NH Medical Society

7 North State Street

Concord, NH 03301

(603) 224-1909

(603) 226-2432 fax

nhmed@nhms.org www.nhms.org Oglesby Young, MD…....President

Palmer P. Jones………….EVP

Catrina Watson…………..Editor

President’s Perspective ...................2 CAP.....................................................5 Meetings, CME, ................................6 Legislative Report ............................7 Humanities ........................................8 Frequently Asked Questions ..........9 Opinions expressed by authors may not always reflect official NH Medical Society positions. The Society reserves the right to edit contributed articles based on length and/or appropriateness of subject matter. Please send correspondence to “Newsletter Editor” at the above address. Do you or a colleague need help?

The New Hampshire Profession-als’ Health Program (NH PHP) is here to help!

The NH PHP is a confidential re-source that assists with identification, intervention, referral, and case man-agement of NH physicians, physician assistants, dentists, and dental hy-gienists who may be at risk for or affected by substance use disorders, behavioral/mental health conditions, or other issues impacting their health and well-being. NH PHP provides recovery documentation, education, support, and advocacy – from evalua-tion through treatment and recovery. For a confidential consultation, please call Dr. Sally Garhart @ (603) 491-5036

Physicians Bi-Monthly

NEW HAMPSHIRE MEDICAL SOCIETY NEWSLETTER NH Medical Society; For The Betterment of Public Health Since 1791

September/October 2008

On September 2nd, Medical Society lead-ers met in Lebanon with Dartmouth Medical School students for the annual DMS Policy 101. Faculty for the program included: doctors Stuart Glassman, Geor-gia Tuttle, Gary Woods and Oge Young; Medical Society lobbyist Janet Monahan; John Bunker and attorney Trish Lucas from New Futures; Joe O'Donnell from DMS; and State Representative Laurie Harding. Students learned the various aspects of advocacy and lined up for an exercise on "How a bill becomes a law." Medical Society President, Dr. Oge Young, spoke of physicians sacrificing much of their youth to medical education so that they can take care of their fellow human beings.

He believes that in turn, society has an obligation to provide a reasonable prac-tice environment for physicians. The advocacy work that is done by organized medicine -- NH Medical Society and the AMA -- is focused on protecting that practice environment to the benefit of patients and our health care system. The students were encouraged to look beyond their medical practices and become com-munity participants and advocates for their patients.

DMS students lined up to pass "Bobble-Head Bill" through the law making process.

Medical Society President Dr. Oge Young and Past President Dr. Gary Woods, talk with students in a small group exercise.

NHMS President Encourages Future Leaders

By: Janet Monahan

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Healthy Beginnings As physicians, we have opportunities to make differ-ences in the health of our communities beyond just the intimate caring relationships we enjoy with our patients. Such an opportunity presented in 1995 when Concord Hospital was planning to build its new ma-ternity unit, “The Family Place.” While understand-ing the importance of creating a setting which en-hances the birth experience, I had a growing concern that we were forgetting about the moms and babies after they left our hospital. It seemed clear that we could devote our efforts to delivering healthy babies, but that there was much more we could do to care for our new families. After a long, hard labor and deliv-ery I have been struck with how often couples look at each other and say “Finally, it’s over.” As an obste-trician and a parent, I whisper to myself, “It’s just beginning.” It was with this whispered thought that I asked Concord Hospital if we could raise money for an endowment fund which would support and educate new parents. I am grateful to Concord Hospital for its vision in creating the Healthy Beginnings Endow-ment. Our message was simple. No matter how well edu-cated or how well motivated, the experience of having a newborn can be overwhelming. All of us want to be good parents, but many of us have not had good mod-eling. Many do not have the resources to be the kind of parents we want to be. Life has changed—the so-

ciety in which we live is different than years ago. Many new moms leave our hospitals without a part-ner. Today 20% of all children live with only one parent. Grandmothers work and many grandparents live elsewhere. Finally, there is no longer the old neighborhood - there is no longer a woman down the street who has six children and welcomes the opportu-nity to help a new mother as she was once helped. For these reasons, I felt we needed to create and sus-tain programs which support and educate new parents in our community. In less than six months we raised over $700,000 for the Healthy Beginnings Endow-ment. Those who contributed most were physicians who understood that if we are to have a healthy adult, we need first to create a healthy child. Our endow-ment has grown to over 1.3 million dollars. In 12 years we have provided over 60 grants totaling more than $400,000 for programs that are making a differ-ence in the first three years of life. What better investment can we make in the health of our community? The first few years of life last for-ever—those of us who love well have been well loved; those of us who care deeply, have been deeply cared for. Psychologists claim that we do half of our learning in the first three years of life—the most im-portant learning when the foundations of love and trust are laid. They tell us we are 90% of who we are by age 5, or at least 90% of how we feel about our-selves. If we want a healthy society—if we want teenagers who choose not to get pregnant, young adults who choose not to abuse themselves or oth-ers—then we must first create 4 and 5 year olds with a deep sense of self worth. I will close with a brief story. A few years ago in the quiet hours of an early morning I was with a 17-year-old woman, who like so many women her age, la-bored well. In the room there was only my young patient, a labor nurse and me. The young woman had never known her father. Her boyfriend had left her long before when he learned she was pregnant. She had not seen her mother for several years—her mom had continued to abuse drugs and alcohol. She gave birth to a beautiful baby boy. As I placed him on her chest, I recognized in her eyes the universal love of all new mothers. This moment was no less sacred than any birth I had attended.

President’s Perspective By: Oglesby Young, MD

Continued on pg. 3

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While acknowledging the many challenges that faced this new mom and baby, I held out hope that with the right support, this young woman could become the mom she wanted to be. And I hoped, too, that unlike his father her son would grow well and that someday he would attend the birth of his baby. It is only with the fulfillment of this hope that we can create the kind of world in which we all want to live. Programs Supported By Healthy Beginnings In 2008

The Baby Steps Program. Our first ever grant in 1996 established the Baby Steps Program which con-tinues today. Every woman who delivers at Concord Hospital is invited back to meet weekly with other new mothers and a nurse facilitator for support during the first few months of the baby’s life. Many of these groups continue as in “Beyond Baby Steps.” Impor-tantly, parents meet other parents who are having the same experiences and they build relationships that can lead to long term friendships and support. This pro-gram directly addresses the problem of isolation, ironically, so common after a woman has a baby to-day. Baby’s First Homecoming. The Concord VNA pro-vides at least one home visit 3-5 days after discharge from our hospital. So often this is the visit when the new mom has all the questions she did not know she would have when she was in the hospital. This visit serves as a good screen. If problems are identified, the mom is referred to her obstetrician and/or the baby referred to his or her physician. Postpartum Depression Support Group. Many of us forget the most common complication of preg-nancy is depression—20% of women experience sig-nificant postpartum depression. This group serves as a lifeline for some new moms. Parent Mentoring Programs. Our endowment pro-vides funding for several parent-mentoring programs. We support the Child and Family Services “Healthy Families Home Visiting Program” which serves at risk women under the age of 25 who are pregnant with their first child. An adult mentor follows a young woman through her pregnancy and the first few years of the baby’s life providing support and educa-tion. Riverbend Community Mental Health has a

similar home mentoring program empowering low income parents to give their child the best possible start in life. Grand Families Group. Parenting classes and sup-port for grandparents who are parenting for a second time. The Children’s Place. A parent cooperative in Con-cord, where we specifically fund a new parent support group and toddler playgroup. Mothers of Multiples. A support group for families caring for twins and some triplets. This special group of mothers share common experiences and provide important support in the first few months home from the hospital. Music and Movement Program. Concord Music School serves low income families by bringing the child and parent together to nourish the musician in each child. Books for Babies Program. Concord Public Library Foundation provides a children’s book for every mother who delivers at our Family Place. Just for Dads. Expectant fathers meet with other new fathers to learn not only how to be a better par-ent, but also how to provide better support for the new mother. Deaf Parent Support. The Northeast Deaf and Hard of Hearing Service provides a parenting skills pro-gram for deaf parents of hearing children. These deaf parents no longer feel isolated as they try to navigate the special challenges of parenting while deaf. Early Learning Project. This year we are support-ing New Hampshire’s new early learning project enti-tled “The Early Years Are Learning Years.” Through a joint effort of the state’s Department of Health and Human Services and the state’s Department of Educa-tion, materials will be created for parents of young children in Concord providing information about early education, health and family support services which are available in our community. Child devel-opment seminars for parents will be held at work places and schools. Concord has been selected as the pilot community for this New Hampshire state early learning project.

President’s perspective continued from page 2

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Frequently Asked Questions

Q I have an older Model Exposure Control Plan for Bloodborne Pathogens booklet the Medical Society pub-lished. Has NHMS done an updated version?

A No, we have not, so much information is available on the internet, you may get the most recent version from OSHA directly by going to www.osha.gov/Publications/osha3186.pdf.

Q I sent my name in to volunteer for the malpractice screening panel ages ago and I have not been called. Am I on the list?

A We have over 600 names on the list and are aiming for 1000. Thank you to everyone that has volunteered and if you have not, it is not too late. The odds of you being called are relatively slim in any given year.

Physicians will be called to serve on the 3 member panels based on specialty and geographic information. You will be called if a physician in your specialty in another part of the state has had a suit filed. In some cases it is difficult to find someone who does not know the people involved and many will be called before a match is made. At other times they may make a match with just a couple of contacts.

Update from NHMS Single Payer Interest Group By: Gary Sobelson, MD

The NHMS Single Payer Interest Group, created to study national and state single payer health care reform proposals and inform the NHMS membership through NHMS communication mecha-nisms, has conducted meetings around the state over the past few months. On August 21, 2008, a meeting was held at the Keene Public Li-brary. State Representative Jill Shaffer Hammond spoke on “Single Payer In New Hampshire? How Do We Get There From Here?” She presented an overview of legislative actions to provide health care in New Hampshire to uninsured and underinsured populations. One ap-proach some states are taking is to allow buy-ins to the state employ-ees’ health insurance plan. Dr. Camilla Jones discussed the need for a national solution for health care and presented a short slide show presentation with a summary of HR 676 (United States National Health Insurance Program). Discus-sion included the benefits of the proposed program for all individuals and especially small businesses.

Interested NHMS members should continue to watch the NHMS e-newsletter for announcements of future meet-ings, or contact Dr. Camilla Jones at cjtatem@roadrunner.com.

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Next NHMS Executive Committee Meeting 3:30

NHMS office

7 N State St. Concord, NH

October 8, 2008

NHMS CAP is a paid membership program whose members meet criteria as posted at www.nhms.org

The New Hampshire Medical Society Corporate Affiliates Offer the following services

Accounting

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Financial

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Transcription

Vaccine programs

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NH Pediatric Society

Children, Pediatricians and the Media October 28,2008

Holiday Inn Concord, NH 7:30am-4:00pm

MEDIA LITERACY - the effect of media on kids and what we can do about it, MEDIA ADVOCACY - promote child health and get your message out in old and new media Keynote speaker: Dr. Vic Strasburger - Chief of the Division of Adolescent Medicine at the University of New Mexico. From TV to movies to the internet and beyond- pick your poison - drug use, obesity, sexuality and vio-lence. Vic is a provocative and engaging author and speaker. Call Catrina 603-224-1909 or Catrina.Watson@NHMS.org for details

NHAFP Annual Meeting

Common Inn Concord, NH November 19, 2008.

6-9pm Guest Speaker James King, MD current AAFP

President

$ 20/pp Spouses are welcome

Please contact catrina.graves@nhms.org Or call 603-224-1909 for information

CME, Meetings & Events

Concord Hospital Grand Rounds Schedule for October

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NH Legislative Report By: Janet Monahan Legislative study committees and study commissions have started meeting now that summer is over and the Legislative Office Building has “re-opened” with new carpeting and wallpaper. (No money for new drapes.) HB1484, a commission to study retail health clinics (mini-clinics or minute clinics); HB1502, a commission to develop alternatives to the disposal of medical sharps in household waste; and SB395, will review NH statutes on HIV education, prevention and control. Some of the NH physicians serving on legislative study commis-sions: Stuart Glassman, MD, on HB1335, a study of the effects of PTSD and traumatic brain injury suffered by NH soldiers and returning veterans. Chuck Capetta, MD, Mary McGowan, MD, and Jon Wahrenberger, MD, HB1422, the prevention of childhood obesity. Gary Woods, MD, HB533, the seat belt commission. The House Health Committee and House ED&A Committee continue to meet to hear the Legislative Budget Assistant staff testify on their performance audit of the Board of Medicine. Some Committee members will likely file legislation for 2009 to make changes and improvements to current Board procedures and functions.

COBRA and NH State Continuation

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that employers with 20 or more employees on at least 50% of its typical business days are to provide former employees and dependents that lose group health benefits with an opportunity to continue group health insurance coverage.

NH State Continuation is applicable to NH residents who are members of an employer group plan.

COBRA and NH State Continuation allow employees who are covered under a group hospital, surgical, medical or dental insurance plan and who becomes ineligible for continued

coverage for any reason, other then termination due to gross misconduct, to continue their coverage for an extended period of time. The length of coverage is determined by the reason for the loss of coverage.

Qualified beneficiaries of COBRA and NH State Continuation are eligible to continue their coverage for a maximum period of:

A) 18 months for termination of employment (for reasons other than gross misconduct) or reduction in hours.1

B) 36 months for a dependent child due to “loss of dependent child status.”

C) 36 months for eligible dependents upon employee becoming Medicare eligible or upon retirement.2

D) 36 months for eligible dependents upon the death of employee. 2

E) 36 months for eligible dependents upon divorce or legal separation. 2

1In some circumstances where a qualified beneficiary becomes eligible for disability benefits under Medicare, the beneficiary may become entitled to an additional 11 months of coverage.

2In cases where NH State Continuation applies, eligible beneficiaries age 54 or younger are entitled to the 36-month maximum. Those beneficiaries 55 years of age or older the extension period shall continue until the beneficiary becomes eligible for other coverage or Medicare.

For more information, contact your NEEBCO service representative at 603-228-1133

Benefits Corner – Brought to you by New England Employee Benefits Company, Inc. Your Employee Benefit Source

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HUMANITIES

Avoid excessive activity in hot weather

*These photos were taken by Dr. Gary Sobelson, MD on a recent trip to Africa.

Maintaining hydration is important when traveling

Partying at night does have its advantages!

“Medical Advice for the Traveler”

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New Hampshire Medical Society 7 North State Street Concord, New Hampshire 03301-4018

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