Mission: Our role as an organization in creating the world we envision.The mission of the New Hampshire Medical Society is to bring together physicians to advocate for the well-being of our patients, for our profession and for the betterment of the public health.

Vision: The world we hope to create through our work together. The New Hampshire Medical Society envisions a State in which personal and public health are high priorities, all people have access to quality health-care, and physicians experience deep satisfaction in the practice of medicine.

NH Medical Society7 North State StreetConcord, NH 03301(603) 224-1909(603) 226-2432 faxnhmed@nhms.org www.nhms.org

William Kassler, MD, MPH .... President Scott Colby..............................EVPCatrina Watson ........................Editor

Asthma Awareness ............................... 1 President’s Perspective ...................... 2EVP Corner ............................................ 4Legislative Update ................................ 5Video Conferencing .............................. 5Advocating for the State’s

Most Vulnerable Citizens ................... 6CME & Meetings ................................... 7Humanities ............................................ 8Hand Hygiene ........................................ 9MMIC Practice Tip ............................... 10CAPS .................................................... 15New Members ..................................... 15

Do you or a colleague need help?The New Hampshire Professionals’ Health Program (NH PHP) is here to help! The NH PHP is a confidential resource that assists with identification, intervention, refer-ral, and case management of NH physicians, physician assistants, dentists, and dental hygienists who may be at risk for or affected by substance use disorders, behavioral/mental health conditions, or other issues im-pacting their health and well-being. NH PHP provides recovery documentation, education, support, and advocacy – from evaluation through treatment and recovery. For a confidential consultation, please call Dr. Sally Garhart @ (603) 491-5036.

*Opinions expressed by authors may not always reflect official NH Medical Society positions. The Society reserves the right to edit contributed articles based on length and/or appropriateness of subject matter. Please send correspondence to “Newsletter Editor” 7 N. State St. Concord, NH 03301.

Physicians’ Bi-Monthly

NEW HAMPSHIRE MEDICAL SOCIETY NEWSLETTERNH Medical Society; For The Betterment of Public Health Since 1791

May/June 2011

Asthma Awareness

Nationally, an estimated 9.6% of chil-dren and 7.7% of adults had asthma in 2009. New Hampshire data from 2008 put prevalence rates at 8.4% for children under 18 years and 10.5% for adults. But beyond the prevalence num-bers, when we look at the integration of public health, health care and quality of care, there are other indicators equally important. Nearly 1 in 2 adults and 1 in 3 children with asthma in New Hamp-shire do not have “well controlled” asthma. Individuals with lower income and less education have more “poorly controlled” asthma, and people with “poorly controlled” asthma have more symptoms, asthma attacks, urgent care visits and emergency room visits.

What contributes to this poor control status? Though smoking rates among adults without asthma have decreased, they have not among adults with asthma - approximately 21% still smoke and more than 30% of children with asthma live in a household with someone who smokes. Almost 70% of adults with asthma are either overweight or obese. Nearly 1/3 of adults and over 2/3 of chil-dren do not meet recommended guide-lines for physical activity.

We also know that asthma management, education, and control of environmen-tal triggers in New Hampshire are not as strong as they could be. Several sen-tinel indicators tell us this: just 25% of

Asthma continued on page 3

2

The Physician’s Role in Advocacy

William, J Kassler, MD, MPH

“If I am not for myself, who will be for me? But if I am only for myself, what am I? And if not now, when?” - Hillel

I was proud to be part of the decision when our Executive Council unanimously voted to take a visible role in the state budget debate, oppos-ing cuts we believe would have serious adverse consequences for the health of our patients and communities. For me, that decision and our subsequent activities are entirely consistent with the mission of our Society. Not surpris-ingly, I heard from several members who do not agree. Some felt this is a political not a medical issue, and that the Medical Society should stay out of politics.

One of the first physicians to view public health through the lens of politics was the 19th Cen-tury pathologist Rudolf Virchow. Virchow is famous for his many contributions to the science of medicine; but he also challenged his fellow physicians to look beyond clinical manifesta-tions of disease to recognize and treat the pover-ty and other social factors that underlie so much human misery. In 1847 Rudolf Virchow was asked by the Berlin City Council to investigate an epidemic of typhus, which had broken out in what is now Poland, but was then essentially a colony. After the outbreak investigation, Vir-chow concluded that the cause of the epidemic

was “mismanagement of the region by the Ber-lin government.” His prescription included full democracy for the region, allowing Polish as the official language, the separation of church and state, shifting the burden of taxation from the poor to the rich, a program for road construction, and improvement of agriculture by establishing farming cooperatives. Naturally, the Council was critical of the report, calling it a political document rather than the scientific report. Vir-chow responded with the now famous statement “Medicine is a social science and politics is nothing but medicine writ large!”

Important policy issues get resolved in the po-litical theater. I respectfully disagree that these are not medical issues, or that we should not engage in the public discourse around broad issues of health. Most would not suggest we avoid political engagement when it comes to our own professional interests, be it in sup-port of tort reform, in opposition to burden-some regulations, or a host of other issues that bear on our practices. What is special about our Medical Society is that we are more than a guild; we have historically looked beyond our own interests to additionally advocate for those we serve.

Physicians are in a unique position to observe the socioeconomic causes of our patient’s health, and we are natural advocates because of our knowledge and perspective. We bring a legitimacy and professional authority to the public discourse that few others can. In fact, the AMA maintains we all have a primary professional and ethical responsibility to “ad-vocate for social, economic, educational and political changes” for the health of community members.

Be it access to care for the disabled or the un-insured, or public policies about smoking, bi-cycle helmets, seatbelts and cancer prevention; the link between public policy and improved health is clear. As professionals who have ded-

President’s Perspective

Advocacy continued on page 3

3

icated our careers to healing others; physicians can and should advocate for policies that im-prove health.

What can we do? Within our practices there are many opportunities to participate in qual-ity improvement and patient safety initiatives. Within our communities, raising awareness about important public health issues can mean writing letters to the paper, contacting represen-tatives, participating in a town forum, or work-ing with others to solve a local health problem. Specialists might want to consider which com-munity factors contribute to poor outcomes in their patients: oncologists may look to cancer prevention, surgeons and emergency physi-cians to injury prevention, pulmonologists to air quality, and pediatricians to immunization or physical activity.

We are challenged, however, given the nature of our biomedical training and the realities of busy practices; to find the opportunities and the means to fully exercise our leadership. To help physicians more effectively engage in public roles, this year’s NHMS Fall Conference will have a leadership track where physicians can attend workshops to enhance their skills in number of areas. Please consider joining us.

There are times in which we must come togeth-er to advocate for ourselves and for our profes-sion; but we are at our best when we work, not for our own interests, but for the betterment of public health. What better time than now? �

References:

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/declaration-pro-fessional-responsibility.page

Gruen et. al. Physician-Citizens – Public Roles and Professional Obligations. JAMA Vol 291, No1. P 94-98

Advocacy continued from page 2adults and 50% of children report ever having received a written asthma action plan; about half of adults with “poorly controlled” asthma report not taking a controller medication, but the other half reports taking a controller medi-cation and they are still poorly controlled; an estimated 50% of families report ever having been advised by a health professional to change things in their home, school or workplace; and more than 40% of adults who report experienc-ing cost barriers to seeing a primary care pro-vider or specialist for their asthma, or buying asthma medications in the last year, also report “very poorly controlled” asthma compared with 16.2% of individuals who report not expe-riencing these same cost barriers.

Improving these health outcomes for asthma call for a varied, integrated and dynamic ap-proach. Access to appropriate medications and comprehensive asthma education for effective patient self-management and control are crucial first steps, and so are the implementation at the practice level of evidence-based interventions to address tobacco addiction and other health and behavioral risk factors that affect asthma con-trol. Likewise, good medical and public health practice cannot avoid the pivotal role of the en-vironment and air quality whether indoor or out-door. Public health stands at the forefront of the integration across clinical practice and chronic disease and environmental public health pro-grams. Together we can work on models such as Patient-Centered Medical Homes and Account-able Care Organizations where providers and patients have the tools they need to promote pre-vention, monitor outcomes and achieve control; in taking advantage of current Healthy Homes and Healthy Schools initiatives in New Hamp-shire; and in ensuring that significant invest-ments in health care and payment reform yield the policies and systems needed to support an effective health delivery system. �

~Dr. Jose Montero

Asthma continued from page 1

4

EVP Corner

Survey Says

Scott Colby

In today’s world, the barrage of communication being hurled in our direction can be overwhelm-ing! We receive telephone calls, voice mail mes-sages, e-mail messages, snail mail, tweets, post-ings on our social networking sites, etc. In short, we receive so much communication that it can be difficult to cull-out the important information from the “junk.”

Recognizing this, the New Hampshire Medical Society [“NHMS”] does not want to contribute to this information overload and burden you with meaningless communication. This would only serve to add to the stress of managing in today’s world. So what actions does NHMS take to com-municate and why am I writing this piece?

NHMS prides itself on effective communication which is limited in its frequency so as to mini-mize the potential overload mentioned above. On a weekly basis, NHMS e-mails its Weekly E-Update. On a bi-monthly basis, NHMS sends its newsletter, Physicians Bi-Monthly. Additional information is sent periodically, most of which pertains to CME programs or conferences.

NHMS is undertaking a comprehensive assess-ment of physicians’ needs, wants and expecta-tions of membership in the NH Medical Society. This also includes an assessment of preferred communication methods. At the time this piece is being written, the final versions of the surveys are being drafted with four target audiences in mind: Current NHMS Members; Former NHMS Members; Non-Members; and Other Healthcare

Professionals. These will be e-mailed to all sur-vey participants.

Over the next several months, members of the NHMS Communications Task Force and NHMS staff will be working to review and assess the re-sults of these surveys to determine what current NHMS offerings are of value to you, what ad-ditional offerings should be considered and the most effective way to communicate to you.

In addition, NHMS staff will begin using e-sur-vey tools on a more regular basis to get a sense from you, as to what your preferences are in ar-eas such as CME program topics, social events, changes in the NHMS insurance program, etc.

It is our desire to maintain a balance in communi-cating by offering you effective communication on topics of interest and importance in a timely manner without adding to the daily stress caused by information overload.

My Ask:In closing, I do have an “ask” of you. If e-mail communication is one of your preferred commu-nication vehicles and you are not receiving the NHMS Weekly E-Update, please send NHMS your e-mail address.

You may send your e-mail address directly to me. Please be sure to include your name to ensure we accurately assign your e-mail address to your member information; OR call the NHMS office. The contact information is scott.colby@nhms.org or 603.224.1909. �

Counseling Older Drivers The latest “Physician’s Guide to Assessing and Counseling Older Drivers” will help you assess and counsel your elderly patients. Resources include material to facilitate discussion with pa-tients and caregivers on driving safety. ama-assn.org/go/olderdrivers

5

Legislative UpdateAs of April 29, NH Medical Society staff can re-port that “It’s too early to tell.” Many important bills are still under consideration and there is still much work to be done.

NHMS continues to work to pass HB489 that will create a public/private entity to govern the electronic exchange of patient information. Ev-ery state received federal grant money to help get such projects moving forward. NHMS has been working with DHHS and 80+ stakeholders on this project for the past 12 months.

HB156, the bill to lower the tobacco tax (NHMS opposed) passed the House and was tabled by the Senate. Too early to celebrate because a tobacco tax cut may or may not be included as part of the final state budget.

There are several bills dealing with the business profits tax and reasonable compensation for small businesses. Again, not sure what the final versions will look like.

Lots of partisan debate this year on a handful of state bills addressing the federal health care reform law. It looks like the push to have NH’s Attorney General join with 28 other state AG’s to challenge the federal law is moving forward. Similar bills passed in both the NH House and NH Senate.

Nearly 30 bills of interest to NHMS have been re-tained by House and Senate Committees.

Two bills opposed by NHMS dealing with NH’s pre-trial panel law have been retained by the House Judiciary Committee. NHMS will be working on all of these bills in the months ahead, with legisla-tive committee recommendations due in late fall.

Help NHMS to be more effective: We still need physicians to sign-up for the AIM (Advocacy in Motion) network. �

~Janet Monahan

NHMS Introduces Video-ConferencingThe New Hampshire Medical Society [“NHMS”] is pleased to announce a video-con-ferencing resource which will allow its mem-bers greater access to NHMS. Regardless of where you practice, live or are traveling, you will be able to access NHMS’ video- confer-encing resource.

This exciting solution was implemented af-ter a long and thorough review of the options available. Under the direction of NHMS’ Vice Speaker and Council member Paul Bergeron, M.D., staff worked with a local consultant to propose the final solution. “Perhaps the most exciting aspects of this video-conferencing so-lution are its low cost, ease of operation and ability to engage physicians throughout the state.” Dr. Bergeron said.

On an ongoing basis, the costs of using this so-lution are a fraction of the costs of traditional “800” dial-in conference calling and it provides a level of engagement through visual participa-tion which can not be achieved through confer-ence calling.

Over the past several months Council members, Legislative Committee members, Communica-tions Task Force members as well as staff have used the video-conferencing resource to con-duct several meetings. With confidence that most of the “kinks” have been worked out, NHMS is pleased to officially offer this re-source to you.

How to Access:

NHMS staff have access to initiate meetings through this video-conferencing resource. If you are interested in participating in a video meeting, please contact staff at 603.224.1909.

Video-Conferencing continued on page 15

6

This year was the first time in many years that the Medical Society felt compelled to testify very openly against a state budget. NHMS’ President, William Kassler, MD, MPH, testi-fied at the Senate budget hearing in Concord on April 21st. He emphasized that he was tes-tifying to express physician concern that the House-passed budget would dismantle New Hampshire’s health care system.

Dr. Kassler pointed out that the uninsured, un-derinsured, mentally ill and disabled citizens will still need care whether the funding is in the budget or not. The House version of the budget shifts financial responsibility for NH’s most vulnerable citizens to cities and towns, and to businesses in the form of higher insur-ance premiums, and to taxpayers. NH hos-pitals, which stand to sustain substantial cuts under the House-passed budget, already carry a huge load in providing uncompensated care to many of these needy individuals. Under the proposed cuts, those individuals will still get care, but in a more expensive setting … the emergency room! Many citizens in need of mental health care will end up in our civil justice system – again another expensive and unnecessary consequence.

In his closing remarks, Dr. Kassler also urged the Senate Finance Committee to not lower the tobacco tax. He reminded them that tobacco is the single greatest cause of premature death and disability in the state, and it’s entirely prevent-able. One out of every three teenagers who take up smoking will die from tobacco-related dis-eases, and it is well documented by economists and public health researchers that even a mod-est increase in tobacco taxes will significantly reduce teen smoking. Reducing the tobacco tax will result in more teenagers who smoke and more who will die from their smoking.

While some have expressed concern that NHMS’ foray into the budget debate might be too political, Dr. Kassler acknowledged the concern and suggested that “Many of us also believe that, as physicians, we have an ethi-cal responsibility to advocate for our patients.” While the ultimate resolution will be crafted by our elected officials, NHMS has provided a voice for the State’s most vulnerable citizens.

Please see a related story under the President’s Perspective.

~Scott Colby

Advocating for the State’s Most Vulnerable Citizens

Congratulations to Charles Wolcott, MD

Voted NHAFP’s Family Physician of the Year

7

COMMUNITY DWELLING OLDER ADULTS AND FALLS:Understanding Fear of Falling to Prevent Falls

Wednesday, June 22, 2011, Fireside Inn, West Lebanon, NHContact Rebecca Desilets

at Rebecca.A.Desilets@dartmouth.edu or call 603-653-3443

Speakers include: Nandini Deshpande, PhD, PT; David P. John, MD, FACEP; Margo Krasnoff, MD; E. Jeffrey Metter, MD; Elizabeth W. Peterson, PhD, OTR/L, FAOTA; and Karen Rose, PhD

May Lecture of the Month:http://www.cmelectures.org/lecture/hepatitis/nhms

HepatitisStephen K. Herrine, MD, is an associate professor of medi-cine in Thomas Jefferson University’s Division of Gastroen-terology and Hepatology, and assistant dean for academic affairs at Jefferson Medical College. Here he discusses chemical testing in liver disease, hepatocellular inflamma-tion, external blockage of biliary drainage, and conjugated and unconjugated hyperbilirubinemia.This lecture and the post-test is worth 1.5 credit hours.Dr. Herrine describes the manifestations and causes of conjugated and unconjugated hyperbilirubinemia, with the conjugated variety being the more common. The unconju-gated form is due to hemolytic states or other hematologic abnormalities, such as Gilbert’s syndrome.The author discusses the estimated incidence, and progno-sis for acute viral hepatitis and the manifestations, presenting disorders, and causes of chronic viral hepatitis. Dr. Herrine goes on to define acute viral hepatitis, its association with hy-perbilirubinemia, its symptoms, lab features, and prognosis. Hepatitis A, he notes, is more common than B or C, but gets less attention. Its high incidence in certain countries, which are shown graphically, means that travelers to those places should be vaccinated. Hepatitis B often leads to fulminant liver failure, as can Hepatitis C but much more rarely even though the C virus is the commonest cause of liver disease and transplantation. Hepatitis C’s causes and symptoms are discussed. An “alarmingly high” incidence of fulminant liver failure occurs in Hepatitis E.Any discussion of hepatitis, he says, would be incomplete without touching upon the “very important topic” of nonal-coholic fatty liver disease. He describes those patients at risk ... and how ultrasound, CT scans, and MRI can detect abnormalities. Dr. Herrine concludes with a definition and discussion of autoimmune hepatitis, a chronic condition characterized by hepatocellular inflammation and necrosis.

For the Betterment of Public Health

NHMS Annual Scientific Conference

November 4-6, 2011Mountain View Grand Resort & Spa in

Whitefield, NH

What does the NH Medical Society mot-to “for the betterment of public health” mean to you? Is your practice limited to just the patient in front of you, or do you see a greater role for you and your office in improving the health of your com-munity? The NHMS fall workshop will help you to become a more effective phy-sician-leader in your neighborhood, in your town and in the medical communi-ty. The meeting will also offer a range of topical clinical and policy presentations on issues of public health significance.

8

NHMS Past President, Peter Forssell, MD, and his wife Mary in Asia

Terra cotta warriors in Xi’an, China: jaw-drop spectacular

Angkor Wat at sunrise

They knew about stegosaurus in 1100 AD

Hong Kong harbor from Victoria Peak

Panda “kindergarten” at Bifengxia Panda Base: The only place in the world where you will see five 1.5 year old pandas together. Consider a donation for panda preservation at www.chinapanda.org.cn

You can get up close and personal

9

Hand Hygiene in Healthcare SettingsIn the United States, hospital patients get nearly 2 million infections each year. That’s about 1 infec-tion for every 20 patients. Infections that patients get in the hospital can be life-threatening and hard to treat. Hand hygiene is one of the most important ways to prevent the spread of infections.

Healthcare providers should practice hand hygiene at key points in time to disrupt the transmission of microorganisms to patients including: before pa-tient contact; after contact with blood, body fluids, or contaminated surfaces (even if gloves are worn); before invasive procedures; and after removing gloves (wearing gloves is not enough to prevent the transmission of pathogens in healthcare settings). For a full list of hand hygiene indications, please see the recommendations in http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf.

Patients and their loved ones can play a role in helping to prevent infections by practicing hand hygiene themselves as well as asking or reminding their healthcare providers to perform hand hygiene.

GuidelinesThe Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and

hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce trans-mission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental con-trol, 1985. Infect Control 1986;7:231--43) and the 1995 APIC guideline (Larson EL, APIC Guide-lines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251--69) were issued and provides an in-depth review of hand-hygiene prac-tices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included. Additional resources can be found at www.cdc.gov. �

10

The Institute of Medicine has reported that there are 7000 patient deaths each year due to medication er-rors. Chart review data indicates over 50% of med-ication errors occur at the interfaces of care. The transfer of care is recognized as a potential critical failure point for patient safety.

Medication reconciliation is a formal process of obtaining a complete and accurate list of each pa-tient’s current medications including name, dosage, frequency, and route, and using this list to guide drug choice usage anywhere within the health care system. Medication reconciliation involves com-paring a patient’s current list of medications with the physician’s new medication orders at any subse-quent interface of care, e.g., admission, unit trans-fer, step-down care transfer, discharge to home and after the patient/physician office encounter.

Implementation Steps for the Medication Reconciliation Process1. Develop guidelines that address the following:

a. Generation of a patient home medication list

b. Identification and resolution of high-risk situations • Patients on high-risk medications • Patients on greater than five medica-

tions • Specific interventions for elderly or

compromised patients2. Adopt a standardized form for reconciling

medications.a. Patient Identificationb. Allergy Verificationc. Preparer Signatured. Physician Signaturee. List each medication

• Dosage • Frequency • Date/Time of last dose

f. Other data • Person providing information • Patient weight • Over-the-counter medications and

herbals • Pregnancy/Breast feeding

3. Assign responsibility for reconciling medica-tions to a healthcare professional with suffi-cient expertise.

4. Place the medication reconciliation form in a highly visible location in the patient’s medical record.

5. Assure reconciliation occurs.a. Identify who is responsible for reconciling

the medication list.b. Compare each medication to the previous

medication list and resolve discrepancies.c. Review and update the medication list

when the patient encounter is a telephone call and there is a medication change.

6. Documentation expectations.a. Document review, revision of the medica-

tion list at each patient encounter. 7. Develop guidelines for clinical staff and pro-

viders.a. Specify conditions that require a consulta-

tion; e.g., greater than five medications, high risk medications.

8. Provide orientation and ongoing education on the established expectations to all healthcare providers.

9. Develop strategies to educate patients/families in monitoring medications and maintaining ac-curate medication lists. Engage other health-care facilities in the process when appropriate.

10. Establish a process for quality improvement.a. Review a random sample of medical re-

cords each month to determine compliance with the guidelines.

b. Encourage reporting of errors identified through the reconciliation process.

c. Develop a strategy to share the results of the review process with staff/providers.

Other considerations for successful implementation:1. After obtaining the patient’s consent, involve

the patient’s family members.2. Involve the facility where the patient resides,

e.g., LTC, SNF, assisted living, independent living.

3. Thoroughly test the process before automation.

Resources: Excellent resources are available by access-ing this practice tip at www.medicalmutual.com Medical Mutual’s “Practice Tips” are offered as refer-ence information only and are not intended to establish practice standards or serve as legal advice. MMIC rec-ommends you obtain a legal opinion from a qualified at-torney for any specific application to your practice.

Medical Mutual Insurance Company of Maine Risk Management Practice Tip: Medication Reconciliation in the Physician Practice

MMIC is a NHMS Corporate Affiliate

11

T here are insurance carriers that have shown themselves to be more than happy to settle a medical professional

liability claim when it’s deemed a less expensive alternativeto defending it — sometimes even when the case is with-out merit. We’ve even heard of cases where the decision tosettle was made without consulting the physician who hadbeen sued. Is that the kind of “coverage” you have?

With Medical Mutual you can be sure that if you’re everthe subject of a significant claim, our Claims Committee, comprised of practicing physicians like you, will review the details of your case. Then they — not businesspeople— determine whether it’s best to settle or defend, based onthe medical facts. And in the end, we believe that since it’syour reputation and record that are on the line, the decisionto settle or defend is your call.

If you prefer that kind of respectful, peer-directed coverage,make it your call to say so. Talk to your practice or hospitaladministrator about making sure you’re insured byMedical Mutual. For more information, contact JohnDoyle toll-free at (800) 942-2791, or via email atjdoyle@medicalmutual.com.

www.medicalmutual.com

Your patient filed a claim. Will your carrier conduct apeer review on your behalf, or a cost-benefit analysis?

12

More than 22,000 healthcare professionals throughout the country depend

on medical malpractice insurance from ProMutual Group for protection

and peace of mind.

• We have the long-term vision and financial resources to provide the

coverage you need today and in the future.

• We proactively partner with you to minimize risk, increase patient

safety and improve patient care.

• And if you do face a claim, we will aggressively defend good medicine

and provide the emotional support you need to rest assured.

To learn more about ProMutual Group, call us at (800) 225-6168 or visit us

online at www.promutualgroup.com.

PROTECT, PREVENT, DEFEND.

ProMutual Group Agents:Terry AbbottTD Insurance, Inc.North Conway, NH – 800-540-6337

Marc BerubeEaton & Berube InsuranceMilford, NH – 603-673-0500

Richard CarrUSI New EnglandManchester, NH – 603-625-1100

Joseph CroteauMarsh USAPortland, ME – 207-774-5911

Gerry GreggWillis of MA, Inc.Boston, MA – 617-437-6900

Joe KilbrideKilbride & Harris Insurance ServicePortland, ME – 207-774-7919

Shawn McLaughlinRisk Transfer Insurance AllianceSouthborough, MA – 508-303-9470

Jeff OlsenFred C. Church InsurancePortsmouth, NH – 888-433-1865

Michelle PerronHUB International New EnglandPortsmouth, NH – 603-436-7069

101 Arch Street, Boston, Massachusetts 02110 | 1.800.225.6168 | www.promutualgroup.com

Emmanuel PsilakisWilliam Gallagher AssociatesBoston, MA – 617-261-6700

Stephen WainwrightGowen & Wainwright Insurance ServicesGilford, NH – 603-528-5255

13

1667 Elm StrEEt, SuitE 3manchEStEr, nh 03101

nhmS DirEct: 1-877-235-0409

www.workplacebenefitsolutions.com

W o r k p l a c e B e n e f i t S o l u t i o n S

Since 2001, WBS has specialized in providing hospitals, health care providers and other companies with innovative tools and

strategies to better manage employee benefit programs.

We are proud to have been named benefits broker for the

New Hampshire Medical Society.

14

15

The New Hampshire Medical Society Corporate Affiliates

NHMS CAP is a paid membership program whose members meet criteria as posted at www.nhms.org

Anthem BCBS

Cigna Healthcare

Crown Healthcare Apparel Service

The Foundry Financial Group, Inc

Graduate Education Foundation

I C System

Kilbride & Harris

Medical Mutual Ins Co of Maine

Morgan Stanley Smith Barney NE Group

Northeast Delta Dental

Northeast Health Care Quality Foundation

Pfizer

ProMutual Group

Professional Office Services

Rath Young and Pignatelli PC

Risk Transfer Alliance, LLC

Shaheen & Gordon P.A.

Smith Barney

Software Advice

Sulloway and Hollis

TD Insurance Inc.

WBS

System Requirements:

For PCs and Mac computers, the minimum requirements are 2GB of RAM. USB webcam and audio are preferred; however laptop webcams and audio devices, (speakers and microphone) will be adequate. For more information on system requirements, please visit the homepage of NHMS’ website, (www.nhms.org), and on the left side click on “Video Conferencing” for more specific information.

What to Expect:

When a meeting is scheduled, an NHMS staff member will e-mail you a URL for the meeting. You simply click the URL, sign in as a “Guest” and wait to be brought into the “Room.” NOTE: The first time you access this resource you will be prompted to download a small application file.

Troubleshooting:

If you experience any difficulties with this solution, please contact NHMS and staff will work with you, your IT professionals and our vendor to resolve the issues.

We are very excited to introduce this new tool which we believe will allow you to engage in im-portant NHMS activities. For more information, please feel free to contact Scott Colby at NHMS. You may call him at 603.224.1909 or e-mail him at scott.colby@nhms.org. �

Video-Conferencing Continued from page 5

New Hampshire Medical Society7 North State StreetConcord, New Hampshire 03301-4018

ADDRESS SERVICE REqUESTED

Prsrt Std.U.S. Postage

PAIDConcord, NH

Permit No. 1584

For the Betterment of Public Health NHMS Annual Scientific Conference

November 4-6, 2011Mountain View Grand Resort & Spa in Whitefield, NH

What does the NH Medical Society motto “for the betterment of public health” mean to you? Is your practice limited to just the patient in front of you, or do you see a greater role for you and your office in improving the health of your community? The NHMS fall workshop will help you to become a more effective physician-leader in your neighbor-hood, in your town and in the medical community. The meeting will also offer a range of topical clinical and policy presentations on issues of public health significance.