County Line
Newsletter XLV October 2003
Contents
Medical Malpractice Legislation
Clark County Health District Disease Statistics – August 2003
Medical Malpractice Legislation
By
Irwin Simon, M.D., Esq.
Under the thin guise of patient concern, Nevada's hospitals and medical insurance payors have required that Nevada physicians carry malpractice insurance. This has been typically set by insurance payors as a $1 million per occurrence/$3 million aggregate. Hospitals as a criterion for staff appointment have settled on the same minimums. Since all surgical specialists and critical care specialists require hospitals in which to practice their specialty, the effect has been to make malpractice insurance coverage an expensive requirement for the privilege of practicing medicine in Nevada for all but a few physicians whose practices have allowed them to eschew hospital appointments.
The Nevada State Board of Medical Examiners has recently proposed several new items, purportedly to ensure that only quality physicians are to remain licensed in Nevada. One proposal requires that all physicians should be on staff at two hospitals. Such a proposal of course has no bearing on the quality of care rendered by a physician. It serves only to require that such physicians maintain a minimum of $1 million/$3 million in liability insurance.
Background
Because Nevada has a relatively small population, insurance companies such as St. Paul Insurance and Chicago Insurance Company had no difficulty garnering significant business by offering an initially low teaser rate to physicians grasping for rope in a sea of climbing insurance rates. In 1995, insurance rates, already rising from insurers such as Medical Insurance Exchange of California, the Doctor's Company, and American Physicians Assurance, were undercut by St. Paul. Understandably, as physicians tried to hold the bottom line on overhead, encouraged by the well-intentioned endorsements of their state and local medical societies, large numbers of physicians turned to these companies.
In our sparsely populated state, the insurers attempted first to cover losses by massive premium increases. It became readily apparent that such increases, even those to 400 percent, could not cover the payouts from large numbers of smaller cases and small numbers of larger settlements and jury awards. Specialty physicians began leaving Nevada.
Once again, the insurers sought and received one-time, large increases in premiums. The Nevada Division of Insurance (DOI) reviewed and authorized these premium increases, hoping it could buy time and avert a mass exodus of qualified physicians. However, based on Nevada's existing insurance rules, there was nothing to prevent the insurers leaving the Nevada market from demanding payments of tail coverage premiums from Nevada's physicians.
Furthermore, such tail coverage premiums (for claims potentially brought after the physician is no longer insured by the company) are based under DOI regulations on a complicated multiple of the last premium charged at the final anniversary/renewal of the physician's policy. Thus, by remaining in the Nevada market for "just one more year" with exponentially higher premiums, these insurers insured themselves of receiving an enormous windfall of tail coverage premiums from Nevada's beleaguered physicians.
Failure to pay such a tail premium leaves the physician at risk that a suit, meritorious or otherwise, could be brought within Nevada's statute of limitations. Such a suit, no longer covered, could bankrupt an average physician, even if defended successfully.
Hence in 2002, Governor Guinn felt the political pressure to call a special session of the state legislature. The legislature enacted significant measures of reform designed to slow the exodus of Nevada's specialty physicians. Most affected are the surgical specialties of obstetrics and gynecology and general surgery.
Medical Malpractice Reform: Outcome of Nevada's
July 2002 Special Session
The Nevada Legislature adjourned at 4:27 a.m. on August 1, 2002, after both houses unanimously passed the medical malpractice bill. The bill, AB 1, included significant changes, most of which became effective October 1, 2002:
h A $350,000 cap on noneconomic damages from each defendant to each plaintiff, such as pain and suffering, in medical malpractice lawsuits. Initially proposed exemptions from the cap included cases involving death, brain damage, paralysis, total blindness, amputation and sterility. The bill as passed limited exemptions to cases involving gross malpractice and "clear and convincing evidence that an award in excess of $350,000 for noneconomic damages is justified under exceptional circumstances."
h A $50,000 civil liability limit for physicians, including emergency room physicians at public and private (for profit) trauma/emergency rooms, if the emergency trauma care is given in good faith. To go above this limit a plaintiff must prove gross negligence on the part of the physician.
h Nevada's Good Samaritan law was expanded to give liability protection to a physician or dentist who renders care or assistance without compensation at a nonprofit or government health care facility as well as those providing free treatment of indigents.
h Nevada's concept of joint and several liability was altered. Doctors who are partly responsible for malpractice would pay a percentage of noneconomic damages that does not exceed their own degree of fault, as determined by a jury.
h A physician who is only partly responsible for malpractice can still be held jointly and severally liable for all economic damages, which include the costs of additional medical care and lost wages.
h Elimination of the state's medical dental screening panel. Previously all malpractice lawsuits required review before they could proceed to district court. Malpractice cases filed after October 1, 2002 may proceed directly to court in a form of "fast tracking" authorized by the bill.
h Mandatory settlement conferences with a judge before a malpractice case proceeds to trial.
h Mandatory reports to the governor and the legislature on disciplinary actions against doctors, lawsuits or claims submitted to arbitration or mediation alleging malpractice, and judgments or settlements against doctors.
h Lawyers who file frivolous cases, as determined by a judge, will be required to pay court costs and defense attorney fees.
h Mandatory reporting of medical error by medical facilities, hospitals, clinics and health professionals to the Board of Medical Examiners.
2003 Legislative Session
The law, effective October 1, 2002, received the endorsement of the American Medical Association. However, many Nevada physicians expressed immediate dissatisfaction with the bill, arguing that it did not go far enough to achieve the purposes of stabilizing the malpractice market in Nevada and ensuring the availability of quality health care throughout Nevada.
The group organized under the name "Keep Our Doctors in Nevada" (KODIN). Specifically, this group of doctors sought:
h To abolish all exceptions to caps on pain and suffering judgments
h To limit attorney fees
h To require that doctors cannot be forced to pay an entire jury award if they are found only partially liable in a malpractice case. Such several liability would extend only to the extent of the individual defendant's liability as determined by a jury. The KODIN initiative would extend several liability to all awards, noneconomic as well as economic.
KODIN filed an initiative petition with the secretary of state's office on September 20, 2002. As per Nevada law, the group was required to obtain over 61,000 valid signatures from 13 of the 17 Nevada counties. This task was accomplished prior to November 12, 2002. Hence, the regular legislative session in 2003 was required to address the initiative.
In justifying limits on attorney's fees, KODIN leaders expressed the desire to ensure that injured patients would receive a large percentage of the funds from settlements or jury awards. Under the KODIN initiative, trial lawyers could collect no more than 40 percent of the first $50,000 awarded, approximately 33 percent of the next $50,000, 25 percent of the next $500,000, and 15 percent of any amount over $600,000.
Under Nevada law the Legislature was required to pass the KODIN initiative as is or reject it within 40 days of the start of the 2003 regular legislative session. As the Legislature voted to reject the proposal, the initiative is required to go before voters on the 2004 ballot. Optionally, the Legislature could have suggested an alternative proposal, which would have gone on the 2004 ballot as well.
Three bills were enacted and aimed at direct control of malpractice insurance rates through legislated controls. Sections of Senate Bills 122 and 250 are intended to give the state insurance commissioner new powers to directly and indirectly control malpractice premium rates. The effectiveness of these new powers has yet to be demonstrated.
AB 320 tightens regulations on insurance companies offering medical malpractice coverage to doctors. AB 320 says the Nevada insurance commissioner will not approve premium increases for doctors' malpractice insurance if the rates were designed to make up for losses in financial markets, or because the insurer lost money by pressing ahead with lawsuits that could have been settled out of court. The bill also mandates that any insurer with at least 40 percent of the market share will have to give the state four months notice before withdrawing.
Suggestions for Potentially Effective Changes
While clearly not popular with trial attorneys, one popular physician alternative would be to allow physicians in Nevada to "go bare" and eschew malpractice insurance. In Florida, physicians are allowed to go bare. The state requires that physicians prominently display a sign in their waiting room, advising potential patients that the physician chooses to go bare. Should the patient find this unacceptable, he or she is free to choose their health provider elsewhere. Hand in hand with this would be legislation prohibiting a health insurance entity and/or any hospital from requiring malpractice insurance as a requirement for contracting or for appointment to a medical staff. Alternatively, legislation could set a lower requirement of insurance and prohibit health care entities from requiring higher amounts.
The DOI could require that any malpractice insurer that offers coverage within the state offer "per occurrence" coverage at reasonable DOI approved rates. Such coverage would preclude the concept of tail insurance.
The DOI could require that any malpractice insurer offering coverage in Nevada in the claims made format, offer mandatory "tail" to physicians, at no extra charge, who remain with the company for a designated period of three to five years. Should any insurer drop the insured or leave the state prior to the completion of the required period, such insurers would be required to offer "tail coverage" to all affected insured physicians, at no additional charge to the physician.
The DOI is in a position to penalize any insurance company that willfully or knowingly insures a problem physician whose record demonstrates an inordinate number of meritorious claims. In our current crisis, both trial lawyers and physician groups agree that some "bad physicians" were kept in business, able to further harm the public, through the greedy business practices of certain malpractice insurance agents and companies.
Nevada, and America, is not out of the woods in recovering from the malpractice insurance crisis. Trial lawyers across America have been forced to admit in some way that such a crisis exists. One simply cannot legislate health. No matter what, illness and injury will continue to plague our society. Even trial lawyers require health care and like all Americans will decry the day that the quality physician of their choice is unavailable because of shortsightedness on the part of doctors, lawyers and legislators.
Irwin Simon is a practicing general and laparoscopic surgeon in Las
Vegas. He is a graduate of the charter class of the UNLV Boyd School of Law and
was admitted to the Nevada Bar in 2002.
© Originally published in Communiqué (July 2003, Vol. 24, No. 7), the
official journal of the Clark County Bar Association. All rights reserved.
President’s Message
By Ed Kingsley, M.D.,
2003-2004 CCMS President
Early last month, headlines in the local newspaper shouted out that doctors and their professional organizations had grossly exaggerated the doctor shortage crisis. The article went on to say how doctors are actually not leaving Nevada in droves and they had the figures to prove it. Then, referring to a recently-released United States General Accounting Office (GAO) report, the article pointed out that there may be a couple of specialties, such as ob-gyn and emergency medicine, in some isolated areas, whose access to patients has decreased but that for the majority of health care providers, there did not appear to be any "crisis".
Unfortunately, this GAO report has grossly underestimated the true nature of the crisis of health care availability in our state. It is a fact that scores of physicians have closed their practices either by retiring early or have chosen another profession to pursue, or have severely restricted the scope of their practice.
The NSMA has performed several surveys of its members over the last 2 years asking physicians how they are responding to the steep rise of medical liability insurance premiums. Of the 223 physicians who responded to the latest survey (January 2003), 55 reported they have closed their Nevada practice because of rising liability costs; 20 reported they have closed their practice by retiring early due to increased liability costs; 13 are in the process of closing their practice; and 135 are "seriously considering" closing their practice for the same reason.
One other major measure of health care provider availability in the state that has been totally ignored by the GAO report and most everyone else is the fact that far fewer physicians are now moving to Nevada to practice medicine.
Over the last ten years, there have typically been 150 -250 newly licensed physicians annually who move to this state to practice medicine. These numbers represent an average increase of about 6.4% annually. For 2002, however, there were only 26 newly licensed physicians who chose to practice within the state, or an increase of only 0.6%, a 90% decrease when compared with the previous 10 years!
In Clark County, there were only 7 more licensed physicians practicing medicine in 2002 compared to 2001! Remember, this is at the same time that approximately 75,000 people moved into the county.
Another way to look at the problem of health care availability is to look at physician to resident ratios. In 1980, Nevada ranked 34th in the nation in physician to resident ratio (144/100,000 compared to the national average of 195/100,000). By 2001, Nevada had sunk to 48th in the country. (See the chart on page 14 for details.)
It seems abundantly clear to me that the residents of Nevada, and especially Clark County, are losing the battle of health care access badly, and there is no question in my mind that it is primarily a result of rising medical liability costs. It is imperative that we as physicians communicate this message to our patients and our legislators so that all understand the absolute necessity of passing KODIN in the November 2004 election.
I would like to congratulate Warren Evins on his excellent summary of the horrific costs of our current medical liability tort system in last month's County Line. For those who missed his front-page article, I highly recommend reading it and keeping it for future reference in our battle to convince voters to pass KODIN. (Previous newsletters are available to read on our web site: www.clarkcountymedical.org)
Some good news for a change: The Community College of Southern Nevada is planning to build a four-story Health Science Nursing building in time for the 2004 fall semester. This facility will accommodate twice as many registered nursing students as before. Once completed, the new facility will be able to admit 128 nursing students annually. According to Fran Brown, community college dean of the division of health sciences, this "will help [us] in meeting the need for health care workers in the Las Vegas Valley and for Southern Nevada". In addition, there are plans to start a new program in radiation oncology therapy. Currently, there is no such program in the state, and there is a high demand for radiation therapy technicians.
If you hadn't heard by now, our legislators passed a bill just a few short months ago requiring all medical licensees, including MD's, emergency medical technicians, nurses, dentists and dental hygienists, and PA's (although curiously not DO's) of this state to take four hours of training on bioterrorism before October 1, 2005. Unfortunately, any bioterrorism training prior to July 1 of this year will not qualify. The details of this legislative mandate are being formulated by our Board of Medical Examiners and will be presented at their next board meeting in December. Although they meet in Reno, the meeting will be video-transmitted to Las Vegas for those who would like to attend. They will also be holding a workshop on this matter before then for interested persons.
New Members for August 2003
Congratulations and Welcome to the Clark
County Medical Society
- Michael A Carducci, MD, Diagnostic Radiology, 2020 Palomino Ln #100, Las Vegas, NV 89106
- Russell P Jayne, MD, Ophthalmology, 6839 W Charleston Blvd, Las Vegas, NV 89134
- Robert H Odell, Jr, MD, Pain Management, 715 Mall Ring Cir #205, Henderson, NV 89014
- Jeffrey J Roth, MD, Plastic Surgery, 299 N Pecos Rd, Henderson, NV 89074
- Henri Wetselaar, MD, Family Practice, 3681 Forestcrest Dr, Las Vegas, NV 89121
- Paul T Wilkes, MD, Maternal/Fetal Medicine, 7720 W Sahara Ave #103, Las Vegas, NV 89117
Welcome Back to Reinstated Members
- Donald Johns, MD, Neurology, 2020 E Desert Inn Rd, Las Vegas, NV 89109
- Richard S Teh, MD, Internal Medicine, 9410 Del Webb Blvd, Las Vegas, NV 89134
- Robert B McBeath, MD, Urology, 5701 W Charleston Blvd #201, Las Vegas, NV 89146
- Sheldon Stein, DO, Osteopathic Medicine, 4550 E Charleston Blvd, Las Vegas, NV 89104
- Jerald Malone, MD, Family Practice, 4550 E Charleston Blvd, Las Vegas, NV 89104
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
- Stuart A Engel, MD General Surgery
- Maureen K McCormack, MD Diagnostic Radiology
- Jason W Pollock, MD Ob-Gyn
- Keita Sakon, MD Ob-Gyn
For information on becoming a member of the Clark County Medical Society, call Marlaina Burns at 739-9989
Referral Tallies – Third Quarter
The following referrals were provided to CCMS members in the third quarter of 2003 (through September 19)
Specialty Referrals
Addiction Medicine 0
Allergy 3
Anesthesiology 1
Cardiology 9
Cardiovascular Surgery 4
Colon & Rectal Surgery 1
Dermatology 8
Diagnostic Radiology 0
Endocrinology 15
Family Practice 31
Gastroenterology 4
General Surgery 5
Geriatrics 4
Gynecologic Oncology 36
Hematology 4
Infectious Medicine 2
Internal Medicine 38
Nephrology 3
Neurology 9
Neurosurgery 5
Ob-Gyn 33
Oncology 12
Ophthalmology 9
Oral/Maxillofacial Surg. 0
Orthopaedic Surgery 24
Otolaryngology 7
Pain Management 8
Pathology 1
Pediatrics 7
Ped. Psychiatry 0
Ped. Surgery 0
Physical Med/Rehab 3
Plastic Surgery 9
Preventative Medicine 0
Psychiatry 12
Pulmonology 4
Radiology 0
Rheumatology 10
Urology 8
Vascular Surgery 1 .
Total 330
CCMS NEWS
Voter Registration is Urgent
The Clark County Medical Society and the CCMS Alliance announces Voter Registration in physicians’ offices. Voter registration is low cost, involves minimal time requirement and allows your patients to assist in accomplishing Medical Malpractice tort reform. Stay tuned for monthly updates.
HealthInsight hosts Seminar
HealthInsight, the Medicare Quality Improvement Organization for Nevada and Utah, will be hosting “Designing Systems for Quality and Safety” from 8 a.m. to 3 p.m. on Tuesday, October 21 at The Palms Casino Resort.
The seminar, held as the third in a series of six collaborative learning sessions, has been developed to help improve the effectiveness and safety of care delivered in a number of settings. Communication strategies and information management will be key issues discussed, along with solutions to common problems that will aid in the reduction of errors.
All health care professionals are invited to attend this free course, which will provide physicians up to 5.25 Category I CME credits. To register for the course or for any questions, contact Shari Nelson with the HealthInsight office in Salt Lake City at (801) 892-6622 or e-mail her at snelson@healthinsight.org.
OB-GYN PHYSICIAN LIST REQUEST FOR CORRECTIONS
By Marlaina
Burns, CCMS Membership Coordinator
The Clark County media, as well as statewide and national medical organizations, have challenged the assertion that a significant number of obstetricians have moved out of state, changed their practices to GYN only, retired, or closed their practice due to the medical malpractice crisis. I have recently updated the attached list. CCMS plans to make it available to inquiring media and other interested parties for their own edification.
Due to space requirements, we are unable to publish the entire list but members are invited to call CCMS to receive a copy of the full list. My research indicates 94 OB-GYNs are practicing in Southern Nevada, including those exclusively with Southwest Medical Associates or UMC. (One of these physicians is on a temporary leave of absence.)
On the following page is a list of the OB/GYN physicians who presumably made changes to their practice due to the ongoing crisis. The remaining licensees are practicing an OB-GYN subspecialty or made changes to their practice prior to 2001.
Kindly peruse the list and call me at the Clark County Medical Society, 739-9989, with any corrections or comments.
CEO Editorial
By Weldon (Don) Havins, M.D., Esq., CCMS CEO
and Special Counsel
"TORT REFORM" IN OTHER STATES
On Saturday, September 13, 2003, the voters in Texas amended their state Constitution to provide that the Legislature could set caps on noneconomic damages on all civil lawsuits. Last year, the legislature passed a bill limiting noneconomic damages to $250,000 against physicians in medical negligence lawsuits. Now this amendment to the Texas Constitution should make it impossible for the courts, including the Texas Supreme Court, to find "unconstitutional" this kind of statutorily provided limitation on damages in civil lawsuits.
This contrasts to Mississippi's recent "tort reform" limitation on noneconomic damages. Mississippi passed a cap of $500,000 on noneconomic damages which will be raised to $750,000 in 2011, and then to $1,000,000 in 2017. The "limitations" on noneconomic damages do not apply if the plaintiff is disfigured by the physician's negligence or if the judge determines that the jury can award punitive damages. HHS reports published in July 2002 and March 2003 indicate that noneconomic damage caps (firm caps) above $350,000 have not demonstrated any ameliorative effect on professional liability insurance premiums. Mississippi physicians are not optimistic that their "tort reform" will have any beneficial effect on their skyrocketing malpractice insurance premiums. Mississippi did eliminate joint and several liability however, in all civil actions.
Ohio passed a noneconomic damages cap of the greater of $250,000 or three times the plaintiff's economic loss, not to exceed $350,000 per defendant or $500,000 for each occurrence of malpractice. Where medical negligence has caused the loss of a limb, "permanent" injury, or substantial deformity, the cap is raised to $500,000 or $1,000,000 per occurrence. Ohio established several liability (proportionate fault liability) for noneconomic damages and bars recovery by the plaintiff if the plaintiff is more than 50% at fault. Further, defendants found 50% or less at fault are only responsible for their proportionate share of the plaintiff's economic damages (elimination of joint and several liability for economic damages where the defendant is 50% or less at fault).
Oklahoma limits to $300,000 awards for medical services for pregnancy, labor, or delivery, as well as for ER care. However, the cap does not apply in cases where the judge finds by "clear and convincing evidence" that the defendant committed medical negligence in a wrongful death case.
In West Virginia, which had experienced a profound exodus of physicians, the voters elected four physicians to the lower legislative house and elected the executive director of the state medical association to the State Senate. West Virginia subsequently lowered its cap on noneconomic damages from $400,000 to $250,000 for each occurrence of malpractice. Where medical negligence involves certain specified injuries or wrongful death, the cap is raised to $500,000 per occurrence. Like Nevada, these caps do not apply unless the physician has at least $1,000,000 in professional liability insurance.
The voters in Idaho reduced their unworkable noneconomic damages cap from $400,000 to $250,000 for each occurrence of medical malpractice.
A.B. 250
The legislature passed, and the Governor signed, a bill requiring all medical doctors, physician assistants, all licensed nurses and all licensed dentists (but no Osteopathic Physicians) to complete, before October 1, 2005, a four hour continuing education course in Bioterrorism and Weapons of Mass Destruction. The BME's proposed regulation regarding this statutory mandate requires the four hours to be in an AMA Category I Credit course which, incidentally, is in addition to the 40 Category I Credit hours requirement for biennial licensure renewal. The course must include the following subjects:
1. an overview of acts of terrorism and weapons of mass destruction;
2. personal protective equipment required for acts of terrorism;
3. common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive, and nuclear agents;
4. syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and
5. an overview of the information available on, and the use of, the Health Alert Network.
Nancy Gerken of the Clark County Health District has developed a course for licensed nurses. Karen Seale of the Southern Nevada Area Health Education Council is, at the time of writing this article, developing a Category I CME course to comply with the statutory mandates. Several CCMS physicians with military expertise in the subject matter have volunteered to assist in developing a CME to comply with the statute. While there probably will be additional sources of CME aimed at complying with the law, the Southern Nevada Area Health Education Council has federal grant money to educate health care providers in this subject matter. Southern Nevada AHEC officials anticipate making the Category I CME available on CDROM as well as on VHS. At the time of this writing, Karen Seale of Southern Nevada AHEC states that the "live" program should be ready be in early November, with the CDROM and VHS available thereafter. The specific date for availability of the CME "enduring media" (CDROM and VHS) will depend on a state commission approval of the program.
One concern raised in some minds is the effect this statutory mandate will have on the nearly 1,000 Nevada licensed medical doctors who do not practice in Nevada. Will a substantial portion of them drop their Nevada license, or have their license suspended or revoked for non-compliance with the statute? What effect will this have on NBME revenue? Will an increase in re-licensure fees be required to make up the shortfall?
ARE PHYSICIANS LEAVING CLARK COUNTY?
In this issue of the County Line is a chart of OBGYNs suspected of changing their practice from 2001 to present due to the medmal crisis. (The full list of OBGYNs is available by calling 739-9989.) Some of these medical doctors have moved out of state, some have retired, and some have suspended performing obstetrics due to medical liability concerns. Marlaina Burns, our Membership Coordinator, requests that you peruse the list and call her at 739-9989 with corrections.
Larry Matheis, Executive Director of the Nevada State Medical Association, has performed a thorough analysis of the 2002 Annual Report of the Nevada Board of Medical Examiners. Larry's analysis sustains NSMA's contention that there has been, particularly in the last two years, a disproportionate number of licensed Nevada medical doctors leave Nevada for practice in other jurisdictions. This conclusion appears to counter an interpretation of the General Accounting Office report of August 2003 stating there has been no significant increase in the number of experienced medical doctors leaving Nevada.
A graph and chart on page 14 demonstrates the growing disproportion between the number of physicians per 100,000 population in Nevada compared to the numbers nationally. While known that Nevada has the lowest number of nurses per capita, it appears that Nevada may be heading for the dubious distinction of the worst physician to population ratio in the United States. With this trend, it is not surprising that the Tuoro School of Osteopathic Medicine has announced intention to establish a school of osteopathy in Southern Nevada.
Alliance Message – Greeting Card
Project begins
Greetings from the Clark County Medical Alliance.
These are desperate times and it is not the Golden Era for doctors. There are more than a few problems and challenges facing our medical community, but there is one overwhelming problem that we think we can do something to change. WE NEED NURSES! We have two new hospitals opening and continue to witness thousands of new residents immigrating to our community every month, but still no NEW nurses.
Clark County Medical Society Alliance is again sponsoring the Holiday Greeting Card Project. This project has been very successful in recent years, and we have been able to provide thousands of dollars to those in need. In previous years, we have sponsored nursing awards in addition to local charities. The project's continued success depends on YOUR support. This year, the revenue from this project will be earmarked for nursing scholarships!
Conveniently, this project also provides an opportunity for physicians to send Holiday greetings to friends and colleagues. All those who contribute a check in the amount of $50.00 will have his/her name and spouse's name listed inside the greeting card.
We would like to encourage additional donations of $150.00 for corporations or group practices, which will be listed separately following the alphabetical listing of physician's names in the greeting card. The corporation or group name will be listed in addition to the name of each individual physician donor. The greeting card will be sent to every physician in Southern Nevada, and our plan is to send it to the physicians' homes rather than their offices.
PLEASE COMPLETE THE ENCLOSED INFORMATION FORM and spell your name (and hopefully also your corporation's name) exactly as you wish it to be printed on the card. Please also fill in your home address. We assure you that your home address will be kept strictly confidential.
Please ENCLOSE YOUR CHECK, made payable to the CCMSA, and return it no later than Friday, November 26, 2003. It would be better to send a separate check for each physician who wishes to be listed on the card, so there is no confusion about which physicians are to be named. Please do not use the name of a group practice for the individual physician donations, but we would certainly appreciate the additional donation to list the name of your corporation or group practice.
Your donation will ensure our continued commitment to the Las Vegas Community.
If you have any question, please call Estela Hansen at 702-496-0456.
CCMSA GREETING CARD PROJECT ORDER FORM
PLEASE PRINT NAMES. We use first names of the physician and
spouse. Enter names exactly as you wish
them to appear on the card.
ENCLOSE $50.00 or more FOR EACH PHYSICIAN
WHOSE NAME IS TO APPEAR.
Enclose $150.00 or more for each
corporation name.
Please provide HOME ADDRESS and Zip Code
for the receipt of completed card. Please provide phone number to contact you
if we have any questions regarding your name or address.
RETURN TO:
Estela Hansen, 612 Runbridge
Street, Las Vegas, NV 89144
DEADLINE:
November 26, 2003
__________________________________________________________________________
Spouse (First Name) Physician (First Name)
__________________________________________________________________________
Last Name
__________________________________________________________________________
Home Address with Zip
Home Phone #
____________________________________________________________
__________________________________________________________________________
Corporation Name
Minutes Synopsis
(Members can receive a full copy of meeting minutes by calling 739-9989.)
CLARK COUNTY MEDICAL SOCIETY BOARD OF TRUSTEES MEETING
Tuesday, August 19, 2003; 6:00 P.M.
Action Items
- The minutes from the Executive Council meeting July 15, 2003 were approved
- Martha Ford of Percy, Taylor, Bowler and Kearns, reported on the annual compilation of CCMS financial statements. She stated it was fairly remarkable CCMS ended the fiscal year with an increase of approximately $50,000 in net assets.
- She performed an analytical test for the dues revenue collected. The actual dues revenue was $247,295 which was a difference of $855 from the analytical dues total of $248,150. This difference is explained by the fact the analytical uses the average number of members which was 722.5 but the actual number of members was 720. This variance was only about 1/3 of a percent. Ms. Ford stated that anything less than one percent was extremely good for an analytical variance. She stated she found nothing al all that would raise any concern on the recording or tracking of the revenue.
- The second test was a random selection of 30 checks tested for authorization and supporting documents. No exceptions were found in the sample of the 30 checks.
Financial Report
- In Dr. Steinberg's absence, Dot Freel reported the first month of the fiscal year financial report.
Committee Reports
- The following members were approved for membership:
- Jeffrey J Roth, MD - General Surgery, Michael A. Carducci, MD - Diagnostic Radiology, Russell P. Jayne, MD - Ophthalmology, Robert H. Odell, Jr, MD - Pain Management, Henri Wetselaar, MD - Family Practice, Paul T. Wilkes, MD - Maternal/Fetal Medicine.
- Dr. Cohler reported there are 2 letters of objection to a member applicant. An ad hoc committee was assigned to evaluate these complaints.
- Dr. George Merino submitted a letter requesting "retired" member status which was granted unanimously by the Executive Council.
- Dr. Bernstein discussed his committee's recommendation that CCMS sponsor a lecture by Dr. Jay Levy, AIDS/HIV expert and committee member Dr. Abu-Samrah is seeking a sponsor.
- The Executive Council endorsed recommending training sessions for the staff at doctors' offices to register patients to vote.
Old Business
- The Executive Council approved Dr. Kingsley's stated goals for this year, including 1) focusing on reducing the malpractice insurance crisis, 2) informing non-members of the benefits of membership, 3) encouraging members to be more active, 4) preparing for the next legislative year, and 5) gearing up for the KODIN Initiative, which will be on the 2004 ballot.
- The KODIN information packets were distributed to attendees and will be submitted to the entire board at the next BOT meeting. It was reaffirmed that CCMS endorses Initiative Petition 1.
- Dr. Havins explained the graphs which show doubling in the frequency of healthcare providers being sued in Clark County District Court since 2001. A summary of the MDSP results since 1986 was distributed. In 1175 of 2121 cases the MDSP finding was "no probable malpractice". Of those, 52% (604 doctors) were not subsequently filed against in District Court.
New Business
- Dr. Kingsley announced the passing of member George Wirges.
- The Executive Council will officially thank Dr. Kazem Fathie and Dr. Joel Bower for their time served on the Nevada Medical Credentialing Board, and recommends the full BOT begin searching for another representative to assign to the NV Medical Credentialing Board. Dr. Mitch Keamy will be asked to submit a (one page) written report on the status of the organization as an update for the edification of the full Board at the next CCMS Board of Trustees meeting.
- Dr. Colletti attended a meeting of the Nevada Medical Industry Cluster Group. Their number one legislative priority will be the passage of the KODIN Initiative Petition.
The next full Board Meeting is scheduled for Tuesday night, September 16, 2003 at 6:00pm.
There being no further business, the meeting was adjourned at 8:00pm.
CME Calendar
American Back
Society 510-536-9929
- 11/13-11/15 - “Advanced Diagnosis & Treatment for Neck & Back Pain,” Riviera Hotel, up to 24 CME hours (40% discount for CCMS members)
Cardiovascular
Consultants 691-9154
Clark County Medical
Society 739-9989
HealthInsight
(801) 892-6622
- 10/21 - “Designing Systems for Quality and Safety: A Collaborative Approach,” 8 a.m. at the Palms Casino Resort, 5.25 CME hours
St. Rose
Hospital 616-5832
Southwest Medical
Associates 242-7347
- 10/9 - “Neuro-Interventional Radiology (Aneurysm, Stroke, and AV Malformation)”
Summerlin
Hospital 233-7572
- 10/4, 10/18, 11/1 - “Bioterrorism and Weapons of Mass Destruction Training,” 8 a.m., 7.5 CME hours
Sunrise Hospital 731-8210
UMC 383-2604
- 10/2 - “Mammography & Sterotactic Biopsy,” 12:15 p.m., 1 CME hour
- 10/9 - “Staging & Surgical Therapy,” 12:15 p.m., 1 CME hour
- 10/10 - “Pediatric Grand Rounds,” 7:30 a.m., 1 CME hour
- 10/16 - “Radiation Therapy,” 12:15 p.m., 1 CME hour
- 10/17 - “Medical & Surgical Case Studies in the Management of Heart Failure,” 7:30 a.m., 1 CME hour
- 10/23 - “Chemotherapy,” 12:15 p.m., 1 CME hour
- 10/24 - “Prehypertension - Redefining High Blood Pressure Parameters,” 7:30 a.m., 1 CME hour
Valley Hospital 388-4847
- 10/14 - “Ophthalmology for Primary Care Physicians,” noon
- 10/28 - “The Safety Initiative,” noon
*Special Note: CCMS members can receive free CME courses on the internet with World Medical Leaders.
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.
Clark County Health District Disease Statistics* -
August 2003
DISEASE CASES REPORTED YEAR TO DATE
Aug 2002 Aug 2003 2002 2003
VACCINE PREVENTABLE DISEASES
DIPTHERIA 0 0 0 0
HAEMOPHILUS
INFLUENZA 1 4 5 8
(invasive)
HEPATITIS A 3 0 16 9
HEPATITIS B 2 7 28 45
INFLUENZA 0 0 59 47
MEASLES 0 0 1 0
MUMPS 0 1 2 2
PERTUSSIS 5 5 18 14
POLIOMYELITIS 0 0 0 0
RUBELLA 0 0 0 0
TETANUS 0 0 0 0
ENTERICS
AMEBIASIS 3 1 14 12
BOTULISM-INTESTINAL 0 0 0 1
CAMPYLOBACTERIOSIS 11 13 81 60
CHOLERA 0 0 0 0
CRYPTOSPORIDIOSIS 0 0 2 5
E. COLI
O157:H7 2 9 11 14
GIARDIASIS 9 7