Newsletter 97 February 2008
Contents
Malpractice Filings
Against Health Care Providers, Jan 2001 – Dec 2007
A
CALL FOR DELEGATES TO THE NSMA ANNUAL MEETING
Southern Nevada
Health Officer Report
THE DOCTOR IS NOT IN
by Donald C. Mohs,
Jr. MD
Many of you, particularly those of you who are primary care physicians who admit patients, ER doctors, hospitalists, and those of you involved in hospital administration, have noted how difficult it has been of late to obtain emergency room or inpatient specialist consultation. Particularly, some specialty consultations, such as Otolaryngology (Ear, Nose and Throat), are extremely tough to procure. Why?
There are
many reasons, and as an Otolaryngologist practicing in
I won't lie and say it doesn't help. The factors involved in the reluctance of specialists to see hospital and ER patients are both economic and non-economic, however. Let's address the non-economic issues first, although they really are intertwined with the economic ones. (I will do this at the risk of sounding like I'm whining, but that risk is present anytime somebody lists problems that concern them.)
I remember, not too long ago (I like to think of myself as not that old) that hospital floors had separate, private, well-stocked examination rooms. A doctor attending to a hospitalized patient had the luxury of bringing that patient from his or her room into this dedicated exam room, with a proper examination table, working otoscope, working ophthalmoscope, and tongue blades, etc. There was privacy, cleanliness, a sense of professionalism, and hospital floors had enough nurses to even allow one to be present to assist the consultant in any minor procedure that had to be undertaken in that room. This scenario appears to have been relegated to the days of Marcus Welby.
Now, when a specialist gets a consultation request to see a patient, it is invariably at the patient's bedside, and I, personally, would feel better equipped if I had seen the patient in his own bed at home.
This is a problem that is especially acute for ENT's, as we are a very equipment-oriented specialty. To do the patient justice, to render an adequate consultation, the otolaryngologist has to essentially carry his office with him to the patient's bed. Otoscopes may or may not be available at the nurses' station. When they are, they often have dead batteries, or lack the proper disposable specula. To obtain the simple, ubiquitous wooden tongue blade requires the finding of a nurse (with interruption of her or his duties) to enter a secret code to access a clean utility room. Ditto for sterile gauze, or even band-aids. I usually hope I get everything I need from that sacred utility room the first time, lest I have to find the nurse again to repeat the process for an item I had forgotten.
Often, specialists have to perform minor (or even not so minor) procedures at bedside on a patient for whom they are consulting. This can be quite an onerous undertaking, as very little support with regard to equipment, supplies and nursing assistance is available right away. Hence, if an otolaryngologist is called to see a patient with a nosebleed, he may have to carry his own nasal endoscopy gear (including fiberoptic light source), and cautery supplies, nasal suctions (the large Yankauer suctions in the clean utility room just don't fit very well up somebody's nose) and nasal packing supplies, and even topical and local anesthetics. Lugging this stuff into the hospital isn't fun (I once remember doing so, crossing the hospital parking lot while wearing a suit at noon in July and arriving at the patient soaked in sweat. Thankfully, my light source is not so heavy now). Any specialist bringing expendable supplies to the hospital costs the practice money that will not be reimbursed. Finally, bringing in fragile equipment from the office also subjects it to breakage or loss, and nasal endoscopes run into the thousands of dollars to replace.
An alternative to this is to call ahead to the nurses' station and ask that all of the proper supplies be brought up from the OR. This, too, is problematic, as many of these supplies are obtained for me by folks that don't regularly use them, and often the wrong supplies are present at the bedside (if they had even arrived there by the time the specialist does.)
This is in contradistinction to when a patient is seen in the office. An otolaryngologist usually has most of the equipment necessary to do evaluations and procedures quickly and efficiently, including some things that just can't be obtained at the hospital, such as a hearing test.
Now, other than being inconvenient to the doctor, why is this scenario an issue? Remember I said that the non-economic issues were tied with the economic ones; a typical patient with a nosebleed might be quickly cared for in the office within 15 minutes. To perform a consultation on a patient in the hospital can take well over an hour, if not hours, especially when travel time to and from the hospital is taken into account. When Medicare is involved, inpatient consultations are often non-reimbursable when done on the same day as an inpatient procedure; an hour of work can be thus relegated by the government as being performed by the specialist gratis.
Actually, that hour of work is not for free-it may cost the consultant money. If the inpatient consultation is done during regular working hours, the specialist may have to forgo seeing patients in the office for the time that it takes to do the consultation. All the while, the office continues to accrue overhead that is not being offset by the relatively low level of income generated from the consultation.
There are
many other non-economic factors that have led to the avoidance of hospital work
by specialists. The rise of specialty
surgical hospitals or same-day surgery centers has taken away some of the sense
of affiliation that specialists may once have had with inpatient medical
facilities. Hospitals have burdensome
rules and piles of paperwork that needs to be fulfilled in order for a
specialist to perform the exact same procedure that could be performed with
less hassle in an outpatient surgery center.
This isn't the hospital's fault; blame the federal government, and its
heavy-handed implement, JCAHO. Unlike
hospitals, same-day surgery centers don't send out biweekly letters threatening
damnation by HIM (no not a deity, but Health
The federal government also inadvertently took actions to sever ties between specialists and hospitals when the Stark laws were passed. I'm no expert, and I defer to our esteemed Clark County Medical Society President, Dr. Don Havins, for more detailed analysis, but my take on these laws was that they were passed with the intention of curbing self-referrals for the purpose of doctor enrichment; but they also prevented hospitals from giving perks or special treatment to affiliated consultants. Such perks included breaks on rent for hospital-associated medical office space. When hospitals were prevented from giving its consultants special treatment, the consultants in turn began to feel no obligation to render special treatment to hospitals.
Another trend that tended to alienate specialists from hospitals is the rise of the use of hospitalists. There is nothing inherently wrong with hospitalists, and I praise them for practicing medicine on tough, complicated patients in the ideal manner I learned in medical school. The problem with the relationship between hospitalists and specialists is purely economic. For a specialty such as otolaryngology, the most income generation due to patient encounters is from outpatient referrals. That is, insurers pay the most for those patients who are seen in the office as a result of a primary care doctor asking the specialist for them to be seen. Let's say a specialist sees a large number of patients per week from a certain family practitioner; if that family practitioner also admits patients and wants an inpatient consultation on one of them, you can be sure that the specialist will honor the request-even for an uninsured patient. This is just business. Specialists will be unwilling to alienate a good referral source by not seeing that doctor's inpatient (unless the specialist is otherwise uncomfortable with the particular problem). When a hospitalist admits a patient, he has no leverage with the specialist: in essence, no pool of outpatient referrals to promise to him in the future. As was mentioned before, inpatient consultations often cost a specialist rather than profit him.
This may
appear to be a harsh, brutal truth, but one that needed to be said. I know plenty of hospitalists, and in part I
write this article to apologize to them, and to explain to them why it's been
tough to get an ENT (or some other specialist) in
We seem to have progressed more into the economic issues that stand between a hospital and access to specialty consultation. Let's continue then.
Much has
been made about the dwindling number of primary care physicians out there, and
the fact that they get paid too little for what they do, especially by
Medicare, and especially in relation to specialists. The perception is that
procedure-oriented specialists are overpaid; nothing is further from the
truth. Otolaryngologists are reimbursed
more for seeing an hour's worth of patients in the office (essentially acting
as an ENT-primary care) than performing an hour's worth of surgery,
particularly when "global periods" of non-reimbursable post-op care
are considered. High overhead costs mean
that private practice ENT's operate with a fairly narrow margin. Substitute the words "inpatient
consultation" for "surgery" and you can see why few
otolaryngologists really want to see hospitalized patients. The prevailing
insurer in
Another economic factor is the increased liability inherent with seeing emergency room patients or very sick inpatients. In the ER, there can be little or no time for development of patient rapport; in the event of a negative outcome, the patient or the patient's family may not have even met the consultant, and may have no compunction against lawsuit. Another factor is the tendency for malpractice attorneys to take a "shotgun" approach to filing lawsuits. As an example: an inpatient has an adverse event such as an MI, and subsequently sues; if a consultant's name is on the chart (even if all he did was clean earwax from the patient), he will be named in the suit, not as an act of extortion, but to remove from the defending attorneys a so-called "empty chair" defense. (Well, it can be an act of extortion too). Recent tort reform measures may have ameliorated this factor, but it's too soon to tell what effect this will have on the willingness of specialists to see inpatients.
There are probably multiple other factors that play a role in the way physicians practice nationally, not just in Las Vegas, and these are too numerous and complex to go into great detail. Loss of physician prestige and autonomy means that physicians in general are not willing to sacrifice (i.e., come into the ER in the middle of the night) for a public less and less inclined to appreciate the value of their sacrifice; insurers continue to ratchet down reimbursements such that doctors are emphasizing having a good lifestyle rather than working harder for diminishing returns. Of course, there is always the debate about who is responsible to care for uninsured patients.
I'm sure there are personal reasons inherent to each and every one of the specialists who have made the personal (and believe it or not, agonizing) decision not to honor the request for some inpatient consultations or take ER call. We are healers after all, and do what we do for reasons that are not altogether economic. The forces that have changed medicine are, however, economic, and since we physicians are denied certain avenues of redress, such as collective bargaining, we often have no choice but to vote with our feet.
I don't pretend to have an answer to this issue. Improved Medicare and insurance reimbursement rates may help, but who really sees that happening? Anyone proposing a mandate that specialists (who are private contractors) see ER patients and inpatients or else be penalized by the government needs to read Atlas Shrugged to see just where that will lead. Attempts by hospitals to simply deny privileges to specialists who don't take call will just have an emptier roster of physicians on staff.
As one final note: this work represents my own opinion, and is the product of my own observations. It is in no way produced by a collective discussion among specialists, lest a hospital administrator or insurer accuse someone of collusion in deciding not to take ER call (as has been done before). Conditions are bad enough and getting worse such that independent practitioners have come to this in and of their own accord.
President’s Message - February
Payment for Physician On-Call Coverage in Hospital
Emergency Departments
By Weldon (Don)
President,
Many physicians are concerned about the legality of receiving compensation for on-call hospital emergency department rotations. The concern rests on the possible violation of two established federal laws. The first is the Federal Self-Referral law (known as the Stark laws) and the second is the Federal Anti-Kickback statute. This article will discuss these two federal laws both of which appear to prohibit on-call hospital remuneration. The article will then discuss a recent opinion of the Office of Inspector General (OIG) of the Department of Heath and Human Service which, under specified circumstances, clearly permits on-call hospital remuneration.
The Federal Self-Referral prohibition statute (Stark law) prohibits a physician from making referrals of Medicare patients to entities in which the physician has an "ownership interest" or "an investment interest" or with which the physician has a "compensation arrangement," unless an exception applies. The prohibited referrals applies to the physician and certain specified relatives. The prohibited referrals apply to designated health services, which include clinical laboratory services, radiology and imaging services, parenteral supplies, outpatient prescription medications, radiation therapy services and supplies, physical therapy, durable medical equipment supplies, occupational therapy, speech language pathology services, and home health services. Under the Stark law, "financial relationship" includes any direct or indirect interest, or any compensation interest, which includes any form of remuneration from a health care entity to a physician. Almost every service an on-call physician would provide in an emergency department would fall under the definition of a designated health service. Under Stark laws, hospitals cannot provide financial incentives to physicians for designated health services unless a recognized exception to the law applies.
The "personal services" and "fair market value" exceptions to the Stark law appears to permit hospitals to pay physicians for services furnished personally by a physician or associated physician in the same group practice as the referring physician. The payments must be limited to "fair market value." "Fair market value" under Stark is limited to “the value in arms length transactions consistent with the general market value” while paying fair market value to physicians to provide on-call coverage is permissible under Stark, fair market value does not generally provide sufficient incentive for physicians to provide on-call coverage and alleviate physicians' concerns about uncompensated care, increased liability exposure, and disruption of lifestyle.
The Antikickback Statutes make it a felony to knowingly and willfully solicit or receive any remuneration, directly or indirectly, in cash or in kind, to induce someone to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under Medicare and/or Medicaid program. A violation of the Antikickback Statute is punishable by a fine of not more than $25,000 and/or imprisonment of not more than five years. In addition to the criminal statute, Medicare law and regulations permit an individual to be excluded from ongoing participation in federal health care programs for violation of the Antikickback Statute. The law also permits the imposition of additional civil monetary penalties if the office of Inspector General finds that an individual or provider has committed any act which would constitute a violation of the Medicare Act. Fear of the draconian sanctions has convinced some physicians that contracting for payment for on-call services is not worth the risk. Likewise some hospital administrators have concluded that the risks of being found in violation of one of these two laws does not justify implementing a compensated ER on-call program. Clearly, excessive contractual payments and greater than fair market value payments to physicians to induce them to provide care and perform tests and procedures paid under a federal health care program constitutes a violation of the Antikickback Statute.
On September 20, 2007 the US Department of Health and Human Services, Office of the Inspector General (OIG), issued its first advisory opinion regarding the permissibility of a hospital paying physicians to provide on-call and indigent care services. The OIG wrote that under certain conditions and circumstances paying physicians to provide emergency room call is permissible. The OIG reviewed an on-call program at one hospital to determine if it violated applicable federal law. That program applied to medical and surgical specialties represented on the hospital's medical staff wherein the hospital agreed to pay specialists for taking part in a rotational call schedule in the emergency room which bound specialists to respond to emergency room calls within specific time frames. The hospital required specialists to provide inpatient follow-up care to any patient seen in the emergency room while on-call if the patient was admitted to the hospital, regardless of the patient's ability to pay. On-call physicians must provide consultative services to hospital and emergency room patients of other physicians while on-call, and complete medical records in a timely manner for patients seen under the program. The OIG determined that the program did not violate applicable federal law. In particular, the OIG noted that the hospital monitored on-call response times to ensure physicians were actually providing the coverage needed, periodically assessed the quality of care delivered, and terminated arrangements with physicians who failed to comply with the program's requirements.
Detailed legal analysis of the OIG opinion revealed that the program should be open to all physicians in relevant specialties. The program should distribute the on-call responsibilities among all physicians within the specialty. The program should obligate physicians to provide inpatient follow-up care of all patients seen in the emergency room regardless of the patient's ability to pay, and the contract for on-call services should include the provision for gratuitous care for the entire hospital stay of the patient unable to pay for services. The hospital should also document the need to pay physicians to provide call coverage and detail the historic difficulties of obtaining sufficient call coverage. The program's compensation should be based upon the burden on a physician and the likelihood that a physician in a particular specialty will actually be required to respond while on-call, as well as the likelihood that the physician will be required to provide uncompensated medical care.
The sources for this article are:
1. Meredith L.
Borden, Esq., A Resolution to the Issue of Paying Physicians to Provide Much
Needed On-Call Coverage, The Health Lawyer, Volume 20, Number 2, December 2007.
2. OIG - HHS Advisory
Opinion No. 07-10 (2007).
3. Lara Carney, Esq., OIG Advisory Opinion 07-10, On-Call Compensation, Healthcare Law Alert, Hanson Bridgett, October 2007.
Clark County District Court Medical Malpractice Filings
2001 2002 2003 2004 2005 2006 2007
Jan 39 33 108 61 41 50 109
Feb 20 14 98 72 63 61
41
Mar 35 30 169 123 64 38
70
Apr 37 34 111 81 70 58
60
May 37 35 126 65 14 71
84
Jun 27 24 103 90 65 83
56
Jul 19 100 114 45 66 74
84
Aug 54 51 76 67 33 82
74
Sep 20 65 105 79 36 51
62
Oct 37 83 110 59 26 74
78
Nov 38 184 59 78 73 50 53
Dec 9 170 67 47 30 28
53
Sum 372 823 1246 867 581 720 824
Member News
Congratulations and Welcome to the
·
Miriam E
Bar-on, MD – Pediatrics,
·
Rita Bella
Chuang, MD - Family Practice, 2629 W
Horizon Rdg Pkwy 140, Henderson, NV 89052
·
Elizabeth
Hamilton, MD - General Surgery, 10001 S
Eastern Ave 200,
·
Krystal H
Pham, MD - Internal Medicine, 3121 S
Maryland Pkwy 502, Las Vegas, NV 89109
·
Mary T Thomas,
MD - Physical Med/Rehab,
Congratulations and Welcome to the
·
Mohammad A
Javed - UNSOM
Welcome Reinstated Members:
·
Oscar Batugal,
MD
·
Gregory P Gex,
MD
·
Rosemary Y
Hyun, MD
·
Thomas Kelly,
MD
Applicants to Go Before Credentialing Committee
· Andrew
Eisen, MD - Pediatrics
· Michael Her,
MD - Internal Medicine
· Frederick
Tanenggee, MD - Internal Medicine
·
If you have any pertinent information about the
membership candidates listed above, please contact:
For
information on becoming a member of the
Alliance
By Wendy Agrawal & Estela Hansen, 2007-08 CCMS
Board of Trustees Meeting Minutes Synopsis
December 18
, 2007
I.
Call to Order - The meeting was called to order by Dr. Havins at
II. Action Items
A. Minutes from the November 20, 2007
meeting were unanimously approved.
B. Financial report was presented by Dr.
Steinberg:
§
General Revenue – Actual for 5 months of Fiscal
Year 2007-08 is $309,850.39 compared to $306,614.77 in Fiscal Year 2006-07 for
an increase of $3,235.62 over last year at this time.
§
Operating Expenses – Actual for 5 months of Fiscal
Year 2007-08 is $171,786.12 compared to $151,584.20 for an increase of
approximately $20,201.92 over last year at this time.
§
Overall,
for the first five months of our fiscal year, revenues exceeded our expenses by
$138,064.27. The bank balance for the
end of November was $625,583.96 compared to $547,678.14 last year at this time.
III. Committee Reports - Dr. Adashek presented the Membership Report:
§
As
of November 30, 2007, total dues-paid membership is 620, compared to 586 last
year at this time. This is a net
increase of 34 members.
§
Total
CCMS members is 906, including 197 dues exempt members.
§
There
are 20 new members, 0 new student members and 6 reinstatements in the Fiscal
Year 07-08.
§
There
are 88 Student members in the Fiscal Year 07-08.
Credentials Committee Report - Janice Poblete presented the
Credentials Committee Report. Members
were unanimously approved.
|
Applicant Names |
Specialty |
|
Miriam Bar-on, MD |
Pediatrics |
|
Rita Chuang, MD |
Family Practice |
|
Elizabeth Hamilton, MD |
General Surgery |
|
Kenneth Mooney, MD |
Internal Medicine |
|
Krystal Pham, MD |
OB-Gyn |
|
Mary Thomas, MD |
Physical Med/Rehabilitation |
|
|
|
Reinstated Members Student
Members
Oscar Batugal, MD Mohammad
Javed, UNSOM
Gregory Gex, MD
Rosemary Hyun, MD
Thomas Kelly, MD
C.
Community
Health/Community Relations Committee (reported out of sequence) - Dr.
Teijeiro presented the report.
§
Several
meetings have been conducted with a focus on providing healthcare for the
uninsured.
§
The
committee discovered several people in the community who are working on similar
projects.
§
Dr.
Abdulla has written a proposal for a pre-natal health care program.
§
A
meeting has been scheduled for January 8, 2008 to bring all parties together
for a collaboration meeting. The guests
will present their projects, and Dr. Mabey has been invited as well to
participate.
§
Dr.
Havins will email the Legislative Council Bureau guidelines for using the
monies designated for the pilot project to develop a non-profit clinic. The monies have to be used by June 2009.
D.
Remodeling
Committee -
Dr. Fathie was not present; therefore, no report was given.
§
Dr.
Havins stated that Kevin Buckley of First Commercial and Ben Cornwall of Crisci
Builders visited the facility this past week at Dr. Jones request.
§
Mr.
Buckley belives the property is worth approximately $1 million, with values
accelerating in the next three years due to the airport expansion. Several building options were discussed,
however, CCMS would be trading a building for debt and property taxes.
§
Ultimately,
Ben Cornwall’s (developer) opinion was that he would spend up to $40,000 in
cosmetic improvements, and keep the property for at least three years.
§
Nancy
Sommer asked Ben Cornwall (developer) if we would be throwing our money away by
improving the aestetics, to which he replied “absolutely not”.
§
Dr.
Havins stated that the Remodeling Committee will continue to develop a proposal
for cosmetic improvements.
IV.
V.
VI.
§
Dr.
McDonald designated Dr. Bar-on to represent UNSOM who provided an update.
§
The
medical school class size has increased to 62 students in the freshman class.
§
Graduates
are receiving top-notch residency programs.
§
Within
the next 4 weeks early matches will be performed for Neurosurgery ENT, Urology,
Orthopedics and Ophthalmology, along with military matches.
§
The
residency re-accreditation process for internal medicine, geriatrics and
internal medicine in the south will begin in 6 months.
§
Dr.
Evins commented that all residents in the medicine program, both internal
medicine and family practice passed their boards, and that 90% of the other
residents passed their boards.
VII.
Touro University
§
Met
with Dr. Trevisan several times regarding collaboration.
§
The
35,000 additional square feet build-out is almost complete. The addition will include the first
§
Touro
will be graduating the first class of DO students in May 2008; hoping to
develop more graduate medical programs so they can keep some of them in the
state.
§
In
the process of hiring a developmental psychologist, pediatric neurologist and
other key personnel to staff the center.
§
Starting
a new practice plan – moving to an electronic (paperless) record keeping system
within the next 90 days.
VIII.
Scholarship Fund Report - Dr. Ellerton was not present;
therefore no report was given.
IX. NSMA Report - Larry Matheis presented the report:
§
Regulatory
process – everyone is very busy with trying to get all the regulations written
within the next three months.
§
A
meeting was held Friday (December 14) on the J-1 Visa waiver issue – they have
a long way to go to resolve the problem.
§
Medicare
– a deal was cut today for a 6 month .5% increase. By July they have to decide if the 10% cut
goes into effect. The only cuts were
from “other services”. The Senate passed
the bill unanimously. The PQRI bonuses
were cut.
§
SCHIP
program was reauthorized at a higher level, but lower than the House Bill. The extension is through March, 2009.
§
Budget
cuts at state level have not been announced. The largest cuts are going to come from the
Department of Health & Human Services budget, or K-12 and university
systems. Physician payment increases
scheduled for June are probably on the table.
§
Today
(December 18), it was formally announced that
IX.
MedPAC Report - Dr. Evins presented the report.
§
MedPAC
is planning a Board meeting in January.
An email will be sent shortly with possible meeting dates.
§
Elections
will be held in April for the 2008-09 fiscal year.
§
The
CCMS BOT will appoint four people to the Board, which should be determined in
February, 2008. Anyone who is interested
in serving on the MedPAC board should contact Dr. Havins or Dr. Evins.
X.
AMA Report - Drs. Horne and Nelson were not
present; therefore, no report was given.
XI. NBME Report - Dr. Rodriguez was not present;
therefore, no report was given.
XII.
President’s Report
§
United/Sierra
Merger Update
®
Dr.
Havins asked Larry Matheis to provide an update.
®
In
a conversation with the AMA yesterday, it was determined that, in the event
that the Attorney General exercised the option to file an anti-trust suit in
the Federal court, the AMA is prepared to take the lead on filing on behalf of
our coalition. At that point the AMA
will be willing to pay all the costs for retaining David Balto and using their
litigation team, with Balto being the leading anti-trust expert.
®
Our
current contract for pre-litigation services would be terminated if the
anti-trust suit is filed.
®
The
AMA stated that the medical members of the coalition would be required to
provide $5,000 annually (each entity, i.e., NSMA, CCMS). Without the coalition’s commitment to pay the
AMA $5,000/each annually, the AMA will not pursue the case.
®
Dr.
Jameson made a motion for CCMS to commit to $5,000/annually to the AMA to
support the anti-trust suit. Dr. Jones
seconded the motion.
®
After
much discussion the BOT voted/passed the motion.
§
Christmas
Eve
®
The
BOT authorized the staff to have Christmas Eve day off with pay and New Year’s
Eve ½ day (1:00 pm to 5:00 pm) off with pay.
XIII.
XIV.
New Business
§
Dr. Evins
suggested that Dr. Lenhart be added to the BOT Agendas to provide a report on
the Nevada Health Sciences System. A motion was made/passed to add Dr. Lenhart
to the Agenda.
§
Dr. Trevisan was
invited and accepted an invitation to be present at the January, 15, 2008 BOT
meeting.
§
Birthday
Celebrations – Dr. Havins and Dr. Evins celebrated birthdays in December. CCMS provided them with a lovely CCMS tie and
coffee mug.
XV.
Old Business -None to report.
XVI.
Future Meetings - Next meeting is scheduled for Tuesday, January 15,
2008 at
XVII.
Adjournment - Meeting adjourned at 6:50 pm.
Attention All Members:
Board of Trustees Elections are Upcoming
The Nominating Committee's slate for the 2008-09 Board of Trustees will be mailed to the entire membership in March.
If you are interested in becoming a nominee, please inform a member of the Nominating Committee or CCMS staff at 739-9989 as soon as possible.
2008 Nominating Committee
George Alexander, MD 702-242-6776
Warren Evins, MD 702-383-3600
Edwin Kingsley, MD 702-952-3400
Ron Kline, MD 702-732-0971
Rhonda Robbins, MD 702-734-9664
Carol Vanderharten, MD 702-733-3771
Per the CCMS bylaws, the committee must choose their slate from physician members having two or more years membership. If you are not on the Nominating Committee’s Slate, you can still be nominated by any voting member. Your endorsement must bear the signature of 4 voting CCMS members in good standing. All nominations must be submitted in writing before April 15, 2008.
A CALL FOR DELEGATES TO THE NSMA ANNUAL MEETING
By Mitchell D. Forman, D.O., FACR, FACOI,
FACP
CCMS Delegate Chair
Don't be a victim of complacency
& inertia. Don't let others decide
the fate of our healthcare system. Be a
part of the process that creates positive change in the healthcare of
Opportunity, challenge and
collaboration have defined my experience since relocating to
The NSMA's 104th Annual Meeting at
the Embassy Suites in
By becoming a Delegate or Alternate
Delegate, you have decided to become a force for positive change. You have decided to take personal
responsibility for the health of our communities and
CCMS Delegates will meet In February and March to discuss and prioritize issues for discussion at the NSMA Annual Meeting and to select CCMS' nominations for the NSMA Community Service Award recipient and the recipient of the Distinguished Physician Award. The registration fee for the Annual Meeting will be reimbursed by CCMS if you are present for the required roll calls . I encourage interested members of the CCMS who desire to be Delegates to contact me or the CCMS as soon as possible.
CME Calendar
AHEC 318-8452
x 258
Online - "Domestic Violence and Medical Ethics"
Bechtel
NV Cancer Institute 822-5290
Jan 4 - “Tobacco Control, Health Eating & Obesity Prevention”
NV Chapter AACE 434-8400
Pri-Med Institute (877)
4PRI-MED
Sierra Health Services 242-7735
Southwest Medical Associates 242-7735
Feb 1 - “Neurovascular Case Discussion”
1.5 CME Credits
Feb 15 - “Pulmonary Embolism” 1.5 CME Credits
UMC
383-2604
Feb 1 - “Pediatric Pain Management”
Feb 8 - “Optimal Type 2 Diabetes Management: Utilizing the New Compounds with Established Agents”
Feb 29 - “Therapeutic Hypotherma after Cardiac Arrest”
Education Opportunities for Practice
Managers 697-5471
ext 134
Call the NV Medical Group Management
Association
Only CME Activities held at the Clark County Medical Society office are specifically endorsed by CCMS.
Southern Nevada Health District Report
Health
District offers information and activities to improve the public's health
By
Southern Nevada Health District
The Southern Nevada Health District is kicking off the New Year by not only providing Clark County residents with updated information on their health status but also providing them with the tools and incentives they need to improve their health through its new Get Healthy Clark County Challenge.
The
Clark County Health Status Report Supplement 2007 is the third in a series of
reports produced by the health district on health-related statistics. The most
recent volume provides data on the occurrence, prevalence, patterns and trends
of selected measures of health and well-being of
The report includes information on self-rated health status, physical and mental health, access to care and selected health risks and chronic health conditions. Key highlights related to physical activity and nutrition from the supplement include:
- About one in two county adults did not undertake physical activities at levels recommended for health benefits, including about one in four who reported no leisure time activity or exercise at all.
- More than one-third of county adults aged 65 years and older did not engage in leisure time physical activities.
- Lack of insufficient physical activity was more frequently reported among county adults of fair or poor health status than those of good or better health status.
As part of the health district’s commitment to improving the health status of the community staff not only assesses and reports on the population’s health, but also takes action based on the data by connecting the public to the resources they need to proactively improve their own health. The Get Healthy Clark County Challenge is one such initiative.
The challenge is a web-based program that offers a weekly challenge and tools to track progress during a 12-week period. Anyone interested in participating in the Get Healthy Clark County Challenge can sign up at www.GetHealthyClarkCounty.org. Each week, an e-mail “health challenge” is distributed. Each challenge encourages healthful living, such as a daily 15-minute walk or eating three servings of vegetables each day. The Get Healthy Clark County Challenge concludes the week of March 24. The site also includes information and resources for non-participants to adopt healthier habits and to keep their own resolutions.
The program promotes making good choices instead of restricting choices and emphasizes a varied diet and daily physical activity as key to a healthy lifestyle. The program is set up to allow participants to incorporate simple and easy healthy habits into their lifestyle rather than drastic changes.
The
For additional information on the Get Healthy Clark County Challenge, contact the Southern Nevada Health District’s Office of Chronic Disease & Health Promotion, (702) 759-1270 or visit www.SouthernNevadaHealthDistrict.org or www.GetHealthyClarkCounty.org.
The Clark County Health Status Report Supplement 2007 is also available on the district website at: www.southernnevadahealthdistrict.org/disease_factsheets/health_status_report.htm.
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