings for common adult procedures and conditions.

TOP 10 MICHIGAN HOSPITAL McLaren Northern Michigan ranked in the top 10 of 164 hospitals in Michigan according to U.S. News & World Report. The ranking is based on careful analysis of patient outcomes and carerelated factors, such as patient safety and nurse staffing, from nearly 5,000 hospitals nationwide. McLaren Northern Michigan was one of two hospitals in the Northwest region to be ranked in the top 10. Each hospital was evaluated and rated in nine specific procedures and conditions. McLaren Northern Michigan was rated as High Performing in seven, including Abdominal Aortic Aneurysm Repair, Aortic Valve Surgery, Colon Cancer Surgery, Heart Bypass Surgery, Heart Failure, Hip Replacement, and Knee Replacement.

GREENEST HOSPITALS IN THE UNITED STATES Two Beaumont hospitals were named among the top 50 in the nation for having the Greenest Hospitals in the United States by Becker’s Hospital Review. Beaumont has taken an active role in reducing its environmental footprint through a variety of sustainability policies and practices and a commitment to environmental responsibility.

MCLAREN BAY REGION AMONG NATION’S TOP PERFORMING HOSPITALS FOR TREATMENT OF HEART ATTACK McLaren Bay Region has received the American College of Cardiology’s NCDR ACTION Registry Silver Performance Achievement Award for 2018. McLaren

Bay Region is one of only 95 hospitals nationwide to receive the honor. The award recognizes McLaren Bay Region’s commitment and success in implementing a higher standard of care for heart attack patients and signifies an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/ American Heart Association clinical guidelines and recommendations.

KARMANOS EXPANDS CANCER NETWORK WITH NEWEST LOCATION AT MCLAREN OAKLAND McLaren Oakland will soon be home to a new 21-bed inpatient state-of-the art oncology unit. The sixth floor of the hospital’s West Tower is undergoing a complete renovation for the 19,000 square foot cancer unit.

“Opening an oncology unit brings us closer to our strategic goal of setting new standards of health care for the community and our patients. We are committed to providing exceptional inpatient cancer care to those requiring surgery or hospitalization for disease complications,” Margaret Dimond, Ph.D., president and chief executive officer, McLaren Oakland.

MHA Organizations like the Michigan Health & Hospital Association (MHA) inspire excellence in the health care field by providing incentives, education and recognition to those willing to go the extra mile. The criteria for such awards is strict, and the competition is intense.

Member hospitals are eligible to win the following awards: • Healthcare Leadership Award • Advancing Safe Care Award • Speak-up Award • Ludwig Community Benefit Award • Meritorious Service Award • Special Recognition Award Learn more at www.mha.org/Awards.

LAUNCH OF VERIFYMICARE HOSPITAL TRANSPARENCY WEBSITE The site, developed by the Michigan Health & Hospital Association, adds to an array of existing websites that offer consumers access to quality data.

However, the MHA site focuses only on Michigan hospitals and offers realtime statistics that are no more than six months old, compared to many competing sites that use year-old or twoyear-old data.

“Consumers need this information to make an informed decision, and it’s imperative that we provide this information,” Tina Freese Decker, COO at Spectrum Health said. “We want to engage consumers and patients in their health care and improve their health, and part of that is engaging them in understanding how they make informed decisions and helping them make those informed decisions, whether it’s based on the quality, or the experience they’re looking for, or the cost.”

Metro Health WOMEN’S CHOICE AWARDS Metro Health Hospital was recognized for exceptional care and treatment of patients and honored as One of America’s Best Hospitals for: Patient Experience, Emergency Care, Obstetrics and Orthopedics. 2016 WEST MICHIGAN’S 101 BEST & BRIGHTEST COMPANIES TO WORK FOR Sponsored by the Michigan Business and Professional Association, this award recognizes companies that have excelled in key areas such as communications, community initiatives, compensation and benefits, diversity, employee development and work-life balance. 2011, 2012, 2013, 2014 and 2015.

CIO 100 AWARD Metro Health was recognized as an organization that exemplifies the highest level of operational and strategic excellence in information technology due to a high performing and very secure virtual desktop that allows users to log in with their own security credentials to quickly and reliably access applications and patient data. 2015.

McLaren Oakland

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www.domoa.org/amoa

A DVO CAT E S F O R T H E M OA

TO G E T H E R W E CA N DO SO MUCH B Y A N G E LA KA LC E C, A M OA P R E S I D E N T

T Angela Kalcec, AMOA PRESIDENT

See you at

the Autumn Convention!

AMOA Reception Friday, November 16 4-6 pm Reserve Wine Bar Directly across from the Amway Grand Plaza

he Advocates for the Michigan Osteopathic Association (AMOA) is proud to introduce a strong and passionate board serving our organization in 2018-2019. The AMOA also includes a very active and enthusiastic Student Advocate Association at MSUCOM, increased interest from Intern Resident Advocate Association groups at Henry Ford Wyandotte and Henry Ford Allegiance, and representatives from McLaren Oakland, McLaren Macomb and McLaren Greater Lansing. All of these organizations help to promote the osteopathic profession, and include families of medical students and residents. We have a busy year planned!

Our theme this year is “Alone we can do so little, and together we can do so much” Part of what we do is raise funds for residents, medical students and spouses. Our seasonal fundraiser will be our annual “Tree of Peace” offering stained glass ornaments for the holidays. With your generous support we can make a difference for our Michigan Osteopathic family.

We hope to build on last year’s work engaging with MSUCOM, MOA, AAOA and various Intern/Resident Groups. The AMOA board is also investigating ways to collaborate with our wonderful MOA board, as well as promote new initiatives such as the “Yellow Ribbon” and physician wellness in Michigan. Our distracted driving awareness program is one we are very proud of, and it continues to be a focus of our organization. The simulator has been taken to a number of health fairs, high schools and even our state capital, and is always well received and requested back.

With all that being said, we hope you will join us on November 16, 2018, from 4-6pm, for our social event at the MOA Autumn Convention at the Reserve Wine Bar. We will be providing hors d’oeuvres and great conversation. We look forward to another successful year of osteopathic advocacy together!

Advocates for the Michigan Osteopathic Association

AMOA The people behind the profession.

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MICHIGAN OSTEOPATHIC ASSOCIATION

14th Annual Autumn

SCIENTIFIC CONVENTION Friday, Nov. 16 – Sunday, Nov. 18, 2018 Amway Grand Plaza, Grand Rapids 24-26 AOA Category 1-A Credits Amway Grand Plaza | 187 Monroe Ave. NW, Grand Rapids, MI 49503 Hotel reservations: call 616-774-2000 or visit www.DOMOA.org/amway Agenda: www.moaautumn.com What to do in Grand Rapids? www.experiencegr.com/moa2018

New, extended CME hours on Friday! (see page 12 for details) The Michigan Osteopathic Association is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians.

The Michigan Osteopathic Association designates the Autumn Scientific Convention for a maximum of 24-26 AOA Category 1-A credits and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.

PHYSICIAN WELLNESS CENTER at Autumn Convention

OSTEOPATHIC MANIPULATION TREATMENT P R I VAT EExperience & G R O U P YO G A S E S S I O N S Educational Asana Class Guided Relaxation & Meditation

YOGA SESSIONS

Guided O M MRelaxation and Meditation

Treatments offered during certain hours

RELAX & REJUVENATE

E LA & Friday R E J U V&I Saturday N AT E 10Ram - 3Xpm, Friday - Sunday!

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For full agenda, visit www.MOAautumn.com

FRIDAY SESSION HIGHLIGHTS ( NEW START TIME –9 AM!) 8:55 AM • AMBASSADOR EAST

Opening Remarks & Welcome Lawrence Prokop, DO, FAAPM&R, FAOCPMR-D, FAOASM, MOA President 9 - 10 AM • AMBASSADOR EAST

Protecting your Adult Patients from Vaccine Preventive Diseases (1.0 credit) Ann P. Ryan, DO, PhD, MDHHS Vaccines prevent many diseases that can be very serious. All adults need vaccines to help protect themselves and others. The recommended vaccines are based on your age, health condition, job, lifestyle, or travel habits.

Vaccines recommended* for everyone: • Influenza vaccine every year during flu season, including pregnant women during any trimester • Tdap vaccine one time, no matter when you got your last tetanus (Td) vaccine. Pregnant women also need Tdap vaccine during every pregnancy • Td vaccine booster every 10 years • Based on age, health conditions, vaccines patient received as a child, and other factors Additional vaccines recommended include: • Chickenpox • Hepatitis A • Hepatitis B • Human Papillomavirus (HPV) • MMR • Meningococcal • Pneumococcal • Shingles

Managing Sleep Health in the Primary Care Setting The National Sleep Foundation (NSF) is dedicated to improving health and well-being through sleep education and advocacy. NSF offers a number of education opportunities for primary care physicians, researchers, and clinicians focused on sleep health, sleep medicine, and communities. One of these programs is Managing Sleep Health in a Primary Care Setting.

Managing Sleep Health in a Primary Care Setting is a regional half-day in-person program that focuses on gaps in medical knowledge and competence related to sleep health and disorders for the family physician audience.

In the presentation on the importance of sleep, attendees will learn how to define sleep health and summarize its clinical importance. They will also learn how to communicate risk factors associated with not getting enough sleep, how to explain the sleep/wake cycle and circadian rhythms, and how to identify common sleep disorders in primary care. Additionally, NSF faculty will explain how to use appropriate diagnostic tools to assess patient’s sleep health.

During the case study workshop, attendees will engage in interactive discussions to learn how sleep health, management, and treatment of sleep disorders contribute to overall well-being. Faculty will also explain how to identify risk factors and symptoms of insomnia, circadian rhythm disorders, restless legs syndrome, and obstructive sleep apnea, as well as how to define and differentiate common treatments available for those conditions.

*Centers for Disease Control and Prevention Guidelines

12 -1 PM

Friday Luncheon LONHALA™ MAGNAIR™ (glycopyrrolate) Inhalation Solution: The First and Only Nebulized LAMA for COPD Including Chronic Bronchitis and/or Emphysema Product Theater by Sunovion (Does not qualify for CME)

You’re invited to the AMOA Reception at Autumn Convention.

4 - 6 pm Friday, November 16 Reserve Wine Bar

(directly across the street from Amway Grand Plaza) Join the Advocates for the Michigan Osteopathic Association for cocktails & conversation. Hors d’oeuvres also provided. No RSVP required, spouses welcome!

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For full agenda, visit www.MOAautumn.com

1 - 4 PM • AMBASSADOR EAST

National Sleep Foundation Workshop: Managing Sleep Health in a Primary Care Setting (3.0 credits) James Weintraub, DO, Facilitator Part 1: The Importance of Sleep Health

SATURDAY SESSION HIGHLIGHTS 7 - 9 AM • AMBASSADOR EAST

Osteopathic Functional Diagnosis: Whole Body Biomechanics Approach (2.0 credits) Shane Patterson, DO Table Trainers: Mary Goldman, DO & Ryan Christensen, DO

Paul Doghramji, MD, Collegeville Family Practice Part 2: Diagnosing and Treating Common Sleep Disorders in Primary Care Larry Culpepper, MD, MPH, Boston University Medical Center Paul Doghramji, MD, Collegeville Family Practice David Neubauer, MD, Johns Hopkins University School of Medicine (Category 1 AMA PRA credits offered)

5:15 - 6:15 PM • AMBASSADOR EAST

Five Ethical Dilemmas Physicians Face in Practice (1.0 credit) Elizabeth Petsche, JD • Meets Florida osteopathic relicensure requirement

Osteopathic manipulative treatement demonstration

8 AM - 12 NOON

SRE COMPETITION JUDGING & AWARDS

Death Records (1.0 credit)

The MOA will once again host a Scientific Research Exhibit (SRE) at the 2018 Autumn Scientific Convention. These competitions provide osteopathic medical students, residents, fellows and attending level physicians an opportunity to present their medical and scientific research to our profession.

The SRE event demonstrates the very best of what osteopathic medicine is and reaffirms the profession's commitment to the advancement of science in osteopathic medicine.

Patrick Hansma, DO, Medical Examiner at Sparrow Hospital

www.domoa.org/sre

for Professional & Medical Ethics • Meets Michigan LARA requirement for Medical Ethics for MD’s

6:15 - 7:15 PM • AMBASSADOR EAST

Up-to-date information regarding the proper completion of the cause of death section of the death certificate.

The objectives for this course are to: • Identify the cause and manner of death • Write cause of death statements • Recognize non-natural deaths • Describe the physician’s role and the medical examiner’s role in death certification • Discuss common misconceptions related to proper death certification Refreshments provided to attendees of 6:15 PM session.

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For full agenda, visit www.MOAautumn.com

SATURDAY SESSION HIGHLIGHTS (CONT.) 1:15 – 2:15 PM • AMBASSADOR EAST

Pedal to the Metal: Speeding up the Clock in the ED (1.0 credit) Joseph Schramski, DO, FACOI

SUNDAY, 11 AM - 12 NOON

Pills + Skills = Success: Trauma Informed Brain-Based Medication Treatment for Complex Children and Adults (1.0 credit) Mark Sloane, DO, FACOP, FAAP

12 -1 PM

Saturday Luncheon Victoza®: Approved to Reduce Major Adverse Cardiovascular Events in Your Type 2 Diabetes Patients With Established CVD Ashish Verma, MD Product Theater by Novo Nordisk (Does not qualify for CME)

4:30 – 5:30 PM • AMBASSADOR EAST

Flu Season Update (1.0 credit)

Anthony Ognjan, DO, FACP

SUNDAY SESSION HIGHLIGHTS 7:30 - 10:30 AM

Pain & Symptom Management (3.0 credits) (Meets Michigan LARA requirement) 7:30 am David Best, DO, MS, ABAM 8:30 am Pam Lynch, Social Worker

9 am William Morrone, DO, MS, FACOFP, DAAPM, ASAM 10 am Panel Discussion

Refer a colleague*

$50 Registration DISCOUNT

Medication treatment of traumatized / Fetal Alcohol Spectrum Disorder (FASD) children is somewhat controversial, especially among non-physician trauma clinicians and researchers. Many mental health / child welfare professionals (and even many prescribing physicians) have become frustrated and disillusioned with the current “state-of-the-art” re psychotropic medication treatment of traumatized / FASD children and adolescents.

Much of this frustration has centered on the still common practice of treating traumatized / FASD (even very young) children / adolescents with multiple potent psychotropic medications even in the absence of a comprehensive assessment. Additionally, significant medication adverse effects frequently have an unintentional yet clearly deleterious impact on the child’s development and behavioral presentation. This pattern of overmedication is at least in part due to severe behaviors in many foster care children and adolescents that threaten placement stability.

These children can generally be much better clinically described by taking a dimensional approach - considering the neurobehavioral / neurodevelopmental impact of the following factors (either alone or in combination): 1) genetic / epigenetic risk for neurological and psychiatric disorders; 2) prenatal factors (including prenatal traumatic stress exposure, as well as prenatal exposure to prescription / illicit drugs, and alcohol); and 3) post-natal maltreatment (including early caregiver-child attachment experiences, family / parental psychopathology, family dynamics, domestic violence exposure, as well as myriad child maltreatment/neglect issues).

In this presentation, Dr. Mark Sloane will review his trauma-informed brain-based medication treatment conceptual model which has been used in the treatment of more than 900 traumatized and prenatally-exposed children, adolescents, and young adults since 2011.

An overview, as well as specifics of this model (which de-emphasizes severe mental illness and is primary carefriendly), will be discussed. Case presentations will also

be discussed during this presentation. *COLLEAGUE MUST BE MOA NON - MEMBER 14

T R I A D | A U T U M N 2018

PROGRAM CONCLUDES AT 1:30 PM

For full agenda, visit www.MOAautumn.com

EXHIBIT HOURS

MICHIGAN OSTEOPATHIC ASSOCIATION

14th Annual Autumn

6:30 AM – 4 PM SATURDAY, NOVEMBER 17

SCIENTIFIC CONVENTION

Physicians have a chance to enter a prize raffle for visiting 5 exhibitors!

MOA AUTUMN SUB - COMMITTEE Chad Kovala, DO, FACOEP, Education Committee Co-Chair R Taylor Scott, DO, Education Committee Co-Chair Kimberly Blom, DO John Bodell, DO, FACOS James Clinton, DO, FACP

Diamond Sponsor

Support

Blue Cross Blue Shield Coverys Experience Grand Rapids of Michigan First National Bank of Michigan MDHSS, Division of Immunization Strategic Partners Michigan Public Health Institute Michigan State University on behalf of the Division for MPHI

Federal Credit Union Vital Records and Health Statistics National Recovery Agency McLaren Health Care National Sleep Foundation Michigan Health &

Novo Nordisk Hospital Association Origami Brain Injury Rehabilitation Center Metro Health Sunovion Pharmaceuticals Beaumont

Mary Goldman, DO Anthony Ognjan, DO, FACP

PRACTI C E MA NAG E RS PROGRAM

Zafar Shamoon, DO, FACOEP

!S

E C N E16,R E2018 F N OC S R E GA N A M E C I TCAR P Friday, November PRACTICE MANAGERS PROGRAM Amway Grand Plaza | Grand Rapids, MI 7102 ,4 .VFRIDAY, O N ,YA DNOVEMBER R U TA S & 316, .VO N ,YA D I R F 2018 EXPERIENCE I MAMWAY , sd ip aGRAND R d n arPLAZA, G | a zGRAND a l P d n aRAPIDS, rG yawm MIA RAPIDS! gisterGRAND at domoa.org/GR2018 Elizabeth Swenor, DO

L U D E S PThere's RO G RA M,toB R A K F A Syour T & stay L U N C H. lots doE during

Grand Rapids. Anticipated.

Find out more at hoursinof CEUs experiencegr.com

Informed in the Physician Office Practice HOTELRefusal RESERVATIONS Tips,CallTools and Techniques to Aggresively Monitor your 616-774-2000 or visit Practice’s Financial Performance www.domoa.org/amway Office Safety MACRA Hiring, Retention & Firing Integrated Care: Where Behavioral Health Intersects with Primary Care

. D E TA P SED .H C N U

• 6 Hours : Dof E RCEUs E V O Canticipated E B OT S C I P OT tneitaP &includes liamE ,spcertificate, pA eliboM - • Registration n o i t a c breakfast and lunch inummoC adpU nat: a g i h c i M fo et a t S • Registeretonline www.domoa.org/practicemanagers S P I M / AR C A M snoitalugeR AP /PN CONTACT: selcyC euneext veR103 Virginia Bernero at 517-347-1555 e t a d p U ec n a r u s n I or vbernero@domoa.org namuH fo smitciV gnizingoceR Thank you to our Sponsors gnikciffarT g n i l a i t n e d e rC lacideM fo noitaicossA naciremA et a d p U ) A M A A ( s t n a t s i s s A

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PAY OFF DEBT AND INCREASE YOUR CREDIT SCORE AT THE SAME TIME

BY DEIDRE DAVIS, CHIEF MARKETING OFFICER FOR MSU FEDERAL CREDIT UNION

T

hinking about life

Know Your Credit Score

after graduation and

The most commonly used credit score among lenders is known as the FICO® score. This credit score was developed using “predictive analytics,” which means information is collected and analyzed to predict what’s likely to happen when it comes to you paying back borrowed funds. To determine one’s credit score, FICO looks to the three reporting credit bureaus — Equifax, Experian, and TransUnion — who each track your credit history.

what the future holds?

If you are unsure of what the future may bring due to your student loan debt and possible low credit score, never fear.

There are many steps you can take to begin to pay off your debt and increase your credit score — at the same time.

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T R I A D | A U T U M N 2018

FICO scores range between 300 and 850, with the higher number representing less risk to the lender. Five main factors go into determining FICO scores, including: • Payment history (35%) • Debt/amounts owed (30%) • Length of credit history (15%) • New credit/inquiries (10%) • Mix of accounts/types of credit (10%)

To better understand your credit score, it is recommended you review your credit report once a year, which you can do for free through annualcreditreport.com. A good practice is to download a free credit report from each of the three credit bureaus monthly. It is also free to get one printed report from each bureau annually. Review this report to understand your credit history and be sure to contact the credit bureau directly if you notice any errors.

Debt Reduction Strategies Once you have an idea of what your credit score is, you can then begin to implement strategies to improve your credit history while reducing your debt.

Here are five strategies to consider:

Make payments on time.

In the FICO scoring model, late payments affect 35% of your credit

score. By simply making payments on time, you impact your score in a positive way.

Address delinquent accounts.

If you have missed payments, bring these accounts current first. Oftentimes, creditors will not penalize you for a late payment as long as it is made current quickly.

Focus on high-interest debts first.

Tackling high-interest rate debts can also help improve your credit score.

Try the Avalanche Method: rank your debts according to the interest rates, from highest to lowest. Then, while making minimum payments on all your debts, put extra funds towards the priority debt (whichever is the one with the highest interest rate). Once the first debt is paid off, extra money can be used to pay off the second priority debt. Continue this process until all debts are paid.

Pay off accounts with low credit limits.

You may also want to prioritize paying off any credit card accounts with a low credit limit. Because the credit bureaus compare the amount you owe in relation to the total credit limit, paying those cards off first can be a good step to take, ensuring your debt-to-limit ratio is not too high.

Keep credit utilization under 30% Finally, keep your credit use lower than 30% of the total credit limit for each credit card. Balances within 30% of your credit limit (per card) are okay, but keep making those payments to reduce your debt!

As you begin to look toward a future after graduation, it makes sense to review your current credit standing.

By putting strategies in place to pay down debt and improve your credit score, you will be better able to take advantage of future opportunities.

A Financial Institution Made for Your Practice Whether you are starting out or well established, we are here to provide the financial products and services you need to run a successful practice.

• Savings and checking accounts • Cash Back Visa Credit Card • ACH and remote deposit services • Merchant processing Contact our Business Services department today. msufcu.org/business 800-678-4968 • 517-333-2424 (Option 5)

Federally insured by NCUA. All loans are subject to credit approval.

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A LEGACY OF EXCELLENCE A N D PUTTING THE PATIENT FIRST CONTRIBUTED BY METRO HEALTH - UNIVERSITY OF MICHIGAN HEALTH

F

rom its beginning, when a group of osteopaths pitched in their own money to start a hospital, to an ability today to make world-leading medicine accessible on a local basis, Metro HealthUniversity of Michigan Health has always set itself apart.

It has done so through a bold commitment to a core belief, that healthcare is best when it focuses on the best patient experience. That commitment shines through as Metro Health continues to set new standards for health care in West Michigan – whether through its 2016 affiliation with University of Michigan or the decision in 2018 to become the first health system in the region to be led by a physician.

This is a place where employees want to work, providers want to practice and where everyone shares an unwavering commitment to the patients. The natural result of this passion is excellence, evidenced in recent awards and accreditations:

American College of Cardiology-

accredited chest pain center

Metro Health was re-accredited as the only American College of Cardiology-accredited chest pain center in West Michigan. Metro Health also is proud to offer intensive, comprehensive cardiac rehabilitation.

Verified Level II Trauma Center

With designation as a Verified Level II Trauma Center by the American College of Surgeons, Metro Health demonstrated its capabilities with an external review of resources and performance.

Distinguished Service Award

Gerri Navarre, administrative director of Medical Education and Associate Designated Institutional Official, was selected as the 2018 recipient of the Michael Opipari, DO, Distinguished Service Award, in recognition of service to Michigan State University College of Osteopathic Medicine’s 37-hospital Statewide Campus System.

Comprehensive Stroke Center

Metro Health earned certification as a Comprehensive Stroke Center by the Healthcare Facilities Accreditation Program in July affirming its capabilities to rapidly treat acute stroke cases. Stroke care has long been an emphasis for Metro Health, a Primary Stroke Center since 2005.

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All of Metro Health’s residency programs are accredited by the American Osteopathic Association and are in the process of transitioning to the Single Accreditation System.

“101 Best and Brightest to Work For”

During a transformative year in which Metro Health cemented its affiliation with University of Michigan Health, the organization was the only Grand Rapids-area hospital included among the “101 Best and Brightest to Work For” selected by the National Association of Business Resources.

Everyone at Metro Health-University of Michigan Health can take pride in these recognitions. But the most important measure remains a consistent commitment to providing the best healthcare experience for patients.

Metro Health’s Board of Directors took a step to reinforce that commitment in August, when it announced the selection of Chief Medical Officer Dr. Peter Hahn as the next President and CEO. Dr. Hahn begins in the new role Oct. 1, succeeding Michael Faas, who last year announced his plan to retire after 25 years at Metro.

A noted pulmonologist, Dr. Hahn will be the region’s first physician-CEO. This is a standard established by the leading health systems in the nation – and it is not that far from how Metro Health got its start.

As one board member said: “Metro Health was founded by physicians.

Now it will be led by one.”

More than a health system, a commitment to providing exceptional care.

TRUE BLUE JOIN OUR COMPASSIONATE TEAM

PRIMARY CARE & SPECIALTY CARE OPPORTUNITIES

Driven by our passion for the health and wellness of our patients and communities we serve, Metro Health – University of Michigan Health is changing the face of health care in west Michigan.

Our health system includes a 208-bed hospital, a wide range of medical specialties, a network of neighborhood physician offices and outpatient specialty offices located throughout the area. We offer a dedicated team of providers, stateof-the-art facilities and the latest advancements in surgery, innovative techniques and treatments.

616.252.5283 metrohealth.net

P RACT IC E M A N AG E R S P RO G RA M Friday, November 16, 2018 Amway Grand Plaza | Grand Rapids, MI

Register at domoa.org/GR2018 I N C L U D E S P RO G RA M, B R E A K F A S T & L U N C H.

Topics:

6 hours of CEUs Anticipated.

Informed Refusal in the Physician Office Practice Tips, Tools and Techniques to Aggresively Monitor your Practice’s Financial Performance Office Safety MACRA Hiring, Retention & Firing Integrated Care: Where Behavioral Health Intersects with Primary Care

Thank you to our Sponsors

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We’ve got plans to cover all of yours.

At Blue Cross Blue Shield of Michigan and Blue Care Network, we appreciate our health care providers for all they do in helping us provide access to quality, affordable care for the people of Michigan.

We’d like you to know that you can also rely on us for your health care coverage.

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“Highest Member Satisfaction among Commercial Health Plans in Michigan”

For J.D. Power 2018 award information, visit jdpower.com/awards. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

1 20R081363_Ad_SummerTRIADMagazine.indd T R I A D | A U T U M N 2018

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6/29/18 9:35 AM

EARLY ADMISSION PROGRAM HELPS PREMED STUDENTS AT T E N D CO L L E G E O F O S T E O PAT H I C M E D I C I N E

BY LAURA PROBYN, MSUCOM

A new agreement will give Grand Valley State University premedical undergraduates early admission assurance into the Michigan State University College of Osteopathic Medicine. The agreement reserves up to five positions for GVSU students per year.

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ccording to Jean Nagelkerk, vice provost for health at GVSU, preference will be given to students who are Pell grant recipients, first-generation college students or graduates of a high school in a medically underserved rural or urban area.

dean. “Our priority is on recruiting candidates who are not only academically talented, but are also dedicated to becoming committed, caring osteopathic physicians. This initiative will enable us to strengthen that effort and produce more of the state’s best doctors.”

“We are so pleased our two public institutions are working together in partnership to help solve a physician shortage and fill gaps in the talent pipeline,” Nagelkerk said.

Qualified students can apply in early February for admission in 2020 to the osteopathic college.

Under the agreement, the MSU College of Osteopathic Medicine will waive supplemental application fees for GVSU students who qualify and provide them with opportunities to network with medical students, faculty and staff members.

“This collaboration will provide a wonderful opportunity, not just for the students, but for all of Michigan,” said Andrea Amalfitano, MSU College of Osteopathic Medicine interim

Maria Cimitile, Grand Valley’s provost and executive vice president for academic and student affairs, said

students accepted into the MSU College of Osteopathic Medicine will not have to submit multiple medical school applications, affording them opportunities to concentrate on broadening their knowledge base and skill set during their senior year at Grand Valley.

“Our partnership with MSU is important as it aligns with Grand Valley's mission of providing relevant experiences for our students,” Cimitile said. “Students who are accepted early will work with our pre-professional advising program and be well on their way to becoming contributing first-year medical students.”

Grand Valley and Grand Rapids Community College entered a similar agreement with MSU’s College of Human Medicine in 2012.

Our priority is on recruiting candidates who are not only academically talented, but are also dedicated to becoming committed, caring osteopathic physicians.

This initiative will enable us to strengthen that effort and produce more of the state’s best doctors.

ANDREA AMALFITANO, INTERIM DEAN, MSUCOM

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ASC RISK MANAGEMENT BEST PRACTICES CHECKLIST CONTRIBUTED BY COVERYS RISK MANAGEMENT

If you manage an ambulatory surgery center (ASC), you know the benefits and the risks that come with performing outpatient surgical procedures.

While ASCs have gained popularity as a convenient and cost-effective alternative to hospital admission, they have seen a gradual increase in medical professional liability claims.

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ecause ASCs usually stand alone, and are not typically located on a hospital campus, a lack of resources can contribute to catastrophic outcomes when something goes wrong. Although only 5 percent of Coverys’ claims in outpatient locations come from ASCs, 34 percent of those incidents resulted in permanent harm or death.

Is your organization prepared to identify and mitigate potential risks? Use the checklist below to assess your level of preparedness.

www.coverys.com

ASC Risk Management Best Practices Checklist 1. Ensure that a comprehensive patient evaluation is performed prior to surgery that includes: • Diagnostic testing to clear the patient for surgery • Anesthesia risk assessment • Comprehensive history and physical (conducted within 30 days of the scheduled surgery) to allow assessment of the patient’s readiness for surgery • A medical record with results of the history and physical present and visible prior to prepping the patient for surgery • A review of the history, physical and patient’s readiness for surgery, by the patient’s surgeon, upon the patient’s admission to the ASC • Consensus that there is nothing about the patient’s overall condition that would prohibit conducting the procedure in an ambulatory setting

3. Require an informed consent discussion to be conducted and documented by the surgeon performing the procedure.

2. Develop ASC policies that address the criteria used to determine which patients may be appropriate for services in the ASC.

4. Develop evidence-based protocols for the performance and management of all ASC procedures and provide staff education and training for preoperative, intraoperative, and post-operative care.

An example may be the use of the American Society of Anesthesia Physical Classification System score: • ASA PS I: Normal healthy patient • ASA PS II: Patient with mild systemic disease • ASA III: Patient with severe systemic disease • ASA IV: Patient with severe systemic disease that is a constant threat to life • An ASC that employs this classification system in its assessment of its patients may decide not to accept patients who are classified as ASA PS IV or higher. For many patients classified as ASA PS level III, an ASC may also not be an appropriate setting, depending upon the procedure and anesthesia.

It should include but not be limited to: • Indications for the proposed procedure • Any alternatives available to treat the condition • The likely outcome(s) if the procedure is not performed • A review of the steps of the proposed procedure in lay terms • The risks and benefits of the procedure • The expectations for the recovery period, including how pain will be managed • When normal activities will most likely be resumed • Any expected residual effects from the surgery

TO CONTINUE READING CLICK BELOW: www.coverys.com/Resources

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https://domoa.org/HCPM

THE INTERSECTION OF HEALTHCARE & POLITICS

BY EWA MATUSZEWSKI

I’m voting for healthcare interoperability in November. How about you?

We know that “Fix the Damn Roads” is a critical imperative for one of Michigan’s gubernatorial candidates – and hopefully both. But is “Fix the damn interoperability problem with electronic health records” another?

T

he intersection of healthcare and politics is obviously not new. I would contend it’s more visible – and vicious – than ever. Still, the focus tends to be on access to care and delivery of care, and I understand that. Interoperability of EHR hardly pulls at the heartstrings or incites passionate conversation from either side of the aisle; accordingly, it doesn’t garner much attention from the consumer media either. That is why it is important for healthcare decision makers to individually and collectively raise awareness of the issue, not just in the healthcare community, but with our elected officials.

To make sure we’re clear on the topic (and in case some politicians are reading this,) interoperability in this context refers to the ability to share and interpret patient data and information electronically across systems and devices among hospitals, insurers, clinics and private practice physicians. I’ve said it before, and I’ll say it again: there ought to be a law. While I disdain the proliferation of excessive 24

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laws that seemingly aim to control our every move, legislation embraced by both parties to establish requirements for the interoperability of individual health care records is critical element of health reform. It empowers both patients and their providers to get sensible, timely care without excessive testing, over-testing and retesting. It is patient-focused and cost conscious, while consistent with population health goals.

If I’m hospitalized and then transferred to another hospital, the assumption is that my records will be immediately available electronically to the receiving hospital. Let’s also touch on emergency room or urgent care activities.

These “urgent” encounters become part of the patient’s permanent health record seamlessly. Right? Similarly, if I had an ultrasound done at hospital “X” last year, the ultrasound results should be available online, with my permission, at hospital “Y” this year, correct? The response to all these scenarios is, “Not necessarily”. Similarly, unless a physician practice uses a registry or an EHR that “speaks” to

a data repository, health plans are also forced to send auditors to the provider to extract much needed HEDIS information, which can get needlessly complicated when the physician doesn’t use a registry at all. (Yes, some physician practices still rely on paper documentation.)

Why is this lack of patient data transfer acceptable in 2018? Surprising to many, interoperability also plays a role in chronic illness surveillance and treatment. Primary care physicians have dramatically increased compliance with diabetic patients for retinal eye exams, thanks to the affordability of mobile eye scanning devices that allow the scan to be taken in the PCPs office. The scans are then immediately sent electronically to a retinal specialist for interpretation; a referral to a local retinal specialist is provided when merited.

Despite multiple state-wide initiatives in recent years to make interoperability a reality, including those spearheaded by state agencies, none of our collective efforts have moved the needle far enough. Rather than getting all the players to the table to discuss interoperability new silos are being created to mask communication inefficiencies. Maybe legislation would help us finally achieve the goal?

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

LEADING-EDGE CANCER CARE.

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Michigan’s Only Proton Therapy Center Speak to a proton nurse navigator today: 248-565-3968 or visit beaumont.org/proton

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GROWTH

INNOVATION

PROGRESS

Moving forward with McLaren As one of Michigan’s largest and growing health care systems with more than 85,500 network providers and a delivery network covering the entire lower peninsula of Michigan, our strength can be attributed to our ability to excel at the very human element of medical care.

We understand that health care must be provided by physicians and other medical professionals who are devoted to healing the sick, relieving pain and advancing research.

We are thankful for the dedication and service of the more than 9,000 osteopathic physicians in Michigan whose contributions make a difference each and every day in the quest to bring the latest technologies and innovations to the communities we serve.

Find out how you too can move forward with McLaren.

To learn more about opportunities around the state, visit JoinMcLaren.org.

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One of the largest health care systems in Michigan with 350 facilities, 14 hospitals and more.

ADVERTISERS TRIAD STAFF 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

2018-2019 BOARD OF TRUSTEES Lawrence Prokop, DO, FAAPM&R, FAOCPMR-D, FAOASM, President Craig Glines, DO, MSBA FACOOG, President-Elect Jeffrey Postlewaite, DO, Secretary/Treasurer John Sealey, DO, FACOS, Immediate Past President

Department of Business Affairs - Directors Lawrence Prokop, DO, FAAPM&R, FAOCPMR-D, FAOASM, President Craig Glines, DO, MSBA FACOOG, President-Elect Jeffrey Postlewaite, DO, MPH, Secretary/Treasurer John Sealey, DO, FACOS, Immediate Past President Bruce Wolf, DO, FAOCR, Past President

Blue Cross Blue Shield of Michigan.....................................20 Coverys...............................................................................28 Healthcare Partners of Michigan..........................................25 Kerr Russell...........................................................................6 McLaren Health Care...........................................................26 Metro Health.......................................................................19 Michigan Health & Hospital Association...............................4 MSU Federal Credit Union..................................................17 MOPAC.................................................................................6 Origami Brain Injury Rehabilitation Center...........................2

Department of Socio Economics - Directors Kevin Beyer, DO Patrick Botz, DO

For advertising inquiries, please email Todd Ross at

Department of Education - Directors

tross@domoa.org or call 800.657.1556.

Emily Hurst, DO Samia Cheema, DO, Resident

Department of Membership - Directors Andrew Adair, DO, FACOFP Stephen Bell, DO, FACOI Matthew Meranda, OMS-II

Department of Healthcare Technology & Informatics - Director David Best, DO, MS, ABAM 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 ©2018 Michigan Osteopathic Association TRIAD

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lawsuits

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EHRs

big data

shifting FDA regulations

risk of medical errors

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