PDF Files - VAFP.org

Summer 2016
Register Now to attend the
VAFP 2016 Annual Meeting &
Exposition scheduled
July 21-24, 2016 at the
Sheraton Oceanfront Hotel
in Virginia Beach, Virginia
1
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2
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VAFP
Virginia’s Family Physicians
V
family physician
The
summer•2016
VAFP Mission Statement
VAFP Vision Statement
The mission of the VAFP is to empower its
members to be personal physicians who provide
high quality, accessible health care, dedicate
themselves to the well-being of the citizens of
Virginia, and are guided by the principle that
the family physician is the specialist of choice for
lifelong health care.
The vision of the VAFP is for Virginia to be
the best place for our citizens to receive their
healthcare and for family physicians to practice
medicine.
OFFICERS
PRESIDENT
Charles Frazier, M.D.
DIRECTORS
Timothy Beirne, M.D.
ADVISORS
MSV DELEGATE
• Vinton
• Williamsburg
Elizabeth Cook, M.D.
Charles Frazier, M.D.
PRESIDENT-ELECT
Lindsey Vaughn, M.D.
• Huddleston
• Suffolk
• Newport News
FIRST VICE-PRESIDENT
Rupen Amin, M.D.
Susan Hundley, M.D.
• Harrisonburg
John Scott Litton, M.D.
PAST PRESIDENT
Robert Elliott, M.D.
• Pennington Gap
• Hurt
• Roanoke
Emmeline Gasink, M.D.
• Clarksville
Brian Unwin, M.D.
TREASURER
Dena Hall, M.D.
• Williamsburg
MSV ALTERNATE DELEGATE
Lindsey Vaughn, M.D.
• Suffolk
EX OFFICIO
MEMBERS
Brian Dickens, D.O.
Virginia College of Osteopathic Medicine
Michael Jeremiah, M.D.
Virginia Tech/Carilion School of Medicine
Tony Kuzel, M.D.
Virginia Commonwealth University
AAFP DELEGATES
Sterling Ransone, Jr., M.D.
• Deltaville
Kurtis Elward, MD, MPH
Christine Matson, M.D.
Eastern Virginia Medical School
Norman Oliver, M.D.
University of Virginia
• Charlottesville
AAFP ALTERNATE DELGATES
Jesus Lizarzaburu, M.D.
• Suffolk
• Grafton
SECRETARY
Kent Willyard, M.D.
Mark Watts, M.D.
• Vinton
• Newport News
EXECUTIVE VICE PRESIDENT
Mary Lindsay White
• Richmond
The Virginia Family Physician is
published by the Virginia Academy of
Family Physicians
1503 Santa Rosa Road
Suite 207
Richmond, VA 23229
Edition 44
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3
VAFP President’s Message
Charles O. Frazier, MD
In my initial installment in
this space, I discussed the many
changes occurring in medicine and
the many challenges and potential
opportunities they are presenting
to our specialty. Well, now, some
of those changes are coming into
sharper focus. On April 27th CMS
released proposed rules to implement
key provisions of MACRA (the
Medicare Access and CHIP
Reauthorization Act of 2015), which
was passed by congress to repeal
the Sustainable Growth Rate (SGR)
formula and to presumptively move
to an approach in paying physicians
based more on value and quality than
on volume.
For Advertising Information
contact Tom Kennedy
Publishing Concepts, Inc.
by phone at
501/221-9986
or by email at
tkennedy@pcipublishing.com
4
I doubt many of us (any of
us?) have read those 962 pages of
proposed rules, and yet it is very
important that we gain a very good
understanding of those regulations,
comment on them as appropriate,
and begin to prepare for their
implementation. As an Academy, we
feel it is our obligation to aid our
members in that preparation, and
we will continue to monitor what
resources the American Academy of
Family Physicians develop and make
sure you are aware of those. We will
also from time to time include items
in this publication about MACRA
(see Lindsey Vaughan’s note on p.
7), as well as include presentations
about it at our meetings, while still
keeping the primary focus of those
meetings on clinical topics. We will
also continue to be a liaison with
other organizations within the state
that may help facilitate adaptation to
the new approach within our region.
How you as an individual family
physician respond to MACRA
depends in large part, I think, on
your current practice situation. Many
of you are employed by large health
systems that have the informatics,
administrative, and reporting
resources to respond to MACRA.
If so, ask your system what they are
doing and planning, become involved
in those preparations, and look to
see what changes you and your team
need to make in your individual
practice. Others of you are part of a
larger independent group that, once
again, may have the resources and
structure in place to implement one
or the other track of MACRA. Again,
become knowledgeable about the
MACRA changes by participating
in the preparation, and make the
changes with your care team to
implement them. Finally, some
of you are in independent private
practice, and now is the time to
become acquainted with the law and
the proposed regulations; to assess
or re-assess your current EMR
strategy; and to explore resources
within the state, such as VCHI or
VHQC, that could help support you
in that change. You may also want to
inquire about and be on the lookout
for a Clinically Integrated Network
(CIN) forming in your area that
might allow you to maintain your
independence, but affiliate with an
organization that could provide the
reporting resources necessary for
MACRA.
The AAFP is developing
resources and has published a
concise, initial guide. It can be
downloaded at http://www.aafp.org/
content/dam/AAFP/documents/
practice_management/restricted/
MakingSenseMACRA.pdf (you’ll
have to log in) or you can refer to
it on pages 8-11 in this publication.
They have many other resources on
the AAFP web site; just log on and
search for “MACRA” to get there.
There will be much more to
follow, but I wanted you to know
that we’re thinking about how we
can best help you adapt to this new
program. As always, thank you very
much for the excellent care you give
the citizens of Virginia.
Respectfully,
Charlie
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5
FLAT FEE
FOR
EMPLOYMENT CONTRACT
The Virginia Academy of Family Physicians and
the Academy’s General Counsel K. Marshall Cook
have agreed that Mr. Cook will review, and
possibly negotiate, employment agreements being
considered by Academy members for any one of
several flat legal fees, depending on the volume of
legal services the physician asks Mr. Cook to
perform. The physician selects from a menu of
three different “packages” of legal services, all
with varying legal fees based on the volume of
legal work the physician wants Mr. Cook to do.
“One goal in this discussion is to give VAFP
members certainty in what they will spend for legal
services to get proposed employment agreements
expertly reviewed, rather than having no control
over the traditional hourly rate billing model most
lawyers use,” said Mary Lindsay White, the
Academy’s Executive Vice President. “Now, our
members know exactly what they will pay for the
legal review of an employment agreement by one
of Virginia’s most experienced and well respected
health care attorneys.”
REVIEW
His peers named Cook among Virginia’s “Legal
Elite” in health law each year in Virginia Business
magazine. He also regularly is named a Virginia
“Super Lawyer” in health law by Richmond
Magazine and among the Best Lawyers in America
in the health care area. A Phi Beta Kappa graduate
of the University of Richmond, he received his law
degree from Richmond’s T.C. Williams School of
Law, where he was a Williams Law Scholar.
This flat fee benefit is available to all VAFP
members. It applies only to Mr. Cook’s review of
employment agreements being offered to VAFP
members. For additional information on this new
member benefit or a description of the various
packages of services available under this flat fee
arrangement, see the link below:
http://vafp.org/wp-content/uploads/2016/05/PhysicianEmployment-Contract-Review.pdf
Mr. Cook has represented the interests of
physicians and other health care providers
exclusively since 1993.
He is the author of a handbook titled “Managed
Care Contract Negotiation: A Discussion of
Virginia Law, Contract Terms and Negotiating
Tips,” described by a Past President of the VAFP
as “a stellar synopsis of managed care contracting
and negotiating techniques.”
is a summary of health care information that
will appear regularly in the Virginia Family Physician.
Although it is written by the Academy’s General Counsel, it
is not legal advice. The Academy and I hope its contents
will be informative and helpful in your medical practice.
K. Marshall Cook, Esq.
VAFP General Counsel
p. (804) 784-1900
f. (804) 784-1903
e. marshall@kmarshallcook.com
6
MACRA
VAFP Colleagues,
Are you ready for the M
edicare Access and CH
IP Reauthorization Act
has taken the place of the
(MACRA)? MACRA
Sustainable Growth Ra
te (SGR) for updating
is essentially moving he
Medicare rates and
althcare from a fee-for-s
ervice or procedure ba
to one that is value dri
sed model of payment
ven. I feel that family me
dic
ine is central to this pa
achieving true value in
yment reform and
healthcare. However, we
need to prepare for MAC
payments and adjustmen
RA now since the
ts for 2019, when the pro
gram starts, will likely
be based on 2017 data.
MACRA is complicate
d, so following is a sum
mary that the AAFP ha
AAFP is placing signifi
s put together. The
cant effort in assisting
family physicians in un
I would encourage you
derstanding MACRA an
all to visit the AAFP we
d
b site. It contains a large
beneficial information.
amount of highly
What you need to know
now is to determine if
you qualify for an Altern
Model (APM). This ess
ative Payment
entially guarantees a 5%
pe
r
year payment increase
the program. Many Med
over the 6 years of
icare Shared Savings Pr
ogram ACO’s do quali
qualifications are listed
fy. Some of the other
in the AAFP summary.
If
your group does not qu
you will fall into the M
alify for an APM, then
erit-Based Incentive Pa
yment System (MIPS),
potential for gain, but
which has an even greate
also places you at risk for
r
loss.
Another important thing
to know now is that pra
ctices with fewer than
a physician shortage are
15 providers, or in
a, may be eligible for tec
hnical assistance with the
allocates $20 million an
transition. MACRA
nually beginning this yea
r.
Finally, MACRA is still
evolving. CMS recently
released the proposed set
with the final rule plann
of MACRA rules
ed for the Fall. Comm
en
ts
on
until June 27, 2016. Fo
the proposed rules may
r additional information
be submitted
, please go to CMS.gov
Program website.
Quality Payment
Lindsey Vaughn MD FA
AFP
VAFP President-Elect
7
MACRA
ready
The Shift to Value-Based Payment
Making Sense of MACRA:
The Big Picture
APRIL 2016
Payment reform is coming,
and your AAFP is here to lend
a hand. Let us help you prepare
today so we can guide you through
the transition tomorrow.
Learn more | aafp.org/MACRAReady
8
Senate
House
(92-8)
(392-37)
Landmark Legislation Alters How
Medicare Will Reimburse Physicians
The Medicare15%
Access and CHIP Reauthorization
45%
30%
Act of
2015 (MACRA) passed
by an overwhelming
bipartisan majority in Congress and was signed into
2020
2021
25%
law by President Barack Obama on April 16, 2015.
15%
50%
ource Use
)
25%
Meaningful Use
EXTENDS
REPEALS
30%
15%
As further rules are proposed and final regulations
are enacted, we’ll get a clearer picture of the impact
of the legislation and continue to keep our members
updated. For now, here’s what we do know.
SHIFTS
Clinical Practice Improvement Activities
House
(392-37)
HouseSenate
(392-37)
(92-8)
Senate
the flawed sustainable
growth rate (SGR)
the Children’s Health
Insurance Program (CHIP)
(92-8)
Medicare toward
value-based payment models
Senate
(92-8)
Physicians will enter one of
two new payment tracks:
THE LAW ACCOMPLISHES THREE
GENERAL OBJECTIVES:
REPEALS
EXTENDS
SHIFTS
Merit-Based Incentive
Payment System
the flawed sustainable
growth rate (SGR)
the Children’s Health
Insurance Program (CHIP)
(MIPS)
Medicare toward
value-based payment models
MACRA permanently repeals the flawed sustainable growth
rate (SGR) formula, preventing a 21 percent cut to Medicare
reimbursement rates. It also extends the Children’s Health
Insurance Program (CHIP) for two years and it sets up a
new, two-track Medicare physician payment system that
emphasizes value-based payment models.
Rules will evolve
As currentlyMerit-Based
written, MACRA
for
Alternative
Incentiveis a general framework
payment reform
and lacks
concepts.
Payment
Models
Payment
Systemdetails on many key
The Centers for Medicare
(CMS) has
(MIPS) and Medicaid Services(APMs)
solicited public comments to help clarify finer points of the
law. To help improve details of the law and advance members’
interests, the American Academy of Family Physicians (AAFP)
responded to 126 questions from CMS. A proposed set of
rules should be released in spring 2016, and the final rule
is anticipated in fall 2016.
BE PREPARED
Performance in 2017
may determine Medicare
payment adjustments by 2019.
EXISTING
SYSTEM
NEW
SYSTEM
Three separate quality
reporting programs
Consolidates existing
programs, plus an
additional performance
category to generate
a composite score
Meaningful Use of
Electronic Health Record
(EHR)
Physician Quality
Reporting System
(PQRS)
Value-Based Payment
Modifier (VBPM)
Quality
Resource Use
Alternative
Payment Models
(APMs)
Incentive payments will
be available to qualified
professionals who practice
in a qualified and eligible
APM. Examples of APMs
include:
CMS Accountable
Care Organizations
(ACOs)
Medical home model
could be expanded under
the Center for Medicare
& Medicaid Innovation
(CMMI)
Meaningful Use of
Electronic Health Record
(EHR)
Demonstration required
by federal law
Clinical Practice
Improvement Activities
(CPIA)
9
MIPS Combines Quality Programs
Beginning in 2019, the Merit-Based Incentive Payment System (MIPS)
will consolidate three existing quality reporting programs and add one
new performance category. Performance in these categories will generate
a composite score (0-100) based on quality, resource use, electronic
health record (EHR) technology use, and clinical practice improvement.
Meaningful Use
(MU)
Physician
Quality
Reporting
System
Value-Based
Payment
Modifier
+
(VBPM)
(PQRS)
Physician Payment
Timeline
Reimbursement
Through MACRA
Medicare
Providers
2016
Clinical
Practice
Improvement
Activities
.5%
Medicare
Providers
(CPIA)
2017
.5%
Medicare
Providers
2018
.5%
Meaningful Use
(MU)
Physician
Quality
Reporting
System
Value-Based
Payment
Modifier
(PQRS)
(VBPM)
Clinical
Practice
Improvement
Activities
+
The clinical practice improvement activities (CPIA) performance category
requires further definition in the rule-making process. Current examples
15% activities include access,
15%
of clinical practice improvement
patient
15%
45% care coordination,
30%
engagement,50%
population health management,
patient safety, and practice assessment.
2020
2019
2021
25% score
25%
Under MIPS, your composite
is based on performance
in each of the
four performance categories, which determines future Medicare payment
adjustments. Weighting of the categories will change from year to year.
30%
10%
15%
The
first three years under MIPS
will be weighted as indicated below.
Quality
Resource Use
50%
2019
25%
Meaningful Use
15%
15%
25%
2020
Clinical Practice Improvement Activities
15%
45%
25%
30%
2021
House
Quality
30%
15%
Resource Use
(392-37)
Meaningful Use
Senate
Clinical Practice Improvement Activities
(92-8)
MACRA states that if a physician is part of a “certified” patient-centered
medical home (PCMH), you will receive the highest score for the CPIA
category. However, the term “certified” has not been defined in this context.
MIPS scores will be compared to a “performance threshold,” which will be set
annually based on the mean or median of the previous year’s MIPS scores.
Adjustments to Medicare Part B payments will be positive, negative, or neutral,
depending on how your composite score compares with the threshold.
House
(392-37)
Senate
(92-8)
The current legislation does not identify which prior year will determine the
performance threshold for the first year of the MIPS (i.e., 2019). Given CMS’s
history, it is likely the mean composite scores for 2017 will serve as the initial
performance year. Beginning in 2026, MIPS participants receive a 0.25%
annual update to their Medicare physician fee schedule.
10
APM
2019
4%
5%
MIPS*
APM
2020
5%
House
5% (392-37)
MIPS*
EX
APM
REPEALS
%
2021
7%
5
MIPS*
APM
2022
9%
5
MIPS*
10%
Annual
Bonus Payment
(CPIA)
MIPS*
25%
House
(392-37)
Potential Annual
Payment Updates
2023
9%
% sustainable
the flawed
growth rate (SGR)
the Ch
Insurance
APM
REPEALS
%
EXTE
5
MIPS*
APM
2024
9
5
%
the flawed
%sustainable
growth rate (SGR)
MIPS Extends at
2025
APM Bonus Ends
MIPS
2026
APM
9% Beyond 2025
.25%
.75%
the Childre
Insurance Pro
Merit-Based Ince
Payment Syste
(MIPS)
*Potential Additional Adjustments
Merit-Based Incenti
Payment System
(MIPS)
APMs: More Security, Less Risk
Beginning in 2019 and continuing through 2024, eligible
professionals who participate in a qualifying Alternative
Payment Model (APM) and meet certain qualification
and eligibility requirements will receive an annual 5%
bonus payment.
A QUALIFYING APM IS ANY OF THE FOLLOWING:
• A Medicare Shared Savings Program Accountable
Care Organization;
• A medical home model expanded under the CMMI, that
is not a Health Care Innovation Award recipient;
Preparing for 2017
Many details about MACRA remain unknown. The AAFP
believes details will emerge during the rulemaking process.
The AAFP will continue to advocate for rules that are
reasonable, appropriately value the care provided by family
physicians, and reduce administrative burden. Until then,
your practice should be doing several things to prepare for
an anticipated 2017 “prior year” performance period.
IN ORDER TO PREPARE YOURSELF
AND YOUR PRACTICE, YOU SHOULD:
• Report data on quality measures through the PQRS;
• A project under either the Medicare Health Care Quality
(MHCQ) Demonstration Program or Medicare Acute Care
Episode Demonstration Program; or
• Know your Quality and Resource Use Report (QRUR);
• An undefined “demonstration required by federal law.”
• If your practice doesn’t provide chronic care management
(CCM) services, consider starting now; and
QUALIFYING APM PARTICIPANTS MUST ALSO
MEET THE FOLLOWING ELIGIBILITY CRITERIA:
• Use of quality measures comparable to those in the
MIPS (which are currently undefined);
• Use of a certified EHR; and
• Assume more than a “nominal financial risk” (which
is undefined) or be in a medical home expanded
under CMMI.
If your practice meets APM qualification and eligibility criteria,
you must have an increasing percentage of payments or
patients coming through the APM.
Eligible professionals not meeting volume thresholds are
considered “partial qualifying” APM participants. They avoid
MIPS penalties, but do not receive financial bonuses.
Beginning in 2026, APM participants will receive a 0.75%
annual update to their Medicare physician fee schedule.
MACRA allocates $20 million annually (from 2016 to 2020)
for technical assistance to practices with fewer than
15 eligible providers, as well as those in rural or health
professional shortage areas to help transition those practices
to an APM or improve their MIPS score. Rules for how this
assistance is distributed are still being developed.
• Use your EHR and attest to meaningful use (MU);
• Investigate different APM options;
• Assess, identify, and participate in clinical practice
improvement activities.
HIGHLIGHTS
• MACRA repeals the SGR formula, extends CHIP, and sets
up two payment tracks for Medicare reimbursement:
MIPS and APMs.
• MIPS consolidates three existing quality reporting
programs PQRS, VBPM, and MU, plus adds a new
performance category, CPIA, to form a composite
score (0-100).
• Under MIPS, physicians who are part of a “certified” PCMH
automatically receive the highest score for the CPIA
category. “Certified” has not been defined in the law.
• The first year for MIPS is 2019. The AAFP anticipates that
performance in 2017 will determine the threshold for the
first year of MIPS.
• Qualifying APM participants receive an annual lump-sum
bonus of 5% upon meeting certain eligibility requirements.
• Beginning in 2026, APM participants will receive a 0.75%
annual update to their Medicare physician fee schedule.
• There are many unknown details in MACRA that will
be clarified during the rule-making process. CMS plans
to release a proposed set of rules in spring 2016, and
the final rule is anticipated in fall 2016.
FINAL NOTE
The AAFP is advocating
the initial performance year
for MIPS be moved to a later
date to give physicians more
time to prepare.
Reprinted with permission from Making Sense of MACRA: The Big Picture
© 2016 American Academy of Family Physicians. All Rights Reserved.
11
VAFP Leaders Attend ACLF and NCCL
Seven family physicians represented
the VAFP at the Annual Chapter
Leader Forum (ACLF) and the
National Conference of Constituency
Leaders (NCCL) May 4-7, 2016 in
Kansas City, MO. VAFP President
Charlie Frazier, MD, VAFP PresidentElect Lindsey Vaughn, MD, VAFP
Director Emmeline Gasink, MD
and VAFP Past President and AAFP
Delegate Sterling Ransone, MD
attended ACLF and Val MutchlerFornili, MD, Susan Osborne, DO and
Sebastian Tong, MD attended NCCL.
ACLF is the AAFP’s leadership
development program for chapterelected leaders, aspiring chapter
leaders, and chapter staff. Among
other roles, ACLF functions as an
orientation for emerging leaders who
serve on chapter boards, as well as
professional development for new and
seasoned chapter staff. Drawing more
than 200 attendees each year, ACLF
also features targeted breakout sessions
Practice Opportunity for
Full time provider.
• Outpatient Practice
Opportunity available
• New Housing opportunities
readily available
• Lab and x-ray on site
• Competitive compensation
and benefit package
Please contact Cathy Brown
804-794-5411 x155 or
cbrown@vaphysicians.com.
A Division of Virginia Physicians, Inc.
12
on chapter governance, advocacy, and
communication.
NCCL is the AAFP’s leadership
and policy development event for
underrepresented constituencies.
NCCL serves as a platform for
different perspectives and concerns of
AAFP members to help bring about
change. The five constituencies with
representation include: Women,
Minorities, New physicians (in the
first seven years of practice following
residency), International medical
graduates (IMG), from schools outside
the U.S., Canada, and Puerto Rico and
gay, lesbian, bisexual, and transgender
(GLBT) physicians or physician allies.
At NCCL, physicians develop skills to
advocate for issues that are relevant to
specific constituencies, practices, the
specialty and patients.
During the conference, the
VAFP received two awards
including the Highest Percent
Retention of Active Membership
and 100% Resident Membership.
Congratulations VAFP!!
Register Today!
www.vafp.org/annualmeeting
VIRGINIA ACADEMY OF FAMILY PHYSICIANS
2016 Annual Meeting & Exposition
July 21-24, 2016
Sheraton Oceanfront Hotel
Virginia Beach, Virginia 13
Resident & Student Corner
Mark Your Calendars and Plan to
Attend!!
2016 National Conference of Family Medicine Residents
and Medical Students
July 28-30, 2016
Kansas City, MO
For more information and to register, visit www.aafp.org/
events/national-conference
Choose Virginia Scholarships
Graduating Medical Students and
Family Medicine Residents
The Virginia Academy of Family Physicians (VAFP)
Foundation is delighted to announce one new medical
student scholarship and one new resident scholarship
annually for assistance with education loan repayment. Many
medical students and family medicine residents in Virginia
have expressed an interest in staying in Virginia after their
graduation to complete a family medicine residency or to
practice in a medically underserved area. Over the past two
years the VAFP Foundation has received donations to support
this effort to keep our own.
Annually the Foundation will offer one graduating Virginia
medical student a $1,000 scholarship. The successful candidate will
meet the following criteria:
1. Graduating Virginia medical student in good academic
standing
2. Entering a Virginia family medicine residency program.
A letter from the program director is required.
3. Will have completed the PGY-1 year successfully and be
entering into the PGY-2 year at that program. A letter
from the program director is required in order to receive
the scholarship check for loan repayment at that time.
4. Must submit a 250-500 word letter explaining why he/
she wants to practice family medicine in Virginia as a
resident and as a family physician.
In addition, the Foundation will offer one $1,500 scholarship for
a graduating PGY-3 Virginia family medicine resident who wishes to
practice in an underserved area of Virginia. The requirements for this
scholarship are as follows:
1. Graduating as a PGY-3 Virginia family medicine resident
2. Have an up-to-date Virginia medical license
3. Practicing family medicine in an underserved medical
area after graduation as designated by United States
Human Resource Service Administration (HRSA) and/
or Virginia Department of Health. A letter verifying this
is required.
4. Must submit a 250-500-word letter explaining why
14
they he/she wants to practice in an underserved area of
Virginia
5. Practicing at the underserved site for one year.
Documentation is necessary to receive the scholarship
check for loan repayment after one year of practice in an
underserved area.
Application letters may be sent to Mrs. Mary Lindsay White
at mlwhite@vafp.org or to Dr. Roger Hofford at rahofford@
carilionclinic.org. The deadline for application letters is June
30, 2016.
If anyone is interested in making tax deductible donation in
support or expansion of this effort, or is interested in learning
more about the VAFP Foundation, please visit our website at
www.vafpf.org.
On behalf of the VAFP Foundation Board of Directors, I
would like to thank those individuals and organizations who
have donated to the VAFP Foundation.
Roger A. Hofford, MD, FAAFP, CPE
Chair, VAFP Foundation
VAFP Career Center
The career hub for physician
employment opportunities in
Virginia.
The Virginia Academy of Family Physicians Career Center
is the premier resource for you to explore employment
opportunities in Virginia.
Manage Your Career
Search and apply to multiple family medicine positions that
are all located in Virginia. Upload your resume anonymously
and allow employers to contact you through the Career
Center’s messaging system.
Set up job alerts specifying your skills, interests, and
preferred location(s) to receive email notifications when a job is
posted that matches your criteria.
www.careercenter.vafp.org
FMIG Contact
Ms. Yeri Park, a student at Virginia Commonwealth
University is the AAFP FMIG Coordinator for the MidAtlantic. Please contact Ms. Park for FMIG information.
PARKYR2@VCU.EDU
Student and Resident Resources
from the American Academy of
Family Physicians
Please visit www.aafp.org/medical-school-residency
Life’s too short to live with limits
SEIZE YOUR OPTIONS
Norfolk
Raleigh
Charlotte
Greenville
If you’re looking for more from the practice of family medicine, consider a
place that feels right, right from the start. Where you’ll sense immediately
that you’ve found colleagues who’ll be your friends for a lifetime.
Vidant Health and The Brody School of Medicine at East Carolina
University are creating the national model for rural health and wellness,
Wilmington
led by dynamic physicians like you. You’ll have the infrastructure you
need to manage a modern medical practice — EHR, financial and
human resources — and a built-in referral network. Explore practice opportunities near beautiful
beaches and in charming waterfront towns. Learn why family-oriented professionals, intrigued by the
coastal lifestyle, find eastern North Carolina a perfect match.
Benefits: Monthly residency stipend • Outpatient only (inpatient optional) • No call (various locations) •
Student loan repayment • Annual stipend • Malpractice with tail • Relocation assistance
Seize your options in family medicine
at VidantHealth.com/PhysicianJobs
or apply directly to
Karen.Gliarmis@VidantHealth.com.
15
Bon Secours Surgical Specialists:
WHY SEND YOUR PATIENTS
ANYWHERE ELSE?
Better outcomes. Greater satisfaction. That’s why more physicians are referring their patients to Bon Secours
Surgical Specialists. Our surgical teams are some of the most experienced in the region and are led by expert
surgeons who are breaking new ground in state-of-the-art minimally invasive surgery, using laparoscopic and
robotic surgical techniques.
Our surgical specialists lead the way across a wide array of specialties including general surgery, bariatric,
colorectal, and surgical oncology. With seven offices across Hampton Roads, your patients will have convenient
access to the innovative, compassionate surgical care they need and deserve—with less pain, shorter recovery
and improved outcomes.
To learn more, visit bshr.com/bsss
DePaul
Maryview
Mary Immaculate
757-278-2220
757-483-3030
757-947-3170
Gregory Adams, MD, FACS
general & bariatric surgery
Elizabeth Barrett, MD, FACS
general & bariatric surgery
Eugene Chang, MD, FACS
surgical oncology & breast surgery
Eric DeMaria, MD, FACS, FASMBS
general & bariatric surgery
Joseph Frenkel, MD, FACS, FASCR
colon & rectal surgery
Charles Ives, MD, FACS
general & breast surgery
Philip Kondylis, MD, FACS, FASCRS
colon & rectal surgery
Chong Lee, MD, FACS, FASCRS
colon & rectal surgery
Jeffrey Riblet, MD, FACS
general surgery
Anthony Terracina, MD, FACS
bariatric surgery
Pete Williams, MD, FACS
general & robotic surgery
Yassar Youssef, MD, FACS
general & robotic surgery
16
Mountain States Medical Group and Russell County Medical Center, located in Lebanon, Virginia, are currently seeking Full Time,
Board Certified, Family Medicine or Internal Medicine Physicians. Qualified candidates will join a Brand New, Out-Patient Clinic in
Lebanon, Virginia to provide services to their Community. These are Hospital Employed positions with the following incentives:
• Competitive Salary and Bonus • Full Benefits • Paid Malpractice • Generous Sign On Bonus • Relocation Assistance •
• Educational Loan Assistance • CME Reimbursement • PTO
Please Contact:
Tina McLaughlin, CMSR, MSHA Senior Physician Recruiter
276-258-4580 • mclaughlint@msha.com
www.mshajobtour.com/russell
An independent, primary care, multi-specialty practice located in Chilhowie, Virginia is currently seeking a BE/BC, MD/DO, Virginia
Licensed, Family Medicine Physician to join their group Full Time. The group will have 2 Physicians and 1 Nurse Practitioner. One
Physician retired, December 2014, and group is recruiting to replace this physician. The clinic is certified as a rural health clinic and
provides a complete range of primary care services. The candidate will step into a thriving, completely independent, 60 year old
practice that has many loyal patients, a hardworking loyal staff with low turnover and excellent standing in the community.
Johnston Memorial Hospital located in Abingdon, Virginia and Smyth County Community Hospital located in Marion, Virginia will
be assisting the group with the following for the qualified candidate:
• Income Subsidy for first 1-2 years • Sign On Bonus • Relocation Assistance • Educational Loan Assistance
• Call: Phone Call Only, Every 3rd Week
Group will provide:
• Competitive Salary • Opportunity to Earn Above Average Income • Comprehensive Benefits Package •
• Medical/Dental/Vision Benefits • 401K Retirement Package with Match Program • Malpractice Insurance Provision •
• Allowance for Dues/Continuing Education
Please Contact:
Tina McLaughlin, CMSR, MSHA Senior Physician Recruiter
276-258-4580 • mclaughlint@msha.com
www.mshajobtour.com/jmh
Mountain States Medical Group and Smyth County Community Hospital, located in Marion, Virginia, are currently seeking a Full
Time, Board Certified, Family Medicine Physician to work in their MSMG FM Rural Retreat Clinic. Qualified candidates will join an
Established, Out-Patient Clinic in Rural Retreat, Virginia to provide services to their Community. This is a Hospital Employed
position with the following incentives:
• Competitive Salary and Bonus • Full Benefits • Paid Malpractice • Generous Sign On Bonus • Relocation Assistance •
• Educational Loan Assistance • CME Reimbursement • PTO
Please Contact:
Tina McLaughlin, CMSR, MSHA Senior Physician Recruiter
276-258-4580 • mclaughlint@msha.com
www.mshajobtour.com/smyth
EOE/AA
17
New Resource for Health Providers:
Oral Health Integration Toolkit
Dental disease is the most common
childhood disease in Virginia – five
times more common than asthma. Poor
oral health is linked to diabetes, heart
disease and preterm birth, and dental
problems account for millions of lost
school and work hours each year. Family
physicians can identify oral health issues,
educate patients and caregivers about the
importance of oral health, and prevent
dental disease progression through
services like fluoride varnish application
and referrals to a dental provider.
In many instances, these services
are reimbursable. In all instances,
integrating oral health into family
medicine enhances comprehensive health
care and improves patient wellness.
The Virginia Oral Health Coalition
(VaOHC) has put together a new
resource for health providers who are
interested in oral health integration:
18
the Integration Toolkit. The toolkit
is hosted on VaOHC website and is
accessible from their homepage (www.
vaoralhealth.org).
The Integration Toolkit is an online
resource that walks you through key
steps of integration, from identifying
your patients’ major health care needs
to analyzing financial models, and more.
The toolkit includes:
• Sample oral health integration
models;
• Prompt questions to consider with
your team;
• An integration checklist; and,
• Many resources you can download
and use today.
VaOHC is also able to provide
onsite training for pediatric practices
who are interested in integrating oral
health services, like fluoride varnish,
including clinical guidance and billing
information. At a recent pediatric
training, a provider in Southwest
Virginia noted that her medical
resident was immediately able to
identify severe early childhood caries in
a young patient, and provide education
and a referral to the child’s mother.
VaOHC developed the Integration
Toolkit with grant funding from the
Richmond Memorial Health Foundation,
in partnership with The Daily Planet
and Community Health Solutions. For
questions and feedback about the toolkit,
or to request a training, please contact
Sarah Bedard Holland at 804.269.8721
or sholland@vaoralhealth.org.
VIRGINIA ACADEMY OF
In Memoriam
VAFP Past President and dedicated
family physician Benjamin Elliott
Norfleet, MD passed away May 12,
2016. After medical school, internship
and two years as a flight surgeon, Ben
practiced family medicine with Dr.
Harry L. Kraus. With the addition of
five Family Doctors this group was
known as Denbigh Family Practice and
helped develop what is today Tidewater
Physicians Multispecialty Group. Ben
retired from practice in 1998 after
thirty-six dedicated years to medicine.
His accomplishments were many
including Diplomat,
American Academy
of Family Practice,
Associate Director
of Riverside
Family Practice
Residency Program,
President, Virginia
Academy of Family
Physicians (198283), Hampton
Roads Academy of
Family Physicians,
Newport News Medical Society,
and Editor of the Thomas Norfleet
1666 Society Newsletter. Ben was a
member and Sunday School teacher
at Asbury Methodist Church for 20
years and became an active member
at Hidenwood Presbyterian Church
in 1982 where he was a teacher and
elder. He also gained much satisfaction
from delivering Meals on Wheels.
Other interests included genealogy
(helping to compile two volumes on the
Norfleet family), flying (commercial
pilots license), skiing, traveling, and
most importantly, sailing with family
and friends.
Ben is survived by his wife of
59 years, “Teeny” (Willie Newkirk
Norfleet), his children, grandchildren
and great-grandchildren. He is also
survived by his brother, VAFP member
Steven M. Norfleet, MD.
Memorial gifts, if desired may be
made to Operation Smile, 3641 Faculty
Boulevard, Virginia Beach, VA 23453
or Hidenwood Presbyterian Church
Memorial Fund, 414 Hiden Boulevard,
Newport News, VA.
FAMILY PHYSICIANS
F O U N D A T I O N
SUPPORT FAMILY MEDICINE
Donate to the Virginia Academy of Family Physicians Foundation
For more information and to donate visit www.vafpf.org
Are you looking for a satisfying career and a life outside of work?
Enjoy both to the fullest at Patient First. Opportunities are available
in Virginia, Maryland, Pennsylvania, and New Jersey.
Open 8 am to 10 pm, 365 days a year, Patient
First is the leading urgent care and primary care
provider in the mid-Atlantic with over 60 locations
throughout Virginia, Maryland, Pennsylvania,
and New Jersey. Patient First was founded by
a physician and we understand the flexibility
and freedom you want in both your career and
personal life. If you are ready for a career with To learn more about fantastic career
opportunities at Patient First, contact
Patient First, please contact us.
Recruitment Coordinator Eleanor
Dowdy
at (804) 822-4478 or
Each physician enjoys:
eleanor.dowdy@patientfirst.com or
• Competitive Compensation
visit prcareers.patientfirst.com.
• Flexible Schedules
• Personalized Benefits Packages
• Generous Vacation & CME Allowances
• Malpractice Insurance Coverage
• Team-Oriented Workplace
• Career Advancement Opportunities
19
CME
CME Calendar
July 21-24, 2016
VAFP Annual Meeting & Exposition
Sheraton Oceanfront Hotel
Virginia Beach
be limited to those who attend the entire
annual meeting. Participants will need to
bring their own laptop computers for these
sessions.) Register Now! www.vafp.org/
annualmeeting
(The Pain Management SAM and the
Critical Thinking for Quality Improvement
in Clinical Care Part IV will be held in
conjunction with the 2016 VAFP Annual
Meeting. Registration for these sessions will
September 14-16, 2016
AAFP PerformanceNavigator®
Workshop
Cardiometabolic Conditions
Diabetes, Hypertension, and
Dyslipidemia
The Williamsburg Lodge
Williamsburg
Register Now! www.aafp.org/cme/
cme-topic/all/cardiometabolicconditions.html
September 17, 2016
Medical Genomics SAM –
Lynchburg (Liberty University)
Register Now! www.vafp.org/moc
IT ALL HAPPENS
October 8, 2016
Care of the Elderly SAM –
Charlottesville (Piedmont
Community College)
Register Now! www.vafp.org/moc
If caring for patients is the reason you became a doctor, join the 650+ physicians
of Carilion Clinic who share your philosophy. A nationally recognized innovator in
health care, Carilion is changing the way medicine is practiced. Our medical-home
approach to primary care lets you focus your energy on the highest risk patients,
while the electronic medical record enables seamless coordination with Carilion
specialists in over 70 fields. And with online access to their medical records,
patients can become more involved in their care, too. With tools that make you
more efficient and an environment that values better care, Carilion gives you the
freedom to focus on your patients’ well-being — without overlooking your own.
Virginia’s western region is one of the best kept secrets. Quality of life in the
Blue Ridge Mountains is high and the cost of living is low. The area offers a fourseason playground for mountain and lake recreation, as well as a rich array of arts,
humanities and cultural experiences.
Family and internal medicine outpatient opportunities are available in the following
western and central Virginia communities:
Bedford*
Bridgewater (available 2017)*
Christiansburg (with OB)
Community Care
Daleville
Dayton
DO Faculty (Residency Program)
Dublin (available 2017)
Floyd*
Fort Defiance
Galax
Giles
Martinsville*
Rocky Mount*
* For information on additional incentives available
for designated locations, contact Amy Silcox,
physician recruiter, Carilion Clinic, 800-856-5206
or amsilcox@carilionclinic.org. You can also meet
with Amy at the VAFP Annual Meeting in Virginia
Beach, Booth 18, July 22-23.
7 hospitals | 650+ physicians | 70+ specialties
220 practice sites| 23 GME programs
20
November 5, 2016
Critical Thinking for Quality
Improvement in Clinical Care Part
IV (afternoon session) – Richmond
(Specific location TBD)
Register Now! www.vafp.org/moc
2017
February 3-5, 2017
VAFP Winter Family Medicine
Weekend
Wintergreen Resort
Wintergreen
Registration materials will be available at
www.vafp.org in October 2016.
2018
CarilionClinic.org/careers
Equal Opportunity Employer - Minorities • Females • Protected
Veterans • Individuals with Disabilities
G109222 AM VAFP Summer Recruit ad 2016 5125x75.indd 1
November 5, 2016
Medical Genomics SAM (morning
session) – Richmond (Specific
location TBD)
Register Now! www.vafp.org/moc
4/21/16 3:36 PM
February 2-4, 2018
VAFP Winter Family Medicine
Weekend
Wintergreen Resort
Wintergreen
FM Faculty position available with 35 year program
Near Coastal South Carolina
McLeod Health is seeking to hire a BC Family Medicine physician with 3-4 years of experience for a
Faculty position. McLeod FM Residency program is growing from 24 residents to 27 residents. We
are located in Florence, South Carolina - 1 hour from Myrtle Beach, South Carolina and 2 hours from
Charleston, South Carolina. We have a beautiful free standing, unopposed facility on the McLeod
Regional Medical Center’s 130 acre campus.
The Weather
Is Beautiful.
Wish You Were
(Practicing) Here.
This position offers the physician a good balance of work and family life with a satisfying career
teaching top FM residents. This is a full time employed position. We offer paid malpractice, a CME
allowance, a competitive salary, sign on bonus, relocation allowance, and a comprehensive benefits
and retirement package.
McLeod is a 565 bed nonprofit, private, tertiary care and teaching facility with over 120 ICU beds.
We have a full spectrum of specialists and sub specialists on staff. McLeod serves over 1 million people
throughout the region. If you would like to learn more about this opportunity, please contact Emily
Bracey at ebracey@mcleodhealth.org or 843-366-2043.
You may also apply online at www.mcleodphysicianrecruiting.org.
Please visit our website: www.mcleodhealth.org
LOOKING FOR A NEW
START IN HEALTHCARE?
AT SIMED, OUR INCENTIVES
ARE ALIGNED WITH YOURS
WANT TO RETURN TO THE
DAYS WHERE A PHYSICIAN’S
VOICE HAD MEANING?
MULTIPLE PHYSICIAN
OPPORTUNITIES AVAILABLE IN
NORTH CENTRAL FLORIDA
100% PHYSICIAN
OWNERSHIP
To learn more about the good things
happening at SIMED, visit us at
SIMEDHealth.com
Life’s too short to practice medicine
just anywhere. Career opportunities
await you with BayCare Medical
Group, part of BayCare, a leading
multihospital health care organization
spanning four counties on the west
central Gulf Coast of Florida.
Opportunities in:
n Family medicine
n Urgent care
Locations are available throughout
Polk, Hillsborough, Pasco and
Pinellas counties.
Email your CV to
BMGProviderRecruitment@BayCare.org.
Contact us at (352) 224-2404
Email: careers@simedhealth.com
No recruiters, please
To learn more about rewarding
physician opportunities:
(813) 636-2009
BayCareMedicalGroup.org
BC1602778-0416
21
THE VAFP WELCOMES NEW MEMBERS
Rhanda Anwar Abd-Elfattah, MD
Zachary Alexis Adams, MD
Khem K Adhikari, MD
Elizabeth D Adzadogo, MD
Rama Albaz, MD
Jennifer M Albrecht, DO
Mohammad Raza Ali, MD
Justin Narayan Amarnani, MD
Michael SeungJun Baek, MD
Luciana Danielle Bester, MD
Allison Anne Bishow, MD
Madalasa Bista, MD
Clifford William Bowers, DO
Joseph Daniel Bradshaw, DO
Stephen Craig Brawley, MD, PhD
Brett Logan Castrodale, MD
Catherine Chen, MD
Craig Scott Coleman, DO
James Stuart Coulter, MD
Meghan Elizabeth Dolmat, MD
Jillian Dur, DO
Joseph Lee Edison, DO
Marissa Wright Esquivel, MD
Robert Noyes Etheridge, MD
Jared Michael Fisher, DO
Menalin Ganal, DO, MPH
Maritza Adinee Garza, MD
Lori Christine Gatzke, MD
Jonathan Thomas Gellman, MD
Michael Glickman, MD
Jeffery P Groesbeck, DO
Asima Haleem, MD
Mazen Farouk Hariri, DO
Jeffrey B Harris, DO
Sophia Estella Horwath, MD
Jennifer Renee Hoyt, MD
Laurie C Hoyt, DO
Jessica Marie Jackson, DO
Zain Javed, MD
Arlesia Glaspy Jones, DO
Samuel Burnett Jones, Jr, MD
Jocelyn Kanarikavunkal Joseph, MD
Benjamin Robert Kaplan-Singer, MD
Pavithra Kesavan, MD
Anoop Singh Kochar, MD
William Markus Koeppel, DO
Timothy Hogook Lee, MD
Jay H Lee, MD
David Leng, MD
Steven Jamarey Lewis, MD
Kristin Anne Liebrecht, MD
Suman Deep Matiana, MD
Benhur Bushara Mohammed, MD
Denee J Moore, MD
Jonathan Bland Moretz, MD
Meghan R Moyle, DO
Priya Murthy, MD, MPH
Seema S Nair, MD
Charlene Ng, MD
Aivi Nguyen-Cao, MD
22
Jillian Elaine Noyes, MD
Emma Jean Pace, MD
Sneha Ramesh Patel, MD
Anu Patel, MD
Krupaben Chaturbhai Patel, MD
Vinay Jay Patidar, MD
Geness Patpatia, MD
David Choy Pong, MD
Ilya Rabkin, MD
Hiram Jose Rodriguez, MD
Mark Everett Rolfs, DO, PharmD
Robert M Rose, MD, BS
Diana Shaghayegh Sepehri-Harvey, DO
Jungook Devin Shin, MD
Laura May Smith, MD
Nicholas Alexander Smith, DO
Seokhan Song, DO
Gretel Alyce Spitzer, MD
Kim Michal Stein, MD
Mark Thomas Stevens, MD
Jennifer Stockhausen, DO
Nicholas Patrick Strasser, DO
Rose Gunter Suaava, DO
Nicole Audrey Szabo, MD
Bhavnita Thakor, MD
Allen Robertson Todd, MD
Minh-Chau Tran, MD
Lindsey Ward, DO
Mary Saprito Whittemore, MD
Aretha Wiggs, DO
Gail L Wiley, DO
Midhuna Mary William, MD
Scott Patrick Williams, MD
Candace J Wise, DO
Jamil R Yasin, MD
Emily Young, DO
Timothy Jinsung Yu, MD
RESIDENTS
Alexandria Bowling, DO
STUDENTS
Mr. Osman Alam
Ms. Jennifer Alejo
Mr. Justin Allen
Ms. Tamara Irma Arnautovic
Ms. Ambika Babbar
Ms. Kethelyne Beauvais
Ms. Shikha Bhatia
Ms. Elizabeth Ashley Bourne
Ms. Chelsea Bradley
Ms. Erin Butler
Ms. Elizabeth Calloway
Ms. Ting Chen
Ms. Jessica Churchill
Ms. Rebecca Corey
Mr. Esteban Cubillos-Torres
Ms. Katya Isabel de Souza
Mr. Jason D Doel
Mr. Erik Eklund
Ms. Nkechinyere Emezienna
Mr. James Erickson
Mr. Shenghao Fang
Mr. Saad Feroz
Ms. Grace Caroline Grogman
Ms. Abena D Hagan-Brown
Ms. Sarah DeHaan Hakkenberg
Ms. Kendall Hancock
Mr. Alazar Haregu
Ms. Helen Harley
Mr. John Heller
Ms. Katrina Herbst
Mr. Jacobi Hines
Ms. Katie Holland
Mr. Brian Jackson
Ms. Christiana Jeukeng
Ms. Nona Jiang
Ms. Kelsey Marion Johnson
Mr. Sanjay Kadari
Mr. Owen Kemp
Ms. Dev Darshan Khalsa
Mr. Samuel Jae Lee
Mr. Adam Lu
Ms. Allison Lure
Ms. Shannon Maj
Ms. Nicole McCann
Ms. Courtney McGuire
Mr. Kevin McGurk
Ms. Alice Elizabeth Meiss
Ms. Nadine Michel
Ms. Anahita Molayi
Ms. Rose Monahan
Mr. Dwayne Morris
Mr. Takahiro Ignacio Nakamura
Mr. Adishesh Kalya Narahari
Ms. Idorenyin Ndem
Ms. Ellen Nein
Mr. Graham Nelsen
Mr. Nguyen D Nguyen, MD
Mr. Ahmed S. A. Rab
Mr. Michael Randall
Mr. Walker Redd
Mr. Pranav Reddy
Ms. Amy Nicole Roach
Ms. Amy Rogers
Ms. Carol Rowley
Mr. Neil Shah
Mr. Nebiyu Shukur
Mr. Caleb Allen Smith
Mr. Destiny Spence
Ms. Sundas Syeda
Ms. Heather Thomas
Mr. Matthew Thomas Van Winkle
Mr. Charles Wang
Ms. Linda Wang
Ms. Bree Ann Young
Mr. Jacob Peter Zaemes
Ms. Patrice Zigrossi
New Members
ACTIVE
Hospitalist, Nocturnist and
Outpatient Practice in Coastal Florida
We are Brevard's largest
multi-specialty physician group.
It includes primary care and multi-specialty
providers offering services in a range of settings
including outpatient clinics, home care, nursing
facilities and Health First hospitals.
When you join our team, you can expect
• A competitive base salary plus bonus plan
• Full benefits offered to the physician and family
• Paid vacation
• Paid CME
• Retirement benefits
• Relocation allowance and much more.
Our location is in close proximity to major airports, shopping and
all Florida attractions, and you can expect excellent public and
private schools and great housing.
Mary Weerts • 321.725.4500 ext.7607
Mary.weerts@mima.com
POSITIONS AVAILABLE IN:
FAMILY MEDICINE
INTERNAL MEDICINE
Little River Medical Center, Inc., is a Federally
Qualified Health Center (FQHC) with 6 sites and over
200 employees located in the Myrtle Beach, SC area.
LRMC Offers:
• Stable Professional Work Environment
• Dedicated Leadership
• FTCA Malpractice Insurance Coverage
• Competitive Compensation And Benefits Package
• Federal Student Loan Payment Program
• NHSC Scholars Program
The Myrtle Beach area is a wonderful place to live with its
warm weather, beautiful wide sandy beaches, and laid back
southern atmosphere. The area also offers diverse cultural and
educational interests, entertainment venues, an array of
restaurants, over 100 golf courses, excellent schools, and an
impressive university influence. These are just a few of the
reasons that make living and working here so great!
Contact Rick Warlick,
rwarlick@lrmcenter.com or
843-343-6956
South Carolina
ranked 2015 Best
State for Doctors
4303 Live Oak Dr
Little River, SC 29566-9138
www.lrmcenter.com
23
The Virginia Academy of Family Physicians
1503 Santa Rosa Road
Suite 207
Richmond, VA 23229
Presorted Standard
U.S. Postage Paid
Little Rock, AR
Permit No. 2437
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24
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payments are declared at the discretion of the MAG Mutual Insurance Company board of directors. Insurance products and
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