ECMS Stethoscope Newsletter, Winter 2023 by TEAM

the Stethoscope the Stethoscope

September 2019 Issue

Quarterly Newsletter of the Erie County Medical Society

Newsletter of the Erie County Medical Society • Winter 2023 Issue

A Message From Your President Hello and Welcome! I am excited and honored to be addressing you as the 143rd President of Erie County Medical Society. I, first, would like to say thank you to Dr. Kelli DeSanctis, our immediate past president who over the past two years has done a tremendous job leading the medical society. I would also like to say thank you to the ECMS Board as well as our staff, Kaela Luchs and Lauren Newmaster because, without all of you, none of this would be possible. Amanda Wincik, DO, MHSA President, ECMS

Kaela Luchs Association Executive kluchs@pamedsoc.org Phone: 833-770-1542 Administrative Office/ Mailing Address: 400 Winding Creek Blvd. Mechanicsburg, PA 17050 eriecountymedicalsociety.org The opinions expressed in this publication are for general information only and are not intended to provide specific medical, legal or other advice for any individuals. The placement of editorial content, opinions, and paid advertising does not imply endorsement by the Erie County Medical Society.

Growing up I was always taught the importance of being active in your community and it was expected that we would start volunteering for local organizations at a young age. As I got older, we even started traveling out of town to help where there was a need. Born and raised in the Erie area, I take great pride in my community and its people. That is one of the reasons I want to focus on Community Health over the next two years as President of the Erie County Medical Society. My goal is to begin the conversation between the medical society and local non-profits to discover ways we can work together to ensure an improved quality of life for everyone in Erie County, especially those most vulnerable. The greatest of all mistakes is to do nothing because you think you can only do a little. — Zig Ziglar On November 1st, 2023, we held the 1st ECMS Awards Gala. The event proved to be a success with a portion of the proceeds being donated to the Emmaus Ministries. Going forward this event shall replace the Annual Business Meeting which was held virtually in 2023. My hope is that we can continue to grow this event each year. Not only to expand the membership of ECMS but also to create an environment where physicians from all over Erie County can celebrate with each other while simultaneously helping a local non-profit. As leader of this organization, it is my pleasure to advocate and support Erie County’s physicians. As physicians, we undoubtedly carry a great deal of responsibility not just for the lives of our patients but for their stories. Some share their miracles, some their unbearable grief. We are trusted with all of it. We see it all and hear it all. It is for this reason we must support and advocate for each other. No one does this alone and I hope the ECMS can grow to become a community of support for all physicians. Please do not hesitate to reach out with any ideas, thoughts, or concerns. I wish you all a Happy and Safe Holiday Season!

Amanda Wincik, DO, MHSA 814-490-5076 awincik@gmail.com

Erie County Medical Society Community Award The recipient of this annual award has aligned themselves either publicly or privately with the mission of the Erie County Medical Society. This organization or individual endeavors to advance, uphold, and serve the medical needs of our community. Congratulations to those who were recognized during our 2023 Annual Awards Gala.

2022

ECMS Mission Statement The Erie County Medical Society is a voluntary, non-profit organization of MDs and DOs that has served the citizens and physicians of Erie County, Pennsylvania since 1828. Our mission is to advance the standards of medical care, uphold the ethics of the medical profession, and to serve the public with important health information.

2023

Morning Rounds John Reilly, M.D.

Very early one spring morning in 1974, having completed “work rounds” on the 14th floor of New York University Hospital, my senior surgical resident and I sat at a table in the elevator lounge and organized our thoughts. We were awaiting the arrival of our chief attending surgeon. Dr. Louis Slattery, then in his late 60s, was acknowledged to have remained a mentally sharp and technically gifted general surgeon. He was tall and slim and stood ramrod straight. He was blessed with a youthful face crowned with a thick head of silvery hair that he combed back to the nape of his neck where it ended in a sporty flip on his collar. He was a gentlemanly professional and, much to the relief of his residents, he was exceptionally good-natured and approachable. Laid back though he was, he expected his residents to be rigorous yet caring in the management of the patients he entrusted to them. Every morning, Dr. Slattery would emerge from the elevator and join us at the table for “attending rounds” during which we would report on the current status of his postoperative patients, an update we had labored to pull together to his satisfaction. Following this meeting, Dr. Slattery would rise and with us in tow, would proceed to retrace our earlier circuit. His uniquely compassionate bedside manner would drive what we dubbed his “social rounds” – a process which, communicated by gentle touches and hushed conversations, provided a dignified conclusion to the busy early morning processes we referred to, collectively, as “morning rounds”. Not all of Dr. Slattery’s patients were recovering from surgery. In room 1450, a large corner room, he had installed Mrs. Alice Wells, an elderly woman whom I understood to be related by marriage to the Wells Fargo family. Mrs. Wells was dying of inoperable cancer. He had permitted her to have her personal furniture, carpets and photos installed in the room. She was also permitted an attendant, a woman who had, evidently, cared for her at home. We would round on Mrs. Wells as we would any active patient. Over time, however, our routine became less intrusive. Rather than enter, we would lightly tap on 1450 and with the door cracked open slightly, we were given an update by her caretaker: Mrs. Wells was usually “sleeping comfortably” and we would report to Dr. Slattery that she was “the same”. Occasionally, if overwhelmed by work rounds, we might bypass room 1450 altogether. Now, even the most dignified New York City gentleman had his idiosyncrasies and Lou Slattery, MD was no exception. He played the ponies. In his off time, it was said that he might be found at one of the premier racetracks in the New York City region. In fact, when he arrived at the hospital lobby early one morning, prior to work rounds, I observed him engaging the guard at the security desk in a review of the “daily racing form” then found in all of New York’s morning newspapers. This was followed by a joint perusal of the “scratch sheet”, the slim “hot off the press” morning rag that reported last-minute odds as well as an updated list of the horses “scratched”, that is dropped, from that day’s races. To the betting man, the accuracy and timeliness of that data was vital to the day’s strategy which surely would have to be reconfigured to accommodate the loss of an entry. I noted that morning’s “recreational rounds” to have been adjourned with mutual satisfaction. After a handshake, Dr. Slattery took leave of the guard and strolled to elevator. Doubtlessly this first floor review was as integral a part of his daily morning routine as the serious business that awaited him on the 14th floor where we would be preparing ourselves for his 6:30 a.m. arrival.

continued on page 4

Morning Rounds continued from page 3

On the above-mentioned spring morning, Dr. Slattery sat facing us with a set of index cards marked with the names of his patients. As was his custom, he held the cards in one hand, fanned out, covering the lower half of his face. (This image prompted me to wonder whether there was also a bit of Mississippi Gambler in our Kentucky Colonel)! One by one my senior resident gave a status report on each patient. Dr. Slattery followed along, touching cards sequentially with his free index finger as he absorbed and considered each update. When we came to Room 1450, my senior casually reported that Mrs. Wells was, as always, “the same”. With that, Dr. Slattery gazed up and remarked: “That’s funny! I just read her obituary in today’s paper!” Freed from her terminal “sameness”, Mrs. Wells had been “scratched”!

What does SafeNet do?

SafeNet is a non-profit organization providing

The Complex Effects of IPV on the Children Who Witness It If a child witnesses abuse, there is always more than one victim in the house. Without the support that helps build resilience, children can carry the emotional, psychological, and physical effects of abuse well into adulthood. Childhood trauma can affect their health, their future relationships, and their success as parents. SafeNet services can help.

IPV and Human Trafficking You have likely treated victims of labor or sexual trafficking. Learn definitions, statistics, case histories of human trafficking, and the importance of referrals for IPV services.

confidential services and support to victims of intimate partner violence. These services include secure shelter, a 24/7 crisis hotline, counseling and advocacy, children’s programs, safety planning, legal assistance, medical response, education and training, community outreach, prevention initiatives, and transitional housing.

SafeNet provides services regardless of the individual’s race, ethnicity, religion, gender identity, sexual orientation, physical or intellectual abilities, age, or socioeconomic status. At SafeNet, survivors find the tools they need to stop the cycle of abuse.

Because intimate partner violence is a healthcare issue...

As Erie’s only accredited domestic violence agency, SafeNet offers the trained staff and resources necessary to build on survivors’ strengths and assist them in restoring their lives. Being an accredited domestic violence agency is important. Programs must be accredited and advocates trained by the Pennsylvania Coalition Against Domestic Violence in order to protect victim safety and preserve confidentiality.

IPV in the Workplace The effects of IPV often follow victims to work. Recognize the signs that a coworker could be experiencing IPV and understand the potential health, safety, productivity, and financial implications. Workplace safety planning will also be discussed.

1702 French Street Erie, PA 16501 Administrative Offices, Counseling, Outreach, and Legal Assistance:

814-455-1774

SafeNet 24/7 Hotline:

Programs for Healthcare Professionals

814-454-8161

TTY: 1-800-654-5982

www.safeneterie.org

ECMS New and Reinstated Members New

Student: Kaleb E. Stevens (December) Rebecca K. Marcus, MD (December) Pritam U. Tayshetye, MD (December)

Reinstated

Scott A. Griffith, MD

Let ’s Get Social 5

Erie County Medical Society Board Members Erie County Medical Society Board Members Erie County Medical Society Board Members

President Amanda Wincik, President DO, MHSA Kelli DeSanctis, DO

President-Elect Laura Gephart, MD, President-Elect MHA Amanda Wincik, DO, MHSA

Secretary/Treasurer Secretary/Treasurer Laura Gephart, MD, MHA

Immediate PastImmediate President President KelliPast DeSanctis, DO Jeffrey P. McGovern, MD, FCCP, FAASM

At-Large Member Geoffrey Betz, MD At-Large Member

At-Large Member Narendra Bhagwandien, At-Large MemberMD Narendra Bhagwandien, MD

Geoffrey Betz, MD

At-Large Member At-Large Member At-Large Member Jeffrey P. McGovern, MD, Timothy D. Pelkowski, MD, Peter S. Lund, MD, FACS At-Large MemberFCCP, FAASM At-Large MemberMS, FAAFP Peter S. Lund, MD, FACS Timothy D. Pelkowski, MD, MS, FAAFP

At-Large Member Kirk Steehler, DO At-Large Member Kirk Steehler, DO

At-Large Member Ingrid Renberg, MD Resident Representative Brendan Dempsey, MD

Resident Representative Casey Gernovich, DO Resident Representative Casey Gernovich, DO

The Erie County Medical Society • 400 Winding Creek Blvd • Mechanicsburg, PA 17050

Ph: 833-770-1542 • E-mail: eriecms@pamedsoc.org The Erie County Medical Society • 400 Winding Creek Blvd • Mechanicsburg, PA 17050 Ph: 1-833-70-1542 • E-mail: eriecms@pamedsoc.org

Exercise for the Holidays and the New Year! Michael J Platto, MD, Physical Medicine and Rehabilitation With the new year fast approaching, starting a new exercise program will soon be on many patients’ minds. Making good on this resolution is much less certain. Doctors understand regular activity is a core component of overall health and wellness. Weight loss, stress reduction, improved immune response, decreased risk of cancer, lessening of anxiety depression, improved cognition and overall improved sense of wellbeing are just some of the known benefits. Despite this knowledge, most Americans still do not exercise the recommended minimum of 150 minutes per week. Barriers to regular exercise are often great. Doctors may prefer to concentrate on other important medical issues, where less effort is required, and behavior can be more easily modified. Indeed, it has been shown that only one third of patients report they have received physical activity counseling by their PCP. Doctors are aware of the multiple barriers to exercise. Common refrains include being “too busy”, “too tired”, “too expensive”, “too painful”, “no childcare”, “gas costs too much”, “too cold out”. Other commonly identified barriers are embarrassment over body image, the feeling exercise is boring, and the lack of motivation. During the holidays, these barriers become even greater.

trying to get a patient to exercise more as a way to treat their symptoms. In the long term however, it is hard to think of any treatment with less side effects and more positive benefit than exercise. The upside is that the patients who are the most difficult to motivate are often the ones who have the most to gain from even a small amount of exercise. Minor increases in physical activity in inactive individuals may lead to marked reductions in the risk for chronic disease and mortality. In motivating patients to exercise, it is important to stress that at least some regular physical activity is better than none. Patients should be encouraged to do what they are able to do, and then gradually increase activity over time. It is important to find out what the patient likes to do, whether it be walking, biking, swimming, going to the gym or to the mall. Walking 10-15 minutes per day is better than sitting on the couch all day. Walking slowly around a warm therapy pool will provide some exercise, which is easily tolerated, even in an older patient with multiple arthritic joints. Stretching in the shower first thing in the morning is another important exercise that can be easily incorporated and serves as a good warm up for the day. The key is finding something a patient likes to do and that they can continue for the long term.

It is of course much more time efficient to prescribe a medication and order a lab test for symptoms of pain, fatigue, and anxiety. In most cases, patients are very satisfied to learn their symptoms can be treated with a pill or could be due to a medical condition such as a low thyroid or B12 level. It is much more difficult, less rewarding and results less impressive, when

Patients should also be reminded that some pain and fatigue is to be expected, especially when first starting to increase activity. If a new activity is started slowly, they should be assured they are not doing “damage”. Often the pain is a sign they are working muscles they are not used to using and can be a sign of improved physical conditioning. Health coaches and personal trainers can also help in motivating and guiding exercise continued on page 8

Exercise for the Holidays and the New Year! continued from page 7

programs. Many insurance plans including UPMC, Highmark, and Aetna provide these free of charge. Physical and/or Occupational Therapy can also be helpful to get a patient started who is severely deconditioned and/ or has multiple medical conditions. With improved strength and confidence, patients can then often be transitioned to a self-directed gym or home exercise program.

Exercise education can be time consuming. It is not specifically reimbursed and may lead to a dissatisfied patient who was expecting a medication, vitamin or hormone supplement and instead got a lecture. In the long-term, however, benefits of improved health, sense of accomplishment and sense of well-being can be much more rewarding to the patient and their physician than another pill. Hazard to Sarah Perry, mother of Oliver; December 14, 1819). Don’t give up this ship!

Legislative Update Dave Thompson, Legislative DIrector, PAMED Shortly after the 2022 House of Delegates last October, the General Assembly approved Senate Bill 225, prior authorization reform legislation. This proposal was the result of nearly six years of stakeholder meetings, physician coalition discussions, meetings with PAMED physician leaders, and grassroots physician advocacy. The new law made changes to the time frames health insurers have to make prior auth decisions, refined the definition of medical necessity related to prior authorizations, streamlined the process of medication step therapy, and enacted changes to the qualifications of peer-to-peer reviewers. Passage of Senate Bill 225 was applauded by physician organizations across the Commonwealth along with members of the legislature. Though more work needs to be done when it comes to the relationship between physicians, health insurers, and patients. We were also happy to see the election of Arvind Venkat, MD, to the state House of Representatives, the first physician to do so since 1961. Since his swearing-in, Dr. Vankat has made a positive impression with members of his caucus and has, more than once, influenced or helped shape healthcare legislation in Harrisburg. We anticipate that Dr. Venkat will continue to be a driving force,

and trusted source of clinical knowledge, to many members of the legislature. It should be noted that PAMED’s political action committee, PAMPAC, was an early supporter of Dr. Venkat’s candidacy. Politics aside, we have seen a number of proposals put forth this legislative session that has PAMED very much engaged. We saw the reintroduction of Senate Bill 25, legislation that would grant CRNPs with independent practice authority and expect to see a companion bill introduced in the House before the end of the year. Legislation was also introduced to allow pharmacists to prescribe medications. A public hearing on this measure, House Bill 1000, was held in September with future stakeholder meetings expected. Staying with the theme of scope of practice expansion, PAMED has been engaged with the PA Chapter of the American College of Obstetricians Gynecologists in considering a legislative proposal that would no longer require nurse midwives to maintain a collaborative agreement with an OB/GYN. As of early December, consideration of these proposals is not expected in the near term.

READ MORE HERE:

Listen in to why Dr. Timothy Pelkowski values PAMPAC 9

WHAT IS A FRONTLINE GROUP? A “Frontline Group” is how PAMED identifies those groups with 100% physician membership. The benefits include: • Group discounts • Ability to split the invoice between multiple locations (satellites) or to one corporate entity (Parent) • Group invoicing, which streamlines the membership process • Free administrative staff membership • Opportunity to attend monthly 30-minute webinars, held the first Thursday of every month, covering the most pertinent topics in PA, only offered to Frontline Groups • Ability for two administrators to attend the bi-annual Practice Manager meetings • Access to bonus materials from trusted vendors, like Norcal December 2023 Erie CMS Front Line Groups Arthritis Associates of Erie 100.00% Bayview Breast Care at Hamot 100.00% Central Erie Primary Care 100.00% Comprehensive Plastic Surgery 100.00% ENT Specialists of NW PA 100.00% EPN Rheumatology 100.00% Erie Retinal Surgery Inc 100.00% Frank C Pregler DO 100.00% Great Lakes Neurosurgery 100.00% Great Lakes Pain Medicine 100.00% Griffith Eye Center PC 100.00% Hand Microsurgery & Reconstructive Orthopaedics LLP 100.00% Harry L Haus MD 100.00%

Hope Direct Healthcare 100.00% Laser Eye Surgery of Erie Inc 100.00% Presque Isle Colon & 100.00% Rectal Surgery Primary Care Associates of Erie 100.00% ReJuv LLC 100.00% Saint Vincent Neonatal Services 100.00% Saint Vincent Occupational 100.00% Health Center Saint Vincent Post-Acute 100.00% Care Services Scott J M Lim DO LLC 100.00% Tri-State Pain Institute LLC 100.00% Wayne Primary Care 100.00%

“ CORNER QUOTE

“ The best way to find yourself is to lose yourself in the service of others.” —Mahatma Gandhi

2024 ECMS Meet Your Team

“

Kaela Luchs—Association Executive

Kaela Luchs has spent the past two years in the Erie County Medical Society’s Association Executive role. From meeting with your board members throughout the year, and working on communications such as The Stethoscope, she also remains your point of contact for your ongoing membership needs. You are bound to meet her whether it be at any ECMS event or PAMED’s HOD meeting in some capacity!

Tom Notarangelo—Design Manager

Tom Notarangelo remains on the team as the Design Manager, continuing to work on all aspects of our graphic design needs. From Erie County Medical Society events to newsletter layouts, you can always find Tom using his creativity and design visions for our ongoing projects!

Ellerie Krot—Meeting Manager

New to our team, meet Ellerie Krot who takes on the role of Erie County Medical Society’s Meeting Manager. From the planning of our ECMS social events, the Annual Meeting and Dinner, and the Health Expo, Ellerie comes from a background of planning a majority of Harrisburg City Events, such as the Kipona Festival. We look forward to the fresh new ideas Ellerie brings to ECMS!

Tanner King—Social Media Coordinator

For the past year, Tanner King has taken on the role of Erie County Medical Society’s Social Media Coordinator. Tanner works on the communications that ECMS members receive via e-mail and our social media posts. Tanner also works alongside our technical support team on our ECMS website updates.

Zachary MacMillan—Junior Web Administrator

For the two past years, Zachary has taken on the role of Erie County Medical Society’s Junior Web Administrator. In collaboration with Tanner King, Zachary works to provide the most up-to-date web content for our ECMS team as well as the content from PAMED.

Janet Thompson—Membership Liaison

With PAMED since 2000, Janet Thompson remains your Membership Liaison and in November 2023, Avery Krot joined the Janet on the PAMED Membership Team. Janet and Avery help ECMS members by guiding them to the many resources PAMED has to offer such as increasing awareness of advocacy, education, and other services.

Website: https://www.eriecountymedicalsociety.org/

Jump into the New Year by donating to Emmaus Ministries! Join Erie County Medical Society in a “Healthy Firsts” Food/Supply drive beginning January 15 to March 29, 2024. DONATION DROP OFFS:

Erie (West Side) Erie (East Side) Drop Off Location: STAY TUNED FOR MORE DETAILS COMING TO St, YOUR INBOX SOON! 204 W 26th Erie, PA 16508

AWARDS Help us recognize physicians for the great care they provide! We are passionate in honoring those who are not only talented in their profession but go above and beyond to help their patients, colleagues, and community. We need you to help us identify these great physicians by nominating those you know today!

Everyday Hero Award Do you know a Pennsylvania physician who goes above and beyond in helping patients? The Pennsylvania Medical Society encourages nominations for this monthly, member award.

Top Physicians Under 40 Throughout the commonwealth are talented early career physicians, who already are performing at a high level. Pennsylvania’s Top Physicians Under 40 recognizes on a yearly basis the best of the best early career physicians. The 2024 deadline is January 14, 2024.

Distinguished Service Award The Distinguished Service Award—given to PAMED members for lifetime achievements in medicine—is PAMED’s highest honor. Jonas E. Salk, MD, was named the award’s first recipient in 1956, for his role in developing the anti-polio vaccine. The 2024 deadline is January 14, 2024.

Physician Award for Voluntary Service Created in 1992, this award recognizes physician members who have donated their time and expertise in community and international settings. In even-numbered years, it recognizes a member for his or her international volunteerism In odd-numbered years, the award recognizes a member for his or her volunteerism in their community. The 2024 deadline is January 14, 2024. The nomination period for the Distinguished Service, Top Physicians Under 40, and Community Voluntary Service awards are now open. Visit www.pamedsoc.org/awards to nominate a deserving physician!

At the end of October, Erie County Medical Society members attended the annual PAMED House of Delegates meeting. We were able to come together to democratically deliberate, consider, and establish broad society policy on health, medical, and governance matters. Special thanks to all of those who participated!

ECMS Year in Review

25 Years of service: Brian Bansidhar, DO Cassie J. Harrington, MD Carla Picardo, MD, MPH

50 Years of service: Jeffrey I. Blake, MD Joseph F. Deimel, MD John C. Reilly, MD

The Pennsylvania Medical Society (PAMED) advances physician leadership and advocates for the ethical practice of medicine, quality patient care, and the public’s health.

ADVOCACY & LEGAL RESOURCES

CME & EDUCATION

COMMUNICATIONS

Advocacy at the PA State Capitol

CME

The Dose— Weekly e-Newsletter

Dues dollars strengthen efforts on issues like prior authorization and telemedicine. Learn more: www.pamedsoc.org/advocacy.

Employment Contract Review Receive a discounted rate for employment contract reviews at www.pamedsoc.org/contractreview.

Quick Consult Gain access to fact sheets on health care laws and regulations at www.pamedsoc.org/quickconsult.

Medical Licensure FAQs Gain access to Medical Licensure FAQs for MDs and DOs.

Gain access to CME required for license renewal, the annual CME Consult publication, and a CME tracker.

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Leadership

Member Communications

Access resources designed for physicians to improve their leadership skills at www.pamedsoc.org/leadership.

Whether it is print or digital, you’ll receive information you care about right when you need it.

Practice Administrator Meetings (Spring, Fall)

Up-to-date information and resources provided to members online, or in text and email alerts at www.pamedsoc.org/PublicHealthAlerts.

Our twice-a-year practice administrator meetings offer key legislative, regulatory, and payer updates.

Public Health Resources

Learn More at www.pamedsoc.org/join.