mecklenburg medicine april 2013

Mecklenburg County Medical Society • Mecklenburg Medical Alliance and EndowmentFounders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach OutMecklenburg County

Medical Society

Mecklenburg MedicineA Publication of the Mecklenburg County Medical Society | www.meckmed.org

April 2013 • Vol. 43, No. 4

One Stepat a Time

The Future of Health Care Comes

2 | April 2013 • Mecklenburg Medicine

New diagnosis? Don’t wait; connect your patient to our cancer patient navigators. These specially trained nurses are the ultimate guide for their journey, whether it’s getting a second opinion, connecting to the best resources or sorting through all the medical terminology. And as a Commission on Cancer-accredited cancer network, you can find the same nationally renowned cancer experts in Charlotte, Huntersville and Matthews.

Call day or night to get connected. Because some questions are just too important to wait.

Cancer called. It wants to put your patient’s life on hold.

Call Presbyterian instead.

704-384-5373 presbyterian.org/cancernavigator

Mecklenburg Medicine • April 2013 | 3

Contents

Features

7 An Update on North Carolina’s Implementation of the Affordable Care Act

9 New Chronic Pain Coalition Kicks Off April Conference

In This Issue ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

4 AHEC Course Offerings

5 President’s Letter: Did Someone Say the “C” Word?

8 MMAE: The Minute Clinic Mindset

8 Physicians Reach Out: We Are Many; We Are One

9 Physicians Reach Out: Answers to Your Frequently Asked Questions about Physicians Reach Out

10 April National Health & Wellness Observances

11 Member News

11 Upcoming Meetings & Events

12 MedLink Update: NC MedAssist Partnering With Second Harvest Food Bank

13 At the Hospitals

15 Advertising Acknowledgement

April 2013Vol. 43 No. 4

OFFICERSJanice E. Huff, MD

PresidentJames B. Hall, MD

President-ElectSimon V. Ward III, MD

SecretaryStephen J. Ezzo, MD

TreasurerMaeve E. O’Connor, MDImmediate Past President

BOARD MEMBERSLloyd L. Bridges, MD

Raymond E. Brown, PAScott L. Furney, MD

Harold R. Howe, Jr., MDScott L. Lindblom, MD

A. Miller Wilson Maxwell, MDJohn P. McBryde, MDParas H. Mehta, MD

Cheryl L. Walker-McGill, MDThomas N. Zweng, MD

EX-OFFICIO BOARD MEMBERSTammy Bridges

President, Mecklenburg MedicalAlliance & EndowmentKeia V. R. Hewitt, MD

President, Charlotte Medical SocietyDocia E. Hickey, MD

NCMS Speaker of the HouseStephen R. Keener, MD, MPH

Medical Director, Mecklenburg CountyHealth Department

Darlyne Menscer, MDNCMS Delegate to the AMA

Douglas R. Swanson, MD, FACEPMedical Director, Mecklenburg EMS Agency

EXECUTIVE STAFFSandi D. BuchananExecutive DirectorTrisha G. Herndon

Director, Meetings & Special EventsStephanie D. SmithExecutive Assistant

MECKLENBURG MEDICINE STAFFEditor

Mark E. Romanoff, MDManaging Editor

Sandi D. BuchananCopy Editor

Lee McCrackenAdvertising

Mark Ethridge 704-344-1980Editorial Board

N. Neil Howell, MDJanice E. Huff, MD

Jessica Schorr Saxe, MDGraphic Design — Wade Baker

Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts.

Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available.

Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word.

Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, call Mark Ethridge at 704-344-1980. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein.

We welcome your comments and suggestions:Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.

1112 Harding Place, #200, Charlotte, NC 28204704-376-3688 • FAX [email protected] 2013 Mecklenburg County Medical Society

Mecklenburg CountyMedical Society


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Affordable pricing for your lower income patients

AHEC Course OfferingsApril 2013

Continuing Medical Education (CME)4/12 2nd Annual Carolinas Multiprofessional Adult Critical Care Symposium4/12–13 52nd Annual Post Graduate Symposium4/25 Chronic Pain: Visions for the Future4/27-28 Pain, Addiction and the Law: Update 2013

Allied and Public Health Education4/27 Surgical Technology National Certification Exam Review

Leadership Development Education4/12 Leadership Strategies for Reducing Avoidable Hospital Readmissions

Nursing Education4/5 2013 Wound Care Conference4/25 Type II Diabetes Continuum: “Not Your Grandparents’ Diabetes”

For more information or to register for these courses, call 704-512-6523 or visit us at www.charlotteahec.org.


Com-mit-tee | k e‘

mite | noun; a person or group of persons elected or appointed to perform some service or function, as to investigate, report on, or act upon a particular matter.

I f you want to elicit the entire gamut of emotions from our colleagues, no need to mention

the Affordable Care Act! Simply say “committee” and stand back. Whether you agree with what is said or not, it is always entertaining.

Very few subjects bring such passion to the forefront. Some react like Beetlejuice when he hears his name spoken, “Nobody says the B (or C) word!” Others unleash a diatribe about the utter needlessness of committees, leaving one to wonder what would happen if they brought that same intensity in a constructive way to a meeting. Still others provide a litany of problems concerning any given committee (if only we could diagnose our patients so easily!).

We all have had our share of committee meetings where we left thinking, “Well, that’s time I’ll never get back.” At times, they seem to be a forum for the latest catchwords: robust, positive energy, opportunity, integration and, let’s not forget, value. Other times we are witness to an ideological debate. An errant remark can lead us through the Looking Glass with Alice. And, more often than we like, the meeting culminates in one of two ways: the decision to meet again, or the decision to form a subcommittee. Political observer and avowed baseball fanatic George Will said, “Football combines the two worst things about America: It is violence punctuated by committee meetings.”

Yet, I will attempt a spirited defense of committees. When done correctly, they can be extremely productive, for

the collective knowledge of the many outweighs that of one. How many times have we been in a meeting and heard someone mirror our own thoughts with their comments, which gets us more engaged? Or better yet, how many times has someone said something we’ve not considered, broadening our mind? Committees can be intellectually stimulating, but often are not. I think this is what frustrates us, since medicine is the ultimate brain challenger.

Certainly we all have had mini-epiphanies in our practices, when we have helped a patient in some unique way, or a patient has related something to us that we believe can be of benefit to others. At those times, we think how gratifying it would be to roll out these ideas on a larger scale. That’s where committees come in — they can take an idea, augment it if necessary, bring it to the attention of others and ultimately be of benefit to the larger community. Everything the Mecklenburg County Medical Society has accomplished throughout its history started with an idea and then a committee.

This is a rather circuitous way of getting to my topic — enlisting some of you to serve on our MCMS committees. My aim is three-fold. First, through a list of the committees and their functions, to impress upon you the value your Medical Society provides. Second, to pique your intellectual curiosity and convince you to sign up for one (or more). And thirdly, to discover the visionaries out there who have ideas that do not fit into our current structure and would like to spearhead committees that can bring their ideas to fruition.

All MCMS committees were listed in the February issue of this magazine with a brief description. Some committees have very defined goals and meet only once or twice a year.

These committees need new members periodically, if you are interested in their particular mission.

Many committees are more dynamic, and their goals are more fluid, depending on the healthcare issues in our community. These committees always need new members. Let me describe some of them here:

The Legislative Committee, chaired by David White and Chris Ullrich, MD, and the Meck PAC Board, chaired by John Williford, MD, stay current with the political issues of our county and state. These are great committees if you want to be an advocate for patients, physicians and physician assistants (PAs), as the ACA and insurance/Medicaid issues, as well as other important healthcare topics, will be determined over the next few years. Now more than ever, strong physician/PA voices are needed in Raleigh.

The Child Health Committee always has been very active under the leadership of Jessica Schorr Saxe, MD. It currently is working on increasing exercise levels, especially outdoors, of our children; advocating for more school nurses; and they always are open to new ideas to promote good health for our kids. The Developmental and Behavioral Services Resource Guide is always being updated and is available on the MCMS website.

The Public Health Committee, co-chaired by Larry Raymond, MD, and Maeve O’Connor, MD, is working on clean air issues, including how to reduce diesel emissions in Mecklenburg County.

The Women Physicians Section, co-chaired by Katherine Pierce, MD, and Nancy Teaff, MD, plans events for women physicians and has an annual fundraiser (with the local attorneys of the Charlotte Women’s Bar) to benefit the Domestic Violence Shelter. As more

Did Someone Say the “C” Word?By Janice E. Huff, MD President

President’s Letter


women enter the ranks of medicine, we expect this Section to remain a lively group, always looking for networking opportunities and fresh ideas.

The Membership Committee, co-chaired by Lloyd L. Bridges, MD, and Paras H. Mehta, MD, is interested in knowing what new member services and benefits you would like, and is working on ideas generated by our consultant and focus groups to increase membership. This committee could use input from all of you — young or seasoned, new or old to Mecklenburg County, residents or attending physicians, men or women.

The Media and Public Relations Committee, ably chaired by Tom Zweng, MD, and Katherine Pierce, MD, serves many vital functions. This year, it is working on clean air issues with the Public Health Committee. For the authors out there, we need you to be

on the editorial board or write articles for this magazine. For the budding actors and actresses out there, we have TV opportunities for you!

There are special project committees, the longest-running of which is the Community Intern Program, which introduces “non-medical” community leaders to the medical world. This group needs volunteers to allow these “non-medical” people to see what your day is like. They also need to know which members of the community-at-large you think could benefit from this experience.

Special project committees in the past have built Habitat Houses, held fundraising golf tournaments and started organizations, such as Physicians Reach Out and MedAssist. If there is a project near and dear to your heart that would benefit patients and/or physicians and physician

assistants of Mecklenburg County, please let your Medical Society know about your idea, and we can start a committee just for you!

As you can see, there are many exciting ways to help your patients and colleagues. In fact, someone near and dear to my heart wants to start the Italian-American Section of the Mecklenburg County Medical Society. Drs. Attori, Tellarico and Dalto, are you interested? I believe Dr. Ezzo would like to join you for a night of Barolo and Bocce!

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Feature

M any patients, physicians and policy-followers are eager to know and understand what is next for healthcare reform in our state and our

community. Here, we summarize some of the biggest steps next for the Affordable Care Act (ACA).

A New Health Insurance MarketplaceA major feature of the ACA is the creation of regulated

health insurance marketplaces, or health insurance exchanges. A recent PricewaterhouseCoopers (PwC) analysis projects these new exchange markets will yield the largest expansion of health coverage in the United States since the creation of Medicare. While North Carolina still has many decisions to make about how the state will meet the ACA requirement for new health insurance marketplaces (in addition to a decision about whether or not to expand Medicaid coverage), implementation of the law is right around the corner. Less than one year remains before the ACA’s major coverage provisions go live; all exchanges must be ready to begin open enrollment on October 1, and be fully operational on Jan. 1, 2014.

North Carolina currently is planning to run a state partnership exchange jointly with the federal government. The state was recently awarded $74 million to help get our health insurance exchange started, with support for IT infrastructure preparation and for the implementation of a consumer assistance program to help facilitate enrollment and ensure access to all eligible North Carolinians. While many decisions about exchange design are pending, and we can expect some adjustment in the 2013 legislative session, now is the time to review the basics of what exchanges will provide and who will be eligible to participate. These new health insurance marketplaces will allow qualified individuals and small employers (less than 100 employees) to purchase qualified health plans. State estimates suggest that more than 300,000 currently uninsured North Carolinians could gain coverage through the exchanges in 2014.

Making Coverage Affordable for Qualified Individuals

People without access to Medicaid or employer-based coverage that meets minimum affordability standards will be eligible to purchase coverage in the exchange. PwC analysis predicts roughly 75 percent of exchange participants previously will have been uninsured and that, initially, nine out of 10 people in the exchanges also will be eligible for federal subsidies. These sliding-scale subsidies, in the form

of advance premium tax credits and cost-sharing reductions, will make coverage purchased in the new health insurance marketplaces more affordable. To be eligible for these sliding-scale subsidies, individuals must have household income between 100 and 400 percent of poverty (between $23,050 and $92,200 a year for a family of four in 2012).

What is a Qualified Health Plan?

Plans offered in the new exchanges must be certified as Qualified Health Plans, meaning they must meet minimum essential benefits standards and have standardized, defined actuarial values (60 percent, 70 percent, 80 percent or 90 percent). These essential benefits standards will guarantee coverage for a set of at least 10 essential health service categories (including maternity and newborn care, mental health and substance abuse services, preventive and wellness services, and pediatric services — including oral/vision care, among others). In North Carolina, the benefits will be benchmarked to the Blue Cross Blue Shield–Blue Options PPO plan, which is the state’s largest small-group plan. Plans will be required to provide standardized information about their plans, including pricing, coverage and network providers, in order to facilitate ease of comparison shopping for consumers.

Care Ring continues to analyze the impact of ACA implementation, particularly as it relates to low-income, uninsured people in Mecklenburg County. Along with the Mecklenburg County Medical Society, Care Ring is a partner in MedLink, which hosted a community forum and companion physician education event on February 26 to explore how programs such as those offered in Mecklenburg County should prepare for full implementation of the ACA.

An Update on North Carolina’sImplementation of the Affordable Care ActBy Katie Benston, Chief Program Officer, Care Ring

Interested in healthcare reform and policy? Follow In the Rings, a blog published by Care Ring Executive Director Don Jonas, PhD, at intherings.org.


We Are Many; We Are OneBy John T. Klimas, MD, Physicians Reach Out

Physicians Reach Out

We are men; we are women.We are PA’s, NP’s; we are dentists or physicians. We are primary care doctors; we are specialists.

We are many, yet we are as one, when we work together giving kind and compassionate care to the poor and sick of Mecklenburg County through Physicians Reach Out.

For more than eight years, more than 1,600 physicians, PA’s, NP’s and dentists, have donated their skills to provide health care for more than 8,000 patients. In dollar amounts, an astounding $80 million in care has been donated by physicians and hospitals — but sheer numbers do not tell the whole story. Many patients have written emotional letters of gratitude, some published in this magazine, as well as in other publications.

“Thank you, Mr. Jonas, you saved my life,” said a grateful PRO patient to Don Jonas, the executive director of Care Ring, at the November annual fundraising luncheon.

During a recent office visit, a patient said the same thing to me. “Thank you, Dr. Klimas, for saving my life.” I was confused at first, as I had not seen her as a patient before this meeting, but then I realized she was thanking me not for my services but for starting PRO.

Some of your PRO patients may not express themselves as demonstratively as these patients did, but in their hearts lies a deep appreciation for what you have done to improve their health and quality of life.

Now for the big question: What happens to the Physicians Reach Out program as we embark on 2013 and the Affordable Care Act?

Looking for omens doesn’t help. The future appears a bit cloudy, and looking into a crystal ball raises more questions than answers.

• Will we see an expansion of Medicaid in North Carolina?• Will insurance exchanges be successfully implemented?• If there is a Medicaid expansion, what happens to the estimated

25,000-50,000 people in Mecklenburg County who will not be insured? Individuals whose insurance costs exceed 8 percent of their household

income are not required to obtain health insurance. Some people who are subject to the “individual mandate” will fail to comply. Also, undocumented immigrants are not subject to the individual mandate and are not eligible for Medicaid.

• Will healthcare providers be willing to take on more Medicaid patients?• What effect will the Affordable Care Act have on Care Ring?• Currently the administrator of PRO, will Care Ring transition into

more of a navigator for the poor and uninsured?Until we know differently, the Physicians Reach Out program will

continue on, faithful to its original mission. As always, I extend my heartfelt gratitude to each participating doctor; it is you who have made PRO the successful program it has become. To your patients, you are the face of Physicians Reach Out and the deliverer of hope and good health. In their eyes, you will always be the person who saved their life.

The Minute Clinic MindsetBy Tammy Bridges, MMAE President

I find myself wondering if the same marketing geniuses who created minute clinics, drive-through banks, fast-food and various other forms of instant gratification, also are responsible for creating a culture of “no patience” patients.

The other day, I stopped by our local drugstore to print some photographs. While walking through the automatic doors, I almost was run down by a young woman rushing past me. Apparently, she had a prescription to drop off at the pharmacy counter. I know this because within 10 minutes she began yelling at the top of her lungs demanding her medicine.

I looked at the photo lab tech, a UNC-Charlotte chemistry major, and asked if this sort of thing happened often. He nodded. Then he added, “The poor pharmacist comes in earlier than I do, stays after the store closes and barely takes a lunch break. Honestly, Mrs. Bridges, I thought I wanted to be a pharmacist but I’m changing my major. They work too hard and get no respect.”

No respect ... hmmm? I wondered how many students might drop out of the pharmacy program if they’d witnessed what I’d

just witnessed. Unfortunately, such behavior is all too common today. Pharmacists, physicians, nurses, educators, bank tellers, bus drivers — almost anyone who deals with the public, is vulnerable to a random attack by the rude and fractious customer.

What has happened to civility and patience? What makes some people think their time, their wants, their needs, are more important than that of others? Have they never heard about how, in rural areas, folks have to wait several days for the town doctor to make it to their small town or farm? Even today, we read about countries, such as Ghana, where people travel by foot and wait 10 hours or more to be seen by a mission physician from America.

I’m trying to raise children who respect their elders, other cultures and the rights of others. Do you know how difficult it is when they see adults throw a tantrum in the drugstore, scream at a cashier or bad mouth their neighbors? Isn’t the South supposed to be the last stronghold of good manners? If so, then surely we can spare more than 10 minutes waiting for a prescription or to be seen by a physician.

MMAE


By Katie BenstonChief Program Officer, Care Ring

Many of the physicians participating in Physicians Reach Out have been donating their time since the

program began almost eight years ago. During this time, practice staff has changed, and so have the procedures at Physicians Reach Out. In this issue, we tackle a few of the frequently asked questions about caring for your PRO patients. Let us know what other topics you would like addressed by emailing Katie Benston at [email protected].

Translating Services

One of the benefits of participating in Physicians Reach Out is that PRO provides translating services for all of our non-English speaking patients at their primary and specialty doctor’s appointments, as needed. If your office uses in-house translation services for PRO, that is fine. For PRO patients using our translation services, it is the patient’s responsibility to call PRO a minimum of five business days prior to his/her scheduled appointment in order to ensure a translator can be present. Patients should not call PRO regarding appointments that are scheduled more than three months out or that occur after his/her eligibility expires. For those situations, it is best for the patient to call closer to the appointment. This process ensures the patient currently is an eligible PRO patient and the scheduled appointment is with a participating PRO provider.

Specialty Referrals

Specialty care is one of the hallmarks of the Physicians Reach Out program. In order to help your patients receive the care they need, we ask that you follow the procedure for specialty referrals.

All requests for specialty care should be sent to PRO via fax to 704-943-3747 or MedData/MedConnect. PRO staff will schedule appointments for your patient within our network of providers. Do not schedule appointments directly with specialty providers — PRO has specific commitments from each provider, and it is important we honor those commitments and ensure patients can have continued access to specialty care. Any appointments scheduled outside of PRO either delay care for the patient or cause them to have to pay out of pocket for the

appointment. One exception: Presbyterian patients can be scheduled for physical therapy directly with Presbyterian Physical Therapy without a referral through PRO.

After sending PRO the referral, allow a minimum of three days for us to process the referral and enter it into our system. If your practice desires an e-mail confirmation for receipt of the referral, provide contact information, including an e-mail address, on each referral you submit. Do not send multiple copies of the same referral, as this can delay processing and could lead to one patient being scheduled for multiple appointments for the same issue. If you are concerned a referral has been lost, or you have a question about a referral, call one of our Access Coordinators for assistance.

Toni Lee coordinates referrals for cardiology, dermatology, ENT, gynecology, neurology and neurosurgery, ophthalmology, pulmonology, sleep medicine, urology and oncology. She can be reached at 704-243-3702 or [email protected].

Grayson Price coordinates referrals for allergy, dental, endocrinology, gastroenterology, general, vascular and colorectal surgery, nephrology, orthopedics, physical therapy, podiatry and rheumatology. He can be reached at 704-243-3706 or [email protected].

Specialty providers are aided when referrals are as detailed and specific as possible. This allows specialty offices to assign patients to the appropriate providers.

Specialty requests are handled on a first-come, first-serve basis. Due to the large volume of referrals we receive, many specialties have a waiting period before appointments can be scheduled. Actual wait time depends on a variety of factors, including volume of referrals for the specialty and provider availability. Rest assured that we request appointments as quickly as we can. As a reminder, PRO does not have the ability to triage referrals and PRO does not provide emergency appointments with specialists.

Once an initial appointment has been made with a specialty provider, the patient schedules any subsequent care, including procedures, with the provider. Referrals are good for one year after the initial appointment. If a patient needs continued follow-up care with a provider after one year has elapsed, a new referral must be sent to PRO.

Some specific specialties are available only to certain hospital systems: Gynecological oncology, neurology — Presbyterian onlyUrology — CMC only

Reference the following list when determining if a particular procedure requires a referral. Requires referral: colonoscopy, endoscopy, stress test, EGDDoes not require referral: mammogram, CT, MRI, X-ray

Requesting Medical RecordsPhysicians Reach Out specialty

providers increasingly are requesting the medical records of patients referred by the PCPs prior to scheduling an appointment. Therefore, not having medical records available sometimes can delay the patient being given the specialty appointment. In order to expedite the specialty appointment process, Physicians Reach Out requests you send medical records along with the referral whenever possible, but in particular for the following specialties: dermatology, endocrinology, gynecology, nephrology, oncology, orthopedics and rheumatology.

Once a specialist appointment has been made, PRO faxes a notice to the referring physician’s office regarding the specialty appointment time. Please note at the bottom of the referral, there is a fax number for you to send medical records to the specialty office (if the records were not originally sent with the referral).

Also, if your practice has an Electronic Medical Record (EMR), please indicate that on the referral form so Physicians Reach Out can inform the specialty office. Note that some specialty offices have not converted to an EMR or may not be affiliated with a particular hospital system, so paper medical records still may be needed.

Answers to Your Frequently Asked Questions about Physicians Reach Out

Physicians Reach Out


New Chronic Pain Coalition Kicks Off April ConferenceCommunity Stakeholders Partner to Decrease Opioid-Related DeathsBy Deb Sauvain, BSN, RN, Chronic Pain Coordinator,Community Care Partners of Greater Mecklenburg

Opioid analgesics are now responsible for more deaths than the number of deaths from both suicide and motor vehicle crashes, or deaths from cocaine and heroin

combined, according to a recent study published by Laxmaiah Manchikanti, MD, et al. in the July 2012 issue of Pain Physician Journal. The study further explains the causes of unintentional overdose deaths as follows:

60 percent occurred in patients given prescriptions, based on prescribing guidelines by medical boards. Of these, 20 percent were due to low-dose opioid therapy equivalent to 100 mg or less of morphine, and 40 percent were from opioid therapy equivalent to 100 mg or more of morphine. The remaining 40 percent of unintentional opioid overdoses resulted from individuals obtaining multiple prescriptions, doctor shopping and drug diversion.

The obstacles facing healthcare practitioners in safely prescribing opioid medication include inappropriate prescribing patterns, lack of knowledge and limited usage of assessment tools and information.

In 2007, Wilkes County had the third highest drug overdose rate in the nation, according to the Center for Disease Control (CDC). At the same time, a Wilkes County hospice chaplain, Fred Brason, saw alarming increases in deaths from unintentional opioid overdoses. Surprisingly, they were not related to terminal illnesses. A year later, Brason started Project Lazarus, which has been successful in reducing the epidemic of needless deaths. In Wilkes County, the success of Brason’s Project Lazarus resulted in a 47 percent decline in unintentional opioid deaths from 2009 to 2010.

The foundation of Brason’s community-based model is a coalition of stakeholders dedicated to:

• Epidemiologic monitoring• Prevention• Rescue treatment• Program evaluation (process and outcomes)Brason’s model has been adopted by Community Care of North

Carolina (CCNC), and local coalitions are being formed within its 14 networks. CCNC provides managed care for North Carolina’s Medicaid Access II patients. Community Care Partners of Greater Mecklenburg (CCPGM) is CCNC’s Charlotte-based network for enrollees in Anson, Mecklenburg and Union counties.

Last year, CCPGM launched a chronic pain initiative that included the formation of the Chronic Pain Coalition of Greater Mecklenburg. The Coalition now includes community stakeholders from various disciplines, including emergency department and primary care physicians, integrative therapists, pharmacists, behavioral health and addiction specialists, and ministers.

Feature

The Coalition is hosting its first chronic pain seminar, “Chronic Pain: Visions for the Future,” in conjunction with its sponsors, The Governor’s Institute, Mecklenburg County Medical Society and Community Care Partners of Greater Mecklenburg. Seminar topics will give evidence-based strategies for managing chronic pain patients and reducing unintentional opioid drug overdoses. The four-hour seminar will be Thursday, April 25, from noon-5 p.m. at the Harris Conference Center. Lunch and networking will be noon-1 p.m. The fee is $100 and registrants are eligible for up to 4.5 AMA PRA Category 1 Credits™. To register, go to www.charlotteahec.org.

For more information about the Chronic Pain Coalition of Mecklenburg, contact Deb Sauvain at [email protected]. CCPGM currently has 168,000 enrollees in Anson, Mecklenburg and Union counties, with 205 providers serving as a medical home. It has been providing managed care for Medicaid Access II enrollees since 2002.

NATIONAL HEALTH & WELLNESS OBSERVANCESApril

National Alcohol Awareness Month

National Cancer Control Month

National Child Abuse Prevention Month

National Counseling Awareness Month

National Donate Life Month

Stress Awareness Month

National Minority Health andHealth Disparities Month

National Occupational Therapy Month

National STDs/Family PlanningAwareness Month

April 1-7

National Public Health Week

April 7

World Health Day

April 15-21

Medical Fitness Week

National Minority CancerAwareness Week

April 21-28

National Infant Immunization Week

April 22

Earth Day

April 25

Take Your Daughters and Sons to Work Day


New Members Ilan D. Avin, MD *General Surgery; *Surgical OncologyCarolina Surgical Clinic2104 Randolph RoadCharlotte, NC 28207704-377-3900Virginia Commonwealth University, 2003

Joseph L. Trask, Sr., MD*Nuclear CardiologyMid Carolina Cardiology10030 Gilead Road #201Huntersville, NC 28078704-887-4530Medical University South Carolina, 1983

John D. Wylie, MD, PhD*Diagnostic Radiology; Neuroradiology; Pediatric NeuroradiologyCharlotte Radiology1701 East Blvd.Charlotte, NC 28203704-334-7800Washington University, St. Louis, 2006

Upcoming Meetings & Events Meetings are at the MCMS office unless otherwise noted.

APRILNote: No MCMS Board Meeting.n Tuesday, April 2

Charlotte Dental Society Board meeting.6:00 p.m.

n Tuesday, April 2Women Physicians Section FundraiserPlanning Committee meeting. Safe Alliance office.6:00 p.m.

n Tuesday, April 9MedLink meeting.8:30 a.m.

n Thursday, April 11Women Physicians Section Girls Night Out.The Comedy Zone.6:30 p.m.

n Thursday, April 11Charlotte Medical SocietyMembership Meeting.6:00 p.m.

n Friday-Saturday, April 12-13AAFP Post-Graduate Symposium.Renaissance Suites-SouthPark.

n Monday, April 15MCMS Executive Committee meeting.5:30 p.m.

n Wednesday, April 17MMAE Board Meeting.10:00 a.m.

n Thursday, April 18CAMGM meeting.Myers Park Baptist Church Cornwell Center.Noon.

n Monday, April 22June magazine deadline.

Member News

Make the connection atwww.meckmed.orgResources for physicians, medical offices, patients and the public.Visit us today!

www.facebook.com/MecklenburgCountyMedicalSociety

Sandi Buchanan@mcmsed

Dispose of unused and expired medications!Law enforcement will be on hand to take medicines and dispose of them properly.

• Keep at-risk medicines out of the hands of young kids and teens • Keep medicine out of the water system

Shopping centers, unless indicated, are near Harris Teeters. Sharps/needles and biohazard materials are not accepted.

n April 20: 10 am-2 pm

Stumptown Park120 S. Trade Street, MatthewsSponsored by the Matthews Police

Northcross Shopping Center9759 Sam Furr Road, HuntersvilleSponsored by the Huntersville Police


Mintworth Shopping Center5706 Wyalong Drive, CharlotteSponsored by the Alcohol Beverage Control Law

Mint Hill Pavilion7036 Brighton Park Drive, Mint Hill

SteeleCroft Shopping Center13000 South Tryon Street, Charlotte


Morrocroft Shopping Center6701 Morrison Blvd., Charlotte

Stonecrest Shopping Center7852 Rea Road, Charlotte

Pikes Pharmacy2133 Shamrock Drive, Charlotte

Polymers Center for Excellence8900 Research Drive, Charlotte (11 am-2 pm)Sponsored by the Charlotte-Mecklenburg Police

www.safekidscharmeck.org or www.levinechildrenshospital.org/operationmedicinedrop


Med Link Update

NC MedAssist Partnering With Second Harvest Food BankBy Susan Royster, Associate Executive Director, NC MedAssist

In August 2012, NC MedAssist began a new partnership with

Second Harvest Food Bank. The nonprofit organization receives shipments of over-the-counter medications and supplies from various retail pharmacies, which they then donate to MedAssist. This partnership has proven to be a huge benefit for our clients and our free clinic partners all over the state. The clients who receive these items, such as ibuprofen, allergy medicines and vitamins for children and adults, are low-income. It is an added stress in their life when they have a throbbing headache or their child has

a fever and they can’t afford to go to the drugstore and purchase Tylenol. Every dollar they can save makes a huge difference to their family budget.

One recent recipient was homeless and extremely grateful for Band Aids, iuprofen and some skin care products for her child. These are items you and I take for granted, as we shop in our local retail pharmacy with our flex-spending card.

Our over-the-counter initiative also is a great opportunity for small groups, families, church groups, etc., to get involved with NC MedAssist. Not only can groups come in to help with sorting and shipping to the free clinics, but they also can volunteer at our OTC giveaway day once a month. On this day, our clients and those in need in the community can come to MedAssist and select five products to take home from our inventory, at absolutely no cost.

Some of our volunteers have been from Carolinas HealthCare System, United Way Young Leaders, Hands on Charlotte and individual families looking for a way to give back to the community.

THE 8TH ANNUAL

MELANOMA AWARENESS GOLF CLASSICMONDAY, JUNE 17 n CARMEL COUNTRY CLUB n SOUTH COURSE

SAVETHE

DATE!

11:00 am Registration & Lunch1:00 pm Shotgun Start6:00 pm Reception

For more information, contact Rebecca Sheaff [email protected] or 704-755-4048

MCMSMembershipDirectory

The 2013 MCMS Membership Pictorial Directory is now available. If you are interested in purchasing a copy, call the MCMS office at 704-376-3688. MCMS members receive a free copy as a member benefit. If you have not received your copy, please let us know.


At the Hospitals

n Novant Health Developmental & n Behavioral Pediatrics Opens

Novant Health Developmental & Behavioral Pediatrics opened on Feb. 21 and is accepting

new patients. Developmental pediatrics is a subspecialty area that diagnoses and treats children with developmental, learning or behavioral concerns. Barbara Kissam, MD, is board-certified

in developmental-behavioral pediatrics; Caitlin Rissler, NP, is board-certified in pediatrics and has completed leadership education in neurodevelopmental disabilities.

Conditions treated at this facility include: autism spectrum disorder; ADHD; learning disabilities; depression; anxiety; obsessive compulsive disorder; oppositional defiant disorder; bipolar disorder; reactive attachment disorder;

developmental delays; genetic syndromes with developmental issues, such as Down syndrome, Fragile X syndrome, Angelman syndrome and Prader-Willi syndrome; NICU graduates with developmental issues; and behavioral problems.

Novant Health Developmental & Behavioral Pediatrics is the first practice of its kind in Charlotte. To schedule an appointment or refer a patient, call 704-316-1155.

n Presbyterian Designated as Centern of Excellence for Minimally Invasive nGynecology

Presbyterian Hospital has been recognized as a Center of Excellence in Minimally Invasive Gynecology (COEMIG) by the AAGL and Surgical Review Corporation. This designation showcases Presbyterian’s commitment to new technologies, patient education and general patient awareness surrounding minimally invasive options for gynecologic surgery patients. James Hardy, MD, and Scott Schneider, MD, are co-medical directors of the center, and they also are designated as Center of Excellence surgeons, according to the standards set by COEMIG. Twelve additional OB-GYN physicians from Presbyterian Hospital, Presbyterian Hospital Huntersville and Presbyterian Hospital Matthews also have met the criteria for the Center of Excellence.

Visit www.presbyterian.org/gynsurgery or contact Pat Campbell at 704-384-4065 or [email protected] for details. To find a Presbyterian-affiliated OB-GYN, visit www.presbyterian.org/obgyndoctor.

n Presbyterian Neuroscience Instituten Offers Support Group for Youngn Stroke Survivors

The Presbyterian Neuroscience Institute offers a support group for young stroke survivors. The group meets monthly at Presbyterian Neurology Center in Suite 400 of Midtown Medical Plaza, at 1918 Randolph

Road. All sessions meet 6-7:30 p.m.Schedule/Topics*• Thursday, May 23 – Beating the Blues Post-Stroke • Thursday, July 25 – Overall Wellness • Thursday, Sept. 26 – Migraines and Stroke • Thursday, Nov. 21 – Holiday Celebration

Survivors are asked to RSVP to Jaime Pimental at [email protected] or 704-316-6239.

If you have questions about the young stroke support group, contact Jaime Pimental at [email protected] or 704-316-6239.

*Topics subject to change.

n Novant Health Announces Strategic Plan for Re-BrandingIn an ever-changing health care industry, the need for transformation is more apparent

than ever before. In 15 years, Novant Health has grown into a significant regional health care system with 13 acute care facilities, more than 100 outpatient facilities and 350 physician practices across four states.

Novant Health is reinventing the health care experience to be simpler, more convenient and more affordable, so consumers can focus on getting better and staying healthy. We are transforming care at the bedside, implementing world-class technology, enabling clinical staff to work at the top of their license and managing the finances of our system to the benefit of our patients and employees.

In February, we announced the next logical step in our transformation — our organization will unify under one name: Novant Health.

While you will see a new visual identity as a part of this re-brand, this is not a simple logo change. We have set in motion a clear, deliberate path to connect our points of access, share best practices, reduce waste and allow for recognized leadership in delivering clinical care. In short, we promise to make health care remarkable.

We publicly revealed our new logo in February, and the rollout begins April 17. To align together, our facilities will be re-named. To learn more about the branding plan and view the new visual identity, visit NovantHealth.org/remarkable.

CURRENT FACILITY NAME NEW FACILITY NAME as of April 17, 2013

Brunswick Novant Medical Center Novant Health Brunswick Medical Center

Clemmons Medical Center Novant Health Clemmons Medical Center

Forsyth Medical Center Novant Health Forsyth Medical Center

Franklin Regional Medical Center Novant Health Franklin Medical Center

Kernersville Medical Center Novant Health Kernersville Medical Center

Medical Park Hospital Novant Health Medical Park Hospital

Presbyterian Hemby Children’s Hospital Novant Health Hemby Children’s Hospital

Presbyterian Hospital Novant Health Presbyterian Medical Center

Presbyterian Hospital Huntersville Novant Health Huntersville Medical Center

Presbyterian Hospital Matthews Novant Health Matthews Medical Center

Prince William Hospital Novant Health Prince William Medical Center

Prince William Hospital Haymarket Novant Health Haymarket Medical Center

Rowan Regional Medical Center Novant Health Rowan Medical Center

Thomasville Medical Center Novant Health Thomasville Medical Center

Upstate Carolina Medical Center Novant Health Gaffney Medical Center

Presbyterian Orthopaedic Hospital Novant Health Charlotte Orthopedic Hospital


n Levine Cancer Institute Expands itsn Hematologic Oncology Services forn Patients With Aggressive Types ofn Blood Cancer

Carolinas HealthCare System’s Levine Cancer Institute has announced that it will offer a hematologic malignancies unit, the first adult treatment center of its kind, to residents in the greater Charlotte region in January 2014. This new space, where bone marrow transplant patients will be treated, is an expansion of the Institute’s hematologic and oncology division that provides local patients with access to cutting-edge technologies, high quality care and the expertise of nationally existing and newly recruited physicians.

Edward Copelan, MD, chair of the Department of Hematologic Oncology and Blood Disorders, is overseeing the development of this expansion, which will allow residents diagnosed with leukemia, multiple myeloma, lymphomas or other hematologic malignancies, to receive their treatment closer to home. Nationally recognized for his more than 30 years of research in hematology and oncology, Dr. Copelan was recruited to the Institute in 2012 from Cleveland Clinic and is currently recruiting additional specialists to the Institute for non-cancer related blood disorders.

n Carolinas Medical Center to Participaten in National Collaborative Care Initiativen for Trauma Patients

Michael Bosse, MD, co-principal investigator and clinical chair of the Major Extremity Trauma Research Consortium (METRC), www.metrc.org, conducted Grand Rounds for physicians and hospital administrators at Carolinas Medical Center (CMC) while announcing the launch of a new national Trauma Collaborative Care Study. CMC is one of only six intervention centers participating in the multi-year study in the United States.

The sites will enroll patients and monitor outcomes following participation in the Trauma Survivor’s Network (TSN) collaborative care model. Other intervention centers in the study include the University of

Maryland, Vanderbilt Medical Center, INOVA Fairfax Hospital, MetroHealth Medical Center in Cleveland, and Wake Forest University.

METRC, funded through the Department of Defense, comprises 24 core Level 1 trauma centers, four military treatment centers, and 30 satellite centers located across the United States. Established in 2009, the overall goal of the Consortium is to establish treatment guidelines, which would then be applied for optimal care of the wounded warrior and ultimately improve the functional and quality-of-life outcomes of both service members and civilians who experience high-energy trauma. CMC, with leadership from Dr. Bosse, is a founding member of METRC.

Launching this spring, the program will be a four-year study designed to add a back-end element to the operating room, while measuring levels of satisfaction for both patients and providers alike. It also will measure cost effectiveness and cost benefits while comparing reductions in emergency room use and hospital readmissions, post-traumatic stress disorder (PTSD), and return to work and function.

The centers participating in the TSN will share the collective data and results nationally to improve future outcomes. Enrolled patients will establish baselines of information (through patient profiles) to better identify which study participants will need additional interventions by specialized teams and personnel.

n Maximizing the Role of ACPsCarolinas HealthCare System is one of

the first health care systems in the country to create a network-wide, comprehensive approach for optimizing the role of advanced clinical practitioners (ACPs) to help us adapt and succeed in the ever-changing healthcare environment.

The three-pronged initiative includes establishing Carolinas HealthCare System’s first Center for Advanced Practice (CAP), a centralized department that will facilitate customized core services for ACPs, such as outreach, education, mentoring, communication and retention; a new graduate acute care nurse practitioner (NP) program, in partnership with UNC-Charlotte, that begins in August and will prepare graduates for the new NP certification in adult/gerontology with acute care focus; and a new ACP fellowship program that starts in October. This post-graduate program is unique — not only will the fellows

receive a stipend, they also will be temporarily hired as employees so they can receive full health benefits. The initial fellowship program will offer six acute care tracks, including urgent care, with the immediate goal of adding multiple primary care tracks.

A large team of physicians, ACPs and administrators have collaborated for more than a year to bring these three programs to life. The steering committee originating this initiative included Mary Ann Wilcox, RN, senior vice president and system nurse executive; Chris Teigland, MD, chair of the McKay Department of Urology at CMC; Ellen Sheppard, EdD, president of Carolinas College of Health Sciences; Dennis Taylor, DNP, ACNP-BC, assistant vice president of system nursing; Brian Jefferson, MSN, RN, ACNP-BC, FCCM, trauma and surgical critical care NP at CMC; Ginger Marshall, ACNP-BC, ACHPN, FPCN, director of Palliative Care Services; and Steve Wagner, PhD, FACMPE, vice president of the Physician Services Group.

Through this ACP initiative, Carolinas HealthCare System is positioned to be a national leader in health care system transformation by refining the care delivery model. This program also supports CHS’ strategic priority of providing clinically-integrated, coordinated care.

n Carolinas College of Health Sciencesn Ranked No. 1 Two Years in a Row

In 2012, the Carolinas College of Health Sciences (CCHS), a subsidiary of Carolinas Medical Center, was ranked the No. 1 two-year college in the nation for a second year in a row by StateUniversity.com, a leading college and university information website. The rankings analyze data from the top 2,000 colleges and universities in the U.S. and are based solely on comparisons of key statistics, including student/faculty ratio, student retention and test scores. CCHS has a 2:1 student to faculty ratio and 100 percent retention among full-time students.

At the Hospitals


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