April 10, 2006

Editor's Column: Empowering The Patient
Executive Director's Column: Who's Got Time?
WCMSSM Resolutions For HOD
WCMS Foundation's 13th Annual Golf Classic
Growing Well Collaborative: Building A Healthy Detroit
News & Notes
Economist, HC Journalist Weigh In On HC Reform
Searching For Authors
MSMS Leadership Summit

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Editor's Column:
Empowering The Patient

By JOSEPH WEISS, MD
Vernon L Smith Nobel Prize winner in economics in 2002, will not win any awards from the medical community. He proposes to empower the patient by channeling the third-party payment through him or her. Laureate Smith doesn’t know we have experience with that plan: it is called master medical. It is fading out because too often the patient kept the money; the effect of master medical was to empower the patient to all but embezzle money meant for health care.

Furthermore, Smith states that the only additional item patients need to control health care costs is education. He seems to believe that the truth will set patients free: make them competent to choose doctors and treatments. He takes no notice that best practice is elusive even for medical specialists, and that decisions in medicine requiring good judgment are a continuum not amenable to repeated trips to Google or Yahoo.

If, like Vernon Smith, you leave it to market forces to control health care you need to take into account that the marketplace works not only for the consumers but for the producers. If you want to give education and dollars to patients, you can expect resulting strategies from the medical community that include outpatient surgical clinics, monopolistic pricing by pharmacies, and lobbying by medical groups for exceptions and inclusions.

Health care is not an offshoot of money and banking, but has its own features with roots in self preservation. A person’s approach to health needs and that of their family is rational only in part. Thus an alternative is in order to the marketplace reliance on rational behavior and the decreasing utility of additional increments of services.

A national authority or possibly several regional authorities are the obvious alternatives; philosophers or economists might devise other means.

A host of present proposals intend to “empower” patients or drive doctors to standards of care beyond the dreams of Cushing and Osler. These ends are not possible in the present market milieu. All the schemes achieve is to fragment the energies of patients and physicians, increase the power and salaries of administrative personnel, and delay the development of necessary but as yet unforeseen radical change.

We need to stop looking for schemes to make patients more savvy than is possible, or push doctors to practice a state of medicine that is beyond reason. We should change the milieu not the multitude.

Executive Director's Column:
Who's Got Time?

BY ADAM JABLONOWSKI, MPA
We completed our membership push last month with the publishing of our DMN magazine and visits by our officers to a number of physician offices. What did we learn from our efforts? Several issues came up; but they can be summarized best by saying - No one recruitment method works better than another. We have to try them all! And we will, as we progress through the year -- that includes calling on you to help recruit your associates who are not members.

As one might expect a big obstacle to recruiting is the availability of the physician(s). Even when the doctor is supposed to be in the office, he/she might be called to the hospital or might be so backlogged with patients that a recruitment call becomes a very low priority. Retaining and recruiting members is a very important priority for the WCMSSM and the MSMS as well as the AMA. Our problem is getting organized medicine's story to the physician. Physicians, overburdened with paper work, second-guessed by insurers, stumped by drug formulary decisions and numerous organizational commitments at the hospital and in the community, put the medical societies in a very secondary position.

How can we change that standing to be more relevant to our members? That is the question that needs addressing. Just the other day we began that process again through our strategic planning committee to assure that what we at WCMSSM do for the next two years will make your professional life more rewarding. Stay tuned as we seek your input and continue to refine our plan over the next few months.

WCMSSM Resolutions For HOD

RESOLUTION 1-06: Pets and Human Food Handling
SUBMITTED By Jean Sinkoff, M.D.

RESOLVED: That the MSMS work with the Departments of Community Health and Agriculture to establish regulations prohibiting the sale of pets in any location that is in close proximity to fresh food sold for human consumption.

RESOLUTION 3-06: Food Handler’s Certification
SUBMITTED By Jean Sinkoff, M.D.

RESOLVED: That the MSMS work with the Departments of Community Health, local health departments and employers to increase education regarding hand washing and hygiene for all individuals who handle non-pre-packaged foods.

RESOLUTION 4-06: Health Procedures at Salons
SUBMITTED By Jean Sinkoff, M.D.

RESOLVED: That the MSMS work with the Departments of Community Health, local health departments and appropriate Specialty Societies to develop hygienic procedures for handling of equipment by nail salons to prevent transmission of skin diseases.

RESOLUTION 7-06: Mandates of Medical Care
SUBMITTED By Martin Daitch, MD

RESOLVED: That MSMS and the AMA work toward enactment of legislation and regulation that no medical care can be mandated by any government or private insurer without appropriate funding, and be it further

RESOLVED: That the legislation include a requirement that all mandates for specific medical care be signed by the authorizing individual and include the basis for his/her authority to issue the mandate.

RESOLUTION 8-06: Realignment of County Medical Societies
SUBMITTED By Joseph J. Weiss, MD

RESOLVED: That the MSMS Board appoint a Task Force to review the present number of county medical societies, and where applicable, recommend changes in county medical society alignment.

RESOLUTION 9-06: Voting at MSMS Annual Meeting by Wireless Voting System
SUBMITTED By Mark R. Villeneuve, MD, Wayne County
Original Author: Mohammed A. Arsiwala, MD

RESOLVED: That MSMS investigate the feasibility of implementing a wireless technology-based voting system at its annual meeting to facilitate accurate and efficient delegate voting.

RESOLUTION 11-06: Effectively Reducing Family Violence
SUBMITTED By Federico Mariona, MD

RESOLVED: That MSMS works closely with the appropriate State governmental agencies, law enforcement authorities, the judiciary, the office of the State Surgeon General, the State attorney general, the Governor and the legislators to create, implement, properly fund and staff a governmental entity with authority and accountability capable of dealing with this most grave social problem of family violence.

RESOLUTION 13-06: Covering the Uninsured as AMA's Top Priority
Submitted By: MSMS Medical Student Section, Federico Mariona, MD, on behalf of Wayne County Medical Society of Southeast Michigan, and Barbara Threatt, MD, on behalf of Washtenaw County Medical Society

RESOLVED: That the MSMS delegation to the AMA House of Delegates support the immediate passage of Resolution 10 (I-05), Covering the Uninsured as AMA's Top Priority.

MSS RESOLUTION 10: Covering the Uninsured as AMA's Top Priority
MSS ACTION: ADOPTED AS AMENDED:

RESOLVED, that the number one priority of the American Medical Association be
comprehensive health system reform that achieves reasonable health insurance for all Americans that emphasizes prevention, quality and safety while addressing the broken medical liability system, flaws in Medicare and Medicaid, and improving the physician practice environment.

WCMS Foundation's 13th Annual
Golf Classic

Monday, May 8 2006
Lochmoor Club, Grosse Pointe Woods
Click here for to register.

Growing Well Collaborative
Building A Healthy Detroit

Initiated by the Detroit Department of Health and Wellness Promotion in the fall of 2004, the Growing Well Collaborative is a partnership of public, private, and nonprofit organizations in the Detroit-area working to create an environment in which Detroit’s youth may acquire the habits and experiences necessary to develop into healthy adults.

The Initiative’s goal - establishment of a unified strategic effort to insure that all children born in the City of Detroit have the opportunity to develop a healthy lifestyle and grow well.

To achieve this goal, the Collaborative identified ten (10) objectives that comprise the framework agenda of the Growing Well Collaborative. They are as follows:

1. Reduce infant mortality to below the state average of 8.2 per 1,000 live births.

2. Increase access to and use of social, emotional and physical supports needed for healthy growth and development of infants.

3. Insure that all children living in the city are fully immunized between the ages of 19 – 35 months.

4. Increase all children’s access to and involvement in regular physical activity.

5. Reduce accidental injuries and resultant deaths among children.

6. Reduce the number of children at risk for chronic disease, e.g., type II diabetes.

7. Eliminate children’s exposure to environmental toxins that precipitate asthma.

8. Eliminate elevated blood lead levels in all Detroit children aged 12-72 months.

9. Insure that all children and youth have access to and consume three healthy meals per day.

10. Improve parental awareness/education on health-seeking behaviors.

Partners
In addition to the Department of Health and Wellness Promotion, participants include; Black Family Development, Inc.; Children’s Aid Society; Children’s Hospital of Michigan; City Connect Detroit; Communities in Schools; Community Foundation for Southeastern Michigan; Community Health Institutes; Detroit Community Health Connection; Girl Scouts of Metropolitan Detroit; the Greater Detroit Area Health Council; Mayor’s Time; Oakland University, College of Nursing; Oasis, Inc.; Sinai-Grace Hospital; Southwest Counseling and Development Services; Wayne County Health Department; Wayne County Department of Human Services; Wayne State University, College of Nursing; and the Youth Sports and Recreation Commission.

For more information, contact Thea Simmons at the Detroit Department of Health and Wellness Promotion, Office of Grants, Contracts and Development (313) 876-4952.

News & Notes

Future Docs Welcomes Next-Generation Physicians
Several hundred Detroit-area children had a chance to stretch their limits and find out first hand what it's like to be a doctor. With parents in tow, about 500 people turned out last Saturday for Future Docs, a WSU School of Medicine event offering fun, educational activities designed for kids of all skill levels.

Dr. Steve Smith, a WSU School of Medicine alumnus from the Class of 1993, brought his 5-year-old daughter, Katie, to Scott Hall to participate. Wearing a surgical mask and cap, fingers bound in a cast and sporting a bag of event goodies, Katie seemed to have overcome the initial reluctance her father said she had about coming.

"She didn't like the idea at first," Dr. Smith said.

"I was scared," Katie confirmed.

However, now she reports that she is considering medicine as a career. "That's something she never would have said a couple hours ago," said Dad.

Children, aged 6 to 12, participated in progressive, hands-on experiences related to medicine and the human body. In addition to studying human brains and eyes, children had a chance to use a robotic therapy seal trained to help sick children feel better; see their hearts beat; listen to lung sounds; and isolate DNA from bananas.

DMC Heads Out To The Ballpark
The Detroit Tigers named the Detroit Medical Center their Official Healthcare Services Provider April 6. The DMC currently provides health care services to the Detroit Red Wings, Detroit Pistons and Detroit Shock.

The DMC team is led by Anthony J. Colucci, D.O. (Detroit Red Wings), Benjamin J. Paolucci, D.O. (Detroit Pistons/Shock), Douglas G. Plagens, M.D. (Detroit Red Wings/Tigers), Robert A. Teitge, M.D. (Detroit Pistons/Shock), Stephen Lemos, M.D. (Detroit Tigers) and Donald W. Weaver, M.D. (DMC Professional Sports Medicine Program). The DMC will offer special health seminars on a range of topics during Senior Days at Comerica Park.

Henry Ford Bone Marrow Transplant Program Receives Accreditation
As one of only three institutions in Michigan and one of only 100 nationally, the Bone Marrow Transplant program at Henry Ford Hospital has received accreditation from the Foundation for the Accreditation of Cell Therapy (FACT).

The Henry Ford Bone Marrow Transplant program has performed more than 750 bone marrow transplantations and offers various types of transplants including autologous, in which patients receive their own cells for treatment, and allogeneic, in which patients receive matching cells from another related or unrelated donor.

The program was the first in Michigan to use peripheral blood stem cell transplantation, a method by which hematopoietic stem cells are obtained from peripheral blood rather than surgically removed from the bone marrow, for the treatment of multiple myeloma, Hodgkin's disease and Non-Hodgkin's lymphoma. Today, whenever possible, hematopoietic stem cells are obtained from peripheral blood, although in rare situations stem cells must still be harvested from bone marrow.

"The inspectors were very impressed with the quality of patient care provided as well as our facility and staffing," says Nalini Janakiraman, M.D., director of the Bone Marrow Transplant program at Henry Ford. "We are proud of the recognition for the high quality standards we provide to our patients."

Further information on the Henry Ford Bone Marrow Transplant program can be found at www.henryford.com.

Henry Ford Hires Service Pro To Head Suburban Facility
HFHS tapped former Ritz-Carlton Hotel Co. Area General Manager Gerard van Grinsven to be its CEO for $310-million, 300-bed West Bloomfield facility slated to open in 2008.

The move is part of the health system's plan to emphasize service and high-quality medical care. Ritz-Carlton hotels are known the world over for their high level of customer service and aggressive recruitment of personnel who can deliver it.

Van Grinsven will join HFHS in June. He has worked in the hospitality industry for 24 years and for Ritz-Carlton for 12 years. He is on the board of the Detroit Regional Chamber and Henry Ford Health System. Van Grinsven holds a bachelor of arts degree in hotel management from the Hotel Management School, Maastricht, The Netherlands.

MSMS Explores E-Prescribing
MSMS is addressing the emerging issue of electronic prescribing at the legislative level, the committee level of MSMS, and through the AMA.

MSMS pushed for the creation of the Technology in Health Care Subcommittee in the Michigan House, chaired by Rep. Gary Newell (R-Saranac), to develop an inventory of existing technology. MSMS also helped to develop a way to create a uniform health information technology system, and will continue to work with Rep. Newell on plans to further explore ways to employ e-prescribing and medical information technology throughout the state.

In a related area, the MSMS Information Technology Committee has organized a convenient section of the MSMS website for electronic medical record information. Find out more online at http://www.msms.org/emrs (http://www.msms.org/emrs).

The MSMS Licensure Committee continues to address e-prescribing relative to the efforts to change the administrative rules to allow pharmacists to accept electronic prescriptions.

Finally, the Michigan Delegation to the AMA will ask the AMA during the annual meeting to petition the US Congress to unify state prescription standards and standard vocabularies, in order to facilitate adoption of electronic prescribing.

For more information, contact Randy Gavorin at MSMS at 517-336-7594 or rgavorin@msms.org.

Economist, Journalist Weigh In On HC Reform

By PAUL NATINSKY
Health economics expert Dana Goldman from Rand wrote in Investor's Business Daily April 3 that pharmaceuticals only account for 15 percent of total health spending, are cost effective treatments for some illnesses, delay health complications, and help patients avoid expensive surgical procedures.

In a climate of increasing insurance copays, Goldman recommends tailoring patient contributions by linking them to medical effectiveness. He goes as far as recommending patients be given cholesterol reducing drugs free, and predicts that alone would result in a $1 billion annual reduction in hospital-related expenditures that total $300 billion. Goldman opines that such approaches would not damage hospitals' bottom line, and writes that the approach could be duplicated for diabetes and other chronic conditions in the future. However, he doesn't write a word about personal responsibility, exercise, diet, or where all the money to buy the drugs would come from. Nor does he discuss the likelihood of such miracle drugs being developed if pharmaceutical manufacturers couldn't rely on heavy profits to cover research and development costs.

Barron's Editorial Page Editor Thomas Donlan provided a nice historical summary of health care reform and the repeated push for national health insurance. He ends with a suggestion: mandatory health insurance. Require those who can afford it to buy it (much like no-fault auto insurance in Michigan) and provide a basic plan at government expense for those who can't. Donlan writes: "With hundreds of insurance companies competing for everyone's business, there would be affordable coverage styles for every budget...Quality assurance could then be left to informed consumers wielding their own money in the market, the most powerful force in the world." Donlan doesn't address what happens when those buying their own plan don't buy an adequate level of coverage, or if the minimum plan becomes unaffordable for average working people.

The Rand author uses a study as the basis for his argument, the Barron's editor clearly did some historical research.

Searching For Authors

If you are a WCMSSM member who has written a book on anything (wines, hunting, fiction, non-fiction, medicine) please let us know. We can help you publicize your work. Contact us at info@wcmssm.org

MSMS Leadership Summit

The 3rd annual MSMS Leadership Summit - scheduled for Wednesday, May 17, in Lansing - will feature timely topics and speakers, as well as the opportunity for physicians to earn six hours of Category I CME credit. This year's summit, titled "Current Directions and Emerging Views in Health Care," will offer participants the opportunity to hear from a number of Michigan's key leaders in health care and business, including Michigan Attorney General Mike Cox and gubernatorial candidate Dick DeVos. Other topics and speakers include the following:

National Health Care Reform
Christopher Conover, PhD, assistant research professor of Public Policy Studies, Duke University

Political Leadership in Michigan
Moderator: Kenneth J. Edwards, Vice Chair, MSMS Board of Directors Mike Cox, Michigan Attorney General Rep. Kevin Elsenhiemer (R-105th District), Chairman of Tort Reform Committee Rep. Gary Newell (R-87th District), Vice Chair, Health Policy Committee, Special Committee on Medicaid Reform and Innovation and Health and Information Technology Subcommittee Jan Whitehouse, President, CyberMichigan

Future of Health Care in Michigan
Dick DeVos, Michigan Gubernatorial Candidate, President, Alticor

Perspectives from Health Plan CEOs
Moderator: Rose M. Ramirez, MD, House Vice Speaker, MSMS Board of Directors Kimberly Horn, President and CEO, Priority Health Roman T. Kulich, President and CEO, Molina Healthcare Thomas L. Simmer, MD, Vice President and Medical Director, Blue Cross Blue Shield of Michigan William E. Moeller, President and CEO United Healthcare Jeff L. Connolly, CPA, President and CEO, PPOM

Lunch Panel - The Future of Medicine: Leading the Way to a Better Health Care System
Moderator: John M. MacKeigan, MD, MSMS Immediate Past President, MSMS Board of Directors Paul Harkaway, MD, President, Huron Valley Physician Association James D. Grant, MD, Vice Chair, Department of Anesthesiology, William Beaumont Hospital Martha Gray, MD, President and CEO, Partners in Internal Medicine, PC & Member Internal Medicine Staff, St. Joseph Mercy Hospital David Share, MD, MPH, Medical Director, The Corner Health Center & Clinical Director, Center for Health Quality and Evaluative Studies, BCBSM

Health Care Outlooks from the Big Three
Moderator: Alan M. Mindlin, MD, MSMS President Joe W. Laymon, Vice President Corporate Human Resources, Ford Motor Company Kate Kohn-Parrott, Director, Integrated Health Care and Disability, Chrysler Group Joe Fortuna, MD, Medical Director Delphi Corporation

State of Michigan's Economy
Moderator: Paul Farr, MD, MSMS President-elect, MSMS Board of Directors Paul W. Brand, President, REAL Health Organization Ed Wolking, Jr., CCE, Executive Vice President, Detroit Regional Chamber James C. Epolito, President and CEO, Michigan Economic Development Corporation

Updates from Michigan Medical Schools
Moderator: Michael A. Sandler, MD, Chair, MSMS Board of Directors Marsha D. Rappley, MD, Acting Dean, Michigan State University College of Human Medicine Robert M. Mentzer, Jr., MD, Wayne State University School of Medicine John E. Billi, MD, Associate Dean for Clinical Affairs, University of Michigan Medical School

Cost of registration is $140 for MSMS and MMGMA members, $185 for non-members. For more information, contact Melinda Sandford at MSMS at 517-336-7575 or msandford@msms.org. To register, visit www.msms.org/eo/courseinfo/courseinfo.asp or contact the MSMS Registrar at 517-336-7584 or abatten@msms.org .

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