The Reporter

First, I would like to congratulate and welcome Dr. Gus Geraci as PAMED’s new Vice President of Physician Leadership in Quality and Value. County medical society presidents and president-elects from across the state had the pleasure of hearing Dr. Geraci elaborate on PAMED’s “Blueprint for Physician Leadership in Quality and Value” at the April 28 Inaugural Statewide Forum for Pennsylvania County Medical Society Leadership.

By examining the role of county medical societies (CMS), participants endeavored to foster better communications and promote a closer working relationship between the county and state societies. Information on advancing leadership skills, focusing on implementation of the Society’s Blueprint initiative, and emphasizing the critical need for physician leadership at the local level were the key elements of the forum.

Other speakers included:
• Dr. Ralph Schmeltz, PAMED President
• Dr. Mark Lopatin, Montgomery County Medical Society Immediate Past President
• Denise Zimmerman, PAMED Executive Vice President
• Scot Chadwick, PAMED Vice President, Governmental Affairs and
• Larry Light, PAMED Vice President, Political Affairs.

The terms “quality” and “value” are being used in a variety of ways by many who should not be defining this for physicians or health care entities. Most of us do not have the time and/or the “expertise” to influence the direction of these discussions and changes. However, we do have advocates that we can support who are both qualified and have the needed time.

Ultimately, it is in everyone’s best interests for physicians to take the leadership role in shaping the future of medicine and the delivery of patient care. This forum and PAMED’s Blueprint is one of many steps being taken to assist and augment physician involvement in the process change that is upon us.

Michele Gaiski, Dauphin County Medical Society’s own Executive Director, and David McKeighan, Montgomery County Medical Society’s Executive Director, facilitated the two break-out groups held at the Forum. Lively discussion ensued during these sessions addressing three critical questions:
• If your CMS were to close its doors tomorrow, what would local physicians replace it with…what roles would the new entity perform?
• What roles are currently being performed by your CMS that would be missed if the organization went away?
• What barriers exist in your local community that make it difficult to perform needed roles…can those barriers be overcome, and how?

Although there were some differences in responses, with many impacted by location, size and structure of CMSs, there was agreement on how critical it is for CMSs and PAMED to increase engagement with one another and with their respective communities.

A summary of comments from the sessions include:
• CMSs are:
A local voice for organized medicine; breeding ground for future leaders; support for practice issues; “safe place;” networking; voice of medicine to local public audiences – patients, employers, media; use public as a sounding board for communications; grassroots political leadership

• Overcoming Barriers:
Find common issues that can bring diversity of physicians and opinions together; be more inclusive; focus on young physicians – social events; fellowship/mentoring; celebrate heroes in medicine; find ways to address physician indifference and/or resistance through education

• NEXT STEPS:
Improve leadership skills; take ideas from session back to respective CMS; discuss what may work; inform PAMED of CMSs needs; get feedback from forum attendees and consider annual forum

Your involvement, however big or small, is invaluable. Ideas that you may have should be shared with me, Dr. Geraci, or other leaders of DCMS or PAMED. Your continued membership is more critical than ever before. Talk with your colleagues to encourage engagement; invite colleagues to DCMS-sponsored social events; challenge colleagues who are not members of DCMS/PAMED.

DCMS’ website address is www.dauphincms.org.
PAMED’s website is www.pamedsoc.org.
Dr. Geraci can be emailed at ggeraci@pamedsoc.org.
I can be emailed at gpoles@pinnaclehealth.org.

Join us at the Senators game on Saturday August 20!

Learning How to Make a Difference
By John Goldman, MD, President Elect

If you talk to the physicians in Pennsylvania and Dauphin County, you hear a lot of discouragement. Doctors are concerned about the malpractice situation, declining reimbursements, and increasing expenses. They are more worried about the future and how changes to the healthcare system might affect them. Most physicians fear that these changes are going to make their life harder, and most of us feel powerless to affect the change we know is coming.

How can an individual physician make a difference? There are several ways. The first and most simple is to make a contribution to our lobbyists...contribute to the Pennsylvania Medical Society’s Political Action Committee (PAMPAC). Physicians have the unfortunate belief that being right (or at least thinking we are right) is enough to affect political change. Unfortunately, the political process relies on lobbyists, their ability to persuade legislators, and often their ability to contribute money to the politicians.

Physicians often feel that they cannot compete with the lobbies of the hospitals, insurance companies, or the trial lawyers. However, this is only true if most of us stay uninvolved. If the majority of Pennsylvania physicians made even a small contribution to PAMPAC, it would be one of the state’s best funded lobbies. There are approximately 45,000 physicians in Pennsylvania. If each physician contributed $100 (less than many people regularly spend on dinner) to PAMPAC, our lobbyists would have a $30 million dollar war chest. This war chest would dwarf the war chest of the hospitals, insurance companies, or trial lawyers.

Physicians can also lobby their legislators directly. Dauphin County Medical Society in conjunction with PAMPAC is asking physicians to meet in small groups with key county legislators. PAMPAC lobbyists coach our participants prior to meeting with the legislators. If you are interested in meeting with one of your state representatives or your state senator, please contact the Dauphin County Medical Society at 558-7849.

Physicians can also polish their legislative skills at the PAMPAC Advocacy Seminar. The Seminar will run from 9 AM to 3 PM on Saturday, September 24, 2011, at the PA Medical Society building in Harrisburg. The seminar will teach physicians how to lobby their legislators either as part of a small group or individually. The seminar costs $50 but is free to PAMPAC members.

There is a clear cure for the malaise which affects Pennsylvania physicians. We should get involved. Give money to PAMPAC; learn how to lobby your legislators by taking the Advocacy Seminar; or be one of the physicians who visits your legislator with PAMPAC. It is up to us to advocate for ourselves. Pennsylvania physicians are the only ones who can truly represent the interests of Pennsylvania medicine.

What's The Republican Medicare Reform Proposal All About?
By Jaan Sidorov, MD, MHSA, DCMS Board Member

U.S. Representative Paul Ryan’s “Path to Prosperity” contains some big changes for Medicare. Persons who are currently less than age 55 would, when they become Medicare eligible, get "premium support payments” that would be used to buy commercial insurance. When this is combined with switching Medicaid to block grants and the repeal of the Affordable Care Act, health care costs measured as a percentage of gross domestic product (GDP) would be halved. In exchange, however, the average beneficiary's out of pocket costs would likely increase. The Congressional Budget Office has calculated the price of a "standardized benefit" and determined that Medicare currently covers about 75% of its cost. All else being equal, under Representative Ryan's plan, Medicare's share would decrease by 2030 to about 68% of the cost, leaving beneficiaries having to pay for the absolute difference of 7%.

Defined Benefit vs. Defined Contribution

In broad terms, the Medicare entitlement (once deductibles, co-pays and other limitations are factored in) covers the "benefit" of all medically necessary services. Representative Ryan proposes the government change that by providing Medicare beneficiaries with a dollar "contribution" that, in turn, can be used by them to buy their own insurance. While the details are fuzzy, the Republicans are proposing that that contribution can be flexed based on income status, pre-existing illness and the evolving price of a standard benefit. That’s why they call it a premium support payment and not a “voucher.”

Those of us working in the private sector have long gotten used to the notion of "defined contribution" in retirement funding. That's obviously less true for public employees, who are grappling with the twin downsides of grumpy taxpayers and government's fickled unwillingness to adequately fund an open ended benefit promise. Medicare's travails are eerily similar, the only difference being that a) this is health care, not retirement (Social Security is not being touched... yet) and b) future Medicare beneficiaries have met the two-headed enemy of taxpayer vexation and government underfunding, and they are us.

The Third Rail?

While this wrinkle on "benefit" versus "contribution" may be noteworthy, are the Republicans dealing with the dreaded "Third Rail?" Given the growing familiarity with "defined" benefit arrangement in the young and middle aged workforce, this may turn out to be less of a showstopper than generally appreciated. Arguments that future Medicare beneficiaries can find a better health insurance plan on their own may resonate with chronically disillusioned and independently minded Generation X'ers. Current Medicare beneficiaries - the ones who vote - won't see any change. Next?

Aside From the Politics, What Else?

Is this all about cutting the budget deficit? A responsible attack on the burgeoning U.S. debt? A repugnant exercise in social injustice? A long needed debate on the role of government? Irresponsible cost cutting that ignores the revenue side of fiscal probity? 2012-style political brinkmanship? It’s all true, but as the debate unfolds, keep an eye out for two additional under-appreciated dimensions in the Republican proposal:

1. What will the Republican plan do to assure that these "premium supported" insurance plans deliver? That includes financial strength, a decent benefit, and the flexibility to adopt novel consumerist features. Given the stubborn pandemic of chronic conditions, there may be a role for government in assuring that insurers cover modern versions of high value health care.

2. While cost cutting is always welcome to the average taxpayer, what do the health insurance actuaries (and international bond markets) have to say about the predictability of the Republican plan? Thanks to countless broken promises, it’s easy to be skeptical about government projections on a "percent of a standard benefit." Yet, one possible advantage of the Ryan Plan is that taxpayers (and holders of Treasuries) won't continue to be held hostage by the open-ended promises of Medicare. We may or may not be able to ultimately afford what the House Republicans are proposing, but at least our budgets may turn out to more predictable than the current Medicare benefit.

Stay tuned!

DCMS Recognizes 50 years of Professional Service

DCMS recently recognized three area physicians for achieving 50 years of professional medical service since their graduation from medical school. This is a long-held tradition of both the state and county medical societies. At the March meeting of the DCMS Board of Governors, Dr. Gwendolyn Poles, President, recognized those that had acheived this milestone.

Recipients named were Maurice J. Lewis, MD, 43-year member and internist practicing in Camp Hill, Thomas J. Rohner, Jr., MD, a retired urologist and 39-year member residing in Elizabethtown, and Bernard I. Zeliger, DO, a 4-year member of the Society and a practicing orthopedic surgeon from Harrisburg.

Submit Your Resolution Today

We encourage the members of the Dauphin County Medical Society to submit a resolution for the Pennsylvania Medical Society's House of Delegates meeting, scheduled for October 15-16, 2011.

A resolution is the vehicle that conveys to the House of Delegates a proposal from an individual, a component or specialty society, or a section on a particular subject. In order for the DCMS delegation to have time to review submissions, please submit your resolutions by Monday, August 22. To save time, please email your resolutions to our office at dauphincms@pamedsoc.org. All resolutions accepted as business of the House will be considered at open hearings of reference committees, which will be held at staggered intervals on Saturday, October 15. Voting on the resolutions will occur on Sunday, October 16.

DCMS Night at the Harrisburg Senators

On Saturday evening, August 20, DCMS invites family and friends to enjoy a picnic while watching the Harrisburg Senators play ball. Register today!

Registration Form

Save the Date for DCMS Educational Program

On Saturday, September 10, 2011, DCMS will host an educational meeting at Harrisburg Area Community College. This year's topic will be Health System Reform. This program has been approved for 5.25 AMA PRA Category 1 Credits. The agenda includes:

Health System Reform in the Practitioner’s Office
Daniel Fischman, MD, PinnacleHealth Internal Medicine Associates

Health System Reform from the Commonwealth’s Perspective of a Republican
Patricia H. Vance, RN, State Senator - 31st District

AMA and Health System Reform
Carl A. Sirio, MD, Trustee, American Medical Association

Professional Liability and Health System Reform – Does It Matter?
Hugh P. O’Neill, III, Esq., Partner, Thomas, Thomas & Hafer, LLP

The Vulnerable Population and What May Happen
Yvette Jackson, Regional Administrator, Food & Nutrition Service, U.S. Dept. of Agriculture

Democratic Perspective on Health System Reform
Sarah A. Newman, Constituent Advocate for U.S. Senator Robert P. Casey, Jr.

Health System Reform Panel
Moderator: Virginia E. Hall, MD, FACOG, PennState Hershey Obstetrics & Gynecology

Registration is now available! Please plan to attend.

Student Chapter Update
By Laura Young, Penn State Student AMA Immediate Past-President

Since our last update, the Penn State AMA-MSS chapter has been kept busy with a variety of events! Our second breakfast service project was completed at the Ronald McDonald House on Saturday, March 26. The breakfast was another success, with dozens of family members being served and about ten medical students participating. That same Saturday, groups of Penn State medical students also volunteered at the DCMS Doc Talk event by providing free blood pressure screenings to all who stopped by our booth. It was a great opportunity for the first-years to get more practice, and for the second-years to brush up on skills before entering rotations next year!

On Monday, April 11, fourteen medical students attended the opening talk and social events at the Pennsylvania Medical Student Advocacy Day. Participants enjoyed networking with other medical students from around the state, and learned a bit more about what the AMA-MSS does on a local level. The following day, four Penn State medical students returned to Harrisburg to meet with state representatives and senators to discuss issues important to medical students and residents.

Most recently, the Penn State AMA-MSS chapter organized the annual campus pig roast on April 29. The many hours spent cooking and preparing made the event a complete success! Over 125 people were in attendance, including medical students, nursing students, graduate students, and their families. New leadership was recently elected for the upcoming academic year. I would like to welcome Peter Eyvazzadeh, the next student section AMA President, Jennie Dunnick, the next Vice President, and John Roberts, who will serve as dual Treasurer/Secretary. Both Peter and Jennie traveled to Chicago on June 16-18 for the annual AMA-MSS National Meeting. If you have any ideas or need student help for your events, please do not hesitate to contact Peter Eyvazzadeh, the new Chapter President, at PEYVAZZADEH@hmc.psu.edu.

Doc Talk VIII A Success!

The eighth annual “Doc Talk” health education event was held Saturday, March 26, at the Capital City Mall. We had a great turnout with a lot of positive feedback from both the participating practices and the public.

We would especially like to thank Andrew Richards, MD, Doc Talk Chair, and our sponsors, HealthAmerica, Highmark, and United Healthcare. Their support enabled us to provide this public health service.

Doc Talk IX is tentatively scheduled for April 14, 2012, so put it on your calendar today!

Learn How to Impact Politics at the PAMPAC Political Seminar

Learn how to effectively communicate your advocacy message with legislators and to make an impact on local politics at PAMPAC's political seminar being held September 24, 2011, from 9 a.m. to 3 p.m. at the Pennsylvania Medical Society. And if running for public office sparks your interest, additional information will be provided on how to get started.

The seminar is presented by AMPAC, the bipartisan political action committee of the American Medical Association. Registration is free for PAMPAC members and is $50 for non-PAMPAC members. Continental breakfast and lunch will be provided.

To register, email your contact information to PAMPAC@pamedsoc.org or call (717) 558-7822 by July 31.

DCMS Alliance Report
Barbara McGrath, DCMSA Immediate Past President

The last few months have been busy ones for the Alliance. Our new officers were installed during a May luncheon. I want to welcome Karen Bloschichak as our new president.

Our 8th annual “Spring into Fashion” show and luncheon was recently held at the West Shore Country Club. Along with ticket sales and sponsorships, the basket raffles and the purse drawing raised monies that the Alliance used to fund our grants program. We are grateful to all 150 guests who attended the show.

We recently provided over $10,000 in grants to the following organizations:

The Shalom House
The Community Check-Up Center
The Harrisburg Area Community College
Saint Joseph Athletic Association
The Interfaith Shelter
Lower Dauphin Communities that Care

It is amazing that such a small group of members are capable of providing so much support within the community! It has been a privilege to be the president over this past year and to work with members of the DCMS and DCMSA.

Please Support the Gunder Fund

We urge you to make a tax-free contribution to the Scott A. Gunder, MD, DCMS Scholarship Fund. We need to raise funds in order to allow us to continue with our current award amount and also have the fund be self perpetuating.

The Gunder Fund currently awards a $1,500 scholarship to a 2nd-year medical student at the Penn State College of Medicine. In 2000, DCMS established the Gunder scholarship in conjunction with The Foundation of the Pennsylvania Medical Society to honor the memory of DCMS President Scott A. Gunder, MD. Dr. Gunder was a Harrisburg gastroenterologist and a clinical assistant professor of medicine at Penn State College of Medicine, Hershey.

Please help us reach our goal!

The Foundation, which administers the Gunder scholarship, provides philanthropic opportunities for physicians and others to support programs that benefit the commonwealth’s medical community. For more information about the annual Gunder scholarship,including how to apply,visit http://www.foundationpamedsoc.org/SFS/Scholarships/Gunder.aspx. Donations to the Gunder scholarship can be made online by going to The Foundation of the Pennsylvania Medical Society website and designate your gift to the Gunder Scholarship Fund. Or you can mail your check payable to The Foundation of the Pennsylvania Medical Society, Attention Student Financial Services, 777 East Park Drive, Harrisburg, PA 17111. Please write “DCMS/Gunder” on the memo line of your check.

Welcome New Members
February 12, 2011 - May 13, 2011
Active Members

Esmeralda Maldia Del Rosario, MD, Urgent Care Medicine
Patient First

Melissa Denham, MD, Urgent Care Medicine
Patient First

Lonnie E. Fuller, Jr., MD, Internal Medicine

Deborah J. Herchelroath, DO, Obstetrics & Gynecology
Woodward & Associates, PC

Ramesh Kodavatiganti, MD, Anesthesiology
Penn State Hershey Anesthesia

Dan Thachdam Nguyen, MD, Neuroradiology
Penn State Hershey Radiology

David Andrew Nikovits, MD, Urgent Care Medicine
Patient First

Jansie Prozesky, MD, ChB, Pediatric Anesthesiology
Penn State Hershey Anesthesia

Charles S. Specht, MD, Anatomic Pathology
Penn State Hershey Anatomic Pathology

Philip Hunter Spotts, MD, Family Medicine
Patient First

Linda M. Taylor, MD, Family Medicine
Patient First

Karine Thevenin-Smaltz, DO, Family Medicine
Patient First

Ayaz Virji, MD, Family Medicine
Patient First

Paul Wu, MD, Internal Medicine
Patient First

Yury Yaroslavsky, MD, Psychiatry
T W Ponessa & Associates Counseling

Isaac Yoon, MD, Family Medicine
Patient First

Administrative Members
Kelly Martin-Dailey
Carrie Welsch

Resident Members
Nicholas James Brandmeir, MD
Moksha G. Ranasinghe, MD
Omar Akram Zalatimo, MD

Student Members
John Baptista Kobilis
Curtis Larson
Joanne Smucker
Matt Varacallo
Rubaina Zaman

Calendar of Events

Board of Governors Meetings
6:15 p.m. at Society headquarters
September 7, 2011
December 7, 2011

Executive Committee (Officers)
6:30 p.m. at Society headquarters
July 6, 2011
August 3, 2011
October 5, 2011
November 2, 2011

DCMS Senators Night
Saturday, August 20, 2011
7:00 p.m.
City Island, Harrisburg

DCMS Health Care Reform Seminar
September 10, 2011
7 a.m.-3 p.m.
Harrisburg Area Community College, Harrisburg

PA Medical Society Annual Business Meeting - House of Delegates
October 15-16, 2011
Hershey Lodge, Hershey

How to Reach Us
777 East Park Drive, PO Box 8820, Harrisburg, PA 17105-8820
Phone: (717) 558-7849 Fax: (717) 558-7841

Michele Gaiski, Executive Director
Kristi Spargo, Staff Editor and Assistant Executive
Lauren Ramsey, Meeting Manager
Tabitha Black, Administrative Secretary

Submission of Newsletter Articles
The Reporter accepts unsolicited newsletter articles, however, there is no guarantee that they will be published. All submissions are subject to review. Articles should be of interest/pertain to physicians, their practice, and health care in the Dauphin County/Capital Region. Local, state, and national perspectives are welcome. Submissions that are self-promotional or commercial in nature will not be accepted. Send your articles to the Society at Dauphincms@pamedsoc.org or fax to (717) 558-7841.
The opinions expressed in this newsletter do not necessarily reflect the opinion of the Society.
Publication of advertising does not imply endorsement of the products advertised or the statements contained in such advertising by the Dauphin County Medical Society Reporter or the Dauphin County Medical Society.

Mission
The Dauphin County Medical Society, founded in 1866, seeks to serve its members, the medical community, and the citizens of Dauphin and surrounding Counties. The Society's mission includes: upholding the ethics and dignity of the medical profession, elevating and maintaining the highest standards of healthcare, promoting and disseminating medical information to members as well as the public, and promoting collegial relations among its members.

Visit our website today @ www.DauphinCMS.org.

To opt out of future electronic (email and fax) communications, please write to dauphincms@pamedsoc.org with the word UNSUBSCRIBE NEWSLETTER in the subject or call (717) 558-7849.