December 28, 2009

IN THIS ISSUE

Editor's Column: Sounds Good, Could Be Better
President's Report: Being A Two-Faced Person
WSUSOM To Host Congressional Hearing Jan. 4
Two DMC Hospitals Earn Top Nursing Honors
Oakwood Joins Henry Ford On Community Health Initiative
Dr. Karpawich Earns Fellowship
Dr. Philip And Colleagues Pen Pancreatic Cancer Report
Children's Holiday Party Contributors 2009

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Editor's Column: Sounds Good, Could Be Better

By JOSEPH WEISS, MD
It sounds good. The Senate version health reform bill HR 3590 would establish a Medicare Commission composed of 15 members, each member serving for a six-year term. The Commission decisions on changes in reimbursements and quality incentives would take effect immediately, except if specifically overruled by an act of Congress.

Critics argue that control of a matter as delicate as physician finances should be decided only by elected officials. Critics further state that the 15-member Commission could not include enough expertise to make the judgments needed for equitable physician payments and incentives.

The counterargument is that leaving financial decisions on physician pay in the hands of politicians has proved disastrous to date. Physicians have in effect had no meaningful increase in pay in seven years under the Sustainable Growth Rate formula and the last-minute 0.5 percent reprieve. Furthermore, does anyone believe that Congress has within its membership more knowledge and understanding of the practice of medicine than a Commission composed of physicians and representatives of the medical community?

The AMA, The American College of Surgeons, and the medical societies of California and Texas oppose establishing the Commission because physicians could see themselves subject to possible payment cuts, and HR 3590 authority would not extend to hospitals and hospice organizations.

(Physicians interested in more details can read the Medicare Advisory Board section of HR 3590 by going to http://thomas.loc.gov.  On that page is a link to HR 3590-Patient Protection and Affordable Care Act. A double left click will bring up the index. Scroll the page until reaching section 3403. Double clicking that section will bring up the 22 pages devoted to the Medicare Advisory Board. If the reader goes another route and brings up the Bill by a PDF file, the Advisory Board section begins on p. 1000.)

Certainly the provisions for the Commission are not perfect, and the sub-sections dealing with cost control are difficult to understand. However, the legislation proposed by HR 3590 breaks the bondage of the Sustainable Growth Rate Formula. For that reason alone physicians should support the Commission concept. If we stay with the Advisory Commission, we will eventually bring the proper proportion to compensation, incentives, quality and change.

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President's Report: Being A Two-Faced Person

By GEORGE SHADE JR., MD
All of our lives we have been taught the virtue of being a person who wears the same face whether you are alone, in the company of best friends or in the midst of total strangers. Well; I'm asking you to depart from that ingrained logic as we approach not only the beginning of a New Year but also the beginning of a New Decade. As you read this article; in the twilight of the old and the dawning of the new, I want you envision yourself as Janus, the ancient Roman god of portals. The Roman deity with two faces; one looking back on where he has been and one looking forward to where he has yet to venture.

A wise question might be; why bother to look back? What does it matter where one has been? Was not Lot told by God not to look back as he and his family fled from their home; from their past? Was there not a serious price to be paid for turning one’s head and glancing behind as they hurriedly traveled forward? Why Look Back?

We look back so that we might be wiser going forward. It was the American Philosopher, Georges Santayana, from whom originated the now famous quote: "...Those who do not remember the past are condemned to relive it..." There is much about the history of mankind and the medical profession that we need to remember lest we are forced to relive those events.

A few years ago; in the driveway leading to the emergency room of a New York City hospital, a young man lay dying on the ground as health care professionals watched from behind the doors of the hospital. Not one individual would step out from behind that private portal and walk less than 100 feet to save the life of another human being. From that event and similar acts of human indifference came the Federal Law, EMTALA, Emergency Medical Treatment and Active Labor Act.

Why look back; because just within this past week, again in New York, two Emergency Medical Technicians watched a waitress who was six months pregnant collapse right in front of them as they ate their lunch. Rather than let human suffering disrupt their noon break; they simply walked out of the restaurant and told people staring in disbelief to call 911 for assistance. The young mother and her unborn child both died.

Over the past decade; we have closed several inner-city hospitals and physician offices leaving many elderly, minority and economically deprived citizens no compassionate or convenient place to go for their much needed medical care. 

In spite of the historical events of the ‘60s and ‘70s in the United States of America, where people struggled for social equality and the opportunity to enjoy their basic Constitutional Rights, only 6 percent of the physicians practicing in America are Native American or African American. Less than 6 percent of the total enrollment in United States medical Schools is African American or Native American.

Irrespective of the fact that America is still the richest nation in the world, we have 50 million people living in this country who have no health insurance. Is it any wonder then that these same individuals turn up in our clogged and congested emergency rooms seeking basic, primary medical care? Just like EMTALA forced many institutions and health care providers to change their attitudes and practices, so will health care reform legislation, that now appears to be inevitable, force us all to change how we apportion and provide medical care.

Yes; there are many reasons why we should try being just a little two faced over this next week. Hopefully; by doing so, we will not have to go forward dragging the specters of Access to Medical Care and Disparities in Healthcare into the New Year and the New Decade. For; just as Charles Dickens stated in his classic novel, A Christmas Carol, of societies two children, Ignorance and Want, I say the same of two more of its children, Access and Disparity; "...recognize them and fear them; fore they spell your doom..."

Just as in the case of Ebenezer Scrooge; it is not too late to change. Sometimes looking back on one’s past life makes for a brighter future for all. With that thought in mind; I wish each and every one of you a Happy, Safe and Prosperous New Year and a New Decade filled with Excitement and Positive Change; lest we be condemned to relive the past.

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WSUSOM To Host Congressional Hearing Jan. 4

The Wayne State University School of Medicine will host a congressional hearing on head and brain injuries suffered by football players at all levels of play, from high school to the National Football League.

House Judiciary Committee Chairman John Conyers Jr. (D-Mich.) scheduled the Jan. 4 hearing, titled “Legal Issues Relating to Football Head Injuries, Part II.” The session is a follow-up to the committee’s Oct. 28 hearing, which examined the NFL’s policies concerning player concussions and the league’s treatment of research involving head and brain injuries. The Detroit hearing, which will include testimony from a School of Medicine neurologist, is expected to revolve around potential improvements to concussion policies.

“Recent scientific research has raised concerns about repetitive mild traumatic brain injuries and concussions and their impact for those playing football and other contact sports,” Conyers said. “The Judiciary Committee’s hearing at Wayne State University, where experts have been analyzing this issue, will examine whether players and families have adequate information about head injuries and whether sufficient steps are being taken to protect players at all competitive levels.”

Congressional members scheduled to take part in the hearing, in addition to Conyers, include U.S. Rep. Steve Cohen (D-Tenn.) and U.S. Rep. Sheila Jackson-Lee (D-Texas).

Witnesses scheduled to testify include DeMaurice Smith, executive director of the NFL Players Association; David Klossner, director of Health and Safety for the National Collegiate Athletic Association; Bennet Omalu, co-director of the Brain Injury Research Institute at West Virginia University and a key researcher of brain damage in football players; Ira Casson, a neurologist and former co-chairman of the NFL committee on concussions who resigned that position last month; Randall Benson, M.D., assistant professor of Neurology for the Wayne State University School of Medicine; and Chris Nowinski, president of the Sports Legacy Institute.

The hearing, which is open to the public, will begin at 1 p.m. in the Margherio Family Conference Center, located in the Richard J. Mazurek, M.D., Medical Education Commons, 540 E. Canfield.

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Two DMC Hospitals Earn Top Nursing Honors

The American Nurses Credentialing Center (ANCC) has granted DMC Huron Valley-Sinai Hospital Magnet recognition for excellence in nursing, the most prestigious award in nursing.

Designation was awarded after a rigorous evaluation process that began in 2004 and included submission of a fifteen-volume application document, multiple stages of review and a three day on-site appraisal conducted by the Magnet Recognition Program. During the on-site visit, appraisers evaluated nursing criteria and interviewed patients, nurses, doctors, executive administrators, and community members.

 “Achieving Magnet designation is a hospital-wide accomplishment that speaks very well to the amazing sense of teamwork, focus on excellence, and willingness to go beyond perceived limitations,” said Lynn Torossian, president of Huron Valley-Sinai Hospital.  I am extremely proud of the team here for achieving this outstanding accomplishment.”

Less than 6 percent of hospitals in the United States have qualified for Magnet status. In Michigan, ten health care organizations have been honored by the Magnet Recognition Program. Only four of those are located in Southeastern Michigan.

“Magnet status is considered the gold standard of nursing care,” said Bette Fitz, vice president of patient care services at Huron Valley-Sinai Hospital.  “This very high honor takes all of us working together to deliver the best possible patient experience and we should all share pride in this achievement.  It also confirms what we already knew to be true, that nurses at Huron Valley-Sinai Hospital are among the best in the country.”

More than 20 years of research indicates there are clear benefits to the communities served by Magnet recognized organizations:

●   Improved patient safety

●   Shorter hospital stays 

●   Fewer medical complications  

●   Lower mortality rates

●   Higher patient satisfaction

The Magnet Recognition Program was developed by the ANCC from research conducted in 1983 that identified 14 characteristics in organizations best able to recruit and retain nurses during the nursing shortages. These characteristics became the ANCC Forces of Magnetism that provide the conceptual framework for the Magnet appraisal process. Hospitals must demonstrate these forces to earn and retain Magnet status: quality of nursing leadership, organizational structure, management style, personnel policies and programs, professional models of care, quality of care, quality improvement, consultation and resources, autonomy, community and the healthcare organization, nurses as teachers, image of nursing, interdisciplinary relationships, and professional development.

Huron Valley-Sinai Hospital joins Children’s Hospital of Michigan and Detroit Receiving Hospital as the third Detroit Medical Center facility to achieve this status, according to DMC.

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Oakwood Joins Henry Ford On Community Health Initiative

Oakwood Healthcare System (OHS) and The Henry Ford have partnered together to present the "Health Through History" program. Designed to motivate participants to exercise their body and mind, the program encourages employees and community members to explore history while exercising through an historic walking tour.

The year-round initiative inspires visitors to exercise, eat healthy and learn more about their health through historical references. “Health Through History" program includes designated walking routes through Henry Ford Museum and Greenfield Village. These paths promote exercise as a fun activity by combining a physical outing with a historic walking tour. Routes are marked on navigational signage and maps as well as downloadable maps on TheHenryFord.org and members walk for free. Utilizing the “Health Through History” program is a great way to kick-start any New Year’s resolution. Walking and healthy foods choices are two simple steps to help anyone succeed in creating a positive lifestyle.

The “Health Through History” program also advocates healthy eating among its visitors. Free heart healthy recipes inspired by American’s Food Heritage and Tradition are another component of the program. Available in the Michigan Cafe and Taste of History restaurants, the recipes include Oakwood health tips and information on how to schedule health screenings. Oakwood certified heart healthy menu items are available at The Henry Ford restaurants as well.

For more information on Oakwood’s “Health Through History” program visit www.oakwood.org.

For more information on The Henry Ford visit www.hfmgv.org.  

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Dr. Karpawich Earns Fellowship

Peter P. Karpawich, MD, professor of Pediatrics for the Wayne State University School of Medicine and director of Cardiac Electrophysiology for Children's Hospital Michigan, was recently elected a Fellow of the American Heart Association, Council of Cardiovascular Disease in the Young.

The Council on Cardiovascular Disease in the Young supports the mission of the AHA by working to improve the health of children and adults with congenital heart disease and cardiovascular disease acquired during childhood through research, education and advocacy.

Dr. Karpawich also served as an invited chair at the 29th annual Heart Rhythm Society meeting, held in Boston. He also was an invited faculty speaker at the fifth Scientific Session of the World Congress of Pediatric Cardiology and Cardiovascular Medicine, held in Cairns, Australia

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Dr. Philip And Colleagues Pen Pancreatic Cancer Report

Philip A. Philip, MD, PhD, professor of Medicine and Oncology for the Wayne State University School of Medicine and multi-disciplinary team leader of Gastrointestinal Oncology at Karmanos Cancer Center, is lead author of a National Cancer Institute consensus report that discusses aspects of developing and testing better treatments for pancreatic cancer. The report looks five years down the road as doctors chart a course for treating the disease.

The “Consensus Report of the National Cancer Institute Clinical Trials Planning Meeting on Pancreas Cancer Treatment,” was published in the Oct. 26 edition of the Journal of Clinical Oncology. Co-authors include Margaret Mooney, Deborah Jaffe, Gail Eckhardt, Malcolm Moore, Neal Meropol, Leisha Emens, Eileen O’Reilly, Murray Korc, Lee Ellis, Jacqueline Benedetti, Mace Rothenberg, Christopher Willett, Margaret Tempero, Andrew Lowy, James Abbruzzese, Diane Simeone, Sunil Hingorani, Jordan Berlin and Joel Tepper.

The report notes that pancreatic cancer remains one of the most deadly forms of cancer in the United States and that most patients die within a year of diagnosis, which has remained unchanged over the last two decades. Conventional chemotherapy has not been effective in improving survival.

The panel recommends that researchers design pilot studies that test potential treatments in smaller groups before proceeding to the kinds of large trials that have in the past yielded disappointing results.

Dr. Philip comments on the consensus report’s findings and recommendations in the Nov. 3 online edition of NCI Cancer Bulletin. The featured article can be found at http://www.cancer.gov/ncicancerbulletin/110309/page2.

“The report is a call to action,” Dr. Philip says in the bulletin article. “We need to do better clinical trials that are based on solid science and patients need to be encouraged to participate in these studies.”

Dr. Philip added that the new strategy will ensure precious resources and patient time are spent on the most promising treatments. But that also presents a challenge because the knowledge of pancreatic cancer biology is still limited. The report notes that researchers must gain a better understanding of the complex signaling pathways in pancreatic tumors and the role of the local tumor environment.

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Children's Holiday Party Contributors 2009

The following is a list of contributors to the WCMS Foundation’s 24^th Annual Holiday Party for underprivileged children that took place Dec. 5 at the New Detroit Science Center. For more information, or to contribute, call (313) 874-1360 or visit www.wcmssm.org

Robert Brent, MD

William Knapp, MD

Nancy Goll

Elizabeth Edmond, MD

Martin Daitch, MD

Benjamin Ramos, MD

Peter Cracchiolo

Robert Borchak, MD

Julian Alvarez, MD

Beth Ann Brooks, MD

Dr. & Mrs. Sajal Choudhury

William L. and Betty G. Knapp

Drs. Safwan Halabi & Razan Asbahi

Joe Weiss & Marilyn Shapiro

Dr. & Mrs. George C. Hill

Neela Sripathi

Homer M. Smathers, MD

Sidney Baskin, MD

John C. Somogyi, MD

Charla Blacker, MD

Todd R. Williams, MD

Iris and Fred Whitehouse

Joseph M. Beals, MD

Stephanie Flom, MD

Dr. & Mrs. Mark F. Pezda

Eudoro Coello, MD

Christopher W. Hughes, MD & Debra J. Hughes

Claus Petermann, MD

Richard D. Cieslak, MD

Daniel S. Moore

Drs. Peter & Alice Watson

Drs. Rachel and Brian Silver

Kathleen Yaremchuk, MD

Anne-Mare' Ice, MD

John M. Malone, MD

Anne Nachazel, MD

Eastside Surgical Specialists

Paul Mazzara, MD

Dr. Richard Pollard

Michael G. Taylor, MD, FACS

Drs. Kenneth & Deborah Granke

Aaron Lupovitch, MD

Keith P. Bartold, MD

Rev. William and Dr. Mary Logan

Scott Monson, MD

Arthur J. Frazier, MD

M. Natacha Umlauf, MD

Phyllis A. Vallee, MD

Michael Schaldenbrand, MD

Heidi R. Gunderson, DO

Paul J. Sullivan, MD

S.V. Mahadevan, MD

Indu & Bala Pai

Chris and Janet Bush

Eve M. VanEgmond, MD

Taufiek Alhadi, DO

Gwendolyn H. Parker, MD

Dr. Ray and Mrs. Marcia Littleton

Drs. Daniel & Margarita Morris

Dr. & Mrs. Laurence E. Stawick

Dr. & Mrs. John Calwell

S. Rao Talla, MD

Ghaus M. Malik, MD

Eastlake Pediatrics PC

Vernon F. Strand, MD and Jane P. Strand

Martin H. Daitch, MD

John Kurtz, MD

Dr. & Mrs. Dan Michael

Mohammed Arsiwala, MD

Livonia Urgent Care

Margaret Dowling, MD

Dr. S. Maitra

George Mogill, MD

Dr. MaryJean Schenk & David Fry

Dr. Grace Engler & Ms. Anna Fedor

Dr. & Mrs. Donald M. Ditmars Jr.

James A. Rowley, MD

Sion Soleymani, MD

Madjid Mesgarzadeh, MD

Dr. & Mrs. Allan Dobzyniak

Helene C. Dombrowski, MD

Drs. Lalitha and Babu R. Vemuri

Robert G. Borchak, M.D.

Patricia A. Kolowich, MD

Joan & Bob Allaben

Advanced Family Health Care

Marcie Treadwell & Gregory Goyert

Dr. Michael Sandler

Tom & Nancy Coles

William G. Nutting, MD

Dr. & Mrs. Edmund M. Barbour

Dr. Philip C. Hessburg

Ron & Diane Strickler

Joseph Mark Tuthill, MD

Deloris Ann Berrien-Jones, MD

Vincent C. Yu, M.D.

Andrew J. Mitchell, MD

Barbara & Adrian Sheremeta

Fred R. Nelson, MD

Ronald E. Trunsky, M.D. & Judy Jenkins Trunsky

Michael R. Harbut, MD

Dorothy M. Kahkonen

Dr. and Mrs. H. Michael Marsh

Lisa T. Cooper, MD

Volna Clermont, MD

Dr. & Mrs. Kost Elisevich

Terrence R. Lock, MD

Halim D. Haber, MD

Dr. & Mrs. James Fordyce

Thomas J. Ruane, MD

Clara and Federico Mariona

Dr. Richard & Gail Smith

Jeff & Wendy Page

Dr. & Mrs. Gilbert B. Bluhm

Robyn J. Arrington, Jr., MD

Irene and Oscar Signori

Gehring T. Sauter, MD

Dr. & Mrs. E. N. Obianwu

Dr. B.J. & Marcia Woodley

Dr. Estigarribia

George H. Shade Jr., MD

Karen Chapel, MD & Doug Arenberg, MD

Clarence H. Schultz, MD

Dr. Stephen Lemos

Robert G. Borchak, MD

Dr. & Mrs. William J. Cosgrove, Jr.

Dr. and Mrs. Mark A. Kelley

Steven A. & Deborah L. Portney

Hassan Amirikia, MD

Sheryl Wissman, MD

Dr. Adnan Munkarah

Paul & Debbie Natinsky

Dr. & Mrs. Mark Tuthill

Dr. Orlando S. Sison

Guat and Dionisia Sy, MD's

Giovanni A. Morreale, MD and Lisa J. Morreale

Dr. & Mrs. Theodore B. Jones

Dragos M. Galusca, MD

Julius V. Combs, MD

Dr. and Mrs. Charles Barone

Melvin L. Hollowell, MD

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