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HEAL™ SC E L lAND at unwers T 1 baltimo«e WOT TO CIRCULATE V uXlTH SCISNC£s librar , OF MARYLAND ATT BALTJMORE— - Not to circulate Digitized by the Internet Archive 2016 in https://archive.org/details/iowamedicine8511iowa 0 U RNAL OF THE IOWA MEDICAL SOCIETY JANUARY 1995 STACKS Special issue on domestic wiofeaice HEALTH SCIENCES LIBRARY A special messagefrom the UNIVERSITY OF MARYLAND AMA BALTIMORE president 9 JAN 20 1335 — Finding the right words 1EGU NQT IN CIRC, advice on talking to victims Break 2 2 Why the victims stay in — abusive relationships Silence the dynamics of power and control 2 4 A survivor's story 2 6 Who are the batterers? 2 8 The effects ofdomestic abuse on children 3 3 Test your knowledge of domestic abuse issues (survey ofIowa physicians ) Begin the Cure INSERT C E N I E R Professional services for your needs financial all •Financial Planning •Retirement Planning Money Market Funds •IRAs/SEPs • •Mutual Funds •IRA Rollovers •Tax-Free Bonds •Stocks •Insured Certificates •Estate Planning of Deposit •Annuities/Life Insurance For information, call your local Merrill Lynch office. The difference is Merrill Lynch. Chuck Wheeler Assistant Vice President Jeff Towle Financial Consultant Call 1-800-937-0231 Merrill Lynch 400 Locust Street, Suite 600 Des Moines, Iowa 50309 Lynch Merrill A tradition oftrust. ©1994MerrillLynch, Pierce,Fenner&SmithInc.MemberSIPC. . IMS DEADLINE news JANUARY 1995 , Late-breaking news of interest to Iowa physicians •AN ARTICLE IN THE DECEMBER IOWA MEDICINE Medical Economics section stated an incorrect amount of total Medicare benefit payments coming into Iowa during 1993. During fiscal year 1993, $1.3 billion was paid for 469,081 Iowa Medicare enrollees. For the same period, the state of Colorado collected $1.42 billion in benefits for 396,453 enrollees. For a complete state-by-state listing, call Donna Bottorff at the IMS, 800/747-3070. •ESTABLISHMENT OF A STATEWIDE TRAUMA SYSTEM will be supported by the Iowa Medical Society in this year's Iowa Legislature (see page 14 of this Iowa Medicine) Any physician who wants more information about the statewide system proposed by the Iowa Trauma Systems Development Project Planning Consortium is urged to call Thomas Foley, MD, 515/752-6391 or Tim Peterson, MD, 515/224-6440. For copies of the Consortium report, call Dick Harmon, Iowa Department of Public Health, 515/281-3741. •THE 11th ANNUAL INTERNATIONAL SYMPOSIUM ON CREATION OF Electronic Health Record Systems and Global Conference on Patient Cards will be held March 14-19 at the Disney Contemporary Resort in Orlando, Florida. For more information on the conference, call Donna Bottorff of the IMS Staff, 800/747-3070. •DON'T MISS THE IOWA TELEMEDICINE CONFERENCE "The Future is Now" Monday evening, January 9 from 7:00 p.m. to 9:30 p.m. The program is designed for physicians, nurses and others. Cosponsored by the IMS, U of I College of Medicine and others, the program will cover what telemedicine can do for providers, how much equipment will cost and reimbursement issues. The program can be seen at 54 different sites around Iowa. For information about the site in your area, call Lyn Durante at the IMS, 800/747-3070. •THE IMS ELECTION PROCESS is beginning with district caucuses to be held around the state this month and in February. At each caucus, physicians will choose a representative and an alternate to the 1995 Nominating Committee. This committee will hold a telephone conference March 12 to compile a slate of candidates. The caucus schedule can be found on page 12 of this issue. •THE IOWA INSURANCE DIVISION is delaying implementation of administrative rules concern- ing employee health care access under Senate File 2282 passed by the legislature last year. The new rules — which are being revised to clarify confusion as to the exact requirements for employers — probably won't go into effect until some time in late February. •TO GET A COPY OF THE FEDERAL REGISTER which contains information regarding Iowa's des- ignation as a single Medicare payment locality with one fee schedule, updated RBRVS and 1995 Medicare payment policies: (credit card order) 202/512-1800; (fax order) 202/512-2250; or write to: New Orders, Superintendent of Documents, PO Box 371954, Pittsburgh, PA 15250. The price is $8, stock number 069-001-000-81-5. •THE AMA EXPRESSED CONCERNS ABOUT PROPOSED MEDICARE CUTS in a letter from James Todd, MD, AMA executive vice president, to President Clinton. According to the letter. Medicare reimbursement of physicians accounts for only 23% of Medicare expenditures, yet physicians have been subjected to 40% of provider cuts. The AMA is proposing examination of premium levels and deductibles and an income related sliding scale for beneficiary cost sharing. For more information about any deadline news item, call Chris Clark at IMS headquarters, 515/223-1401 or 800/747-3070. Iowa Medicine JANUARY 1995 / VOLUME 85 / 1 Editorials Watch for red flags Every Iowa physician should be on the lookout for signs of domestic violence in their patients. About the Cover 0 The Presides! Comments It isestimated between 20,000and 44,000Iowa women are battered by theirintimate partners Give the gift of hope eachyear. This issue and theFebruary issue The American Medical Association president has a message for Iowa ofIowaMedicineare physicians regarding ethical responsibilities and domestic violence. devoted toeducating physicians onhow to 0 RobertMcAfee MD , helpvictims. The logo on thecoverwas designed byIMS fl mass media reality check AlliancePresident 12 BarbaraBell. Should the media accept a share ofresponsibilityfor the explosion of 13 violence in America? The IMS Alliance president says yes. # Barbara Bell, IMSA President IowaMedicine, Journalof 14 the IowaMedical Society (ISSN0746-8709), is published monthlyby the IowaMedical Society. Current Issues Subscription price: $25 per year. Second class postage paid at DesMoines, Iowa and at additional mailing oSfefnicdesa.ddPrOeSsTsMcAhSanTgEeRs:to 12 In the news IowaMedicine,Journal of the IowaMedical Society, 1001 GrandAvenue, West DesMoines, Iowa50265. NATIONALADVERTISING: IMS Update StateMedical Publishers • District caucus schedule, award nominees sought Network, 9534Marshall Drive, ShawneeMission, KS 66215, phone 913/888- Futures 8781. IOWAADVERTIS- ING: JaneNieland,Iowa • AMA concerned over possible Medicare cuts Medicine, 1001 Grand Avenue,WestDesMoines, Iowa 50265. Phone 515/ Legislative Affairs 223-1401. EDITORIAL CONTENT: The Society is • IMS will support definition ofsurgery legislation unable toassume responsi- bilityfor theaccuracyof 15 Medical Economics that which issubmitted. Manuscripts oreditorial • Runner-up gets Medicaid contract; IFMG officer slate inquiriesshouldbe directed to the Editor, IowaMedicine, 1001 17 Practice Management GrandAvenue,West Des Moines, Iowa 50265. • E & M Coding revisions Copyright 1995 Iowa Medical Society. 19 Newsmakers • Letter to the editor, awards . JOURNAL OF THE IOWA MEDICAL SOCIETY Articles F E A T U R e 21 Break the silence, begin the cure Seventy-five percent of partner battering victims seek treatment for immediate or long-term effects ofabuse. However, these victims are hardly ever identified. The articles on the following pages are designed to give Iowa physicians information they can use in their practices. Finding the right words Testyour Experts in partner battering offer excellent advice on how to talk to victims. knowledge of domestic Why do they stay? violence issues . . Victims ofdomestic violence often take years to leave the abusive relationship. A counselor discusses the insidious dynamics ofpower and control. % KayMaher-Sharp Don’t missthe survey of Iowa A survivor’s story physicians in the centerof During her 12-year marriage, she was degraded, stalked and nearly beaten to death. this Iowa Now she’s putting her life back together. % Christine Clark Medicine Who are the batterers? A counselor with the Polk County Domestic Abuse Intervention Service discusses common characteristics ofabusers. # D.ale Chell Science and Education Editorial Board IMSPresident JamesWhite,MD 33 A child’s perspective ScientificEditor MarionAlberts,MD The author discusses the effects ofdomestic violence on children. ExecutiveEditor % Dower Dewdney, MD Eldon Huston ManagingEditor ChristineClark Production/Advertising Manager Behavioral “repertoires” common to batterers. %Truce Ordona, MD JaneNieland Allarticlespublished in IowaMedicine 37 The Editor Comments are listed in IndexMedicus 39 Physician Learner BlueCross BlueShield of Iowa Provider Service Center: Statewide: 800-562-2218 Des Moines: 515-245-4688