On Call - The Journal of Palm Beach County Medical Society (May-June 2011) by Palm Beach County Medical Society

The Journal of The Palm Beach County Medical Society

Great People Doing Great Things

May â&#x20AC;&#x201C; June 2011

A Salute to Our 2011 Heroes in Medicine

Everyday Heroes… We’re going to need a lot more

ongratulations to all who were nominated for the 2011 Heroes In Medicine Awards…and not just those who won. Just being nominated by your peers in Medicine as well as in the community should be considered a huge honor.

Is the public willing to look at outcomes as the standard of good care? Or, do they still want the private hospital rooms and 10 choices on the menu? Other countries expect a family member to help an ill or elderly relative both in the hospital and at home. Here, we expect the insurance company or the government to do so. Did you get sick, receive the care your doctor ordered and get well and go home?

We’re going to need more heroes as the discussion goes on in our country, not just about healthcare reform, but how do we live within our means, something we have not done for years as budget deficits reach unheard of levels. It seems like the credit card company that is starting to call in our debts, to lower our credit limits, even though they were the ones who gave us ever increasing credit limits that, in hindsight, we could not afford. We, as Physicians, are going to be called on to continue to provide excellent care, even required to provide care, when nobody knows how it will be paid for. We, both Physicians and hospitals, are not allowed to take a day off while the powers that be try to figure this out. We can’t turn our backs on our patients, nor close the Emergency Departments.

That should be the standard. Unfortunately, we will still need tort reform to help in this area, because unhappy patients sue doctors and hospitals, and the unhappiness may start with their hospital room and menu and their expectations, and not the quality of the Physician’s care.

Our country has become hooked on “entitlements.” Benefits that were an excellent idea at the time, are now becoming difficult, if not impossible in some areas, to pay for. People look at care we provide as a right…but the Physicians and hospitals are supposed to provide this “right,” and people don’t want to hear about what it costs. We will be called upon to re-analyze the care we give, the medications we use, the procedures and tests we order, and look at basic science and research, eliminating the emotional component, to justify what we do. We are lucky that, as Physicians, we usually worry about where we go to eat, not if we can eat. We have provided the best care to everyone, without regard to cost, and sometimes without regard to evidence on effective outcomes in end-of-life or catastrophic cases. Many times we have to work with families’ demands and expectations. But we are going to have to address which services we can continue to provide….unless the country wants to actually pay for the care it wants. Do you give a 98-year-old a pacemaker and start dialysis? Now, we do.

This is not to say that we cannot do better in communicating with our patients. This is one of the most common complaints in hospitalized patient. We still need to strive to be compassionate professionals, true Physicians, to be role models for our medical students. We need to protect the good reputation we have for quality. The Medical Society has cooperated with the State’s Attorney and County Sheriff on the issue of pill mill pain clinics, which employ doctors (not true Physicians) who damage the image of all good Physicians. We will continue to work with the hospitals to provide excellent care to the people of Palm Beach County. But we need to continue to inform our government leaders about the challenges we face every day in our offices in providing this care.

President’s Report

James J. Byrnes, M.D. I President, Palm Beach County Medical Society

We all need to stay involved, even at the end of an exhausting day. We need to remind the public, the Government….and ourselves, that we are everyday Heroes to our patients, that WE provide the excellent care that people have become accustomed to. We need to strive to be able to say, “Thank you for Father for they DO know what we do!”

We CAN provide all the care people want and expect. However, will the American public make cuts in other areas? Will we pay professional athletes less? Will we value a Physician more than a basketball player? How many Family Physicians could we pay with the salaries of the Miami Heat?! Is the public, or the athlete, willing to give up the money we pay for sports? Is the American public willing to cut military/defense spending to pay for top notch medical care? What care could we provide to the poor with just the cost of one cruise missile or one fighter jet? The State Dept. was given over $2 BILLION for operations in Iraq this year. How many children in this country could we care for with $2 billion?

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OnCall I May â&#x20AC;&#x201C; June 2011

7 Feature I7I

FMA 2011 State Legislative Session Summary

Articles I8I

The Physicianâ&#x20AC;&#x2122;s Guide to Hiring a Lawyer

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Building and Office Disaster Plans

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Money and Medicine

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Understanding the Types of Professional Liability

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Summer School for Physicians & Staff

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Med Memo / Classifieds

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Disability Awareness

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Membership Applications

Cover photo: 2011 Heroes: Geoffrey Campbell; Malcolm Dorman, M.D.; Karen Harwood, American Association of Caregiving Youth, Charles L. Moore, M.D. and Richard Busto

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Palm Beach County Medical Society Tenna Wiles I CEO, Palm Beach County Medical Society

In today’s ever changing healthcare landscape, one thing is clear; there are more unknowns than knowns. As legislators at the state and federal level juggle the future of medicine, no one knows what will happen, how it will impact physician practices and the patients they serve. When we asked the question, “How can we help our members?” the adage “ knowledge is power” inspired us to develop PBCMS Summer School for Physicians and Office Staff. Our goal is to keep you informed and prepared for increased regulatory burdens and the expansion of technology. I hope that you will take the opportunity to participate in one of the outstanding programs. We are very fortunate to have the expertise of outstanding healthcare attorneys, management consultants and business leaders. We are also busy gearing up for the Florida Medical Association’s Annual Meeting. Alan Pillersdorf MD is serving as the Speaker of the House of Delegates. Our delegation, led by President James Byrnes MD is a member of the South Florida Caucus working in cooperation with Dade and Broward County Medical Associations. Serving as a delegate to the FMA is an excellent opportunity to represent your profession and to shape the future of medicine. This year’s meeting will be held July 28-30 in Orlando. It is also important to note that Palm Beach County will be well represented at the AMA Annual meeting in Chicago, by delegates Jose Arrascue MD, Alan Pillersdorf MD, Mark Rubenstein MD and President James Byrnes. Special recognition and thanks to the Palm Beach County Healthcare District and the United Way of Palm Beach County for their generous funding of Project Access. Both organizations have recognized the invaluable services of our physicians, hospitals and healthcare providers in serving our low income uninsured patients. Be sure to mark your calendar for October 27-29 for the Future of Medicine V. This year’s expanded Summit will be held at the Palm Beach County Convention Center. Michael Dennis, MD, summit chair, and his committee are bringing together nationally recognized healthcare leaders for what promises to be an outstanding educational opportunity. I encourage you to join us in our efforts to educate , advocate and represent your profession.

Director’s Desk

Knowledge is Power.

2011 Board of Directors

James J. Byrnes, M.D.. . . . . . . . . . . President Jack Zeltzer, M.D.. . . . . . . . . . . . . . President-Elect K. Andrew Larson, M.D.. . . . . . . . . First Vice President Richard Raborn, M.D.. . . . . . . . . . Second Vice President Malcolm Dorman, M.D.. . . . . . . . . Secretary Ronald Zelnick, M.D.. . . . . . . . . . . Treasurer Lawrence Gorfine, M.D.. . . . . . . . . Immediate Past President Brandon Luskin, M.D. . . . . . . . . . . Member at Large Michael Lakow, M.D. . . . . . . . . . . . Member at Large Andrew Shapirio, M.D. . . . . . . . . . Chair, Council on Communications Brent Schillinger, M.D.. . . . . . . . . Chair, Council on Ethical & Judicial Affairs Richard Greenwald,, M.D.. . . . . . . Chair, Graduate Medical Education Daniel R. Higgins, M.D.. . . . . . . . . Chair, Health Information Technology Larry Gorfine, M.D.. . . . . . . . . . . . . Chair, Council on Legislation and Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . on Medical/Legal Affairs Daniel Kapp, M.D.. . . . . . . . . . . . . . Co-Chair, Council on Legislation and . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Council on Medical/Legal Affairs David Soria, M.D. . . . . . . . . . . . . . . Chair, Council on Public Health & . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Emergency Medicine K. Andrew Larson, M.D.. . . . . . . . . Chair, Council on Membership William Adkins, M.D.. . . . . . . . . . . Chair, Retired Physicians Section Maureen Whelihan, M.D. . . . . . . . Chair, Women Physicians Section Hatem Abou-Sayed, M.D. . . . . . . Chair, Young Physicians Section Richard Shugarman, M.D. . . . . . . Chair, Specialty Section Harish Madhav, M.D.. . . . . . . . . . . Co-Chair, Ethnic/Minority Section Roger Duncan, M.D.. . . . . . . . . . . . Co-Chair, Ethnic/Minority Section Randy Gershwin, M.D.. . . . . . . . . . Chair, Hospital Relations Mark Rubenstein, M.D.. . . . . . . . . Chair, Bylaws Stephen Babic, M.D.. . . . . . . . . . . . Chair, MEDPAC Andrew Shapiro, M.D.. . . . . . . . . . West District Representative Shawn B. Baca, M.D.. . . . . . . . . . . . South District Representative Mark Brody, M.D. . . . . . . . . . . . . . . Central District Representative Alan B. Pillersdorf, M.D. . . . . . . . . AMA/ FMA Liaison Jose F. Arrascue, M.D. . . . . . . . . . . PBCMS Services Liaison Jacqueline Pevny, M.D.. . . . . . . . . Member at Large Joan St. Onge, M.D. . . . . . . . . . . . . Member at Large Dyani Loo. . . . . . . . . . . . . . . . . . . . . Medical Student Representative

Palm Beach County Medical Society 2011 Board of Trustees

Lawrence Gorfine, M.D. Maureen Whelihan, M.D. Daniel R. Higgins, M.D. Jose F. Arrascue, M.D. Alan B. Pillersdorf, M.D. Brent M. Schillinger. M.D.

Mark Rubenstein, M.D. Jack Zeltzer, M.D. K. Andrew Larson, M.D. James J. Byrnes, M.D. Richard Raborn, M.D.

Staff: Tenna Wiles, CEO Yvonne Shapiro, Director of Communications Ashley Eckes, Director of Disaster Services Deanna Lessard, Director Member Services & Education Nicola Chung, Project Access Program Director Victoria McMath, Project Access Senior Program Coordinator Mindi Tingler, Administrative Assistant Natalie Gonzalez, Receptionist Lauren Tomé, Receptionist

OnCALL Managing Editor: Tenna Wiles Advertising Assistant: Yvonne Shapiro Subscriptions to OnCALL are available for an annual rate of $50. For more information, please contact Yvonne Shapiro at (561) 433-3940. The opinions expressed in OnCALL are those of the individual authors and do not necessarily reflect official policies of the Palm Beach County Medical Society, unless so stated. Advertising in OnCALL does not constitute endorsement by the Palm Beach County Medical Society or its committees.

Last OnCall Issue

Available online at pbcms.org

OnCALL is owned and published (6) times per year by the Palm Beach County Medical Society, Inc. 3540 Forest Hill Blvd., West Palm Beach, FL 33406 (561) 433-3940 & (561) 276-3636. © Copyright 2011 Palm Beach County Medical Society, Inc.

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Florida Medical Association 2011 State Legislative Session Summary By Madelyn Butler, M.D.

The 2011 Legislative Session was one of the Florida Medical Association’s most challenging in many years. The sheer number and intensity of legislative proposals affecting the practice of medicine exceeded our expectations. The battles began with the very first committee on the first day of session, and they didn’t end until the Legislature adjourned at 3:30 a.m. on May 8. In spite of those challenges, the FMA achieved a major victory for Florida physicians with overwhelming passage of our medical malpractice reform bill, HB 479. We also were successful in extending sovereign immunity protection to physicians at teaching hospitals, defeating inappropriate scope-of-practice expansion attempts, limiting noneconomic damages for physicians sued by Medicaid patients, and much more. The following is only a snapshot of the FMA’s achievements this session on your behalf. A comprehensive summary is available here.

Successful Legislation Supported by the FMA Medical Malpractice Reform: HB 479 (SB 1590) This medical malpractice reform bill, one of the FMA’s most significant pieces of legislation in 20 years, contains key provisions that will hold expert witnesses accountable for their testimony. These provisions include: • Requiring an M.D., DO, or D.D.S. licensed in another state to obtain an expert witness certificate before being able to provide expert testimony in Florida. • Giving the Boards of Medicine, Osteopathic Medicine, and Dentistry the specific authority to discipline any expert witness, both those licensed in state and those with an expert witness certificate, who provide deceptive or fraudulent expert witness testimony. • Providing that the expert witness who submits the pre-suit verified expert medical opinion is no longer immune from discipline. (There are many more provisions in this bill, and they can be viewed in the comprehensive summary.) Sovereign Immunity: SB 1676 (HB 1393) The main effect of this legislation is that it confers sovereign immunity on the University of Miami medical school faculty who treat patients at Jackson Memorial. It has the potential to benefit other institutions as well. PPACA/Mandatory Insurance: SJR 2 (HB 1) This proposed constitutional amendment, which would undo the Patient Protection and Affordable Care Act’s (PPACA) mandatory insurance provision, will be submitted to voters in the next general election. In order for the resolution to pass, 60 percent of voters must approve it. This resolution: • Would make it unconstitutional for any law or rule to compel any person or employer to purchase, obtain, or otherwise provide for health care coverage. • Would provide that a healthcare provider may accept direct payment for lawful health care services and may not be required to pay penalties or taxes for doing so. Spouses of Active Duty Members of the Armed Forces: HB 1319 (SB 1228) Provides that a healthcare professional board may issue a temporary professional license to the spouse of an active duty member of the Armed Forces, under certain conditions. The chief condition is that the applicant hold a valid license to practice issued by another state, and is not the subject of any disciplinary proceeding. I7I

University of Florida J. Hillis Miller Health Center: (HB 395) • Specifies that University of Florida (UF) Board of Trustees will lease Shands Teaching Hospital and Clinics on the Gainesville campus to Shands Teaching Hospital and Clinics, Inc. • Provides that Shands Jacksonville Medical Center, Inc., and its parent, Shands Jacksonville HealthCare, Inc., are private not-for-profit corporations organized primarily to support the health affairs mission of the UF Board of Trustees. • Provides requirements for lease, contract, or agreement between the Board of Trustees and corporations, etc.

Bills Defeated by the FMA Scope-of-Practice Expansion: SB 1892; HB 1067 (SB 1544); HB 585 (SB 1268); HB 4103 (SB 2038); SB 356 The FMA routinely fights non-physicians’ attempts to inappropriately expand their scope of practice, and this year was no different. The FMA defeated all such bills this year, including those that would have: • Allowed ARNPs to prescribe controlled substances. • Allowed optometrists to prescribe oral medications. • Allowed pharmacists and technicians to administer pneumonia and shingles vaccines. • Allowed ARNPs to sign death certificates. • Repealed the physician supervision requirements of ARNPs, undoing important legislation the FMA passed in 2006. PIP Insurance: HB 967 This bill, under the guise of fraud and abuse legislation, would have made it more difficult for a physician to receive fair compensation for treating an auto accident patient. It also would have imposed burdensome new requirements on physicians who treat such patients.

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The Physician’s Guide

to Hiring a Lawyer

By: Timothy E. Monaghan, M.B.A., J.D.

The purpose of this article is to provide the physician with tips for hiring a lawyer. Just as different patients need different doctors, different doctors need different lawyers. In the same way that a diagnosis leads to a particular physician/specialist, your specific needs and personality should lead to a particular lawyer. This article will address a handful of issues and situations commonly faced by physicians when selecting and working with lawyers. One caveat. The relationship between the doctor and his lawyer can be complicated and this is a short article. Accordingly, I will need to make general statements on broad topics and will also make some generalizations to make my points. Nonetheless, I think you will find this article useful. I hope to take away some of the stress associated with hiring a lawyer and make you a better consumer of legal services. Question the lawyer’s experience and expertise. Don’t hesitate to ask questions such as: “Do you specialize in healthcare law?” “What percent of your practice is healthcare-related?” “Have you done this type of deal before?” “Can you supply me with references?” The world in which the doctor lives and works is foreign to most lawyers. As you are painfully aware, health care is one of the most regulated areas of business in this society. The typical general business lawyer is not equipped to handle healthcare matters and can get you in trouble. If you’re selling a house, you need a real estate lawyer, but if you’re selling your practice, you need a healthcare lawyer. Doctors need lawyers who understand healthcare law. Consider the benefits of a “full-service” law firm. The business of health has become complex. When representing medical practices, I handle most issues myself. However, I also often find myself seeking a quick consult with the expert down the hall who specializes in leases, employment matters, litigation, insurance or corporate law. Sometimes it is also especially helpful to have a colleague who “brainstorm” with you on a Stark or self referral law question. All this is found in the right large firm. Don’t hire a litigator to do a business transaction. Litigation and transactions require two very different sets of skills and two very different mindsets. These are different specialties. Litigation is war. Transactions are about collaboration. The litigator sets out to defeat the other side while the transactional attorney seeks to represent his client’s interests while crafting a deal that is still acceptable to both sides. The most expensive deals I’ve done have been those deals where the other side was represented by a litigator. On the other hand, I’m not a litigator and when the contract has been seriously breached and the business relationship is gone, I consult a litigator.

Don’t keep secrets from your lawyer. Thanks to the ambulance chasers, doctors typically view lawyers as the enemy and it may be hard to suspend your suspicions, even with the lawyer you’ve hired to represent you. However, if you want your lawyer to fully represent your interests, you must tell him everything there is to know about your situation. This is particularly critical in litigation. A litigator’s worst nightmare is to be blind-sided in court by some embarrassing fact that his client failed to reveal to him and for which he is, therefore, unprepared to defend. Insist on detailed billing. Most law firms bill on a monthly basis - this is the way it should be, because it enables you to track the course of your matter and keep a handle on the costs. Many law firms provide billing statements that only summarize or describe in general terms the work performed by the firm. In my opinion, this is not sufficient. You should insist on a detailed bill of all activity for the month. In a detailed bill, the typical entry would read, for example - Telephone call to Dr. Smith regarding noncompetition provision - 2. This tells you who was called, what was discussed, and the amount of time that was spent on the call - 2/10 of an hour or 12 minutes. Finally, if you have a question regarding the bill, don’t hesitate to ask for an explanation. Timeliness. The number one complaint about lawyers is that they don’t return their phone calls. Make it clear to your lawyer, at the outset, that you expect your calls to be returned within the same half-day, that is within, four hours. At the end of the conversation, agree on the next step to be taken by the lawyer and get a commitment on a deadline for completion of that task. Follow up on deadlines and let the lawyer know that timeliness is important to you. Finally, demonstrate your commitment to timeliness by paying your legal fees in a timely fashion. This last step will breed loyalty in your lawyer. Don’t try to be the lawyer. You’re a doctor - not a lawyer. If you don’t trust your lawyer’s advice, it’s time to get a new lawyer. On the other hand, if you think you have a good lawyer, then you should follow his advice. Choose carefully. A good lawyer is worth his weight in gold - the lousy ones should be euthanized. Its may be worthwhile to interview a few lawyers before hiring one. Take your time. It’s an important decision. © 2011 SHUTTS & BOWEN, LLP. All rights reserved. Republication with attribution is permitted.

If you’re contemplating litigation, hire the right litigator. Litigation should always be viewed as a business proposition - comparing the projected costs (times two) with the potential benefits. If it doesn’t make good sense as an investment/business venture - its probably going to be an expensive game of tit for tat. Beware of the lawyer who doesn’t first explore settlement, who is too eager to sue and who appears to be stoking the fires of controversy.

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No business should risk operating without a disaster plan. The Palm Beach County Medical Society has compiled this Disaster Response Plan to assist you in the preparation and response to emergency situations. It should serve as a guide for more efficient internal communication and provide a basic understanding of duties and responsibilities of your staff. Planning prior to a disaster is the sensible, logical way to begin to cope with an emergency in order to minimize the associated trauma of suffering loss of life, injury and property damage. Policies and procedures should be flexible in order to respond to a disaster. When you start to develop your disaster plan consider three subjects: human resources, physical resources and business community. Think about how a disaster could affect your employees, patients and workplace. Think about how you could continue doing business if the area around your facility is closed or streets are impassable. Think about what you would need to serve your customers even if your facility is closed. Finances • Provide authorization for limited expenses. • Arrange access to checkbook and petty cash. • Include provision for staff affected by disaster.

Building and Office Basics • Determine structural soundness • Ensure adequate insurance is in place • Secure copies of important documents • Computer data base backup tapes and files • Insurance documents • Titles for vehicles & insurance policies • Master inventory list • Previous year’s tax records & financial statements • Archives • Personnel records • Make arrangements for alternate site to maintain an office-post-disaster • Provide for equipment & general supplies • Assemble as much as possible prior to storm • Instruct personnel to secure office • Back up computer files • Unplug electrical equipment • Move equipment away from window • Clear desk tops & table surfaces. • Remove items from floor, store at least two feet above floor • Cover equipment with plastic sheeting • Seal documents in double plastic bags • Remove personal items from building • Identify essential files that need to be moved with red/orange dots

Communication • Prepare and maintain list of all personnel with home phone numbers and addresses. • Create key contact and reference list. • Establish a buddy system with another physician’s office in a different geographic location. • Have redundant communication systems (landline, mobile, and walkie talkie or out-of-state phone). • Establish an affiliate agreement with another practice in another part of the county to use phone line and office. • Check Palm Beach County Medical Society web site (www.pbcms.org) and local media for current information. • Post and distribute informational flyers to your patients.

• If you have a voice mail system at your office, designate one remove number on which you can record messages for employees. Provide the number to all employees.

Staff Responsibilities • Identify key staff positions and responsibilities. • Develop chain of command and communications procedures. • Notify staff where and when to return to work after a disaster. • If a staff member is severely affected, they should be helped within 24-28 hours.

• Back up computer data frequently throughout the business day. Keep a back-up tape off site.

Operational Conditions Hurricane Watch: Indicates a hurricane is near enough that everyone in the area should listen for advisories and be ready to take precautionary actions in case hurricane warnings are issued. Implies the possibility of dangerous conditions within 36 hours. Hurricane Warning: Indicates that winds of 74 MPH and higher, or a combination of dangerously high water and very rough seas, are expected in a specific coastal area. Hurricane conditions are considered imminent and may begin immediately or at least within the next 24 hours. All precautionary measures and actions should be instituted immediately for the protection of life and property. Impact: All staff should take shelter. Recovery: All clear. • All staff should notify key contact of their safety. • Contact the Medical Society at 433-3940 if assistance is needed.

• Arrange for programmable call forwarding for your main business line(s). Then, if you can’t get to the office, you can call in and reprogram the phones to ring elsewhere. • If you may not be able to get to your business quickly after an emergency, leave keys and alarm code(s) with a trusted employee or friend who is closer.

• Use UL-listed surge protectors and battery backup systems. They will add protection for sensitive equipment and help prevent a computer crash if the power goes out. • Stock a minimum supply of goods, materials and equipment you would need for business continuity. • Purchase a NOAA Weather Radio with a tone alert feature. Keep it on and when the warning signal sounds; listen for information about possible severe weather and protective actions to take. • Consult with your insurance agent about special precautions to take for disasters that may directly impact your business. Remember, most policies do not cover earthquake and flood damage. Protect valuable property and equipment with special riders. Discuss business continuity insurance with your agents. • Keep emergency supplies handy, including – Flashlights with extra batteries, first aid kit & tools • Food and water for employees and customers to use during a period of unexpected confinement at your business, such as if a tanker truck overturned nearby and authorities told everyone in the area to stay put for an extended period. I 10 I

Better Futures by Leon Fooksman This year’s Heroes In Medicine winners shared one common characteristic: they gave countless people inspiration, support and hope to live healthier and enjoy brighter futures. The eight winners were honored on May 11 at a luncheon at Kravis Center for the Performing Arts in West Palm Beach. The event, hosted by Palm Beach County Medical Society, was a fundraiser for Project Access, which is a network of physicians, hospitals and laboratories that provides free healthcare service to

hundreds of low-income, uninsured patients every year. “Project Access doctors and other medical professionals are true heroes who volunteer their time and skills to give a healing touch to those who cannot afford or obtain healthcare any other way,” said Sally Chester, 2011 Chair of the Heroes in Medicine In all, 31 people and organizations were finalists in eight categories honoring the work of physicians, community leaders, students and many others whose commitment to bettering lives have improved communities locally and internationally. Leon Fooksman is a writer for On Call. You can reach him at leon@astorytellingcompany.com.

Here is information on the 2011 Heroes in each category:

Community Outreach Hero

Healthcare Provider Hero

Heroes: • Barbara O’Donnell, President, Personal Ponies • Karen Perry, Co-Founder, NOPE Task Force • Edward Mostel, M.D. and R. Scott McFarland, M.D., CPR – Pre-Medicine Magnet Program, Palm Beach Gardens High School

Heroes: • Jubica “Jibby” Miskovic, Parent-Child Center • Ila Swick, RNC-OB, Jupiter Medical Center • Flor Utria, Palm Beach Gardens High School.

Recipient: American Association of Caregiving Youth Founded on the idea that when a youth leaves school to care for a family member or underachieves because of the burden of home responsibilities, society as a whole suffers longterm consequences. Connie Siskowski started the organization more than a decade ago. With support from the Robert Wood Johnson Foundation, the Schmidt Family Foundation, Toppel Family Foundation, and Palm Healthcare Foundation, her group has brought awareness to the issues that surround youth caregivers. Her programming now serves more than 350 students and their families.

Recipient: Susan Korman, a licensed nurse practitioner, works at the Florida Resource Center for Women and Children, Inc., which provides free medical care and education to uninsured/ underinsured residents of public housing communities. She goes above and beyond for her patients, once helping pay the funeral costs for a patient without life insurance. Patients who see Korman are often battling barriers of shame, ignorance and denial, but they know that with her, they have a safe place to discuss their fears and the need to take personal responsibility for their health.

Bruce Rendina Professional Hero

Physician Hero

Heroes: • Robert Broadway, Vice President of Corporate Strategy, Bethesda Memorial Hospital • Jonathan Satter, Chairman of the Board of Commissioners of the Health Care District of Palm Beach County

Heroes: • Robert Borrego, M.D., St. Mary’s Medical Center • Gail A. Cooney, M.D., Hospice of Palm Beach County • Daniel Lichtstein M.D., Regional Dean for Medical Education at the Miller School of Medicine regional campus in Palm Beach County. • Louise Morrell, M.D., Christine E. Lynn Cancer Center, Boca Raton

Recipient: Dick Busto, father of a 14-year-old autistic boy, is the founder and president of the Autism Project of Palm Beach County, a nonprofit serving individuals with an autism spectrum disorder. He is also the founder and chair of the Renaissance Learning Academy, a charter school serving students with autism. He is a regular volunteer at the academy and gives tirelessly of his time and money to bolster the support and educational network for families affected by autism.

Recipient: Malcolm Dorman, M.D., a worldrenowned, board certified cardiovascular surgeon, is the medical director of cardiac surgery at JFK Medical Center in Atlantis. Recognized for his pioneering work in repairing mitral valves, and trained by Dr. Michael Debakey, the former chairman at Miami Heart Institute for 25 years has presented his research nationally and internationally. Dr. Dorman’s community involvement has been intensive, providing charitable work to numerous organizations and volunteering his services to the uninsured.

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2011 Heroes in Medicine

InspIrIng

2011 Heroes in Medicine

2011 Heroes in Medicine Awards

2011 Heroes in Medicine

Alan Pillersdorf, M.D.; Richard Busto and Todd Varney

Charles L. Moore, M.D. is presented the Lifetime Achievement Award by William Adkins, M.D. and Emanuel Newmark, M.D.

Roger Kirk and Bob Broadway

Malcolm Dorman, M.D.; James J. Byrnes, M.D. and Jay Midwall, M.D.

John Straswimmer, M.D.

Matt Gracey, Co-Chair and Sally Chester, Chair

Brent Schillinger, M.D. presents the Posthumous Award to the daughters of Richard Bruno, M.D.

Jeffrey Bishop, D.O.; Geoffrey Campbell and Jim Sugarman

Malcolm Dorman, M.D.; Chauncy W. Crandall IV, M.D. and Jonathan Satter

Barbara Krantz, D.O.; Chauncey W. Crandall IV, M.D. and Jose F. Arrascue, M.D.

Physician Hero - International

Student Hero

Heroes: • Daniel B. Kairys, M.D., Lakeside Medical Center • John M. Strasswimmer, M.D., Boca Raton Regional Hospital, Caridad Clinic • Mitchell Schuster, M.D., Boca Raton Regional Hospital

Heroes: • Carson Dowd, Cardinal Newman High School • Palm Beach Atlantic Student Nurses:Stephanie Carter, Johanne Alexandre, Michelle Flammia, Thuy Nguyen, Kim Sansone, and Fernanda Serrano

Recipient: Chauncey W. Crandall IV, M.D., a cardiologist at Jupiter Medical Center, has turned grief into goodness and generosity by providing healthcare management solutions for indigent populations using a faith-based approach. After the tragic loss of his son in 2004, he created the Chadwick Foundation in his honor. Dr. Crandall has been providing infectious disease support, both clinically and through educational efforts performed by him and in partnership with other missionary organizations, to reduce the death rates of pediatric populations in Third World countries. He has worked in the cholera camps in Haiti, treating patients as well as developing protocols and training for Haitians to help treat and prevent the spread of the deadly disease. Dr. Crandall’s outreach partnerships also extend to South America, east Africa and Europe.

Posthumous Award Richard Bruno, M.D., an assistant professor at Lynn University, was one of two faculty members leading students on a mission trip to Haiti when he died of injuries sustained during the earthquake of January 12, 2010. He was 59 years old. Dr. Bruno spent his life in the service of medicine and education. Prior to Lynn University, Dr. Bruno worked as a U.S. Department of State family physician with 21 years of experience in the Foreign Service, managing U.S. embassy health units in Africa, Europe, South America and the Caribbean. During those years, he provided educational opportunities to healthcare personnel and evacuated seriously ill patients from the Middle East and elsewhere. A consummate global citizen, Dr. Bruno embraced life with vigor and was always willing to pursue a new adventure. Most importantly he was deeply devoted to his three daughters, Lauren, Kelly and Anna Marie.

Recipient: Geoffrey Campbell has volunteered at the Caridad Center dental clinic for more than three years. A fourth-year biology/pre-med student at Florida Atlantic University, he identifies with the pain and suffering of the patients and hopes to someday provide medical care to the poor.

Lifetime Achievement Award Charles L. Moore, M.D. began his practice of General and Thoracic Surgery in 1961 in Lake Worth, and it lasted for 39 years. A decorated veteran of World War II, he was chief of surgery at Lake Worth General Hospital and a founder of Doctors Hospital and JFK Memorial, becoming the first chief of surgery in both facilities. On two occasions, he was named acting CEO of JFK. In the late 80’s, Dr. Moore was credited with guiding JFK through a major transition in which the hospital received Accreditation with Commendation from Joint Commission and got national recognition as the “turn around” hospital of the year. In addition, Dr. Moore was instrumental in developing the first intensive care unit in Florida with Dr. Jesse Meredith. The two initiated the first comprehensive course for ambulance drivers, police officers and firefighters that recently was recognized as the model for our present national EMT program. Dr. Moore was the team physician for the Washington Redskins and served as the physician for the Lake Worth Trojans.

2011 Heroes in Medicine

Hearts. Hope. Healing.

2011 Heroes in Medicine

2011 Heroes in Medicine Host Committee Jean Acevedo William R. Adkins, M.D. Cheryl Anders Annette Baine Mary Barnes Claudia Kirk Barto Elizabeth Breslin Madelyn Christopher Tammy B. Clarke Michael Coady Elena E. Contreras Jan Dymtrow Silvia C. Garcia

Bari L. Goldstein Shawn Griffin Mary Jo Higgins Meredith Hughes Jeremy Johnson Gary Lesser, Esq. Anthony Lofaso Brandy Monteleone Emanuel Newmark, M.D. Tina Newmark Peter A. Nicoletti Owen O’Neill Patti Patrick

Marnie Poncy, Esq. Nancy Proffitt Greg Quattlebaum Sherra Sewell Tammy Shiverdecker Ben Starling Lynn Stockford Jim Sugarman S. Slade Sundar Scott Velozo Jean Wicken

Thank You to Our Sponsors Presenting Benefactor Rendina Companies Grand Benefactor JFK Medical Center Medical Staff Patron Content Creators Healthcare REIT Management Services Group JFK Medical Center Wellington Regional Medical Center Wellington Regional Medical Center Medical Staff Special Friend Acevedo Consulting Inc. Alzheimer’s Community Care Bethesda Memorial Hospital Medical Staff Lesser, Lesser, Landy, & Smith Friend Alpern Rosenthal Christine D. Hanley & Associates, P.A. First United Bank Shoes for Crews Video Underwriter Hanley Center

Table Sponsors Danna-Gracey FirstPath, LLC Good Samaritan Medical Center Health Care District of Palm Beach County Jupiter Medical Center Lynn University MDVIP Charles L. Moore, M.D. Palm Beach County Medical Society Alliance Palm Beach Kennel Club Quantum Foundation Richard Perry St. Mary’s Medical Center Contributors evansewell advertising Hoffman’s Chocolates J & R Printing Quattlebaum Funeral Home Scripps Florida Two Men and a Truck

Media The Palm Beach Post The Sun-Sentinel South Florida Hospital News

Music & Entertainment Monte Lambert, piano Matt Farmer, soloist

Money and Medicine The Future of Healthcare Banking

By Michael Coady, IronStone Bank

ank’s healthcare customers are facing an unprecedented amount of uncertainty from financial and technological demands. Additionally, today’s strategic decisions may be grounded in solid business fundamentals, but may burst under the unknown future changes of healthcare reform. Here are some thoughts to consider about the impact to banks from current healthcare reform and provider response to healthcare reform. All healthcare is local. There is little correlation in healthcare market strategy between markets due to population demographics, payer differences, market competition, employers, etc. Unfortunately, what works in Chicago will probably not work in West Palm Beach. Each market must be underwritten on its own merit eliminating the ability to replicate healthcare banking services nationwide. Customer underwriting will be deeper with more emphasis on strategy versus current financial viability. A key to the healthcare credit portfolio will be dependent upon the market share, capital structure, operating cost structure and leadership of the customer. There has never been a time whereby management affects the ultimate results of a high-stakes poker game. For the next three years, this evaluation of the customer’s ability to withstand change and make the right investments will be critical to its organization, as well as to the financial results of healthcare banking services. Credit demand for technology and working capital will increase as healthcare reform will adversely impact all participants in the cost of collection as well as the cost to implement and measure quality healthcare. Increasing participants in the healthcare payments business and payer technology requirements will slow down the adjudication of payments regardless of the abilities of the customer. The paradox for these healthcare participants and healthcare bankers will be the increasing demand for term and revolving credit while margins and credit quality will decline.

The sheer convergence of physicians into larger physician groups and physician-hospital alignment models will consolidate the banking customer. While the task of finding fewer and larger prospects may be easier, more banks will seek the same prospect list, ultimately, generating more competition for treasury management and credit needs. The margin for bank services for the physician will erode as these groups grow and become part of a larger healthcare system. With an expected decline in bank revenues and, therefore, margins due to this convergence and consolidation, banks must revise their thinking related to branch locations, over-the-counter deposits and proximity to healthcare delivery systems. Imagine a branch bank in a medical office building. Imagine a healthcare office in a retail shopping center. Both of these scenarios exist today. Treasury management services will continue to expand on a basic level to more consolidated groups at lower, more competitive prices. Due to increased patient payments, we expect more cash transactions and a higher percentage of paper transactions in healthcare. While payers may consolidate, the patient will be the key as more payments from patients will be expected due to higher deductibles, higher coinsurance and fewer covered services. While remote image deposit check scanner capture and traditional wholesale lockbox services will continue to increase, so will the number of zero balance accounts and less available DDA balances. If you are facing these issues you are not alone and recommend that you query your current banker for guidance or please feel free to contact Michael Coady at IronStone Bank at 561.253.8132 and we’d be happy to answer questions.

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REAL ESTATE DEVELOPMENT

RendinaCompanies.com

A Trusted Source For All Your Medical Real Estate Development Needs

(561) 630-5055 Integrity • Loyalty • Professionalism • Entrepreneurship • Passion • Teamwork

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UNDERSTANDING THE TYPES OF PROFESSIONAL LIABILITY By the Risk Management Experts at First Professionals Insurance Company

n this age of expanding theories of tort liability, physicians may find themselves responsible for more than their own acts. Most physicians realize they have responsibility for the actions of their office staff or those who are directly employed by them. However, they give little thought to the fact they may also be responsible for the acts of their partners, office staff, or others that act under their control or supervision. Liability can be divided into two broad categories – direct and vicarious. Direct Liability Direct liability is defined simply as being responsible for your own acts. If you deviate from the acceptable standard of care in the manner in which you practice medicine, then you are negligent and directly responsible. Vicarious Liability Vicarious liability encompasses those situations where you may have acted appropriately but find yourself responsible for the failure of another individual. The most obvious type of vicarious liability exists for partners. Some physicians have organized themselves into professional associations to avoid this situation. A partner is liable to the full extent of their own assets for the acts of their partner, which were conducted in the furtherance of the business of the partnership. This occurs even though one partner may have never seen the patient nor participated in the care. Physicians organize into corporate entities, such as professional associations, to avoid this scenario. Once the corporation is established, the physicians become employees rather than partners. Employees are generally not responsible for one another’s acts. Therefore, unlike in a partnership, the physician-employees of the professional association are effectively shielded from the vicarious liability for another physician-employee’s acts or omissions. However, a corporate entity does create another category of responsibility. The corporation employs physicians, physician extenders, and others to accomplish the work of rendering medical care. Consequently, the corporation (professional association) becomes the master and each of the employees becomes a servant. As a result, a theory of law called “respondent superior” comes into play. Under this theory, the corporation is responsible for the acts of each of its employees. A common example occurs when an office assistant renders medical advice on behalf of the physician by telephone. If, in doing so, the physician has fallen below the acceptable standard of care, this physician/employer or corporate employer can be held responsible. Captain of the Ship In addition to the categories of partners and employees are situations entailing a division of responsibility and thus, liability. State laws vary significantly in this regard. One of the most common examples is the operating suite. As the “captain of the ship”, the surgeon is generally thought to be in control of all activities occurring in the operating suite and, therefore, responsible for all treatment during the operation. The captain of the ship legal principle has evolved over the years. It is now recognized that there are other specialists in the operating room who perform independently of the direct supervision of the surgeon. The most obvious example is the anesthesiologist. Although surgeons have ultimate control over the operation, they do not have the technical skill or knowledge to control the details of the anesthesiologist’s activities, although the law is less clear with regard to nonphysicians, such as a nurse anesthetist. Liability exposure under a captain of the ship legal principle may exist despite the absence of a statutory provision. Surgical assistants generally have been held to be the responsibility of the surgeon. Although an operating assistant may have the same degree of skill as their operating surgeon, the surgeon actually directs the activities. The nurses may not fall under the responsibility of the operating room surgeon. It generally has been held that when they are performing acts that require professional judgment, they are under the surgeon’s supervision and control

and, therefore, the surgeon’s responsibility. However, when they perform ministerial acts, such as sponge counting, they are under the responsibility of the hospital that employs them. Borrowed Servant The same rules that apply in the operating suite can be utilized to judge responsibility in other circumstances. If the physician exercises direct supervision and control over the acts of another, then they may have assumed responsibility for those acts. A good example is that of interns or residents in a hospital. If the physician is employed by the hospital, then the hospital becomes the master. Generally, the hospital will be responsible for their negligent acts. However, if the individual temporarily comes under the physician’s exclusive control and direction, the intern may have become the physician’s “borrowed” servant and the physician therefore may have assumed responsibility for the intern’s acts. Assessing liability generally is driven by the degree of control the master exercises over the servant. The question of the consulting physician can be most closely analogous to that of the surgeon and anesthesiologist. If a physician finds it necessary to call in a specialist for a consulting opinion, one generally selects an individual with greater knowledge in that particular area. One does not exercise direct supervision and control over the consulting physician’s acts. As a result, the physician is not the master and not responsible for that individual. However, this does not mean that the physician calling in the consultant will always escape liability if the consultant performs incorrectly. Once a physician has taken on the obligation and duty of rendering medical care and attention, the physician cannot escape that duty by delegating the responsibility to others. If the physician fails to use reasonable judgment in selecting a consultant or in ensuring that the consultant has performed the task, direct liability for selecting the consultant arises as well as liability for the consultant’s negligent act or omissions. Apparent Agency There are situations where one can assume responsibility for another even though one did not intend for the other to perform tasks on one’s behalf. This theory of law is called “apparent agency.” A real agency is created when one party confides to the other the management of some business to be transacted in the former’s name or on their behalf. An example of this is the office assistant or employee who passes along medical advice by telephone at the physician’s request. However, what if the physician had instructed the assistant not to act in such a fashion? In spite of the doctor’s instruction, the assistant gives advice, which is erroneous and results in an injury. Generally, an employer is not liable for or bound by the acts or contracts of an agent, which are not within the scope of the actual or apparent authority of the agent. However, if a physician has conducted the affair in such a way as to lead patients to reasonably conclude that the agent, or assistant in this circumstance, is acting within his or her authority, the physician may be responsible. The most common examples of “apparent agency” occur in hospitals. In most hospitals, the emergency room and department of radiology are staffed by independent staff physicians. However case law has held the hospitals liable for the acts of the staff physician on a theory of “apparent agency.” The courts applied the general reasoning set out above. They noted a reasonable person would have assumed the staff physician was either the employee or agent of the hospital. If that person relied upon that representation in seeking care, then both the hospital and the individual rendering the care would be held liable. The information below does not establish a standard of care, nor is it a substitute for legal advice. The information and suggestions contained here are generalized and may not apply to all practice situations. First Professionals recommends you obtain legal advice from a qualified attorney for a more specific application to your practice. This information should be used as a reference guide only.

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Summer School for Physicians & Staff For Physicians Date

Time

Topic

Location

7/13

6:00 pm - 7:30 pm

Clinical Integration and why it is important for your practice’s success

Broad & Cassell 7777 Glades Road Boca Raton, FL 33434

7/20

6:00 pm - 7:30 pm

Formation of Groups (doctors = groups)

Shutts & Bowen 525 Okeechobee Blvd., Suite 1100 West Palm Beach, FL 33401

8/10

6:00 pm - 7:30 pm

Proper Billing for PA’s and ARNP’s

Acevedo Consulting 2605 W. Atlantic Ave., D-102 Delray Beach, FL 33445

8/24

6:00 pm - 7:30 pm

How Physician and Chiropractors can work together, share revenues and the legal issues involved

The Florida Healthcare Law Firm 909 SE 5th Ave. #200 Delray Beach, FL 33483

For Practice Managers and Staff Date

Time

Topic

6/15

Noon - 1:00 pm

Conflict Resolution - presented by Nancy Proffitt

PBCMS Office

6/29

Noon - 1:00 pm

Topic TBD - GSBB

PBCMS Office

7/13

9:00 am - 12:30 pm

Basic Training for Office Staff

PBCMS Office $75 pp

7/20

Noon - 1:00 pm

Smile While You Dial - presented by Barbara Burns, Windstream Communications

PBCMS Office

7/27

Noon - 1:00 pm

ICD-10 - presented by Jean Acevedo, LHRM

PBCMS Office

8/3

Noon - 1:00 pm

IT issues & Solutions in the world of EHR - presented by PBCMS Office Larry Mellgren, ThinSolutions

8/10

9:00 am - 12:30 pm

8/17

Noon - 1:00 pm

The Financial Value of Time Strategies - Morgan Stanley PBCMS Office

8/24

Noon - 1:00 pm

Medical Practice Retirement Plans

Basic Training for Office Staff

Location

PBCMS Office $75 pp

PBCMS Office

TO RSVP and for additional information regarding a Summer School Program email deannal@pbcms.org or call 561-433-3940.

Unless otherwise indicated there is no charge to attend

Med Memo May - June 2011 MEMBER DINNER: NAVIGATING HEALTHCARE REFORM Understanding the Challenges and Opportunities & Managing Change - June 23, 6-8 PM, Airport Hilton, West Palm Beach Prepare for changes affecting your practice and your economic future, learn techniques to minimize financial risks and boost the bottom line, understand and prepare for changes in the new models of medical practice and payment for services, prepare for the expanded use of health information technology as an underpinning of new quality. Presentations by: Jeff Cohen, Esq., Jim Farrell, Esq., Tim Monaghan, Esq., Mike Segal, Esq., Jean Acevedo, Nancy Proffitt and the South Florida Regional Extension Center. No charge for PBCMS members. Nonmembers and guests: $40. Register on line at www.pbcms.org (events)

Heroes in Medicine Thank You Reception

OnCall I May – June 2011

BASIC TRAINING FOR MEDICAL OFFICE STAFF This program is designed to train your staff on the knowledge and skills essential for a successful medical practice - patient customer service, patient confidentiality and patient rights, staff working as a team. The one day program will be offered three times: June 8, July 13, August 10 9 am – 12:30 pm. $75 per session – Members, $125 – Nonmembers. For additional information contact deannal@pbcms.org or call 561-433-3940 OR register online at www.pbcms.org (events). SAVE THE DATE 2011 FUTURE OF MEDICINE SUMMIT V October 27-29 (Thursday – Saturday). Palm Beach County Convention Center Featuring nationally recognized speakers, the three day Summit will focus on: Prevention & Wellness, Physician Viability, Access to Care, and Quality and Patient Safety. Sponsorship opportunities available. For additional information call 561-433-3940.

Jack Zeltzer, M.D.; June Daughterty and Charles L. Moore, M.D.

Jonathan Satter and Larry Gorfine, M.D.

Mrs. and Dr. William Adkins

J. John Goodman, M.D.; Judy Goodman; Geoffrey Campbell and James J. Byrnes, M.D.

Christine Brooks and Joanne Masella

ANTHRAX Treatment Information

he Palm Beach County Health Department (PBCHD), Office of Public Health Preparedness, has recommended that Floridians prepare for a possible biological episode or bioterrorist attack. The PBCHD is aligning itself with residential communities, municipalities, large businesses, faith-based organizations, colleges and universities, in an effort to recruit additional Points of Dispensing (POD) sites in the event of a public health emergency that may require prophylaxis of 100% of the County’s residents in 48-hours. The primary concern is INHALATION ANTHRAX which may initially appear to be a common cold. After several days, breathing problems may occur, followed by shock, and possibly death. Other symptoms may include fever, muscle aches and fatigue. Person-to person spread is extremely unlikely. Early antibiotic intervention can help prevent the disease and its complications. The three most commonly prescribed oral antibiotics for anthrax are Doxycycline, Ciprofloxacin and Amoxicillin.

PBCHD continues its campaign to recruit additional entities. Medical providers should be aware that their patients may come to them seeking medical advice and recommendations regarding these three antibiotics. Patients with special medical conditions, women who are pregnant or breastfeeding, and children under the age of 18 will require specific dosing and medication management. To prepare, consulting with their physician regarding a treatment plan is recommended. Anthrax treatment information can be made available to health care providers by the PBCHD or at http://emergency.cdc.gov/agent/anthrax/faq. For additional information please contact: Philip Levenstein Palm Beach County Health Department 561-671-4017 Philip_Levenstein@doh.state.fl.us

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Disability Awareness

Your largest asset is not your home, health or pension, it is your ability to earn an income In a recent study, it was found that only 16 percent of Americans believe their most important asset is their paycheck. In today’s world, most people are set up for payments through automatic withdrawals and automated payments, which causes some people to forget just how reliant they become on a consistent stream of income and how they would fill a financial gap in the unfortunate circumstance that they were to become disabled. It can’t happen to me The thought of becoming disabled is troubling at best, but it is a far more common occurrence than most realize. In fact, a recent study found that people have a 3 out of 10 chance of suffering a disability illness or injury that lasts 90 days or more. Due to the progress made in modern technology, a person in their 40s is now more likely to become disabled than to pass away. Awareness A shocking fact, 43 percent of employees with employer provided disability did not even know they were covered, showing a lack of awareness of the importance of disability insurance. However, those who are covered under their employer are still susceptible to not having sufficient income upon disability due to the fact that employer disability insurance only covers 60 percent of their current income. Furthermore, the 60 percent that is covered under employer sponsored disability is considered taxable income because the employer pays the premiums, further eroding your income stream in event of a disability and creating a “gap.”

Any occupation vs. own occupation for Medical Professionals Knowing the difference between “any occupation” and “own occupation” can have resounding effect on the amount of disability you will receive for your injuries or illness. All “own occupation” definitions of total disability consider your ability to perform the principal duties of your occupation at the time of claim. These duties are the tasks that you perform regularly on a day-to-day or week-to-week basis and play a role in your ability to earn an income. All “own occupation” definitions look at your principal duties, not your title when determining your eligibility for total or partial benefits. The extent to which you can perform these principal duties is the main factor in determining whether you are considered totally disabled or partially disabled.

For effective group or individual solutions to protect your most valuable asset contact: David H. Coldwell, CLU, CLTC 561-622-4699 davidcoldwellclu@aol.com

David Laser 561-962-2931

Grant D. Coldwell, CLTC 561-630-6300

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FMA update continued from page 7 Bills Modified by the FMA FMA/NRA Compromise: HB 155 (SB 432) Early in the session, The FMA was hit with a legislative bomb from the powerful National Rifle Association: a bill that would have made any physician who asked a patient about firearm ownership guilty of a thirddegree felony and subject to a $5 million fine. We strongly opposed this bill as filed and worked relentlessly to kill it in committee. At the urging of House and Senate leadership, the FMA eventually reached a compromise with the NRA that removed criminal and civil penalties, and ensured that physicians can continue asking patients about gun safety. This bill does NOT prevent a physician from entering information about firearm ownership into a patient’s medical record if, according to the physician, the information is relevant to the patient’s medical care and safety, or the safety of others. Considering the NRA’s lobbying power, this compromise represents a huge win for Florida physicians. Medicaid Reform and Noneconomic Damages: HB 7107 and 7109 This legislation establishes the Medicaid program as a statewide, integrated managed care program for all covered services, and is a massive undertaking. The FMA worked diligently to craft provisions limiting noneconomic damages for physicians who are sued for medical liability by Medicaid patients. • The final bill contains a provision that caps noneconomic damages at $200,000/$300,000 in medical liability suits against physicians brought by a Medicaid patient.

• If there are multiple defendants, noneconomic damages may not exceed $300,000 per claimant. • The cap can be exceeded only if there is a clear and convincing standard of evidence that the physician acted in bad faith, with malicious purpose, or with wanton and willful disregard of human rights, safety, or property. Pill Mills and Controlled Substance Abuse HB 7095 (SB 818): Legislators were under tremendous pressure to “do something” about the pill mill scourge and controlled substance medication abuse. The Senate took a measured approach, calling for harsher penalties on those who break the law. The House approach was more radical, backing legislation that would have banned physicians and small pharmacies from dispensing ANY controlled substances. It also would have required all physicians who dispense controlled substances for the treatment of chronic, nonmalignant pain to register with the state, pay a fee, and follow certain guidelines for which the failure to comply would have been a mandatory six-month suspension and $10,000 fine. Despite the FMA’s aggressive lobbying and attempts to amend the final product, this legislation passed out of both chambers. This is a mammoth bill containing numerous provisions. Please view the full report for further details.

NAVIGATING HEALTHCARE REFORM Understanding the Challenges and Opportunities – Managing Change Presenters: Jeff Cohen, Esq., Jim Farrell, Esq. Timothy Monaghan, Esq., Mike Segal, Esq., Jean Acevedo, Nancy Proffitt South Florida Regional Extension Center

Why You Should Attend: • Prepare for changes affecting your practice and your economic future

June 23, 2011

Airport Hilton 150 Australian Ave., WPB

• Learn techniques to minimize financial risks and boost the bottom line

Reception: 6:00 – 6:45 p.m. Dinner & Program: 6:45 – 8:00 p.m.

• Understand and prepare for changes in the new models of medical practice and payment for services

PBCMS Members: No Charge Guests: $40

• Prepare for the expanded use of health information technology as an underpinning of new quality

PBCMS Circle of Friends

The Palm Beach County Medical Society is most grateful to its Circle of Friends. Your support helps us provide services to physicians, healthcare providers, patients and our community. We couldnâ&#x20AC;&#x2122;t do what we do without you! Acevedo Consulting Coding & Compliance Specialists 561-278-9328 jacevedo@acevedoconsulting.com Alpern Rosenthal Accounting & Tax Consultants 561-689-7888 tclarke@alpernfl.com Anderson Moore Construction 561-753-7400 jschumacher@amcbuild.com Avisena Revenue Cycle Management 305-446-8599 bfoster@avisena.com Broad & Cassel Attorneys at Law 305-373-9430 msegal@broadandcassel.com Danna-Gracey Medical Malpractice & Workmenâ&#x20AC;&#x2122;s Compensation Insurance 561-276-3553 matt@dannagracey.com FPIC Medical Malpractice Carrier 800-741-3742 hakes@fpic.com

Gulfstream Business Bank 561-665-4212 jchen@gsbb.com

Suntrust Bank 954-765-7194 elizabeth.breslin@suntrust.com

Ironstone Bank 561-253-8135 laura.king@ironstone.com

The Florida Healthcare Law Firm 561-455-7700 jcohen@floridahealthcarelawfirm.com

Managed Care Advisory Group (MCAG) 800-355-0466 jgadd@mcaginc.com

ThinSolutions Remote Control IT Management 941-741-4287 lmellgren@thinsolutions.com

Morgan Stanley Smith Barney 561-393-1535 patricia.c.corbett@mssb.com Northwestern Mutual 561-622-4699 david.coldwell@nmfn.com 561-962-2931 david.laser@nmfn.com Proffitt Management Solutions Business Coach 561-582-6060 nancy@proffittmanagement.com Shutts & Bowen, LLP 561-835-8500 tmonaghan@shutts.com

VNA of Florida Home Health Agency 1-800-318-0399 Windstream Communications 954-727-2121 barbara.burns@windstream.com

Classified Ads Job Position: PROJECT ACCESS SYSTEM NAVIGATOR Palm Beach County Medical Society Project Access, a program that assists qualifying uninsured individuals to obtain health care has an opening for a system navigator. This individual will screen the uninsured residents of Palm Beach County to finding access to healthcare coverage. Requirements: Experience with health related customer service issues, strong communication skills in English and/or Creole or Spanish. Has knowledge of medical terminology, skill using Microsoft Office applications and a personal vehicle available for daily local travel. Education: High school diploma or GED and equivalent in a field related to job responsibilities. AA or AS Degree preferred or degree in a field related to job responsibilities. Submit resume to:Palm Beach County Medical Society- Project Access, fax to (561) 969-6688, or email to projectaccess@pbcms.org OFFICE SPACE FOR RENT OR SALE Office space for rent or sale, 3000 sq. ft. located on Glades Road, Boca Raton, Florida. Ready to use, has cardiology nuclear camera, ultrasound and ekg equipment, four exam rooms with tables. Easy access to I-95, minutes from Boca Raton Regional Hospital. For further information call 561-750-8676 or 561-212-6411. MEDICAL OFFICE SPACE AVAILABLE 1400 sq foot medical office fully equipped perfect for internist or group, centrally located off Palm Beach Lakes Blvd in West Palm Beach, available full or part time for lease or sale. Call 685-2613

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Palm Beach County Medical Society Membership Applicants Thomas A. Bolton, MD 2013 Ponce de Leon Ave., West Palm Beach, FL 33407 Phone: 561-659-0770 Fax: 561-659-0413 Email: pathwizard@aol.com Specialty: Pathology-Anatomical/Clinical Medical School: University of South Florida 1980 Internship: University of South Florida College of Medicine 1980-1981 Residency: University of South Florida College of Medicine 1981-1984 Board Certification: American Board of Pathology - Pathology-Anatomical/Clinical & Cytopathology Hospital Affiliations: Palm Beach Gardens Medical Center, Martin Memorial Medical Center, St. Mary’s Hospital & Jupiter Medical Center Date of Birth: 10/25/1955 Addie Dissick, MD 7301-A W. Palmetto Park Road Suite 301A, Boca Raton, FL 33433 Phone: 561-672-7950 Fax: 561-672-7953 Email: addie@drdissick.com Specialty: Internal Medicine Medical School: SUNY 2003 Internship: Lenox Hill Hospital 2003-2004 Residency: Jackson Memorial Hospital 2004-2006 Fellowship: Georgetown University Hospital 2006-2008 Board Certification: American Board of Internal Medicine (Internal Medicine & Rheumatology) Hospital Affiliations: None Date of Birth: 08/04/1977 Jeffrey Elian, MD (Retired) 8521 Club Estates Way, Lake Worth, FL 33467 Phone: 561-779-4265 Fax: 561-963-4957 Email: ophmdge@gmail.com Specialty: Ophthalmology Date of Birth: 10/22/1943 Michael A. Gleiber, MD 2141 S. Alternate A1A, Suite 220, Jupiter, FL 33477 Phone: 561-972-6464 Fax: 561-972-6515 Email: drmichaelgleiber@gmail.com Specialty: Orthopedic Surgery Medical School: George Washington University 2002 Internship & Residency: Columbia University Medical Center 2002-2007 Fellowship: Leatherman Spine Fellowship 2007-2008 Board Certification: None Hospital Affiliations: St. Mary’s Medical Center and Good Samaritan Hospital Date of Birth: 09/15/75 Yolanda Gonzalez, DO 3319 State Road 7, Wellington, FL 33449 Phone: 561-333-4000 Fax: 561-333-8851 Email: yolandaerdoctor@comcast.net Specialty: Emergency Medicine Medical School: University of Central Del Carib 1993 Internship: University of Puerto Rico 1993-1994 Residency: University of Puerto Rico 1994-1997 Board Certification: American Board of Emergency Medicine Hospital Affiliations: Lawnwood Regional Medical Center Date of Birth: 01/23/1968 Benny Menendez, MD 3319 State Road 7, Suite 102, Wellington, FL 33449 Phone: 561-333-4000 Fax: 561-333-8851 Email: bennymenendez@aol.com Specialty: Emergency Medicine Medical School: University of Puerto Rico 1986 Internship: University District Hospital, San Juan, Puerto Rico 1986-1987 Residency: University of Puerto Rico 1987-1990 Board Certification: American Board of Emergency Medicine Hospital Affiliations: Broward General Medical Center Date of Birth: 05/09/1960 Zoya Mohiuddin, MD (Resident) 160 JFK Drive, Suite 102, Atlantis, FL 33462 Phone: 561-548-1450 Fax: 561-548-1459 Email: dr.zmohiuddin@gmail.com Specialty: Internal Medicine Medical School: Royal College of Surgeons 2008 Hospital Affiliations: JFK Medical Center Date of Birth: 03/26/1984

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Paige Elizabeth Morris, MD 525 Okeechobee Blvd., West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Email: morrisp@ccf.org Specialty: Internal Medicine Medical School: Southern Illinois University 1994 Internship & Residency: Southern Illinois School of Medicine 1994-1997 Board Certification: American Board of Internal Medicine Hospital Affiliations: Cleveland Clinic Hospital Date of Birth: 7/31/1966 Robert Nisenbaum, DO 3319 State Road 7, Suite 102, Wellington, FL 33449 Phone: 561-333-4000 Fax: 561-333-8851 Email: erdoctor@bellsouth.net Specialty: Emergency Medicine Medical School: Nova SE University Div. FT 1990 Internship: Coney Island Hospital 1990-1991 Residency: Henry Ford Hospital 1991-1994 Board Certification: American Board of Emergency Medicine Hospital Affiliations: Palms West Hospital Date of Birth: 07/30/1964 Sonali Pandya, MD 2800 S Seacrest Blvd., Ste 200, Boynton Beach, FL 33435 Phone: 561-736-8200 Fax: 561-736-4635 Email: pansonali@gmail.com Specialty: Surgery-Breast Medical School: St. George’s University 2004 Internship: Albany Medical Center 2004-2005 Residency: Albany Medical Center 2005-2009 Fellowship: Women’s & Infants Hospital at Brown University 2009-2010 Board Certification: American Board of Surgery Hospital Affiliations: Bethesda Memorial Hospital Date of Birth: 4/5/1978 Evan Peck, MD 525 Okeechobee Blvd, Suite 1400, West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Email: pecke@ccf.org Specialty: Physical Medicine & Rehabilitation Medical School: University of Virginia 2005 Internship: Baylor College of Medicine 2005-2006 Residency: Baylor College of Medicine 2006-2009 Fellowship: Mayo Clinic 2009-2010 Board Certification: American Board of Physical Medicine & Rehabilitation - Physical Medicine & Rehabilitation & Sports Medicine Hospital Affiliations: Cleveland Clinic of Florida Date of Birth: 9/7/1977 Steven Eric Schultz, MD 5955 Ponce de Leon Blvd., Coral Gables, FL 33146 Phone: 305-661-1515 Fax: 561-881-0958 Email: picumd@yahoo.com Specialty: Pediatrics Medical School: Albert Einstein College of Medicine 1994 Internship: Montefiore Medical Center 1994-1997 Residency: Montefiore Medical Center 1997-1998 Fellowship: Children’s Hospital of Philadelphia 1998-2001 Board Certification: American Board of Pediatrics Hospital Affiliations: St. Mary’s Medical Center Date of Birth: 6/20/1967 Anthony Shaya, MD 600 Heritage Drive, Suite 210, Jupiter, FL 33458 Phone: 561-354-1515 Fax: 561-354-1516 Email: clewis@partnersinwomenshealth.com Specialty: OB-GYN Medical School: Tulane University 1998 Internship & Residency: Tulane University 1998-2002 Board Certification: American Board of Obstetrics and Gynecology Hospital Affiliations: Jupiter Medical Center, Columbia Hospital and St. Mary’s Hospital Date of Birth: 3/25/1970 Albert Ventzek, MD (Retired) 147 Arklow Avenue, Jupiter 33458 Phone: 561-401-9281 Date of Birth: 05/28/1933

PRSRT STD US POSTAGE

PAID WEST PALM BEACH, FL PERMIT NO. 515

3540 Forest Hill Blvd., Suite 101, West Palm Beach, FL 33406 RETURN SERVICE REQUESTED

The Future

When the government made money available to help doctors make the move to electronic health records (EHR), they entrusted just a few organizations with the funding and training to help doctors make that transition.

The Team

South Florida Regional Extension Center is the local organization that has been selected to help you transition to EHR and use it in a meaningful way to improve patient care and safety. That’s why the Palm Beach County Medical Society (PBCMS) has partnered with and supports the REC. Our highly trained specialists will help you ask the right questions to select the best EHR solution for your practice and help you reach the government standards for EHR meaningful use.

The Cost

For the first 2,500 priority primary care physicians who sign up with the South Florida REC, this critical service is 100% FREE. There is no need to hire expensive consultants or search through a multitude of vendors. The South Florida REC will save you time and money in your transition to EHR. Not only that, The South Florida REC will help speed your journey toward meaningful use and the government incentives that go along with reaching that goal.

The Incentive

Practices that accept Medicaid are eligible to receive up to $63,000 in incentive money once they reach the government standards for meaningful use. Practices that accept Medicare are eligible to receive up to $44,000 in incentive money once they reach the government standards for meaningful use.

The Regional Extension Center

Because the REC is funded, trained and approved by the Office of National Coordinator, we are the recognized experts on EHR selection and implementation and the government’s standards for meaningful use.

SOUTH FLORIDA

REGIONAL EXTENSION CENTER®