The Clark County Medical Society joined with the Clark County Medical Society Alliance (CCMSA) to host the “Protect Nevada Medicine” Dinner on January 11 at the Monte Carlo. More than 250 physicians and their spouses met with key lawmakers to discuss issues and strategy prior to the start of Nevada’s 2003 Legislative Session.

Dr. Donald J. Palmisano, president-elect of the AMA, delivered an inspiring presentation that touched on national and local issues, including the widespread medical liability insurance crisis. CCMSA also presented their Voice of Alliance award to Senator John Ensign, who sent a message of strong support.

Legislators attending included Nevada State Senators Ann O’Connell and Sandra Tiffany, and Nevada Assemblymen Josh Griffin, Dr. Joe Hardy and Dr. Garn Mabey, and U.S. Representative Shelley Berkley.

Photo Captions: Top: Keep our Doctors in Nevada President Dr. Rudy Manthei, AMA President-Elect Dr. Donald J. Palmisano, and CCMS President Dr. Warren Evins. Left: Freshmen Nevada Assemblymen Dr. Joe Hardy and Dr. Garn Mabey with CCMS Alliance President Karen Schroeder and Palmisano.

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Calendar of Events

· February 3 - Nevada Legislature commences 2003 session in Carson City.

· March 7 to March 8 - Nevada Board of Medical Examiners meeting at Embassy Suites on Paradise Rd. in Las Vegas.

· March 31 - CCMS Nominating Ballots mailed to members.

· May 1 - CCMS Election Ballots mailed to members, with closing of the polls at 5 p.m. on May 15.

· May 31 - CCMS Installation Dinner. Time and location to be announced.

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Andrew Bruton, MD, December 28, 1967 - January 7, 2003

We are saddened to announce the death of Dr. Andrew Bruton. Dr. Bruton was a fourth-year OB-GYN resident at UMC.

OB-GYN residents at UMC have been working extremely hard, and limiting their work week to the recommended 80-hour work week has not been possible to date due to a dramatic rise in deliveries at UMC. The chairman of the OB-GYN Department at the School of Medicine has received two warning letters from the residency accrediting body because of the excessive number of deliveries being performed by residents.

On the afternoon of Monday, January 6, UMC and one other resident were served with a complaint for medical malpractice, a case in which Dr. Bruton was also named. Several hours later Dr. Bruton took his own life.

Correction to be printed in March 2003 County Line: The University of Nevada School of Medicine has informed the Clark County Medical Society that CCMS’ press release of January 24, 2003 and February 2003 County Line contained three significant errors.

During the time Dr. Andrew Bruton was a resident in OB/GYN, the following has occurred:

There has been a significant decrease in resident work hours. Although the ACGME will implement new standards effective July 1, 2003 the University of Nevada School of Medicine had already modified its work schedule to bring the residents work week within the anticipated standards established by the ACGME. This change occurred a year early.
In fact, the number of babies delivered by the residents has decreased dramatically over the last three years in part because the School of Medicine has hired four Nurse Midwives to assist the residents and the faculty attending physicians.
The earlier release stated that the Chairman of the OB/GYN Department at the School of Medicine received two warning letters from the residency accrediting body. The Chair did not receive two warning letters. A report from an ACGME site visit in 2000 cited an excessive obstetrical workload at that time. However, the Program was reviewed, most recently in August 2001, and in a letter dated November 13, 2001 from the ACGME to the Director of the OB/GYN Residency Program there were no citations relating either to the number of hours worked by the residents or the number of babies delivered by the residents. As of November 13, 2001 the Program was fully accredited and remains in that status today.

CCMS regrets any inconvenience the incorrect information received and published by CCMS may have caused. CCMS retracts that portion of the press release in conflict with these facts.

Weldon (Don) Havins, MD, Esq.

CEO and Special Counsel, Clark County Medical Society

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President’s Message

By Warren Evins, M.D., PhD, 2002-2003 CCMS President

The Nevada State Legislature

On February 3, 2003, the Secretary of State of Nevada will deliver to the Nevada State Legislature notice that the Keep Our Doctors In Nevada (KODIN) Initiative has been certified for the November 2004 ballot. The Legislature will then have until mid-March 2003 to prevent the Initiative from being presented to the Nevada voters for approval at the November 2004 general election. We want the Legislature to enact the entire Initiative into law, which will relieve KODIN of the major education and marketing campaign which will again be needed to defend the Initiative in the 2004 election from the anticipated misinformation efforts of the Trial Lawyers.

Committee hearings will be held during which physician testimony will be taken. Our representatives intend to participate in these hearings. The committee records and minutes will be important documentation for the Nevada Supreme Court to consider when responding to Constitutional challenges of the Initiative's proposals from the Nevada Trial Lawyers.

Physicians themselves have very little influence on the Legislature's enactment of legislation; Nevada residents must speak. I believe that the Special Session of the Nevada Legislature in late July 2002 did not occur directly because of physicians' concerns about the Medical Malpractice crises. It occurred because of the public's response to the closure of UMC's Trauma Center. It occurred because Governor Guinn made promises to the trauma surgeons that allowed the Trauma Center to re-open.

Assembly Bill 1 of the Special Session was most successful in providing protection to the trauma surgeons for their treatment of trauma patients. Other doctors caring for a trauma patient's non-trauma related problems (such as pre-existing chronic medical conditions e.g. hypertension, diabetes, pregnancy, etc.) are now the "deep pockets" for medical problems resulting from a trauma patient's hospitalization.

During this short 40-day window at the Legislature, physicians and the public have an unequaled opportunity to advance by about 1-½ years any real solutions to the Medical Malpractice crises. (This is the time between July 1, 2003 when legislation enacted during the 2003 session becomes effective and the time when passage of the voter Initiative proposal will become effective in November 2004).

Enactment of the Initiative's proposals can only occur with strong support of the public - a "grass roots" lobbying effort.

The KODIN Initiative is supported by a diverse array of the public, business, and labor communities: physicians, nurses, health care workers and institutions, hospitals, senior citizens, lawyers, large and small business people, and citizens who are concerned about protecting access and availability of quality health care in Nevada. We need to energize this varied group of people. We want these groups: their employees, families and friends to contact their legislators and elected officials, including Governor Guinn, to speak for passage of the Initiative's proposals.

Further delay costs money, loss of physicians, financial ruin to some doctors, limitations on access to medical care and deterioration of the Quality of Health Care in Nevada. Do not count on others to carry the banner for you, YOU MUST GET PERSONALLY INVOLVED.

The KODIN Initiative

The initiative has proposed 5 key points:

1. Limit Runaway Lawyer Fees

2. Stop "Double Dipping" (expenses covered by others)

3. Extend Payments (installments)

4. Stop Exceptions (strengthens non-economic damage award limits)

5. Create "Fair Share" Liability (not joint and several liability)

CCMS strongly urges all physicians to support the initiative by calling 1-888-5-REFORM (1-888-573-3676) and sending in a written endorsement and financial support to:

Keep our Doctors in Nevada

P.O. Box 50154

Henderson, NV 89016

Tax ID # 47-0889225

"Stop Exceptions"

The $350,000.00 limitation on non-economic damages does not apply to each injury or patient. It applies to each defendant from each plaintiff. One injured patient may engender legal actions on behalf of multiple plaintiffs for non-economic damages: spouses, children, parents, other relatives, partners, etc. If a physician carries a minimum of $1/$3 Million Liability coverage, the maximum awards limitation (Assembly Bill 1) is $1 Million (or $3 Million according to some lawyers), not $350,000. This exception has to be stopped!

Protect Nevada Medicine Dinner

What a night! Voice of the Alliance Award to Senator John Ensign, Senator Ensign's letter of support to physicians, AMA President-Elect Donald J. Palmisano, MD, JD's rousing speech, KODIN information, vendor booths, good food-what more could you ask for. If you were not there, you really missed out.

CCMS Mini-Internship

About 25 community leaders, legislators, district court judges, school board trustees, and media representatives followed a CCMS member physician around and learned what the doctor does behind the scenes. We then met at McCormick & Schmick's Seafood Restaurant to share our experiences and discuss a physician's life. We all had a great time and learned from each other.

Continuing Medical Education

CCMS continues its bimonthly well attended CME courses through August. Free to our members with advance registration.

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Mini-Internship Participation Doubles

By Deborah Barton, CCMS Public Relations Coordinator

The CCMS Mini-Internship Program welcomed 20 “interns” for the session, held January 13-16. This class of interns is the largest since the inception of the program in 1994. The Mini-Internship culminated in a debriefing dinner, sponsored by Wybtrak, at McCormick & Schmick’s Seafood Restaurant on January 16.

The Mini-Internship is an event held each year that pairs community leaders, elected officials, and members of the media with CCMS member physicians to give them an opportunity to see a “day in the life” of a doctor. Previously, the event had been held on a single day, but was expanded to four days to allow the greatest flexibility for both the interns and the physicians.

“Interns” indicate their preferences for the specialties or procedures they would like to observe with their availability for the internship period. Physicians are then recruited to host an intern in their office or operating room for half or full days, as scheduling allows. All participants then come together to “debrief” and share their experiences.

Due to the success of this year’s program, another may be held this fall. CCMS members interested in participating can contact Deborah Barton at 739-9989.

Photo Caption: Mini-Internship Participants: (standing) Dr. Sheldon Freedman, Las Vegas Valley League of Women Voters President Margi Mark, Dr. Charles Walton, Dr. Michael Colletti, Assemblywoman Valerie Weber, Wybtrak representative Troy Johns, Dr. Warren Evins, Dr. Malcolm Poon, District Court Judge Michael Cherry, State Senator Barbara Cegavske, CCSD Regional Superintendent Marsha Irvin, District Court Judge Mark Denton, Assemblyman Walter Andonov, CCMS CEO Dr. Weldon Havins, (sitting) Channel 8 producer Rick Andrews, Assemblywoman Peggy Pierce, Dr. Marietta Nelson, Dr. William Canada, Dr. Bashir Chowdhry, Dr. LeRoy Bernstein, Channel 13 producer Heather Angel, (on floor) Dr. Raj Chanderraj, View reporter Ginger Mikkelsen, Dr. Jeffrey Cichon. Not Pictured: Interns Las Vegas Review-Journal reporter Joelle Babula, District Court Judge Stewart Bell, Assemblyman David Brown, Assemblyman Chad Christensen, Assemblyman Tom Collins, Assemblyman Josh Griffin, State Board of Education Member Theresa Malone, Assemblyman John Oceguera, and State Senator Ray Shaffer. Physicians Dr. Larry Cohler, Dr. Charles Ebert, Dr. William Evans, Dr. Thomas Johnson, Dr. Edwin Kingsley, Dr. David Steinberg, Dr. Aleisa Wagner, and Dr. Kenneth Westfield.

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2003 Nevada State Legislature Contact Information

Please Note:

At the start of one of the most crucial legislative sessions for Nevada physicians, it is imperative that each of us stays informed of the development and status of bills that will help or hinder our ability to continue to deliver quality medical care to our patients.

The information to the right provides the phone numbers and e-mail addresses for all Nevada State Legislators as listed on their web site: http://leg.state.nv.us/

If you are not certain of your representatives in the Senate and Assembly, you can call 455-VOTE to reach the Clark County Election Department or go to their web site: http://www.co.clark.nv.us/election/Lookup.htm

Senate	First	Last	Phone	E-mail
Capital Sen Dist	Mark	Amondei	775-687-0202	mamondei@sen.state.nv.us
Clark No 7	Terry	Care	702-388-0098	tcare@sen.state.nv.us
Clark No 2	Maggie	Carlton	702-452-3619	mcarlton@sen.state.nv.us
Clark No 8	Barbara	Cegavske	702-873-0711	bcegavske@sen.state.nv.us
Clark No 10	Bob	Coffin	702-384-9501	bcoffin@sen.state.nv.us
Clark No 12	Warren B.	Hardy	702-227-0536	whardy@sen.state.nv.us
Washoe No 1	Bernice	Mathews	775-673-2086	bmathews@sen.state.nv.us
Cnt NV Sen Dist	Mike	McGinness	775-423-5889	mmcginness@sen.state.nv.us
Clark No 4	Joseph	Neal	702-399-2114	jneal@sen.state.nv.us
Clark No 9	Dennis	Nolan	702-838-3838	dnolan@sen.state.nv.us
Clark No 5	Ann	O'Connell	702-451-3444	aoconnell@sen.state.nv.us
Washoe No 3	William	Raggio	775-786-5000	wraggio@sen.state.nv.us
Clark No 6	Raymond D.	Rawson	702-651-5591	rrawson@sen.state.nv.us
N NV Sen Dist	Dean	Rhoads	775-756-6582	drhoads@sen.state.nv.us
Clark No 11	Michael	Schneider	702-876-5121	mschneider@sen.state.nv.us
Clark No 1	Raymond C.	Shaffer	702-647-8683	rshaffer@sen.state.nv.us
Clark No 5	Sandra	Tiffany	702-451-7301	stiffany@sen.state.nv.us
Clark No 7	Dina	Titus	702-895-3756	dtitus@sen.state.nv.us
Washoe No 4	Randolph	Townsend	775-825-5111	rtownsend@sen.state.nv.us
Washoe No 2	Maurice	Washington	775-331-3826	mwashington@sen.state.nv.us
Clark No 3	Valerie	Wiener	702-871-6536	vweiner@sen.state.nv.us
Assembly	First	Last	Phone	E-mail
Washoe No 31	Bernie	Anderson	775-358-8113	banderson@asm.state.nv.us
Clark No 21	Walter	Andonov	702-269-8321	wandonov@asm.state.nv.us
Washoe No 26	Sharron	Angle	775-787-6017	sangle@asm.state.nv.us
Clark No 7	Morse	Arberry Jr.	702-562-2323	marberry@asm.state.nv.us
Clark No 17	Kelvin	Atkinson	702-457-9995	katkinson@asm.state.nv.us
Clark No 4	Bob

Contents

More than 250 attend dinner to ‘Protect Nevada Medicine’ with AMA President-Elect Palmisano

Calendar of Events

Andrew Bruton, MD, December 28, 1967 - January 7, 2003

President’s Message

Mini-Internship Participation Doubles

2003 Nevada State Legislature Contact Information