January/February - New Hampshire Medical Society

Physicians Bi-Monthly
NEW HAMPSHIRE MEDICAL SOCIETY NEWSLETTER
NH Medical Society; For The Betterment of Public Health Since 1791
January/February 2010
Mission: Our role as an organization in creating
the world we envision
The mission of the New Hampshire Medical Society
is to bring together physicians to advocate for the
well-being of our patients, for our profession and
for the betterment of the public health
Vision: The world we hope to create through our
work together
The New Hampshire Medical Society envisions a
State in which personal and public health are high
priorities, all people have access to quality healthcare, and physicians experience deep satisfaction
in the practice of medicine
NH Medical Society
7 North State Street
Concord, NH 03301
(603) 224-1909
(603) 226-2432 fax
nhmed@nhms.org www.nhms.org
John Robinson, MD.......... President
Palmer P. Jones..........................EVP
Catrina Watson........................ Editor
President’s Remarks........................... 1
Farewell................................................ 6
CME, Meetings.................................... 7
Inauguration Photos........................... 8
Risk Management............................... 9
Palmer Jones Award......................... 10
CAPS.................................................. 11
Do you or a colleague need help?
The New Hampshire Professionals’ Health
Program (NH PHP) is here to help!
The NH PHP is a confidential resource that
assists with identification, intervention, referral, and case management of NH physicians,
physician assistants, dentists, and dental
hygienists who may be at risk for or affected
by substance use disorders, behavioral/
mental health conditions, or other issues impacting their health and well-being. NH PHP
provides recovery documentation, education,
support, and advocacy – from evaluation
through treatment and recovery.
For a confidential consultation, please call
Dr. Sally Garhart @ (603) 491-5036
Opinions expressed by authors may not always
reflect official NH Medical Society positions. The
Society reserves the right to edit contributed
articles based on length and/or appropriateness
of subject matter. Please send correspondence to
“Newsletter Editor” at the above address
New Hampshire Medical Society
Welcomes its 178th President
Changing Physician Employment Demographics:
Challenges and Opportunities
Taken from the inaugural speech of John Robinson, MD
Along with the rest of the country, physicians are witnessing an overdue tectonic
shift in the way health care is organized
and paid for in this country. These federal
reforms will compound and magnify other
changes already underway and, combined,
will likely transform the very nature of
the profession of medicine. I hope here to
highlight some of these changes, to explore
some of their implications and sound a call
to action for more physicians to shift from
a reactive to proactive involvement as this
revolution unfolds.
A Personal Illustration of the
Changing Profession
I am compelled to focus on these changes
because your election of me to be the 178th
president of the New Hampshire Medical
Society is itself illustrative of some of the
shifts in practices and attitudes in the medical profession.
Not all member physicians outside of the
Executive Council and Committee are fully
aware that 15 years ago, I left my solo neurology practice in Portsmouth to start a second career in administrative medicine as an
associate medical director for Healthsource.
I had a variety of reasons for this change
including the model of my own father, in
attendance here tonight, who undertook a
late life career change by leaving his general
practice in rural Pennsylvania to start a psychiatry residency at Maine Medical Center;
if he could do it, so could I.
But not everyone saw my career change as
a positive thing. At that time in 1995, I was
the Vice President of the Medical Society
expecting to move along the executive
officer chain as was the normal progresContinued on page 2
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sion. But 15 years ago electing a health insurance
medical director to the office of President was not a
tolerable idea even to the Executive Committee, let
alone the membership and so I was not nominated
to become President-Elect. To the great credit of the
Society however, a new At-Large position was constructed and I was able to continue to participate in
the leadership of the organization. After a two year
“exile” from the Medical Society while working at a
Medicaid plan in Massachusetts during their health
care reform, I was repatriated to New Hampshire by
Schaller Anderson, an Aetna company with a NH
Medicaid contract and again offered my services to
the Society. This time I was not only welcomed back
but placed immediately in the executive officer lineup. As I said, things are changing.
The Changes
But let us examine some of these changes in the
profession further. In particular let us explore the
changes in employment demographics for physicians
that are sweeping inexorably over the state and the
country and let us consider the ripple effects of those
changes and then let us construct some possible
responses.
First let me share a startling factoid provided by
Steve Ahnen, EVP of the NH Hospital Association:
fully 70% of primary care physicians in NH are employed by hospitals or clinics. This figure is really
an educated guess because in fact specific statistics
about employment status are only now being tabulated by the Board of Medicine in the process of
physician license renewals and reliable statistics will
not be available for another cycle or two.
Surveys conducted by the Center for Studying
Health System Change provide a snapshot of figures at a national level. One of the principle drivers
of employment change is the decreasing ability of
small practice self-employed physicians to afford
fixed cost overhead for items such as EMR systems,
malpractice premiums, education loans and recruitment. Also data collection requirements necessary to
realize bonus incentives may be significant. Increasingly, even specialist physicians are participating in
this shift.
Many such changes started in reaction to managed
care activities in the 90’s such as a trend toward
multi-specialty groups.
Lately the trend has been away from multi-specialty
groups and toward large single specialty practices, in
part in an effort to leverage more favorable contract
terms and in part because the backlash against the
overreaches of managed care in the 1990’s led to less
restrictive network arrangements.
But the size of even single specialty practices is
shifting significantly away from solo and small group
practices toward mid-size practices employing six to
50 physicians. More importantly for this presentation, physicians increasingly are giving up practice
ownership in favor of employment by large organizations. Again, this is true not only for primary
care but for medical and surgical specialties as well.
Although there are greater opportunities for proceduralists to gain economies of scale from ownership
of diagnostic and treatment devices and ambulatory
facilities even they are not immune to the larger
economies afforded by hospitals and integrated
delivery systems.
Practice Characteristics Accompanying the
Changes
The shift away from private ownership of small practices has been accompanied by a shift in compensation arrangements away from those based purely
on the financial performance of the practice. Many
practices favor productivity adjustments to individual
physician income. While quality-of-care, peer-profiling and patient satisfaction measures still account
only for 10-15% of compensation, more in primary
care practices and more often in smaller practices,
this factor continues to increase and is likely to be
accelerated by federal reform efforts.
The trend away from very small practices toward
larger non-owned practices is actually higher among
physicians 51 years and older although small practice ownership is still highest among older physicians. The lower trend among young physicians is
explained partly by the lower number in small and
owned practices to begin with; they were more likely
to join large practices right out of training than was
the case with older physicians. From this factor
alone, a generation from now there will likely be
only a handful of small owned practices in existence.
Importantly for federal reform plans, the acceptance
of new Medicaid patients varies by practice characteristics. Those in larger practices or in specialties
dealing with episodic conditions and those in rural
areas, are more likely to accept new Medicaid
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patients. But primary care physicians in mid-size
practices, especially those with institutional ownership are less likely to accept new Medicaid patients.
This is also the case with acceptance of any charity
care cases.
Implications and Effects of the Changes
Quality and Administrative Activities
Finding adequate physician human capital to attend
to governance and quality improvement activities
has been a perennial problem. Now regulatory and
accreditation requirements along with quality-based
reimbursement incentive programs are increasing
the demand for physician administrative work at the
same time that productivity demands and increasing
complexity of patient care administrative needs are
reducing the time available for physicians to meet
these needs.
Employment trends may compound these problems.
Administrative duties are unavoidable for physicians
in small practice settings and a certain pride of ownership may increase the sense of satisfaction from
tending to these tasks. In larger practices however
it may be easier to let someone else step forward for
such duties. Further, younger physicians comprised
of an increasing percentage of part-time workers and
females, who place a higher value on lifestyle priorities, compounds the challenges.
On the other hand, employed status may engender
more engagement for administrative duties including
quality improvement work, especially if they are part
of the salary structure. However financial compensation by itself does not necessarily lead to effectiveness. So one question is whether the move toward
larger practices and employed status is reducing
the sense of mission felt by physician providers as
they engage in their daily work. And if that sense of
mission is diluted then what are the implications for
physicians taking a leadership role for activities outside of their work setting? They would be even less
inclined to participate in ad hoc task forces which
might be convened to fully realize the promises of
federal health reform efforts than they are to engage
in the bureaucratic activities of their own organization.
One other solution to the problem of insufficient
physician human capital for administrative activities
has been to hire physicians specifically dedicated
to these requirements. These are the Chief Medical
Officer (CMO) and Vice President of Medical Affairs (VPMA) positions that almost all mid-size and
large hospitals have developed over the last several
years. Typically CMO positions are focused more
on hospital medical staff policy issues including
documentation, credentialing and disruptive behavior
policies whereas VPMA positions are more often focused on hospital and clinic affiliated providers and
their governance, technical and quality improvement
infrastructure.
Having such dedicated administrative physicians
does much to ensure continuity and effectiveness of
effort compared to the volunteer part-time members
of a medical staff, a critical element for success when
dealing with accreditation and contracting activities. But one challenge for this new arrangement is
the effect on cohesiveness of medical professional
cultures and attitudes. Is the CMO seen by the rest
of the staff as a shill for hospital administration? Is
the VPMA tending to the needs of the employed
physicians differently than for the independent
practitioners on the staff? Similar to the issues of
the emerging hospitalist movement, another emerging employment trend, there is a question of whether
increased efficiency in one arena is coming at the
cost of increased fragmentation of care delivery and
professional relationships.
Medical Ethics
Medical professionals moved from a simple ethical
standard of beneficence in the patriarchal days of
medicine to one inclusive of concerns for the principle of patient autonomy. The profession now faces
the prospects of more systematically addressing the
principle of justice whereby we are directly charged
with decisions involving the allocation of scarce
resources.
As physician employment demographics change
there is a possibility that this previous separation of
physicians from any in-depth knowledge of the cost
of care may accelerate. Insofar as a physician owes
an obligation to his employer, she must consciously
husband the employer’s resources. Will doctors attend too much to use of their employer’s resources
but not enough to any cost implications for patients?
Since they may not be as fully engaged in the
fiduciary operation of the organization compared to
physicians who own their own practices, employed
doctors may defer to managers and administrators.
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Patients may then get less information than they need
about the costs of care decisions which, in turn, could
increase non-adherence rates as they find themselves
unable to afford the doctor’s recommendations.
resources to communication and collaboration such
as researching the particulars of a patient situation to
determine whether a given intervention is duplicative
contrary to another provider’s plan of care for that
patient.
Acceptance of New Patients and Government
Payment Programs
In terms of the effects of changing employment
demographics on the viability of the ACO concept,
again the effects are not clear at this time. Employed
status would perhaps allow the employer, probably a
hospital, to direct its staff to participate in the ACO
model and to make sure that physicians are engaged
in its design and operation. Additionally an employed situation makes it more likely that a unified
EMR or other communications system is available
and used effectively. Conversely small, largely rural
areas such as NH are likely to have difficulty gathering all the necessary providers including specialists under one organization and the divide between
employed and independent practitioners in such communities may be very difficult to bridge so that true
integration may not be achieved.
The likely effects of acceptance rates for new patients, particularly those with government sources of
payment, are difficult to predict. On the one hand
increasing institutional ownership appears to indicate decreasing acceptance of government payment
programs, especially Medicaid with its poor reimbursement rates. Insofar as federal reform efforts
rely on enrollment of previously uninsured patients
into Medicaid expansion programs, access for these
newly covered patients could prove problematic, especially in non-rural areas. On the other hand coverage of previously uninsured patients reduces the need
to provide charity care. This positive effect on access
to health care will be magnified if new coverage options include reimbursement rates at Medicare levels
or better. But, as the Massachusetts experience has
taught us, there is a pent up demand for primary care
services which could significantly tax system capacity once coverage is available.
Emergence of Accountable Care Organizations
(ACO)
The concept of an ACO is still quite new in the medical world. There are no fully functioning ACOs anywhere in the country although some of the larger and
more mature delivery systems such as Inter-Mountain Health Care in Utah and The Geisinger Clinic in
Pennsylvania contain most of the elements necessary
to take this concept from theory to practice. Design
principles are still being worked out but likely would
include a robust governance structure, advanced ability to share clinical information electronically, data
gathering and analysis capacity and financial distribution capabilities. In many ways the concept of an
ACO is an expansion of the concept of the Patient
Centered Medical Home (PCMH). In the PCMH
there is a premium paid for undertaking coordination of care activities centered on patient needs and
values in a primary care setting. In a fee for service
environment such efforts are not reimbursable. The
ACO expands these concepts so that an entire system
of care is incented in the direction of devoting the
Responses and a Call to Action
The challenge to the profession of medicine and to
the Medical Society is how to embrace these changes. How do we cultivate further the positive effects
of these changes on society and on health care? How
do we preserve the special, indeed sacred, nature
of the doctor-patient relationship where the balance
remains in favor of the moral principles of physician beneficence and patient autonomy while not
discounting the principle of distributive justice when
allocating scarce resources? How do we keep the
practice of medicine an enjoyable and uplifting calling?
Let me suggest a few answers to these questions.
First, medical care is always about the patient; but
we need to continue to cultivate and broaden that
concept. We need to find ways to move beyond the
complaint- or disease- or episode-driven interaction
with a patient to a more holistic evaluation of their
total needs, a so-called biospychosocial model of
care. And we should strive to learn more about the
drivers of patient satisfaction and not just be content
with good medical outcomes.
Second, helping our patients with cost considerations
requires that we expend more effort to compile a
working knowledge of the costs of care that we are
ordering. Some data sets have been constructed in
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NH to bring greater transparency to cost information for providers and consumers, for example the
all payer data set of the NH Department of Insurance
and the data found at NH Health Cost along with
information at the NH Hospital Association web site.
But much more needs to be done.
In terms of comparative data, one concrete proposal
being discussed in NH envisions an all-payer and
all-provider database similar to the Regional Health
Information Exchange in operation in Maine. Discussions to date have involved the construction of a
“trusted independent entity” yet to be further defined
but possibly a State or Regional Health Improvement Collaborative that would be funded voluntarily
by insurance plans and perhaps hospitals and other
sources. This independent entity would have responsibility for analysis and reporting with results made
available to health care delivery systems to help
them operate an ACO. Physicians should engage in
the further discussion about this concept, ensuring
that the data is indeed meaningful, transparent and
properly adjusted to reflect different health and insurance risks.
Third, we need to do all we can to cultivate more
physician leaders and change champions. Over the
last decade the NH Medical Society Executive Council and Committees have had increasing representation from administrative physicians including managed care medical directors. But we have had little
representation by hospital Chief Medical Officers or
VPs of Medical Affairs and we have had virtually no
representation from hospitalists. The Foundation for
Healthy Communities operates a CMO committee
to share best practices and discuss challenges and
opportunities for their specialty. To my knowledge
there is no similar venue for VPs of Medical Affairs.
I propose that we should do more to facilitate interactions among and between these emerging specialties and to bring their perspectives to the operations
of the Medical Society. In addition we would be
well-advised to encourage open and frank dialogue
between these specialties and physicians who are and
who prefer to remain independent practitioners. As
with the Third Party Payer Liaison Committee of the
Medical Society, venues and forums such as I envision would reduce misunderstandings and misapprehensions about motives and agendas. They would
help to ensure that we engage in constructive rather
than destructive exchanges and are seen by others as
leaders rather than obstructionists in the evolution of
health care.
Summary
The medical profession in NH is far up the face of a
wave of change that, with the promises and challenges of federal health reform, is about to crest and alter
the nature of professional practice for the foreseeable
future. Decreasing practice ownership and increasing employment status trends are well-established
and will accelerate. Physician compensation will be
increasingly tied to productivity, quality and satisfaction metrics. More slowly due to cultural, political
and technical issues, health care delivery systems
are being reorganized away from solo practitioners
engaged in individual encounters in a fee-for-service
environment toward true clinical integration and
teamwork mentality supported by information infrastructures and focused on patient-centered values and
interests.
Many of these changes will create strife and upheaval for some physicians. But most changes are desirable and will better serve the interests of individual
patients and society at-large in terms of moderation
of costs and major improvement in the consistency
and quality of health care. The medical profession in
general and the Medical Society specifically should
embrace these changes but in such a way as to ensure
the preservation of the core values of the doctorpatient relationship. We should continue to facilitate interaction and dialogue with physicians in all
specialties including administrative specialties and
with physicians in all types of employment settings,
avoiding any sort of guild mentality. We should
rejuvenate the professional value of collegial sharing
of expertise and mentoring each other. And we strive
again to seek and maintain leadership among all
stakeholders as health care reform evolves.
Thank you.
John Robinson, MD
Thank you to our dinner sponsors:
AETNA, Anthem Blue Cross and Blue
Shield, New England Employee Benefits
Company, Portsmouth Regional Hospital
and Sulloway & Hollis
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A reflection on serving as President of the NHMS in 2009:
It has been a pleasure
to serve as President
of the NHMS in 2009.
Not surprisingly, it
has been very busy
but it has also been
fun to travel around
to a number (nine) of
the state’s hospitals
to discuss some of
the issues the NHMS
is working on. The
visits have given me
a much broader insight into the issues we face
around the state in trying to practice high quality
medicine.
I have also had the opportunity to partake in
several political forums, three different trips to
Washington, DC as well as AMA meetings in
Orlando and Chicago. These events, particularly
in this year of intense work on health care reform,
have given me the chance to voice some of the issues of concern to physicians and also learn much
about how our political system works. Please be
in touch with your state and federal representatives
when there are issues of importance to the practice
of medicine. If you don’t speak up, these issues
will be ignored by those making policy! The
AMA makes it super easy with an “800” number
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that will connect you to your representatives office
in less than one minute.
I had hoped to focus some of this year on topics
of communication. We had a successful annual
scientific meeting in Durham with excellent presentations on various aspects of communication
in medicine. We have also upgraded our communications in our Bi-Monthly newsletter as well as
adding a “president’s note” and expanded bulletin
board in the weekly E-News.”
The NHMS has added two energetic and excellent
physicians to our presidential line:
Bill Kassler and Cindy Cooper.
We will bring on a new executive vice-president
this summer as Palmer Jones retires. I am optimistic that the NHMS will continue in its mission
of improving the public health and making the
practice of medicine deeply satisfying for all of us
who take care of patients.
A special thanks to the staff at the NHMS who
continue to move the organization forward in our
ability to improve the health of New Hampshire
citizens and help to make it satisfying to practice
medicine in New Hampshire.
Thank you for this opportunity to represent you.
Charles Blitzer, MD
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CME MEETINGS & EVENTS
CME IN THE WHITE MOUNTAINS
April 16-18 Mountainview Grand Resort
Female Urinary Incontinence
Erectile Dysfunction
Female Sexual Dysfunction
Nutrition
Cardiovascular Disease
Practice
Enhancement
Many activities available at the hotel
including swimming, horseback riding,
hiking, spa treatments, fitness center,
game room and more
Catrina.watson@nhms.org for information or visit www.nhafp.org for brochure
*This program has been awarded 15.5 CME credits by American Academy of Family Physicians
A Discourse on Suicide Through Film
SAD
Lonely Silence
Sin? Hurt Pain
regret
Save
Guilt
HEAL
Help
Withdrawn
Sorry
Cry
ANGER
Love
Hope
Why?
Accept
SAVE THE DATE:
May 12, 2010 Grappone Center
Concord, NH
Getting a Handle On Autism:
Screening, Diagnosis, Treatment and
Support in the Pediatric Medical Home
NH Pediatric Society (NHPS)
LOST
Faith
Grow
Tears Forgive
The Suicide Prevention Council invites you to join us for a
viewing of Ordinary People.
The movie will be followed by a discussion facilitated by
Humanist Maren Tirabassi for those who wish to participate
Ordinary People will be shown at Derry Public Library
on February 27th from 1-4pm and Portsmouth Community
Campus February 28th from 1-4pm.
Email catrina.watson@nhms.org for registration information
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PRESIDENT’S INNAUGURATION
8
Rear Left to Right: Brianna Kling, Travis Murray, Edward Robinson, MD,
Front: John Robinson, MD, Ellen Perry Harris, Jacquelyn Robinson
Albee Budnitz, MD, Barbara Brown, Renata Dutton, Catrina Watson,
Front: Vivian Rowe, Devra Cohen, MD, Mark Sadowsky, MD, Joy Potter, Mary Pyne
Jeanine Poole, Mike Lehman, Doug Chamberlain, Front: Jan McClure, (Mrs. Mike
Lehman), Peter Meyer, Nicole Schultz-Price, Martin Honigberg, Melissa Hanlon
Peter Forssell, MD, Gary Woods, MD, Charles Blitzer, MD , Mae Bradshaw, Burt
Dibble, MD, Front: Mary Forssell, Renia Woods, Janet Monahan, William Kassler,
MD, Doris Lotz, MD
Carol Sobelson, Seddon Savage, MD, Carl Cooley, MD,
Front: Karl Lanocha, MD, Julie Lanocha, Pamela Clairmont, Tom Clairmont, MD,
Gary Sobelson, MD
Bill Shaheen, Sally Abdulla, MD, Alwan Haider, Dr. Selesnick, Linda Selsnick,
Jen Frizzell; Front: Cinde Warmington, Karyn Forbes, Bill Christie and Don
Crandlemire (all of Shaheen & Gordon)
Medical Mutual Insurance Company of Maine:
Risk Management Practice Tip
Faxing Patient Information
Maintaining the confidentiality of patient information is the responsibility of all healthcare entities.
Communication of patient information occurs
through many different mediums including traditional paper and electronic faxing. When faxing is
used, a policy should be in place to assure that the
confidentiality of the information is protected.
Policy The following elements should be considered for inclusion in a policy.
I.
Location
•• Assure the fax machine or computer (if
faxing electronically) is located in a secure
area, not accessible to unauthorized persons.
II. III.
••
Sender facility name, address and
sender’s name if relevant
••
Patient’s name
••
Receiving facility’s name, telephone
number, fax number
••
Authorized receiver’s name
••
Number of pages transmitted
••
Statement addressing redisclosure of
information
••
Instructions to verify receipt of
documents
••
Verify availability of receiver before
beginning transmittal.
••
Request authorized receiver to acknowledge the receipt of the documents.
••
Document the receiver’s acknowledgment in the patient’s medical record.
Receiving Fax
•• Paper method
••
Identify one individual to monitor the
fax machine.
••
Count the number of pages to assure
the correct number was received.
Read cover letter and follow the instructions for acknowledgement of the transmission.
••
Deliver or send the documents electronically to the intended receiver.
Misdirected Fax
•• If a fax transmission fails to reach recipient, check internal logging system
of the fax machine (for paper faxes) to
obtain recipients fax number or retrieve
through the software program, the fax
number to which an electronic fax was
sent. Fax a request to the recipient, using
the incorrect fax number, explaining the
misdirection and asking that all received
documents be immediately returned via
mail. Note that electronic faxes may be
able to be rerouted to the sender.
•• Cover sheet should display: Date and time of transmission
Remove the documents from the tray
immediately upon completion of the
transaction.
••
IV.
Faxing Documents
••
••
•• Notify the sending physician of the error
and the corrective action taken.
•• Keep a log of misdirected faxes, identify
causes/trends and implement procedural
changes to prevent a reoccurrence.
V.
VI.
Faxes should not be used:
••
As the sole notification method of abnormal test results
••
To communicate urgent requests
Faxing Prescriptions
•• Laws and regulations for faxing prescriptions must be followed and may vary by
state. For Schedule II Controlled Substances
and III-V Substances please refer to the Drug
Enforcement Administration (DEA) website or
access the latest version of the Drug Enforcement
Administration Practitioner’s Manual also found
on-line.
Continued on page 10
9
Continued from page 9
Summary
Implementation of the above recommendations will assist in minimizing the risk of unauthorized access and the breach of patient confidentiality. While utilizing either method to fax patient information is
acceptable, electronic faxing may offer greater security. Faxing directly from a software program allows
faxes to be directed from the privacy of the user’s computer. Incoming faxes can be password protected
and can be directed only to specified individuals, thereby, assuring tighter security. The electronic option
prevents access by unauthorized individuals and the potential misplacement or loss of a paper document.
Medical Mutual’s “Practice Tips” are offered as reference information only and are not intended to establish practice standards or serve as legal advice. MMIC recommends you obtain a legal opinion from a
qualified attorney for any specific application to your practice.♣
The AMA presented Palmer Jones, EVP of NHMS,
with the 2009 Medical Executive Lifetime Achievement Award to honor his contributions to the goals
and ideals of the medical profession. The award was
presented at the AMA’s semi-annual policy making
meeting in Houston.
Palmer Jones has served the physicians of NH as the
Executive Vice President of the state medical society
with integrity, distinction and dedication for 24 years. He is as patient and supportive of those physicians
and students who are just learning the process of legislation and leadership as he is with the most seasoned
veteran. He has also earned the respect of the leadership in our statehouse, our state hospital association
and our Congressional delegation.
Palmer considers his service to physicians as a “calling” rather than a job. He understands the stress of
practicing medicine and the priorities physicians place
on the care for their patients. His kindness and his
empathy are unmatched.
Palmer taught those of us who have worked with him
many valuable lessons. Each of us who have had the
privilege of his guidance carries those lessons with us
and uses them daily. We are never “angry.” Rather we
are “confused” and need “clarification.” We know that
our adversary today may well be our ally tomorrow.
Palmer is respectful of physicians, treating all as equals. As the only male on the NH Medical Society
staff, he is truly a “man among women!”
I know that I am not the only physician that Palmer has gently guided into a leadership role; that is his
strength and the reason we all care so deeply for him. It is therefore with the greatest respect and admiration that I place the name of Palmer P. Jones into nomination for this well-deserved recognition. ~
Georgia Tuttle, MD
10
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The New Hampshire Medical Society
Corporate Affiliates
Affinity Marketing Group
iSekurity
ProMutual Group
Anthem BCBS
Kilbride & Harris
Rath Young and Pignatelli PC
Athenahealth
Maxim Healthcare Services
Risk Transfer Alliance, LLC
Cigna Healthcare
Medical Mutual Ins Co of Maine
Sage Solion
Crown Healthcare Apparel
Service
NEEBCO
Sulloway and Hollis
Northeast Delta Dental
Wyeth Pharmaceuticals
Graduate Education
Foundation
I C System
Northeast Health Care Quality
Foundation
NHMS CAP is a paid membership program whose members meet criteria as posted at www.nhms.org
11
PROTECT, PREVENT, DEFEND.
More than 17,000 healthcare professionals in the Northeast depend on
medical malpractice insurance from ProMutual Group for protection
and peace of mind.
• We have the long-term vision and financial resources to provide the
coverage you need today and in the future.
• We proactively partner with you to minimize risk, increase patient
safety and improve patient care.
• And if you do face a claim, we will aggressively defend good medicine
and provide the emotional support you need to rest assured.
To learn more about ProMutual Group, call us at (800) 225-6168 or visit us
online at www.promutualgroup.com.
101 Arch Street, Boston, Massachusetts 02110 | 1.800.225.6168 | www.promutualgroup.com
ProMutual Group Agents:
12
Terry Abbott
TD Insurance Agency
North Conway, NH – 800-540-6337
Joseph Croteau
Marsh USA
Portland, ME – 207-774-5911
Marc Berube
Eaton & Berube Insurance
Milford, NH – 603-673-0500
Michelle Perron
Joe Kilbride
Kilbride & Harris Insurance Service HUB International New England
Portsmouth, NH – 603-436-7069
Portland, ME – 207-774-7919
Richard Carr
USI New England
Manchester, NH – 603-625-1100
Shawn McLaughlin
Risk Transfer Insurance Alliance
Southborough, MA – 508-303-9470
Jeff Olsen
Fred C. Church Insurance
Portsmouth, NH – 888-433-1865
Anthony Pirri
HRH Northern New England
Manchester, NH – 603-627-9583
Emmanuel Psilakis
William Gallagher Associates
Boston, MA – 617-261-6700
Stephen Wainwright
Gowen & Wainwright Insurance Services
Gilford, NH – 603 - 528-5255
Don’t forget the Chamber’s
8th Annual Chamber Ski Day on
Friday, February 26th: Skiing, snowboarding, X-country, snowshoeing
and the Chamber Challenge fun race, all for only
$40 per person for Chamber members and their
families! Please register online at
www.concordnhchamber.com. Sponsored by
All-Ways Accessible, Inc.
Greater Concord Chamber of Commerce
40 Commercial Street
Concord, NH 03301
Tel 603.224.2508/Fax 603.224.8128
www.concordnhchamber.com
13
14
15
New Hampshire Medical Society
7 North State Street
Concord, New Hampshire 03301-4018
Prsrt Std.
U.S. Postage
PAID
Concord, NH
Permit No. 1584
Address Service Requested
10
Reasons NHMS Members Get a Good
Night’s Sleep
NH Medical Society…
1. Defends medical liability reform
2. Advocates for your interest with health insurance companies to reduce hassles, eliminate payment problems.
3. Collects and records your CME credits.
4. Offers members health, dental, life and disability insurance.
5. Successfully lobbied in 2009 to defeat five of six “trial attorney” bills relating to medical liability, with the
remaining one referred for further study.
6. Prevents under-trained health professionals from practicing.
7. Maintains a presence with the business community through membership in the NH Business & Industry
Association, including participation with the Fiscal Policy, Human Resources and Health Subcommittee.
8. Represents physicians at the quarterly meetings of the New England Medicare Carrier Advisory Committee.
9. Publishes and distributes bi-monthly newsletters and weekly E-updates.
10. Offers money and time saving resources for your practice.