What's New...

Reminder about EMR – Implementing Electronic Medical Records in your Office

By Karen Wendland

Upcoming Workshop at CMS

When: August 18

Time: Noon to 1:30 pm

Where: Meeting Room at Capital Medical Society

Teacher: Brendan Draper

Lunch: A light lunch will be provided, at no charge

CMS is offering workshops this summer for you to attend, in order to practice and learn the electronic referral process using BigBendHealth.com (Big Bend RHIO). Whether or not you have an EMR system in your office, you can begin to send and receive patient referrals electronically, using your current computer system and accessing the website: www.BigBendHealth.com.

In addition to referrals, we will cover clinical messaging and how you can access clinical information. Attend this helpful workshop! RSVP is required. Space is limited, so no more than two representatives from each office. RSVP by calling 877-9018, or by emailing Karen Wendland () or Shannon Dent ().

Reminder

As a reminder, the CMS office is ready to serve as a resource for you and your medical office if you are researching EMR vendors. At our May Membership Meeting, we distributed two very important documents that we continue to make available to our members. One is a "Worksheet" we created that gives you a very helpful overview of the important steps to take as you prepare, research, select and implement an EMR. We are also distributing a list we call the "Tallahassee EMR Vendor List." We have compiled a list of the EMR vendors who are in Tallahassee, indicating which groups in town are using the EMR product. This list is a "work in progress" and we will continue to update it. Call us for a copy of these helpful resources. Or, go to the "Members Only" section of our website for a copy. Remember, we are here for you and we are in this EMR thing together.

Our New Look for Cap Scan

By Karen Wendland

With the issue this month, you will see the debut of a new look for Cap Scan. CMS staff — Rosalie Carlin, Shannon Dent and I — have worked with our information design specialist, Tracy Ippolito and her firm, Itech Information Design to come up with new artwork for the cover of the CMS newsletter. We loved the look the newsletter has had for more than 20 years! But, we thought it was time for an updated and fresh look.

We will be using new technology to produce the newsletter too. We are moving to a more streamlined and cost-effective production and printing process. This prompted us to seize the opportunity of change and re-design some features of Cap Scan. It won't look completely different! Hopefully, you will feel right at home with the new Cap Scan.

Dr. Charles Moore, our Editor, created the image of the "inkwell, pen, and Caduceus" that has graced the cover of Cap Scan for these many years. With some graphic magic, Ms. Ippolito has transformed the image into an electronic file so that we can keep using it in different parts of the newsletter. You will see the image appear in the newsletter next to the list of Publication Committee members, and alongside articles that are submitted from our CMS members. We thank Dr. Moore for his on-going editorial support and the wonderful articles he authors for the newsletter.

We are interested in what you think of Cap Scan…not only the look, but the content too. Please contact me, Rosalie, or Shannon with any comments you might have. We would love to hear from you.

Donate to the CMS Foundation – We Thank our Donors

We thank the following physicians who made a donation to the CMS Foundation, along with their annual dues payment. Please consider doing so this year, as you pay your CMS due.

We Thank Our Donors

Rodrigo Agbunag, M.D.

Efren Baltazar, M.D.

Charles Cooper, M.D.

Charles Mathews, M.D.

James Stockwell, M.D.

Reasons to Donate

Remember, you can make a donation to the CMS Foundation in memory of someone who has passed away or you can make a donation in honor of someone, such as a fellow physician you hold in high esteem or has taken care of you or your family. CMS will send a letter to those you honor.

Endowment Funds

CMS Foundation has created three endowment funds in order to establish long-term financial stability to meet our mission. You can donate at any time to one of the CMS Foundation's Endowment Funds.

1. The General Endowment Fund
2. The Scholarship Endowment Fund
3. The We Care Network Endowment Fund

Make your check out to the CMS Foundation and indicate on the "For line" which Endowment Fund you are donating to. Bring your check to the CMS Office (we would love to see you) or mail it: Capital Medical Society ~ 1204 Miccosukee Road ~ Tallahassee, Fl 32308.

The mission of the Capital Medical Society Foundation is to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community's health needs through innovative projects that are exemplary, affordable and dignified.

How to Buy More Simpler Times

By Karen Wendland

New sales location: The Gift Shop at Capital Regional Medical Center!

We are very grateful to Dr. Charles Williams that he has decided to donate to the We Care Network, proceeds from the sales of his new book and sequel, More Simpler Times.

The cost is $20 per book.

You can buy copies of the book at:

• The CMS office – 1204 Miccosukee Road
• The Gift Shop at Capital Regional Medical Center
• The Gift Shop at Tallahassee Memorial Hospital
• Tallahassee Nurseries – 2911 Thomasville Road
• Bradley's Country Store – 10655 Centerville Road
• My Favorite Things – 1950 Thomasville Road

Checks should be made out to: CMS Foundation. This means you are making a tax-deductible donation to your CMS Foundation.

My Two Cents on the AMA

By Charles D. Williams, M.D., FACR, FAAP

I had the opportunity and privilege to attend the June 2010 AMA meeting in Chicago and the November 2009 meeting in Houston as a delegate. I do not and did not agree with their strategy and tactics with the Obama Healthcare Reform. However, by attending I hoped in some small way to have my input and perhaps speak for some others and perhaps lay some seed for changing direction.

Like most of you, I closely followed every twist and turn of the healthcare reform rollercoaster. I will never forget the way my jaw dropped and stomach sank as I stood in the surgical lounge with my colleagues, watching President Obama declare the AMA's support for the healthcare bill. I asked myself, "How can this be? After all of our discussions at the House of Delegates in November of 2009 about the importance of supporting the principles, not bills, how can this be?"

It appeared to all of America, including physicians, that the AMA had swallowed this legislation hook, line and sinker; the good "such as insurance reforms" with the bad. If there was any question about the AMA's contributions to the passage of this massive bill, that doubt was erased when the AMA was second only to the AARP in speaker Nancy Pelosi's list of "thank you's" prior to the House vote in March.

But where was the liability reform, the SGR fix, and the right to privately contract? Did the AMA really support the IPAB and the expansion of PQRI without requiring physician determined quality measures?

As one of my colleagues in another state told me, "We all withdrew from the AMA en mass in our office over their support of the healthcare bill." And this sentiment is wide spread, with many other of my colleagues questioning whether or not the AMA still represents practicing physicians. Clearly, for the AMA to remain relevant, it must be valued by its members. But if physicians do not feel that the AMA represents all of us, what is the point of membership? Recently surveys were held with various questions. Members were asked to consider the three most pressing issues facing the AMA in 2010. This was an open-ended question; respondents were asked to provide up to 3 responses. The most common responses were: Improve AMA membership, address (or repeal) health system reform, repeal the SGR, implement medical liability reform, and listen and reconnect with the AMA membership.

Members were requested also to list their concerns and the most common responses included: "Listen to the grassroots; act on the needs of physicians not politics; get back to basics. Listen to our members and non members from the bottom up." "Listen to physicians." Members were also asked whether they agreed or disagreed with the AMA's approach to healthcare reform. Approximately 64% disagreed. Some of the comments included "We played right into aggressive liberal hands – got nothing in return. It took everything in me not to drop my AMA membership." "95% of my hospital staff was disappointed with the AMA's stand with healthcare reform. We were lied to and achieved nothing." "The Obama administration used us and gave us practically nothing in return." "Supported early. Got nothing."

The passion on the side of those who disagreed seems much more intense than those who agreed.

Well, I believe the AMA can – and must – be a strong organization that is able to effectively represent physicians. This is exactly the reason why I attended the AMA meeting at this critical juncture in the AMA's history.

The impact that the AMA can have as a champion for practicing physicians cannot be overstated.

• Our AMA must be personally accountable. Board members must be willing to stand by the votes they cast and these votes must be recorded and be open to review by the entire House of Delegates.
• If the votes in the House of Delegates are divided, then it should be made public that all physicians do not see the issue in the same light. Thus, when unanimity is reached, it is all the more significant.
• The Board must ensure that all opinions are heard and all points of view considered before it makes critical decisions that affect all physicians. The Board must adhere to the policies passed by the House of Delegates and stand by the principles in which all physicians believe.
• The AMA must re-double its efforts to achieve major advocacy goals, including a permanent SGR fix, proven medical liability reform, the right to privately contract without penalty, repeal of the Independent Payment Advisory Board and ensuring that the determination of quality is made by the profession, not by the government or other third party payors.
• The AMA must be the voice of all physicians.

If these principles are kept, more physicians will see the relevance and value of the AMA, whatever position it takes. And once this happens, I can proudly call my colleagues from the 26 physician practices (and others) and recruit them to rejoin the AMA.

I say this at a time when many physicians are angry over the AMA's performance on healthcare reform. It is important to recognize the depth and intensity of physician disappointment. The AMA failed to accomplish four major advocacy goals for physicians; (1) Elimination of SGR; (2) Modification of the Independent Payment Advisory Board for Medicare; (3) Stopping "payment for quality" until reliable methods exist; (4) Medical liability reform.

The problem was not policy; our policies are clear. The problem was tactics. Critics say the AMA should have withheld support until the goals for physicians were achieved. Now is the time to be vocal and demanding on physician issues. The threat of adverse effects on patient gains is gone, and physician issues must be our focus.

Many physicians have lost trust in the AMA. Regaining their trust will take a major effort.

After making major decisions, the Board has held conference calls with the Federation. This process of talking to physicians after the fact portrays the Board as patronizing ("the Board knows best"). This sends the wrong message. Conference calls with the Federation might be held before Board decisions. Technology exists to set up these calls within hours of email notification to Federation members. Physicians must feel that the Board has factored their input into Board deliberations. This should help achieve both exchange of ideas and transparency of process.

Another step toward transparency and accountable in Board decisions is to record and publish Board votes on advocacy issues. While the business process must be confidential, it should be feasible to separate business and advocacy issues.

For the Board to regain trust, physicians must know that their opinions are being heard and count. Physicians must have a vocal and effective AMA working for them! Now is the time to focus on what doctors need to grow and flourish as physicians. We as physicians cannot sit idly by and let the AMA continue on its current path. We need to reverse the current course of the AMA or we will continue to lose members.

Cecil B. Wilson, M.D., a Florida Physician, Becomes the 165th President of the American Medical Association

By Charles D. Williams, M.D.

Cecil B. Wilson, M.D., an internist from Winter Park, Fla., has been a member of the American Medical Association (AMA) Board of Trustees (BOT) since 2002 and served as chair of the AMA-BOT from 2006 to 2007. Dr. Wilson has also been a member of the AMA House of Delegates since 1992, and was previously elected to two terms as a member of the AMA Council on Constitution and Bylaws, of which he also served as vice chair.

Dr. Wilson has a distinguished record of service and leadership in organized medicine. He was president of the Florida Medical Association (FMA) and chair of its board of governors and executive committee. In 2003 Dr. Wilson was recognized by the FMA with its highest award, the Certificate of Merit. He served as president of the Orange County Medical Society, and of the medical staffs of the Winter Park Memorial Hospital and Florida Hospital Medical Center, Orlando, Fla.

After receiving his bachelor's degree in history and his doctorate from Emory University, Atlanta, Dr. Wilson interned at the U.S. Naval Hospital, Portsmouth, VA., and completed his residency in internal medicine at the U.S. Naval Hospital, San Diego. He served as a Navy flight surgeon, rising to the rank of commander. Dr. Wilson has been in private practice of internal medicine in Central Florida for more than 30 years. He is board-certified in internal medicine and a Master of the American College of Physicians (ACP).

Dr. Wilson's service in organized medicine includes leadership in his specialty of internal medicine. He is past chair of the ACP Board of Regents. He also served on the board of the American Society of Internal Medicine (ASIM) and was a member of the merger committee between ACP and ASIM, which resulted in the largest medical specialty society in the United States. At the state level, Dr. Wilson has received the prestigious Laureate Award for service to internal medicine from the Florida chapter of ACP.

In addition to his work within organized medicine, Dr. Wilson served as a board member of COLA, a physician-run organization that accredits more than 8,000 physician office laboratories nationwide. He is currently a national fellow and advisor for the Center for Global Health and Medical Diplomacy at the University of North Florida, and a clinical professor in health administration in the Brooks College of Health at the university. He is also a past president of the Florida Statewide Health Council and past chair of the Local Health Council of East Central Florida.

Dr. Wilson and his wife, Betty Jane, past president of the FMA Alliance, have two sons, a daughter and three granddaughters.

Dr. C. William Applegate Retires from Medical Practice

By Shannon Dent

On July 15th, North Florida Nephrology Associates hosted a retirement reception for Dr. Clarence William Applegate at Goodwood Conference Center. Dr. Applegate will be missed in the physician community. Dr. Applegate went into practice in Tallahassee in 1975, 35 years ago. He is credited with establishing nephrology in our area, including the start of dialysis programs in the hospitals and for outpatients. He also founded North Florida Nephrology Associates, the only kidney specialty group in town. He is a past-president of the Capital Medical Society (1987) and served as chief of staff for TMH.

Pictured here are (l-r): Dr. Cynthia Gaboury; Dr. Avon Doll; Judy Feinberg, Office Manager at North Florida Nephrology Associates; Dr. Applegate; Dr. Gary Hansen; and Dr. John Peterson. (Not pictured is Dr. Hari Kolli, new partner at North Florida Nephrology Associates – who was on call!)

Attention CMS Members! A New Member Benefit

TMH Credit Union, through its business lending arm United Member Business Services (UMBS), is pleased to provide Capital Medical Society members with an enhanced member benefit. The new benefit, a business product being offered from UMBS, is preferred financing options on owner occupied real estate for medical and dental offices and equipment financing packages.

As a CMS member, you will be able to take advantage of a special pricing structure based on the underwriting guidelines of TMH Credit Union just as Dr. Philbert Ford and Dr. Michele Hoggatt did. "We have undertaken major financing activity with UMBS with minimal red tape, and after comparing multiple other lenders, UMBS had the best financing options in town."

This enhanced member benefit is being offered through Capital Medical Society to add value to your membership. Please contact Kevin McAlpine at or call 684-1811 and get the details on our long term fixed rate options. You'll have the same great experience as Dr. Wendy Thompson, "Kevin is wonderful to work with. He made my experiences easy and painless. He allowed me to focus on what was important, seeing my patients, not being overwhelmed by paperwork. Everything was clear, precise and to the point. Just the way it should be."

Take advantage of your membership in Capital Medical Society today.