2015 January Newsletter - Madison County Medical Society

W
elcome
Norman McCoomer, MD
Pain Management
460 Lanier Rd Ste 206
256-464-7855
David Cole, MD
Aerospace Medicine
4100 Goss Rd
256-876-0517
Brenda Peak, DO
Family Medicine
532 Madison Street
256-489-2238
Jitesh Kar, MD
Neurology
201 Governors Dr Ste 420
256-881-4112
John Panico, MD
Anesthesiology
303 Williams Ave Ste 129
256-469-7895
Daniel Fox, MD
Internal Medicine
201 Sivley Rd Ste 500
256-265-3880
Medical Students
Courtney Culbreath
Katie Tucker
Change seems to happen at a faster
pace each year. As physicians, we have
been prepared for new advances in
medical knowledge since we began our
practices. We anticipated these changes
and understood that this type of change
was part of the practice of medicine.
The changes affecting our practices
now have a different character - more
administrative and clerical than clinical. We have burdens in almost every direction
we turn - new EHR requirements, ICD-10, Obamacare, RCOs, and
RAC audits to name a few. It has changed the nature of practice in
the community.
UAB IM Residents
Ali Alhusseini, MD
Sawsan Alkurabi, MD
Amir Azarbal, MD
Swetha Bheemanathni, MD
Mounika Boyeinpally, MD
Aartee Deshpande, MD
Ashokkumar Gaba, MD
Cesar Garcia, MD
Anshum Goel, MD
Esmeralda Gutierrez-Asis, MD
Jacob Tyler Hughes, MD
Ashley Jackson, MD
Durga Jonnalagadda, MD
Zainab Kakakhel, MD
Rajashekar Kumar, MD
Jyothika Mamadgi, MD
Sara Ocheltree, MD
Imran Osmani, MD
Neha Patil, MD
Mohammed Raja, MD
Abdur Raziq, MD
Morgan Scully, MD
Nemil Shah, MD
Vineet Veitla, MD
We are often left burdened, behind, and overwhelmed. Our
workload goes up but our bottom line decreases. Where does this
end? Some of our colleagues retired early and many chose the
security of a hospital based practice. Many have developed a quiet
anxiety about the unknown future.
How do we prepare for the unknown?
Since what we do not know may scare us, I think we should
concentrate on what we do know well. Each other.
There has been a slow division of responsibility among physicians
over the last few years. More physicians have decided to stay solely
in the hospital or in the clinic and few actively do both.
This has been an understandable result of economic realities and
lifestyle choices. The unintended consequence has been a slow,
but steady widening of the distance between physicians. But this is
not an insurmountable distance. While we may practice in different
settings, we still have common goals and beliefs that bind us
together in caring for both the sick and healthy in our community.
Our Board will focus on physician-physician communication and
physician-community education this year. We hope you will join us
as we try to promote and preserve communication as a cornerstone
to improve quality of care of all our patients in Madison County.
THE
OUR MISSION
The Madison County Medical Society has been
organized to serve its members as an advocate
for the physician/patient relationship, and to
promote and preserve the highest standards of
professional, educational, and moral conduct.
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MCMS Quarterly Newsletter
Winter 2015
Inside
LOOK
Member
SPOTLIGHT
Member Spotlight
Name: Debbie Kolb, MD
Specialty: Family Medicine
Practice Name: Madison Family Medicine
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Annual Session
3
NAMRC/MCMA
4
Practice Management
5
Rx Theft and Forgery
6
New Physicians Reception
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What do you like best about your current practice? I love the independence of private practice. Although
the current issue of Medical Economics has it right when it says you must learn to be a “mixed martial arts
champion in practice management.” That is exactly what I am learning to do with the help of my fellow
Society members. The supportive nature of the MCMS has been invaluable. I am blessed to be one of many
second generation physicians in the local medical community, and I am grateful to my colleagues who helped
me build my practice nearly fifteen years ago when I returned home. (Although it was difficult to maintain a
professional demeanor when one patient I had referred out told me “The doctor said he remembered little
Debbie Booher when she was running around in diapers!”)
What advice would you give to someone just entering the profession of medicine? I have always
believed the old adage “If you love what you do, you’ll never work a day in your life.” Don’t be dissuaded by
the evolving nature of healthcare. I always left the politics to my husband, but I wanted to have a seat at the
table and help influence where things are heading to help my patients. As I continue to educate myself on the
issues, I appreciate how welcoming and supportive my colleagues have been. There is a need for all types of
providers, but we physicians are a unique bunch and we MUST stick together. I appreciate how phenomenal
the Alliance has been in facilitating that.
Who or what has had the most influence on your professional career? I could not do what I do without
my amazing family. My husband, Chris, retired from the US Coast Guard when we moved here and not only
serves as the Practice Administrator (monitoring ARs and making COSTCO runs!) but holds down the fort
with our three boys when I am working late or have a meeting. My parents and sisters have always been so
supportive and encouraging and are a phone call away when we need help. This is a team sport.
Tell us about yourself – anything you’d like to share…As the only girl in my house I have learned to
embrace testosterone! Our boys (Peter-12, James-9, Joshua-9) are all about tent camping with Dad, but
Mom is only good for three nights in a row, tops! Every summer we pack up and drive somewhere new for an
adventure. We have camped in Redwood NP, Grand Canyon NP, Grand Tetons NP, Yellowstone NP, Glacier
NP and Banff. I did successfully negotiate for a spa day at the Fairmont in Lake Louise at the end of our
most recent trip. I also enjoy reading, scrapbooking, and sport shooting at Cavern Cove Rimfire.
Your
MCMS extends
our sympathy to the family of
Dr. Richard A Brown
Jan. 7, 1941 - Jan. 4, 2014
h
Donations in memory of
Richard’s life can be made to
communityfoundationhsv.org,
donor advised fund,
Richard Brown Fund.
This fund was established to
support medical care,
education, and research.
BOARD 2015
Executive Board
PRESIDENT: Amit Arora, MD VICE PRESIDENT: James Gilbert, MD
SECRETARY/TREASURER: Debbie Kolb, MD
Board of Trustees
William Brix, MD / James Byrd, MD / Michael Conrad, MD
Deason Dunagan, MD / Tobin Fisher, MD / Daniel Fox, MD
Sharon Gardepe, MD / Akram Haggag, MD / Heather Haley, DO
Erik Henninger, DO / Scott Lynn, MD / Dawn Mancuso, MD
Philip McGee, MD / Alan McCrory, MD / Brad Rice, MD / Sherrie Squyres, MD
Paul Tabereaux, MD / Alex Talalight, MD / Tarak Vasavada, MD
Ex Officios
COUNTY DISASTER LIAISON: John Higginbotham, MD / Norman Sabio, MD
MASA FIFTH DISTRICT CENSOR: Dan Gifford, MD / MASA PLACE 2 CENSOR: Tim Stewart, MD
REDSTONE ARSENAL LIAISON: David Cole, MD
IM RESIDENT REP: Ashley Jackson, MD / FP RESIDENT REP: Tate Hinkle, MD
MEDICAL STUDENT: Courtney Culbreath / NAMRC DIRECTOR: Brooke Rawlins
Board of Censors
Jeremy Russell, MD / Irma de Leon, MD / Amit Arora, MD / James Gilbert, MD / Debbie Kolb, MD
MCMS Administrative Staff
EXECUTIVE DIRECTOR: Laura Moss / ADMIN ASSISTANT/ MEMBERSHIP: Amy McDonald
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Holiday Cheer
Embassy Suites
Tuesday, December 2nd
6 - 9 pm
Thank you Dr. Jeremy Russell
for your leadership in 2013-14 &
welcome Dr. Amit Arora as our
2015-2016 President!
Drs. James Gilbert, Amit Arora & Jeremy Russell
2014 MCMS Executive Board
Madison County Medical Society
General Membership Meeting
Sponsored by Crestwood Medical Center,
ProAssurance, and Renasant Bank
Thank you 2014 Board of Trustees for your dedication, support and time given to serve the MCMS Membership!
In December, MCMS had the pleasure
of presenting Outstanding Contribution to
Medicine Awards to two physicians.
Retired Internist Dr. George Knox joined
MCMS in 1967 after completing his
Internal Medicine Residency as well as fellowships
in Cardiology and Nephrology. He was introduced by
Dr. Debbie Kolb who shared stories of his
meticulous patient histories, renowned
diagnostic acumen, and great intelligence.
This “doctor’s doctor” was honored for possessing
many outstanding qualities that helped him deliver
unparalleled patient care throughout his career.
Before recently retiring, Dr. Patrice Knight,
MCMS member since 1990 and past MCMS
Board Member, practiced as a pediatrician
with a fellowship in neonatology.
George
E. Knox, Sr., MD
Dr. Sherrie Squyres enlightened many as she told of Dr. Knight’s impressive history and instrumental role in developing the pediatric ICU in Huntsville after repeatedly seeing “sick babies being
transferred to Birmingham.” Dr. Squyres noted that “before our community was fortunate to recruit
pediatric subspecialists, we had Patrice Knight.” Dr. Knight also taught for many years at
UAB Huntsville’s Medical School sharing her talents with countless students and residents.
Congratulations to both of these deserving recipients!
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Patrice
Knight, MD
Connect on Facebook
NORTH
ALABAMA
medical
reserve
corps
The mission of the North Alabama Medical Reserve Corps is to
recruit and train medical and non-medical volunteers to supplement
existing community organizations in preparing for and responding
to an emergency or disaster and to provide community education in
disease awareness and prevention during non-crises times.
It’s not too late! We have over 40 people registered and still have room
for more. AMA Alliance President, Sarah Sanders and SMA Alliance
President, Karen Morris will be in attendance, as well as many of our
alliance friends from across the south. Whether this is your first alliance
event or your tenth, you will walk away with some useful information.
We will have an informative Tech Toys demonstration, as well as,
a financial consultant warning us of the pitfalls to avoid in investing.
There is something for everyone.
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1,
We will host a Welcome Reception on Thursday, January 22nd at the
Huntsville Museum of Art. We would love to have a great turnout from
our local medical families for this event. For registration and conference
information, visit the Alliance page on the MCMS website.
We hope you’ll consider attending both the Welcome Reception
and the Conference. Partial registration is available for
those who might only be able to attend one day.
In October and November, the NAMRC teamed up with
Huntsville Hospital and the North Alabama Community Care
to offer free flu shots in Madison County.
NAMRC volunteers helped administer more than 1,500 shots.
MCMA had over 70 guests attend our annual Christmas Coffee
in early December. Our lovely hostess, Linda Akenhead, did not
disappoint in providing a warm and festive setting in her home.
In the spirit of the season, the Alliance gave $1,000 to
Huntsville Hospital Foundation’s Mobile Medical Unit, $1,100 to the
Huntsville Madison County Senior Center for their Health Room and
$2,000 to the North Alabama Medical Reserve Corps. Our members also
donated blankets and coats for the NAMRC to hand out
when doing health programs and clinics this winter.
k
n
a
h
T
you!
The NAMRC is grateful for the
ongoing support from the
Our October business meeting was short and sweet,
so we could have time for a great presentation at the InBloom Studio.
Members enjoyed a great lunch from the
Chicken Salad Chick provided by our friends at Servis1st Bank.
Madison County MediCal Alliance.
The MCMA generously awarded the
NAMRC with a $2,000 grant.
We had two members attend the Southern Medical Association Alliance
annual meeting this fall. MCMA was awarded first place in Medical
Heritage for our Past President’s Brunch- Celebrating 80 Years of MCMA
and our Health Project at the Huntsville Madison County Senior Center.
We received a cash award of $250 for our Medical Heritage project, too.
This year marks the 90th year of the SMAA, so we had many history
lessons and celebrations of accomplishments over the years.
SMAA founded Doctor’s Day on
March 30, 1933 in Widner, Georgia.
These funds will benefit
the health outreach
initiatives in 2015.
UPCOMING EVENT
Volunteer Orientation
January 15, 2015
6 p.m. until 8 p.m.
320 Fountain Circle
Huntsville, AL
The Alliance is grateful to the Society, it’s
members, board of trustees and staff for
all the support you’ve given us in 2014.
We want to congratulate Dr. Amit Arora
along with the 2015 Board of Trustees.
We look forward to working together in
the coming year.
NAMRC STAFF
DIRECTOR: Brooke Rawlins
www.northalabamamrc.com
Have you heard we are hosting the AMAA’s Southern Regional
meeting January 22-25th? AMASA and MCMA are excited to host
physician families from across the south here in Huntsville.
We’d like to recognize MASA for their generous support with a
$5,000 sponsorship, as well as, Pro Assurance, AMASA,
AMA Alliance and MCMA for each granting us a $1,000 sponsorship.
This meeting would not be possible without our generous partners.
Ashley Clark
MCMA President 2014-15
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Thanks 2015
ANNUAL SPONSORS
Ambulatory Surgery Centers – Be Sure to Assess Your Risk
by ProAssurance
Ambulatory surgery centers (ASC) are a great option for patients whose surgical procedures do
not require in-hospital stays. And for physicians, they may provide more control over scheduling,
delays, limited operating room availability, and the like, according to the Ambulatory Surgery
Center Association, concerns that led physicians to develop the model of the ASC.
There are many advantages of an ambulatory surgery center (ASC) for patients, such as no
overnight stay and potentially less expensive procedures, but performing procedures at an ASC
carries some inherent liability for physicians.
Each of those centers represents these areas of concern:
•
Medical staff and facility staff credentialing and competency
•
Emergency response processes
•
Risk management/quality improvement/patient safety
•
Equipment and resources
•
Discharge planning
Medical staff and facility staff credentialing/competency process: Ensure physicians and
other health care providers at the ASC are appropriately credentialed and privileged to perform
specific procedures. Policies should be in place to address the qualifications and scope of
practice for surgical assistants and other allied health care providers.
Additionally, facility staff should be trained to respond to emergencies, such as initiating CPR,
ACLS or PALS, and their competency should be assessed at least annually. It’s also a good idea
to assess facility staff competency before using new equipment or performing new procedures.
Crisis Situations and Emergency Response: The first step in effectively handling crisis
situations is having emergency response procedures in place. Procedures should detail the
responsibility of the center and its staff to respond to an emergency, as well as timely transfer
of patients to a hospital. For example, a fully stocked emergency crash cart is only as effective
as the skills of the people using it. Are staff members properly trained? Is the equipment
periodically checked to ensure accessibility and functionality?
Additionally, procedures should identify basic requirements for handling emergencies:
•
Be sure staff members understand their individual responsibilities during an emergency – e.g., who will provide basic life support, which staff member will arrange transport to a hospital, etc.
•
Paste emergency numbers by telephones and at the nurses’ stations. It’s recommended that all clinical staff have BLS training; periodic re-certification is required.
In minor emergencies, patients may refuse transport by ambulance to a hospital or emergency
department, or they may refuse to go to the ED at all. In such cases, risk management experts
recommend physicians explain the seriousness of the patient’s condition and associated risks
of not following medical advice. It is further recommended the discussion be documented in the
patient’s medical record.
Equipment/Resources and Discharge Planning
Concerning equipment and resources, risk management experts recommend you assess
whether the ASC has adequate resources to care for the patient.
For example, do operating rooms contain necessary equipment, such as cardiac monitors, SA02
monitors, resuscitative equipment like defibrillators and suction?
It’s a good idea to assess whether the staff is properly trained to use the equipment and
resources and whether the ASC has a procedure for updating that training. Also, ensure that
equipment is maintained and periodically tested.
Resources represent another area of concern. Does the ASC maintain an adequate inventory of
supplies, implants, medications, etc., to safely care for patients?
Regarding discharge procedures, it’s important to ensure the patient will be adequately
monitored following the procedure and/or administration of moderate or deep sedation or
anesthesia. Patients should be evaluated by physicians for proper recovery prior to their
discharge from the ASC.
Experts recommend discharge instructions be reviewed by the patient and/or the responsible
adult accompanying the patient, if applicable. Instructions should include information about postoperative conditions that require immediate medical attention, signs and symptoms to report to
the physician, medication instructions and potential side effects, as well as follow-up directives.
Experts recommend patients be discharged from the post-anesthesia care unit either by a
physician or by staff who follow rigorous criteria, such as the Post Anesthesia Discharge Scoring
System.
ProAssurance insured physicians and their practice managers may contact Risk Resource for prompt
answers to liability questions by calling 205-877-5015 or via e-mail at riskadvisor@proassurance.com.
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Rx Theft and Forgery: How It Happens and What You Can do About It
By Jeremy A. Wale, JD, ProAssurance Risk Resource Advisor
Prescription medication abuse is rampant throughout the United States. According
to the Centers for Disease Control and Prevention (CDC), 16,500 people died in
2010 from overdoses tied to common narcotic pain relievers.1 In 2009, 15,500
people died from opioid painkiller overdoses, more than deaths from heroin and
cocaine combined.2 According to the CDC, approximately 1.4 million ED visits in
2011 were a result of pharmaceuticals misuse and/or abuse.3
Who is stealing prescription drugs?
Pharmacists, pharmacy techs, nurses, receptionists, doctors, patients, and
even police officers have been caught stealing or forging prescriptions, stealing
prescription pads, or stealing prescription medications. It can happen anywhere,
by anyone.
How does this affect you?
Prescription theft or forgery by an employee in your practice may have legal and
ethical ramifications for all professionals employed by the practice. If the practice
fails to take proper precautions to prevent these actions, an injured person may
attempt to sue for negligence. If you have a medical practitioner practicing medicine
under the influence of narcotics, there are myriad negative ramifications affecting
patient care, patient safety, or staff safety. You may also discover recordkeeping
errors or inaccurate medical records.
A healthcare provider also may encounter issues with the federal Drug Enforcement
Administration (DEA) if there is suspected drug diversion going on in the practice.
A DEA investigation could result in suspension or even revocation of a healthcare
provider’s DEA license.
Prescription theft and/or forgery could lead to loss in business, unhappy staff,
increased medical errors, increased malpractice exposure, and more challenging
defenses of potential malpractice claims.
What can you do?
Electronically prescribing medications can help limit the availability of paper
prescription pads in your office. Electronic prescriptions also may have the added
benefit of preventing pharmacy staff from making alterations to the prescription.
One of the best ways to prevent prescription pad theft is to keep them under
lock and key. Only trained healthcare providers with prescription-writing authority
should have access to prescription pads. It is also a good idea to avoid pre-signing
prescription pads.
In addition, most states have an electronic drug monitoring program aimed to
combat prescription drug abuse. These programs track prescriptions given to each
patient. Some states allow practitioners to request a patient’s prescription data to
help determine whether the patient may be abusing prescription drugs. If you have
a patient displaying possible drug-seeking behavior, you may want to consider
obtaining data from your state’s electronic program to help determine if there is an
issue. Be sure to check your state’s laws regarding access to this information; you
may need to submit a formal request. Some states will not dispense this information
to healthcare providers.
Maintaining accurate medication lists and limiting refills are also good ways to help
determine whether a patient is abusing prescription medications. You may want to
consider using NCR (no carbon required) prescription pads so your practice has
accurate records of exactly what was prescribed and to whom.
Being proactive about the process of prescribing controlled substance will help limit
your practice’s susceptibility to prescription theft and/or forgery.
“Physicians insured by ProAssurance may contact Risk Resource for prompt
answers to liability questions by calling 844.223.9648 or via e-mail at riskadvisor@
proassurance.com.”
Sponsored by
BlueCreek Investment Partners,
Huntsville Hospital & Regions Bank
Dr. Jeremy and Kerry Russell
Drs. Amit and Aruna Arora
(Endnotes)
1 Koba M. Deadly epidemic: prescription drug overdoses. USA Today. July 28, 2013. http://
www.usatoday.com/story/money/business/2013/07/28/deadly-epidemic-prescription-drugoverdoses/2584117/. Accessed September 3, 2014.
2
Buntin J. America’s biggest drug problem isn’t Heroin, it’s doctors. http://www.governing.
com/topics/health-human-services/gov-biggest-drug-problem.html. June, 2014. Accessed
September 3, 2014.
3 Prescription drug overdose in the United States: Fact Sheet. Centers for Disease Control
and Prevention Web site. http://www.cdc.gov/homeandrecreationalsafety/overdose/facts.
html. Updated July 3, 2014. Accessed September 3, 2014.
Copyright © 2014 ProAssurance Corporation
This article is not intended to provide legal advice, and no attempt is made to suggest more or less
appropriate medical conduct.
ProAssurance is a national provider of medical professional liability insurance and risk resource services.
For more information about the company, visit ProAssurance.com.
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Welcome New Physicians
to MASA/MCMS and Madison County!
Stephanie Israel, Matthew Israel, Norman McCoomer, David Cole,
Beatrize Garcia-Cardona, Shaf Holden, Jitesh Kar, Donald Tighe,
Aaron Hoffman, Ashley Jackson, Brett Davenport, Charisse Jordan,
Melissa Layno and Jay Hughey
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Madison County Medical Society
3330 L&N Drive, Suite I
Huntsville, AL 35801
Visit us at:
www.madisoncountydoctors.org
Send us your news!
amymcms@bellsouth.net
Office Manager
Roundtable Meeting
JAN 20
The Ledges
11:30-1pm
Spring Fling
TBD
Governmental Affairs Conference
FEB 7-10
www.masalink.org/govaffairs
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