On September 10th I received a phone call from the columnist at the Las Vegas Sun asking about Senator Joe Heck, DO., and his record of voting against cancer patients and their treatment. I asked for some printed information before I could comment. I received a fax copy of a slanderous mailer declaring the Senator as “In it for himself” and accused the Senator of opposing cervical cancer screening coverage. The real issue was a complicated personal decision involving an adolescent or pre-adolescent female and payment by her parent(s) for the Gardasil vaccine. The vaccination is expensive and the insurance companies WOULD pass the cost on to their policyholders. The practical value of the vaccine has not yet been proven past a 10-year window.

The misleading mailers were sent, according to the article, with the agreement (if not the involvement), of Dr. Heck’s opponent, although no names were mentioned. One campaign consultant estimated the cost for the 3 mailers at $60,000. Apparently, the opponent’s political party did not have the confidence in their candidate’s ability to be elected on their own experience and qualifications. I think the mastermind of the smear campaign should step forward and accept responsibility for their work and stop hiding!!

It should be mentioned that J. Patrick Coolican and Brian Eckhouse from the Las Vegas Sun did an extremely fair and thorough job in their reporting.

Thank you to Senator Joe Heck for representing physicians, medicine and the interest of our patients.

Communication

Thank you to Antoinette Sparkuhl for this month’s article on the Best Defense is a Good Offense, describing communications between physicians and patients.

I am practicing listening more and speaking less.

Thank You

The CCMS Board of Trustees thanks Dr. Weldon “Don” Havins for the past 71/2 years of excellent service to CCMS and our physician members. Congratulations on your new position as Executive Director for the Nevada State Board of Osteopathic Medicine.

Top

HealthInsight to Assist Healthcare Providers Improve Quality and Safety of Care

Quality Improvement Organization Granted a Multi-Million Dollar Contract for Health Care Improvement

Las Vegas – On August 1, 2008 HealthInsight announced a new, three-year, $7.8 million contract with the Centers for Medicare & Medicaid Services (CMS), the federal agency of the U.S. Department of Health and Human Services that runs Medicare, to improve the quality of health care for every person in Nevada.

HealthInsight, the Medicare Quality Improvement Organization (QIO) for Nevada, provides free expert resources to healthcare providers in hospitals, physician offices, and nursing homes to improve the care they provide to their patients so that it is safe, effective, patient-centered, timely, and equitable. The new work with Medicare will build upon the successes HealthInsight and Nevada providers have achieved in recent years, and sets new joint goals.

“We look forward to continuing our partnership with CMS and Nevada providers in our mission to improve health care quality,” said Marc Bennett, president and chief executive officer for HealthInsight. “We have made progress in many areas, such as heart and pneumonia care, as well as reducing bed sores and physical restraints in nursing homes. But there is still work to do. Opportunity exists to help providers’ further improvement through QIO expertise and intervention,” he said.

Over the next three years, HealthInsight will work collaboratively with providers in these key areas:

• Improving safety for hospital patients. HealthInsight will provide assistance to eligible hospitals to improve care for heart failure and reduce surgical complications. Hospitals will also work to prevent methicillin-resistant Staphylococcus aureus (MRSA) infections and prevent and treat bed sores.

• Improving the quality of life for nursing home residents. With a new safety focus, nursing homes that are in the greatest need of assistance will have the opportunity to work with HealthInsight to reduce bed sores and the use of physical restraints.

• Helping doctors improve preventive care by using technology. HealthInsight will assist up to 16 primary care practices in using electronic medical records systems (EMR) to improve preventive care for breast and colorectal cancer, pneumonia and influenza.

• Ensuring patients receive safer prescription drugs. HealthInsight will work with physicians, pharmacists and prescription drug plans to reduce the use of drugs that are potentially harmful for seniors.

• Helping providers prevent and manage chronic kidney disease. HealthInsight will utilize existing collaborative efforts and develop new mechanisms to support a community effort in controlling chronic kidney disease.

For the first time, HealthInsight will be working with providers and stakeholders to detect the incidence and slow the progression of chronic kidney disease among Medicare beneficiaries. HealthInsight was one of 13 QIOs across the country selected for this endeavor.

“The government and consumers will continue to demand better quality from the health care system. The QIO program is dedicated to providing valuable expertise and assistance to help those who need it the most,” said Mr. Bennett.

HealthInsight, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, supports hospitals, physician offices, nursing homes, home health agencies, and health insurance purchasers in achieving healthcare excellence through a wide range of services aimed at improving quality and providing safe, effective, and efficient care. For more information or links to Medicare data and other resources, visit www.healthinsight.org.

This material was prepared by HealthInsight, the Medicare Quality Improvement Organization for Nevada and Utah, 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. # 9SOW- NV-2008-00-001

sss

Top

MedPac’s Endorsed Candidates List

Top

Clark County District Court Medical Malpractice Filings

2001 2002 2003 2004 2005 2006 2007 2008

Jan 39 33 108 61 41 50 109 64

Feb 20 14 98 72 63 61 41 77

Mar 35 30 169 123 64 38 70 3126

Apr 37 34 111 81 70 58 60 505

May 37 35 126 65 14 71 84 225

Jun 27 24 103 90 65 83 56 116

Jul 19 100 114 45 66 74 84 171

Aug 54 51 76 67 33 82 74 117

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 4401

Top

Member News

Applicants to go before the

Credentialing Committee

Syed Ahmad, MD - Internal Medicine

Chowdhury Ahsan, MD - Cardiology

Mandip Arora, MD - Internal Medicine

Peter Bernstein, MD - Diagnostic Radiology

Galen Eversole, MD - Anatomic & Clinical Pathology

Arjun Gururaj, MD - Cardiology

Stephanie Hansen, DO - Internal Medicine

Frank Hsu, MD - Diagnostic Radiology

Monsuru Ibraheem, MD - Internal Medicine

Jedediah Jones, MD - Orthopaedic Surgery

Shahabbudin Khan, MD - Cardilogy

Prem Kittusamy, MD - Cardiology

Gopalakrishna Leela, MD - Internal Medicine

Joel Lin, DO - Radiology

Staci McHale, MD - Ob-Gyn

John Middaugh, MD - Preventive Medicine

Rebecca Sinai, DO - Internal Medicine

Kevin Petersen, MD - General Surgery

Matthew Pham, MD - Internal Medicine

David Rosenstein, MD - Internal Medicine

Adam Rovit, MD - Ophthalmology

Terence Scipione, MD - Diagnostic Radiology

Kord Strebel, MD - Ob-Gyn

Charles Tadlock, MD - Anesthesiology

Matthew Treinen, DO - Radiology

Muhammad Tufail, MD - Internal Medicine

Thomas W. Umbach, MD - General Surgery

Rafael Valencia, MD - Cardiology

Richard Wasserman, MD - Ob-Gyn

Colby Young, MD - Orthopaedic Surgery

David Zipf, MD - Internal Medicine

If you have any pertinent information

about the membership candidates listed above, please send written information to:

Clark County Medical Society

2590 E Russell Rd

Las Vegas, NV 89120

For information on becoming a

member, call Janiceanne Poblete,

CCMS’ Membership Coordinator at

739-9989 or download an application

from the CCMS website: www.clarkcountymedical.org

CCMS regrets to announce the passing

of long time member

Bruce Robbins, MD - Cardiovascular Surgery

Congratulations and Welcome to the Clark County Medical Society New Members – August 2008

Javier Kamisato, MD

Internal Medicine

1707 Civic Center Dr #1
N Las Vegas, NV 89030

Renee Ngo, MD

Psychiatry

3680 Sunset Rd #100

Las Vegas, NV 89120

Welcome to the Clark County Medical Society Reinstated Members - August 2008

Anjum Ismail, MD - Internal Medicine

Timothy Sauter, MD - Ob-Gyn

Sara Stephenson, DO - Ob-Gyn

For information on becoming a member of the Clark County Medical Society, call Janiceanne Poblete at 739-9989.

Top

The Best Defense is a Good Offense: How to Effectively Communicate with your Patients

By: Antoinette Pretto-Sparkuhl, RN, BSN, MHA

Effective communication with the patient is a vital component of the physician-patient relationship. However, research has shown that clinicians allow the patient only 18 seconds to present the story of their illness before interrupting. Additionally, only 2% of those patients are ever allowed to complete their story. There are many benefits related to effectively communicating with patients which promote patient safety without an increase in the length of an office visit. Some of these benefits include: improved patient compliance with the treatment plan; improved patient outcomes; increased patient understanding of health problem; improved patient satisfaction; improved diagnostic accuracy by physician; reduced patient anxiety; and improved formation of a therapeutic and trusting relationship between physician and patient. Effective communication also can reduce the risk of a malpractice claim in the face of a bad outcome. Therefore, the manner in which a physician communicates information to a patient is just as important as the information being communicated.

As leaders, physicians set the tone of a patient’s healthcare experience and therefore must be equipped with effective communication strategies. Although each physician develops his or her own personal style of communication; there are five key communication skills that have been identified by the Accreditation Council for Graduate Medical Education that are necessary for effective communication to occur. These five key communication skills are: 1. Listening effectively; 2. Eliciting information using effective questioning skills; 3. Providing information using effective explanatory skills; 4. Counseling and educating patients; 5. Making informed decisions based upon patient information and preference. From a practical standpoint, the following are some helpful strategies which will enhance physician-patient communication and rapport:

Strategies to effectively communicate with patients:

1. Introduce yourself/greet the patient: Remember you don’t get a “second” chance to make a “first” impression.

2. Ask for input and feedback from the patient regarding the plan of care/treatment. Don’t assume the patient has the same understanding as you.

3. Involve family and significant others (with patients permission).

4. Give the patient a timeline for treatment, even if it is only approximate as patients need time to prepare.

5. Discuss with the patient when a consult is required and advise him or her what the consultant’s role will be.

6. Summarize your understanding of what the patient’s understanding is. Clarify any patient misperceptions.

7. Tailor the information to the patient’s level of understanding.

8. Educate patients about what they can realistically expect as unrealistic expectations can be a contributing factor in lawsuits.

9. Provide patients feedback about their clinical status. Explain what the recommended plan of action is.

10. Sit down with the patient as patient perception of quality time spent is improved if both parties are sitting.

11. Acknowledge and further explore the patient’s emotions while being empathetic. Do not minimize the patient’s feelings, and avoid being judgmental as physicians who avoid doing either are less likely to be viewed as uncaring by their patients.

12. Provide information in a slow and deliberate fashion with appropriate pauses. This provides the listener time to comprehend new information and formulate appropriate questions which the physician can then use to provide further information.

13. Be attentive to the patient’s nonverbal cues. Facial expressions are good indicators of sadness, worry or anxiety. Also be aware of your own nonverbal cues; do not act hurried or uninterested such as looking away while the patient is talking.

14. Consider providing an office brochure which outlines office hours, phone numbers, scheduling information, insurance/billing practices and other helpful information about your practice.

15. Consider the use of brochures, videotapes, newsletters, and websites as educational adjuncts can enhance the patient learning experience.

16. Consider the use of a patient satisfaction survey for your practice which will identify strengths and weaknesses. Appropriate interventions can then be formulated and implemented based upon the survey results, which can improve office processes and reduce risk exposure.

Physician-patient communication is an integral part of clinical practice. Although mastering communication skills takes both time and effort on the part of the physician, sharpening these skills are essential in order to maximize the chances of developing a productive physician-patient relationship. Not only can effective communication assist in the prevention of legal action, it also strengthens other important aspects of the physician-patient relationship which in turn promotes patient safety.

Antoinette Pretto-Sparkuhl can be contacted at 700 Shadow Lane #430, Las Vegas, NV 89106.

sss

Top

CCMS Referrals for the 3^rd Quarter

The following CCMS member referrals were provided to the public in the 3rd quarter of 2008 (through September 16)

Specialty Totals

Allergy 1

Addiction - Medicine 3

Anesthesiology 1

Cardiology 9

Colon & Rectal Surgery 1

Dermatology 7

Endocrinology 6

Family Practice 17

Gastroenternology 3

General Surgery 5

Geriatrics 5

Gynecologic Oncology 2

Hematology 1

Infectious Medicine 3

Internal Medicine 17

Nephrology 1

Neurology 3

Neurosurgery 1

Ob-Gyn 3

Occupational Medicine 1

Oncologist 1

Ophthalmology 6

Orthopeadic Surgery 11

Otolaryngology 3

Pain Mngt. 22

Pediatrics 2

Ped Endo 1

Plastic Surgery 5

Psychiatry 10

Pulmonology 2

Radiology 0

Rheumatology 6

Urology 4

Web Referrals 39

TOTALS 204

Top

2008-09 CCMS Annual Pictorial Directories to arrive in your mailboxes soon!

All members should receive a copy of the annual directory in the next few weeks. We provide our members with a complimentary copy every year and sell additional copies to members at the reduced price of $25. We sell directories to the public at the price of $50. If you would like any additional copies, please mail a check to CCMS, 2590 E Russell Rd, Las Vegas, NV 89120 along with a note, a return address and we will mail the additional copy to you.

If your photo is not next to your information, please take the time to email your headshot to ccms@lvcm.com so your photograph will be in the next year's edition. We plan to have RCL Photography out again next year to take photos of members for our directory. You do not have to pay for any photos unless you would like some and they will give us a photo of you for the directory at no charge. Please keep this in mind if we do not have a photo of you or if you would like an updated or different picture in next year's directory. If we do not receive a new photo next year, we will use the same photo as we used in this year's edition.

The purpose of the directory is to facilitate professional familiarity with fellow physicians in Clark County. Our goal is to produce the most comprehensive, accurate directory available in Southern Nevada. We try very hard to keep our database up-to-date with our membership information. Please contact Janiceanne Poblete, CCMS Membership Coordinator at 739-9989 with any corrections to your information.

sss

Top

Past President’s Message

By Marietta Nelson, MD

CCMS Past President 1995-96

I was honored to serve as President of the Clark County Medical Society in it’s 40th year, 1995 to 1996. It was an interesting year.

After a fun-filled and inspirational inaugural dinner in June of 1995, I arrived in my office the following morning, filled with enthusiasm and resolve.

On my desk was a four inch high stack of bound papers looking suspiciously like a lawsuit, addressed to me. It was indeed a lawsuit naming the medical society and me (as president) in an action faulting our lack of a sidewalk on the Russell Road side of our building. “Wow,” I thought. “this job might be tougher than I thought.” Fortunately, thanks to mostly Larry Matheis and staff, the sidewalk was built and the lawsuit was dropped.

Work on legislative and regulatory issues began early in the year. AB 520 had been passed earlier in the year bringing about some minor tort reforms. At our legislative dinner I introduced then Congressman John Ensign and Senator Harry Reid at their first debate, when Congressman Ensign was running for a Senate seat against Senator Reid. The medical society worked on Nev CAP (the Nevada Coalition Allied for Patient Protection) to further the cause of tort reform. We continued to work on Health Access Nevada, which was our state medical society proposal for improving access to healthcare in our state. Nevada became the 10th state to allow medical savings accounts. On a national level, Stark II legislation expanded restrictions on physician referral including lab, radiology and other services.

During the year we sponsored 2 internship programs to help community leaders get a first hand perspective on issues facing physicians. Our annual charity ball raised a record $14,000 which we donated to Child Haven and in the annual scholarship golf tournament we raised money for medical and nursing students. We also cosponsored a March of Dimes fundraiser with the Alliance. The CCMS Auxiliary actually became the Alliance that year and excellent Alliance officers included Pat Robbins and Jan Crossley.

One of our advisory seminars for physicians during the year was titled “Survival of the Fittest” and was subtitled, “Managed healthcare is Here to Stay.”

It was great to work with the dedicated and hardworking officers and staff of the medical society.

sss

Top

CME CALENDAR

Bechtel Nevada 702-295-0208

NV Chapter AACE 702-434-8400

NV Cancer Institute 702-822-5290

Pri-Med Institute 877-4PRI-MED

Sierra Health Services 702-242-7735

Southern Nevada AHEC 702-318-8452

Southwest Medical Assoc 702-242-7735

Sunrise Hospital 702-731-8210

www.sunrisecme.com

Oct 3 - "Evidence-Based Guidelines to Detect and Treat Sepsis"

Oct 17 - "Ethical Issues in Cancer Genetic Testing"

UMC 702-383-2604

www.umcsn.com/events/cme/asp

Oct 3 - "From 'Breakfast Club' to 'Gossip Girl': Have Adolescent Health Risk Behaviors Changed?"

Oct 10 - "They Run Better Unleaded: Childhood Lead Poisoning Prevention in Southern Nevada"

Oct 17 - "Schizophrenia - Optimizing Patient Compliance for Better Patient Outcomes"

Oct 24 - "Diabetes"

Valley Hospital 702-388-4847

Education Opportunities for Practice Managers, Call the NV Medical Group Management Association: 702-697-5471 ext 134.

Only CME Activities held at the Clark County Medical Society office are specifically endorsed by CCMS.

Top

Executive Council Meeting Minutes Synopsis July 15, 2008

I. Call to Order - The meeting was called to order by Dr. Jones at 6:09 pm.

II. Action Items

A. Minutes from the June 17, 2008 meeting were unanimously approved.

B. Financial report was presented by Dr. Havins:

General Revenue – Actual income for 12 months of Fiscal Year 2007-08 is $458,967.53 compared to $454,737.07 in Fiscal Year 2006-07, for an increase of $4,230.46 over last year at this time.

Operating Expenses – Actual expenses for 12 months of Fiscal Year 2007-08 is $397,071.10 compared to $366,843.57, for an increase of approximately $30,227.53 over last year at this time.

Overall, for 12 months of our fiscal year, revenues exceeded our expenses by $61,896.43. The bank balance for the end of May was $545,989.01 compared to $487,428.76 last year at this time.

C. The 2008-09 Budget was presented by Dr. Havins:

The proposed budget projects $411,700.00 in revenues and $461,554.00 in expenses which includes $50,000 earmarked for remodeling the CCMS facility. The budget was unanimously approved.

III. Committee Reports

A. Membership Count - Dr. Adashek was not present; therefore, Janice Poblete presented the Membership Report:

As of June 30, 2008, total dues-paid membership is 733, compared to 788 last year at this time. This is a net decrease of 55 members.

Total CCMS members is 1,020, including 197 dues exempt members.

There are 38 new members, 90 new student members and 20 reinstatements in the Fiscal Year 07-08.

B. Credentials Committee Report - Dr. Vanderharten presented the Credentials Committee Report. The following candidates for membership were unanimously approved: Matthew Fouse, MD – Orthopaedic Surgery, Povya Mohajer, MD – Anesthesiology, Orrenzo Snyder, MD – Urology, Michael Tay, MD – Internal Medicine, and Steven Thomas, MD – Maternal Fetal Medicine. The following members were reinstated: Lawrence Copeland, MD – Internal Medicine, Arthur Tayengco, MD – Ob-Gyn, and Patricia Pierce, MD.

The BOT discussed the member disciplinary process. A motion was made/passed to task the Bylaws Committee to develop an amendment stating:

o A member under investigation (at the direction of the Board of Trustees) by the Credentials Committee who voluntarily resigns prior to the end of the investigation is still subject to further investigation by the Credentials Committee.

o The Credentials Committee may complete the investigation and report their findings to the Board with recommendations.

o The Board will reserve the right to officially remove the member even though they have voluntarily resigned.

C. Community Health/Community Relations Committee - Dr. Forman stated he will have the first meeting in September. In the meantime he will meet with Dr. Teijeiro and be oriented to the ongoing projects.

D. Remodeling Committee - Dr. Fathie stated that the committee will meet tomorrow with Bobbie Jo Kinsey, President of the Nevada Chapter of the American Society of Interior Designers (ASID) who has expressed an interest in the project by certifying the facility as a historic building and thereby acquiring some of the services/materials at no cost.

IV. Alliance Report - Beverly Daly-Dix presented the report.

The “Mercedes” co-sponsored event has not been finalized. More information will be given when the details are worked out.

V. County Health Officer Report (report in packets)- Dr. Sands presented the report.

Dr. John Midiaugh has been hired to be the new Community Health Director.

SNHD has received over 5,000 Hepatitis C Exposure Registry Enrollment Forms.

Approximately 1,400 patients have requested their records from the Endoscopy centers.

Back to School immunizations – SNHD is reminding parents and caregivers that summer is an excellent opportunity to get school children caught up on immunizations.

VI. University of Nevada School of Medicine Report - Dr. Bar-on was not present; therefore, no report was given.

VII. Nevada Health Sciences System Report - Dr. Lenhart was not present; therefore, no report was given.

VIII. Touro University College of Osteopathic Medicine Report - Dr. Forman presented the report.

Touro is scheduled to admit the next class of 135 students.

Touro is actively pursuing GME, with a focus on keeping graduating students in Nevada.

Collaboration in Education between the medical schools and osteopathic schools is progressing.

IX. Scholarship Fund Report -Dr. Ellerton was not present; therefore, no report was given.

X. NSMA Report - Dr. Seher provided the report.

A proposal to consolidate the licensing and investigative boards is moving forward (26 states already operate under this model).

United – AG Mastro has proven to be a friend to the physicians with regard to the complicated merger issues.

Relief from rented PPO’s would be helpful to all physicians in Nevada. Working on legislation to obtain relief on this issue.

Sally Hardwick formed a working group (as a result of the Hepatitis C outbreak) and eventually wants to have a summit to fine tune a preparation plan to deal with such health crises.

NEMPAC Meeting – of all the elections, the Supreme Court Justices will be the most critical.

Medicare Bill – passed both houses and is now law.

Medicaid – Proposing a large cut, eliminating pediatric and obstetric adjustments (meaning, going back to the 2002 Medicaid schedule).

XI. MedPAC Report - Dr. Evins was not present in time to provide a report.

XII. AMA Report - Dr. Nelson presented the report.

The AMA annual meeting was held in June.

Dr. Nelson gave a brief summary of the agenda/itinerary of the annual meeting, likening it to the NSMA annual meeting, but on a grander scale. She also gave a brief summary of the different CME’s and resolutions.

XIII. NBME Report - Dr. Rodriguez was not present; therefore, no report was given.

XIV. President’s Report

Dr. Jones congratulated Nancy Sommer and the staff for an exceptional Installation Dinner.

Dr. Jones stated that a mass email was sent to all CCMS members along with an attached template letter to our Senator requesting his favor on the Medicare vote.

Two new features in the County Line this fiscal year will be a message from former Presidents, and a patient safety column, penned by Antoinette Sparkuhl.

Membership campaign is in progress. Dr. Jones has been diligently calling physicians and has received assurance from several large groups that they intend to join. Dr. Jones encouraged all BOT members to recruit colleagues to join CCMS. Dr. Jones would like to see the membership totals grow to 1,000 by the end of Fiscal Year 2008-09.

XV. Administrative Report - Dr. Havins provided the Administrative Report.

Dr. Havins requested a salary increase to bring him up to his contracted amount. Dr. Jones stated a personnel session would be conducted at the end of the balance of the agenda items.

At the end of the personnel session, it was decided that an Emergency BOT meeting would be held to discuss Dr. Havins’ request with input welcomed by the entire Board.

XVI. New Business

Dr. Jones stated that the Ruvo Brain Institute may have a reception at their hospitality facility for CCMS. They are very interested in working with the community and the medical socities. More details on the possible event will be forthcoming.

The Community Health/Relations Committee continues to work with the Department of Family Services, and through the Alliance possibly develop some panel for respite care. Beverly Daly-Dix stated that Debbie Ebert has volunteered for this project.

XVIII. Future Meetings - Next meeting is scheduled for Tuesday, August 19, 2008 at 6:00pm. This will be an Executive Council meeting, though all BOT members are welcome to attend.

sss

Top

2008-2009 CCMS Alliance Co-Presidents Message - September

By Beverly Daly Dix and Sheila Bazemore

September was a busy month for members of the Clark County Medical Society Alliance. We planned the Homecoming Luncheon inviting all former members, longtime members, new members, and potential members to attend and join or rejoin CCMSA for the 2008-2009 year. Karen Schroeder, a past president, state, and national AMAA office holder and current co-membership chair graciously offered her gorgeous Grand legacy Golf course home as the setting for this first luncheon of the year.

CCMSA members were also very busy planning and arranging for the long anticipated Mercedes-Benz Legislative Mixer. This exciting event was planned in partnership with CCMS and MEDPAC. During this legislative year our intent was to provide a wonderful opportunity for physicians and spouses to meet face to face with MEDPAC endorsed candidates for elected office, mingle with friends, enjoy great catered hors d’oeuvres, relax with a glass of wine, and tour the newest luxury vehicles.

October will be a busy month as well as we work to increase our membership numbers, and to provide educational opportunities for our members to learn more about the candidates. The October CCMSA luncheon is scheduled for October 14, 11:30am at Josette’s Bistro. In addition to our featured legislative speaker, you are invited to enjoy a complimentary skin assessment by nationally recognized Audry from A Gentle Touch Med Spa.

This year’s charity, the Nevada Childhood Cancer Foundation will host the Danny Gans Champions Run for Life on Saturday, October 11, at the District at the Green Valley Ranch. All those who may be interested in participating with our CCMSA team are encouraged to join us. For more information check the website at www.nvccf.org. We will be supporting the Nevada Childhood Cancer Foundation in a variety of ways this year. Please remember to save March 26, for the Annual Fundraiser Fashion Show at the Four Seasons Resort to benefit NCCF. We continue to actively seek a committee chair person or chair team to be in charge of coordinating the fashion show. Please consider stepping up to serve in this very worthwhile role.

The Annual Holiday Greeting Card Project is well underway. Many physicians, physician groups, and corporate sponsors have already responded with their checks to fund nursing scholarships. If you have not yet returned your form and check, please do so today. Special thanks to April Stewart and Janice Burt who are co-chairs of this committee. Thanks also to the members who showed up at April’s lovely home to stuff more than 3000 envelopes.

Monterey Brookman is much more than the board member in charge of Public Relations. She is working with Debbie Ebert and others to assist foster families of medically fragile children. Most recently Monterey has successfully networked to make an extremely significant contribution to the CCMS renovation project. More details will be available soon. Thanks Monterey for all your contributions!

CCMSA continues to encourage physician spouses to join the Alliance and help make a difference in our community. Visit our website for all the details, www.CCMSA-LV.org.

sss

Top

Executive Council Meeting Minutes Synopsis August 19, 2008

I. Call to Order - The meeting was called to order by Dr. Jones at 6:04 pm.

II. Action Items

A. Minutes from the July 15 & 29, 2008 meetings were unanimously approved.

B. Financial report was presented by Dr. Alexander:

• General Revenue – Actual income for 1 month of Fiscal Year 2008-09 is $21,186.00 compared to $29,769.25 in Fiscal Year 2007-08, representing $8,583.25 less in revenues over last year at this time.

• Operating Expenses – Actual expenses for 1 month of Fiscal Year 2008-09 is $27,181.52 compared to $33,743.63, representing $6,562.11 less in expenses over last year at this time.

• Overall, for 1 month of our fiscal year, expenses exceeded our revenues by $5,995.52. The bank balance for the end of July was $539,993.49 compared to $480,292.81 last year at this time.

III. Committee Reports

A. Membership Count - Dr. Adashek was not present; therefore, Janice Poblete presented the Membership

Report:

• As of July 31, 2008, total dues-paid membership is 744, compared to 802 last year at this time. This is a net decrease of 58 members.

• Total CCMS members is 1,029, including 197 dues exempt members.

• There are 38 new members, 90 new student members and 20 reinstatements in the Fiscal Year 2007-08.

• Dr. Jones requested Janice to send a letter to the recently resigned members to encourage them to renew. Dr. Jones will author the letter.

B. Credentials Committee Report

Dr. Vanderharten presented the Credentials Committee Report. Candidates for membership were unanimously approved: Javier Kamisato, MD – Internal Medicine and Renee Ngo, MD – Psychiatry. The following members were reinstated: Anjum Ismail, MD – Cardiology, Timothy Sauter, MD – Ob-Gyn, and Sara Stephenson, DO – Ob-Gyn.

C. Community Health/Community Relations Committee - Dr. Forman stated he will have the first meeting in September. In the meantime he will

meet with Dr. Teijeiro and be oriented to the ongoing projects.

D. Remodeling Committee

• Dr. Fathie stated that the committee will meet August 20 with Bobbie Jo Kinsey, President of the Nevada Chapter of the American Society of Interior Designers (ASID) to hear her presentation.

• The summary scope of work will be emailed to the BOT.

E. Bylaws Committee - Dr. Evins read the suggested changes as follows:

1. Article V, Section E, Paragraph 1 : Add at the end : The President has one vote on the Board of Trustees, the Executive Council.

2. Article IX, Section C, Paragraph 2: Add at the end : The Presidentially appointed Committee Chair has a vote at every Committee meeting.

3. Article III, Section E

Disciplinary Procedures:

a. Label current paragraph in Article III, Section E as #1.

Add: b. In the event that the Board of Trustees believes that significant charges against a current member warrant an investigation, the Board may delegate this task to the Credentials Committee. The Credentials Committee shall determine if creditable evidence exists that a member has deviated from the requirements for membership in this Society, as stated in Article IX, Section H. The Committee shall report to the Board of Trustees the results of its investigations and its recommendations for discipline. Discipline may include conditions, remediation, a letter of reprimand, suspension, or expulsion.

c. If a member under investigation (at the direction of the Board of Trustees) by the Credentials Committee voluntarily resigns prior to the end of the investigation, the investigation will end.

• After much discussion, it was decided that further refinement of the last paragraph (“c” above) was to be discussed at a future BOT meeting.

IV. Alliance Report

Beverly Daly-Dix presented the report.

• The “Mercedes” co-sponsored legislative mixer will be held September 25. The invitations are being created and will be mailed shortly.

• The advertising methods for the event will be via full page ad in the September County Line (distributed August 30), two fax blasts, mailed invitation and email invitation.

• The fax and email notifications will encourage members to bring a non-member to the event.

• It was suggested that the Alliance and MedPAC provide handouts to the attendees listing the endorsed candidates, as well as visual aids, i.e., posters of district maps, etc.

• The greeting card project is underway, and there will be an insert in the September County Line to participate. All proceeds go to nursing scholarships.

V. SNHD Chief Health Officer Report (report in packets) Dr. Sands presented the report.

• Genetic testing and results of the epidemiologic investigation allowed the epidemiology team to positively identify the two source cases in the Hepatitis C outbreak.

• SNHD has received over 6,000 Hepatitis C Exposure Registry Enrollment Forms.

• The first West Nile Virus case has been identified this year.

• Dr. Middaugh has been named as the Community Health Division Director. His public health career spans more than 25 years.

VI. University of Nevada School of Medicine Report

Dr. Bar-on presented the report.

• The Class of 2012 began matriculation August 18.

• The Class of 2010 passed their boards, with scores above the national average.

• Dr. Thienhaus is working with Dr. Forman to develop a memorandum of understanding for the purpose of collaboration between the two schools.

• The Class of 2008 OB graduates all passed their written boards. Next year they will take their oral boards.

• The Class of 2008 Pediatrics program graduates all passed their written boards.

• A 2007 Psychiatry resident passed written and oral boards.

• August 20 will be the first assembly of the new Division Of Health Sciences at the new Crowley building. Dr. McDonald will be the master of ceremonies.

VII. Nevada Health Sciences System Report

Dr. Lenhart was not present; therefore, no report was given.

VIII. Touro University College of Osteopathic Medicine Report - Dr. Forman provided the report.

• One of Touro’s partners at Valley Medical Center has been acknowledged as one of 25 hospitals nationally that has significantly improved patient care and quality of care.

IX. Scholarship Fund Report - Dr. Ellerton was not present; therefore, no report was given.

X. NSMA Report - Larry Matheis provided the report.

• The NSMA council will meet September 6 (Saturday).

• Work continues with the national hepatitis patient advocacy group at the CDC Foundation to develop materials for educational programs for all health professions. Nevada will be the testing place for the materials which is scheduled to be distributed in September. The results will be reported back to the CDC in preparation for a national campaign.

• Vaccine availability for children – the State of Nevada is going to significantly limit availability of vaccines. Larry and Dr. Sands are participating in a weekly meeting with the State to try and work out a viable solution to the issue.

• The prescription drug abuse task force meets Friday August 22.

• The legislative activity is in high gear. The State budget continues to be a critical focus.

XI. MedPAC Report

Dr. Evins presented the report.

• The next election is critical to the medical profession and anyone who has a malpractice policy. There is a distinct possibility that the assembly will introduce tort reform measures.

• Dr. Evins advised that NemPAC has over 600 members, whereas, MedPAC has a little over 40 members, and encouraged all BOT members to join.

• A new solicitation for membership will be sent next week via facsimile.

• MedPAC will conduct candidate interviews August 28 so as to select/endorse the additional races and invite the endorsees to attend the Mercedes Benz Legislative Mixer September 25.

• In the primary, all MedPAC endorsed candidates won, with the exception of Jack Supure, MD (Assembly Clark 2) and Susan Baucum (8th District, Seat 25). MedPAC will interview the remaining candidates in those two races.

• Supreme Court Race -- NemPAC has endorsed Judge Deborah Schumacher. In a joint pact with NemPAC/MedPAC an endorsement is being seriously considered for Kris Pickering. MedPAC has interviewed both candidates.

• The two critical races are Senator Joe Heck (Senate 5) and Senator Bob Beers (Senate 6). If they lose and the Senate goes Democrat, we can be assured that tort reform changes will be introduced.

XII. AMA Report - Dr. Kline stated that the report will be presented by both Dr. Kline and Dr. Nelson at the

September BOT meeting.

XIII. NBME Report - Dr. Rodriguez provided the report.

• Dr. Ling has been appointed as the new Executive Director for the NBME.

• The next board meeting will be the first week in October.

XIV. President’s Report

• Dr. Jones advised that CCMS will begin reimbursing staff for business use of personal vehicles. Reimbursements will occur at the end of each month.

• Dr. Jones advised that CCMS may consider having BOT meetings at offsite locations. Dr. Sands and Dr. Forman offered the use of their conference rooms.

XV. Administrative Report

Dr. Havins provided the Administrative Report.

• Dr. Havins announced that the compilation of Fiscal Year 2007-08 has been completed by PBTK and they will be attending/presenting at the September BOT meeting.

• Dr. Havins advised that his last day is tentatively August 31. He asked the BOT if they would like him to stay until a suitable replacement is hired. The Executive Council voted to keep Dr. Havins on staff until a replacement is hired.

• Dr. Forman inquired as to the Attorney position for CCMS. Dr. Jones stated that Dr. Havins is welcome to submit a proposal to provide attorney services for the BOT as well as members utilizing a monthly stipend basis for compensation.

XVI. New Business

• New computer for Janice Poblete – Nancy Sommer advised that Janice’s computer is 7 years old, and provided a quote for a new computer. The BOT approved a motion to purchase a new computer for Janice with a maximum budget of $1,200.00.

• Nancy Sommer advised the BOT that the IT Consultant used by CCMS recommended a high speed desktop scanner for approximately $500 that could be utilized to scan/archive much of the paperwork thereby reducing the need for extensive storage. The BOT approved the purchase.

XVII. Old Business

• Dr. Jones advised that Nancy Sommer found minutes dating back to the first Board meeting (November 19, 1955) and encouraged the BOT to take a look at the historical minutes.

• Minutes were provided to Dr. Davidson and Swissman to refresh their memory of their presidential years (1976 and 1982, respectively) so they can provide a “Past President’s Message” for the County Line. Dr. Nelson has promised to write a column as well.

XVIII. Future Meetings

Next meeting is scheduled for Tuesday, September 16, 2008 at 6:00pm. This will be a regular meeting for full attendance by the Board of Trustees.

sss

Top

SNHD Health Officer Report

Nevada faces immunization challenges

By Lawrence K Sands, DO, MPH, Chief Health Officer, Southern Nevada Health District

The Centers for Disease Control and Prevention (CDC) recently released the results of its 2007 National Immunization Survey (NIS) in September 2008. Based on the survey results, CDC is touting that nationwide childhood immunization rates remain at near or record levels, with at least 90 percent coverage for all but one of the recommended individual vaccines.

Unfortunately these immunization successes are not reflected in Nevada’s rates of childhood immunizations and our state remains at the bottom of the rankings. While Nevada’s childhood immunization rate showed a 3.6 percent improvement among children 19-36 months of age between 2006 and 2007, Nevada ranks 51st overall.

At a time when state budget shortfalls and reduced federal dollars have left no program untouched, immunization programs are no exception. Despite the lack of available resources, and the threat of further reductions, the demand and need for immunizations continues to grow. Since 1995 the recommended immunizations schedule has more than doubled, from seven vaccines to a total of 16 in 2008. The average cost for a parent to immunize their children has increased from $45 in 2005 to $900 for males and $1,200 for females in 2008.

These issues will be further compounded by the decision made by the Nevada State Health Division, in response to a recent 22 percent reduction in funding from a federal program which provides vaccines to states coupled with an increase in the number of routinely recommended vaccinations, to discontinue its practice of providing vaccines to all children younger than 18.

This decision by the State Health Division means our state will go from a Universal-Select program, which provides some of the recommended vaccinations to all children, to a Vaccine for Children (VFC) only program effective January 1, 2009.

While children who are uninsured, underinsured, eligible for Medicaid, Native American or Alaska Native, will continue to receive free vaccine through the state’s VFC program, parents of children considered insured may face substantial out-of-pockets costs to cover varying co-pays and charges not covered by their insurance provider.

These changes and issues are especially troubling in light of the challenges we face in raising the immunization rates for children aged 2 to 36 months. Traditionally, Nevada’s rates for school-age children have been closer to the national average, however there are several factors that contribute to the abysmal rates of our state’s pre-school aged children including:

• The lack of a medical home.

• Limited access to health care, lack of insurance or fluctuating insurance coverage.

• Limited VFC providers.

• Language and cultural barriers.

• Poor immunization records.

• The transient nature of the population.

As public health and health care professionals we are responsible for providing care and services to more than 70 percent of our state’s population and the impacts of these shortfalls and program cuts on our community and resources could prove to be a huge setback to the small gains we have made and even more devastating if we experience a resurgence in vaccine preventable disease outbreaks.

If we are to meet these challenges it is imperative the health care and public health communities come together to form strategies not only to maintain our levels of service, but to improve the immunization rates of children in Nevada. We need to examine the inadequate vaccine reimbursement rates for private providers and educate major insurers on the need for improvements, and we need to encourage and support the state’s efforts to implement and maintain a statewide immunization registry.

This is a complex issue and one that could have long-lasting effects on our local community. The Southern Nevada Health District will continue to work with our partners to clarify information related to changes in the immunization program and to solicit input and provide suggestions and alternative solutions to our counterparts at the state.

More information on the 2007 NIS is available at www.SouthernNevadaHealthDistrict.org.

sss

Top

SNHD Disease Stats Aug 08

Top

Congratulations!

Each year, members of the Nevada Academy of Family Physicians vote to select a “Consultant of the Year” and “Family Physician of the Year.” Their was a tie for “Consultant of the Year” between Alan H. Greenberg, MD, and Gilbert M. Nyamuswa, MD. Both physicians met all of the criteria such as being knowledgeable about and supportive of Family Practice, as well as communicating regularly with FPs about referrals. Part of the criteria for the person selected by the Academy as “Family Physician of the Year” is providing his/her patients with compassionate, comprehensive, and caring family medicine on a continuing basis and be a credible role model professionally and personally to his/her community. This year, Herve Bezard, MD, has been selected by his peers to be honored with this title. We congratulate the three recipients and look forward to honoring them at a NAFP membership dinner meeting on October 2.

Top

Classifieds

locum tenens doctor needed to monitor/be available for telephone consults for PA's in Henderson practice Oct 20-24. Call 263-4555.

FOR RENT—VIP ROOM. Crystal chandelier, Amethyst Crystal water fountain, Original Art, Ancient Fossils, in Green Valley VIP Clinic. Share with FP, Plastic Surgery, Hair Salon/Spa, Podiatry, Dietitians, Audiology, etc. Call 419-8256, view us at www.hrwellness.net.

Join us for a review and analysis of the years events in workplace drug testing. AAMROs Annual Drug Testing Symposium, November 7-9, 2008. The Mirage Hotel, Las Vegas, Nevada. Call 800-489-1829 or www.aamro.com

LEASING INCENTIVES, visit Sahara Rancho, 2250 S. Rancho. Prime Location, I-15/ Sahara, Access to Hospitals, 2,000-15,000 S.F. 4% Commission, 702-384-1494, dfsteinberg@gmail.com

Las Vegas Dermatology & H.L. Greenberg,M.D. are accepting dermatology patients at their new Summerlin hospital location: 653 N. Town Center Dr., Suite #410 Las Vegas, NV 89144 Contact us for your dermatology needs: phone- (702) 456-3120, fax- (702) 823-1069, www.lasvegasdermatology.com

SUBLEASE OFFICE SPACE: Behavioral Medicine clinic has an office space to rent near Valley & UMC Hospitals. Approx. 175 sq. ft. incl. utilities and use of waiting room, etc. $500/mo. Billing, scheduling, telephone services also available. Call Eileen at 702-405-6644

for lease medical facility: Free standing 6500 sqft (+/-) building on W Charleston Blvd close to Valley and UMC hospitals, freeways & downtown. Ample parking. Ideal for medical, dental & rehab facility. Call Richard Krieger at 271-2746 for further details.

Add another zip code to your letterhead by sharing office space near Summerlin. Westside “timeshare space” for lease. New medical office building (full or half days available) convenient to 215 near Flamingo Hualapai. Call 458-4263 ext 209

seeking pediatrician: North Vista Hospital campus, bilingual spanish helpful. Open to different arrangements. Email interest, ideas to rotyf72@aol.com

Ernest Sussman, MD is pleased to announce the opening of his solo practice specializing in Urology with emphasis on sexual medicine, male infertility (vasectomy and reversals), incontinence (female urology), and voiding disorders including BPH. For more information, please call 702-293-0176.

sss

Top

County Line Advertisers

Nevada Mutual Insurance Company ….. 798-6001 ….. www.nevadamutual.com

Medicus……..512-467-2800 ……. www.medicusinsurance.com

Consultants in Marketing for Hutchison & Steffen ……944-2464 www.wemarketo.com

The Firm for Comprehensive Cancer Centers ….702-739-9933

SK+G for NV Cancer Institute … 478-4122 … www.skgadv.com

IND………697-6400………… www.ind-insurance.com

Ensemble Real Estate, LLC …. 562-7595

Ferguson Advertising for Medical Protective 260-426-4401 …. www.medpro.com

Premier Physicians Insurance Company…..860-6130 ... www.ppicmedmal.com

Status Group, LLC…. 702-252-7005 … www.statusgroupllc.com

E & S Medical Billing … 362-9494

The Bauserman Group for Jones Vargas … 775-784-9400… www.thebausermangroup.com

21^st Century Oncology ……274-2000 … www.21stcenturyoncology.com

Purdue Marion and Associates for Colliers International ………..702-222-2362

Jacob Hafter, Esq … 702-405-6700 … www.hafterlaw.com

St Joseph’s Hospital ….602-406-3929 or 877-602-4111

Joe Kaufman Physician Mgnt Co …..702-318-6517

BJC Investments, LLC ……228-7464 …. www.priorityonecommercial.com

Nevada Docs Support Association, Inc ….. 702-215-4894… www.nvdocs.com

Azure Disk, LLC … 702-893-8968

Medical Group Management Association ….. 697-5471 ext. 134

Merrill Lynch Michael Libraty .. 702-227-7030

Top

Contents

President’s Message – October