Newsletter 72 January 06
Contents
Malpractice Filings Against Health Care Providers, Jan 2001 – Nov 2005
A Growing Problem: The Uninsured, What can you do? Join Access
Health today!
LIMITED ENGLISH PROFICIENT
PATIENTS AND PHYSICIAN MANDATES
Unethical Medical Expert Witness
Testimony: A Bold Proposal for Reform and Action
Clark County Health District Report
Clark County Health District Disease Statistics – November 2005
President’s Message
By Ron Kline, MD,
2005-2006
Keeping Our Focus
The
So what was the source of our great political strength? We don't have the ability to turn out large numbers of members to walk precincts, as do the labor unions. We are traditionally miserly when it comes to contributing to political campaigns, confident that we are morally right, and shouldn't have to dirty our hands by contributing to campaigns to defend our interests as the trial lawyers do (even though we are financially as well off). Ultimately, our political strength lies in the fact that our patients trust us. This is not a trite or trivial statement. Each of us works many hours each day (and many days each week) to serve our patients. Whether it is the reassuring phone call at the end of a long day telling our patients that all the scans and tests were negative, or spending long hours helping a patient and family through a difficult medical problem, what we all fundamentally share is that our profession is about helping people. Yes, there are the managed care hassles, the billing hassles, keeping all of your employees happy and working together, but when you distill it all down, our work days are about helping people.
How else to explain our victory on Questions 3, 4, and
5? What we all told our patients was
that this was an important issue to us that affected our ability to continue to
practice medicine in
One of the political tools that was most effective in 2004, were the banners that many of us placed in our offices to tell our patients how we felt about the issues. Think about it; a couple of hundred patients and family members travel through our offices in any given week. Ultimately, those people are there because they trust us. What better political advertisement can we make than to tell a group of self-selected people who like and trust us, how we feel about issues that are important to us. We must prepare to do this again in the coming elections.
As we continue to celebrate our victory, we must not be
complacent. Question 3 must still pass
muster with an elected and highly political state Supreme Court. The same court that worked so hard to prevent
Question 3 from even being on the ballot (and would have succeeded were it not
for Secretary of State Dean Heller's intervention). We must once again summon up our political
motivation for the 2006 Supreme Court elections and ask our patients to once
again trust us. If trial lawyer supported
candidates win in 2006, we can say good-bye to malpractice reform. Do not for a moment believe that this cannot
happen. It has happened in many states
already. Politicians will posture for a
short time, a few editorials will be written, and then medicine in
Clark County District Court Medical Malpractice Filings
Against Health Care Providers, Jan 2001 – November 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
Aug 54 51 76 67 33
Oct 37 83 110 59 26
Nov 38 184 59 78 68
Sum
372 823
1246 867
New Members
Congratulations and Welcome to the
October 2005
- Arthur M Cambeiro, MD, Plastic
Surgery,
- Terrence B Higgins, MD, Plastic Surgery, 7135 W Sahara Ave 200, Las Vegas, NV 89117
- Tony Y Maung, MD, Radiology, 2020 Palomino Ln 100, Las Vegas, NV 89106
- John Oh, MD, Radiology,
- Gary D Wright, MD, OB-Gyn, 1470
Calvada 300,
Reinstated Members
- Craig Morrow, MD, Internal
Medicine
In Memorium
The Clark County
Medical Society regrets to announce the passing of Internal Medicine member
Russell Miller, M.D., on December 8. He was a founding
Applicants To Go Before Credentialing Committee
If you have any pertinent information about
the following membership candidates, please contact:
- John M Baldauf, MD, Orthopaedic
Surgery
- Vasana Cheanvechai, MD, Vascular
Surgery
- Charlie C Huynh, MD, Physical
Med/Rehab
- Curtis C Huynh, MD, Physical
Med/Rehab
- Michael L Lee, MD, Orthopaedic Surgery
- Archie C Perry, Jr., MD, Orthopaedic
Surgery
For information on becoming a member of the
***New Member Special*** $390 New members can join for half price
their first year.
A Growing Problem: The Uninsured, What can you do? Join Access Health today!
By
Nancy Witman, Access
Health
We have an
emergency in
The AMA newspaper over the last few months has had several articles about this growing problem in our nation. The problem is the rapidly growing number of patients with no health insurance. A survey done by the AMA showed the following:
1) 60% of the members considered the issue a major problem.
2) The survey generated one of the highest response rates yet for a Member Connect Survey, showing how deeply physicians care about the uninsured.
3) It asked for information about programs that help the uninsured.
4) It showed that over 33%, one third, of its members provide five or more hours of charity care per week, and 16% spent ten or more hours of charity work per week (another way of evaluating time given was estimating the debt last year from nonpayment of services).
5) The greatest systematic obstacles in the treatment of the uninsured were getting prescriptions filled, diagnostic tests and procedures.
There is a program called Access
Health, which now exists in
The program links a prescreened uninsured patient with a primary care home (ex: Health Clinic of Nevada) and a network of specialty providers (you), who give their services at a discounted fee (determined by you), to always be paid at the time of service-never billed. What is to keep anyone in town from trying to take advantage of your discounted rate? Access Health participants must be at 100 - 250% of poverty level. Access Health financial personnel screen them carefully. These individuals are generally the working poor. They are not eligible for Medicaid yet they cannot afford insurance. If you have doubts or concerns you may speak with other physicians who are participating to verify this issue. The program makes clear to the participants that they are expected to pay the full amount at the time of services. There is no preauthorization or billing. Need I say, even with marked discounted rate many physicians get paid more than popular insurances will pay, and without hassle.
Some of you
may think, "Why should I care about the growing number of the uninsured?", I know from the AMA survey that 60% of you
care very much about the uninsured patients, and are already caring for them in
your offices. Indeed, often they are our
family, friends, coworkers, staff, and neighbors. They are also those who are impacted
by the loss of jobs, illness, per diem, or part time jobs, minimum wage, and
employees of someone who can no longer afford to offer health care coverage
(many small doctor's offices). Now there
is a program out there, here in
Also as we
know, here in
We can turn
this into a win-win situation. Patients
will get great care at discounted rates, the doctors will enjoy giving service
to the patient in need, and be paid a reasonable rate, hassle free. We all improve our
"Pick
almost any index of social well being and
Please call Access Health and sign up today, (702) 221-2087. If you’re overwhelmed call anyway and tell them you will just start with one needy patient a week. Take those 50 patients and multiply them by 100 doctors. This amount will total over 5,000 very grateful patients a year. You probably have a lot of questions about the details regarding pharmacies, radiology services, procedures, and hospitals. These facilities are growing in numbers. Access Health will explain all the details.
LIMITED ENGLISH PROFICIENT PATIENTS AND PHYSICIAN MANDATES
By
While
95% of
In response to those problems and complaints, the Office of Civil Rights of the Centers for Medicare and Medicaid Services, in August 2003, issued a revised Policy Guidance. The revised Policy Guidance recognized financial burden imposed upon small providers. The Policy distinguished between Part A Medicare providers (such as hospitals, nursing homes, and home health agencies) and Part B Medicare providers, including most physicians in private practice. The Guidance indicates that the onerous rules mandating the provision of interpreters would not apply to private practice physicians for routine office visits. For these types of visits, private practice physicians are not mandated to bear the cost of interpreters. The issue does not end there.
1. Explained to the patient in general terms without specific details, the procedure to be undertaken;
2. Explained to the patient alternative methods of treatment, if any, and their general nature;
3. Explained to the patient that there may be risks, together with the general nature and extent of the risks involved, without enumerating such risks; and
4. Obtained the signature of the patient to a statement containing an explanation of the procedure, the alternative methods of treatment, and the risks involved.
Implied in
the requirement of providing the informed consent is the requirement that
patients understand the explanations undertaken. Under federal revised Guidance Policy,
consent forms are "vital documents" which should be translated. Consent forms should be available in the
languages of the patient when those patients constitute greater than 5% of the
population of persons likely to be encountered" by the provider. Many specialty societies offer common
procedure written consent forms in foreign languages frequently encountered in
the
The statute requires that the procedure, alternative methods of treatment, risks of the procedure and the alternatives must be explained orally to the patient. This requires the use of interpreters. The Guidance indicates that this can be accomplished by hiring bilingual staff, hiring staff interpreters, contracting for interpreters, using telephone interpreter lines, using community volunteers, and using family members or friends. Medicare Part A providers will need to bear the costs of interpreters. Medicare Part B providers apparently are not required to assume the costs.
The use of family and friends as interpreters, while most economical, practical, and common, is the least favored option in the revised Guidance. This should be the patient's choice however. Using family and friends can give rise to privacy issues, confidentiality issues, and may involve financial conflict issues. The Guidance suggests that the use of family or friends is inappropriate where it appears abuse or neglect may be involved and the patient's interpreter may have a conflict of interest in having the abuse or neglect properly diagnosed or reported, and where a complex service or procedure is being discussed and it appears the interpreter does not understand the terms being used to describe the diagnosis or treatment.
The revised Guidance provides that special caution should be used when the LEP person chooses to use a minor as the interpreter. While the LEP person's decision to use a minor should be respected, there may be additional issues of competency, confidentiality, or conflict of interest. Providers should take reasonable steps to ascertain whether the LEP person's choice is voluntary, whether the LEP person is aware of the possible problems if the interpreter is their minor child, and whether the LEP person knows that other modes are available to provide a competent interpreter.
Lack of
consent for examination or treatment, and particularly for surgical procedures,
may give rise to a case of action (lawsuit) for the tort of battery. This tort is independent of a claim for
medical malpractice.
In addition
to the lack of consent issues, physicians rendering medical services to an LEP
person with a language barrier have been held liable for medical malpractice
for delayed, incorrect, or improper medical care because a competent
interpreter was not provided. Insurers
may refuse to cover a battery of tests sought by the physician when ordered
because a language barrier provokes the physician into "covering all the
bases". If a physician is using a
specific interpreter business, the physician should obtain a "business
associate" contract under HIPAA privacy laws. Not doing so subjects the physician to a
HIPAA violation if the interpreter working for the business discloses protected
health information to a third party, and a
In summary, while a physician is free to choose to whom he or she may render professional services, federal and state law prevent discrimination against a person on the basis of race, national origin or alienage. Most physicians will therefore be faced with providing medical care to persons with limited English proficiency (LEP). The 2003 revised Guidance policy of the CMS does relieve most private practice physicians of the obligation to bear the cost of providing interpreters for LEP individuals. This only relates to cost. The physician remains responsible for communicating adequately with his or her patients and for obtaining truly informed consent before undertaking a surgical procedure. This may involve the use of a competent interpreter. Physicians are also tasked with taking reasonable measures to assure the privacy and confidentiality of protected patient healthcare information, including instances in which interpreters are utilized.
Physicians are advised to include a note in the patient medical records each time an interpreter is present. A patient bringing an interpreter, including a family member or friend, implies the patient considers the interpreter to be a sufficient communicator. A note indicating the physician believes the interpreter to be competent and that the patient appeared to understand the communication will go far to convince a court that the patient's limited English proficiency was reasonably accommodated.
Unethical Medical Expert Witness Testimony: A Bold Proposal for
Reform and Action
By David M. Priver, MD
Vice-President Coalition and Center for Ethical Medical
Testimony
If you are completely satisfied with the state of medical jurisprudence in this country, do not read any further.
Item 1: A
young
Item 2: A
28 year old
Item 3: A 26 year old female tested positive for group B Streptococcus (GBS) in her 37th week of pregnancy but was delivered by another obstetrician who did not attempt to retrieve the positive test result. Although the infant was unharmed, the mother developed Group B strep meningitis and now suffers permanent epilepsy. An infectious disease expert witness testified that the infection resulted from GBS colonizing the mother's normal low back skin injected through an accidental thecal puncture during an attempted administration of epidural anesthesia, and further that high dose Penicillin prior to delivery would not have prevented the mother's infection. Based on the latter testimony, the jury found the defendants negligent, but denied damages for lack of causation. The world's literature reveals no known cases of GBS colonization of normal back skin, since it requires a moist damp environment.
What can be made of these cases? These three reflect only a tiny sample of recent cases reported. It is evident that there exists a problem with dishonest and unprofessional testimony, both for the plaintiff and the defense. Additionally, over the past decade, there has been a growing concern for what has come to be called "junk science" in the courtroom. By creating fanciful and unscientific theories, experts have often misled juries into rendering verdicts that are unjust. In many instances, the welfare of patients has been compromised as a result. In the early 1980s the very effective "morning sickness" drug, Bendectin, was pulled from the market after its manufacturer had expended millions of dollars in defending it against altogether unsupportable claims that it had caused birth defects. Since then, hyperemesis of pregnancy has become much more difficult to treat. Similarly, silicone breast implants were taken off the market by the FDA after hundreds of lawsuits, fueled by junk science testimony, contended that they caused any number of physical ailments, none of which has ever been verified. Here again, patients clearly have been the losers.
The patients, however, are not the only ones who lose. The domino effect of unethical testimony upon the medical profession can hardly be overstated: when physician experts testify dishonestly in court, the credibility of the medical profession suffers; malpractice cases without merit proliferate while some with merit fail, malpractice insurance premiums skyrocket, and young physicians are driven away from high-risk specialties. The field of OB/GYN has become so inundated by lawsuits that its training programs are finding themselves largely without applicants. Young physicians have correctly determined that there are far less stressful ways to make a living. It is anyone's guess who will be delivering the coming generations of babies in this country.
What policies are in place to police expert witnesses? Few, to date, have been effective. Since 1997, it has been the position of the American Medical Association that expert medical testimony by a physician constitutes the practice of medicine and, therefore, should be subject to peer review. Despite this, only a handful of cases have been peer reviewed and few physicians disciplined. The reasons for this are various. A good many physicians have been so traumatized by the ordeal of malpractice that they want only to put it behind them. Others are fearful that filing a grievance against an expert could result in filing of a lawsuit by the expert against them. Finally, despite being matters of public record, the details of lawsuits can be exceptionally difficult to expose and some believe that exposure could subject the one who exposes them to charges of violation of HIPAA.
It is apparent that there is a need to shine a bright light upon the problem of unethical testimony in general and by physicians in particular. Patients cannot be expected to have confidence in a physician's ability to care for them with honesty and integrity when they see some behaving as "hired guns". For physicians to continue to be respected as members of a noble profession there must be a system of ethical accountability in medical jurisprudence equal to that which exists in the arena of clinical medical practice.
A group of concerned individuals - physicians, attorneys, and others - representing widely divergent specialties in different geographic areas, has come together to create an organization which has committed itself to achieving accountability of experts. The Coalition and Center for Ethical Medical Testimony (www.CCEMT.org) has as its major goal the establishment of ethical standards both for testifying experts and the attorneys who hire them. The CCEMT's positions seek to be genuinely fair and balanced between medicine and law, between plaintiff and defendant.
CCEMT's proposals requiring experts to adhere to an Ethical Accountability standard will not impair access to justice for plaintiffs with legitimate claims: experts who abuse their position of trust on behalf of defendants would be scrutinized as rigorously as plaintiff's experts. Indeed, plaintiffs with meritorious claims would be more likely to prevail as defense experts would be discouraged from testifying dishonestly against them. Arguably, when all sides are required to meet reasonable standards for ethicality and truth telling, the system is empowered to do what it is intended to do: assure justice for all.
CCEMT is currently conducting a nationwide education and membership campaign. The goal of ethical testimony reform from within - particularly reform spearheaded by two professions ordinarily thought uneasy bedfellows - is, indeed, a bold proposal. But then, 'bold' well describes CCEMT's accomplishments to date:
· CCEMT has published examples of unethical testimony, complete with names, on its website. So as to ensure fairness, it has offered the offending testifiers the opportunity to justify their courtroom statements. Almost without exception, none have done that. Instead the CCEMT receives threatening letters, but publishes anyway, believing that exposure of dishonesty in front of one's peers is a powerful disincentive to such behavior.
· CCEMT has had an impact upon major medical associations, such as the AMA and a number of specialty societies which have adopted 'expert witness affirmation statements" which are designed to facilitate regulation of expert witnesses by colleagues.
· In May 2004, the Federation of State Medical Boards passed a resolution requiring that "A Guide to the Essentials of a Modern Medical Practice Act" indicate that "false, fraudulent or deceptive testimony given by a medical professional while serving as an expert witness should constitute unprofessional conduct, as defined in the act."
· CCEMT maintains a members-only library of articles related to expert witness issues. Filled with scholarly material, this library was recently voted by members as the most popular service offered to them.
· CCEMT has received the attention of the media with presentations by The ABA Journal, The American Lawyer, American Medical News, The Chicago Tribune, The New York Times, The New York Daily News, Physicians Financial News, Physicians Money Digest, JAMA, Cutis, CNN, and more.
If you share the view that expert witnesses must be held to an ethical standard which will insure honesty and integrity in the courtroom, then join our efforts by becoming a member of CCEMT. This worthy cause can be accomplished at the minimal rate of about 30 cents per day or less than you spend for your daily newspaper. The projects which we have already initiated as well as others we are planning can only be accomplished if we have a solid base of members. If you wish to serve on one of our committees, we would welcome it.
Please sign on to our website at www.ccemt.org. You will find there information about becoming a member. Read about what we have done and what we hope to do soon. See if you do not agree that this effort is worthy of your support. We hope the time will come when you will be able to participate in a medico-legal system which reflects fairness and honesty. At that point, you will be gratified to realize that you played a role in that monumental accomplishment. Future generations of physicians and other medical providers will be forever in your debt. For them, as well as for yourself, we encourage you to join with CCEMT in a mutual effort to achieve accountability in the arena of professional testimony.
"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order of things because the innovator has for enemies all those who have done well under the old conditions and lukewarm defenders in those who may do well under the new."
Machiavelli, The Prince
Editorial Staff Note Disclaimer:
The views expressed in this article are those of the author alone and do
not necessarily reflect the views of the Clark County Medical Society, its
Board of Trustees, or its membership.
Clark County Health District Report
By Donald Kwalick,
MD, MPH, Chief Health Officer
Planning for a potential
pandemic is a community effort
In early December 2005, U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt hosted separate meetings with state representatives and business leaders to coordinate federal, state and local pandemic planning.
Of note was the emphasis on individual communities as a front line defense in the effort to stop or contain a pandemic. Although a pandemic would have global implications it will be essential for communities to have a local response plan in place. These individual, yet coordinated, efforts are the cornerstone of an effective worldwide response.
The Clark County Health District has developed a comprehensive plan for responding to a flu pandemic or an outbreak of respiratory illness. The health district plan addresses the phases of a pandemic as outlined by the World Health Organization. The distinction between the different phases is based on the risk of human infection or disease posed by circulating strains in animals and an assessment of the risk of a pandemic. For each pandemic phase the health district plan addresses issues concerning: command and control; surveillance; prevention and containment; the use of antivirals; the use of available vaccine; health systems and critical infrastructure; and public communications.
The success of our planning activities relies on the inclusion of response partners and built-in flexibility, so while an effective response is outlined, it can still be tailored to meet the unique features of a particular outbreak. To this end, the health district has been working with the different jurisdictions and emergency response agencies to provide information materials and coordinate planning efforts.
As important as these efforts are, it is vitally important that not just emergency response agencies and health care organizations be aware of the implications of a pandemic; business leaders in our community must also be aware of the affect a pandemic could have on their operations. It is for this reason HHS released planning information and checklists not just for government agencies but for private businesses as well.
These checklists are not intended to set forth mandatory requirements, but rather to provide guidance for state and local jurisdictions as we identify preparation activities specific to the needs of our community. In addition to addressing each phase of a pandemic, the health district plan is also reflective of the HHS checklist created for government. While these sections address issues mentioned above, including command and control, surveillance and the use of antivirals and vaccine, the checklist created for businesses includes information on assessing the potential impact to a business and the actions to take in preparation for a pandemic.
This business checklist also has useful information for government agencies, health care organizations and private companies. The checklist includes steps for planning for the impact on business operations, employees and customers, the allocation of resources, the development of policies, internal communication and external coordination with the community.
As integral members of the health care system, these are important issues for us all to consider as we continue to assess and update our plans. For more information on the health district's planning effort look for a CCHD avian flu television special to run on cable channels 2 and 4 during the month of January.
Additionally, complete planning information and checklists can be accessed on the HHS website: pandemicflu.gov. More information is also available on these websites:
World Health Organization: www.who.int/csr/disease/avian_influenza/en/index.html
Centers for Disease Control and Prevention: www.cdc.gov/flu/pandemic/
HealthInsight Launches Effort to Transform Healthcare Quality
Special assistance will be offered to Nevada
By Robert W Shreck
MD, FAAFP, Vice President of Medical Affairs, HealthInsight
High quality health care is increasingly becoming an expectation of purchasers, policy makers, and consumers. With public information on patient care in physicians' offices more readily available throughout the nation, and with quality indicators showing mostly incremental improvements, we are still more than 20 years away from optimal care.
HealthInsight,
the Medicare Quality Improvement Organization (QIO) for
We plan to specifically focus on three areas as part of this push for improved quality:
· Assist physicians in selecting and utilizing information technology, including electronic medical records (EMR) systems, to improve healthcare quality and efficiency.
· Work with physicians to create a more patient-centered care system. Particular emphasis will be placed on chronic conditions like diabetes, as well as preventive services such as cancer screening and adult immunizations.
· Increase cultural competency by building on existing programs in physicians' offices, which will lead to more successful health outcomes for racial and ethnic minority patients.
At the turn of this century, when the average industry was investing $8,000 per employee on computer technology, health care was spending $1,000. By now, if you belong to a frequent shopper club, your grocery store almost certainly has far more computerized data than your health care provider.
Most physicians and hospitals are still working in the dark ages, dependent on pen, paper, and manila folders. EMRs have improved dramatically over the last five years. Nationally, there have been pilot studies by Medicare to encourage physicians to use information technology in their practices. Coordinating chronic disease management can be extremely difficult without electronic interconnectivity provided by EMRs and web-based links to appropriate diagnostic services. EMR applications in the physician office setting improves the availability of information, enhance communication and decision support, improve safety and quality, and can provide economic benefit to the physician.
Many of these focus areas are not new to HealthInsight's traditional work with physicians. We recognize that physicians share a vision of improved quality and we also know that there are proven best practices out there that can help make this vision a reality. Information technology with decision support and evidence-based protocol reminders can bring this vision into focus quickly and efficiently, whether your office is considering a full EMR, a registry for chronic diseases, or simply an electronic prescription writer.
With assistance from QIOs across the country, physicians have made significant improvements in the quality of care that they provide. Studies have shown that the use of EMRs in a practice reduced the number of medical errors by 18 percent. In my experience, the prescription writer that I use has reduced pharmacy callbacks and alerted me to medication interactions when prescribing new medications for a patient.
Dramatic improvements have also been made in the management of diabetes-related complications through registries during the past three years. For example, Dr. Jim Snyder, a Medical Director at HealthInsight, worked with our Diabetic Collaborative group in accomplishing significant improvement in the care of diabetics for many physicians' practices.
These examples point to the need for a better, more connected healthcare system that can be provided through health information technology.
QIOs
nationwide are leveraging their impact through innovative partnerships and
collaborations with organizations that share this vision. HealthInsight looks forward to working with
For more information, contact Kevin Kennedy at 702-933-7311or kkennedy@healthinsight.org.
This
material was prepared by HealthInsight, the Medicare Quality Improvement
Organization for
Alliance
By Shanila Choudhury,
2005-06
The year is moving along quickly as we
begin the
I am proud to announce the success of the annual Greeting Card Project which raised $16,000 thanks to the support of all our local physicians and hospitals. Kim Watson worked tirelessly with Annette Mohs, and Lisa Gollard. A special thanks goes to Donna Davidson who for the first time approached our local hospitals to participate. These women have been working from the beginning of the year on this project. I want to commend them for their hard work. Our members joined together at Annette Mohs's home on December 9th and stuffed 5,000 envelopes. Due to our member participation, we completed this task in record time. We had 8 people continuously working. I want to thank Julie Leon for taking all our cards to the main post office and mailing them out on her own.
We are getting ready for our March Fundraiser to raise money for the Susan G. Komen Breast Cancer Affiliate. We need all of your help by advertisements for our program book as well as Silent Auction donations. Please support our endeavors. We are also participating in the “Race for the Cure.” For more information please contact Sheila Bazemore at 328-2254 or email: csbazemore@cox.net. We are an active group making a difference. Come join us! Our fundraiser is open to the public. Tell All!
5th Annual
Spring Fashion Show
"Think Pink"
Benefiting the
Susan G. Komen Breast
Cancer Foundation
Special Guest Paula Francis
Silent Auction
and Other Surprises
Held at
On Tuesday, March 14, 2006
At
This is a pre-paid event. Please buy your tickets
as soon as possible For tickets and more information
please contact Shanila Choudhury at (702) 355-2019 or
email: choud@aol.com
Nevada
State Medical Association ’s 102nd Annual Meeting and
Scientific Session
Mark Your Calendars!
This is the first time in years that this meeting will be
held in
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
Minutes Synopsis
Executive Council
MEETING
Tuesday,
Minutes Synopsis
The minutes for the
October meeting were approved unanimously.
Financial Report
Revenue was
$246,528.90 for the fiscal year which was down about $2,000 from last year at
this time. Expenses were 99,674.24 which
was about $13,000 less than last year at this time. The bank account balance at the end of the
last month was $422,916.88, which was about $100,000 more than this time last
year.
Credentials Report
The five applicants
were approved for active membership: Arthur Cameiro, MD - Plastic Surgery;
Terrence B Higgins, MD - Plastic Surgery; Tony Y. Maung, MD - Radiology; John
Oh, MD - Radiology; and Gary D Wright, MD - OB-Gyn. There was 1 reinstatement: Craig B Morrow, MD
- Internal Medicine.
Membership Report
Dr. Doubrava
reported there were 600 dues paid members, a decrease from the 767 paid members
last year at this time. At this time
there are total of 714 members, which includes the dues exempt members.
Bill Welch presented
the Hospital Associations' views on the progress of the AMC planning
meetings. Dr. John MacDonald responded that
UNSOM has an all day planning session set for November 22 and that they would
comply with the Chancellor's request to present UNSOM's vision for the
Community Health Committee
Dr. Jones reported
the committee continues working on the "Dear Doctor" project. They have 22+ articles and hope to submit to
them to the Review Journal by Thanksgiving.
Bylaws, Policies and Procedures Committee
Dr. Evins explained
the proposed Administrative Policies and Procedures manual revisions
recommended by the committee. After
discussion, the revisions were approved and effective immediately.
Annette Mohs
presented the report for the
Health District Report
Dr. Kwalick was
unable to attend the meeting but sent a report to the Board on current Health
District concerns.
UNSOM Report
Dr. MacDonald
announced that Dr. John Fildes has been appointed the functional chief of
trauma training for the
Dr. Forman announced
they recently opened a
NSMA Report
Larry Matheis stated
the Governmental Affairs Commission was working on the legislative strategy for
the next legislative session. The NEMPAC
board met last week and authorized donations to a number of candidates who are
likely to support our issues and are likely to win. Dr. Evins stated NEMPAC donated almost all
their funds, and that NSMA/
AMA Report
Dr. Horne reported
the AMA just met, and he showed a brief video of the AMA commercial and new
logo. He stated about 60 resolutions
passed at that meeting. Most of the
discussion was over the flawed Medicare Sustainable Growth Formula. He urged members to call our federal
legislators and recommend they cease the cuts in the flawed formula. The next AMA meeting will be in June. Any AMA member wishing to submit a resolution
at that meeting should contact Dr. Horne.
President's Report
Dr. Kline stated he
spoke to Christina Dugan from the Chamber of Commerce and there is interest in
building a coalition between
Dr. Kline stated
Attorney Greg Morris looked into protecting
Dr. Kline just
returned from a Wellpoint-West Leadership Conference where pay for performance
was a big issue. He indicated next
month's County Line President's column will provide more information about this
issue.
Administrative Report
Dr. Havins
reiterated Annette Mohs' invitation to attend a fundraiser for Senator Barbara
Cegavske at the home of
New Business
There was a request
that
Future Meetings
The next BOT meeting
will be next year (no meeting to be scheduled in December) on
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.
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
New Office Space: Near Southern
FOR
LOOKING FOR BOARD
CERTIFIED PHYSICIANS: in Hematology, Nephrology, Neonatology, Emergency
Medicine, Thoracic/CV Surgery, Rheumatology, and Transplants to do chart
reviews. URAC accredited Independent
Review Organization. Hourly rate. Fax CV to
physician turned author: Death by
Any Means, by Leonard Kreisler, MD www.durbanhouse.com (publisher) Available at
Barnes and Noble, Walmart.com, Target.com OR inscribed from the author: $14.95
+ $3.00 S&H (Total $17.95) to Leonard Kreisler, MD,
For Lease: 4000(+/-) sq ft,
HOUSE FOR