wake county physican magazine april 2014

contents

5 doing something different—wcms alliance update

7 6

8

welcome new wcms members

improving medication compliance

navigating the new health insurance marketplace

10 wcms thanks project access practices and physicians for the donated care provided in 2013!

16 why join wcms

4 betsy tilson receives 2014 health care hero award

20 the madness of lady macbeth: the other tragedy

22

ncms spearheads initiative to educate health community

on accountable care

WAKE COUNTY PHYSICIAN | 1

Publisher

Editor

Wake County Medical Society

Officers and Executive

Council

Council Members

WCMS Alliance

Co-Presidents

Wake County Medical Society

Paul Harrison

2014 President | Patty Pearce MD Secretary | Robert Munt, MDTreasurer | Robert Munt, MD President Elect | Andrew Wu, MDPast President | Dick McKay, MD Founding Editor | Assad Meymandi, MD, PhD, DLFAPA

Terry Brenneman, MDMaggie Burkhead, MDWarner L. Hall, MDKen Holt, MDM. Dixon McKay, MDAssad Meymandi, MD, PhD, DLFAPARobert Munt, MDPatricia Pearce, MDDerek Schroder, MDMichael Thomas, MD Brad Wasserman, MDAndrew Wu, MD

Deb Meehan Louise Wilson

WCPM

Wake County Medical Society2500 Blue Ridge Road, Suite 330

Raleigh, NC 27607 Phone: 919.792.3644

Fax: 919.510.9162 [email protected]

www.wakedocs.org

“The Wake County Physician Magazine is an instrument of the Wake County Medical Society; however, the views expressed are not necessarily the opinion of the Editorial Board or the Society.”

April 2014

contributors

L. Jarrett Barnhill, MD is a professor of Psychiatry at the UNC School of Medicine and the director of the Developmental Neuropharmacology Clinic within the Department of Psychiatry. He is a Distinguished Fellow in the American Psychiatric Association and Fellow in the American Academy of Child and Adolescent Psychiatry.

Angela McGee, PharmDis a clinical pharmacist that started working for Community Care of Wake and Johnston Counties in July 2013. She received her Bachelor of Science degree in Biology from North Carolina State University in 2005 and her Doctorate of Pharmacy degree from the University of North Carolina-Chapel Hill in 2009. Angela’s primary role with Community Care of Wake and Johnston Counties is to perform medication reconciliation in collaboration with care managers and to communicate and follow-up with primary care physicians on drug therapy problems identified for patients.

2 | APRIL 2014

Deborah Owens is a Federally Facilitated Marketplace (FFM) Navigator working in Wake and Johnston Counties.

Melanie Phelpsis Associate Executive Director, NCMS Foundation, Deputy General Counsel (NCMS).

Ben MacDonald is a care management nurse with Community Care of Wake and Johnston Counties. He also holds a degree in English Literature from UNC-Asheville.

Deborah Harrell Meehan As a physician’s spouse, Deborah responded to a personal invitation to join the Wake County Medical Society Alliance in 2006, a non-profit organization dedicated to bringing together the families of the medical community. After years of service in various roles, Deborah is currently the co-president of the Wake County Medical Society Alliance and serves on the Board of Directors for the North Carolina State Medical Alliance. She continues to serve the community as an advocate for the empowerment of women and the health and safety of women and children everywhere.

Deborah and her husband, Dr. David V. Meehan, are parents to eight wonderful children and three granddaughters.

Wake County Physician Magazine (WCPM) is a publication for and by the members of the Wake County Medical Society. WCPM is a quarterly publication and is digitately published January, July, April, and October.

All submissions including ads, bio’s, photo’s and camera ready art work for the WCPM should be directed to:

Tina FrostGraphic Editor [email protected] 919.671.3963

Photographs or illustrations:Submit as high resolution 5” x 7” or 8” x 10” glossy prints or a digital JPEG or TIF file at 300 DPI no larger than 2” x 3” unless the artwork is for the cover. Please include names of individuals or subject matter for each image submitted.

Contributing author bio’s and photo requirements: Submit a recent 3” x 5” or 5” x 7” black and white or color photo (snapshots are suitable) along with your submission for publication or a digital JPEG or TIF file at 300 DPI no larger than 2” x 3”. All photos will be returned to the author. Include a brief bio along with your practice name, specialty, special honors or any positions on boards, etc. Please limit the length of your bio to 3 or 4 lines.

Ad Rates and Specifications:Full Page $800 1/2 Page $400 1/4 Page $200

Additional contributors include:Paul Harrison | Executive Director, WCMSPam Carpenter | Project AccessDeborah Earp | Membership Manager, WCMS


Dear WCMS Executive Council Members,

Please note the following Executive Council meeting dates for 2014. Dates: May 13, 2014 Sept. 9, 2014 Nov. 11, 2014

Time: All meetings will take place at 6pm

Where: 2500 Blue Ridge Rd. #330 | Raleigh NC 27607 A light dinner will be served at each meeting.

On behalf of Susan Davis, Executive Director of Community Health Foundation and myself, we look forward to working with you throughout 2014.

Thank you,Paul HarrisonExecutive DirectorWake County Medical Society

4 | APRIL 2014

On Thursday, March 20th, Triangle Business Journal hosted the 2014 Health Care Heroes Awards at the Marriot

City Center in Raleigh. According to Bryan Hamilton, publisher of Triangle Business Journal, “these awards were created to recognize the many people who have put innovation and compassion to work to improve the human condition. The winners exemplify what it means to be heroes. Whether serving those in need or striving for innovation, these heroes do whatever it takes to offer critical services to change people’s lives.”

In consideration of this spirit of innovation and service, Elizabeth Cuervo Tilson, MD, MPH, was selected as a winner in the 2014 Health Care Heroes Award in the “physician” category.

Dr. Tilson is Board Certified in Preventive Medicine and Pediatrics, and serves patients in our community on two levels: as a practicing pediatrician in a safety net clinic in Wake County, and as a leader in population health with Community Care of Wake and Johnston Counties (CCWJC), a regional network of Community Care of North Carolina (CCNC).

In her direct patient care role, Dr. Tilson provides pediatric primary care in the Wake County Human Services (WCHS) Child Health

Clinic. Dr. Tilson’s work at WCHS is closely tied to quality improvement initiatives that have led to improved patient outcomes. Asthma is a major practice focus and the clinic is a leader in this area, having met 100% of the key quality metrics for asthma care for the past 3 years. There has also been a dramatic decrease in the rate of asthma related ED visits and hospitalizations for the patient population.

In addition to her role at WCHS, Dr. Tilson’s training in prevention and public health allows her to significantly impact the health of her local community, and to demonstrate “best practice” for other health care professions through her role as the Medical Director of Community Care of Wake and Johnston Counties (CCWJC). CCWJC is one of the regional networks of the statewide CCNC program. The CCNC networks provide population health, quality improvement, and care management services for Medicaid and other populations. The CCWJC network is administered through the Wake County Medical Society Community Health Foundation and encompasses approximately 155 primary care practices and 120,000 Medicaid patients and other populations. In her role as Medical Director, Dr. Tilson directs clinical initiatives, leads an internal team of physicians, fosters strategic

This year’s Health Care

Heroes Award

goes to... Betsy Tilson

By Ben MacDonald

[continued on page 20]


Doing Something DifferentReaching

into the same

bag of tricks inevitably leads to repeating the same ol’ same ol’…especially if you have a small bag and a

limited number of tricks! Telling the same great joke eventually gets boring…How many times can you laugh at the same punch line? If you haven’t already heard, this year’s WCMSA has broken out of the normal and somewhat expected routine. I can honestly say that with the active and passionate leadership of our Board of Directors, we have infused energy and enthusiasm into our mission, setting sparks…if not FIRES… of creativity, thus breathing new life into the organization! And…WE LOVE IT! On Sunday, March 2, the evening of the Academy Awards, we threw our FIRST EVER

Oscar Pre-Party Event from 5 – 7pm. Hosted by Dan and Karen Albright, their home was transformed into a Hollywood mansion, complete with a Red Carpet photo shoot, mini statues, catered delicacies and endless bubbly! We used this opportunity as a fundraising event for our target organization, F.I.G.S., selling raffle tickets to vote for our choice of Oscar Nominees in six categories...AND…there were great prizes! Not only did we raise significant dollars for our charitable organization, but we also recruited 3 new members for the Alliance and had a total blast doing it! It’s simply amazing what a few fresh ideas, combined with that spark of creativity can do to take your organization to the next level! Watch out…There’s more to come!

Cheers!Deborah Harrell MeehanCo-President, Wake County Medical Society Alliance, 2013-2014

wcms alliance update

6 | APRIL 2014

Kevin M. Bowman, MDPractice: Raleigh OphthalmologySpeciality: OphthalmologyMedical School: Wake Forest University School of MedicineGraduation: 2008Hobbies: Hiking, camping, kayaking

Matthew Kanaan, DO, MS, CAQSM Spouse: Amanda KanaanPractice: Wake Sports Medicine Speciality: Primary Care Sports Medicine / Nonsurgical Orthopedics Medical School: Lake Erie College of Osteopathic Medicine Graduation: 2009Hobbies: golf, tennis

Marshall A. Kuremsky, MDSpouse: Cara KuremskyPractice: Triangle Orthopaedic AssociatesSpeciality: Orthopaedic SurgeryMedical School: Columbia University, College of Physicians & SurgeonsClass of: 2003

Michael (Mike) F. Soboeiro, MDSpouse: Elizabeth SoboeiroPractice: WakeMed Garner Primary CareSpeciality: Internal MedicineMedical School: UNC Graduation: 1991Hobbies: Golf, church, yoga, social justice

Peter H. Adler, MD | Emergency MedicineWilliam T. Bradford, MD | American Anesthesiology of NC-Wake Practice CenterEdwin R. Cadet, MD | Raleigh Orthopaedic ClinicWilliam T. Cushing, MD, MBA, JD | William T. Cushing, MD, JDRobin L. Elledge, PA-C | Bariatric Specialists of North CarolinaMaxlyn L. V. Ellison, MD | Ellison & Associates of RaleighJ. Todd Harris, MD | Raleigh Children & Adolescent MedicineKimberly D. Jones, PA-C | Triangle Orthopaedic AssociatesAndreas W. Linke, PA | Fast Med Urgent CareKimberly Livingston, MD | WakeMed Faculty PhysiciansJennifer L. R. Long, MD | Raleigh Children & Adolescent MedicineNisha T. Manickam, DO | Raleigh Infectious Diseases AssociatesLori A. McLamb, PA-C | Raleigh Orthopaedic ClinicIshtiaque H. Mohiuddin, MD | Premier CardiovascularLanning R. Newell, MD | Triangle GastroenterologyJessica O’Neill, PA-C | Wake Nephrology AssociatesAlison S. Powell, MD | American Anesthesiology of NC-Wake Practice CenterCarl L. Smith, DO | Triangle Orthopaedic AssociatesSarah Stout, PA-C | Bariatric Specialists of North CarolinaChristopher M. Terry, MD | American Anesthesiology of NC-Wake Practice CenterDonna A. Theodore, PA | Wake Nephrology AssociatesAnne T. Tuveson, MD | Wake Dermatology AssociatesFrank J. Wessels, MD | Saleeby & Wessels, MDSung-Eun Yoo, MD | Cary Endocrine & Diabetes Center


3.8 billion prescriptions are written every year in the United States, yet more than 50% of them are taken incorrectly or not taken at all. Non-compliance continues to be an epidemic that is contributing to poor outcomes for patients with chronic diseases and increased costs to the health care system, as it accounts for 33-69% of medication-related adverse events resulting in hospital admissions. Compliance remains poor even after life-threatening events such as an MI. Research has shown that within 2 years of starting therapy post-hospitalization for an acute MI, only half of patients were still taking prescribed statins, beta-blockers, ACE inhibitors, or ARB’s. The question still remains: How can we get patients to be more compliant and what steps are we taking locally in our community to improve these staggering statistics?

Compliance is such a challenge due to its complexity and unfortunately there is no universal solution. Multiple factors can play a role in patient non-compliance and reasons why patients may go off-regimen vary from person to person, but may include forgetfulness, perceived side effects, denial, lack of knowledge, financial barriers, psychological barriers, health literacy, complexity of regimen, and provider-patient relationship. From a provider standpoint, it is becoming more difficult for them to engage patients in conversations and explore how patients view their chronic diseases and medications due to time constraints. Strengthening the provider-patient relationship is one stepping stone that may have a positive influence on patient behaviors and they may therefore be more likely to comply with the recommendations and advice provided to them.

Community Care of Wake and Johnston Counties’ multi-disciplinary team of nurses, social workers, pharmacists, patient coordinators and provider services specialists act as extensions to a patient’s primary medical home to assist with and facilitate coordination of care in an effort to improve patient outcomes. When a patient is discharged from the hospital, a patient coordinator follows up with them within 72 hours and attempts to make arrangements for a care manager to complete a home visit with the patient to assess for potential care deficits. Data including discharge information and medication lists from multiple sources are gathered prior to a home visit. Medications are assessed during the

home visit and compliance is evaluated with the use of open-ended questions and motivational interviewing techniques to determine if there are specific barriers patients may have to taking certain medications as directed. CCWJC pharmacists work collaboratively with care managers to look for any additional drug therapy problems and provide reporting to physicians for any concerns, including compliance issues, requiring notification or follow-up.

CCWJC also partners with local pharmacies in our community that participate and engage in programs to address some of the socioeconomic, patient-related, and therapy-related concerns that lead to compliance issues. Some of the services currently offered include synchronizing and blister packaging medications, filling pill boxes, delivering medications, and coordinating payment plans in cases where there are financial barriers to taking medications, which CCWJC finds is a major burden for many of our patients. For a list of local pharmacies involved in some of these specialty services in the Wake and Johnston County area please email your CCWJC network pharmacy representative at [email protected].

The concept of improving compliance seems

Improving Medication Compliance: A Collaborative

Approach

By Angela McGee


8 | APRIL 2014

My father was a physician in a small town in eastern North Carolina. His hero was Margaret Thatcher and so

our discussions on health care delivery touched on the evolution of the American and British systems and lots of free-wheeling discussions of the efficacies, judgments, economics and political considerations inherent in the practice of American medicine.

He was a great diagnostician, opined that the only two good things to ever come out of

Boston were anesthesia and the New England Journal of Medicine, and like his hero Maggie, considered himself an old school Conservative. His voice is one of the many things that run through my head each day as I meet with clients as a Navigator for the Health Insurance Marketplace (HIM).

The Affordable Care Act (ACA) has brought about some significant changes for many people. Young adults can remain on their parents’ insurance, pre-existing conditions don’t affect eligibility for coverage, lifetime and yearly coverage limits have been eliminated,

and insurance plans are more comprehensive. One of the biggest impacts is the access to affordable insurance for people who were uninsured, underinsured, or unable to afford comprehensive health plans. People can now go online, call or mail in applications for coverage, receive assistance by phone or in-person, and easily compare plans whose benefits are clearly and simply spelled out.

The CapitalCare Collaborative (CCC) has long had a focus on increasing access to health care

for the uninsured, so when the opportunity arose to join a consortium in order to apply for funds to bring on HIM Navigators, it was an easy decision. This initiative fit well with our mission, and because of our partnerships and collaborations we were confident that we could play a big role in getting people in Wake and Johnston Counties connected with affordable coverage.

Open Enrollment began October 1, 2013 and runs through March 31, 2014, but the first couple of months were problematic with the www.healthcare.gov system. Much of the time Navigators spent with consumers was spent on

Navigating the New Health Insurance Marketplace

By Deborah Owens



Rotunda, North Carolina State Capitol, Raleigh, North Carolina Ranked #27 of 135 attractions in Raleigh Created Date:1833 to 1840

Architectural Note: The structure is one of North Carolina’s finest and best pre-served Greek Revival public buildings. A sequence of architects were involved in the project. Nichols functioned only in the capacity of architect on this project In 1970, a marble replica of the Canova Washington was added. The building was restored to its original paint colors and granitizing in the 1990s. Historical Note: The building is listed on the National Register of Historic Places, both as a North Carolina Historic Site and as a National Historic Landmark. Photo by John Elk

WHERE IN RALEIGH?

10 | APRIL 2014

American Anesthesiology of NC Ajinder Chhabra, MDAl Melvin, MDAmanda Crow, MDAmanda Froment, MDAndrew Lutz, MDAsra Ali, MDBenjamin Antonio, MDBruce Janson, MDBrendon Howes, MDBryan Max, MDCarrie Gill-Murdoch, MDCharles Nicholson, MDChrista Gray, MDClarence Huggins, MDDaniel Amitie, MDDeborah Pellegrini (Quint), MDDeitra Williams-Toone, MDDonald Edmondson, MDEarl Crumpler, Jr.

Edgar Garrabrant, III, MDEdward Bratzke, MDElee Stewart, MDErhan Atasoy, MDEric Mason, MDFrancis “Fran” Abdou, MDFrancis “Greg” Brusino, MDGerald Maccioli, MDHsiupei Chen, MDJack Lam, MDJafar Shick, MDJames Collawn, MDJames Cummings, II, MDJeremy Reading, MDJohn McDowell, MDJonathan Blank, MDJustin Hauser, MDKaren Meyers, MDKassell Sykes, Jr., MDKeith Kittelberger, MD

Kimberly Greenwald, MDManu Gupta, MDMatthew Atkins, MDMelanie Lutz, MDMichael Hauser, MDMichael Lish, MDMichael Neville, MDNathan Christie, MDNevin Shrimanker, MDNicole Scouras, MDPaul Woodard, MDRalph Ramos, MDRandy Efrid, MDReed VanMatre, MDRobert Alphin, MDRobert Marshall, III, MDRobert “Paul” Rieker, Jr., MDRobert Seymour, III, MDRobert Treadway, Jr., MDRonald Gore, MD



Russell Ford, MDScott Garrison, MDScott Tyrey, MDShawn Kruse, MDShehzad Choudry, MDSherman Lee, MDStephen Rogers, MDSteven Sherman, MDSusan Steele, MDThomas Buchheit, MDThomas Monaco, MDTimothy Gruebel, MDVincent Hoellerich, MDWalter Daniel, MDWendell Zee, MDWhitney Scott, MDWilliam Bolding, MDWilliam Corkey, MDWilliam Crocker, MD

Andrus & Associates Dermatology, PA

Rebekah M. Oyler, MD

Associated Urologists of North Carolina

Mark Jalkut, MDTimothy P. Bukowski, MDSteven Shaban, MDBrian Bennett, MDScott Baker, MDMarc Benevides, MDDaniel Khera McRackan, MDJoseph Neighbors, MD

AUNC Cary Urology PAKevin Khoudary, MDKevin Perry, MDFrank Tortora, MDWilliam Kizer, MD

Bariatric Specialists of NCMichael A. Tyner, MD

Cancer Centers of North Carolina

Alan Kritz, MDCharles F. Eisenbeis, MD PhDElizabeth Campbell, MDJohn Reilly, MDMargaret Deutsch, MDMark Yoffe, MDNeeraj Agrawal, MDP.J. Singh, MD

Roy Cromartie, MDScott Sailer, MDStephen Tremont, MDVirgil Rose, MDWilliam Berry, MDJohn F. Reilly, MDScott D. Meredith, MDMonica B. Jones, MD

Capital Area Ob-Gyn Associates, PA

Christin N. Richardson, MDGeorge M. Tosky, MDKatherine E. Barrett, MDMichael F. Buckley, MDPaige L. Gausmann, MD

Capital Nephrology Associates, PA

Daniel W. Koenig, MDFrederick S. Jones, MDJames E. Godwin, MDJeffrey G. Hoggard, MDKevin M. Lee, MDMichael I. Oliverio, MDPrabhakar N. Vaidya, MD

Capital Neurology & Headache Center

David H. Cook, MD

Capitol Ear Nose & Throat, PADavid A. Clark, MDH. Craig Price, MDJeevan Ramakrishnan, MDMark S. Brown, MDR. Glen Medders, MDStanley Wilkins, MDSteven H. Dennis, MD

Capitol Raleigh ENTH. Clifton Patterson, MDKevin M. Doyle, MDLaura Devereux Brown, MDMark W. Clarkson, MDMatthew J. Gerber, MDStephen E. Boyce, MDSteven J. McMahon, MDWilliam F. Durland, Jr., MD

Caroling Cardiology - WMFPWilliam Parsons, MDJames Nutt, MD

Carolina Endocrine, P.A.Michael J. Thomas, MD, PhDKhushbu Chandarana, MDCourtney Koppenal, PA-CEllie Andres, PA-C

Cary DermatologyCatherine Hren, MDHeidi Mangelsdorf, MDCary Ob-GynMichael Anthony, MDSharon Stephenson, MD

Centre Ob-GynAnn Collins, MDErika Clark, MDJerome Gardner, MDRandolph Scott, MDRobert Littleton, MDTanneisha Barlow, MD

Creedmoor Centre Endocrinology

Julia Warren-Ulanch, MD

Dermatology Skin Cancer CenterEric D. Challgren, MDGregory J. Wilmoth, MDLaura D. Briley, MDMargaret B. Boyse, MDW. Stacy Miller, MDTracey S. Cloninger, PA-C

Digestive HealthcareMurtaza K. Parekh, MDColm O’Loughlin, MDKaren Saville, FNPKenneth R. Kohagen, MDM. Dixon McKay, MDRuth Mokeba, MDNaveen V. Narahari, MDRig S. Patel, MD

Duke Cardiology of RaleighLawrence Liao, MDRadha Kachhy, MDJames Peterson, MDMark Leithe, MDStephen Robinson, MD

Duke Cancer Center of RaleighMichael Spiritos, MDSharon Taylor, MDYuri Fesko, MD

12 | APRIL 2014

Duke Eye Center of RaleighChristopher Boehlke, MDEric Postel, MDGrace Prakalapakorn, MDJason Liss, MDLeon Herndon, MDPaul Hahn, MD

Duke Gastroenterology of Raleigh

Aaron Woofter, MDJane Onken, MDJesse Liu, MDMichael Feiler, MDRebecca Burbridge, MD

Duke Neurology of RaleighPaul Peterson, MD

Duke Otolaryngology of RaleighSeth Cohen, MD

Duke Radiology of RaleighAlan Rosen, MDMarc Finkel, MDMorgan Camp, MDRobert Vogler, MDTedric Boyse, MDVernon W. Pugh, III, MD

Duke Thoracic SurgeryDavid White, MDKatie Gillis, PA-C

ENT & Audiology AssociatesDouglas K. Holmes, MD

Eye Specialists of Carolina Demetrius Dornic, MD

Friendship Medical Center Annette Troy, MD

Fuquay Chiropractic & Wellness Cente, PLLC

Jill M. Miehe Currin, DC

Joyner OphthalmologyWalton Joyner, MD

Kamm, McKenzie, Harden, Smith, Bass

Ashley N. Rush, MDBrian Bass, MD

Crystal Privette, MDCynthia Saacks, MDJoel M. Berstien, MDLauren M. Wheeler, MDMichael D. Smith, MDPaul B. Harden, Jr., MDSheppard McKenzie, III, MD

Mann ENTCharles H. Mann, MDJared E. Spector, MDRichard M. Jones, MD

Mid Carolina Obstetrics & Gynecology, PC

Amy O. Groff, MDEloise Watson, MDLeon F. Woodruff, MDMyra Lynn Teasley, MDRuth Wind, MDSarah Maddison, MD

Orthopaedic Foot & AnkleSarah E. Dewitt, MD

Piedmont Foot & Ankle Clinic, PA

Jason E Nolan, DPMRichard J. Hauser, DPMRobert J. Lenfestey, DPM

Raleigh Endocrine AssociatesElizabeth M. Holt, MD

Raleigh Endoscopy CenterRaleigh Infectious Diseases

Christopher Ingram, MDEdwin Brown, MDHenry Radziewicz, MDHenry T. Radziewicz, MDJohn Engemann, MDNisha Manickam, MDPaul Becherer, MDRavi Padmanabhan, MDDebra Kosko, FNPDiane Tilley, FNPDrew Bullington, ANPLaurie Hogan, ANP

Raleigh Neurology Associates, PA

A. Thomas Perkins, MDDavid Konanc, MDEric Kirch, PA-C

Gregory Bertics, MDKaren Riley, NPKatharine Kovacs, PA-CKeith Hull, MDKelly Pate, NPKenneth Carnes, MDMichael Bowman, MDPatricia Naslund, MDPavan Yerramsetty, MDRhonda Gabr, MDS. Mitchell Freedman, MDScott Binford, PA-CSusan Glenn, MDTheresa Behil, NPWanda Cecil, NPWilliam Ferrell, MD

Raleigh Neurosurgical ClinicRobin Koeleveld, MD

Raleigh Ophthalmology & Surgical Eye Associates

Timothy Jordan, MD Raleigh Orthopaedic ClinicBradley K. Vaughn, MDCara B. Siegel, MDCarroll D. Kratzer, MDDaniel J. Albright, MDDavid W. Boone, MDDwayne E. Patterson, MDG. Hadley Callaway, MDHarrison Gray Tuttle, MDJeffrey K. Kobs, MDJohn B. Chiavetta, MDJoseph U. Barker, MDKeith P. Mankin, MDKevin Logel, MDLeonard D. Nelson, Jr., MDLyman S.W. Smith, MDMark R. Mikles, MDMatthew T. Boes, MDNeil C. Vining, MDRobert T. Wyker, MDScott M. Wein, MDWallace F. Andrew, MDWilliam M. Isbell, MD

Raleigh Pathology LabsRaleigh Plastic Surgery

Glenn Lyle, MDRhett High, MD

Raleigh RadiologyAndrew B. Weber, MD


Andrew G. Moran, MDCynthia S. Payne, MDDonald G. Detweiler, MDGintaras E. Degesys, MDGregory A. Bortoff, MDGregory C. Hinn, MDJason R. Harris, MDJeffrey Browne, MDJennifer S. Van Vickle, MDJerry L. Watson, MDJohn G. Alley, Jr., MDJoshua B. Mitchell, MDJuilia K. Taber, MDKirk D. Peterson, MDLaura O. Thomas, MDMark H. Knelson, MDMichael C. Hollingshead, MDNeil A. Ramquist, MDSatish Mathan, MDSteven R. Carter, MDSvati Singla Long, MDTodd J. Roth, MDTracey E. O’Connell, MDW. Kent Davis, MD

Rex Heart & VascularGeorge Adams, MDJames G. Jollis, MD, FACCSameh K. Mobarek, M.D.,

F.A.C.C.Deepak Pasi, M.D., F.R.C.P.,

F.A.C.C., F.S.C.A.I., F.A.A.C.Mohit Pasi, M.D., F.A.C.C.,

F.S.C.A.I.Bruce Usher Jr., M.D., F.A.C.C.Ben Walker, M.D.James Zidar, M.D. F.A.C.C,

F.S.C.A.I.

Rex Hematology Oncology Associates

Marie Carr, PAAshley Bragg, PAClare Bremer, PADenise Pescaro, NPJeremiah Boles, MDNirav Dhruva, MDMaha Elkordy, MDErin Adcock, PAJeffrey Crane, MDJoEllen Speca, MDLola Olajide, MDSusan Moore, MDBeverly Neely, NPRobert Wehbie, MD

Rex Pathology AssociatesF. Catrina Reading, MDJohn D. Benson, MDJohn P. Sorge, MDKeith V. Nance, MDPreeti P. Parekh, MD Keith Volmar, MDTimothy R. Carter, MDVincent C. Smith, MD

Rex Surgical SpecialistsDustin M. Bermudez, M.D.Tricia A. Burns, P.A.-C.Woodward Cannon, M.D.,

F.A.C.S.Richard A. Chiulli, M.D.,

F.A.C.S.Joel B. Dragelin, M.D., F.A.C.S.David B. Eddleman, M.D.,

F.A.C.S.Kirk B. Faust, M.D., F.A.C.S.Rachel Goble, D.O.Thomas W. Maddox, M.D.,

F.A.C.S.Peter M. Milano, M.D., F.A.C.S.Peter C. Ng, M.D., F.A.C.S.Paul B. Park, M.D.Yale D. Podnos, M.D., F.A.C.S.David C. Powell, M.D.,

F.A.C.S., R.P.V.I.Lindsey S. Sharp, M.D.David, A. Smith, M.D.Jerry A. Stirman, M.D., F.A.C.S.Matthew J. Strouch M.D.

Daniel R. Vig, M.D., F.A.C.S.Seth M. Weinreb, M.D.,

F.A.C.S.

Rex/UNC Radiation OncologyCatherine Lee, MDCharles W. ScarantinoJustin Wu, MDLawrence Marks, MDLeroy Hoffman, MDRobert Ornitz, MDRoger F. Anderson, MD

Richard D. Adelman, MDRichard D. Adelman, MDDonna GriffithKathleen Janus, FNPSouthern Eye AssociatesJerome Magolan, MDPhilip Martin, MDTaylorRetinal CenterJeffrey Taylor, MDJ. Carey Pate, MDNitin Gupta, MDThe Raleigh Eye CenterAlice Lin, MDHolly P. Johnson, MDJames W. Kiley, MDR. Jeffrey Board, MD


14 | APRIL 2014

Triangle Radiation OncologyTriangle Orthopaedic Associates, PA

Brett J. Gilbert, MDDavid B. Musante, MDElliot Kopp, MD (rheum)Eugenia F. Zimmerman, MDJoseph B. Wilson, MDKurt J. Ehlert, MDMark A. Burt, MDPaul J. Kemer, MDPerico N. Arcedo, DOShepherd F. Rosenblum, MDTony Ning, MD (rheum)William D. Hage, MDWilliam P. Silver, MD

Wake Endoscopy CenterChris Schwarz, MDMichael Battaglino, MDMonica Manzi, PA-CNeeraj Sachdeva, MDRonald Schwarz, MDSubhash Gumber, MDTracy Jones, PA-CWake GastroenterologyBulent Ender, MD

Wake Nephrology Associates, PAKarn Gupta, MDMark Rothman, MDMichael Casey, MDMichael Monahan, MDPhillip Timmons, MDSammy Moghazi, MDSamsher Sonawane, MDSejan Patel, MD

William Fan, MD

Wake Opthalmology AssociatesRobert Stone, Jr., MDChristopher Rusinek, MD

Wake Radiology Consultants, PA Wake Radiology Diagnostic Imaging, Inc.Wake Radiology Oncology Services

Alan B. Fein, MDAndrew C. Wu, MDAndrew S. Kennedy, MDBrent Townsend, MDBryan M. Peters, MDCarmello Gullotto, MDCarroll C. Overton, MDCatherine Lerner, MDCharles V. Pope, MDClaire M. Poyet, MDDanielle L. Wellman, MDDavid Ling, MDDavid Schulz, MDDennis M. O’Donnell, MDDuncan Rougier-Chapman,

MDEithne T. Burke, MDElizabeth A. Rush, MDG. Glenn Coates MS, MDHolly J. Burge, MDImre Gaal, Jr., MDJ. Mark Spargo, MDJared B. Bowns, MDJohn Matzko, MDJohn Sierra, MDJoseph B. Cornett, MD

Joseph W. Melamed, MDKaren A. Coates, MDKerry E. Chandler, MDLaura Meyer, MDLouis F. Poscillico, MDLyndon K. Jordan, III, MDMargaret R. Douglas, MDMark Marchand, MDMartin Rans Douglas, MDMelissa C. Lipton, MDMichael D. Kwong, MDMichael L. Ross, MDNikunj P. Wasudev, MDPaul A. Haugan, MD Peter L. Leuchtmann, MDPhillip C. Pretter, MDPhillip R. Saba, MDR. David Mintz, MDRandy D. Secrist, MDRichard E. Bird, MDRichard J. Max, MDRobert A. Cerwin, MDRobert E. Schaaf, MDRussell C. Wilson, MDScott R. Sailer, MDSendhil K. Cheran, MDSteven R. Mills, MDSusan L. Kennedy, MDSusan M. Weeks, MDThomas L. Presson, Jr., MDWilliam G. Way, Jr., MDWilliam James Vanarthos, MDWilliam T. Djang, MD

Williams, Benavides, Marston & Kaminski, MD, PA

Randall Williams, MD

Mental Health ProvidersCynthia Dowdy, PhDE. Janice Morgan, LCSWGayle Gonzalez-Johnson,

LCSWJohn O Donoghue LMFT Lou Murray, Substance Abuse

CounselingMargaret J. Dorfman, MD

North Raleigh PsychiatryJeffrey Snow, MDJohn Olarte, MDBrady Lamm


simple. There are essentially 4 steps involved: receiving the correct prescription, filling the prescription, remaining on the medication for at least 6 months when rates of non-compliance are highest, and continuing the medication as directed for an indefinite period. Since there is no “magic bullet” suitable for addressing medication non-compliance for all patients, health care providers are often charged with determining the breakdown in these steps in a world where time constraints prohibit in-depth patient interactions. Providers working as part of an integrated team that may include nurses, social workers, pharmacists, and local resources such as pharmacies that target noncompliance may be our best defense in confronting this health care epidemic. §

REFERENCES:1. Cutler DM, Everett W. Thinking outside the pillbox – medication adherence as a priority for health care reform. N Engl J Med. 2010,362:1553-1555.2. Why Are So Many Patients Noncompliant? Medscape. Available from www.medscape.com/viewarticle/818850. Jan 16, 2014.3. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-489. 4. Akincigil A, Bowblis JR, Levin C, et al. Long-term adherence to evidence based secondary prevention therapies after acute myocardial infarction. J Gen Intern Med. 2008;23:115-121.5. World Health Organization. Adherence to Long-Term Therapies: Evidence for Action. Publication WHO/MNC/03.01. Geneva, Switzerland: WHO; 2003.

[Improving Medication continued from page 12]

National Doctor’s Day is commonly celebrated in healthcare organizations as a day to recognize the contributions of doctors to individual lives and communities.

community partnerships, and provides guidance, resources and education to providers in the network.

Over the last six years, Dr. Tilson helped forge and lead a collaborative multi-disciplinary team from CCWJC, WCHS, and Wake County Environmental Services to address environmental triggers for pediatric asthma patients. The program, entitled “Environmental Asthma Trigger Home assessment Program” has been shown to improve the lives of children by improving their asthma control and making their home a safer place to live. This collaboration has also resulted in decreased asthma-related ED use, hospitalizations, and health care costs, and has led to a national health award for Wake County from the National Association of Counties.

Dr. Tilson’s effective leadership as the medical Director of CCWJC was summarized in a recent CCNC site review, where descriptions of network performance included: “Outstanding leadership team with a balance of clinical and operational leadership;” “The Network has created a quality based, mission driven culture that has improved population health outcomes;” and “Leadership has been forward thinking and has worked to engage strategic partners in population management initiatives.”

Dr. Tilson’s peers echo this praise. As one of her peer physicians in the network stated, Dr. Tilson “has a wealth of knowledge regarding the resources that are available in the county for Medicaid clients and the initiatives being brought

forth at the state and local level. This sharing of information is a huge benefit to all of our staff.” Another physician offered, “…with the guidance of the leaders in Community Care, we physicians are shown better, more cost effective ways of managing our most complicated patients. This is good for everyone.” Yet another peer exclaimed, “Joining CCWJC is the best thing we ever did for our practice.”

Dr. Tilson reflects on her work saying, “I recognize and value the enormous privilege and responsibility I have been given to care for people. As such, I am motivated by a sincere desire to improve the health and health care system for the patients and populations I serve, especially the most vulnerable in our community. I greatly value the respect I have been shown from my colleagues and peers as a trusted source of guidance, information, support, and leadership and I continually strive to be worthy of and build upon that trust. Finally, I am honored to receive some of the credit for the successes of the whole CCWJC staff and network providers, including our network receiving the highest level of assessment by the CCNC central office.”

Given the scope and impact of her innovations and leadership in our community, Dr. Tilson is clearly deserving of this year’s Health Care Heroes Award. §

[Medical Hero continued from page 4]

16 | APRIL 2014

From left to right: Dr. Allen Dobson, President of Community Care of North Carolina; Hugh Tilson, husband; Dr. Elizabeth Tilson; Susan Davis, Executive Director of Wake County Medical Society Community Health Foundation.


From left to right: Dr. Allen Dobson, President of Community Care of North Carolina; Hugh Tilson, husband; Dr. Elizabeth Tilson; Susan Davis, Executive Director of Wake County Medical Society Community Health Foundation.

18 | APRIL 2014

educating them on the ACA and estimating the subsidies they would likely be eligible for. Before the website fix towards the end of November, it was unusual to be able to sign someone up, but now it’s unusual not to be able to do so. Despite the slow start, the payoff has been great. We are seeing the reduced stress of a consumer base that was making high cost COBRA payments that were draining their savings accounts or that were in high risk insurance pools that could cost half of their monthly income. Now there is excitement from the large volume of uninsured for whom January 1st (the first effective date of coverage) couldn’t come fast enough.

And while I’ve still got a few errant insurance card e-mails in my inbox, people often write and tell me things like they’ve gotten flu and shingles vaccinations, treatment for ACL tears, and much needed medications – or even that they have begun discussions with a provider about a bone marrow transplant. Through these consumers, I hear the nascent work-a-day delivery of health care to folks who had either been left out or priced out – often for many years.

While meeting with these good folks over these fast few months, I’ve been struck by so many things. I have been reminded that employment is still extremely scarce, and that the very nature of it has been altered beyond many people’s recognition, including the delinking of health care to employment in many cases. The doldrums of the economy has certainly been a factor. The stories are vast and varied. There is the diabetic who desperately needed health coverage but who had been denied coverage for being “too sick”. There was the couple digging into their retirement savings well before retirement age to pay for COBRA and health costs after a cancer diagnosis that followed a lay off. I’ve met with

middle class folks who never in a million years would have thought they would have found themselves with not savings and uninsured, but there they are. In short, I’ve seen a sea of need out there.

For some people, it’s the first time ever, or in a long time, that they’ve had coverage. I have seen people pulling out their “readers” and getting out sharp pencils as they look at their out-of-pocket expenses when comparing plans. The ACA has made insurance policies more transparent, with long listings of Summary of Benefits that I have spent hours mulling over with clients. While some previously insured are dealing with higher premiums (and richer plans), our lower and lower middle income consumers are facing deductibles and co-insurance - that “skin in the game” - along with the multitude of calculations that go on when prescription drugs are thrown into the mix.

Lately we’ve begun seeing those “young invincibles” drift in to balance out the risk pool, perhaps encouraged by their parents or because they got information at an outreach or enrollment event. These young folks probably don’t spend much time lying awake worrying about a catastrophic illness or accident wiping out a family’s resources, but there is a big push to educate them and encourage their participation to help balance out the pool - to offset the costs that will be incurred by those who are older and less healthy.

Deborah Owens is a Federally Facilitated Marketplace (FFM) Navigator working in Wake and Johnston Counties. The CapitalCare Collaborative, one of the service programs for the Wake County Medical Society Community Health Foundation received funding to provide this service within our community. Other CCC staff received training to assist any of the uninsured patients they worked with as certified application

[Navigating the New HIM continued from page 8]


counselors. Navigators meet with people, one-on-one, in

clinics, libraries, churches, and community centers. People are scheduled either by a centralized call center or by host site clinics – whose goals include getting as many eligible patients signed up as possible in order to open up slots for those with fewer resources. Navigators attend community events, health fairs, telethons, information sessions and enrollment fairs. They educate people on the ACA via news programs and through media interviews. They inform their friends who are self-employed or who are hairdressers, artists, baristas, and restaurant workers. They spread the word

through social media and at churches and schools. They are committed, passionate, and tireless in their efforts. Such efforts are paying off in NC. Through the end of January, about 1,000 people have been assisted by the CCC Navigation team. Recent data shows that NC had the third highest enrollment (107,778 through December) of FFM states - only falling behind much larger Florida and Texas. In addition, 9 out of 10 people that enrolled in NC received financial assistance (8 out 10 nationally). County specific data will be coming soon to provide more detailed information on enrollment at the local level. §

In Act 1 of Shakespeare’s Macbeth, Lady Macbeth appears as

an ambitious, driven, and strong-willed woman. By Act 5 she is a tormented, traumatized sleep walker re-enacting the murder she her husband towards. She ends up murdering a dissociated self, allowing death to free her from the psychological consequences of Duncan’s murder. Did Lady Macbeth’s increasing self-alienation, represent guilt-laden madness, did it arise from the recognition of the monster she unleashed? In this sense Shakespeare created a parallel tragedy within his tragedy- the fall of Lady Macbeth

Macbeth is a play driven by dark, supernatural catalysts. Both Macbeth and Banquo were men of action who meet three bearded, otherworldly hags after a bloody victory. The heroes hear favorable prophecies but question their veracity. Yet Macbeth steps aside to reveal his darker place. Banquo has

no soliloquy. Perhaps his unimaginative nature gives him immunity to the witch’s seduction. But Macbeth wears different robes. He contacts Lady Macbeth and sets her aflame with volcanic ambition and verbal ruthlessness. Whatever her pre-prophecy character she tries to metamorphose into a savage woman who fears her husband’s vacillation. Once at home he does falter, and confirms her suspicions.

Macbeth’s imagination nearly shuts the doorway to murder. His stunning soliloquy paints the grim, cosmic consequences of murdering a kinsman, his king and his guest. At this stage of the play Shakespeare depicts Macbeth as a fierce warrior but an uncertain murderer. In his anguish he hallucinates, a dagger pointing toward his damnable crime. After the murder he returns to Lady Macbeth, frozen in horror, transiently catatonic. He cannot return the blood stained murder weapons to frame the guards. It is Lady

Macbeth who bloodies herself while planting the incriminating evidence. Macbeth will sleep no more as he becomes a darker, bloodier minister who is so deep in blood that he dare not return.

Shakespeare’s tells us nothing about Lady Macbeth before her descent into murky hell. Her fall is as mysterious as the witches’ magic. Just as they mix potions, she arms her tongue for action, summons dark ministers to unsex her, change her milk to gall, and close every portal to conscience. In a moment of verbal savagery, she unsexes Macbeth by viciously attacking his masculinity. She proclaims that he is “too filled with the milk of human kindness” to act decisively, a dissonant image of a man who just defeated two armies. Enraged by his continuing vacillation, she joins the witches of Shakespeare’s time as she verbally dashes the brains out of a suckling infant at her breast. But do Lady Macbeth

THE MADNESS OF LADY

the other tragedy

By L. Jarrett Barnhill, MD

20 | APRIL 2014


or the witches inflame Macbeth to murder, or does his reign of terror arise from within.

Lady Macbeth seems unaware that her husband ordered the murders of his friend Banquo and Fleance to remove the one who begat kings. Likewise she seems unaware of Macbeth’s murder of Macduff’s family to remove to any threats to his power. Lady Macbeth proclaims that by murdering Duncan he be not only king, but also a man. Her “prophecies” are as full of ambiguity as those offered by the weird sisters. Interestingly their last appearance together is at a dinner when Banquo’s ghost appears. Like Hamlet’s mother, Lady Macbeth cannot see the ghost. Likewise she is not fully aware that Macbeth is metamorphosing into one of the demons she desired to possess her.

Yet in spite of all her fury she remains in the role as a helpmate. In modern terms, we could say that behind every Macbeth is a Lady Macbeth. But unsexed or not, she stops short of murder. She casually dismisses the stain of regicide by cleansing with a little water; repressing the horror of the deed and eventually covering for Macbeth during his unexplainable collapse at the banquet. She knows nothing of Banquo’s murder and cannot see his ghost.

But after this scene she retreats into the shadows, reappearing only as a sleepwalker. She wanders about haunted by her conscience as she follows her candle to “dusty death”.

But there are dissonant foreshadowings. In spite of her ruthless façade, she cannot kill Duncan. He looks too much like her father. We can only speculate when she begins to realize that Macbeth has exceeded her heinous expectations. She evaporates as the hags from the stage. But does she also fear that Macbeth might ignore the sisters and murder her to find another who can produce male heirs? Does she realize that she now belongs to Mephastophilis and that no amount of water or perfume can unbind her from her bloody contract? Perhaps the horror of Macbeth’s savagery unseams her. Young Siward’s death is collateral damage but her suicide is the last murder in Macbeth’s reign of terror. Her death ends her role as a “poor player that struts and frets ‘her’ hour upon the stage and then is heard no more.” Lady Macbeth’s death is filled with “sound and fury, signifying nothing”.

By today’s standards, Lady Macbeth descends into catastrophic depression and commits self-murder. Macbeth responds by soliloquizing on meaninglessness. Once he

discovers that Macduff ‘is not of woman borne”, he finds meaning in a fight to the death. He is a soldier again, defending his kingdom and castle. Lady Macbeth is hardly Malcolm’s “fiendish queen” as she tortures herself, then suicides.

The play closes with only male warriors and no visible hope for offspring. The world that made Macbeth, Lady Macbeth and Malcolm king will fall to Fleance and eventually his descendent James I. Their great speeches are barren soliloquys spoken by poor actors in a tale told by idiots. Only Fleance signifies the future. Oddly, Lady Macbeth like Medea cracks the veneer of a society filled with Macbeths. She unsexed herself to become a warrior, only to go mad in the process. She disappears into the sterile earth along with Hecate and the weird sisters. Perhaps this descent is the fulfillment of another unstated prophecy- that she would die as a queen in her sleep. §

the other tragedy

22 | APRIL 2014

The health care landscape in North Carolina has changed dramatically in the past five years and will continue to do so for

the foreseeable future as the approach to health care delivery undergoes significant transformation. In that short time period, the number of independent hospitals in NC fell from 142 to 24, and that trend is likely to continue. Employment of physicians by hospitals and health systems has increased, and this trend will likely continue. More physician practices are looking into forming accountable care organizations (ACOs) or aligning themselves with ACOs or with other physician groups in order to remain viable as accountable, or value-driven, care gains momentum.

And just last month, the NC Department of Health and Human Services announced their proposal to reform the state’s Medicaid system, which places ACOs as the backbone to the overhaul. The legislature will consider the proposal during their upcoming May session, and the North Carolina Medical Society (NCMS) and other health care organizations are working closely with the department and legislators to ensure the reforms promote the best outcomes for patients and their doctors. The State Health Plan also has expressed interest in exploring the possibilities offered by the ACO model.

The proliferation of ACOs, whether hospital or physician-owned is quite notable. Medicare alone has approved over 400 ACOs, and there are numerous non-Medicare ACOs under development with the support of the private sector. North Carolina currently has 22 ACOs

that cover the vast majority of the state (see map).

For this new model of care to work, however, physician leadership is imperative to ensure that changes are clinically-driven and in the best interests of the patients. To assist physicians in this epic journey, the Wake County Medical Society, the NCMS and 37 other state, local and specialty medical societies and organizations have joined together to create and deploy the Toward Accountable Care (TAC) Consortium and Initiative. TAC is designed to provide the

medical community with the knowledge and tools needed to understand,

participate in, navigate, lead and succeed in a

value-driven health care system. TAC Consortium

member organizations are the vehicles for disseminating resources created for the Initiative (see below for list of TAC Consortium members).

Since its inception almost two years ago, TAC has produced

numerous articles, webinars, presentations

and the following toolkits/guides:

• The Physician’s Accountable

Care Toolkit • Accountable Care Legal Guide

• Distribution Based on Contribution: A Merit- based Shared Savings Distribution Model

• Accountable Care Guide for Neurologists • Accountable Care Guide for Urologists • Accountable Care Guide for Psychiatrists • Accountable Care Guide for Radiologists

The above mentioned guides are posted on the TAC website, which was launched last year and is a dedicated site for the TAC Initiative—www.tac-consortium.org. Accountable Care

NCMS Spearheads Initiative to Educate Health Care Community on Accountable Care

By Melanie Phelps


Guides for emergency medicine physicians, cardiologists, oncologists and hospice & palliative care are undergoing final approval and will be posted on the website soon. A guide dedicated to bundled payment arrangements also is under development. In addition, TAC currently is convening small groups of pediatricians, OB/GYNs and child psychiatrists, to begin the development of accountable care guides for those specialties. A guide for community supports also will be developed in the next quarter. Once these guides are complete, 11 more are slated to be developed.

The TAC Consortium and Initiative, which is spearheaded by the NCMS, also sponsors the NC ACO Collaborative. The Collaborative is comprised of representatives of existing NC ACOs and aspiring ACOs or ACO participants. The group’s quarterly meetings provide an opportunity for emerging and developing ACOs to share experiences and ideas about transitioning to accountable, value-driven, health care delivery systems and to identify and discuss possible solutions for facilitating that transition. Meeting locations are rotated among the membership. Interest in this learning collaborative continues to increase.

The TAC Consortium and Initiative is guided by a Physician Advisory Committee comprised of national and state leaders in innovative health care delivery: Nancy Henley, MD; Perrin Jones, MD; John Meier, MD; Devdutta Sangvai, MD; and Grace Terrell, MD. Staff includes Julian “Bo” Bobbitt from Smith Anderson law firm in Raleigh; and Melanie Phelps and Steve Keene from the NCMS , which has committed significant staff resources to ensure that this Initiative remains viable and that other Consortium members remain engaged. For more information about the TAC Consortium and Initiative or the NC ACO Collaborative, please contact Melanie Phelps at [email protected]. §

Specialty SocietiesCarolinas Chapter, American Association of

Clinical EndocrinologyNorth Carolina Academy of Family PhysiciansNorth Carolina Chapter of the American

College of PhysiciansNorth Carolina College of Emergency

PhysiciansNorth Carolina Council on Child and

Adolescent PsychiatryNorth Carolina Dermatology AssociationNorth Carolina Neurological SocietyNorth Carolina Obstetrical and Gynecological

SocietyNorth Carolina Orthopaedic AssociationNorth Carolina Pediatric SocietyNorth Carolina Psychiatric AssociationNorth Carolina Radiologic SocietyNorth Carolina Society of AnesthesiologistsNorth Carolina Soc. of Asthma, Allergy &

Clinical ImmunologyNorth Carolina Society of Eye Physicians and

SurgeonsNorth Carolina Society of GastroenterologyNorth Carolina Society of Otolaryngology –

Head and Neck SurgeryNorth Carolina Oncology AssociationNorth Carolina Society of PathologistsNorth Carolina Society of Plastic SurgeonsNorth Carolina Spine SocietyNorth Carolina Urological Association

State Society / OrganizationsCommunity Care of North Carolina Carolinas Center for Hospice and End of Life

Care North Carolina Academy of Physician Assistants North Carolina Community Health Center

AssociationNorth Carolina Foundation for Advanced

Health ProgramsNorth Carolina Medical Group ManagersNorth Carolina Medical Society

TAC Consortium MembersCleveland County Medical SocietyCraven-Pamlico-Jones County Medical SocietyDurham-Orange County Medical SocietyMecklenburg County Medical SocietyForsyth-Stokes-Davie County Medical SocietyNew Hanover-Pender County Medical SocietyPitt County Medical SocietyRutherford County Medical SocietyWestern Carolina Medical SocietyWake County Medical Society

CURRENT PROGRAMSProject Access - A physician-led volunteer medical specialty service program for the poor, uninsured men, women, and children of Wake County.

Community Care of Wake and Johnston Counties CCWJC has created private and public partnerships to improve performance with disease management initiatives such as asthma and diabetes for ACCESS Medicaid recipients.

CapitalCare Collaborative - The CCC program is a membership of safety net providers working corroboratively to develop initiatives to improve the health of the region’s medically underserved such as asthma and diabetes for Medicaid and Medicare recipients.

JOIN TODAY!

The Wake County Medical Society (WCMS) is a 501 (c) 6 nonprofit organization that serves the licensed physicians and physician assistants of Wake County. Chartered in 1903 by the North Carolina Medical Society.

A portion of your dues supports the volunteer and service programs of WCMS. Membership is also available for PA’s. There is even an opportunity for your spouse to get involved by joining the Wake County Medical Society Alliance.

To become a member of the Wake County Medical Society contact Deborah Earp, Membership Manager at [email protected] or by phone at 919.792.3644

HOW TO JOIN

Membership in the Wake County Medical Society is one of the most important and effective ways for physicians, collectively, to be part of the solution to our many health care challenges. A strong, vibrant Society will always have the ear of legislators because they respect the fact that doctors are uniquely qualified to help form health policies that work as intended. It’s heartening to know so many of Wake County physicians, more than 700 to date, have chosen to become members of the Wake County Medical Society.

JOIN TODAY!

Become a Member of Wake County Medical Society and help support the indigent care and community service

programs associated with the Society.

WHY JOIN

To serve and represent the interests of our physicians; to promote the health of all people in Wake County.

WCMS MISSION

Service Programs - The spirit of volunteerism is strong in Wake County. Hundreds of local physicians volunteer to help our indigent. The Society coordinates several programs that allow low income individuals access to volunteer doctors and to special case management services for children with diabetes, sickle cell anemia or asthma.

Publications - Members receive the peer-reviewed The Wake County Physician Magazine four times a year, and we keep you informed regularly via pertinent emails. The magazine focuses on local health care issues in Wake County.

Socializing with your physician colleagues - Many physicians feel too busy to do anything except work long hours caring for patients. But, the WCMS provides an opportunity for physicians to nourish relationships through social interaction with one another at our dinner meetings featuring prominent speakers and at other events.

Finally, joining the WCMS is plain and simple the right thing to do - Physicians and the community benefit from our membership and our leadership in local affairs.

BENEFITS OF MEMBERSHIP

HOW TO JOIN

Are you interested in becoming a Wake County Medical Society member? Simply visit our website at www.wakedocs.org and complete the online application or contact us by phone at 919.792.3644.

A portion of your dues contributes to the volunteer and service programs of WCMS. Membership is also available for PA’s. There is even an opportunity for your spouse to get involved by

joining the Wake County Medical Society Alliance.

JOIN TODAY!

wake county physican magazine april 2014

Documents

community care of wake

medical community

md president

wake county physician

care managers

donated care

primary care physicians

johnston counties