March 1, 2004

Delegate Body ponders resolutions
WCMS Delegates considered a number of resolutions at the group’s Jan. 25 meeting. More resolutions are needed. Suggested issue areas include: Medicaid/Medicare reimbursement, bioterrorism, health crisis in Detroit, nutrition/obesity, liability insurance costs, pharmaceutical costs/advertising.

The Delegate Body’s next meeting is March 24. Previously submitted resolutions will be further considered for approval and introduction at this year’s MSMS House of Delegates meeting.

To submit resolutions, please contact WCMS at (313) 874-1360. The fax number is (313) 874-1366 and e-mail is wcms1@msms.org.
Four resolutions were considered by the Delegate Body.

Physician/legislator discusses this year's agenda
By CHRIS BUSH, MD
The Wayne County Medical Society Legislative Committee met on Jan. 16. Recent legislative issues and concerns were presented by Brian Reuwer of the MSMS Governmental Affairs Department. Following his report and a question-and-answer session the Committee welcomed State Sen. Hanson Clarke (D-Detroit).
A broad range of topics were discussed in detail, including the development of the Wayne County Health Care Authority, the fate of Detroit hospitals and the Detroit Medical Center, care for the uninsured and underinsured and the current health status of the citizens of Michigan. The Committee emphasized that organized medicine is ready and willing to assist Sen. Clarke to advocate on behalf of Michigan residents. We have asked him to visit the Society in the future to continue the dialogue on these important issues.
On Jan. 26, I attended a breakfast fundraiser for State Sen. Raymond Basham (D-Taylor) that was well-attended by Downriver-area dignitaries representing all walks of life as well as the following legislators: Barbara Farrah (D-Southgate), Hoon-Young Hopgood (D-Taylor), Kathleen Law, (D-Gibraltar) and William O'Neil, (D-Allen Park). Issues discussed included municipal revenue-sharing, environmental concerns, unemployment, education and the health care needs of the residents of Downriver.

On Feb. 11, the Michigan State Medical Society and MDPAC sponsored a workshop that featured State Sen. Tom George, MD (D-Portage). Dr. George is a practicing Anesthesiologist and is the only physician in the Senate. Dr. George has been very active for many years in MSMS activities and is an expert in end-of-life issues.
The senator told the story about his start in politics, his House and Senate campaigns and life in Lansing as a legislator. He related that in many ways, a politicians' life is much easier than that of an average practicing physician. He encouraged all physicians and their spouses to become active in the political process and those who are interested to run for office. In fact, two physicians currently running for office were in attendance at the meeting.

Roger N. Kahn, MD, a Saginaw County Cardiovascular specialist, is running for election to the Michigan House in the 94th District. Philip Zazove, MD, is a Washtenaw County Family Physician standing for election for the 52nd House District. Dr. George expressed his support for these physicians and the other three Michigan physicians that are also running for office. He asked MSMS members and the Alliance to organize Grassroots activities on their behalf.
Dr. George went on to discuss the four fronts or challenges that physicians constantly face: governmental (federal, state, local), third-party payors, scope of practice and medical liability
He discussed the above issues in detail and offered strategy regarding approaches to address these concerns.

A considerable amount of time was devoted to recent Blue Cross-Blue Shield of Michigan issues. These problems were brought to the forefront by a group of Oakland County Ob-Gyns. They have experienced serious cash flow problems due to unilateral changes in coding and billing by BCBSM. There is also a lawsuit against BCBSM by these physicians seeking a remedy to their losses and reform by BCBSM. At this time there is new legislation introduced by Rep. David Robertson (R-Grand Blanc) to address these issues. Dr. George supported these actions in principle and offered advice on how best to proceed. He pledged to support the bills when they are taken up in the State Senate. The meeting was well attended by WCMS physicians and Alliance members.

The Legislative Committee  is looking forward to co-hosting the Greater Detroit Meet & Greet this spring, tentatively scheduled for March 25.

Meet the CandidatesThe Executive Council was presented the following slate of candidates at its March 3 meeting:

President Elect
Federico Mariona, MD
Jean Sinkoff, MD

Secretary
Robert Jackson, MD
Sophie Womack, MD

Board of Trustees
Lonnie Joe, MD
H. Michael Marsh, MBBS

President's Page: First Impressions Of Two In The View
By EDWARD JANKOWSKI, MD
WCMS President
Mr. Mike :Duggan. Right-hand man to former Wayne County CEO Bill McNamara. The deal maker for the Detroit downtown sports complexes and the new Detroit Metropolitan Airport. Newly elected Wayne County presecutor. At present, the DMC CEO. An attorney running the Detroit Medical Center. A tough, smart, no-nonsense politician who has earned the respect of friends and foes alike.
A recent breakfast meeting with health-care leaders revealed a man who engaged in an open, straightforward discussion of the Medical Center’s plight. My general impressions: he showed he had done his homework. He will rule and designate from the top. However, he will also plunge into the grassroots and look in from the patient’s and physician’s perspectives. The CEO will likely micromanage in order to streamline protocols from the entry points into the DMC behemouth -- ER, admissions, outpatient services, etc. He seems realistic, but also bold. The Detroit Medical Center shakeup has begun.

Gov. Jennifer Granholm. Former assistant Wayne County prosecutor. Recent Michigan Attorney General under the Engler adminstration, the highest ranking Democrat at that time. The first female governor of our state. She was a handpicked candidate strongly endorsed by the McNamara political machine.

A recent luncheon with health-care and business leaders revealed a very bright, energetic lady who enjoys a commanding presence in a room. She openly engages with people and listens. The governor will and has taken on controversy and difficult situations with a smile. She stands firm on her principles. She had shown political skill in the art of compromise  as in the recent budget negotiations. We will fight to protect Medicaid and preserve health-care quality and access. I hope our governor will also maintain our liability reform -- don’t forget, she is an attorney, too.

Your president so far has positive first impressions of these two people whose histories are closely intertwined. They will be viewed in the spotlight  for the next few years. At present, both of these leaders deserve full support as well as any benefit of the doubt. May God grant them wisdom and courage.

Letter:
Editor:
A New York Times article on preventive medicine and primary care from Dec. 12, 2003, said that primary care, particularly preventive medicine, is becoming unteneble in the era of 15-minute office visits. A study published this year in The American Journal of Public Health estimated that it would take over four hours a day for a general internist to provide the preventive care that is recommended for an average-size panel of adult patients. “The amount of time is overwhelming,” the authors wrote.

Primary care doctors already are overstretched. Urgent issues have to take precedence during office visits. Increasingly, this means preventive care gets short shrift.

What can doctors do nowadays to stem the tide of shortchanging patients?
Victor Bloom, MD

Editorial: Speaking With A Unified Voice
By JOSEPH WEISS, MD
Editor
Editor's note: The meeting referenced in the following editorial was  held to discuss Michigan State Medical Society legislative and state government priorities for the year. It featured discourse on issues ranging from Medicaid to mental health parity and included core physician issues such as scope-of-practice expansion for non-physician providers, medical malpractice reform and antitrust issues.

On Wednesday, Feb. 11 at the Southfield Westin Hotel, Dr. Tom George, an MSMS member and Michigan legislator made a telling point. He told the doctors assembled that medicine needs to: "Speak with one voice." Then he illustrated what he meant. He pointed out that the per-pupil grant for Michigan students in the public schools has steadily risen. He expressed the opinion that the money per pupil would likely survive any attempt to cut it down even in this time of great financial pressures on the state treasury.

The reason was because state legislators were subject to hearing a single voice. When people from the Michigan Education Association came by, they would say, "Don't decrease the per-student grant." When principals from schools came by, the legislators heard, "Don't touch the per-student education grant," when PTA groups came by, the legislators heard the same. When legislators went to their home districts, they heard the same: "Don't touch the per-student grants." The single voice, the repeated theme, from all sides of the educational community is effective and leads to keeping those grants.

The medical community can take Dr. George's advice and apply it to present policy. On the state level, we should speak on a single theme: preserve Medicaid funding. Whether we represent ourselves, our specialties, MSMS, the Michigan Health and Hospital Association, or other professional groups, we should make that theme -- preserve Medicaid funding -- our single voice.

Dr. George's advice indicates a goal for national policy. Each group within the medical community should no longer go lobbying in Congress asking for special help. The experience of the oncologists as victims of the prescription bill, is an example of what may happen. Working for more funds for your group may lead you to a loss if someone with more powerful political position squeezes you out.
Instead, we should come together on a national health strategy whether it be single pay, extension of Medicare and Medicaid laws already in place, or development of regional care as is happening now in Chicago and Denver. Rather than asking for Congress to help us as individualists or specialists, we should speak with a single voice on a system of health care that we believe we can live with, and that our patients can benefit from.

Rob Beattie, our MSMS member services representative
The Wayne County Member Service Representative from the Michigan State Medical Society is Rob Beattie. You can expect a visit from Rob in your office to make sure you are familiar with all that MSMS offers. He can provide you with easier access to MSMS services and products available exclusively to members. Whether the topics are HIPAA compliance, coding, member benefits, endorsed services, or liability insurance, Rob can answer your questions. There is no charge to have him visit your office. To schedule an appointment, contact him in the MSR Department of MSMS at (517) 336-5776 or rbeattie@msms.org.

Obituary:
Well-rounded gentleman had a twinkle in his eye
When Dr. Ralph Cooper died on February 6, 2004 not only his family, but also the medical profession and our whole community lost a constant, stalwart husband, father, friend and contributor. He was also a happy man; happy in his marriage, his family, professional accomplishments, home, travels and lifestyle. When he was 80, he was in the Hebrides, and at 88, he was photographing lions in Kenya. He always looked younger than his years, and now we know why.
Dr. Cooper was born March 19, 1913 in Leesville Michigan, now part of Detroit. He  claimed he was called to a career in Medicine when he was only 11. At that time, while ill, he was so impressed by the demeanor and abilities proffered by his attending physician, he decided then to become a doctor. After graduating from the University of Michigan Medical School in 1937, he remained in Ann Arbor to enlist in the Army during World War II, and served at the U of M Base Hospital unit (1942-1946) in France, Belgium and England. There he developed a fondness for French culture which lasted the rest of his life.

After the war he returned to practice at Harper, Bon Secours, St. John, Cottage, Saratoga, Holy Cross and Detroit General hospitals. For many years he was also physician to the employees of Children’s Hospital. Dr. Cooper served the Wayne County Medical Society on many committees, most notably the ethics committee, and was our secretary, then president during 1962. Afterward, he served on the board of trustees.

Ralph had two happy marriages. With his first wife, Mary Reeder, there were three children; Elizabeth, Jessup, Lynne (Dr. James) Robertson, and Dr. Michael Cooper (Sylvia). In 1982, Mary died. Four years later, the stage was set for the staid physician widower to meet the lovely, stylish Ann Garred at the senior singles group of Christ Church in Grosse Pointe.

Understandably, a romance flourished and the two were married in 1986. Ann’s two girls Lynne (Dr. David) Cameron and Tracy (Jeffrey) Meyers completed the family.

Dr. Cooper retired in 1988 to travel and enjoy his family, now with Ann, the children and their 12 grandchildren. At the memorial services he was remembered fondly as an excellent father, grandfather, host and gentle practical joker; and always with a twinkle in his eye.
-- Ned  I. Chalat, MD

Membership
ACTIVE NEW

Daniel P. Elskens, MD
Neurosurgery
Medical School: U of MI, Ann Arbor, MI 1986
Internship: Henry Ford Hospital, Detroit MI 1986-1987
Residencies: Children's Hospital of MI April 1991-June 1991
Henry Ford Hospital, 1987-1992
Office: 22201 Moross #352, PB II, Detroit MI 48236
Tele: 313-343-7900, Fax: 313-343-7001

Antoine E. Geffrard, MD
Internal Medicine, Physical Medicine & Rehabilitation
Medical School: MI State U Coll. of Human Med, East Lansing 1994
Residency: Wayne State U-DMC 1994-1999
Office: 261 Mack Ave., Suite 83, Detroit MI 48201
Tele: 313-745-1160, Fax: 313-745-1063
Email: ageffrar@dmc.org

Devon A. Hoover, MD
Neurosurgery
Medical School: Indiana U School of Medicine, Indianapolis IN 1996
Residency: Henry Ford Hospital 1996-2002
Louisiana State U School of Medicine, January - March 2001
Children's Hospital of MI, April - June 2001
Office; 22201 Moross #352, Detroit MI 48236
Tele: 313-343-7900, Fax: 313-343-7001
Email: devonhoover@hotmail.com

Sunday T. C. Ilechukwu, MD
Psychiatry
Medical School: U of Lagos, College of Medicine, Nigeria 1973
Residency: U Ottawa Fac. Medical Hospital; Wayne State U - DMC 1994-1997
Office: 3990 John R, Detroit MI 48201
Tele: 313-745-9255

Latha T. Kannan, MD
Infectious Diseases
Medical School: Madurai Kamaraj U, India 1993
Residencies: Madurai Kamaraj U, India 1993-1994
Wayne State U, Detroit MI 1997-2000
Fellowship: Wayne State U, Detroit 2000-2002
Office: 6071 W. Outer Drive, Detroit MI 48235
Tele: 313-966-3652, Fax: 313-966-1738
Email: lathatg@cs.com

Youssef S. Rizk, DO
Vascular Surgery
Medical School: Nova Southeastern U, Miami FL 1995
Residency: Botsford General Hospital 2001
Fellowship: Union Memorial Hospital 2002
Office: 22201 Moross, Suite 170, Detroit MI 48236
Tele: 313-886-8787

Parveen N. Siddiqui, MD
Internal Medicine
Medical School: U Minneapolis Medical School, Minneapolis MN 1997
Residency: U of Minneapolis Hospital, Minneapolis MN 1997-2000
Office: 23501 E. Jefferson, St. Clair Shores MI 48080
Tele: 586-778-4080, Fax 586-778-6055
Email: parveensiddiqui@comcast.net

Matthew P. Steffes, MD
Orthopedic Surgery
Medical School: Wayne State U, Detroit MI 1996
Residency: DMC - Wayne State U 1996- 2001
Office: 23550 Park St., Suite 100, Dearborn MI 48124
Tele: 313-730-0500, Fax: 313-730-0606

ACTIVE REINSTATED

Faina M. Gutin, MD
Allergy & Asthma
Medical School: First Pavlov Medical School, St. Petersburg, Russia 1984
Residencies: Pavlov Medical School Hospital 1984-1987
Oakwood Hospital, Dearborn, MI 1998-2001
Fellowship: Children's Hospital, Detroit, MI 2002-2003
Office: 20200 Outer Drive, Dearborn, MI 48124
Tele: 313-565-3565, Fax: 313-565-7723

Michael D. Khoury, MD
Vascular Surgery
Medical School:  Wayne State U 1982
Residencies: St. John Hospital 1982-1983, 1983-1987
U Iowa Hospitals 1987-1989
Office: 25511 Little Mack, Suite B, St. Clair Shores, MI 48081
Tele: 586-772-4444, Fax: 586-772-4411
Email: mdkhoury@aol.com

David C. Kmak, MD
Obstetrics & Gynecology
Medical School: Wayne State U, Detroit MI 1986
Residency: Wayne State U- DMC 1986-1990
Office: 4727 St. Antoine, Suite 304, Detroit, MI 48201-1461
Tele: 313-745-0499

Oscar A. Linares, MD
Internal Medicine
Medical School: U Central Del Este, San Pedro De Macoris 1981
Residencies: U of MI, Ann Arbor 1982, Oakwood Hospital, Dearborn, MI 1983-1984
Office: 1611 Monroe, Dearborn MI 48124
Tele: 313-278-7100

Swarn Mahajan, MD
Psychiatry
Medical School: Govt.  Med. College, Punjabi U, Patiala, Punjab, India 1965
Residency: Nassau Co. Medical Center 1994
Office: 10501 Telegraph Road, Suite 102, Taylor MI 48180-3376

Augustine O. Osagie, MD
Internal Medicine
Medical School: U of Lagos, College of Med. Lagos, Nigeria 1988
Residency: Bronx-Lebanon Hospital Center 1996-1999
Office: 15565 Northland Drive, Suite 503W, Southfield, MI 48075
Tele: 248-552-9673, Fax: 248-552-9931
Email: aosagie@metrohospitalists.com

Balakrishna R. Pai, MD
Pediatrics
Medical School: Karnataka Inst. Med. Science, Hubli, Karnataka, India 1972
Residency: Sinai-Grace Hospital 1984-1987
Office: 19401 Hubbard Dr., Dearborn, MI 48126-2641
Tele: 313-593-8278
Email: bpai@hapcorp.org

Shababa Rasheed, MD
Internal Medicine
Medical School: U of Health Science, Hyderabad, AP, India 1992
Residency: Wayne State U 1992-1995
Office: 3800Woodward #504, Detroit, MI 48201
Tele: 313-831-8688, Fax: 313-831-8690
Email: shabbu28us@yahoo.com

MEDICAL STUDENT
Thomas J. Hewson   2007

ASSOCIATE MEMBER
Julie A. Gleason-Comstock, PhD
HIV/AIDS Research
WSU Assistant Professor
904 UHC, 4201 St. Antoine, Detroit, MI 48201
Tele: 313-577-9143 Fax: 313-577-0316
Email: jgleason@med.wayne.edu

Meet the Press
WCMS and MSMS officials met with reporters from Crain’s Detroit Business, a weekly newspaper that covers business in the Detroit area.
Attending the meeting were: WCMS President-Elect Rick Smith, MD; MSMS Managing Director Kevin Kelly; WCMS Board Chairman Michael Sandler, MD; WCMS Executive Director Adam Jablonowski; MSMS President Hassan Amirikia, MD; Dorothy Kahkonen, MD; and CDB editor Dave Barkholz and reporter Katie Merx.
Physicians and staff briefed the journalists on a wide range of issues during the hour-and-a-half lunch meeting Feb. 12 at WCMS’ administrative office.
Among the issues discussed were: Medicaid funding, Medical liability, Detroit Health Authority, Blue reform, Obesity, the undersupply of physicians in Michigan, and administrative costs in medicine.
The group then took questions from the Crain’s representatives.

WCMS Resolutions under consideration
BILLING THE UNINSURED FOR HOSPITAL SERVICES
Submitted by: Richard Henderson, MD
Whereas, hospitals will bill the full cost  of their services to the uninsured, while insured or government funded patients benefit from negotiated pricing, and
Whereas, when uninsured patients are turned over to collection agencies, they may be driven into bankruptcy because they are unable to pay the full cost of services, now, therefore, be it
Resolved that the MSMS and the AMA work with the MHHA and the AHA to discourage aggressive collection methods directed toward the uninsured that would result in undue financial hardship, and be it further
Resolved that the MSMS and the AMA propose regulatory or legislative remedies to allow hospitals to bill uninsured patients on a needs tested sliding fee scale.
MSMS Fiscal Note: Negligible

BLUE CROSS/BLUE SHIELD REFORM
Submitted by Federico Mariona, MD
Whereas, :Blue Cross/Blue Shield continues to deny physicians timely payment for their services, and
Whereas, Blue Cross/Blue Shield arbitrarily and without adequate notice changes procedure codes for physician services, now, therefore, be it
Resolved: that the MSMS vigorously pursue any and all remedies (legislative, judicial) at any and all levels (state, federal) to insure that Blue Cross/Blue Shield reimburses physicians with both timely payment and timely notice of any changes in coding.

PRESCRIPTION REFILL CYCLE (amended 1/28/04)
Submitted by Martin Daitch, MD
Whereas, patients with chronic diseases such as diabetes, hypertension, arthritis are in need of prescription medication for the rest of their lives, and
Whereas, in Michigan, patients can only have prescriptions refilled for 30 days (one month) at a time by local pharmacists, and
Whereas, patients in many other states can have prescriptions refilled for a three-month supply, and
Whereas, this restriction may cost the patient as much as $30 per month per prescription in copays, require unnecessary trips to the pharmacy and involve additional time for the physician and staff, therefore, be it
Resolved: that the MSMS work with the appropriate Michigan government and pharmaceutical benefit agencies to change the pharmacy rules to allow prescriptions for chronic illnesses and non-narcotic drugs to be written and filled for a 90-day supply so that patients will avoid costly copays.

Fiscal Note: None

AFFORDABLE HEALTH INSURANCE COVERAGE FOR ALL
Submitted by Richard Henderson, MD
Whereas, at least 44 million Americans lack health insurance, and almost that many more may lack coverage during the course of a year, and as a result, lack access to optimal health care, and
Whereas, this includes millions of uninsured children and millions of uninsured workers and their dependents, now, therefore, be it
Resolved: that the AMA, for 2004 and for as long as necessary, make its No. 1 priority affordable health insurance coverage for all Americans. In this respect the AMA should allocate a specific amount of its financial resources to this issue that is comparable to the amount it allocates physician advocacy issues.

MSMS fical Note: Negligible