MARCH/APRIL2012Volume 42, No. 2

ESCAMBIA COUNTY MEDICAL SOCIETYin conjunction with SANTA ROSA COUNTY

President’s MessageA Well Kept Secretby George A.W. Smith, MD

Dr. George A.W. Smith

Founded in 1873

I have a very exciting discovery that I can

hardly wait to share with you. I have been

practicing medicine in Pensacola for the past

seventeen years and perhaps this may not be

news to you. I suspect however that with the

exception of the past presidents of the Escam-

bia County Medical Society this is a well-kept

secret. Having just assumed the presidency of

the Society, I learned last month my responsi-

bilities include representing the medical soci-

ety on the Rehabilitation Foundation of North-

west Florida. Of course having never heard

of them before I was very happy to meet with

their Executive Director Robert Bowman, Ed.D

to hear more about this organization and the

role I would play.

It turns out that the Rehabilitation Foundation

of Northwest Florida followed the successful

initial funding and establishment of the Reha-

bilitation Institute of West Florida in 1975. In

1973-74 a community based feasibility study

concluded that the community needed and

could support a combined inpatient rehabili-

tation and a vocational rehabilitation center

for the physically handicapped. The initial 38

beds of the Institute were designed into the old

Medical Center Clinic on Palafox Street and full

rehabilitation hospital services were available

in 1976. It soon became apparent that a signif-

icant number of the severely disabled needing

rehabilitation had no funding source. Thus in

1980 the Foundation was started with several

small contributions and a $20,000 grant from

the Gannett Foundation. In 1983 the Institute

Trustees voted to sell to any local hospital in an

effort to secure funds for the foundation. The

West Florida hospital’s offer of about $3.3mil-

lion was accepted and most of this money was

transferred to the Rehabilitation Foundation to

fund rehabilitation services to individuals with

physical disabilities who were needy and had

no other funding source. Foundation invested

assets grew over the years and although the

Institute Trustees stipulated that only the in-

vested earnings would be used, to date over

$6 million has been awarded to local citizens

of both Escambia and Santa Rosa counties.

Most of the funds have been awarded for inpa-

tient rehabilitation, but awards are also made

for out-patient therapy, orthotics and prosthet-

ics and rehabilitation equipment.

www.escambiacms.org

Upcoming Events

Friday March 23, 2012ECMS Doctors Day

CelebrationIce Flyers Hockey

Game, 7:05pPensacola Civic Center

Please rsvp by March 16

Tuesday April 10, 2012Florida State

Representative Doug Broxson

“Update on Florida Regulation”

McGuire’s Irish Pub, 5:30p

Wednesday May 9, 2012Annual

Mini Health FairPaul’s on the Bay, 5:30p

RSVP: 478-0706info@escambiacms.org

ECMS BulletinThe Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/ Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.

EditorsChristopher Burton, MD

Erica Laxson, Executive Director

AD PLACEMENTContact Erica Laxson at 478-0706

Ad Rates¹∕₈ page: $100 • ¼ page: $150 • ½ page: $300

2012 ECMS OfficersPresident

George A.W. Smith, M.D.President-Elect

Wendy Osban, D.O.Vice President

Susan Laenger, M.D.Secretary /Treasurer

Christopher Burton, M.D.

Pages 4 A Successful First Year for the Go Seniors! Transportation Program!

Page 5 Ways to Maximize Effective Cash Flow in an Ever Challenging High Self-Pay Environment

Page 6 Merging Practices? Be Sure to Protect Yourself

Vision for the Bulletin:-Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond.- Collaborate with the Alliance to bring together Escambia and Santa Rosa County medical families. To know the needs of the community and promote the healthcare needs.- A powerful instrument to attract and induct members to organized medicine. Views and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the directors, staff or advertisers.

Escambia County Medical Society in conjunction with Santa Rosa County

2012 Calendar of Events

Friday March 23, 2012DOCTORS DAY

Ice Flyers Hockey Game, 7:05p

Tuesday April 10, 2012General Membership Meeting

Legislative Update, Doug BroxsonMcGuire’s Irish Pub, 5:30p

Wednesday May 9, 2012ANNUAL MINI HEALTH FAIR

Paul’s on the Bay, 5:30p

Tuesday July 10, 2012General Membership Meeting

EHR/Meaningful UseCactus Flower, 5:30p

July 27-29, 2012FMA ANNUAL MEETING

Boca Raton, Fl

Tuesday August 14, 2012General Membership Meeting

Heritage Hall, 5:30p

Sunday September 30, 2012WOMEN IN MEDICINE BRUNCH

Tuesday October 9, 2012General Membership Meeting

[1AMA PRA Category 1 CreditsTM]Breast MRI, Patricia Green, MD

5:30p

Tuesday November 13, 2012General Membership Meeting

Saturday January 19, 2012ECMS INAUGURAL BALL

MembershipESCAMBIA COUNTY MEDICAL SOCIETY in conjunction with SANTA ROSA COUNTY3

Santa Rosa Countyin conjunction with

Escambia County

MEDICAL SOCIETY10 Dinner Meetings in 2012: Opportunities to receive Free Florida Man-

dated Courses.

Representation in Legislature: ECMS has members actively participat-

ing in the FMA and AMA. Such topics include: Managed care legislation,

PRN sovereign Immunity, Mandatory malpractice, tort reform, and grass

roots efforts. ECMS gives our physicians’ updates through our newslet-

ters, email, and faxes.

Malpractice Insurance Discount: The Doctors Company/FPIC gives

ECMS members a 5% discount. In addition, FPIC’s claim-free program

currently allows for the following discounts: 25% claims-free 15= years;

20% claims feree10-14 years; 10% claims-free 5-9 years.

20% Discount on Pensacola Opera Tickets

DocBookMD: ECMS providers are now listed on the ECMS iPhone and

Android application.

Workers’ Compensation Insurance: Members can receive up to 24.8%

return on insurance premiums with OptaComp.

CME: ECMS offers free CMEs to our members at many of our meetings.

Directory and Website: ECMS website and Member directory, which in-

cludes you office information and picture, as well as allows you to control

Benefits of Membership 2012the information and register for ECMS events. We also work with physi-

cians to create and manage their own internet site.

Patient Referral: ECMS refers patients to our physicians daily.

Physician Information Service: ECMS has connections in Pensacola.

The Society is pleased to research, ask, and retrieve information for you

or your office personnel.

Vested Vendor Resource Guide: These vendors are financially and per-

sonally invested in the success of the practice of medicine. They sup-

port our CME events, dinners, special events and our Bulletin newsletter.

Please make sure to call a supporter of ECMS.

The Florida Healthcare Law Firm: At no charge members of the Es-

cambia County Medical Society may call the hotline 561-306-5699 with

questions regarding specific legal issues.

Crown Plaza: Mention “Medical Society” for a yearly discounted rate on

you or your guest next stay.

Transworld Systems: Member discount on professional services. Please

contact Lin Engie #850-725-4408.

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Happiness for you, your staff and your patients

MembershipESCAMBIA COUNTY MEDICAL SOCIETY in conjunction with SANTA ROSA COUNTY4

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A loan that’s good for your business is also good for your peace of mind.James Ferreira, Community Banker70 North Baylen Street | Pensacola, FL 32502 | 850.444.1210

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A Successful First Year for the Go Seniors! Transportation Program!by Erica Laxson, ECMS Executive Director

This May the Escambia County Medical Society Foundation (ECMSF) will celebrate their one year anniversary of the GO SENIORS! program. For the last year this program has provided Yellow Cab of Pensacola vouchers to eligible seniors living in Escambia and Santa Rosa Counties. Funded by The Fellows Memorial Fund, it is designed to encourage independent community mobility for seniors who need transportation assistance that may find the cost of transportation prohibitive to meet healthcare needs.

The Fellows Memorial Fund was founded in 1961 under the will of the late Earle W. Fellows-Williamson, widow of the beloved Pensacola physi-cian, Dr. J. Hugh Fellows. The Fellows Memorial Fund assists in providing loans for students in the field of medicine, nursing, medical technology, and ministry, as well as fund programs around the elderly at risk popula-tion in our community. The ECMS Foundation is involved in providing ser-

vices to at risk populations and currently supports the WeCare program has focused on providing specialty physician care to the working poor. With financial support of The Fellows Memorial Fund and physicians the Go Seniors! program has helped provide door-to-door transportation for healthcare related needs to more than 1000 patients living in Escambia and Santa Rosa Counties.

Go Seniors! transportation vouchers have been distributed by ECMS physicians, Health and Hope Clinic, St. Joseph’s Clinic, Good Samaritan Clinic, and the Escambia County Community Clinic. To be eligible, a per-son must be 60 years of age and be certified by a healthcare professional as needing door-to-door assistance. For more information call Escambia County Medical Society Foundation (850) 478-0706. Congratulations on a

very successful first year!

Wishing you Success & Happiness in the New YearAttention Members!

Call Susan Prescott Today!Phone: (850) 484-5154Susan_Prescott@doh.state.fl.us

Foundation

You may be eligible for 10 Continuing Medical Education Credits, Sovereign Immunity, and a Free Florida License.

Submit Your We Care Hours!

It is now time to send in your updated information for the 2012 ECMS Pic-torial Directory. Our Medical Society directory is very beneficial for many reasons with use by members, non-members, and other health commu-nity providers.

As a benefit to our members, the directory will list the physicians alpha-betically and by specialty. The directory will contain the physician name, address, phone number, specialty, NPI, picture, and website address if applicable. Our 2012 ECMS Directory will be distributed to each member at no cost.

The purpose of this directory is to promote the concept of members do-ing business with both members and supporters, as well as to provide a comprehensive, easy to use reference and referral guide.

Thank you to our friend Malcolm Ballinger and his team for all of their hard work in putting our Pictorial Directory together.

Should you have any questions please do not hesitate to call me, Erica Laxson, Executive Director, at 478-0706 ext 2.

Practice ManagementESCAMBIA COUNTY MEDICAL SOCIETY in conjunction with SANTA ROSA COUNTY5

Ways to Maximize Effective Cash Flow in an Ever Challenging High Self-Pay Environmentby Lin Engie, Transworld Systems, Inc.

Accounts receivable are a major concern for medical practices in today’s

world. Many practices struggle with how to deal with self-pay patients and

insurance companies who don’t pay on time, or not at all. With today’s

trend of ever higher deductible plans, and larger self-pay amounts, this is

becoming a more critical cash flow issue for a majority of medical prac-

tices. According to an MGMA study, self-pay increased from 12% in 2007

to 20% in 2010, trending to 30% in 2012. This means a third of a practice’s

revenue now comes from self-pay. Can you afford to solely focus on in-

surance resolution for your practice’s cash flow? For many practices, the

answer is clearly “no.”

Here are some proven ways to maximize cash flow and collections. First,

have a clearly defined and carefully communicated, yet diplomatic pay-

ment policy to help avoid difficult collections situations. By following these

simple steps, you can watch your practice thrive while retaining good,

professional relationships with your patients.

Developing and implementing a sound collection policy is vital to running

a successful practice. If your staff is not well informed, and patients are

not educated on payment expectations, chances of late or non-payment

increase. Ensure that your practice’s terms of payment are clearly stated

in writing for both staff and patients. If you don’t have a systematic invoice

and billing system, get one. Studies show that the faster you mail invoices,

the sooner you’ll be paid. An invoice should clearly show the amount due

and when payment is expected, or else they may fall to the bottom of the

patient’s payment stack.

In addition to your policy and billing procedures, contacting late payers

every 10-14 days enables you to diplomatically remind the patient of your

terms of payment. Remember when evaluating accounts, use the data

on your aging sheet, not your feelings, because if you’re not being paid,

someone else probably is. In the event that a patient has moved without

providing you the new address, the USPS will research their information

and provide you with the change of address, if available. So make sure

that your outgoing envelopes state “Address Service Requested”.

For more difficult situations, make sure your staff is trained to be firm, yet

courteous, when dealing with patients. Train your collections staff on cus-

tomer service because they must “sell” your patients on the idea that you

expect to be paid in a timely manner, without alienating them. And, if your

practice makes a mistake, quickly admit it and correct it. Denying an obvi-

ous error only fans the flames of resentment your patient may already feel.

There may be a point in which your internal procedures are not effective

enough. A third party can motivate a patient to pay, simply because the

demand for payment is coming from an outside agency. Another reason to

outsource is if you do not have the internal resources to consistently and

systematically (every 10 to 14 days) follow up on every past due account.

Before paying a percentage to a collection agency, or using small claims

court or an attorney, check into using a flat fee, diplomatic pre-collection

service, where you may collect more without giving up a percentage of

your revenue. If you decide to outsource, make sure to use a reputable

and financially stable company, and one that is HIPAA-compliant.

Always remember that in many states, medical practices are governed

by the same collection laws as collection agencies. If you’re not sure of

your own procedures, call your state’s department of finance or consult

an attorney.

In the end, remember that even with a carefully designed and adminis-

tered collection plan, there are some accounts that will never be collect-

ed. Adopting an early intervention plan to identify these few accounts that

have no intention of paying you will save your practice time and money

while benefiting from improved cash flow from the vast majority of ac-

counts that will pay.

Medical/LegalESCAMBIA COUNTY MEDICAL SOCIETY in conjunction with SANTA ROSA COUNTY6

Merging Practices? Be Sure to Protect Yourselfby Georgette A. Samaritan, RN, BSN, Senior Risk Management Consultant

Many practices are considering mergers with, or selling to, another prac-tice as a way to reduce overhead expenses and take advantage of econo-mies of scale. If your practice is moving down that path, along with all the other details, please don’t overlook how you will insure and protect the physicians’ medical professional liability in this new organization.

If both practices use the same insurer, the process of combining the poli-cies is simple, and may even result in a larger group discount. Notify your carrier, and they will walk you through the process.

If the practices currently use different carriers for medical professional li-ability insurance, or are seeking a new carrier for the new entity, there are some important factors to consider:

1) Prior Acts coverage (also called “nose” coverage). It is essential that you confirm that any new policy covers prior acts for all of the physicians included in the new entity. This means that the new insurance company will assume responsibility for claims that arise, reaching back as far as each physician’s retroactive date (or original inception date) of coverage. If Prior Acts coverage is not available from the new carrier, seriously con-sider purchasing an Extended Reporting Endorsement (tail coverage) from the current insurance companies. While these can prove expensive, they give the newly merged practice the opportunity to start over with the new insurer for less premium.

Without the purchase of either an Extended Reporting Endorsement or Prior Acts coverage, there will be no insurance protection available for any patient care delivered prior to the new effective date (and new retroactive date).

For example, consider Dr. Lincoln. He has purchased new coverage effective 3/1/2011 and the retroactive date with his previous insurer is 3/1/1997. If Dr. Lincoln’s new insurance company agrees to provide Prior Acts coverage, they will now be responsible for any future claim arising back to 3/1/1997. If the new company cannot provide, or is unwilling to provide, Prior Acts coverage, they will give him a new retroactive date,

3/1/2011, and will only cover claims incurred after this date. Dr. Lincoln must then purchase an Extended Reporting Endorsement from his old insurer, or go without coverage for any future claims from his practice arising between 3/1/1997 and 3/1/2011.

Before making any changes, make sure that all known or potential claims have been reported to your current carrier.

2) Coverage trigger. Check policies from both the old and new insur-ance companies for what is considered a claim, or the “coverage trigger”. Look for a policy that considers a claim to be reported on the date you re-port an incident to the insurance company (incident reporting or incident sensitive), whether or not a lawsuit has been filed.

3) Financial strength. You want to know that the company selected will be there when you need them, to protect your livelihood and reputation. AM Best ratings are a good source of independent information on insurance companies. You can also inquire about a company’s total assets and sur-plus and review prior annual reports or financial statements.

If your practice is being acquired by a hospital, insist on individual physi-cian coverage with a company you know and trust. This may be pivotal if a lawsuit arises against you and the hospital-employer. The entity paying the premiums usually has some say in the decisions about the lawsuit. Also, in a hospital, all physicians’ medical professional liability insurance is often lumped together and applied to overhead – making is possible that your rates could increase greatly over time.

There are many important factors to consider when merging practices with or selling your practice to a hospital. Prior to making such a signifi-cant decision, do your due diligence by reviewing your current and poten-tial insurance policies and other contracts. Thoroughly evaluate the pros and cons of the opportunity along with the assistance of legal counsel and other professionals who specialize in such sales or mergers before you finalize your decision.Georgette Samaritan is a Senior Risk Management Consultant with MAG Mutual Insurance Company, Atlanta, GA

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Sacred Heart Medical Group Welcomes

James Williams, MD

Paul Tamburro, MD

Mark Grise, MD

Dr. James Williams, Interventional Cardiologist, is fellowship-trained in cardiology and has special interests in diagnosis and management of heart disease, preventive cardiology, interventional cardiology, cardiac pacemakers, stress testing and ICU-related procedures.

Dr. Paul Tamburro, Cardiologist and Medical Director of Sacred Heart Cardiovascular Services, is fellowship-trained in cardiology and has special medical interests in valvular heart disease, congestive heart failure, coronary-artery disease, arrhythmias, cardiac catheterization and noninvasive cardiac testing.

Dr. Mark Grise, Interventional Cardiologist, is fellowship-trained in cardiology, critical care and interventional cardiology. Dr. Grise specializes in a minimally invasive intervention in which the catheter is inserted into the radial artery instead of the femoral artery.

Now accepting new patients.Sacred Heart Medical Office Building,

Suite 404. Physician Referral Line: 850-416-4763.www.sacredheartmedicalgroup.org

In The CommunityESCAMBIA COUNTY MEDICAL SOCIETY in conjunction with SANTA ROSA COUNTY7

Hospital News

Baptist Health Care NewsNew Cath Lab Coming to Gulf Breeze Hospital.

Construction recently began on a new, state-of-the-art cardiovascu-

lar catheterization laboratory at Gulf Breeze Hospital, which will provide

even more convenient cardiovascular care for residents of Santa Rosa

County. The $1 million project will bring additional cardiovascular diag-

nostic services which are currently not available in Gulf Breeze and near-

by communities. Construction on the lab is scheduled for completion in

May 2012.

Baptist Hospital Completes $35 Million Campus Transformation

Less than two years ago, Baptist Hospital, the flagship facility for

Baptist Health Care, announced a vision that would transform its cam-

pus into one of the most aesthetic and technologically advanced medical

facilities in the nation. In March, that vision came to fruition and exceed-

ed even the greatest expectations with the completion of its $35 million

project, the largest in Baptist Health Care’s 60-year history. The project

includes a new main entrance, two-story main lobby, enhanced family

waiting areas, operating room expansion, progressive care unit, outpa-

tient surgery and more. Visit BuildingABetterBaptist.org to see photos and

learn more details about the recent transformation.

Sacred Heart NewsInterim CEO Selected for Sacred Heart Health System In mid-January, former SHHS President and CEO Laura S. Kaiser an-nounced that she would be leaving Sacred Heart and Ascension Health to become the executive vice president and chief operating officer of Inter-mountain Healthcare, a large nonprofit health system, based in Salt Lake City and serving Utah and Idaho. A search committee comprised of leaders from Ascension Health and the SHHS Board of Directors recently announced the selection of Susan L. Davis, RN, Ed.D., as interim CEO to lead the Health System while recruiting of a permanent CEO continues. Susan began work at Sacred Heart in early March. In addition to her interim role at Sacred Heart, Susan also will retain her role as Ascension Health Ministry Market Leader for New York and Connecticut, and will add the markets of Florida and the Gulf Coast, where she will provide leadership and strategic direction for Sacred Heart and the ministries in Mobile and Jacksonville. Partnership With Bay Medical Center Approved Culminating months of negotiations, the Bay County Commission-ers recently voted to accept the proposal of the joint-venture company of Sacred Heart Health System and LHP Hospital Group, Inc., to lease and operate Bay Medical Center in Panama City for the next 40 years. The partnership with the 323-bed regional medical center will pro-vide funding for Bay Medical to eliminate its debt and gain the financial and clinical resources of two larger healthcare organizations. The agree-ment also allows Sacred Heart to fill a gap in its service area and strength-en its presence in a key market in Northwest Florida.

RETURN SERVICE REQUESTED

8880 University Pkwy., Suite BPensacola, FL 32514Ph: 850-478-0706 Fx: 850-474-9783Email: info@escambiacms.orgExecutive Director: Erica Laxson

PRSRT STDU.S. POSTAGE

PAIDPERMIT #258

PENSACOLA, FL

View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission.

Member Benefit: The Health Care Attorney On Call Hotline (561) 306-5699

www.escambiacms.org

MECOP Reminder

43rd Annual Pediatric SymposiumMemorial Day WeekendSaturday, May 26, through Monday, May28Hilton Sandestin Beach Golf Resort and Spa7 a.m. until Noon each dayvisit www.mecop.org for topics and agendaContact 850.477.4956 (option 1) to register

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