Michigan Medicine

THE OFFICIAL MAGAZINE OF THE MICHIGAN STATE MEDICAL SOCIETY » VOL. 117 / NO. 2

March /April 2018

INSIDE Michigan Facing Ongoing

Hepatitis A Outbreak Page 8

Rx for Patient Safety:

Ask Me 3 Page 19

Health care is among the industries most affected by “customer satisfaction.’” Story begins on page 12. www.msms.org

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FEATURES & CONTENTS March / April 2018

08

Michigan Facing Ongoing Hepatitis A Outbreak

BY JACKLYN CHANDLER, M.S.

19

Rx for Patient Safety: Ask Me 3

BY VICTORIA H. ROLLINS, MHA, RN Contributed by The Doctors Company

COLUMNS 04 President's Perspective

BY CHERYL GIBSON FOUNTAIN, MD

06 Ask Our Lawyer

BY DANIEL J. SCHULTE, JD

10 Ask Human Resources

12

BY JODI SCHAFER, SPHR, SHRM-SCP

DEPARTMENTS 07 Welcome New Members 22 MSMS Educational Courses 24 In Memoriam 26 MSMS Medical Opportunities

COVER STORY

BY NICK DELEEUW FOR THE MICHIGAN STATE MEDICAL SOCIETY

Health care is among the industries most affected by ‘customer satisfaction.’

Read more about it beginning on page 12.

STAY CONNECTED!

MAR / APR 2018 |

michigan MEDICINE 3

MICHIGAN MEDICINE® Chief Executive Officer JULIE L. NOVAK

perspective

Managing Editor KEVIN MCFATRIDGE KMcFatridge@msms.org Marketing & Sales Manager TRISHA KEAST TKeast@msms.org Graphic Design STACIA LOVE, REZÜBERANT! INC. rezuberantdesign@gmail.com Printing FORESIGHT GROUP staceyt@foresightgroup.net Publication Office Michigan Medicine 120 West Street East Lansing, MI 48823 517-337-1351 www.msms.org All communications on articles, news, exchanges and advertising should be sent to above address, ATT: Trisha Keast.

Postmaster: Address Changes Michigan Medicine Hannah Dingwell 120 West Street East Lansing, MI 48823

Michigan Medicine®, the official magazine of the Michigan State Medical Society (MSMS), is dedicated to providing useful information to Michigan physicians about actions of the Michigan State Medical Society and contemporary issues, with special emphasis on socio-economics, legislation and news about medicine in Michigan.

The MSMS Committee on Publications is the editorial board of Michigan Medicine and advises the editors in the conduct and policy of the magazine, subject to the policies of the MSMS Board of Directors.

Neither the editor nor the state medical society will accept responsibility for statements made or opinions expressed by any contributor in any article or feature published in the pages of the journal. The views expressed are those of the writer and not necessarily official positions of the society. Michigan Medicine reserves the right to accept or reject advertising copy.

Products and services advertised in Michigan Medicine are neither endorsed nor warranteed

by MSMS, with the exception of a few.

Michigan Medicine (ISSN 0026-2293) is the official magazine of the Michigan State Medical Society, published under the direction of the Publications Committee. In 2018 it is published in January/February, March/April, May/ June, July/August, September/October and November/December. Periodical postage paid at East Lansing, Michigan and at additional mailing offices. Yearly subscription rate, $110.

Single copies, $10. Printed in USA. ©2018 Michigan State Medical Society

4 michigan MEDICINE | MAR / APR 2018

CHERYL GIBSON FOUNTAIN, MD, MSMS PRESIDENT

By Cheryl Gibson Fountain, MD, Michigan State Medical Society President

®

Getting It Right Matters

P

hysicians dedicate their entire lives to putting their patients first.

We’re focused each and every day on their wellbeing, their health, and their recoveries. With all that effort, it’s important we also go the extra

mile to ensure they’re fully satisfied with the care they’re receiving, from the reception area to the exam room.

In this edition of Michigan Medicine®, you’ll read about what the Michigan State Medical Society is doing to help you increase your patients’ satisfaction, through dynamic patient experience analysis, web presence monitoring, post-visit survey systems, our public-facing physician directory and more.

There was little wonder last year when Medical Economics published its top 10 list of challenges facing physicians and kicked the list off with patient satisfaction scores.

Yelp, RateMDs, Healthgrades.com and other patient review and referral services have made it as easy as a click of the mouse for patients to read what others have to say about a practice, and one positive review—or one negative one— can make a world of difference in whether or not the patient ever dials a provider’s phone number.

“In this edition of Michigan Medicine® you’ll read about what the Michigan State Medical Society is doing to help you increase your patients’ satisfaction, through dynamic patient experience analysis, web presence monitoring, postvisit survey systems, our public-facing physician directory and more.”

Getting it right matters, but none of it’s easy. That’s why MSMS has invested in support services and organizations to help their members through the process.

We hope you’ll enjoy the read and then get a hold of us here at the office and ask how we can help put you a step ahead maximizing patient satisfaction.

I also want to draw your attention to an important section on page 23 of this month’s edition, discussing continuing medical education requirements and your licensure. We’re making some important information available that you won’t want to miss.

You are doing incredible work and the world deserves to know it!

MAR / APR 2018 | michigan MEDICINE

5

ASK OUR LAWYER

2017 Prescribing Requirements Add Burdens to Physician Practice

By Daniel J. Schulte, JD, Michigan State Medical Society Legal Counsel

Q: Can you explain the new requirements for physicians when prescribing drugs?

In December, seven bills were

These laws fail, for the most part, to reflect

EFFECTIVE MARCH 31, 2018:

signed into law effecting

the concerns of and points raised by and advocated for by MSMS and other organi-

Physicians may not prescribe a controlled

controlled substance (with and

zations representing prescribers. There are

without opioids) prescribing

meaning of these laws and how they are to

and substance abuse disorder

several unanswered questions regarding the be applied and enforced. MSMS is working to educate its members and will be seeking

services. The Michigan

guidance/clarification. The following, in a

Legislature and the Governor’s

new requirements for physicians (the new

nutshell, is what is known regarding the

office enacted these laws in

laws apply to all prescribers).

response to well publicized

EFFECTIVE MARCH 27, 2018:

concerns regarding drug misuse, diversion and addiction.

Physicians who treat a patient for an opioid-related overdose are required to provide information to the patient on “substance

substance listed in schedules 2 to 5 unless the physician is in a “bona fide prescriber-patient relationship” with the patient.

This requires that a treatment or counseling relationship between the physician and patient exists in which: (a) the physician has reviewed the patient’s relevant medical or clinical records and completed a full assessment of the patient’s medical history and current medical condition including a relevant medical evaluation of the patient conducted in person or via telehealth; and

abuse disorder services”. It is not known

(b) the prescriber has created and main-

at this time whether the Michigan De-

tained records of the patient’s con-

partment of Health and Human Services

dition in accordance with medically

(MDHHS) will be developing this infor-

accepted standards.

mation for physicians to use in fulfilling this requirement.

In addition, the physician must either provide follow up care to monitor the efficacy

When administering a controlled substance

of the use of the controlled substance or re-

directly to a patient, physicians must report

fer the patient to the patient’s primary care

the dispensing to the Michigan Automated

physician or another physician acceptable

Prescription System (MAPS).

to the patient for follow up care.

DANIEL J. SCHULTE, JD, MSMS LEGAL COUNSEL IS A MEMBER AND MANAGING PARTNER OF KERR RUSSELL

6 michigan MEDICINE

| MAR / APR2018

Welcome New Members Berrien Richard Lichtenberg, MD

Clinton Osman Ahmedfiqi, MD

Clark Conant, III, DO Matt Rosenberg, MD Channing Smith, MD

Srdjan Ostric, MD Edward Shields, MD Lawrence Madden, MD

Livingston

Oakland

Rene Franco Elizondo, MD Pouya Abhari, MD Muhammad Miran, MD Saqib Nakadar, DO Mamoon Elbedawi, MD

Jonathan Gupta, MD Sharon McManus, DO, FAAP

Hillsdale

Catherine Bodnar, MD

Brett Bender, DO Wendy McFalda, DO Dianne Schlachter, MD Dwijen Misra, MD Ajay Raman, DO Jennifer Swearingen, MD Karl Kado, MD Matthew Osher, MD

Muskegon

Saginaw

Matthew Sunderlin, MD Byron Hissom, Jr, MD Janice Kim, MD Marette Zaki, MD Jennifer Bradley, MD Kristina Gaunt, MD

Michael Fazzini, DO Ali Hachem, MD Albert Linden, MD, PhD Chandramouli Mandalaparty, DO Matthew Newman, MD Zhilwan Rahim, DO

Genesee

Deborah Havens, DO

Ingham Sara Cramton, MD

Jackson Gene Kielhorn, DO, MPH William Leppert, DO

Macomb

Midland

Venkataramana Somisetty, MD Haritha Yedla, DO Christopher DeVries, MD Jennifer Henrich, MD Anushka Magal, MD Alexa Shepherd, MD Menelito Lilagan, DO

Washtenaw Tara Shankar, MD Claire Ward, MD Stephen Bloom, DO

Wayne Gina Buccalo, MD Erin Miller, MD

MAR / APR 2018 |

michigan MEDICINE 7

MDHHS UPDATE

Michigan Facing Ongoing Hepatitis A Outbreak Jacklyn Chandler, M.S., Outreach Coordinator, MDHHS Division of Immunization

Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in Michigan. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. While the outbreak cases began in Southeast Michigan, cases with the outbreak strain have been confirmed as far north as Grand Traverse County.

F

rom August 1, 2016, to January 24, 2018, there have been 715 people infected with hepatitis A virus (HAV) in Michigan, of which 582 people have been hospitalized. Outbreak cases have ranged in age from less than 1 year to 90 years (median 41 years), and 65.7 percent are male.

Forty-nine percent of cases disclosed substance abuse. Among male cases, 14.3 percent report sexual contact with men (MSM). Among cases with available laboratory results, 2.5 percent have a history of hepatitis B, while 27.2 percent have a history of hepatitis C. Twenty-four people have died from hepatitis A, which could have been prevented with a safe and effective vaccine.

Unfortunately, most adults are not protected against hepatitis A. With low vaccine coverage across populations, infection persists in a community. According to Michigan Care Improvement Registry (MCIR) data from January 21, 2018, the estimated proportion of adults 19 years or older who received at least 1 dose of hepatitis A vaccine was only 13.4 percent. While adult vaccination record submission to the MCIR is not required, over 7.7 million Michigan adults have an immunization record in the registry.

Due to the ongoing and evolving nature of this outbreak, seek the most current information including the current confirmed cases and affected jurisdictions at www.mi.gov/hepatitisAoutbreak.

8 michigan MEDICINE

| MAR / APR2018

In previous hepatitis A outbreaks, hospitalization rates have been documented as less than 40 percent; however, Michigan jurisdictions associated with this outbreak are reporting case hospitalization rates over 80 percent. The following populations are thought to be at greatest risk in this outbreak setting and vaccination efforts are ongoing: Persons who use injection or non-injection drugs Men who have sex with men

Whether patients are from the risk groups identified in the current Michigan outbreak or the risk groups recommended per

Persons currently homeless or in temporary housing

Advisory Committee on

Persons who have been recently incarcerated

Immunization Practices

Persons with chronic liver disease (including hepatitis B, C, or cirrhosis)

(ACIP) guidelines:

The public health and infection control costs that go with outbreak response to vaccine-preventable pathogens are staggering to a community in both financial and societal costs. Public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. MDHHS requests your partnership to end this outbreak. All health care providers are encouraged to practice their role in preventing hepatitis A infection and further transmission: Assess for signs and symptoms of hepatitis A infection; Educate patients on how to minimize risk of infection through hygiene, disinfection, and vaccination; Routinely screen for population risk groups and vaccine status; Recommend and offer vaccine to patients identified at-risk Remember, hepatitis A vaccinations are covered by Medicaid and most insurances. For patients without insurance coverage, please refer to your local health department. Thank you for your commitment to protecting the people of Michigan and for your partnership.

1. Refer patients to known immunization providers in the area if you do not stock hepatitis A vaccine.

2. Follow up to confirm that patients received recommended vaccines that you referred them to get from other immunization providers.

MAR MAR/ /APR APR2018 2018 | |

michigan michiganMEDICINE MEDICINE 99

ASK HUMAN RESOURCES

Court Time: Managing Employees with Legal Obligations

By Jodi Schafer, SPHR, SHRM-SCP

Q: Several of my employees have been spending a lot of time in court lately.

We have had just about everything— divorce, child custody, probate issues and parental guardianship. We also had a number of jury duty obligations.

As you can imagine, these absences caused a great deal of disruption in the office.

Is there anything I can do to minimize this impact?

10 michigan MEDICINE

| MAR / APR2018

Unfortunately, there is not much you can do about staff members’ legal obligations. In Michigan, we must comply with the Revised Judicature Act of 1961 (MI STAT. Sec 600.1348). The law protects employees who are called for jury duty from any discipline. However, you are not completely helpless. You can control certain aspects of the process, which may minimize the impact. To do this you will need a policy that communicates: 1. Notification of a court related obligation and 2. If and how they will be compensated.

When a person is subpoenaed, s/he must report, whether as a witness, defendant or plaintiff, or as a potential juror. Employees should, however, know of their legal obligation to attend a hearing or serve on a jury well in advance of the date. This allows you to establish a policy that requests employees inform you as soon as they are aware of this legal obligation. This provides time to line up a replacement. Notice I used the word “request” rather than require. There is really no way to require notice since you are unable to place consequences on an

employee’s failure to notify. Michigan law disallows any discipline against employees who must miss work due to jury duty obligations. There can be no adverse impact if the employee does not notify you on a timely basis. So why have the policy? Most employees are compliant and will provide you the information.

You also have control over compensation. You are not required to compensate non-exempt employees for time appearing in court. You may, however¸ choose parameters for compensation as long as these parameters are within the regulations of the Fair Labor Standards Act (FLSA). For example, you may opt to provide compensation to employees who are on jury duty but not pay for employees who have been arrested and are missing work while on trial. This policy must be carefully drafted to avoid any problem with regulations and possible unintended claims of discrimination. For example, in Michigan marital status pro-

tected, so if you pay for employees on jury duty yet you do not compensate employees for court for matters of divorce, separation, for custody, you may find yourself trying to defend a claim of unintentionally discrimination based on marital status.

requires employees to call in the morning of the assigned Michigan law days to learn if they have disallows any to report. If you’ve already discipline against found someone to cover employees who for that person or you canmust miss work celed his/her appointments, due to jury duty you may not need them to obligations. return to work. You may also request employees return to work When it comes to compensation, emas soon as their obligation had been met ployees designated as exempt (salary) for that day. Since Michigan law prohibmust be paid for the week to maintain its mandating employees return to work their status as exempt. So, if an exempt on the same day, I again used the word employee is in court four out of five days “request”. Be careful of this language, as yet works the fifth day, this employee it could be interpreted as a mandate to should receive the full week’s’ pay. You return to work. can, however, have a policy that requires an employee to pull from any available paid time off bank to cover absences (even in court matters). If they are out of PTO though, you may still need to compensate them for the week.

Your policy can also establish parameters for returning to work. Jury duty often

Establish a policy that meets the needs of the practice, is easy to administer and understand, and is legal. Be sure your policy does not punish your employees for their court obligations. In reality, you don’t have much say in the matter.

It is the judge who is in charge.

MAR / APR 2018 |

michigan MEDICINE 11

PaTiENT SaTisFaCTiON 12 michigan MEDICINE

| MAR / APR2018

Service was incredibly slow. I waited 15 minutes before I was even seated, then another 15 before the server came to the table. The food was only lukewarm. Everyone on staff seemed stressed. Felt like my being there was a burden to them and they didn’t really care about my business. Lots of restaurants out there. Next time I’ll eat somewhere else.

Hardly a ringing endorsement.

Online customer review services (think Yelp) and Internet savvy consumers have revolutionized the way restaurants “make the sale,” and put a premium on the way they relate their experiences to others.

When Harvard Business School Assistant Professor Michael Luca examined the impact of customer satisfaction ratings on restaurant revenue, the results jumped off the plate at him. In a report titled Reviews, Reputation, and Revenue: The Case of Yelp.com, Luca reveals that increasing customer satisfaction ratings by a single Yelp star led to anywhere from a five to nine percent increase in restaurant revenue.

It will come as no surprise that researchers have identified similar trends in other industries. Among those most affected by ‘customer satisfaction?’

Health care.

Patients Care About Their Health Care Experience

W

est Corporation is a global health care communications and technology firm that specializes in better connecting patients with providers. Last October, the organization published the results of a study and survey data that found patients more likely than ever to shop around and to switch providers if they are not completely satisfied with their care.

Their report’s topline findings won’t surprise physicians. “As the healthcare industry adapts to increasing consumerization," they wrote, “healthcare organizations and providers must expand their efforts to measure and improve patient experiences.”

Better patient experiences lead to greater satisfaction.

The numbers tell the story. West found that 94 percent of patients say it is important to feel satisfied with their health care providers and 88 percent confirm they would switch providers “without hesitation” if they felt dissatisfied.

Still, health care leaders have been slower than those in other industries to adopt strategies to improve patient satisfaction metrics. That’s starting to change.

94 percent of patients say it is important to feel satisfied with their health care providers and 88 percent…would switch providers “without hesitation” if they felt dissatisfied.

Cheryl Gibson Fountain, MD, is a practicing obstetrician and gynecologist in Grosse Pointe Park, and president of the Michigan State Medical Society (MSMS). As a working provider, she’s acutely aware of the importance of patient satisfaction and, as president of the state’s largest physician society, she’s made it a priority to increase members’ access to tools and resources to improve satisfaction scores and patient feedback.

“Physicians dedicate their entire lives to putting their patients first,” says Doctor Gibson Fountain. “We’re focused each and every day on their wellbeing, their health, and their recoveries.

With all that effort, it’s important we also go the extra mile to ensure they’re fully satisfied with the care they’re receiving, from the reception area to the exam room.”

Continued »

MAR / APR 2018 |

michigan MEDICINE 13

Important Steps for Improving Scores

T

here was little wonder last year when Medical Economics published its top 10 list of challenges facing physicians and kicked the list off with patient satisfaction scores.

“When we talk about reputation management, we talk about what it looks like if I’m a new patient looking for a physician somewhere in Michigan,” says Ms. Matson. “I might start by finding out who accepts my insurance, I’ll check for providers in my area, but one of the glaring things I’ll look at are the reviews that show up online.”

Yelp, RateMDs, Healthgrades.com and other patient review and referral services have made it as easy as a click of the mouse for patients to read what others have to say about a practice, and one Getting positive review—or one negit right ative one—can make a world matters, of difference in whether or but none of not the patient ever dials a it’s easy. provider’s phone number.

Getting it right matters, but none of it’s easy. That’s why MSMS has invested in support services and organizations to help their members through the process.

MSMS has made a number of tools and resources available to member physicians, from web presence monitoring services to a public-facing physician directory, where its members can complete their online profile that will help drive positive referrals.

Amber Matson is a Web Presence Advisor with Officite, the firm endorsed by MSMS to offer local independent physicians with a host of web presence solutions, from website creation to online reputation management, and dynamic post-visit survey systems designed to get positive experiences onto the web and in front of patients looking for a new provider.

The challenge facing providers is how to maximize patient satisfaction, cut down on bad experiences, and ensure satisfied patients share their stories.

“There’s a lot to take into account when it comes to your online reputation,” says Ms. Matson. “When a patient searches for your phone number, right away she

AMBER MATSON, WEB PRESENCE ADVISORK OFFICITE

| MAR / APR2018

Officite provides a three-step reputation management program, and web presence advisors like Ms. Matson walk providers through the process one careful item at a time.

First, they’ll review and standardize a physician’s online profiles. Ensuring a provider’s Google profile and Healthgrades profile and Yelp and Facebook listing all have the appropriate contact numbers and address bring important professionalism to a provider’s online presence and ensure patients don’t fall through the cracks because of bad information or incomplete profiles.

Long gone are the days when a quality yellow pages listing and an attractive shingle had new patients beating down the doors. They’ve been replaced by the era of the Internet savvy patient, Google reviews, Healthgrades reviews, Facebook reviews, star ratings. Patient satisfaction has always mattered, but a patient’s bad experience no There’s a lot to longer exists in a vacuum.

It’s on the web for everytake into account one to see. The good news? when it comes Patients are having great to your online experiences, too. reputation.

“When someone reading reviews sees that a physician cares about negative feedback and proactively and respectfully attempts to address concerns, they’re more likely to believe the problem was fixed.”

14 michigan MEDICINE

will see your Google star rating. Do you have a complete profile? Are you missing information? Before, you’d look in the phone book and ask your friends. Patients have so many more options nowadays.”

Second, Officite installs monitoring programs that notify providers the minute a new review is left anywhere online. When providers log on to check out the profile, the system offers tips and tricks on how best to respond, whether that’s leaving a comment thanking someone for a positive review or responding respectfully to negative feedback.

According to the White House Office of Consumer Affairs, news of bad “customer service” reaches twice as many ears as praise for good service. In other words, resolving those complaints quickly and effectively is a big deal.

“When someone reading reviews sees that a physician cares about negative feedback and proactively and respectfully attempts to address concerns, they’re more likely to believe the problem was fixed,” says Ms. Matson.

Generating positive feedback is also important. The third step Officite recommends is a post-appointment survey system that proactively prompts positive online reviews.

“Patient experience correlates positively with clinical outcomes.

Patients who have a positive experience are more engaged in their care, more adherent to care plans, and achieve better outcomes.”

“There’s no way to get rid of negative reviews,” says Ms. Matson. “But we can bury them with positive reviews.”

Instead of relying on a quick reminder during the checkout process, Officite’s system sends a survey on behalf of the practice asking seven general questions, and at the end of the survey, if the patient rated their experience a nine or a ten on a ten point scale, a box pops up with icons for various practice review sites, encouraging the patient to make a single click and leave a positive review.

Even the timing of the “ask” matters.

“A physician or office staff can ask a patient to write a review, but often patients are more focused on getting home, getting the kids to bed, or getting dinner on the table,” according to Ms. Matson. “The last thing they’re going to remember is that you asked them to write an online review.”

By connecting with patients during a quiet moment at their desktop or on their smart phone, the program is able to better generate supportive feedback.

Patients whose survey responses rate their experience eight or lower receive a comment box to leave feedback directly with the provider or practice to help get to the bottom of any issues or concerns, or to make practice improvements.

The challenges facing physicians are how to increase patient satisfaction, and how, once that’s accomplished, to make sure everyone knows it.

Of course, providers recognize that patient satisfaction is often ultimately only a symptom— positive or negative—of an underlying condition: the patient experience.

BOB PARISH, CO-DIRECTION, MiPEC

Addressing the Condition, Not Just the Symptoms

O

ne group of local experts is on the ground working on a sweeping, multi-year initiative to provide actionable data that strikes at the heart of patient satisfaction by looking more broadly to measure and analyze patient experiences.

Lisa Mason and Bob Parrish are MiPEC’s co-directors and the individuals on the ground working today with over 200 primary care practices and 11 physician organizations representing over 1,000 individual providers from one corner of the state to the next.

“We have a threefold goal,” says Ms. The Greater Detroit Area Health CoMason. “To measure patient experience alition (GDAHC) is the nation’s lonand share it with providers so they have gest-standing multi-stakeholder collaboactionable data, and to publicly report rative dedicated to improving the health the data because consumers and wellbeing of the diverse want to know what othcommunities of southeastActionable er consumers say, and we ern Michigan, but their data delivers want to answer that with work doesn’t stop there. the tools evidence-based data. Lastly, In 2014, recognizing the and resource and most importantly, this growing importance of pais about improving patient to improve tient experience—not just care and performance. Acpatient care. satisfaction—and its imtionable data delivers the pact on providers, GDAHC tools and resources to do that.” launched a groundbreaking initiative, the Michigan Patient Experience of Care Initiative, or MiPEC, a voluntary, statewide collaborative working to fill unmet needs related to measuring, reporting, and improving patient experience of care in the physician practice setting.

Their vision is to create one standardized statewide initiative to measure, report and improve patient experience of care and to offer providers actionable data to make improvements.

The researchers are acutely aware of the difference between patient experience and patient satisfaction, and insist that understanding that difference is important to affect real change.

“Patient satisfaction is asking the patient to provide a value judgment as to how satisfied they were with the care, the ambiance, the environment, or whatever else is asked,” says Mr. Parrish, a consul-

Continued

MAR / APR 2018 |

»

michigan MEDICINE 15

providers understand that tant with MiPEC, and President of Future Directions in for every complaint, an esExperience data Health Care. “Patient expe- can be standardized timated 26 others have rerience, on the other hand, is and better analyzed mained silent about their asking the patient from his dissatisfaction. because it moves or her point of view, to relate “Patient experience corbeyond patient via survey responses what relates positively with clinopinion and was their experience? Did ical outcomes,” says Mr. describes facts. the patient experience these Parrish. “Patients who have particular characteristics or events during a positive experience are more engaged in the course of his or her interaction with their care, more adherent to care plans, a provider or practice? E.g., did someone and achieve better outcomes.” from the office talk to you about specific Better experiences lead to greater satisfacgoals for your health?” tion. Greater satisfaction leads to better Experience data can be standardized and reputation and referrals. Better reputation better analyzed because it moves beyond and referrals also lead to greater reimpatient opinion and describes facts, in bursements. pursuit of the things that matter most For physicians or practices participating for a patient’s wellbeing and their satisin health plan incentive plans and payfaction. That’s especially important when

for-performance measurements, those better outcomes also have a positive effect on the bottom line. Hospitals saw Medicare reimbursements tied to patient satisfaction surveys under the Affordable Care Act, and failing to live up to expectations can be pricey.

According to The New England Journal of Medicine’s Catalyst, the U.S. government withheld an estimated $1.7 billion in reimbursements to hospitals with poor performances on patient satisfaction surveys.

Smaller, independent and private practice physicians understand those pressures better than anyone. Patient satisfaction measures doesn’t just drive Medicare reimbursements, they are driving prospective patients in the door—or away from it. For a smaller provider, that has an even more profound impact on the bottom line.

Physicians' Experiences Matter, Too Patient experience, it turns out, also impacts physician satisfaction.

“There is growing evidence that physicians and providers who communicate well with patients, and whose patients are rating them as having a positive patient experience, tend to have lower rates of burnout and job dissatisfaction, which is a major issue,” says Mr. Parrish.

Just this January, Reuters Health published an analysis of physician burnout, identifying patient satisfaction and online survey responses as a notable driver.

“We’ve made a huge array of services available to help Michigan physicians spread the word,” says Doctor Gibson Fountain. Take advantage of DocExchange. Take advantage of our web presence solutions. When your patients have a great story to tell, make sure they know how to tell it.”

Ms. Matson agrees. “Getting your best version of your practice out there can be tough. Physicians didn’t go to medical school to become Facebook experts. That’s where services like these come in, to allow providers to focus on patients, and to let us focus on the other things that help you bring patients in the door.”

16 michigan MEDICINE

| MAR / APR2018

“Michigan physicians are doing incredible work and the world deserves to know it.”

CHERYL GIBSON FOUNTAIN, MD MSMS PRESIDENT

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Rx for Patient Safety: Ask Me 3

By Victoria H. Rollins, MHA, RN, Director, Patient Safety Programs, The Doctors Company

It makes sense that people with a clear understanding of health instructions will make fewer errors when taking medications and that they are better prepared to manage their own health outcomes.

I

n the precious few moments a physician has with a patient, clear communication can be an extraordinary challenge. It is common for patients to nod their heads as an indication that they understand what the physician is saying.

However, they sometimes leave the physician’s office and tell a friend or family member they “did not understand a word that was said.”

What happens during the patient-physician communication? Research has shown that most physicians interrupt the patient 22 seconds after he or she begins speaking.

When given the opportunity to speak, however, most patients will only talk for about two minutes. Frequent interruptions and distractions may result in unclear and imprecise communications between the physician and the patient.

To promote clear communication, the Institute for Healthcare Improvement/National Patient Safety Foundation offers a patient education program called “Ask Me 3.” Educational materials to implement the Ask Me 3 program may be downloaded free on the website at www.npsf.org/ askme3. Additional information available on the site includes a white paper, research studies, and other resources.

The Ask Me 3 program is a time-efficient, effective tool that encourages the patient to participate in his or her own healthcare by understanding the answers to three questions:

1 What is my main problem?

2 What do I need to do?

3 Why is it important for me to do this?

During the visit, the patient is provided with a preprinted Ask Me 3 form and instructed to write down the answers to the three questions in the presence of the physician.

It is important for the physician to have some idea of the literacy level of the patient and to maintain a safe environment so that the patient does not feel intimidated or rushed. Use everyday language, avoid medical terminology, and utilize friendly body mechanics such as being at the same eye level as the patient.

Once the patient has written the answers, the physician asks the patient to repeat back his or her understanding of the responses. The patient keeps the original copy, and the physician may choose to keep a copy in the patient’s medical record, as it is a good tool to use at the next visit.

The benefits of this unique program include the patient’s increased responsibility for his or her healthcare outcomes, a better understanding of medications (purpose, dosage, and times), documentation of the conversation in the medical record, and effective physician-patient communication that may help reduce or prevent malpractice claims.

For additional information and to view the forms, visit www.npsf.org/askme3.

Reprinted with permission. ©2018 The Doctors Company (www.thedoctors.com)

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

MAR / APR 2018 |

michigan MEDICINE 19

Physicians bring economic health to Michigan’s communities.

Beyond their role in safeguarding the health of our communities, physicians in Michigan are a major driver of the state economy, spurring economic growth and creating jobs across all industries.

Michigan physicians hire locally, buy locally and support the local economy. Through the creation of jobs with strong wages and benefits paid to workers across the state, physicians empower a high-quality, sustainable workforce that generates state and local tax revenue for community investments. Physicians’ economic output—the value of the goods and services provided—helps other businesses grow through their own purchasing and through the purchasing of their employees. Each dollar in direct output applied to physician services supports $2.03 in economic activity in Michigan, and physician-driven economic activity is greater than legal services, home health care, higher education, and nursing home and residential care.

View the 2018 American Medical Association Economic Impact Study to learn more about the contributions physicians make to the health of Michigan’s economy at PhysiciansEconomicImpact.org.

VITAL SIGNS: THE ECONOMIC IMPACT OF PHYSICIANS IN MICHIGAN1

Jobs

305,298

Direct jobs ..............................................................................................................................................113,837 Indirect jobs ..........................................................................................................................................191,461 Average jobs supported by each physician ...................................................................................12.9

Economic activity

$51.9 billion

Direct economic output ..................................................................................................... $25.5 billion Indirect economic output .................................................................................................. $26.3 billion Percent of total GSP/GDP2 ...................................................................................................................11% Average economic output generated by each physician ................................$2.2 million

Wages and benefits

$ 24.8 billion

Direct wages and benefits ................................................................................................. $16.0 billion Indirect wages and benefits ................................................................................................$8.8 billion Average wages and benefits supported by each physician ..........................$1.0 million

State and local tax revenue

$2.0 billion

Average state and local tax revenue generated by each physician ................ $83,979 1. The economic impact of physicians in Michigan (QuintilesIMS, January 2018).

2. US Bureau of Economic Analysis: Current-Dollar GDP by State, 2015.

2018 AMA ECONOMIC IMPACT STUDY

© 2018 American Medical Association. All rights reserved. 17-167526:11/17

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Educational Offerings MSMS On-Demand Webinars: Educational Conferences — CME When You Want It! REGISTER TODAY! Balancing Pain Management and Prescription Medication Abuse Billing 101 The CDC Guidelines* CDL – Medical Examiner Course Choosing Wisely Part 1: Stewards of Our Health Care Resources Choosing Wisely Part 2: Change Strategies to Implement Choosing Wisely Claim Appeals Compliance in the Office Conscientious Objection Among Physicians* Credentialing From Physician to Physician Leader Health Care Providers’ Role in Screening and Counseling for Interpersonal and Domestic Violence: Dilemmas and Opportunities HEDIS Best Practices HIPAA Security and Meaningful Use Compliance Human Trafficking* ICD-10 (2018) and Routine Waiver of Copays ICD-10: What We Have Learned & What We Need to Know In Search of Joy in Practice: Innovations in Patient Centered Care Inter-professionalism: Cultivating Collaboration Legalities and Practicalities of HIT – Cyber Security: Issues and Liability Coverage – Engaging Patients on Their Own Turf: Using Websites and Society Media MACRA Webinar Series Managing Accounts Receivable Michigan Automated Prescription System (MAPS) Update* Opioids and Michigan’s Compensation Webinar Pain and Symptom Management* Patient Portals as a Tool for Patient Engagement Physician On-line Rating and Reviews: Do’s and Don’ts Preparing for the Medicare Physician Value-Based Payment Modifier Reading Remittance Advice The Role of the Laboratory in Toxicology and Drug Testing* Section 1557: Anti-Discrimination Obligations Understanding and Preventing Identity Theft in Your Practice Tips and Tricks on Working Rejections Treatment of Opioid Dependence* What’s New in Labor and Employment Law Year-End Wrap Up *Fulfills Board of Medicine Requirement

22 michigan MEDICINE

| MAR / APR2018

A Day of Board of Medicine Renewal Requirements Date: Wednesday, April 18, and Wednesday, October 3 Time: 9:00 am – 2:45 pm Location: MSMS Headquarters, East Lansing Note: Continental breakfast and lunch will be provided Intended for: Physicians, resident, students and other health care professionals Contact: Caryl Markzon 517/336-7575 or cmarkzon@msms.org

Taking Control of MACRA Date: Wednesday, May 9 Time: 9:00 am – 3:15 pm Location: MSMS Headquarters, East Lansing Note: Continental breakfast and lunch will be provided Intended for: Physicians, admin's, office managers and other health care professionals Contact: Caryl Markzon 517/336-7575 or cmarkzon@msms.org

Spring Scientific Meeting Morning, afternoon and evening clinical courses available Date: Thursday, May 17 and Friday, May 18 Location: DoubleTree Hotel, Dearborn Note: Continental breakfast and lunch will be provided Intended for: Physicians and all other health care professionals Contact: Marianne Ben-Hamza 517/336-7581 or mbenhamza@msms.org

153rd MSMS Annual Scientific Meeting Morning, afternoon and evening clinical courses available.

Date: Wednesday, October 24 - Saturday, October 27 Location: Sheraton Detroit Novi Hotel, Novi Note: Continental breakfast and lunch will be provided.

Intended for: Physicians and all other health care professionals Contact: Marianne Ben-Hamza 517/336-7581 or mbenhamza@msms.org

22nd Annual Conference on Bioethics Date: Saturday, November 10 Time: 9:00 am – 4:30 pm Location: Holiday Inn, Ann Arbor Note: Continental breakfast and lunch will be provided Intended for: Physicians, bioethicists, residents, students, other health care professionals, and all individuals interested in bioethical issues Contact: Caryl Markzon at 517/336-5755 or cmarkzon@msms.org

Visit www.msms.org/OnDemand for complete listing of On-Demand Webinars.

Register online at msms.org/eo or call the MSMS Registrar at 517-336-7581.

New Categories of Continuing Medical Education (CME)

Michigan's CME Licensure Requirements

The Board of Medicine has updated the previous six Categories of Credit into two categories. As before, each medical doctor is required to complete 150 hours of continuing medical education approved by the board of which a minimum of 75 hours of the required 150 must be earned in Category 1 activities. The following is a breakdown of the two Categories for licensure:

As previously reported by the Michigan State Medical Society, the State of Michigan, Department of Licensing and Regulatory Affairs announced in December of 2016 revised Medical Rules. With these new rules came new requirements for Continuing Medical Education. Significant changes to be aware of include:

CATEGORY 1 A. Activities with accredited sponsorship – Maximum 150 hours B. Passing specialty board certification or recertification – Maximum 50 hours C. Successfully completing MOC that does not meet requirements of (A) or (B) above – Maximum 30 hours D. Participation in a board approved training program – Maximum 150 hours

CATEGORY 2 A. Clinical instructor for medical students engaged in postgraduate training program – Maximum 48 hours B. Initial presentation of scientific exhibit, poster or paper – Maximum 24 hours C. Publication of scientific article in a peer-reviewed journal – Maximum 24 hours D. Initial publication of a chapter or portion of a chapter in a professional health care textbook or peer-review textbook – Maximum 24 hours E. Participation in any of the following as it relates to the practice of medicine – Maximum 18 hours

Training Standards for Identifying Victims of Human Trafficking –

This is a one-time training that is separate from continuing education.

Education on Pain and Symptom Management – Starting in

December 2017, a minimum of three- hours of continuing education must be earned in the area of pain and symptom management every licensure cycle.

Medical Ethics – A minimum of one-hour of continuing education

must be earned in the area of medical ethics every licensure cycle.

CME modules are available online in the On-Demand Webinars (www.MSMS.org/ OnDemandWebinars) section of the MSMS website.

This training will also be included at the 2018 Annual Scientific Meeting and SSM. You may also visit the LARA CME Requirements document online at www.MSMS.org/LARACERequirements for more information.

1. Peer Review Committee dealing with quality of patient care 2. A Committee dealing with utilization review 3. A health care organization committee dealing with patient care issues

More CME Information

4. A national or state committee, board, council or association

If you have questions regarding the new categories

F. Until December 6, 2019, attendance at an activity that was approved by the Board of Medicine prior to December 6, 2016 – Maximum 36 hours

of Continuing Medical Education or licensure

G. Independently reading a peer-reviewed journal prior to December 6, 2016, that doesn't satisfy the requirements of Category 1, subdivision (A) – Maximum 18 hours H. Prior to December 6, 2016, completing a multi-media self-assessment program that doesn't satisfy the requirements of Category 1, subdivision (A) - Maximum 18 hours

requirements, please contact Brenda Marenich (bmarenich@MSMS.org), Director Physician Education and Leadership, MSMS at 517/336-5780.

MAR / APR 2018 |

michigan MEDICINE 23

In Memoriam

MEMBERS OF THE MICHIGAN STATE MEDICAL SOCIETY REMEMBER THEIR COLLEAGUES WHO HAVE DIED.

DAVID J. HORNING , MD KENT COUNTY MEDICAL SOCIETY 1/22/18 RICHARD D. GOLDNER , MD SAGINAW COUNTY MEDICAL SOCIETY 1/18/18 RICHARD J. MCMURRAY , MD GENESEE COUNTY MEDICAL SOCIETY 1/28/18 RUDI ANSBACHER , MD WASHTENAW COUNTY MEDICAL SOCIETY 1/3/18

x TO MAKE A GIFT OR BEQUEST: REBECCA BLAKE, DIRECTOR, MSMS FOUNDATION 517-336-5729 OR EMAIL RBLAKE@MSMS.ORG

RUDI ANSBACHER , MD 1/28/2018 GENESSEE COUNTY MEDICAL SOCIETY Rudi Ansbacher, MD, earned his degree from the University of Virginia School of Medicine in 1959, and his MS degree from the University of Michigan in 1970.

Throughout his career, he was committed to training female faculty members and preparing them for leadership positions.

In 2014, the University of Michigan Medical School established the Rudi Ansbacher Women in Academic Medicine Leadership Program to accelerate the development of women in senior positions in academic medicine and health care. Doctor Ansbacher was very involved with the Michigan State Medical Society. He served as a member of the MSMS Board of Directors, serving from 1996 to 2005 as one of the District 14 Directors, from 2001-2003 as the Chair of the Scientific and Educational Affairs Board Committee, and from 2005-2006 as the Board Secretary. Doctor Ansbacher also served several years as a member of the MSMS Foundation Board of Directors. He was actively involved as a Delegate for the MSMS House of Delegates, representing Washtenaw county and served on several MSMS committees throughout his involvement. Doctor Ansbacher also served as Chair of the Physician Review Organization Board, a partner of MSMS.

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24 michigan MEDICINE

| MAR / APR2018

Practices for Sale 1.5 Million Dollar Pediatric Gross Practice to be OFFERED CHEAP! After many years of practice, the doctor is passing on the torch to someone younger. Must be able to see 60 patients/day or have help. Must be Boarded in Pediatrics. The price is less than $100K. In 25 years of practice sales I have never seen a better buy. Building is being offered for less than assessment as well, flexible terms.

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FREE 877-862-9295 Officite.com/Mar/MSMS Offer expires 3/31/18. (New clients only.)

Websites and Online Marketing Solutions for Healthcare Practices

Bordering Oakland and Wayne County PRIMARY/URGENT CARE Practice with potential to reach million dollar mark per year (again). Call Joe and find out more about what could be your flag ship or second practice!

Highly visible, busy road. Set up for success, just need a Primary Care Doctor and maybe a Mid Level.

Fabulous New Medical Space Livonia New concept in medical offices with indoor parking, multi-suite and specialty clinics with room for adult day care !! So much is being done with this building. Located central to Botsford, St Mary's, Providence Park.

Offered at competitive rates.

Dearborn – General Practice Semi-retired Physician has a 2-3 day practice 20-30 patients per week, $20,000 for practice or free when you lease or buy building.

ENT with mostly Allergy Patients, Westland Hearing aid tenant and small general medicine tenant in building. Buy practice (asking $25K) and rent on short or long term agreement, very reasonable rates. Plenty of room and parking.

Rochester hills Urgent Care/Walk In For years a big money maker, recently due to losing major Carriers the Gross is way down and Physician Owner wants to retire. If you are Primary care, have no license restrictions so you can boost this place back up to the Million Gross per Year. Offered Cheap! ( UNDER $100K) Flexible with terms.

Near M-59 so can be reached by several communities. Joe 248-240-2141.

Pediatrics in Westland near Canton 30 years, high volume, yes it does a big gross! A Pediatrician Physician can work into the practice and take over EARN and purchase transaction.

Only a Boarded Pediatrician, potential to earn substantial income.

Call Joe for details, Cell: 248-240-2141.

Looking for Part time/Full time Work as a Provider?

Different locations available. Call Joe Zrenchik.

Joe Zrenchik, Broker 248-240-2141 (cell) • 734-808-0147 (eFax) bestdoctors@yahoo.com 248-919-0037(office) www.michiganmedicalpractices.com

Thinking about retirement, relocation or expansion of your medical practice? We have buyers and sellers for primary care, internal medicine and cardiology practices.

MAR / APR 2018 |

michigan MEDICINE 25

MSMS Medical Opportunities msms.medopps.org

msms.medopps.org

MSMS Medical Opportunities has been connecting physicians with employers since 1944. It is a nonprofit program through the Michigan Health Council designed to simplify your job search by posting jobs that match your practice preferences.

Learn more at msms.medopps.org.

UP Health System Gastroenterologist Marquette, MI Med Op ID #7918

St. John Providence Family Medicine Faculty St. Clair Shores, MI Med Op ID #11499

Overview Michigan's Upper Peninsula. Great location for family friendly activities and outdoor enthusiast. Searching for a Pediatrician to replace a retiring provider. 1:3 call.

Team setting for the care of patients.

Overview Seeking a family medicine physician with qualifications in OB to join St. John Family Medical Center as a faculty member located in St. Clair Shores, MI. The family medicine residency program is part of St. John Hospital & Medical Center, a fully accredited residency program that was established back in 1973. The residency program has a strong academic record and well respected community and hospital presence.

Key Qualifications Board Eligible/Board Certified Compensation Package Competitive salary, relocation, sign on bonus, eligible for clinical and organizational bonuses, CME allowance.

Practice Highlights • 1:3 call • Clinic onsite hospital at beautiful new facility

Overview UP Health System in Marquette, Michigan is seeking a Gastroenterologist to join our Digestive and Liver Specialist Practice. Our Duke LifePoint Hospital is growing, not only with a BRAND NEW FACILITY IN 2018, but also within our team of over 200 Experienced Providers.

Key Qualifications BC/BE Gastroenterologist Compensation Package High-performing physicians earn up to $825k.

Sign-on and work RVU bonuses, comprehensive benefits package including: malpractice coverage, CME, paid holidays, and deferred compensation. Opportunity for monthly residency stipend and student loan repayment.

Relocation assistance.

Practice Highlights • New Olympus/Pentex Equipment • Capsule Endoscopy/Hyrdogen Breath Testing Equipment within Clinic • 8/9 Procedures Per Day • On-Site, Well Established CGRN Nursing Staff • Strong, Cohesive Hospital-Employed Medical Group • High Earning Potential with Reasonable Cost of Living • Federally Designated Regional Referral Center • Level II Trauma Center • Lake Superior Shoreline with Outdoor Sports/ Activities Year Round • Home to Northern Michigan University • ”One of the Top 10 Micropolitan Cities“ Site Selection Magazine (2011)

26 michigan MEDICINE

Upper Great Lakes Health Pediatrics Hancock, MI Med Op ID #8992

| MAR / APR2018

St. John Providence Bariatrician Madison Heights and Novi, MI Med Op ID #12643 Overview St. John Providence is actively seeking a full-time Bariatrician to join our comprehensive Bariatric Program with locations in Madison Heights and Novi. The Bariatrician will work in collaboration with three board certified Bariatric Surgeons and provide medical weight management of nonsurgical and post-surgical patients.

Key Qualifications • MD/DO, Board certified in Internal Medicine or Family Medicine • Diplomate with the American Board of Obesity Medicine (ABOM) • Three years of clinical experience including physician leadership responsibility • Proven track record of building relationships and growing existing programs • Demonstrated excellence in patient care, passion for teaching, teamwork, medical administration and leadership • Strong interest in weight loss management Program Highlights The program offers a team approach to treating severe obesity and includes dietitians, a clinical psychologist, mid-level providers and nurses who work with each patient before, during, and after the surgery to ensure patients receive the best care possible. This highly visible position reports directly to the Ascension Medical Group Presidents. There is a Practice Director who provides day-to-day administrative oversight for the program, as well.

Key Qualifications • A graduate of an accredited medical school and Family Medicine residency program • BC/BE in Family Medicine and qualifications in OB preferred • Interest in teaching residents and med students Practice Highlights The practice sees approximately 500 outpatient visits per week. Visits include full scope family medicine including, office procedures, pediatrics, geriatrics, and newborn care.

St. John Providence Family Medicine-Academic St. Clair Shores, MI Med Op ID #12951 Overview Seeking a family medicine physician to join Masonic Medical Center as a faculty member located in St. Clair Shores, MI. The family medicine residency program is part of St. John Hospital & Medical Center, a fully accredited residency program that was established back in 1973. The residency program has a strong academic record and well respected community and hospital presence.

Key Qualifications • A graduate of an accredited medical school and Family Medicine residency program • BC/BE in Family Medicine and qualifications in OB optional • Interest in teaching residents and medical students • Meet requirements for medical licensure to practice in Michigan Program Highlights The practice sees approximately 500 outpatient visits per week. Visits include full scope family medicine including, office procedures, pediatrics, geriatrics, and newborn care.

St. John Providence Family Medicine East China, MI Med Op ID #11108

St. John Providence Internal Medicine Southfield, MI Med Op ID #13069

St. Joseph Health System Internal Medicine Tawas City, MI Med Op ID #11438

Overview Well established Family Medicine Practice located in East China, Michigan is seeking to add two (2) BC /BE Family Medicine Physicians to the Practice.

Overview Looking for a well-rounded individual who enjoys the Great Lakes and four-seasons of Michigan to join Omni Medical, a part of Ascension. A wellestablished practice located in Southfield, MI on the campus of Providence Hospital, seeks to add a full-time Internal Medicine physician to a team of two board certified physicians and one nurse practitioner. Office procedures include minor surgical procedures, PFT, electrocardiogram, and onsite lab.

Overview St. Joseph Health System in Tawas City, MI is seeking an Internal Medicine Physician!

Outpatient, Inpatient or a blend of both!

Key Qualifications Candidates (MD, DO) must be BC/BE and meet the requirements to obtain a Michigan medical license.

Program Highlights • There are currently 5 Physicians in the Practice as well as 1 Supervisor and 18 staff associates.

• Outpatient visits average 350 to 450 per week and consist of primary care visits with minor office procedures.

• On-site ancillary services include lab and x-ray.

Two members of the group continue inpatient care and are supported by the hospitalist as needed for call.

• Inpatient care is optional and not required.

Practice uses Athena as their EMR. • This position entails 100% clinical practice time.

Office hours are Monday – Friday.

St. John Providence Internal Medicine Detroit, MI Med Op ID #12711 Overview Associate physician needed to join an employed practice which has been in practice for over 25 years. The solo practitioner sees approximately 120 outpatients per week ranging in age from 18-105 years old. Outpatient visits include but are not limited to physical examinations, follow up from hospital stays, EKG's, blood draws, nebulizer treatments, pulmonary function testing, ABI testing, and general counseling to patients and family members.

Key Qualifications Candidates must have successfully completed training in an accredited Internal Medicine residency. Candidates must be BE/BC in Internal Medicine and must meet the requirements for medical licensure to practice in Michigan.

Candidates with knowledge of Patient Centered Medical Home and able to work on Athena for EMR are preferred.

Program Highlights • Call schedule is 1:2.

• On-site ancillary services: blood draws. Patients requiring other ancillary services are referred to St. John Hospital & Medical Center.

• Office hours: M, Tu/Thu, 8:45 a.m. - 4:00 p.m., F, 8:45 a.m. – 3:00 p.m. The office is open one Saturday per month and closed on Wednesdays.

• Full benefits and competitive salary.

• Specialty interest in Geriatric medicine is a plus.

Key Qualifications • Board Certified or Board Eligible (BC preferred) • Graduate of an accredited residency program Program Highlights • Practice sees approximately 150 outpatient visits per week • Inpatient census is 12-15 per day • Payor mix consists primarily of Medicare and Blue Cross

St. John Providence Neurology Suburban Detroit Med Op ID #12943 Overview Suburban Detroit, a well-established general neurology practice is looking to add an associate to a solo practice. This is an employed opportunity for 2 years and then transition seamlessly into the private practice. The position entails a mix of outpatient visits, in-office testing, inpatient rounding and stroke call on a rotational basis with other neurologists on staff.

Key Qualifications • Completion of accredited residency in neurology • Board certified in neurology • Fellowship training a plus • Ability to meet requirements for State of Michigan license Practice Highlights • On average, 10-15 new and follow-up patients/ day are seen in the office in addition to fullspectrum neurological testing (EEG’s, EMG’s, evoke potential and echo carotid.)

• One office has 2 exam rooms and 3 rooms that are used for testing. The other office has 4 exam/ testing rooms. Both offices are open M-F, 9a-5p.

• Inpatient rounding consists of 10-15 patients/ day and Stroke Call averages an additional 5-10 inpatients/day.

• Practice employs one office manager, 4 PT receptionists, 1 FT tech and 3 PT techs.

• Call schedule is 24/7 via answering service. When physician is out of town, there is an arrangement in place with another nearby, highly reputable neurology practice to cover.

• There is an opportunity to teach and round with medical students and resident physicians.

Key Qualifications • Board Certified or Board Eligible (BC preferred) • MD/DO of an Accredited Residency Program • Licensed or eligible to obtain a license with the State of Michigan Program Highlights • Full Time hospital employed position with St. Joseph Health System • Highly Competitive Salary • Educational Loan Reimbursement Allowance • Relocation Allowance • Full comprehensive benefit package • Rural family orientated community • Iosco County population is approximately 25,000 • Access to 134,000+ acres of national wildlife refuge, state forest, parks and recreation areas • 2-3 hours from Detroit, Lansing and Ann Arbor

St. Joseph Health System Orthopedic Surgery Tawas City, MI Med Op ID #10027 Overview St. Joseph Bone and Joint Center, a well-established practice in Tawas City, Michigan is seeking a Full-time general Orthopedic Surgeon to join the team.

Key Qualifications • Board Certified or Board Eligible (BC in specialty preferred) • MD/DO of an Accredited residency program • Licensed or eligible to obtain a license with the State of Michigan Practice Highlights • Hospital employed position with St. Joseph Health System • Office procedures include joint injections, casting, cast care and trigger point injections • On-site ancillary services include X-ray and PT • Outpatient visits include acute, establishment of new patients, fracture care • Surgeries include general orthopedic procedures • Dedicated surgery block time of 2 full days per provider with extra half day every other week • Located in a multi-specialty practice building • 4.5 day work week • Competitive salary with a full comprehensive benefit package • Iosco County population is approximately 25,000 • Access to 134,000+ acres of national wildlife refuge, state forest, parks and recreation areas • 2-3 hours from Detroit, Ann Arbor and Lansing

MAR / APR 2018 |

michigan MEDICINE 27

Crittenton Hospital Medical Center Family Medicine-Academic Rochester, MI Med Op ID #12725

St. Mary's of Michigan-Standish Hospital Family Medicine or Internal Medicine Standish, MI Med Op ID #10143

St. Mary's of Michigan Neurology Saginaw, MI Med Op ID #10023

Overview Seeking a board certified family medicine physician to join Ascension Medical Group as a faculty member. The Family Medicine Physician Faculty assists the Program Director in all facets of the academic program. Core faculty members will adhere to the ACGME program requirements for patient care without residents.

Overview Standish Family Medicine is located on the campus of St. Mary's of Michigan Standish Hospital and is seeking a Full-time Employed Family Medicine or Internal Medicine Physician.

Overview St. Mary’s of Michigan, Saginaw is seeking a Neurologist for a well-established, busy and respected Neurology practice. Saginaw County is rich with natural resources. The county has over 500 acres of park land, over 25 public and private golf courses and 80 acres of trail system. Saginaw County, located in the central portion of Michigan’s lower peninsula is part of the Great Lakes Bay Region. Saginaw Bay is connected to beautiful Lake Huron.

Key Qualifications • Qualified applicants will be a M.D. or D.O. graduate from an accredited medical school and residency program • Preferred qualifications in geriatrics, sports medicine, hospice and palliative care, maternity care, etc.

• Previous graduate medical education experience and board certification required Licensure • Must possess and be able to obtain licensure and certification as required by applicable law and accrediting organizations.

• Shall maintain medical staff appointments at participating institutions.

• Must fulfill the requirements for and obtain a faculty appointment with the applicable department of Wayne State University School of Medicine Clinical • Staff privileges at all member hospitals/facilities will be maintained with academic work rounds and attending rounds. Faculty will be engaged in providing quality education in a clinical environment, service diverse patients, including the medically underserved and low-income population. Call coverage shall be performed in accordance with the Family Medicine oncall schedule, which may include weeknight, weekend, and holiday call coverage.

• Provide clinical supervision, in conjunction with other faculty, for resident clinics, outpatient procedures, and in-patient settings including evaluation of residents and/or medical students in the hospitals.

• Maintain an independent practice without educational responsibilities for medical students and residents.

• Supervise residents and/or medical students who may be taken on electives and inpatient services.

Administrative • Departmental leadership responsibilities, medical directorships, etc.

Research • Contributes to the departmental research objective on a continual basis.

28 michigan MEDICINE

| MAR / APR2018

Key Qualifications • MD/DO of an Accredited Residency Program • Board Certified or Board Eligible (BC preferred) • Licensed or eligible to obtain a license with the State of Michigan Program Highlights • We are designated as a Rural Health Clinic with special interests in women's and children's health, office-based gynecology and preventative medicine. The practice is open Monday through Friday. Planning is underway for an After-Hours Clinic.

• Highly competitive salary with a full comprehensive benefit package. Educational Loan Reimbursement Allowance is negotiable.

St. Mary's of Michigan Family Medicine Saginaw, MI Med Op ID #11075 Overview St. Mary’s of Michigan-Saginaw has an immediate Full-time Employed Family Medicine opportunity available. St. Mary's is a 268-bed hospital which has evolved from Saginaw’s oldest and northern Michigan’s first hospital into a regional leader. St. Mary’s primary care physicians provide patients with high quality personalized care. With over 20 specialty centers in the area, St. Mary’s has established itself as a technological pioneer and patient advocate throughout the state.

Key Qualifications • MD/DO of an Accredited Residency Program • Board Certified or Board Eligible (BC preferred) • Licensed or eligible to obtain a license with the State of Michigan Program Highlights • Cardiac Sciences: Over 20,000 open heart surgeries performed – more than any other hospital in the region • Neurosciences: Region’s first designated Primary Stroke Center • Cancer Care: Region’s first and only Cyberknife • Trauma & Emergency Care: – ACS Verified Level II Trauma Center & first accredited air medical service – FlightCare • Orthopedics: Pioneers in total joint replacement with 30 years of experience • Outpatient Care: Full-service outpatient care • Competitive compensation with comprehensive benefit package including malpractice coverage

Key Qualifications • MD/DO of an Accredited Residency Program • Licensed or eligible to obtain a license with the State of Michigan • Stroke expertise is a plus, but not required Program Highlights • Full Time hospital employed position • Position will see adult patients • Inpatient and outpatient cases • Practice in general neurology • Competitive salary with a full comprehensive benefit package • Saginaw population is approximately192,000 • Approximately1.5 hours north of Detroit, Ann Arbor and Lansing

Whitney Recruitment, LLC PM&R or Physiatrist Three Rivers, Michigan Med Op ID #10747 Overview Permanent part time position, 20 hours per week, in rural hospital.

Key Qualifications • Must be Board Certified (or eligible) team player Program Highlights • Compensation package negotiable • CARF accredited Rehab unit • Great small town, near larger cities

Three Rivers Health Hospitalist Locums or perm Three Rivers, MI Med Op ID #12195 Overview Looking for Hospitalist, Int Med, or FP to do perm locums (possible permanent position.)

Key Qualifications • Must be either Internal Medicine, FP Board certified (or eligible), team player Program Highlights • Compensation package negotiable • CARF accredited Rehab unit • Great small town, near larger cities

Three Rivers Health Hospitalist Locums or perm Three Rivers, MI Med Op ID #12195

Three Rivers Health and Sturgis Hospital Gastroenteroloigst to be shared Three Rivers, MI and Sturgis, MI Med Op ID #13101

Central City Integrated Health Nurse Practitioner, Psychiatry - Adult Detroit, MI Med Op ID #11848

Overview Looking for Hospitalist, Int Med, or FP to do perm locums (possible permanent position.)

Overview Two rural hospitals, close to each other, need Gastro to share (2 days at each office.)

Overview Nurse Practitioner, Psychiatry - Adult

Key Qualifications • Must be either Internal Medicine, FP Board certified (or eligible), team player

Key Qualifications Board certified (or eligible), team player

Program Highlights • Compensation package negotiable • CARF accredited Rehab unit • Great small town, near larger cities

Sturgis Hospital OBGYN physician Sturgis, MI Med Op ID #11765 Overview Join another OBGYN in rural area, share call, employed or independent contractor.

Key Qualifications • Must be Board Certified (or eligible), team player Program Highlights • Compensation package negotiable • Great medical staff, nice rural area, good schools, outdoor activities

Sturgis Hospital Pediatrician Sturgis, MI Med Op ID #11766 Overview Perm locums pediatrician, contract direct with hospital, rural.

Key Qualifications • Board Certified or Eligible, team player, availability negotiable Program Highlights • Small hospital, well liked Pediatrician, good pay

Sturgis Hospital Midlevel NP or PA Sturgis, MI Med Op ID #13100 Overview Need NP or PA to work in either Primary Care facility or weekends in Urgent Care Key Qualifications Certified or soon to take boards, team player Program Highlights • Compensation package negotiable • Small hospital, rural area, close to larger cities

Program Highlights • Compensation package negotiable • Great small hospitals, create your own schedule, make good money

Three Rivers Health and Sturgis Hospital Urologist Three Rivers, MI and Sturgis, MI Med Op ID #12254 Overview Urologist to work 2 days at each small rural hospital.

Key Qualifications Board certified (or eligible), team player Program Highlights • Compensation package negotiable • Great small hospitals, create your own schedule, make good money

Central City Integrated Health Mental Health, Psychiatry - Adult Detroit, MI Med Op ID #11846 Overview Psychiatrist Position - Full and Part Time Key Qualifications • M.D./D.O. with a license to practice in Michigan • Certified or eligible for Board Certification Program Highlights • Responsible to the Chief Psychiatrist at Detroit Central City Community Mental Health • Incorporated for the provision of specialized psychiatric services which include, but are not limited to: psychiatric evaluations, medication reviews, and consultation on an on-going basis to the Treatment Team in the development and implementation of direct services

Key Qualifications • Master’s Degree in Psychiatric/Mental Health Nursing – Current Michigan Practitioner License Master’s Level – American Nurses Credentialing Center (ANCC) Certification in Psychiatric/Mental Health Nursing, NP or CNS • Minimum two (2) years of related experience • Current Registered Nurse Licensure • State of Michigan Nurse Practitioner Licensure Program Highlights • Provides advanced clinical nursing care to a selected population of clients.

• Assumes leadership and provides expertise for intake health history.

• Collaborates with Psychiatrist to provide psychiatric evaluation and team members to recommend program placement and coordinate interim treatment planning.

• Improves clinical staff quality of care through consultation with and education of nursing personnel, clients, and their significant others.

• Serves as preceptor for undergraduate and nursing graduate students.

Family Health Care Family Medicine or Internal Medicine Physician White Cloud, Michigan Med Op ID #11743 Overview Family Health Care was one of the first community health centers in the nation to develop a “one-stop shopping” concept for health care services. We’ve been in the business of taking care of families since 1967 and offer medical, dental, laboratory, radiology, pharmacy, vision, and behavioral health.

Key Qualifications • State of Michigan Medical License • State of Michigan Controlled Substance License • Federal DEA License • Graduation from accredited school of Medicine • Board Certified Program Highlights Full Benefits Package including Health, Dental, Vision, STD, LTD, Life, 401(k), PTO Family Health Care - White Cloud is a one-stopshop for health care in White Cloud MI. The office is completely outpatient and provides onsite Primary Medical Care, Dental, Behavioral Health, Pharmacy, Laboratory, Radiology, Vision, and Community Outreach. All departments have a patient-centered focus with limited productivity requirements.

MAR / APR 2018 |

michigan MEDICINE 29

Henry Ford Allegiance Health Palliative Hospice Medical Director Jackson, MI Med Op ID #3899

Henry Ford Allegiance Health Adult Psychiatry Jackson, MI Med Op ID #12692

Overview Palliative Hospice Medical Director in South Central Michigan. Join a reputable, wellestablished and expanding employed practice.

Overview Come live, work and play in the beautiful South Central Michigan. Jackson is a family oriented community with excellent schools, is in close proximity with two Big Ten Universities and provides affordable housing. Our four-season climate provides the perfect formula for unlimited year-round recreational activities.

Key Qualifications • Family Medicine, Geriatrics Program Highlights • Currently 1-1/2 board-certified geriatricians/ hospice & palliative medicine, 4-NPs, 1-RN, 1-MA, 1-LMSW and clinical support staff.

• Allegiance Senior Health Center is an outpatient clinic which offers primary geriatric care, comprehensive geriatric assessment, home care, inpatient and outpatient palliative care as well as coverage for our freestanding Hospice Residence and our In-home Hospice Program.

Henry Ford Allegiance Health Neurologist Jackson, MI Med Op ID #12101 Overview Henry Ford Allegiance Health is seeking BC/BE Neurologist to join a reputable practice with 2.75 outpatient providers, 1 nurse practitioner and 1.75 inpatient neurology hospitalist.

Join a robust, reputable practice with 2.75 outpatient Neurologists, 1 Nurse Practitioner, and 1.75 inpatient Neurology Hospitalists.

The Neurology Hospitalists cover 44 of 52 weeks, and the eight weeks remaining are split among four (one private practice) providers.

The Hospitalist is the feeder system for follow up care for our outpatient Neurologist.

Key Qualifications • BC/BE Neurologist

30 michigan MEDICINE

Overview Henry Ford Allegiance Health is looking for Core Faculty. The faculties are clinical psychiatrist responsible for supervision of the psychiatry residents and other trainees on psychiatry rotations. We have opportunities focusing on substance abuse, and geriatrics as well.

The faculties are clinical psychiatrist responsible Psychiatry for supervision of the psychiatry residents and • Full service for Behavioral Health other trainees on psychiatry rotations. We have • Outpatient (Geriatrics, Child/Adolescent, Adult) opportunities focusing on substance abuse, and • Partial day programs (intensive outpatient) geriatrics as well.

• http://www.allegiancehealth.org/services/ Faculty members will contribute to the behavioral-health/services/partialadvancement of the discipline of Psychiatry hospitalization-program as demonstrated by peer-reviewed funding; publication of original research or review articles Inpatient Adult/Geri Unit • Neuropsychology in peer reviewed journals, or chapters in textbooks; publication or presentation of case reports (only neuropsychology service in Jackson county) or clinical series at local, regional, or national professional and scientific society meetings; • http://www.allegiancehealth.org/locations/ henry-ford-allegiance-neuropsychology or, participation in national committees or educational organizations.

Crisis Assistance All faculty members will participate in some • Addiction recovery center administrative activities as a function of other • http://www.allegiancehealth.org/locations/ elements of the job (e.g., leading curriculum henry-ford-allegiance-addiction-recovery-center committees or task-forces, organizing education, Substance Abuse Services QI teams, etc.) While the Program Director has primary responsibility for administration of the Henry Ford Allegiance Health residency, the faculty will participate in resident Rheumatologist and faculty or staff recruitment activities, program Jackson, MI evaluation, accreditation work, as delegated.

Med Op ID #1007 Overview Reputable, very busy Rheumatology opportunity.

Henry Ford Allegiance Health seeks a fourth BE/ BC Rheumatologist to join well-established and reputable practice (20 years).

Key Qualifications BE/BC Rheumatologist

Program Highlights • The compensation package includes a base salary with bonus opportunity, malpractice and health insurance, CME, PTO, and a 403(b). Henry Ford Allegiance Health also provides a housing incentive to any physician that relocates his/ her primary residence to Jackson County within the first year, student loan forgiveness, moving allowance, and a signing bonus.

• 7 exam rooms • 2 medical office supports (hiring for a 3rd who will be part time) • 4 MAs • 1 NP rounds inpatient • Perform EMGs in the office • Botox injections, research and med trials are being done by one of the providers

| MAR / APR2018

Henry Ford Allegiance Health Psychiatry: Core Faculty/ Substance / Geriatrics Jackson, MI Med Op ID #11775

Program Highlights • Very competitive salary, productivity bonus and signing bonus.

• Paid benefits include medical, dental, short and long term disability, life insurance, pension and 403b plan, four weeks vacation, one week CME. • Recruitment Incentives include paid interview expenses, moving expenses, malpractice insurance, student loan repayment up to $50K, a $30K relocation stipend if you purchase a home in Jackson County.

• Current board-certified Rheumatologists see an average of 24 patients/day and are scheduling new patients up to 6 months out.

• Office equipped with 8 exam rooms and fully staffed with 2 LPN's, office manager and receptionist / medical assistant / medical biller.

• Limited call of 1:4. "

Key Qualifications • Graduate of a medical school • Graduate of an ACGME or AOA training program • Current certification in the specialty • Two years’ experience working as a licensed psychiatrist Program Highlights • Henry Ford Allegiance is redesigning behavioral health in our community and needs to be sure candidates are interested in helping to build a ‘new’ academic program. Program is focusing on population health management, integration.

• Competitive salary Signing bonus Housing incentive for a provider purchasing his/her primary home in Jackson County Student Loan Forgiveness.

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