aoma digest winter 2015

Volume 30, No. 1Winter 2015

— WHAT’S INSIDE —

Get InvolvedAOMA 93rd Annual Convention

Practice Management Articles

AOMA Digest Winter 20151

2014-2015 Board of TrusteesPresident

Adam Nally, D.O.

President Elect

Kristin Nelson, D.O.

Immediate Past President

Craig Phelps, D.O., FAOASM

Vice President

Jonathon Kirsch, D.O.

Secretary/Treasurer

Shannon Scott, D.O., FACOFP

Executive Director/Editor

Pete Wertheim

Trustees

Craig Cassidy, D.O., FACOO

Donald Curran, D.O.

Angela DeRosa, D.O., MBA, CPE

William Devine, D.O.

David P. England, D.O.

Michelle Eyler, D.O.

Charles A. Finch, D.O., FACOEP

Patrick Hogan, D.O.

Christopher Labban, D.O.

Julie A. Morrison, D.O.

Laurel Mueller, D.O., MBA

Kathleen Naegele, D.O., MBA, MIS, MPH

George Parides, D.O., FACOI

Wendell Phillips, D.O.

Bunnie Richie, D.O.

Resident Trustee

Mansoor Jatoi, D.O.

Student Trustees

Ryan Martin, AZCOM

Joshua Nead, SOMA

Speaker of the House of Delegates

Jeffrey Morgan, D.O., MA, FACOI

Vice Speaker of the House

Scott Welle, D.O., FACOS, FACS

AOMA STAFF LISTINGDirector of Education & Managing Editor

Janet Weigel

Member Service Manager

Sharon Daggett

Executive Assistant

Teresa Roland

Opinions expressed in the AOMA Digest are those of authors and do not necessarily reflect viewpoints of the editors or official policy of the AOMA, or the institutions with which the authors are affiliated unless explicitly specified. AOMA Digest does not hold itself responsible for statements made by any contributor. We reserve the right to edit articles on the basis of content or length.

Although all advertising is expected to conform to ethical medical standards, acceptance does not imply endorsement by this magazine. The appearance of advertising in the AOMA Digest is not an AOMA guarantee or endorsement of the product, service or claims made for the product or service by the advertiser.

Copyright 2015

The Journal of the Arizona Osteopathic Medical Association

ContentsCOLUMNS2 President’s Message

4 Executive Director’s Message

7 What We Have Done For You Lately

8 Just D.O. It!

FEATURES10 AOMA Business Partners

13 Welcome New AOMA Members

14 PDMP Report Card: Will You Be at the Top of the Class?

17 Enabling Statewide Health Information Exchange: From Legislative

Origins to Improved Care Coordination and Quality Across the State

19 “Difficult Patients” May Have Low Health Literacy

21 Onboarding New Physician Hires – Is Your Plan in Place?

22 Achieving Cost Effective Patient-Centered Healthcare for Arizonans

25 The Importance of Advocacy in the Disability Claim Process

28 Navigating a Grief Journey Begins with a First Step

AOMA NEWS29 Get Involved

32 AOMA 93rd Annual Convention

34 AOMA 34th Annual Fall Seminar

OSTEOPATHIC COMMUNITY NEWS37 Tucson Osteopathic Medical Foundation

39 Arizona Society of the American College of Osteopathic Family Physicians

40 A.T. Still University School of Osteopathic Medicine in Arizona

44 Midwestern University Arizona College of Osteopathic Medicine

47 Advertisers Index

47 Calendar of Events

AOMA Digest Winter 2015 2

President’s Message

Should your doctor be involved in the political arena? It is

the first question that comes to mind when I hear the word

Advocacy. It is a very good question. The Latin definition of

doctor is translated as “teacher.” However, in today’s society the

doctor is also an advocate for his or her patient. We advocate for

our patients on a daily basis, most of the time that is behind the

exam-room door or with a third party that is directly involved with

the patient’s care or well-being. But occasionally, we must step

outside the exam room to advocate for or against an issue that has

significant impact upon our patient’s or upon our ability to provide

good care for those patients. The physician, therefore, is placed in

the position of advocacy whether we like it or not. In this sense,

the definition of advocacy is specifically “public support for or

recommendation of a particular cause or policy.”

The individual question is do you personally become involved?

And if so, how involved should you become? Stepping into the

quagmire of political discourse has its drawbacks, as it often leaves

the all-to-familiar oratory odor. Been there . . . done that . . . didn’t

really enjoy it.

Avoidance of the oratory odor often occurs when the difference

between policy and politics isn’t understood. It is very important,

from the perspective of voice, to make a distinction between policy

and politics when we interact. Policy is “a course of action based

upon principles or values.” Politics is the “inter-relationships

or activities that we engage in to move policy in a desired

direction.” Don’t confuse the two as they are distinctly different

yet interrelated. Advocacy, thereby,

encompasses the use of politics

in public support for a policy or

cause. I find it interesting that

many physicians and patients don’t

understand the difference between

policy and politics and how this

affects their ability to advocate for

one another.

When listening to the talking

heads and political pundits, it is

essential that we look for and try

to see the difference. Just spewing

rhetoric without understanding our position on a policy seems to be

what fuels the cesspool-like arena of politics. It is often what turns

us away from important and productive political conversation about

policy. We seldom do this unless we understand the principles we

hold dear and our own values or the values of those for whom we

advocate.

In the words of Sir Francis Bacon, “He that gives good advice

builds with one hand; he that gives good counsel and example

builds with both; but he that gives good admonition and bad

example builds with one hand and pulls down with the other.”

(Whether you agree or not, anyone who holds the same name as

one of the most delicious breakfast foods on the planet should be

paid some attention.)

In a time when transparency is at the forefront, being genuine

and true to our values is essential for our patients and the business

of medicine. Yet, transparency is often subjective. Exposing one’s

views, beliefs, or values has variable interpretation from person to

person based on age, morals, background, ethnicity, etc. Through

social media and daily office interactions, we each frequently come

in contact with many physicians’ and patients’ viewpoints and can’t

help but compare them with our own.

For this reason, healthcare advocacy is often posed within a

value based system of the “Iron Triangle.” The “Iron Triangle” is

made up of three value-based vertices or sides: cost, quality, and

access. In our current healthcare system, the triangle is made up

of trade-offs. You can improve one or two sides of the triangle,

but only at the expense of the third. Improving access comes at

Adam S. Nally, D.O.2014–2015 AOMA President

Policy, Politics, & AdvocacyAdam S. Nally, D.O.


the reduction of quality, increased cost, or both. Reduction in cost

comes at the price of reduced quality or a decrease in access.

Advocacy for a single side of the triangle comes at the expense

of one of the other sides. We inherently understand this, and

I suspect this is the real reason why many of us shy away from

political advocacy. Anyone who tells you that he or she can make

the healthcare system more universal, improve quality, and also

reduce cost is in denial or misleading you. They are often politicians.

If we are to advocate honestly, which is part of the Osteopathic

Oath that each of us took upon graduation from our medical

training, then we should acknowledge that improvement in one

area will come at the sacrifice of another. The politicians among

us seem to be afraid of telling the hard truth and acknowledging

reality. Advocacy requires us to tell the hard truth. This is where the

physician advocate shines. Many of us do this daily when we inform

a patient they should place their affairs in order due to a terminal

illness. Why can’t we tactfully do the same when we advocate for

a particular cause or policy? Our Oath requires us to “retain the

confidence and respect [of our patients] both as a physician and a

friend . . . with scrupulous honor and fidelity . . .”

We live in a society of fast cars, fast food, instant messages,

and instant pictures. We want it our way and we want it now. As a

family practitioner, I feel pressured by both patients and insurance

companies to serve up a diagnosis and a low cost generic pill

with the same speed. No, the practice of medicine is not like fast

food. If it were, then I would install a drive up window next to

my office desk, and place a large marquee with a clown wearing

a stethoscope at my front door and a sign that says “Free prostate

checks here today with your first order of Lipitor!!!”

Medicine is an art. A picture is painted of the patient by

what is seen, heard, felt, and understood through the eyes of

the practitioner. This can’t be done over the phone or through a

drive-through window. It requires a patient who is willing to place

his or her history, symptoms, feelings, private concerns, and trust

upon the examination table. It requires the astute observer to see

all the reflections of light and shadows and all the highlights. It

requires the observer, the doctor, to recognize that many times this

is difficult for the patient. That trust is built through a relationship

that occurs over a period of minutes and a period of years. The

beauty of the art occurs when the practitioner and the patient

understand one another and application of healing can begin.

The art of medicine paints a different picture every time.

That’s why art isn’t sold under the golden arches or at the corner

pharmacy. No, the practice of medicine is not like fast food.

Honest advocacy cannot be done in 140 characters, either. It

comes through the formation of relationships and inter-relationships

of understanding and trust. Tweeting your weekly weight loss or meal

plan may be motivational for some, but is too-much-information

(TMI) for others. Just as spouting off one’s political views in 140

characters may encourage some, without appropriate relationships of

trust, it is offensively too much for others.

How can you be a better advocate?

1. Get involved with your state medical society. Form

relationships, real relationships, with your colleagues. The

Arizona Osteopathic Medical Association’s mission and

purpose is to advocate for you and your patients. There

are many areas that your help and participation make a

difference. If you are not a member, join us. If you are a

member, consider serving on one of many committees

helping to improve healthcare in Arizona.

2. Come join us on Tuesday, March 10th, 2015, at the Arizona

State Legislature for “D.O. Day at the Legislature” and

get the chance to speak one-on-one with your state

representatives. You, as a physician, interact with and have

relationships with up to 6000 members of the community

each year. Your legislators want to hear what you have to say

and what your patients have to say.

3. Participate in and contribute to your State and National

Political Action Committee (PAC). Your contributions help

to foster relationships with, support, and endorse candidates

with like-minded vision of what value in medicine really

means.

4. Consider becoming a Health Policy Fellow. Money

motivates neither the best people, nor the best in people. It

can move the body and influence the mind, but it cannot

touch the heart or move the spirit; that is reserved for

belief, principle, and morality. This program helps prepare

future leaders with the skills to analyze and react to current

health policy at the local, state, and national level. It was

designed with the practicing physician in mind.

To put it another way, if you stand up to be counted, from time

to time you may get yourself knocked down. However, remember

this: A man flattened by an opponent can get up again . . . A man

flattened by conformity stays down for good.


Executive Director’s Message

Scope of practice expansion battles are becoming all too

common in the modern era of healthcare. It is one the most

important issues the AOMA contends with each legislative

session and unfortunately the trend is accelerating.

As revenues to improve the delivery of healthcare become scarce,

legislators struggle to find fresh ideas and meaningful solutions to

satisfy the demands of their constituents. Expanding the scope of

practice to health professions is an alluring access to care remedy as

opposed to addressing the underlying problem which is a workforce

shortage.

The interesting and overlooked paradox about the expanding

scope of practice is that while it may appear to legislators to

improve access to care it can actually exacerbate the most expensive

and challenging problem limiting access to care: the physician

workforce shortage.

For many years we have advocated for additional graduate

medical education funding in hopes of attracting and retaining

physicians in Arizona. It is a challenging issue and overshadowed

by the continuous demands on the state general fund to solve

the more visible and immediate problems. Constituents expect

instantaneous results from their legislators and graduate medical

education is very much a long term investment.

When we analyze the reasons physicians decide where to

practice, they frequently include measurements such as tort reform,

managed care penetration, regulatory pressure, reimbursement rates,

weather, and physician-to-patient ratios. It is unclear why scope of

practice encroachment is left off many of these measurements.

The Physicians Foundation surveyed 630,000 physicians in

2012 about the current state of the medical profession. According

to the Foundation this survey was one of the largest and most

comprehensive ever undertaken in the United States. When asked

about factors leading to the decline of the medical profession, 43.7

percent of physicians stated that scope of practice encroachment

was a “very important” factor in the decline. For physicians under

the age of 40, the number was slightly higher at 44.6 percent

suggesting it is a growing concern.

Although scope of practice

encroachment was the not the

most important issue cited by

physicians in the survey, too much

regulation/paperwork was. It is a

significant concern weighing on

the minds of physicians. Scope of

practice encroachment in Arizona

has been a problem in the past and

when efforts fail to prevent it, the

problem becomes even worse.

The Arizona Naturopathic

Medical Association submitted a

sunrise application last year in hopes of getting it approved to clear

the way for legislation to allow naturopathic physicians equivalent

prescribing privileges as DOs and MDs. Arizona naturopathic

physicians are already privileged to possess one of the most liberal

scopes of practice and prescribing formularies in the nation.

They were seeking the ability to prescribe all Schedule II drugs, a

significant deviation from the practice of naturopathic medicine.

The AOMA invested quite a bit of time and political capital to

sway enough legislators and the sunrise application was withdrawn

due to lack of support. They will likely bring the issue back again

and we will have to work even harder next time to defeat it.

Imagine for a moment the physician perception of Arizona if

this proposal were to become law. There are approximately 1,800

osteopathic physicians and more than 750 naturopathic physicians

licensed to practice and living in Arizona. With the stroke of the

Governor’s pen on a bill, more than 750 naturopathic physicians

without the burden of completing a 3-7 year residency and only

needing about half the number of hours of pharmacology training,

would get a shortcut to DO equivalency.

The impact of this would be far reaching. You would expect the

number of naturopathic physicians coming to Arizona to quickly

increase as word spread that Arizona is one of the best states for

them to practice.

The Scope of Practice Encroachment Threat in Arizona

Pete WertheimAOMA Executive Director


Executive Director’s Message

We already witnessed this phenomena in 1992 when Arizona

law was changed to allow naturopaths to provide many of the

same healthcare services as allopathic and osteopathic physicians.

Building on that momentum, in 2002 their scope of practice was

expanded to allow naturopathic physicians to prescribe Schedule

II morphine, any Schedule III, IV or V drug, and refill the same

as physicians. In 2002 Arizona had 302 licensed naturopathic

physicians. Following the success of the scope of practice

expansion, their population grew to 400 plus licensees in 2004,

more than 10 percent of the nation’s licensed naturopaths.

Expanding scope of practice to allow full Schedule II

prescribing privileges to unqualified naturopathic physicians would

greatly undermine the hard work of the more than 1,800 Arizona

osteopathic physicians who spent a significantly longer amount

of time in the classroom and many years through clinical training

to become qualified to prescribe Schedule II drugs. Furthermore,

students enrolled in medical schools or considering enrolling in

medical school would question, and rightfully so, why they must

undergo so much additional training when others can become a

physician with a nearly identical scope of practice after just a four

year program and 60 hours of pharmacology courses. Physicians

might reconsider moving their practice to Arizona once they learn

about this inequitable competition.

We must get more physicians involved in protecting their

profession by supporting their state associations and contributing to

their Political Action Committees. Scope of practice encroachment

will continue to escalate as other professions increase their strength

and numbers to convince legislators they can fulfill the unmet needs

of patients in their districts.

The AOMA Legislative Affairs Committee will be busy this

year working on your behalf to protect and preserve the integrity

of the osteopathic medical profession. We are in good hands with

Dr. Kit McCalla leading the way as an outstanding chair but we

need your support through your membership with the AOMA,

volunteering on the Legislative Affairs Committee, and financial

support of the AOMA PAC. Your contribution and the collective

support of everyone will ensure that Arizona is a great place to

be a DO.


What We Have Done For You Lately

What We Have Done For You LatelyThis regular feature of the AOMA Digest provides members with a recent update of the Association’s activities. We are representing the profession

as a healthcare stakeholder and are the voice of osteopathic medicine in Arizona. This update covers the four month period from October 1, 2014

to January 31, 2015.

Advocacy/ Legislative Af fairs- Lead efforts to oppose and defeat scope of practice expansion

sunrise applications submitted by the naturopathic physicians

and the pharmacists

- Updated the AOMA website and launched a Legislative Affairs

Advocacy Resource Center. The new page contains information

about effective advocacy, training opportunities, advocacy tools,

D.O. Day at the Legislature, elections and voting, and the

Political Action Committee

- Facilitated the safety net providers orientation for new state

legislators

- Conducted an AHCCCS Physician Reimbursement Cut Survey;

survey results are being used to share with legislators about the

impact of previous cuts and proposed additional cuts

- Attended the 26th Annual Southwest Medical Legislative Group

Symposium

American Osteopathic Association (AOA) - Attended the AOA Advocacy for Healthy Partnerships meeting

in Phoenix

- Organized a sponsored reception for the Association of

Osteopathic State Executive Directors

- Attended the American Osteopathic Association CME

Conference in Los Angeles

Continuing Medical Education - Sponsored 12.5 hours of Category 1-A CME credit for AOMA

34th Annual Fall Seminar

- Sponsored five offerings of 4.0 hours of Category 1-A CME

credit for Opioids: The Epidemic That You Can Cure

- Implemented online attestation and evaluation form for AOMA

CME offerings

Osteopathic Charities - Raised more than $2,000 through 2015 Birdies for Charities

campaign

- Launched Amazon Affiliates program to provide ongoing

revenue to Charities from purchases made on Amazon.com

- Installed Barbara Mendelson as a new board member

- Announced Annual Scholarship Essay Contest to AZCOM and

SOMA students

Member Services- Introduced a new “Get Involved” feature on the AOMA website

to help educate members about AOMA leadership and volunteer

opportunities

- Relaunched AOMA Career Center Job Flash eNewsletter

- Redesigned all AOMA membership marketing materials

Political Action Committee- Contributed $6,100 to 21 candidates who won their elections

Public Health- Represented AOMA at the Governor’s Council on Infectious

Disease Preparedness and Response meetings on the Ebola

outbreak

- Represented AOMA at the Arizona Department of Health

Services Vaccine Financing & Availability Advisory Committee

and at The Arizona Partnership for Immunization (TAPI) Steering

committee meeting

Public Relations- Moderated panel discussion on graduate medical education for

American College of Physicians, Arizona Chapter

Students – the future of the osteopathic profession - Provided public policy and advocacy training to the Student

Osteopathic Medical Association and the AZCOM Healthcare

Policy Club

- Student doctors served as moderators at the AOMA 34th Annual

Fall Seminar

- Announced 2015 AOMA Clinical Case and Poster Competition

- Developed the Amanda Weaver Student Health Policy Grants

to provide financial incentive to osteopathic medical students

to learn about health policy and develop effective health policy

tools

- Added 9 students to AOMA committees

For more information about any of these updates, please AOMA at

(602) 266-6699 or email [email protected]


Just D.O. It

A Guiding Hand

Doctors Brent and Nicole Nedella believe in a guiding hand.

As osteopathic physicians they employ the healing power of

hands to treat patients. In their personal lives, they witness

the guiding hand of faith every day.

Both native Arizonans, Brent and Nicole met as undergraduates

at Grand Canyon University (GCU) fifteen years ago. They practice

family medicine at Pinnacle Family Medicine in Litchfield Park,

Arizona with David Engstrom, DO and Kevin Houlihan, MD.

While their lives today are shared both personally and professionally,

their individual paths to osteopathic medicine were different.

Dr. Brent grew up on the northwest side of Phoenix and knew

by the age of thirteen he wanted to be a doctor. He was the first

member of his family to attend college and thought he would

pursue orthopedic surgery. Brent was raised within a faith-based

family, and it was during medical school and residency that his

commitment to community outreach evolved.

Dr. Nicole was raised in the east Valley and was fortunate to

travel internationally. She remembers at an early age travelling to

Mexico and being touched by the poverty of the local residents. As

a teenager living with her family in Japan, she was part of a youth

ministry and saw the tremendous need there and in Malaysia.

During her years at GCU, Nicole originally planned to become a

veterinarian but she so loved her human anatomy classes that she

changed her focus to medicine.

After graduation from GCU, Brent and Nicole attended

Midwestern University Arizona College of Osteopathic Medicine

(AZCOM) in Glendale, Arizona. They both acknowledge Jeffrey

Morgan, D.O. as having a huge influence on their academic and

professional careers, guiding their paths. During medical rotations,

Brent and Nicole found they loved every aspect of osteopathic

medicine and decided that their life purpose would be best served

in family medicine.

After medical school and residency, the Nedellas came

home to Arizona to practice. In the middle of the recession, the

opportunity to practice together was not very promising. Enter

David Engstrom, DO, a family medicine practitioner in Litchfield

Park. Dr. Brent responded to a physician opportunity posted by Dr.

Engstrom through the Christian Medical and Dental Association.

After interviewing for the position, Dr. Brent asked if there was

the possibility of also bringing Dr. Nicole into the practice. Dr.

Engstrom hadn’t originally considered the option, but after securing

additional funding from Banner Estrella, both Dr. Brent and Dr.

Nicole joined Pinnacle Family Medicine in 2010. The practice

continues to grow and added Dr. Houlihan in 2014

Dr. Engstrom was already doing mission work in Thailand and

Mexico when a friend, Pastor Patrick Youngs, approached him in

2012 about putting together a mission trip to Uganda to address

the enormous need for medical care in that country. After much

prayer and consideration, all three DOs rose

to the challenge embarking on the first trip in

June 2012 with no definite knowledge of what

to expect.

Arriving in Uganda after 40 hours of

travelling, the first clinic was set up in a

church with a dirt floor. The team of four

physicians and four staff saw patients for nine

hours. With no infrastructure, no medical

equipment except stethoscopes and blood

pressure cuffs, no testing materials except

The 2014 mission team: From top left, clock-

wise: Patricia Plum, MSW; Stacey Engstrom;

Roger Engstrom; Jamie Engstrom, PA-C; David

Engstrom, D.O.; Patrick Youngs; Larry Hirose;

Cortney Mitchell, RN; Stephanie Bradley, RN;

Nicole Nedella, D.O.; Priscilla Vera, MA; and

Brent Nedella, D.O.


Just D.O. It

those for malaria, and limited medications, the medical care was

offered in a sometimes chaotic environment using volunteer

interpreters. They conducted four clinics in 10 days seeing nearly

1000 patients. Miraculously the malaria test kits and medications

they brought from the United States carried them through to the

very last patient on the very last day of the clinic.

Subsequent mission trips in 2013 and 2014 were held in

Bundibugyo, Uganda in the schoolhouse at the Mt. Zion Boarding

School run by Bishop Hannington Bahemuka. A stone’s throw

from the Congo border, both Ugandans and Congolese natives

receive care at the clinic.

The Nedellas related an account from Pastor Youngs about one

of the many patients the team treated during the 2014 mission trip:

“Before we arrived, a 13-year-old orphan girl named Pamela (pa

MEL a) had skinned her knee, an injury that for most American

children is not generally of great concern. Unfortunately, Pamela’s

small wound quickly became infected and she found herself in

so much pain, she could not even walk. Over the course of just

a few days, her condition went from bad to worse. Her body

could no longer fight the infection and it began to spread. By the

time she was brought to us, she was in agonizing pain and her knee

was four to five times its normal size. Pamela was in desperate need

of a hospital that could provide her with weeks of an intravenous

antibiotic drip but the medicine was not available. Our doctors

took action, opening up her knee and caring for the wound. It

was extremely painful and her deafening screams would last for

approximately an hour. We provided her with oral antibiotics, but this

alone was simply not enough. The doctors agreed that this situation

was quickly becoming life threatening and the only thing left to do

was pray. Over the next few days, we were amazed to see her smiling

and regaining her strength. Ultimately, the Pamela’s infection was

completely cured. Medically, it is simply unexplainable.”

The physicians and staff are truly a family. Everyone at Pinnacle

Family Medicine may go on the mission trips if they wish, with

paid time off. Dr. Engstrom also provides funding for plane

tickets and other expenses for those staff members who could not

otherwise afford to go on the mission.

The patients receiving care are not the only ones who are touched

by the mission experience. After several years of trying to start a

family of their own, the Nedellas were seeing a fertility specialist.

During the first mission trip in 2012, with hands on her womb, the

mission team in prayed that Dr. Nicole might soon have a child.

Less than six months later, just before she was to resume fertility

treatments, the guiding hand that had led them to Uganda brought

them their now 18-month-old son, Jesse Hannington Nedella.

The Nedellas don’t know where the guiding hand will lead them

next. Of course, they will continue to practice family medicine here

in Arizona and there are definite plans for a permanent physical

facility. The Betheseda Health Center is under construction in

Bundibugyo with the ultimate goal to have a full-time physician

and fully-stocked pharmacy to treat chronic conditions and provide

continuous care. Future mission trips are scheduled and both Dr.

Brent and Dr. Nicole will be part of those trips. Beyond that, the

future is in His hands.

Doctors treat Pamela’s knee infection under light provided by cell

phones.Bethesda Clinic under construction in Bundibugyo, Uganda


Business Partner Listings

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BANKING

Bankers TrustKeith Kormos, Senior Vice President2325 E. Camelback Rd., Ste. 100Phoenix, AZ 85016(602) [email protected]

Bankers Trust provides core banking services, mortgages, treasury services and trust accounts. To AOMA members (private banking clients) will receive: free checking, free printed checks, free electronic statements and free mobile banking.

BANK CARD PROCESSING

AffinipayVisit the AOMA website, Member Services Business Partner Listings or call (800) 644-9060 Ext. 6974

AOMA members are entitled to a very special processing package from Affinipay. Their on-line reporting lets you quickly see your deposit and payment information.

BILLING & COLLECTIONS

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A technologically superior medical collection agency. They provide cutting-edge services like real-time online performance results. Delivery Financial Services maintains an excellent record for ethical and professional standards with its clients with an outstanding A+ rating. All AOMA members will receive a significant discounted fee.

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J.R. Brothers Financial, Inc. ( JRB) is a medical collection agency since 1986. AOMA members are offered a lower collection fee with exceptional service and recovery. Clients can access the status of their accounts online through the JRB Client View Program.

XOLMed Revenue Cycle Management Corp.J. Patrick Laux(602) 396-5900 [email protected]

We provide exceptional billing, coding, and collection services for physician practices. We offer AOMA members a comprehensive billing and chart preview at no charge to determine how we can increase practice revenue, and shorten collection cycles.

CAR RENTAL

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FINANCIAL

Mosaic Financial AssociatesAnthony C. Williams, President4650 E. Cotton Center Blvd. #130Phoenix, AZ 85040(480) 776-5920Fax: (480) [email protected]

Mosaic Financial Associates provides a holistic approach to wealth management. They believe your financial advisor should provide a pathway to the financial goals you dream of and work hard to achieve, while taking into account all aspects of your life and building a long-term relationship based on trust and top-notch service.


Business Partner Listings

HEALTH INFORMATION TECHNOLOGY Information Strategy Design (ISD)Michele Liebau(480) 970-2255 [email protected]

Information Strategy Design (ISD), a leading healthcare technology solutions provider with its central office in Mesa. ISD has been providing network design and implementation to Heathcare Practices in the South West since 1996. ISD’s focus is on medical practices to allow them to provide cost-effective computer networking, telephony, off-site backup and remote monitoring. ISD’s value offering to AOMA members allows for one time and ongoing discounts based on using two or more ISD services.

INSURANCE

AFLACKaren Jones, Independent Agent16211 N Scottsdale Rd., Ste. A6A 614Scottsdale, AZ 85254(602) 229-1970 x213

No Deductible, No Copay, No Preauthorization. AFLAC supplemental insurance policies are available at special Association Rates for AOMA members and their families.

Mutual Insurance Company of Arizona (MICA)(602) 956-5276(800) 352-0402www.mica-insurance.com

Each medical practice is unique with individual risk management needs based on specialty and practice characteristics. Their experienced Risk Management Consultants can assist you in assessing and providing service designed to reduce your risk of a malpractice claim or suit. MICA is owned by all of the physicians it covers and provides educational grants to AOMA.

LEGAL –– DISABILITY INSURANCE CLAIMS AND HEALTHCARE LITIGATION

Comitz|BeetheEdward O. Comitz, Esq. Scottsdale Spectrum 6720 N. Scottsdale Rd., Ste. 150 Scottsdale, AZ 85253 (480) 998-7800 Fax (480) 219-5599 [email protected] www.disabilitycounsel.net

Mr. Comitz has extensive experience in disability insurance and healthcare litigation, representing physicians in reversing the denial or termination of their disability insurance benefits. Mr. Comitz has earned a national reputation for prosecuting claims based on fraud and unfair practices in the insurance industry. A free consultation is provided to AOMA members.

MEDICAL RECORD SCANNING & MANAGEMENT

ASDD Document DestructionRyan Shinn(480) [email protected] www.assuredsecurityaz.com

ASDD Company is an offsite and onsite “AAA” certified document

shredding, electronic media and x-ray destruction. We are HIPPA and FACTA compliant. We offer AOMA members discounts on offsite and onsite services.

PAYROLL PROCESSING

Human Capital StrategiesNick.Mawrenko (480) [email protected] www.hcscando.com

Human Capital Strategies is a national provider of Professional Employer Organizations (PEO) Services, Administrative Services, Organizations (ASO) Services, and Payroll Services. Managing every aspect of payroll, human resources, taxes, employee benefits, 401(k) plans and workers’ compensation management is what makes Human Capital Strategies “the next best thing to no employees!” Human Capital Strategies offers a 10% discount and $0 setup fees for AOMA Members.

Payroll Strategies GroupNick Mawrenko (480) [email protected]

Payroll Strategies Group is a local payroll service that is designed for the small medical practice. If you have one employee and don’t want to do your own payroll, call Nick. Our custom service enables us to reduce overhead and pass the savings on to you. Call Nick to see if our approach will fit your practice. Payroll Strategies Group offers AOMA members a $0 setup fee.

PRACTICE MANAGEMENT

Wolfe Consulting Group Jim Wolfe, Owner(602) [email protected]

AOMA members will receive a free initial problem definition meeting and also receive a discount on a wide array of business consulting services. Services, from Improving Income to Practice Sale for Retirement, will serve as the basis for the free initial consultation. A listing of these services can be reviewed at www.wolfeconsultinggroup.com. Real Estate services from Office Leasing to Building Purchase are also available through a wholly owned subsidiary of Wolfe Consulting Group, Ltd., Healthcare Realty Advisors, Inc., at no direct cost to AOMA’s members.

REAL ESTATE

RE/Max ExcaliburKevin Weil, Realtor(602) [email protected]

Kevin Weil of RE/Max Excalibur is one of the top realtors in the valley and specializes in serving the needs of physicians. AOMA members are entitled to video previewing of homes of interest and other services uniquely designed to save the time of, and maximize the interests of AOMA members. Kevin and RE/Max Excalibur have selected Arizona Osteopathic Charities as the charity to receive a donation based upon member participation.


Welcome New Members

Welcome New AOMA Members

_________ First Year Member _________

Robert Gordon, D.O.

Occupational Medicine

Kingman, Arizona

(928) 514-9433

_________ Third Year Member _________

Sarah E. Mitchell, D.O.

Family Medicine – Board Certified

OMM - Board Certified

Mesa, Arizona

(480) 833-1800

________________________________ Military Member _______________________________

Brian F. McCrary, D.O.

Occupational Medicine – Board Certified

Aerospace Medicine – Board Certified

Underseas Medicine & Hyperbaric Medicine – Board Certified

Aerospace Medicine – Board Certified

Scottsdale, Arizona

(702) 203-1833

_______ Second Year Members _______

Trudy Lynn Dockins, D.O.

Psychiatry – Board Certified

Mesa, Arizona

(480) 218-3280

Michael N. Lokale, D.O.


Oro Valley, Arizona

(520) 544-4100

Tyler M. Martinez, D.O.

Emergency Medicine

Phoenix, Arizona

(510) 350-2777

Virginia Avelar Savala, D.O.

Obstetrics & Gynecology

Casa Grande, Arizona

(520) 381-0380

_________________________________ Full Members _________________________________

Gary L. Cornette, D.O.

Gastroenterology – Board Certified

Internal Medicine – Board Certified

Flagstaff, Arizona

(928) 773-2547

Ryan W. Felix, D.O.

Physical Medicine & Rehabilitation –

Board Certified

Phoenix, Arizona

(480) 467-2273

Kelli Marie-Koski Glaser, D.O.


Mesa, Arizona

(480) 265-8070

Jeffrey H. Miller, D.O.

Family Practice

Sedona, Arizona

Jeny M. Pothen Itty, D.O.

Internal Medicine

Phoenix, Arizona

(602) 406-4636

______Out of State Members______

Rick I. Miller, D.O.

Obstetrics & Gynecology –

Board Certified

Charleston, Illinois

(217) 258-2360

IN MEMORIAMWe are all diminished when one of our number leaves us.

We will miss them and strive on for the betterment of our profession in their memory.

Zoila Denno, D.O.


Features

On December 10, 2014 the Arizona Prescription Drug

Misuse and Abuse Initiative held a planning summit

to review the results of a 24-month pilot program

conducted in five Arizona counties: Yavapai, Pinal, Mohave,

Greenlee, and Graham.

One of the five strategies employed in the program to fight

prescription drug misuse and abuse was to Promote Responsible

Prescribing and Dispensing Policies and Practices. The goals

identified for this strategy were:

1. Encourage sign up and use of the Controlled Substance

Prescription Monitoring Program (CSPMP)

2. Provide education and training and increase awareness

of individual prescribing habits

To achieve these goals, the Arizona Criminal Justice

Commission and the Arizona State Board of Pharmacy

PDMP Report Card: Will You Be at the Top of the Class?

Ten Reasons Why You Should Use the Prescription Drug Monitoring

Program Data Base1. Easier to use – prescribers can now identify a designee

to access the data base 2. More accurate – 24-hour reporting by dispensers3. Alerts prescribers to patients at highest risk of abuse

and overdose4. Identifies criminal prescribers and clinics – “pill mills”5. Detects doctor shoppers6. Monitors and detects geographic areas where increased

abuse/misuse is occurring7. Recognizes potential need to refer a patient for

substance abuse treatment8. Reduces illicit acquisition and diversion of prescription

drugs9. Limits your liability as a prescriber10. Saves lives!

developed the PDMP Report Card as a tool to convey pertinent

information to prescribers on their prescribing habits for

hydrocodone, oxycodone, carisoprodol, benzodiazepine, and

other pain relievers. During the pilot program approximately

1,600 prescribers were individually sent a quarterly report card

detailing

1. the number of prescriptions dispensed and

2. the total number of pills dispensed under their DEA

number.

The report included a comparison of the prescriber’s

individual data to the average data for prescribers of their

specialty type in the same county. The report card also contains

the prescriber’s registration status with the PDMP. (A sample

report card appears on page 15.)

According to the Arizona Criminal Justice Commission, the

following successes were identified from

the pilot program:

• from 2012 to 2014, Arizona saw a

20% reduction in the rate of youth

prescription drug misuse and abuse

• there was a 109% increase in the

number of prescribers signed up to

use the CSPMP

• there was an 84% increase in the

number of queries actively being

made to the CSPMP

• rates of prescriptions and pills

dispenses have decreased in all five

prescription drug categories tracked

(range = 2.3% to 16.3%)

• pilot counties achieved a 28%

decrease in opioid-related deaths,

compared to a 4% increase in non-

pilot counties

Based on the success of the pilot

program, the Arizona Prescription

Drug Misuse and Abuse Initiative is


Features

expanding the program across the

state. Pima and Maricopa counties

will be online by the end of the

second quarter of 2015. All other

Arizona counties are expected have

some kind of program in place by

the end of 2015.

The PDMP Prescriber Report

Card is also being expanded to

convey additional information:

• # of patients who received

100 mg or more Morphine

Equivalent Daily Dose

(MEDD) of prescription

narcotics

• # of patients at risk for a

dangerous drug combination

involving the five monitored

drugs

• # of patients prescribed

opioids/this prescriber

• # of patients going to more

than 5 prescribers and 5

pharmacies

In 2015, if you aren’t receiving

one already, your quarterly PDMP

Report Card will be sent to you

by the Arizona CSPMP. To get

the most of the data, be sure that

you are registered as a prescriber

with the CSPMP (as required by

Arizona statute), sign up to access

the data base (you may identify

a designee to access the data base), and periodically request

a report on each of your patients, especially if they are being

prescribed one or more controlled substances.

Your participation, awareness, and vigilance can aid in

reducing the incidences of prescription drug misuse and abuse.

For more information about the CSPMP contact Dean Wright,

RPh, CSPMP Director at (602) 771-2744 or dwright@

azpharmacy.gov. For questions about the Arizona Prescription

Drug Misuse and Abuse Initiative visit www.azcjc.gov/acjc.web/

rx or email Shana Malone at [email protected].


Features

Since its inception in

2007, Arizona Health-e

Connection (AzHeC) has

had a core mission to collaborate

and coordinate public policy

initiatives to advance health

information technology (HIT)

and health information exchange

(HIE). This has meant researching,

developing and advocating

legislation such as the collaborative

effort in 2011 to lead community

support for passage of House Bill

2620 which helped enable statewide HIE in Arizona. While

the successful passage of House Bill 2620 ended a successful

collaborative effort of Arizona healthcare stakeholders, it

began the process of meeting the requirements of the law

and providing a valuable statewide HIE platform (called The

Network) to help providers better coordinate care and improve

quality across the state.

2011: Removing barriers and providing patient choice

and privacy

House Bill 2620 (now Arizona Revised Statutes (ARS) 36-

3801, et seq.) included these essential features:

• The law defines health information organizations (HIOs)

and permits providers and clinical laboratories to securely

share health information through an HIO, so long as

HIPAA privacy requirements are met.

• The law allows any patient or consumer to “opt out” of

participating in an HIO, restricts how HIOs may use

health information and requires HIOs to have policies

in place to protect the privacy and security of the health

information that they handle.

• The law defines the notification and “opt out” process that

participating providers must have in place for their patients.

2012-2013: Initial operations of The Network, Arizona’s

statewide HIE

There was strong support by Arizona healthcare stakeholders,

including hospitals, health plans and a statewide reference

laboratory, to implement a statewide HIE platform. These

organizations came together and through The Network,

Arizona’s statewide HIE, have been able to offer the following

statewide HIE options since 2012:

• Virtual health record (VHR) – View only access to patient

information from available sources.

• Bidirectional clinical data exchange – A two-way pipeline

for sending and receiving patient information.

• Health plan solution – Provision of clinical data for health

plans to use for care coordination, care management and

case management of their beneficiaries.

2013: Development of a Consent Notification and Opt-

Out Toolkit for participating providers

To help providers implement the required notification

process for patient visits, AzHeC developed a Consent

Notification and Opt-Out Toolkit1 in 2013 that includes:

• A Toolkit Guide – A step-by-step guide that provides a

summary of the law and instructions for setting up a patient

notification process.

Enabling Statewide Health Information Exchange: From Legislative Origins to Improved Care Coordination and Quality Across the State

Melissa A. Kotrys, MPH

CEO Arizona Health-e

Connection

Health Information

Network of Arizona

1 The Consent Notification and Opt-Out Toolkit is available for reference or downloading by clicking Benefits & Services under The Network tab at www.azhec.org. Health Information Exchange continued page 18


Features

• Key Documents – Templates and documents needed to

implement the patient notification process required by

law.

• Patient Education Materials – Helpful materials that

providers may use with patients to help explain their rights

under Arizona law.

2014: Evaluation and Redesign of The Network’s

Capabilities

To streamline and improve operations, AzHeC and The

Network formally affiliated and combined operations in February

2014, creating one statewide organization for providers and other

healthcare stakeholders to come to for all of their HIT and HIE

needs. To ensure that The Network continued to provide value to the

community, there was an immediate focus on responding to market

changes such as the growth of accountable care organizations

(ACOs) and the need for improved care coordination across

healthcare organizations. The result was an evaluation and redesign

of statewide HIE capabilities involving three critical tasks in 2014:

The evaluation and development of new services – this review

focused on identification of services that are best provided by a

statewide HIE.

The evaluation and selection of an upgraded technology platform

– the review involved broad community input and participation and

the evaluation of eight top technology platforms. Mirth Corporation,

one of the nation’s top HIE vendors, was selected, with a launch of

the new HIE platform scheduled for April 2015.

Support for a new operating and service model – the adoption

of a new technology platform required the adoption of a new

operating and service model.

2015: Launch of New Network Services

In addition to the initial data exchange services provided by The

Network, the current technology upgrade will support several new

value-added services in 2015:

• Direct exchange or secure email for the delivery of clinical

information

• Delivering alerts based on admissions/discharges/transfers and

abnormal test results

• Public health reporting to support Meaningful Use Stage 2

• Connecting to eHealth Exchange, a national network that

supports exchange with federal agencies, such the Indian Health

Services and Veterans Affairs, as well as other state HIEs.

Arizona has seen a lot of progress in HIE since the original

2011 legislation – from ensuring patient choice under the law to

responding to changing market needs to providing practical tools to

improve care coordination and quality across healthcare systems. If

you have questions or would like to learn more about the statewide

HIE services of The Network, please contact us at (602) 688-7200

or [email protected].

Health Information Exchange continued from page 17


Features

There’s no doubt about it - communicating with patients has

become tougher. Visits are shorter, yet patients want more

face time. They may arrive armed with dubious medical advice

from the Internet; and physicians are challenged to try to relate to

patients while typing into the electronic medical record.

A special skill set may be needed with some of your patients.

These are the so-called

difficult patients. They

just don’t seem to

follow your plan or

may be disagreeable to

you or your staff. It’s

actually more accurate

to think of these as

difficult relationships,

rather than difficult

people.

Relationship

difficulties between the

physician and patient

tend to develop when

success is frustrated, expectations are misaligned or flexibility is

insufficient. It is useful to examine the relationship to see which of

those may be a factor. For example, a chronic condition can leave

both parties feeling frustrated. The patient may seem to have given

up and the physician is at a loss at how to motivate adherence when

neither party is assured of success.

Bring the difficulty out into the open. Let the patient share

their frustration and discuss ways to work together to set new

goals. Explore to see if the patient’s expectations are out of

alignment with your own. Maybe this is leading to non-compliance.

Talk about it. Perhaps the patient is being inflexible – refusing

your recommendations – or perhaps you have been inflexible in

recommending something that is not compatible with the patient’s

home situation or lifestyle.

Critical to the understanding of the difficult patient-physician

relationship is the rising epidemic of low health literacy. Health

“Difficult Patients” May Have Low Health Literacy

Judy Avery, RN, BSN, Education Coordinator, RMS, MICA

literacy is the ability to read, understand, and act on healthcare

information. Functional health literacy is the ability to apply

reading and numerical skills in a healthcare setting. The health

literacy problem is a crisis of understanding medical information

rather than one of access to information. Recent healthcare reform

efforts have focused on providing patients with more health

information. One

solution has been to

produce more written

materials. This is at

odds with the finding

that nearly half of our

patients cannot read

or comprehend much

of the information we

provide.

Many patients,

because they are

embarrassed or

intimidated by the

healthcare system, do

not ask physicians to explain difficult or complicated information.

One of the main reasons low health literacy is overlooked is

because it is not always easy to detect in your interactions with

the patient. Literacy researchers are frequently surprised at the

poor reading skills of some of their most poised and articulate

patients. People who have difficulty reading are often ashamed

and hide their poor literacy from healthcare professionals, friends,

and even close family members.

If patients do not understand medication and self-care

instructions, a crucial part of their medical care is missing, which

may then have an adverse effect on their clinical outcomes. In fact,

theoretically, the health of 90 million people in the United States

may be at risk because of difficulty experienced in understanding

and acting on health information.

Difficult Patients continued page 20


Features

As realization dawns on the far reaching nature of this problem,

clinicians may feel overwhelmed when considering strategies to

assist low-literacy patients. A few simple measures can make a vast

difference to this patient population, and should prove helpful to all

your patients.

Create a “shame-free” environment where low-literate patients

can seek help without feeling stigmatized. Shame may prevent poor

readers from asking for simpler materials or seeking help when

they don’t understand medication labels, medical forms, or self-care

instructions. Using a statement such as “Many of my patients have

trouble understanding this stuff, let me read it to you so you can ask

me questions” often works well. This approach also works well for

patients with undisclosed visual impairments.

Routinely assess your patient’s ability to understand directions

and information, especially if non-compliant or “difficult.” Health

literacy may be an underlying cause of patient management

problems such as not keeping appointments, chronic lateness, non-

compliance with treatment, returning incomplete forms, excessive

phone calls, and overuse of the emergency room.

Know your patient demographics and consider this when

developing written materials or providing verbal instructions. How

old are they? Is English their first language? What is their average

level of education? What are their cognitive and sensory limitations?

Create forms and handouts which can be understood by patients

with lower literacy levels. Use large fonts, simple language, and

short sentences. Make good use of illustrations and white space.

Consider the environment. Do patients have adequate time

to read material or to complete a form? Is the environment

sufficiently free of distractions? Will a staff member be available

to answer questions in a non-obtrusive manner? Encourage the

patient to invite family or friends into the teaching sessions. Not

only does this establish a warm and supportive environment,

but it also educates those who later can reinforce and clarify

information.

It’s important to verify understanding by finding out what a

person comprehends and what he or she doesn’t. Find out what

patients think is happening, and what they still need to learn. You

can do this by asking concrete questions and offering opportunities

for patients to let you know how they will implement their care

plan. Use the “teach back” method to assure patients can accurately

carry out your instructions.

Those are excellent suggestions, but doesn’t all this take a

lot of time? In your busy medical practice, time may be your

most precious commodity. You may want to consider time as an

investment you make in your patients’ health and well being, in your

own personal satisfaction, and in your success in the business of

medicine. Time spent in clear and effective communication is often

under-appreciated yet may yield huge dividends.

Spending 5 or even 10 additional minutes on a first time

patient or a patient with a new serious complaint seems like a

lot, but the time redeemed may be significant. Ineffective and

inefficient patient-physician communication: drains time and

energy, increases the chance for non-adherence and poor patient

outcomes, and increases the chance for a missed diagnosis or

a malpractice suit. We know it’s not whether you’ll spend time

communicating; it’s how you spend your time communicating.

Think of the time you spend communicating, especially with your

more challenging patients as an investment. What kind of returns

are you getting now?

Difficult Patients continued from page 19

Photo credit: pixshark.com


Features

Onboarding is the process that starts at the first contact

with a potential new hire, in which you build and establish

engagement early in the hiring process and continues after

the traditional orientation program ends.

There are important benefits from the successful onboarding of

new physician hires:

• The physician will become financially viable sooner with

greater job satisfaction and will contribute to your organization

in a more meaningful way.

• When integrated into your general community and medical

community in an organized manner, the physician and his

or her family will feel welcomed and connected. Strong

integration validates membership in the medical community

and establishes referral patterns sooner.

• The more quickly the new physician is and feels an integral

“part” of the community, the better the intangible “happy

doctor” factor and improved odds for long-term retention. Your

organization will reap financial benefit in earlier productivity,

reduced turnover and associated recruitment costs.

Pre-Of fer StageOnboarding begins at the earliest stages of recruitment.

Known as the "pre-offer” stage, your first contact with interested

candidates sets the tone for all future communications. After

determining mutual interest, your conversation should inform

the physician of your culture, mission, expectations and

responsibilities of the physician. Subsequent conversations

regarding compensation, revenue management, and productivity

expectations should be clear and collaborative. These conversations

usually take place during the on-site interview and may continue

with post interview telephone conversations.

Of fer StageWhen the process moves to the state of an offer to the physician,

the act of engagement takes on a more collaborative role. Clear,

direct communications regarding practice specifics and contract

negotiations establishes your working relationship. Now is the time

to discuss practice management and policies, marketing plans, and

productivity standards. Make sure the contract offered honestly

reflects your communications about this position so there are no

surprises to the physician.

This stage is also an excellent time to formalize the physician

mentor relationship. Assign a physician mentor to your candidate

before he or she signs the contract. Begin this “connection” process

early and the physician will know his or her importance to your

organization. The power of relationships in workplace satisfaction and

successful integration to a new work setting cannot be overstated.

Also involve the candidate at this time in the early beginnings

of the next phase of the onboarding process, the Integration

Phase. Begin talks about the steps the physician can or must

take to ensure success in the new position. At this time, briefly

begin discussing marketing plans, timely applications for licenses

and insurance panels, physician receptions, and the physician

orientation program.

Integration StageOnce your candidate signs the contract with an anticipated

start date, the onboarding plan enters the integration stage.

Assimilating new physicians into the community at large and

the medical community takes careful planning.

If your candidate is relocating, pay careful

attention to real estate and relocation issues

to ensure a smooth transition. Be prepared

to offer support and information to

the physician’s spouse and family

regarding job opportunities and

schools. Consider enlisting

another physician’s family

to act as ambassadors.

Having someone to

follow up on these

details may make the

difference between a

happy doctor and an

unhappy one.

As the start date

approaches, be sure

to have your orientation

program in place. Include

introductions to physicians on the

medical staff, administration, and

service line directors. Schedule ongoing

physician mentor meetings and check in with

your new physician at regular intervals. Ensure that

any promises made have been kept and plans discussed have been

implemented. Seek the new physician’s input regarding process

and the progress of integration. Encourage open dialogue at any

time and meet with your new physician at 30, 60, and 90 days and

again at 180 days. Listen to him or her and take the opportunity

to improve your best practices based on the feedback you receive.

And after a year, even if done informally, celebrate your mutual

first anniversary!

If you would like more information about onboarding new

physicians, please contact us.

Onboarding New Physician Hires – Is Your Plan in Place?

Joan Pearson, President, Catalina Medical Recruiters, Inc.


Features

Healthcare costs have doubled over the past three decades,

creating financial pressures on patients, families,

employers, and government budgets. This has led to an

atmosphere of uncertainty, with fear of becoming ill raising the

daunting specter of expensive medical care and limiting patient

willingness to seek needed treatments. As a result, access to

care is diminished with providers’ ability to forge successful

patient relationships significantly affected. But quality care does

not have to mean expensive care. By engaging patients and

their families in an all-encompassing quality care strategy, the

healthcare experience becomes more participatory, resulting in

improved health promotion and disease prevention and a better

quality of life. Patient centeredness at all levels of healthcare

helps foster care that is respectful of and responsive to individual

patient needs and values while ensuring that clinical decisions

expand individual care, advance the health of populations and

communities, and lower costs through quality improvement.

Putting Patients First

Healthcare is personal, and the way we experience care

is different for each person. However, the U.S. healthcare

system is enormously complex. All too often individual patient

circumstances are overwhelmed by bureaucratic red tape or

competing demands on an overtaxed healthcare system. Despite

this, focusing on the individual can lead to improved processes

and patient outcomes.1

Patients need to be understood in their social context in

order for providers to fully involve them in their own healthcare

decisions. Strong personal, professional, and organizational

relationships should be fostered throughout Arizona communities

to create a healthcare framework that is meaningful and valuable

to the individual patient. To help bridge the gap between large,

systemic changes and the need for patient-centered care, it is vital

to recognize diversity and remove the socioeconomic, educational,

and cultural barriers that may prevent access to healthcare.

Health Services Advisory Group (HSAG) is the

Medicare-designated Quality Innovation Network-Quality

Improvement Organization (QIN-QIO) for Arizona,

California, Florida, Ohio, and the U.S. Virgin Islands. As

the largest QIN-QIO in the United States and its territories

dedicated to improving healthcare quality at the community

level, HSAG is in a unique position to lead this vital shift in

the healthcare paradigm by bringing together providers and

community stakeholders through learning and action networks

that provide tools and guidance on involving patients in

their own healthcare decision-making processes. In turn, this

shift in patient involvement can foster national healthcare

quality improvement goals, because HSAG conducts quality

improvement activities in a way that puts patients first and

helps providers to do the same.

Since 1979, HSAG has developed lasting relationships

and partnerships with stakeholders and providers in Arizona

Achieving Cost Effective Patient-Centered Healthcare for Arizonans

Mary Ellen Dalton, PhD, MBA, RN • Howard Pitluk, MD, MPH, FACS


Features

using innovative approaches that engage communities beyond

traditional healthcare settings to bring specific tools and

resources to those most in need. These quality improvement

interventions not only reach out to beneficiaries but also

include physician offices, hospitals, nursing homes, home

health agencies, and other healthcare settings. Because

Arizona has a strong, diverse healthcare system made up

of government agencies, private and public organizations,

community stakeholders, patient advocates, and providers,

HSAG collaborates with all of our partners to ensure services

are delivered in an effective and equitable way that avoids

duplication and maximizes efficiencies.

To ensure patient-centered care, HSAG and the Medicare

QIO Program also promote responsiveness to beneficiary and

family needs. This is particularly important as the culture of U.S.

medicine continues to shift toward more accountability and

knowledge sharing where patients benefit from increased public

reporting and transparency. Furthermore, patient participation

will continue to drive the availability of preventive services

offered by healthcare providers. These efforts can help improve

outcomes and lower costs by creating a more personal and less

bureaucratic Medicare that is transforming from a passive payer

of services to an active purchaser of healthcare. By providing

opportunities for listening to and addressing beneficiary and

family concerns, resources for beneficiaries in health-related

decision making, and feedback from information gathered from

individual experiences, HSAG and its partners are leading the

way to patient-centered care that involves patients and families

in the healthcare decision-making process.

This focus on patient centeredness can lead to lower medical

costs and a reduction in the need for some healthcare services

as patients assume a more proactive role in managing and

promoting their own health.2 Fostering collaboration at all

levels of care promotes health through individual care decisions,

health system learning, and community-based interventions.

Through our dedicated involvement with Arizona’s healthcare

community, HSAG’s mission to improve quality healthcare for

all of our population can help ensure that patients, providers,

partners, and stakeholders will be recognized and empowered

for years to come.

Mary Ellen Dalton, PhD, MBA, RN, is Chief Executive Officer; and Howard Pitluk, MD, MPH, FACS, is Vice President,

Medical Affairs & Chief Medical Officer.

This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona,

under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human

Services. The contents presented do not necessarily reflect CMS policy. Publication No. AZ-11SOW-XC-01162015-01

REFERENCES

Weiner, SJ, Schwartz A, Sharma G, et al. Patient-centered decision making and healthcare outcomes: An observational study. Annals of Internal Medicine. 2013; 158(8): 573–79.

Bertakis, KD, Azari, R. Patient-centered care is associated with decreased healthcare utilization. The Journal of the American Board of Family Medicine. 2011; 24(3) 229–39.


Recruit a new member,get a $100 AOMA credit!

Do you know someone who isn’t a member of the

Arizona Osteopathic Medical Association . . .

and should be? Recruit a New Member and both the New

Member and you receive a $100 Credit towards

membership dues or Continuing Medical

Education fees!As a member, you understand the value of AOMA’s membership.

Share that knowledge firsthand with your colleagues in the

medical field. A growing and healthy AOMA means greater

recognition for the profession, more resources to support

member programs, more representation with healthcare leaders,

and a stronger voice when advocating issues with state and

national legislative members.

Recruiting new AOMA members is simple: • Review your network of colleagues. You may be surprised who

is not a member.

• Check their membership status using the online member

directory or by calling the AOMA office at (602) 266-6699.

• Ask them to join! Express how membership has benefited you.

For all the details on how to recruit a new member* and receive

your credit, visit the AOMA website at www.az-osteo.org under

the Members tab or contact Sharon Daggett, Member Services

Manager, at [email protected]

*New member must be an active, dues paying member. Does not apply to

recruitment of “out-of-state” or “retired” members.

Update Your Member Profile and Win!

You could win a $100 VISA gift

card. Please take the time to visit

the AOMA website and login to

update your professional profile

information for the online AOMA

Directory. Deadline

to be entered into

the gift card drawing is March 31,

2015.

Check out the Get Involved

section of the website, nominate

a peer for an AOMA Award,

and register for the 93rd Annual

Convention! See what’s new on

your AOMA website

Come back often for future

enhancements and features.


Features

Many doctors have purchased disability insurance policies to

protect their income in the event they are not able to work.

Although purchasing adequate insurance is a critical first

step in protecting you and your family from unforeseen disability,

collecting benefits under the policy can be another matter.

The Reality of Disability Insurance and Physician Claims

Disability insurance companies are under increasing financial

pressure on several fronts. Claim numbers and costs have increased

as the American population ages.1

At the same time, insurance company investment yields have

been uncertain as interest rates remain at record lows.2 Many

disability insurance companies have stopped writing individual

disability insurance policies altogether.3 Others have tightly

limited the benefits permitted under the policies. For example,

many insurance policies now require objective medical evidence of

disability, impose restrictions on the duration of certain types of

claims, and limit benefit amounts.

For insurance policies that have already been issued, though,

the only way insurance companies can cut costs is through more

aggressive strategies designed to reduce their claim liability by

denying or terminating benefits. Claims made by physicians present

particularly attractive targets for disability insurance companies for

a number of reasons.

First, because of their incomes, physicians usually have much

higher benefit amounts and more liberal policy provisions than

the general population. Therefore, the insurance companies can

often save more money by terminating one physician’s claim than

they can by terminating several other claims. Insurance companies

also know that even if they must spends tens, or even hundreds,

of thousands of dollars to justify a decision to terminate a claim,

they can save money in the long run on a high dollar claim.4 As

a result, insurance companies are often willing to invest in costly

and invasive tactics like video surveillance, independent medical

examinations, functional capacity evaluations, and medical peer

reviews to determine whether there is a basis to deny benefits.

Insurance companies also understand the psychological toll that

filing a disability claim can take on doctors. Physicians have spent

many years training for their profession, and often try to work as

long as possible before filing a claim. This frequently results in a

physician unknowingly prejudicing

his or her ability to recover under a

disability insurance policy when it

becomes impossible to keep working.5

For example, a physician may reduce

the number of hours he is working,

stop performing certain types of

procedures altogether, or shift to

working in a more administrative

capacity, which can change the criteria

the physician must meet in order to

establish his disability.

Additionally, insurance companies often rely on the social

stigma attached to the concept of disability, as well as their

policyholders’ unfamiliarity with the law. Many doctors equate

disability with a state of total helplessness, and may be reluctant

to file a claim for disability benefits because they do not think of

themselves as disabled, and do not want others to perceive them

as helpless. In fact, under most policies sold to physicians, the

insurance company is contractually obligated to pay benefits as long

as the doctor is unable to perform the “substantial and material

duties” of his or her specialty. Therefore, doctors can often qualify as

being totally disabled within the meaning of a disability insurance

policy, yet still live active lives, and in some cases even continue

working in a new field.

Obstacles in the Disability Insurance Process

The disability insurance process should be simple. Ideally, you

would simply fill out a straightforward claim form, outlining the

medical condition causing your disability, submit a statement from

your doctor verifying the severity of your disability, and receive the

income protection for which you have spent years paying premiums.

In reality, the process is weighted against claimants from the

beginning and can be daunting. The insurance companies expect

that the convoluted nature of the process will cause some attrition

as doctors choose not to pursue valid disability claims, rather than

attempt to navigate the claims process. Many other doctors will

make mistakes during the process that will allow the company to

The Importance of Advocacy in the Disability Claim Process

Patrick T. Stanley, Esq

Advocacy continued page 26


Features

justify denying or limiting the benefits available under the policy.

The following are some of the potential obstacles you may face in

filing a claim:

• Complicated Policy Language. Disability insurance policies

are complicated and can vary greatly from one company

to another, and even within the same company, depending

on when the policy is issued. Most doctors, and even many

lawyers who are unfamiliar with disability insurance policies,

may not fully understand how the provisions should be

read together or how the policies will be applied. If you do

not know your rights and obligations under your disability

insurance policy, you can unknowingly waive your ability to

collect some of the benefits to which you might otherwise be

entitled.

For example, many disability insurance policies are

marketed to doctors as being “own occ” policies, meaning

that they pay a total disability benefit as long as the doctor is

unable to work in his own occupation. However, some policies

provide that the doctor is only totally disabled if he is unable

to work in his own occupation and not working in another

occupation. If a doctor stops practicing clinical medicine, but

resumes working in another field, no matter how unrelated, he

could lose his total disability benefit.

• Confusing and Misleading Claim Forms. The forms the

insurance company requires in connection with a claim

are often convoluted and contain trick questions that the

insurance company can use in a way you never intended.

For example, a claim form may ask you to list all of your

job duties and apportion the percentage of your day typically

spent doing each of those duties. Since no day is typical in

modern medical practice, this is often impossible. However,

the insurance company will take your answer and use it to

determine whether you can perform some of the listed job

duties on at least a part time basis. If it can, the insurance

company may only pay residual, or partial, disability benefits.

• Undue Delays. Most states, including Arizona, require that

claim decisions be made in a timely manner, usually within

thirty days of receiving sufficient information to make a

decision on the claim. In many cases, the insurance company

will draw this process out for several months by requesting

information that has little, if any, relevance to the claim.

For example, after you submit the initial claim forms, the

insurance company will often request your tax returns, CPT

codes, profit and loss statements, and other financial data on

a piecemeal basis. You may be understandably reluctant to

provide this information, since it has no bearing on whether

you are able to continue practicing medicine within your

specialty. However, even if you do provide it to the insurance

company, the company will then delay its decision until it has

had an opportunity to review the new information.

• Field Interviews. In most cases, an insurance company will

send a field interviewer, usually a private investigator, to your

home to speak with you about your claim. Ostensibly, the

insurance company will tell you the private investigator just

wants to better understand your claim. However, these visits,

which are often unannounced, are also used as reconnaissance

for future surveillance, to look for discrepancies with the

answers on your claim forms and to try to ferret out additional

information that can be used against you.

• Surveillance. If you file a disability insurance claim you

will almost certainly be under surveillance. There is nothing

inherently wrong with the insurance company conducting

surveillance. However, the surveillance footage is often

misused or taken out of context to suggest that a doctor is

capable of doing more than he has reported to the insurance

company.6 Additionally, surveillance can cross the line

to the point where it becomes harassing, and sometimes

dangerous, as private investigators follow you to try to create a

justification to terminate your claim.

• Peer to Peer Calls. This tactic involves an insurance company’s

in-house medical consultant contacting your doctors directly

to discuss your condition, restrictions, and limitations. The

insurance company’s consultant will often try to pressure your

doctor into agreeing with an overly optimistic assessment

of your condition, and will send a “summary” of the call, in

which the consultant subtly, or in some cases not so subtly,

misrepresents the substance of the call. The insurance company

then uses the consultant’s report both to justify its claim

decision and to drive a wedge between you and your doctor.

The Role of the Advocate in the Disability Insurance Process

The above examples should not dissuade you from purchasing

disability insurance. To the contrary, disability insurance is a crucial

tool to help you protect yourself in the event of an unforeseen

disability. However, they do highlight some of the challenges you

Advocacy continued from page 25


Features

may face when you submit your claim.

The advocate’s role in the disability process is to help you

navigate through these obstacles and help re-balance the scales so

that claims are administered fairly, in accordance with the terms

of the insurance policy. After all, insurance claims personnel

each handle hundreds of claims every year, and have experienced

analysts, field investigators, medical consultants, and lawyers at

their disposal. Most doctors, on the other hand, typically have no

previous experience dealing with disability insurance and it can be

overwhelming to face a billion dollar industry by yourself.

Additionally, when you become disabled, your focus is often on

getting better, not filling out forms or meticulously documenting

your disability. Many times, particularly if you become disabled due

to a musculoskeletal problem or a traumatic injury, you may also

be distracted by constant pain. Therefore, the advocate will ease

your burden by serving as the point of contact between you and the

insurance company, respond to any requests for information, and

limit the interaction you must have with company.

Often, simply having an experienced attorney involved with

your claim will deter insurance companies from engaging in some

of the more egregious practices and eliminate their ability to engage

in others. A qualified and knowledgeable attorney will typically

restrict the insurance companies’ access to its clients’ physicians,

require that any field interviews take place in our office, review

requests from the insurance company for financial information to

determine whether it is necessary, and ensure that the insurance

company is provided with the information it needs to make a

decision in a timely and fair manner, among other things.

However, every case presents its own unique set of challenges,

and advocates may take different approaches depending on your

particular set of circumstances. The best thing you can do if you

are facing a potentially career-ending disability is to speak with an

advocate early in the process, before you file a claim, to maximize

your chances of receiving the benefits you will need.

* Patrick T. Stanley, Esq. is a shareholder practicing in the Healthcare Law and Disability Insurance Practice Sections

at Comitz | Beethe. Mr. Stanley has extensive experience in disability insurance coverage and bad faith litigation, primarily

representing medical and dental professionals. For more information about disability insurance issues, please visit our website

at www.disabilitycounsel.net.

ENDNOTES1 See, 2014 Long Term Disability Claims Review, Council for Disability Awareness (accessed 12/30/14). http://www.disabilitycanhappen.org/research/CDA_LTD_Claims_Survey_2014.asp.

2 See, Search for Yield Has Insurers Running to Alternatives, Reuters, June 2, 2014 (accessed 12/30/14).http://www.reuters.com/article/2014/06/02/us-usa-insurance-yield-analysis-idUSKBN0ED21D20140602

3 For example, Unum Group, the parent company of Unum, Paul Revere Life Insurance and Provident Life and Accident, and the largest disability insurer in the United States, stopped writing individual policies in 2006.

4 See, Why is it So Hard to Collect on My Disability Insurance Policy?, Edward O. Comitz, AOMA Digest 2008.

5 See, The Injured Dentist: Is Your Work Ethic Hurting You and Your Patients?, Edward O. Comitz and Patrick T. Stanley, Inscriptions, 2013.

6 See, Attorneys’ Multi-Case Battle With Hartford Insurance Over Use of Surveillance Video and Intimidation Tactics To Deny Disability Claims Featured on Good Morning America, Mass Media Distributions, LLC. http://www.mmdnewswire.com/disability-insurance-law-group-7847.html


Features

Stepping Stones of Hope offers children,

teens, adults, and families much needed

help in making the first step of their grief

journey after the death loss of a loved one.

While still in medical school, Dr. Charles

Finch realized there was a critical lack of

grief resources to help children deal with

the death of someone in their life. In 1999,

Dr. Finch founded Camp Paz for Kids. This

weekend camp program, held twice a year,

reaches out to grieving children by providing

an environment where friendships are

created and profound healing takes place.

The success of Camp Paz for Kids

uncovered the need for grief support for

families within the community and Camp

Paz for Grown-Ups was established. The

organization evolved to become Stepping

Stones of Hope in 2003, a 501(c)(3) non-

profit, to help address the shortage of support-

based weekend programs and education, and

be among the leaders in grief support for the

community and across the state.

In March 2014, the Arizona Republic

reported research completed by the U.S.

Centers for Disease Control & Prevention

that revealed 57% of Arizona youths

have had at least one adverse childhood

experience. One of the adverse childhood

experiences included on the list is the

death of a parent. At the October 2014

camp weekend, 53% of the children had

experienced the death of a father so it’s easy

to see how important the mission is and the

impact this has on the community!

How do you reach out to a child who

has experienced the death of someone they

love? How does an adult family member

explore and cope with grief, yet still support

a child’s loss?

Stepping Stones of Hope provides an

opportunity to answer these questions during

the many programs offered. From First Steps

support group to One Day At Camp and

the number of weekend, overnight camps,

programs reach out to children, teens, and

adults in separate, synergistic settings that

have been designed to provide a nurturing,

expressive, creative, and fun environment for

healing to transpire.

Death is a difficult concept for children

to grasp. Children often feel responsible for

a death, regardless of the cause. Not knowing

how to communicate their pain and not

wanting to add to an adult’s grief burden,

kids often keep their emotions hidden. They

will not talk about their pain and choose to

grieve alone or not at all. Many feel guilty

for having fun and often suffer low self-

esteem. Stepping Stones of Hope’s programs

provide a safe place for children to express

themselves.

Through art, music, role-playing, and a

lot of talking and laughing, kids learn about

death and dying. Moreover, they learn how

to begin to cope. At the same time nearby,

and in a separate location, adult family

members are learning too, exploring their

grief through journaling, music, art, self-care,

relaxation, and dialogue. Additionally, they

discover ways to best support the children

who share their loss.

Briefly, Stepping Stones of Hope is

dedicated to providing comprehensive

support-based programs, continuum of

care, and education. The organization also

embraces the following primary objectives:

• Respect all children and families who

are grieving regardless of culture,

values, or socioeconomic status

• Provide comprehensive support,

understanding, and education about

grief and bereavement

• Uphold confidentiality and integrity in

all situations and circumstances

• Commit to a high level of internal and

external client service

• Work with other agencies to provide

the best level of care and continuum of

care for grieving children and families

• Serve the community, work with

stakeholders to provide services, and

educate the community about the

needs of grieving children and families

Currently Stepping Stones of Hope offers

three unique camps for kids and grown-ups.

These camps are held throughout the year;

Camp Paz, Camp Samantha, and One Day

at Camp. In addition, REACH is a camp

designed specifically for grieving teens

and Journeys, a weekend camp for adults.

First Steps, a monthly program held in the

Stepping Stones of Hope office, provides

individuals and families support wherever

they are in their grief journey.

For more information on making a

donation to Stepping Stones of Hope,

attending a camp, referring a friend

or family to camp or for volunteer

information, please visit the website. www.

SteppingStonesofHope.org.

Navigating a Grief Journey Begins with a First Step

Natalie Beck, Beck Marketing Services on behalf of Stepping Stones of Hope

EDITOR'S NOTE

Stepping Stones of Hope is one of the worthwhile causes supported by Arizona Osteopathic Charities.


AOMA News

Advocacy An important function of the AOMA is advocating on behalf

of the osteopathic medical profession. AOMA provides various

opportunities to get involved in political advocacy. The AOMA

strives to be the first and best option for policymakers seeking

honest, trustworthy, dependable, and objective information, with

the goal of making sure that whether a policymaker makes a good

or a bad decision, it is always an informed decision.

Legislative Affairs Committee

Reviews pending legislation which may impact the profession

and makes recommendations whether to support or oppose

proposed legislation. The Committee implements effective

strategies to educate and engage legislators and AOMA members

to ensure advocacy efforts are successful.

Political Action Committee (PAC)

Contributions made through the PAC allow AOMA to endorse

and support candidates for state public office who share our

concern for the future of high quality, cost effective healthcare. All

AOMA members are eligible to make a voluntary contribution to

the PAC.

Student Advocacy Program

Working closely with A.T. Still University and Midwestern

University faculty and student leaders, the AOMA provides

opportunities for students to get involved with the Legislative

Affairs Committee and help protect their future osteopathic

profession.

Advocacy Training

The AOMA offers advocacy support and assistance for speaking

with legislators, understanding the legislative process, and tracking

legislation. The AOMA is available to provide training to help

members understand the legislative process and become effective

advocates for the profession.

2015 D.O. Day at the LegislatureWho: D.O.s and osteopathic medical students

What: Wear your white coat and meet with legislators,

accompanied by an AOMA member D.O. Additionally, leadership

from the Governor’s office and the Senate and House Health

committees will come and speak to the group.

Where: Arizona State Legislature, 1700 W. Washington St.,

Phoenix, AZ 85007

When: Tuesday, March 10 from 7:30 a.m. – 12:00 noon.

Why: To discuss issues impacting osteopathic medicine.

How: Registration is available on the AOMA website at www.az-

osteo.org/DODayRSVP.

One of the best ways to get the most out of your membership with the AOMA is by getting involved in leadership opportunities and

participating in one of many membership activities throughout the year.

Get Involved

Get Involved continued page 30


AOMA News

There will be an orientation offered on Monday, March 2, 2015 at

6 p.m. via teleconference and at 7:30 a.m. at the Capitol on D.O. Day.

Participants will receive talking points and issue briefs one week prior.

GovernancePhysicians and students can get involved in the AOMA

governance through participation and attendance at the House of

Delegates, Board of Trustees, and District meetings.

• AOMA House of Delegates

o the legislative and governing body of the AOMA

o represents the membership in association affairs

o delegates are elected by the Districts

o AOMA Bylaws allow for one delegate and one alternate

to be elected to the AOMA House of Delegates from each

school with voice and vote

o meets twice a year – at the Annual Convention and the Fall

Seminar

• AOMA Board of Trustees

o transacts the business of the AOMA, led by the Executive

Committee

o one seat per school on the Board of Trustees

o trustees are elected by Districts

o new Trustees begin their terms in June of each year

o meets four times per year

• AOMA Districts

o seven regional districts, organized by zip code

o meets annually at the beginning of the year

o elects the representatives to the House of Delegates and

Board of Trustees

o discuss issues pertinent to the osteopathic medical

profession and AOMA

CommitteesThrough committee involvement, many future AOMA executive

officers and trustees emerge to become leaders in the osteopathic

medical profession in Arizona and nationally.

Participating on a committee is a minimal time commitment.

Most of the committees meet four times a year and meetings are

scheduled outside of regular work hours, usually lasting no more

than an hour. Teleconferencing is available for all of the meetings.

Legislative Affairs is responsible for developing, analyzing, and

influencing healthcare legislation and taking the lead on advocacy

efforts to protect and promote osteopathic medicine on behalf of

physicians and students.

Membership and Credentials works to further the growth

of AOMA membership, retain current members, and develop

services and activities which will serve to enhance the professional

growth of osteopathic physicians and students. The Committee

also explores new areas of professional development and stays in

close contact with Arizona students by disseminating information

concerning AOMA.

New Physicians Committee educates new physicians on

practice management, trends and changes in healthcare delivery,

provides networking/collegiality, and sharing of ideas to

introduce new physicians to the association and identify future

leaders.

Payor Relations Committee advocates for equality and fairness

with third-party payers on issues regarding physician guidelines,

quality initiatives, plan regulations and patient safety, and educates

members on third-party reimbursement.

Professional Education Committee determines the educational

offerings of Continuing Medical Education (CME) for the Annual

Convention, Fall Seminar and other programs, based on the needs

of members and attendees, using assessment tools to identify their

areas of interest.

Public Awareness Committee develops strategies to enhance

the image and presence of the osteopathic medical profession. The

Committee works to promote osteopathic medicine through media

relations, networking, and community engagement.

Osteopathic Charities & Support for Residents & Students

Arizona Osteopathic Charities is a 501(c) 3 non-profit

charitable organization. Its mission is to educate and promote safe

and healthy living for children, students, and families. The Charities

provides financial support for three worthwhile causes: Stepping

Stones of Hope, Team of Physicians for Students (TOPS), and

DOCARE International.

In addition, the Charities underwrites an annual scholarship

essay competition and clinical case and poster forum, offering

monetary prizes to the winners.

• Scholarship Essay Competition – two scholarships are

awarded each year to osteopathic medical students. Scholarships

are awarded to one student at both the Arizona College of

Osteopathic Medicine (AZCOM) in Glendale and the School

of Osteopathic Medicine in Arizona (SOMA) in Mesa. To be

considered, students are required to write an essay. The Arizona

Osteopathic Charities Board of Directors judges the entries and

selects the winners. |

• Clinical Case and Poster Forum – Residents and students

are invited to submit entries for the Case Forum (top three entries

present their case during the Convention) or abstracts for the

poster competition (all poster abstracts are displayed and presented

during the Convention). The competition entries are judged by a

group of osteopathic physicians and other educators. The winners of

the case forum and poster forum receive a $500 award. Details are

available at www.az-osteo.org/PosterForum.

For more information or to take part in any of these

opportunities, please contact Sharon Daggett at sharon@az-osteo.

org or via phone: (602) 266-6699.

Get Involved continued from page 29


AOMA News

More than 175 osteopathic physicians, students, and other practitioners gathered in Tucson in November for the AOMA 34th

Annual Fall Seminar.

The two-day event at the Hilton El Conquistador Resort offered 12.5 hours of AOA Category 1-A CME credits including specialty

credits in Family Medicine/OMT, Cardiology, Gastroenterology, Infectious Diseases, Internal Medicine, Interventional Cardiology,

Psychiatry, Neuromusculoskeletal Medicine, Otolaryngology & Facial Plastic Surgery, Pediatrics, and Sleep Medicine.

The AOMA Professional Education Committee, chaired by Lori Kemper, D.O., FACOFP, recognizes all the speakers who

contributed to the success and prestige of the Seminar with their expertise and experience in the lectures. Thank you to Amy Foxx-

Orenstein, D.O., FACG, FACP; Bryan Friedman, D.O.; Anthony Galeo, M.D., MS, FACC, FACCP; Joseph Hayes, D.O., FAAP;

Karen Nichols, D.O., MA, MACOI, CS; Robert Orenstein, D.O., FACP, FIDSA; Kenneth Pettit, D.O.; Steven Pitt, D.O.; Anthony

Pozun, D.O.; Scott Steingard, D.O.; Senator Kelli Ward, D.O., MPH; Anthony Will, D.O.; and Karen Wright, RN, BSN.

AOMA 34th Annual Fall Seminar

1 Tom McWilliams, D.O., and Stanley Brysacz, D.O. enjoy catching up in Tucson.

2 Chris Berry, Christine Morgan, Ed.D., and Angela DeRosa, D.O. attend the cocktail reception at the AOMA Fall Seminar.

3 Robert Orenstein, D.O. and Otto Shill, ATSU SOMA OMS II connect at the AOMA Fall Seminar.

1 2

3


AOMA News

4 ATSU SOMA student doctors Daniel Ebbs, Julian Hirschbaum, and Seth Loofbourrow attend their first AOMA Fall Seminar.

5 Jennifer Miller, D.O. and Ed Miller, D.O. traveled from St. Thomas, U. S. Virgin Islands to attend the AOMA Fall Seminar.

6 Timm McCarty, D.O. and Samuel Feinstein, D.O. look forward to attending the Fall Seminar each year.

7 Scott Steingard, D.O., Karen Nichols, D.O., and Senator Kelli Ward, D.O., participated in a panel discussion on Expanding the Influence of Medicine, moderated by Lori Kemper, D.O. (far right).

4

5

6

7


Osteopathic Community News

For decades the Tucson Osteopathic Medical Foundation (TOMF) and the Arizona Osteopathic Medical Association (AOMA) have

been your best resources for quality AOA Category 1A credit in Arizona. Although friendly competitors, both TOMF and AOMA

work together to be your two local sources for family medicine and internal medicine specialty credits. After all, YOU are why we are

in business.

Each year, TOMF and AOMA offer more than 80 hours of AOA Category 1A CME credit presented at four separate conferences. In

addition, TOMF and AOMA sponsor multiple individual lectures throughout the year. You can satisfy most of your Arizona state licensure

and AOA membership requirements right here in the Grand Canyon State with little-to-no travel expenses, minimal down time from your

practice, all while supporting our local economy. Why go anywhere else? As you look for programs to fulfill your CME requirements, keep

these upcoming homegrown CME opportunities in mind:

Need CME? Keep it LocalBy Nicole Struck, Program and Meetings Manager, Tucson Osteopathic Medical Foundation and

Janet Weigel, Director of Education, Arizona Osteopathic Medical Association

■ Tucson Osteopathic Medical Foundation

24th Annual Southwestern Conference on Medicine

April 23 - 26, 2015

JW Marriott Star Pass Resort and Spa

Tucson, Arizona

■ Tucson Osteopathic Medical Foundation

4th Annual Southwestern Conference on Medicine

Primary Care Update

October 24, 2015

Conference Center at TOMF

Tucson, Arizona

■ Arizona Osteopathic Medical Association

93rd Annual Convention

May 6 - 10, 2015

Arizona Grand Resort

Phoenix, Arizona

■ Arizona Osteopathic Medical Association

35th Annual Fall Seminar

November 7 - 8, 2015

Tucson El Conquistador Resort & Spa

Tucson, Arizona

Things to Remember

As you rev up for the final year of the AOA Osteopathic

Continuous Certification 2013-2015 Cycle here are a few things to

remember.

In order to maintain a license to practice osteopathic medicine

in the state of Arizona, osteopathic physicians are required to

obtain 20 hours of CME per year. Of that, at least 12 hours must

be 1A credit provided by a Category 1 CME sponsor. No more

than 8 hours may be provided by an accredited AMA or ACCME

provider and certified as AMA PRA Category 1 credit.

Category 1A Credit is granted for live programs provided by

Category 1 CME sponsors. Category 1B is granted for programs

of a more casual nature (online, teaching, writing) provided by

Category 1 CME sponsors. Category 2A is granted for live

programs sponsored by non-AOA accredited providers. Category Need CME? continued page 38

2B is granted for programs of a more casual nature (online,

teaching, writing) sponsored by non-AOA accredited providers.

AOA recertifying physicians must fulfill 120 hours of CME

credit during each three year CME cycle. 150 hours are required for

the American Osteopathic Board of Family Practice, the American

Osteopathic Board of Neuromusculoskeletal Medicine, and the



American Osteopathic Board of Anesthesiology.

The 120/150 hours may include a variety of credit levels (1A,

1B, 2A, 2B) but must include at least 30 1A credits and 50 specialty

credits in primary specialties. Previous policy dictated that no

more than 25 of the 50 required specialty credits per three year

cycle may come from any one of the four categories including

osteopathic foundation seminars, state society seminars, college

of medicine seminars or acute care hospital programs. This

specialty credit cap has been removed for 2015. Further discussion

regarding this policy will take place throughout 2015 with decisions

on the future of the cap expected in July.

For physicians holding certifications of added qualification

(CAQs), a minimum of 13 credits must be earned at the level

of the CAQ. At least 15 credits must be earned in the primary

certification.

Practice Performance Assessment and Improvement is the

only new component in the osteopathic continuous certification

process. Physicians must engage in continuous improvement

through comparison of personal practice performance measured

against national standards in their medical specialty. Physicians

must submit patient surveys and/or quality improvement data to

the board based on their current practice. The data is reviewed

against national standards for patient care, and the physician

receives a report with recommendations for improvement. At that

time, physicians should make a plan for ongoing improvement, to

be submitted during the next recertification period. It is notable

that any specialty board may insert another form of review in place

of this component. Physicians who do not see patients or advise

residents during the cycle may request an affidavit for the removal

of this component from the continuous certification process.

Specialty certifying board contact information is available at

www.osteopathic.org. Please contact them for complete details

about eligibility for certification, requirements for maintaining

certification, and recertification.

Questions regarding certification status and general

OCC information may be directed to the AOA Division of

Certification by emailing [email protected] or (800)

621-1773, ext. 8266. For verification of certification please visit

www.DOProfiles.org.

If you have additional questions regarding available CME

programs in Arizona, please contact TOMF at www.tomf.org or

AOMA at www.az-osteo.org.

Need CME? continued from page 37



Jane, not her real name, has

been a patient of mine for

years. She is in her late

40s and is a cancer survivor. I

saw her recently in my office

for a routine matter and the

conversation turned to the

ongoing surveillance of her

treated breast cancer. “I read

something the other day” she

said starting a long conversation

about screening and treatment.

“I read that ductal carcinoma

in situ (DCIS) wasn’t even

considered a cancer until a few years ago.” Her background is

that she is a very healthy woman who did her due diligence

and got her yearly mammograms starting around age 40.

A few years back, a screening mammogram found, in her

words, “a calcium cluster” and she then had additional views

and ultrasound that identified a tiny nodule. She had biopsy

that showed DCIS and her surgeon advised mastectomy.

Subsequent to that surgery, she had additional surgeries to

help with reconstruction. Since her natural breasts were on

the large side, they were unable to reconstruct the breast

adequately. This led to a reduction in the healthy breast to

compensate and another to “even things out.”

It was clear the regret that she felt in starting down the

road of screening and treatment because she had a somewhat

bad outcome and that she felt that the DCIS might have been

something that she lived with her whole life and not caused her

death or harm.

Now, we can never know if her cancer would have caused her

harm or if the screening and identification of that cancer saved

her life but this story highlights what I feel is a coming change

in attitude toward medical care. Many medical societies and

the U.S. Preventive Services Task Force are changing screening

suggestions to reduce “over screening” and then the subsequent

overtreatment. Popular media has picked up on this trend and

is advising patients to have more frank discussions with their

healthcare providers about not only the benefits but also the

risks associated with screening. A recent article in Men’s Journal

advised patients on “How to Say No to Your Doctor” and listed

the pros and cons of prostate cancer screening, cholesterol

treatment and more.

In the past, doctors have been motivated to do all we can

for patients because inaction seemed anathema when medical

boards, medical societies, drug companies, hospital committees,

and others seemed to push that more is better and that failing to

screen and diagnose was tantamount to malpractice.

In the future, I predict we will see more and more patients

having the same discussion with their provider about their

regrets of “going down the rabbit hole” of screening and

treatment. Men may, for instance, read that prostate cancer

screening is not recommended and that watchful waiting is

sometimes as good as medical or surgical treatment for prostate

cancer. If they are suffering from impotence and incontinence

they may feel that they have been harmed by the process and

either seek recompense or just avoid the medical community

due to mistrust.

Our duty as physicians is to give patients good advice

about both the benefits and the risks of all the screenings

and treatments we recommend. That is the basis of informed

consent. Reducing our biases and avoiding anecdotes

and focusing on the science is key in making good

recommendations. Our patients are reading in non-medical

media about how they should be suspicious of doctors that sell

or push recommendations. We should have good and thorough

explanations for them or else they may seek care elsewhere.

Arizona Society of ACOFP

Aaron B. Boor, D.O.

2014-2015 President

Arizona Society of the

American College of

Osteopathic Family Physicians



For Julian Hirschbaum, OMS II, A.T.

Still University-School of Osteopathic

Medicine in Arizona (ATSU-SOMA),

having his second-year medical school

community campus experience at El Rio

Community Health Center (CHC) in

Tucson, Ariz., was a natural transition

from his volunteer experiences in serving

the medically underserved. Hirschbaum

currently serves as the health disparities

officer for the Student Osteopathic Medical

Association. In addition, he also co-founded

Capacidad, a student organization whose

main goal is to train community health

workers in remote areas of the Peruvian

Amazon, empowering their communities to

train more community health workers.

Since 1970, El Rio CHC has been

providing accessible and affordable healthcare

primarily to underserved populations in

greater Tucson. Approximately 26 percent

of patients seen at El Rio have no health

insurance, and 76 percent are at or below the

federal poverty line.b

A call to serve the underserved as a

physician

Hirschbaum has always felt being a

physician would be a fulfilling profession.

He remembers his father telling him a

doctor is among one of the most honorable

professions. He passed away when

Hirschbaum was just age 5.

One of the first instances in which

Hirschbaum truly knew he would become

a physician was when he

was on the Caribbean

Coast of Nicaragua

and witnessed the gross

shortage of healthcare

providers. “There was no

nurse, midwife, or doctor

around anywhere closer

than three hours by

boat,” said Hirschbaum.

“I came to understand,

through community

service projects and

public health-related

classes, that there were

also many communities in the U.S. where

healthcare practitioners were desperately

needed.”

Osteopathic medicine appealed to

Hirschbaum for two reasons. “First, as a

group of physicians, osteopathic medicine

historically arose out of the need for doctors

in underserved areas, and second, I admired

the way in which the humanity of medicine

is incorporated via touch, into the practice

of osteopathy,” says Hirschbaum.

Choosing a medical school

“When I was volunteering on the

Arizona-Mexico border and working with

migrants and those who had recently been

deported, I attended a Binational Health

Conference where I met El Rio’s Pasqua

Yaqui clinical director and El Rio’s former

regional medical director of education

(RDME), Dr. Laura de la Torre. She

spoke to me about ATSU-SOMA and its

mission of training future primary care

providers to practice in areas lacking access

to healthcare. I am a strong proponent

of primary care and its power to mitigate

health disparities, and I believe that future

doctors need to be knowledgeable and

concerned about the social determinants

of healthcare. ATSU-SOMA has taught

me these things and is preparing me with

real-world experience. In addition, I chose

ATSU because of the experience we have

from the start of our second year. I feel

that my time in the clinic has taught me

more about patient care than any textbook

ever could.”

RDMEs at El Rio helping to train

Hirschbaum are Drs. Chris Dixon and

Roy Wagner. Dr. Dixon, who has been an

RDME for about three months and whose

Beyond the campus walls: ATSU-SOMA student at El Rio CHC finds a perfect fit with his personal mission



ATSU announces groundbreaking partnership with the National Association

of Community Health Centers

Craig M. Phelps, DO, ’84, president of A.T. Still University (ATSU), and Ron Yee, MD,

MBA, chief medical officer of the National Association of Community Health Centers

(NACHC), announced a groundbreaking, joint research partnership on Nov. 11, 2014. The

innovative partnership between ATSU and NACHC will help create and advance interprofessional

scholarly activity within Bureau of Primary Healthcare supported community health centers, and

it will help improve the

health status of patients

and communities across

the nation.

“ATSU is looking

forward to collaborating

with NACHC on this

important initiative

focused on improving

the health of our nation,”

said Dr. Phelps. “Research

projects inclusive of basic

scientists, clinicians from

multiple professions, and ATSU students will seek opportunities to provide timely outcomes for

expeditious application.”

In an effort to advance scholarly activity opportunities, ATSU and NACHC will focus on:

• developing, implementing, and assessing evidence-based medicine guidelines.

• diagnosing, preventing, and treating diabetes, obesity, skin cancer, metabolic syndrome,

traumatic brain injury/concussions, spine pain, and HIV/AIDS.

• evaluating oral health disease prevention and treatment programs.

• measuring and encouraging physical activity and its impact on health and wellness.

• designing, organizing, and evaluating population management teams and patient navigator

models.

“Focusing on scholarly activities that are academic, yet practical, helps deepen the relationship

and experience of students,” said Dr. Yee.

NACHC represents the nation’s safety-net of community health centers. Community

health centers receive base funding from the Public Health Service, Health Resources and

Services Administration, and the Bureau of Primary Healthcare to improve the health status of

underserved communities, provide access to health services, and offset some costs of caring for

the uninsured.

NACHC and ATSU seek to foster community health scholarship to strengthen this safety-

net, and ultimately improve the health status of these communities.

“NACHC’s partnership with ATSU over the years has yielded some of the most well-prepared

and dedicated healthcare professionals, especially in service to vulnerable populations and

communities,” said Tom Van Coverden, president and CEO of NACHC. “NACHC fully supports

this important work as it will benefit many of our medically underserved communities and further

advance quality patient care in community health centers.”

NACHC and the national safety-net of Community Health Centers also support ATSU in

many ways, including access to clinical rotations; introductions to potential funding partners;

residency development; data gathering; student scholarship opportunities; and national exposure

of ATSU’s schools, programs, faculty, and staff.

background is in family medicine says, “The

best part of being an RDME is working

with the students, teaching and learning

from them, and seeing their excitement to

learn and progress in their ability to care for

patients.”

He loves working for El Rio because

the people he works with are dedicated to

fulfilling El Rio’s mission, which involves

providing comprehensive quality healthcare

to improve the health and well-being of the

patients in the local community, which is also

the community where Dr. Dixon grew up.

Dr. Ray Wagner, who has been an

RDME at El Rio for five years and is a

pediatrician, echoes Dr. Dixon sentiments

about training ATSU-SOMA students.

“Teaching is an honor and integral to

the profession,” says Dr. Wagner. “The

best part of being an RDME is sharing

knowledge and teaching /learning daily. It

is an opportunity to teach and be a mentor

to students.” Dr. Wagner also added ATSU

fits in with his personal mission of being

a lifelong learner and continuing to serve

those in need.

Future plans

Hirschbaum plans to continue filling the

primary care gap and serve the underserved

when he graduates from medical school.

“I will continue volunteering with people

whose health needs are not met by the

healthcare system,” says Hirschbaum. “I

have been working with migrants from

Mexico and Central America for several

years and feel a very strong connection

to that unique population. I also plan to

continue work with Capacidad. In addition

to working abroad, I also want to provide

primary healthcare to those who are

underserved in the United States. I would

really like to work in a CHC and build

relationships with my patients over their

lifetime.”



Compassion, a day remembering those lost on Flight 5966.

Other events during Founder’s Day included the first-year

versus second-year Kirksville College of Osteopathic Medicine

women’s flag football game; a First in Whole Person Healthcare

exhibit dedication at the Museum of Osteopathic Medicine; and

the annual Still-A-Bration - a community

barbeque and bonfire. Festivities

concluded with the Founder’s Day 5K run

and half mile walk.

The Arizona campus honored Dr.

Still through a week of healthy activities

including tai chi, yoga, guest speakers and

a healthy breakfast for the entire campus.

Friday, Oct. 24 marked the culmination of

Founder’s Day with games and family activities, a barbeque and live

music on the campus’ front lawn.

ATSU celebrates Dr. Still during annual Founder’s Day festivities

ATSU hosts third annual interprofessional education competition

Students from A.T. Still University (ATSU)

and area universities came together on

November 3 and 8 in Missouri and Arizona

for the annual Interprofessional Education

Collaborative Case Competition (IPE-CCC).

The competition provides health

professions students with an interprofessional

teamwork experience to gain insight

into collaborative practice competencies.

Additionally, IPE-CCC reveals the

complexity of healthcare delivery and the

need for collaboration between healthcare

professionals in order to reach the best health

outcomes for clients and patients.

Students from ATSU, Arizona School of

Professional Psychology at Argosy University,

Arizona State University (ASU), Arizona

Summit Law School, Grand Canyon

University, and Truman State University,

worked collaboratively for six weeks building

an interprofessional team to care for a

hypothetical patient and their family. At

the end of the process, they presented their

findings and recommendations for enhanced

collaboration to a panel of judges representing

leaders from various disciplines within the

healthcare programs.

The William McKinney Award was

presented to first-place teams on both the

Arizona and Missouri Campus. The Dr.

William McKinney Award, made possible

by O.T. Wendel, PhD, senior vice president

for ATSU university strategic initiatives,

is a living tribute to Dr. McKinney, who is

considered the founding father of biomedical

ultrasound. Dr. McKinney inspired Dr.

Wendel to go on to pursue a graduate health

degree in pharmacology and served as a

mentor and motivator to him throughout his

education.

On the Missouri Campus, the first place

Dr. William McKinney Award was presented

to Jessica Stevens, communication disorders

student at Truman State University; Austin

Stephenson, athletic training student at

Truman State University; Anna Wang, health

sciences student at Truman State University;

Ashley Anderson, D1; and Molly Roberts,

nursing student at Truman State University.

On the Arizona Campus, the first place

award went to Vy Vy Vu, D1; David Bunzell,

nursing student at Grand Canyon University;

Ecila Barnett, social work student at ASU;

and Daniel Schweibert, law student at

Arizona Summit Law School.

Second and third place teams were also

recognized for their presentations.

On the Missouri Campus, second place

went to Alexis Hackett, health science

student at Truman State University; Michele

Draper, health science student at Truman

State University; Katelyn Thomason, nursing

student at Truman State University; and Josh

Coffey, D1. The third place team consisted

of Liz Turnure, nursing at Truman State

University; Emma Staecker, health science

student at Truman State University; Meghan

Crider, communication disorders student

at Truman State University; and Maryann

Forsell, D1.

On the Arizona Campus, second

place recognition went to Jessica Randall,

psychology student at Arizona School of

Professional Psychology, Argosy University;

Sara Ceglio, D2; Cassandra Woodland, PT,

’16; and Kathryn Weber, OMS I. Third place

recognition went to Mary Shouse, OT, ’17;

Nisharag, Shah, PT, ’17; Chase Taylor, D1; Ina

Blue, social work student at ASU; and Tiffani

Doan, OMS I.

A.T. Still University’s (ATSU) annual Founder’s Day festivities

kicked off to a great start this year on the Missouri campus

through a three-day celebration starting

Thursday, Oct. 16. The party continued to

Arizona where Wellness Week sparked a

week of activities for students and employees.

On the Missouri campus, alumni,

students, employees and friends of the

University, participated in events including

the George Blue Spruce Hero Healer

speaker series, Founder’s Day Osteopathy

Lecture and the ATSU Honorary Ceremony. On Friday, Oct. 17,

the Missouri campus and community members attended Day of



ATSU named to Victory Media’s 2015 Military Friendly® Schools list

A.T. Still University has been designated

a 2015 Military Friendly® School by

Victory Media, the leader in successfully

connecting the military and civilian

worlds.

Now in its sixth year, the Military

Friendly® Schools designation

and list by Victory Media

is the premier, trusted

resource for post-

military success.

Military Friendly®

provides service

members transparent,

data-driven ratings about

post-military education and career

opportunities.

The Military Friendly® Schools

designation is awarded to the top 15

percent of colleges, universities and trade

schools in the country that are doing the

most to embrace military students, and to

dedicate resources to ensure their success

in the classroom and after graduation.

The methodology used for making the

Military Friendly® Schools list has

changed the student veteran landscape

to one much more transparent, and has

played a significant role over the past six

years in capturing and advancing best

practices to support military students

across the country.

The survey captures over 50 leading

practices in supporting military students

and is available free of charge to the more

than 8,000 schools approved for Post-9/11

GI Bill funding. As in past years, the 2015

Military Friendly® Schools results were

independently tested by Ernst & Young

LLP based upon the weightings and

methodology developed by Victory Media

with input by its independent Academic

Advisory Board.

ATSU president’s staff meet with U.S. Acting Surgeon General.

Craig Phelps, DO, ’84, president of A.T. Still University (ATSU), G. Scott Drew,

DO, FAOCD, ’87, chair of ATSU’s Board of Trustees, and members of the

president’s staff, enjoyed an opportunity to meet United States Acting Surgeon

General Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, during a recent trip

to Washington, DC.

As Acting United States Surgeon General, RADM Lushniak oversees operation

of the U.S. Public Health Service Commissioned Corps, and is also responsible for

articulating the best available scientific information to the public regarding ways to

improve personal health and the health of the nation.

A goal of the Surgeon General’s office is to increase the number of Americans who

are healthy at every stage of life. Going hand in hand with that goal is the Surgeon

General’s Every Body Walk! Initiative.

Walking is currently the most commonly reported form of physical activity among

U.S. adults. The Every Body Walk! Initiative encourages Americans to take the initiative

to walk more often to improve overall health.

The Surgeon General’s National Prevention Strategy emphasizes priorities that are

most likely to reduce the burden of the leading causes of preventable death and major

illness. Initiatives include tobacco free living, healthy eating, active living, and mental

and emotional well-being.

Since its inception, ATSU has focused on whole person healthcare and community

health. The shared ideology between the University and the office of the Surgeon

General will help in creating a healthier nation.



Midwestern University Arizona College of Osteopathic Medicine

As a testament to Midwestern

University’s commitment to

community service, the University once

again earned a spot on the President’s

Higher Education Community Service

Honor Roll.

This year marks

the seventh

consecutive year

that Midwestern

has been named

to this national

honor roll of

colleges and universities committed to

bettering their communities through

service and service learning. The University

received the highest level of recognition:

Honor Roll with Distinction.

“One of the fundamental missions

of our University is to reach out to our

communities through service,” said

Kathleen H. Goeppinger, Ph.D., President

and CEO of Midwestern University. “I am

both grateful and proud of the dedication

shown by our students, our faculty, and

our staff to helping our neighbors. Their

compassion, caring, and enthusiasm are

values that we encourage and strive for on

both a professional and personal level.”

Out of 766 institutions considered

for the honor, only 121 received

the recognition of Honor Roll with

Distinction. The distinction is an

indication that Midwestern University

displays an outstanding institutional

commitment to service and has formed

compelling partnerships that produce

measurable results.

The award, which is the highest federal

recognition a college or university can

achieve for its commitment to service

and civic engagement, is presented by the

Corporation for National and Community

Service (CNCS) in collaboration with the

U.S. Department of Education.

IN THE NEWS…

Midwestern University President and CEO named Business Leader of the Year

Midwestern University President and Chief Executive Officer, Kathleen H.

Goeppinger, Ph.D., has been named Arizona Business Leader of the Year by

Arizona Business Leaders magazine.Dr. Goeppinger received the award at a special presentation held at the Montelucia

Resort in Scottsdale, AZ, on Thursday, October 30. The

Honorable Greg Stanton, Mayor of Phoenix, also spoke at the

event, which honored Arizona’s top business and community

leaders as judged by Arizona Business Leaders.

The Arizona Business Leader of the Year Award was

presented by Robert Milligan, Chief Financial Officer of the

Healthcare Trust of Arizona, Inc.

Dr. Goeppinger is the primary administrator for Arizona’s

largest health professions university and exercises direct

executive oversight for all educational and clinical operations

of the University and its healthcare facilities at campuses in

Glendale, Arizona and Downers Grove, Illinois. Under Dr. Goeppinger’s leadership,

Midwestern University has undertaken a determined effort to expand medical residency

programs within the State of Arizona to address critical shortages in family medicine,

particularly in the state’s rural areas. Dr. Goeppinger has championed the importance

of providing new physicians and affordable healthcare for Arizonans, and works closely

with State legislators and community groups to make sure this happens. Forty-four

percent of the over 6,500 graduates from all Midwestern University programs since

1995 have remained and established their practices in the state.

Kathleen H. Goeppinger, Ph.D.

Midwestern University Named to President’s Higher Education Community

Service Honor Roll with Distinction



AZCOM Students Offer

Exams, Healthcare Education

to Homeless

Students from the Arizona College of

Osteopathic Medicine are learning first-

hand about patient care and examinations

through participation in Midwestern

University’s Health Outreach through

Medicine and Education (H.O.M.E.),

a volunteer-based organization whose

mission is to improve the health of

homeless individuals in the Greater

Phoenix Area.

Established as an extracurricular club at

Midwestern University in 1999, H.O.M.E.

is an entirely student-organized project.

H.O.M.E. is composed of a dedicated team

of community healthcare professionals and

students from a variety of disciplines—

osteopathic medicine, pharmacy, dental,

physician assistant, podiatry, clinical

psychology, with optometry, veterinary, and

physical and occupational therapy coming

soon—who visit homeless shelters to offer

basic medical care and health education.

The H.O.M.E. project is always in

need of qualified physicians and healthcare

professionals to volunteer as preceptors.

For more information, contact Michelle

Mifflin, D.O., Assistant Clinical Professor,

at 623.537.6123 or by e-mail at mmifflin@

midwestern.edu. H.O.M.E. volunteer

professionals can qualify for CME category

2-b credit.

Companion Animal Clinic at the Animal Health Institute Opens at

Midwestern University

The Midwestern University

Companion Animal Clinic, a part

of the Animal Health Institute, opened

in December, providing quality primary

and specialty care for small animals.

The 111,800-square-foot teaching

clinic is designed to provide learning

opportunities for students as they serve

the local community’s pets and their

owners. Initial appointments will be

managed by clinic veterinary faculty, with

students beginning rotations during their

third year. Services will include primary

care, preventive medicine/wellness,

dental care, surgery, radiology, senior pet

care, and other specialties. The state-of-

the-art facility includes 14 exam rooms,

four surgical suites, and two specialty

suites, and is the largest clinic at any U.S.

veterinary school.

The Animal Health Institute is part

of the Midwestern University College of

Veterinary Medicine, the first veterinary

college in the state of Arizona, which

matriculated its inaugural class in

September.

AZCOM APPOINTMENTS, AWARDS & GRANTS

Fourth-year AZCOM student Kristen Young received the United

States Public Health Service 2014 Excellence in Public Health Award

for her medical and educational service to the homeless through

Midwestern University’s Health Outreach through Medicine and

Education (H.O.M.E.) program.



Recipients of Midwestern University’s Littlejohn Awards were

recognized by Midwestern University President and Chief Executive

Officer Kathleen H. Goeppinger, Ph.D., at the University’s annual

recognition dinner held in September at the Renaissance Hotel in

Glendale, Arizona.

This year’s honorees are Midwestern University alumnus Howard

B. Babcock, D.O., Chair of the Midwestern University Alumni

Senate; faculty member Shari M. Burns, CRNA, Ed.D., Program

Director, Nurse Anesthesia, College of Health Sciences-Glendale;

and staff member Judith A. DeLorme-Loftus, D.Min., M.S.W.,

LCSW, Manager of Student Counseling. A special Littlejohn Award

was presented to John R. Burdick, Ph.D., Vice President of Clinic

Operations and Dean of Basic Sciences.

The Littlejohn Awards take their name from the Littlejohn

brothers, physicians who in 1900 founded the American College

of Osteopathic Medicine & Surgery, the precursor to the Chicago

College of Osteopathic Medicine, which was the founding college of

Midwestern University. The awards, which have been presented annually

since 2000 by Dr. Goeppinger, are Midwestern University’s highest

honor. Littlejohn Award winners are selected from Midwestern faculty,

staff, and alumni for their outstanding service to the community, the

health professions, and the University.

Littlejohn Awards Bestowed to Four New Honorees

Midwestern University Gearing Up to Introduce High Schoolers to Healthcare Careers

High school students interested in pursuing healthcare careers

can look forward to a full slate of special programs offered by

Midwestern University in 2015.

Beginning on February 4 with the Arizona

Regional Brain Bee, Midwestern University

will then host its annual Health Sciences Career

Day on March 5. The capstone event, the

eight-day Health Careers Institute for High

School Students, takes place from July 9 – 18.

A live competition similar to a spelling

bee, the Arizona Regional Brain Bee

offers students the chance to compete for

scholarships and other prizes by answering

questions about the brain and central

nervous system. Participation is free, and

the winner will receive a $2,000 first prize

scholarship to any Midwestern program as

well as up to $900 in reimbursements for

expenses to attend the National Brain Bee in

Washington, D.C.

The Health Sciences Career Day is designed for high school

classes to visit University labs, tour the campus, and attend

interactive presentations by healthcare professionals. Classes will

have the opportunity to choose hands-on workshops highlighting

careers in osteopathic medicine, optometry, dental medicine,

pharmacy, physician assistant studies, occupational therapy,

biomedical sciences, perfusion, podiatric medicine, clinical

psychology, physical therapy, nurse anesthesia,

and veterinary medicine.

For students who want to learn about

health careers more in depth, Midwestern

University will offer its eight-day Health

Careers Institute for High School Students

in July. Each day from 9:00 am to 4:00

pm, Midwestern faculty and advanced

students will teach workshops in anatomy,

physiology, and introductory skills for

various health professions, with a special

focus on how to prepare for college and

what to expect from each profession. Guest

lectures for this exciting summer program

will include current medical topics such as

Emergency Medicine, Sports Medicine,

Drug Abuse, Healthcare Volunteer

Opportunities, and more. In addition, participants will attend

a medical field trip to Arrowhead Hospital and an interactive

Emergency Medical Services mock rescue scenario presented

by the Glendale Fire Department.

March 10, 2015

7:30 a.m. to 12:00 p.m.

D.O. Day at the Legislature

Arizona State Capitol

1700 West Washington

Phoenix, AZ 85007

May 6, 2015

AOMA Board of Trustees Meeting

7:00 p.m.


May 6 – 10, 2015

AOMA 93rd Annual Convention


8000 Arizona Grand Parkway

Phoenix, AZ 85044

May 7, 2015

AOMA House of Delegates

4:00 p.m.


June 20, 2015

AOMA Board of Trustees Meeting and Retreat

9:00 a.m.

A.T. Still University

Mesa, Arizona

July 15 – 19, 2015

AOA House of Delegates

Chicago, IL

November 6, 2015

AOMA Board of Trustees Meeting

7:00 p.m.

Tucson El Conquistador Resort

November 7, 2015

AOMA House of Delegates

3:00 p.m.


November 7 & 8, 2015

AOMA 35th Annual Fall Seminar


10000 N. Oracle Road

Tucson, AZ 85704

2015 Meeting Dates and Locations

Advertisers’ IndexMICA .............. Inside front cover

Hospice of the Valley ........Page 12

Arizona Health-e

Connections ..................Page 16

ProAssurance ....................Page 36

Amazon ............................Page 38

Catalina Medical

Recruiters ....... Inside back cover

Arizona Osteopathic

Charities .................. Back cover

Meeting Dates & Locations

Arizona Osteopathic Charities5150 N. 16th Street, Suite A-122

Phoenix, AZ 85016

aoma digest winter 2015

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