16
FEBRUARY EDITION, VOLUME 2015, NO. 2 CAPITAL MEDICAL SOCIETY 2015 MEETINGS CALENDAR March 26, 2015 Celebration Awards Dinner 6:30 pm FSU University Center Club April 21, 2015 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks May 19, 2015 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks A MESSAGE FROM THE CMS PRESIDENT By Joshua Somerset, M.D. Welcome to 2015! I have the pleasure of serving as your CMS president this year. I have been on the Capital Medical Society Board of Governors for the last 4 years, which pales in comparison to the years of service from physicians like Drs. Skilling, Mahoney and Hellgren (to name a few). What an eminent organization with a simple focus, “To promote the practice of medicine for the ultimate benefit of the patient.” And in case you haven’t noticed, the practice of medicine could use a little promoting. Our healthcare system can be challenging to navigate. When the tables get turned and one finds their spouse, children or parents becoming the patient, a more complete and unflattering picture of healthcare emerges. I don’t want to sound pessimistic because I think our healthcare system has some incredible assets and a bright future. I just think that the current healthcare costs are unsustainable and the system is not inclusive. These 2 factors, cost and exclusions, are going to spawn a high cost system with mediocre outcomes. How many articles have you seen blasting the US Healthcare System as having the highest costs in the world with average outcomes? As a physician I feel defensive about this, but also feel as if I have little control over it. The cost of overconsumption of food/ beverage, lack of exercise and poor lifestyle choices including smoking can make an otherwise healthy population present with preventable diseases. These preventable diseases substantially impact the cost of healthcare; at the same time they worsen the outcomes. Look at the negative effects the obesity epidemic has had on healthcare costs and outcomes. Despite seeing this effect daily in my clinical practice, most of my overweight patients cringe when I touch on lifestyle changes. Most people do not welcome input on weight loss; similarly our cigarette smoking patients roll their eyes when we tell them to stop smoking. As a Gastroenterologist, I treat patients chronically infected with hepatitis C. The progress over the last 10 years in this area has been astounding. Only more astonishing has been the cost of this progress. Current hepatitis C medication can cost $1000 per pill daily for an expected 90 day treatment course. With over 3 million people in the United States chronically infected with hepatitis C, this new therapy will breach some budgets. This is just another example of how healthcare system costs can explode and individual physicians may have little control of costs. I am sure those of you in other areas of medicine have numerous examples of how complex and overwhelming the healthcare system can be. We are faced with an outsized challenge and we need to respond. In these situations, there is a tendency to think that individual efforts at improving the system are futile. Add a busy practice, a busy family, and spare time is at a premium. This is where CMS can help. CMS can help physicians focus on common goals. CMS is a support network for physicians. CMS can play an integral role in Florida’s healthcare industry by addressing issues to improve quality and affordability of patient care. I look forward to having a great year and building on the momentum of past CMS presidents. I look to collaborate and build with you in 2015 and beyond. CMS

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 1

FEBRUARY EDITION, VOLUME 2015, NO. 2

CAPITAL MEDICAL SOCIETY 2015 MEETINGS CALENDAR

March 26, 2015Celebration Awards Dinner

6:30 pmFSU University Center Club

April 21, 2015CMS Membership & CME Meeting

6:00 pmMaguire Center for Lifelong Learning at

Westminster Oaks

May 19, 2015CMS Membership & CME Meeting

6:00 pmMaguire Center for Lifelong Learning at

Westminster Oaks

A MESSAGE fROM ThE CMS PRESIDENTBy Joshua Somerset, M.D.

Welcome to 2015! I have the pleasure

of serving as your CMS president this

year. I have been on the Capital Medical

Society Board of

Governors for the last

4 years, which pales

in comparison to the

years of service from

physicians like Drs.

Skilling, Mahoney and

Hellgren (to name a

few). What an eminent

organization with

a simple focus, “To

promote the practice of medicine for the

ultimate benefit of the patient.” And in

case you haven’t noticed, the practice of

medicine could use a little promoting.

Our healthcare system can be challenging

to navigate. When the tables get turned

and one finds their spouse, children or

parents becoming the patient, a more

complete and unflattering picture of

healthcare emerges.

I don’t want to sound pessimistic

because I think our healthcare system

has some incredible assets and a bright

future. I just think that the current

healthcare costs are unsustainable

and the system is not inclusive. These

2 factors, cost and exclusions, are

going to spawn a high cost system

with mediocre outcomes. How many

articles have you seen blasting the

US Healthcare System as having the

highest costs in the world with average

outcomes? As a physician I feel

defensive about this, but also feel as if

I have little control over it.

The cost of overconsumption of food/

beverage, lack of exercise and poor

lifestyle choices including smoking can

make an otherwise healthy population

present with preventable diseases. These

preventable diseases substantially impact

the cost of healthcare; at the same time

they worsen the outcomes. Look at the

negative effects the obesity epidemic has

had on healthcare costs and outcomes.

Despite seeing this effect daily in my

clinical practice, most of my overweight

patients cringe when I touch on lifestyle

changes. Most people do not welcome

input on weight loss; similarly our

cigarette smoking patients roll their eyes

when we tell them to stop smoking.

As a Gastroenterologist, I treat patients

chronically infected with hepatitis C.

The progress over the last 10 years in

this area has been astounding. Only

more astonishing has been the cost

of this progress. Current hepatitis C

medication can cost $1000 per pill daily

for an expected 90 day treatment course.

With over 3 million people in the United

States chronically infected with hepatitis

C, this new therapy will breach some

budgets. This is just another example of

how healthcare system costs can explode

and individual physicians may have little

control of costs.

I am sure those of you in other areas of

medicine have numerous examples of

how complex and overwhelming the

healthcare system can be. We are faced

with an outsized challenge and we need

to respond. In these situations, there is a

tendency to think that individual efforts

at improving the system are futile. Add

a busy practice, a busy family, and spare

time is at a premium. This is where CMS

can help. CMS can help physicians focus

on common goals. CMS is a support

network for physicians. CMS can play

an integral role in Florida’s healthcare

industry by addressing issues to improve

quality and affordability of patient care.

I look forward to having a great year and

building on the momentum of past CMS

presidents. I look to collaborate and build

with you in 2015 and beyond. CMS

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2 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS fAMILY fUN NIGhT

Nelson Kraeft, M.D. – 1st

Robert Steinmetz, M.D. – 1st

Bert Morales, M.D. – 2nd

David O’Bryan, M.D. – 2nd

Brian Sherman, M.D. – 3rd

C. Raymond Cottrell, M.D. – 4th

Shakra Junejo, M.D. – 6th

Wade Douglas, M.D. – 7th

Ramel Failma, M.D. – 7th

Donald Loucks, M.D. – 7th

James O’Neill, M.D. – 7th

Stephen Quintero, M.D. – 7th

William Thompson, M.D. – 7th

Frank Gredler, M.D. – 8th

John MacKay, M.D. – 8th

Michael Cavallaro, M.D. – 9th

Larry Harper, M.D. – 10th

Krista Rankin, M.D. – 10th

Jeannine Silberman, M.D. – 10th

Satish Mital, M.D. – 11th

hAPPY BIRThDAY! WE ARE SO GLAD YOU WERE BORN!

MISSION: TO PROMOTE ThE PRACTICE Of MEDICINE fOR ThE ULTIMATE BENEfIT

Of ThE PATIENT. (850) 877-9018 Fax: (850) 878-0218

www.capmed.org

BOARD OF GOVERNORSJoshua Somerset, M.D., PresidentJ. Daniell Rackley, M.D., President-ElectTracey Hellgren, M.D., Secretary/TreasurerAlfredo Paredes, M.D., Immediate Past-PresidentShelby Blank, M.D.Garrett Chumney, M.D.David Dixon, D.O. Shakra Junejo, M.D.Maribel Lockwood, M.D.Amy Pagano, CMS Alliance PresidentParesh Patel, M.D.Philip Sharp, M.D.Ernesto Umaña, M.D.Kenneth Whithaus, M.D.Pam Wilson, Executive DirectorFamily Medicine ResidentsWilliam Carlson, M.D./Anna Hackenberg, M.D.Internal Medicine ResidentsChris Rosadzinski, M.D./Prerna Satyanarayana, M.D.

PUBLICATIONEDITORCharles E. Moore, M.D.,

GRAPhIC DESIGNYoung Design

ARE YOU INTERESTED IN WRITING AN ARTICLE FOR CAP SCAN? Please contact Dr. Charles Moore at

[email protected] and Shannon Boyle at [email protected]. All articles submitted will be reviewed by your peers prior to publishing.

Cap Scan is published during the first week of each month and is the official publication of the Capital Medical Society. Advertising in Cap Scan does not imply approval or endorsement by the Capital Medical Society. The opinions expressed are those of the individual authors and do not necessarily reflect the official policies of the Capital Medical Society.

If you are a member of the Capital Medical Society and would like a copy of the Minutes from the Board of Governors meeting, please call the CMS office. Thank you.

MANAGING EDITORShannon Boyle

IN T

HIS

IS

SU

E:

DiD We MiSS yOUr birthDay? iF SO, pLeaSe eMaiL rOSaLie CarLin at [email protected]!

William Simmons, M.D. – 14th

Kenneth Kato, M.D. – 15th

Chris DeRosier, M.D. – 16th

Jacqueline Lloyd, M.D. – 16th

Jose Rodriguez, M.D. – 16th

Garrison Rolle, M.D. – 16th

Robert Snyder, M.D. – 16th

Robert Atwater, M.D. – 18th

Narlito Cruz, M.D. – 19th

Meredith McKinney, M.D. – 19th

Jerry Ford, M.D. – 21st

Joseph Camps, M.D. – 22nd

Jamell Walker, M.D. – 22nd

James Geissinger, Jr., M.D. – 23rd

Angela Spencer, M.D. – 24th

Elizabeth King, M.D. – 25th

Abbey Peters, M.D. – 25th

Joseph Baker, M.D. – 26th

Gregory Albright, D.O. – 28th

Charles Bianco, M.D. – 28th

A Message from the CMS President… 1

Celebration Awards Dinner ... 3

CMS New Members ... 4

2015 CMS Foundation Board of Directors ... 5

CMS Lunch & Learn … 6

Doctor of the Day Program … 7

Reflections from the Editor … 9

Viewpoint … 12

CMS Foundation: We Care Network … 13

CMS Foundation … 14

Medical/Legal … 15

hAPPY BIRThDAY!{FEBRUARY BIRTHDAYS}

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 3

CELEBRATION AWARDS DINNER

2015 MEETINGS CALENDAR

MAY 28, 2015CMS DOCTOR/DAUGhTER BANqUET

6:00 PMGOLDEN EAGLE COUNTRY CLUB

SEPTEMBER 15, 2015

CMS MEMBERShIP & CME MEETING

6:00 PMMAGUIRE CENTER FOR LIFELONG LEARNING AT WESTMINSTER OAKS

OCTOBER 20, 2015CMS MEMBERShIP & CME MEETING

6:00 PMMAGUIRE CENTER FOR LIFELONG LEARNING AT WESTMINSTER OAKS

NOvEMBER 10, 2015CMS MEMBERShIP & CME MEETING

6:00 PMMAGUIRE CENTER FOR LIFELONG LEARNING AT WESTMINSTER OAKS

DECEMBER 3, 2015CMS fOUNDATION hOLIDAY AUCTION

6:30 PMLOCATION: TBA

Celebrate the profession of medicine with your colleagues! Mark

your calendars for the Capital Medical Society’s annual Celebration

Awards Dinner on Thursday, March 26th at 6:30 pm at the University

Center Club at Florida State University. Our Celebration Awards Dinner

honors Doctors’ Day, which is on March 30th every year.

An exciting part of this event is the presentation of two

prestigious awards. The I.B. Harrison, M.D. Humanitarian Award will

recognize a local physician’s humanitarian effort to help patients.

The Outstanding Physician Award will recognize a local physician’s

effort to help the profession of medicine. The 2015 winners will be

announced in early February.

Invitations will be sent in early March. We hope to see you there!

Mark Your Calendar for the 14thAnnual Celebration Awards Dinner

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4 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS NEW MEMBERS

CAPITAL MEDICAL SOCIETY IS PLEASED TO WELCOME ThE fOLLOWING NEW MEMBERS:

Andrew Hsia, M.D.Medical School: University of FloridaInternship: Shands University of FloridaResidency: George Washington University HospitalFellowship: University of AlabamaSpecialty: OphthalmologyPractice: Southern Vitreoretinal Associates

Sharron Foster, M.D.Medical School: University of Medicine & Dentistry of New JerseyInternship/Residency: University of Medicine & Dentistry of New JerseySpecialty: Internal MedicinePractice: Neighborhood Medical Center

Omodele Awoniyi, M.D.Medical School: University of South FloridaInternship/Residency: University of MiamiFellowship: University of TennesseeSpecialty: Internal Medicine/EndocrinologyPractice: TMH Physician Partners, Endocrinology Specialists

Babatunde Adekola, M.D.Medical School: Mayo Medical SchoolInternship/Residency: Mayo ClinicFellowship: University of MinnesotaSpecialty: Pain ManagementPractice: Tallahassee Neurological Clinic

Join your colleagues for a

hAPPY hOUR SOCIALThursday, February 19, 2015

5:30 pm – 7:30 pm

Hors d’oeuvres and first select beer or wineprovided by our sponsor:

The Front Porch1215 Thomasville Road

Please RSVP by February 12 to Rosalie Carlin at (850) 877-9018 or [email protected].

This event is limited to 75 people.Be sure to RSVP today to reserve your spot!

* Due to space limitations, this event is for Active and Associate CMS Members Only.

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 5

2015 CMS fOUNDATION BOARD Of DIRECTORS

John Mahoney, M.D.PresidentPathologyPathology AssociatesMarried to Barbara MahoneyUniversity of florida

Al McCully, M.D.Vice PresidentUrologyRetiredUniversity of Tennessee

Barbara Williams, M.D.Secretaryfamily MedicinePatients firstMarried to Dennis Williams, M.D.University of florida

Kenneth R. Wasson, M.D.TreasurerPulmonary MedicineRetiredMarried to Lee Wassonvanderbilt University

Walt Colón, D.M.D.DentistryMarried to Marybeth ColónUniversity of Kentucky

Avon Doll, M.D.NephrologyNorth florida Nephrology AssociatesMarried to Louie DollOral Roberts University

Tracey hellgren, M.D.Family MedicinePatients firstMarried to Brian BrysonUniversity of florida

David Jones, M.D.PediatricsCapital health PlanMarried to Dottie JonesOhio State University

Nelson Kraeft, M.D., EmeritusCardio/Thoracic SurgeryRetiredvanderbilt University

fred Lindsey, M.D., EmeritusRadiologyRetiredMarried to Jimmie LindseyMedical College of Georgia

Nancy Loeffler, M.D.AnesthesiologyAnesthesiology Associates of TallahasseeMarried to Duane PickelBaylor College of Medicine

J. Daniell Rackley, M.D.CMS President-ElectUrologySoutheastern Urological CenterMarried to Jennifer RackleyMedical College of Georgia

Katrina Rolle, Esq.AttorneyMarried to Gary Rolle, M.D.University of florida

J. Brian Sheedy, M.D.Hematology/OncologyRetiredMarried to Wende SheedyState University of Buffalo

Joshua Somerset, M.D.CMS PresidentGastroenterologyDigestive Disease ClinicMarried to Wendy Somerset, M.D.University of florida

David Stewart, M.D.PathologyPathology AssociatesMarried to Gillian StewartUniversity of New Mexico

hugh vanLandingham, M.D.Family MedicineTallahassee Primary Care AssociatesMarried to Mary vanLandinghamUniversity of florida

Jay Walton, D.D.S.DentistryMarried to Susan WaltonEmory University

Charles Williams, M.D.RadiologyRadiology AssociatesMarried to Pat WilliamsMedical College of Georgia

Pam WilsonExecutive Director, Capital Medical SocietyMarried to Jim Guerry

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6 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS LUNCh & LEARN

Capital Regional Heart and Lung Surgical Associates accepts Capital Health Plan and most all other insurance carriers.

Welcomes Natarajan Rajagopalan, MD

850.402.0202 2626 Care Drive, Suite 106

Tallahassee, FL 32308

www.CapitalRegionalPA.com

Now Accepting Patients

Services Include: • Allergies and Asthma• Chronic Obstructive

Pulmonary Disease/Emphysema

• Lung Cancer• Bronchiectasis• Sarcoidosis• Chronic Bronchitis• Shortness of Breath• Vocal Chord Dysfunction• Sleep Disorders• Interventional Pulmonology

• M.B.B.S Kilpauk Medical College (affiliated to University of Madras), India

Medical Education• Fellow of the American College of

Chest Physicians

• Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine and Sleep Medicine

• Residency in Internal Medicine at Baylor College of Medicine, Houston, Texas

• Fellowship in Pulmonary Medicine at University of Toronto, Canada

• Fellowship in Critical Care Medicine at Mayo Clinic, Rochester, MN

• Asst. Professor of Medicine, Department of Pulmonary Medicine, Critical Care and Sleep Disorders UMass Medical Center, Worcester, MA

Professional Experience

P U L M O N A R Y A S S O C I AT E S

CAP-6404 CapScan Dr. Rajagopalan Welcome Ad_B&W_7.5x5.indd 1 12/8/14 10:11 AM

Time: 12 Noon to 1:30 PM (Seminars start at 12:30 PM)Place: CHP Auditorium, 2nd Floor, 1491 Governors Square Blvd. • Cost: $10 per person, per seminar

CAPITAL MEDICAL SOCIETY LUNCh & LEARN SEMINARS SPRING 2015

february 18, 2015

Method to the Madness: 10 Payment Collection Strategies That Work

“Are you like a lot of medical organizations, up against unprecedented revenue and margin pressure, and figuring out how to boost revenue has become the focal point of your work life? You’re not alone. With significant payment responsibility shifting to consumers, medical businesses are increasingly battling bad debt, long A/R cycles and reduced revenue. Historically, most payment collection

activities occurred long after the patient left facility, which creates back-end work that can significantly

delay payment and reduce total collections. But health care reform, the growth of high-deductible health plans and decreasing reimbursements are forcing a shift of collection efforts upstream. The

session will provide you with best-practice guidance from Patient Access experts, lessons learned from our most successful customers and leading market

research all in one session.”

Speaker: Colleen Wood, Vice president, availity

Sponsor: tom Mchaffie, aargus Facility Services

March 18, 2015

Reputation Intelligence: hear What Your Patients Are Saying About You Online

Speakers: Scott r. Marshall and Josh Vanderpool, boardroom alliance Sponsor: tony Shah, express printing

April 15, 2015

Affordable Care Act: Status/Overview and Legislative Updateshear from the only insurer offering coverage in Florida

through the federal marketplace-Florida blue. - Overview of the changing health insurance market

- implications of aCa on the Florida health insurance market - impacts on operations for insurers and providers

Speakers: gordon F. bailey, ii, asst. general Counsel, and Kelly

James, Senior Manager – government affairs, Florida blue Sponsor: terry bush, Office Depot

May 20, 2015

Payment Advocacy Speaker: Jarrod Fowler, Florida Medical association

Sponsor: Diana Cureton, hancock bank

FOR MORE INFORMATION OR TO REGISTER, CALL ROSALIE CARLIN AT 877-9018.

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 7

DOCTOR Of ThE DAY PROGRAM

Since the 1960s, the Florida Legislature's Doctor of the Day

program has provided lawmakers with medical care during

Legislative Session while serving to strengthen physician-

legislator relations. Two physicians — one for the House

of Representatives and one for the Senate — provide any

necessary care to legislators, their staff members, and others

at the Capitol. If the House or Senate is in full session on

a day when a physician is volunteering, either the House

Speaker or the Senate President will introduce the Doctor

of the Day. Within the House or Senate Chambers, the

physician may sit with his or her local delegation.

DOCTOR Of ThE DAY PROGRAM

If the House and Senate are not in session, physicians are

encouraged to attend committee meetings and/or visit

legislators' offices. Your participation not only provides a

valuable service, but also continues a noble tradition and

helps the physician community build valuable relationships

within the Legislature. Decisions made at the state Capitol

and in Congress have a major impact on medicine, making

it vitally important for physicians to be engaged at all levels.

The 2015 Legislative Session begins Tuesday, March 3,

2015, and the Florida Office of Legislative Services is

seeking volunteer physicians to participate in the Doctor

of the Day program. Physicians who are willing to spend a

day in Tallahassee during the Legislative Session perform

an invaluable service by providing health care for members

of the legislature and legislative employees. The 2015

Legislative Session is scheduled to adjourn on Friday, May

1, 2015.

Tuesdays and Wednesdays of session are usually the most

exciting as Mondays and Fridays are often used as “travel

days” for the legislators. In addition, should you want

to ensure the chambers are in actual session (where all

members of the House or Senate are in chambers), it would

be best to volunteer any day the last 2 weeks of session

(the weeks of April 20th and April 27th), but volunteers

are needed for all of the Legislative Session. The time

commitment is typically from 8:00 a.m. – 3:00 p.m. on any

given day. The legislature has a clinic onsite that is staffed

by 2 full-time RNs.

If you are interested in serving as a Doctor of the Day

or have more questions about the program, please

contact Takeshia Stokes with the Office of Legislative

Services by email at [email protected] or

call her at 850.717.0301.

CMS

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8 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

1616 Physicians Drive | Tallahassee | 850-431-5100

Tallahassee Memorial Behavioral Health Center Welcomes

Esther Undag-Elphick, MD

Specialty: Child and Adolescent Psychiatry

Medical School: Angeles University Foundation, College of Medicine, Angeles City, Philippines

Residency: The Ohio State University Columbus, OH

Fellowship: The Ohio State University Columbus, OH

Accepting New Patients.

Esther Undag-Elphick, MD

AN EVENING WITH DR. JOHN AGWUNOBI: LEADERSHIP THROUGH PREPARATION, PREVENTION, AND RESPONSE

Imagine juggling the responsibilities of responding to four major hurricanes and the nation’s first-ever anthrax attack while combating a high infant mortality rate and rising youth tobacco use. This was just a normal workday for former Secretary of Health Dr. John Agwunobi. Join us for an intriguing evening of shared stories about the unprecedented Public Health challenges he faced during his appointment.

MARCH 19, 2015 | 5:30 PM – 7:30 PM

400 S. MONROE STREET | TALLAHASSEE, FL 32399-1100 | (850) 487-1902 | WWW.FLHISTORICCAPITOL.GOV

The Florida Historic Capitol Museum gratefully

acknowledges the following sponsors and partners:

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 9

CONTINUED ON PAGE 10

WORTh POSSIBLY DEBATING By Charles Moore, M.D.

Amidst all the forgettable

thises and thats that my wife

found in the depths of her

Christmas stocking, there at

least lurked a “Samsung Note 4,” with an elegantly pointed

stylus with which she could write an elegantly scripted memo

to herself lest she forget to buy milk, eggs, and caviar next

time she went to Publix or Harrod’s. She spent the week after

Christmas lost in this device, which compared to her merely

primitive, early edition iPhone propelled her into warp-speed

mode. She stares at it with the intensity of any teen-ager,

practicing at it as assiduously as any aspiring young gun-

slinger in some fifties Western. It is, as we all know, a marvel

of this and that, all packed into a slender, shiny little package

containing far more than our poor, aging brains can fully

fathom. And it is innocent: altogether passive, even when

turned on, unless you believe that holding it up to your ear

will give you a glioblastoma.

For her birthday, which was only two weeks before Christmas

(and such a challenge this is for us lovers of wives) among

other thises and thats she got an “I-bot,” or is it a “Roomba;”

I’m not sure I know the difference. Lynn is one of these rare,

beautiful women who almost loves to vacuum, thankfully, for

in order to stay ahead of the fur-balls in our house, as well as

the other fuzz and dust-bunnies that I am responsible for, she

is generally found vacuuming constantly. Now she is grateful

for robotic assistance. With the arrival of the Samsung Note,

and Lynn’s engagement with it, we were delighted that the

Roomba/I-bot was in operation, doing its business without

complaint, beating back fuss and fur while Lynn discovered

yet another App. The I-bot works pretty well, too, except

when Rosie, our Maine Coon cat, a big girl, rides about on

it, and accidentally pushes the off button. At least I know

enough about it to push the “on” again. So I vacuum too!

1405 Centerville Road, Suite 400 | Tallahassee, FL | 850-877-6212

Specialized Surgical Care.

Here in Tallahassee.

TMH Physician Partners welcomes

Tim Ruark, M.D. General Surgery, Board Certified

Jeffrey Crooms, M.D. General Surgery, Board Certified

Eliot Sieloff, M.D. General Surgery, Board Certified

Services by Tallahassee Surgical Associates

REfLECTIONS fROM ThE EDITOR

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10 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Yes, we are in the grip of our smart electronics, whose A.I.

remains so far fully obedient to our will, capable of being

turned on or off even by a cat. Well, the I-bot does have

enough sense to stop at a step, and very cleverly backs off

rather than precipitating itself into the void. I suppose that’s

“intelligence” of some sort, but purely

mechanical and thoughtless for all that.

On the other hand, everyone knows

these charming devices are harbingers

of things to come. They are to

“intelligence” what Lillienthal’s gliders

were to flight in the 1890s. How can we

not, being human and always craving

to “go where no man has gone before,”

do other than develop intelligent robots that will, just for the

fun of it, outstrip in speed and strength anything our own

poor biological brains and muscles can ever be made to

perform. Yes, yes…I heard on the radio something of that

interview with Hawking: his ominous remark, made all the

more doleful by the artificiality of his prosthetic, prophetic

voice, saying of “Artificial Intelligence” that “It would take

off on its own, and re-design itself at an ever-increasing rate,

(and that) we Humans, who are limited by slow biological

evolution, couldn’t compete, and would be superseded.”

My humanity, my human pride in having after all these

millennia risen from a paramecium to the heights we have

achieved, blasting ourselves into space and carrying in our

pockets the power of the Samsung Note, surely is forgivable.

We are a remarkable species, and there is Hawking and, I

suppose, LeBron James and Jameis Winston to prove it.

Throw in Fleming and Salk, Newton and Einstein as well;

which also reminds me not to neglect the other side of the

coin, Hitler, Stalin, Pol Pot, and Idi Amin. There is so much

we have created and (more or less) conquered. But there is so

much we have not: as Pogo so famously observed way back

when in the fifties, “we have met the enemy, and he is us.”

And we will always be “us,” for it has taken us all these

millennia to become so, and despite the utopian wishes of

idealists we will never be more than what we are, which

sadly includes some serious flaws.

Ah, but wait!

I have an idea, which may be worth debate at some place like

the Oxford Union or Leon High: “Might it be better, for the sake

of the world, if the human race were to voluntarily relinquish

its claim to superiority, and grant it to robots endowed with an

artificially intelligent, superhuman capability?”

Don’t get me wrong if for the moment I choose to take the

affirmative position. Let me cast aside my human pride;

or rather, and even better, take pride in embracing the

self-sacrificial, call it even (if you will) noble position that

the world might be better off ruled by something of our

creation, but which, in fact, is better than we.

Yes, with gestures of elegant emphasis I would argue that we,

so captivated by ourselves, so demanding of nature, of this

earth and this delightful universe, might consider abdicating

our crown. Does anyone really think there will ever be a time

when the wars we make are no more? That prisons will vanish

from the face of the earth? That we will ever be content living

within the natural world that surrounds us, instead of wasting

it? Will greed vanish from the face of the earth?

“We talk,” I would finally summarize to powerful effect,

“about ‘evolving man,’ but man is what he is, and will

always be.” Our brains will not grow bigger or better, and

no tinkering with our chromosomes will guarantee some

perfect balance between heart and mind. But how much to

our credit it would be if we were to become the creators of

an entity, even if it were to supersede us, that would make

us as Gods, giving to the world, so in need of a gentler,

kinder care, a more perfect creature capable of it.

Of course there will be questions. Could the creature turn

Frankensteinian? And what about love? Would it ever really

be possible for your I-bot to love you? What about feelings?

What about initiative and spontaneity? What about sudden

insight? What about art? Music? The Haiku? Where is all of

this in a world roamed by a perfection of robots with giga

gigs of information and intelligence? Are we simply to be

trampled underfoot by these devices?

Who knows, but let me reminisce a bit. I remember in

college when, instead of taking biology one and chemistry

one-half, I took a course on “modern” drama for some

reason; you know: Ibsen, Shaw, and that lot. It included also

a play that appeared in 1920 by the Czech playwright Karel

REfLECTIONS fROM ThE EDITOR

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CMS

Who can guess how this transmutation occurred. It was a

play. But I wonder if we mortal designers of A.I. software

will be able to grant so much to our own A.I. creations, no

matter how well they may do on a college entrance exam or

playing chess?

Give me a break, and appreciate the possibility. Otherwise,

enough being enough, I must find my wife, which should be

easy since all I have to do is find her Samsung Note.

She’ll be right with it, rapt, intertwined, enmeshed and

in love with her smart little A.I. proto-robot. And in the

background I hear the soothing whirr of I-bot, glance

smugly at the spiffy floor, and Rosie, the cat, riding on its

back, the best cat toy ever devised.

So far, so good.

REfLECTIONS fROM ThE EDITOR

Capek called “R.U.R.,” or “Rossum’s Universal Robots.”

Previously called “Automata,” it was Capek who first

introduced the word “robot” to language, deriving it from

the Czech word for a “forced laborer” or serf. Interestingly,

but only parenthetically (and begging your pardon) Spencer

Tracy made his theatrical debut on Broadway playing the

role of a Rossum’s robot in 1922.

Rossum’s robots, which were more like what we would

call “androids,” were so endowed with intelligence that

poor humanity was simply overwhelmed. We were dead

ducks; and the world left to these unfeeling beings of our

own creation, until…at the end of

the play…guess what happens? Two

handsome drop-dead beautiful robots

fall…yes…in love. The proof of it is

demonstrated with a more than mere

Turing-Test rigor when each of these

two…never mind the details…will beg

to accept its own destruction if the

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12 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS

My mother claimed that I announced I was going to be a doctor when I was three years old. This should not seem a prescient forecast from a toddler’s mouth since my father was an ophthalmologist and my mother a nurse. However much I wanted to become a physician came up against the harsh reality of the first year of medical

school, arguably the worst year of my life. After graduating as an English major from a small liberal arts college, I was thrown among the highly competitive science majors at the University of Alabama in Birmingham, long steeped in the principles of William Osler, the father of modern internal medicine. For the first time I could not assume that I was going to be in the top ten percent of the class since everyone else there had been in the top ten percent of their respective classes. After slogging through the first year, I took a summer elective in ophthalmology at the University of Miami which had one of the top eye programs in the country. I found the field engaging, but UAB had been directed by Tinsley Harrison, one of the great medical educators of the twentieth century and still memorialized in Harrison’s online website. Internal medicine was THE most important department at UAB, and many students had been inspired by the patient-centered teachings of Harrison. I naturally gravitated to the men (there were virtually no women in academic medicine in the early 1970s) in that department. However, I found that I enjoyed all of my clinical rotations.

I liked general surgery, but thought the hyper-competitive, supercharged atmosphere and the long hours of residency too demanding to be my life’s work. Pediatrics was interesting, but not as much as internal medicine. Psychiatry was also interesting, but there were not many biological applications at the time, and I wasn’t sure about being a psychoanalyst. On the gynecology rotation I was inspired by one of the cancer surgeons as he tried to save women’s lives from the scourge of cervical carcinoma, a common occurrence in rural Alabama at the time. My obstetrical rotation was tough: thirty six hours straight on duty with teenagers in tiny labor rooms. The medical students were supposed to transfer the mothers to the large delivery room in time for the entire staff to be present. After I let two girls labor too long at 4 AM

and deliver in the labor room rather than the delivery room, I knew that the obstetrician’s life was not for me. One of the African-American mid-wives who assisted the medical students looked up at me after we delivered the second baby and said, “Dr. Skilling, I just don’t see you getting up at night to deliver babies.” She was right.

As many graduates did at the time, I chose an internship in internal medicine with the thought that it would be useful later no matter which field I chose. I spent a year at the University of Miami in a free-wheeling program that was supersaturated with very sick patients, often with very unusual diseases. But I struggled with the choice of internal medicine versus ophthalmology. I had excellent mentors in both fields, and I just couldn’t make a decision. Fortunately, I had a military obligation (this was the Vietnam era), so I deferred my choice while I spent two years as a general medical officer with the Navy and Marine Corps. While serving overseas with the Marines I decided to try for an ophthalmology residency since they were more competitive. If I didn’t get in one, I could apply for internal medicine, and if I didn’t like ophthalmology after one year as a resident, I told myself I could switch back to medicine as well. While on active duty, I also found out that I didn’t like being a general practitioner running a night clinic where military dependents showed up to get tranquilizers or refills for birth control pills when they didn’t feel like going to the regular day clinics.

I was accepted at the University of Texas Medical Branch in Galveston for an ophthalmology residency. After feeling that I was floundering around a bit the first year, I started the second year with the realization that I had learned a lot of ophthalmology, and I really liked it. It is a field that encompasses medicine, surgery, physical diagnosis, laboratory examination, pathology, and, most importantly, the eye is a direct extension of the brain, an organ that fascinates me. I always wanted to be in a clinical field that had direct patient contact, and ophthalmology offered as much as I wanted. It felt like I was home, and I’ve never looked back. I still have twinges of envy when I see some of my colleagues who are great internists solving and treating some of the most daunting medical problems, but I like the variety of diagnoses and treatments that ophthalmology has afforded me, and I like being able to help patients who have vision-threatening problems live more normal lives. Would I choose the same specialty today? Emphatically yes, but I still admire the internists who walk in William Osler’s footsteps.

The Eyes have ItBy Frank Skilling, M.D.

vIEWPOINT

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 13

CMS fOUNDATION: WE CARE NETWORK

13

PHYSICIANSricardo ayala, M.D.Marie becker, M.D.Dhananjay bendre, M.D.alexander brickler, iii, M.D.tim broeseker, M.D.Viet bui, M.D.Carlos Campo, M.D.Joseph Camps, M.D.ray Dolly, M.D.David Durden, M.D.tanya evers, M.D.Spencer gilleon, M.D.Sergio ginaldi, M.D.Joseph gray, M.D.Kristin harmon, M.D.Celeste hart, M.D.David huang, M.D.iman imanirad, M.D.amit Jain, M.D.arjun Kaji, M.D.James Killius, M.D.Stephanie Lee, M.D.Maribel Lockwood, M.D.Michael pentaleri, M.D.Duncan postma, M.D.Jeffrey rawlings, M.D.James renehan, M.D.bryan robinson, M.D.andres rodriguez, M.D.

William Sawyer, M.D.Scott Sellinger, M.D.Jeannine Silberman, M.D.hardeep Singh, M.D.J. Orson Smith, M.D.robert Snider, M.D.robert Snyder, M.D.Joshua Somerset, M.D.Joseph Soto, M.D.Mary Swain, M.D.timothy Sweeney, M.D.David Vermess, M.D.tony Weaver, M.D.William yaakob, M.D.

DENTISTSeric amundson, D.D.S.Susan byrne, D.M.D.Walter Colón, D.M.D.William McFatter, D.D.S.e. Lynn McLarty, D.D.S.Jim McSoley, D.M.D.Lawrence pijut, D.M.D.Frank Swerdzewski, D.D.S.James Sykes, D.M.D.Jay Walton, D.D.S.Lawrence Weaver, D.D.S.ronald Willis, D.M.D.ed Zapert, D.M.D.

FACILITIESaffordable Denturesanesthesiology associatesbeachton Denture ClinicCapital regional Medical CenterDermatology associatesDesloge home OxygenLeon County Dental Clinicpathology associatesradiology associatesSeven hills Surgery CenterSoutheastern Surgery Centertallahassee Diagnostic imagingtallahassee endoscopy Centertallahassee health imagingtallahassee Memorial healthCaretallahassee Orthopedic and Sports physical therapytallahassee Outpatient Surgery CentertMh Family Medicine residency programWomen’s imaging Center

ThANK YOU!

The We Care Network strongly encourages our volunteer

physicians and dentists to send their value of donated

services to us. The value of donated services is important

for us to share with our funders and the community.

You can send your value of donated services via fax to

Monica Demott, R.N. at (850) 201-0085 or mail to 1204

Miccosukee Road, Tallahassee, FL, 32308. Thank you!

Please contact Monica Demott, R.N. at [email protected] or 201-0130 if you are a We Care volunteer and you provided volunteer

specialty care in the month of December 2014 and your name is omitted.

To our CMS members and We Care partners who saw new patients for the We Care Network in December 2014.

Your generosity and support of the We Care Network

makes a difference.

During The MonTh of DeCeMBer, The We CAre NetWork:

RECEIvED 76 REfERRALS, WITh 57 PATIENTS NEW TO

ThE PROGRAM

SChEDULED 67 APPOINTMENTS WITh vOLUNTEER PhYSICIANS

AND DENTISTS

$170,293 in donAted CAre WAS REPORTED BY WE CARE

vOLUNTEERS

anne ananga, arnp

Viralkumar bhanderi, M.D.

Faith blocker, arnp

Daniel breivogel, arnp

tim broeseker, M.D.

acquinonette bryant, M.D.

Viet bui, M.D.

Kendall Campbell, M.D.

Joseph Camps, M.D.

Jeffrey Crooms, M.D.

Lysmar Dinguis, M.D.

Susan Dunbar, arnp

Cynthia evans, arnp

tanya evers, M.D.

elizabeth Fajer, M.D.

anneka gaffney, arnp

Judy griffin, arnp

richard henry, M.D.

hantz hercule, M.D.

Susan horton, arnp

iman imanirad, M.D.

Simha Jagadeesh, M.D.

eve James-Wilson, D.M.D.

David Kahn, M.D.

Marta Klisinska, M.D.

esaias Lee, M.D.

Kurt Luhmann, M.D.

J. true Martin, M.D.

helen nitsios, M.D.

Whit Oliver, M.D.

rose Origa, arnp

paresh patel, M.D.

adrian roberts, M.D.

William Sawyer, M.D.

hardeep Singh, M.D.

alanna Steaple, arnp

nina Sumlar, M.D.

Christopher Sundstrom, M.D.

Frank Swerdzewski, D.D.S.

tallahassee Va Clinic

Marianne towler, arnp

Jeffrey Wasserman, D.O.

Quandra Whaley, arnp

Donald Zorn, M.D.

We thank our referring providers from

December 2014:

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14 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS fOUNDATION

We thank the following people who made a donation to the CMS Foundation:

In HonorJerry Harris, M.D. – in honor of Nicole Balmer, M.D., Anthony Clark, M.D., Marc Fisher, M.D., Lisa Flannagan, M.D., John Mahoney, M.D., Charles F. Manning, Jr., M.D., Nola Munasifi, M.D., Margaret Havens Neal, M.D., Christopher Price, M.D., Steve Sarbeck, M.D., Stephen Sgan, M.D., David Stewart, M.D., and Kenneth Whithaus, M.D.

In MemoryBarbara Johnson – in memory of Robert P. Johnson, M.D.

For the CMS FoundationCharles A. Frueauff Foundation

For the We Care NetworkAnonymous – for the We Care Dental Network Charles A. Frueauff Foundation Charles F. Manning, Jr., M.D.

For the We Care Network Year end AppealRay Bellamy, M.D. C. Raymond Cottrell, M.D. Ron Saff, M.D. David Stewart, M.D.

For ScholarshipsCharles F. Manning, Jr., M.D. Kenneth Wasson, M.D.

For CMS Foundation endowment Fund Lenox Family Limited Partnership John Mahoney, M.D. J. Brian Sheedy, M.D. – in memory of Jack MacDonald, M.D. David Stewart, M.D.

Along with their annual dues payment: C. William Applegate, M.D. Myrle Grate, Jr., M.D. Valerie Lazzell, M.D. James Patty, M.D. Drew Williams

DONATE TO ThE CMS fOUNDATION

WE ThANK OUR DONORS

The mission of the Capital Medical Society Foundation is to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified.

Reasons to Give: Funds raised by generous donors benefit the We Care Network. The We Care Network is a past

Blue Foundation Sapphire Award winner and its

impact on the community is featured in the Sept/

Oct 2014 issue of the Tallahassee Magazine. The

We Care Network provides over $5 million in

donated specialty medical and dental care to

the community’s low-income uninsured annually.

In addition, donations support medical school

scholarships for first and second year students at

FSU College of Medicine committed to returning to

NW Florida after completion of their residencies.

In 2014, $40,000 in scholarships were awarded to

nine FSU College of Medicine students.

Gifts to Honor and in Memoriam:You can make a donation to the CMS Foundation

in memory of someone who has passed away or

in honor of someone, such as a fellow physician

you hold in high esteem or has taken care of you

or your family. CMS will send an acknowledgement

letter to those you memorialize and honor.

How to Give:Through the generosity of donors, three funds have

been created in order to establish financial stability

to meet our mission. You can donate any time to

one of CMS Foundation’s funds.

1) The CMSF Endowment

2) The We Care Network Endowment

3) The Scholarship Fund

Checks should be made payable to the CMS

Foundation and indicate on the memo line of your

check to which fund you would like to donate.

Bring your check to the CMS Office or mail it:

Capital Medical Society ~ 1204 Miccosukee Road ~

Tallahassee, FL  32308.

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 15

MEDICAL/LEGAL

Nearly 30 million children and adults in the United States

have diabetes, and another 86 million Americans have

prediabetes and are at risk for developing type 2 diabetes.*

Because diabetes has the potential for serious complications

and requires immense involvement by patients and physicians

for successful outcomes, healthcare professionals who treat

diabetic patients may be at risk for malpractice lawsuits.

In a study of claims closed from 2007 to 2013, The Doctors

Company identified four common allegations made by

patients with diabetes: improper management of treatment

(37 percent), failure or delay in diagnosis (31 percent),

failure to treat (9 percent), and improper management of

medication regimens (6 percent).

Diabetic patients’ treatment is often managed by a

multidisciplinary care team, which may include a primary

care physician, endocrinologist, dietician, ophthalmologist,

podiatrist, and dentist. When patients file claims, it’s not

uncommon for them to name the entire care team in the

complaint, alleging failure to properly diagnose, supervise,

monitor, and/or treat their disease.

To promote patient safety, the healthcare team should

engage the patient in collaborative care planning and

problem solving to produce an individualized care plan

as well as team support when problems are encountered.

Other ways to promote patient safety and mitigate the risk

of malpractice claims related to diabetes care are:

• Communicate. Talking openly with diabetic patients

about their condition and encouraging them to take an

active role in decision making enhances patient safety.

- Overcome patients’ fears about their disease by

taking time to answer questions.

- Discuss all associated risk factors, including weight

gain. As obesity and diabetes rates continue to increase

in the U.S., it is worthwhile for physicians to recognize

their own barriers to such communication and seek

assistance. The American Medical Association and

American Diabetes Association have resources available

to help physicians talk to their patients about weight

and diabetes. Primary care physicians can refer their at-

risk patients to a diabetes educator for more information

on how to successfully manage their condition.

- Provide written instructions and information about

adverse effects for prescription drugs and complex

prescription drug regimens.

- Communicate with the patient and prepare written

information in the language and at the literacy level

that the patient understands.

- Ask patients to repeat the information shared, not

just whether they understand what they have been told.

• Educate. Educate patients about the importance of

self-management to help increase their compliance and

to reduce the risk of patients attributing their injuries

to substandard care. Diabetic patients should be able

to articulate the importance of lab tests, medication

management, diet, and exercise. Barriers to self-

management such as financial issues or lack of social

support, healthcare literacy, and patient-caregiver

relationships should be assessed.

• Document. Document any and all patient interactions

and discussions regarding the patient’s condition, including

diagnosis, specialist referrals, and treatment options.

• Manage care. Implement a program that ensures

timely follow-up when a patient fails to schedule

an appointment, misses an appointment, or cancels

an appointment and does not reschedule. Failure to

follow up and provide intensive patient management

can lead to missed or delayed diagnoses, accelerated

disease symptoms, morbidity, and/or mortality.

COMMUNICATION IS KEY TO IMPROvING DIABETIC PATIENT OUTCOMES AND REDUCING LIABILITY

Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.

Susan Shepard, MSN, RN, is the director of patient safety education at The Doctors Company. She earned a master’s degree in nursing administration from Medical Colleges of Virginia–Virginia Commonwealth University, a master of arts degree in management from Webster University, and a bachelor of science degree in nursing from St. Louis University.

Reference *American Diabetes Association. American Diabetes Month®. http://www.diabetes.org/in-my-community/american-diabetes-month.html. Accessed September 17, 2014.

By Susan Shepard, Director, Patient Safety

Education, The Doctors Company

CMS

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