Wayne County Medical Society of Southeast Michigan

March 3, 2008

Editor's Column: Mark With Care
AMA President Ron Davis, MD, Diagnosed With Cancer
WSU-DMC Dispute Stirs Up Students, Residents
DMC Opens Macomb Facility
Cover The Uninsured Week Features New Alliances
Legislative Lineup Lengthens

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Editor's Column: Mark With Care

By JOSEPH WEISS, MD
A Wall Street Journal blog posted by Jacob Goldstein on February 15 reported that CVS Caremark had paid $38.5 million to settle a law suit brought by several state attorneys general. Their investigation found that Caremark phoned physicians to change medications to different prescription drugs because, according to the CVS-Caremark representative, the change would help both patients and the health plan save money.

What CVS Caremark failed to say was that the drugs chosen for substitution were drugs that provided CVS Caremark with rebates. The attorneys-general investigation indicated that the savings accrued only to Caremark

CVS Caremark publicly denied the allegations but privately settled with the attorney generals. In addition, CVS Caremark has agreed to stop switching patients to a different brand name drug from a drug that is about to go off patent or has a generic alternative.

The settlement included generic drugs because the way the federal government establishes average wholesale price, CVS Caremark makes much more money dispensing generics than brand name drugs.

Physicians need to know of this settlement. Beware of hidden motives for changing drugs, when called on by CVS Caremark pharmacy benefit mangers. Keep in mind that CVS Caremark is a company within the CVS pharmacy chain. You could receive calls from the drugstore’s pharmacist to change a medication for the “the patient’s benefit.”

Take “Care.”

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AMA President Ron Davis, MD, Diagnosed With Cancer

The American Medical Association today announced that President Ron Davis, MD, has informed members of the Board of Trustees that he has been diagnosed with pancreatic cancer.

Dr. Davis will continue to serve as AMA president, but his activities on behalf of the nation’s largest physician’s organization will be curtailed while he begins immediate treatment to fight this disease.

While Dr. Davis is focusing on his health, his treatment and his family, other members of the AMA Board will assume responsibility for some of his official duties.

Dr. Davis is an esteemed member of WCMSSM and has made many contributions to medicine on the local, state and national levels. He is a preventive medicine physician with Henry Ford Health System, where he has been director of the Center for Health Promotion and Disease Prevention since 1995. He served as chief medical officer in the Michigan Department of Public Health from 1991-1995. On the national level, Dr. Davis was a member of the Medicare Coverage Advisory Committee from 1999-2005, and chaired that panel from 2003-2005.

Long a crusader against the ravages of tobacco use, he was the founding editor (1992-1998) of Tobacco Control, a peer-reviewed journal published by the British Medical Association.

Dr. Davis was profiled in the Detroit Medical News magazine in August 2006, after his election to the AMA’s top post. Visit www.wcmssm.org to find archives of past issues.

It is Dr. Davis’ wish to openly share information about his health and treatment with his family, friends and colleagues. To meet the challenge of effectively communicating with those who might wish to share their thoughts and prayers, Dr. Davis established a personal Web page at CarePages.com where he and his family will post updates, and where visitors can post messages and read the notes left by others.

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WSU-DMC Dispute Stirs Up Residents

By PAUL NATINSKY
The recent announcement of $12 million cuts in payments to Wayne State University School of Medicine physicians for treatment of Medicaid patients has spurred students and residents participating in joint WSU/DMC programs to action…once again.

Students and residents were active last year, when acrimony over a new contract between WSU and DMC bubbled over and ultimately had to be resolved by an arbitrator appointed by Gov. Jennifer Granholm.

This time around, payment cuts, which the DMC says are in response to new Medicaid money appropriated by the state to WSU, could cause WSU to lay off physicians reducing access to health care for poor people. DMC initiated the cuts, which are retroactive to Oct. 1, 2007, because it believes the new Medicaid money amounts to “double payment” for the WSU physicians. WSU regards the cuts as necessary money to continue to care for Medicaid patients and argues that even with the new government money, physicians are still not receiving adequate payment for services.

All of this has the students and residents busy at their computers sending e-mails to whoever they believe is interested. I’ve received 33 and counting since Friday.

As was the case in the contract flap, the doctors-to-be aren’t taking sides, just urging a quick and equitable settlement that doesn’t jeopardize their education or the continuation of programs they believe benefit citizens and doctors alike.

Here’s a sampling of the form letter:

My name is Tyler Southwell, I am a 4th yr medical student at WSU School of Medicine, and am very proud to be a part of an institution whose mission is to serve the region’s uninsured/underinsured. I am concerned that the egregious and unjustifiable action by the Detroit Medical Center to break its contract with our School for services provided by our faculty physicians to the uninsured or underinsured (concerning withholding State DSH dollars), will have immediate negative consequences for our institution and our mission, which will ultimately hurt our regions poor. I only ask that you please look into this issue and use your influence and powers to help resolve it, for the sake of one of the state’s most important medical care safety nets.

Thank you for your time,

Tyler Southwell, MSIV

WSU School of Medicine

Student Senate President

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DMC Opens Macomb Facility

For the first time, parents and physicians will have access to a wide variety of DMC Children’s Hospital of Michigan pediatric specialists and services in a single, pediatric-dedicated medical facility in Macomb County. Located at 42700 Garfield Road south of 19 Mile, the Stilson Specialty Center will open today with nearly a dozen outpatient pediatric specialties and diagnostic testing.

“The Stilson Specialty Center is unique in that during every phase of planning, we ensured that the environment would be child- and family-friendly, from the interior colors to creating space for the kids-only optical shop to constructing a therapeutic rock climbing wall and even the detail of decorating the building with original art by children living in Macomb County. This pediatric outpatient center truly is just for them,” says Herman B. Gray, MD, president, Children’s Hospital of Michigan.

A number of outpatient children’s services and pediatric specialties will open at the new 48,000 square-foot facility over the next several months, including MRI, CT Scan, X-Ray, fluoroscopy, ultrasound, a sleep lab and specialties, including gastroenterology, physical therapy, occupational therapy, audiology, general surgery, neurology, ophthalmology, orthopedics, allergy, ENT, and psychology. The site will also include a pediatric optical shop and retail pharmacy.

The Children’s Hospital of Michigan Stilson Specialty Center is a ‘first’ for both the hospital and Macomb County. The Center is the first facility that the hospital has built from the ground-up beyond the main campus in Detroit. In addition, the Stilson Specialty Center is the County’s first medical facility exclusively dedicated to pediatrics.

“Macomb County is one of the few areas in Southeast Michigan where the population of families with children is increasing. Children’s Hospital of Michigan has treated many of them for many years at our main campus in Detroit. In 2007 alone, more than 19,000 of our patients lived in Macomb County,” added Dr. Gray. “Now, we can offer convenient access to the internationally renowned physicians, nurses and other pediatric specialists that they’ve come to rely upon right in their own community.”

The Children’s Hospital of Michigan Stilson Specialty Center is expected to initially bring 50 jobs to Clinton Township and represents a $10 to $13 million investment from Children’s Hospital of Michigan to the city over the next decade.

The center is made possible in part through a significant gift from Earl Stilson, a successful Macomb County businessman. The Vietnam veteran and self-made entrepreneur is a former patient of Children’s Hospital of Michigan. He needed immediate surgery after being born with his eyes fused shut. Over the next several years, Stilson underwent multiple surgeries and rehabilitation at Children’s Hospital.

Since receiving approval for the new medical facility in July 2006, Earl Stilson and a number of community leaders, such as Macomb County Commissioner Vice President Dana Camphous-Peterson, Macomb County Sheriff Mark Hackel, Chippewa Valley Schools Superintendent Mark Deldin, and Macomb County 16th Judicial Court Judge Hon. Tracey A. Yokich have worked with Children’s Hospital President Herman Gray, MD, Board of Trustees Chair John Baker, MD, and Vice President Luanne Thomas Ewald to complete the project.

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Cover The Uninsured Week Features New Alliances

Cover the Uninsured Week is April 27-May 3 this year. A host of events are scheduled; a sampling from the campaign’s newsletter is featured below.

Public education, advocacy, and enrollment are the cornerstones of this year's Cover the Uninsured campaign in Michigan. The Michigan Cover the Uninsured Network (MCTUN) is forging new partnerships and creating new opportunities for collaboration among a variety of organizations and initiatives designed to expand access to healthcare and insure stable and affordable healthcare coverage for all of our citizens.

Join thousands of people during Cover the Uninsured Week 2008 (April 27 - May 3) here in Michigan to show your support to cover America's uninsured. Go to www.CovertheUninsured.org to learn more.

Health Expo for Uninsured

Sponsored by Wayne County and the City of Detroit

Monday, April 28 - Wayne County Health & Human Services in partnership with the City of Detroit Health & Wellness Promotion kick off CTUW 2008 with a Health Expo For the Uninsured at Cobo Hall.

The Health Expo will be open to the public from 8:30am – 4 p.m. More than 30 vendors offering free health screenings, resource information, MIChild and Healthy Kids enrollment, small business coverage options and more are expected. Breakfast and boxed lunches will be provided. 500 to 2000 participants anticipated.

A News Conference is being scheduled for 10:30am with Governor Granholm (invited) and elected officials.

If you're interested in providing services and want to reserve a table, please contact Naomi Ruth at (313) 874-7178 or nruth1@hfhs.org .

Health and Enrollment Fairs

Project Healthy Living and MCTUN Unite

This year, MCTUN is partnering with the United Health Organization in sponsoring several Health and Enrollment events throughout southeastern Michigan. Ten major events will be held over two- to three-day periods at area shopping malls, community centers, and faith based locations.

Community residents will be able to obtain free health screenings, health insurance information, and be able to enroll their children in state sponsored health insurance programs on the spot. They will also be able sign up for the ballot initiative to get a "health coverage for all" amendment to our state constitution and pledge support for the AARP Divided We Fail pledge campaign.

For more information, contact Ifetayo Johnson at (248) 703-5684.

Coverage Options for Small Business Owners

Business Round Tables

Tuesday, April 29 - The Greater Detroit Area Health Council (GDAHC) is hosting a breakfast roundtable to discuss health care options for small business owners.

This will be the first in a year-long, statewide series of meetings with business owners and opinion leaders to discuss solutions for the growing number of uninsured.

Details to follow. For more information, contact Naomi Ruth at (313) 874-7178.

Interfaith Prayer Breakfast

Myth, Fact & How to Act

Thursday, May 01 - The Interfaith Health & Hope Coalition is sponsoring an Interfaith Prayer Breakfast at Tabernacle Missionary Baptist Church in Detroit. The event will be held from 8:30 - 10:30a.m., details and registration information to follow. Contact Ron Beford at (810) 923-6940 for more information.

Special Advisors
Spencer Johnson Joins MCTUN

Spencer Johnson, President & CEO of the Michigan Health & Hospital Association will serve as a Special Advisor to the 2008 Michigan Cover the Uninsured Network initiative, joining Marianne Udow-Philips, Gail Warden, Janet Olszewski, Dr. Charles Barone, Reggie Turner, and Michael Brennan.

Strategic Partners
University Of Michigan Hospitals & Health Centers Join MCTUN

The University of Michigan Hospitals & Health Centers have joined Henry Ford Health System, Trinity Health, St. John Health, Beaumont, DMC Children's Hospital of Michigan, Oakwood, United Way for Southeastern Michigan, the Detroit Regional Chamber and the Michigan AFL-CIO as a strategic partner of the MCTUN 2008 initiative.

Health Care Security in Michigan
Ensuring Coverage

The Health Care Security Campaign is collecting signatures across the state to get a proposed Constitutional Amendment on the ballot for November. The Amendment, if passed, would require the government to make sure that everyone in the state has access to health care coverage. That means you would continue to have coverage even if you lose a job; or if your employer decided to stop giving health insurance as a benefit; or if you lose coverage for any other reason.

That is the goal behind the ballot initiative campaign for the "Health Care Security Amendment." The drive is to amend the State Constitution's Article 4, Section 51 to add this language:

The State Legislature shall pass laws to make sure that every Michigan resident has affordable and comprehensive health care coverage through a fair and cost-effective financing system. The Legislature is required to pass a plan that, through public or private measures, controls health care costs and provides for medically necessary preventive, primary, acute and chronic health care needs.

Uniting for Health Care
AARP Launches Divided We Fail Campaign at State Capital

AARP Michigan, state legislative leaders and leaders of the state's business and labor communities joined together Monday, February 11, to launch Divided We Fail. The diverse Divided We Fail alliance will work together in Michigan over the next nine months, leading up to the presidential election on November 4, 2008, to urge action from elected leaders on the issues of health and long-term financial security.

The launch, held at the State Capitol building in Lansing, included speeches from AARP Michigan State President Eric Schneidewind, Senator Mark Schauer (D-Battle Creek), Representative Rick Shaffer (R-Three Rivers), Secretary/Treasurer for SEIU Heath Care Michigan Marge Faville and State Director for the National Federation of Independent Business/Michigan Charles Owens.

"Together we represent more than 50 million Americans and their families," Schneidewind, said. "We are standing united - here in Michigan and across the country - to demand action, answers and an end to gridlock."

For more information about Divided We Fail efforts, go to www.dividedwefail.org .

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Legislative Lineup Lengthens

Just in time for spring and rolling right into the annual House of Delegates Meeting, MSMS has ramped up its legislative agenda. Below is a sampling of issues on tap. For more information, visit the MSMS website at www.msms.org .

Emerging Health Care Legislation: 'Fair Contracting' & More

At a meeting this week of the MSMS Committee on State Legislation & Regulations, physicians took a close look at a number of emerging legislative issues, including House Bill 5767, the first of several pieces of "Fair Contracting Legislation" from MSMS. The bill, sponsored by Paul Condino (D-Southfield), which would legally define the term "covered benefit," addresses the issue raised in the 2004 lawsuit filed by MSMS against Blue Cross Blue Shield.

Discussion focused on the factors reducing emergency access to specialists; House Bill 4646, which asks for liability relief for emergency care unless gross negligence is proven; regionalization of trauma care as one possible long-term solution for certain specialties; and opportunities for hospitals and physicians to collaborate on solutions.

The Committee also discussed upcoming legislation regarding chiropractic scope of practice, electronic prescribing of controlled substances, and proposed legislation that could threaten Michigan's tort laws.

Hear from Legislators, Examine EMR Case Studies at Physician Issues Forum

Concurrent with the 2008 MSMS House of Delegates meeting in Dearborn (May 2-4), all physicians are invited to hear from several lawmakers and learn about electronic medical record case studies during two afternoon sessions on Saturday, May 3, at the Ritz Carlton.

The Physician Issues Forum (noon until 2 p.m.) will feature guest speakers Sen. Tom George (R-Portage), Michigan Supreme Court Chief Justice Clifford W. Taylor, and Rep. Andy Meisner, (D-Oak Park).

"EMR: Lessons Learned" (2:30-4:30 p.m.) will explore MSMS's recent study of 14 physician practices and their implementation of electronic medical records. The programs are free and open to any MSMS member.

To register, contact Jeanne Miller at 517-336-5726 or jkmiller@msms.org.

Meet Lawmakers at Greater Detroit Meet-n-Greet on April 10

MSMS will hold the 11th annual Greater Detroit Meet-n-Greet on Thursday, April 10, 6:30-9 p.m., at Fishbone's Rhythm Kitchen in Detroit's Greektown. This event is helps foster a connection between physicians in the greater Detroit metropolitan area and their state lawmakers. Also, participants will have the opportunity to discuss health care legislation and state budget issues. (View the 2008 MSMS Legislative Agenda online at www.msms.org/legagenda.)

Hors d'oeuvres and refreshments will be provided during the event, co-sponsored by MSMS, the Detroit Medical Society, the Wayne County Medical Society of Southeast Michigan, and the Wayne County Osteopathic Society.

MSMS convened the Consortium to Address Emergency Call Coverage to address the increasing problem of insufficient specialist coverage for emergency departments around the state. More than 20 specialty, physician organization, and hospital representatives participated in the initial discussion.

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