Table Of Content

Bulletin of the Mahoning County Medical Society Third Quarter 2010 If ObamaCare is Bad, What Would Be Better? By Doctor Alieta Eck ObamaCare is a wildly unpopular law for anyone who states should merely oversee that the contract terms are knows anything about healthcare. The election proved met, but not mandate what is to be covered. that. Physicians came together in Washington, DC to film the following national ad:http://www.youtube.com/ Thirdly, safety net non-governmental charity clinics could be watch?v=aPwEVXstFdA&feature=youtube_gdata_player scattered throughout every county in every state with each clinic deciding ways to determining the eligibility of those Perhaps it is time for the politicians to admit that the seeking the free care. government cannot provide health care. Period. All government can do is set up an administrative scheme The Zarephath Health Center was started in central New that pays many people to decide who qualifies for which Jersey in 2003 and uses volunteer physicians and nurses to government program, gives out entitlement “insurance” provide free care to the poor. Patients include the homeless, cards, but then underpays for the actual care. the mentally ill, the jobless, the undocumented immigrants and even patients with Medicaid cards. Physicians there Bureaucrats get paid while physicians do not. Taxpayers diagnose and care for patients with acute and chronic get fleeced. illnesses. The patients are treated with kindness by those who are willing to donate their time, and currently 300-400 Before 1965, the administrative costs in a doctor’s office patients get free care each month. were negligible, especially when it came to caring for the poor. Typically the doctor would not even bother to write The cost to provide services at the ZHC comes to $15 per out a bill. For the average patient, the doctor charged a patient visit compared to $150 per patient visit at the reasonable fee and if the patient had insurance, it was his federally qualified clinic in the neighboring town. The latter job to get reimbursed. People bought “hospitalization” clinic has huge bureaucratic administrative overhead and insurance policies. collects funds from the federal and state governments and the patients. They are constantly asking government for Today the poor seek Medicaid— the huge federal/state more money. program that entitles the recipient to “free” care. But since the physicians must fill out forms only to be given a The Federal Tort Claims Act of 1996 provides free medical fraction of a reasonable fee several months later, most malpractice coverage for professionals who volunteer at any refuse to take Medicaid at all. So Medicaid recipients with free clinic. Freed from the specter of frivolous lawsuits, the sore throats inappropriately clog up the emergency rooms physician can offer common sense care leaving compliance with twice the frequency of the uninsured. The system is up to the patients. expensive for taxpayers, demeaning to patients and generally unworkable. Why not devise a similar plan with state rather than federal government involvement? An innovative solution to our health care crisis would involve several layers of care. We could set up a system where the physicians donate, say, four hours per week in free care. A surgeon might agree The first layer could involve the average person paying his to take on one charity case per week. Then, to compensate doctor directly for services rendered. Paperwork would be the professionals who donate their time and expertise, each minimal, patient-physician confidentiality would be state could agree to provide full medical malpractice maintained, and prices would be kept down by simple coverage for their entire practice. Such coverage is already competition. Living healthy lifestyles would save money. provided for physicians who work or teach in medical school university hospitals. The state would not be laying out A second layer would be personally obtained, non- money for medical malpractice insurance, but just agree to cancelable health insurance for unforeseen major medical pay the costs of litigation and payouts. maladies and accidents. These policies should have the coverage and deductible that fit a family budget. The 1 Continued on Page 7 Bulletin CALENDAR Editor Michael T. Engle, MD Managing Editor Karyn Frederick November 12, 2010 Cirque du Soleil: Dralion Editorial Board Covelli Centre Dean R. Ball, DO Charles A. Crans, MD November 20, 2010 DocBook Launch Party The Bulletin is published bimonthly by the NEOUCOM Conference Center Mahoning County Medical Society, 565 E. Main Street, Suite 220, Your choice for CME Canfield, Ohio 44406. December 17, 2010 Disney on Ice Princess Wishes Phone (330) 533-4880 Fax (330) 533-4940. Covelli Centre www.mahoningmed.org The opinions and conclusions expressed herein do not necessarily represent the January 18, 2011 Council and Officers views of the editorial staff nor the official view of the Mahoning County Medical Installation Dinner Society. Advertisements do not imply sponsorship or endorsements by the Mahoning County Medical Society of products or services advertised. The Bulletin reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted, including advertisements. Subscription rate of $20.00 per year is included in MCMS dues. Correspondence and changes of address should be mailed to the above address. Classifieds 2010 Council MCMS Members - place your classified ad here Officers FREE! Up to 25 words. Call 330-533-4880 for DEAN R. BALL, DO President more information. Classified ads of 25 words or THOMAS E. ALBANI, MD President-elect less are available to non-members for $35. MICHAEL T. ENGLE, MD Secretary/Treasurer CHARLES A. CRANS, MD Immediate Past President Visit our newly revised website at Delegates to OSMA www.mahoningmed.org DEAN R. BALL, DO DENISE L. BOBOVNYIK, MD CONSTANTINE G. ECONOMUS, MD EUGENE L. POTESTA, MD Get your Bulletin via E-mail Alternate Delegates to OSMA Send us your email address and we will send the RAYMOND S. DUFFETT, MD CHARLES A. CRANS, MD Bulletin directly to your inbox. Send your email SEAN T. McGRATH, MD LYN E. YAKUBOV, MD address to: [email protected] Members-at-Large SHANNON BARILLARE, MD MICHAEL T. ENGLE, MD MICHAEL K. OBENG, MD VIVIAN I. STARR, DO LISA N. WEISS, MD Executive Director 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 KARYN L. FREDERICK 112233445566778899001122IIIII33445566778899nnnnn0011223344 556677MMMMM8899001122112233445566eeeee778899mmmmm001122334455oo66ooo7788rr99rrr0011ii22iii3344aaaaa55667788mmmmm99001122112233445566778899001122334455 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 Foundation Trustees 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 RASHID A. ABDU, MD DAVID J. DUNCH, MD 11223344556677889900112233445566778899001122334455667788990011221122334455667788990011223344556677889900112233445566778899001122112233445566778899001122334455 1122334455R6677889900o11223344b55667788e990011r223344t5566 7788A9900112211.2233 4455B66778899r001122o33445566w7788990011n22334455,66 7788M99001122112233D445566778899001122334455 NORTON I. GERMAN, MD JAMES STILLE, MD 11223344556677889900112233445566778899001122334455667788990011221122334455667788990011223344556677889900112233445566778899001122112233445566778899001122334455 1234567890123456789012345678901212345678901234567890123456789012123456789012345 PRABHUDAS LAKHANI,MD C.CONNER WHITE, MD 11223344556677889900112233445566778899001122334455667788990011221122334455667788990011223344556677889900112233445566778899001122112233445566778899001122334455 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 1234567890123456789012345678901212345678901234567890123456789012123456789012345 2 FROM THE DESK OF THE EDITOR Michael T. Engle, MD Skin up all the patients! The most popular topic in today’s medical environment seems to be our “health care crisis,” and all of the players in the problem. We hear about how insurance companies are bilking patients and employers out of billions in profit each year. “THEY are the villains,” we hear. Next comes us, the doctors, who are supposedly ordering unnecessary tests and using unproven, costly treatments. “THAT is the problem,” we hear. “No….it’s the lawyers,” we get next. If it weren’t for frivolous lawsuits, those tests would NEVER be done. Tort reform is the answer. Finally, and most popular today, is to attack the government. “Obamacare is a disaster,” they chant. Government needs to stay out of our lives. However, the one player in this problem we rarely, if ever, hear about is the patient. What role do patients play in our staggering health care costs? Let me tell you about a patient recently treated by one of my colleagues: “John” is a fairly healthy 50 year old male who is CEO/Owner of a successful mid-sized manufacturing plant in Columbiana County. He came to the office with complaints of back/hip pain which started about three weeks earlier. He had no previous treatments, other than over the counter medications. He arrived to the office with an MRI of the lumbar spine, as well as, and MRI of the left knee. When asked why he had a knee MRI, he replied that about six months ago he “hurt” his knee. The pain resolved within about four weeks, and he had NO residual problems. “So why did you have an MRI?” asked the doctor. “I wanted to make sure there was no damage done,” was his reply. When confronted with the idea that this type of behavior was driving up the health care costs for his own company, he seemed dumbfounded. Contrast this with another patient I saw in the office last month. “Joe” is an otherwise healthy 50 year old male who presented with typical “sciatica” pain down one leg. Pain was six to ten in severity. We discussed treatment options, including oral medications, physical therapy, epidural injections, and surgical referral. He had neither x-rays NOR and MRI performed. BUT…… his health insurance was an HSA plan where HE was responsible to pay the first $2500 per year of his costs. He had not met this amount for the year. After discussing any risks of delayed treatment, HE elected to “wait it out” to see if it would just get better on it’s own. He didn’t think the cost of any of the treatments was worth it. I gave him some appropriate home exercises and advised him on safe use of over the counter anti-inflammatory medication. One major problem we have with our system of medicine today is that most patients have “no skin in the game.” Their employer pays the premiums, and they fight hard for low co-pays and co-insurance. Patients never really see the true “cost” of the care they receive. They figure that the MRI should be ordered, and don’t even worry about the cost to the system. They show up at the ER for things that could have waited till the next morning. They demand the “best” pills even if they cost ten times as much as a closely related generic. Our country will never get this health care issue right until we get the cost of health insurance out of the hands of employers and the government and into the hands of the patients. Only THEN, will patients have a REAL incentive to be reasonable in how they access and utilize health care resources. 3 From the President by Dean R. Ball, DO Hopefully by the time you read this most of the fall leaves will be down and the blowing and raking will begin. Now if we could get all the political signs down as well. Why so many of these signs I don’t know. I guess name recognition. I wonder how many of our members made their decision on how to vote based on these signs? Or maybe voting for the candidate with the most signs. I guess stranger things have happened. There was an excellent meeting with the Ohio Health Information Partnership, the Regional Extension Center, and the OSMA about electronic health records (EHR) that some of you missed. There were representatives from all three organizations who spoke regarding choosing a provider as well as the federal dollars that are available. Ohio Health Information Partnership is a non profit that will assist in physicians in adopting electronic health records. This entity is important since there are federal dollars available that physicians can receive if they choose to go electronic and meet “meaningful use”. From what I gleaned from this meeting there is no requirement that a physician has to change from paper to electronic records. However, there are ways as the federal government will “encourage” physicians to choose EHR. You guessed it -- lower reimbursements if you do not. The OHIP will assist in assessing practices to help determine what they need from an EHR. They will also help select the EHR providers. There are already five companies that are deemed ‘preferred”. OHIP will also provide help in implementing EHR for physicians and help to work with practices to achieve the “meaningful use” of the EHR so the practices will qualify for federal money. This meaningful use is important because the provider needs to qualify for the incentive program by meeting certain initial requirements to receive the federal monies. All very important issues. The ultimate goal of this program is to create Health Information Exchanges that will provide connectivity between providers. And of course the first step is getting 6,000 physicians to adopt EHR by 2012. Priority is given to Primary Care Providers (family physicians, internal medicine, pediatricians, and OB/ GYNs). Physicians can qualify under either Medicare or Medicaid. To qualify for Medicaid incentives physicians must have between 20-30% Medicaid patient volume. To qualify for Medicare incentives there is no minimum. Physicians that provide 90% hospital based care do not qualify. If you are a physician that qualifies, under Medicare providers can draw down up to $44,000 over five years beginning in 2011. Medicaid will reimburse up to $63,750. There are some very important decisions that physicians have to make in choosing an EHR vendor as well as in implementing it. Fortunately, the Mahoning County Medical Society is actively involved in working with the Regional Extension Center to get this information out to its members. Just one more reason it is very beneficial and important to be an active member in this organization. Be on the look out for further meetings in the upcoming months! 4 123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212 123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212 1122334455667788990011223344556677889900112233445566778899001122112233445566778899001122334455667788990011223344556677889900112211223344B5566i77t8899s0011 2233‘44n5566’77 8899P001122i33e4455c6677e889900s1122112233445566778899001122334455667788990011223344556677889900112211223344556677889900112233445566778899001122334455667788990011221122 123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212 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Poor patients would get care. Physicians would be rewarded with lower office overhead, not having to Medical Opportunities in Ohio (MOO) pay expensive medical malpractice premiums. Taxpayers www.ohmoo.org – serves hospital would not have to fund the enormous Medicaid bureaucracy employers and private practices or payments for actual office-based care to the poor. with an online recruitment program, Unnecessary defensive medical tests would be eliminated designed to connect Physicians, causing health insurance premiums to drop for everyone. Physician Assistants, and Nurse The number of lawsuits would diminish. Practitioners with jobs in Ohio. Job seekers register for FREE! It is time to think “outside the box,” come up with workable Our database of Physicians solutions, and lower the cost of healthcare for all. President spans more than Obama said he is willing to entertain any reasonable 85 specialties! proposals. Let’s start the discussion. Charity care and tort reform — perfect together! Employers, contact us today Reprinted with permission to learn more about how the MOO program can work for you! Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied 100’s of Physicians Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. seeking jobs in Ohio John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. Dr. 800.479.1666 Eck is a long time member of the Christian Medical Dental Association and in 2009 joined the board of the Association of American Physicians www.ohmoo.org and Surgeons. In addition, she serves on the board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children, one in medical school in NJ. C o n t a c t D r . E c k at: [email protected], 732-463-0303 Who is Eligible to Hold Office? There are several open Council positions to be voted on by the membership for the two-year term beginning January 1, 2011. Nominations are being accepted for the position of President-elect, two Delegate positions, two Alternate Delegates, and two Council-at-Large members. President-elect nominees must have served two or more years on Council. Past presidents may serve addi- tional terms. Dr. Thomas Albani is currently the President-elect and will assume the presidency in January. Delegates to the OSMA are eligible by virtue of having served as an Alternate Delegate and having attended at least one Annual Meeting of the OSMA House of Delegates. Currently holding these positions are Drs. Dean Ball and Eugene Potesta. Alternate Delegates to the OSMA are eligible if they have served at least one year on Council. Completing their terms as Alternate Delegates are Dr. Charles Crans and Dr. Raymond Duffett. Every Active member of the MCMS is eligible to serve as Council Member-at-Large. Drs. Lisa Weiss and Michael Obeng are finishing two-year terms, and Dr. Shannon Barillare is completing a one-year term replacing Dr. Sean McGrath who moved up to Alternate Delegate last year. All current office holders are eligible to run for their current positions, or any other position for which they are eligible. 7 Join us for the much-anticipated launch of the DocBook app for your iPhone! Dr. Tim Gueramy, the creator of DocBook, will be with us to demonstrate this unique way for you to connect with your member colleagues. The DocBook is a complete MCMS membership directory in your phone. An exclusive benefit available only to members of the Mahoning County Medical Society. 8 Friday, December 17 7:00 P.M. Covelli Centre Tickets ~ $32 per person Mahoning County Medical Society members may order as many tickets as they wish. Tickets are limited and will be sold on a first-come, first-served basis. No free tickets. must Tickets will be sold on a first-come, first-served basis. Payment accompany ticket request. Member Name: Total Number of Tickets @ $32 each: Check Enclosed for: $ Make checks payable and send to: Mahoning County Medical Society 565 E. Main Street, Suite 220 Canfield, OH 44406 9 Delinquent Account Collection ________________________________________ MILLSTONE & KANNENSOHN Attorneys-at-Law OVER 30 YEARS EXPERIENCE IN FULL SERVICE MEDICAL COLLECTIONS FREE CONSULTATION FOR ALL MEDICAL PROVIDERS, CREDIT MANAGERS & ACCOUNTS RECEIVABLE SUPERVISORS. 4531 BELMONT AVE., SUITE 2C, YOUNGSTOWN, OH 44505 (330) 743-5181 FAX (330) 743-7268 JOIN US! Leading Medical Practice Practice Seeks Physicians • No Administrative Responsibilities • Augmented Income • Flexible Schedules • Liability Insurance Coverage • Any Specialty Welcome For more information: 888-309-4738 www.arssuboxone.com ARS – Making a Difference 10