KCMS KCOA Bulletin

BulletinK C M S K C O A

THE OFFICIAL JOURNAL OF THE KENT COUNTY MEDICAL SOCIETY & THE KENT COUNTY OSTEOPATHIC ASSOCIATION FALL 2015

PAGE 4New Members

PAGE 17 KCMSA Annual Charity Event

PAGE 6KCMS President’s Message

Generic Prescription Prices Soar for Patients

A look at drug pricing, market intervention and proposed solutions to address

high pharmaceutical costs.

PAGE 6

PROTECTION

UNCOMPROMISING

As the nation’s largest physician-owned medical malpractice

insurer, with 77,000 members, we constantly monitor emerging

trends and quickly respond with innovative solutions. And our

long-standing relationships with the state’s leading attorneys and

expert witnesses provide unsurpassed protection to our nearly

4,700 Michigan members. When these members face claims,

they get unmatched litigation training tailored to Michigan’s legal

environment, so they enter the courtroom ready to fight—and win.

Join your colleagues—become a member of The Doctors Company.

CALL OUR EAST LANSING OFFICE AT 888.896.1868 OR VISIT WWW.THEDOCTORS.COM

IN MICHIGAN, WE PROTECT OUR MEMBERS WITH THE BEST

OF BOTH WORLDS: NATIONAL RESOURCES AND LOCAL CLOUT

UNCOMPROMISINGIN MICHIGAN, WE PROTECT

OUR MEMBERS WITH THE BEST OF BOTH WORLDS: NATIONAL

RESOURCES AND LOCAL CLOUT

PROTECTION

5455_MI_Kent_CMS_UP_3rdQuarter2015_flat_f.indd 1 10/19/15 4:03 PM

2 KCMS/KCOA BULLETIN FALL 2015

ContentsFall 2015 • Vol. 100, No. 4

KCMS Memorials 4

New Members 4

Meetings of Interest 5

KCMS Social 9

Directory Changes 10

KCOA Meetings of Interest 12

President’s Message 13

CONTRIBUTORS 15 Kent Medical Foundation 16 Alliance Heartbeat 20 MSU - College of Human Medicine 21 Kent County Health Department

GET INVOLVED: Learn more about the Kent County Medical Society at www.kcms.org. Learn more about the Kent County Osteopathic Association at www.kcoa.us.

EDITORIAL COMMITTEE

Gregory J. Forzley, MD — EditorMichelle M. Condon, MDPatrick J. Droste, MS, MDHarland T. Holman, MDHerman C. Sullivan, MD

PUBLISHED BY

Kent County Medical Society & Kent County Osteopathic Association

233 East Fulton, Suite 222 Grand Rapids, MI 49503

Phone 616.458.4157 Fax 616.458.3305

www.kcms.org • www.kcoa.us

AFFILIATED AGENCIES

Kent County Medical Society Alliance Kent Medical Foundation

All statements of opinions in The Bulletin are those of the individual

writers or speakers, and do not necessarily represent the opinions of the Kent County

Medical Society and the Kent County Osteopathic Association.

The Bulletin reserves the right to accept or reject advertising copy. Products and services advertised in The Bulletin are neither endorsed nor warranted by the

Kent County Medical Society or the Kent County Osteopathic Association.

BULLETIN

K C M S K C O A

Cover Story Page 6KCMS President David E. Hammond, MD examines the dilemma of high cost generic medications

In MemoriamJOHN P. CHAMPION, MDDr. John Champion passed away on October 3, 2015. He earned his medical degree from Indiana University Medical School and pursued a career in Radiology following his service in the Navy from 1949 to 1951. Dr. Champion moved from Indiana to Grand Rapids in 1954 to take a position at Blodgett Memorial Hospital. He went on to become Chief of Radiology; his career was highlighted by the advent of new technologies in radiology at Blodgett such as the first CAT scan apparatus in West Michigan and the creation of a Department of Nuclear Medicine.

Welcome KCMS MembersNEW ACTIVE MEMBERSELIZABETH D. KOWAL, MD(Child and Adolescent Psychiatry)Helen DeVos Children’s Hospital35 Michigan St. NE, Ste. 4150Grand Rapids, MI 49503616-267-2850

JAN “JOHN” M. RAJLICH, MD(Family Practice)A.F. Associates Family Medicine, PC2849 Michigan St. NEGrand Rapids, MI 49506616-285-6455

REINSTATED MEMBERSCHAD E. AFMAN, MD(Otolaryngology)Spectrum Health Medical Group ENT4069 Lake Drive SE, Ste. 315Grand Rapids, MI 49546616-267-7758

CHRISTOPHER M. CHAMBERS, MD, PHD(Vascular Surgery)Spectrum Health Medical Group Vascular Surgery4069 Lake Drive, Ste. 312Grand Rapids, MI 49546616-267-8700 TRANSFERRED MEMBERGERALD E. VAN WIEREN, MD(Internal Medicine)Gerald E. Van Wieren, MD, PC71 S. FrontGrant, MI 49327231-834-5676

KC

MS

Board Positions Open The KCMS Board is seeking members interested in serving on the KCMS Board. If you are interested in serving the Membership and provide direction and leadership for a three-year term, please contact the KCMS office at 458-4157 or [email protected]. The Board meets monthly at 6:30 p.m. in addition to its periodic Membership meetings and events.

DETROIT

NEW YORK

CLEVELAND

SOLID ADVICE. REAL SOLUTIONS.

FOR HEALTH CARE BUSINESS.

• Appeals of RAC, Medicare, Medicaid & Other Third Party Payor Claim

Denials & Overpayment Demands

• Health Care Billing & Reimbursement

• Health Care Contractual, Corporate & Transactional Matters

• Stark, Anti-Kickback, Fraud & Abuse & Other Regulatory Analyses

• Physician Group Practice Ancillary Services Integration & Contractual

Joint Ventures

• Health Care Litigation

• Health Care Investigations

• Civil & Criminal False Claims Defense

• Licensure & Staff Privilege Matters

• Compliance

• HIPAA

TheHLP.com [248.996.8510]

The HLP attorneys represent clients in substantially all areas of health law, with particular emphasis on:

REMINDER

PLEASE PAY YOUR 2016 DUES Prompt payment of your KCMS dues is greatly appreciated! MEMBER OF THE KCMS VENDOR PROGRAM


Join Us

For event details, check out our website kcms.org

KCMS MEETINGS OF INTEREST

Visit usOUR MISSION:

The Kent County Medical Society is a professional association, uniting the physicians in Kent County

into a mutual, neutral organization; preserving and promoting the health of the citizens of Kent County,

the physician/patient relationship, the medical profession, and the interests of physicians.

PRESIDENT David E. Hammond, MD

PRESIDENT-ELECT Jayne E. Courts, MD

PAST PRESIDENT Donald P. Condit, MD, MBA

SECRETARY-TREASURER Herman C. Sullivan, MD

DIRECTORSMegan Edison, MDEric L. Larson, MD

PRESIDENT, MICHIGAN STATE MEDICAL SOCIETY

Rose M. Ramirez, MD

PRESIDENT-ELECT, MICHIGAN STATE MEDICAL SOCIETY

David M. Krhovsky, MD

5TH DISTRICT DIRECTORSAnita R. Avery, MD

Todd K. VanHeest, MD

DELEGATION CHAIRDomenic R. Federico, MD

MSMS DELEGATES TO JANUARY 2016

Lee P. Begrow, DO R. Paul Clodfelder, MD

Donald P. Condit, MD, MBA Michelle M. Condon, MD Patrick J. Droste, MS, MD David E. Hammond, MD

Brian A. Roelof, MD

MSMS ALTERNATE DELEGATES TO JANUARY 2016Mark Clark, MDSal F. Dyke, MD Meg Edison, MDKhan Nedd, MD

MSMS DELEGATES TO JANUARY 2017

John H. Beernink, MDJayne E. Courts, MD

Paul O. Farr, MDDomenic R. Federico, MD

John H. Kopchick, MDEric L. Larson, MD

John B. O’Donnell, MDJohn E. vanSchagen, MDDavid W. Whalen, MDPhillip G. Wise, MD

MSMS ALTERNATE DELEGATES TO JANUARY 2017

Douglas Ellinger, MDTammy Kreuzer, MDJudith L. Meyer, MD

Ryan K. Miyamoto, MDScott Russo, MD

Herman C. Sullivan, MD

KCMS OFFICERS & DIRECTORS

JANUARY 16, 2016KCMS ANNUAL MEETINGCalvin CollegeDetails to follow

FEBRUARY 8, 2016LEGISLATIVE COMMITTEE LUNCHEONMasonic Center, 4th Floor I Noon

APRIL 4, 2016LEGISLATIVE COMMITTEE LUNCHEONMasonic Center, 4th Floor I Noon

APRIL 30–MAY 1, 2016HOUSE OF DELEGATESThe Henry, Dearborn

MEMBER OF THE KCMS VENDOR PROGRAM

REMINDER

PLEASE PAY YOUR 2016 DUES

KC

MS

FALL 2015 KCMS/KCOA BULLETIN 5

KC

MS

PRESIDENT’S MESSAGE

Physicians, hospitals, insurance carriers and patients across our nation have become increasingly concerned by the sky rocketing and uncontrolled prices of prescription medicines over the past several years. The effects of these high costs have been particularly detrimental to our patients.

The Dilemma of High Cost Generic Medications

My message being conveyed to our KCMS membership in this article is intended to offer our members some background information about drug pricing, explore the notion of market intervention and propose appropriate solutions to change these high pharmaceutical costs.

Spending on prescription drugs in the United States increased 13 percent in 2014 reaching $374 billion. This far outpaced inflation which has been between zero and two percent over the past 3 years. Although much of this increase was driven by expensive new drugs, more than 80 percent of prescriptions are filled with supposedly less expensive generics. In 222 generic drug groups, prices increased by 100 percent or more between 2013 and 2014.

In my dermatologic practice, oral doxycycline hyclate prices have increased 1,000 percent, desonide lotion 447 percent, betamethasone

dipropionate cream 400 percent and permethrin used to treat scabies, 250 percent. Drugs such as albuterol sulfate inhalers have increased 4,000 percent. The CEO of Turing Pharmaceuticals recently tried to raise the price 5,000 percent of Daraprim, a drug used to treat toxoplasmosis in

HIV immunocompromised patients.

In theory, it appears as if drug manufacturers are unduly “milking” American health care reimbursements even as it runs dry for insurers and medical providers. In a recent survey, 73 percent of Americans find the cost of drugs to be unreasonable and most blame drug manufacturers for setting these prices too high.

The financial success of Big Pharma is brought about by its medical innovations with newer drugs, the absence of price intervention and a hands off policy by the federal government controlling drug pricing. In fact, Medicare is

David E. Hammond, MD2015 KCMS President, Board of Directors

In a recent survey, 73 percent of

Americans find the cost of drugs

to be unreasonable and most blame drug

manufacturers for setting these prices too high.


barred from negotiating drug policies with manufacturers and the FDA does not consider cost in the approval of the newer drugs. In contrast, Canada, Australia and certain European countries can negotiate medication prices, often by conducting their own studies to evaluate therapeutic benefits.

So what are the causes of generic drug price increases? Some reasons could be drug shortages brought about by a decrease in raw materials, manufacturing facility issues and production slowdowns due to tightened quality control and increased regulations by the FDA. Another theory is that consolidation among drug makers or the departure of existing manufacturers is limiting competition in the generic drug market. If there is a drug shortage, the people in the market can raise the drug prices in relation to the laws of supply and demand.

The high cost of branded drugs is defended by pharmaceutical companies who point to their costs of research and development. But many generic drugs have been in the market place for years and by federal law are supposed to be priced at no more than 80 percent of branded versions. For decades, generic drugs manufacturers continually have reduced prices to increase their market share as they competed with one another.

But a new trend began in 1965 with the advent of Medicare and Medicaid. These new economic factors slowly changed the face of the market for drugs. Before 1965, most patients paid for their drugs out of pocket and shopped for the best prices. Then Medicare and Medicaid paid for drugs and more insurance plans began to cover drugs through defined patient/employee benefit plans.

In the 1970s, inflation began to drive up costs cutting the profit margins of drug manufacturers. With third party payers covering the cost of drugs, manufacturers developed new business models to restore their lost profits. In those new models, manufactures could make their selling prices

very high and then give a rebate to the buyer to get the price down to the original competitive price. Then if the costs went up, they would decrease the rebate and establish a “buffer” on their profit margin. This idea of creating a high price and then giving a rebate became the new standard in the pharmaceutical industry.

Manufacturers continued to use this confidential rebate system with buyers who were situated between them and the consumers. These buyers or “middlemen” included wholesalers, chain pharmacies and large third parties. Today these middlemen or Pharmacy Benefit Managers (PBM) control the drug benefits of 210 million Americans of which 28 million are Medicare Part D patients. The four largest PBMs in the United States are Express Scripts, CVS Caremark, Optum Rx and Catamaran Corporation.

More recent changes in generic price increases began in 2008 during a great economic upheaval in the form of a massive recession coupled with the adoption of the Affordable Care Act. At this same time, drug manufacturers stopped worrying about market shares and raised prices to increase their profits. Then the

CONTINUED ON PAGE 8

KC

MS


KC

MS

middlemen or PBMs also began increasing their prices in addition to holding on to their own confidential rebates form drug manufacturers. Thus, drug prices became completely out of control.

Therefore, the solution to the dilemma of exorbitant drug prices is a challenging one. In my opinion, price concessions from drug manufacturers should be transparent and passed onto the consumers. This rebate business with confidential contract pricing with the middlemen should not be confidential. Instead it should be out on the table in a transparent way for all potential consumers to see. Let everyone be aware of these rebates and their effect on high drug prices.

If one tries to introduce federal legislation to better control drug prices, you have to clearly understand the market place and the implications regulations put on these market places. On the other hand, in these monopoly-like drug markets federal regulations should set caps on drug price increases. In addition, antitrust federal regulations should carefully review drug company merger proposals to ensure that such mergers eventually result in operating efficiencies that lead to reductions in drug prices.

In summary, the financial success of Big Pharma is important in ensuring continued innovations in the development of newer and significant drug treatment breakthroughs. However, the ability to change drug prices based on what the market will bear coupled with the lack of collaboration among the market players has propelled prescription drug cost to become a major reason why the United States spends substantially more on health care than other developed countries.

Meanwhile insurance payers, medical institutions and patients will continue to grapple with ways to survive financially in the face of these rising prices. Unfortunately, we are on an unsustainable playing field that is likely on the brink of a major makeover.

I would like to acknowledge Jacob Levitt, MD, Associate Professor of Dermatology at Mount Sinai Hospital in New York City, for providing some of the statistical data and historical facts used in this article. He presented this information at a discussion session at the 2015 summer meeting of the American Academy of Dermatology in New York City.

Order Your Referral Guide Today

Name/Contact Person: ______________________________________________________________________________

Practice Name: _____________________________________________________________________________________

Address: __________________________________________________________________________________________

City, State, Zip ______________________________________________________________________________________

Phone:_________________________________Ordered By: _________________________________________________

Please make check payable to Kent County Medical Society. Mail payment with order form to:KCMS/KCOA, 233 East Fulton, Suite 222, Grand Rapids, MI 49503

KCMS and KCOA Member Referral Guides are available for $10 each. Please contact the KCMS office at (616) 458-4157 with questions.

I would like to order ____________ Referral Guides ($10 each) Payment: I’m enclosing $ __________________

PRESIDENT’S MESSAGE CONTINUED FROM PAGE 7


Name/Contact Person: ______________________________________________________________________________

Practice Name: _____________________________________________________________________________________

Address: __________________________________________________________________________________________

City, State, Zip ______________________________________________________________________________________

Phone:_________________________________Ordered By: _________________________________________________

PRESIDENT’S MESSAGE CONTINUED FROM PAGE 7

thoroughC A R E & C O U N S E L

DickinsonWrightpllc

AR I ZONA K ENTUCKY M I CH IGAN N E VADA OH IOTENNESSE E WASH INGTON DC TORONTO

In the healthcare industry, providers face a number of unique regulatory and compliance issues. Our rm’s interdisciplinary healthcare

practice group has the expertise and experience to provide comprehensive and sophisticated counsel to clients in a broad range of healthcare-related legal matters.

For more information on our rm and our For more information on our rm and our healthcare practice, please contact Brian Fleetham, Billee Ward or Leslee Lewis

at 616.458.1300.

www.dickinsonwright.com

KCMS SocialOn September 21, over 90 KCMS Members enjoyed a sneak peek of ArtPrize while visiting with friends and colleagues at EVE.

KC

MS


Colwill, MD, John C.Home address CORRECTION:4189 Sabal Pointe Ct. SEGrand Rapids, MI 49546

PAGE 14Crane, MD, Keith H.NEW home address:1175 Highway A1A, Apt. 509Satellite Beach, FL 32937

Crawford, MD, Michael J.NEW home address:4116 W. Gables Ct. NEGrand Rapids, MI 49525

PAGE 15Deane, MD, Frederick (Rob)NEW home address:3696 Cook Blvd. SEGrand Rapids, MI 49546

PAGE 18Dugan, MD, Albert R.NEW home address:2804 Central Pkwy. NE, #204Grand Rapids, MI 49505

Eary, Jr., MD, L. EdmondNEW home address:21008 N. Verde Ridge Dr.Sun City West, AZ 85375

Please make the following changes to your Membership Directory to ensure that it is

current and correct. If you have any changes you would like to make please call the office

at 616-458-4157, email [email protected], or fax the form at right to 616-458-3305.

Directory Changes

Charitable giving is an important part of the legacy you choose to leave. At this

time of year, many of us are considering our year-end philanthropic support. Please

consider one of the non-profit charitable organizations associated with Kent County

Medical Society. Checks should be endorsed to the specific agency you wish to

support (see below). You may mail these checks in care of the Kent County Medi-

cal Society Office at 233 East Fulton, Suite 222; Grand Rapids, MI 49503. Each

organization will issue a charitable receipt.

Did you know that, making charitable contributions through your will allows you to support the organizations you care about, while maximizing the tax benefits to your estate? You may make a bequest to any of these charities as well. You may also do so by creating a new will, providing an amendment to your existing will or naming one of them in your living trust. Simply use the following sample language.

I give, devise, and bequeath $__________ or __________% of my estate to:

❑ Kent Medical Foundation

❑ KCMS Alliance Foundation

Feel free to contact the KCMS office at 616.458.4157 with questions. As 501(c)(3) organizations,

your gift is tax deductible to the extent provided by law.

Leave a Legacy

Finta, MD, BohuslavMOVED out of state

PAGE 26Heeringa, MD, Wm. GeneNEW mailing address:PO Box 738Grandville, MI 49468

PAGE 28Hoekman, MD, Ronald, A.NEW home address:10369 Lakeshore Dr.West Olive, MI 49460

PAGE 29Horning, MD, David J.NEW home address and e-mail:710 Clark Crossing SEGrand Rapids, MI [email protected]

PAGE 31Jones, MD, Clifford B.MOVED out of area

PAGE 37Lineberger, lll, MD, AdrianMOVED out of state

PAGE 38Machiorlatti, MD, Kenneth L.NEW home address:1164 Shelter Ln.Lansing, MI 48912

PAGE 44O’Donnell, MD, Joseph R.NEW home address:538 Bond Ave. NW, Apt. 302Grand Rapids, MI 49503

PAGE 46Petersen, MD, David P.NEW home address:3068 Scenic Dr.Muskegon, MI 49445

PAGE 48Ramirez, MD, Rose M.REVISED CORRECTION!NEW office address:Jupiter Family Medicine, PC6250 Jupiter Ave., Ste. ABelmont, MI 49306Ph: 301-2500 Fx: 301-2501

Reifler, MD, David M.NEW office address:7474 Cascade Rd. SEGrand Rapids, MI 49546Ph: 942-7377 Fx: 942-5003

PAGE 49Rightmire, MD, Daniel A.NEW home address:7135 Ryans RunStanwood, MI 49346

PAGE 53Sidell, MD, Richard H.NEW home address:3600 E. Fulton, Apt. A104Grand Rapids, MI 49546

PAGE 56Ten Have, MD, RalphNEW home address:458 Cherry Ln.Holland, MI 49424

PAGE 61Wassink, MD, Roger N.NEW home address:2772 Pfeiffer Woods Dr. SE, Apt. 3306Grand Rapids, MI 49512

Please Submit Your Directory Changes

Please submit any changes that are needed to the Membership Directory. Please print clearly. Fax (616) 458-3305 or mail completed form to the KCMS/KCOA office: 233 East Fulton, Suite 222, Grand Rapids, MI 49503.

Name: ______________________________________________________________________________________

Phone: _____________________________ Email: _________________________________________________

Requested Change: ___________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

KC

OA

PRESIDENTJennifer Hemingway, DO

PRESIDENT-ELECTErik M. Ratchford, DO

PAST PRESIDENTBrad A. Irving, DO

SECRETARY/TREASURERLaura A. Tinning, DO

DIRECTORS

Ann M. Auburn, DODiane C. Bigham, DOAdam T. Wolfe, DO

SPEAKER OF THE HOUSE OF DELEGATES MICHIGAN OSTEOPATHIC

ASSOCIATION

Craig H. Bethune, DO

MOA DELEGATION

Bradley Clegg, DO William Cunningham, DO

Joanne Grzeszak, DO Norman Keller, DO

Edward Lee, DO Gary Marsiglia, DO

Jeffrey Postlewaite, DO Karlin Sevensma, DO Susan Sevensma, DO

Carl Eugene Soechtig, DO Jeffrey Stevens, DO Adam Wolfe, DO John Wolfe, DO

KCOA OFFICERS & DIRECTORS

VENDOR PROGRAM

MEMBER OF THE KCOA

K

E N T C O U N T Y

OST

EO

PATH IC ASSOCIAT

IONJoin Us

KCOA MEETINGS OF INTEREST

FEBRUARY 8, 2016LEGISLATIVE COMMITTEE LUNCHEONMasonic Center, 4th Floor I Noon APRIL 4, 2016LEGISLATIVE COMMITTEE LUNCHEONMasonic Center, 4th Floor I Noon APRIL 17–23, 20162016 NATIONAL OSTEOPATHIC MEDICINE WEEK

MAY 12, 2016 MOA HOUSE OF DELEGATESRoyal Dearborn Hotel and Conference Center (Formerly Hyatt) MAY 13-15, 2016ANNUAL SPRING SCIENTIFIC CONVENTIONRoyal Dearborn Hotel & Convention Center600 Town Center Dr, Dearborn, MI JUNE 16-19, 20162016 NMOA ANNUAL SUMMER CONFERENCEMackinac Island, MIFor more information, please visit www.domoa.org or call 517-347-1555 x100

For event details, check out our website kcoa.us

Visit usOUR MISSION:

Kent County Osteopathic Association seeks to advocate for the physicians of Kent County, advance the science

and practice of osteopathic medicine, and provide an arena of osteopathic physicians to support and educate

each other and their community.


KC

OAPRESIDENT’S MESSAGE

Renew Your Membership Today for Continued KCOA Benefits

Your membership gives Osteopathic Physicians a local voice. Your KCOA Board colleagues are hoping you will continue your support of efforts by renewing your dues at $175.00. Visit our website at www.kcoa.us (using our PayPal option). You can also mail your check, written to the KCOA, to the KCOA Office at 233 East Fulton, Suite 222, Grand Rapids, MI 49503. Membership payment is due by December 31.

By renewing your dues, you will:• Receive the quarterly Bulletin magazine;• Learn of special meetings on particular issues, and laws;• Learn of Osteopathic CME opportunities—provided to you with a member discount;• Gain access to a mailing service for your office news announcements;• Benefit from a joint Legislative Committee with KCMS and the KCMS Alliance

members;• Be included in the KCOA and KCMS Membership Directory

We are working hard to represent you. Please renew today— your prompt renewal saves staff time and expense!

The KCOA represents our Osteopathic colleagues, locally and in Lansing—whether navigating the Affordable Care Act, educating others on legislative issues, or assisting members and their office staff with ICD-10 implementation.

Jennifer Hemingway, DOKCOA President, Board of Directors

REMINDER

PLEASE PAY YOUR 2016 DUES Prompt payment of your KCOA dues is greatly appreciated!

VENDOR PROGRAM

M

EMBER OF THE KCOAK

E N T C O U N

TY

OST

EO

PATHIC ASSOCIATIO

N


XxxxxxxxxXxxxxxxxx

kent medical foundation

Holiday CardCAMPAIGN

Contribute to this annual campaign and your name will be listed among other donors who have helped make the annual Holiday Card possible!

CONTRIBUTIONS

Holiday Card Campaign Gifts received by November 30 will be included in the 2015 Holiday Card, which will be mailed the first week of December. You can contribute in two ways:

CHECK Please make check payable to Kent Medical Foundation. Complete donor registration at right and mail to:

Kent Medical Foundation 233 East Fulton, Suite 222Grand Rapids, MI 49503

ONLINE VIA PAYPALGo to www.kcms.org/kmfor simply scan this QR code.

QUESTIONS?

Please contact the Kent Medical Foundation at 616-458-4157.

$1,000 $750 $500 $250 $100 $______ Please keep my donation anonymous.

Please print your name(s) below exactly as you would like to be presented on the Holiday Card insert.

Name(s): _______________________________________________________________________

Address: _______________________________________________________________________

Email: ___________________________________________ Phone: _________________________

YES! Count me/us in to continue the mission to assist The Kent Medical Foundation in community outreach endeavors and health promotion projects. Please find my/our check enclosed for the following amount (contribution amounts are NOT disclosed on the card):

Contributions are tax deductible.

donor registration

Please return to: Kent Medical Foundation | 233 East Fulton, Suite 222 | Grand Rapids, MI 49503

kent medical foundation

Holiday CardCAMPAIGN

Share your holiday wishes WHILE HELPING THE KENT MEDICAL FOUNDATION RAISE FUNDS TO SUPPORT COMMUNITY PROGRAMS


FEATURE

We discussed the 2015 Holiday Card Project, our annual fundraising event. The initial solicitation for donations was sent to KCMS members in early September, and a solicitation was included in the third quarter Kent County Medical Society Bulletin. Please send your donations to KMF by November 30 if you would like to have your name included in the holiday card. The money raised from this annual event allows KMF to provide grants for non-profit groups seeking support for community projects related to health.

We then discussed the NICOTeam poster project, initially reviewing how the program has been run in the past. KMF is a consistent sponsor for this project, supporting the poster contest completion portion of the NICOTeam program. The KMF support for this program began almost a decade ago, providing an average of $2,000 per year for the past few years. We anticipate continuing our annual grant sponsorship at a similar level for 2016.

We discussed the possible partial sponsorship of a running/walking race to improve our name

recognition as well as to support local exercise/sports endeavors. We discussed a few other fundraising ideas as well.

We have had a good year giving away grant money for worthwhile projects in our community. The supported projects have provided access to exercise and educational activities for children in elementary schools and their families, students at the medical school, and adults in the Kent County community.

Please remember to include the Kent Medical Foundation in your end-of-year contribution plans. We appreciate your donations.

The next KMF Board of Trustees report will be given at the KCMS annual meeting on January 16, 2016. We have a great Board of Trustees who have enthusiastically shown their ongoing support with their time and interest. I have been privileged to serve as the Chair of the Board this past year. Thank you for this opportunity.

Holiday Card Campaign Donation Deadline is Nov. 30

KENT MEDICAL FOUNDATION

Jayne Courts, MD2015 KMF President, Board of Trustees

The Kent Medical Foundation Board of Trustees met on September 14, 2015, to discuss a full agenda. The Board reviewed the financial reports and an update on archive document preservation efforts.

Please remember to include the Kent Medical Foundation in your end-of-year contribution plans. We appreciate your

donations.

KM

F


FEATURE

Alliance HeartbeatThe Kent County Medical Society Alliance is focusing its work on becoming more current and relevant to its younger and growing membership. This fall, the Alliance drafted a new vision and mission statement in order to help refocus and energize the organization. Their annual charity event is also being reinvigorated by using a new fundraising format called a “silent auction with a twist,” created by local development guru Christina Rosloniec.

Marybeth WeberKCMS Alliance President

With their vision of “Connecting and growing for a healthier Kent County,” the Alliance hopes to focus more on fellowship amongst its members and building strong relationships for their annual charity event with the three largest hospital systems that employ our families; Spectrum Health, Mercy Health Saint Mary’s, and Metro Health.

The annual Dose of Generosity Charity Event will be held on Saturday, January 30, 2016 at New Vintage Place in Grand Rapids. This year’s beneficiaries are Family Promise and the YWCA Nurse Examiner Program. Monies raised at the event will allow Family Promise to find permanent housing for 60 children and their families, and for the YWCA to acquire the furnishings and specialized equipment for the creation of the child and family areas that will exist within the reconfigured NEP medical suite.

The event will feature a strolling dinner with signature cocktails while partygoers pledge money for the organizations to purchase specific needs, such as an examination table. This money will be matched by the evening’s Matching Title Sponsor. Then, a live auction will occur followed by an after-glow party with dancing. Attendees will be treated to a truly special and fun evening in a relaxed environment!

Tickets can be purchased online via credit card by going to www.kcmsalliance.org/registration for $100 through November 15, or $125 up until the event. Tables run $1,200 through November 15, and $1,500 thereafter.

If you are interested in sponsorship, please go to www.kcmsalliance.org/become-a-sponsor or email the KCMSA President at [email protected].

KC

MSA


FEATURE

KC

MSA

KCMSA CHARITY event sponsorship❏ THE platinum ALTRUIST $10,000 Recognized as the 2016 Charity Auction Lead Sponsor in all

promotions, including radio, tv & print. Full-page ad in program. Name and logo placement in the program. One premium table for 10 guests with table signage.

❏ the gilded GIVER $5,000 Recognized as a 2016 Charity Auction Gold Sponsor in all

promotions, including radio, tv & print. Full-page ad in the program. Name & logo placement in program. One premium table for 10 guests with table signage.

❏ the silver sponsor $2,500 Recognized as a 2016 Charity Auction Silver Sponsor. Name & logo

placement in program. Reserved table for 10 guests with table signage.

❏ the contributor up to $2,499 Recognized as a 2016 Charity Auction Contributor in the program.

PROGRAm advertisments❏ 1/4 PAGe (5" x 2") $200

❏ 1/2 PAGE (5" x 4") $300

❏ FULL-PAGE (5" x 8") $500

event RESERVATIONS individual tickets x ❑$100per person until 11/15/15 x ❑$125per person after 11/15/15

preferred TABLE x ❑$1200 until 11/15/15

x ❑$1500 after 11/15/15Seating for 10 guests

Please send this form & payment before (12/21/15) to:

KCMSA Treasurer Susan Jebson5534 Alhambra Drive SE, Grand Rapids, MI. 49546

KCMSA Foundation may charge my credit card:

CREDIT CARD #

SECURITY CODE (CVV#) EXPIRATION DATE

NAME (As it appears on the credit card.)

SIGNATURE

CONTACT PERSON

COMPANY NAME

ADDRESS

E-MAIL PHONE

$

$Enclosed is my check made payable toKCMSA Foundation in the amount of:

Online payment available via PayPal at KCMSAlliance.org or via mail:Please supply ads as high resolution PDF’s & logos as vectors (.AI/.EPS), outline all fonts. Send to:[email protected]

For questions regarding sponsorship, corporate tables, or programadvertising, please contact Alexis Boyden at [email protected].

KCMSALLIANCE.ORG/CHARITY.


FEATURE

BY KEITH DENNENMember, Dickinson Wright

I n September, the Department of Health and Human Services (HHS) released proposed anti-discrimination regulations that, if adopted, change the playing field in

which physicians and other healthcare providers practice. These regulations are significant because:• They apply to all healthcare providers (including providers

who do not accept Medicare or Medicaid).• The sanctions available for violations include possible

exclusion from Medicare.• The regulations change the ability of providers to decline

or terminate patients.• They require providers to incur additional expenses for

items that many small providers have not previously been required to possess.

The proposed regulations are the agency’s attempt to flesh out the Affordable Care Act’s (ACA) mandate prohibiting discrimination “on the basis of race, color, national origin, sex, age or disability” in the provision of services with respect to any health program or activity that receives federal financial assistance. Specifically, the ACA states that healthcare providers cannot discriminate in the provision of healthcare on the basis of any of the following:• Title VI of the Civil Rights Act of 1964 (Race, color and

national origin);• Title IX of the Education Amendments of 1972 (Sex);• The Age Discrimination Act of 1975;• Section 794 of Title 29 (Disability).

According to the commentary, the regulations seek to “ensure that vital health care services are broadly and nondiscriminatorily available to individuals throughout the country.”

The following is intended to describe these changes and what they mean for healthcare providers.

LIMITED ENGLISH PROFICIENCY The most complicated change, and perhaps the one that would require the most from providers, is the requirement to provide accommodations to people with limited English proficiency, created under the ban on “national origin” discrimination.

Qualified InterpretersAll healthcare providers will be required to provide a “qualified interpreter” “in a timely manner” to any person with limited English-speaking ability whom they serve (patients) “or encounter” (anyone else) in administering services. The commentary explains that interpreters are required “when oral communication is a reasonable step to provide meaningful access” to the healthcare system. • Who is a “qualified interpreter”? The regulations define

the term “qualified interpreter” very broadly as “an individual who has the characteristics and skills necessary to interpret for an individual with a disability [i.e., American sign language], for an individual with limited English proficiency, or for both.” A qualified interpreter must:

1. Be able to interpret “effectively, accurately and impartially … using any necessary specialized vocabulary,” and/or

2. Demonstrate proficiency in “and have above average familiarity with speaking and understanding” of both English and the foreign language, “using any necessary specialized vocabulary.”

• Can anyone be an interpreter? The short answer is “no.” The regulations don’t require any particular certification to be a qualified interpreter, but the commentary specifically states that merely having an above-average familiarity with a language is not enough.

• Can it be an employee? While neither the regulations nor the commentary expressly state that an employee can’t be a qualified interpreter, the interpreter must be familiar with and adhere to “generally accepted interpreter ethics principles, including client confidentiality.” An example in the commentary states that a bilingual nurse who is competent to speak to the patient in her native language may not be a qualified interpreter “if serving as an interpreter would pose a conflict of interest with the nurse’s treatment of the patient.”

• Can it be a family member? Yes, in some cases. Providers are expressly prohibited from requiring the foreign-language speaker to bring his or her own interpreter (be it a family member or anyone else), but a family member or person accompanying the non-English speaker can serve as an interpreter under the following circumstances:

1. In an emergency situation when no qualified interpreter is immediately available; or

2. If the non-English speaking patient requests that the

PAID ADVERTISEMENT

HHS’s New Anti-Discrimination Regulation Proposal, Explained


FEATURE

accompanying adult interpret for him/her, and the accompanying adult agrees to do so.

A child may only be used as an interpreter in “an emergency involving an imminent threat to the safety or welfare” of the person or the public.

• If I can’t use an employee or a family member, where am I going to find an interpreter? An internet-based service, possibly. The commentary states specifically that most entities will, at a minimum, have the capacity to provide qualified interpreters remotely via telephone online service at a “relatively low-cost.”

• I think I need an interpreter. Simply put, healthcare providers will need to provide the availability of a qualified interpreter, and preferably not involved in the treatment and care of patients. While, in some cases, it may be a family member that interprets for the patient, providers may not require it, and will have to make arrangements for those who don’t bring someone to interpret. HHS suggests that a telephone-based or internet-based service may be a cost-effective option for providers.

Written NoticesProviders will also be encouraged, but not required, to post notices “in the most prevalent languages used in a covered entity’s service area, as determined by the covered entity.” They are required, however, to publish “taglines” in a prevalent language for the provider’s area alerting patients to the availability of language services. • But I don’t speak Farsi. Neither do I. But HHS states

that it will provide sample notices translated in each of the most prevalent languages (Spanish, Chinese, Vietnamese, Korean, Tagalog, Russian, Farsi, French, French Creole, Portuguese, Polish, Japanese, Italian, German and Arabic). The required taglines will be available electronically in these 15 languages and, thus, the agency, says, the providers should experience no burden by this requirement.

GENDER IDENTITY Another area addressed in the regulations is “gender identity,” which refers to an individual’s “internal sense of gender, which may be different from that individual’s sex assigned at birth.” The proposed regulations seek to prohibit providers from discriminating against, for example, an individual who is female but prefers to be treated as a male, and vice versa. This, of course, includes transgender people. The agency reasons that this is prohibited under sex discrimination laws, and such discrimination would expose the provider to liability.

SEX STEREOTYPING“Sex stereotyping” involves notions like hairstyle, voice, mannerisms or body characteristics that are stereotypically associated with one gender but not the other. In 1989, the U.S. Supreme Court ruled in Price Waterhouse v. Hopkins that Title VII bars employment discrimination against a person because

he or she doesn’t act like his sex “should act.” This rule would apply the same standard to providing medical care.

ASSOCIATION DISCRIMINATION“Association discrimination” originated in the Americans With Disabilities Act. It occurs when a person is discriminated against because of the person’s association with a disabled person, e.g., an employer refuses to hire a mother because she has a child with special needs. In the regulations, the agency extends “Association discrimination” to association (e.g., friendship, relationship) with any member of a protected class.

What about same-sex discrimination? Interestingly, HHS doesn’t include discrimination on the basis of a person’s sexual orientation in its definition of sex discrimination. In the commentary, the agency wrote that it supports the prohibition of sexual orientation discrimination, but acknowledged that no federal appellate court has concluded that Title IX’s prohibition on discrimination based upon sex applies to discrimination based on sexual orientation. The commentary noted, however, that some district courts “have reached the opposite conclusion.” The agency requests comments on whether to extend discrimination based upon sex to include sexual orientation.

GRIEVANCE PROCEDURES AND ELECTRONIC INFORMATION REQUIREMENTSThe proposed regulations would also require all physicians and other providers to take certain administrative steps, including:• Periodically certifying compliance with the ACA and its

regulations;• Designating at least one employee as a compliance coordinator;• Adopting grievance procedures that incorporate

“appropriate due process standards,” and;• Providing “prompt and equitable” resolution to grievances.

In the commentary, HHS stated that it realizes the potential burden these requirements may impose, and included an exception for instances when compliance results in undue financial burden, administrative burden, or a fundamental alteration of the health program or activity. In such instances, the provider is required to provide information in a format that would ensure, to the maximum extent possible, that disabled patients receive the same information.

COMMENT PERIODHHS is required by federal law to provide an opportunity for the public to comment on the proposed regulations. This comment period is a great opportunity for providers to offer their opinions on the regulations and offer some suggestions to the agency, particularly on the practical administration and implementation of compliance programs. The comment period ended on November 9, 2015.

GRAPIDS 99998-2636 384323v1

PAID ADVERTISEMENT

HHS’s New Anti-Discrimination Regulation Proposal, Explained


FEATURE

MS

U-C

HM

We continue our preparation for the launch of our new Shared Discovery Curriculum next fall and have completed our leadership searches. We welcome the following faculty:

Finally, the College of Human Medicine is one of 10 medical schools participating in the AAMC pilot project studying Core Entrustable Professional Activities for Entering Residents, known as CoreEPAs. The goal of the project is to understand what will best enable students to be entrusted to perform 13 key tasks required of new interns to maximize patient safety. The project aims to instill new resident competence and confidence at the transition from undergraduate education to residency training. Planning is taking place for accomplishing this within both our present curriculum and our new curriculum structures.

MSU COLLEGE OF HUMAN MEDICINE

Shared Discovery CurriculumLeadership Welcomed Ahead of LaunchWith the appointment of Aron Sousa interim dean for the college, I have been asked to step in to Dr. Sousa’s former role as senior associate dean for academic affairs. Angela Thompson-Busch, MD, PhD, is the new community assistant dean in Grand Rapids, filling my previous position. Dr. Busch is an assistant professor of pediatrics and human development and a pediatrician in academic general pediatrics with Spectrum Health Medical Group.

Margaret Thompson, MDGrand Rapids Associate Dean, Michigan State University College of Human Medicine

• Dianne Wagner, MD Associate Dean for Undergraduate Medical Education

• Robin DeMuth, MD Assistant Dean for Clinical Experiences

• Matt Emery, MD Medical Director of Simulation

• Gary Ferenchick, MD Director of JustInTime/Chief Complaints and Concerns

• Heather Laird-Fick, MD Director of Assessment

• Brian Mavis, PhD Director of the Academy

• Patricia Brewer, PhD Learning Society Chief

• Jonathan Gold, MD Learning Society Chief

• Sath Sudhanthar, MD Learning Society Chief

• Angela Thompson-Busch, MD, PhD Learning Society Chief


FEATURE

Studies Show Age Shift in Pertussis Cases

KENT COUNTY HEALTH DEPARTMENT

Pertussis (whooping cough), is a highly contagious, vaccine preventable disease caused by the bacteria Bordetella pertussis. Pertussis is a nationally notifiable disease and cases require reporting to the local health department in which the patient resides. While pertussis is commonly known as a childhood illness, several studies have revealed that an age shift is occurring, and that booster vaccines could reduce the number of cases in adolescents and older adults. This article provides a brief overview of pertussis epidemiology at the national, state and local levels.

CONTINUED ON PAGE 22

The number of pertussis cases reported to the Nationally Notifiable Disease Surveillance System (NNDSS) initially declined after the licensing of the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in 2005. However, following the initial decrease, pertussis incidence has steadily risen (Figure1). During 2010, reported cases increased considerably, with 27,550 reported nationwide and 1,226 and 17 in Michigan and Kent County (Figure 2), respectively. Pertussis received a great deal of media attention in 2010 due to the large outbreak in California, where over 9,000 cases and ten deaths occurred during the year. State and local increases in reported cases also occurred in 2014, when 1,161 confirmed cases in Michigan and 17 in Kent County were reported. Through September 2015, 19 cases have been reported in Kent County, the highest number of cases reported in the past 20 years. Despite the recent increase in the number

of reports, it is likely that pertussis continues to be under-reported in Kent County. In 2014, the rate of pertussis in Michigan was 11 cases per 100,000 population, compared to 2.8 cases per 100,000 in Kent County. Based on state reporting rates, 66 cases would be expected in Kent County during 2014.

Infants aged less than one year continue to have the highest reported rates of pertussis nationwide, with school-aged children 7-10 years of age making up another large proportion of cases seen in the United States. Similarly, infants aged less than one year have the highest reported rates of pertussis in Kent County, with four cases reported in 2015 and an average of 4.2 cases per year over the past 20 years. The fewest number of cases are reported in those

aged 65 years and older, with one case reported in 2015 and 0.2 cases reported per year over the past 20 years. Figure 3 presents the number of

Mark Hall, MD, MPH& Chelsey Mahoney

Pertussis received a great deal of media attention in

2010 due to the large outbreak in California, where over 9,000 cases and ten deaths occurred

during the year. State and local increases in reported cases also occurred in 2014, when 1,161 confirmed cases

in Michigan and 17 in Kent County were reported.

KC

HD

MSU COLLEGE OF HUMAN MEDICINE


FEATURE

pertussis cases stratified by two age groups (0-10 and 11 and older). While the total number of cases is still dominated by those 10 years of age and younger, there is some local evidence to support the potential age shift that has been documented elsewhere, with 11 cases reported so far in 2015 in patients 11 and older.

There are several possibilities for the increased incidence of pertussis, including increased awareness of pertussis in adults and adolescents and the decreased use of the vaccine. Decreased vaccine-induced immunity, which occurs 6-12 years after the last booster dose, is also a potential and preventable cause. The absence of a defined explanation for the rise in pertussis cases has emphasized gaps in our understanding of pertussis epidemiology, and how other factors

such as age, race, or sex may be contributing to the recent distribution of disease. Each confirmed case of pertussis reported to the local health department provides the opportunity to not only protect close contacts who have been exposed to an infected individual, but to further describe the epidemiology of this highly infectious disease at the local level. In addition to encouraging pertussis vaccination in all patients, especially among adolescents and adults, physicians are encouraged to support local surveillance efforts by considering pertussis testing in patients who present with extended cough illness. If you do not have the appropriate testing supplies (nasopharyngeal swab and transport materials), please contact the Kent County Health Department at 616-632-7228 and we can assist you in obtaining appropriate testing kits

KENT COUNTY HEALTH DEPARTMENT CONTINUED FROM PAGE 21

KC

HD

Source: Centers for Disease Control and Prevention

FIGURE 1

Reported NNDSS pertussis cases, 1922-2014


FEATURE

Kent County Health Department Communicable Disease Section

700 Fuller N.E. Phone (616) 632-7228

Grand Rapids, Michigan 49503 Fax (616) 632-7085 Notifiable diseases reported for Kent County

www.accesskent.com/Health residents through end of month listed above.

AIDS (Cumulative Total - 971) 0 15 19

AMEBIASIS 1 5 4

CAMPYLOBACTER 5 68 55

CHICKEN POXa

1 11 21

CHLAMYDIA 334 2852 2642

CRYPTOSPORIDIOSIS 4 14 17

Shiga Toxin Producing E. Colib

2 12 N/A

GIARDIASIS 6 50 65

GONORRHEA 72 608 537

H. INFLUENZAE DISEASE, INV 1 9 5

HEPATITIS A 0 1 2

HEPATITIS B (Acute) 0 0 3

HEPATITIS C (Acute) 0 0 1

HEPATITIS C (Chronic/Unknown) 29 366 220

INFLUENZA-LIKE ILLNESSc

1283 29409 34430

LEGIONELLOSIS 0 9 7

LYME DISEASE 0 11 3

MENINGITIS, ASEPTIC 17 51 24

MENINGITIS, BACTERIAL, OTHERd

1 15 5

MENINGOCOCCAL DISEASE, INV 0 0 1

MUMPS 1 1 0

PERTUSSIS 2 19 8

SALMONELLOSIS 3 36 48

SHIGELLOSIS 5 41 5

STREP, GRP A, INV 0 29 20

STREP PNEUMO, INV 3 48 34

SYPHILIS (Primary & Secondary) 0 15 7

TUBERCULOSIS 1 12 11

WEST NILE VIRUS 0 0 1

Kawasaki Syndrome 4 Creutzfeldt-Jakob Disease 1

Streptococcal Toxic Shock 2 Toxic Shock 1

Guillain-Barre Syndrome 1 Hepatitis E 1

Cyclosporiasis 1 Malaria 1

Hemolytic Uremic Syndrome 3a. Chickenpox cases are reported primarily from schools. Confirmed and probable cases are included.

b. In November 2010, cases of E. coli O157:H7 were combined into the category "Shiga-toxin producing E. coli (STEC)"

c. Includes "Influenza-Like Illness (ILI)" and lab-confirmed influenza. ILI cases have flu-like symptoms and are reported primarily by schools.

d. "Meningitis, Bacterial, Other" includes meningitis and bacteremia caused by bacteria OTHER THAN H. influenzae, N. meningitidis, or

S. pneumoniae .

Except for Chickenpox & Influenza-Like Illness, only confirmed cases (as defined by National Surveillance Case Definitions:

http://wwwn.cdc.gov/nndss/script/casedefDefault.aspx) are included.

Reports are considered provisional and subject to updating when more specific information becomes available.

NOTIFIABLE DISEASES OF LOW FREQUENCY

Notifiable Disease ReportSeptember, 2015

DISEASE NUMBER REPORTED MEDIAN CUMULATIVE

This Month Cumulative 2015 Through September 2010-2014

NUMBER REPORTED

Cumulative 2015DISEASE

Cumulative 2015

NUMBER REPORTEDDISEASE

KC

HD


Kent County Medical SocietyKent County Osteopathic Association233 East Fulton, Suite 222 Grand Rapids, MI 49503

K C M S K C O A

PRSRT STDU.S. POSTAGE

PAIDTraverse City, MI

Permit No. 29

Prsrt StdU.S. Postage

PAIDNorthern Speech

Services

Prsrt StdECRWSS

U.S. PostagePAID

Traverse City, MIPermit No. 29

Prsrt StdECRWSS

U.S. PostagePAID

Lake Leelanau, MIPermit No. 8

Presorted First-Class MailU.S. Postage

PAIDTraverse City, MIPermit No. 29

Nonprofit OrganizationAUTOCR

U.S. Postage PAIDTraverse City, MIPermit No. 29

Nonprofit OrganizationU.S. Postage

PAIDTraverse City, MIPermit No. 29

These are stored on Macintosh HD

Mark Your Calendar

AGENDA• 2015 Year in Review

KCMS President David E. Hammond, MD

• Election of New Officers

• Appointment of Delegates and Alternate Delegates

• Installation of 2016 KCMS President Jayne E. Courts, MD

Saturday, January 16, 2016Immediately following January 16 Educational Event

Prince Conference Center, Calvin College1800 East Beltline SE, Grand Rapids, MI 49546

KCMS 113TH

ANNUAL MEETING

OF THE MEMBERSHIP

MEMBER OF THE KCMS VENDOR PROGRAM

KCMS KCOA Bulletin

Documents

Transcript of KCMS KCOA Bulletin