ON CALL magazine
The Official Publication of the Palm Beach County Medical Society
Quarter Two 2012
®
ON CALL MAGAZINE QUARTER TWO 2012 / PRESIDENT’S REPORT
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President’s
REAL ESTATE DEVELOPMENT
REPORT Jack Zeltzer, MD
Quarter Two 2012
President, Palm Beach County Medical Society
THE PRACTICE OF MEDICINE IS UNDERGOING REVOLUTIONARY CHANGES. AND THE LIST KEEPS GOING: Many entities in health care are flexing their muscles to achieve their own vested interests. Physician autonomy is under siege and this primarily threatens our patients’ well being and rocks the foundation of our noble profession. How best to protect our patients and ourselves? The best means to protect our individuality rests in our collective strength. The Palm Beach County Medical Society offers that common ground by which we Physicians can “Stand and Deliver.”
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Integrity • Loyalty • Professionalism • Entrepreneurship • Passion • Teamwork
We believe the future of medicine should be decided by physicians. The best way to address the challenging issues facing medicine today is by becoming engaged at the local level. PBCMS is the largest and most powerful organization representing physicians in our community. We advocate on your behalf locally, statewide and nationally. We help you secure new patients. We ensure the most qualified companies and individuals are available to help you run your practice. We train your office staff.
WE WANT TO SHOW YOU WHAT WE HAVE BEEN DOING LATELY . ON ADVOCACY: • Traveled to Washington, DC in March 2012 to support advocacy efforts to maintain Medicare physician payments and avoid the 27.4% Medicare pay cut. • Sponsored The State of Medicine & Legislative Dinner in January 2012 where Florida Legislators, the Vice President of the FMA, and local health care leaders spoke on key issues in health care. • Ensured the continuation of physician retroactive payment with the Health Care District of Palm Beach County, resulting in $1.6 million in payments to physicians. • In collaboration with the FMA, PBCMS leaders traveled to Tallahassee to participate in Palm Beach County Days, where PBCMS delegates met with Bud Kniep, Chief of Staff for Chief Financial Officer Jeff Atwater, to discuss the issue of The Florida Birth-Related Neurological Injury Compensation Association (NICA). • Successfully averted potentially harmful legislation in 2011 by working with the FMA. • Three PBCMS members are actively engaged delegates to the American Medical Association. • Our Medical Advocacy Taskforce brought together hospital and physician leaders to address health care issues.
• PBCMS’ 21 delegates to FMA’s House of Delegates. Dr. Alan Pillersdorf & Dr. Jose Arrascue were elected to leadership positions. • PBCMS welcomed Dr. Malcolm Dorman and Dr. Alan Pillersdorf into the honorable 1919 Society, where they joined the 8 other physician members. • PBCMS spoke at a number of general staff meetings and medical executive committees. Can we speak at yours? •P BCMS expanded the Hippocrates Society, an annual opportunity for hospital medical staffs to support our programs. • PBCMS extended membership to 184 Medical Students. • PBCMS will host the sixth annual Future of Medicine Summit on September 27-28, bringing nationally recognized health care leaders to Palm Beach County. • Attended Triple AIM Initiative in San Diego to discuss issues of cost versus quality. Through PBCMS Services we have likewise accomplished some important public health initiatives, and you can read more in the Annual Report which you can find later in this edition. Palm Beach County Medical Society proudly offers a robust array of benefits for our physicians, most of which are featured in this special membership issue of On Call. Maybe instead of asking “what have we done lately,” a better question would be “what haven’t we done lately?” To remain effective, to carry the cause forward, to win the day takes time, effort, energy, and, yes, financing. We need everyone’s participation; we need to increase our membership to expand our force and influence. In closing, I will remind everyone of Teddy Roosevelt’s Call to Action: “It is not the critic who counts. Not the man who points out how the strong man stumbled or where the doer of deeds could have done better. The credit goes to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs and comes short again and again; who knows the great enthusiasms, the worthy devotions; who spends himself in a worthy cause. Who, at the best, knows in the end the triumph of high achievement, and who, at the worst, at least fails while daring greatly, so that his place shall never be with those timid souls who know neither victory nor defeat.” and never realizing that within themselves still remains the Power to effect Change.”
ON CALL MAGAZINE QUARTER TWO 2012 / THIS ISSUE
Planning for a financially secure retirement is now more challenging than ever.
SAVE THE DATE DATE:: Sept. 27 – 28, 2012
The rules of retirement are in need of a rewrite for physicians who are in private practice.
Future of Medicine Summit VI
The reduction of professional fees, concerns over malpractice claims and a volatile investing world are among the forces that make planning for a financially secure retirement so challenging.
Palm Beach County Convention Center, West Palm Beach, FL
You don’t have to go it alone, there is specialized planning services available for physicians in private practice.
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Celebrating 28 Years of Innovation and Leadership in 2012
Striving for Medicine’s Better Future
Featuring National & Local Health Care Leaders Carol Beasley, Director, Institute of Health Care Improvement Rick Cameron, Navigant Consulting Jeff Cohen, Esq., Florida Healthcare Law Firm Chris Dawe, Dir. Delivery System Reform, US Health & Human Services Vincent DeGennaro, MD, President-Elect, Florida Medical Association Phil Galewitz, Correspondent, Kaiser Health News Jeff Goldsmith, PhD, Health Care Economist & President, Health Futures Jeremy Lazarus, MD, President, American Medical Association Miguel Machado, MD, President, Florida Medical Association Joe Mott, VP, Healthcare Transformation, Intermountain Healthcare Parag Shah, President, HealthPrime International Donna Shalala, President, University of Miami Mike Segal, Esq., Broad and Cassel Above are confirmed. Other Palm Beach County health care leaders will also speak.
Presentations by Scripps Florida Researchers: Diabetes, Mental Health & Heart Disease
SPONSORSHIP OPPORTUNITIES AVAILABLE Visit www.pbcms.org/FOM or call 561-433-3940
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This Issue FEATURES
7 SPOTLIGHT ON MEMBERSHIP
12
12 2 011 SERVICES ANNUAL REPORT
16 A NOTHER VALUABLE MEMBER BENEFIT: PBCMS MSO
21
18 A HEALTH REFORM
CONUNDRUM: SPECIALIST PARTICIPATION IN ACOS
20 C ASE STUDY: LACK OF
INFORMED CONSENT COMPLICATED BY RECORD ALTERATION
20
This Issue
Gulf Atlantic Legal Defense Insurance, Inc.
54
21 WHAT’S NEW IN TB TESTING
ARTICLES
22 PAST PRESIDENTS
2 PRESIDENT’S REPORT
23 MED MEMO
24 P BCMS FEATURE MEMBER:
ANDREW R. BERKMAN, MD
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25 M ED SOCIETY NEWS: NEW MEMBERS
26 CLASSIFIEDS
24
7 1920’s
1950’s 1980’s 22 1990’s
ON CALL MAGAZINE QUARTER TWO 2012 / DIRECTOR’S DESK
Find out why we are the only agency endorsed by the Palm Beach County Medical Society. We make it our practice to genuinely care about yours. As a long-time supporter of the Palm Beach County Medical Society, we do much more than just negotiate the best med mal rates available. We are financially and actively involved, both locally and statewide, in seeking solutions to some of healthcare’s most pressing issues. Call us today to see what we can do for you.
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Did you receive money back on your premium last year? Many doctors have through the Palm Beach County Medical Society Workers’ Compensation Program. The rates for all physicians throughout the state are set by the State of Florida. Your practice will pay the same price no matter where you choose to secure coverage. However, under the OptaComp program, you may be eligible for a potential dividend of up to 24.8%. Your membership with the PBCMS can provide savings that can be paid back in dividends. OptaComp has returned a dividend for 12 straight years, with over $4 million over the past six years to Florida medical societies’ members: $600,000 of that went to PBCMS members. The OptaComp (rated “A” by A.M. Best) program is endorsed by the PBCMS and is offered by Danna-Gracey, Inc. For more information, please call Tom Murphy at 800.966.2120.
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DIRECTOR’S
DESK
Tenna Wiles, CEO
Palm Beach County Medical Society
Physicians are Our Heroes
Recently we hosted the Heroes in Medicine Awards Luncheon, and many of the honorees and participants were physicians who go above and beyond: setting up new medical school programs in our county, caring for others even when undergoing personal hardship, founding nursing programs in Iraq, helping generations of women conceive, and developing programs to improve the quality of medical care in our community. And the list goes on and on. Proceeds from this successful event help our Services’ Project Access, which provides health care to our uninsured neighbors. All physicians are our heroes, and every day we thank you for the work you do caring for our families, friends, professional colleagues, and the countless, nameless others. You care for people every day. We want you to let us care for you – every day. PBCMS exists for physicians. The PBCMS family of medicine represents physicians from many sectors – medical students and residents, private practice and hospital based physicians, medical school and residency faculty, researchers, administrative, public health, entrepreneurs and retired physicians. Our diversity is our strength and we strive to provide programs and services that meet the collective needs of our members. I hope you will take time to review our member benefits and call the Society for the “5 Minute Benefit Check Up.” Perhaps you would like to learn more about our Health Insurance Plan, or our new MSO. Have you taken advantage of our excellent Workers Comp Program, professional liability products, or practice consultants? PBCMS Circle of Friends offers a wide range of valuable services that have been vetted by the Board of Directors. While we believe that all physicians should participate in organized medicine, we understand that we must demonstrate value for your membership. Please let us hear from you. Share with us what we can do to help you. We want to be your hero! In this edition of On Call we are focusing on member benefits and services. Our board of directors has worked diligently to research and select. But we can do more. How? By increasing the number of physicians who are members. By increasing the numbers of current members who are actively involved and telling us how we can best help you. PBCMS is YOUR Society, and we want to be YOUR Heroes.
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Palm Beach County Medical Society
2012 BOARD OF DIRECTORS Jack Zeltzer, MD President K. Andrew Larson, MD President Elect, Chair, Leadership Development Council Ronald Zelnick, MD First Vice President, Chair, Council on Membership & Member Services Stephen Babic, MD Second Vice-President, Chair, Council on Legislation & Physician Advocacy Malcolm Dorman, MD Secretary, Co-Chair, Council on Finance & Governance James T. Howell, MD Treasurer, Chair, Council on Finance & Governance James J. Byrnes, MD Past President, Leadership Development Hatem Abou-Sayed, MD William R. Adkins, MD Jose F. Arrascue, MD Shawn Baca, MD Jeffrey Bishop, DO Mark Brody, MD Jeff Davis, DO Michael Dennis, MD Roger Duncan, MD Karen Flannery, MD Randy Gershwin, MD James Goldenberg, MD Lawrence Gorfine, MD Richard Greenwald, MD
Daniel Higgins, MD Beth Lesnikowski, MD Brandon Luskin, MD Harish Madhav, MD Alan B. Pillersdorf, MD Mark Rubenstein, MD Brent Schillinger, MD Richard Shugarman, MD Andrew Shapiro, MD David Soria, MD Joan St Onge, MD Maureen Whelihan, MD Jeffrey Wisnicki, MD Kenneth Woliner, MD
Palm Beach County Medical Society
2012 BOARD OF TRUSTEES Jose F. Arrascue, MD Stephen Babic, MD James J. Byrnes, MD Malcolm Dorman, MD Lawrence Gorfine, MD K. Andrew Larson, MD
Alan B. Pillersdorf, MD Richard Raborn, MD Brent M. Schillinger, MD Maureen Whelihan, MD Ronald Zelnick, MD Jack Zeltzer, MD
ON CALL magazine
STAFF Tenna Wiles, CEO Tara Auclair Ryan, Director of Marketing & Community Relations John James, Director of Public Health & Disaster Services Deanna Lessard, Director of Member Services & Education Nicola Chung, Project Access Program Director Maria Turkki, Project Access Program Coordinator Sadia Peck, Project Access Program Coordinator Mindi Tingler, Administrative Assistant Natalie Gonzalez, Administrative Assistant, PBCMS Services Lauren Tome, Receptionist Patricia Beeler, Receptionist Managing Editor: Tara Auclair Ryan Subscriptions to On Call are available for an annual rate of $50. For more information contact Tara Auclair Ryan at 561-433-3940 x15. The opinions expressed in On Call are those of the individual authors and do not necessarily reflect official policies of Palm Beach County Medical Society or its committees. On Call is owned and published four (4) times per year by Palm Beach County Medical Society, Inc., 3540 Forest Hill Blvd., #101, West Palm Beach, FL 33406. (561) 433-3940 & (561) 276-3636. ©Copyright 2012 Palm Beach County Medical Society, Inc.
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ON CALL MAGAZINE QUARTER TWO 2012 / MEMBERSHIP SPOTLIGHT
MEMBERSHIP SPOTLIGHT / ON CALL MAGAZINE QUARTER TWO 2012
REIMBURSEMENT ASSISTANCE
MISSION:
THE PALM BEACH COUNTY MEDICAL SOCIETY IS A NOT FOR PROFIT ORGANIZATION DEDICATED TO UNITING PHYSICIANS TO SERVE THE COMMON INTEREST OF THE PROFESSION, DEVELOPING AND MAINTAINING THE HIGHEST PROFESSIONAL AND ETHICAL STANDARDS OF THE MEDICAL PROFESSION, ADVOCATING THE INTERESTS OF PHYSICIANS AND THEIR PATIENTS AND COLLABORATING WITH OTHERS TO IMPROVE THE COMMUNITY’S HEALTH. PBCMS exemplifies this mission daily, and we exist to serve our valued members. To that end, in this edition of On Call we want to remind our members of the various ways we can serve you on a daily basis. Maybe you will even learn about some new ways we can help you and your practice. When in doubt or if you ever have a question, do not hesitate to contact PBCMS. If you want a list of contact information for all of the organizations that provide services and benefits to PBCMS members, contact us at 561-433-3940 x28 or deannal@pbcms.org.
DAY-TO-DAY ASSISTANCE DAILY PRACTICE ADVICE Don’t know who to call? Call PBCMS PBCMS has full time staff to assist with any of your practice management questions. Not only do we have extremely knowledgeable full time professionals, we can connect you with experts in any area where you have questions. Insurance reimbursements issues, any type of legal situation, membership and benefit clarification, technology confusion, or any of the other aspects of helping your practice run more smoothly.
SUPPORT FOR at anytime for membership clarification, YOUR OFFICE benefit guidance, or suggestions to make your society work better for you. MANAGER
We know that physician office m a n a g e r s face complex challenges on a daily basis, and we hope they know that the full time staff at PBCMS are here for them. We can answer questions regarding medical records and dismissing patients from a practice. If you have a legal question, we can point you in the right direction. Everyone is talking about EMRs and we can answer EMR billing questions associated with medical records and how much to charge. If you have a question, we can find out the answer.
CODING CONUNDRUMS
FREE CLASSIFIED POSTINGS Are you looking for a part-time staff person? Do you have some office space that another physician may be interested in leasing? Are you the chair of a valuable community outreach activity in which other members may want to participate? Let us know! We’re happy to post your classified at no cost in MedLink, the weekly enewsletter, and members receive a significant discount when publicizing items in On Call, the quarterly magazine.
HELPING YOU HELP YOUR PATIENTS Your patients often look to you for recommendations when they need help after surgery or have suffered a major illness. Interim Healthcare can help by providing in home care services based on the individual needs of your patients.
Coding is complex – yet vital to any practice – and become more so when ICD-10 is finally implemented. Who can you turn to? PBCMS consultant Acevedo Consulting can help you through the maze of Medicare coverage and reimbursement issues, answer staff questions, develop and implement compliance plans, provide in-house education and consultative services on your Medicare- and coding-related concerns.
SEARCH PBCMS’ ONLINE RESOURCE LIBRARY
MEMBERSHIP QUESTIONS
FREE OR DISCOUNTED ATTENDANCE AT PBCMS SEMINARS
PBCMS exists for one reason and one reason only: to serve our physician members – YOU. To that end, we work diligently to provide our members with superb membership benefits and we want to ensure that you can utilize them for a strong return on your investment. Call us
Members and their staff have a host of valuable information at their fingertips, simply by logging on to www.pbcms. org. The Resource Library contains a plethora of information on a variety of topics ranging from how to establish a new practice to answers to your human resources questions to how long you have to keep medical records. What else? Go to www.pbcms.org and find out!
Every month PBCMS hosts educational events to help you and your office staff. Most events are free of charge – including CME courses – and if there is a nominal fee, our members and their staff receive a discount.
Are you having trouble getting paid for services rendered? PBCMS has resources to help you get the support you need to be reimbursed for your professional efforts. Managed Care Advisory Group is the nation’s leading expert and most experienced service company when it comes to obtaining HMO settlement payments for physicians.
ACCESS RECORDED PBCMS SEMINARS Did something come up and you weren’t able to attend the Future of Medicine segment you were interested in hearing? Let us know! We have recorded seminars available to you for free if you missed them.
CLAIM DENIALS & REJECTIONS SLOWING DOWN YOUR REVENUES? Experience an industry-leading clean submission rate of 95% + by switching to Physicians Advantage Services’ profession billing solutions.
PAYER CONTRACT ANALYSIS PBCMS works with a number of professionals who can help physicians with the contract review process, including proposed contract amendments. The Florida Healthcare Law Group can provide access to objective written analyses of major health plan contracts, are here to help physicians understand their rights and options when contracting with a third-party payor, and provide an understanding of contract provisions that are prohibited by Florida law. Members can call the Attorney On Call hotline for a free 15 minute consultation.
COMMUNICATE BETTER, SAVE MONEY Windstream Communications provides high-speed broadband Internet, phone service and Digital TV packages. PBCMS members receive a free bill audit of current local, long distance. New customers after 5/1/2012 will get 10% off regular price for each new business location.
IMPROVE YOUR PRACTICE AND FAMILY’S FINANCIAL HEALTH LEGAL SERVICES FROM PBCMS’ LEGAL EXPERTS PBCMS legal experts cover a wide range of professional disciplines and can provide timely advice for whatever complications arise. No matter what your need, the attorneys at Broad and Cassel and The Florida Healthcare Law Firm can help you. Broad and Cassel offers PBCMS member one complimentary consulting session, with no time limit.
INVEST TO MEET YOUR GOALS
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PURCHASING, REFINANCING, OR LINES OF CREDIT? Comerica can help. A bank that knows health care and cares. PBCMS members do not pay a fee for financial planner, will have a dedicated private banker, have preferred rates on money markets and CDs, and no closing costs on home equity lines up to $500,000.
PBCMS HAS GOOD CITIZENS First Citizens Bank works closely with physicians to help you understand the complexities in managing the practice finances.
IT’S NEVER TOO EARLY TO THINK ABOUT LIFE INSURANCE
MorganStanleySmithBarney can help you define and strive to meet your goals by delivering a vast array of resources to you in the way that is most appropriate for how you invest and what you want to achieve. PBCMS members receive complimentary financial reviews, asset gathering, and free Forever IRA if the client rolls over $50,000 (No IRA fees; does not refer to investment fees).
MetLife is the number one life insurance company in the U.S. with 140+ year history of financial strength, providing benefits to over 90 of the top 100 Fortune 500 companies. Offers a full range of insurance, financial products and services for individuals, families, professionals, business owners, and employees.
HIPAA COMPLIANCE ADVICE
PBCMS members can purchase group health insurance at competitive rates through our new PBCMS Health Insurance Trust.
HIPAA is here to stay and we want to ensure that you have the resources you need to remain compliant. We can help.
TRUST YOUR BANK SunTrust Bank provides PBCMS members with Treasury Management, Practice Financing Solutions, Risk Management, and Employment Benefits.
SUPPORT NO MATTER WHERE THE CURRENT TAKES YOU Gulfstream Business Bank helps with all your financial needs, be it medical equipment financing, equipment leasing, cash management, commercial mortgages, accounts receivable financing, letters of credit or commercial real-estate financing. $1,000 credit toward closing costs on a new commercial mortgage (subject to credit approval).
KEEP YOU, YOUR FAMILY, AND YOUR STAFF HEALTHY
PROFESSIONAL LIABILITY INSURANCE Danna-Gracey, Inc. is dedicated solely to medical malpractice insurance coverage placement for Florida physicians and surgeons, as well as placement of medical facilities’ and physician practices’ workers compensation coverage. PBCMS members receive a discount on medical liability insurance. The Doctors Company/FPIC provides Florida physicians with local claims, underwriting and patient safety services. PBCMS members qualify for a 5% premium discount.
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ON CALL MAGAZINE QUARTER TWO 2012 / MEMBERSHIP SPOTLIGHT
MEMBERSHIP SPOTLIGHT / ON CALL MAGAZINE QUARTER TWO 2012
GOING BARE? Medical Defense Solutions provides an alternative to physicians who find themselves in a position of going “bare.” PBCMS members a 25% discount on joining fee.
KNOW WHEN TO SPEND FROM THE RIGHT FINANCIAL BUCKET And when to avoid spending from the wrong bucket. Eppy Financial can help you reduce risk. PBCMS members receive a 25% discount on disability income insurance, 10% discount on long term care insurance, and complimentary consultations.
WHY DID YOU BECOME A DOCTOR? Not to run a business, so let Alpern Roesnthal help you with accounting, tax planning, and consulting.
DON’T RETIRE WITHOUT SOUND CHOICES Northwestern Mutual offers complimentary business needs or personal needs analysis for doctors, PAs, or Practice Administrators. PBCMS members receive a discount for 4 or more individual disability income policy owners, and a discount for 3 or more individual long term care policy owners from the same practice or business.
PBCMS MEMBERS RETURNED $550,000 Danna-Gracey offers a special workers’ compensation plan to PBCMS members through OptaComp, and PBCMS members can receive a potential dividend of up to 24.8 percent on worker’s compensation premiums.
PROFESSIONAL DEVELOPMENT Organized medicine both at the county (PBCMS) and state (FMA) levels provides physicians the unique opportunity to help create solutions to help their profession and industry. Developing the required skills to act as an essential advocate occurs over time, and membership in PBCMS can elevate your capacity to make a difference. To that end, the professional and personal growth and
development can occur at various levels within the organization. • Learn advocacy by heeding the call of the myriad calls to action through out the year. • Participate as a member on one of the various PBCMS Councils, including the Legislation & Physician Advocacy, Communications & Technology, Medical Education, Membership, Finance & Governance, and Leadership Development. • Help plan the Future of Medicine Summit. •P articipate in PBMCS Services programs. • Get engaged on a statewide level by participating as a Palm Beach County Delegate to the FMA.
PERFORMANCE AND PROFITABILITY ARE LEARNED Proffitt Management Solutions is a nationally recognized health care and business coaching firm working with organizations whose success depends on the commitment and performance of others.
PROMOTE AND BUILD YOUR PRACTICE GAIN ACCESS TO PBCMS MEMBER MAILING LIST Ensure that other physicians in Palm Beach County can refer their patients to you easily, and that you have the most up to date information on your colleagues. You can access the PBMCS member list with your www.pbcms.org password.
PHYSICIAN LOCATOR Daily we receive calls for patients looking for physicians. We only include practicing members online at the Physician Locator at www.pbcms.org.
BRICKS AND STICKS Anderson Moore Construction offers comprehensive and value-based services for health care construction projects, regardless of size or complexity.
KEEP EVERYONE UP TO DATE Create and manage your online physician profile at www.pbcms.org. Or don’t forget to let us know if you’ve moved offices or your number has changed!
IT’S NOT BRAGGING – WE’RE PROUD OF YOU In each edition of MedLink, PBCMS’ weekly enewsletter, we include a section entitled “Our Members in Action. Did you publish a book? Appear on a local or national news story? Accomplish life saving heroics in an overseas mission? We want to know, and we want to share it with your colleagues!
FREE ANNOUNCEMENTS We will include any practice announcements free of charge in MedLink, and at a very low cost in the On Call Classifieds.
ADVERTISE IN ON CALL AT A DISCOUNT Not only do our members receive discounts to advertise in On Call, but they also have the ability to promote their practice in a splashy 4-page center spread at a lower price. Each edition of On Call is read by over 1,500 physicians, hospital executives, business and community leaders and others throughout Palm Beach County and beyond.
BECOME A MEDIA SPOKESPERSON PBCMS regularly receives calls from television, newspapers, and radio stations looking for physician experts for a variety of subjects. Be the expert! We will always connect our members to the media to increase promotional efforts.
COMMUNICATION BREEDS ACTION STAY LINKED Members with email addresses receive MedLink weekly at no charge. In MedLink physicians will find information pertinent to them and their practice: relevant news stories, advocacy action items, educational opportunities, colleague success stories, invitations to special events, etc.
CONNECT WITH PBCMS For those of our members with Internet and smart phones, connect with PBCMS on Facebook, Twitter and Linked In. These social media channels enable us to communicate relevant and fun information in a timely manner. Get connected!
ON CALL, DELIVERED TO YOU Each edition of PBCMS quarterly professional magazine, On Call, is read by over 1,500 individuals. Members receive a complimentary subscription, reduced fees for advertising, and discounted classified ads.
PRACTICE MANAGEMENT TRAINING
Our members are certainly the experts in their fields, and we want everyone to know. PBCMS hosts educational conferences for physicians and the general public alike, and our goal is to secure our member’s places as subject matter experts and expand their CVs.
NEED “SOUND ADVICE AND SUPERIOR SERVICE?” Abacoa Insurance Group has the full spectrum of insurance and investment companies available to help meet PBCMS members’ needs and planning goals.
FREE ASSISTANCE – JUST PICK UP THE PHONE Anytime your office manager has a question and doesn’t know who to call, all they have to do is pick up the phone and call PBCMS. Our educated staff is qualified to answer a wide range of practice management questions, free of charge.
RESOURCES ONLINE – ANYTIME PBCMS.org contains a plethora of resources relevant to your staff available 24/7. Access PBCMS-endorsed Circle of Friends to receive expertise and discounts to save practices time and money.
ENSURE STAFF ACCESS The members’ only web pages at www. pbcms.org are not only for physicians, but to office managers and other staff as well to enable easy resource access.
OPPORTUNITIES TO NETWORK
Each year PBCMS offers numerous CME courses to help our members earn their required credits, for free.
Just as it’s vital for physicians to network to build their practice, it’s as important for office managers to get to know their counterparts. By encouraging practice managers to attend PBCMS events, you will enable your staff to further develop to their best potential.
LEARN ABOUT OTHER EDUCATIONAL OFFERINGS
LET TECHNOLOGY IMPROVE YOUR PRACTICE
EARN YOUR CMES WITH PBCMS. SPEAK AS A PROFESSIONAL EXPERT
and other staff the most current practice advice. Topics range from billing and coding, to HIPAA, to HR, and other relevant subject matter.
Many hospitals and other organizations regularly ask us to promote their educational opportunities to our members. Some are conveniently located right here in Palm Beach County, others may be further afield yet provide an excellent excuse for an excursion.
OFFICE MANAGER ASSISTANCE OFFICE MANAGER INSTITUTES OFFERED REGULARLY. PBCMS contracts with professional experts to give you, your office managers,
MEMBERS ONLY ACCESS TO HIPAA COMPLIANT DOCBOOK MD Sometimes you need to access your patients’ records on the go, so members with smartphones, iPads, and other similar devices can receive a free subscription to HIPAA compliant DocBookMD. You will have access to PBCMS member contact information at your fingertips, and be able to give or receive a consult, communicate with images, find nearby pharmacies, etc.
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USE SOCIAL MEDIA TO CONNECT Connect and “tweet” with other “Friends” of PBCMS on Facebook, Twitter and LinkedIn. Increasing numbers of colleagues, patients and others are using the various social media channels to reach their target markets.
GET HELP WITH EHR Electronic health records are here to stay, and PBCMS helps physicians adapt to the ever-changing health care technology arena. Whether by attending a technology seminar, becoming active in the Communications & Technology Council, or simply by connecting with another physician who has already implemented EHR, your membership in PBCMS will help move your practice to the 21st century.
JOIN THE SOUTH FLORIDA REC Interested in learning more about electronic health records but don’t know where to turn for objective advice? PBCMS can help connect members to the South Florida Regional Extension Center, an independent non-profit organization assisting and guiding health care providers in transforming health care through electronic health records.
ADVOCATE AND BECOME A PART OF THE SOLUTION LET YOUR VOICE BE HEARD PBCMS leaders have over time developed meaningful relationships with both appointed and elected decisionmakers in Palm Beach County and throughout Florida. Each year PBCMS and MEDPAC host events to give physicians the opportunity voice their concerns directly with the people who can make a difference. MEDPAC is PBCMS’ political action committee. By supporting MEDPAC you can help identify and elect candidates that support physicians, patients, and the health care industry.
Considering
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ON CALL MAGAZINE QUARTER TWO 2012 / FEATURE - PBCMS MSO
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Our health care attorneys are ready to assist you through this transformation with the following services: n Creating Accountable Care Organizations n Navigating Antitrust Concerns n Understanding the New Health Reform Law (ACA) n Providing Guidance Regarding Clinical Integration n Advising on Stark and Anti-kickback Regulations n Creating Medical Homes n Implementing Payment Bundling n Instructing on Compliance with HITECH Act
BOCA RATON n DESTIN n FT. LAUDERDALE n MIAMI n ORLANDO n TALLAHASSEE TAMPA n WEST PALM BEACH
Another Valuable Member Benefit: PBCMS MSO A management service organization (MSO) by definition provides independent physicians and small groups with practice management support and technology, as well as the infrastructure necessary for the physicians to achieve success in the rapidly changing health care environment. The Palm Beach County Medical Society MSO has been established to provide our physicians with the highest quality, physician-specific infrastructure services in areas such as Information Technology (including electronic health records and e-prescription tools), human resources, revenue cycle management (central billing and collections), and other services. Participation with the PBCMS MSO provides our members with access to specialized and experienced professionals adept in practice management, information technology, managed care contracting, financial management, business development,
Revenue Cycle Management
Streamline your billing and collections and ensure accurate reimbursements through the expertise of our team.
Frustrated with your healthcare practice?
Group Purchasing
Leverage the strength of our combined buying power for clinical and office supplies, malpractice insurance, payer contracting and more. The inherent integration of previously separate business services results in cost savings we pass along to you.
Transcription Services
Boost your ROI without adding patients or staff. Expect outcomes like these: • Employee turnover down 500% • Timely reporting with 98% accuracy • Consistent cash flow • And more!
Reduce overhead expenses and save your valuable time with this highly cost effective service.
1 in 2 The chances of needing some form of long term care insurance 1 Do you know the cost of care? How will you pay for it?
Get a free Healthcare Management Checklist by visiting proffittmanagement.com/healthcare coach got one?
Endorsed by the Palm Beach County Medical Society turning potential into performance
561-582-6060 nancy@proffittmanagement.com
Electronic Health Records:
The core benefit of participation with the PBCMS MSO is the opportunity to utilize an electronic health record and e-prescription (eRx) system. Leverage your EHR to optimize government incentives, staff and physician productivity.
Staff Administration
Quit the headaches associated with benefit administration, payroll and liabilities, and have the MSO manage it for you. The PBCMS MSO promotes administrative efficiency while allowing the participating physician to maintain
954.689.9476 www.eppyfinancial.com
LTC Tree, retrieved from http:/www.longtermcareinsurancetree.com
13 16
independence.
Compliance Support
Utilize our services for compliance program management including coding reviews, training, and education.
marketing, fee setting, billing and collections. In turn, physicians are enabled to keep their autonomy and practice control, while providing high quality medical care with less administrative responsibilities. Participation with our MSO offers numerous opportunities. You may be interested in only one service to assist your practice or a full range of services. The choice is yours. PBCMS MSO services will help you develop the strategies and tactics for confident decision making. Sound analytics and decision support are the cornerstones of our MSO implementation effort. Let us help you assess the courses of action available, and guide you to the decision that best meets your personal and professional objectives.
For more information, please contact PBCMS at
561-433-3940. Practice Management
Simplify your operations oversight, business management, budgeting, and strategic planning by leaving it to our capable team.
Real Estate
Let us help you increase your cash flow and create additional value by developing your own medical facility.
Ancillary Services
Bring extra value to your patients and your practice by developing in-house ancillary services.
Provider Education
Physicians face tremendous challenges to stay current on new reimbursement strategies and to make measured decisions on the future of their practice. Many wonder if becoming a hospital employee is the best way to go to secure their financial outlook. Others might prefer to stay independent and wait to see what might happen once the dust settles and they can strategize more clearly. Hospitals are typically ill prepared themselves for the advent of large scale physician employment, as there are potential ramifications to their medical staff relationships and to their organizational bottom line. Most know just enough to be uneasy about the changes and are unnerved with the idea of trying to keep up with everything. Our expert team navigates the ever-changing health care administration landscape so that you can focus on the most important part of your practice – patient care.
ON CALL MAGAZINE QUARTER TWO 2012 / FEATURE - SPECIALIST PARTICIPATION IN ACO’S 15 18
Building Stronger Communities Together
A Health Reform Conundrum:
Specialist Participation in ACOs
By:Heather Patricia C. Corbett and Morgan Stanley Smith Barney is proud to support the Palm Beach County Medical Society Patricia Corbett, CFP® Vice President Financial Advisor 595 S. Federal Highway, 4th Floor Boca Raton, FL 33432 561-393-1535 patricia.c.corbett@mssb.com www.fa.smithbarney.com/pattycorbett
© 2011 Morgan Stanley Smith Barney LLC. Member SIPC.
NY CS 6693029 04/11
S. Miller, Esq.
The government has taken an active role in shaping the way that health care will be provided in the future by passing the controversial Patient Protection and Affordable Care Act (“PPACA”). Shortly thereafter, Congress, recognizing there were a number of provisions in PPACA that needed further refinement, enacted the Health Care and Education Reconciliation Act of 2010 (“HCERA”). PPACA and HCERA are collectively referred to as the Affordable Care Act (“ACA”). Congress included provisions in ACA to restructure the traditional fee-for-service reimbursement system currently used by the Medicare program to a system that reforms care delivery and compensates providers who meet certain cost and quality criteria. One such provision is the Medicare Shared Savings Program (“MSSP”). On November 3, 2011, the Centers for Medicare & Medicaid Services (“CMS”) published the final rules (the “Final Rule”) setting forth the parameters for the MSSP namely, the formation of organizations that will take responsibility for the overall care of a patient and which CMS refers to as Accountable Care Organizations (“ACOs”). ACOs must, among other things, be able to: (i) coordinate the full continuum of patient care across multiple delivery sites using electronic medical records, (ii) use technology to measure, monitor, and report quality, clinical and financial performance, (iii) be capable of reducing the cost of providing health care to their patients, and (iv) adhere to guidelines for diagnosis and treatment. The Final Rule defines an ACO as a legal entity that has a certain Taxpayer Identification Number (“TIN”), and which is comprised of one or more “ACO participants”. An ACO participant is an individual or group of provider(s) and supplier(s) (e.g. hospitals, physicians, and others involved in patient care) that are identified by a Medicare-enrolled TIN. Under the MSSP, providers who participate in an ACO that meets certain cost and quality criteria will be entitled to share in any cost savings achieved by it. For the time being, ACOs will only be able to share in those cost savings derived from Parts A and B of the Medicare program. 1. P atient Protection and Affordable Health Care Act of 2010, Pub. L. no. 111-148, 124 Stat. 119 (March 2010). 2. Health Care and Education Reconciliation Act of 2010, Pub. L. no. 111-152, 124 Stat. 1029 (March 2010). 3. P PACA at § 3021 and 3022. 4. Id. at § 3022, Pub. L. no. 111-148, 124 Stat. 119 (2010), as modified by HCERA § 10307, Pub. L. no. 111-152, 124 Stat. 1029 (2010). 5. 42 C.F.R. § 425.20 6. PPACA at § 3021, 3022.
Senior Counsel, Broad and Cassel
Many in the health care industry have been focusing on how primary care physicians can increase their earnings and leverage in the health care industry by forming an ACO and serving as the “gate keeper” of their patients’ health care. There has been less immediate focus on the role that specialists will play in an ACO. One of the concerns of specialists who are interested in joining an ACO is their ability to participate in more than one ACO. In the Final Rule, CMS included provisions that provide flexibility for specialists to participate in multiple ACOs. However, specialists may not have as much flexibility as the Final Rule appears to provide to them. A beneficiary is assigned to an ACO based on the physician that provides the plurality of primary care services to that beneficiary. An ACO participant’s TIN, and its associated physicians “upon which beneficiary assignment is dependent,” must be exclusive to one ACO. If beneficiary assignment is not dependent on the ACO participant’s TIN, an ACO participant and its associated physicians may participate in multiple ACOs. Therefore, when a beneficiary assignment is made to an ACO, any physician assigned a beneficiary will likely cause that physician’s group to be exclusive to one ACO since the assignment of the patient is based on that physician’s TIN. Moreover, even when an ACO participant does not have primary care physicians, if one of its specialists provides the plurality of primary care services to a beneficiary, and that beneficiary does not receive primary care services from any primary care physician, that beneficiary will be assigned to the ACO based on that specialist’s TIN. The specialist physician will then be treated like a primary care physician in that he or she (and other physicians billing under the ACO participant’s TIN) may only participate in one ACO. At first glance, the Final Rule appears to provide specialists with the flexibility to belong to multiple ACOs. However, whether intended or not, many specialists may find their options are foreclosed by virtue of the nature of the services other physicians under their TIN render, or the services they render as part of their practices.
Heather Siegel Miller is senior counsel in the Boca Raton and Miami offices of the statewide law firm, Broad and Cassel. A member of the Firm’s Health Law Group, Heather focuses her practice on health law and complex healthcare transactions on behalf of physicians and hospitals. She is a member of the current class of Leadership Palm Beach and has been named for the past two years as a “Rising Star” by Super Lawyers Magazine. She may be reached at hmiller@broadandcassel.com or 561-218-8861.
ON CALL MAGAZINE QUARTER TWO 2012 / FEATURE - INFORMED CONSENT CASE STUDY
17 20
CASE STUDY: LACK OF INFORMED CONSENT COMPLICATED BY RECORD ALTERATION By: Robert E. White, Jr. EDITOR’S NOTE: THIS CASE STUDY ANALYSIS REFLECTS AN ACTUAL THE DOCTORS COMPANY/FPIC CASE.
CASE ANALYSIS A 74-year-old male was seen in consultation by the insured dermatologist for revision of a long, contracted scar resulting from bypass surgery with complaint of pain immediately below the xiphoid process. The insured performed revision surgery on the scar in the lower abdomen, including a skin graft taken from the right arm. Consent for the procedure indicated “excision with local flap—in the chest area.” Postoperatively the patient complained of continued pain and inadequate scar revision. The dermatologist later argued that a “staged” approach had been taken, starting with the lower abdomen. The patient then underwent revision by a plastic surgeon to correct the contracted chest scar. Suit was filed alleging lack of informed consent and negligent performance by the dermatologist. The treating plastic surgeon testified that there was a departure in the standard of care relative to informed consent. Investigation revealed that the dermatologist did not adequately document his pre-op discussion and later admitted to “editing” his office notes regarding same. Consequently, settlement of the case was necessitated.
RISK MANAGEMENT DISCUSSION Lack of informed consent is one of the most prevalent legal issues in medical malpractice claims, yet one of the most easily avoided types of allegations. Frequently, such allegations are directly tied to unrealistic patient expectations. Patient education is inherent to the informed consent process and essential for establishing realistic expectations. Through the informed consent process, physicians can proactively manage patient expectations, improve diagnostic accuracy, and increase the likelihood of adherence to therapeutic regimens. Loss prevention measures shown to deter lawsuits before they are pursued and preserve defenses necessary to defeat the unavoidable claim include: Provide a detailed yet simplistic explanation of proposed treatments or procedures.
DISCLOSE: • The nature of the patient’s illness • The nature of the proposed therapy • Reasonable alternative therapies to the proposed therapy
Sr. Vice President, Regional Operating Officer The Doctors Company/FPIC/APAC
• The chance of success of the proposed therapy or the likely results • The substantial risks inherent in the therapy and the potential hazards • Provide an opportunity for the patient to ask questions. Encourage interactive discussion. • Utilize the “Reasonable Person” standard. • The more elective the procedure, generally the greater the degree of disclosure needed. • Disclose those complications that are most frequent or most severe. • Offer to disclose other, less frequent or severe complications if the patient desires. • Assess the patient’s ability to understand and process the information being provided. • Document all informed consent discussions, including questions and answers. • Do not delegate responsibility for the informed consent discussion. • Obtain informed consent before every test, procedure, treatment, or prescription if material risks are involved. • Know that materiality of risk may vary by patient and clinical situation. • Obtain informed consent on each occasion that there is a significant change in treatment or medication if a material risk is involved. • Disclose generally recognized material risks associated with the proposed treatment or procedure in terms of their degree of frequency and severity. • Implied consent in emergency situations remains unchanged. • Utilize specific consent forms. • Don’t be a salesperson! Don’t guarantee the result. • Seek legal or risk management advice when uncertainty arises. This information 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. The Doctors Company/FPIC 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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ON CALL MAGAZINE QUARTER TWO 2012 / FEATURE - PAST PRESIDENTS 22
FEATURE - TB TESTING / ON CALL MAGAZINE QUARTER TWO 2012
Presidents
WHAT’S NEW IN
PAST
TB TESTING? By:
PALM BEACH COUNTY MEDICAL SOCIETY 1919-2011
Savita Kumar, MD
We have many challenges to eliminate Tuberculosis from the USA due to HIV co-infection, not screening high risk population, and not diagnosing TB infection early with newer and reliable tests. Targeted Testing: Targeted testing is a TB control strategy used to identify, evaluate and treat persons who are at high risk for latent tuberculosis infection (LTBI) or at high risk for developing TB disease once infected with M. tuberculosis. As part of their routine evaluation, health care providers should identify and test high risk persons. Currently there are two methods available for the detection of M. tuberculosis infection in the US: • Mantoux tuberculin skin test (TST) • Interferon-gamma release assays (IGRAs) A negative reaction to a TST or IGRA does not exclude the diagnosis of LTBI or TB disease. Interferon-Gamma Release Assays (IGRAs) IGRAs detect the presence of M. tuberculosis infection by measuring the immune response to TB proteins in whole blood. IGRAs cannot differentiate between LTBI and active TB disease. As with the TST, additional tests are needed to diagnose or rule out TB disease. IGRAs may be used for surveillance purposes or to identify people who are likely to benefit from treatment, including people who are or will be at increased risk of progression to TB disease if infected with M. tuberculosis. Two IGRAs are commercially available and approved by the U.S. Food and Drug Administration (FDA) as aids in diagnosing M. tuberculosis infection. You can order them from your lab. The blood specimen has to be processed at the point of collection with in 12-24 hours of collecting the blood. • •
QuantiFERON® - TB Gold In-Tube test (QFT-GIT); and T-Spot®. TB test.
General Recommendations for the Use of IGRAs An IGRA may be used in place of (but not in addition to) a TST in all situations in which CDC recommends a TST to aid in diagnosing M. tuberculosis infection. Some IGRA benefits are: • Patient does not need to return for second visit as they do with TST reading. • Preferred for testing persons who have received BCC (as a vaccine or for cancer therapy). • Generally should not be used for testing children younger than 5 years of age unless used with TST. • May be used in place of TST to test recent contacts of persons with infectious TB disease with special consideration for followup testing:
• IGRAs offer the possibilito of detecting M. tuberculosis infection with greater specificity than with a TST; • Data on the ability of IGRAs to predict subsequent TB are limited; • If IGRAs are to be used in contact investigations, negative results obtained prior to 8 weeks typically should be confirmed by repeating the test 8 to 10 weeks after the end of exposure; • It may be used in place of a TST for periodic screening that addresses occupational exposure to TB disease (e.g., surveillance programs for health care workers). • IGRAs do not boost subsequent test results and can be completed following a single patient visit.
Bacteriologies Examination of Clinical Specimens: TB disease can occur in almost any anatomical site; thus a variety of clinical specimens other than sputum (e.g. urine, cerebrospinal fluid, and pleural fluid, pus, or biopsy specimens) may be submitted for examination when extrapulmonary TB disease is suspected. AFB Smear: In addition to AFB smear NAA tests are used to amplify DNA and RNA segments to rapidly identify the microorganisms in a specimen. CDC recommends that NAA testing be performed on at least one respiratory specimen from each patient with signs and symptoms of pulmonary TB for whom a diagnosis of TB is being considered but has not yet been established, and for whom the test result would alter case management to TB control activities, such as contact investigation. Clinicians should interpret all laboratory results in the context of the clinical situation. A single negative NAA test result should not be used as a definitive result to exclude TB disease, especially when the clinical suspicion of TB information in making clinical decisions, to expedite testing for an alternative diagnosis, or to prevent unnecessary TB disease treatment. Many TB patients have negative AFB smears with a subsequent positive culture. Negative smears do to exclude TB disease. Direction Detection of M. tuberculosis in Clinical Specimen Using Nucleic Acid Amplification (NAA) NAA tests are used to amplify DNA and RNA segments to rapidly identify the microorganisms in a specimen. NAA testing can reliably detect M. tuberculosis bacteria in specimens in hours as compared to 1 week or more for culture. • Earlier laboratory confirmation of TB disease • Earlier treatment initiation • I nterruption of transmission by early diagnosis, respiratory isolation and appropriate treatment • Earlier, more efficient use if respiratory isolation Culture remains the gold standard for laboratory confirmation of TB disease, and growing bacteria are required to perform drugsusceptibility testing and genotyping. For some cases if the clinician suspects TB disease, it can be reported and treated for TB as a clinical case of TB without AFB smear or culture positive for M tuberculosis. Report TB suspect and cases: Surveillance, TB Program, Palm Beach County Health Department Tel: 561-803-7342 Fax: 561-840-0195
For comments and questions, contact Savita Kumar, MD, MSPH at Savita_kumar@doh.state.fl.us or 561-803-7316. Reference for detail information: 1.Core Curriculum on Tuberculosis: What the clinician should know, www.cdc.gov/tb (to download or order a free copy use CDC Publication on line ordering system)
1920’s
1950’s
1930’s
1960’s
1940’s
1970 ’s 2000’s
1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929
1930 1931 1932 1933 1934 1935 1936 1937 1938 1939
1940 1941 1942 1943 1944 1945 1946 1947 1948 1949
C. M. Merrill, MD C. M. Merrill, MD L. A. Peek, MD R.O. Cooley, MD T.D. Gunter, MD W.E. Van Landingham, MD J.A. Powell, MD R.O. Cooley, MD G. M. Dawson, MD J.A. Powell, MD F.K. Herpel, MD
V.D.Stone, MD W.L. Shackleford, MD L.J. Netto, MD S.W. Fleming, MD W.Y. Sayad, MD W.W. George, MD L.M. Rozier, MD B.B. Sory, MD V.M. Johnson, MD R.G. Lewis, MD
J.H. Pittman, MD W.O. Arnold, MD J.R. Sory, MD K.E. Montgomery, MD J.L. Carlisle, MD R.H. Baldwin, MD (resigned) E.W. Stephens, MD (VP to P) G.W. Heath, MD C.J. Derrick, MD V. Clarholm, MD W.E. Bippus, MD
1950 1951 1952 1953 1954 1955 1956 1957 1958 1959
1960 1961 1962 1963 1964 1965 1966 1967 1968 1969
1970 1971 1972 1973 1974 1975 1976 1977 1978 1979
C.M. Harris, MD R.M. Overstreet, MD C.M. Peek, MD G.W. King, MD T.E. Daly, MD E.W. Brown, MD W.R. Newbern, MD E.W. Wood, MD W.L. Shackleford, MD Y.A. Staton, MD
W.F. Ande, MD W.H. Proctor, MD James F. Cooney, MD S.A. Manalan, MD R.D.D. Hoover, MD David W. Martin, MD Vernon B. Astler, MD C.E. Andrews, MD J. Russell Forlaw, MD Bernard Kimmell, MD
J.R. Brandon, MD Jerry F. Cox, MD Richard B. Moore, MD Curtis W. Cannon, MD George L. Ford, MD Dick L. Van Eldik, MD Charles Metzger, MD Reginald J. Stambaugh, MD Arthur L. Trask, MD Luis R. Guerrero, MD
1980’s 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989
John Corbitt, MD Ben R. Thebaut, MD V.A. Marks, MD Richard C. Cavanaugh, MD Lee A. Fischer, MD William T. Romanos, Jr., MD R. Robert Eastridge, MD Milton R. Tignor, MD Gilbert R. Panzer, MD Joseph F. Phillips, MD
1990’s 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
John Hildreth, MD McKinley Cheshire, MD Frank E. Kucera, MD Mas G. Massoumi, MD Robert A. Brodner, MD Nathan E. Nachlas, MD Brent M. Schillinger, MD Douglas D. Dedo, MD Jana K. Rasmussen, MD Jean M. Malecki, MD
G. Clay Baynham, MD Bradley S. Feuer, DO, JD Ross G. Stone, MD Alan B. Pillersdorf, MD Stuart B. Himmelstein, MD Ivy Faske, MD Mark A. Rubenstein, MD Jose F. Arrascue, MD Daniel R. Higgins, MD Maureen Whelihan, MD
2010’s
2010 Lawrence Gorfine, MD 2011 James J. Byrnes, MD
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ON CALL MAGAZINE QUARTER TWO 2012 / FEATURE - NEW MEMBER PROFILE
MED MEMO / ON CALL MAGAZINE QUARTER TWO 2012
Med memo
Quarter Two 2012
SAVE THE DATES June 19, 2012 Cocktail Reception Palm Beach Yacht Club June 30, 2012. Miami Marlins vs. Philadelphia Phillies Baseball Game September 27-28, 2012. Future of Medicine Summit VI, Palm Beach County Convention Center December 1, 2012. Annual Gala, Kravis Center Cohen Pavilion
HELP ELECT PRO-MEDICINE CANDIDATES BY SUPPORTING MEDPAC MEDPAC is the bipartisan political action committee of the Palm Beach County Medical Society. Its goal is to support and elect pro-medicine candidates at the state and local level. Every year, there are critical legislative votes made in Tallahassee that have a major impact on the practice of medicine. MEDPAC has proven to be valuable asset in educating legislators about the concerns of medicine. Visit www.pbcms.org/medpac to learn more and download an application. GRASSROOTS EFFORT TO SUPPORT THE MEDICARE PATIENT EMPOWERMENT ACT The AMA has launched a grassroots initiative to generate public support for Congressional passage of H.R. 1700 and S. 1042, the Medicare Patient Empowerment Act, introduced by Rep. Tom Price (R-GA) and Sen. Lisa Murkowski (R-AK), respectively. This legislation, based on policy developed by the AMA House of Delegates, will create a new Medicare option to allow patients and physicians to enter into private contract arrangements without penalties for either party. The focus is on securing House and Senate cosponsors for this important legislation. A range of resource material to support this work has been developed. Visit http://mymedicare-mychoice.org.
PBCMS FMA DELEGATES SERVE YOU – OUR MEMBERS A unique benefit of PBCMS membership is the opportunity to become actively involved in matters that affect the medical profession. PBCMS will have 21 delegates representing our physicians at the FMA Annual Meeting to be held July 27-29 at the Boca Raton Resort & Club. There is no cost for registration for FMA members. Thank you to the PBCMS members who serve as FMA delegates: Hatem Abou-Sayed, MD; Jose Arrascue, MD; Stephen Babic, MD; Shawn Baca, MD; Alan Bauman, MD; James Byrnes, MD; Cynthia Clayton, MD; James Goldenberg, MD; Larry Gorfine, MD; Marc Hirsh, MD; James Howell, MD; K. Andrew Larson, MD; Beth-Ann Lesnikoski, MD; Harish Madhav, MD; Emanuel Newmark, MD; Norman Pevsner, MD; Alan Pillersdorf, MD; Mark Rubenstein, MD; Brent Schillinger, MD; Ross Stone, MD; Kenneth Woliner, MD; Ronald Zelnick, MD; and Jack Zeltzer, MD. EDUCATIONAL OPPORTUNITIES July 27-29. Florida Medical Association Annual Meeting. Boca Raton Resort & Club, Boca Raton, FL. www.celebratemedicine.com/2012 Sept. 27-28. Future of Medicine Summit VI. Palm Beach County Convention Center, West Palm Beach. www.pbcms.org/FOMSummit NEW ON CALL ADVERTISING RATES OnCall is published quarterly, and new advertising rates can be found at http://www.pbcms.org/advertise.
Follow Us! For the latest news & information on PBCMS
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PBCMS Feature Member: Andrew R. Berkman, MD
PBCMS would like to welcome new member Andrew R. Berkman, MD to our well-regarded group of physicians. Dr. Berkman joined PBCMS in February 2012 and currently is an Internal Medicine physician at Medical Specialists of the Palm Beaches. After earning his Bachelor of Science in Psychology from the University of Florida, Dr. Berkman attended Tufts University for his Masters in Developmental Psychology, then proceeded to earn his medical degree at the University of Miami School of Medicine. He completed residency training in Internal Medicine at the University of Florida College of Medicine. Dr. Berkman is Board Certified in Internal Medicine, and has hospital privileges at JFK Medical Center. Besides his impressive professional credentials, here is some more information about Dr. Berkman. success
Q: Why did you join PBCMS? A: T he future of health care is changing rapidly. I am concerned that physicians do not have an equal seat at the table in the negotiation of how our nation’s health care dollars are going to be spent or how future regulations concerning medical homes, ACO’s, and Medicare are going to affect private practice medicine. As a private practice internist for nearly three years I feel PBCMS represents my goal of helping to ensure that the future of health care is bright for both patients and doctors.
Q: Where did you grow up? A: I was born in Dobbs Ferry, New York, but I have been a Florida resident for more than 20 years. Q: What is your favorite restaurant? A: That’s easy, Chez Jean Pierre in Palm Beach. Q: What do you enjoy doing when you’re not working? A: Relaxing with friends and family and watching Gator Football...Go Gators! Q: Any other information that you want our readers to know? A: Before becoming an internist I performed IQ testing on children and adults.
Welcome Dr. Berkman! Note: If any new members would like to be featured in future issues of On Call, please contact Tara Auclair Ryan at tarar@pbcms.org or call 561-433-3940.
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ON CALL MAGAZINE QUARTER TWO 2012 / NEWS & CLASSIFIEDS
NEWS & CLASSIFIEDS / ON CALL MAGAZINE QUARTER TWO 2012
Med SocietyNews PALM BEACH COUNTY MEDICAL SOCIETY WELCOMES NEW MEMBERS March to April 2012 David J. Bjorkman, MD Phone: 561-297-4341 Fax: 561297-0914 Specialty: Gastroenterology Medical School: University of Utah Internship: Brigham & Women’s Hospital (Internal Medicine) Residency: Brigham & Women’s Hospital (Internal Medicine) Fellowship: Brigham & Women’s Hospital (Gastroenterology) Board Certification: Internal Medicine, Gastroenterology
Lindsey Henson, MD 777 Glades Rd., BC-71, Boca Raton, FL 33431 Phone: 561-297-2219 Fax: 561-297-2221 Specialty: Anesthesiology Medical School: UCLA 1976-1980 Internship: Harbor UCLA Medical Center 1980-1981 Residency: UCLA Medical Center 1989-1991 Fellowship: Harbor UCLA Medical Center 1981-1983 Board Certification: American Board of Anesthesiology Hospital Affiliations: FAU Faculty
Dudley Brown, MD 1800 Forest Hill Blvd., Ste. B13-B15, West Palm Beach, FL 33406 Phone: 561-357-6277 Fax: 561-9679895 Specialty: Obstetrics and Gynecology Medical School: University of Florida Residency: Cook County Hospital 19932003 Board Certification: American Board of Obstetrics and Gynecology Hospital Affiliations: Good Samaritan Medical Center
Agustin Ibarrola, MD 1397 Medical Park Blvd., Ste. 100, Wellington, FL 33414 Phone: 561-798-1515 Fax: 561-7983425 Specialty: General Surgery Medical School: University Michoacan San Nicolas 1975-1982 Internship: Waterbury Hospital 1990-1991 Residency: Central Hospital Petroleos 1984-1988 Fellowship: Tulane University 1989-1990 Board Certification: American Board of General Surgery Hospital Affiliations: JFK Medical Center, Wellington Regional Medical Center, Palms West Hospital
Arul B. Chidambaram, MD 1397 Medical Park Blvd., Ste. 100, Wellington, FL 33414 Phone: 561-798-1515 Fax: 561-798-9282 Specialty: General Surgery Medical School: Madras Medical College India 1987 Internship: Madras Medical College 19851986 Residency: Beth Israel Medical Center 1994-1999 Board Certification: American Board of General Surgery Hospital Affiliations: JFK Medical Center, Wellington Regional Medical Center, Palms West Hospital Joseph Forstot, MD 1050 NW 15th St., Ste. 212, Boca Raton, FL 33486 Phone: 561-368-5611 Fax: 561-361-6818 Specialty: Rheumatology Medical School: University of Miami 1975 Internship: University of Miami 1975-1976 Residency: University of Miami 1976-1978 Fellowship: University of Colorado 1978-1979 Board Certification: Rheumatology Hospital Affiliations: Boca Raton Regional Hospital, Delray Medical Center, Pinecrest Rehabilitation Hospital Marianne Hazelitt, DO Phone: 561-389-3552 Fax: 561408-0227 Medical School: Touro University, NV Specialty: Resident Internal Medicine Internship: JFK Intern Residency: JFK Medical Center
Waqar Khan, MD 1395 S. State Road 7, Ste. 400, Wellington, FL 33464 Phone: 561-424-5555 Fax: 561-424-5550 Specialty: Cardiology Medical School: King Edward Medical College, Lahore, Pakistan 1980-1986 Internship: St. Louis University School of Medicine 1989-1990 Residency: University of Texas Medical School 1990-1992 Fellowship: University of Texas Medical Branch at Galveston 1992-1994 Board Certification: American Board of Cardiovascular Disease Hospital Affiliations: Wellington Regional, Delray Medical Center, Bethesda Memorial Hospital Edu A. Kirindongo, MD 601 N. Congress Ave., Ste. 404, Delray Beach, FL 33445 Phone: 561-541-5377 Fax: 561-793-6355 Specialty: Family Medicine Medical School: Loma Linda University 1984-1989 Internship: Howard University 1989-1990 Residency: MC Keesport 1990-1994 Hospital Affiliations: Bethesda Memorial Hospital, Palms West Hospital, Palm Beach Gardens Hospital
Savita Kumar, MD 850 Avenue P, Riviera Beach, FL 33404 Phone: 561-803-7316 Fax: 561-840-0195 Specialty: Preventative Medicine Medical School: Meerut University 1980-1982 Residency: Palm Beach County Public Health 1982 Board Certification: American Board of Preventative Medicine Hospital Affiliations: Department of Health Carlos Leon, MD 5511 S. Congress Ave., Ste. 125, Atlantis, FL 33462 Phone: 561-439-0961 Fax: 561-439-0963 Specialty: Gastroenterology Medical School: Universidad Central Del Caribe 1992-1996 Residency: MCP Hahnemann University 1996-1999 Fellowship: MCP Hahnemann University 2000-2003 Board Certification: American Board of Internal Medicine, IMGastroenterology Hospital Affiliations: JFK Medical Center Ann-Jerry Peters, MD Phone: 561-291-6997 Fax: 888-5453147 Specialty: Primary Care/Preventative Medicine Medical School: University of Medicine and Dentistry of New Jersey Internship: St. Barnabas Medical Center Residency: St. Elizabeth Health Center Fellowship: Brooks Air Force Base Board Certification: American Board of Family Medicine Malayandi Rajamanickam (Raja), MD Phone: 561-7436928 Fax: 561-769-9496 Specialty: Retired (Otolaryngology) Medical School: Madras Medical College 1953-1957 Residency: Long Island College Hospital 1969-1970, St. Luke’s Hospital Center 1970-1973 Board Certification: American Board of Otolaryngology
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Padmanabhan Siddharth, MD Phone: 561-624-6115 Specialty: Retired (General Surgery) Medical School: Madras Medical College 1958 Emmanouil Tsounias, MD 5325 Greenwood Ave., West Palm Beach, FL 33407 Phone: 561-558-1212 Fax: 561-8814540 Specialty: Pediatric Cardiology Medical School: GR. T. Popa University of Medical and Pharmacy 1991-1997 Internship: Flushing Hospital Medical Center 2004-2005 Residency: Flushing Hospital Medical Center 2005-2007 Fellowship: University of Texas- Medical School at Houston Board Certification: American Board of Pediatrics Hospital Affiliations: St. Mary’s Medical Center, West Boca Medical Center Korey Ullrich, MD 105 NW 15th St., Ste. 212A, Boca Raton, FL 33486 Phone: 561-368-5611 Fax: 561-361-6818 Specialty: Rheumatology Medical School: University of Texas Health Science 2001-2005 Internship: University of Texas at Houston 2005-2006 Residency: University of Texas at Houston 20062008 Fellowship: University of Colorado-Denver 2009-2011 Board Certification: American Board of Internal Medicine Hospital Affiliations: Boca Raton Regional Hospital, Delray Medical Center
Classifieds Medical Suite: WPB 1840 Forest Hill Blvd., #201, 1,200 sf with 3 exam rooms, 2 offices, reception and business areas; ample parking; $1,900 per month. 561-801-0544 or joemschneider@yahoo.com. Primary Care Physician Wanted Three physicians in an established primary care practice are looking for an Internal Medicine or Family Practice physician. Excellent Opportunity for an ambitious physician. Competitive salary and benefits. Call 561-622-7699, fax 561-622-4651, or email to jgatyas@comcast.net.
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Palm Beach CMS - 8.5x11 - color - quarterly - On Call
WEST PALM BEACH, FL
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Palm Beach CMS - 8.5x11 - color - quarterly - On Call
RETURN SERVICE REQUESTED Palm Beach CMS - 8.5x11 - color - quarterly - On Call
We hate lawsuits. We loathe
Donald J. Palmisano, MD, JD, FACS Board of Governors, The Doctors Company Former President, American Medical Association Donald J. Palmisano, MD, JD, FACS Board of Governors, The Doctors Company Former President, American Medical Association
litigation. We help doctors head We hate lawsuits. We loathe off claims at the pass. We track litigation. We help doctors head new treatments and analyze We hate lawsuits. We loathe off claims at the pass. We track medical advances. We are head the litigation. We help doctors new treatments and analyze eyes in theatback of your off claims the pass. Wehead. track medical advances. We are the We CME and easy,analyze free, and newmake treatments eyes in the back of your head. online. do extra homework. medicalWe advances. We are the We make CME easy, free, and We goodofmedicine. eyesprotect in the back your head. online. We do extra homework. We your guardian angels. We are make CME easy, free, and We protect good medicine. We are We Thedo Doctors Company. online. extra homework. We are your guardian angels. We protect good medicine. We are The Doctors Company. We are your guardian angels. We are The Doctors Company.
Donald J. Palmisano, MD, JD, FACS Board of Governors, The Doctors Company Former President, American Medical Association
The Doctors Company is devoted to helping doctors avoid potential lawsuits. For us, this starts with patient safety. In fact, we have the largest Department of Patient Safety/Risk Management of any medical malpractice insurer. And, local physician advisory across the country. Whystarts do wewith The Doctors Company is devoted to helping doctors avoidboards potential lawsuits. For us, this go this far? Because sometimes thelargest best way to look outoffor the doctor is to start with the patient. patient safety. In fact, we have the Department Patient Safety/Risk Management of any The Doctors Company is devoted to helping doctors avoid potential lawsuits. For us, this starts To learn more about our medical liability program, callacross us at (800) 352-0320 or dowith medical malpractice insurer. And,professional local physician advisory boards the country. Why we patient safety. In fact, we have the largest Department of Patient Safety/Risk Management of any visit www.thedoctors.com. go this far? Because sometimes the best way to look out for the doctor is to start with the patient. medical malpractice insurer. And, local physician advisory boards across the country. Why do we To learn more about our medical professional liability program, call us at (800) 352-0320 or go this far? Because sometimes the best way to look out for the doctor is to start with the patient. visit www.thedoctors.com. To learn more about our medical professional liability program, call us at (800) 352-0320 or visit www.thedoctors.com. Endorsed by
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