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The Official Journal of the Arizona Osteopathic Medical Association
Citation preview
Volume 30, No. 1Winter 2015
— WHAT’S INSIDE —
Get InvolvedAOMA 93rd Annual Convention
Practice Management Articles
AOMA Digest Winter 20151
2014-2015 Board of TrusteesPresident
Adam Nally, D.O.
President Elect
Kristin Nelson, D.O.
Immediate Past President
Craig Phelps, D.O., FAOASM
Vice President
Jonathon Kirsch, D.O.
Secretary/Treasurer
Shannon Scott, D.O., FACOFP
Executive Director/Editor
Pete Wertheim
Trustees
Craig Cassidy, D.O., FACOO
Donald Curran, D.O.
Angela DeRosa, D.O., MBA, CPE
William Devine, D.O.
David P. England, D.O.
Michelle Eyler, D.O.
Charles A. Finch, D.O., FACOEP
Patrick Hogan, D.O.
Christopher Labban, D.O.
Julie A. Morrison, D.O.
Laurel Mueller, D.O., MBA
Kathleen Naegele, D.O., MBA, MIS, MPH
George Parides, D.O., FACOI
Wendell Phillips, D.O.
Bunnie Richie, D.O.
Resident Trustee
Mansoor Jatoi, D.O.
Student Trustees
Ryan Martin, AZCOM
Joshua Nead, SOMA
Speaker of the House of Delegates
Jeffrey Morgan, D.O., MA, FACOI
Vice Speaker of the House
Scott Welle, D.O., FACOS, FACS
AOMA STAFF LISTINGDirector of Education & Managing Editor
Janet Weigel
Member Service Manager
Sharon Daggett
Executive Assistant
Teresa Roland
Opinions expressed in the AOMA Digest are those of authors and do not necessarily reflect viewpoints of the editors or official policy of the AOMA, or the institutions with which the authors are affiliated unless explicitly specified. AOMA Digest does not hold itself responsible for statements made by any contributor. We reserve the right to edit articles on the basis of content or length.
Although all advertising is expected to conform to ethical medical standards, acceptance does not imply endorsement by this magazine. The appearance of advertising in the AOMA Digest is not an AOMA guarantee or endorsement of the product, service or claims made for the product or service by the advertiser.
Copyright 2015
The Journal of the Arizona Osteopathic Medical Association
ContentsCOLUMNS2 President’s Message
4 Executive Director’s Message
7 What We Have Done For You Lately
8 Just D.O. It!
FEATURES10 AOMA Business Partners
13 Welcome New AOMA Members
14 PDMP Report Card: Will You Be at the Top of the Class?
17 Enabling Statewide Health Information Exchange: From Legislative
Origins to Improved Care Coordination and Quality Across the State
19 “Difficult Patients” May Have Low Health Literacy
21 Onboarding New Physician Hires – Is Your Plan in Place?
22 Achieving Cost Effective Patient-Centered Healthcare for Arizonans
25 The Importance of Advocacy in the Disability Claim Process
28 Navigating a Grief Journey Begins with a First Step
AOMA NEWS29 Get Involved
32 AOMA 93rd Annual Convention
34 AOMA 34th Annual Fall Seminar
OSTEOPATHIC COMMUNITY NEWS37 Tucson Osteopathic Medical Foundation
39 Arizona Society of the American College of Osteopathic Family Physicians
40 A.T. Still University School of Osteopathic Medicine in Arizona
44 Midwestern University Arizona College of Osteopathic Medicine
47 Advertisers Index
47 Calendar of Events
AOMA Digest Winter 2015 2
President’s Message
Should your doctor be involved in the political arena? It is
the first question that comes to mind when I hear the word
Advocacy. It is a very good question. The Latin definition of
doctor is translated as “teacher.” However, in today’s society the
doctor is also an advocate for his or her patient. We advocate for
our patients on a daily basis, most of the time that is behind the
exam-room door or with a third party that is directly involved with
the patient’s care or well-being. But occasionally, we must step
outside the exam room to advocate for or against an issue that has
significant impact upon our patient’s or upon our ability to provide
good care for those patients. The physician, therefore, is placed in
the position of advocacy whether we like it or not. In this sense,
the definition of advocacy is specifically “public support for or
recommendation of a particular cause or policy.”
The individual question is do you personally become involved?
And if so, how involved should you become? Stepping into the
quagmire of political discourse has its drawbacks, as it often leaves
the all-to-familiar oratory odor. Been there . . . done that . . . didn’t
really enjoy it.
Avoidance of the oratory odor often occurs when the difference
between policy and politics isn’t understood. It is very important,
from the perspective of voice, to make a distinction between policy
and politics when we interact. Policy is “a course of action based
upon principles or values.” Politics is the “inter-relationships
or activities that we engage in to move policy in a desired
direction.” Don’t confuse the two as they are distinctly different
yet interrelated. Advocacy, thereby,
encompasses the use of politics
in public support for a policy or
cause. I find it interesting that
many physicians and patients don’t
understand the difference between
policy and politics and how this
affects their ability to advocate for
one another.
When listening to the talking
heads and political pundits, it is
essential that we look for and try
to see the difference. Just spewing
rhetoric without understanding our position on a policy seems to be
what fuels the cesspool-like arena of politics. It is often what turns
us away from important and productive political conversation about
policy. We seldom do this unless we understand the principles we
hold dear and our own values or the values of those for whom we
advocate.
In the words of Sir Francis Bacon, “He that gives good advice
builds with one hand; he that gives good counsel and example
builds with both; but he that gives good admonition and bad
example builds with one hand and pulls down with the other.”
(Whether you agree or not, anyone who holds the same name as
one of the most delicious breakfast foods on the planet should be
paid some attention.)
In a time when transparency is at the forefront, being genuine
and true to our values is essential for our patients and the business
of medicine. Yet, transparency is often subjective. Exposing one’s
views, beliefs, or values has variable interpretation from person to
person based on age, morals, background, ethnicity, etc. Through
social media and daily office interactions, we each frequently come
in contact with many physicians’ and patients’ viewpoints and can’t
help but compare them with our own.
For this reason, healthcare advocacy is often posed within a
value based system of the “Iron Triangle.” The “Iron Triangle” is
made up of three value-based vertices or sides: cost, quality, and
access. In our current healthcare system, the triangle is made up
of trade-offs. You can improve one or two sides of the triangle,
but only at the expense of the third. Improving access comes at
Adam S. Nally, D.O.2014–2015 AOMA President
Policy, Politics, & AdvocacyAdam S. Nally, D.O.
AOMA Digest Winter 20153
the reduction of quality, increased cost, or both. Reduction in cost
comes at the price of reduced quality or a decrease in access.
Advocacy for a single side of the triangle comes at the expense
of one of the other sides. We inherently understand this, and
I suspect this is the real reason why many of us shy away from
political advocacy. Anyone who tells you that he or she can make
the healthcare system more universal, improve quality, and also
reduce cost is in denial or misleading you. They are often politicians.
If we are to advocate honestly, which is part of the Osteopathic
Oath that each of us took upon graduation from our medical
training, then we should acknowledge that improvement in one
area will come at the sacrifice of another. The politicians among
us seem to be afraid of telling the hard truth and acknowledging
reality. Advocacy requires us to tell the hard truth. This is where the
physician advocate shines. Many of us do this daily when we inform
a patient they should place their affairs in order due to a terminal
illness. Why can’t we tactfully do the same when we advocate for
a particular cause or policy? Our Oath requires us to “retain the
confidence and respect [of our patients] both as a physician and a
friend . . . with scrupulous honor and fidelity . . .”
We live in a society of fast cars, fast food, instant messages,
and instant pictures. We want it our way and we want it now. As a
family practitioner, I feel pressured by both patients and insurance
companies to serve up a diagnosis and a low cost generic pill
with the same speed. No, the practice of medicine is not like fast
food. If it were, then I would install a drive up window next to
my office desk, and place a large marquee with a clown wearing
a stethoscope at my front door and a sign that says “Free prostate
checks here today with your first order of Lipitor!!!”
Medicine is an art. A picture is painted of the patient by
what is seen, heard, felt, and understood through the eyes of
the practitioner. This can’t be done over the phone or through a
drive-through window. It requires a patient who is willing to place
his or her history, symptoms, feelings, private concerns, and trust
upon the examination table. It requires the astute observer to see
all the reflections of light and shadows and all the highlights. It
requires the observer, the doctor, to recognize that many times this
is difficult for the patient. That trust is built through a relationship
that occurs over a period of minutes and a period of years. The
beauty of the art occurs when the practitioner and the patient
understand one another and application of healing can begin.
The art of medicine paints a different picture every time.
That’s why art isn’t sold under the golden arches or at the corner
pharmacy. No, the practice of medicine is not like fast food.
Honest advocacy cannot be done in 140 characters, either. It
comes through the formation of relationships and inter-relationships
of understanding and trust. Tweeting your weekly weight loss or meal
plan may be motivational for some, but is too-much-information
(TMI) for others. Just as spouting off one’s political views in 140
characters may encourage some, without appropriate relationships of
trust, it is offensively too much for others.
How can you be a better advocate?
1. Get involved with your state medical society. Form
relationships, real relationships, with your colleagues. The
Arizona Osteopathic Medical Association’s mission and
purpose is to advocate for you and your patients. There
are many areas that your help and participation make a
difference. If you are not a member, join us. If you are a
member, consider serving on one of many committees
helping to improve healthcare in Arizona.
2. Come join us on Tuesday, March 10th, 2015, at the Arizona
State Legislature for “D.O. Day at the Legislature” and
get the chance to speak one-on-one with your state
representatives. You, as a physician, interact with and have
relationships with up to 6000 members of the community
each year. Your legislators want to hear what you have to say
and what your patients have to say.
3. Participate in and contribute to your State and National
Political Action Committee (PAC). Your contributions help
to foster relationships with, support, and endorse candidates
with like-minded vision of what value in medicine really
means.
4. Consider becoming a Health Policy Fellow. Money
motivates neither the best people, nor the best in people. It
can move the body and influence the mind, but it cannot
touch the heart or move the spirit; that is reserved for
belief, principle, and morality. This program helps prepare
future leaders with the skills to analyze and react to current
health policy at the local, state, and national level. It was
designed with the practicing physician in mind.
To put it another way, if you stand up to be counted, from time
to time you may get yourself knocked down. However, remember
this: A man flattened by an opponent can get up again . . . A man
flattened by conformity stays down for good.
AOMA Digest Winter 2015 4
Executive Director’s Message
Scope of practice expansion battles are becoming all too
common in the modern era of healthcare. It is one the most
important issues the AOMA contends with each legislative
session and unfortunately the trend is accelerating.
As revenues to improve the delivery of healthcare become scarce,
legislators struggle to find fresh ideas and meaningful solutions to
satisfy the demands of their constituents. Expanding the scope of
practice to health professions is an alluring access to care remedy as
opposed to addressing the underlying problem which is a workforce
shortage.
The interesting and overlooked paradox about the expanding
scope of practice is that while it may appear to legislators to
improve access to care it can actually exacerbate the most expensive
and challenging problem limiting access to care: the physician
workforce shortage.
For many years we have advocated for additional graduate
medical education funding in hopes of attracting and retaining
physicians in Arizona. It is a challenging issue and overshadowed
by the continuous demands on the state general fund to solve
the more visible and immediate problems. Constituents expect
instantaneous results from their legislators and graduate medical
education is very much a long term investment.
When we analyze the reasons physicians decide where to
practice, they frequently include measurements such as tort reform,
managed care penetration, regulatory pressure, reimbursement rates,
weather, and physician-to-patient ratios. It is unclear why scope of
practice encroachment is left off many of these measurements.
The Physicians Foundation surveyed 630,000 physicians in
2012 about the current state of the medical profession. According
to the Foundation this survey was one of the largest and most
comprehensive ever undertaken in the United States. When asked
about factors leading to the decline of the medical profession, 43.7
percent of physicians stated that scope of practice encroachment
was a “very important” factor in the decline. For physicians under
the age of 40, the number was slightly higher at 44.6 percent
suggesting it is a growing concern.
Although scope of practice
encroachment was the not the
most important issue cited by
physicians in the survey, too much
regulation/paperwork was. It is a
significant concern weighing on
the minds of physicians. Scope of
practice encroachment in Arizona
has been a problem in the past and
when efforts fail to prevent it, the
problem becomes even worse.
The Arizona Naturopathic
Medical Association submitted a
sunrise application last year in hopes of getting it approved to clear
the way for legislation to allow naturopathic physicians equivalent
prescribing privileges as DOs and MDs. Arizona naturopathic
physicians are already privileged to possess one of the most liberal
scopes of practice and prescribing formularies in the nation.
They were seeking the ability to prescribe all Schedule II drugs, a
significant deviation from the practice of naturopathic medicine.
The AOMA invested quite a bit of time and political capital to
sway enough legislators and the sunrise application was withdrawn
due to lack of support. They will likely bring the issue back again
and we will have to work even harder next time to defeat it.
Imagine for a moment the physician perception of Arizona if
this proposal were to become law. There are approximately 1,800
osteopathic physicians and more than 750 naturopathic physicians
licensed to practice and living in Arizona. With the stroke of the
Governor’s pen on a bill, more than 750 naturopathic physicians
without the burden of completing a 3-7 year residency and only
needing about half the number of hours of pharmacology training,
would get a shortcut to DO equivalency.
The impact of this would be far reaching. You would expect the
number of naturopathic physicians coming to Arizona to quickly
increase as word spread that Arizona is one of the best states for
them to practice.
The Scope of Practice Encroachment Threat in Arizona
Pete WertheimAOMA Executive Director
AOMA Digest Winter 20155
Executive Director’s Message
We already witnessed this phenomena in 1992 when Arizona
law was changed to allow naturopaths to provide many of the
same healthcare services as allopathic and osteopathic physicians.
Building on that momentum, in 2002 their scope of practice was
expanded to allow naturopathic physicians to prescribe Schedule
II morphine, any Schedule III, IV or V drug, and refill the same
as physicians. In 2002 Arizona had 302 licensed naturopathic
physicians. Following the success of the scope of practice
expansion, their population grew to 400 plus licensees in 2004,
more than 10 percent of the nation’s licensed naturopaths.
Expanding scope of practice to allow full Schedule II
prescribing privileges to unqualified naturopathic physicians would
greatly undermine the hard work of the more than 1,800 Arizona
osteopathic physicians who spent a significantly longer amount
of time in the classroom and many years through clinical training
to become qualified to prescribe Schedule II drugs. Furthermore,
students enrolled in medical schools or considering enrolling in
medical school would question, and rightfully so, why they must
undergo so much additional training when others can become a
physician with a nearly identical scope of practice after just a four
year program and 60 hours of pharmacology courses. Physicians
might reconsider moving their practice to Arizona once they learn
about this inequitable competition.
We must get more physicians involved in protecting their
profession by supporting their state associations and contributing to
their Political Action Committees. Scope of practice encroachment
will continue to escalate as other professions increase their strength
and numbers to convince legislators they can fulfill the unmet needs
of patients in their districts.
The AOMA Legislative Affairs Committee will be busy this
year working on your behalf to protect and preserve the integrity
of the osteopathic medical profession. We are in good hands with
Dr. Kit McCalla leading the way as an outstanding chair but we
need your support through your membership with the AOMA,
volunteering on the Legislative Affairs Committee, and financial
support of the AOMA PAC. Your contribution and the collective
support of everyone will ensure that Arizona is a great place to
be a DO.
AOMA Digest Winter 20157
What We Have Done For You Lately
What We Have Done For You LatelyThis regular feature of the AOMA Digest provides members with a recent update of the Association’s activities. We are representing the profession
as a healthcare stakeholder and are the voice of osteopathic medicine in Arizona. This update covers the four month period from October 1, 2014
to January 31, 2015.
Advocacy/ Legislative Af fairs- Lead efforts to oppose and defeat scope of practice expansion
sunrise applications submitted by the naturopathic physicians
and the pharmacists
- Updated the AOMA website and launched a Legislative Affairs
Advocacy Resource Center. The new page contains information
about effective advocacy, training opportunities, advocacy tools,
D.O. Day at the Legislature, elections and voting, and the
Political Action Committee
- Facilitated the safety net providers orientation for new state
legislators
- Conducted an AHCCCS Physician Reimbursement Cut Survey;
survey results are being used to share with legislators about the
impact of previous cuts and proposed additional cuts
- Attended the 26th Annual Southwest Medical Legislative Group
Symposium
American Osteopathic Association (AOA) - Attended the AOA Advocacy for Healthy Partnerships meeting
in Phoenix
- Organized a sponsored reception for the Association of
Osteopathic State Executive Directors
- Attended the American Osteopathic Association CME
Conference in Los Angeles
Continuing Medical Education - Sponsored 12.5 hours of Category 1-A CME credit for AOMA
34th Annual Fall Seminar
- Sponsored five offerings of 4.0 hours of Category 1-A CME
credit for Opioids: The Epidemic That You Can Cure
- Implemented online attestation and evaluation form for AOMA
CME offerings
Osteopathic Charities - Raised more than $2,000 through 2015 Birdies for Charities
campaign
- Launched Amazon Affiliates program to provide ongoing
revenue to Charities from purchases made on Amazon.com
- Installed Barbara Mendelson as a new board member
- Announced Annual Scholarship Essay Contest to AZCOM and
SOMA students
Member Services- Introduced a new “Get Involved” feature on the AOMA website
to help educate members about AOMA leadership and volunteer
opportunities
- Relaunched AOMA Career Center Job Flash eNewsletter
- Redesigned all AOMA membership marketing materials
Political Action Committee- Contributed $6,100 to 21 candidates who won their elections
Public Health- Represented AOMA at the Governor’s Council on Infectious
Disease Preparedness and Response meetings on the Ebola
outbreak
- Represented AOMA at the Arizona Department of Health
Services Vaccine Financing & Availability Advisory Committee
and at The Arizona Partnership for Immunization (TAPI) Steering
committee meeting
Public Relations- Moderated panel discussion on graduate medical education for
American College of Physicians, Arizona Chapter
Students – the future of the osteopathic profession - Provided public policy and advocacy training to the Student
Osteopathic Medical Association and the AZCOM Healthcare
Policy Club
- Student doctors served as moderators at the AOMA 34th Annual
Fall Seminar
- Announced 2015 AOMA Clinical Case and Poster Competition
- Developed the Amanda Weaver Student Health Policy Grants
to provide financial incentive to osteopathic medical students
to learn about health policy and develop effective health policy
tools
- Added 9 students to AOMA committees
For more information about any of these updates, please AOMA at
(602) 266-6699 or email communications@az-osteo.org
AOMA Digest Winter 2015 8
Just D.O. It
A Guiding Hand
Doctors Brent and Nicole Nedella believe in a guiding hand.
As osteopathic physicians they employ the healing power of
hands to treat patients. In their personal lives, they witness
the guiding hand of faith every day.
Both native Arizonans, Brent and Nicole met as undergraduates
at Grand Canyon University (GCU) fifteen years ago. They practice
family medicine at Pinnacle Family Medicine in Litchfield Park,
Arizona with David Engstrom, DO and Kevin Houlihan, MD.
While their lives today are shared both personally and professionally,
their individual paths to osteopathic medicine were different.
Dr. Brent grew up on the northwest side of Phoenix and knew
by the age of thirteen he wanted to be a doctor. He was the first
member of his family to attend college and thought he would
pursue orthopedic surgery. Brent was raised within a faith-based
family, and it was during medical school and residency that his
commitment to community outreach evolved.
Dr. Nicole was raised in the east Valley and was fortunate to
travel internationally. She remembers at an early age travelling to
Mexico and being touched by the poverty of the local residents. As
a teenager living with her family in Japan, she was part of a youth
ministry and saw the tremendous need there and in Malaysia.
During her years at GCU, Nicole originally planned to become a
veterinarian but she so loved her human anatomy classes that she
changed her focus to medicine.
After graduation from GCU, Brent and Nicole attended
Midwestern University Arizona College of Osteopathic Medicine
(AZCOM) in Glendale, Arizona. They both acknowledge Jeffrey
Morgan, D.O. as having a huge influence on their academic and
professional careers, guiding their paths. During medical rotations,
Brent and Nicole found they loved every aspect of osteopathic
medicine and decided that their life purpose would be best served
in family medicine.
After medical school and residency, the Nedellas came
home to Arizona to practice. In the middle of the recession, the
opportunity to practice together was not very promising. Enter
David Engstrom, DO, a family medicine practitioner in Litchfield
Park. Dr. Brent responded to a physician opportunity posted by Dr.
Engstrom through the Christian Medical and Dental Association.
After interviewing for the position, Dr. Brent asked if there was
the possibility of also bringing Dr. Nicole into the practice. Dr.
Engstrom hadn’t originally considered the option, but after securing
additional funding from Banner Estrella, both Dr. Brent and Dr.
Nicole joined Pinnacle Family Medicine in 2010. The practice
continues to grow and added Dr. Houlihan in 2014
Dr. Engstrom was already doing mission work in Thailand and
Mexico when a friend, Pastor Patrick Youngs, approached him in
2012 about putting together a mission trip to Uganda to address
the enormous need for medical care in that country. After much
prayer and consideration, all three DOs rose
to the challenge embarking on the first trip in
June 2012 with no definite knowledge of what
to expect.
Arriving in Uganda after 40 hours of
travelling, the first clinic was set up in a
church with a dirt floor. The team of four
physicians and four staff saw patients for nine
hours. With no infrastructure, no medical
equipment except stethoscopes and blood
pressure cuffs, no testing materials except
The 2014 mission team: From top left, clock-
wise: Patricia Plum, MSW; Stacey Engstrom;
Roger Engstrom; Jamie Engstrom, PA-C; David
Engstrom, D.O.; Patrick Youngs; Larry Hirose;
Cortney Mitchell, RN; Stephanie Bradley, RN;
Nicole Nedella, D.O.; Priscilla Vera, MA; and
Brent Nedella, D.O.
AOMA Digest Winter 20159
Just D.O. It
those for malaria, and limited medications, the medical care was
offered in a sometimes chaotic environment using volunteer
interpreters. They conducted four clinics in 10 days seeing nearly
1000 patients. Miraculously the malaria test kits and medications
they brought from the United States carried them through to the
very last patient on the very last day of the clinic.
Subsequent mission trips in 2013 and 2014 were held in
Bundibugyo, Uganda in the schoolhouse at the Mt. Zion Boarding
School run by Bishop Hannington Bahemuka. A stone’s throw
from the Congo border, both Ugandans and Congolese natives
receive care at the clinic.
The Nedellas related an account from Pastor Youngs about one
of the many patients the team treated during the 2014 mission trip:
“Before we arrived, a 13-year-old orphan girl named Pamela (pa
MEL a) had skinned her knee, an injury that for most American
children is not generally of great concern. Unfortunately, Pamela’s
small wound quickly became infected and she found herself in
so much pain, she could not even walk. Over the course of just
a few days, her condition went from bad to worse. Her body
could no longer fight the infection and it began to spread. By the
time she was brought to us, she was in agonizing pain and her knee
was four to five times its normal size. Pamela was in desperate need
of a hospital that could provide her with weeks of an intravenous
antibiotic drip but the medicine was not available. Our doctors
took action, opening up her knee and caring for the wound. It
was extremely painful and her deafening screams would last for
approximately an hour. We provided her with oral antibiotics, but this
alone was simply not enough. The doctors agreed that this situation
was quickly becoming life threatening and the only thing left to do
was pray. Over the next few days, we were amazed to see her smiling
and regaining her strength. Ultimately, the Pamela’s infection was
completely cured. Medically, it is simply unexplainable.”
The physicians and staff are truly a family. Everyone at Pinnacle
Family Medicine may go on the mission trips if they wish, with
paid time off. Dr. Engstrom also provides funding for plane
tickets and other expenses for those staff members who could not
otherwise afford to go on the mission.
The patients receiving care are not the only ones who are touched
by the mission experience. After several years of trying to start a
family of their own, the Nedellas were seeing a fertility specialist.
During the first mission trip in 2012, with hands on her womb, the
mission team in prayed that Dr. Nicole might soon have a child.
Less than six months later, just before she was to resume fertility
treatments, the guiding hand that had led them to Uganda brought
them their now 18-month-old son, Jesse Hannington Nedella.
The Nedellas don’t know where the guiding hand will lead them
next. Of course, they will continue to practice family medicine here
in Arizona and there are definite plans for a permanent physical
facility. The Betheseda Health Center is under construction in
Bundibugyo with the ultimate goal to have a full-time physician
and fully-stocked pharmacy to treat chronic conditions and provide
continuous care. Future mission trips are scheduled and both Dr.
Brent and Dr. Nicole will be part of those trips. Beyond that, the
future is in His hands.
Doctors treat Pamela’s knee infection under light provided by cell
phones.Bethesda Clinic under construction in Bundibugyo, Uganda
AOMA Digest Winter 2015 10
Business Partner Listings
AOMA Business PartnersProvide Services for a Health Practice and your Finance
USE YOUR MEMBER DISCOUNT
ACCOUNTING
McGladreyJason Bernstein, CPA501 N. 44th St., Ste. 300Phoenix, AZ 85008(602) 760-2798jason.bernstein@mcgladrey.com
McGladrey is a leading provider of tax planning and compliance (individual and practice), assurance and consulting services to physicians, physician groups and healthcare companies. AOMA members will receive a 20% discount off regular fees.
BANKING
Bankers TrustKeith Kormos, Senior Vice President2325 E. Camelback Rd., Ste. 100Phoenix, AZ 85016(602) 224-2023www.bankerstrust.comkkormos@bankerstrust.com
Bankers Trust provides core banking services, mortgages, treasury services and trust accounts. To AOMA members (private banking clients) will receive: free checking, free printed checks, free electronic statements and free mobile banking.
BANK CARD PROCESSING
AffinipayVisit the AOMA website, Member Services Business Partner Listings or call (800) 644-9060 Ext. 6974
AOMA members are entitled to a very special processing package from Affinipay. Their on-line reporting lets you quickly see your deposit and payment information.
BILLING & COLLECTIONS
Delivery Financial Services, LLC.Dean Grandlienard – Sales Manager(602) 490-3956 Direct Linewww.deliveryfinancial.comdean@deliveryfinancial.com
A technologically superior medical collection agency. They provide cutting-edge services like real-time online performance results. Delivery Financial Services maintains an excellent record for ethical and professional standards with its clients with an outstanding A+ rating. All AOMA members will receive a significant discounted fee.
J.R. Brothers Financial, Inc.Robert Antenucci – President (602) 371-1001www.jrbfinancial.comjeff@jrbfinancial.com
J.R. Brothers Financial, Inc. ( JRB) is a medical collection agency since 1986. AOMA members are offered a lower collection fee with exceptional service and recovery. Clients can access the status of their accounts online through the JRB Client View Program.
XOLMed Revenue Cycle Management Corp.J. Patrick Laux(602) 396-5900 x101www.xolmedrcm.comjplaux@xolmedrcm.com
We provide exceptional billing, coding, and collection services for physician practices. We offer AOMA members a comprehensive billing and chart preview at no charge to determine how we can increase practice revenue, and shorten collection cycles.
CAR RENTAL
Avis & HertzDiscount coupons available through the AOMA Office, call (602) 266-6699 or our toll free number (888) 266-6699. You may also request coupons by emailing sharon@az-osteo.org, or go to the AOMA website www.az-osteo.org and under Member Services, select Business Partner Services.
FINANCIAL
Mosaic Financial AssociatesAnthony C. Williams, President4650 E. Cotton Center Blvd. #130Phoenix, AZ 85040(480) 776-5920Fax: (480) 776-5925anthony@mosaicfa.com
Mosaic Financial Associates provides a holistic approach to wealth management. They believe your financial advisor should provide a pathway to the financial goals you dream of and work hard to achieve, while taking into account all aspects of your life and building a long-term relationship based on trust and top-notch service.
AOMA Digest Winter 201511
Business Partner Listings
HEALTH INFORMATION TECHNOLOGY Information Strategy Design (ISD)Michele Liebau(480) 970-2255 x107michele@isdesign.com
Information Strategy Design (ISD), a leading healthcare technology solutions provider with its central office in Mesa. ISD has been providing network design and implementation to Heathcare Practices in the South West since 1996. ISD’s focus is on medical practices to allow them to provide cost-effective computer networking, telephony, off-site backup and remote monitoring. ISD’s value offering to AOMA members allows for one time and ongoing discounts based on using two or more ISD services.
INSURANCE
AFLACKaren Jones, Independent Agent16211 N Scottsdale Rd., Ste. A6A 614Scottsdale, AZ 85254(602) 229-1970 x213
No Deductible, No Copay, No Preauthorization. AFLAC supplemental insurance policies are available at special Association Rates for AOMA members and their families.
Mutual Insurance Company of Arizona (MICA)(602) 956-5276(800) 352-0402www.mica-insurance.com
Each medical practice is unique with individual risk management needs based on specialty and practice characteristics. Their experienced Risk Management Consultants can assist you in assessing and providing service designed to reduce your risk of a malpractice claim or suit. MICA is owned by all of the physicians it covers and provides educational grants to AOMA.
LEGAL –– DISABILITY INSURANCE CLAIMS AND HEALTHCARE LITIGATION
Comitz|BeetheEdward O. Comitz, Esq. Scottsdale Spectrum 6720 N. Scottsdale Rd., Ste. 150 Scottsdale, AZ 85253 (480) 998-7800 Fax (480) 219-5599 ecomitz@cobelaw.com www.disabilitycounsel.net
Mr. Comitz has extensive experience in disability insurance and healthcare litigation, representing physicians in reversing the denial or termination of their disability insurance benefits. Mr. Comitz has earned a national reputation for prosecuting claims based on fraud and unfair practices in the insurance industry. A free consultation is provided to AOMA members.
MEDICAL RECORD SCANNING & MANAGEMENT
ASDD Document DestructionRyan Shinn(480) 730-4233ryanshinn@tch-az.com www.assuredsecurityaz.com
ASDD Company is an offsite and onsite “AAA” certified document
shredding, electronic media and x-ray destruction. We are HIPPA and FACTA compliant. We offer AOMA members discounts on offsite and onsite services.
PAYROLL PROCESSING
Human Capital StrategiesNick.Mawrenko (480) 577-2552nick.mawrenko@hcscando.com www.hcscando.com
Human Capital Strategies is a national provider of Professional Employer Organizations (PEO) Services, Administrative Services, Organizations (ASO) Services, and Payroll Services. Managing every aspect of payroll, human resources, taxes, employee benefits, 401(k) plans and workers’ compensation management is what makes Human Capital Strategies “the next best thing to no employees!” Human Capital Strategies offers a 10% discount and $0 setup fees for AOMA Members.
Payroll Strategies GroupNick Mawrenko (480) 577-2552nmawrenko@gmail.com
Payroll Strategies Group is a local payroll service that is designed for the small medical practice. If you have one employee and don’t want to do your own payroll, call Nick. Our custom service enables us to reduce overhead and pass the savings on to you. Call Nick to see if our approach will fit your practice. Payroll Strategies Group offers AOMA members a $0 setup fee.
PRACTICE MANAGEMENT
Wolfe Consulting Group Jim Wolfe, Owner(602) 324-0405chh@wolfecon.com
AOMA members will receive a free initial problem definition meeting and also receive a discount on a wide array of business consulting services. Services, from Improving Income to Practice Sale for Retirement, will serve as the basis for the free initial consultation. A listing of these services can be reviewed at www.wolfeconsultinggroup.com. Real Estate services from Office Leasing to Building Purchase are also available through a wholly owned subsidiary of Wolfe Consulting Group, Ltd., Healthcare Realty Advisors, Inc., at no direct cost to AOMA’s members.
REAL ESTATE
RE/Max ExcaliburKevin Weil, Realtor(602) 793-7492kevin@kevinweil.com
Kevin Weil of RE/Max Excalibur is one of the top realtors in the valley and specializes in serving the needs of physicians. AOMA members are entitled to video previewing of homes of interest and other services uniquely designed to save the time of, and maximize the interests of AOMA members. Kevin and RE/Max Excalibur have selected Arizona Osteopathic Charities as the charity to receive a donation based upon member participation.
AOMA Digest Winter 201513
Welcome New Members
Welcome New AOMA Members
_________ First Year Member _________
Robert Gordon, D.O.
Occupational Medicine
Kingman, Arizona
(928) 514-9433
_________ Third Year Member _________
Sarah E. Mitchell, D.O.
Family Medicine – Board Certified
OMM - Board Certified
Mesa, Arizona
(480) 833-1800
________________________________ Military Member _______________________________
Brian F. McCrary, D.O.
Occupational Medicine – Board Certified
Aerospace Medicine – Board Certified
Underseas Medicine & Hyperbaric Medicine – Board Certified
Aerospace Medicine – Board Certified
Scottsdale, Arizona
(702) 203-1833
_______ Second Year Members _______
Trudy Lynn Dockins, D.O.
Psychiatry – Board Certified
Mesa, Arizona
(480) 218-3280
Michael N. Lokale, D.O.
Family Medicine – Board Certified
Oro Valley, Arizona
(520) 544-4100
Tyler M. Martinez, D.O.
Emergency Medicine
Phoenix, Arizona
(510) 350-2777
Virginia Avelar Savala, D.O.
Obstetrics & Gynecology
Casa Grande, Arizona
(520) 381-0380
_________________________________ Full Members _________________________________
Gary L. Cornette, D.O.
Gastroenterology – Board Certified
Internal Medicine – Board Certified
Flagstaff, Arizona
(928) 773-2547
Ryan W. Felix, D.O.
Physical Medicine & Rehabilitation –
Board Certified
Phoenix, Arizona
(480) 467-2273
Kelli Marie-Koski Glaser, D.O.
Family Medicine – Board Certified
Mesa, Arizona
(480) 265-8070
Jeffrey H. Miller, D.O.
Family Practice
Sedona, Arizona
Jeny M. Pothen Itty, D.O.
Internal Medicine
Phoenix, Arizona
(602) 406-4636
______Out of State Members______
Rick I. Miller, D.O.
Obstetrics & Gynecology –
Board Certified
Charleston, Illinois
(217) 258-2360
IN MEMORIAMWe are all diminished when one of our number leaves us.
We will miss them and strive on for the betterment of our profession in their memory.
Zoila Denno, D.O.
AOMA Digest Winter 2015 14
Features
On December 10, 2014 the Arizona Prescription Drug
Misuse and Abuse Initiative held a planning summit
to review the results of a 24-month pilot program
conducted in five Arizona counties: Yavapai, Pinal, Mohave,
Greenlee, and Graham.
One of the five strategies employed in the program to fight
prescription drug misuse and abuse was to Promote Responsible
Prescribing and Dispensing Policies and Practices. The goals
identified for this strategy were:
1. Encourage sign up and use of the Controlled Substance
Prescription Monitoring Program (CSPMP)
2. Provide education and training and increase awareness
of individual prescribing habits
To achieve these goals, the Arizona Criminal Justice
Commission and the Arizona State Board of Pharmacy
PDMP Report Card: Will You Be at the Top of the Class?
Ten Reasons Why You Should Use the Prescription Drug Monitoring
Program Data Base1. Easier to use – prescribers can now identify a designee
to access the data base 2. More accurate – 24-hour reporting by dispensers3. Alerts prescribers to patients at highest risk of abuse
and overdose4. Identifies criminal prescribers and clinics – “pill mills”5. Detects doctor shoppers6. Monitors and detects geographic areas where increased
abuse/misuse is occurring7. Recognizes potential need to refer a patient for
substance abuse treatment8. Reduces illicit acquisition and diversion of prescription
drugs9. Limits your liability as a prescriber10. Saves lives!
developed the PDMP Report Card as a tool to convey pertinent
information to prescribers on their prescribing habits for
hydrocodone, oxycodone, carisoprodol, benzodiazepine, and
other pain relievers. During the pilot program approximately
1,600 prescribers were individually sent a quarterly report card
detailing
1. the number of prescriptions dispensed and
2. the total number of pills dispensed under their DEA
number.
The report included a comparison of the prescriber’s
individual data to the average data for prescribers of their
specialty type in the same county. The report card also contains
the prescriber’s registration status with the PDMP. (A sample
report card appears on page 15.)
According to the Arizona Criminal Justice Commission, the
following successes were identified from
the pilot program:
• from 2012 to 2014, Arizona saw a
20% reduction in the rate of youth
prescription drug misuse and abuse
• there was a 109% increase in the
number of prescribers signed up to
use the CSPMP
• there was an 84% increase in the
number of queries actively being
made to the CSPMP
• rates of prescriptions and pills
dispenses have decreased in all five
prescription drug categories tracked
(range = 2.3% to 16.3%)
• pilot counties achieved a 28%
decrease in opioid-related deaths,
compared to a 4% increase in non-
pilot counties
Based on the success of the pilot
program, the Arizona Prescription
Drug Misuse and Abuse Initiative is
AOMA Digest Winter 201515
Features
expanding the program across the
state. Pima and Maricopa counties
will be online by the end of the
second quarter of 2015. All other
Arizona counties are expected have
some kind of program in place by
the end of 2015.
The PDMP Prescriber Report
Card is also being expanded to
convey additional information:
• # of patients who received
100 mg or more Morphine
Equivalent Daily Dose
(MEDD) of prescription
narcotics
• # of patients at risk for a
dangerous drug combination
involving the five monitored
drugs
• # of patients prescribed
opioids/this prescriber
• # of patients going to more
than 5 prescribers and 5
pharmacies
In 2015, if you aren’t receiving
one already, your quarterly PDMP
Report Card will be sent to you
by the Arizona CSPMP. To get
the most of the data, be sure that
you are registered as a prescriber
with the CSPMP (as required by
Arizona statute), sign up to access
the data base (you may identify
a designee to access the data base), and periodically request
a report on each of your patients, especially if they are being
prescribed one or more controlled substances.
Your participation, awareness, and vigilance can aid in
reducing the incidences of prescription drug misuse and abuse.
For more information about the CSPMP contact Dean Wright,
RPh, CSPMP Director at (602) 771-2744 or dwright@
azpharmacy.gov. For questions about the Arizona Prescription
Drug Misuse and Abuse Initiative visit www.azcjc.gov/acjc.web/
rx or email Shana Malone at smalone@azcjc.gov.
AOMA Digest Winter 201517
Features
Since its inception in
2007, Arizona Health-e
Connection (AzHeC) has
had a core mission to collaborate
and coordinate public policy
initiatives to advance health
information technology (HIT)
and health information exchange
(HIE). This has meant researching,
developing and advocating
legislation such as the collaborative
effort in 2011 to lead community
support for passage of House Bill
2620 which helped enable statewide HIE in Arizona. While
the successful passage of House Bill 2620 ended a successful
collaborative effort of Arizona healthcare stakeholders, it
began the process of meeting the requirements of the law
and providing a valuable statewide HIE platform (called The
Network) to help providers better coordinate care and improve
quality across the state.
2011: Removing barriers and providing patient choice
and privacy
House Bill 2620 (now Arizona Revised Statutes (ARS) 36-
3801, et seq.) included these essential features:
• The law defines health information organizations (HIOs)
and permits providers and clinical laboratories to securely
share health information through an HIO, so long as
HIPAA privacy requirements are met.
• The law allows any patient or consumer to “opt out” of
participating in an HIO, restricts how HIOs may use
health information and requires HIOs to have policies
in place to protect the privacy and security of the health
information that they handle.
• The law defines the notification and “opt out” process that
participating providers must have in place for their patients.
2012-2013: Initial operations of The Network, Arizona’s
statewide HIE
There was strong support by Arizona healthcare stakeholders,
including hospitals, health plans and a statewide reference
laboratory, to implement a statewide HIE platform. These
organizations came together and through The Network,
Arizona’s statewide HIE, have been able to offer the following
statewide HIE options since 2012:
• Virtual health record (VHR) – View only access to patient
information from available sources.
• Bidirectional clinical data exchange – A two-way pipeline
for sending and receiving patient information.
• Health plan solution – Provision of clinical data for health
plans to use for care coordination, care management and
case management of their beneficiaries.
2013: Development of a Consent Notification and Opt-
Out Toolkit for participating providers
To help providers implement the required notification
process for patient visits, AzHeC developed a Consent
Notification and Opt-Out Toolkit1 in 2013 that includes:
• A Toolkit Guide – A step-by-step guide that provides a
summary of the law and instructions for setting up a patient
notification process.
Enabling Statewide Health Information Exchange: From Legislative Origins to Improved Care Coordination and Quality Across the State
Melissa A. Kotrys, MPH
CEO Arizona Health-e
Connection
Health Information
Network of Arizona
1 The Consent Notification and Opt-Out Toolkit is available for reference or downloading by clicking Benefits & Services under The Network tab at www.azhec.org. Health Information Exchange continued page 18
AOMA Digest Winter 2015 18
Features
• Key Documents – Templates and documents needed to
implement the patient notification process required by
law.
• Patient Education Materials – Helpful materials that
providers may use with patients to help explain their rights
under Arizona law.
2014: Evaluation and Redesign of The Network’s
Capabilities
To streamline and improve operations, AzHeC and The
Network formally affiliated and combined operations in February
2014, creating one statewide organization for providers and other
healthcare stakeholders to come to for all of their HIT and HIE
needs. To ensure that The Network continued to provide value to the
community, there was an immediate focus on responding to market
changes such as the growth of accountable care organizations
(ACOs) and the need for improved care coordination across
healthcare organizations. The result was an evaluation and redesign
of statewide HIE capabilities involving three critical tasks in 2014:
The evaluation and development of new services – this review
focused on identification of services that are best provided by a
statewide HIE.
The evaluation and selection of an upgraded technology platform
– the review involved broad community input and participation and
the evaluation of eight top technology platforms. Mirth Corporation,
one of the nation’s top HIE vendors, was selected, with a launch of
the new HIE platform scheduled for April 2015.
Support for a new operating and service model – the adoption
of a new technology platform required the adoption of a new
operating and service model.
2015: Launch of New Network Services
In addition to the initial data exchange services provided by The
Network, the current technology upgrade will support several new
value-added services in 2015:
• Direct exchange or secure email for the delivery of clinical
information
• Delivering alerts based on admissions/discharges/transfers and
abnormal test results
• Public health reporting to support Meaningful Use Stage 2
• Connecting to eHealth Exchange, a national network that
supports exchange with federal agencies, such the Indian Health
Services and Veterans Affairs, as well as other state HIEs.
Arizona has seen a lot of progress in HIE since the original
2011 legislation – from ensuring patient choice under the law to
responding to changing market needs to providing practical tools to
improve care coordination and quality across healthcare systems. If
you have questions or would like to learn more about the statewide
HIE services of The Network, please contact us at (602) 688-7200
or thenetwork@azhec.org.
Health Information Exchange continued from page 17
AOMA Digest Winter 201519
Features
There’s no doubt about it - communicating with patients has
become tougher. Visits are shorter, yet patients want more
face time. They may arrive armed with dubious medical advice
from the Internet; and physicians are challenged to try to relate to
patients while typing into the electronic medical record.
A special skill set may be needed with some of your patients.
These are the so-called
difficult patients. They
just don’t seem to
follow your plan or
may be disagreeable to
you or your staff. It’s
actually more accurate
to think of these as
difficult relationships,
rather than difficult
people.
Relationship
difficulties between the
physician and patient
tend to develop when
success is frustrated, expectations are misaligned or flexibility is
insufficient. It is useful to examine the relationship to see which of
those may be a factor. For example, a chronic condition can leave
both parties feeling frustrated. The patient may seem to have given
up and the physician is at a loss at how to motivate adherence when
neither party is assured of success.
Bring the difficulty out into the open. Let the patient share
their frustration and discuss ways to work together to set new
goals. Explore to see if the patient’s expectations are out of
alignment with your own. Maybe this is leading to non-compliance.
Talk about it. Perhaps the patient is being inflexible – refusing
your recommendations – or perhaps you have been inflexible in
recommending something that is not compatible with the patient’s
home situation or lifestyle.
Critical to the understanding of the difficult patient-physician
relationship is the rising epidemic of low health literacy. Health
“Difficult Patients” May Have Low Health Literacy
Judy Avery, RN, BSN, Education Coordinator, RMS, MICA
literacy is the ability to read, understand, and act on healthcare
information. Functional health literacy is the ability to apply
reading and numerical skills in a healthcare setting. The health
literacy problem is a crisis of understanding medical information
rather than one of access to information. Recent healthcare reform
efforts have focused on providing patients with more health
information. One
solution has been to
produce more written
materials. This is at
odds with the finding
that nearly half of our
patients cannot read
or comprehend much
of the information we
provide.
Many patients,
because they are
embarrassed or
intimidated by the
healthcare system, do
not ask physicians to explain difficult or complicated information.
One of the main reasons low health literacy is overlooked is
because it is not always easy to detect in your interactions with
the patient. Literacy researchers are frequently surprised at the
poor reading skills of some of their most poised and articulate
patients. People who have difficulty reading are often ashamed
and hide their poor literacy from healthcare professionals, friends,
and even close family members.
If patients do not understand medication and self-care
instructions, a crucial part of their medical care is missing, which
may then have an adverse effect on their clinical outcomes. In fact,
theoretically, the health of 90 million people in the United States
may be at risk because of difficulty experienced in understanding
and acting on health information.
Difficult Patients continued page 20
AOMA Digest Winter 2015 20
Features
As realization dawns on the far reaching nature of this problem,
clinicians may feel overwhelmed when considering strategies to
assist low-literacy patients. A few simple measures can make a vast
difference to this patient population, and should prove helpful to all
your patients.
Create a “shame-free” environment where low-literate patients
can seek help without feeling stigmatized. Shame may prevent poor
readers from asking for simpler materials or seeking help when
they don’t understand medication labels, medical forms, or self-care
instructions. Using a statement such as “Many of my patients have
trouble understanding this stuff, let me read it to you so you can ask
me questions” often works well. This approach also works well for
patients with undisclosed visual impairments.
Routinely assess your patient’s ability to understand directions
and information, especially if non-compliant or “difficult.” Health
literacy may be an underlying cause of patient management
problems such as not keeping appointments, chronic lateness, non-
compliance with treatment, returning incomplete forms, excessive
phone calls, and overuse of the emergency room.
Know your patient demographics and consider this when
developing written materials or providing verbal instructions. How
old are they? Is English their first language? What is their average
level of education? What are their cognitive and sensory limitations?
Create forms and handouts which can be understood by patients
with lower literacy levels. Use large fonts, simple language, and
short sentences. Make good use of illustrations and white space.
Consider the environment. Do patients have adequate time
to read material or to complete a form? Is the environment
sufficiently free of distractions? Will a staff member be available
to answer questions in a non-obtrusive manner? Encourage the
patient to invite family or friends into the teaching sessions. Not
only does this establish a warm and supportive environment,
but it also educates those who later can reinforce and clarify
information.
It’s important to verify understanding by finding out what a
person comprehends and what he or she doesn’t. Find out what
patients think is happening, and what they still need to learn. You
can do this by asking concrete questions and offering opportunities
for patients to let you know how they will implement their care
plan. Use the “teach back” method to assure patients can accurately
carry out your instructions.
Those are excellent suggestions, but doesn’t all this take a
lot of time? In your busy medical practice, time may be your
most precious commodity. You may want to consider time as an
investment you make in your patients’ health and well being, in your
own personal satisfaction, and in your success in the business of
medicine. Time spent in clear and effective communication is often
under-appreciated yet may yield huge dividends.
Spending 5 or even 10 additional minutes on a first time
patient or a patient with a new serious complaint seems like a
lot, but the time redeemed may be significant. Ineffective and
inefficient patient-physician communication: drains time and
energy, increases the chance for non-adherence and poor patient
outcomes, and increases the chance for a missed diagnosis or
a malpractice suit. We know it’s not whether you’ll spend time
communicating; it’s how you spend your time communicating.
Think of the time you spend communicating, especially with your
more challenging patients as an investment. What kind of returns
are you getting now?
Difficult Patients continued from page 19
Photo credit: pixshark.com
AOMA Digest Winter 201521
Features
Onboarding is the process that starts at the first contact
with a potential new hire, in which you build and establish
engagement early in the hiring process and continues after
the traditional orientation program ends.
There are important benefits from the successful onboarding of
new physician hires:
• The physician will become financially viable sooner with
greater job satisfaction and will contribute to your organization
in a more meaningful way.
• When integrated into your general community and medical
community in an organized manner, the physician and his
or her family will feel welcomed and connected. Strong
integration validates membership in the medical community
and establishes referral patterns sooner.
• The more quickly the new physician is and feels an integral
“part” of the community, the better the intangible “happy
doctor” factor and improved odds for long-term retention. Your
organization will reap financial benefit in earlier productivity,
reduced turnover and associated recruitment costs.
Pre-Of fer StageOnboarding begins at the earliest stages of recruitment.
Known as the "pre-offer” stage, your first contact with interested
candidates sets the tone for all future communications. After
determining mutual interest, your conversation should inform
the physician of your culture, mission, expectations and
responsibilities of the physician. Subsequent conversations
regarding compensation, revenue management, and productivity
expectations should be clear and collaborative. These conversations
usually take place during the on-site interview and may continue
with post interview telephone conversations.
Of fer StageWhen the process moves to the state of an offer to the physician,
the act of engagement takes on a more collaborative role. Clear,
direct communications regarding practice specifics and contract
negotiations establishes your working relationship. Now is the time
to discuss practice management and policies, marketing plans, and
productivity standards. Make sure the contract offered honestly
reflects your communications about this position so there are no
surprises to the physician.
This stage is also an excellent time to formalize the physician
mentor relationship. Assign a physician mentor to your candidate
before he or she signs the contract. Begin this “connection” process
early and the physician will know his or her importance to your
organization. The power of relationships in workplace satisfaction and
successful integration to a new work setting cannot be overstated.
Also involve the candidate at this time in the early beginnings
of the next phase of the onboarding process, the Integration
Phase. Begin talks about the steps the physician can or must
take to ensure success in the new position. At this time, briefly
begin discussing marketing plans, timely applications for licenses
and insurance panels, physician receptions, and the physician
orientation program.
Integration StageOnce your candidate signs the contract with an anticipated
start date, the onboarding plan enters the integration stage.
Assimilating new physicians into the community at large and
the medical community takes careful planning.
If your candidate is relocating, pay careful
attention to real estate and relocation issues
to ensure a smooth transition. Be prepared
to offer support and information to
the physician’s spouse and family
regarding job opportunities and
schools. Consider enlisting
another physician’s family
to act as ambassadors.
Having someone to
follow up on these
details may make the
difference between a
happy doctor and an
unhappy one.
As the start date
approaches, be sure
to have your orientation
program in place. Include
introductions to physicians on the
medical staff, administration, and
service line directors. Schedule ongoing
physician mentor meetings and check in with
your new physician at regular intervals. Ensure that
any promises made have been kept and plans discussed have been
implemented. Seek the new physician’s input regarding process
and the progress of integration. Encourage open dialogue at any
time and meet with your new physician at 30, 60, and 90 days and
again at 180 days. Listen to him or her and take the opportunity
to improve your best practices based on the feedback you receive.
And after a year, even if done informally, celebrate your mutual
first anniversary!
If you would like more information about onboarding new
physicians, please contact us.
Onboarding New Physician Hires – Is Your Plan in Place?
Joan Pearson, President, Catalina Medical Recruiters, Inc.
AOMA Digest Winter 2015 22
Features
Healthcare costs have doubled over the past three decades,
creating financial pressures on patients, families,
employers, and government budgets. This has led to an
atmosphere of uncertainty, with fear of becoming ill raising the
daunting specter of expensive medical care and limiting patient
willingness to seek needed treatments. As a result, access to
care is diminished with providers’ ability to forge successful
patient relationships significantly affected. But quality care does
not have to mean expensive care. By engaging patients and
their families in an all-encompassing quality care strategy, the
healthcare experience becomes more participatory, resulting in
improved health promotion and disease prevention and a better
quality of life. Patient centeredness at all levels of healthcare
helps foster care that is respectful of and responsive to individual
patient needs and values while ensuring that clinical decisions
expand individual care, advance the health of populations and
communities, and lower costs through quality improvement.
Putting Patients First
Healthcare is personal, and the way we experience care
is different for each person. However, the U.S. healthcare
system is enormously complex. All too often individual patient
circumstances are overwhelmed by bureaucratic red tape or
competing demands on an overtaxed healthcare system. Despite
this, focusing on the individual can lead to improved processes
and patient outcomes.1
Patients need to be understood in their social context in
order for providers to fully involve them in their own healthcare
decisions. Strong personal, professional, and organizational
relationships should be fostered throughout Arizona communities
to create a healthcare framework that is meaningful and valuable
to the individual patient. To help bridge the gap between large,
systemic changes and the need for patient-centered care, it is vital
to recognize diversity and remove the socioeconomic, educational,
and cultural barriers that may prevent access to healthcare.
Health Services Advisory Group (HSAG) is the
Medicare-designated Quality Innovation Network-Quality
Improvement Organization (QIN-QIO) for Arizona,
California, Florida, Ohio, and the U.S. Virgin Islands. As
the largest QIN-QIO in the United States and its territories
dedicated to improving healthcare quality at the community
level, HSAG is in a unique position to lead this vital shift in
the healthcare paradigm by bringing together providers and
community stakeholders through learning and action networks
that provide tools and guidance on involving patients in
their own healthcare decision-making processes. In turn, this
shift in patient involvement can foster national healthcare
quality improvement goals, because HSAG conducts quality
improvement activities in a way that puts patients first and
helps providers to do the same.
Since 1979, HSAG has developed lasting relationships
and partnerships with stakeholders and providers in Arizona
Achieving Cost Effective Patient-Centered Healthcare for Arizonans
Mary Ellen Dalton, PhD, MBA, RN • Howard Pitluk, MD, MPH, FACS
AOMA Digest Winter 201523
Features
using innovative approaches that engage communities beyond
traditional healthcare settings to bring specific tools and
resources to those most in need. These quality improvement
interventions not only reach out to beneficiaries but also
include physician offices, hospitals, nursing homes, home
health agencies, and other healthcare settings. Because
Arizona has a strong, diverse healthcare system made up
of government agencies, private and public organizations,
community stakeholders, patient advocates, and providers,
HSAG collaborates with all of our partners to ensure services
are delivered in an effective and equitable way that avoids
duplication and maximizes efficiencies.
To ensure patient-centered care, HSAG and the Medicare
QIO Program also promote responsiveness to beneficiary and
family needs. This is particularly important as the culture of U.S.
medicine continues to shift toward more accountability and
knowledge sharing where patients benefit from increased public
reporting and transparency. Furthermore, patient participation
will continue to drive the availability of preventive services
offered by healthcare providers. These efforts can help improve
outcomes and lower costs by creating a more personal and less
bureaucratic Medicare that is transforming from a passive payer
of services to an active purchaser of healthcare. By providing
opportunities for listening to and addressing beneficiary and
family concerns, resources for beneficiaries in health-related
decision making, and feedback from information gathered from
individual experiences, HSAG and its partners are leading the
way to patient-centered care that involves patients and families
in the healthcare decision-making process.
This focus on patient centeredness can lead to lower medical
costs and a reduction in the need for some healthcare services
as patients assume a more proactive role in managing and
promoting their own health.2 Fostering collaboration at all
levels of care promotes health through individual care decisions,
health system learning, and community-based interventions.
Through our dedicated involvement with Arizona’s healthcare
community, HSAG’s mission to improve quality healthcare for
all of our population can help ensure that patients, providers,
partners, and stakeholders will be recognized and empowered
for years to come.
Mary Ellen Dalton, PhD, MBA, RN, is Chief Executive Officer; and Howard Pitluk, MD, MPH, FACS, is Vice President,
Medical Affairs & Chief Medical Officer.
This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona,
under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human
Services. The contents presented do not necessarily reflect CMS policy. Publication No. AZ-11SOW-XC-01162015-01
REFERENCES
Weiner, SJ, Schwartz A, Sharma G, et al. Patient-centered decision making and healthcare outcomes: An observational study. Annals of Internal Medicine. 2013; 158(8): 573–79.
Bertakis, KD, Azari, R. Patient-centered care is associated with decreased healthcare utilization. The Journal of the American Board of Family Medicine. 2011; 24(3) 229–39.
AOMA Digest Winter 2015 24
Recruit a new member,get a $100 AOMA credit!
Do you know someone who isn’t a member of the
Arizona Osteopathic Medical Association . . .
and should be? Recruit a New Member and both the New
Member and you receive a $100 Credit towards
membership dues or Continuing Medical
Education fees!As a member, you understand the value of AOMA’s membership.
Share that knowledge firsthand with your colleagues in the
medical field. A growing and healthy AOMA means greater
recognition for the profession, more resources to support
member programs, more representation with healthcare leaders,
and a stronger voice when advocating issues with state and
national legislative members.
Recruiting new AOMA members is simple: • Review your network of colleagues. You may be surprised who
is not a member.
• Check their membership status using the online member
directory or by calling the AOMA office at (602) 266-6699.
• Ask them to join! Express how membership has benefited you.
For all the details on how to recruit a new member* and receive
your credit, visit the AOMA website at www.az-osteo.org under
the Members tab or contact Sharon Daggett, Member Services
Manager, at sharon@az-osteo.org
*New member must be an active, dues paying member. Does not apply to
recruitment of “out-of-state” or “retired” members.
Update Your Member Profile and Win!
You could win a $100 VISA gift
card. Please take the time to visit
the AOMA website and login to
update your professional profile
information for the online AOMA
Directory. Deadline
to be entered into
the gift card drawing is March 31,
2015.
Check out the Get Involved
section of the website, nominate
a peer for an AOMA Award,
and register for the 93rd Annual
Convention! See what’s new on
your AOMA website
Come back often for future
enhancements and features.
AOMA Digest Winter 201525
Features
Many doctors have purchased disability insurance policies to
protect their income in the event they are not able to work.
Although purchasing adequate insurance is a critical first
step in protecting you and your family from unforeseen disability,
collecting benefits under the policy can be another matter.
The Reality of Disability Insurance and Physician Claims
Disability insurance companies are under increasing financial
pressure on several fronts. Claim numbers and costs have increased
as the American population ages.1
At the same time, insurance company investment yields have
been uncertain as interest rates remain at record lows.2 Many
disability insurance companies have stopped writing individual
disability insurance policies altogether.3 Others have tightly
limited the benefits permitted under the policies. For example,
many insurance policies now require objective medical evidence of
disability, impose restrictions on the duration of certain types of
claims, and limit benefit amounts.
For insurance policies that have already been issued, though,
the only way insurance companies can cut costs is through more
aggressive strategies designed to reduce their claim liability by
denying or terminating benefits. Claims made by physicians present
particularly attractive targets for disability insurance companies for
a number of reasons.
First, because of their incomes, physicians usually have much
higher benefit amounts and more liberal policy provisions than
the general population. Therefore, the insurance companies can
often save more money by terminating one physician’s claim than
they can by terminating several other claims. Insurance companies
also know that even if they must spends tens, or even hundreds,
of thousands of dollars to justify a decision to terminate a claim,
they can save money in the long run on a high dollar claim.4 As
a result, insurance companies are often willing to invest in costly
and invasive tactics like video surveillance, independent medical
examinations, functional capacity evaluations, and medical peer
reviews to determine whether there is a basis to deny benefits.
Insurance companies also understand the psychological toll that
filing a disability claim can take on doctors. Physicians have spent
many years training for their profession, and often try to work as
long as possible before filing a claim. This frequently results in a
physician unknowingly prejudicing
his or her ability to recover under a
disability insurance policy when it
becomes impossible to keep working.5
For example, a physician may reduce
the number of hours he is working,
stop performing certain types of
procedures altogether, or shift to
working in a more administrative
capacity, which can change the criteria
the physician must meet in order to
establish his disability.
Additionally, insurance companies often rely on the social
stigma attached to the concept of disability, as well as their
policyholders’ unfamiliarity with the law. Many doctors equate
disability with a state of total helplessness, and may be reluctant
to file a claim for disability benefits because they do not think of
themselves as disabled, and do not want others to perceive them
as helpless. In fact, under most policies sold to physicians, the
insurance company is contractually obligated to pay benefits as long
as the doctor is unable to perform the “substantial and material
duties” of his or her specialty. Therefore, doctors can often qualify as
being totally disabled within the meaning of a disability insurance
policy, yet still live active lives, and in some cases even continue
working in a new field.
Obstacles in the Disability Insurance Process
The disability insurance process should be simple. Ideally, you
would simply fill out a straightforward claim form, outlining the
medical condition causing your disability, submit a statement from
your doctor verifying the severity of your disability, and receive the
income protection for which you have spent years paying premiums.
In reality, the process is weighted against claimants from the
beginning and can be daunting. The insurance companies expect
that the convoluted nature of the process will cause some attrition
as doctors choose not to pursue valid disability claims, rather than
attempt to navigate the claims process. Many other doctors will
make mistakes during the process that will allow the company to
The Importance of Advocacy in the Disability Claim Process
Patrick T. Stanley, Esq
Advocacy continued page 26
AOMA Digest Winter 2015 26
Features
justify denying or limiting the benefits available under the policy.
The following are some of the potential obstacles you may face in
filing a claim:
• Complicated Policy Language. Disability insurance policies
are complicated and can vary greatly from one company
to another, and even within the same company, depending
on when the policy is issued. Most doctors, and even many
lawyers who are unfamiliar with disability insurance policies,
may not fully understand how the provisions should be
read together or how the policies will be applied. If you do
not know your rights and obligations under your disability
insurance policy, you can unknowingly waive your ability to
collect some of the benefits to which you might otherwise be
entitled.
For example, many disability insurance policies are
marketed to doctors as being “own occ” policies, meaning
that they pay a total disability benefit as long as the doctor is
unable to work in his own occupation. However, some policies
provide that the doctor is only totally disabled if he is unable
to work in his own occupation and not working in another
occupation. If a doctor stops practicing clinical medicine, but
resumes working in another field, no matter how unrelated, he
could lose his total disability benefit.
• Confusing and Misleading Claim Forms. The forms the
insurance company requires in connection with a claim
are often convoluted and contain trick questions that the
insurance company can use in a way you never intended.
For example, a claim form may ask you to list all of your
job duties and apportion the percentage of your day typically
spent doing each of those duties. Since no day is typical in
modern medical practice, this is often impossible. However,
the insurance company will take your answer and use it to
determine whether you can perform some of the listed job
duties on at least a part time basis. If it can, the insurance
company may only pay residual, or partial, disability benefits.
• Undue Delays. Most states, including Arizona, require that
claim decisions be made in a timely manner, usually within
thirty days of receiving sufficient information to make a
decision on the claim. In many cases, the insurance company
will draw this process out for several months by requesting
information that has little, if any, relevance to the claim.
For example, after you submit the initial claim forms, the
insurance company will often request your tax returns, CPT
codes, profit and loss statements, and other financial data on
a piecemeal basis. You may be understandably reluctant to
provide this information, since it has no bearing on whether
you are able to continue practicing medicine within your
specialty. However, even if you do provide it to the insurance
company, the company will then delay its decision until it has
had an opportunity to review the new information.
• Field Interviews. In most cases, an insurance company will
send a field interviewer, usually a private investigator, to your
home to speak with you about your claim. Ostensibly, the
insurance company will tell you the private investigator just
wants to better understand your claim. However, these visits,
which are often unannounced, are also used as reconnaissance
for future surveillance, to look for discrepancies with the
answers on your claim forms and to try to ferret out additional
information that can be used against you.
• Surveillance. If you file a disability insurance claim you
will almost certainly be under surveillance. There is nothing
inherently wrong with the insurance company conducting
surveillance. However, the surveillance footage is often
misused or taken out of context to suggest that a doctor is
capable of doing more than he has reported to the insurance
company.6 Additionally, surveillance can cross the line
to the point where it becomes harassing, and sometimes
dangerous, as private investigators follow you to try to create a
justification to terminate your claim.
• Peer to Peer Calls. This tactic involves an insurance company’s
in-house medical consultant contacting your doctors directly
to discuss your condition, restrictions, and limitations. The
insurance company’s consultant will often try to pressure your
doctor into agreeing with an overly optimistic assessment
of your condition, and will send a “summary” of the call, in
which the consultant subtly, or in some cases not so subtly,
misrepresents the substance of the call. The insurance company
then uses the consultant’s report both to justify its claim
decision and to drive a wedge between you and your doctor.
The Role of the Advocate in the Disability Insurance Process
The above examples should not dissuade you from purchasing
disability insurance. To the contrary, disability insurance is a crucial
tool to help you protect yourself in the event of an unforeseen
disability. However, they do highlight some of the challenges you
Advocacy continued from page 25
AOMA Digest Winter 201527
Features
may face when you submit your claim.
The advocate’s role in the disability process is to help you
navigate through these obstacles and help re-balance the scales so
that claims are administered fairly, in accordance with the terms
of the insurance policy. After all, insurance claims personnel
each handle hundreds of claims every year, and have experienced
analysts, field investigators, medical consultants, and lawyers at
their disposal. Most doctors, on the other hand, typically have no
previous experience dealing with disability insurance and it can be
overwhelming to face a billion dollar industry by yourself.
Additionally, when you become disabled, your focus is often on
getting better, not filling out forms or meticulously documenting
your disability. Many times, particularly if you become disabled due
to a musculoskeletal problem or a traumatic injury, you may also
be distracted by constant pain. Therefore, the advocate will ease
your burden by serving as the point of contact between you and the
insurance company, respond to any requests for information, and
limit the interaction you must have with company.
Often, simply having an experienced attorney involved with
your claim will deter insurance companies from engaging in some
of the more egregious practices and eliminate their ability to engage
in others. A qualified and knowledgeable attorney will typically
restrict the insurance companies’ access to its clients’ physicians,
require that any field interviews take place in our office, review
requests from the insurance company for financial information to
determine whether it is necessary, and ensure that the insurance
company is provided with the information it needs to make a
decision in a timely and fair manner, among other things.
However, every case presents its own unique set of challenges,
and advocates may take different approaches depending on your
particular set of circumstances. The best thing you can do if you
are facing a potentially career-ending disability is to speak with an
advocate early in the process, before you file a claim, to maximize
your chances of receiving the benefits you will need.
* Patrick T. Stanley, Esq. is a shareholder practicing in the Healthcare Law and Disability Insurance Practice Sections
at Comitz | Beethe. Mr. Stanley has extensive experience in disability insurance coverage and bad faith litigation, primarily
representing medical and dental professionals. For more information about disability insurance issues, please visit our website
at www.disabilitycounsel.net.
ENDNOTES1 See, 2014 Long Term Disability Claims Review, Council for Disability Awareness (accessed 12/30/14). http://www.disabilitycanhappen.org/research/CDA_LTD_Claims_Survey_2014.asp.
2 See, Search for Yield Has Insurers Running to Alternatives, Reuters, June 2, 2014 (accessed 12/30/14).http://www.reuters.com/article/2014/06/02/us-usa-insurance-yield-analysis-idUSKBN0ED21D20140602
3 For example, Unum Group, the parent company of Unum, Paul Revere Life Insurance and Provident Life and Accident, and the largest disability insurer in the United States, stopped writing individual policies in 2006.
4 See, Why is it So Hard to Collect on My Disability Insurance Policy?, Edward O. Comitz, AOMA Digest 2008.
5 See, The Injured Dentist: Is Your Work Ethic Hurting You and Your Patients?, Edward O. Comitz and Patrick T. Stanley, Inscriptions, 2013.
6 See, Attorneys’ Multi-Case Battle With Hartford Insurance Over Use of Surveillance Video and Intimidation Tactics To Deny Disability Claims Featured on Good Morning America, Mass Media Distributions, LLC. http://www.mmdnewswire.com/disability-insurance-law-group-7847.html
AOMA Digest Winter 2015 28
Features
Stepping Stones of Hope offers children,
teens, adults, and families much needed
help in making the first step of their grief
journey after the death loss of a loved one.
While still in medical school, Dr. Charles
Finch realized there was a critical lack of
grief resources to help children deal with
the death of someone in their life. In 1999,
Dr. Finch founded Camp Paz for Kids. This
weekend camp program, held twice a year,
reaches out to grieving children by providing
an environment where friendships are
created and profound healing takes place.
The success of Camp Paz for Kids
uncovered the need for grief support for
families within the community and Camp
Paz for Grown-Ups was established. The
organization evolved to become Stepping
Stones of Hope in 2003, a 501(c)(3) non-
profit, to help address the shortage of support-
based weekend programs and education, and
be among the leaders in grief support for the
community and across the state.
In March 2014, the Arizona Republic
reported research completed by the U.S.
Centers for Disease Control & Prevention
that revealed 57% of Arizona youths
have had at least one adverse childhood
experience. One of the adverse childhood
experiences included on the list is the
death of a parent. At the October 2014
camp weekend, 53% of the children had
experienced the death of a father so it’s easy
to see how important the mission is and the
impact this has on the community!
How do you reach out to a child who
has experienced the death of someone they
love? How does an adult family member
explore and cope with grief, yet still support
a child’s loss?
Stepping Stones of Hope provides an
opportunity to answer these questions during
the many programs offered. From First Steps
support group to One Day At Camp and
the number of weekend, overnight camps,
programs reach out to children, teens, and
adults in separate, synergistic settings that
have been designed to provide a nurturing,
expressive, creative, and fun environment for
healing to transpire.
Death is a difficult concept for children
to grasp. Children often feel responsible for
a death, regardless of the cause. Not knowing
how to communicate their pain and not
wanting to add to an adult’s grief burden,
kids often keep their emotions hidden. They
will not talk about their pain and choose to
grieve alone or not at all. Many feel guilty
for having fun and often suffer low self-
esteem. Stepping Stones of Hope’s programs
provide a safe place for children to express
themselves.
Through art, music, role-playing, and a
lot of talking and laughing, kids learn about
death and dying. Moreover, they learn how
to begin to cope. At the same time nearby,
and in a separate location, adult family
members are learning too, exploring their
grief through journaling, music, art, self-care,
relaxation, and dialogue. Additionally, they
discover ways to best support the children
who share their loss.
Briefly, Stepping Stones of Hope is
dedicated to providing comprehensive
support-based programs, continuum of
care, and education. The organization also
embraces the following primary objectives:
• Respect all children and families who
are grieving regardless of culture,
values, or socioeconomic status
• Provide comprehensive support,
understanding, and education about
grief and bereavement
• Uphold confidentiality and integrity in
all situations and circumstances
• Commit to a high level of internal and
external client service
• Work with other agencies to provide
the best level of care and continuum of
care for grieving children and families
• Serve the community, work with
stakeholders to provide services, and
educate the community about the
needs of grieving children and families
Currently Stepping Stones of Hope offers
three unique camps for kids and grown-ups.
These camps are held throughout the year;
Camp Paz, Camp Samantha, and One Day
at Camp. In addition, REACH is a camp
designed specifically for grieving teens
and Journeys, a weekend camp for adults.
First Steps, a monthly program held in the
Stepping Stones of Hope office, provides
individuals and families support wherever
they are in their grief journey.
For more information on making a
donation to Stepping Stones of Hope,
attending a camp, referring a friend
or family to camp or for volunteer
information, please visit the website. www.
SteppingStonesofHope.org.
Navigating a Grief Journey Begins with a First Step
Natalie Beck, Beck Marketing Services on behalf of Stepping Stones of Hope
EDITOR'S NOTE
Stepping Stones of Hope is one of the worthwhile causes supported by Arizona Osteopathic Charities.
AOMA Digest Winter 201529
AOMA News
Advocacy An important function of the AOMA is advocating on behalf
of the osteopathic medical profession. AOMA provides various
opportunities to get involved in political advocacy. The AOMA
strives to be the first and best option for policymakers seeking
honest, trustworthy, dependable, and objective information, with
the goal of making sure that whether a policymaker makes a good
or a bad decision, it is always an informed decision.
Legislative Affairs Committee
Reviews pending legislation which may impact the profession
and makes recommendations whether to support or oppose
proposed legislation. The Committee implements effective
strategies to educate and engage legislators and AOMA members
to ensure advocacy efforts are successful.
Political Action Committee (PAC)
Contributions made through the PAC allow AOMA to endorse
and support candidates for state public office who share our
concern for the future of high quality, cost effective healthcare. All
AOMA members are eligible to make a voluntary contribution to
the PAC.
Student Advocacy Program
Working closely with A.T. Still University and Midwestern
University faculty and student leaders, the AOMA provides
opportunities for students to get involved with the Legislative
Affairs Committee and help protect their future osteopathic
profession.
Advocacy Training
The AOMA offers advocacy support and assistance for speaking
with legislators, understanding the legislative process, and tracking
legislation. The AOMA is available to provide training to help
members understand the legislative process and become effective
advocates for the profession.
2015 D.O. Day at the LegislatureWho: D.O.s and osteopathic medical students
What: Wear your white coat and meet with legislators,
accompanied by an AOMA member D.O. Additionally, leadership
from the Governor’s office and the Senate and House Health
committees will come and speak to the group.
Where: Arizona State Legislature, 1700 W. Washington St.,
Phoenix, AZ 85007
When: Tuesday, March 10 from 7:30 a.m. – 12:00 noon.
Why: To discuss issues impacting osteopathic medicine.
How: Registration is available on the AOMA website at www.az-
osteo.org/DODayRSVP.
One of the best ways to get the most out of your membership with the AOMA is by getting involved in leadership opportunities and
participating in one of many membership activities throughout the year.
Get Involved
Get Involved continued page 30
AOMA Digest Winter 2015 30
AOMA News
There will be an orientation offered on Monday, March 2, 2015 at
6 p.m. via teleconference and at 7:30 a.m. at the Capitol on D.O. Day.
Participants will receive talking points and issue briefs one week prior.
GovernancePhysicians and students can get involved in the AOMA
governance through participation and attendance at the House of
Delegates, Board of Trustees, and District meetings.
• AOMA House of Delegates
o the legislative and governing body of the AOMA
o represents the membership in association affairs
o delegates are elected by the Districts
o AOMA Bylaws allow for one delegate and one alternate
to be elected to the AOMA House of Delegates from each
school with voice and vote
o meets twice a year – at the Annual Convention and the Fall
Seminar
• AOMA Board of Trustees
o transacts the business of the AOMA, led by the Executive
Committee
o one seat per school on the Board of Trustees
o trustees are elected by Districts
o new Trustees begin their terms in June of each year
o meets four times per year
• AOMA Districts
o seven regional districts, organized by zip code
o meets annually at the beginning of the year
o elects the representatives to the House of Delegates and
Board of Trustees
o discuss issues pertinent to the osteopathic medical
profession and AOMA
CommitteesThrough committee involvement, many future AOMA executive
officers and trustees emerge to become leaders in the osteopathic
medical profession in Arizona and nationally.
Participating on a committee is a minimal time commitment.
Most of the committees meet four times a year and meetings are
scheduled outside of regular work hours, usually lasting no more
than an hour. Teleconferencing is available for all of the meetings.
Legislative Affairs is responsible for developing, analyzing, and
influencing healthcare legislation and taking the lead on advocacy
efforts to protect and promote osteopathic medicine on behalf of
physicians and students.
Membership and Credentials works to further the growth
of AOMA membership, retain current members, and develop
services and activities which will serve to enhance the professional
growth of osteopathic physicians and students. The Committee
also explores new areas of professional development and stays in
close contact with Arizona students by disseminating information
concerning AOMA.
New Physicians Committee educates new physicians on
practice management, trends and changes in healthcare delivery,
provides networking/collegiality, and sharing of ideas to
introduce new physicians to the association and identify future
leaders.
Payor Relations Committee advocates for equality and fairness
with third-party payers on issues regarding physician guidelines,
quality initiatives, plan regulations and patient safety, and educates
members on third-party reimbursement.
Professional Education Committee determines the educational
offerings of Continuing Medical Education (CME) for the Annual
Convention, Fall Seminar and other programs, based on the needs
of members and attendees, using assessment tools to identify their
areas of interest.
Public Awareness Committee develops strategies to enhance
the image and presence of the osteopathic medical profession. The
Committee works to promote osteopathic medicine through media
relations, networking, and community engagement.
Osteopathic Charities & Support for Residents & Students
Arizona Osteopathic Charities is a 501(c) 3 non-profit
charitable organization. Its mission is to educate and promote safe
and healthy living for children, students, and families. The Charities
provides financial support for three worthwhile causes: Stepping
Stones of Hope, Team of Physicians for Students (TOPS), and
DOCARE International.
In addition, the Charities underwrites an annual scholarship
essay competition and clinical case and poster forum, offering
monetary prizes to the winners.
• Scholarship Essay Competition – two scholarships are
awarded each year to osteopathic medical students. Scholarships
are awarded to one student at both the Arizona College of
Osteopathic Medicine (AZCOM) in Glendale and the School
of Osteopathic Medicine in Arizona (SOMA) in Mesa. To be
considered, students are required to write an essay. The Arizona
Osteopathic Charities Board of Directors judges the entries and
selects the winners. |
• Clinical Case and Poster Forum – Residents and students
are invited to submit entries for the Case Forum (top three entries
present their case during the Convention) or abstracts for the
poster competition (all poster abstracts are displayed and presented
during the Convention). The competition entries are judged by a
group of osteopathic physicians and other educators. The winners of
the case forum and poster forum receive a $500 award. Details are
available at www.az-osteo.org/PosterForum.
For more information or to take part in any of these
opportunities, please contact Sharon Daggett at sharon@az-osteo.
org or via phone: (602) 266-6699.
Get Involved continued from page 29
AOMA Digest Winter 2015 34
AOMA News
More than 175 osteopathic physicians, students, and other practitioners gathered in Tucson in November for the AOMA 34th
Annual Fall Seminar.
The two-day event at the Hilton El Conquistador Resort offered 12.5 hours of AOA Category 1-A CME credits including specialty
credits in Family Medicine/OMT, Cardiology, Gastroenterology, Infectious Diseases, Internal Medicine, Interventional Cardiology,
Psychiatry, Neuromusculoskeletal Medicine, Otolaryngology & Facial Plastic Surgery, Pediatrics, and Sleep Medicine.
The AOMA Professional Education Committee, chaired by Lori Kemper, D.O., FACOFP, recognizes all the speakers who
contributed to the success and prestige of the Seminar with their expertise and experience in the lectures. Thank you to Amy Foxx-
Orenstein, D.O., FACG, FACP; Bryan Friedman, D.O.; Anthony Galeo, M.D., MS, FACC, FACCP; Joseph Hayes, D.O., FAAP;
Karen Nichols, D.O., MA, MACOI, CS; Robert Orenstein, D.O., FACP, FIDSA; Kenneth Pettit, D.O.; Steven Pitt, D.O.; Anthony
Pozun, D.O.; Scott Steingard, D.O.; Senator Kelli Ward, D.O., MPH; Anthony Will, D.O.; and Karen Wright, RN, BSN.
AOMA 34th Annual Fall Seminar
1 Tom McWilliams, D.O., and Stanley Brysacz, D.O. enjoy catching up in Tucson.
2 Chris Berry, Christine Morgan, Ed.D., and Angela DeRosa, D.O. attend the cocktail reception at the AOMA Fall Seminar.
3 Robert Orenstein, D.O. and Otto Shill, ATSU SOMA OMS II connect at the AOMA Fall Seminar.
1 2
3
AOMA Digest Winter 201535
AOMA News
4 ATSU SOMA student doctors Daniel Ebbs, Julian Hirschbaum, and Seth Loofbourrow attend their first AOMA Fall Seminar.
5 Jennifer Miller, D.O. and Ed Miller, D.O. traveled from St. Thomas, U. S. Virgin Islands to attend the AOMA Fall Seminar.
6 Timm McCarty, D.O. and Samuel Feinstein, D.O. look forward to attending the Fall Seminar each year.
7 Scott Steingard, D.O., Karen Nichols, D.O., and Senator Kelli Ward, D.O., participated in a panel discussion on Expanding the Influence of Medicine, moderated by Lori Kemper, D.O. (far right).
4
5
6
7
AOMA Digest Winter 201537
Osteopathic Community News
For decades the Tucson Osteopathic Medical Foundation (TOMF) and the Arizona Osteopathic Medical Association (AOMA) have
been your best resources for quality AOA Category 1A credit in Arizona. Although friendly competitors, both TOMF and AOMA
work together to be your two local sources for family medicine and internal medicine specialty credits. After all, YOU are why we are
in business.
Each year, TOMF and AOMA offer more than 80 hours of AOA Category 1A CME credit presented at four separate conferences. In
addition, TOMF and AOMA sponsor multiple individual lectures throughout the year. You can satisfy most of your Arizona state licensure
and AOA membership requirements right here in the Grand Canyon State with little-to-no travel expenses, minimal down time from your
practice, all while supporting our local economy. Why go anywhere else? As you look for programs to fulfill your CME requirements, keep
these upcoming homegrown CME opportunities in mind:
Need CME? Keep it LocalBy Nicole Struck, Program and Meetings Manager, Tucson Osteopathic Medical Foundation and
Janet Weigel, Director of Education, Arizona Osteopathic Medical Association
■ Tucson Osteopathic Medical Foundation
24th Annual Southwestern Conference on Medicine
April 23 - 26, 2015
JW Marriott Star Pass Resort and Spa
Tucson, Arizona
■ Tucson Osteopathic Medical Foundation
4th Annual Southwestern Conference on Medicine
Primary Care Update
October 24, 2015
Conference Center at TOMF
Tucson, Arizona
■ Arizona Osteopathic Medical Association
93rd Annual Convention
May 6 - 10, 2015
Arizona Grand Resort
Phoenix, Arizona
■ Arizona Osteopathic Medical Association
35th Annual Fall Seminar
November 7 - 8, 2015
Tucson El Conquistador Resort & Spa
Tucson, Arizona
Things to Remember
As you rev up for the final year of the AOA Osteopathic
Continuous Certification 2013-2015 Cycle here are a few things to
remember.
In order to maintain a license to practice osteopathic medicine
in the state of Arizona, osteopathic physicians are required to
obtain 20 hours of CME per year. Of that, at least 12 hours must
be 1A credit provided by a Category 1 CME sponsor. No more
than 8 hours may be provided by an accredited AMA or ACCME
provider and certified as AMA PRA Category 1 credit.
Category 1A Credit is granted for live programs provided by
Category 1 CME sponsors. Category 1B is granted for programs
of a more casual nature (online, teaching, writing) provided by
Category 1 CME sponsors. Category 2A is granted for live
programs sponsored by non-AOA accredited providers. Category Need CME? continued page 38
2B is granted for programs of a more casual nature (online,
teaching, writing) sponsored by non-AOA accredited providers.
AOA recertifying physicians must fulfill 120 hours of CME
credit during each three year CME cycle. 150 hours are required for
the American Osteopathic Board of Family Practice, the American
Osteopathic Board of Neuromusculoskeletal Medicine, and the
AOMA Digest Winter 2015 38
Osteopathic Community News
American Osteopathic Board of Anesthesiology.
The 120/150 hours may include a variety of credit levels (1A,
1B, 2A, 2B) but must include at least 30 1A credits and 50 specialty
credits in primary specialties. Previous policy dictated that no
more than 25 of the 50 required specialty credits per three year
cycle may come from any one of the four categories including
osteopathic foundation seminars, state society seminars, college
of medicine seminars or acute care hospital programs. This
specialty credit cap has been removed for 2015. Further discussion
regarding this policy will take place throughout 2015 with decisions
on the future of the cap expected in July.
For physicians holding certifications of added qualification
(CAQs), a minimum of 13 credits must be earned at the level
of the CAQ. At least 15 credits must be earned in the primary
certification.
Practice Performance Assessment and Improvement is the
only new component in the osteopathic continuous certification
process. Physicians must engage in continuous improvement
through comparison of personal practice performance measured
against national standards in their medical specialty. Physicians
must submit patient surveys and/or quality improvement data to
the board based on their current practice. The data is reviewed
against national standards for patient care, and the physician
receives a report with recommendations for improvement. At that
time, physicians should make a plan for ongoing improvement, to
be submitted during the next recertification period. It is notable
that any specialty board may insert another form of review in place
of this component. Physicians who do not see patients or advise
residents during the cycle may request an affidavit for the removal
of this component from the continuous certification process.
Specialty certifying board contact information is available at
www.osteopathic.org. Please contact them for complete details
about eligibility for certification, requirements for maintaining
certification, and recertification.
Questions regarding certification status and general
OCC information may be directed to the AOA Division of
Certification by emailing certification@osteopathic.org or (800)
621-1773, ext. 8266. For verification of certification please visit
www.DOProfiles.org.
If you have additional questions regarding available CME
programs in Arizona, please contact TOMF at www.tomf.org or
AOMA at www.az-osteo.org.
Need CME? continued from page 37
AOMA Digest Winter 201539
Osteopathic Community News
Jane, not her real name, has
been a patient of mine for
years. She is in her late
40s and is a cancer survivor. I
saw her recently in my office
for a routine matter and the
conversation turned to the
ongoing surveillance of her
treated breast cancer. “I read
something the other day” she
said starting a long conversation
about screening and treatment.
“I read that ductal carcinoma
in situ (DCIS) wasn’t even
considered a cancer until a few years ago.” Her background is
that she is a very healthy woman who did her due diligence
and got her yearly mammograms starting around age 40.
A few years back, a screening mammogram found, in her
words, “a calcium cluster” and she then had additional views
and ultrasound that identified a tiny nodule. She had biopsy
that showed DCIS and her surgeon advised mastectomy.
Subsequent to that surgery, she had additional surgeries to
help with reconstruction. Since her natural breasts were on
the large side, they were unable to reconstruct the breast
adequately. This led to a reduction in the healthy breast to
compensate and another to “even things out.”
It was clear the regret that she felt in starting down the
road of screening and treatment because she had a somewhat
bad outcome and that she felt that the DCIS might have been
something that she lived with her whole life and not caused her
death or harm.
Now, we can never know if her cancer would have caused her
harm or if the screening and identification of that cancer saved
her life but this story highlights what I feel is a coming change
in attitude toward medical care. Many medical societies and
the U.S. Preventive Services Task Force are changing screening
suggestions to reduce “over screening” and then the subsequent
overtreatment. Popular media has picked up on this trend and
is advising patients to have more frank discussions with their
healthcare providers about not only the benefits but also the
risks associated with screening. A recent article in Men’s Journal
advised patients on “How to Say No to Your Doctor” and listed
the pros and cons of prostate cancer screening, cholesterol
treatment and more.
In the past, doctors have been motivated to do all we can
for patients because inaction seemed anathema when medical
boards, medical societies, drug companies, hospital committees,
and others seemed to push that more is better and that failing to
screen and diagnose was tantamount to malpractice.
In the future, I predict we will see more and more patients
having the same discussion with their provider about their
regrets of “going down the rabbit hole” of screening and
treatment. Men may, for instance, read that prostate cancer
screening is not recommended and that watchful waiting is
sometimes as good as medical or surgical treatment for prostate
cancer. If they are suffering from impotence and incontinence
they may feel that they have been harmed by the process and
either seek recompense or just avoid the medical community
due to mistrust.
Our duty as physicians is to give patients good advice
about both the benefits and the risks of all the screenings
and treatments we recommend. That is the basis of informed
consent. Reducing our biases and avoiding anecdotes
and focusing on the science is key in making good
recommendations. Our patients are reading in non-medical
media about how they should be suspicious of doctors that sell
or push recommendations. We should have good and thorough
explanations for them or else they may seek care elsewhere.
Arizona Society of ACOFP
Aaron B. Boor, D.O.
2014-2015 President
Arizona Society of the
American College of
Osteopathic Family Physicians
AOMA Digest Winter 2015 40
Osteopathic Community News
For Julian Hirschbaum, OMS II, A.T.
Still University-School of Osteopathic
Medicine in Arizona (ATSU-SOMA),
having his second-year medical school
community campus experience at El Rio
Community Health Center (CHC) in
Tucson, Ariz., was a natural transition
from his volunteer experiences in serving
the medically underserved. Hirschbaum
currently serves as the health disparities
officer for the Student Osteopathic Medical
Association. In addition, he also co-founded
Capacidad, a student organization whose
main goal is to train community health
workers in remote areas of the Peruvian
Amazon, empowering their communities to
train more community health workers.
Since 1970, El Rio CHC has been
providing accessible and affordable healthcare
primarily to underserved populations in
greater Tucson. Approximately 26 percent
of patients seen at El Rio have no health
insurance, and 76 percent are at or below the
federal poverty line.b
A call to serve the underserved as a
physician
Hirschbaum has always felt being a
physician would be a fulfilling profession.
He remembers his father telling him a
doctor is among one of the most honorable
professions. He passed away when
Hirschbaum was just age 5.
One of the first instances in which
Hirschbaum truly knew he would become
a physician was when he
was on the Caribbean
Coast of Nicaragua
and witnessed the gross
shortage of healthcare
providers. “There was no
nurse, midwife, or doctor
around anywhere closer
than three hours by
boat,” said Hirschbaum.
“I came to understand,
through community
service projects and
public health-related
classes, that there were
also many communities in the U.S. where
healthcare practitioners were desperately
needed.”
Osteopathic medicine appealed to
Hirschbaum for two reasons. “First, as a
group of physicians, osteopathic medicine
historically arose out of the need for doctors
in underserved areas, and second, I admired
the way in which the humanity of medicine
is incorporated via touch, into the practice
of osteopathy,” says Hirschbaum.
Choosing a medical school
“When I was volunteering on the
Arizona-Mexico border and working with
migrants and those who had recently been
deported, I attended a Binational Health
Conference where I met El Rio’s Pasqua
Yaqui clinical director and El Rio’s former
regional medical director of education
(RDME), Dr. Laura de la Torre. She
spoke to me about ATSU-SOMA and its
mission of training future primary care
providers to practice in areas lacking access
to healthcare. I am a strong proponent
of primary care and its power to mitigate
health disparities, and I believe that future
doctors need to be knowledgeable and
concerned about the social determinants
of healthcare. ATSU-SOMA has taught
me these things and is preparing me with
real-world experience. In addition, I chose
ATSU because of the experience we have
from the start of our second year. I feel
that my time in the clinic has taught me
more about patient care than any textbook
ever could.”
RDMEs at El Rio helping to train
Hirschbaum are Drs. Chris Dixon and
Roy Wagner. Dr. Dixon, who has been an
RDME for about three months and whose
Beyond the campus walls: ATSU-SOMA student at El Rio CHC finds a perfect fit with his personal mission
AOMA Digest Winter 201541
Osteopathic Community News
ATSU announces groundbreaking partnership with the National Association
of Community Health Centers
Craig M. Phelps, DO, ’84, president of A.T. Still University (ATSU), and Ron Yee, MD,
MBA, chief medical officer of the National Association of Community Health Centers
(NACHC), announced a groundbreaking, joint research partnership on Nov. 11, 2014. The
innovative partnership between ATSU and NACHC will help create and advance interprofessional
scholarly activity within Bureau of Primary Healthcare supported community health centers, and
it will help improve the
health status of patients
and communities across
the nation.
“ATSU is looking
forward to collaborating
with NACHC on this
important initiative
focused on improving
the health of our nation,”
said Dr. Phelps. “Research
projects inclusive of basic
scientists, clinicians from
multiple professions, and ATSU students will seek opportunities to provide timely outcomes for
expeditious application.”
In an effort to advance scholarly activity opportunities, ATSU and NACHC will focus on:
• developing, implementing, and assessing evidence-based medicine guidelines.
• diagnosing, preventing, and treating diabetes, obesity, skin cancer, metabolic syndrome,
traumatic brain injury/concussions, spine pain, and HIV/AIDS.
• evaluating oral health disease prevention and treatment programs.
• measuring and encouraging physical activity and its impact on health and wellness.
• designing, organizing, and evaluating population management teams and patient navigator
models.
“Focusing on scholarly activities that are academic, yet practical, helps deepen the relationship
and experience of students,” said Dr. Yee.
NACHC represents the nation’s safety-net of community health centers. Community
health centers receive base funding from the Public Health Service, Health Resources and
Services Administration, and the Bureau of Primary Healthcare to improve the health status of
underserved communities, provide access to health services, and offset some costs of caring for
the uninsured.
NACHC and ATSU seek to foster community health scholarship to strengthen this safety-
net, and ultimately improve the health status of these communities.
“NACHC’s partnership with ATSU over the years has yielded some of the most well-prepared
and dedicated healthcare professionals, especially in service to vulnerable populations and
communities,” said Tom Van Coverden, president and CEO of NACHC. “NACHC fully supports
this important work as it will benefit many of our medically underserved communities and further
advance quality patient care in community health centers.”
NACHC and the national safety-net of Community Health Centers also support ATSU in
many ways, including access to clinical rotations; introductions to potential funding partners;
residency development; data gathering; student scholarship opportunities; and national exposure
of ATSU’s schools, programs, faculty, and staff.
background is in family medicine says, “The
best part of being an RDME is working
with the students, teaching and learning
from them, and seeing their excitement to
learn and progress in their ability to care for
patients.”
He loves working for El Rio because
the people he works with are dedicated to
fulfilling El Rio’s mission, which involves
providing comprehensive quality healthcare
to improve the health and well-being of the
patients in the local community, which is also
the community where Dr. Dixon grew up.
Dr. Ray Wagner, who has been an
RDME at El Rio for five years and is a
pediatrician, echoes Dr. Dixon sentiments
about training ATSU-SOMA students.
“Teaching is an honor and integral to
the profession,” says Dr. Wagner. “The
best part of being an RDME is sharing
knowledge and teaching /learning daily. It
is an opportunity to teach and be a mentor
to students.” Dr. Wagner also added ATSU
fits in with his personal mission of being
a lifelong learner and continuing to serve
those in need.
Future plans
Hirschbaum plans to continue filling the
primary care gap and serve the underserved
when he graduates from medical school.
“I will continue volunteering with people
whose health needs are not met by the
healthcare system,” says Hirschbaum. “I
have been working with migrants from
Mexico and Central America for several
years and feel a very strong connection
to that unique population. I also plan to
continue work with Capacidad. In addition
to working abroad, I also want to provide
primary healthcare to those who are
underserved in the United States. I would
really like to work in a CHC and build
relationships with my patients over their
lifetime.”
AOMA Digest Winter 2015 42
Osteopathic Community News
Compassion, a day remembering those lost on Flight 5966.
Other events during Founder’s Day included the first-year
versus second-year Kirksville College of Osteopathic Medicine
women’s flag football game; a First in Whole Person Healthcare
exhibit dedication at the Museum of Osteopathic Medicine; and
the annual Still-A-Bration - a community
barbeque and bonfire. Festivities
concluded with the Founder’s Day 5K run
and half mile walk.
The Arizona campus honored Dr.
Still through a week of healthy activities
including tai chi, yoga, guest speakers and
a healthy breakfast for the entire campus.
Friday, Oct. 24 marked the culmination of
Founder’s Day with games and family activities, a barbeque and live
music on the campus’ front lawn.
ATSU celebrates Dr. Still during annual Founder’s Day festivities
ATSU hosts third annual interprofessional education competition
Students from A.T. Still University (ATSU)
and area universities came together on
November 3 and 8 in Missouri and Arizona
for the annual Interprofessional Education
Collaborative Case Competition (IPE-CCC).
The competition provides health
professions students with an interprofessional
teamwork experience to gain insight
into collaborative practice competencies.
Additionally, IPE-CCC reveals the
complexity of healthcare delivery and the
need for collaboration between healthcare
professionals in order to reach the best health
outcomes for clients and patients.
Students from ATSU, Arizona School of
Professional Psychology at Argosy University,
Arizona State University (ASU), Arizona
Summit Law School, Grand Canyon
University, and Truman State University,
worked collaboratively for six weeks building
an interprofessional team to care for a
hypothetical patient and their family. At
the end of the process, they presented their
findings and recommendations for enhanced
collaboration to a panel of judges representing
leaders from various disciplines within the
healthcare programs.
The William McKinney Award was
presented to first-place teams on both the
Arizona and Missouri Campus. The Dr.
William McKinney Award, made possible
by O.T. Wendel, PhD, senior vice president
for ATSU university strategic initiatives,
is a living tribute to Dr. McKinney, who is
considered the founding father of biomedical
ultrasound. Dr. McKinney inspired Dr.
Wendel to go on to pursue a graduate health
degree in pharmacology and served as a
mentor and motivator to him throughout his
education.
On the Missouri Campus, the first place
Dr. William McKinney Award was presented
to Jessica Stevens, communication disorders
student at Truman State University; Austin
Stephenson, athletic training student at
Truman State University; Anna Wang, health
sciences student at Truman State University;
Ashley Anderson, D1; and Molly Roberts,
nursing student at Truman State University.
On the Arizona Campus, the first place
award went to Vy Vy Vu, D1; David Bunzell,
nursing student at Grand Canyon University;
Ecila Barnett, social work student at ASU;
and Daniel Schweibert, law student at
Arizona Summit Law School.
Second and third place teams were also
recognized for their presentations.
On the Missouri Campus, second place
went to Alexis Hackett, health science
student at Truman State University; Michele
Draper, health science student at Truman
State University; Katelyn Thomason, nursing
student at Truman State University; and Josh
Coffey, D1. The third place team consisted
of Liz Turnure, nursing at Truman State
University; Emma Staecker, health science
student at Truman State University; Meghan
Crider, communication disorders student
at Truman State University; and Maryann
Forsell, D1.
On the Arizona Campus, second
place recognition went to Jessica Randall,
psychology student at Arizona School of
Professional Psychology, Argosy University;
Sara Ceglio, D2; Cassandra Woodland, PT,
’16; and Kathryn Weber, OMS I. Third place
recognition went to Mary Shouse, OT, ’17;
Nisharag, Shah, PT, ’17; Chase Taylor, D1; Ina
Blue, social work student at ASU; and Tiffani
Doan, OMS I.
A.T. Still University’s (ATSU) annual Founder’s Day festivities
kicked off to a great start this year on the Missouri campus
through a three-day celebration starting
Thursday, Oct. 16. The party continued to
Arizona where Wellness Week sparked a
week of activities for students and employees.
On the Missouri campus, alumni,
students, employees and friends of the
University, participated in events including
the George Blue Spruce Hero Healer
speaker series, Founder’s Day Osteopathy
Lecture and the ATSU Honorary Ceremony. On Friday, Oct. 17,
the Missouri campus and community members attended Day of
AOMA Digest Winter 201543
Osteopathic Community News
ATSU named to Victory Media’s 2015 Military Friendly® Schools list
A.T. Still University has been designated
a 2015 Military Friendly® School by
Victory Media, the leader in successfully
connecting the military and civilian
worlds.
Now in its sixth year, the Military
Friendly® Schools designation
and list by Victory Media
is the premier, trusted
resource for post-
military success.
Military Friendly®
provides service
members transparent,
data-driven ratings about
post-military education and career
opportunities.
The Military Friendly® Schools
designation is awarded to the top 15
percent of colleges, universities and trade
schools in the country that are doing the
most to embrace military students, and to
dedicate resources to ensure their success
in the classroom and after graduation.
The methodology used for making the
Military Friendly® Schools list has
changed the student veteran landscape
to one much more transparent, and has
played a significant role over the past six
years in capturing and advancing best
practices to support military students
across the country.
The survey captures over 50 leading
practices in supporting military students
and is available free of charge to the more
than 8,000 schools approved for Post-9/11
GI Bill funding. As in past years, the 2015
Military Friendly® Schools results were
independently tested by Ernst & Young
LLP based upon the weightings and
methodology developed by Victory Media
with input by its independent Academic
Advisory Board.
ATSU president’s staff meet with U.S. Acting Surgeon General.
Craig Phelps, DO, ’84, president of A.T. Still University (ATSU), G. Scott Drew,
DO, FAOCD, ’87, chair of ATSU’s Board of Trustees, and members of the
president’s staff, enjoyed an opportunity to meet United States Acting Surgeon
General Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, during a recent trip
to Washington, DC.
As Acting United States Surgeon General, RADM Lushniak oversees operation
of the U.S. Public Health Service Commissioned Corps, and is also responsible for
articulating the best available scientific information to the public regarding ways to
improve personal health and the health of the nation.
A goal of the Surgeon General’s office is to increase the number of Americans who
are healthy at every stage of life. Going hand in hand with that goal is the Surgeon
General’s Every Body Walk! Initiative.
Walking is currently the most commonly reported form of physical activity among
U.S. adults. The Every Body Walk! Initiative encourages Americans to take the initiative
to walk more often to improve overall health.
The Surgeon General’s National Prevention Strategy emphasizes priorities that are
most likely to reduce the burden of the leading causes of preventable death and major
illness. Initiatives include tobacco free living, healthy eating, active living, and mental
and emotional well-being.
Since its inception, ATSU has focused on whole person healthcare and community
health. The shared ideology between the University and the office of the Surgeon
General will help in creating a healthier nation.
AOMA Digest Winter 2015 44
Osteopathic Community News
Midwestern University Arizona College of Osteopathic Medicine
As a testament to Midwestern
University’s commitment to
community service, the University once
again earned a spot on the President’s
Higher Education Community Service
Honor Roll.
This year marks
the seventh
consecutive year
that Midwestern
has been named
to this national
honor roll of
colleges and universities committed to
bettering their communities through
service and service learning. The University
received the highest level of recognition:
Honor Roll with Distinction.
“One of the fundamental missions
of our University is to reach out to our
communities through service,” said
Kathleen H. Goeppinger, Ph.D., President
and CEO of Midwestern University. “I am
both grateful and proud of the dedication
shown by our students, our faculty, and
our staff to helping our neighbors. Their
compassion, caring, and enthusiasm are
values that we encourage and strive for on
both a professional and personal level.”
Out of 766 institutions considered
for the honor, only 121 received
the recognition of Honor Roll with
Distinction. The distinction is an
indication that Midwestern University
displays an outstanding institutional
commitment to service and has formed
compelling partnerships that produce
measurable results.
The award, which is the highest federal
recognition a college or university can
achieve for its commitment to service
and civic engagement, is presented by the
Corporation for National and Community
Service (CNCS) in collaboration with the
U.S. Department of Education.
IN THE NEWS…
Midwestern University President and CEO named Business Leader of the Year
Midwestern University President and Chief Executive Officer, Kathleen H.
Goeppinger, Ph.D., has been named Arizona Business Leader of the Year by
Arizona Business Leaders magazine.Dr. Goeppinger received the award at a special presentation held at the Montelucia
Resort in Scottsdale, AZ, on Thursday, October 30. The
Honorable Greg Stanton, Mayor of Phoenix, also spoke at the
event, which honored Arizona’s top business and community
leaders as judged by Arizona Business Leaders.
The Arizona Business Leader of the Year Award was
presented by Robert Milligan, Chief Financial Officer of the
Healthcare Trust of Arizona, Inc.
Dr. Goeppinger is the primary administrator for Arizona’s
largest health professions university and exercises direct
executive oversight for all educational and clinical operations
of the University and its healthcare facilities at campuses in
Glendale, Arizona and Downers Grove, Illinois. Under Dr. Goeppinger’s leadership,
Midwestern University has undertaken a determined effort to expand medical residency
programs within the State of Arizona to address critical shortages in family medicine,
particularly in the state’s rural areas. Dr. Goeppinger has championed the importance
of providing new physicians and affordable healthcare for Arizonans, and works closely
with State legislators and community groups to make sure this happens. Forty-four
percent of the over 6,500 graduates from all Midwestern University programs since
1995 have remained and established their practices in the state.
Kathleen H. Goeppinger, Ph.D.
Midwestern University Named to President’s Higher Education Community
Service Honor Roll with Distinction
AOMA Digest Winter 201545
Osteopathic Community News
AZCOM Students Offer
Exams, Healthcare Education
to Homeless
Students from the Arizona College of
Osteopathic Medicine are learning first-
hand about patient care and examinations
through participation in Midwestern
University’s Health Outreach through
Medicine and Education (H.O.M.E.),
a volunteer-based organization whose
mission is to improve the health of
homeless individuals in the Greater
Phoenix Area.
Established as an extracurricular club at
Midwestern University in 1999, H.O.M.E.
is an entirely student-organized project.
H.O.M.E. is composed of a dedicated team
of community healthcare professionals and
students from a variety of disciplines—
osteopathic medicine, pharmacy, dental,
physician assistant, podiatry, clinical
psychology, with optometry, veterinary, and
physical and occupational therapy coming
soon—who visit homeless shelters to offer
basic medical care and health education.
The H.O.M.E. project is always in
need of qualified physicians and healthcare
professionals to volunteer as preceptors.
For more information, contact Michelle
Mifflin, D.O., Assistant Clinical Professor,
at 623.537.6123 or by e-mail at mmifflin@
midwestern.edu. H.O.M.E. volunteer
professionals can qualify for CME category
2-b credit.
Companion Animal Clinic at the Animal Health Institute Opens at
Midwestern University
The Midwestern University
Companion Animal Clinic, a part
of the Animal Health Institute, opened
in December, providing quality primary
and specialty care for small animals.
The 111,800-square-foot teaching
clinic is designed to provide learning
opportunities for students as they serve
the local community’s pets and their
owners. Initial appointments will be
managed by clinic veterinary faculty, with
students beginning rotations during their
third year. Services will include primary
care, preventive medicine/wellness,
dental care, surgery, radiology, senior pet
care, and other specialties. The state-of-
the-art facility includes 14 exam rooms,
four surgical suites, and two specialty
suites, and is the largest clinic at any U.S.
veterinary school.
The Animal Health Institute is part
of the Midwestern University College of
Veterinary Medicine, the first veterinary
college in the state of Arizona, which
matriculated its inaugural class in
September.
AZCOM APPOINTMENTS, AWARDS & GRANTS
Fourth-year AZCOM student Kristen Young received the United
States Public Health Service 2014 Excellence in Public Health Award
for her medical and educational service to the homeless through
Midwestern University’s Health Outreach through Medicine and
Education (H.O.M.E.) program.
AOMA Digest Winter 2015 46
Osteopathic Community News
Recipients of Midwestern University’s Littlejohn Awards were
recognized by Midwestern University President and Chief Executive
Officer Kathleen H. Goeppinger, Ph.D., at the University’s annual
recognition dinner held in September at the Renaissance Hotel in
Glendale, Arizona.
This year’s honorees are Midwestern University alumnus Howard
B. Babcock, D.O., Chair of the Midwestern University Alumni
Senate; faculty member Shari M. Burns, CRNA, Ed.D., Program
Director, Nurse Anesthesia, College of Health Sciences-Glendale;
and staff member Judith A. DeLorme-Loftus, D.Min., M.S.W.,
LCSW, Manager of Student Counseling. A special Littlejohn Award
was presented to John R. Burdick, Ph.D., Vice President of Clinic
Operations and Dean of Basic Sciences.
The Littlejohn Awards take their name from the Littlejohn
brothers, physicians who in 1900 founded the American College
of Osteopathic Medicine & Surgery, the precursor to the Chicago
College of Osteopathic Medicine, which was the founding college of
Midwestern University. The awards, which have been presented annually
since 2000 by Dr. Goeppinger, are Midwestern University’s highest
honor. Littlejohn Award winners are selected from Midwestern faculty,
staff, and alumni for their outstanding service to the community, the
health professions, and the University.
Littlejohn Awards Bestowed to Four New Honorees
Midwestern University Gearing Up to Introduce High Schoolers to Healthcare Careers
High school students interested in pursuing healthcare careers
can look forward to a full slate of special programs offered by
Midwestern University in 2015.
Beginning on February 4 with the Arizona
Regional Brain Bee, Midwestern University
will then host its annual Health Sciences Career
Day on March 5. The capstone event, the
eight-day Health Careers Institute for High
School Students, takes place from July 9 – 18.
A live competition similar to a spelling
bee, the Arizona Regional Brain Bee
offers students the chance to compete for
scholarships and other prizes by answering
questions about the brain and central
nervous system. Participation is free, and
the winner will receive a $2,000 first prize
scholarship to any Midwestern program as
well as up to $900 in reimbursements for
expenses to attend the National Brain Bee in
Washington, D.C.
The Health Sciences Career Day is designed for high school
classes to visit University labs, tour the campus, and attend
interactive presentations by healthcare professionals. Classes will
have the opportunity to choose hands-on workshops highlighting
careers in osteopathic medicine, optometry, dental medicine,
pharmacy, physician assistant studies, occupational therapy,
biomedical sciences, perfusion, podiatric medicine, clinical
psychology, physical therapy, nurse anesthesia,
and veterinary medicine.
For students who want to learn about
health careers more in depth, Midwestern
University will offer its eight-day Health
Careers Institute for High School Students
in July. Each day from 9:00 am to 4:00
pm, Midwestern faculty and advanced
students will teach workshops in anatomy,
physiology, and introductory skills for
various health professions, with a special
focus on how to prepare for college and
what to expect from each profession. Guest
lectures for this exciting summer program
will include current medical topics such as
Emergency Medicine, Sports Medicine,
Drug Abuse, Healthcare Volunteer
Opportunities, and more. In addition, participants will attend
a medical field trip to Arrowhead Hospital and an interactive
Emergency Medical Services mock rescue scenario presented
by the Glendale Fire Department.
March 10, 2015
7:30 a.m. to 12:00 p.m.
D.O. Day at the Legislature
Arizona State Capitol
1700 West Washington
Phoenix, AZ 85007
May 6, 2015
AOMA Board of Trustees Meeting
7:00 p.m.
Arizona Grand Resort
May 6 – 10, 2015
AOMA 93rd Annual Convention
Arizona Grand Resort
8000 Arizona Grand Parkway
Phoenix, AZ 85044
May 7, 2015
AOMA House of Delegates
4:00 p.m.
Arizona Grand Resort
June 20, 2015
AOMA Board of Trustees Meeting and Retreat
9:00 a.m.
A.T. Still University
Mesa, Arizona
July 15 – 19, 2015
AOA House of Delegates
Chicago, IL
November 6, 2015
AOMA Board of Trustees Meeting
7:00 p.m.
Tucson El Conquistador Resort
November 7, 2015
AOMA House of Delegates
3:00 p.m.
Tucson El Conquistador Resort
November 7 & 8, 2015
AOMA 35th Annual Fall Seminar
Tucson El Conquistador Resort
10000 N. Oracle Road
Tucson, AZ 85704
2015 Meeting Dates and Locations
Advertisers’ IndexMICA .............. Inside front cover
Hospice of the Valley ........Page 12
Arizona Health-e
Connections ..................Page 16
ProAssurance ....................Page 36
Amazon ............................Page 38
Catalina Medical
Recruiters ....... Inside back cover
Arizona Osteopathic
Charities .................. Back cover
Meeting Dates & Locations
Arizona Osteopathic Charities5150 N. 16th Street, Suite A-122
Phoenix, AZ 85016
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