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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
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}
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
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.
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
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.
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
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:
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
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
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 11
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
Capital Regional Heart and Lung Surgical Associates accepts Capital Health Plan and most all other insurance carriers.
Welcomes Saurabh Sheel, MD
850.402.0202 2626 Care Drive, Suite 105.
Tallahassee, FL 32308
www.CapitalRegionalPA.com
Now Accepting Patients
• Pulmonary Critical Care Fellowship Medical College of Wisconsin, Froedert Hospital
• Internist/Hospitalist Ogallala Community Hospital, Banner Health Facility, Ogallala, Nebraska
• Medical Director Garden County Health Services Oshkosh, Nebraska
Services Include: • Allergies and Asthma• Chronic Obstructive
Pulmonary Disease/Emphysema
• Lung Cancer• Bronchiectasis• Sarcoidosis• Chronic Bronchitis• Shortness of Breath• Vocal Chord Dysfunction
Professional Experience
• Maulana Azad Medical College, New Delhi, India
Medical Education
P U L M O N A R Y A S S O C I AT E S
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other be spared. We realize that these two are to be the new,
enlightened Adam and Eve, whose legacy will indeed be a
more perfect world. They are granted a conscience, call it a
soul if you prefer, willing to sacrifice itself for another.
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
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:
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.
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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