April 17-18, 2015 | Fayetteville
Transcription
April 17-18, 2015 | Fayetteville
Vol.111 • No. 11 APRIL 2015 Join us for the 139th Annual Session of the Arkansas Medical Society April 17-18, 2015 | Fayetteville NUMBER 11 APRIL 2015 • 217 Only a away! Connect to free resources and tools for your patients! Go to www.afmc.org and get instant access to information that health care providers like you need every day. You’ll find free quality improvement tools available for order and download, details about AFMC’s quality improvement projects, survey results, professional publications geared toward Arkansas providers and MORE! 218 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC), THE MEDICARE QUALITY IMPROVEMENT ORGANIZATION FOR ARKANSAS, UNDER CONTRACTS WITH THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS), AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE ARKANSAS DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL SERVICES. THE CONTENTS PRESENTED DO NOT NECESSARILY REFLECT CMS AND ARKANSAS DHS POLICIES. THE ARKANSAS DEPARTMENT OF HUMAN SERVICES IS IN COMPLIANCE WITH TITLES VI AND VII OF THE CIVIL RIGHTS ACT. QP3-AMS.CNNCT.AD,2-4/14 VOLUME 111 ON THE COVER Join us for the 139th Annual Session of the Arkansas Medical Society April 17-18, 2015 | Fayetteville COMMENTARY BY FRANK GRIFFIN, MD A Closer Look at Quality 220 228 Winner of the ASAE Excellence in Communications Award Volume 111 • Number 11 April 2015 Established 1890. Owned and edited by the Arkansas Medical Society and published under the direction of the Board of Trustees. Advertising Information: Penny Henderson, (501) 224-8967 or [email protected]. #10 Corporate Hill Drive, Suite 300, Little Rock, Arkansas 72205. Postmaster: Send address changes to: The Journal of the Arkansas Medical Society, P.O. Box 55088, Little Rock, Arkansas 72215-5088. AMS Benefits, Inc. Annual Report to the Arkansas Medical Society Nominating Committee, AMS Board of Trustees 221 Arkansas Department of Health 222 ARKANSAS STATE MEDICAL BOARD 2014 ANNUAL REPORT 226 Medical Education Foundation for Arkansas (MEFFA) 227 Minutes of the Arkansas Medical Society 230 Minutes of the Arkansas Medical Society 232 House of Delegates Executive Committee Meeting Minutes of the Arkansas Medical Society Subscription rate: $30.00 annually for domestic; $40.00, foreign. Single issue $3.00. Board of Trustees Meeting The Journal of the Arkansas Medical Society (ISNN 0004-1858) is published monthly, except twice in the month of August by the Arkansas Medical Society, #10 Corporate Hill Drive, Suite 300, Little Rock, Arkansas 72205. (501) 224-8967. Arkansas Medical Society Printed by The Ovid Bell Press Inc., Fulton, Missouri 65251. Periodicals postage is paid at Little Rock, Arkansas, and at additional mailing offices. Articles and advertisements published in The Journal are for the interest of its readers and do not represent the official position or endorsement of The Journal or the Arkansas Medical Society. The Journal reserves the right to make the final decision on all content and advertisements. 2015 BUDGET REPORT 139th Annual Session Registration Form NUMBER 11 234 236 238 Join us to stay updated on health care news in Arkansas. © Copyright 2015 by the Arkansas Medical Society. www.ArkMed.org 221 Feature Articles facebook.com/ArkMedSoc twitter.com/ArkMedSoc ArkMed.org APRIL 2015 • 219 COMMENTARY FRANKIE GRIFFIN, MD P rotecting the financial and social rewards that accompany becoming a physician should be a priority as the U.S. works through reform of our health care delivery system. Be- coming a doctor should remain a way for our best and brightest students to pursue the American Dream. American Dreamers others, and a requirement of continued dedication and hard work once the status is reached. Doctors deserve the financial and social success that they have traditionally enjoyed. For 2014-15, UAMS estimated that 4 years of medical school will cost the student a total of $221,757. Another source noted that the average medical student nationwide graduates with over $167,000 in debt. Only 7 percent of the 2,379 applicants to UAMS 2014 entering medical school class were accepted. Thus, some of the top students in the If we hope to preserve the future financial and social security of the profession, doctors must become a part of the solution by working to protect the integrity of the profession. One area where we can do better is by adopting policies that allow state medical boards to be more aggressive and proactive in going after our colleagues who game the system for financial gain. Physicians are in the best position to regulate other physician’s billing practices, and where we have fallen short, more and more others—with less expertise—continue to step in to do what must be done. We should push for and support The idea that hard work, perseverance and state of Arkansas are becoming physicians at dedication would lead to success in life was drilled great financial cost to themselves. After medical into my head while working in the soybean and rice school, they will work long hours during residency A second area where we need to focus is fields of Northeast Arkansas; to my dad and the training. Most of those talented students (who on regaining our ability to practice independently other farmers around whom I grew up, this idea was likely could have chosen virtually any profession) of hospitals and larger organizations. Hospitals a core value…a foundation upon which to build the will be somewhere between 29 and 32 years of are rapidly buying up physicians’ practices. One American Dream. As a senior in high school, I looked age before they can start their practices. When physician-recruiting firm noted that in 2004 only at the class pictures hanging in the hallways of New- they do finally enter practice, they will work an 11% of doctors worked for hospitals whereas by ark High School and could not find a single person average of 52 hours per week and will generally 2013, the number had grown to 63%. This is an who had gone on to become a physician. It seemed handle difficult life-altering and life-or-death de- understandable trend in the current environment pretty far-fetched that a farm boy from a high school cisions multiple times per day. Over half will likely of EMRs, ACOs, etc. Many doctors are rightfully class of 25 students in a town of less than 1,000 be “burned out” in a relatively short time period. running for cover. However, we must continue to people could go on to become a doctor, but based upon the foundational values I learned on that farm, I decided it was worth a try. Doctors are not the cause of the high costs of health care, yet we get an inordinate amount of attention and blame for those costs. Accord- For many of our brightest students, becoming ing to the Kaiser Foundation in 2013, physician a physician is one path to the American Dream. By payments accounted for only 12% of Medicare working hard, making good grades in college and spending on Healthcare. Others have estimated striving to be their best, countless Americans have overall that doctors’ payments account for only pursued and many have accomplished the goal. 8% of health care spending (Jackson Healthcare). There is hardly a more certain path to financial se- Reducing doctors fees are not the answer to con- curity and social prestige in our society than becom- self-regulation of our profession. fight for and restore regulations and methods that facilitate physician independence. Doctors are in the best position to look out for patients’ best interests when we are not inhibited by the shortsighted, financial motivations of business people who are now our bosses. As more and more doctors become hospital employees, we must fight to leave a trail of breadcrumbs for doctors to trace to get back out of these arrangements in the future. trolling healthcare costs. In 2010, the Institute Our best and brightest deserve the chance to ing a physician. It takes many years of hard work, of Medicine noted that 190 billion was spent on achieve the American Dream by becoming doctors. dedication and delayed gratification to achieve the excessive administrative costs. Our focus should Their success is in the best interests of our country goal…making it the epitome of the foundational val- be on eliminating those excessive administrative and our health care system. As a profession, we ues behind the American Dream. There is no more costs and other inefficiencies in the system. Ad- must work toward preserving that dream. I hope deserving profession because medicine requires ministrative tasks and hassles are also making that my great grandchildren grow up in a country a high degree of talent and skill, a commitment of physician’s lives miserable and account for much where becoming a doctor can still be…the Ameri- many years of difficult study, a dedication to serving of the “burn out.” can Dream. 220 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 AMS Benefits, Inc. Annual Report to the Arkansas Medical Society David Wroten Executive Vice President Nicole Richards Communications Coordinator Jeremy Henderson Art Director EDITORIAL BOARD Frankie Griffin, MD Orthopedic Surgery Robert Hopkins, MD Pediatrics/Internal Medicine David Hunton, MD Surgery Laura Sisterhen, MD Pediatrics Sandra Johnson, MD Dermatology Issam Makhoul, MD Oncology EDITOR EMERITUS Alfred Kahn Jr., MD (1916-2013) ARKANSAS MEDICAL SOCIETY 2014-2015 OFFICERS Alan Wilson, MD, Crossett President Omar Atiq, MD, Pine Bluff Immediate Past President G. Edward Bryant, MD, West Memphis President Elect William Dedman, MD, Camden Vice-President Chad Rodgers, MD, Little Rock Secretary Frankie Griffin, MD, Van Buren Treasurer Michael Saitta, MD, Fayetteville Speaker, House of Delegates Clay Ferguson, MD, Nashville Vice Speaker of the House of Delegates Dennis Yelvington, MD, Stuttgart Chairman of the Board of Trustees NUMBER 11 STEPHEN MAGIE, MD, CHAIRMAN OF THE BOARD A MS Benefits is a for-profit subsidiary of the Arkansas Medical Society established in 1991 to provide insurance benefits to AMS members, family and staff. The Company operates as a licensed insurance agency that markets life, health and disability products. I would like to encourage all Arkansas Medical Society members to take advantage of this specialized service that was created by request from you to meet the needs of Arkansas Physicians. AMS Benefits provided over $150,000 in 2014 to AMS for the use of executive staff, space/equipment and support of AMS projects. AMS Benefits advertised on the AMS Website and in the Journal of the Arkansas Medical Society. AMS Benefits provides support at specialty society meetings, clinic manager meetings and educational workshops. AMS Benefits staff includes two full-time licensed employee agents. They also contract with two independent sales agents. I would like to give a special thanks to the AMS Benefits Board of Directors for their service to this organization dedicated to providing support to our members by providing the best service available for those products they provide. AMS Benefits Staff Alanna Scheffer Emily Clark Alan White (contract agent) Travis Mulhearn (contract Agent) Board Members Stephen Magie, MD (Little Rock) Alan Wilson, MD (Crossett) G. Edward Bryant, MD (West Memphis) Brenda Powell, MD (Hot Springs) Barry Pierce, MD (Mt. View) Jan Hundley, (Little Rock) David Wroten (AMS) Nominating Committee The members of the Arkansas Medical Society Nominating Committee are Drs. Omar Atiq, William Waldrip, Tommy Wagner, Richard Kyle, Dennis Yelvington, Amy Cahill, John Hearnsberger, Brenda Powell, James Hagler, and Vickie Henderson. The Nominating Committee would like to present to the Society the following nominees: President-elect: Scott Cooper, MD, Rogers Vice President: William D. Dedman, MD, Camden Secretary: Chad Rodgers, MD, Little Rock Treasurer: Amy Cahill, MD, Pine Bluff Speaker of the House: Michael Saitta, MD, Fayetteville Vice Speaker of the House: Clay Ferguson, MD, Nashville AMA Delegate: Michael Moody, MD, Salem AMA Alternate Delegate: Edward Bryant, MD, West Memphis Medical Student: Parth Shah The election of officers will be the first order of business at the House of Delegates meeting, Saturday April 18, 2015. Additional Nominations for positions elected by the House of Delegates may be made by any member of the House of Delegates in attendance at the meeting. APRIL 2015 • 221 Arkansas Department of Health - Report on Activities by NATHANIEL SMITH, MD, MPH, DIRECTOR AND STATE HEALTH OFFICER W hile 2014 will be remembered for Ebola and its illustration of the critical importance of public health, it was only a fraction of the work the Arkansas Department of Health (ADH) conducted to protect and improve the health of Arkansans. ADH has an “always on” surveillance, investigation and control system that monitors disease trends and identifies high-risk groups. This ensures the ability to quickly respond to Ebola and other new or emerging diseases. ADH continues to offer Ebola guidance and training to health care providers and others so anyone exposed can be identified, monitored and treated. ADH monitors all travelers who have traveled to outbreak-affected countries for 21 days after their return to Arkansas. Vigilance against older, more familiar diseases also continued with new school immunizations requirements for Tdap, Hepatitis A, polio, meningococcus and varicella. ADH and the American College of Physicians are also working to raise adult immunization rates. The 2013-14 flu season caused 76 deaths, making it the deadliest in Arkansas in over 30 years. ADH continues to hold seasonal no-cost Mass Flu and School Flu Clinics statewide providing 252,571 flu shots during the 2013-14 season. ADH epidemiologists prepare and distribute weekly reports that track flu activity. During 2014, ADH worked with partners throughout the state to keep Arkansas communities safe from a variety of threats. Arkansas has a serious prescription drug abuse problem with overdoses and deaths almost doubling since 1999. The Prescription Drug Monitoring Program (PDMP) has helped identify individuals who are “doctor-shoppers,” leading to a steady drop in the number of people who visit multiple prescribers and pharmacies. Over 18 million prescription records are in the PDMP database, and authorized users have made more than a million queries. New prescribing guidelines for emergency room physicians are now available. Another danger for Arkansans that can be significantly reduced is healthcare-associated infections (HAI). ADH tracks antibiotic-resistant, surgical site, Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream and C. difficile infections. The HAI Advisory Committee promotes antimicrobial stewardship in inpatient hospital settings and is expanding efforts to outpatient settings. Electronic cigarette use among Arkansas youth is an increasing public health concern. E-cigarette use doubles the likelihood that youth will smoke tobacco cigarettes, and 75 percent of teens who smoke continue smoking as adults. E-cigarettes normalize smoking and undermine efforts to curb tobacco use. Arkansas was one of the first states to pass a law prohibiting the sale of e-cigarette products to minors. 222 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY The Arkansas Trauma System has coordinated the transportation of over 59,000 trauma patients since January 2011. Sixty-nine designated trauma centers, better trauma training, a statewide communications system, quality improvement initiatives, increased injury and violence prevention efforts, and expanded use of technology have all helped to reduce injury-related deaths in Arkansas. In 2014, the following ADH activities and collaboratives expanded initiatives to address chronic diseases. • A team of community physicians, pharmacists, health units, area hospitals and insurance providers are addressing hypertension in Nevada and Poinsett Counties with an Association of State and Territorial Health Officials (ASTHO) Million Hearts Learning Collaborative grant. • The UAMS Arkansas Prevention Research Center and Fay Boozman College of Public Health are focusing on hypertension by testing the effectiveness of an intervention in a rural, medically-underserved, high-risk community. • The Arkansas Stroke Registry (ASR) continues to collect patient and hospital data and educate health care providers to ensure stroke patients receive the most effective and timely pre-hospital care. • A statewide obesity prevention plan was developed with the Winthrop Rockefeller Institute, Arkansas Center for Health Improvement, and UAMS. “New Frontiers in Combating Obesity - A Ten Year Plan for Arkansas” will be released soon and addresses nine priority areas of obesity prevention. • The second Arkansas Minority Barber & Beauty Shop Health Initiative was held in Pulaski, Clark, Chicot and Jefferson counties. Health screenings were available at no cost to adults at participating locations to educate African American and Latino populations about heart disease and stroke. • Thirty-eight thousand adult Arkansans may be living with Hepatitis C (Hep C) and may face permanent liver damage or early death. ADH has been testing for three months and has tested 658 individuals, of whom 56 tested positive. Doctors should discuss Hep C testing with all patients born between 1945 and 1965. New treatments for Hep C are more effective, easier to tolerate and shorter in duration. Some of the new treatments have cured more than 90 percent of patients. The public health accomplishments of 2014 were considerable. However, there remain significant challenges for 2015, and ADH will continue to work with partners to strengthen efforts to improve the health and safety of Arkansans and address new threats. VOLUME 111 For all the road blocks in life. Now what? Let us help Pointe your family in the right direction. When families become stressed by behavioral issues, they need a caring environment. Pinnacle Pointe is the largest child & adolescent behavioral care hospital in Arkansas. Programs and Services: •AcuteInpatient •ResidentialInpatient •Outpatient •School-Based Pinnacle Pointe is the only Tricarecertified residential program in the state. Contact us for a free, confidential assessment. B E H AV I O R A L H E A LT H C A R E www.PinnaclePointeHospital.com NUMBER 11 2009 President’s Award for Outstanding Juvenile Programs 2008 ATRS Facility of the Year 2007 APA Residential Facility Arkansas’ only Tricare-certified of the Year for Outstanding Service residential program. 1-800-880-3322 11501 Financial Centre Parkway Little Rock, AR 72211 APRIL 2015 • 223 5 1 April 17-18, 2015 | Fayetteville 0 2 join us for the 139th Annual Session of the Arkansas Medical Society sion l Ses nnua A AMS Registration Form on Page 238 Join fellow physicians in Fayetteville to network, share, debate and have some fun. The meeting will provide educational programs and the opportunity to discuss advocacy efforts and society business. It Schedule of Events will also showcase select vendors’ products and services. Get involved and make a difference in the future of medicine for you and your patients. Schedule Friday, April 17, 2015 9:00 a.m. – 5:00 p.m. 12:00 p.m. – 1:00 p.m. 1:00 p.m. – 2:00 p.m. 2:00 p.m. – 5:00 p.m. 2:30 p.m. – 4:30 p.m. 4:30 p.m. – 5:00 p.m. 6:00 p.m. – 7:00 p.m. 7:00 p.m. – 9:00 p.m. AMS Registration Open Committee Meetings (TBD) MEFFA Board Meeting Exhibits Open SVMIC Educational Program Break with Exhibitors AFMC Welcome Reception Inaugural Gala & President’s Reception Saturday, April 18, 2015 7:30 a.m. – 8:30 a.m. 8:30 a.m. – 9:00 a.m. 9:00 a.m. – 10:00 a.m. 10:00 a.m. – 10:30 a.m. 10:30 a.m. – 11:30 a.m. 10:30 a.m. – 11:30 a.m. 11:30 a.m. – 2:30 p.m. AMS Board of Trustees Breakfast with Exhibitors Dirk Haselow, MD, PhD Emerging Diseases Update Break with Exhibitors Scott Smith, JD, Legislative Recap 50 Year Club Social Hour Awards Luncheon & AMS House of Delegates (includes 50 Year Club) 224 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY Register Today! Featured Events Inaugural Gala Dr. Edward Bryant of West Memphis will be installed as the 2015-2016 president of the Society during the President’s Inaugural Gala on Friday night. Attendees will enjoy dinner and a dessert reception. Marvin Caston, associate director of the Razorback Foundation will be the featured speaker at the Gala. The former Arkansas fullback played for the 1998 Razorbacks team that shared the SEC Western Division title. He was a member of the 1999 SEC Academic Honor Roll and earned a bachelor of arts and a master in education from the U of A. AMS Awards Luncheon The Asklepion Award and Shuffield Award will be presented at the AMS Awards Luncheon on Saturday. Awards will be presented to an AMS member and a lay person who have benefited patients and health care in Arkansas through their outstanding work in the health care field. AMS House of Delegates The House of Delegates, composed of delegates from component medical societies, specialty societies, members of the Board of Trustees, AMS past presidents and the vice speaker, is AMS’ legislative and policy making body. Any dues-paying member of the society has full-voting rights. All members are invited to attend the House of Delegates meeting. Any member may submit a resolution to AMS for consideration. Deadline for submission is March 27. Any item of business not submitted by March 27 must have two-thirds consent of attending delegates for introduction at the meeting. Fifty Year Club Any AMS member who has practiced medicine for 50 years or more is eligible to attend the Awards Luncheon where we will honor new inductees, as well as the Fifty Year Club Social Hour. Watch your mail for a special invitation. VOLUME 111 Educational Sessions Emerging Diseases Update You will not want to miss AMS returning speaker, Dirk Haselow, MD, PhD, State Epidemiologist, Medical Director, Communicable Diseases, UAMS. Dr. Haselow has served as the Arkansas State Epidemiologist and Medical Director for Communicable Disease since 2012. He completed a PhD in Infectious Disease Epidemiology at the University of Maryland and an MD and a residency in Pediatrics at the University of Arkansas for Medical Sciences (UAMS). He is an adjunct Assistant Professor of Pediatrics and Epidemiology at UAMS and has taught Infectious Disease Epidemiology to MPH students since the inception of the UAMS College of Public Health. Legislative Session Recap Contributors Exhibitors & AMS will once again have a limited number of exhibit booths. Companies with exhibit booths as of February 13, 2015, are listed below. Gold Contributors AMS Benefits, Inc. State Volunteer Mutual Insurance Company (SVMIC) Bronze Contributors Arkansas Foundation for Medical Care From preserving the “private option” to defending the Peer Review Fairness Act to advocating for enhanced Medicaid reimbursement rates and everything in between, the AMS Governmental Affairs team has been hard at work at the Capitol. Director Scott Smith, JD, will wrap up the session during this presentation, providing a full recap of what went on and how it will affect you and your patients. Other Contributors & Exhibitors AHIN Professional Services Arkansas National Guard, Medical Recruiting First Security Bank UAMS Physician Relations Reservations for The Chancellor Hotel may be made over the phone by calling 855-285-6162. The AMS room rate will be $114 but you must identify yourself as part of the Arkansas Medical Society group when you call to receive the rate. State Volunteer Mutual Insurance Company’s 2015 General Seminar for Physicians and Non-Physicians The Chancellor Hotel | Fayetteville, Arkansas Friday, April 17, 2015 | 2:30 p.m. – 4:30 p.m. State Volunteer Mutual Insurance Company will be offering a Risk Management seminar on Friday, April 17 from 2:30 p.m. to 4:30 p.m. The 2015 General Risk Management Seminar, “9 Habits of Safe and Effective Medical Practices,” will describe the nine habits we see among physicians and their staff that contribute to the safest and most effective medical practices. This seminar is designed for physicians and their staff to attend together. Register online at www.SVMIC.com. AMA Credit Designation: The University of Tennessee College of Medicine designates this live activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Accreditation: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Tennessee College of Medicine and State Volunteer Mutual Insurance Company. The University of Tennessee College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. SVMIC Registration Fees $75.00 for Physicians $25.00 for Non-Physicians (non-refundable) Registration is available through SVMIC Lunch provided at noon 10% Premium Credit for SVMIC Policyholders www.SVMIC.com | 800.342.2239 NUMBER 11 “20-MINUTE RULE” Please be advised: The Risk Management Committee has determined that policyholders attending an SVMIC seminar for credit must participate in the entire program to fully benefit from the program and qualify for a 10% premium discount. We will count in attendance only those participants who are signed in within the first 20 minutes of the seminar. Late arrivals will no longer be considered present for satisfaction of the 10% premium credit or CME credit. APRIL 2015 • 225 ARKANSAS STATE MEDICAL BOARD 2014 ANNUAL REPORT The 2014 members and officers of the Arkansas State Medical Board are as follows: Joseph M. Beck, II, MD Chairman; Sylvia D. Simon, MD, Vice-Chairman; Bob E. Cogburn, MD, Secretary; Harold B. Betton, MD, Treasurer; Omar T. Atiq, MD; Stephen L. Cathey, MD; Jim C. Citty, MD; William F. Dudding, MD; John E. Hearnsberger, II, MD; Veryl D. Hodges, DO; Larry D. “Buddy” Lovell; Scott Pace, PharMD, JD; John H. Scribner, MD and John B. Weiss, MD The Board met bimonthly and addressed complaints, hearings, and other pertinent business affecting health care in the State of Arkansas. 2014 Licensing Statistics Medical Doctors and Doctors of Osteopathy Licensed ............. 606 Medical Doctors and Doctors of Osteopathy (total)................. 9,587 Complaint Allegations (including investigations) 2.......................................................................................Advertising 1..................................................APN Collaborating Physician Issues 17....................................... Attestation/Renewal Affirmative Answers 6.............................................................................Monitoring Issues Medical Doctors and Doctors of Osteopathy (in state)............ 6,382 15........................................................................... Behavior/Attitude Occupational Therapists Licensed............................................... 102 17................................................................. Billing/Insurance Issues Occupational Therapists (total)................................................. 1,371 Occupational Therapy Assistants Licensed....................................92 11..............................................Board Actions Taken by Other States 5......................................................................... Criminal Allegations 2................................. Lack of Communication or Miscommunication Occupational Therapy Assistants (total) ..................................... 474 1...............................................................................CME/CEU Issues Physician Assistants Licensed .......................................................44 59...................................... Dissatisfaction with Treatment/Procedure Physician Assistants (total)........................................................... 293 Respiratory Care Therapists Licensed......................................... 118 2....................................................................................HIPAA Issues 4............................................................................Hospital Reporting 6........................................................................... Inmate Allegations Respiratory Care Therapists (total) .......................................... 1,970 23............................................................... Inappropriate Prescribing Radiologist Assistants Licensed...................................................... 3 44................................................ Lack of Attention to Medical Needs Radiologist Assistants (total)............................................................ 6 22.................................................................. Malpractice Regulation Radiology Practitioner Assistants (total)...........................................4 Withdrawn Applications...................................................................18 16............................................. Medical Records – Failure to Provide 6........................................................ Medical Records –Discrepancy 6....................................................................................Misdiagnosis 24................................................................................Miscellaneous Summary of Board Proceedings for 2014 Individual Discussions and Issues (total)................................. 508 Complaints (including investigations and other issues involving licensed practitioners)............................................ 385 Issues..................................................................................... 123 25....................................................... Over-Prescribing/Over-Testing 1.......................................Patient felt Offended/Violated by Physician 1.......................................................................Patient Abandonment 4................................... Doctor Refuses to Prescribe/Refill Pain Meds 1.... Didn’t/Won’t Comply with Patient’s Request to Complete Paperwork 8...........................................................................Staff-Generated Issues 2............................................... Self-Prescribing or Prescribing to Family 2014 Board Actions Suspension............................................................................... 16 Revocation.................................................................................. 1 Revocation (stayed)................................................................... 2 Surrendered.............................................................................. 2 Reprimand.................................................................................. 2 Consent Orders......................................................................... 13 4............................................................Sexual or Romantic Relationship 1..........................................................................................Telemedicine 16............................................................................... Terminated Patient 1............................................................. Lawsuit Filed Against the Board 14.................................................................................... Licensure Issue 1.........................................................................Regulation 35 Reporting 17..................................................................................................Update To see the amended regulations for the calendar year as well as the full report, visit http://www.armedicalboard.org. 226 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 Medical Education Foundation for Arkansas (MEFFA) Alan K. Wilson, MD, President T he Arkansas Medical Society organized the Medical Education Foundation for Arkansas (MEFFA) in 1959. MEFFA is a tax exempt foundation (501(c)(3) and all contributions are tax deductible. MEFFA’s mission is to promote the art and science of medicine and the betterment of the health of the public by providing educational grants, primarily to the UAMS College of Medicine. A large part of the MEFFA funds are held by the Arkansas Community Foundation. Current members of the board are Drs. Jim Citty, Searcy; Muhammad Jaffar, Little Rock; Steve Magie, Little Rock; Renee Montgomery, Sherwood; W. Martin Eisele, Life Member; Alan K. Wilson, President; and Mr. Daniel Hubbs, Medical Student Representative. Serving as ex-officio members with voting power are the Arkansas Medical Society president, president-elect, immediate past president, and the dean of the University of Arkansas College of Medicine. The Board approved the following requests from UAMS for 2014-2015: (Total awarded $25,390.00) $4,000.00 AMS Distinguished Lecture Series – grants of $1,000 for each of the following speakers: $3,772.00POGIL Workshop – 1-day training workshop on Process Oriented Guided Inquiry Learning. • ULF Lerner DDS, PHD, Professor of Molecular Periodontology and Senior Consultant in Dentistry at the Centre of Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. (requested by the Department of Physiology and Biophysics.) $2,500.00 COM Curriculum – Support for the annual Teach the Teacher Conference $5,673.00 Pathology in Human Structure Module – implement, assess and publish the results of a joint interdisciplinary and multifaceted effort to increase the content of pathology in the UAMS College of Medicine’s new Human Structure module. $9,445.00 Lightly Embalmed cadavers for clinical skills training – feasibility study to assess the implementation of the preparation of “lightly embalmed” fresh cadavers for anatomical teaching and clinical skills training in the College of Medicine at UAMS. • Elizabeth Stuart, MD, Clinical Professor of Pediatrics at Stanford University School of Medicine. (requested by the Division of Pediatrics.) • Jeffry Koh, MD, Professor of Anesthesiology and Pediatrics at Oregon Health Sciences University and a former UAMS faculty member. (requested by the Department of Pediatrics) • Atul Gawande, MD, an American surgeon and journalist. (requested by the COM curriculum office.) “ WHEN I MOVED HERE, IT WAS VERY EASY TO MAKE FRIENDS.” WHEN STARTING THE NEW SCHOOL, FRANKI DIDN’T HAVE TO WAIT LONG TO FIND NEW FRIENDS. “When I moved here from Stockholm, Sweden, it was very easy to make friends.” On her first day at The New School, two classmates walked her to class and became fast friends. They now spend their days coding on computers, learning about social studies and watching science come to life. “I really like all the activity choices we have here like computers and gym, those are really fun and I really like doing social studies and science. We did this really fun thing in science where we got to name our own worms and got to do projects about the worms.” THE NEW SCHOOL IS A SPECIAL PLACE WHERE A WELCOMING ENVIRONMENT IS MATCHED WITH A CURRICULUM THAT COMES TO LIFE. Learn how The New School can help your child discover the world in a new way. Schedule a tour today by calling 479-521-7037 or visit thenewschool.org. Franki 3rd grader 8TH GRADE BEGINNING FALL 2015 TheNewSchoolNWA NUMBER 11 TheNewSchoolTweets TheNewSchoolAR NORTHWEST ARKANSAS’ PREMIER INDEPENDENT SCHOOL SERVING PRESCHOOL THROUGH GRADE 7 APRIL 2015 • 227 A LOOK AT QUALITY C L O S EA CLOSER R L O O K A T Q U A L I T Y EDITORIAL PANEL Lynda Beth Milligan, MD, FAAFP, CPE, CHCQM; Michael Moody, MD; David Nelsen, MD, MS; Steven Strode, MD, MEd, MPH; J. Gary Wheeler, MD, MPS Newborn screening improvements in Arkansas BY STEVE CHASTEEN, MNSc, RN, CPHQ N ewborn screening is a public health activity carried out in every state in the nation and in nearly all developed countries. Newborns are screened to identify conditions that are present but not clinically evident in the newborn period. Early identification and subsequent treatment of selected disorders can prevent permanent mental or physical damage, or death in affected children. The goal of newborn screening is to identify newborns who have clinically unapparent rare but treatable syndromes. This can prevent the occurrence of developmental impairments, delayed physical growth, severe illness and death. Newborn screening has been under scrutiny by public health officials since a November 2013 article was published in the Milwaukee Journal Sentinel. The article reported that thousands of hospitals throughout the country are late in sending newborn blood samples to state labs that perform the screening tests. The Journal Sentinel analyzed nearly three million newborn screening tests from hospitals across the country to determine how long it took for newborns’ samples to reach state laboratories. The newspaper began its investigation after learning that a newborn Arkansan experienced significant developmental delay from an easily treatable condition because the hospital where she was born delayed sending her blood sample for testing. The newborn was critically ill by the time her blood sample reached the state lab, five days after it was collected. It took an additional three and a half weeks The Arkansas Department of Health’s (ADH) laboratory tests newborn blood samples for 28 genetic disorders, providing an invaluable snapshot of information about the newborn’s health. for the abnormal test to be returned to the treating physicians.1 Arkansas hospitals were slow in sending newborn screening samples to the Arkansas Department of Health’s (ADH) state health laboratory for testing. At the end of the 2013 state fiscal year, only about 13 percent of the samples collected had been delivered within the specified time period. RECOMMENDED TIME PERIODS The American Academy of Pediatrics recommends that blood specimens be collected after the newborn is at least 24 hours old.2 A specimen collected prior to 24 hours of age can be used to screen for some disorders but is not reliable for amino acid disorders, cystic fibrosis, hypothyroidism and several others. Analyses of screening results suggest that a specimen taken on the second day of life is suitable for all testing. This small delay allows testing to be performed only once and has minimal effect on the outcomes of the condition of interest. The American College of Medical Genetics recommends3 that newborn screening samples arrive at a lab for testing no more than three days after they are collected, with a five-day maximum elapsed time between birth and the availability of test results. With some of these abnormal conditions, a newborn baby often appears healthy at birth, becoming extremely ill within days. If not treated, it can lead to disability or death within a few weeks. The Arkansas State Board of Health’s Rules and Regulations Pertaining to Testing of Newborn Infants purpose is to assure that all Arkansas newborns have the opportunity to be screened for genetic metabolic THE ARKANSAS FOUNDATION FOR MEDICAL CARE, INC. (AFMC) WORKS COLLABORATIVELY WITH PROVIDERS, COMMUNITY GROUPS AND OTHER STAKEHOLDERS TO PROMOTE THE QUALITY OF CARE IN ARKANSAS THROUGH EDUCATION AND EVALUATION. FOR MORE INFORMATION ABOUT AFMC QUALITY IMPROVEMENT PROJECTS, CALL 1-877-375-5700. 228 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 A A CLOSER C L O S E R L O LOOK O KAT QUALITY A T Q U A L I T illnesses. For healthy infants born in medical facilities, the optimum time for blood specimen collection is 24 to 72 hours after birth. The collected specimen should be submitted to the ADH’s Public Laboratories in Little Rock within one business day, (previously 48 hours) of collection. In Arkansas, the newborn screen is collected between 24 and 72 hours after birth. Blood samples from the newborn are collected by pricking the heel of the baby and collecting drops of blood on a piece of filter paper. The blood sample should be sent to the state lab within one business day. That means the next working day for the lab, such as when a state holiday coincides with a weekend. The ADH laboratory tests newborn blood samples for 28 genetic disorders, providing an invaluable snapshot of information about the newborn’s health. Some health disorders may cause serious lifelong damage within the first five days of life. The earlier the lab processes the tests, the sooner families can be notified of health concerns, and can consult with their physicians about further testing or treatment. Hospital and public health officials in many states, including Arkansas, have pledged to end delays by changing processes and improving how newborn blood samples get to state labs. Arkansas offers a courier service to transport blood samples from county health units to the ADH lab at no charge to hospitals. Hospitals also have the option to utilize overnight delivery services. Recently the ADH lab added Saturday hours of operation for newborn blood samples. STATEWIDE EFFORTS ARE WORKING In January 2014, the Arkansas Department of Health, Arkansas NUMBER 11 Medicaid Services (AMS), Arkansas Foundation for Medical Care (AFMC), Arkansas Hospital Association, and Arkansas birthing hospitals began a coordinated effort to reduce newborn screening delays in Arkansas. Leveraging the innovative and successful Arkansas Medicaid Inpatient Quality Incentive (IQI) program, AFMC and AMS developed two newborn screening quality measures. These measures both challenge and incentivize Arkansas hospitals to reduce the time between taking newborns’ blood-screening samples and sending them to the ADH lab in Little Rock. Newborn screening specimen collection and submission requirements from the Arkansas Board of Health were the basis for development of the IQI newborn screening quality measures. The two quality measures are: n Newborn Screen 1 (NBS-1): Timely Collection of Newborn Screening Specimen n Newborn Screen 2 (NBS-2): Timely Submission of Newborn Screening Specimen These quality measures will complement ongoing efforts in birthing facilities to examine their current process for collection and submission of the newborn blood sample and enhance their ongoing quality improvement efforts. Each facility must determine the best approach that will meet its needs and that will assist the facility in reaching established targets. Since Nov. 2013, the ADH reports that Arkansas’ hospitals have increasingly reduced the time it takes to deliver newborn blood samples to the public health lab for testing. From July through September 2014, about Y 50 percent of newborn blood samples collected at Arkansas hospitals arrived at the state laboratory within the department’s target time span of 48 hours. Arkansas hospitals are working hard to achieve the more stringent 48-hour target. Many hospitals in Arkansas have addressed and eliminated issues with collection and delivery of newborn blood samples. Time is critical, and the newborn screening process is a team effort. Hospital physicians, nurses and related staff take care of newborns. Newborns’ blood specimen samples are typically drawn from the baby before it is released from the hospital. After blood specimens are sent to the state lab for testing and the results are obtained, the ADH sends the test results to the physician for follow-up. The physician can then advise and assist families in finding the right resources and the right team of specialists to get the appropriate treatment. Getting the right treatment, which starts with timely collection and testing of blood samples, makes a great difference in affected infants’ chances for a healthy outcome. s Mr. Chasteen is the manager of quality programs for the Arkansas Foundation for Medical Care. REFERENCES 1. Gabler E, journalsentinalonline. Nov. 16, 2013. Available at: http://www.jsonline.com/watchdog/watchdogreports/ Deadly-Delays-Watchdog-Report-Delays-at-hospitals-across-the-country-undermine-newborn-screening-programsputting-babies-at-risk-of-disability-anddeath-228832111.html 2. Update of Newborn Screening and Therapy for Congenital Hypothyroidism. American Academy of Pediatrics. (2006). Pediatrics, Vol. 117, No. 6:2290-2303. 3. American College of Medical Genetics. (2006) Newborn Screening: Toward a Uniform Screening Panel and System. Genetics in Medicine, May 2006, Vol. 8, No. 5, Supplement: 44S. APRIL 2015 • 229 Minutes of the Arkansas Medical Society House of Delegates May 3, 2014 The Arkansas Medical Society House of Delegates met at 1:00 p.m., on Saturday, May 3, 2014, at the Winthrop Rockefeller Institute at Petit Jean Mountain. The following business was received and transacted. 1. Dr. Michael Saitta called the meeting to order. There were 57 voting members present. 2. Dr. Steven Strode gave the invocation and remembered AMS members that passed away during the past year. 3. Dr. Michael Saitta reminded members to check in at the registration desk so that there would be an accurate count of voting members and introduced the people at the head table. 4. Dr. Michael Saitta presented plaques to the following members for their service: Board of Trustees: Drs. William D. Dedman, Jacky Dunn, Clay Ferguson, Len Kemp, and medical student Matt McNelley Officers: G. Edward Bryant, Vice President 5. Dr. Gene Shelby thanked the Nominating Committee and introduced the slate of officers. The following officers were elected: President-elect: Edward Bryant, MD, West Memphis Vice President: Bill Dedman, MD, Camden Secretary: Chad Rodgers, MD, Little Rock Treasurer: Frankie Griffin, MD, Van Buren Speaker of the House: Michael Saitta, MD, Fayetteville Vice Speaker of the House: Clay Ferguson, MD, Nashville Delegates to the AMA AMA Delegate: Joe Stallings, MD, Jonesboro AMA Alternate Delegate: E. Scott Ferguson, MD, West Memphis Board of Trustees confirmed: District 1: Bradley Bibb, MD, Ash Flat District 2: Seth Barnes, MD, Batesville* District 3: George Conner, MD, Forrest City District 4: Jeffrey Reinhart, MD, Monticello District 5: Erin Goss, MD, Camden* District 6: George Covert, MD, Ashdown* District 7: Richard Pellegrino, MD, Little Rock District 8: Tracy Baltz, MD, Little Rock District 8: Lydia Lane, MD, Little Rock District 8: Kristen Lienhart, MD, Little Rock District 8: Renee Montgomery, MD, Sherwood District 8: Emillo Tirado, MD, Little Rock District 9: Curtis Hedberg, MD, Rogers District 9: Robert Gullet, Jr., MD, Fayetteville District 10: Vickie Henderson, MD, Russellville* Medical Student: Hannah Henson, Little Rock* 6. Minutes from the May 4, 2013, House of Delegates meeting were approved. 7. Requests for life/emeritus/affiliate dues exemptions were approved. 8. Dr. Gene Shelby gave a report on the Board of Trustees meeting held prior to the House of Delegates meeting. 9. Omar Atiq, MD addressed the Board as outgoing President. 10. David Barbe, Chairman of the AMA Board of Trustees provided an AMA update. 11. The following reports were placed on the Consent Calendar and accepted for information: • AMS Benefits, Inc. - Stephen Magie, MD, Chairman • Arkansas Health Care Access Foundation – William Rutledge, MD, President • Arkansas Medical Society Board of Trustees – Gene Shelby, MD, Chairman • Arkansas Medical Society 2014 Budget – Frankie Griffin, MD, Chairman • Arkansas State Medical Board – Joseph Beck, MD, Chairman • Medical Education Foundation for Arkansas (MEFFA) – Alan K. Wilson, MD, President • Arkansas Department of Health – Nathaniel Smith, MD, MPH Director and State Health Officer 12. The following amendments to the Constitution and Bylaws were approved: CONSTITUTION: ARTICLE XIII. Amendments The House of Delegates may amend any article of this constitution by a twothirds vote of the delegates present at any meeting of the House of Delegates, provided that the amendment shall have been mailed communicated to all members at least 90 45 days prior to the meeting. BYLAWS: CHAPTER XII. Amendments The House of Delegates may amend any chapter of these bylaws by a twothirds vote of the delegates present at any meeting of the House of Delegates, provided that the amendment shall have been mailed communicated to all members at least 90 45 days prior to the meeting. BYLAWS: Chapter VII, Section 9. Committees B. Budget Finance and Auditing Committee The Budget Finance and Auditing Committee shall consist of (a) four seven members appointed by the chairman of the Board from among the district *new appointment 230 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 trustees, and (b) the Arkansas Medical Society treasurer. The four seven trustees shall be appointed to four-year terms, staggered so that one member is no more than two members are replaced each year. The terms shall begin on January 1 and end on December 31 of the appropriate years. The member with the most seniority Arkansas Medical Society treasurer shall serve as chairman. The Budget Finance and Auditing Committee shall: Resolved, that AMS representatives to the Arkansas State Medical Board and the Arkansas State Board of Health be encouraged to periodically attend and participate in AMS Board of Trustees and/or House of Delegates meetings, and their attendance should be recognized and serve as an opportunity to highlight the important work carried out by these two boards, and (a) Present to the Board, before the first of each year, an annual budget consisting of anticipated revenue and expenses for the ensuing year as well as a report of the Society’s committed and non-committed reserves. Any significant request for funds not included in the annual budget should be reviewed by the Budget Finance and Auditing Committee before they are committed. Resolved, that when making nominations and reappointments to these boards, the AMS shall take into consideration the attendance and participation of applicants, and (b) The Budget shall provide for an annual independent financial audit and work to maintain the most prudent use of Society assets. Shall appoint a certified public accountant or firm to conduct an annual independent financial audit. The auditor shall present the results of the audit directly to the Committee. A copy of the audit and any irregularities or concerns identified by the audit shall be presented to the Board of Trustees. (c) Work with the executive vice president to review and monitor the financial reserves of the Society and recommend investment policy changes when necessary or recommended by Arkansas Medical Society financial advisors. Resolved, that those serving on these boards must attend an average of at least one AMS meeting every two years in order to be considered for re-nomination. The meeting adjourned at 4:00 p.m. October 31, 2014 The Arkansas Medical Society House of Delegates met at 10:00 a.m., on Friday, October 31, 2014, at The Lodge at Mount Magazine. The following business was received and transacted. 1. Alan Wilson, MD, welcomed attendees. 2. Michael Saitta, MD, called the meeting to order. There were 42 voting members present. 3. Minutes from the May 3, 2014, House of Delegates meeting were approved. 4. Dennis Yelvington, MD, gave a report on the Board of Trustees meeting held prior to the House of Delegates meeting. 5. Joe Thompson, MD, Arkansas Surgeon General, gave an update on the Private Option and a recent Arkansas Hospital Association report. He also discussed the Payment Improvement Initiative. 6. Tracy Baltz, MD, gave a report on the Arkansas Medical Society Political Action Committee (ARKMED-PAC). The total number of PAC members for 2014 is 250. 7. Dirk Haselow, MD, PhD, State Epidemiologist and Medical Director for Communicable Diseases discussed health concerns physicians should be aware of. 8. State Representatives Deborah Ferguson, DDS and Steve Magie, MD discussed their experiences serving as legislators and encouraged AMS members to get involved and stay in touch with their legislators. Whereas, physicians filling those positions assume a tremendous level of responsibility and authority to influence the practice of medicine and care of our patients, and 9. Whereas, it is vitally important that members of these two boards interact with AMS leadership on a regular basis in order to develop a strong, mutually beneficial relationship that supports the mission of AMS and the mission of these two boards. Therefore be it Scott Smith, JD, AMS Director of Governmental Affairs, gave a report on issues that may be debated during the 2015 legislative session. (d) Monitor the financial resources of the Society and make recommendations, as appropriate, to ensure the availability of necessary funding to achieve the short term and long term mission and purpose of the Society. Chapter V. Election of Officers, Section 3 Nominations from the Floor Nothing in this Chapter shall be construed to prevent additional nominations being made by members of the House of Delegates. Additional nominations for positions elected by the House of Delegates may be made by any member of the House of Delegates in attendance at the meeting. Nominations from the floor may also be made for any District Trustee positions remaining vacant after the election process provided for under Section 5. 1. Resolution #1 was adopted. To Encourage Participation of AMS Appointees to the Arkansas State Medical Board and Board of Health – Submitted by Eddie Bryant, MD (West Memphis) Whereas, the Arkansas Medical Society is statutorily required to make nominations to the Governor of the State of Arkansas for positions on the Arkansas State Medical Board and the Arkansas State Board of Health, and NUMBER 11 The meeting adjourned at 12:00 p.m. APRIL 2015 • 231 Minutes of the Arkansas Medical Society Executive Committee Meeting T January 22, 2014 he Arkansas Medical Society Executive Committee met at 4:30 p.m. on Wednesday, January 22, 2014. Members attending the meeting were Drs. Gene Shelby, Eddie Bryant, and Frank Griffin. Members attending via conference call were Drs. Omar Atiq and Alan Wilson. AMS staff attending were David Wroten, Scott Smith, Kay Waldo, and David Ivers, AMS legal counsel. The meeting was called to order at approximately 4:30 p.m. and the following business was received and transacted. review is to ensure appropriate physician representation on the governance structure. 7. Community Care of North Carolina has requested a letter of support from Arkansas Medical Society. They are bidding to provide Medicaid Care Coordination in Arkansas. The Executive Committee approved the letter of support if AAFP also provides a letter of support to this group. 8. Dr. Bryant discussed his plans to submit a resolution requiring AMS appointees to the AR State Med Board and Board of Health to attend at least one Board of Trustee meeting or House of Delegates meeting annually. 1. The committee discussed Medical Marijuana March 26, 2014 Ballot Initiatives that may be on the ballot in the fall. Arkansas Medical Society staff will provide additional information to the Executive Committee for review including AMA policy on this issue. Future discussions will include a suggestion that an ad hoc committee be formed and possibly polling Arkansas Medical Society members. 2. A contribution of $1000 was approved for AR Health and AR Jobs. Arkansas Medical Society is a member of this multi-organization coalition supporting continued funding for the Private Option during the upcoming Fiscal Session. 3. Dr. Atiq discussed opening up the election of all Arkansas Medical Society officers by the general membership rather than the House of Delegates. He is considering presenting this at the annual meeting in the form of a resolution that can be discussed by the House of Delegates. 4. Mr. Wroten gave an update on the Arkansas Blue Cross Blue Shield fee schedule for the metallic health plans. 5. Requests for direct membership were approved. 6. ACHI is applying to a RFP from the AR Insurance Department to build an “all payer claims data The Arkansas Medical Society Executive Committee met at 4:30 p.m. on Wednesday, March 26, 2014. Members attending the meeting via conference call were Drs. Omar Atiq, Gene Shelby, Eddie Bryant, Chad Rodgers, and Frankie Griffin. Also attending was David Wroten, AMS Executive Vice President. The meeting was called to order at approximately 4:30 p.m. and the following business was received and transacted. 1. AMS received notice from the AMA that during 2013 AMA membership in Arkansas increased above 2000, making Arkansas eligible for an additional delegate and alternate delegate. After discussion, the Committee agreed that the new positions could be filled this year with physicians already planning to attend the meeting. 2. Dr. Shelby gave a brief report on the AMA Advocacy Conference. 3. Mr. Wroten informed the Committee that Arkansas Blue Cross Blue Shield has decided to amend its reimbursement schedule for the metallic health plans effective July 1, with an overall 10% reduction from the 2013 fee schedule. 4. Mr. Wroten informed the Committee about a potential new opportunity to support a group ter of support from Arkansas Medical Society. purchasing program for members. A proposal The executive committee asked Mr. Wroten to will be forthcoming at a later date. review the RFP before granting support. The base.” Dr. Joe Thompson has requested a let- 232 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY 5. Discussed the 2014 Fall Meeting and the poll of Trustees. The majority of responders indicated they would like to have the meeting at Hotel 21C in Rogers/Bentonville, followed closely with Mt. Magazine. After comparing costs for the two locations, AMS staff recommended Mt. Magazine. The Committee agreed. Meeting adjourned. June 25, 2014 The Arkansas Medical Society Executive Committee met at 4:30 p.m. on Wednesday, June 25, 2014. Members attending via conference call Drs. Gene Shelby, Alan Wilson, Eddie Bryant, Frank Griffin, Chad Rodgers, and Bill Dedman. AMS staff attending were David Wroten, Scott Smith and Mike Mitchell. The meeting was called to order at approximately 4:30 p.m. and the following business was received and transacted. 1. Discussed a lawsuit filed to overturn the Peer Review Fairness Act of 2013, filed by Baptist Health, Mercy Health Systems, and Washington Regional. Agreed to seek intervention in the case and request support and/or intervention by the Litigation Center of the AMA and State Medical Societies. 2. Agreed to sign on to a letter asking CMS to reconsider a new rule that would allow hospital systems with multiple campuses to only have one (1) medical staff organization. Current rules require each hospital to have its own medical staff and medical staff leadership (committees, etc.). 3. Discussed telemedicine issues concerning licensure and insurance reimbursement. Dr. Griffin volunteered to work with staff and others on this issue for possible legislation. 4. Medical Marijuana ballot initiatives were briefly discussed. It was noted that AMS already had taken a position on the issue in the 2012 elections and that the position had not changed. The question was asked about a public pronouncement of AMS opposition and it was agreed that VOLUME 111 AMS should consider that if and when the initiatives were successful in getting on the ballot. 5. Approved Direct Member requests. 6. Accepted information for an email from Dr. Janet Cathey asking AMS to intervene in a lawsuit over abortion legislation passed during the 2013 legislative session. 7. Mr. Wroten reported on a recent trip to the Independence County Medical Society to provide them with information on Clinically Integrated Networks. There being no further business, the meeting adjourned. September 24, 2014 The AMS Executive Committee met on Wednesday, September 24, 2014 beginning at 4pm. Present: Drs. Dennis Yelvington, Chad Rodgers, William Dedman, Alan Wilson (phone) Frankie Griffin (phone), Eddie Bryant (phone), Omar Atiq (phone). Also, David Wroten, Scott Smith, and Mike Mitchell. Dr. Gene Shelby participated by phone as a guest. 1. Dr. Shelby discussed ways to encourage physicians to register for the Prescription Drug Monitoring Program. Currently, only 30% of prescribers are registered users of the PDMP. The Committee asked that a letter be sent to the Arkansas State Medical Board formally requesting that the Board provide a link to the PDMP registration page as part of the physician licensure renewal process. The link would make it easier for physicians to register for the PDMP but would not mandate that they do so. The Committee also agreed to request that language be added to the Hospital Rules and Regulations proposed revisions requiring hospitals to adopt guidelines for prescribing opioids in the Emergency Department. The language would not dictate what those policies are but would simply require the hospital to have them. It was noted that the AMS, AHA, Health Department and other organizations developed and approved a suitable set of guidelines/policies nearly two years ago. 2. The Committee was asked to advise staff on wording for specific provisions in the proposed revision of rules governing hospitals. The issue involved who could authenticate records for pa- tients in the hospital (i.e. H&Ps, discharge summaries, etc.). Should it be the person performing the service (physician or midlevel), the attending or treating physician, or “any” physician. The Committee agreed that it should be treating or attending physician. 3. Mike Mitchell reported on the status of the lawsuit seeking to overturn the 2013 Peer Review Fairness Act. Judge Tim Fox denied AMS request to intervene even though there were no objections by the plaintiffs. The Order did not specify reasons. It was felt not to be worthwhile to pursue a Motion for Reconsideration. 4. Scott Smith gave an update on potential legislative issues including the impact of rescheduling hydrocodone combination products on PA/APRN midlevel practitioners who work for physicians, CRNA’s requesting removal of physician supervision, telemedicine, POLST, and prescription drug abuse. 5. The Committee granted approval of all requests for Direct Membership. There being no further business, the meeting was adjourned. Medical Board Legal Issues? Call Pharmacist/Attorney Darren O’Quinn 1-800-455-0581 www.DarrenOQuinn.com Little Rock, Arkansas You’d be surprIsed how manY medIcal professIonals ask, “Is there an accountant In the house?” More than 170 medical professionals rely on Bell & Company for expert accounting and financial advice. How can we put our 150 years of combined experience to work for you? Let’s start now. Call us today for a free consultation. bellandcompany.net / 501.753.9700 NUMBER 11 APRIL 2015 • 233 Minutes of the Arkansas Medical Society Board of Trustees Meeting February 12, 2014 May 2, 2014 The Arkansas Medical Society Board of Trustees met at 4:00 p.m. on Wednesday, February 12, 2014, at the Arkansas Transit Association located at 620 West Broadway Street in North Little Rock. Members attending the meeting were Drs. Omar Atiq, Bradley Bibb, Ian Birkett, G. Edward Bryant, Amy Cahill, Josh Chance, George Conner, Scott Cooper, William Dedman, Monica Dellimore, Jacob Dickinson, Jacky Dunn, Gary Edwards, Clay Ferguson, Frankie Griffin, Robert Gullett Jr., John Hearnsberger, Curtis Hedberg, Jay Jeffrey, Len Kemp, Lydia Lane, Gale McFarland, James Meserow, Renee Montgomery, Amir Qureshi, Chad Rodgers, Michael Saitta, Robert Sanders, Gene Shelby, Emilio Tirado, Tommy Wagner, Gary Wheeler, and Danny Wilkerson. AMS Past Presidents present were Drs. Scott Ferguson, David Jacks, Lloyd Langston, Larry Lawson, Charles Logan, Stephen Magie, Michael Moody, Brenda Powell, Joe Stallings, and Steven Strode. AMS staff present was Billie Jean Davenport, Penny Henderson, Alanna Scheffer, Scott Smith, Kay Waldo, David Wroten, and Mike Mitchell. Guests present were Jay Shue, Arkansas Medicaid Inspector General. The Arkansas Medical Society Board of Trustees met at 3:00 p.m. on Friday, May 2, 2014, at the Winthrop Rockefeller Institute at Petit Jean Mountain. Members attending the meeting were Drs. Omar Atiq, Bradley Bibb, Ian Birkett, G. Edward Bryant, Amy Cahill, Josh Chance, George Conner, Scott Cooper, William Dedman, Jacky Dunn, Gary Edwards, Robert Gullett Jr., Curtis Hedberg, Muhammad Jaffar, Jay Jeffrey, Len Kemp, Kristen Lienhart, Gale McFarland, Renee Montgomery, Richard Pellegrino, Amir Qureshi, Chad Rodgers, Michael Saitta, Robert Sanders, Gene Shelby, Emilio Tirado, Tommy Wagner, Gary Wheeler, Danny Wilkerson, Alan Wilson, and Dennis Yelvington. AMS Past Presidents present were Drs. Joseph Beck, John Burge, John Crenshaw, Scott Ferguson, David Jacks, Lloyd Langston, Larry Lawson, Charles Logan, Stephen Magie, Michael Moody, Brenda Powell, Joe Stallings, Steven Strode and Dwight Williams. AMS staff present was Kay Waldo, David Wroten, Penny Henderson, Billie Jean Davenport, Alanna Scheffer and Scott Smith. Guests present were Drs. Seth Barnes, George Covert, Robert Bell, and Mr. Cecil Suitt of LAMMICO. Chairman, Dr. Eugene Shelby called the meeting to order and the following business was received and transacted. Chairman, Dr. Eugene Shelby called the meeting to order and the following business was received and transacted. 1. The board approved the minutes of the following meetings: 1. Welcome and Disclosure of Conflicts of Interest. • November 13, 2013 Board of Trustees Meeting 2. The board approved the minutes of the following meetings: • February 12, 2014 Board of Trustees Meeting • January 22, 2014 Executive Committee Meeting 2. Jay Shue, Arkansas’ first Medicaid Inspector General addressed the Board. This new state agency works to detect Medicaid fraud & abuse and maximize recovery of improper Medicaid payments. 3. David Wroten presented the membership & budget reports for information. Wroten also announced the establishment of a PA/APRN Interest Group and encouraged the board to enroll their staff. • January 22, 2014 Executive Committee Meeting • March 26, 2014 Executive Committee Meeting 3. Cecil Suitt, a Senior Field Representative from LAMMICO presented a check to Eugene Shelby, MD for the Arkansas Medical Foundation for $5000. 4. Gene Shelby, MD, Joseph Beck, MD, and Nathan Smith, MD discussed Prescription Drug Abuse issues with the State. 5. Chad Rodgers, MD, reported the Arkansas Healthcare Access Foundation will no longer receive funding resulting in the dissolution of the Foundation effective July 1, 2014. AHCAF wishes to enter into an agreement with AMS to oversee the legal, financial and practical steps involved in the dissolving the Foundation. The Foundations assets will be used to compensate AMS for their services and any remaining assets will be conveyed to the Medical Education Foundation for Arkansas. The Board voted to accept this contract. 6. District Trustee Reports were given by Drs. Jay Jeffrey, Amy Cahill, Ian Birkett, and Jacky Dunn. 7. Dr. Shelby announced there will be an election for a new Board Chairman at the August meeting. 8. David Wroten presented the membership and budget reports which were accepted for information. The 2013 tax return was offered to trustees for their review. 10. Dr. Joe Stallings gave a report of the AMA Interim Meeting held in November, 2013. 9. The Board approved the 2015 annual meeting dates and location. The meeting will be held April 17-18 at the Chancellor Hotel in Fayetteville. There being no further business the meeting adjourned. There being no further business the meeting adjourned. 4. Scott Smith and Dr. Scott Ferguson reported on activities at the state capitol including an update on the private option coverage and SGR Repeal. 5. District Trustee Reports were given by Drs. Len Kemp, Bill Dedman, and Scott Cooper. 6. Dr. Gene Shelby provided information about the AMPAC Campaign School and Candidate School. 7. Dr. Omar Atiq discussed the current process for election of officers. 8. Dr. Eddie Bryant suggested that AMS members appointed to boards, i.e. State Medical Board, Board of Health, etc. be asked to attend at least one AMS Board meeting or the Annual meeting at least once a year. He will consider introducing a resolution so that the House of Delegates can discuss and possibly support the idea. 9. District Trustee ballots were provided for voting for the 2014 elections. 234 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 August 13, 2014 October 31, 2014 The AMS Board of Trustees met at 4:00 p.m. on Wednesday, August 13, at Independent Insurance Agents of Arkansas located at 5000 North Shore Drive in North Little Rock. Members attending the meeting were Drs. Lee Archer, Omar Atiq, Tracy Baltz, Bradley Bibb, Ian Birkett, Robert Breving, G. Edward Bryant, Josh Chance, Scott Cooper, George Covert, William Dedman, Monica Dellimore, Jacob Dickinson, Gary Edwards, Clay Ferguson, Frankie Griffin, Robert Gullett Jr., Curtis Hedberg, Muhammad Jaffar, Jay Jeffrey, Lydia Lane, Kristen Lienhart, Renee Montgomery, Richard Pellegrino, Amir Qureshi, Jeff Reinhart, Chad Rodgers, Michael Saitta, Robert Sanders, Gene Shelby, Emilio Tirado, Danny Wilkerson, Alan Wilson, and Dennis Yelvington. AMS Past Presidents present were Drs. David Jacks, Larry Lawson, Michael Moody, Brenda Powell, and Steven Strode. AMS staff present were Kay Waldo, David Wroten, Billie Jean Davenport, Alanna Scheffer, Scott Smith and Gloria Boone. Guests present were Nate Smith, MD, David Ivers, JD, Parth Shah, and Christian Kurth. The Arkansas Medical Society Board of Trustees met at 7:30 a.m. on Friday, October 31, 2014, at The Lodge at Mount Magazine. Members attending the meeting were Drs. Omar Atiq, Tracy Baltz, Seth Barnes, Bradley Bibb, Ian Birkett, Robert Breving, G. Edward Bryant, Amy Cahill, Josh Chance, George Conner, Scott Cooper, Jacob Dickinson, Erin Goss, Frankie Griffin, Robert Gullett Jr., John Hearnsberger, Curtis Hedberg, Vickie Henderson, Muhammad Jaffar, Jay Jeffrey, Lydia Lane, Kristen Lienhart, James Meserow, Renee Montgomery, Amir Qureshi, Chad Rodgers, Michael Saitta, Robert Sanders, Danny Wilkerson, Alan Wilson, and Dennis Yelvington. AMS Past Presidents present were Drs. Scott Ferguson, David Jacks, Stephen Magie, Michael Moody, Brenda Powell, Gene Shelby, Joe Stallings, and Steven Strode. AMS staff present were Billie Jean Davenport, Alanna Scheffer, Laura Hawkins, Scott Smith, Gloria Boone, Kay Waldo, David Wroten, and Mike Mitchell, AMS Legal Counsel. Guests present were Michael Buffington, MD, Kenneth Vest, MD, Donald Blagdon, MD, Joe Thompson, MD, State Representative Deborah Ferguson, Ali Jarallah, and Randy Meador, State Volunteer Mutual Insurance Company. Chairman, Dr. Eugene Shelby called the meeting to order and the following business was received and transacted. Chairman, Dr. Dennis Yelvington called the meeting to order, reminded members of the AMS conflict of interest policy and the following business was received and transacted: 1. 1. Dr. Shelby welcomed attendees and reminded them of the AMS Disclosure Policy. 2. The board approved the minutes of the following meetings • May 2, 2014 Board of Trustees Meeting • June 25, 2014 Executive Committee Meeting 2. Dr. Frankie Griffin, Chairman of the AMS Finance and Auditing Committee, presented the 2015 proposed budget in Executive Session. The Board approved the budget. State Volunteer Mutual Insurance Company was approved to be an AMS Endorsed Service Provider. The board approved the minutes of the following meetings: • August 13, 2014 Board of Trustees Meeting • September 24, 2014 Executive Committee Meeting 3. Robert Breving, MD, Hot Springs, was approved to fill an unexpired term as 7th District Trustee replacing Lonnie Wright, MD. The term will expire 2015. 3. Randy Meador, State Volunteer Mutual Insurance Company presented Dr. Yelvington with a $22,000 check for the Arkansas Medical Society to use for leadership development. • MEFFA – Muhammad Jaffar, MD, was approved to fill the vacancy of Jim Kolb, MD 4. • Finance and Auditing Committee – Brad Bibb, MD, Erin Goss, MD, and Danny Wilkerson, MD, were approved to serve on the Finance and Auditing Committee. Dr. Yelvington notified the board members of the vacancy within the Finance and Audit Committee. Amy Cahill’s term will expire December 31, 2014 and will be filled at the January Board meeting. 5. Gloria Boone gave an update on AMS efforts with the Arkansas Payment Improvement Initiative. 5. David Ivers, JD, gave an update on the Challenge of Arkansas’ Peer Review Fairness Act of 2013. 6. Mr. Wroten presented the AMS Membership & Budget Reports for information and noted AMS membership has reached a record high. 6. David Wroten reported AMS has sent comments to the Arkansas Insurance Department regarding proposed Rule 108 specifically who can lead a Patient Centered Medical Home (PCMH). 7. The Board approved the following candidate names to be sent to the Governor for consideration to the Arkansas State Medical Board positions in the Fourth Congressional District: 7. The July membership and cash budget reports were presented for information. Mr. Wroten also gave an update on AMS Benefits, Inc. 8. Drs. Shelby and Nate Smith discussed Pennsylvania Prescribing Guidelines for Chronic Non-Cancer Pain. The board agreed this needed further review and potentially a committee to consider adopting similar guidelines. 4. 9. Appointments Position 1 • Sylvia Simon MD, Monticello – Family Practice • John E. Hearnsberger, MD, Nashville – General Surgery • Robert E. Breving, MD, Hot Springs – General Surgery Position 2 • John E. Hearnsberger, MD, Nashville – General Surgery Dr. Moody reported on the AMA meeting held in June. 10. David Wroten and Scott Smith facilitated a legislative planning session. Potential topics were identified and will be considered by the AMS Legislative Committee. • Sylvia Simon MD, Monticello – Family Practice • Jason D. Richey, MD, Paris -- Family Practice 8. A motion was made and approved to include budget information in packets mailed to AMS past presidents. 9. Shane Smith, MD was elected to fill the unexpired term for Tommy Wagner, MD, in District #1. Dr. Wagner’s term expires in April, 2015 11. Dennis Yelvington, MD, was elected Board of Trustees Chairman. There being no further business the meeting adjourned. There being no further business the meeting adjourned. NUMBER 11 APRIL 2015 • 235 Put your business or service in the hands of 4,400 Arkansas physicians, advertise in: Arkansas Medical Society 2015 BUDGET REPORT INCOME Dues..........................................................................................$1,093,754.00 Journal and Directory.......................................................................81,339.00 Annual Meeting................................................................................24,500.00 Website & Grants............................................................................239,944.00 Interest /Investment Income............................................................72,113.00 Specialty Desk..................................................................................48,840.00 Educational Programs......................................................................95,000.00 TOTAL REVENUE........................................................... 1,655,490.00 EXPENSE For advertising information, contact Penny Henderson at 501.224.8967 or [email protected] Salaries...........................................................................................751,086.00 Travel and Convention......................................................................51,200.00 AMA Delegation................................................................................35,000.00 President’s Account...........................................................................6,000.00 Taxes................................................................................................51,500.00 Retirement........................................................................................81,257.00 Stationery & Printing.........................................................................13,675.00 Office Supplies & Expenses.............................................................35,171.00 Telephone - AMS................................................................................8,008.00 Rent..................................................................................................30,000.00 Postage, Communications, Web......................................................24,400.00 Insurance & Bonds.........................................................................161,850.00 Auditing..............................................................................................5,700.00 Board & Executive Committee...........................................................6,000.00 Journal and Directory.......................................................................70,000.00 Dues & Subscriptions.......................................................................15,400.00 Gifts & Contributions AMS.................................................................5,000.00 Legal Services..................................................................................91,800.00 Public Relations..................................................................................1,500.00 Miscellaneous, Legal guide Exp.........................................................4,000.00 Office Equipment & Furniture...........................................................11,000.00 AMS Resident & Student....................................................................6,000.00 Annual Meeting................................................................................31,000.00 Educational Programs......................................................................34,000.00 Physician’s Health Com...................................................................10,000.00 Investment Fees...............................................................................20,000.00 TOTAL EXPENSE........................................................... 1,560,547.00 236 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 111 NUMBER 11 APRIL 2015 • 237 2015 Annual Session Registration Form Arkansas Medical Society Educational Program & Expo | 139th AMS Annual Session Chancellor Hotel | Fayetteville, Arkansas | April 17-18, 2015 Section 1: Registrant Information Member Name: ___________________________________________________________________________________________ Spouse or Guest Name: ____________________________________________________________________________________ Address: ________________________________________________________________________________________________ City: _______________________________________________________________ State: ______ Zip: _____________________ Phone: ____________________________________________ Fax: __________________________________________________ Email:___________________________________________________________________________________________________ Section 2: Registration AMS Physician Members or their Staff: Registration Fee $135 Per Person Physician Non-Members or their Staff: Registration Fee $235 Per Person Spouse or Guest: Registration Fee $ 65 Per Person Attending House of Delegates Meeting ONLY: (No Charge) Please help us make an accurate meal order by indicating the number of people who will attend the following: ____________ Inaugural Gala (Friday) ____________ Awards Luncheon (Saturday) Medical Student and Resident Members or their Guests: Registration Fee $ 15 Per Person Total Registration Fee $ ____________________________ Section 3: Payment Payment Method: □ Check □ VISA □ Mastercard Name on credit card: ______________________________________________________________________________________ Signature: _______________________________________________________________________________________________ Billing Address: ___________________________________________________________________________________________ City/State/Zip: ____________________________________________________________________________________________ Total Amount to be charged to card: $ _________________________________________________________________________ oo/oo ooo oooooooooooooooo Credit Card Number Expiration Date 3-Digit Code Registrations made by credit card may be faxed to 501-224-6489. If you have any questions, please call 501-224-8967 or 800-5421058. Refunds requested prior to April 1, 2015, will be at the full amount. Refunds requested after that date will be charged a $25 processing fee. All refunds will be mailed after the convention. Special Assistance Available: If you are a person with a disability or have special dietary needs, please let the Society office know in advance so we can arrange to make your attendance as convenient and comfortable as possible. 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We have local representatives in Arkansas to serve your needs. Contact Sharon Theriot or Mandy Holmes at [email protected] or call 800.342.2239. Exclusively endorsed carrier of the Arkansas Medical Society 240 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY 31 Consecutive years SVMIC has maintained an “A” (Excellent) or better financial rating from A.M. Best; industry-leading financial stability means we will be here when you need us. Mutual Interests. Mutually Insured. Follow us @SVMIC • www.svmic.com VOLUME 111