Inside - The Memphis Medical Society

Transcription

Inside - The Memphis Medical Society
Bulletin Cover_Winter12_4c_Cover 11/28/11 5:49 PM Page 1
Volume 14, Number 4
Winter 2012
Inside:
The Employed Physician
Semmes-Murphey
Celebrates 100 Years
of Neurological Care
Bulletin Cover_Winter12_4c_Cover 11/28/11 5:49 PM Page 2
contents
Volume 14, Number 4
The mission of the
Society is to unite
the physicians of
Memphis & Shelby
County into an
organization to
promote the highest
quality of medical
practice and the
health of our citizens.
Winter 2012
Features
6
10
The Employed Physician
by: Jerome W. Thompson, M.D.
If Only Ben Casey Could See Us Now
by: Paul N. Bourassa
In Every Issue
3
Editorial
4
From the President
24
New Members
26
Calendar
Back Page
on the cover:
28
The University of Memphis School of Public Health
Lucas Elijovich, M.D.
Photo by Greg Campbell
2
Medical Society Quarterly
The Memphis Medical Society
1067 Cresthaven Road, Memphis, TN 38119-3833
(901) 761-0200 • FAX (901) 761-2944
www.mdmemphis.org
Executive Vice President
Michael Cates, CAE
Executive Assistant
Janice Cooper
Communications & Membership Director
Victor J. Carrozza
Finance Director
Leah S. Lumm
Business Services Division:
MedTemps Manager
Betty Lee
Senior Staffing Coordinator
Freda Reed
Accounting Coordinator
Paula Lipford
Medical Society Quarterly
Victor J. Carrozza, Editor
Editorial
Thomas C. Gettelfinger, M.D.
Editorial Committee
Thomas C. Gettelfinger, M.D.
Stuart M. Polly, M.D.
Webster Riggs, M.D.
Photography
Greg Campbell - cover photo
Victor J. Carrozza
Graphic Design
Liz Petzak
Winter 2012
Editorial
Thomas C. Gettelfinger, M.D.
Tales of Two Lives
What would Sir William Osler have thought?
On my mind are two biographies published this year, each
with some Memphis connection: those of Keith Richards and
Steve Jobs.
Life, the biography of the Rolling Stones guitarist, starts with
an almost drug bust in 1975 in Fordyce, Arkansas, as Keith
Richards and part of the band left Memphis headed for Dallas.
His life was classic sex, drugs, rock and roll. In 2006, while in Fiji,
he fell 7 feet from a palm tree branch, hitting his head, and two
days later developed severe headaches. Air evacuated to New
Zealand with an acute subdural hemorrhage, he developed a rebleed a week later and had a large centimeter and a half thick
gelatinous blood clot removed and a bleeding artery controlled.
Able to go anywhere in the world, he followed the advice of his
New Zealand surgeon and was operated in a timely fashion. Born
in 1943, addicted to heroin for years and apparently using almost
all drugs known to man, he is a medical marvel of survival.
Steve Jobs, born in 1955, health conscious, a one-time LSD
proponent and fad-diet addict much of his life, had his metastatic
cancer-ridden liver transplanted by Dr. James Eason in Memphis
in March 2009. The connection to Memphis was facilitated in
part by George Riley, an outside counsel to Apple and Memphis
native “whose parents had been doctors at Methodist Hospital”.
His islet cell pancreatic cancer was first incidentally detected in
October 2003 from a CAT scan ordered to evaluate his kidneys
and ureters because of kidney stones. He delayed surgery, the only
accepted approach, for nine months, instead treating himself,
keeping to “strict vegan diet with large quantities of fresh carrot
and fruit juices”. He lived eight years after diagnosis, among the
most productive years of his life, work intensified by knowledge
of his mortality, often refusing medication so that his thinking
and emotions were not manipulated.
Sir William Osler recommended long ago that we, as
physicians, spend some time everyday in nonmedical reading. He
may have meant Shakespeare or Milton or Somerset Maugham or
even his equivalent of Jacquelyn Susann, but many of us find little
time to follow his suggestion. I don’t know what he would have
made of the biographies of Keith Richards or Steve Jobs.
There may or may not be a message in all this. I just send it
to you for your own conclusions.
3
President’s Message
Jerome W. Thompson, M.D.
“Misvalued” RVUs
The new health care reform bill has many problems,
but one of the most disturbing issues for physicians is that
the government plans on correcting “misvalued” RVUs.
However, what they fail to understand is not just how RVUs
were created, but how they are managed.
In 1985, Harvard began the Resource-Based Relative Value
Scale (RBRVS) study as a means to determine how much money
should be paid to medical providers. William Hsiao was the
principal investigator who organized a multi-disciplinary
team of researchers that included statisticians,
physicians, economists and measurement
specialists to develop the RBRVS. In 1989,
President George Bush signed the
Omnibus Budget Reconciliation Act of
1989. It enacted the physician
payment schedule based on an
RBRVS.
The RBRVS assigns a relative
value for services performed by a
medical provider, which is adjusted
by geographic region. This value is
then multiplied by a fixed dollar
conversion factor defined by the
government or insurer, which
determines the amount of payment.
This factor changes yearly. The RBRVS
system is mandated by the Centers for
Medicare and Medicaid Services (CMS).
The data for it appears in the Federal Register.
The RBRVS itself is based on three separate factors:
physician work (52%), practice expense (44%), and malpractice
expense (4%). (GAO 05 119)
The AMA/Specialty Society RVS Update Committee or
RUC was created in 1991 to modulate the RVUs as times and
science changes. The RUC researches the effort, practice
expenses, and legal exposure for a CPT by analyzing data
provided by surveys of providers. Then, after deliberation and
negotiation with the specialty and primary care societies, it
makes a recommendation to CMS for the value of a CPT or for
the creation of any new CPTs. It is a zero sum game though,
in that there is a finite pool of CMS funds for Medicare.
Therefore, if one code goes up, then another one must go
down. The insurers also follow shortly afterwards.
It is currently the house of medicine that determines a
CPT’s relative value unit. The process is not arbitrary. It is
done with a great deal of research and effort. I have been a
part of this committee process for my Academy. Thus, I
understand the effort involved. The government
should leave it as it is.
In closing, I wanted to take this
opportunity to let each of you know how
much I appreciate this platform to
express my views over the past year.
As my year as president of The
Memphis Medical Society draws to
an end, I wish to thank each of the
members and staff who have made
this a wonderful and memorable
term. I want to extend a special
thank you to our Board who
banded together to tackle difficult
financial times. It is through their
hard work that we came out stronger
and more sound than before.
Mike Cates, our Executive Vice President
is an invaluable asset to the organization.
His guidance has more than once kept my
foot out my mouth. I owe him a sincere measure
of gratitude for his efforts on my behalf and value his
friendship. Victor Carrozza is a man of many talents and the
engine that keeps the society rolling. He organizes the annual
meeting, makes events happen and is a good friend who I really
appreciate. I want to thank my wife and children for tolerating
the many meetings, nights away from home, my absence
from the dinner table and from the family. And finally,
I wish to thank my friend Neal Beckford for recruiting me
into the Medical Society, which has opened so many doors
of expression to me. Thank all of you very much.
“...what
(government
plans) fail to
understand is not
just how RVUs
were created, but
how they are
managed.”
4
Medical Society Quarterly
The Employed Physician
by: Jerome W. Thompson, M.D.
A few months ago, I once again became an employed
physician. For the first eleven years of my medical career, I was
in private practice. Then, for the next fifteen years, I worked
for the University of Tennessee / UT Medical Group
(UT/UTMG). Now, I am employed by UT Le Bonheur
Pediatric Specialists (ULPS). When I first joined UT/UTMG,
it was different working for a medical group that had only run
medical practices, rather than working for one’s self. Now, to
be employed by a predominantly hospital driven group is yet
an entirely different experience.
Initially, I had my concerns, which were rooted in the
1980s when hospitals went on a buying binge for physician’s
practices. This ultimately led to disaster for both entities.
However, this time I had the unique experience to have an
advanced meeting with three very wise men; Dave Archer, Gary
Shorb and Steve Reynolds. We met last year at The Memphis
Medical Society office and discussed the lessons learned from
the past. Both stated that they realized that these types of
practice models had failed in the 1980s, because of too much
micromanagement and not enough physician incentives and
leadership. Studies from that era substantiate this reasoning.1
But why were there problems? First, hospital systems
are policy driven, while physician’s practices are more
experientially or empirically driven. And thus, this difference is
a source of possible conflict and prolonged friction. Treatments
change, and trends of care and styles evolve, therefore care must
be fluid to succeed and be financially successful, as well.
Second, employees bond to their physicians in a private
practice setting, but less so in a hospital environment where the
hospital’s human resources office does the hiring and firing.
So, why do physicians want to be employed? Initially,
there are the financial security benefits of being employed.
The physician and his practice do not have to worry about
meeting the payroll each month or any of the other overhead
expenses associated with the day-to-day operations. Other
concerns, such as the massive electronic medical records (EMR)
requirements of the government are also eliminated. These all
become someone else’s problem. A Deloitte Consulting white
paper predicts that 23% of all physicians will be hospital
6
employees by 2013.2 Furthermore, 49% of new residency
grads have joined hospital owned practices. And, of established
physicians that were seeking a job, 65% were placed in a
hospital owned practice.3 Hopefully, this new generation
of hospital administrators has learned the lessons of past efforts
and will allow more physician input. I want to believe so,
or I would not have been as eager to accept and adapt this
practice structure.
Nevertheless, threats are visible on the horizon. The
problem with the perceived new security in hospitals is that
the funding of health care will become a zero net sum game
in the near future. The new employer, the hospital will
eventually have to tighten their belts and make health care
more economical. This means cutting their costs, which might
include physicians’ salaries, as well as everyone else’s pay.
They will have to either do that or have a very hefty RVU
production quota. This is why negotiating initial contracts at
the time the physician becomes an employee is so important.
Being part of the Tennessee Medical Association (TMA) keeps
physicians informed and involved, while helping them with
this process. Financial problems for hospitals could be years
away or as close as the next election. I am betting that being
an employed physician will work for me. More insights will
be shared in the next edition from some of the other specialties
of employed physicians.
1. Halley M: The Evolution of Physician Employment
as an Integration Strategy, Physician/Hospital
Integration Newsletter, halleyconsulting.com, issue 1,
spring 2009.
2. Deloitte Consulting, Physician and Hospital
Alignment: Employment Agreements, Jun 2011.
3. Medical Group Management Association, Physician
Placement Report. Englewood Co. MGMA Press,
Jun 2010.
Medical Society Quarterly
Practice setting
2011
2001
Hospital
32%
3%
Partnership
28%
21%
Single specialty group
10%
24%
Multispecialty group
10%
28%
Outpatient clinic
6%
8%
Academic
2%
N/A
Locum tenens
1%
3%
Solo
1%
8%
Association
<1%
0%
HMO
<1%
1%
Unsure
9%
N/A
Other
N/A
4%
Healthcare Legislation Breakfast
with Rep. Blackburn
On Tuesday, November 8, The Memphis Medical
Society and the Germantown Economic Development
Commission hosted a Healthcare Legislation Breakfast.
Shelby County physicians and practice administrators along
with City of Germantown Mayor Sharon Goldsworthy and
other Germantown officials attended the event held in
The Great Hall and Conference Center. The Honorable
U.S. Congresswoman Marsha Blackburn (R-Dist. 7)
addressed the approximately 75 individuals in attendance.
She updated them on the latest legislative initiatives
pertaining to scope-of-practice issues that impact the
practice of medicine.
Source: 2011 Survey of Final-Year Medical Residents,
Merritt Hawkins & Associates, Oct. 5
Group practice fades in popularity
Merritt Hawkins, a physician-staffing company based
in Irving, Texas, asked residents to select their most desired
work setting. Becoming a hospital employee is a much more
popular choice than it was ten years ago, but a majority
of final-year medical residents still prefer to work in a solo
or group practice.
Congresswoman Marsha Blackburn talks with a group of Shelby County
physicians
L-R: Keith G. Anderson, M.D., TMA Board member; David Rea, practice
administrator of The Jones Clinic; Congresswoman Marsha Blackburn
and Jerry Klein, Chairman of the Germantown Economic Development
Commission
Winter 2012
7
Reception Held to Celebrate Twenty
Years of the MEMPHIS Plan
On Monday, October 24, 2011 the Church Health Center
(CHC) celebrated twenty years of the MEMPHIS Plan. Scott
Morris, M.D., founder of the CHC said, “The MEMPHIS
Plan is managed care for the uninsured, which most people
would say is impossible. It is possible, because doctors in our
city continue to say ‘yes’ and continue to care for their
neighbors, and because we have good friends who have helped
us along the way.” To mark the occasion, the CHC in
partnership with The Memphis Medical Society hosted a
reception to recognize the volunteer providers who have given
their time and talent over the past two decades to care for those
most in need. The event, attended by approximately 100
people was held at the home of Dina and Brad Martin. All
physicians who have, throughout the years, shown their
commitment and compassion to this endeavor were invited to
attend. The gathering specifically recognized Maury Bronstein,
M.D. for his many years of devotion and service at the CHC.
Dr. Bronstein’s humanitarian efforts and tremendous impact
on caring for the working poor in Memphis and Shelby
County has helped the MEMPHIS Plan grow and prosper
since its inception in 1991.
Claudette J. Shephard, M.D. and Scott Morris, M.D. present an award to
Maury Bronstein, M.D. to honor his many years of volunteer service.
Save the Date!
Primary Care Physicians: Let Your
Voice Be Heard!
Email or call now to participate in the Tennessee Practice
Improvement Survey and help give voice to the real needs of
primary care physicians in Tennessee! The Memphis
Medical Society, Tennessee Medical Association, Tennessee
Academy of Family Physicians, Healthy Memphis Common
Table, BlueCross BlueShield of Tennessee, UTHSC and the
University of Memphis are working together to survey 1,200
internal medicine and family practice physicians throughout
Tennessee about their real practice improvement needs.
Send an email to mssrc@memphis.edu to get your private
login information to participate in the online survey. You may
ask your office manager or practice administrator to complete
the survey for you. You may also call Wayne Pitts, Ph.D.
at the Mid-South Survey Research Center at 901-678-5662
to conduct the survey over the phone. Please take 15 minutes
to complete the survey today!
8
PITCH - 2012
Physicians Involved in
Tennessee’s Capitol Hill
Wednesday, March 7, 2012
Bus will depart Society at 6:30 am
There is no coat to attend.
Lunch will be provided compliments of the TMA.
We are asking that each practice designate
at least one physician to attend.
The return trip (leave Nashville) will be
at approximately 4:00 pm.
If you are a physician, please wear your white coat.
Medical Society Quarterly
SPOTLIGHT
If Only Ben Casey Could See Us Now
by: Paul N. Bourassa
For many in the Boomer generation, their first exposure to
the word neurosurgeon was from the TV show “Ben Casey”
back in the mid-1960s. Those who remember the show also
remember how frustrating it was for Dr. Casey to cope with the
low rate of success of these surgeries, until Dr. Zorba (Ben’s
boss) reminded him of how many they had saved. Today, some
50 years later, we can understand how the colleagues to follow
the neurosurgeons and neurologists of that era would come to
easily understand the view of Dr. Zorba because of the work of
pioneering neuroscience groups, begun 50 years before Ben
Casey picked up his first scalpel.
Locally, we can trace this beginning back 100 years to the
time Dr. Raphael Eustace Semmes (1885-1982), the first
neurosurgeon in the area, followed his passion for training the
surgeons of the future. Born in Memphis, Tennessee in 1885
Eustace Semmes attended the
University of Missouri and the Johns
Hopkins University Medical School.
Graduating Phi Beta Kappa, he was
selected to be a surgical intern at
Johns Hopkins. During this time,
Dr. Semmes opted for a rotation
under Dr. Harvey Cushing (the
Father of Neurosurgery) which
began his introduction to
neurosurgery. After his residency at
the Women’s Hospital in New York,
he returned to Memphis in 1912 and Eustace Semmes, M.D.
(1885-1982)
was appointed to the staff of the newly
reorganized University of Tennessee
Medical School. The new Baptist Hospital opened the same
year and was where his practice was centered throughout a large
part of his career. During WWI, Dr. Semmes answered the call
for more neurosurgeons and after completing a refresher course
in neurosurgery at the New York Neurological Institute was
assigned to a hospital in France. Following his discharge at the
end of the war, he returned to Memphis limiting his practice to
neurosurgery.
In 1933, Dr. Francis Murphey, while interning in Chicago,
came to Memphis to talk with Semmes. Murphey (born in
1906, and attended school in Macon, Mississippi) was
interested in a career in neurosurgery and was even thinking of
practicing in Memphis. Dr. Murphey was invited to come to
Memphis after completion of his internship, and become
Semmes’ first trainee. This would later lead to the formation of
the Semmes-Murphey Clinic.
Returning to the brooding Dr. Casey, had he kept up with
his reading, he would have discovered a monograph written by
Dr. Semmes, published in 1964 by Charles C. Thomas
Publishing. In the monograph Dr. Semmes relates how he did
10
post-surgical follow up questionnaires to a large base of his
patients to judge the effectiveness and results of his operations.
Over 97 % indicated that they benefited from the procedure.
Only thirty-eight patients required another operation and no
deaths occurred in the total 6,000 tracked surgeries. No
wonder Dr. Zorba was so confident. Perhaps he spent some
time at Semmes-Murphey earlier in his career (as an actor).
If fact, the number of prominent neurosurgeons who
found powerful and willing mentors at Semmes- Murphey
seems to be extensive. Dr. Semmes’ passion for training the
next generation of surgeons and Dr. Murphey’s inspiration as
an astute clinician and an extremely thorough examiner
continue today at the Semmes-Murphey Clinic, as
approximately 12 neurosurgery residents are being trained at
any point in time. Each residency lasts six years.
Continuing the focus on training, the efforts of SemmesMurphey Clinic, Methodist Health Systems, Inc. and Baptist
Memorial Healthcare Corporation led to the founding in 1995
of the Medical Education Research Institute (MERI). MERI is
a teaching and research laboratory designed to conduct
workshops to teach new surgical techniques and devices to
physicians. It is also designed with laboratory space which may
be leased for large or small research projects. Dr. Kevin Foley
of Semmes-Murphey was instrumental in establishing MERI
and is currently serving as MERI’s Medical Director.
The mentoring reach of Semmes-Murphey currently
extends far beyond this local area with the participation of
Semmes-Murphey doctors in training programs in other
countries through the Semmes-Murphey International
Neurosurgery Outreach and Education Program. Dr. Kenan
Arnautovic , along with several other Semmes-Murphey
physicians, have made a total of seven trips to Sarajevo since
2003. This is a major, ongoing commitment that involves the
surgeons donating their time and paying all their own trip
expenses to help train Bosnian surgeons on the more complex
surgical procedures that may represent a gap in their local
training capabilities.
Semmes-Murphy physicians continue to seek out advanced
treatment options, which led Dr. Jason Weaver to take a
leading role in bringing to Memphis the CyberKnife
instrument, which allows a noninvasive surgical technique at
Baptist Hospital-Memphis. The CyberKnife uses very highly
focused, image guided radiation, targeted specifically to the
tumors, so that all the normal tissues around that tumor are
spared from the toxic effects of radiation and only the tumor
gets a killing dose. Depending on the case, this can be used
with or without other elements in the treatment array. The
beauty of a technology like this is that in some cases the patient
can be on the treatment table wearing their own clothes,
Medical Society Quarterly
SPOTLIGHT
listening to an iPod and be out of the surgery and go back to
their normal activities that afternoon.
Awareness of the full range of options for treatment is a
legacy from the thoroughness exhibited by the founders. While
surgical options are always there when needed, there is a
growing focus on interventional neurology for less invasive
treatments. One of this new breed of interventional
neurologists is Lucas Elijovich, M.D., who is fellowship-trained
in endovascular with a multidisciplinary team approach to
treatment.
He notes that while aneurysms are commonly treated
with surgical clipping which requires a craniotomy, a newer
procedure (developed in the 1990’s) called endovascular
coiling has been evaluated in the International Subarachnoid
Aneurysm Trial (ISAT: Lancet Neurology, May 2009) and was
favored over surgical clipping among patients (who qualified
for both procedures) over the long term due to mortality rates.
The procedure involves threading a microcatheter into the
aneurysm and placing detachable platinum coils inside the
lumen of the aneurysm, stopping blood flow and preventing
re-rupture.
In addition to this procedure, Dr. Elijovich observes that
techniques such as intra-arterial thrombolysis and mechanical
embolectomy for acute ischemic stroke, angioplasty and
stenting of atherosclerotic carotid stenosis as well as liquid
embolic embolization for arteriovenous malformations and
tumors of the brain, spine, head and neck, and spinal cord,
are among the current techniques used by today’s
interventional neurosurgeons and neurologists.
Again, continuing with the emphasis on training,
Dr. Elijovich explains that the neuro-endovascular team at
Semmes-Murphey has a one to two year fellowship that trains
qualified vascular/critical care neurologists, neurosurgeons,
or neuroradiologists who have completed residency in their
respective disciplines.
Semmes-Murphey’s commitment to advancement and
education remains the hallmark of the 100 year tradition of
mentoring begun by Dr. Raphael Eustace Semmes. Dr. Casey,
you may rest easy. The future of neuroscience is well in hand.
Oh, and keep up with your journal reading!
Dr. Clarence Watridge discusses a procedure with a young physician in
one of the fellows programs at Semmes-Murphey
Dr. Kenan Arnautovic directs a Bosnian sugeon in a complicated surgical
technique during a training visit
Paul N. Bourassa is Vice President of Blue Moon, Inc.
Marketing and Public Relations Consultants.
www.bmooninc.com
Winter 2012
11
Russian Physicians Visit Memphis
On Wednesday, November 2 The Memphis Medical
Society met with a delegation of sixteen physicians visiting
Tennessee from Kirov, Russia. Their visit was facilitated
through the congressionally sponsored program, Open World.
The program brings emerging leaders from Eurasian countries
to the United States in order to give them firsthand exposure
to the American system of participatory democracy and free
enterprise. Healthcare is one of four primary areas of focus
for the program. It is administered by the Open World
Leadership Center, an independent entity in the U.S. legislative
branch. It is facilitated through a network of over 6,100 U.S.
host families. Friendship Force Memphis, the local chapter of
Friendship Force International served as the host organization.
Wiley T. Robinson, M.D. a past president of the Medical
Society and 2012 president-elect of the Tennessee Medical
Association greeted and met with the delegation. Dr. Robinson
discussed with them the role organized medicine plays at the
local and state levels. He answered questions pertaining to such
topics as medical education, medical liability reform and the
hierarchy of the county medical society, state medical
association and AMA.
Wiley T. Robinson, M.D., 2012 TMA President-elect and Delegation of
Russian Physicians
Alliance 2011 Holiday Sharing
Card a Big Success
Thanks to all of you who contributed to this year ’s
Memphis Medical Foundation Holiday Sharing Card!
A proud tradition that the Alliance continues to
support. This year, we received 122 donations for a
total of $16,100. It is through these fundraising
efforts, that the Foundation can assist medical
students and improve the lives in our community.
Mrs. Peggy Larkin
Chair - 2011 Holiday Sharing Card
“Firestone’s Downtown Store Display Windows”
About the Photograph: In 1940, the display windows of the Firestone store in downtown
Memphis, TN were filled with gift items for both children and adults. The Alliance wishes
to thank Patricia McFarland for her assistance in obtaining this photograph.
By permission - Memphis and Shelby County Room of the Public Library
12
Medical Society Quarterly
LEGAL BRIEF
Accountable Care Organizations – the Final Rule
by: David W. Donnell
Pay-for-performance was born as a revolutionary
reimbursement concept and has become somewhat a small
force in health care reimbursement. So much so, that when
Washington rolled out the Patient Protection and Affordable
Care Act (PPACA) in late March 2010, a form of the model
(the “Medicare Shared Savings Program”) was introduced on
a national scale for the first time. Pay for performance models
provide financial incentives for hospitals, physician practices
and other health care providers to collaborate and increase
the overall quality of health care provided to patients. Simply
put, the better the outcome, efficiency and patient experience
are, the better the financial reward. An accountable care
organization (ACO) is the network of physicians and
hospitals collaborating as a unit to manage the delivery of
care to patients.
While the introduction of ACOs in PPACA seemed small
(only seven pages were devoted to the concept), the recently
released final rules grew to in excess of 600 pages. The rules
are complicated and veer somewhat from the model initially
unveiled. CMS now allows for a “one-sided” risk model which
allows coalitions to participate in the ACO reimbursement
program with no risk of losing money even if certain
benchmarks (33 in total) were not achieved. Those who are
willing to share in the risk and subject one selves to losses
when benchmarks are not satisfied stand to gain higher
rewards. For example, if the ACO members yield a reduction
in hospitalizations for their population, the ACO participants
would receive financial rewards, the amount of which would
depend on whether they opted to share the risk of loss if such
measures had not been met.
Those providers willing to participate in ACOs must
form formal, legal organizations. This will result in higher
collaboration among physicians, hospitals and other health
care providers. Providers in rural areas can even apply for
advanced payments to establish the ACO. However, there
are strict governance requirements for ACOs, as well as
many federal regulations, such as Stark, Anti-kickback and
Anti-trust laws that must be carefully considered before
forming an ACO. Applications for participation in the
14
program begin on January 1, 2012 and dates of implementation
start April 1, 2012.
David Donnell is a health care partner at Adams and Reese, and
can be reached at david.donnell@arlaw.com.
Alabama - Florida - Louisiana - Mississippi Tennessee - Texas - Washington, DC
Letter to the Editor
Dear Dr. Gettelfinger,
Thank you so very much for sending me your
editorial in the Memphis Medical Society fall 2011
Quarterly.
I thought your comments to be concise and to the
point. It is gratifying to know that someone else actually
cares about what is happening to patients that must take
certain drugs and have no other options. The price of
Syprine has since gone up even higher. My last
prescription cost me $1,600 for 80 days worth of
medication, (wholesaler was out so I was 10 days short)
which pushed me into the donut hole. The retail price is
now $4,147.29 for an 80 day supply. Obama saw to it,
that eventually, I only have to pay 50% of cost after
getting into the donut hole! Seems he forgot to put a cap
on the retail prices. Where does it stop?
Hopefully if there is enough outrage, our lawmakers
will do something about this situation; but I won’t be
holding my breath…
Regards,
B. Frayser
Patient of Tom Gettelfinger, M.D. - MECA
Medical Society Quarterly
The Newly Refined da Vinci SI Surgical System at
The da Vinci SI surgical system is the latest addition to the
da Vinci product line. It is the world’s only robotic surgical
system with enhanced high-definition 3D vision for superior
clinical capability. The Saint Francis Hospital-Memphis robotic
program has a dedicated OR team, open scheduling and no
blocked times.
Robotic-assisted surgery provides surgeons with a steady
set of hands that can hold and manipulate instruments under
that the surgeons control. During the procedure, the surgeon’s
hand movements are translated through the computer to the
robot’s arms that then do the work. Safety mechanisms are in
place to ensure that the robot only moves under control of the
surgeon. If the surgeon looks away from the computer
terminal, the robot locks in place.
The robot helps during laparoscopic surgeries that involve
special instruments that are inserted through several small
incisions in the body. One of the robot’s arms holds a special
camera that provides three-dimensional views, including
magnification of the area where the surgeon is working.
Surgeons using the da Vinci surgical system report that the
robotic instruments move more freely than the human wrist
does, enabling them to get the instruments placed at the correct
angle. Plus the robot can hold instruments without any of the
fine motor movement that a human’s hands would have,
making the surgery more precise. The robot’s arms can get to
areas of the body that are harder to reach compared to
traditional open and laparoscopic surgery.
What types of surgery can the da Vinci system do?
Surgeons may use the da Vinci system for a number of
laparoscopic procedures including:
· Hysterectomy
· Radical prostatectomy (removal of the prostate gland)
· Gallbladder removal
What are the benefits of robotic-assisted surgery?
Robotic-assisted surgery uses smaller incisions than
traditional open surgery. These incisions may be smaller than
those in a laparoscopic procedure without robot assistance.
These smaller incisions may mean:
· Faster recovery time
· Less pain and bleeding
· Less risk of infection
· Shorter hospital stays
· Smaller scars
Winter 2012
Any surgical procedure has risks, including reactions to
medications, difficulty breathing, bleeding and infection.
Patients should discuss the options for any surgical procedure,
including whether an open, laparoscopic or robotic-assisted
procedure would be more appropriate for their health and
condition. They also should discuss the risks and benefits of
any procedure before making a decision. For credentialing
information on the da Vinci SI surgical system, please contact
the Saint Francis Medical Staff Office at 901-765- 1813.
Annual Soles4Souls Event Provides Foot Care,
Shoes to Community’s Homeless
On Monday, November 21, the 5th Annual Soles4Souls
event took place at the Memphis Union Mission's Opportunity
Center. Residents Chris Potts, M.D. and Rob Murphy,
M.D. along with Soles4Souls coordinator David Richardson,
M.D. and fellow Kelly McCormick, M.D. all of Campbell
Clinic were among the medical professionals who participated
in the event. More than 100 homeless men received free shoes,
socks, foot and nail care.
15
Keeping Fiscally Fit
William B. Howard, Jr., ChFC, CFP
Question: I was playing golf the other day with one of my colleagues at our continuing education conference.
He mentioned he has a pension plan for his practice that allows large contributions and his corporation gets a deduction
in the amount of the contribution. His advisor told him he should have a defined benefit or a “big boy” pension plan.
My retirement plan limits the amount I can contribute. Should I change to a defined benefit pension plan?
Answer:
Your current retirement plan is a defined
contribution plan, and the annual contribution is limited by tax
law in the amount of $49,000 for 2011. If you have the ability to
contribute more towards your retirement, the large contributions
and tax deductions available in a defined benefit pension plan
make it extremely attractive over your current option.
The defined benefit pension plan your colleague is
describing provides a stream of income at retirement based on a
benefit amount (percentage of your current income) that you
select. The annual contributions needed to fund the plan are
calculated by an actuary who uses specific inputs (current age,
current compensation, retirement age, and accumulated plan
assets) in a formula that will determine the amount of the
contributions. Defined benefit pension plans often work well
for older physicians who have the cash flow to make large
contributions to their retirement plans. Defined benefit
pension plans allow for tax-deferred accumulations on interest,
dividends, and capital gains, and the annual contributions are
considered a tax deductible business expense. In addition, the
annual contributions to the defined benefit pension plan can
potentially lower your personal tax liability by reducing your
income. There are tax laws that limit the amount of the annual
benefit a participant may receive. In 2011, that amount is
$195,000 or 100% of the participant’s average annual
compensation for their highest three years of service, so you
contribute an amount to the plan that would fund that level of
benefit during your retirement. If you are seriously considering
a switch to a defined pension plan, consult a financial advisor
in your area for a more detailed explanation on the rules and
regulations. These are complicated plans but in the right
situation, the benefit from this pension plan would be worth
the effort.
William Howard & Co.
Financial Advisors, Inc.
Fee only Financial Planning
and Investment Advisory Services
William B. Howard, Jr. ChFC, CFP
International Place II
6410 Poplar Ave. Suite 330
Memphis, TN 38119
Telephone: (901) 761-5068 Facsimile: (901) 761-2217 E-mail: whoward@whcfa.com.
16
Medical Society Quarterly
— A Home Away from Home
by: Scarlet Thompson
There’s no place like the American Cancer Society
Harrah’s Hope Lodge, which has just reached a milestone of
serving cancer patients seeking treatment in Memphis. The
facility has now served those affected by cancer for a full year.
The facility opened its doors in late November 2010, joining
the more than thirty already in operation across the nation.
“The Hope Lodge is a much needed resource in Memphis as it
is the first to offer free housing for adult cancer patients,” said
Kim Culbreath, American Cancer Society Harrah’s Hope
Lodge Director.
The Hope Lodge offers patients and
their caregivers a place to stay in a warm,
caring, and supportive environment
where their main focus can be fighting
their disease and getting well. While at
the Lodge, guests are encouraged to
make themselves feel at home by
preparing meals, joining in evening
activities, watching television, or
unwinding in their own private room.
Sharon and Jeff Humm
The forty guest room facility was
built after much dedication from
volunteers in the Memphis area, and also financial supporters
like the Harrah’s Foundation. The group funded the Lodge
with a two million dollar grant. It’s the largest one-time
donation received by the Mid-South Division of the American
Cancer Society. “It is our hope that through this donation, the
American Cancer Society will make a positive, life changing
impact in many of our neighbors’ and families’ lives when they
need it most,” said R. Scott Barber, advisory board member,
Caesar’s Entertainment Inc. and regional president, Harrah’s
Mid-South.
That impact has truly been felt by Sharon and Jeff Humm.
The Illinois couple holds the unique distinction of being
Winter 2012
the Lodge’s first two official guests. “It’s a
home away from home,” says Jeff. “The Hope
Lodge is such a special haven during a very
trying time for families facing cancer.”
The Humms travelled to Memphis for care
after they learned Sharon had breast cancer
and her doctor had relocated here. Once here,
the Humms found a free room with private
bath, and resources like a community kitchen
and a library. The Lodge even has a shuttle
service for trips back and forth to treatment. “Knowing that
someone is there to care, to comfort, to provide, to help
encourage, all without invading one’s private time, is more
than I can put into words. We have never experienced a place
like it,” says Jeff.
Any patient can receive the assistance of the American
Cancer Society by staying at the American Cancer Society
Harrah’s Hope Lodge in Memphis on 718 Union Avenue.
All that is needed is a referral from a doctor or social worker.
Please call 901-524-5500 for more information about this
service or call toll-free with questions about the help the
American Cancer Society provides at 1-800-227-2345.
17
R E A L E S TAT E U P D AT E
Medical Office Space More Expensive
Than Traditional Office Space
by: Jon D. Albright, CCIM, SIOR, SRES
“Why is Medical Office Space
More Expensive than Traditional
Office Space?” I have been asked
this question in a number of ways
and at various times over the years.
Most of the time it occurs when I am representing medically
related clients who are searching for suitable space to lease or
own. Although it is not always the case, medical office space is
generally more expensive than standard office space.
There are several factors which can contribute to the
increased cost. Most of them center on what is typically needed
in many medical practices. For example, in many medical
offices additional plumbing is required. In some instances, each
individual exam room may require a sink, additional drains and
a lab may be needed as well, which will add significantly to the
overall costs of the tenant related improvement costs. Upon
further review, some offices can have a centrally located sink
which can be easily accessed from multiple exam rooms.
However, not every office will require additional plumbing and
a careful analysis can help in this regard.
Also, most medical offices require a lot of storage space.
This is needed for many reasons. Cabinetry and millwork can
be extremely expensive. Medication, supplies and equipment
are all important components of a practice. But, careful
planning can help to minimize the excess need for extra costs in
Dr. Schanzer Receives AAO 2011
Outstanding Humanitarian
Service Award
Mary Cathleen Schanzer, M.D.
recently received the 2011 Outstanding
Humanitarian Service Award from the
American Academy of Ophthalmology
at their October 1 meeting in Orlando,
Florida. Dr. Schanzer was nominated
by the Baylor Ophthalmology Alumni
Association. She is the medical director
and chief surgeon as Southern Eye Associates. Dr. Schanzer has
been on numerous medical mission trips. She began in 1988
to the small Nigerian village of Abak. Her greatest missionary
challenge came in 2004 when the Archbishop of Sierra Leone
asked her to establish a medical/surgical eye clinic in his home
village of Serabu. The Southern Eye clinic opened in 2006.
Dr. Schanzer has travelled to the clinic twice a year to perform
more than 200 surgeries per trip. The clinic is open year
round, providing free eye care, medicine, glasses and surgeries.
18
this area. In some cases, purchasing movable / lockable cabinets
or filing cases can be an option that can help.
Although this has changed for some practices, the number
of rooms can also be a factor. What I mean by this is multiple
small rooms add to the labor and costs to construct. The
number of doors and hardware needed can be much higher than
ordinary office uses.
It is very difficult to see past an “old” and worn space, but if
plumbing is in place and the general layout is workable, the
cosmetic (wall color and flooring selections) aspects can be
much less expensive than having to demolish or construct a new
space from a shell condition. A previous space that has all you
may need is not always available in the area you want.
Nevertheless, if you can local something that is suitable, it can
help lower your costs if you are open to considering it. As
always, consult members of your team to properly analyze and
discuss what you need in your new or current medical space.
Jon D. Albright, CCIM, SIOR, SRES; Investec Realty Services
51 Germantown Court, Ste 215 • Memphis, TN 38018
901-758-2424 phone • jon@investectn.com
2012 OSHA Seminars
Annual Compliance Training
for Healthcare Workers
The Memphis Medical Society
1067 Cresthaven Road
Two Seminars to choose from:
Wednesday, January 11
8:00 am - 10:30 am*
OR
1:00 pm - 3:30 pm*
*Registration and meal begins 30 minutes prior to each session.
These information sessions are tailored exclusively for healthcare workers in an office setting. Each session
fulfills OSHA’s requirements for annual training. Attendees
receive a certificate of attendance for two (2) contact hours.
901-761-0200
Registration includes all instruction fees, handouts, certificate and
meal - breakfast for the morning/lunch for the afternoon.
$75 per person
Presented by:
The Memphis Medical Society in conjunction with Doctors Management
Medical Society Quarterly
American College of Surgeons Names
Le Bonheur Level 1 Trauma Center
L to R: Sam Sheppard,
trauma data analyst;
Trey Eubanks, M.D.,
medical director
of trauma;
Kathryn Stewart,
trauma registrar;
and Kerri Deaton,
trauma program
manager
Only pediatric center within 400 miles of Memphis
Le Bonheur Children’s Hospital has been named a Level 1
Trauma Center by the American College of Surgeons (ACS).
The verification is an important distinction and a guidepost for
improving the hospital’s standard of care. Le Bonheur is the
first accredited pediatric ACS Level 1 Trauma Center in the
region. The closest pediatric centers are in Lexington, Ky., and
Dallas. “Our entire hospital is committed to continuing to
provide excellent health care to children throughout the entire
region,” said Le Bonheur Medical Director of Trauma James W.
“Trey” Eubanks, M.D. “This rigorous designation shows our
level of dedication to being a national leader in pediatrics.
I am thrilled that we have been honored in this way.”
While Le Bonheur is already designated as a children’s
trauma center on the state level in Tennessee and Arkansas, the
ACS accreditation is a national designation that requires both
high quality clinical care and research in the field of trauma
with continued innovation. Pediatric surgeons, emergency
physicians and nursing staff provide outreach and education to
partner facilities throughout Tennessee, Arkansas and
Mississippi as part of the designation.
In June, an on-site review was conducted by a team of
reviewers experienced in the field of trauma. The ACS
Committee on Trauma’s verification program confirmed that
Le Bonheur has demonstrated its commitment to providing the
highest quality trauma care for all injured patients. “This
designation by experts in pediatric surgery speaks volumes
about the quality of care provided at Le Bonheur,” said Le
Bonheur President/CEO Meri Armour, MSN/MBA. “I am so
proud of the teamwork, planning and commitment to
excellence demonstrated by entire staff. Through hard work
and collaboration, we have distinguished Le Bonheur as the
best place to care for children involved in traumas within 400
miles of Memphis.” Le Bonheur joins the ranks of only 33
pediatric ACS Level 1 Trauma Centers in the country.
Insurance Billing Clerks
X-Ray Technologists
Medical Secretaries
Medical Assistants
Transcriptionists
Phlebotomists
Coding Clerks
Permanent and Temporary Placement
Cashiers
20 years experience
staffing all positions
LPN/RNs
in doctors’ offices/clinics
Receptionists
MLTs
Over
Call Betty or Freda
761-0200
20
Medical Society Quarterly
UTHSC College of Medicine Recognizes Two Outstanding Alumni
On Friday, September 16, 2011 the University of
Tennessee Health Science Center recognized two members
of the Medical Society at their annual Outstanding Alumni
Awards luncheon at the Peabody Hotel. The individuals
who were honored were James H. Beaty, Jr., M.D. and
Allen S. Boyd, Jr., M.D. Each of these UT alums has
exuded commitment, creativity and courage in improving
the health care industry. Dr. Beaty is a professor of
orthopedics and chief of staff at Campbell Clinic. He has
held numerous leadership positions in the American Board
of Othopaedic Surgery, the Pediatric Orthopaedic Society of
North America, the Mid-America Orthopaedic Association
and the Tennessee Orthopaedic Society. Dr. Boyd is a
retired neurologist from Semmes-Murphey Clinic. He is
currently a clinical associate professor at UTHSC College of
Medicine. He has been active with the Tennessee
Neurosurgical Society, the Memphis Neurological Society
and the American College of Surgeons. Dr. Boyd is a
volunteer for medical mission trips to Southeast Asia and
Africa, as well as at the Church Health Center.
Winter 2012
Paul Huffstutter, President of the UT College of Medicine Alumni
Council with James H. Beaty, Jr., M.D. (L) and Allen S. Boyd, Jr., M.D. (R)
Photos courtesy of UTHSC – Thurman Hobson, Jr., photographer
21
A Lot of Hard Lessons
by: Bill Appling
I can’t take credit for the title of this column. The credit
needs to go to Bruce Hopkins, President, West Tennessee
Region, First Tennessee Bank. Bruce said, “The financial crisis
has made us a more efficient company and more productive,
because we’ve had to work harder for the business. There have
been a lot of hard lessons that have been learned. But, they are
good lessons.” Healthcare and banking have been compared to
one another in many ways. One way is that they are two of the
most regulated industries in the country.
As many of you know, I am involved with both the
Medical Group Management Association (MGMA) and the
American College of Medical Practice Executives (ACMPE).
At this year’s annual meeting, the two organizations voted to
become a combined association on January 1, 2012. This new
entity will be better positioned to serve members and the
industry in a rapidly changing healthcare market. The new
association will continue to use its established MGMA and
ACMPE brands and will investigate ways to align these brands
for the future. The MGMA and the ACMPE Boards have
been engaged in a joint visioning process for almost two years
to determine how to meet members’ needs in a transforming
environment. I have been appointed to the combined Board
of Directors for 2012.
The last two years have been the most intense years in my
capacity of serving on the ACMPE Board. Is this intensity
something that you can relate to as physicians? We have a
unique and historic opportunity to lead our members into the
future of managing physician-led care and helping members
navigate a variety of complex delivery models. The joint board
concluded that we can achieve that goal more efficiently as one
cohesive entity. After much work, due diligence, input from
both stakeholders and volunteer leaders, the MGMA and
ACMPE Boards were unanimous in proposing to the members
that MGMA and ACMPE unite to form this new association.
Members of both the MGMA and ACMPE voted to approve
this new association.
With 22,500 members, MGMA is the largest professional
membership association for medical practice leaders. ACMPE
is the most respected certification and standard-setting
organization for medical practice leaders, and has 6,750
members. Current members of the two organizations will
automatically be transitioned to become members of the new
association and will pay a single dues amount. Members of the
new association who wish to pursue Board certification
through ACMPE will no longer need to join a separate
organization and pay separate dues each year.
We were proactive in both anticipation of healthcare
reform and the changing processes over the timeline of reform,
with 2011 being one of the most significant years. We did not
allow the Federal Courts to delay us in our planning, even
though much discussion ensued. We had to move forward
with the information that was readily available. With this
newly formed association, we will eliminate duplication of staff
services and some costs. MGMA has always been a strong
advocate in Washington for practice administrators. Stronger
membership growth will allow us to have an even greater voice
in these advocacy efforts, as well as to increase membership
engagement to provide more opportunities for leadership roles.
The expanded brand recognition and leveraging of our
credentials increases the visibility of the combined entity
throughout the healthcare industry. Now is the time to reinvent the organization and put into action what we have
learned.
Yes, Bruce Hopkins there has been a lot of hard lessons
learned, as you said. But hopefully, they will be good lessons.
Again, Bruce, thank you for the title of my column. And who,
but a fellow partner along with Watkins Uiberall and Blue
Cross Blue Shield (BCBS) who support Memphis Health Care
Heroes each year could have such a “clear crystal ball”?
You, Calvin Anderson of BCBS and I should have some
good material for the Heroes of 2012.
Bill Appling, MBA, FACMPE is president of Waktins Uiberall Health Care Consulting.
He has faculty appointments at the University of Memphis in the Fogelman College of Business and Economics,
where he teaches in the Masters of Health Care Administration program.
22
Medical Society Quarterly
The Memphis Medical Society is pleased to welcome the following new
members from Methodist Le Bonheur Healthcare:
Bruce Stephen Alpert, M.D.
Mohammed Hashem
Alsheikh-Ali, M.D.
Kanwaljett S. Anand, M.D.
Courtney Leroy Anthony, M.D.
Alejandro Redaelli Arevalo, M.D.
Sandra Arnold, M.D.
Rana Assfoura, M.D.
Bettina H. Ault, M.D.
Bindiya Bagga, M.D.
Jean Ann Ballweg, M.D.
Judith Anne Becker, M.D.
Helen Beeman, M.D.
Paras M. Bhattarai, M.D.
Dennis D. Black, M.D.
Umar Sekou-Toure Boston, M.D.
Thomas F. Boulden, M.D.
Andrew Brittan, M.D.
Monica L. Brown, M.D.
Steven C. Buckingham, M.D.
Mark C. Bugnitz, M.D.
Patricia Joan Chesney, M.D.
Russell W. Chesney, M.D.
Thomas Kiang Chin, M.D.
Asim F. Choudhri, M.D.
Harris L. Cohen, M.D.
Winter 2012
Mary Ellen Conley, M.D.
Mark R. Corkins, M.D.
Cynthia D. Cross, M.D.
Noel Mores Delos Santos, M.D.
John Peter Devincenzo, M.D.
Alicia Diaz-Thomas, M.D.
Matthew Theodore Eison, M.D.
Boyce Keith English, M.D.
John K. Eshun, M.D.
Ignacio Fernandez-Nievas, M.D.
Robert Jean Ferry, M.D.
Mayte Ideliz Figueroa, M.D.
Stephen Fulton, M.D.
Dana W. Giel, M.D.
Steven Peter Goldberg, M.D.
Katherine Gyves-Ray, M.D.
Brent Haberman, M.D.
Debra L. Hanna, M.D.
Marion Hare, M.D.
Margaret Colleen Hastings, M.D.
John R. Hill, M.D.
Masanori Igarashi, M.D.
Laurie L. Imsand, M.D.
Valerie P. Jameson, M.D.
Ryan Christopher Jones, M.D.
Vijaya Madhukar Joshi, M.D.
Christopher John Knott-Craig, M.D.
David Arnold Kube, M.D.
Karen Lakin, M.D.
Linda F. Lazar, M.D.
Henrique Lederman, M.D.
Dukhee Betty Lew, M.D.
Florentina Litra, M.D.
Charles Bruce MacDonald, M.D.
Mary Kathleen Mazel, M.D.
Amy L. McGregor, M.D.
Jennifer D. McLevy, M.D.
Kathryn Anne McVicar, M.D.
Ruby Mehta, M.D.
Christie F. Michael, M.D.
Robin L. Morgan, M.D.
Linda Kay Myers, M.D.
Deborah D. Nelson, M.D.
Peggy A. O’Cain, M.D.
Frederick B. Palmer, M.D.
Louis S. Parvey, M.D.
Freedom F. Perkins, M.D.
Stephen D. Pishko, M.D.
Eniko K. Pivnick, M.D.
Gerald J. Presbury, M.D.
Shyam Sathanandam, M.D.
Robert A. Schoumacher, M.D.
Andreas Schwingshackl, M.D.
Jeffrey Alan Scrugham, M.D.
Georgette R. Sevier, M.D.
Namrata S. Shah, M.D.
Samir H. Shah, M.D.
Sunil Kumar Sinha, M.D.
Stephanie K. Slagle, M.D.
Chandrea Smothers, M.D.
Thomas Spentzas, M.D.
Saumini Srinivasan, M.D.
James Kevin Stamps, M.D.
Rosemary Stocks, M.D.
Dennis Clifton Stokes, M.D.
Stephanie A. Storgion, M.D.
James Dudley Tutor, M.D.
Katherine Van Poppel, M.D.
Benjamin Rush Waller, M.D.
Jewell Catherine Ward, M.D.
Glenn T. Wetzel, M.D.
James W. Wheless, M.D.
Toni Michele Whitaker, M.D.
Matthew Whitehead, M.D.
Robert Sidney Wilroy, M.D.
Robert J. Wyatt, M.D.
George Young, M.D.
23
NEW MEMBERS
Charles W. Dorroh, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Missouri – Columbia, 1981
University of North Carolina –
Winston-Salem (R-AN)
Charles D. Akins, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1973
University of Tennessee – Memphis (R-AN)
Frances X. Camillo, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
New York Medical College – Valhalla, 1993
New York Medical College – Valhalla (R-OS)
William E. Albers, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Case Western Reserve University, 1977
Case Western Reserve University (R-OS)
Scott L. Bartusch, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1991
University of Tennessee – Memphis (R-AN)
David A. Benoit, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Texas, 1995
Tulane University (R-AN)
Ajit K. Biswas, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Rajshahi Medical College, 1969
New York Poly Clinic Hospital (I-IM)
University of Tennessee – Memphis (R-AN)
James N. Boutte, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Louisiana State University, 1989
University of Tennessee – Memphis (R-AN)
John F. Burda, M.D.
Interventional Radiology
Mid-South Imaging & Therapeutics, PA
6305 Humphreys Blvd., Ste. 205
Memphis, TN 38120
901-226-3001
Drexel Univ. College of Medicine, 2000
Hahnemann University Hospital –
Philadelphia (R-DR)
Washington University – St. Louis (F-IR)
24
David L. Cannon, M.D.
Hand Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Cornell University Medical College, 1991
Duke University (R-OS)
University of Southern CA – San Diego (F-HS)
Kevin B. Cleveland, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Mercer University School of Medicine, 1996
University of Tennessee – Memphis (R-OS)
Miriah Beth Denbo, M.D.
Obstetrics and Gynecology
Adams Patterson Gynecology and Obstetrics
6215 Humphreys Blvd., Ste. 301
Memphis, TN 38120
901-767-3810
Indiana University School of Medicine, 2007
University of Tennessee – Memphis (R-OB/GYN)
J. Dee Dockery, M.D.
Physical Medicine and Rehabilitation
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Emory University School of Medicine, 2002
University of Tennessee – Memphis (I-IM)
University of AL – Birmingham (R-PMR)
Vijaya L. Duggirala, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Kurnool Medical College, 1974
New York University Medical Center (R-IM)
University of Tennessee – Memphis (R-AN)
Alvaro R. Encinas, M.D.
Family Practice
Medicos Para La Familia
3030 Covington Pike, Ste. 100
Memphis, TN 38128
901-383-8889
Ross University – Dominica, 2007
Somerset Family Practice (R-FP)
David W. Fanning, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
East Tennessee State Univ., 1982
University of Tennessee – Memphis (R-AN)
Terry Fong, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Mahidol University – Bangkok, 1968
Medical College of Ohio – Toledo (R-IM)
University of Tennessee – Memphis (R-AN)
William R. Funderburg, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Alabama, 1990
Kansas University – Kansas City (R-AN)
Charles Gairhan, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Arkansas, 1992
University of West Virginia – Morgantown (R-AN)
Raymond J. Gardocki, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of Southern CA – Los Angeles, 1997
University of Southern CA – Los Angeles (R-OS)
Carl S. Getto, M.D.
Psychiatry
The Regional Medical Center at Memphis
877 Jefferson Avenue
Memphis, TN 38103
901-545-7888
Loyola University – Stritch School of Medicine, 1972
University of Colorado – Denver (R-PSYH)
Thomas V. Giel, III, M.D.
Orthopedic Surgery
OrthoMemphis
6286 Briarcrest Avenue, Ste. 200
Memphis, TN 38120
901-259-1600
University of Tennessee, 2005
University of Tennessee – Memphis (R-OS)
Mississippi Sports Medicine – Jackson (F-SM)
Roberto R. Gonzalez, M.D.
Family Practice
Medicos Para La Familia
3030 Covington Pike, Ste. 100
Memphis, TN 38128
901-383-8889
Instituto Techologico de Santo Domingo, 2000
John Peter Smith Hospital (R-FP)
William J. Gorline, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
St. Louis University, 1974
Emory University (R-AN)
Stephen T. Hood, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Mississippi, 1967
U. S. Naval Hospital – Philadelphia (R-AN)
John C. Hyden, M.D.
Sports Medicine
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of Tennessee, 2005
Wake Forest University (R-FM)
Boston University (F-SM)
Bhanu V. Kanakamedala, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Hyderabad Karnataka Medical College, 1985
Wayne State University – Detroit (R-IM)
Loyola University – Maywood, IL (R-AN)
Medical Society Quarterly
Vincent K. Samuel, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Univ. Technologia de Santiato, 1985
University of Tennessee – Memphis (R-AN)
Christine L. Kasser, M.D.
Addiction / Pain Medicine
5200 Park Avenue, Ste. 202
Memphis, TN 38119
901-751-7080
University of Kansas, 1981
Univ. of Kansas Medical Center (R-IM)
Derek M. Kelly, M.D.
Pediatric Orthopedics
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of AR – Little Rock, 2002
University of AR (R-OS)
Texas Scottish Rite Hospital for Children (F-PO)
Reed S. Landau, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1985
University of Connecticut – Farmington (R-AN)
Angela G. Laster, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1997
Howard University (R-GS)
Johns Hopkins Hospital (R-AN)
Stuart J. Lazarov, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1987
University of Tennessee – Memphis (R-AN)
Herbert L. Lindsay, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Mississippi, 1990
University of Tennessee – Memphis (R-AN)
William M. Mihalko, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Medical College of Virginia, 1993
State University of NY – Buffalo (R-OS)
Missouri Bone & Joint Center (F-OS)
Rajendra K. Moolchandani, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Bombay, 1982
New York Hospital (R-AN)
Robert J. Moskop, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1989
Duke University (R-AN)
Andrew B. Nearn, M.D.
Pediatrics
Pediatrics East, Inc.
8110 Walnut Run Road
Cordova, TN 38108
901-754-9600
University of Tennessee, 2008
University of TN – Memphis (R-PD)
Jeffrey R. Sawyer, M.D.
Pediatric Orthopedics
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of Rochester, 1993
University of PA – Philadelphia (R-OS)
University of Tennessee – Memphis (F-PO)
Zachary B. Self, M.D.
Family Practice
Medicos Para La Familia
3030 Covington Pike, Ste. 100
Memphis, TN 38128
901-383-8889
University of Tennessee, 2008
Ventura County Medical Ctr. (R-FP)
Marc S. Silberberg, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1982
Boston University (R-AN)
Phalgun J. Patel, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Gandhi Medical College, 1991
SUNY – Brooklyn (R-AN)
J. Lacey Smith, M.D.
Gastroenterology
UT Medical Group, Inc.
1407 Union Avenue, Ste. 700
Memphis, TN 38104
901-866-8025
Baylor UniversityHouston, 1973
Baylor University – Houston (R-IM)
Baylor University – Houston (F-GST)
Christopher H. Livesay, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
George Washington University, 1989
Naval Medical Center – Portsmouth (R-AN)
Ashley L. Park, M.D.
Physical Medicine and Rehabilitation
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
St. George’s University, 1987
University of PA – Philadelphia (R-PMR)
Georgia Spine and Sports Physicians (F-OPM)
Raj K. Stephens, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
Madurai Medical College, 1974
Medical College of Ohio – Toledo (R-AN)
Anthony A. Mascioli, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
State Univ. of NY – Downstate, 2003
University of Tennessee – Memphis (R-OS)
Matthew I. Rudloff, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Medical College of Ohio – Toledo, 2003
University of Tennessee – Memphis (R-OS)
Denver Health Medical Center (F-OS)
Thomas W. Throckmorton, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of Iowa, 2002
Vanderbilt University (R-OS)
Mayo Clinic – Rochester (F-SES)
Winter 2012
Patrick C. Toy, M.D.
Orthopedic Oncology
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
University of Tennessee, 2003
University of Tennessee – Memphis (R-OS)
University of Florida (F-OO)
John T. Walsh, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1982
St. Joseph Hospital – Denver (R-GS)
University of Tennessee – Memphis (R-AN)
Ben P. Webber, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Tennessee, 1971
University of Tennessee – Memphis (R-AN)
John C. Weinlein, M.D.
Orthopedic Surgery
Campbell Clinic Orthopaedics
1400 South Germantown Road
Germantown, TN 38138
901-759-3100
Robert Wood Johnson Medical School, 2004
University of Tennessee – Memphis (R-OS)
Hennepin County Medical Center (F-OS)
Steven J. Weiss, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Miami, 1983
Loyola University – Maywood, IL (R-AN)
Ana Elizabeth Whitten, M.D.
Anesthesiology
Metropolitan Anesthesia Alliance, PLLC
1900 Exeter Road, Ste. 210
Germantown, TN 38138
901-818-2160
University of Federal de Bahia, 1977
Baylor College of Medicine – Houston (R-AN)
Editor’s Note: The fall 2011 issue
incorrectly identified Howard Lee
Martin, III, M.D. as being affiliated
with Duckworth Pathology Group.
Dr. Martin is not a member of this
practice. We apologize for this error.
25
CALENDAR
MEMORIAM
December 6
9
William B. Burrow, Jr.
July 24, 1935 – October 31, 2011
Raza A. Dilawari
26
January
September 28, 1946 – September 18, 2011
2
10
10
Eugene Wesley Fowinkle
11
September 2, 1934 – August 26, 2011
18
Frank Jackson Osborn
28
August 12, 1935 – October 14, 2011
February
William Wood Taylor, Jr.
7
New Year’s Holiday
Medical Society Closed
Board of Directors Meeting
Medical Society, 6 pm
Memphis Academy of Internal Medicine
Fogelman Executive Center – room 304, 6:30 pm
OSHA Seminars
8:00 am to 3:30 pm
The Memphis Medical Society
Bluff City Medical Society Meeting
Location & speaker - TBA, 6:30 pm
135th Annual Meeting
Holiday Inn – University of Memphis
15
Board of Directors Meeting
Medical Society, 6 pm
Bluff City Medical Society Meeting
Location & speaker - TBA, 6:30 pm
7
PITCH – Physicians Involved in
Tennessee’s Capitol Hill – Nashville, TN
November 19, 1940 – August 30, 2011
March
Board of Directors Meeting
Medical Society, 6 pm
Bluff City Medical Society
Holiday Celebration, 6:30 pm
Home of Dr. and Mrs. Neal Beckford
Christmas Holiday
Medical Society Closed
Memphis Medicine:
A History of Science and Service
135th Annual Meeting
and Installation of Officers
presented by
Saturday, January 28, 2012
Holiday Inn - University of Memphis
6:00 p.m. - Cocktails & Hors d’oeuvres
7:00 p.m. - Dinner followed by
Awards and Installation of Officers
Members with guest attend at no charge.
Cash Bar
Enjoy the opportunity to bid on numerous
silent auction items, with all proceeds benefiting
the Memphis Medical Foundation.
26
Makes a perfect holiday gift!
Co-authored by: Patricia LaPointe McFarland
and Mary Ellen Pitts, Ph.D.
This beautiful coffee table book chronicles
healthcare in our city, including the 1878
yellow fever epidemic, the accounts of the
death of Elvis and Martin Luther King, Jr.,
as well as many other historical facts.
Copies of the book may be purchased for $45
at The Memphis Medical Society
or The Booksellers at Laurelwood
Medical Society Quarterly
BACK PAGE
28
The University of Memphis School of Public Health
by: Mark D. Hendricks
In Benjamin Franklin’s day it was worth a pound of
cure. But on today’s market, with health care reforming,
foreclosures rising, and debt ratings falling, what is an ounce
of prevention truly worth? Arriving at that valuation, along
with discovering and applying solutions to a host of
extremely challenging public health care issues, is the task of
the faculty and students at the University of Memphis’ new
School of Public Health.
Under the leadership of its founding dean, Dr. Lisa
Klesges, the newly formed school is spearheading
community efforts to improve public health and promote
urban health equity through
education, research and
outreach. Dean Klesges, a
Ph.D. graduate of the
University of Minnesota
School of Public Health
with 106 peer-reviewed
research articles currently
published, recruited
eminent scholars at the
outset to conduct rigorous
research while championing
Dr. Lisa Klesges, dean
the role of public health in
the community and
building meaningful partnerships in the region. At the
same time, Dr. Klesges is working to assure that the next
generation of the public health workforce is receiving the
highest quality education and practice opportunities
available in the field of public health.
Why Memphis? Why now? In some ways, Memphis
and the Mid-South have come a long way in addressing
public health issues since 1921. That was the year Memphis
businessmen were quoted in the New York Times saying that
they considered President Harding’s assertions of a ‘pellagra
plague’ identified by public health professionals as “tending
to prove disastrous to business interest and should be
soundly denied.” Today’s Memphis business leader is more
enlightened regarding public health’s impact on the work
force. But in other ways, the city and the region remain in
the starting gate.
Although Memphis is home to two of the nation’s
larger private health care systems, as well as notable
physicians with worldwide reputations, there is still a
disconnect between the health care delivery system and the
“social determinants of health”. If the health and lives of
Mid-Southerners are to be improved any time soon, then
the conditions that make them sick must be addressed now.
With the Mid-South suffering a disproportionate number of
conditions related to socioeconomic and racial disparities in
health, determining how to best address those conditions
requires an urgent and direct approach. At the School of
Public Health, “We emphasize both discovery and
application with the goal of moving ‘knowledge into action’
locally, nationally and globally,” says Dean Klesges.
Moving “knowledge into action” is critical. Like many
health care professionals, the U of M School of Public
Health faculty and students are aware that social conditions
often affect health care to a greater degree than medical care
does. If the academic community fails to address unhealthy
behaviors and social needs along with issues in health equity
and policy, the ability of the physician to treat patients
effectively is impaired. After all, what is the long term effect
of the prescription instructing ‘take with food’ if the family
has no access to quality food?
Equally important, the promise of turning “knowledge
into action” has drawn students from across the nation and
internationally to pursue either a Master in Public Health or
Master in Healthcare Administration degree at the School.
They are attracted by the School’s stated aspiration to
become one of the nation’s premier centers for health
disparities research and by the prospect of applying the
results of that research directly in the community.
Additionally, students seeking cutting-edge advanced
training for academic and research careers currently have
two Ph.D. degrees to choose from; one in Epidemiology
and the other in Social and Behavioral Sciences. The
School’s promise of “knowledge into action” is key to
guaranteeing a pipeline of well-trained and motivated health
care leaders who will seek to build a healthier population
through prevention.
So what is that ounce of prevention truly worth today?
Well, we know an apple a day now costs about fifty cents
and an aspirin for cardiovascular health about a penny. But,
as the credit card ads remind us, there are some things
money can’t buy. Today, as any U of M School of Public
Health student can tell you, an ounce of health care
prevention is priceless.
For further information, please visit our website:
www.memphis.edu/sph
Medical Society Quarterly
Bulletin Cover_Winter12_4c_Cover 11/28/11 5:49 PM Page 3
Bulletin Cover_Winter12_4c_Cover 11/28/11 5:49 PM Page 4
The Memphis Medical Society
1067 Cresthaven Road
Memphis, TN 38119-3833
PRSRT STD
U.S. Postage
PA I D
Memphis, TN
Permit No. 1107