This bill mandates that any insurer requesting rate increases in professional liability insurance for physicians, dentists, and nurses, shall not base any part of the rate increase on investment losses or wrongdoing of the insurer or the insurer's executives. It provides rights to interested individuals to testify at rate hearings before the Insurance Commissioner. SB 122 limits the cost of "tail coverage" to twice the current annual premium rate. Insurers cannot rate OB premiums based on volume of deliveries unless such rating is based on the loss experience of the insurer or upon factors other than the volume of deliveries. "Essential" medical specialties are protected from cancellation or termination by a 120 day notice of intent to do so by the insurer.

Perhaps most significantly, Section 16 of SB 122 removes the confidentiality of professional negligence claim settlements as to: names of the parties; dates of the incidents or events giving rise to the claim or action; the nature of the claim as set forth in the complaint and the answer that is filed with the district court. To date, insurers have only been reporting the allegations in the complaint (the "subject matter of the claim") to the Division of Insurance and to the Nevada Board of Medical Examiners. The NBME has placed information regarding medical malpractice settlements over $5,000 on their web site for public perusal. This information includes the subject matter or allegations of the complaint as stated by the insurer. There is no provision for information regarding the answer to the complaint. This provision of SB 122 will require insurers to report the substance of the answer to the allegations against the physician. Hopefully, the NBME will include the answer to the allegations of malpractice in their web site information once they begin receiving this information. This new law applies to all medical and dental malpractice when the cause of action (causative event or conduct) accrues (occurs) on or after October 1, 2003.

AB 320

Section 1 of this bill definitively prohibits an organization from charging health care providers "panel fees". An organization violating this law shall be subject to a court awarding costs and reasonable attorney's fees, as well as payment of twice the amount of the fee charged. Larry Matheis and NSMA have worked very hard to see this law to fruition.

Section 2 says that any managed care organization or HMO contracting with a provider of health care shall: (i) if requested at the time the contract is made, submit a copy of the schedule of payments applicable to the provider of health care; or, (ii) if requested by a provider of health care, submit the schedule of payments within 7 days after receiving the request.

Virtually the same as SB 122, this bill provides that any interested person may, as a matter of right, intervene in any hearing or other proceeding conducted to determine whether the applicable rate or proposed increase should be approved and complies with the applicable law. Insurers cannot request an increase in premiums when that requested increase is directly or indirectly related to investment losses or executive wrongdoing.

A continuity of care provision requires up to 120 days of care from a terminated provider if the insured is undergoing a medically necessary course of treatment and the provider and insured agree that the continuity of care is desirable. The terminated provider will be paid on the same basis as existed before the provider was terminated by the health care organization. Obstetric patients may continue their care until 45 days after delivery or after the end of the pregnancy. This provision of law does not apply if the provider was terminated for medical incompetence or professional misconduct.

Section 10 provides for a universal credentialing form. A contract between an insured and a provider may be modified upon the insurer giving the provider 30 days' written notice of the modification. If the provider fails to object in writing to the modification within the 30 day period, the modification becomes effective at the end of that period. If the provider objects to the modification within the 30 day period, the modification must not become effective unless agreed to by both parties.

Section 19 provides that if a settlement or judgment exceeds the limits of liability coverage of a health care provider (physician, dentist or nurse), the Commissioner of Insurance shall review the settlement or judgment. If the Commissioner finds, after notice and hearing, the insurer violated any provision of the insurance code regarding settlements or judgments, the Commissioner may suspend, limit, or revoke the insurer's certificate of authority.

If an insurer declines to issue a health care provider a professional liability insurance policy, the insurer shall, upon request of the practitioner, disclose to the practitioner the reasons for the denial. If an insurer sets the premium for the policy at a higher rate than standard for that specialty, the insurer shall, upon request of the practitioner, disclose the reasons for the higher rate.

NRS 41A is amended to provide that at any settlement conference, the judge may recommend that the action be settled for the limits for the policy of insurance. If the judge so recommends, the defendant is entitled to an independent counsel opinion letter explaining the defendant's rights, obligations, and potential consequences regarding the recommendation, paid by the insurer (up to $1500).

The Commissioner of Insurance shall develop the uniform credentialing form prior to July 1, 2004. The other provisions discussed become effective October 1, 2003.

SB 332

Effective upon passage and approval (immediately), this Bill creates an "administrative physician" category of medical licensure. An administrative physician may not engage in the practice of medicine, but must comply with all the statutory requirements for continued licensure.

If the Governor determines that there are critically unmet needs regarding the number of physicians practicing in a medical specialty within the state, the Governor may declare that a state of critical medical need exists for that medical specialty. The NBME may then waive some of the requirements for licensure. An applicant may be licensed if the applicant intends to practice medicine in the designated medical specialty, has completed one year of training in an approved residency, has a minimum of 5 years practical medical experience, and meets all the other requirements for a license to practice medicine. The license granted is a restricted license for 3 years after which time the physician may apply for an unrestricted license.

The Board may issue a license by endorsement to practice medicine to an applicant licensed in another state if the applicant submits to the Board proof of passage of an examination approved by the Board, meets all the statutory requirements for licensure, and completes any additional requirement relating to fitness of the applicant to practice as required by the Board.

The provision providing a class D felony for a non-licensed physician displaying his or her "M.D." has been deleted. Retired physicians who have not maintained their Nevada license may now breathe easier.

An applicant for medical licensure who is certified by an ABMS specialty may now use that Board certification in lieu of USMLE passage (within seven years). ABMS board certified physicians in emergency medicine, preventive medicine or family practice, who agree to maintain certification for the duration of the licensure, can substitute their Board certification for the 36 months of progressive postgraduate education requirement for licensure.

SB 250

Information gathered in an investigation of a licensee up to the point of determining whether to proceed with a disciplinary action is confidential and is not a public record. Thus, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to initiate disciplinary action are confidential. However, if the regulatory body decides to proceed with disciplinary action against the licensee, all proceedings conducted after that decision are public records and are subject to the Open Meeting Law (NRS 241.020). Specifically, the complaint or other document filed by the Board to initiate disciplinary action and all documents and information considered by the Board when determining whether to impose discipline are public records. If a regulatory body enters into a consent or settlement agreement, that agreement is a public record. An order that imposes discipline and the findings of fact and conclusions of law supporting an order sanctioning a licensee are public records. The Board may not administer a private reprimand.

The chief executive officer of the Nevada Board of Medical Examiners (NBME) shall be known as the "Executive Secretary". Employees of the NBME are "at will" employees serving at the pleasure of the gubernatorial appointed NBME members. A hearing officer employed by the NBME may not serve the NBME in any other capacity and may not be employed by the NBME for at least 2 years after resignation or termination of employment with the NBME.

While there is a 36 months progressive, approved postgraduate training program requirement for licensure, section 35 of SB 250 requires now that the applicant submit to the Board a certificate of completion of progressive postgraduate training from the residency program where the applicant received the training. In effect, this appears to lengthen the postgraduate years of training required from 36 months to the length of training in that program.

SB 250 provides that the NBME may issue a letter of warning, a letter of concern, or a non-punitive admonishment to a person whom the Board has reason to believe has violated or is about to violate any provision of the Medical Practice Act (NRS 630).

The old law required a licensee to report to the NBME a claim for medical malpractice filed against the licensee within 30 days of filing, notwithstanding the fact that the licensee defendant could legally be served with the complaint for up to 120 days after filing. SB 250 amends that unreasonable requirement to mandate that a licensee report to the NBME within 45 days of being SERVED NOTICE, via service of a summons and complaint. Any claim submitted to arbitration or mediation must be reported to the NBME within 45 days of submission. Settlements, judgments, and any other disposition of any action or claim, must be reported to the NBME within 45 days of that disposition. Any sanctions reportable to the National Practitioner Data Bank must be reported not later than 45 days after the sanctions are imposed. Any violation of these requirements may result in the NBME imposing a fine of not more than $5000 for each violation, in addition to any other fines or penalties permitted by law. All reports made by a physician under this provision are public records.

When the NBME receives a report indicating that a judgment has been rendered or an award has been made against a physician regarding an action or claim for malpractice, or that such an action or claim has been resolved by settlement, the NBME SHALL conduct an investigation to determine whether to impose disciplinary action against the physician, unless the NBME has already commenced or completed such an investigation before it receives the report. At one point there was concern that the NBME would be required to investigate every action or claim filed against licensees. This may well have been onerous with the more than doubling of the frequency of medical malpractice lawsuits filed against healthcare providers since the elimination of the Medical Dental Screening Panel. Mr. Bob Byrd, the president of the Medical Liability Association of Nevada, testified before the Nevada Senate Judiciary Committee that 75% of claims filed against physicians are resolved without an indemnity payment to the plaintiff (20% are settled and 5% proceed to court where the defendant physicians win the majority).

Section 42 of the Bill provides that "for the protection and benefit of the public, the Legislature delegates to the Board of Medical Examiners the power and the duty to determine the initial and continuing competence of physicians…." Further, "the Board must exercise its regulatory power to ensure that the interest of the medical profession do not outweigh the interests of the public. The Board must ensure that unfit physicians … are removed from the medical profession so that they will not cause harm to the public."

"The Board must encourage and allow for public input into its regulatory activities to further improve the quality of medical practice within this state." "Meetings of the Board must be held at a location at which members of the general public may testify via telephone or video conference between Las Vegas and Carson City or Reno."

The Board shall not place any information on its web site that has not been approved by the Board members except that information specifically required by law. Among that information required by law: an alphabetical list of physicians and disciplinary action taken against physicians; names of physicians whose license has been revoked by the Board; all financial reports received by the Board; and all financial reports prepared by the Board.

The provisions of this law become effective on July 1, 2003.

This report constitutes a summary of some of the new laws affecting physicians. These Bills, and others, can be obtained and read through the Legislative Counsel Bureau's excellent web site: www.leg.state.nv.us CCMS members are encouraged to print and peruse the full text of these and other Bills affecting the practice of medicine.

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President’s Message

By Ed Kingsley, M.D., 2003-2004 CCMS President

I would like to welcome everyone to our new Board of Trustees for 2003-2004 as listed adjacent to this Message. I personally know each one and have had the opportunity to work with the majority of them. Every trustee brings a great deal of experience and enthusiasm to the board, and I look forward to working with them this next year. I also look forward to working with the CCMS staff members, with whom I've already had the pleasure of working over the last six years.

Although many of us would rather be taking a break from the oppressive heat of summer that we are now experiencing and find ourselves taking an extended vacation anywhere outside of southern Nevada, there are still many important issues and events that demand our attention.

As I write this, our legislature is still in special session, convened by Governor Kenny Guinn, to formulate a tax plan to meet the demands of the recently approved Nevada budget for 2003-2005, and they still haven't come to any consensus on how much to raise our taxes. There has been much bickering and mudslinging between the legislators and the governor. There has been a hue and outcry from some, especially the Clark County School District, toward our politicians for their failure to meet the perceived financial needs of the state in a timely fashion. On the other hand, there has been a great deal of concern expressed by others over the enormity of the budget increase, over $800 million, for the next two years. How could this tax plan affect physicians? You and I could be paying a "gross receipts" tax on everything we purchase as part of our medical practice (read: "business"), which could easily amount to several tens of thousands of dollars annually for some doctors. Of course, failure of the legislature to procure sufficient funding for the schools could directly affect all of us who have school-aged children, and, eventually, everyone else, indirectly.

Another issue that directly affects many of us is the recent decision by the Nevada Division of Healthcare Financing and Policy (DHCFP) to severely reduce Medicaid reimbursement for some medical specialties. These cuts have been in place since early May of this year and are particularly damaging for some surgical and radiology services to children. This is forcing many physicians who used to provide pediatric care to withdraw from the Medicaid program altogether which may in turn force many children with serious disorders to seek medical care outside of Nevada. It is my understanding that the care provided these children out of state may actually cost more then had they received their care here under the previous Medicaid reimbursement guidelines. However, I also understand that the DHCFP now intends to adjust the reimbursement rate to a percentage over the Medicare rates that equals the rates paid prior to early May as soon as the Medicaid budget is secured by the legislature. Hopefully, that happens soon before the Medicaid program loses any more physicians.

We are still awaiting the Nevada State Board of Medical Examiners decision regarding their proposed "physicians' competency testing", which I understand may be forthcoming in December. There has been virtually unanimous opposition to this proposal but the NSBME hasn't seen fit to let it die yet.

On the national scene, the Senate and House have each passed separate bills addressing a medication prescription plan for Medicare recipients. Now, a joint committee from both bodies will try to hammer out a compromise bill that is acceptable to President Bush, who is strongly in favor of some type of prescription plan for our seniors. Of course, the question will inevitably be, who's going to pay for this extraordinarily expensive program? You and I, the tax payers, of course! In addition, a little recognized but very significant part of both the Senate and the House bills will drastically reduce the amount of funds provided for cancer treatment of Medicare patients.

As many of you may know, our own Senator John Ensign is sponsoring a MICRA-like medical liability reform bill S 11 called "The Patients First Act of 2003". This bill would:

1. Allow patients to recover unlimited economic damages such as future medical expenses and loss of future earnings while establishing a cap on non-economic damages, such as pain and suffering, of $250,000.

2. Allocate damages fairly, in proportion to a party's degree of fault.

3. Limit the number of years a plaintiff has to file a healthcare liability action to ensure that claims are brought while evidence and witnesses are available.

4. Mandate that relevant medical experts testify in malpractice trials, as opposed to highly paid "expert witnesses" who are often used to influence juries and foster abuses in the legal system.

The AMA supports this bill, which is modeled after California's medical liability reform legislated in 1975 and that has saved Californians more than $1 billion annually in liability premiums since then. You can personally thank Senator Ensign by writing him at:

senator@ensign.senate.gov

One last thing to remember in our ongoing fight against our medical malpractice crisis is the option of using the "Mutual Binding Arbitration Agreement" for all new patients we see in our offices. This provides an alternate avenue of resolving disputes between patients and their physicians as "determined by submission to arbitration as provided in Nevada law, and not by lawsuit or resort to court process except as Nevada law provides for judicial review of arbitration proceedings". Anyone interested in this option should contact the CCMS for more information.

By the time this Message is published, our CCMS committees and their chairmen/women will have been selected. I would like to thank them in advance for their willingness to accept their assignments and I look forward to working with them this coming year. Enjoy the summer!

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Membership Applicants To Go Before Credentialing Committee

If you have any pertinent information about the following membership candidates, please contact:

Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120

Michael C Edwards, MD - Plastic Surgery
Laura A Gorski, DO - Ob-Gyn
Keir F Hales, MD - Radiology/Nuclear Radiology
James G Marx, MD - Anesthesiology
Uma C Nair, MD - Internal Medicine
Young S Shin, MD - Diagnostic Radiology
Jon L Siems, MD - Ophthalmology

For information on becoming a member of the Clark County Medical Society, call Marlaina Burns at 739-9989

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In Memorium

The Clark County Medical Society is saddened to announce the passing of neurosurgeon Dr. Steven Agata on June 6, 2003. Dr. Agata was a 21-year member of CCMS.

CCMS also regrets to announce the passing of Life Member Dr. Robert Balin on July 1, 2003. Dr. Balin was a member of the Clark County Medical Society since 1971.

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New Members for June 2003

Congratulations and Welcome to the Clark County Medical Society

Michael J Anderson, MD, Radiation Oncology, 1176 Vegas Valley Dr., Las Vegas, NV 89109
Roger A Fontes, MD, Orthopaedics, 106 E. Lake Mead Dr. #108, Henderson, NV 89015
Jay W Kang, MD, Radiology, 2020 Palomino Ln. #100, Las Vegas, NV 89106
Paul K Treadwell, MD, Radiation Oncology, 1176 Vegas Valley Dr., Las Vegas, NV 89109
Randall T Weingarten, MD, Otolaryngology, 6301 Mountain Vista #203, Henderson, NV 89014

Transfer from Washoe County Medical Society

Paul Havens, MD, Family Practice, Mesquite, NV

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NSMA Resolutions from the 2003 Annual Meeting

Following are resolutions submitted by Delegates at the 2003 NSMA Annual Meeting at the Atlantis Casino in Reno, Nevada.

#2003-01, "Memorial Resolution", was passed.

Resolved: that the Nevada State Medical Association House of Delegates expresses its sorrow at the passing of the following:

Frederick M. Anderson, MD, WCMS, 01/28/2003

Jeffrey Arenswald, MD, CCMS, 01/2003

Thomas Armour, MD, CCMS, 03/04/2003

William M. Edwards, MD, WCMS, 02/04/2003

Avron Genser, MD, CCMS, 04/15/2003

Harry O. Hendrick, MD, WCMS, 08/18/2002

Thomas K. Hood, MD, ECMS, 01/28/2003

C. Robert Locke, MD, WCMS, 01/26/2003

Jacob Malin, MD, WCMS, 07/13/2002

Ronald Oseas, MD, CCMS, 10/01/2002

John G. Scott, Sr., MD, WCMS, 11/20/2002

And, be it further

Resolved: that upon passage of this resolution, the House of Delegates rise in silent tribute.

Resolution #2003-02, "Dues reduction", was passed as amended.

Resolved: that physicians joining for the first time be given a 50% dues decrease for the first year and this resolution be referred to the internal affairs commission for consideration of participation incentives for additional discounts.

Resolution #2003-03, "Improve public access to governmental regulatory body meetings in Nevada", was passed as amended.

Resolved: the NSMA supports legislation to amend the open meeting act that would require the BME to; 1) allow public comment before they vote on an agenda item; 2) require emailing agenda notices if requested; 3) provide meeting agendas on their web site; 4) conduct public meetings accessible to both Northern and Southern Nevada.

Resolution 2003-04, "Bill to expand authority of the NSBME to act in the public's interest", was referred to council for action and report back to the 2004 House of Delegates.

Resolution #2003-05 and 2003-06, "Nevada State Board of Medical Examiners reporting", was passed as amended.

Resolved: that NSMA encourage the BME to publish annually a reminder to Nevada physicians regarding process and requirements of reporting problematic physicians to the board; and be it further

Resolved: that NSMA encourage the BME to provide a physician contact to receive these concerns.

Resolution #2003-07 and 2003-08, "Medical-Dental Screening Panel", were combined and passed as amended.

Resolved: that Nevada State Medical Association continue to work for the reinstitution of an improved Medical-Dental Screening Panel

Resolution #2003-09, "NSMA membership", was passed as amended.

Resolved: the NSMA develop new mechanisms to convince all active medical practitioners licensed in the State of Nevada of the need for their membership and financial support of the activities of the Nevada State Medical Association and its county societies from which they benefit.

Resolution #2003-10, "Schedule annual meeting in Las Vegas", was recommended for a do pass as amended.

Resolved: the NSMA shall meet in 2006 in the Las Vegas area.

Resolution #2003-11, "Liability insurance requirements by hospitals and plans", was referred to council.

Resolution #2003-12, "Health care access", was passed as amended.

Resolved: that the Nevada State Medical Association continue to work with the Nevada State Legislature to improve access to quality health care in Nevada.

Resolution #2003-13, "Non-English resources", was passed as amended.

Resolved: that Nevada State Medical Association work to identify and promote resources that can help health care providers in Nevada communicate with non-English speaking patients.

Resolution #2003-14, "School vending machines", was passed as amended.

Resolved: that NSMA recommend to school boards throughout the state, as well as individual public and private schools, that nutritious foods be added to school vending machines and school menus; and be it further

Resolved: our AMA delegates take this proposal to the AMA for adoption nationwide.

Resolution #2003-15, "Organ donation priority" was not passed.

Resolution #2003-16, "Comprehensive child care", was referred to council.

Resolution #2003-17, "Advanced directive listed on driver's license", was not passed.

Resolution #2003-18, "Expert testimony", was passed as amended.

Resolved: that Nevada State Medical Association work with attorneys, physicians and the legislature to establish quality standards for expert medical testimony.

Resolution #2003-19, "State laboratory report policy" was passed as amended.

Resolved: that NSMA continue to support Senate Bill 24, or other legislation, which would amend NRS 652.190 to allow laboratory results to be reported to: (a) the person requesting (ordering) the test or procedure; (b) the health care provider who is treating or providing assistance in the treatment of the patient; (c) the health care provider to whom the patient has been referred; and (d) the patient for whom the testing or procedure was performed.

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2003-2004 Clark County Medical Society Committees

Bylaws, Policies and Procedures

Warren Evins - Chair

Max Doubrava

John Kurlinski

David Marmaduke

Chandra Narala

Michael Verni

Building Committee

Frank Shreck

Annette Teijeiro

Community Relations/Community Health

LeRoy Bernstein - Chair

George Alexander

Sameer Abu-Samrah

Joel Bower

Robert Buckley

Jerry Cade

Christina Dixon

Warren Evins

Howard Gelfand

James Heroy

Cheryl Jayne

J. Kreed Lovell

Paul Michael

Marietta Nelson

Richard Schwartz

Robert Shreck

Kayvan Taghipour-Khiabani

Carol Vanderharten

CME Committee

Michael Gross - Chair

Farooq Abdulla

Arthur Del Rosario

Allan Ebbin

Warren Evins

Kazem Fathie

Cheryl Jayne

Noel Rowan

Joram Seggev

Ole Thienhaus

Paul Wilkes

Credentials Committee

Larry Cohler - Chair

Farooq Abdulla

Mark Doubrava

Kazem Fathie

James Heroy

Russell Jayne

Jack Kane

Chandra Narala

Joram Seggev

Ole Thienhaus

Michael Verni

Delegation 2004

Carol Vanderharten - Chair

Sherif Abdou

John Adan

George Alexander

LeRoy Bernstein

Michael Clifford

Michael Colletti

Richard Diskin

Christina Dixon

Max Doubrava

John Ellerton

Warren Evins

Charles Graham

Michael Gross

Robert Lynn Horne

Florence Jameson

Jerry Jones

Ronald Kline

Edwin Kingsley

John Kurlinski

Donald Kwalick

David Mulkey

Chandra Narala

Marietta Nelson

Robert Shreck

David Steinberg

Annette Teijeiro

Arnold Wax

Government Affairs

Ron Kline - Chair

Sherif Abdou

Sameer Abu-Samrah

John Adan

Alvin Blumberg

Raj Chanderraj

Mark Doubrava

Max Doubrava

Warren Evins

David Marmaduke

Chandra Narala

Marietta Nelson

Internal Affairs

Michael Colletti, MD - Chair

Ed Kingsley, MD

David Steinberg, MD

Membership Committee

Scott Boman - Chair

Farooq Abdulla

Arthur Del Rosario

Cheryl Jayne

Russell Jayne

Chandra Narala

Mini-Internship Committee

LeRoy Bernstein - Chair

John Adan

David Marmaduke

Carol Vanderharten

Nominating Committee

Marietta Nelson - Chair

Raj Chanderraj

Warren Evins

Howard Hoffman

Raul Meoz

Frank Nemec

Robert Shreck

Professional Standards Council

Arnold Wax - Chair

Sameer Abu-Samrah

John Adan

Joel Bower

Larry Cohler

Maria Gaerlan

Howard Gelfand

Anjum Ismail

Jack Kane

John Kurlinski

Paul Michael

Carol Vanderharten

Robert Voy

Steve Winkler

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Clark County District Court Medical Malpractice Filings Against Health Care Providers

Jan 2001 - Jun 2003

2001 2002 2003

Jan 39 33 80

Feb 20 14 72

Mar 35 30 75

Apr 37 34 74

May 37 35 70

Jun 27 24 58

Jul 19 100

Aug 54 51

Sep 20 65

Oct 37 83

Nov 38 184

Dec 9 170

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The Medical Liability Crisis: Talking Points

This information can be found on the American Medical Association web site: http://www.ama-assn.org/ama/pub/category/7861.html

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Minutes Synopsis

(Members can receive a full copy of meeting minutes by calling 739-9989.)

CLARK COUNTY MEDICAL SOCIETY BOARD OF TRUSTEES MEETING

Tuesday, June 17, 2003; 6:00 P.M.

Action Items

The minutes from the May 20th Board meeting were approved.
Dot Freel reported the eleven month total revenue exceeds the budgeted amount, although the total year to date revenue is down compared to last year at this time. The expenses are down compared to the expenses last year at this time. The budget for the next fiscal year will be presented for approval next month at the Executive Council meeting.

Committee Reports

Dr. Hyer thanked Deb Barton for all her work on the successful Installation dinner.
Dr. Manthei reported SB 97 was killed so the Initiative Petition will be on the 2004 ballot as IP1. The board commended all of the hard work Dr. Manthei has done as the President of KODIN.
The following applicants were approved for membership: Michael J Anderson, MD; Roger A Fontes, MD; Jay W Kang, MD; Paul K Treadwell, MD; and Randall T Weingarten, MD

Alliance Report

Annette Mohs reported the Alliance is currently working on their annual membership drive and the logistics of a CCMS/CCMSA voter's registration drive at physicians’ offices was discussed.

County Health Officer Report

Dr. Kwalick reported the Southern Nevada Public Health Laboratory is on schedule to open in early August, grand opening to be Labor Day. AB 460 which is awaiting the Governor's signature has amendments which would prohibit tobacco use in day cares and arcades. There is no monkey pox disease in Nevada at this time. There have been concerns regarding possible suspect cases for SARS.

President's Report

Dr. Evins asked for a moment of silence honoring the passing of member Steven Agata.
Dr. Evins presented the action kit he had received from the AMA. The kits are good for displaying in doctors' offices. Physicians, even non-members of the AMA, can request kits at no charge by calling the AMA.
Dr. Dave Slattery, President of the Emergency Physicians Society, asked for CCMS support in their request for a grant to educate local community physicians on Bio-terrorism. The board approved the endorsement.
Dr. Evins reported the NBME tabled the proposed competency testing regulations at the May 30th board meeting. Dr. Baepler stated he would bring up this issue again at the next board meeting in December. This issue and proposals are very much alive and under continuing consideration.
Dr. Manthei reported he attended the Federation meeting in Chicago and the Federation said there are no programs for competency testing and they are not recommending competency testing regulations be implemented at this time.

Administrative Report

Per the bylaws, the NBME officers who are members of CCMS are ex-officio members of the CCMS board. As such, they have been invited to attend the CCMS board meetings but there have been no responses to date.

Old Business

The water conservation xeriscape final inspection was completed and the check should be processed in 30 days. The landscaping cannot change for 5 years or CCMS would be subject to returning the water district rebate money.

New Business

Two board members were moved up to officer positions leaving two trustee positions available. Dr. Kingsley appointed Ron Kline, MD and Richard Diskin, DO as their replacements.
CCMS will place a half page ad in the Nevada Nurses Association yearbook.

The next meeting will be for the Executive Council on Tuesday, July 15, 2003 at 6 PM.
There being no further business, the meeting was adjourned by Dr. Evins at 7:35 pm.

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Election Department Offers Field Registrar Training

By Deborah Barton

CCMS Public Relations Coordinator

Although the next statewide election is not until November 2004, it will be very important to physicians. The "Keep Our Doctors In Nevada" Initiative will be on the ballot and will give voters an opportunity to pass MICRA-like tort reform in Nevada.

Because of this, many physicians have indicated an interest in making it easy for their patients to register to vote by making registration materials available in their offices. However, the Clark County Election Department allows individuals to take no more than 50 registration applications without becoming a Field Registrar.

Fortunately, becoming a Field Registrar is a simple process. Any Clark County registered voter who is not running for an office can take the two-hour training course to become a Field Registrar. For information about the course, go to the Election Department web site at www.co.clark.nv.us/election/Fieldreg.htm.

The course is offered throughout the year at the Clark County Election Center at 965 Trade Drive in North Las Vegas. For details or to reserve a seat at one of the upcoming courses, call the Election Center at 455-0076 or 455-0118.

Upcoming Courses:

Thursday, August 12 at 10 a.m.
Wednesday, August 18 at 10 a.m.
Tuesday, August 24 at 10 a.m.
Tuesday, August 24 at 6 p.m.
Wednesday, September 15 at 10 a.m.
Wednesday, September 15 at 6 p.m.
Tuesday, September 21 at 10 a.m.
Thursday, September 23 at 10 a.m.
Thursday, September 23 at 6 p.m.

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CME Calendar

American Association of Professional Ringside Physicians www.aaprp.com

9/11-9/14 - 3rd Annual Medical Meeting

Cardiovascular Consultants 691-9154

Clark County Medical Society 739-9989

8/16 - “Patient Consent and Rights,” 8:45 - 11 a.m., 2 CME hours

Future Programs Planned

August - “End of Life”

September - “Health Care Fraud and Abuse”

St. Rose Hospital 616-5832

Southwest Medical Associates 242-7347

8/14 - “Assessing Your Patient’s Risk for Breast and Ovarian Cancer: Current Strategies for Risk Reduction”
9/11 - “Chiropractic Myths and Truths”

Sunrise Hospital 731-8210

UMC 383-2604

Valley Hospital 388-4847

8/12 - “Length of Stay and Costs,” noon
8/26 - “Radiation Oncology Relating to Breast and Prostate Cancer,” noon
9/9 - “Nosocomial Infections in the NICU,” noon
9/23 - “Weight Loss - Practical Approaches,” noon

To have your CME courses listed on our calendar, please contact Deborah Barton at 739-9989 prior to the deadline of the 12th each month.

*Special Note: CCMS members can receive free CME courses on the internet with World Medical Leaders.

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CLARK COUNTY HEALTH DISTRICT DISEASE STATISTICS* - June 2003

DISEASE CASES REPORTED YEAR TO DATE

Jun. 2002 Jun. 2003 2002 2003

VACCINE PREVENTABLE DISEASES

DIPTHERIA 0 0 0 0

HAEMOPHILUS INFLUENZA 0 2 4 4

(invasive)

HEPATITIS A 0 3 9 9

HEPATITIS B 2 10 21 35

INFLUENZA 0 0 59 47

MEASLES 0 0 0 0

MUMPS 1 1 2 1

PERTUSSIS 9 2 10 7

RUBELLA 0 0 0 0

TETANUS 0 0 0 0

SEXUALLY TRANSMITTED DISEASES

AIDS 24 16 126 122

CHLAMYDIA 303 414 2250 2293

GONORRHEA 151 171 852 894

HIV 11 19 88 117

SYPHILIS 0 0 5 4

(Primary & Secondary)

SYPHILIS (Early Latent) 0 0 4 15

ENTERICS

AMEBIASIS 2 0 11 9

BOTULISM-INTESTINAL 0 0 0 1

Contents

Changes in Nevada’s Laws Impact Physicians

President’s Message

Membership Applicants To Go Before Credentialing Committee

In Memorium

New Members for June 2003

NSMA Resolutions from the 2003 Annual Meeting

2003-2004 Clark County Medical Society Committees

Clark County District Court Medical Malpractice Filings Against Health Care Providers

The Medical Liability Crisis: Talking Points

Minutes Synopsis

Election Department Offers Field Registrar Training

CME Calendar

CLARK COUNTY HEALTH DISTRICT DISEASE STATISTICS* - June 2003