JANUARY2009 Volume85Number1 SponsoredbyEmergencyMedicalCentreofFlint GENESEECOUNTYMEDICALSOCIETY Organized Medicine’s Leading Edge GENESEECOUNTYMEDICALSOCIETY Organized Medicine’s Leading Edge The Future of the American Health Care “System” February 5, 2009! Presidents' Ball 2008 Review! The Future of the American Health Care “System” February 5, 2009! Presidents' Ball 2008 Review!
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JANUARY�2009 Volume�85�Number�1
Sponsored�by�Emergency�Medical�Centre�of�Flint��
GENESEE�COUNTY�MEDICAL�SOCIETYOrganized Medicine’s Leading Edge
GENESEE�COUNTY�MEDICAL�SOCIETYOrganized Medicine’s Leading Edge
The Future of the AmericanHealth Care “System”
February 5, 2009!
Presidents' Ball 2008 Review!
The Future of the AmericanHealth Care “System”
February 5, 2009!
Presidents' Ball 2008 Review!
Our Vision That the Genesee County Medical Society maintain its position as the premier medical society
by advocating on behalf of its physician members and patients.
Our Mission The mission of the Genesee County Medical Society is leadership, advocacy, education,
and service on behalf of its members and their patients.
PLEASE NOTEThe GCMS Nominating Committee seeks input from members for nominations for the GCMSPresidential Citation for Lifetime Community Service. The Committee would like to be made
aware of candidates for consideration.
EDITORDaniel J. Ryan, M.D.
ASSOCIATE�EDITORPeter Thoms, M.D.
ASSISTANT�EDITORSCathy O. Blight, M.D.Hesham Gayar, M.D.Ayman Haidar, M.D.
Lakshmi Tummala, GCMSA
GENESEE�COUNTY�MEDICAL�SOCIETY�OFFICERS�2008-2009
President – John Waters, M.D.President Elect – Venkat Rao, MD
THE BULLETIN is published monthly by The Genesee County Medical Society.
By subscription $60 per year. Member subscription included with Society dues. Periodicals postage is paid atFlint, Michigan and additional mailing offices. POSTMASTER: send address changes to THE BULLETIN,
4438 Oakbridge Dr., Ste. B, Flint, Michigan 48532. Contributions to THE BULLETIN are always welcome.Forward news extracts or material of interest to the staff before the 5th of the month. All statements orcomments in THE BULLETIN are the statements or opinions of the writers and are not necessarily the
4 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
Compassionate Caring! We hopethis is how we treat all of our patients.It is a noble goal. Unfortunately, duringthese difficult economic times evenmore will be demanded of the medicalcommunity in the way of compassionand charitable care.
Some would argue we shouldprovide charitable care because healthcare is a right. I disagree. I disagreebecause it cannot be a classic right, as itis not inherent in our being. Rather,health care is a necessity, just like foodand shelter. It is because of theHippocratic Oath and basic humanity that I argue forcharitable and compassionate care.
Throughout this country's history our governmentalong with physicians have failed many people.That failure is a main reason we haveentitlements today and an unfortunate reasonthat we have such significant health disparities.How do you rectify a history that was notcreated by us personally? We voluntarily takeresponsibility for improving the course ofhistory and steering the present into a futurewe can be proud of.
It starts with compassion and continueswith our efforts to become culturallycompetent physicians who provide the bestcare for each individual patient who enters ourdoorways. When you ask patients if they trustdoctors, some say “no.” When you ask patientsif they trust their doctor, they invariably say“yes.” That response is a powerful testament tothe fact that as individuals, we are personallymaking a difference in the lives of ourpatients.
It will take all of us personally to helprestore trust in the health care system andactually help those most vulnerable to reduce
their dependence on governmententitlements with our compassionatecaring, cultural competence andpartnerships within our community. Indoing so, we take the focus off of healthcare as a right, and place the focus onproviding the “right” kind of care.
I don't need to tell you, as MedicalSociety members, the importance of ourmission, because you have contributedgreatly to the charitable care of ourcitizens via our practices, the GeneseeCounty Free Medical Clinic, GeneseeHealth Care, and Covering the
Uninsured. I applaud our efforts and encourage you topursue compassionate caring. If only other componentsof our community would give similarly.
John A. Waters, M.D.
COMPASSIONATE CARING
P R E S I D E N T ’ S M E S S A G E
Please mail check withreservations to:
Genesee County Medical Society4438 Oak Bridge Dr., Ste. B
Flint, MI 48532
Call Marcia at 810-733-9923 formore information.
2/5/09TOPIC
The Future of the American Health Care “System”
Presenters: Peter Pratt of PublicSector Consultants
and Senator Deb CherryOTHERS PENDING
GENESEE COUNTY MEDICAL SOCIETY
DINNER
BUSINESS
MEETING
It's what everyone is discussing. In the wake of the presidential
elections the economic crisis, thepending VEBA, and other stimuli,
what is coming? Come hear the viewsand interact with experts on theFuture of the American Health
Care “System”.
All physicians, spouses, and familymembers, members and non-membersof GCMS and GCMSA and interested
other professionals are invited.
$20 per personHospital Residents $10
Reservations required by January 29, 2008.
FLINT GOLF CLUB3100 Lakewood Dr., Flint, MI 485076 p.m. Registration and Social Hour
6:30 p.m. Dinner7 p.m. Meeting
7:15 p.m. Presentation
7JANUARY�2009The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�6 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
IS AN OUNCE OF PREVENTIONWORTH...THE COST?
The New Year has arrived, fasterthan a speeding bullet it seems, andalong with the flip of the calendar pagecomes a litany of New Year's Resolutionsfrom friends, family, patients, colleagues,and even ourselves. These pledges tend tofocus on correcting behaviors that effectour physical and financial health andlongevity, such as smoking cessation,weight loss, increasing exercise, savingmore, spending less, an on and on.Noble as these promises are, comeFebruary, most are forgotten or fallvictim to procrastination. They are akinto the promises made by candidates in the heat of apolitical race. When reality strikes, expediency movesinto the driver's seat.
Just as some resolutions do result in lifestyle changesin individuals, we can always hope that the newadministration's pledge to reform the health care systemin the United States is genuine and serious. A story inTime magazine this past November sought to outlineproblems and trends in our current system. The articlepoints out that, “The biggest problem with the U.S.health care system is that it has long been designed torespond to illness rather than prevent it.” It's hard toargue with that statement. So does this mean that ouremphasis should be geared more toward preventivemedicine?
Preventive medicine used to mean keeping peoplewell by promoting healthy habits, just like those of ourpreviously mentioned resolvers. Lately, the basic medicalmodel seems to be less about health promotion and moreabout early diagnosis. Early diagnosis is generally a goodthing, but it usually involves not saving money butactually spending more. We have to test a lot of healthypeople to make sure they are not sick. Some advancedcases of disease are prevented, but any savings aredwarfed by the cost of intervening early in millions ofother cases. Early diagnosis often leads to treatment of
others for a disease that may never havebothered them. This is called over-diagnosis. Also, treatments can haverisks for harm to patients. Over-diagnosis can be a boon topharmaceutical manufacturers,hospitals, and physicians. It may createlots of patients who are payingcustomers. But does it make us ahealthier nation at reasonable andaffordable cost?
It seems we have a dilemma here.For those who are the recipients of anearly diagnosis, the costs and risks are
far outweighed by the benefit to them. However, thosewho are well are at risk of over-diagnosis. Over-diagnosedpatients cannot be helped by prevention because there isnothing to prevent.
The leading cause of death in this country is thesame today as it was in 1900, heart disease. It kills650,000 of us every year. Now, we all have to die ofsomething, but tremendous medical and surgicaladvances in the treatment of heart disease have notchanged this fact. The National Commission onPrevention Priorities has formulated a list of the mostvaluable preventive services to aid in the fight againstheart disease on the basis of two measures; health impactand cost effectiveness. The five clinical preventive servicesthat would have the most impact (in order from greatestto least) include, 1) aspirin therapy , 2) smokingcessation advice and help to quit, 3) cholesterol screeningin the past five years, 4) hypertension screening andtreatment, and 5) influenza immunization in adults 50years and older. These measures are not high-tech, high-cost, or high-risk, but they are found to be preventive.
So the question becomes, is preventive medicine ahelp or a hindrance? Probably both. But careful attentionto priorities and cost/benefit ratios is the key to effectiveprevention. In effect, all physicians should practicepreventive medicine and remind our patients that goodhealth is its own reward.
E D I T O R I A L L Y S P E A K I N G
Daniel Ryan, MD
8 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�8 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
E X E C U T I V E D I R E C T O R ’ S M E S S A G E
This issue of the magazine willpresent you with a verbal andphotographic taste of the 2008Presidents' Ball. The Holiday Inn waspacked. It was visually magnificent.The music was phenomenal andcaptured the sense of A Passage toIndia. The food was delicious. Peoplegenuinely had a blast. Theentertainment was wonderful. Don'tmiss it next year. An incrediblecommittee put it together: LakshmiTummala, Chair, Cheryl Thoms,Jeanette Rivera, Kee Kang, Vicki Saalwaechter, VelyndaMakhene, Mona Sahouri, Felicity Thompson, AnitaMannam, and S. Bobby Mukkamala, MD, MarciaGzym, and myself.
The Presidents' Ball has become a significantfundraiser for the society. If you know any potentialsponsors for 2009, please do not hesitate to let meknow. We appreciate our sponsors very much. Theyinclude the following: Genesys Regional MedicalCenter, Hurley Medical Center, McLaren RegionalMedical Center, Blue Cross Blue Shield ofMichigan/Blue Care Network, Dr. AppaRaoMukkamala, American Physicians Assurance, CitizensBank, HealthPlus of Michigan, McLaren Health Plan,Meritel Group, MSMS Physicians Insurance Agency,Complete Eye Care, Meadowbrook InsuranceAgency/Star Insurance, Medical Protective, CV
Michael Boucree, MD, Dr. & Mrs.Clifford Cox, Raymond Rudoni, MD,Allen F. Turcke, MD, and Dr. & Mrs.Robert Soderstrom.
If you would like to read the text ofDr. Anné speech, please go towww.gcms.org, go to the “MembersOnly” section, sign in and go to the“Member Information” section. If you
do not have a password please contact Marcia at810-733-9923.
Two issues which we have been working on mightbe of interest to the membership. The Board assignedDr. Paul Dake and me to meet with the state police todevelop an avenue that physicians and their staff can usewhen prescription fraud rears its ugly head. In the nearfuture, we expect to work with more police jurisdictions,and involve more physicians in this process.
There have been several incidents of Medicaidpatients being referred to Genesee County withtransportation and even hotel stays provided becausecare is not available in their home community as faraway as the east and west coast of the state. This is anissue which we are working on. As far as we know theactivity has stopped at least as it relates to referrals intothis county. Please let us know if there are other
examples that we are not aware of. As the year begins, we all know that health care
system reform was one of the primary issues in thejust completed presidential campaign. Pleasereserve February 5 to come to the next DinnerBusiness meeting: The future of the AmericanHealth Care "system". We will all hear from expertsin the fields which will influence this process.
THE BALL, PRESCRIPTION FRAUD,MEDICAID CROSS-STATE REFERRAL
convenient, single sign-on portal. It willuse Compuware's Covisint subsidiarytechnology, securely connectingphysicians to patient information and toeach other for referrals and consultations- as well as to labs, patient registries andother resources.
MSMS Will Push for ICD-10Delay - MSMS will push for a delay inthe implementation of the InternationalClassification of Diseases, Tenth Revision(ICD-10), which is set to take effect onOctober 1, 2011. MSMS contends thatphysicians and their staff will not haveadequate time to transition smoothlyfrom 17,000 to 155,000 codes (an almost
tenfold increase) by that date, and that the transitionmust allow for steps that cannot be rushed, such asphysician education, software vendor updates, codertraining, and testing with payers.
10 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
An election year can seem like aneternity, especially when it's surroundedby threats of Medicare cuts, an uninsuredcrisis, unemployment, market deflation,and…well…you know the rest.
But sometimes an election year canbring with it a new enthusiasm, a chanceto start over with promising ideals andlofty aspirations. At the recent meeting ofthe MSMS Board of Directors, I can tellyou that enthusiasm and positivity filledthe room. Your medical societyunderstands that where there is crisis,there is opportunity.
So, as we look ahead to the new year,I wanted to use this column to discusssome of the problems opportunities we will be facing in2009.
Fixing the Medicare Payment Formula - MSMSadvocacy helped to pass the “Medicare Improvements forPatients & Providers Act of 2008,”which kept the 0.5 percent physicianpayment update and an additional 1.1percent update in 2009. Despite thetemporary fix, organized medicineremains vigilant. GCMS, MSMS andthe AMA continue to work withlegislators and we believe that apermanent solution may be withinreach this year.
MSMS Establishes Nation's FirstStatewide Physician Network -MSMS recently announced that,starting in January, it will be offering toits members a statewide physician-sponsored electronic portal calledMSMS Connect. The basic portal is afree benefit to members that securelyconnects physicians to patient data andto key resources - all through a
Venkat Rao, MDDistrict VI Director
NO REST FOR THE WEARY:A LOOK AT THE YEAR AHEAD
M S M S D I S T R I C T V I U P D A T E
Educational Opportunity:Patient Centered Medical Homes- MSMS will continue its timelyand relevant educationalprogramming by offering a series ofthree educational sessions on thepatient centered medical home, amodel of health care delivery thatprovides comprehensive care forchildren, youth and adults.Programs will be held in Troy onWednesday, January 28;Wednesday, February 25; andWednesday, March 25. For moreinformation or to register, visitwww.msms.org/eo.
Smoke-free Air in Michigan'sWorkplaces - It has been a long,uphill battle so far, but Lansinglawmakers know that the Campaignfor Smokefree Air (of which GCMSand MSMS are a part) is not goingaway until Michigan's workforce issafe from deadly second-handsmoke.
Protecting Patients byProtecting Scope of Practice -Your medical society will continueto work diligently to stop legislationthat would expand chiropracticscope of practice from the "spinalcolumn" to the "musculoskeletalsystem." The bills specifically wouldadd "differential diagnosis" and"physical modalities andrehabilitative services" tochiropractors' scope. In addition,this would allow chiropractors toorder MRI, CT scans, PET scans,and almost any other imaging test.
Remember: You can readabout all these issues - and takeaction through the online MSMSAction Center - simply by visitingwww.msms.org.
If there is one event in town that brings the whole medical communityand its friends together, it is the GCMS/GCMSA Presidents' Ball in honor ofthe past presidents of both organizations. This much-awaited and mostenjoyable gala was held at the Holiday Inn - Gateway Center on Saturday,November 1. The theme this year was, "A Passage to India" in honor of theout-going GCMS President Dr. Suresh Anne who hails from India. The BallCommittee worked hard to put together this event giving much attention toevery detail, from the beautiful invitations to the table decorations, from the
The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
Presidents’Ball
�
�
APassage to IndiaAPassage to IndiaBy Lakshmi Tummala
�2008
15JANUARY�200914 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
scintillating music to the delicious and spicy food. The fall evening called for balmy weather. Guests
started arriving dressed in their finest attire. The Indianladies turned up in their traditional silk saris with exoticand rich designs. Some physicians even sported theirtraditional garb. The cocktails and hors d’oeuvres wereserved in the beautiful and spacious atrium. The placesoon filled with guests socializing with each other andhelping themselves to tasty tidbits. Soon, it was time fordinner and the guests were ushered into the ballroomwhich was transformed into a bygone era in Indianhistory. Crushed silk tablecloths in shades of sunsetcolors covered the tables. The center pieces weredecorated with carved, wooden pillars filled withbeautiful flowers, in rich fall colors, and dripping withjewels. At the far end of the room, was a gazebo drapedin beautiful saris. This being the time of Diwali, theIndian "Festival of lights" celebrated throughout India,hundreds of tea lights were placed around the center ofthe tables, cast a soft light on the gems spread all overthe table. The effect was spell binding, reminiscent ofthe rich banquet rooms of royal palaces.
Dr. Anne welcomed everyone and recognized theevening's distinguished guests: Congressman DaleKildee, MSMS Executive Director Julie Novak, MSMSPresident Dr. Michael Sandler and MSMS President-elect Dr. Richard Smith, MSMSA President LakshmiTummala, MSMS Past Presidents Drs. Cathy Blight andAppaRao Mukkamala. After a short business meeting,he turned the podium over to Dr. Srinivas (Bobby)Mukkamala who was the evening's Master ofceremonies. Dinner was announced and the guests wereled to the buffet tables laden with a wide variety ofmouth-watering dishes. The carefully prepared food haddishes for everyone's taste. The chef went out of his wayto include some all time Indian favorites like chickencurry, mixed vegetable masala, basmati pulao and raita.Soft music on the "sitar" (Indian string instrument)played in the background.
After dinner, a special video produced by Dr. BobbyMukkamala on Dr. Anne was shown. Bobby's sonDeven and Dr. Samasandrapalya Kiran played Dr.
Anné’s role during his childhoodand later years; Bobby'swife Dr. Nita Kulkarniplayed a cameo role in thishilarious movie. Dr. JagdishShah played a couple ofmusical numbers on an Indianstring instrument, the "bul bultarang” that every one listened to with greatinterest. It was back to business as usual.GCMSA President, Beth Schumacher wasinvited to give a report on the Alliance. Then,Dr. Edward Gullekson installed Dr. John Watersas the 2008-2009 President of GCMS. Dr. SureshAnné, in his exaugural speech thanked his board,staff, and colleagues for the tremendous supportgiven him during his tenure. To read Dr.Anné’s speech in its entirety please go tothe GCMS website www.gcms.org. It isin the “Members only” section, and under“Member Information.” For a passwordplease contact Marcia Gzym at 733-9923.The highlight of the evening was a songrendered by Lajari Anné dedicated to herfather Suresh. Her beautiful and haunting voicebrought the house down. Dr. Waters, in hisacceptance speech, said that it was an honor to beelected president of GCMS and that he was lookingforward to a very productive year. CongratulationsDr. Waters!
It was then time for dancing and revelry. PeteLevine, Executive Director, GCMS recognized the pastpresidents from GCMS and GCMSA. They were askedto join Drs. Suresh and Aruna Anné on the dance floor.The disc jockey played a wide selection of music. Thedanced floor was soon filled with dancers swaying to amusic mix of old and new, pop and jazz numbersinterspersed with some catchy Indian songs fromBollywood movies. The delectable lemon and cheesecakes plus an assortment of Indian desserts disappearedin no time! The evening offered all the guests a taste ofIndia.
Presidents’ Ball
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16 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
G C M S / M S M S N E W M E M B E R S
APPLICATIONS
Seann E. Wilson-Carr, MDOrthopedic SurgeryFamily Orthopedic Associates4466 W. Bristol Rd., Flint, MI 48507PH: (810) 733-1200 Fax: (810) 733-1265Dr. Wilson-Carr received her medical degreefrom Wayne State University, Detroit, MI in2002. She performed her residency at theUniversity of Chicago, Chicago, IL andScripps Clinic, La Jolla, CA. Dr. Wilson-Carris sponsored by Amitabha Banerjee, MD andS. Bobby Mukkamala, MD.
Syed Aftab Karim, MDInsight Institute of Neurosurgery &Neurosurgery (IINN)4800 S. Saginaw, Ste 1800, Flint, MI 48507PH: (810) 732-8336 Fax: (810) 2394346Dr. Karim received him medical degree fromBrown University, Providence, RI in 1999.He completed his residency at Louisiana StateUniversity, Shreveport, LA in 2006. Dr.Karim is sponsored by Amitabha Banerjee,MD and S. Bobby Mukkamala, MD.
19JANUARY�2009The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�18 JANUARY�2009 The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�
Motion:That the Budget Report for the period ending September 30, 2008 and projections for October 31, 2008 be approvedas presented. The Motion Carried.
Motion:That the proposed Budget in its amount of $258,200 for Fiscal Year 2008-2009 be approved as presented. The Motion Carried.
Motion:That GCMS investigate and implement a process to have residents and fellows seated on the GCMS Delegation. The Motion Carried.
Motion:That requests for membership be approved as presented.Request for Membership:Gordon Mc Climans, II, DO Joyce Stevens, MD John Bitner, MD
Genesee County Medical SocietyBoard of Directors Meeting – October 28, 2008
MINUTES
Request for Associate Membership: Requesting Reinstatement:Richard Frank, MD Jon Schriner, DO
Motion:That the same physicians that attended the spring meeting with HealthPlus on its Clinical Quality Scoring andMember Satisfaction Program be reconvened to meet with Eric Helm and others of HealthPlus in the near future. The Motion Carried.
Motion:That Drs. Suresh Anné and John Waters as President and President-Elect, Dr. Abd Alghanem, as a Board of Medicinemember, and Peter Levine meet with the editor of The Flint Journal to note GCMS's concern about placement of suchan article in newspaper at all. The article itself is very slanted and positioned on the front page. The Motion Carried.
POLITICAL ACTION STRIKE FORCE(Subcommittee of Legislative Liaison)Dr. Abd & Fadwa Alghanem Dr. Peter & Marianne AlmeidaDr. Cathy BlightDr. Fritz & Tammy BrueningDr. Maurice ChapinKathy CoxDr. George and Sunny DassDr. Ali & Lila EsfahaniBrad EshbaughDr. Edwin and Rosemarie GulleksonDr. Ayman HaidarDr. Shawky HassanBrian HayesKee KangDr. Sunil & Vibha KaushalDr. Prasad & Jay KommareddiDr. Paul & Sue LauberJames Long, Jr.Jane MacksoodDr. Ramotsumi & Velinda MakhenePete Levine & Mamie DayDr. Sreen & Anita MannamMary Lou MathiasDr. Alan & Sheila MorganDrs. AppaRao & Sumathi MukkamalaDr. Sunil & Sumita NagpalDrs. Bobby Mukkamala & Nita KulkarniDr. David & Darcy OjedaGary PaavolaDr. Vivekanand PalavaliKitty PrasadDr. Vikram & Samira RaoDr. Seif SaeedDr. Saed and Mona SahouriBetty SalimiDrs. Mona Hardas &
Samasandrapalaya KiranDr. Randy & Beth Schumacher
Dr. Thomas ShusterDr. Robert & Sue SoderstromDr. Peter & Laura StoyanoffDr. Timur SumerDr. Peter & Cheryl ThomsDr. Jawahar & Lakshmi Tummala Dr. Venkat Rao
On December 1, the Legislative LiaisonCommittee met with RepresentativesBrenda Clack, Lee Gonzales, and DavidRobertson. During the meeting, theCommittee reviewed election results,implementation of the ballot initiativeswhich passed, and projected activities bythe legislature during the lame ducksession. In addition, Dr. Blight presentedBoard Proclamations of Appreciation toterm-limited State RepresentativesBrenda Clack and David Robertson.
The GCMS Bulletin Sponsored�by�Emergency�Medical�Centre�of�Flint�26 JANUARY�2009