the north carolina - NC Academy of Family Physicians

Transcription

THE
NORTH CAROLINA
Volume 11 Issue 2 / Spring 2015
quarterly news in north carolina family medicine
The 2015 north carolina
Family
Medicine Gala
Sat., Aug. 29th, 2015
Raleigh Convention Center
Raleigh, North Carolina
Supporting
North carolina Medical Students
HELP THE NCAFP FOUNDATIoN MAKE AN
EVEN LARGER IMPACT ON
STUDENT INTEREST
The Family Medicine Gala will be a fun and glamorous black tie (optional) event that will
include food, spirits and an evening spent honoring and roasting a legend in the field of
Family Medicine in North Carolina — Dr. Jim Jones. Proceeds from this inaugural event will be used to support the NCAFP Foundation’s
Family Medicine Interest Initiatives. These programs play a key role in helping to
ensure the future of Family Medicine in our state by providing valuable experiences
and opportunities to North Carolina medical students.
For more information or to reserve your seat at the Gala, please visit: www.ncafp.com/2015gala. To participate as a Gala Sponsor, please contact
Tracie Hazelett at thazelett@ncafp.com or 919-833-2110.
Inside
11
2014 NCAFP Annual Report
4
President’s message
The Future of Family Medicine:
Let’s Connect the Dots!
8
policy & advocacy
Legislative Session Marked by
Wide Range of Health Proposals
Meetings & education
Sun, Sand & CME:
The Perfect Combination
10
Chapter affairs
North Carolina Family Medicine
Takes Center Stage
Medical students
28 Students to Participate in
NCAFP’s 2015 Summer Programs
Practice managment
Medicare Payment Changes
on The Horizon
23
26
30
THE
NORTH CAROLINA
DEPARTMENTS
PUBLISHED BY
THE NORTH CAROLINA ACADEMY OF FAMILY PHYSICIANS, INC.
R aleig h , N o rt h C aro lin a 2 7 6 0 5
919.833.2110 • fax 919.833.1801 • www.ncafp.com
MANAGING EDITOR, DESIGN and PRODUCTION
P eter T. Gr a be r, Dir e c tor of Communic a tions
President’s Message.......................... 4
Policy & Advocacy................................ 8
CME Meetings & Education................. 10
Chapter Affairs.................................... 23
Student Interest.................................. 26
Practice Management......................... 30
HAVE A NEWS ITEM WE MISSED? NCAFP members may send news items to the
NCAFP Communications Department for publishing consideration. Please send via
email to pgraber@ncafp.com.
PRESIDENT’S
By: Dr. Thomas R. White
2014-2015 NCAFP President
MESSAGE TO MEMBERS
The Future Of Family Medicine...
The Fall of The Incas ... and Grasshoppers!
What IS the future of Family Medicine?
I have asked myself that question many
times recently.
Will ours be the most admired and
valued specialty among the public and
payors? Will Family Medicine be the
most coveted and desirable career choice
of medical students? Will we one day
occupy a suite in the House of Medicine?
Or for that matter, will we have our
OWN house, with others knocking at
OUR door asking for our blessing and
for permission to enter? Will we jump
forward like grasshoppers and land upon
the sweet spot we all envision?
Recently I attended and participated in
the Health is Primary event in Raleigh.
This was an incredible opportunity to
shine a light on the value of primary
care and share some amazing stories.
One fellow family physician told me
later that he drove home from the event
feeling so proud and more optimistic
than ever for Family Medicine.
4
clinical professionals, pharmacists, and
other health professionals side-by-side,
and how in practice they can all work
together as a team to better serve the
patient. We showed how creative, "out
of the box", flexible approaches can
benefit employers and employees.
We highlighted the work of family
physicians out in their communities
giving of their time and expertise to
enhance the health of the public.
As a listener to these stories, I was
in awe. As a participant who got to
share his own community project
(a project actually more modest and
less impressive than the many other
activities of my fellow family physicians
in their own communities), I felt
honored to represent them.
How could you not be?
Indeed, the future of Family Medicine
seems bright. We have the intellect, the
creativity, the commitment, the passion,
and the willingness to meet the needs
of our patients as we move into a new
world of value-based care, and be THE
specialty we all want and envision. We
are all grasshoppers.
We told stories of practices being
transformed to better deliver the
Triple Aim of better care, improved
outcomes, at a lower cost. We
demonstrated the value of educating
and training physicians, advanced
But what if we are wrong? What if
Family Medicine fails to reach its
potential? What if Family Medicine
actually continues to muddle and
struggle along our path - in the back
room or the outhouse of the House of
THE NORTH CAROLINA FAMILY PHYSICIAN • Spring 2015
Medicine - or, shudder to think - what if
Family Medicine ceases to exist? What if
we DON'T jump forward?
Crazy. No way. Surely not, you say.
But I confess, I have had those dark
thoughts. Here's why.
This past November I had the
opportunity to visit Peru, and do
something I have always wanted to
do: see Machu Picchu. Machu Picchu,
as you know, is the "lost city" of the
Incas. It was built by the Incas around
1450 in a very hard to reach location
at an elevation of approximately 8000
feet high up in the Andes Mountains.
Abandoned by the Incas when
their civilization dissolved, it was
rediscovered by an American historian
and Yale professor, Dr Hiram Bingham,
in 1911.
I chose to reach Machu Picchu by
joining a group of 7 other crazy tourists,
8 amazing porters, 1 much-appreciated
cook, and an always upbeat, inspiring,
knowledgeable guide of Inca descent.
We hiked and camped the 26+ mile
Classic Inca Trail over 4 days to Machu
Picchu. It was one of the hardest and
most rewarding things I have ever done.
It crossed my mind then, and I continue
to ponder the question: How did
2014-2015 NCAFP
Board of Directors
a culture like the Incas, with their
incredible architectural, engineering,
and scientific skills, become, for
all practical purposes, an extinct
civilization? How did Machu Picchu
become an abandoned city, hidden
under the overgrowth of the jungle
for hundreds of years high up in the
Andes, until shared with the world by
Dr Bingham?
Why did the Incas "fail"? The reasons
are many, and much has been written
on the subject. I will try to summarize
the generally agreed upon contributing
factors:
Before Pizarro, the Spanish explorer,
landed in Peru around 1532 and began
to search for the rumored treasures
hidden in the Andes, the Incas had
created an empire stretching some 3000
miles along the western coast of South
America. They believed themselves
to be invincible. They were, to use a
sports analogy, ranked Number One and
undefeated. Too big to fail, as they say.
However, by 1572, the Spaniards were
able to claim victory and what we know
today as Peru was colonized.
Executive Officers
President
Thomas R. White, MD
President-Elect Rhett L. Brown, MD
Vice President Charles W. Rhodes, MD
Secretary/Treasurer
Tamieka M.L. Howell, MD
Board Chair
William A. Dennis, MD
Past President (w/voting privileges)
Shannon B. Dowler, MD
Executive Vice President Gregory K. Griggs, MPA, CAE
Fortunately for Pizarro and the
Spaniards, at the very time they invaded
the Inca Empire, the Incas were in
the midst of their own civil war. Two
Inca half-brothers, sons of a powerful
ruler, were pitted against each other
for control of the empire. After a bitter
fight for power, one prevailed. But the
price paid was a divided and vulnerable
nation.
District Directors
District 1 - Jessica Triche, MD
District 2 - Gilbert Palmer, MD
District 3 - Eugenie M. Komives, MD
District 4 - Shauna L. Guthrie, MD, MPH
District 5 - Janice E. Huff, MD
District 6 - Alisa C. Nance, MD
District 7 - David A. Rinehart, MD
At-Large
Jason T. Cook, MD
Pizarro and his men were actually
outnumbered. The Incas could have
easily annihilated their visitors. But the
Incas were intimidated by the Spaniards'
horses, guns, and threats. Many of
the Incas believed the Spaniards to be
At-Large
Jennifer L. Mullendore, MD
IMG Physicians
Joseph P. Pye, MD
Minority Physicians
Benjamin F. Simmons, MD
Osteopathic Family Physicians
Mark Sakr, DO
Continues on p. 6
New Physicians
Cody A. Wingler, MD
NC Family Medicine Departments
Brian A. Kessler, DO (Campbell)
Family Medicine Residency Directors
Geoffrey Jones, MD (MAHEC-Hendersonville)
Resident Director
Deanna M. Didiano, DO (Cabarrus)
Resident Director-Elect
Margarette Shegog, DO (MAHEC-A)
Student Director
Christian A. Jasper, MPH (WFU)
Student Director-Elect
Jeffrey Pennings (Campbell)
Medical School Representatives & Alternates
Chair (Campbell) Brian A. Kessler, DO
Alternate (Duke) J. Lloyd Michener, MD
Alternate (ECU) Chelley Kaye Alexander, MD
Alternate (UNC) Warren P. Newton, MD, MPH
Alternate (Wake) Richard W. Lord, Jr., MD, MA
AAFP Delegates & Alternates
AAFP Delegate Michelle F. Jones, MD
AAFP Delegate Karen L. Smith, MD, FAAFP
AAFP Alternate Richard W. Lord, Jr., MD, MA
AAFP Alternate Robert L. ‘Chuck’ Rich, Jr., MD
The NCAFP Family Medicine Councils
Advocacy CouncilRobert L. Rich, Jr., MD, Chair
Brian Kessler, DO, Vice-Chair
CME Council
Alisa C. Nance, MD, Chair
Membership & Workforce
Jessica Triche, MD, Chair
Benjamin Simmons, MD, Vice-Chair
Practice Management Council
Joseph Pye, MD, Chair
Thomas Wroth, MD, Vice-Chair
Public Relations & Marketing
5
5
William A. Dennis, MD, Chair
Brian Blank, Vice-Chair
in our country, and
nearly 3000 in North
Carolina. The AAFP
is strong and wellorganized and wellrun. Our state chapters
are effective and
strongly supported,
especially ours here in
NC. We have residency
programs across the
country. We have
strong relationships
with our patients. One
out of every 4 office
visits in the United
States is made to a
family physician.
We are here. We are
entrenched. We aren't
going anywhere. We
are grasshoppers,
jumping forward, not
backward.
Aren't we?
"gods." They believed the Spaniard's
promise of wealth, independence, and
freedom. They chose to negotiate, were
lured into a trap, and the Spaniards
killed many of the Incas in a famous
bloody surprise attack, thus gaining a
powerful psychological advantage.
Before the Spaniards, the Incas because of their geographic and social
isolation - were naive to many of the
infectious diseases common to the rest
of the world. The Spaniards introduced
smallpox, flu, typhoid, among other
diseases, leading to the death of many
Incas and further weakening the empire
psychologically and physically.
And lastly, once the Incas realized their
once seemingly-invincible world had
been torn apart and severely crippled,
defeat seemed imminent in their
minds, they lost their pride and their
will. They surrendered and fled to the
jungle. Those who remained succumbed
to their conquerors. A lost city, a lost
culture, and essentially a lost people.
Is it possible we will follow the fate of
the Incas, and one day be a footnote
in the history of medicine? Likely not
you say. We are here now. There are
more than 90,000 Family Physicians
6
Yes, I agree, but let's
take a moment to
pause and consider what we can learn
from the Incas:
As big as we are, and as organized as we
are, we must remain wary and on-guard.
We must never become complacent.
There may well be "others" in our midst
who believe we can be replaced. (After
all, how hard can "primary care" really
be? Can't we just replace those FPs with
cheaper workers to check the boxes
and keep the conveyor belt moving?)
We must focus on making our specialty
even more attractive to medical
students and to the public. We must
be more aggressive in our recruitment
efforts. We are big, but not nearly big
enough. We must be very intentional
and strategic as we jump forward, in
order to not merely survive, but to
reach what we all believe is our deserved
position in the health care system, an
outcome which we all believe would be
in the best interest of the public.
clinical practice vs academicians vs
administrative roles vs all the other
careers family physicians have chosen.
Family Medicine is diverse. But there are
ties that bind us, and at the end of the
day, we must commit to come together
and stay together for the sake of our
specialty.
We tend to underestimate ourselves.
We must not obsequiously fall into
the trap that we are going up against
invincible "gods." We tend to forget
that our greatest allies and advocates
may not be (gasp) other physicians
(who chose other specialities) but
our patients, WHO HAVE CHOSEN
US. (Sorry to be politically incorrect).
Should we negotiate to achieve our
goals? Absolutely! Should we be naive
and forget our own strength? Never.
There are many potentially "infectious"
threats out there: greed, egos, jealousy,
and pettiness. These can weaken and
decimate us. We must put our personal
issues and needs aside, and continue to
focus on what is best for our patients.
In the end, what is best for our patients,
and not ourselves individually, will be
best for Family Medicine.
We absolutely must not back down,
assume we have been defeated, turn
and run. We are so close. We cannot be
intimidated and "sell out." We must stay
the course. We must speak the truth as
we believe it, even if at times it angers
others and invites their threats and their
opposition. We have been threatened
and we will be threatened again. We
must be strong. Because we can be.
So, is our future bright? Actually, I am
confident that it is. We will maintain
our values. We will do the right things.
We will not lose our way. We will not
be the Incas of health care. We will be
united and strong. We will make Family
Medicine the specialty of choice.
Fellow grasshoppers, we will jump
forward.
Not sideways. Certainly not backward.
There are many real and potential
conflicts within our own ranks.
Employed vs Independent physicians.
Traditional business models vs
alternative models, such as Direct
Primary Care. Single payer vs
multipayer advocates. Those in
Forward. Strongly. Confidently.
Deservedly.
We must. Our future depends on it.
SECURITY BREACHES ON THE RISE – ARE YOU COVERED?
The recent cyber-attacks on one of the largest health insurers, Anthem Inc., underscores the fact physicians and other
health care entities are increasingly exposed to privacy related claims such as lost laptops, hacking, and virus attacks,
which can result in an embarrassing and costly loss. Does your practice have adequate cyber-liability coverage in the
event of a security breach?
In the case of Anthem, hackers stole personal information relating to current and former customers after breaching an IT
system containing data on approximately 80 million people, the company reported. Cyber-security has become a major
concern both for U.S. firms facing a barrage of attacks, as well as insurers trying to figure out how much of that risk they
can afford to underwrite.
Medical identity theft is often not immediately identified by patients or their provider, giving criminals years to milk such
credentials. That makes medical data more valuable than credit cards, which tend to be quickly canceled by banks once
fraud is detected. “The [Anthem] information is a treasure trove for cybercriminals. It can easily be sold on underground
markets within hours and used for a wide variety of identity fraud schemes,” said Stuart McClure, chief executive of cybersecurity firm Cylance Inc. (Insurance Journal, 2/5)
Experts say that even in light of the Anthem and other recent breaches, it has been a challenge to convince health care
organizations to step up their spending and reverse their chronic underinvestment in information technology security.
Even before the Anthem data breach, there had been 1,172 breaches large enough to expose 500 or more individuals’
records, or 40.9 million individuals’ medical records in all, according to the breach list compiled by the Department of
Health and Human Services’ Office for Civil Rights.
Dr. James Madara, CEO of the American Medical Association, expressed hope that the recent breaches will lead to
greater security spending. Data security hasn’t made many top-five problem lists among health care organizations,
Madara said. The Anthem breach “will bring some light to that. If cyber-security isn’t something that’s at the top of your list
as an insurer or an integrated system, it has to get there very quickly.” (Modern Healthcare, 2/7)
In today’s data-driven world, where sensitive patient information is collected, stored, and communicated electronically,
physician and surgeon practices of all sizes are especially vulnerable to costly and damaging liabilities from data security
breaches. Cybercrime, including identity theft, is the fastest growing criminal activity. Whether your data is compromised
by a hacker, virus, cyber thief, or simply because of lost or stolen computers, laptops, flash drives or smart phones, the
breaches can have serious ramifications. The cost to recreate compromised patient data is staggering, and includes the
expense of notifying customers—now legally mandated by 46 states—possible fines, and legal expenses. Your practice
can also suffer immense damage to its reputation and from the interruption to business.
Traditional liability insurance products only cover “tangible” assets. Electronic data is not considered “tangible” under the
typical policy definition. Cyber-liability coverage fills that gap. There may be a small amount of coverage on a professional
liability policy, but this amount can be quickly eroded. It is highly recommended that all health care offices purchase
additional cyber liability coverage.
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HEALTH POLICY
By: Joanna Spruill, JD
NCAFP Director of Government Relations & General Counsel
ADVOCACY & GOVERNMENTAL AFFAIRS
2015 Legislative Session Marked by Wide-Ranging Healt
T
he 2015 legislative
session is well under
way in Raleigh, North
Carolina. The snow
days in February
did not slow down
lawmakers one bit,
though they made the weeks leading
up to crossover a bit more hectic. As of
early May, lawmakers had filed more
than 1,600 bills this session.
The NCAFP governmental affairs
team has been monitoring any and
all health legislation that is filed and
introduced. So far this session, there
have been a variety of bills dealing
with health policy including: reforming
the state's Medicaid program, ending
the Primary Care Case Management
contract, prohibiting children under 18
from using commercial indoor tanning
equipment, mandating chiropractor
co-pay parity to primary care, requiring
testing for Type 1 childhood Diabetes
at certain age intervals, allowing
independent practice for advanced
practice registered nurses, changing the
minor consent law, and reforming the
state's certificate-of-need process.
Out of the 1,600 bills filed, only some
of them will actually become law. Once
a bill is filed, it must not only receive
a favorable vote in any of its assigned
committees, but it must also pass the
full chamber's approval on the floor,
and then it is only half-way done. It
must go through a similar journey in
the other chamber, before it can be
presented to the Governor, who then
must sign it into law.
8
White Coat Wednesday
Push April 15, 2015
Almost two-dozen NCAFP members
attended family medicine's first White
Coat Wednesday for the legislative
session, advocating on several key issues
important to Family Medicine, including
the need to continue to support
Community Care of North Carolina,
to build on what's currently working
in Medicaid, and to support physicianled, patient-centered medical homes.
Physicians, residents, and students
all had productive meetings with
legislators. The day began at NCAFP
offices, where the NCAFP governmental
affairs team briefed members on relevant
issues, reviewed talking points, and
discussed what to expect in a meeting.
NCAFP's final White Coat Wednesday of
2015 is scheduled for June 10, 2015.
Crossover -- April 30, 2015
While the North Carolina General
Assembly has no limits on when it
must end its session, crossover is a
provision that at least attempts to limit
the number of bills the legislature must
juggle as the session progresses. It is
the last day by which most bills not
involving raising or spending money
must pass either the House or Senate in
order to be eligible for consideration the
rest of the year and for the following
short session. This year the legislature
set the crossover deadline
as April 30, 2015.
The weeks leading up to crossover are
busier than usual at General Assembly.
The daily calendar is full of committee
meetings and session often creeps into
Two dozen NCAFP members visited with legislators
is planned for Wednesday, June 10, 2015.
the late evening. This year was no
exception. The House held a marathon
session Wednesday, April 29th that
went into early morning Thursday. They
debated bills for ten hours and finally
gaveled out around 2:30am on April
30th. In the other chamber, the Senate
took a more methodical approach,
holding session regularly each day.
Medicaid Reform Recap
Reform of the state's $14 billion
Medicaid program continues to remain
a priority this session for both the House
and Senate. So far, six bills have been
filed: Senate Bill 696 (House Bill 525):
Medicaid Modernization; Senate Bill
701: Discontinue Medicaid Contract
for PCCM; Senate Bill 703: Medicaid
Transformation; Senate Bill 574 (House
Bill 372): 2015 Medicaid Reform;
You belong on our team.
th Proposals
FAMILY MEDICINE
Physician Career Opportunities
members. This conference committee
negotiates the full budget.
The very first step in the budget
process is the Governor's Budget
recommendations. In early March,
Governor Pat McCrory presented
his budget recommendations to the
General Assembly. Highlights from
his budget include:
• $1.2 million each year to
invest in the oversight and
administration of accountable
care organizations.
in mid-April. The Academy’s next advocacy push
and Senate Bill 568: NC Health Care
Modernization. NCAFP's governmental
affairs team continues to monitor these
bills and advocate for a physician-led
solution to reform - one that leverages
the investments we have already made
and shifts to a value-based healthcare
delivery system.
The State Budget
The method for developing a $21
billion tax-and-spending plan is a
lengthy process. This year the House is
tasked to develop and adopt its budget
proposal first. Once the House adopts
their version, the Senate is then tasked
to adopt its own version. Once both
chambers have adopted versions of
the budget, legislators will appoint a
conference committee made up of a
smaller number of House and Senate
• A Medicaid Rebase of $287
million in for the first year
and $460 million in the
second. The Medicaid Rebase
includes forecasted changes
in enrollment, utilization of
services, federal matching funds,
and changes in anticipated costs
per recipient.
• A Medicaid Risk Reserve fund
totaling $175 million over two
years.
• $5.3 million over two years to
improves services at the Office
of the Chief Medical Examiner.
• $8 million allocation of funds
to the Brody School of Medicine
at East Carolina University.
Notably, no cuts to Medicaid
reimbursement to physicians were
included in the Governors budget or
the budget proposed by the House.
The NCAFP advocacy team will be
closely monitoring the budget as it
continues through the process.
Carolinas HealthCare System, a
national leader in the transformation of
healthcare services, is actively seeking
dynamic Family Medicine physicians to
join our growing team throughout North
and South Carolina.
General details include:
 Primarily outpatient only with a few
locations offering inpatient
 Positions are Monday–Friday,
8 a.m.–5 p.m.
 Comprehensive Care Teams
At Carolinas HealthCare System, you
will work as a key member of a
supportive team that is responsive to
your opinions and respects your
expertise. With more than 1,000 primary
care physicians across our System, we
are One team dedicated to transforming
the delivery of healthcare while
providing a superior patient experience.
Our service area allows for an
exceptional quality of life, giving you the
option of living and working anywhere
between the world-famous Carolina
beaches and the breathtaking Blue
Ridge mountain chain.
We offer a comprehensive
compensation and benefits program
designed to be competitive and
responsive to the varied needs of our
diverse workforce.
For more information about a career with
Carolinas HealthCare System,
please contact:
MICHELE ROCCO
PHYSICIAN RECRUITER
Michele.Rocco@CarolinasHealthCare.org
(800) 847-5084
EOE/AA
EDUCATION
By: Kathryn Atkinson
NCAFP Meetings & Events Manager
2015 NCAFP
Mid-Summer Meeting
Sun,
Sand
&
CME
The Perfect
Combination
I like when things are combined into
threes ... and to me, this is the perfect
combination!
Sun, Sand & CME! Throw in a few
practical and popular workshops,
general sessions that end by 1:15
pm each day and family fun that
memories are made of, and the perfect
combination gets even better!
I'm talking about our Mid-Summer
Family Medicine Digest scheduled for
Sunday, June 28 through Friday, July
3, 2015 at the Kingston Plantation
and Embassy Suites in Myrtle Beach,
SC. This annual event features up to
30+ AAFP Prescribed Credits, a free
interactive-mobile conference app
and includes lectures addressing the
medical issues you see most often on the
practical topics that you have requested.
Dr. Alisa Nance, Program Chair, has
assembled an outstanding line-up
of lecture topics to include: Obesity,
Sleep Disorders, Onychomycosis,
10
Problems During Pregnancy, Diabetes,
Pediatrics, Sports Medicine, Lung
Cancer, Varicose Veins, Adult
Immunizations, and many more.
She has also planned for some lively
interactive team-based learning on
Hypertension and Lipids, as well as
helpful workshops such as Mastering
Valuable Hands-On Procedures,
Practice Management, and a SAMS
Study Working Group on Early
Childhood Illness.
By the way, you won't need to shuck
oysters to take home a pearl or two of
your own from Myrtle Beach. When
our knowledgeable and expert guest
speakers take center stage, you are
sure to come away with pertinent,
useful information on various topics
that you can begin using in your
practice right away. Our faculty of
carefully-chosen speakers includes Dr.
B. Wayne Blount, Dr. Richard W. Lord,
Jr., Dr. Rhett L. Brown, Dr. Thomas
R. White, Ms. Emily Hill, Dr. Brian R.
Forrest, Dr. Carolyn Dunn, Dr. Paul M.
Berman, Dr. Kevin Burroughs, Dr. James
W. McNabb, Dr. David G. Weismiller,
Dr. Americo Fraboni, and many more. If
you have ever attended an NCAFP event
before, then you know that we only
invite the best!
Did I mention this event is hosted
each year in the perfect location? The
Embassy Suites / Kingston Plantation is
oceanfront and offers several sleeping
room options. Whether you enjoy
your week by the sea in the hotel,
the villas or the condos, the beach is
only steps away! The Embassy Suites /
Kingston Plantation can be reached at
800-Embassy or by calling 800-876-0010.
Hotel room rates range from $245 to
$448 per night, depending on size and
location. Be sure to mention the NCAFP
for our group rates and make your hotel
arrangements early, as the hotel is likely
to sell out for this event.
Finally, your week of CME includes
plenty of time outside the lecture hall.
A flexible conference schedule allows
you time in the afternoons to make
memories with friends and family.
Enjoy splashing in the ocean, strolling
along the beach, floating in the Lazy
River pool and visiting the many
area restaurants and entertainment
attractions at your leisure. The NCAFP
also has discount tickets to the Alabama
Theater on Thursday night and we
encourage everyone to participate in
Wednesday morning's Fourth Annual 5K
Beach Fun Run.
Watch your email or visit our
conference website at www.ncafp.com/
msfmd for additional announcements,
updated schedule information, lecture
topics, confirmed speakers and to
register online. Contact Kathryn
Atkinson in the Meetings Department at
919-833-2110 (or 800-872-9482 in NC
only) at ext. 114 or at Katkinson@ncafp.
com with any questions you may have.
Mark your calendar, dust off your flip
flops and start making plans soon for
your own perfect combination of sun,
sand and cme in Myrtle Beach. I look
forward to seeing you soon! #ncafpcme
North Carolina
Academy of Family
Physicians
2014 Annual
Report
2014 State of the Academy
What could best be described as a whirlwind year, 2014 was marked by big opportunities, shifting
challenges, and a more publicly-visible North Carolina Academy. From the highs of speaking alongside
Governor Pat McCrory at the Governor’s mansion to the continued uncertainty of state Medicaid
Reform, the NCAFP’s leadership team had one of its most demanding, but also one of its most
successful years in its 66-year history. Throughout the year, we grappled with change, pressed forward
with our goals, and positioned the NCAFP for an even stronger future.
Dr. William A. Dennis
NCAFP President
2013-2014
A Demanding Legislative Year
Ask any NCAFP leader about the machinations at the North Carolina General Assembly in 2014, and
one common theme you might discover is how demanding it was for a so-called ‘short’ session.
Keeping NCAFP’s advocacy team busy at every turn was the ongoing Medicaid Reform debate, a
dominating discussion that changed direction multiple times and had NCAFP leaders working both inside and outside of the legislature. All of this led to family physicians playing a leading role in advocating
for physicians and patients and becoming an important voice in the legislative discussion. NCAFP
leaders testified several times before the Medicaid Reform Advisory Group, a panel that sought to
gather perspectives on how best to reform Medicaid. Family physicians also played visible roles in other
ways, including providing one-on-one insight with key state leaders, executing a very public and
proactive media campaign, and supporting our healthcare allies in several coordinated advocacy
efforts. This work paid tremendous dividends for Family Medicine, the most notable of which was raising the profile of the specialty with state leaders and the media across North Carolina. The high point
came with NCAFP’s involvement at a major news conference held by Governor McCrory which included
myself speaking in front of a throng of media. Never before has a family physician been awarded such
an honor and it speaks to the steady progress our chapter has made in the last few years in raising our
profile. This event generated near hundreds of media mentions across the state and is an experience I
shall never forget.
Membership
At the chapter level, we were just as busy and the Academy worked hard to refine and improve how
we serve our members. The seeds of this effort were planted in 2013 when the chapter conducted a
comprehensive member needs assessment. This generated feedback and insight that helped Academy
4000
NCAFP Membership
Growth
3500
3000
2013
2014
2500
2000
1500
86%
Market
Share
in NC
1000
500
0
12
Total
Actives
Students
Residents
3rd highest in the nation at 86%
leaders better understand the changing needs
of our membership. The most striking shift our
assessment confirmed was the movement
towards practicing in employed roles for many
of our members. Responding to this trend and
others we discovered, your Academy took a
number of steps, including crafting an updated
strategic plan and realigning our main councils.
In each of these, embracing change was the
common thread, and our Academy remains
committed to providing you, the member, with
the most value it can and doing whatever is
necessary to help our members thrive today
and tomorrow.
Expanding Collaboration
Another important investment area was your
Academy’s work in enhancing our relationships
t
% (AAFP 76.3%).
to strengthen primary care. We seated an
osteopathic physician representative on
the Academy’s board of directors and also
continued to work closely with our osteopathic colleagues at the North Carolina
Society of the American College of
Osteopathic Family Physicians. Additionally,
we collaborated with organizations across
primary care, including the NC Pediatric
Society and the NC Community Health
Centers Association, to help improve the
overall practice environment.
Education & Development
On the education front, your Academy
continued to provide exceptional education
and professional development. From our
conferences that continue to be very well-
attended to the growing lineup of workshops, seminars and online programs your
Academy provides, our excellent education
continues to improve. We helped train more
than 400 physicians to be DOT-certified
medical examiners and also educated
multiple hundreds at our annual conferences. Continue to look to the NCAFP for
great CME!
I will never forget my experience serving as
your president, especially in acting as your
voice and advocate during such a
demanding and challenging time. What
I’ve mentioned above is just a small
snapshot of what occurred in 2014, and I
haven’t even mentioned one of my proudest moments: hearing Dr. Mott Blair’s name
called out as one of the new AAFP Board
Members at the Congress of Delegates
in Washington, DC. More on that elsewhere in this Annual Report. But none
of this would have been possible without
our members or the hardworking and
dedicated physician leaders I have been
privileged to work alongside. Thank you for the trust you placed in me
and in a leadership experience I shall
never forget. 97.1%
95.1%
87.6%
Active Member Retention (2013-2014)
First place, large chapter category with 97.1% Active member renewals (AAFP 94.4%)
New Physician Retention (2013-2014)
First place, large chapter category at 95.1% (AAFP 89%).
Resident-to-Active Conversion (2013-2014)
4th highest large chapter at 87.6% (AAFP 76.8%).
Academy Year in Review
Greg Griggs, MPA, CAE, NCAFP Executive Vice President
Another Successful Year!
It is an honor and privilege to continue
to work for the NC Academy of Family
Physicians. Few days go by when I don’t
enter the office excited to go to battle for
the family physicians of our state. Why
because you – the family physicians of
North Carolina – always put the needs of
your patients and communities first. That
simple fact sets your organization and your
specialty apart – caring about the patients
and communities of North Carolina. And
that is what your Chapter leaders and
staff always try to remember as well. And
that is exactly what breeds success as an
organization. Here are just a few of the
successes from 2014.
Membership
Your Chapter continues to grow, surpassing
3,700 members in 2014. That includes
almost 2,400 practicing family physicians
across the state, nearly 800 students and
nearly 300 residents. Some key facts:
certification exam to give physicians to
truck drivers. Other key facts:
• Membership grew by a total of 189
individuals in 2014.
• Over 240 people attended our
Mid-Summer Meeting, and 31 companies
exhibited. At that meeting, we rolled out a
new “app,” which 72% of the attendees used
during the course of the week.
• We retained a higher percentage of
members than any other large AAFP
Chapter in the country.
• We also retained new physician members
(less than seven years out of residency) at
a higher percentage than any other large
Chapter.
Continuing Medical Education
We continue to offer numerous valuable
educational programs. In 2014, we added
DOT Medical Examiners training to our
basket of services, helping nearly 400
physicians across the state pass the
• Our Annual Meeting once again
approached 800 attendees, with total
registration of 778 plus 79 exhibits.
Governor Pat McCrory attended our annual
meeting, filming a special year-end edition
of NC Spin with Tom Campbell. McCrory
then took questions from the audience.
• We launched another MOC Part IV Online
Program in conjunction with CCNC and the
NC Pediatric Society, this one on Caring for
Foster Children.
2013-2014 NCAFP Board of Directors
President
President-Elect Thomas R. White, MD
Vice President Rhett L. Brown, MD
Secretary/Treasurer
Charles W. Rhodes, MD
Board Chair
Brian R. Forrest, MD
Past President (w/voting privileges)
Executive Vice President Gregory K. Griggs, MPA, CAE
IMG Physicians
Joseph P. Pye, MD
Minority Physicians Benjamin F. Simmons, MD
Osteopathic Family Physicians
Robert Agnello, DO
New Physicians
Matthew G. Kanaan, DO
NC Family Medicine Departments
Family Medicine Residency Directors
Brian A. Kessler, DO (Campbell)
Geoffrey Jones, MD (MAHEC-Hendersonville)
Resident Director Resident Director-Elect Student Director District Directors
14
District 1
Jessica Triche, MD
District 2
Matthew M. Williams, MD
District 3
Eugenie M. Komives, MD
District 4
Tamieka Howell, MD
District 5
Janice E. Huff, MD
District 6
Alisa C. Nance, MD
District 7
David A. Rinehart, MD
At-Large
Holly Biola, MD
At-Large
Jennifer L. Mullendore, MD
Student Director-Elect
Aaron George, DO (Duke)
Deanna M. Didiano, DO (Cabarrus)
Julie Barrett (ECU)
Christian A. Jasper, MPH (WFU)
Medical School Representatives & Alternates
Chair (Campbell) Brian A. Kessler, DO
Alternate (Duke) J. Lloyd Michener, MD
Alternate (ECU) Kenneth K. Steinweg, MD
Alternate (UNC) Warren P. Newton, MD, MPH
Alternate (Wake) Richard Lord, Jr., MD
Advocacy and Government Affairs
While you probably have heard more about
Medicaid Reform than any other government
affairs topic that is just one of many of the
issues we tackled in 2014. And while we
did continue to advocate against corporate
managed care and for provider led solutions,
here are some of the other actions you’re your
Government Affairs Team:
• Finalized and submitted comments regarding
the Hydraulic Fracturing Chemical Disclosure
Rules that sought further clarification on how
the rules could impact the physician-patient
relationship.
• Launched the NCAFP Capitol Report, a weekly
update on legislation, policy, and politics initially
sent to Advocacy Council and NCAFP Board
members, to increase member engagement in
our advocacy efforts. Now, anyone can sign up
for this special report by just e-mailing Joanna
Spruill, JD, at jspruill@ncafp.com.
we have now increased our Foundation’s
endowment for medical student programs to
almost $1.1 million.
• Coordinated and promoted a series of
White Coat Wednesday Advocacy events,
culminating with a press conference at the
Governor's Mansion to support the House's
provider-led Medicaid reform plan.
And that’s Not All
In 2014, your communications team relaunched a new and improved NCAFP website
at www.ncafp.com. In addition, we expanded
our quarterly NC Family Physician magazine
to 32-pages.
And at the national level, we were proud to
report that Dr. Mott Blair won a three-year
term on the AAFP Board of Directors in a
hard fought campaign culminating at the
2014 Congress of Delegates in Washington,
DC. At that same meeting, Dr. Robert L.
(Chuck) Rich was named chair of the AAFP
Commission on Health of the Public and
Science, continuing a long line of AAFP
Commission Chairs from NC that recently
included Dr. Blair, Dr. Karen Smith, Dr. Tom
Koinis, Dr. Conrad Flick and Dr. Viviana
Martinez-Bianchi.
Our student programs continue to roll along
with growing student interest in family
medicine. Nationally, one in four medical
students are now members of the AAFP. And
Here’s looking to continued success for
the NCAFP, and most importantly for the
family physicians of North Carolina and your
patients.
• Increased media exposure and grassroots
presence through letters to the editor, calls
to action, and earned media focusing on
Medicaid reform.
NCAFP Past Presidents (L to R from above): Drs. Tom Koinis (97); Tommy Newton (96); Shannon Dowler (13); Karen Smith (05);
Chip Watkins (10); Mott Blair (03); Maureen Murphy (01); Bob Gwyther (02); Bill Dennis (14); Conrad Flick (04); Tom White (15); Rich
Lord (11); Bill Hedrick (76); Brian Forrest (12); Chuck Rich (09); Christopher Snyder (08); Carson Rounds (06); Michelle Jones (07); Allen
Dobson (99); and Jim Jones (73).
AAFP Delegates & Alternates
AAFP Delegate AAFP Delegate AAFP Alternate AAFP Alternate AAFP Commissions, Committees & Appointments
Mott P. Blair, IV, MD
Karen L. Smith, MD, FAAFP
Michelle F. Jones, MD
Robert L. ‘Chuck’ Rich, Jr., MD
AAFP Foundation Board of Directors
AAFP Commission on Continuing Professional DevelopmentRichard Lord, MD
AAFP Commission on Governmental Advocacy
Karen L. Smith, MD, FAAFP
AAFP Commission on Health of the Public & ScienceRobert L. Rich, Jr., MD
AAFP Commission on Membership & Member Services
The NCAFP Family Medicine Councils
Advocacy CouncilRobert L. Rich, Jr., MD, Chair
CME Council
Alisa C. Nance, MD, Chair
Health of the Public Council
Charles W. Rhodes, MD, Chair
Practice Enhancement CouncilRhett L. Brown, MD, Chair
AAFP Commission on Quality & Practice
AAFP Congress of Delegates - Student Delegate
AAFP Commission on Education, Student Representative
AAFP Resident Delegate to the AMA House of Delegates
AAFP FMIG Regional Coordinator, Southeast
AAFP Student Rep. to the Annals of FM Editorial Board
Gregory K. Griggs, MPA, CAE
Brian Blank (UNC)
Brian Blank (UNC)
Aaron George, DO (Duke)
Cleveland Piggott (UNC)
Samantha Heuertz Moore (UNC)
15
CME Meetings & Conferences
2014 Midsummer Family Medicine Digest
2014 DOT Medical Examiner Certification Training Courses
• 6 AAFP Prescribed Credits
• 36.50 AAFP Prescribed Credits
• Program Chair: Thomas R. White, MD
• Program Chair: Thomas R. White, MD
• Program Vice-Chairs: Michael Busman, MD and Nicolas Bird, MD
• Program Vice-Chair: Alisa C. Nance, MD
• 243 Registrations; 31 Exhibitors
• 204 Registrations (142 Members / 62 Non Members) - Raleigh 2014
• 185 Registrations (107 Members / 78 Non Members) - Hickory 2014
2014 Winter Family Physicians Weekend
• 34 Registrations (24 Members / 10 Non Members) - Charlotte 2014
• 34 AAFP Prescribed Credits
2014 NCAFP Leadership Retreat - The Pinehurst Resort
• Program Chair: Charles W. Rhodes, MD
• Non-CME
• Program Vice-Chair: Jennifer L. Mullendore, MD
• Program Chair: William A. Dennis, MD
• 778 Registrations; 79 Exhibitors
• 45 Registrations
NCAFP’s Frontline CME Programs
2014 Mastering Valuable Hands-On Procedures – Part V. Conducted workshops at NCAFP Mid-Summer and Winter Meetings.
Our Raleigh, NC workshop was filmed for an online program.
New Insights in the Management of Fibromyalgia: Refining the Response of Patients to Individualized Treatment – Chapter Lecture Series –
Part II. The NCAFP in joint sponsorship with Consensus Medical Communications, conducted lectures at eight AAFP chapters during 2013 and 2014.
Improving Adherence and Maintaining Remission in Major Depressive Disorder – Chapter Lecture Series – Part II. The NCAFP, in joint sponsorship with Consensus Medical Communications, conducted lectures at eight AAFP chapters during 2013 and 2014.
ID OC: Identifying & Addressing Opioid-Induced Constipation Opioid-Induced Constipation in Individuals – Chapter Lecture Series – Part I. Conducted lectures at several regional AAFP chapter meetings aimed at recruiting four chapters. NCAFP is continuing to work in joint sponsorship
with Spire Learning to develop CME content.
Maintenance of Certification Part IV Project - Creating A Medical Home For Children and Youth In Foster Care and Promoting Dental Homes
for Young Children Through Screenings, Varnishing, and Referrals. Two additional MOC Part IV projects of five where developed and launched.
These projects were grant supported by Federal CHIPRA funding program through Community Care of North Carolina.
2014 Educational Supporters
AAFP Chapter Lecture Series: ADHD in Females
Forest Laboratories, Inc.
Supported by an educational grant from Shire.
Fortis Spectrum
Boehringer Ingelheim Pharmaceuticals, Inc.
Supported by an educational grant from Takeda Pharmaceuticals, Inc.
California Academy of Family Physicians Member of the
collaborative on REMS Education (CO*RE)
Integrity Continuing Education
Supported by an independent educational grant from the ER/LA Opioid
Analgesics REMS Program Companies (RPC.)
Legally Mine
Center for Independent Healthcare Education and Vemco MedEd
LipoScience
Supported by an educational grant from Astellas Scientific and
Medical Affairs, Inc.
Lilly USA, Inc.
Creative Educational Concepts
National Kidney Foundation
16
2014 Educational Supporters continued...
New Jersey Academy of Family Physicians
This activity is supported by an educational grant
from Takeda Pharmaceuticals, Inc.
North Carolina Academy of Family Physicians and
Spire Learning
from Takeda Pharmaceuticals, Inc.
North Carolina Academy of Family Physicians and
Spire Learning
from Genentech.
OMEW- Outcomes Management Educational
North Carolina FAMPAC
Workshops
Primary Care Consortium, Inc.
Purdue Pharma L.P.
Contributions to FAMPAC, the Academy’s political action committee for Family
Medicine, totaled $15,644.50 from a total of 54 NCAFP members in 2014. FAMPAC
made contributions to 20 candidates in 2014 totaling $15,750.00. The ending balance
in the committee’s account as of December 31, 2014 was $2,164.68. The following
members made contributions:
University of Nebraska Medical Center, Center for
Continuing Education and the North Carolina Medical
Robert Agnello, DO
William S. Kelly, MD
Board and the France Foundation
Bailey Balentine, MD
Brian Kessler, DO
Daniel D Bellingham, MD
Mary F. Knox, MD
Janalynn F. Beste, MD
Eugenie Komives, MD
Holly Biola, MD
Richard Lord Jr., MD
2014 Educational Partnerships
Mott P. Blair, IV, MD
John Mangum, MD
MagMutual
Janet Bowen, MD
Tim McGrath
Medical Mutual Insurance
Rhett L. Brown, MD
James W. McNabb, MD
Lisa A. Cassidy-Vu, MD
Jennifer Mullendore, MD
Maureen Murphy, MD
Shannon Dowler, MD
Alisa Nance, MD
J. Wesley Earley, MD
J. Thomas Newton, MD
Howard Eisenson, MD
Donald A. Nisbett, MD
Janice Huff Ezzo, MD
Michael Pass, MD
Garett Franklin, MD
D. Michael Payseur
Aaron E. George, DO
Joseph Pye, MD
Bonzo Reddick, MD
Michael Gross, MD
Robert Gwyther, MD
Robert L. Rich Jr., MD
David Hall, MD
Douglas I. Hammer, MD
J. Carson Rounds, MD
Gala Henson, MD
Benjamin F. Simmons, MD
Dimitrios Hondros, MD
Christopher Snyder, III, MD
Tamieka Howell, MD
Beat Steiner, MD
Mary Ibarra, MD
R.W. Watkins, MD
James Jones, MD
Thomas R. White, MD
Matthew Williams, MD
2014 Frontline Programs
Gebauer’s Pain Ease
2014 Non-CME Satellite Programs
Merck
Exact Sciences
Marley Drug
Novo Nordisk
Health Diagnostic Laboratory, Inc.
Galderma
17
Awards & Honors
2014 NC Family Physician of the Year
Maureen E. Murphy, Concord, NC
A passionate advocate for patients while striving to educate and mentor
the next generation of family physicians. These core traits have defined
the remarkable medical career of Dr. Maureen Murphy of Concord, NC,
a family physician, medical educator and mentor to countless medical
students and residents. Dr. Murphy was recognized for effortlessly
blending adept clinical skill with compassion and wisdom while embracing
all of the key ideals of the specialty, including a lifelong commitment to
delivering both comprehensive and coordinated care, helping to advance
the specialty of Family Medicine, and tirelessly serving North Carolina’s
communities.
Dr. Murphy began her career in communications, working as a
television reporter and public relations writer. This path led her to join the
Society of Teachers of Family Medicine as their membership and public
relations director in 1977. It was in this role where Dr. Murphy would
discover her true life’s calling: family medicine. Murphy currently serves
patients as a member of the teaching faculty at Cabarrus Family Medicine
in Concord.
2014 Outstanding Family Medicine Residents
2014 Community Teaching Award Winners
Cabarrus Family Medicine Residency Program
The Brody School of Medicine at East Carolina University
Jacob A. Frady, MD
Ken T. Yang, MD
Carolinas Medical Center Family Medicine Residency Program at Charlotte
Duke University School of Medicine
Jessica L. Grass, MD
Patti Wheeler, MD
Carolinas Medical Center Family Medicine Residency at Union Regional
University of North Carolina School of Medicine
David E. Small, MD
Cone Health Family Medicine Residency Program
Edward V. Williamson, MD
Bobby M. Levy, MD
Wake Forest School of Medicine
Ted J. Nifong, MD
Duke University Family Medicine Residency Program
Jonathan P. Bonnet, MD
East Carolina University Family Medicine Residency Program
Vontrelle Roundtree, MD
MAHEC Family Medicine Residency Program at Asheville
Katharine C. Rasche, MD
MAHEC Family Medicine Residency Program at Hendersonville
2014 Family Medicine Faculty Advisors
The Brody School of Medicine at East Carolina University
R. Aaron Lambert, MD
Susan K. Keen, MD
Susan A. Schmidt, MD
Vontrelle Roundtree, MD
Cristin M. O’Grady, MD, MPH
New Hanover Family Medicine Residency Program
Duke University School of Medicine
Nancy J. Weigle, MD
William C. McLeod, DO
Jerry M. Wallace School of Osteopathic Medicine at Campbell University
Southern Regional AHEC Family Medicine Residency Program
Alexander C. Gelou, MD
UNC Chapel Hill Family Medicine Residency Program
Keyona C. Gullett, MD
Wake Forest School of Medicine Family Medicine Residency Program
Elizabeth M. Nelson, MD
Charlotte Paolini, DO
University of North Carolina School of Medicine
Kelly Bossenbroek Fedoriw, MD
Thomas F. Koonce, MD, MPH
Wake Forest School of Medicine
C. Randall Clinch, DO, MS
WOMACK Family Medicine Residency Program
Ashley A. Roselle, DO
18
Financial
Summary
The following represents the 2014 year-end
financial summary for the NCAFP Academy.
This Summary is only a part of the complete
financial statements examined by Thomas, Judy
& Tucker, P.A., Certified Public Accountants. The
complete Financial Statements are available to
any member of the North Carolina Academy of
Family Physicians, Inc. upon request at the NCAFP
headquarters.
Assets
Dec. 31, 2014
Dec. 31, 2013 Dec. 31, 2012 Current Assets:
Cash and Cash Equivalents
587,000
887,015
883,019
Accounts Receivable, net of Allowance for
Doubtful Accounts of $500 in 2014 and 2013 75,014
100,293
38,198
Prepaid Expenses
17,230
18,298
19,865
Certificates of Deposit
300,000
Investments
1,392,350
1,289,450
973,671
Total Current Assets
2,071.594 2,595,0561,914,753
Property and Equipment:
Land
Building and Improvements
Furniture and Equipment
Less Accumulated Depreciation
Net Property and Equipment
205,000
668,305
285,859
205,000
642,835
278,080
205,000
625,108 243,873
(526,682)
(504,191)
(471,538)
632,482
621,724
602,443
Other Assets
Investment, Deferred Compensation
130,047
Certificates of Deposit
Total Assets
Liabilities and Net Assets
125,045
120,235
300,000
2,834.123 3,341,8252,937,431
Dec. 31, 2014
Current Liabilities:
Accounts Payable
103,833
Deferred Revenue - Membership Dues
248,635
Deferred Revenue - Programs
52,139
Accrued Retirement Contributions
Accrued Paid Time-Off
15,509
Total Current Liabilities
420,116
Dec. 31, 2013 Dec. 31, 2012 343,108
253,777
347,715
31,500
15,371
157,300
239,065
200,983
13,025
991,471610,373
Long-Term Liabilities:
Deferred Compensation
130,047
Total Liabilities
550,1631,116,516 730,608
125,045
120,235
Net Assets
Undesignated
Board Designated
2,257,764
26,196
2,154,805
70,504
2,137,301
69,522
Total Net Assets
2,283,960
2,225,309
2,206,823
Total Liabilities and Net Assets
2,834,123 3,341,8252,937,431
FOUNDATION
2014 NCAFP Foundation
Board of Trustees
Foundation Executive Officers
President
Vice President
Christopher Snyder, III, MD, FAAFP
Secretary/Treasurer
Robert L. Rich, Jr., MD, FAAFP
Executive Vice President
Physician Trustees
Mott P. Blair, IV, MD, FAAFP
L. Allen Dobson, MD, FAAFP
Dimitrios P. Hondros, MD
Michelle F. Jones, MD, FAAFP
Viviana Martinez-Bianchi, MD, FAAFP
David E. Lee, MD
Robert L. ‘Chuck’ Rich, Jr., MD, FAAFP
Christopher Snyder, III, MD, FAAFP
Thomas R. White, MD, FAAFP
Trustee Emeritus
Maureen E. Murphy, MD, FAAFP
Corporate Trustees
Marina Calabrese, Medical Mutual Insurance Company
JJ Darby - Johnson & Johnson Services, Inc.
Patti Forest, MD, MBA, FAAFP - Blue Cross & Blue Shield of NC
Foundation
Financial Summary
The Foundation ended 2014 with $2,268,972.00 in total assets. Grant revenue
was $194,350.00 and total revenues for the year were $320,808.00.
Contributions
Contributions from Member Dues
$26,430.00
Individual Designated Contributions:
Individual Contributions $10,818.00
(includes General Fund, Tar Wars,
Interest & Scholars Fund and Silent Auction Cash Contributions)
Medical Student Endowment
$3,122.00
Corporate Member Contributions
$4,500.00
Silent Auction Contributions $16,727.00
Including Corporate Sponsorship
AAFP Foundation Grant for Student Externships
$1,250.00
AAFP Foundation Grant for Student $7,000.00
Rural Health Programs Grant Funded Projects
Blue Cross and Blue Shield of NC $177,100.00
Foundation-FM Interest & Scholars Program
2014 Corporate Membership Program
The following organizations contributed at least $1,000 to the Foundation and
were named corporate members for the year:
Medical Student Endowment Fund
The endowment now totals $1,074,787.00
The Annual Foundation Silent Auction
This event generated revenue of $16,727.00, with expenses of $10,511.00
for a net gain to the Foundation of $6,216.00.
Resident Trustees
Farhad Modarai, DO (Duke)
Holly L. Stegall, MD (Cabarrus)
Student Trustees
Marlana R. Sheridan (ECU)
Lauren A. Visser (UNC)
20
• Blue Cross and Blue Shield of North Carolina Foundation
• GlaxoSmithKline
• Medical Mutual Insurance Group
• NC Academy of Family Physicians
Student Activities
Family Medicine Interest Groups – The Foundation supported all North
Carolina interest groups with funding and staff support. Financial support
totaled over $32,400.00 directly to FMIGs and/or students and included the
following: support to offset FMIG annual banquet costs, student attendance
at the AAFP National Conference for Family Medicine Residents and Medical
Students, the ability to bring national-level speakers to FMIGs, and support to
help students attend the NCAFP Annual meeting in Asheville.
Family Medicine Student Leaders – The Foundation provided over $5,200.00
in support for elected NCAFP student leaders to attend Academy and Foundation board meetings. Student leaders include two Student Trustees on the
NCAFP Foundation Board of Trustees, as well as the NCAFP Student Director
and Student Director-Elect.
Family Medicine Rural Health Externship Programs – Two, 2-week programs
were offered in partnership with the Hendersonville Family Medicine Residency
Program and the Brody School of Medicine at East Carolina Family Medicine
Residency Program. The residency programs/medical school provided their
leadership and the Foundation provided coordination and support in the
amount of over $22,000.00. Twenty students participated, ten in each twoweek experience.
Family Medicine Externship Program – A total of 8 students participated in
the Foundation’s summer externship, for a total cost of $8,000.00. The
Foundation was able to secure grants from the AAFP Philanthropic Consortium
of $1,250.00 to offset some program expenses.
remained in the program. During the year, a total of $91,970 was paid directly
to and/or for students and preceptors. This included stipends awarded to
students and preceptors totaling $26,955.00. Additional support to student
participants in this program included: $9,656.00 to attend the NCAFP annual
meeting; $4,708.00 to attend the AAFP National Conference for FM Residents
and Medical Students; $4,700.00 to participate in the NCAFP Leadership
Elective; and, $10,033.00 for travel expenses to other national conferences.
An additional $10,918.00 was paid for CME registration fees and for preceptor
faculty development at our Annual Meeting. Finally, $25,000.00 was paid for
initial scholarship payments for students in the second class of Family Medicine Scholars that matched into Family Medicine. From this second class of
scholars, of the ten that entered the MATCH in 2014, four selected the specialty
of Family Medicine. Four of the remaining six entered other specialties of need
in North Carolina (psychiatry (2), med/peds and peds). Those entering Family
Medicine residency programs include:
Joshua T. Carpenter (ECU) - Cabarrus Family Medcine Residency - Concord, NC
Katy A. Kirk (ECU) - Banner Good Samaritan Medical Center - Phoenix, AZ
William C. Mclean (UNC) - MAHEC - Asheville, Asheville, NC
Amy J. Nayo (UNC) - University of North Carolina Chapel Hill, NC
NCAFP/Student Scholarship/Loan Program – A total of $11,000 was awarded
to 4 students. Mr. Ian Lateef Cannon (UNC), now entering Family Medicine
training in Asheville, NC; Jered Cope Meyers (ECU) current 3rd year student;
Jessica Freidman (Duke), current 3rd year student; and Scott Gremillion (ECU)
now entering Family Medicine training in Charlotte, NC.
Family Medicine Interest & Scholars Program – In 2014, the Scholars aspect
of the program started with 38 students. Following graduation, 28 students
21
2014 NCAFP Foundation Contributors
NCAFP members and supporters of the Academy are encouraged to make gifts of on-going significance or annual contributions to the NCAFP
Foundation. The following individuals contributed to the Foundation in 2014:
22
Robert and Kerry Agnello, DO
Taylor Fie
Eugenie M. Komives, MD
Murali D. Pisharody, MD
D. Landon Allen
Kaylan Fisher
Hervy B. Kornegay, Sr., MD
Jesse C. Pittard, MD
Mark D. Andrews, MD
Janet Fontanella
Abby Lancaster
Lara J. Pons, MD
Ray Antonelli
Patti L. Forest, MD
David E. Lee, MD
Lincoln Pratson
Evan Ashkin, MD
Robyn Levine
Elizabeth Ramsey
Sarah Asman
Daniel James Frayne, MD
Kyle Levitt
Camille Ratliff
Emily Bardolph
Sarah Frederick
Richard Lord, Jr., MD
Audra Reiter
Julie E. Barrett
Nancy R. Freeman, MD
Mark Lorenzi
John F. Baumrucker, MD
Jessica L. Friedman
Alexander Madeira
Robert L. Rich, Jr., MD
Timothy M. Beittel, MD
Endya L. Frye
Angie Maharaj
Christopher Benton
Aaron E. George, DO
Makda Majette
Mark D. Robinson, MD
Mark A. Bernat, MD
John Gerhing
John R. Mangum, MD
Michael Robinson
Yvonne E. Berstler, MD
Donald B. Goodman, Jr., MD
J. Paul Martin, MD
J. Carson Rounds , MD
Janalynn F. Beste, MD
Scott Gremillion
Alexa Martin
Corey Sadler
Holly Biola, MD
Viviana Martinez-Bianchi, MD
Charles Semelka
Mott P. Blair, IV MD
Elias Gunnell
Alfred T. May, III, MD
Margaret Shaffe
Janet Bowen, MD
Robert E. Gwyther, MD
Michaela S. McCuddy
Marlana R. Sheridan
Charles O. Boyette, MD
Wayne A. Hale, MD
Geeta J. McGahey, MD, MPH
Kristina Simeonsson, MD
Tracey Brader
Mary N. Hall, MD
John Patrick McGee
Priyanka Sista
Dalia Brahmi, MD, MPH
Douglas I. Hammer, MD
William C. McLean, MD
Nadine Skinner, MD
Sarah Burroughs
Diana E. Hancock
David McMullen
Christopher Snyder, III, MD
William D. Byars, MD
Jonathan Hanson
Sean McRitchie
Kelly Stanley
Kenya Caldwell
Jillian Hartwell
Julia Mead
Holly L. Stegall, MD
Brittany Carr
Carl L. Haynes, Jr., MD
Sudha Meghan
Naima Stennett
Alexander Carrese
Tracie L. Hazelett
Kira Mengistu
Tarreyca Taylor
Jane T. Carswell, MD
Margot Hedlin
Shannon Mentock
Kathryn Taylor
Lisa Cassidy-Vu, MD
Jessica Herman
Lloyd Michener, MD
Kate Timberlake
Jimmy Chen
M. Mark Hester, MD
Asiyah Mikell
Robert T. Toborg, MD
Beth Cherveny
Shannon Hicks
Farhad Modarai, DO
Robert G. Townsend, MD
Sandra C. Clark, MD
Brittany Pierce Hipkins
Caroline Moffett
Jessica L. Triche, MD
Laura Cone
Jordan E.K. Hitchens
Daniel Moses
Lily Trout
Collin Conrad
Dimitrios P. Hondros, MD
Jennifer Mullendore
Blake Turvey
Sarah Conrad
James Hooper
Jered Cope Meyers
Talia Horwitz
Michael Murphey
Kari Usinarkaus, MD
Elizabeth Crowder
Tamieka Howell, MD
Maureen E. Murphy, MD
Katarina Velickovic
Alyssa D’Addezio
Janice E. Huff, MD
Jessica Deffler
Jessica L. Hulbert
Alisa C. Nance, MD
Scott and Melodye Visser, MD
Willam Dennis, MD
Elizabeth Isak
Dan-Thanh Nguyen
William Visser
Jinal Desai
Christian A. Jasper, MPH
Andrew Norris
Heather Wagner
Stephen Despins
Geoffrey L. Jones, MD
Nellie O’Connor
Garland E. Wampler, MD
Hallum Dickens
James G. Jones, MD
Christopher O’Keeffe
Edina Wang
Deanna M. Didiano, DO
Samuel Olson
Alexa Waters
Rosemarie Dizon
Chase Jones
Patrick O’Shea
Demetria Watford
Claudia Douglas
Travis C. Kauffmann
Michael Ouzts
Suzanne Watson
Genni Kee
Jill Palchinsky
Jamie Weaver
Patrick Downs
William S. Kelly, MD
Oana R. Panea, MD, MSPH
Jessica Webb
J. Wesley Earley, MD
Brian A. Kessler, DO
J. Ashely Parker, MD
Robert Wergin, MD
Howard J. Eisenson, MD
Yoon Hie Kim
Anthony J. Parker
Thomas R. White, MD
Marietta Ellis
Robert S. Kline, MD
Robert W. Patterson, MD
Matthew M. Williams, MD
Carol A. Ervin
Kyle Knowlson
Jeffrey Pennings
Rachel Wilson
Elizabeth Ferruzzi
Kevin Kohler
Paul Pikman
Maryshell B. Zaffino, MD
and Mr. Joshua Evans
and Mr. Scott Maxwell
Porshia G. Underwood
Lauren Visser
CHAPTER
AFFAIRS, UPDATES & BRIEFS
North Carolina Family Medicine Takes Center
Stage at Health is Primary’s City Tour in Raleigh
O
n a beautiful Thursday
afternoon in Raleigh
in late April, North
Carolina’s family
medicine community
took center stage in Family Medicine’s
largest and most ambitious
communications effort ever undertaken.
In a room packed with state health
care representatives, Family Medicine
professionals, and several members
of the media, the national Health is
Primary campaign showcased Family
Medicine’s unique power to improve
quality, lower health costs and keep
patients healthier. The audience heard
about several primary care innovations
happening in North Carolina, the
majority being driven by family
physicians.
The event was part of an ongoing
nationwide city tour developed by
Health is Primary, the 3-year, $22M
communications campaign that’s
working to complement Family
Medicine for America’s Health
(FMAHealth) and promote the value of
patient-centered family medicine and
primary care. Health is Primary plans to
visit multiple cities across the country
this year to raise awareness of local care
innovations and primary care’s ability to
help advance the nation’s health system.
North Carolina was selected as a tour
site largely due to the high number of
innovations taking place in the state.
The centerpiece of the event was a panel
discussion moderated by TR Reid, a wellknown national reporter, documentary
film maker and NY Times Best Sellers
author. FMAHealth Board Chair and
AAFP Past President Dr. Glen Stream,
NCAFP President Dr. Thomas R. White,
and several family physicians and
health professionals sat on the panel as
well. Cathie Pettit, Executive Director
of DirectNet, LLC was also a panelist;
DirectNet is a Hickory, NC-based
preferred provider organization that
serves four self-insured employers and
helps them address rising healthcare
costs through patient-centered
approaches.
In describing DirectNet, Petit outlined
how the insurer has developed
patient-centered medical homes at
approximately twenty local primary
care practices. DirectNet also operates
eleven worksite clinics that continue to
generate positive patient satisfaction,
Continues on next page
23
and have also been instrumental in
helping acheive significant financial
rewards for DirectNet’s member
companies. One key example Pettit
highlighted was Vanguard Furniture,
a 500-employee, family owned
manufacturer of furniture and case
goods that had been struggling to
contain its ever rising healthcare costs.
In 2009, Vanguard was grappling with
a significant rise in its healthcare costs.
Working with DirectNet, Vanguard began
to offer employees an attractive, easy-touse PCMH-based plan designed to lower
primary care access barriers. DirectNet
also continued to provide a worksite
clinic at Vanguard’s manufacturing
facility, which employees consider a
key benefit, accoding to Pettit.
“One of the most profound testimonies
we have learned from this effort has
come from a physician who told us this
approach has changed the way they
practice medicine,” noted Pettit. “He
expressed he now understands what the
population wants from a primary care
physician.”
Another North Carolina innovation
discussed was Carolina Advanced Health
(CAH), the unique collaboration between
UNC Health Care and Blue Cross and
Blue Shield of North Carolina. Aimed at
managing adult patients with multiple
chronic conditions, CAH has been
aggressive in utilizing a full spectrum,
technology-enabled and patient-centered
approach to improve quality and lower
costs. Dr. Thomas Warcup, CAH’s
Medical Director, noted that CAH views
the health of their population through
more than 22 quality metrics, each
reviewed on a monthly basis. Dr. Warcup
explained that CAH has identified several
significant trends, including reductions
in ER and urgent care utilizations and
hospitalizations.
The panel also highlighted several other
examples. Panelist Dr. Edward Bujold,
a family physician from Granite Falls,
described how his practice’s hospital
admission rates dropped 80% in five
years by utilizing the key tenets of
the patient-centered medical home.
Additionally, NCAFP Past President Dr.
Karen Smith (05) of Raeford, noted how
the use of health information technology
has enabled her practice to improve
quality.
NCAFP President Dr. Thomas White of Cherryville shares his experiences with a unique program
NCAFP President Dr. Thomas White
of Cherryville, NC, described a
unique project, stressing that system
improvements (and savings) can also
be realized upstream, by educating
defined populations about their specific
risk factors. Dr. White described a
unique collaboration between himself
and the Cherryville Fire Department
that educates firefighters on their
risks of cardiovascular disease. Acute
cardiovascular disease is the leading
cause of death among firefighters -- heart
attacks being the leading line-of-duty
killer -- accounting for approximately
45 percent of firefighter deaths every year.
Dr. White went on to describe that much
like firefighters who are trained to cover
each others backs, family physicians too
work in tandem alongside their patients.
The panel generated a lot of great
discussion and a number of key insights.
Health is Primary expects to use some of
the examples in a compilation project
that will be introduced towards the end
of the campaign.
Media Coverage
and Videos
The Health is Primary
event generated a
number of media
interviews, including
coverage on radio
and television that
aired across the state.
FMAHealth’s Dr. Glen
Stream was interviewed
by four NC-based radio
stations, and Time
Warner Cable’s Capitol
Tonight news magazine
broadcaset a 6-minute
interview with NCAFP
Watch the full video of
President Dr. Thomas
White. Related followup coverage in the Charlotte Observer
and News & Observer was also published,
including a mid-May editorial viewpoint
on primary care pipeline issues.
Finally, the NCAFP produced and
made available several video interviews
recorded at the event, one of which
Photos with this story (including on the cover) by David Keith Photography
24
Executive’s Desk
By Gregory K. Griggs, MPA, CAE,
NCAFP Executive Vice President
The Physician-Patient
Relationship Must Remain
Sacred
that is educating firefighters on their risk factors.
the event at www.ncafp.com/hip
includes TR Reid sharing his thoughts
on the value of primary care. In addition
to Mr. Reid’s perspectives, additional
short videos featuring NCAFP members
Dr. Warren Newton, as well as NCAFP
Past President and current AAFP Board
member Dr. Mott Blair are also available.
To view these videos, visit NCAFP’s
YouTube channel, see www.ncafp.com/yt
Each year it seems that the NCAFP
is battling more and more legislative
and bureaucratic issues. And as
your elected leaders make decisions
about how to handle these issues,
there are some basic principles that
rule the day. One such principle is
the sanctity of the physician-patient
relationship.
Of late, we have seen more
excursions into the exam room by
both insurance company bureaucrats
and our own elected legislators.
While many of the issues that come
up in this arena are controversial,
we ultimately believe it should be
between you and your patient to
decide. Let’s examine just two of the
issues that have developed during
this legislative session. While very
different, they both represent a
potential intrusion of lawmakers
into the exam room, a space that
should be reserved for the physician
and their patient.
Type 1 Diabetes Screening
A bill filed in the NC General
Assembly this year would have
mandated screening for Type 1
diabetes at birth, 12 months of
age and 24 months of age, despite
little to no evidence that such
screening would benefit your young
patients. While the legislator who
introduced the bill was acting out
of real concern (a young child in
their District had died from Type
1 Diabetes), we believe these types
of decisions should be left up to
your scientific expertise and the
prevailing evidence, not decided by
a law. At this point, the bill now
encourages physicians to educate
parents about the warning signs of
Type 1 Diabetes at various intervals as
opposed to mandating a screening or a
certain test or conversation.
Guns
While we by no means oppose gun
ownership, we do believe that it is
appropriate for a physician to educate
their patients (especially patients with
young children) about how to avoid
the safety risk from improperly stored
firearms. We also believe in the use of
evidence-based screening tools. This
year, another bill before the General
Assembly, would limit the use of
evidence-based screening tools when
they asked about gun ownership or gun
storage. We’re certainly not demanding
that you ask every patient about safe
gun storage, but we also don’t want
you to be prohibited from asking such
a question or using such a screening
tool, if you deem it appropriate for that
patient. Homicide and suicide now rank
as the second and third leading causes
of death among 15-24 year olds in the
United States. Asking about gun safety
should be no different than asking if a
patient uses seat belts or is involved in
other risky behaviors that could result in
negative health outcomes.
While these are two very different laws,
we believe they both represent potential
intrusions into the exam room. The
bottom line, we want you to decide
what conversations are appropriate to
have with your patient. An elected
official or bureaucrat should not dictate
whether a conversation should or
should not occur, and your decisions
about testing should remain evidencebased. After all, the physician-patient
relationship is sacred, and we believe it
should stay that way.
25
STUDENTS
By: Tracie Hazelett
NCAFP Student Interest & Initiatives Manager
INTEREST & INITIATIVES
28 Medical Students to Participate in NCAFP’s Summer Programs
The NCAFP Foundation recently
announced the selection of twentyeight rising 2nd-year students for
experiences in summer programs that
will take place May through August of
this summer. Selected students will
participate in paid opportunities in the
four-week clinical Externship Program
or one of the two-week Rural Health
Experiences. Additional students have
opted to participate in experiences
without a stipend that will better meet
their scheduling needs and availability.
All students who applied for programs
demonstrated the potential to excel
in Family Medicine and offer very
diverse academic, work and volunteer
experiences. We have truly impressive
medical students in North Carolina!
Summer Programs
Congratulations to the following
program participants:
Brody School of Medicine at ECU
Davita Brockington, Laddie Crisp, III,
Alyssa D’Addezio, Elizabeth Ferruzzi,
Stuart Hedgpeth, Amanda Morgan,
Lauren Morris, Kody Pratson, Taylor
Sears, and Rachel Williams
Jerry M. Wallace School of
Osteopathic Medicine
Sarah Burroughs, Benjamin Byerly,
Stephanie Carbone, Emma Ciborowski,
Joseph Hale, Natalie Kandinata, Anjuli
Maharaj, Alexa Martin, Nicholas May,
Alison Mitchell, Courtney Moore, Paul
Pikman, Cara Puzzio, Timothy Rabe, and
Claire Unruh
UNC School of Medicine
Kevin Courts and Brianna Sexton
Wake Forest University School
of Medicine:
Katherine Murray
P romoting family medicine on campus
NCAFP Promotes Health is Primary, Helps FMIGs Attract National Speakers
In addition to the clinical experiences offered to rising 2nd year
students, the Academy has been involved in numerous events
with the state’s five medical schools. The Health is Primary
campaign went on the road to three schools this spring and will
be visiting the remaining
two in the fall. To date
Greg Griggs, Executive Vice
President of the NCAFP,
has promoted the Health is
Primary campaign to more
than 150 medical students.
FMIG Support
All five medical schools also
recently took advantage of
support provided by the
NCAFP Foundation to bring national-level Family Medicine
speakers to their campuses for banquets or other activities. Dr.
Lew Hofmann visited Wake Forest FMIG for their annual spring
banquet and shared his version of “It’s a Wonderful Life” with
stories about his truly unique worldwide journey through Family
26
Medicine. Dr. Hofmann is a family physician who is a
former White House physician to the Vice President and
a former Flight Surgeon to Air Force One. Dr. Hofmann
continues to practice in Maryland.
Dr. Wanda Filer,
AAFP President-Elect,
completed a four-campus
tour in late April and
had the opportunity to
address or personally
meet with over 200
medical students, Family
Medicine residents and
other Family Medicine
faculty. Dr. Filer shared
personal experiences and many stories about her path to
Family Medicine and beyond. Her passion was inspirational
for many and as more than one student noted, “just what
we needed to hear to renew our interest in Family Medicine
after a tough exam!”
Find Your Kind in
an AAFP Member
Interest Group
The AAFP is committed to giving all
members a voice within our increasingly
diverse organization. Member interest
groups (MIGs) have been created as a
way to define, recognize, and support
AAFP members with shared professional
interests. MIGs support members
interested in professional and leadership
development and provide connections to
existing AAFP resources, opportunities
to suggest AAFP policy, and networking
events with like-minded peers.
Current AAFP MIGs include:
• Direct Primary Care
• Emergency Medicine/Urgent Care
• Global Health
• Hospital Medicine
• Independent Solo/Small
Group Practice
• Oral Health
• Reproductive Health Care
• Rural Health
• Single Payer Health Care
• Telehealth
Visit aafp.org/mig to
learn more, join a MIG,
or start your own.
AN OUNCE OF
PREVENTION
WHERE HEALTH IS PRIMARY.
Patients with access to primary care are more likely to receive
preventive services and timely care before their medical conditions
become serious – and more costly to treat.
Family doctors work with their patients to keep them healthy. We want to
ensure that all patients have access to and use regular preventive care.
Let’s make health primary in America.
Learn more at healthisprimary.org.
#MakeHealthPrimary
28
POINT OF VIEW
By: Margarette Shegog, MD, MPH
NCAFP Resident Director-Elect
A Resident’s Perspective
Dr. Shegog is a 2nd-year resident at
the MAHEC-Asheville Family Medicine
Residency Program.
R esident V iewpoint
Support Patients and Show Ourselves as Allies
With this hectic life, it is easy to lose sight of the
“world
around us and the events that will ultimately
affect our practices. We are physicians, family, friends,
and ultimately people. In this time of great change, it
is important to remember the little things we can do to
support our patients and show ourselves as allies.
— Margarette Shegog, MD, MPH
November 25th, 2014, I was in clinic standing
at the nurse’s station with a nurse and one of
the janitorial staff. We were all reeling from the
same decision- Officer Darren Wilson would
not have a trial. That was not the first time
that Black Americans gathered to find solace,
nor was it the last. Throughout this winter and
spring much of the Black community has been
dealing with the violence and injustice against
our community. While this is not new, recently
it has been brought more to light. While I was
well aware of this problem, it made me think
about the health disparities that we as black
Americans face as well.
According to CDC data, black Americans
have the lowest life expectancy of any race
in the United States at 74.6 years, more than
4 years less than white Americans. Black
American infant mortality is more than twice
that of any other race. Black Americans have
higher preventable hospitalization rates than
other races. JAMA noted in their April 14th
article that black American men have the
lowest life expectancy of any group and often
only experience primary care through military
or prison service. These data, in addition to
the frequent reports of police brutality, make
one feel powerless.
One day I happened to see a colleague
wearing a “Black Lives Matter” button. With
that one gesture I knew I had an ally. “I was so
upset I had to do something,” she responded
when I thanked her. That acknowledgement of
the current situation meant so much to me. I
”
could not imagine what it would mean for a
patient. JAMA calls for action in the medical
community through supporting community
partnerships and programs that address
environmental and social health. This can
seem daunting and some may wonder where
to start. As I reflected on my colleague’s pin
I wondered, what simple and powerful ways
can we be allies and advocate for our patients.
Also along the lines of people affected by
inequality, there has been much debate in
the news media surrounding women’s health
and rights.
Women’s wages, maternity
care, birth control and bodily rights have
all come under fire in the last few years.
With North Carolina’s failure to expand
Medicaid, approximately 277,000 women are
ineligible for health care (State of Women’s
Health, 2013). And recently there was House
Bill 847 which would have significantly
decreased young people’s access to mental
health care, STI, and pregnancy care without
having notarized permission from a parent.
Fortunately, these provisions of that bill
were removed. We often support women
individually on a daily basis in our offices.
However, by using our voices over the phone
or in person to our elected officials in Raleigh
and Washington, we can begin to support
women in a larger way.
On April 15th NCAFP had a White
Coat Wednesday and among the different
topics discussed was H.B 465.
H.B 465
would significantly limit family physicians
ability to provide care for women in North
Carolina. Making it to Raleigh for White
Coat Wednesday is wonderful, but it can be
as simple as picking up the phone.
Another common marginalized group
is the GLBTQQ (Gay Lesbian, Bisexual,
Transsexual, Queer and Questioning)
community.
AAFP has long accepted
and supported all families.
However,
GLBTQQ teens are still twice as likely as
their heterosexual peers to have attempted
suicide. About 25% of Transgender youth
have attempted suicide (CDC GLBT Youth).
At MAHEC’s diversity discussion, one woman
discussed how welcomed she felt when a
physician wore a rainbow rod of Asclepius.
I have had patients express to me how
refreshing it was to have a physician who was
sex positive and discuss how to have healthy
consensual relationships with their chosen
partners. Being a sex-positive physician can
involve domestic violence screening in samesex relationships, answering questions about
hormones for transitioning and gender queer
patients, and discussing how to make dental
dams out of condoms. Many GLBTQQs avoid
going to the physician for fear of judgement.
Creating a non-judgmental environment
is a first step to creating a space where all
patients feel comfortable seeking medical
care. This can be as easy as making sure that
a preferred name is seen in the EMR, using a
preferred pronoun or wearing a pin.
Daily events are occurring which affect our
communities, our patients, our communities
and ourselves. As physicians, we have busy
lives of examining patients, completing
notes, continuing our education and
managing practices. With this hectic life, it
is easy to lose sight of the world around us
and the events that will ultimately affect our
practices. We are physicians, family, friends,
and ultimately people. In this time of great
change, it is important to remember the little
things we can do to support our patients and
show ourselves as allies. We are allies not
only in their health, but also of their overall
wellbeing. Wear a pin or a button. Ask the
question. Make a call.
29
PRACTICE
MANAGEMENT, NEWS & INSIGHTS
National and State Practice Management Briefs...
Chronic Care Management
Covered by Medicare Advantage
Says CMS
CMS recently clarified some ambiguity
and confusion around the payment
for Chronic Care Management (CCM)
services for Medicare Advantage
beneficiaries. Early this year, the
CMS could not verify that Medicare
Advantage (MA) plans were required
to recognize the code and the AAFP
communicated with CMS, calling for it
to specify the requirement for all MA
plans. In a conference call attended
by the AAFP and several other groups
earlier this spring, CMS clarified
the requirement, noting that while
physicians serving MA patients could
bill for the code, it does require an
appropriate contract provision between
the provider and the plan. For patients
that choose and out-of-network provider
to provide CCM services, the MA plan
must pay the CCM fee as a out-ofnetwork physician service as well.
New AAFP Breastfeeding
Toolkit Excellent for Clinical,
Coding and Education
The AAFP has created a handy new
resources toolkit on breastfeeding
(http://www.aafp.org/patient-care/
public-health/breastfeeding/toolkit.
html) aimed at assisting family
physicians with the clinical, coding,
and patient education challenges
around the issue. The toolkit, which
bolsters AAFP policy, also includes
the breastfeeding position paper that
the Academy released in November
with updates informed by evidencebased research that occurred since
30
the previous position paper’s 2008
release. The toolkit provides office- and
community-based tools, advocacy
resources, evidence-based knowledge
and educational material.
SGR REPEALED
Medicare Payment
Changes on Horizon
Now that the flawed Sustainable Growth
Rate formula (SGR) has been repealed by
Congress, family physicians and practices
will need to begin planning for the coming
Medicare payment changes on the horizon.
While MACRA (The Medicare Access and
CHIP Reauthorization Act of 2015) does
provide Medicare payment stability over
the next ten years with annual payment
increases of 0.5%, capturing bonus payments in 2019 and beyond (as well as annual payment updates beginning in 2026)
will require providers to make an informed
choice relative to their elected payment
pathway. Physicians and practices will
need to decide whether to opt for payments
based on alternative payment models
(such as PCMH) or for the more traditional
fee-for-service model that’s now called the
Merit-Based Incentive Payment System.
The AAFP has already published online
resources answering some common
questions (see aafp.org) and is expected of
offer additional information in the coming
months. Look to the AAFP and NCAFP
for notification on when these become
available.
NC’s Controlled Substances
Reporting System Gets Revamp
Family physician users of North
Carolina’s Controlled Substances
Reporting System (CSRS) should have
noticed a brand new look and feel to the
tool. NCCSRS rolled out the redesign in
mid-April, the aim of which is making
the system more clinically-valuable tool
for patient care and increasing its usage
across the care continuum. The new
interface is more intuitive and aprovides
new features as well, including a more
streamlined password reset function, an
enhanced user profile updating process,
and easier to read reports that contain
new information.
NC Medicaid Reprocessing
Claims as Part of 3% Rate
Reduction
The NC Medicaid program announced
has begun re-processing of physician
payment claims to take into account
the NC General Assembly’s 2013 Session
Law 360 which cut payment rates by
3%. This means that for physicians
who attested for ACA-enhanced
payments before June 30, 2014, claims
between 1/1/2015 and 3/1/2015 will
be reprocessed. Claims reprocessing is
taking place over multiple checkwrites
due to claim volume and began with the
checkwrite of April 28th. According to
estimates provided by NC Medicaid, the
average repayment amount for an ACAattested physician is $240.27.
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