Our annual Nevada State Medical Association meeting this year, for the first time in many years, will be held in Las Vegas. This represents an excellent opportunity for those of you who do not usually attend. The meeting will be held at the Alexis Park Resort from April 27-30.

Why attend? First, to interact with the people who deal with tort reform, who coordinate efforts for all legislative medicine-related issues and who deal with the regulatory issues that affect us every day. This is your chance to have direct input into these activities, to act instead of complain.

Second, to voice your opinions about the mission and purpose of our organization. Do you see a need for change? Now’s your time to be heard.

Third, to exchange ideas with physicians from throughout the state and from many specialties about any topics - from problems with hospitals or insurance companies, to public health issues.

Fourth, to participate in CME, which will cover several different timely topics this year, now being finalized.

Fifth, to have fun. There are many events for members and spouses or guests to enjoy.

An additional incentive this year is that the Clark County Medical Society will reimburse the registration cost (approximately $300) to members who will serve as delegates. To receive this reimbursement, you must attend at least the opening and closing sessions of the meeting.

To find out more, call Dot Freel at the Society, 739-9989, or any board member.

See you there!

Marietta

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President’s Message

By Ron Kline, MD, 2005-2006 CCMS President

The following is Dr. Kline’s testimony to the Pharmacy Board:

Good Morning. My name is Ron Kline, and I am the President of the Clark County Medical Society. I am a pediatric hematologist-oncologist practicing in Las Vegas and I speak for the 850 members of our society.

The Clark County Medical Society supports the full implementation of AB 195 passed by the legislature in 2005 and signed by the governor. Although we are not legal experts, we believe the intent of the legislature was clear, and that legal acrobatics should not thwart the will of the people's elected representatives. In reviewing the legislative discussion prior to the passage of the bill, it is clear to us that the reference to FDA approved drugs rather than drugs approved by Canada's Health Protection Branch was intended to prevent the importation of the occasional drug approved in Canada but not approved in the United States. It was NOT intended to be a legal loincloth used to thwart the legislative intent of this bill.

As physicians, drugs are the tools that we use to practice the art of medicine. When our patients cannot afford the medicines we must dispense to heal and prevent illness, our life's work is sacrificed to the profits of the pharmaceutical industry. We are sensitive to the needs of the pharmaceutical industry to earn a reasonable profit. We are also sensitive to the time, effort, and risk that goes into the development of each new drug; but when drugs in the Unites States cost 50 to 100 percent more than they do in Canada, then it is clear to us that consumers in the United States are shouldering a disproportionate burden of the costs of medical research because of inefficiencies in our health care system.

It is usually at this point in the discussion that some harbinger of doom predicts that life-saving drugs will not be available to Americans unless we continue to pay twice what other nations pay for their drugs. If this is in fact true, then those same dark souls should be able to easily document numerous drugs available in the United States that are not available in Canada or Europe. The plain fact is that they cannot. All of the drugs we have available here in the United States are available in other developed countries with equally stringent quality control mechanisms, at half the price. In fact, if they were not, then we would not even be sitting here today debating this issue, because the drugs we need would not be available for purchase in Canada. They are!

The current debate reminds me of the debates of a decade ago about the addictive characteristics of nicotine. We all remember those tobacco company CEO's raising their hands in unison and swearing that nicotine was not addictive, even though their internal documents for decades back showed clearly that it was. They were on the wrong side of history; they were trying to defend the indefensible.

Our pharmaceutical companies have made billions of dollars selling drugs in the United States for twice the price that they were sold for in other countries. Fortunately for US consumers, computer technology allows us to discover these amazing price differentials quite easily; and our geographic proximity to Canada has made this practice unworkable. They too are on the wrong side of history; they too are trying to defend the indefensible.

The Clark County Medical Society sincerely hopes that the Nevada Board of Pharmacy will not try to defend the indefensible. We hope you will make the right decision for the people of Nevada. Thank you.

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Clark County District Court Medical Malpractice Filings

Against Health Care Providers, Jan 2001 – December 2005

2001 2002 2003 2004 2005

Jan 39 33 108 61 41

Feb 20 14 98 72 63

Mar 35 30 169 123 64

Apr 37 34 111 81 70

May 37 35 126 65 14

Jun 27 24 103 90 65

Jul 19 100 114 45 66

Aug 54 51 76 67 33

Sep 20 65 105 79 36

Oct 37 83 110 59 26

Nov 38 184 59 78 68

Dec 9 170 67 47 30

Sum 372 823 1246 867 581

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Reinstated Members

· Dean L Mondell, MD, Physical Med/Rehab

· Joseph M Gnoyski, MD, Physical Med/Rehab

· John B Bedotto, MD, Cardiovascual Disease

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

***New Member Special*** $390 New members can join for half price their first year.

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CEO Article

By Weldon (Don) Havins, M.D., Esq., CEO, Special Counsel

MANDATED REPORTING OF SURGERIES WITH CONSCIOUS SEDATION

Assembly Bill 555 contains a mandate requiring reporting of surgeries using sedation to their licensing board by medical doctors and doctors of osteopathic medicine. The "number and type of surgeries requiring conscious sedation, deep sedation, and general anesthesia" performed by a licensee at his office or any facility, except those performed at a medical facility as defined in NRS 449.0151, must be reported. NRS 449.0151 enumerates the excepted facilities.

NRS 449.0151 "Medical facility" defined. "Medical facility" includes:

1. A surgical center for ambulatory patients;

2. An obstetric center;

3. An independent center for emergency medical care;

4. An agency to provide nursing in the home;

5. A facility for intermediate care;

6. A facility for skilled nursing;

7. A facility for hospice care;

8. A hospital;

9. A psychiatric hospital;

10. A facility for the treatment of irreversible renal disease;

11. A rural clinic;

12. A nursing pool;

13. A facility for modified medical detoxification;

14. A facility for refractive laser surgery; and

15. A mobile unit.

“Sentinel events”, defined in the Bill as “an unexpected occurrence involving death or serious physical bodily or psychological injury or the risk thereof,” including “the risk of loss of limb or functio” must also be reported. The term “surgeries” is not defined in the Bill.

The reporting must be accomplished on a form developed by the respective regulatory Boards. The two Boards coordinated their efforts and produced a common reporting form. You should have received the reporting form from your Board recently.

The Boards' reporting form does not consider the exception to the reporting requirement when oral medication is/was administered to a patient only to relieve a patient's anxiety or pain, if that medication is given in a dosage insufficient to induce a controlled state of depressed consciousness or unconsciousness similar to general anesthesia, deep sedation or conscious sedation. "Surgeries", wherein only oral anxiolytics (Valium, for instance) or oral pain medication (Tylenol #3, for instance) is administered, are not required to be reported.

Several radiologists and radiological oncologists have queried the Medical Society as to whether "radiology" procedures are considered "surgeries". Often, radiologists will mildly sedate a patient before a procedure (Valium 10 mg before an MRI, for instance) to reduce the anxiety of the procedure. These procedures do not "induce a controlled state of depressed consciousness" and therefore would appear not to require reporting, under the exception.

How this provision found it's way into a Bill sponsored by Assemblyman Dr. Garn Mabey is instructive of the political lawmaking process. The Nevada Board of Medical Examiners, due to changes in administrative leadership and other distractions, did not find a sponsor for the Bill they intended to have introduced in the Legislature. AB 555 was a rare "shell" Bill Dr. Mabey had reserved months earlier. The Medical Board approached Dr. Maybe to "carry" their Bill. After consulting with the medical societies, Dr. Mabey agreed to carry the Medical Board's legislation in AB 555. Those provisions are found in Section 2 through 8 in the final version of AB 555.

How did the other provisions get into the Bill? Assemblywoman Susan Gerhardt, a Democrat from Green Valley, submitted AB 120 at the beginning of the legislative session. This Bill contained the reporting mandates. The original Bill was amended in the Assembly to require annual, rather than biennial reporting, and provided the specific information was confidential. This Bill passed out of the Assembly with only 6 dissenting votes. It was apparent to Assemblyman Dr. Garn Mabey and Senator Dr. Joe Heck that the Bill might tend to induce physicians to avoid providing pre-procedure anti-anxiety and/or pain medication to patients. Therefore, in the Senate Commerce and Labor Committee, upon which he sits, Senator Heck amended AB 120 to provide for exceptions to reporting when only oral medications were used before surgery to reduce anxiety or pain. AB 120 appeared to die on the Senate floor, largely through the efforts of Senator Sandra Tiffany who expressed doubt that such reports were necessary and would only increase the paperwork burden on physicians to no positive effect. AB 120 never received a vote on the Senate floor.

Many physicians wanted the Good Samaritan Act (NRS 41.505) amended so that physicians could render gratuitous medical services in their offices for governmental entities and nonprofit organizations and receive medical liability protection. The Good Samaritan Act provided only for liability protection if the physician rendered the medical services in the healthcare facility of the governmental entity or nonprofit organization. This restriction eliminated the availability of many specialists who require sophisticated equipment and staff, available only in their office, to care for patients. Senator Dennis Nolan presented Senate Bill 316 containing the provisions expanding the Good Samaritan laws to permit the gratuitous medical care with liability protections. Dr. Brad Selgestad, a senior UMC clinic physician, presented compelling testimony to the Senate Commerce and Labor Committee of the practical necessity of expanding the Good Samaritan law to include this provision. SB 234 passed the Committee unanimously and passed out of the Senate without a dissenting vote. SB 234 was then assigned to the Assembly Judiciary Committee where Committee Chairman Bernie Anderson refused even to bring the Bill up for discussion. SB 234 died in the Assembly.

Death is a relative thing in the Nevada Legislature. AB 120, the sedation reporting Bill, was dead in the Senate, and SB 234 was dead in the Assembly. Dr. Mabey's Bill, AB 555, the Bill of the Nevada Board of Medical Examiners, however, made it through the Assembly and through the Senate. However, because the Bill had minor differences between the Assembly and amended Senate language, the Bill went to a joint conference committee at the near-end of the legislative session when "the rules" were suspended. Joint Conference Committees (JCC) contains two members of the majority party and one member of the minority party from each House. The JCC consisted of 3 Republican and 3 Democrats. Assemblyman Mabey realized the importance of expanding the Good Samaritan law to provide liability protection to physicians rendering gratuitous medical services to uninsured and poor Nevadans. The Democrats on the JCC wanted Assemblywoman Gerhardt's sedation reporting mandates to go forward into law. Each party could block the other's wishes, but in doing so they would kill the NBME's provisions which their effective lobbyist, Mr. Keith Lee, insisted were critical to protection of the public by the Medical Board.

Thus, each side amended their otherwise moribund provisions into AB 555, and that amended AB 555 passed both the Senate and Assembly unanimously.

This is an example of how law is made in Nevada. Health care providers are so very fortunate to have Assemblyman (and Minority Leader) Dr. Garn Mabey and Senator Dr. Joe Heck in the Legislature, along with the excellent Assemblyman Dr. Joe Hardy. These dedicated public servants richly deserve our adulation, and our political support.

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Board of Trustees Elections are Upcoming

Attention All Members:

The Nominating Committee's slate for the 2006-07 Board of Trustees will be mailed to the entire membership in March.

If you are interested in becoming a nominee, please inform the CCMS staff at 739-9989 as soon as possible.

2006 Nominating Committee

Frank Nemec, MD - Chair

Michael Colletti, MD

Warren Evins, MD

Ed Kingsley, MD

Ronald Slaughter, MD

Annette Teijeiro, MD

Michael Verni, MD

Per the CCMS bylaws, the committee must choose their slate from physician members having two or more years membership and having served on a standing committee in the previous five years. If you do not meet the committee criteria, you can still be nominated by any voting member. Your endorsement must bear the signature of 4 voting CCMS members in good standing. All nominations must be submitted in writing before April 15, 2006.

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MedPac 2006

By CCMS MedPac Chairman, David Steinberg, MD

Dear Colleagues:

It seems like the battles in the last Legislative session, the fight "to the death" over Ballot Question 3 tort reform, and the war to turn back the trial lawyers Questions 4 and 5 were just yesterday. However, the next Legislative election is already upon us. Excellent Legislators who support medicine and access to quality medical care are formulating strategies for their re-election. Candidates who are pro-medicine are now asking for and need our financial support. This is the first Legislative session where the provisions of Nevada's medical tort reform can be amended (as long as the amendment becomes effective after November 24, 2007). This Legislature could "wipe-out" some or all of the hard fought tort reforms we all labored so hard to make a reality. This must not happen.

There is already talk among some plaintiff trial lawyers of pushing for the passage of a medical "three strikes law" - that is, three findings of medical malpractice against a physician and the physician's license is revoked. Ridiculous you say? It is the law in Florida now. Many Florida docs are complaining that this law is just a means to extort unjustified settlements in frivolous medical malpractice suits (because "settlements" are not "findings" of medical malpractice). You think your medmal premiums are reasonably affordable now, and that you have never been sued for malpractice? Just imagine what will happen if this law passes in Nevada!

Physicians must support those who supported us during the last Legislative session, and support those who will support our Legislative concerns in the next Legislative session - incumbent or candidate. To be successful, we must have your contribution. Political contributions are now just a fact of life in the practice of medicine. You can contribute a reasonable amount now, or you can pay a whole lot more in the foreseeable future. Or you can move to California ("Taxifornia" where state income tax alone is over 11%) or Florida (where you can't even purchase 1million/3 million medmal insurance in most counties, and the rates are impossibly high for what is available).

Because of the tremendous effort of the health care community, Nevada now has one of the very best tort reform laws in the Nation. If we want to keep it, each of us must pay for good government operating under good laws - and that means good Legislators. For that, we must have your contribution of $300.00.

Please send your $300.00 check NOW to:

MEDPAC

2590 E. Russell Road

Las Vegas, NV, 89120

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Clark County Health District Report

By Donald Kwalick, MD, MPH, Chief Health Officer

Syphilis cases on the rise in Clark County

During the past several years, cases of syphilis reported to the Clark County Health District have significantly decreased, with 61 primary and secondary cases being reported from 2000 through 2004. However, in 2005 the health district received reports of 102 primary and secondary cases. Also of note, six cases of neurosyphilis were reported during the past year.

In response to this outbreak, the health district formed a task force composed of district staff with expertise in the Sexually Transmitted Disease clinic and HIV and STD surveillance and prevention projects. Additionally, the Centers for Disease Control and Prevention (CDC) was contacted and a pre-deployment Rapid Response team visited Clark County to advise the community regarding interventions designed to curtail the spread of primary and secondary cases.

While the increase in local cases mirrors an increase occurring nationally, an analysis by the CDC revealed unique characteristics of the local outbreak. A review of the available data indicated there is no readily identifiable at-risk population. The conclusion drawn by the CDC team is that there is a "rainbow effect" in Clark County, meaning cases of primary and secondary syphilis have been identified in a range of age groups, racial and ethnic groups, and all genders. This differs from previous outbreaks which primarily have affected men who have sex with men.

The health district has employed a number of recommended interventions and strategies to combat the outbreak in our community. The health district partnered with CDC to train nine additional disease investigation specialists in syphilis intervention, as well as co-morbid sexually transmitted infections/diseases. The health district has also worked to enhance community education of health care providers through Grand Round presentations and the distribution of information.

In related activities, the health district assembled a strike team of staff from the STD and HIV surveillance projects to: identify persons potentially at high risk for syphilis; identify characteristics of infected persons; develop hypotheses regarding risk factors and to design and target interventions.

The ongoing response of health district staff includes contacting persons infected with syphilis, or their reporting health care providers; ensuring patients with early syphilis are staged correctly, treated with appropriate therapy and offered partner-management services to prevent re-infection and additional transmission by sex partners.

In order for the health district to be successful in its response to this outbreak, it relies heavily on reports from diagnosing clinicians. It is important for health care providers to keep in mind syphilis infections should be categorized and reported by stage at the time of initial examination, not at the time of treatment or interview. Primary and secondary stage determination should be based on clinical, as well as serological information or an epidemiological link to another confirmed case.

All cases of suspected or confirmed syphilis must be reported to the health district within one working day, per Nevada Revised Statutes (NRS 441A.210) and the Nevada Administrative Code (NAC 441A.695). To report a case, health care providers can call the syphilis hotline at (702) 759-0888. Complete treatment guidelines for all STDs are available at www.cdc.gov/STD/treatment. The health district has also created an informational web site for the public that can be accessed at http://www.cchd.org/syphilis/syphilis_main.htm.

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Alliance Message

By Shanila Choudhury, 2005-06 CCMS Alliance President

I would like to wish everyone a very Happy New Year and invite you all to continue supporting the CCMSA with its philanthropic endeavors for many local charities. My board and I are busy in planning our upcoming yearly fundraiser and are making sure it will be and event to be remembered.

The Clark County Medical Society Alliance

5th Annual Spring Fashion Show

"Think Pink"

Benefiting the

Susan G. Komen Breast Cancer Foundation

Special Guest Paula Francis

Silent Auction

And other Surprises

On Tuesday, March 14, 2006

At 10:30 am

At Caesars Palace Augustus Ballroom in the

Palace Tower

Cost

$100 Charitable Donation

This is a Pre-paid event.

Please buy your tickets

As soon as possible.

For tickets and more information contact

Shanila Choudhury at

(702) 355-2019

or email Choud@aol.com

for more information

go to out website www.ccmsa-lv.org

For those of you, who would like to advertise in our program book, please contact Estela Hansen for more details at 240-3149 or 496-0456 cell. We are expecting 300 to 500 people. This is an event open to the public and a chance for us to let the community know the physicians and their families are making a difference here in the Las Vegas Community.

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Nevada State Medical Association’s 102nd Annual Meeting and Scientific Session

Mark Your Calendars! April 27-30, 2006 at the Alexis Park Resort in ***Las Vegas, Nevada***

This is the first time in years that this meeting will be held in Las Vegas. We need Delegates. We hope to have the best attendance ever. The number of Delegates we are allowed is based on a percentage of our membership. Last year we could have had 36 Delegates and we only had 11. This annual meeting determines the policies and programs of the Association. Listed below is a sample of what happens at the annual event:

1. A half day Scientific Session

2. President’s Luncheon (usually has an interesting speaker)

3. Very Informative Governmental Affairs Meeting

4. Reference Committee meetings where resolutions are discussed and perfected to become policy

5. Dinner and Awards ceremony where the NSMA and NSMAA Presidents are inaugurated

This year the Delegation Chair for CCMS is Dr. Marietta Nelson. Please call Dot Freel at 739-9989 to sign up or get more information.

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Classifieds

highest percent reimbursement: Shortest turnaround time, we work with your patients to answer all billing questions. Electronic submission, 10 years experience. The Billing Office, LLC, accurate, fast, personable, lowest price. Interested? Skeptical? Diane will anwer your questions, (702) 992-0890.

Attractive medical office suite available FOR SUBLEASE: March 2006, 3,128sqft available. 10001 S Eastern Avenue, Suite 407, Henderson, NV 89052 (Del Webb Medical Plaza/St Rose Hospital. Contact Mgr. @ Children’s Bone and Spine, 702-434-6920.

NEW MEDICAL OFFICE AVAILABLE FOR LEASE: Windmill Medical Center, 1,500-5,000sqft available, 1525 E Windmill Lane, Las Vegas, NV 89123 (I-215 & Windmill). Lease rate $2.00sqft + NNN and $40sqft TI Allowance. Contact Mgr @ Children’s Bone and Spine Surgery. 702-434-6920.

general practice physician: PRN physician for physical exams. Must have current license; recent family/internal/occ med experience. Residency program new graduate acceptable. Hourly rate + paid malpractice. Email jobops21738@yahoo.com or fax 1-888-999-2594-EOE.

house for rent: Located inside RedRock Country Club, 3 bedrooms, 31/2 baths, 3 car garage, custom landscape, view of water, golf course mountains, easy access to I-215. Available Dec 05, call 813-1470.

MEDICAL OFFICE SPACE FOR RENT. Great location, currently renting half/full days, 1100 sq ft, 3-exam rooms/lab/Drs. Office, large check in/out. Fully furnished. Del Webb building/adjacent to Siena Hospital. Please contact Gayle at (702) 454-6226.

FOR SALE: Rosenthal China - Bettina pattern. Service for 20, includes some serving pieces. Retails at $3,500. Yours for $1,500 or best offer, call Joan at 255-3545.

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CME CALENDAR

Bechtel Nevada 295-0208

NV Chapter AACE 434-8400

Pri-Med Institute (877) 4PRI-MED

Sierra Health Services 242-7735

2/9 – “Updates on Viral Hepatitis (Hepatitis A-E)”

Southern Nevada AHEC 318-8452

Southwest Medical Associates 242-7735

Summerlin Hospital 233-7572

Sunrise Hospital 731-8210

UMC 383-2604

Valley Hospital 388-4847

Only CME Activities held at the Clark County Medical Society office are specifically endorsed by CCMS.

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Clark County Health District Disease Statistics* - December 2005

CLARK COUNTY HEALTH DISTRICT

DISEASE STATISTICS* - December 2005

DISEASE CASES REPORTED YEAR TO DATE

Dec 2004 Dec 2005 2004 2005

VACCINE PREVENTABLE DISEASES

DIPTHERIA 0 0 0 0

HAEMOPHILUS INFLUENZA 1 0 7 10

HEPATITIS A 0 0 6 11

HEPATITIS B 1 0 47 20

INFLUENZA 0 0 53 119

MEASLES 0 0 0 0

MUMPS 0 0 0 1

PERTUSSIS 3 0 10 29

POLIOMYELITIS 0 0 0 0

RUBELLA 0 0 0 0

TETANUS 0 0 0 0

SEXUALLY TRANSMITTED DISEASES

AIDS 16 14 232 183

CHLAMYDIA 366 616 4378 5118

GONORRHEA 206 235 2293 2202

HIV 16 25 266 241

SYPHILIS (Early Latent) 0 9 9 31

SYPHILIS (Primary & Secondary) 2 7 34 90

ENTERICS

AMEBIASIS 0 0 12 13

BOTULISM-INTESTINAL 0 0 0 1

CAMPYLOBACTERIOSIS 7 12 84 87

CHOLERA 0 0 0 0

CRYPTOSPORIDIOSIS 0 0 2 6

E. COLI O157:H7 4 0 20 11

GIARDIA 6 10 65 69

ROTAVIRUS 42 16 595 422

SALMONELLOSIS 11 17 110 134

SHIGELLOSIS 7 10 51 50

TYPHOID FEVER 0 0 1 0

VIBRIO 0 0 4 0

YERSINIOSIS 1 1 3 2

OTHER

ANTHRAX 0 0 0 0

BOTULISM INTOXICATION 0 0 0 0

BRUCELLOSIS 0 0 0 0

COCCIDIOIDOMYCOSIS 5 8 52 58

ENCEPHALITIS 0 0 1 3

HANTAVIRUS 0 0 0 0

HEMOLYTIC UREMIC (HUS) 0 0 0 0

HEPATITIS C 0 0 3 0

HEPATITIS D 0 0 0 0

INVASIVE STREPTOCOCCAL0 4 1 13

LEGIONELLOSIS 0 0 4 14

LEPROSY 0 0 1 0

LEPTOSPIROSIS 0 0 0 0

LISTERIOSIS 0 0 5 0

LYME DISEASE 0 0 0 0

MALARIA 0 0 5 0

MENINGITIS, ASEPTIC/VIRAL 5 4 79 73

MENINGITIS, BACTERIAL 2 3 17 13

MENINGOCOCCAL DISEASE 0 0 4 7

PLAGUE 0 0 0 0

PSITTACOSIS 0 0 0 0

Q FEVER 0 0 0 1

RABIES (HUMAN) 0 0 0 0

RELAPSING FEVER 0 0 0 0

ROCKY MTN SPOTTED FEVER 0 0 0 0

RSV 34 54 1081 1365

TOXIC SHOCK SYNDROME 0 0 2 3

TOXIC SHOCK SYN 0 0 2 2

(STREPTOCOCCAL)

TUBERCULOSIS 6 10 67 85

TULAREMIA 0 0 0 0

UNUSUAL ILLNESS 0 0 2 1

WEST NILE VIRUS 0 2 12 5

(ENCEPHALITIS)

WEST NILE VIRUS (FEVER) 4 0 11 2

*Numbers include confirmed and probable cases.

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County Line Advertisers

Consultants in Marketing….944-2464

DMSL Medical Management & Billing Service ….. 558-2326

Investment Equities….221-3375…. www.investmentequity.com

Mason Medical Management …..458-2455….. no website

Mass Media……..433-4331…..www.massmedia.com

Medical Group Management Association ….. 697-5471 ext. 134

Medical Liability Association of Nevada (MLAN) ….. 804-7333 ….. www.mlan.org

Nevada Mutual Insurance Company ….. 798-6001 ….. www.nevadamutual.com

Priority One Commercial ….. 228-7464 ….. www.priorityonecommercial.com

Protrans ….. 877-6333 ….. www.protranslv.com

Red Rock Radiology ….. 731-2888 ….. www.redrockradiology.com

Schadler Kramer Group …933-3000…. www.skglasvegas.com

United Blood Services ………228-4483

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Contents

“Why you should serve as a Delegate to this Year’s Annual Meeting”