|
AMA President Nelson weighs
in on key issues during Detroit visit
By PAUL NATINSKY
Managing Editor
Our health care system is a boat on a stormy see, buffeted by strong
waves and in great peril, AMA President, John Nelson, MD, told attendees
of the WCMSSM and Detroit Medical Society Joint Membership Meeting Sept.
21 in Detroit.
But the future doesn’t have to be that way, he said, provided physicians
work hard to change the current climate. The AMA has a plan to address
major issues facing physicians (see page 8) but needs the help and action
of individual physicians to move forward.
“Medicine is three interlocking circles that comprise the tide of professionalism,” said
Dr. Nelson. “You can’t control the waves unless you control the tide.”
Dr. Nelson identified the first circle as an evidence base. “It’s science,
it’s the truth, it’s what makes us tick as physicians,” he said.
The second circle is the circle of caring; not only caring for patients,
but caring about them.
The final ring is ethics, the principle that puts patients first.
“If we don’t control the tide, someone else will,” said Dr. Nelson. “They might
not use an evidence base, they might not care about our patients and they might
not have the same ethics that we do.”
Dr. Nelson, an OB/GYN, told the story of Mary, a patient who for whom
he delivered three healthy babies through three challenging pregnancies.
When she moved to a distant town, he thought he’d seen the last of her.
That is until she got pregnant and drove a great distance to receive
his services. Her reason: Dr. Nelson is her doctor.
As rewarding as such instances must be, Dr. Nelson told other stories.
Stories of the “waves” that can sink the boat. He told a story at the
request of a family about a man who was in a serious car accident on
the way to McCarran Airport in Las Vegas. The Level I trauma center at
the University of Nevada Las Vegas was minutes away, but had closed two
days prior because doctors there couldn’t pay the high medical liability
insurance premiums anymore.
Dr. Nelson also told of a Wyoming woman who had to drive out of state
to have a caesarean section delivery because she couldn’t find a hospital
any closer that would perform the procedure.
Dr. Nelson spoke strongly about three issues he views as top priorities.
“The most significant problem facing America today is 45 million people without
access to health care coverage. We've got to solve that problem. The AMA has
a plan of which I'm proud. It talks about advanceable, refundable tax credits
inversely related to income. Advanceable means you get them at the first of the
year when you need them. Large enough to buy real insurance that works. Refundable
means you get them whether you pay taxes or not. Inversely related to income
means the poorest get the most help because that's fair. That project alone will
cover 85 percent of those 45 million people because 85 percent of those people
either have a job or live in a family where somebody has a job. I don't know
if it will cover the other 15 percent. But if it doesn't, maybe you have an idea
that will help cover that 15 percent.”
Dr. Nelson also discussed the flawed Medicare payment system, particularly
the Sustainable Growth Rate formula used to determine remuneration for
physicians.
“The sustainable growth rate. Those three words are the biggest lie in Washington.
It is a rate, it's not sustainable and it's not growth - it's a cut. What happened
last year was the correction of a clerical error. We got an act of Congress.
It restored $58 billion over 10 years to the Medicare program that was only taken
out in the first place because of a clerical error.
“The Medicare Modernization Act came up, with some warts on it. Nonetheless,
it was the first time Medicare had been substantively changed since 1965. We
got a reprieve. We were given two years to come up with a better formula. One
of those years is gone. No one wants to talk about it because we have an election.
They want to talk about ‘substantive’ things. But the AMA has a plan to fix the
formula and we're grateful for that.
“We need to have appropriate payment so that physicians can keep their offices
open. A doctor in Florida told me the other day that it costs him $10 more to
keep his office open than what he is paid. He can't keep his office open at a
loss, that is why I'm concerned.”
Dr. Nelson illustrated the damage caused by our “broken medical liability
system.” He said only 68 percent of OB/GYN residencies were filled during
the past year. Four-hundred neurosurgeons are retiring each year, but
the nation’s medical schools are training only 100 per year. The result
is what Dr. Nelson called “a law of diminishing returns.”
He said medical liability premiums force many doctors to retire, restrict
their practices or move to a state where liability reform has taken place.
The result is reduced access to health care in many parts of the country.
“The AMA has a plan for that too,” said Dr. Nelson. “We believe that when there
has been an injury caused by a physician, that person who has been harmed should
be paid all of the money that that person is owed, for medical care, prostheses,
medication, lost wages, hospice care, future earnings; and that there is pain
and suffering. So we want to pay them a reasonable amount of money. We suggest
a quarter-million dollars per case where there is negligence. Others say there
should be no limit. What happens is there is a tremendous amount of money given
in the so-called pain and suffering area, which is not quantifiable. It is easy
to write a check when someone else is paying the money. So what's happened is
that the premiums have gone up tremendously.
2004 WCMSSM Children’s Holiday Party Contributors
Beth Ann Brooks, MD
Gwendolyn H. Parker, MD
Dr. S.V. Mahadevan
Dr. Mary and Rev. William S. Logan
Homer Smathers, MD
Dr. Michael and Halena Yurkanin
Dr. & Mrs. Mark F. Pezda
John M. Malone, Sr., MD
M. Natacha Umlauf, MD
Indu & Bala Pai
Dr. and Mrs. Homer A. Howes
Arthur J. Frazier, MD
Phyllis A. Vallee, MD
Eastside Dermatology/
Dr. Lisa Manz-Dulac & Associates
Dr. David & Mrs. Barker
Iris & Fred Whitehouse
Dr. and Mrs. Ellis J. Van Slyck
Michael A. Sandler, MD
Louis Z. Shifrin, MD
Dr. and Mrs. Martin Daitch
Andrew Wilson, MD
Kathleen Yaremchuk, MD
In Memory of Drs. Shailesh & Ishu Acharya
Scott Monson, MD
Paul Mazzara, MD
Elizabeth W. Edmond, MD
Louis J. La Joie
Grosse Pointe Dermatology Assoc.
Maryjean Schenk
Dr. & Mrs. John Calwell
John Kurtz, MD
Kurt A. Kralovich, MD
Krishna & Pamela Sawhney
Joseph J. Weiss, MD
John M. Flack, MD, MPH & Jennifer Flack, JD
Vincent Yu, MD
Drs. Lalitha and Babu R. Vemuri
EDITORIAL: In The Name Of Clarity, More Confusion
By JOSEPH WEISS, MD
Editor
In a letter sent to all physicians on Sept. 9, BCBS stated
that their purpose was to clarify two issues: (1) TRUST office
visit fees as applied to Auto workers, and (2) The Blue Preferred Plus
plan to drop 700 primary care physicians.
On the same day, the Michigan State Medical Society filed a law suit
seeking a court judgment stating that physicians are not obligated to
charge TRUST office visit fees to auto workers. In addition, the MSMS
suit requested an injunction preventing BCBS from terminating a physician
from all BCBS insurance business if that physician refused to implement
the BCBS arrangement.
The BCBS letter began by stating that the TRUST agreement covers BCBS
underwritten and administered plans, the administered ones being the
self-funded plans for which BCBS is not the underwriter. Physicians should
disregard that statement. MSMS legal counsel has already established
that TRUST agreements as now written can only apply to BCBS underwritten
plans. There is no basis in TRUST contracts signed by doctors or in contract
law that allows BCBS to transfer the TRUST agreements to BCBS's arrangements
with the automakers.
The next paragraph in the letter possibly is a concession by BCBS. Originally
the Blues stated that any physician not accepting the imposed fees on
office visits would be dropped from any and all BCBS and BCBS sponsored
plans in which the physician participated. This statement is the reason
the MSMS suit asks for an injunction.
The Blues Sept. 9 letter states a different stance: "We also want
to assure physicians that they will not affect their business relationship
with BCBS by charging Auto/UAW patients higher fees than the TRUST fee
schedule for office visits. "Likely, physicians can take that statement
to mean that BCBS will not drop a physician for charging an independent
fee. A clearer statement would be to say outright that BCBS is rescinding
its initial declaration to drop doctors not accepting the office visit
part of the Auto/UAW agreement.
BCBS could have avoided this whole controversy. The Blues could have
informed the state's physicians of the Auto/UAW agreement, and asked
doctors who wanted to participate to sign a contract which included the
reimbursement arrangement on office visits. Likely, most doctors when
given a choice to choose would have agreed.
Remember, the present controversy is not on fees but over principle.
MSMS filed a lawsuit because the BCBS use of the TRUST agreement in the
auto contracts cannot go unchallenged. If the precedent taken by BCBS
in this contract is allowed to stand, there is nothing to prevent BCBS
from negotiating anything the employer wants or adding other services
that are "covered" but require a 100 percent copay by the patient.
Physicians cannot accept the imposition of such contract conditions.
The second part of the letter deals with Blue Preferred Plus (BPP) network
and BCBS's announcement that it will drop 700 primary care physicians
from the network. The Sept.9 letter states that the reason is because: "Declining
membership and high benefits costs compelled our auto customers to make
a business decision…"
The letter does not explain that if the cost/patient is say, $9,000 a
year, with a pool of 4,000 doctors, why the cost will become any less
per patient, if that auto group is cared for by 3,300 physicians. Furthermore,
the letter states that physicians to be terminated will be informed at: "…the
end of October." Three paragraphs down, BCBS states that physicians
wanting a reconsideration of termination must have the request for review
into BCBS no later than Oct. 23. Also, sandwiched in between these statements
is an acknowledgement by BCBS that termination of a physician requires
a 60-day advanced notice.
In the Sept. 9 letter BCBS deals in fuzzy thinking and arcane legal logic
at the expense of common sense and fairness. The physician community
that faithfully fulfills its commitments deserves better; what we cannot
obtain by cooperation we will gain through conflict. Let the court battle
rage.
EDITORIAL: Tax Breaks, Vouchers May Answer
Health Insurance Needs
The following editorial first appeared in the Detroit
News Sept. 29. It is reprinted with permission.
A proposal by doctors to help the uninsured buy coverage
offers common sense solutions to crisis. The Detroit News The
American Medical Association is offering a refreshing new approach
that relies on the power of consumers to bring down the cost
of health insurance and put affordable coverage within the reach
of the uninsured. It deserves a serious hearing in Washington.
The ballooning population of uninsured is not a theoretical worry for
the association, which represents doctors. They understand that uninsured
patients wait too long to seek care, and then that care becomes much
more costly. Ultimately, taxpayers and insured patients end up covering
the bill. The AMA proposes a health care tax credit allowing the cost
of health insurance purchased by individuals to be deducted from their
taxes, which is similar to the credits big corporations receive for providing
employee health insurance benefits. Those who don't earn enough to pay
income tax would get an advance voucher from the government to help cover
the cost of insurance premiums. What sets apart the AMA's plan is that
it would extend tax credits not just to the uninsured, but to all Americans,
even those who currently get coverage from their employers. That would
increase coverage options for workers not satisfied with employer plans.
And since they own the insurance policy, individuals would keep it even
if they lose their job. The AMA is betting that consumers who buy their
own insurance will demand more cost-effective options, bringing more
diversity of coverage and lower prices into the health insurance market.
The biggest impediment faced by individuals attempting to buy health
insurance is the high cost - since they can't pool their risk like large
employers do, they get much higher premiums. The AMA would reform the
insurance market to make it easier for individuals to form pools to purchase
group insurance. The AMA's proposal has some drawbacks. Universal tax
credits would raise the government's health care obligations at a time
when it is having difficulty paying for current programs. The association
estimates the credit would cost the federal treasury at least $50 billion
a year. But inaction is also costly. The indirect cost of the uninsured
to government and insured patients exceeds that $50 billion figure. The
AMA is offering a credible blueprint for fundamental health care reform.
It deserves a hearing in Congress.
Canadian health care workers get certification extension
Move intended to avoid disruption in patient care
US Citizenship and Immigration Services (USCIS) announced
this summer that certain foreign health care workers from Canada
and Mexico will remain exempt, for a period of one year, from
the foreign health care worker certification requirement. The
announcement was published in the Federal Register. This exemption
applies only to Canadian and Mexican TN (NAFTA professional)
health care workers who were employed as TN nonimmigrant health
care workers before Sept. 23, 2003 and held a valid license from
a US jurisdiction before Sept. 23, 2003.
On July 23, 2003, USCIS announced that, after July 26, 2004, foreign
health care workers, other than physicians, who are subject to the foreign
health care worker certification requirement, are inadmissible, and ineligible
for an extension of status or change of status if already in the United
States, unless they present a certificate granted by an approved credentialing
organization.
That one-year transition period was sufficient for the vast majority
of foreign health care workers. In the case of Canadian and Mexican TN
health care workers, however, USCIS has determined that an extended transition
period is needed. Many Canadian and Mexican citizens working in the border
regions regularly travel across their respective borders. Because the
process of obtaining certification is not an immediate one, USCIS has
extended the transition period for Canadian and Mexican TN health care
workers only for an additional year. This will ensure that there is no
disruption to the regional health care systems along the Canadian and
Mexican borders.
Congress mandated the certification requirement in the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996.
(See related story, page 10 – Ed.)
MSMS Payer Solutions Network News:
ICD 9 update reminder
It is important that you now begin using the updated ICD-9 CM
diagnosis codes since the US Centers for Medicare & Medicaid Services
eliminated the 90-day grace period for transitioning new codes, which
became effective on October 1. HIPAA requires usage of the medical code
sets that are valid at the time the service is provided.
Changes to the ICD-9 codes are categorized as new codes, revisions to
existing codes, and discontinued codes (codes that will no longer be
valid after Oct. 1).
For more information about reimbursement issues, contact Stacie Saylor
at MSMS at (517) 336-5722 or ssaylor@msms.org.
For more news and information, view MSMS publications such as Medigram,
Michigan Medicine, and the Monthly Top 10 online at www.msms.org.
MSTRO Resident Competition Awards
On May 13, 2004, the Michigan Society of Therapeutic Radiologists and
Oncologists (MSTRO) held their annual 2004 Delmar H. Mahrt, MD, Resident
Research Competition. The meeting is an opportunity for the residents
from the four radiation oncology training programs in Michigan to present
their clinical and laboratory projects. Residents from Henry Ford Hospital,
the Detroit Medical Center, William Beaumont Hospital and the University
of Michigan Medical Center participated this year with eight abstracts
presented.
The abstracts presented this year were diverse in subject and all the
submissions were of high quality, indicating everyone’s hard work over
the past year. The winner of the clinical competition was Dr. Daniel
Krauss from William Beaumont Hospital. He presented, “Dedicated Cardiac
MRI Assessment of Reduced Irradiated Left Ventricular Volume Via Active
Breathing Control in Left Sided Breast Cancer.” The winner of the laboratory
competition was Dr. Daniel A. Hamstra from the University of Michigan
Medical Center. He presented, “Non-Invasive Imaging of p53 Dependent
Gene Expression in Vivo Following Chemoradiotherapy.”
The meeting supports the important mission of MSTRO to support research
in Radiation Oncology. In addition, it is the only forum for the residents
from all the training programs in Michigan to come together in a collegial
setting.
The AMA’s Big Six Issues
The AMA has identified six issues that warrant special focus
in support of patients, physicians and policy makers to cure
our troubled health care delivery system:
FINANCE CARE FOR
LOW-INCOME PATIENTS
The AMA will seek to expand health insurance options through changes
in the federal tax code that will facilitate the transition from an employer-based
to an individually owned insurance system. This will empower patients,
preserve the patient-physician relationship, and facilitate the development
of new strategies to extend coverage to the uninsured.
HEALTH INSURANCE REFORM
The AMA proposes expanding health insurance coverage and patient choice
of health plans by: (1) enabling individuals to choose and control
coverage for themselves and their families through a system of "defined
contributions," (2) fostering a health insurance market that
offers products that are affordable for individuals and families
and is responsive to their needs, and (3) providing refundable tax
credits to enable and encourage the uninsured to purchase health
insurance.
MANAGED CARE ISSUES/
PRIVATE SECTOR ADVOCACY
The AMA has several tools designed to help physicians solve problems
with managed care companies and insurers, including devices for reporting
difficulties with individual plans. See the AMA Web site at www.ama-assn.org for
more information.
PATIENT SAFETY
House and Senate bills create confidential, voluntary reporting systems
in which physicians and other health care providers can report information
on errors to entities to be known as Patient Safety Organizations
(PSO). The PSOs will collect and analyze unique “patient safety data” and
provide feedback on patient safety improvement strategies.
Specifically, this legislation creates a confidential, voluntary reporting
system in which physicians, hospitals, and other health care providers
can report information on errors to organizations known as Patient Safety
Organizations (PSOs); allows PSOs to collect and analyze unique “patient
safety data” and then provide feedback on patient safety improvement
strategies; provides that "patient safety data" will be confidential
and legally protected; does not limit or affect the availability of any
information or evidence that is currently available from sources other
than the PSO and can be collected under existing law; provides for appropriate
penalties for unlawful disclosures; recognizes and preserves the protection
of confidential patient information under the Health Insurance Portability
and Accountability Act of 1996; does not preempt other state and federal
peer review laws.
On July 22, 2004, the Senate passed S.720, an important quality improvement
initiative that would create a system in which health care professionals
share and analyze information about errors to prevent similar incidents
from recurring. Now, the House and Senate will conference then
send the bill to President Bush for his signature on this critically
important legislation for the safety of our patients.
The S.720/H.R. 663 Senate conferees are Sens. Gregg (NH), Frist (TN),
Enzi (WY), Alexander (TN), Kennedy (MA), Dodd (CT), and Jeffords (VT).
House conferees have yet to be named.
AMERICA’S LIABILITY CRISIS
The US House of Representatives has repeatedly passed strong medical
liability reforms and President Bush has called for action on this
issue. The final hurdle is the US Senate. Please contact your Senators
today and tell them that it is time to put America’s Patients First
by passing strong medical liability reform!
On Wednesday, May 12, 2004 the US House of Representatives passed H.R.
4280, The HEALTH Act of 2004 by a vote of 229-197. This legislation is
an important step in solving today’s medical liability crisis in America
which is threatening access to quality medical care, slowing efforts
to improve patient safety, and adding billions of dollars in additional
costs to our health care system. Because of skyrocketing insurance premiums
and a broken liability system, physicians are being forced to limit services,
retire early or move to a state with medical liability reforms leaving
patients unable to receive the care that they deserve.
The HEALTH Act of 2004 (Help Efficient Accessible, Low-Cost, Timely Health
Care) will safeguard patients' access to care through the common sense
reforms and help to relieve a system that is already strained to the
breaking point.
This common sense legislation allows patients to recover economic damages
such as future medical expenses and loss of future earnings while establishing
a cap on non-economic damages, such as pain and suffering, of $250,000.
The law would also allocate damages fairly, in proportion to a party's
degree of fault and limit the number of years a plaintiff has to file
a health care liability action to ensure that claims are brought while
evidence and witnesses are available.
The US House of Representatives passed a similar measure in March of
2003 and President Bush has said he would sign a medical liability reform
bill into law if it came to his desk.
It is now up to the US Senate to pass this important legislation which
will work to solve the medical liability crisis in America and provide
relief to patients and physicians.
STRENGTHENING MEDICARE
The underlying formula that sets Medicare payments to physicians, known
as the Sustainable Growth Rate (SGR), is fundamentally flawed, and
leads to dangerous payment cuts that jeopardize Medicare patients'
access to care. The AMA believes the time has come to replace the
flawed SGR formula with an annual update system that reflects actual
increases in physicians' costs. The AMA is working with the Bush
Administration and congressional leaders in both parties to lay the
groundwork for change.
Recently, the US Senate and House sent letters concerning Medicare's
flawed SGR formula to the Centers for Medicare and Medicaid Services
(CMS). Seventy-three Senators signed the Senate letter and 241 Representatives
signed the House letter.
Canadian health care workers can
continue critical work in Michigan
Congresswoman Candice Miller heralded a decision by the Department of
Homeland Security (DHS) to extend the deadline for Canadian nurses – who
have been certified to work in the United States since on or before Sept.
23, 2003 – for one year until July 26, 2005, in accordance with a law
prohibiting foreign health care professionals from crossing the border
without a certificate from the Commission on Graduates of Foreign Nursing
Schools (CGFNS).
The law previously stated that all foreign health care professionals
must have their CGFNS certificate starting July 26, 2004. All Canadian
nurses certified after Sept. 23, 2003 must still comply with the deadline
at the end of this month.
"Every day, more than 3,000 health care professionals leave their homes
in Canada and commute to Michigan to treat Michigan patients in Michigan hospitals," Miller
said. "These new restrictions from DHS threatened to severely clog the daily
flow of health care workers into Michigan, with so many people needing their
certificates and only one organization available to process their applications.
Without DHS intervention, many nurses would have been denied entry into our country,
effectively disrupting the quality of hospital services."
In April, Rep. Miller and her colleagues in Michigan's congressional
delegation sent a letter to DHS Secretary Tom Ridge asking for a solution
to ensure these Canadian health care professionals could both meet these
new requirements by the July 26 deadline and continue to work in Michigan
hospitals.
DHS announced that foreign health care professionals certified to work
in the United States prior to Sept. 23, 2003 (when the regulation was
issued) will be given an additional year to comply with the new requirements. According
to figures supplied by DHS, this new regulation should eliminate more
than 90 percent of the outstanding cases and get rid of the looming backlog
of applications.
"This is great news, particularly for those of us in Southeast Michigan,
where a majority of these Canadian healthcare professionals work," Miller
said. "With this compromise in place, we can rest assured knowing that caring
and competent nursing professionals are ready and available when you need them.
EDITIORIAL: The Car Repair Model For Health Care
By PAUL NATINSKY
Managing Editor
Debates about health policy often become steaming cauldrons of emotion
and cause the debaters to lose perspective. Gaining back that perspective
could prove beneficial to all involved and maybe even lead to some solutions.
When the delivery of and payment for health care services is considered
from a broad perspective it finds itself in close company with other
basic needs in modern society, such as the acquisition of food, shelter,
and transportation.
The need for transportation is a good point of comparison because it
ranks as an important basic need and serves as an apt analogy for how
we might more efficiently and fairly deliver and pay for health care
services.
Its rank as an important need might at first blush seem peripheral but,
upon closer inspection, it becomes primary. Lack of transportation is
a barrier to receiving adequate health care services. There are not many
physician offices in inner cities. Those who are too poor to own a car
or pay for a taxi in a metropolitan area that lacks effective public
transportation find themselves in a quandary when seeking primary and
preventive health care services.
How we obtain and maintain a source of transportation (in this city namely
a car) provides a terrific analogy for how we might consider health care
delivery. State law requires that drivers buy car insurance and drivers
who can afford it tend to buy more than the minimum in case an automotive
catastrophe befalls them. Typically, we buy the coverage we can afford,
only use it if we get in an accident, and pay a substantial deductible
before receiving our insurance benefit. If we are too poor to buy much
insurance, a safety net protects us by paying for our injuries and/or
lost income, but not for the damage to our car.
However, if our car develops a problem on it's own, our water pump blows,
or our radiator springs a leak, our insurance benefits do not come into
play. If chronic neglect causes our car to suffer complete engine destruction
in the middle of the Lodge Freeway, our insurance pays not a penny.
Somehow, most people find a way to pay for car repair and insurance.
They might be forced to put repairs on expensive credit cards or drive
used cars. Most cities have public transportation that greatly assists
those too poor to own, insure and maintain a car.
So what if we expected patients to pay $50 for an office visit when they
are sick? What if we asked them to "change their oil and filters" by
coming in periodically for a checkup, which might cost a little bit more
money? What if paying out-of-pocket for "repairs" and "routine
maintenance" to our bodies helped doctors get paid and reduced our
insurance premiums? For those who can't afford it, we have "public
transportation," read Medicaid.
Paying for routine and preventive care would put a strain on some families
to be sure. But increasingly this responsibility is being shifted to
patients anyway. Consider the "100-percent copay" put into
place by one of the Big Three automakers, or the $5,000 deductible put
into place by another. Perhaps it's too late to end the folly of first-dollar
coverage before it is forced on patients by their employers.
Perhaps it's not too late to late for patients and physicians to reap
some benefit from the shift toward direct patient payment for services.
If patients forewent first-dollar coverage in favor of catastrophic coverage
for high-ticket services such as heart surgery, cancer treatment or treatment
for severe trauma, premiums could decrease, freeing up money to spend
on routine care or save for future emergencies, medical or otherwise.
If this sounds like a pitch for tax-deductible medical savings accounts,
it’s not. This kind of perspective works even if patients save the money
in bank accounts, use it for education or invest it. Money not spent
on premiums for first-dollar coverage is free to be employed elsewhere.
While it could be used to cover future routine care, the choice would
remain with the individual.
Other side benefits might accrue. Choice of physicians, particularly
for primary and preventive care could increase as the need to keep patients
in physician networks would abate. Payments in most cases would be made
directly from patients to physicians, cutting out troublesome administrative
costs and allowing physicians to charge and receive market value for
their services.
Whether these additional benefits occur or not, the trend is toward patients
paying more and doctors increasingly being caught between patients and
insurance plans. If patients are going to pay a greater share of their
health care service bills and doctors are going to be asked to collect
it, shouldn't they be the parties who decide the terms?
OBITUARIES
Jack Mandiberg, MD
Jack Mandiberg, MD, passed away in 2003. He was born December 2, 1914.
Dr. Mandiberg was beloved husband of Helen Mandiberg, dear father of
David Mandiberg, Lois (Richard) Friedland, Dr. Joseph (Linda) Mandiberg
and Takao Nagai. Dear grandfather of Rachel and Ben Friedland, Michael
and Stephen Mandiberg. WCMSSM members morn his loss and pass their condolences
to Dr. Mandiberg’s family and friends.
Rafael E. Quinones, MD
WCMSSM members and staff fondly remember Rafael E. Quinones, MD, who
died November 23, 2003. He was born November 11, 1925. A University
of Tennessee Medical School graduate in 1949, Dr. Quinones then completed
his internship at Grace Hospital in Detroit. Dr. Quinones was a surgeon
who completed a four-year fellowship at the Mayo Clinic.
Donald I. Bryan, MD
Donald I. Bryan, MD, 88, died March 1, 2004 in Home of Hope Hospice in
Grand Rapids. He was born in Stevens Point, Wisconsin, February 9,
1916. Dr. Bryan earned his medical degree from the University of
Minnesota School of Medicine. He served in the Army Medical Corps
during World War II in Africa, Italy and France. Preceding him is
death was his beloved wife, Laura, who passed away November 10, 1996.
Surviving are his son, Donald Quinn (Peggy) Bryan; his daughters,
Margaret Bauw, and Elizabeth Bryan; three grandchildren, Heather
Bryan, Laura (Ronald ) Pleune, J. Bryan Bauw; and several cousins.
Harvey Vincent Kroll, MD
WCMSSM was saddened to learn that Harvey Vincent Kroll, MD, passed away
June 22, 2004 in Rancho Mirage, California. He was 90 years of age. He
was a very well known and highly respected cardiologist in the Detroit
area for more than 50 years. Dr. Kroll is survived by seven children,
12 grandchildren and seven great-grandchildren. WCMSSM members and staff
will deeply miss Dr. Kroll and his contributions to the Detroit health
care community.
Charles Kessler, MD
Charles Kessler, MD, 83, of Huntington Woods, died July 3, 2004. After
graduating with a medical degree from the University of Virginia,
Dr. Kessler practiced urology in the Detroit area for 37 years. He
coached little league baseball, was an avid reader and took classes
in French. Dr. Kessler is survived by his wife, Josephine “Jo” Kessler;
son and daughter-in-law, Dr. Daniel Kessler and Cathy Cordes; daughters
and sons-in-law, Amy Kessler and Jim Slowik, Dr. Susan Kessler and
Bruce Shaw; grandchildren, Jonathan, Emily and Sarah Shaw; sister
and brother-in-law Bertha and Al Raifman; brother-in-law and sister-in-law
Lenora and Al Dorenfest; brother-in-law, Raymond Dreezer.
Lawrence Comstock, MD
Lawrence Comstock, MD, died August 13, 2004. He was 94 years old. Dr.
Comstock cared for thousands of patients during a career that spanned
more than 50 years. He was the chief of staff at the former Wyandotte
General Hospital and Seaway Hospital in Trenton. He had a private
practice in Trenton and was that city’s health officer during the
1950s. He earned his medical degree from the University of Michigan
in 1940. Survivors include two daughters, Martha Ebeling and Susan
Cole; a son, Charles; 10 grandchildren; and two great-grandchildren.
Frank P. Raiford III, MD
Frank P. Raiford III, MD, died from complications of kidney disease August
25, 2004. He was 84, and still had his family medicine practice in
Detroit. Dr. Raiford’s father was a physician and a co-founder of
Detroit’s Trinity Hospital at East Congress and DuBois streets. He
graduated from from the University of Michigan Medical School in
1943 and served in World War II as a medic. Survivors include three
daughters, Schera Byas, Perryne Thompson and Jill Hewitt; a son,
Kevin; six grandchildren; and a great-grandson.
Richard A Wahl, MD
Richard A. Wahl, MD, recently passed away. He was an OB/GYN born February
23, 1934. He earned his medical degree from the University of Illinois
in 1959. He performed his residency at Providence Hospital in Detroit
in 1960-1963. He will be missed by colleagues in the medical community.
WCMSSM was sorry to hear of his passing.
WCMSSM Foundation Memorial Fund
Contributers
(All in memory of Agnes Borchak)
Darlene Henderson
Dr. & Mrs. Martin Daitch
Dorothy Borchak Ambrozy
Krishna & Pamela Sawhney
Contributions to the Memorial
Fund are always welcome and a nice way to remember friends
and colleagues who have passed away.
The following active members were dropped from
WCMSSM and MSMS
for Non-Payment of 2004 Dues
James D. Adamo, MD
Samira Ahsan, MD
James J. Andonian, MD
Ila Bansal, MD
Elaine A. Barbieri, MD
Sean C. Blackwell, MD
Frank M. Bogun, MD
Cecilia A. Buot, MD
Ginette V. Busschots, MD
David Carswell, MD
Vincent C. Chan, MD
Kassem M. Charara, MD
D. Hari-Kumar Dandapantula, MD
Gunter Deppe, MD
Jose-Marie Albert El-Amm, MD
Naser M. Elsouri, MD
Helen Etemadi, DO
Naiel G. Faraj-Rahim, MD
Frank M. Fayz, MD
Dawn D. Foster, MD
Carl D. Fowler, MD
Thomas Giancarlo, DO
Lisa Rene Gnas, DO
Robert J. Gordon, DO
Narshimha R. Gottam, MD
Issa T. Haddad, MD
Maurice Adams Hall, MD
Magdy M. Hanna, MD
Nafees Hasnie, MD
Paul D. Havenstein, MD
Charlene B. Irvin, MD
Elsa A. Isip, MD
Jitender K. Jain, MD
Raymond Jones, MD
Latha T. Kannan, MD
Velji K. Kansara, MD
Adi Kaza, MD
Riad Khatib, MD
Kathleen M. Kleinert, DO
Conrad C. Maitland, MD
Jesus A. Martinez, MD
Philip J. Mayer, MD
Holly A. McKeever, MD
Madeline M. Melencio-Posadas, MD
Joram O. Mogaka, MD
Lisa M. Moody, MD
Robert T. Morris, MD
Alfred K. Newton, MD
Wafa Odeh, MD
Kavitha Ponduri, MD
Shabana Rasheed, MD
Pamela L. Reaves, MD
Pritpal Sandhu, MD
Donn M. Schroder, MD
Iva A. Smolens, MD
James M. Tucci, MD
Rennard B. Tucker, MD
James F. Urbanick, MD
Peter V. Vaitkevicius, MD
Mary W. VanDike, MD
Martin B.VanDort, MD
Jaya L. Vankayalapati, MD
David A. Vila, MD
Sudhir S. Walavalkar, MD
Denege A. Ward, MD
Deborah L. Webb, MD
Jerome Wilborn, MD
|
