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TheCOMPASS

Official Publication of the California Association of Oral and Maxillofacial Surgeons

N

CompassDirection

Volume V, Issue 1, Spring 2003

President’s MessageJohn Bond, D.M.D.

In preparing for our recent 3rd

Annual CALAOMS Meeting inSanta Barbara in early January,I made a few notes to myselfabout where our organization has

been, where it is, and importantly whereit is going. Following this highlysuccessful meeting, the thoughts I putdown seem even more poignant.Accordingly, I would like to share themwith you.

But first let me report that by allstandards, the Annual Meeting held atthe Four Seasons Biltmore in SantaBarbara was an unequivocal success.It began with a well attended PastPresident’s Dinner in which PastPresidents from CALAOMS,NCSOMS and SCSOMS all had thechance to remember and share pastexperiences over the years withorganized OMS in California. On

Saturday and Sunday, the continuingeducation portion of the meeting,featuring Karen Baker from theUniversity of Iowa, kept everybodyengaged. As an experienced educatorin medical and dental education, Karenbrought back into focus and frequentlyprovided all in attendance with new andmeaningful insight into the everydaypharmacology we all need to know and

understand, particularly from ananesthetic perspective in treating ourpatients. At our membership luncheonon Saturday, Dr. Sam Aanestad, wasawarded our Distinguished ServiceAward for all that he has done over theyears for Dentistry and Oral andMaxillofacial Surgery in Californiawith his past service in Sacramento inthe Assembly and now as a CaliforniaSenator. Dr. Tim Silegy was awardedCALAOMS’s Committeeperson of theYear Award for his work instandardizing and improving our OralAssistant’s Course. Senator JackieSpeier, a long time friend of dentistryand oral surgery, was our featuredlegislator speaking to some of thecurrent issues facing California’s health

scene, particularly in the context of thestate’s budget crisis. On Saturdaynight, the installation of this year’sofficers occurred, as well as a time tohonor Dr. Bernard Kingsbury, to whomthe meeting was dedicated. And last,but not least, for those choosing to stayan extra day, a well attended andsuccessful PALS course wasconducted. Bravo to Pam Congdon,Lynda Bradley and all the CALAOMSstaff for putting together this greatmeeting.

Continued on 0

Dr. John Bond Leads CALAOMS in 2003

CALAOMS needs tocontinue being the voice andconscience of oral andmaxillofacial surgery inCalifornia

President’s Message Page 1

Editorial Page 4

Letters To The Editor Page 5

Point - CounterPoint Page 7

Santa Barbara in Review Page 8

USF 10th Int. Symposium Page 11

Thank you Dr. Franklin Page 14

Report from Anesthesia Page 16

General Announcements Page 18

Upcoming Events Page 18

OMSA Chair Speaks Out Page 19

In Memorium Page 19

AAOMS Dist VI Update Page 20

Classified Ads Page 22

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The Compass - Spring 2003

The COMPASSpublished by the

California Association of Oraland Maxillofacial Surgeons

Board of DirectorsJohn S. Bond, D.M.D.President (408) [email protected]

P. Thomas Hiser, D.D.S., M.S.President-Elect (619) [email protected]

Michael E. Cadra, D.M.D., M.D.Vice President (209) [email protected]

Gerald Gelfand, D.M.D.Treasurer (818) [email protected]

Murray K. Jacobs, D.D.S.Secretary (209) [email protected]

Mary Delsol, D.D.S.Past-President (949) [email protected]

Bruce L. Whitcher, D.D.S.Director (805) [email protected]

Larry J. Moore, D.D.S., M.S.Director (310) [email protected]

Ned L. Nix, D.D.S.Director (408) [email protected]

Lester Machado, D.D.S., M.D.Director (858) [email protected] CongdonExecutive Director (800) [email protected]

Corrine A. Cline-Fortunato, D.D.S.Editor (408) [email protected]

Steve KrantzmanNewsletter Production Manager(800) [email protected]

Published 3 times a year by the California Association ofOral and Maxillofacial Surgeons. The Association solicitsessays, letters, opinions, abstracts and publishes reports ofthe various committees; however, all expressions ofopinion and all statements of supposed fact are publishedon the authority of the writer over whose signature theyappear, and are not regarded as expressing the view of theCalifornia Association of Oral and Maxillofacial Surgeonsunless such statement of opinions have been adopted by itsrepresentatives. Acceptance of advertising in no wayconstitutes professional approval or endorsement.

Your CALAOMSCentral Office Staff

Executive DirectorPamela CongdonPhone Extension: 12email: [email protected]

Associate DirectorLynda BradleyPhone Extension: 11email: [email protected]

Information Systems DirectorSteve KrantzmanPhone Extension: 13email: [email protected]

Administrative AssistantBarbara HoltPhone Extension: 10email: [email protected]

Administrative AssistantDebi CuttlerPhone Extension: 14email: [email protected]

151 North Sunrise Avenue, Suite 1304Roseville, CA 95661

Office: (916) 783-1332Office: (800) 500-1332Office: (800) 491-6229Fax: (916) 772-9220

Web Site: www.calaoms.org

Your staff is here to help you withany questions about membership,continuing education courses, certi-fication, and events. Please do nothesitate to contact us with questionsor concerns at:

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The Compass -Spring 2003

Editorial

Editor’s Corner

I was both honored and excited tobe asked to serve the membershipthis year as editor of TheCompass. I have to admit this ismy first editorial position of any

substance (I don’t think my garden clubnewsletter qualifies). Therefore, I inviteand welcome your thoughts, commentsand perspectives. I hope we are able toprovide you with articles and updatesreflective of the interests expressed by ourmembership. Having said this, please feelfree to contact me with any submissions,topics of interest, pictures, concerns oropinions you would like to share. I lookforward to hearing from you and sharingyour feedback. Phone: (831) 475-0221Email: [email protected]

Valley and the Monterey Bay areas“home”. What continues to amaze me isthat for such a large and diverse state,California still manages to be a trendsetterfor the rest of the nation. It’s trueculturally, socially, economically andprofessionally. I recall enquiries by myEast Coast colleagues in the early ‘90’sabout the effect increasing HMO/PPOplans were having on the practice ofdentistry. They had “heard about it outin California” and wanted to know whatrealities were in store for them. (Icouldn’t say being in an OMS trainingprogram at the time).

More recently my colleagues callwith questions about “alternativetherapies”. They relate tales of patientson “homeopathic medications” or “herbalsupplements” (some prescribed…others

self-administered). For most of uspracticing in California this is nothingnew. Most of us have had patients bringin their “laundry list” of supplements.This increasing trend prompted our officeto add a question to our health historyform about herbal/homeopathicsupplements. Initially, I was surprised bythe number of patients who were taking“herbs” but did not know the compositionof their “formula”. Many were curiousas to why we would ask about suchremedies. The general assumption beingif it was “natural” it was “safe”. Somehow“herbal” translated to “nontoxic”, “noside effects” and “non-allergenic”. Manypatients were shocked, even skeptical, tolearn these products could pose certainhealth risks when taken in combinationwith other substances (prescribed or not)or in large enough quantities (if a littlewas good more must be better). I foundmyself increasingly recommendingsources such as the Review of Natural

Products and Alternative Medical Alertfor specific product effects. Both sourceswere extremely helpful, but cumbersomein a quick passed practice setting.

This year, I was fortunate enough toorder the 2003 Deluxe Lab-Coat PocketEdition of the Tarascon PocketPharmacopeia. I usually get the ShirtPocket Edition but the Lab Coat Editioncame with a sheet magnifier. (It was allabout the larger print…I’ll admit it.) Inaddition, it has an entire section on herbaland alternative therapies. In my neck ofthe woods, I use it every day (Ah, beautifulSanta Cruz…home of the only, and nowdefunct, marijuana B&B…but that’s adifferent story). While not quite ascomprehensive as the previouslymentioned sources, it is succinct,compact, convenient and exceeds myneeds. I have found it very helpful.

Please don’t misunderstand my levityas an attempt to make light of the benefitsof herbal remedies. Rather it is myhumble attempt to share what I believe isa growing trend. Many people just don’tcategorize these substances as “drugs” or“medicine” and may therefore fail toinclude them in their health history unlessotherwise prompted to do so.

As health care providers it isimportant to stay abreast of the potentialdrug interactions, surgical implicationsand adverse effects this expanding aspectof self-administered pharmacologypresents.

It’s never easy being trendsetters.

Corrine Cline-Fortunato, D.D.S.Editor, The Compass

Corrine Cline-Fortunato D.D.S.

Editorial

I’m a native Californian, but when arecent inquiry about my hometownelicited a noticeable and uncomfortablepause prior to my reply I felt guilty. It’snot that I’m ashamed of the area (PismoBeach…what’s not to love!?). But for thefirst time I guess I realized what a truly“locally nomadic” life-style I’ve lived. Atone point or another I’ve had theopportunity to call the Greater LosAngeles Basin, L.A.’s South Bay, theInland Empire, the Central Coast, Silicon

Many patients wereshocked, even skeptical, tolearn these products couldpose certain health risks...

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Letters to the Editor

“Brevital is ComingBack….So Big Deal”

I wanted to put some of my thoughtsdown on paper to hopefully arousesome of our critical thinking. Weare confronted with decisions to bemade as things change and move

forward in the daily practice of ourspecialty.

Many of us trained using bothBrevital and Propofol. Our attending oraland maxillofacial surgeons (OMSs)professed they had been using Brevital for30 years and it has always worked fine,“in their hands.” In my hands duringtraining, I experienced the two pack-a-day smoker who just coughed andwheezed as we continued to pour in theBrevital, 30 mg, 100 mg, 200 mg. Thepatient was moving around in the chairas my co-resident held the patient downand we rushed through the procedure.The patient continued to “tach-away” atrates well above 100/min.

Then there was the asthmatic. Thepatient’s airway appeared to be reactiveto secretions and wheezing and coughingagain ensued. We gave more Brevital anddeepened the anesthetic as our attendingsuggested, “Deepening your anestheticwill decrease airway reactivity.” “You dohave succinylcholine ready in the eventof a laryngospasm, don’t you? Ourattending professed, “We usually just put

the patient deeper in our office.” “It mustbe the response to increased histaminerelease.” “The tachycardia is thedisinhibition at the central nervoussystem.” It always seemed to me thesecases could have run smoother. I wasnever really comfortable putting thepatient with co-morbidities into a deeperplane of anesthesia (I still don’t mindputting the ASA I patient as deep as I needthem). It just seemed to be an anestheticcomplication waiting to happen. We alsoused to take ‘breaks’ in our surgeries nowand then to ventilate the patients with full-face mask oxygen. I don’t do that whenusing Propofol.

The resident team always made thecase for the administration of Propofol.We all used it on our four to five monthanesthesia rotations. Our anesthesiaattendings continued to ask, “You guysstill use Brevital down in the clinic?” “Wehaven’t used methohexital up here foryears.” Our OMS attendings continuedto object, “I just don’t feel comfortablewith Propofol.” “I have been usingBrevital for years.” “Why should I changethe way I have been doing things if I havebeen doing it successfully for yearswithout adverse outcomes?” I was taughtto always question authority. I havealways hated the reasoning, “We havebeen doing it this way for years.” We oweit to our patients to be lifetime learners. Ithink dentistry tends to be a science basedmainly on clinical experience; while OMS

seems to be more reliant on evidencedbased dentistry and medicine.

Our literature is replete withevidenced based trials studying the useof Propofol. Propofol with Versed,Propofol with Ketamine, Propofol withKetamine and Versed, Propofol alone,Propofol through a pump, etc. How longis the “If it’s not broken, don’t fix it,”adage going to substitute for sound,evidence based clinical decisionsregarding what is best for our patients?At last year’s AAOMS meeting, I spoketo a group of OMS who said, “What arewe going to do now that Brevital isunavailable.” I received calls from‘seasoned vets’ in New York where Itrained asking me, “What are you guysdoing out in California?” Hopefully,these people have realized there are otherdrugs available in the sedative-hypnoticclass that can produce general anesthesia.Maybe the unavailability of the drug hasencouraged these clinicians to exploreother avenues, maybe even pick up theirJournal.

New techniques and therapies arealways being presented to us. It seemedlike every time I heard Bruce Epker speak,he was always saying, “You guys are stilldoing that!” This was about the time Ihad just finished the chapter in the latestedition of his book. What importantlycomes to mind is the need for criticalthinking involving the non-depolarizingneuromuscular blocker Rapacurium. Thismedication was touted by members of ourspecialty as the replacement forsuccinylcholine in emergency protocols.After clinical trials, there werecomplications and deaths associated withits administration in the operating room.Remember the Duract samples everybodywas given? This NSAID caused kidneyfailure and death in patients. I havealways liked to wait a while and reviewreports of new techniques and therapiesbefore ‘jumping on the band wagon.’

I feel strongly that now is the timeto let go of the ‘security blanket’ that is

Ned Nix, D.D.S.

I feel strongly that now isthe time to let go of the‘security blanket’ that isBrevital, and move forwardwith a drug that is better andsafer for our patients

Continued on Page 6

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Brevital and move forward with a drugthat is better and safer for our patients. Ittook everybody time to learn how to useBrevital effectively. It is time to givePropofol the same chance. I dose itsimilarly to Brevital. Its distribution half-life is shorter than that of Brevital (the goodnews is so is its elimination half life). I haveused the infusion pump, a ‘piggy back’ driptechnique and the ‘bump’ technique we alluse for Brevital. All of these techniqueswork. It just takes time to develop thetechnique that works best in eachindividual’s hands. At first, I had difficultygiving it in one to three milliliter doses(‘bumping it’). I seemed to have more luckwith the pump, or my drip titrationtechnique (a 20 ml vial mixed in a 250 mlbag, piggy backed with a 60 drop per mlIV set). As I learned to use it titrated withVersed and Sublimase, I actually developedthe ability to bump it along and produce asmoother and safer general anesthetic thanI was able to provide with Brevital.

I do not see airway hyper reactivitywith asthmatics who get Propofol. I havenever seen a laryngospasm in patients whoreceive Propofol. Patients are waking upfaster, more alert and report feeling‘fresher’, rather than ‘lethargic’. Propofolhas excellent antiemetic properties. Mypatients report less nausea and vomitingpostoperatively (even the patients that getKetamine) than the patients who used to getBrevital. Since droperidol was “black-box”warned I don’t even care that it has beeneliminated from my armamentarium. I feelbetter knowing patients are alert at homewithout long residual sedative effects,especially those taking post operativenarcotic analgesics (supervised or not) athome.

What about Propofol’s drawbacks?Propofol used to be about five times moreexpensive per case (now in its generic formit is only 25% more expensive, if you canhelp from wasting your unused portion), hasa short shelf life, and has a ‘learning curve’in its titration to effect. I have found thatsome patients exhibit a ‘Stage II effect’

apparently having a problem moving fromStage I analgesia into an acceptable surgicalplane of Stage III surgical anesthesia(described by Guidel for ether anesthetics,but a good analogy here). Propofol can bequite euphoric in some patients. Thesepatients can appear ‘Stoned’ and somewhatrestless. Like my Brevital anesthetics,Ketamine works wonderfully here as a“rescue drug” to smooth the anesthetic andreturn the patient into a workable Stage IIIplane of anesthesia (Ketamine in 10 to 20mg doses).

Brevital is a good drug. It works verywell on most patients. In my hands, I haveused it successfully for years. I would liketo keep it as an option in my armamentariumfor IV general anesthesia. My contentionis that all the evidence is there for the useof Propofol as the first line drug for generalanesthesia in our practices. Maybe the bestthing that happened recently to the safedelivery of ambulatory general anesthesiain the OMS office was Eli Lilly closing the‘old’ Brevital plant. I have cancelled thatlong-standing order.

Ned Nix, DDS

Letter to the Editor Continued from page 5

The Santa Barbara meeting was ashowcase for a successful meeting of theCalifornia Association of Oral andMaxillofacial Surgeons. That meeting wasa tribute to the evolution and maturationof CALAOMS. There has been quite achange since 1986. At that time asuccessful plaintiff planned to use a largejury award to prevent dentists fromadministering general anesthesia in theoffice. CALAOMS had then only recentlyformed, really because of necessity. It hadbecome clear that the two oral andmaxillofacial surgery societies inCalifornia should unite and form anassociation. The California Dental

Association was used as a model for thecertification and utilization of componentsocieties.

The original goals of CALAOMSwere to increase communication and speakin a unified voice to the AmericanAssociation of Oral and MaxillofacialSurgeons, CDA, the California Legislatureand the Dental Board of California. Aliability insurance program was urgentlyneeded and was secured for all CALAOMSmembers. CALAOMS members nowoccupy many key positions in AAOMS andCDA. Our political action committee hasbeen very active and successful. We shouldall be proud that one of our members, Dr.Alan Kaye, is now President of the DBC.

All OMS in California are fortunatelyriding the wave of success, and enjoysuccessful practices. We are the envy ofmany medical and dental specialties.However, we must beware of the wipeout.Another dental specialty continues toemphasize the placement of dentalimplants in graduate training programs.MD anesthesiologists frequentlyadminister general anesthesia in dentaloffices for dental, surgical and restorativeprocedures. We are currently experiencinga constant change in the dental diseasecomplex and a definite shift towardprevention and esthetics. We must continueto bind ourselves together and protect ourspecialty, our turf, and plan for the future.

CALAOMS members may be bestserved by the formation of the rebirth andvitalization of at least two componentsocieties and the certification of studyclubs. This concept will result in improvedtotal CALAOMS member participation,the coordination of meetings and possiblyincreased revenue. However, the primaryobjective should be increasedcommunication among the membership.California is a very large state. CALAOMSwas started as an association of twosocieties. There is ample room for severalcomponent societies. Our numbers willcertainly increase in the future. Regionalmeetings will result in more total memberparticipation. The maintenance of

Point

CALAOMS: The Pastand The Future, An

Opinion

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friendships and fellowship is important forthe continued progress of our specialty. Ithas been written elsewhere that whenevertwo or more people get together, goodthings may happen. Personally, I havefound that I occasionally learn more atmeetings by talking to colleagues duringbreaks than at the actual didactic portionof the meeting.

CALAOMS members should not fearattending specific meetings because it maybe politically incorrect. Speakers should beable to accept an invitation without fear ofoffending anyone and enjoy the freedom ofspeech as guaranteed in the Constitution.CALAOMS must have constant feedbackfrom the entire membership in order toremain responsive and democratic. It is theAmerican way. Representation of themembers will be best accomplished by theestablishment of component societies.Local OMS societies should be able to sendnominees for positions on the CALAOMSBoard of Directors. This concept hasworked very well for CDA and it continuesto flourish. Trustees to CDA are responsiveand serve the CDA membership very well.We should continue to follow this model.

Ross W. Prout, D.D.S.Past President CALAOMS

Past President SCSOMS

CounterPoint

Heraclitus taught us “You cannot steptwice into the same river, for fresh watersare ever flowing in upon you.” The visionwith which CALAOMS was founded in1986 has guided the leaders of our specialtyin this state for almost two decades. Indeed,it seems the crises that precipitated itsformation then are not far removed fromthose we face today. Threats to office-basedanesthesia, assaults on scope of traditionalas well as contemporary practice, erosionof a stable malpractice industry, and

inequitable reimbursement are issues aliveand well. Our advantage today is that ourspecialty is represented by a unified,proactive association with close ties withour national organization (AAOMS), ourstate dental association (CDA), the stateDental Board, and our state legislature.

However, true vision remains fluid; itresponds to shifting trends and changingcircumstances. It is progressive andproactive. A strategic plan formulated 20years ago is obsolete today unless it hasresponded to the changes in theprofessional, legal, and legislative arenas.

The unification of the two statesocieties was a response to burgeoningfinancial and manpower considerationsfaced by this association. Recentleadership undertook the formidable taskof creating an efficient organization thatdelivered significant membership serviceswithout demanding onerous duescontributions. A central office with anexperienced staff is able to conduct thebusiness for the entire state in aprofessional and competent manner.

The CDA model is an attractive one,but one that requires incredible manpowerand financial resources. The difference inmembership numbers explains the differentcapabilities of a state dental association anda specialty organization —— CDA hasover 15,000 members that serve as a poolof monetary and volunteer resources, whileCALAOMS has barely 600. Each CDAcomponent society has a Board ofDirectors, an Executive Secretary, andnumerous employees to staff committeeson membership, mentoring, publicrelations, continuing education, publicservice, newsletter publication, etc. All thisleads to unwieldy payroll and budgetaryimplications. The creation of even twostate component societies would bringincreased bureaucracy that would engulfrevenues that are much better spent onfighting the issues critical to our specialty.

California is indeed a big state andproviding accessible continuing educationopportunities is a constant challenge. But

fractionalization and division of resourcesare not the answers. Last year, theContinuing Education Committee offered14 meetings throughout the state, providingnumerous opportunities for membershipparticipation. This committee is constantlyasking for feedback and suggestions toimprove its offerings for future meetings,but seldom is input received. Thecommittee is open to volunteers to proposeand plan local or regional meetings, but fewstep forward. The creation of local studyclubs certified and funded by CALAOMSis an excellent idea to promote two keygoals of this association: provision ofaccessible CE opportunities and fellowshipamong members. Anyone willing toestablish such a study club will mostcertainly be a welcome addition to ourvolunteer corps.

The enemy waits outside the gate.CALAOMS faces daunting challenges: thepreservation of our ability to practice ourspecialty as we know it today, thetremendous competition for revenuesources, and continual assaults on ourrecord of safety and competence. Oursuccess as an association, and as a specialty,hinges on the commitment of our membersto support and participate in a focused andunified body.

Mary Delsol, D.D.S.CALAOMS Past President

The opinions expressed in the“Letters to the Editor” and “Point- CounterPoint” sections, are theviews of the authors and only theauthors. These are not the viewsof CALAOMS, nor doesCALAOMS endorse these views.Nor should any assumptions bemade about endorsements of viewsand opinions, by CALAOMS as anorganization, by its Board of Di-rectors as governing body, by itsGeneral Membership as a whole,or by it’s Editor.

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Santa Barbara in ReviewTHANK YOU CALAOMS

or (If I Only Knew Then What I Know Now)

I had the most enjoyable time at the recent CALAOMSmeeting in Santa Barbara. Thank you, Pam and crew for allyour efforts. The results certainly showed your attention to themany details that are required to obtain a smooth running event.The facility was truly Four Star. We were arriving late Friday at2:00 am and we called the hotel for directions. Usually the staffmember manning the desk at that time would have minimalexperience and had been relegated to the graveyard shift. Wewere pleasantly surprised to have a sharp and efficient youngman named Erin who had the bellman waiting outside in thecold when we drove up. We were in our room in no time. Therest of the time, the hotel staff were ever present but unobtrusive.My wife took advantage of the spa facilities next door and took adriving tour of the adjacent hills. With a subtle manner, thehotel generated a natural relaxing and calm atmosphere. Thisincluded the use of three wheeled bikes for the porters. I guess Ishould start staying in better places!

The meeting program itself was better than expected. I hadalready attended Dr. Baker’s presentation at the Montereymeeting last year and was expecting a sleepy rehash of thematerial (I fall asleep a lot!). But, much to her credit, Karen(since I’ve heard her twice) has such a strong grasp of the clinicalrelationship of pharmacology that she can even keep a sleepyhead like me interested. Her handouts are priceless.

The PALS course was stress free. The format was one ofkeeping things simple and trying to look systematically at theprecipitating causes of an infant or child arrest. It trulyencouraged one to learn more. The course also made me feel

that the PALS course should be one that I repeat at least everytwo years.

On the road home, my wife asked me two questions. First,“If you had such a good time, why haven’t we come to one insuch long time?” And, the second question was, “Where are therest of the guys?

The answer to the first is laziness. For awhile, things weregoing well and the effort to go and spend a weekend talking oralsurgery was not too inviting. What changed? It seems to me, asI talk to some of my contemporaries, that the concern for stayingup with the current state of oral surgery is becoming a biggerissue. Finding ways of “keeping up” seems to be getting harder.Finding opportunities of spending a relaxing weekend with yourspouse and obtaining some meaningful continuing education atthe same time is even more difficult. I think CALAOMS did awonderful job of fulfilling these requirements in Santa Barbara.My wife enjoyed the respite, she enjoyed meeting other spouses,and I think she would look forward to attending other meetings.

The answer to the second question is harder to answer. Iwas surprised that the meeting had only limited attendance. Ibelieve we have approximately 700 plus members. Only 95 signedup. The PALS course had only 24 participants. I know I had alltypes of excuses for not attending CALAOMS meetings but iffuture meetings are of a similar caliber, I would certainly endorsethe meetings to all my colleagues. I hope that CALAOMScontinues to bring forward excellent speakers at ideal locales atan affordable fee. The weekend format certainly fits the demandsof my office.

Thanks again.Norman G. Wat, DDS

On Monday following the CALAOMS Annual Meeting inSanta Barbara, 22 OMS’s stayed to take the PALS (PediatricAdvanced Life Support) course. To the tune of the pop song“Fever” sung so often by our instructor Shari Coleman, RN, MSN,that it became a mantra, we learned the assessment parametersand interventions to treat shock in newborns, infants and children.Aided by her husband Chuck Coleman- and our own DukeYamashita, DDS, Shari led us along an easy path through a forestof physiology, diagnosis, normal values and failing organ systems.At performance stations, we practiced CPR, intubation, vascularaccess (including intraosseous technique) and defibrillation.

Although we covered a lot of material that was largely newinformation, most attendees would agree that the most difficultpart of the course was having to be indoors on such a beautifulday! The location at the Biltmore Hotel in Monticello, the superblunch, and the supportive teaching style of the instructor madethe day’s experience pleasant as well as practical.

Shari Coleman has agreed to teach the PALS course againnext January at the Anesthesia Symposium weekend in PalmSprings. If you missed the opportunity to take the course thisyear, put it on your calendar for the January 17-18 meeting nextyear.

PALS Were Found in Santa Barbara

Roger S. Kingston, D.D.S

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CALAOMS would like to thank the following Companies for contributing above and beyond the call forexhibitors by sponsoring events at the Santa Barbara Meeting. These companies are listed below by thelevel of their sponsorship, and the event they proudly sponsored. It would be very difficult to put on thequality of events we provide without the support of these valued partners. Thank You, from CALAOMS

Platinum Level

� Hal’s Med-Dent SupplyInstallation Banquet Dinner

� The SCPIE CompaniesScientific Sessions

Gold Level

� Littell Industries, Inc.Exhibitor Cocktail Party

Silver Level

� W. Lorenz Surgical, Inc.Past President’s Dinner

Bronze Level

� OMS National Insurance Co.Registration Gift

� INION , Inc.Membership Lunch

CALAOMS President, Dr. John Bond, presents Dr. Tim Silegy(OMSA Committee Chairman), the “Committee Chairperson of theYear” Award at the Installation Banquet.

CALAOMS President, Dr. John Bond presents Senator SamuelAanestad, D.D.S. the 2002 “Distinguished Service” Award atthe Installation Banquet.

State Senator Jackie Speier presented her views on the safety recordof Oral Surgeons, the State Budget, and other issues that affect theability of professionals to work with the state legislature.

Current President John Bond, and Past President TimShahbazian discuss issues facing CALAOMS after the BoardMeeting, which proceeded the Annual Meeting.

10


With the holiday rush behind usand feeling somewhat settled into ournewly remodeled home, Anne and Idecided to attend the CALAOMSAnnual Meeting in Santa BarbaraJanuary 10-13. We had not ever visitedthe Four Seasons Biltmore so theanticipation seemed to make the drivefrom Corona del Mar go faster. Ourfirst event was the Past President’sDinner near the hotel on Friday night.There was an excellent turn-out for thedinner with abundant camaraderie anda pleasant dining atmosphere. Wechecked into our room late and werepleasantly surprised by its warmth andcomfort. The entire hotel had beenrecently facelifted, so our “timing” forthis meeting was excellent. I was upearly Saturday for the continentalbreakfast and the first session with Dr.Karen Baker from the University ofIowa. The hype for the meeting wasright on, since Karen’s approach isbasically an avalanche of information.The handouts were a necessity, sincethe pace required for note-taking wouldhave been beyond a court-stenographer.I really didn’t want to miss any of theeducational seminars, because theinformation was so pertinent to ourpractices and Dr. Baker was also veryentertaining as a speaker. Duringlunch, we were entertained by theexcellent speaking ability of SenatorJackie Speier. We learned a little aboutthe reality of the legislative processwhen seeking “expanded” privileges.”Ms. Speier floated a few concepts suchas a services tax to help balance thestate shortfall. Needless to say, this

elicited some hissing from theassemblage. Jackie feels strongly aboutthe need for an improved health caresystem and that we need to bettereducate the public about what we doas OMS’s. She stated that mostCalifornians are “an accident away, ahealth problem away, from disaster andfinancial disability.” Perhaps payrolltaxes could be used to help financeuniversal health coverage, according toSenator Speier. Jackie did a good job,I felt, of explaining how the budgetshortfall occurred due to the lack ofstock options to exercise by the state.

Saturday night came quickly aftera wonderful afternoon with free timeto see the beautiful tropical grounds ofthe hotel, and walk around town toenjoy the many art venues and shoppingopportunities. The exhibitor cocktailreception and dinner were enjoyableand excellent. Our CALAOMSofficers under the direction of our newPresident, Dr. John Bond, wereinstalled.

Sunday brought another excellentand informative session with Dr. Baker.Her information on drug interactionsand various computer based programsto make this confusing evaluationprocess for each patient more accuratewas excellent. Although I could notstay for the PALS program, I felt thatthe overall evaluation of the meetinghad to be top-notch. More than 90doctors and 30 exhibitors attended.CALAOMS is absolutely providing thehighest level of continuing educationprograms statewide with qualityspeakers and modern, relaxing venues.Getting back to beautiful SantaBarbara was certainly worthwhile!

Gary Carlsen , D.D.S.

President’s Message Continued FromPage 1

And now, to my notes. As I lookforward to this year and the work wehave before us, I find it comforting toknow that all one really has to do iscontinue down the path of those PastPresidents who have preceded me inrecent years. I think of Lee Heldt, JeffPersons, Tim Shahbazian and mostrecently Mary Delsol. Importantly, Ialso believe we all do well to reflectover where CALAOMS was just threeor four years ago, where we are now,and the strides we have made.Thoughts that come to mind are:

a.) Our influence in and withCDA

b.) Our success andrepresentation on the Dental Board ofCalifornia

c.) Our influence and stature inSacramento with elected officials

d.) The quality and quantity ofcontinuing education we provide

e.) The maturation of ourCommittee structure

f.) Our relationship and influencewithin AAOMS, District VI andWSOMS including committeerepresentation and chairmanships

g.) Our success in expanding ourmembership, particularly new youngOMSs

There are undoubtedly others areasone might bring to mind, but Ipersonally find these the mostcompelling.

CALAOMS needs to continuebeing the voice and conscience of oraland maxillofacial surgery in California.This needs to be played out in thearenas of advocacy, continuingeducation, membership services andrecruiting and preparing those who areto follow and pick up the reins ofleadership in organized oral surgery

Santa Barbara, A PastEditor’s PerspectiveOn the 3rd AnnualCALAOMS Meeting

11


within the state and nationally. Inkeeping with our strategic plan, as thetime proves to be right we are preparedto introduce legislation in California toinclude the ADA’s definition ofDentistry and OMS. Importantly, forthe health and welfare of oral andmaxillofacial surgery in California andall its varied members, we need to reachout and be inclusive and to meet theeducation and practice needs of thisdiverse group. As OMSs we need toavoid factious and divisive actions thatseparate us, and rather nurture and seekout ways of unifying ourselves withinour wonderful profession. There areenough others out there seeking andwishing us ill will to preclude any urgeor tendency for us to wish ill will orcause harm to one another. This is truewhether as individual practitioners oras organizations.

We need to be vigilant in the areaof anesthesia and the single operator-anesthetist model, as well as insistingthat all of those who administersedation drugs in a dental setting,regardless of the method ofadministration, do it safely and with theappropriate oversight. The malpracticeinsurance woes that face many aroundthe country are always of concern.Fortunately, MICRA exists inCalifornia and one would hope it willhelp to stave off some of the problemsin other states, but this must not betaken for granted. And probably mostimportant of all is the need to recruit,educate and involve the new young oraland maxillofacial surgeons into theheritage and future of this great andhonored profession.

To these ends, I pledge to do mybest as I serve as your President thisyear. Please feel free to call on myselfand/or any of the officers, directors orstaff throughout the coming year. May

god bless you and yours, as well as thisgreat country of ours as we moveforward in the months and years tocome.

John S. Bond, D.M.DPresident, CALAOMS

Participants in the 10 International Symposium in OMS frome left to right are: Drs.Bertolami, Kent, Allen, Quinn, Lieblich, Piecuch, Challacombe, Preciious, Worthington,Pogrel, Pikos, and Turvey (not pictured).

UCSF 10th InternationalSymposium in OMFS

It is hard to believe that anotheryear has passed and the UCSFSymposium in OMS was presented bya distinguished faculty to the largestattendance in the series. The 2003program “Controversies, Choices andNew Ideas” was presented in Januaryin Kauai, Hawaii. The participants wereable to go whale watching, snorkeling,and , of course, golfing.

Most of all, the educationalprogram featured a list of guestspeakers know throughout the specialtyfor their expertise. The week beganwith Dr. David Precious, from Halifax,Nova Scotia, and Dr. Timothy Turvey,from North Carolina; followed the nextday by Dr. Stuart Lieblich fromConnecticut, and Dr. StephenChallacombe (Oral Medicine) fromLondon, England. The third dayfeatured discussions on TMJ surgeryby Dr. Peter Quinn from Philadelphia,and Dr. John Kent from LSU. Dr.Phillip Worthington from Seattle,Washington, and Dr. Joseph Piecuchfrom Avon Conn., discussedmalpractice and considerations inimpacted third molar teeth.. The finalday brought a discussion of Allodermby Dr. Edward Allen from Dallas, andDr. Michael Pikos, from Florida. whopresented a discussion on Mandiibularblock autografts.

Symposium directors Dr.Charles Bertolami, Dean UCSF Schoolof Dentistry and Oral andMaxillofacial Surgeron, and Dr. M.Anthony Pogrel, Chairman OMS atUCSF are to be congratulated for yetanother excellent meeting.

14


As I gazed out the window of our two-engineprop plane, I realized that our flight attendanthad been right. When we had boarded the planeback to San Francisco from our AnnualCALAOMS Meeting in Santa Barbara, she

had told us that we would enjoy the view - that it was muchbetter than the view from the larger commuter jets flyingseveral thousand feet above us. That spectacular view didindeed easily compensate for the drone of the engines in thebackground. We were close enough to the tops of the cloudsthat it was as if one could walk upon them and bask in themauve, maroon and violet pastel hues which began to imbuethe sky of the day with the aura oftwilight. What a wonderful setting inwhich to curl up with a good book duringthe hour’s flight. With his birthday buta week away I had chosen BenjaminFranklin’s biography by H.W. Brandsentitled The First American. My choiceproved to be fortuitous. When I got topage 512, Franklin’s words virtually leptfrom the page and imprinted themselveson the expanse of the great welkin as ifwritten by some phantom skywriter in a 1930’s bi-plane:“Yes, we must indeed all hang together, or most assuredlywe shall all hang separately.” His words resonated acrossthe two and a quarter centuries which temporarily separatedus.

In his ageless wisdom, Franklin was able to put to wordsthe frustration I had felt as I had departed the meeting. Ourspeaker Karen Baker had been both informative anddelightful. The venue was beautiful, the weather perfect andthe camaraderie wonderful. Why then did we not see farmore of our members in attendance? For every CALAOMSmember present, 4 or 5 has stayed home. Why was it that somany appeared to not appreciate the importance of our“hanging together” as oral and maxillofacial surgeons. “Ah,”say you -“surely Rich is not trying to convince us that if wedon’t attend CALAOMS meetings we will be hanged.” No

I’m not, but I do feel that we all need to realize that ourfreedom to practice as we have in the past and wish to continuein the future should not be taken for granted. Unfortunately,as Aldous Huxley opined “Most human beings have an almostinfinite capacity for taking things for granted.” If one doubtsthat our freedom to practice as we wish could be in jeopardy,one need only look at the example of organized (ordisorganized) medicine. When our physician colleagues werefaced with the threat of their practices becoming controlledby the mid-level insurance managers, actuaries and insuranceclerks of managed care they were unable to band together topreserve their practice autonomy. When an organization suchas the American Medical Association cannot even claim 50%of physicians as members, what sort of voice does it provide?But as oral and maxillofacial surgeons, surely we have thepride to rise above this abysmal state of affairs.

We of your CE Committee, yourBoard of Directors and your ExecutiveCouncil felt that we had provided for ourannual meeting all of the things which ourmembers wished, and that we would seea good turnout. I am sure that for manyof those who were not able to attend therewere excellent reasons: sickness, a deathin the family, being there for your kidwhen he got the lead in the school play,

etc. But were there truly 400 legitimate reasons for thosewho did not attend the meeting?

But let us not dwell on all the reasons why one may nothave attended, but rather on why we should attend ourmeetings whenever we can. Certainly excellence ofcontinuing education is one of those reasons. As you willrecall, two years ago we surveyed our members to get yourinput. The overwhelming number of our nearly 200respondents put office anesthesia, surgical complications andmanagement of medical emergencies and of the medicallycompromised patient at the top of the list. Your committeehas responded to your wishes and we have fielded courses inthese areas which have received the highest accolades fromattendees. If our members said they wanted this material,and the attendees felt that the courses were excellent, why doso many other CALAOMS members fail to attend? Let’s

THANK YOU AGAIN, DR. FRANKLINA Commentary By Richard Robert, D.D.S

Franklin’s words virtuallylept from the page......“Yes, we must indeed allhang together, or mostassuredly we shall all hangseparately.”

Richard Robert, D.D.S, M.S.

15


face it, we are all required by law to take CE - and it wouldbe essential for our advancement, even if the regulations werenot there. So why not support your society when you takeCE? As you look through your CE brochure, you will seenumerous excellent courses that will enable you to fulfillyour CE requirements, both personal and legislated. If youhaven’t been attending these courses, talk to those who did.I think you will find very good reason to reconsider.

A second and essential role of our meetings is in theestablishment of a political foothold for oral and maxillofacialsurgery in the State of California. Through the efforts of ourboard, our legislative committee and our excellent lobbyistMark Rakich, we are beginning to put ourselves on thepolitical map. At our first three annual meetings we havehad such political not attuned to the changes which couldtake place around us, the changes that do take place maywell take us by surprise. Come to our meetings and shareyour thoughts and experiences with one another. Sit next toa board or committee member and tell him or her how youfeel. Find out what is going on and give us your input. Thesuperstructure of our organization is much like that of arepublic. It only works if those who are chosen to representyou know your feelings. What’s more, you will probablyfind that there are a lot of really nice people out there thatyou haven’t met yet. Since our Northern and Southernsocieties merged three years ago, I have had the occasion tomeet many people whom I probably would have never metwith the separate societies. And I will have to say, I haven’tmet one that I didn’t like or regretted the chance to meet.Our annual meetings are an excellent place for you to meetyour colleagues from all over the state (and those from otherstates as well, as oral surgeons from other areas get wind ofour excellent programs).

Perhaps you have some issues with CALAOMS whichhave discouraged your participation. That’s fine, bring themforth. Grab a board member or officer by the arm, pull himor her aside and tell him your position. If you prefer to do itin writing, write a letter to the editor of this newsletter orspeak with our editor and ask to write an article. Remember,this is your organization - it is not just the organization ofthe officers, the board, or councils and committees. Haveyour voice heard, don’t just sit on your concerns.

Yet another important reason to attend our CALAOMSmeeting is exploring and enjoying the beautiful state in whichwe are privileged to live. Santa Barbara was absolutelybeautiful and our accommodations at the Biltmore excellent.I can assure you that the Inn at Squaw Creek at Lake Tahoe

in October will beequally desirable.Come enjoy thesewonderful places, bringyour family and evenmake a few browniepoints with yourteenage kids if you areso lucky as to havethem.

A final reason toparticipate in thefunctions ofCALAOMS is toperpetuate the legacy oforal and maxillofacialsurgery. We all remember our days in training when we asdentists worked to establish a foothold in a hospital settingpredominated by physicians. It was we, the oral andmaxillofacial surgeons, who fought for the fractures throughthe emergency room, always bent over backward to makethe best presentations at ground rounds and delighted inmaking a medical diagnosis which had eluded the medicalresidents beside whom we worked. It was like Hertz andAvis, and as oral and maxillofacial surgeons we were alwayssure we went the extra mile (“We try harder”). We never letit be in question whether we were the equals of any othergroup of healthcare providers. We stood together then - canwe not still stand together now to protect our own interests?

Alas, our flight was over and our little bird descendedthrough those magnificent white celestial billows for a smoothlanding on the tarmac at SFO. Like clockwork, as our crafttaxied to the gate, my daughter Katie’s cell phone bellowedits obnoxious ring and she fumbled through her purse to findit. I laughed to myself as she responded to her caller “Yes,we just landed at SFO and I would love to hang out with youtonight.” There was that word “hang” again. Katie knewthe value of hanging out with her friends. How was it that somany of our colleagues somehow no longer appreciated howimportant it was for us as oral and maxillofacial surgeons tohang together. If Katie could take Dr. Franklin’s words toheart, perhaps so could we. Yes, Dr. Franklin, thank youagain for sharing your wisdom with us, and may God pleasegive us the wisdom to heed it.

Rich Robert D.D.S.CE Committee, CALAOMS

16


A few years ago I wasconsulting with atwenty-eight year oldmale patient. I amalways interested in

what people do for a living anddiscovered he was a police officer.I also discovered he goes on specialassignments for the military. Whileon such an assignment to rescueAmericans in Tehran, Iran ahelicopter next to his blew up andhis mission was scrubbed. I askedif he was carrying his gun and as itturned out he was. I asked him tosurrender it while undergoingtreatment. After separating themagazine from the gun andremoving the bullet from thechamber we placed all three inseparate secured areas.

The difficult horizontalimpactions and general anesthesiawent well but upon emerging fromthe anesthetic he did what appearedto be karate moves. I instructed thestaff not to touch him without givinghim advanced warning (I didn’twant anyone getting hurt) andescorted him to the recovery room.He was able to walk with assistanceand appeared to be more lucid. Aminute later he went for his gun,which was of course not there. Hethen took to the floor on his backand simulated crawling underbarbed wire. He then went into thedark room where he squatted withhis back against the wall and wentfor his gun a second time. At thatpoint I called 911 and explained Ihad a patient who was a policeofficer and behaving irrationallywhile recovering form generalanesthesia. While awaiting thearrival of the police, his wifequestioned if we had removed hisankle revolver and “ninja star” aswell.

Within five to six minutes eightpatrol cars arrived with eighteenofficers, including a paramedic teamand an undercover agent. I told theofficer in charge about thepossibility of additional weapons. Iwould never presume to tell a lawenforcement officer how to proceedin his field any more than I wouldexpect him tell me how to dosurgery.

However, I explained myconcern that in his altered state mypatient might attempt to disarm theofficers. The next thing I knew myoffice manager, escorted by two ofthe officers, was leaving the officewith a large Nordstrom’s bag full ofrevolvers to be secured in the trunkof a patrol car. Fortunately, mypatient was not carrying additionalweapons, and with additional timethe effects of the anesthetic wore off.His lucidity returned, and the eventended without further incident. Ithad been a very interesting morning!

The same patient had returnedlater to the office to address ableeding issue. I asked him abouthis actions the previous morningand he replied he had no recall ofthe events.

I learned he was a third degreeblack belt in karate, as well as ablack beret who goes on specialcovert assignments. He wasacquainted with the Mossad (an eliteIsraeli antiterrorist group), and itwas then that I realized we weredealing with a real “high roller”.

(I suppose they need oralsurgery too).

The moral of my story: Evenwhile “off duty” and wearing“plainclothes” law enforcementofficers often carry their weapons.They may also carry subconsciousbaggage from their profession. Forthese reasons it is important toidentify them and require them toleave their weapons in a safe andsecure place if they are going to betreated with mind alteringmedications.

Guns And GeneralAnesthesia Do Not Mix!

(I Think I Have YourAttention.)

Report from the AnesthesiaCommittee

Stuart Green D.D.S.Anesthesia Committee Member

18


General Announcements

Upcoming EventsNew Vistas In Reconstruction - Palm SpringsMeetingApril 5-7, 2003 Palm Springs

ACLS - CALAOMSApril 12, 2003 Solano

ACLS - CME AssociatesMay 3-4, 2003 San Diego

OMSA (Assistant’s Course) SouthMay 17-18, 2003 Irvine

OMSA (Assistant’s Course) NorthJune 21-22, 2003 Sacramento

PALSAugust 16, 2003 San Francisco

Effective Organization of Office EmergenciesOctober 1, 2003 TBA South Area

Fall Meeting - Resort At Squaw CreekOctober 10-12, 2003 Lake Tahoe

OMSA (Assistant’s Course)October 25-26, 2003 Irvine

ACLS - CALAOMSTBA Oct.-Nov. Solano

SCPIE/Risk Management SeminarNovember 5, 2003 TBA South Area

SCPIE/Risk Management SeminarNovember 12, 2003 TBA North Area

MRL AED Special PurchaseThrough McKesson Medical-Surgical Corporation,

CALAOMS was able to negotiate a bulk purchase price on MRLAEDs. The resulting price plus additional accessories that MRLthrew in resulted in a net savings of $860 below MSRP on theJumpstart, and $1,235 below MSRP on the Lifequest. The Mem-bership had the choice of the basic model the Jumpstart, or thenext model up the Lifequest. Each Unit was shipped with extrabattery, extra pads, wire mounting rack, carrying case, and in-service video.

This was such a successful endeavor with 80 units ordered,that CALAOMS is going to extend the offer to members thatwere not able to take advantage of this offer the first time. Weare also going to extend the offer to WSOMS as well. If youmissed out the first time, contact our Director of InformationSystems, Steve Krantzman at the central office, to find out aboutplacing an order for AEDs. All orders for this second offer mustbe in by March 31, 2003. Look for other special offers in thenear future on items such as Monitors/Pulse Oximeters. This isjust one way that CALAOMS is looking to better serve its mem-bership.

Even though we have made great strides in the quality ofthe content, and production of the newsletter; are you tired ofseeing articles written by the same authors over and over? Doyou have ideas, thoughts, antidotes, or valued input? Why notsubmit an article of your own? We now have a “letters to theeditor” section for general comments. Or you can submit a hard-hitting piece for other sections of the newsletter. The choice isyours. Contact our new Editor, Corrine Cline-Fortunato withyour ideas or a submission. Her email address [email protected]. Take an active roll in the asso-ciation. Make the Compass your vehicle for delivering yourthoughts and ideas to the general membership!

A Call To Duty

Palm Springs 2003Don’t forget that this years Palm Springs Meeting is a joint ven-ture with the International Congress on ReconstructivePreprosthetic Surgery. It is April 5-7, 2003. Hope to see you there.

19


In MemoriamDr. Don DanaNovember 29, 1929 - December 6, 2002

Dr. Donald S. Dana, born in Ruthven, Iowa November 29, 1929passed away on December 6, 2002. I have always counted Don asone of my closest professional colleagues as have so many othersover the years. Don was fondly called “Double D” or “TheDonald”.

Don graduated from the University of Iowa with a B.A. in 1954.He returned following two years as a lieutenant in the U.S. Navyto complete an Oral Surgery Residency at the University of IowaHospital where he graduated with a M.S. Degree in 1962.

Afterward, he joined Dr. B.C. Kingsbury and Dr. Hal Young (alsodeceased) in private practice (Now that was quite a trio!). Donwas laer to establish his own practice in Fremont from 1962 until1993. When he retired, he and his lovely wife Sandy moved toScottsdale Arizona, where they made their home for the past sevenyears.

A past president of NCSOMS in 1982, Don was subsequentlyelected a member of the Board of Trustees of the AAOMS repre-senting our District, and serving for two terms. In 1986, he wasawarded Committeeman of The Year in recognition of his out-standing efforts. I remember Don when he took over the presi-dency of the NCSOMS and discovered it was nearly bankrupt! Itwas his skill along with that of Dr. John Steel, that got us back onour feet.

As a person, Don was especially strong in both his presence andhow he conducted himself. He paid attention to detail in every-thing he did and his intelligence and ability to articulate histhoughts in a brief fashion highlighted his personality. His con-tinued long and close friendships with Dr. Michael Matzkin andDr. Ron Marks, both past president of the AAOMS, and manyothers with whom he had worked so hard through the years, werea tribute to the kind of person he was.

Don succumbed this December after a long fight with IdiopathicPulmonary Fibrosis. This disease tired his body, but never hisstrong spirit. He is survived by his wife Sandra, daughters KathyDana, Michele Dana, and step daughter Monet Bonson.

A Celebration of Life Party was given by his wife Sandra on Janu-ary 12th in Arizona to honor Don and the memory of his faithfuldog Barney who accompanied him throught his illness and dieda few days later.

We will miss you Don... Thanks for the years of Memories.

Al Steunenberg, DDS, MS

The efforts of CALAOMS to increase the number of certifiedoral surgery assistants in the workforce is progressing well.Currently, 196 assistants are enrolled in the five-month homestudy course, which culminates with a weekend seminar and finalexamination given in Irvine on May 17, and Sacramento on June21.

Assistants holding a current OMSA certificate can renew bytaking just the weekend course and final exam. Please note thatassistants must be registered for the course PRIOR to theexpiration of their certificate. No exception can be made. Theregistration deadline for the Spring recertification course is May

5, 2003. Fliers for the fall courses will be sent to the membershipin April.

Presently, the OMSA Committee members are hard at workrewriting and improving their lectures, revising course objectives,standardizing the examinations and developing a new “online”course manual.

The transition to internet based testing is going smoothlythanks to the efforts of Steve Krantzman. It has been very wellreceived by those course participants who elected to participate,and has dramatically decreased the workload of CALAOMS Staff.

CALAOMS realizes the importance of a well trained staffand will continue to develop programs to educate our assistants.Members with questions or comments about the OMSA course aencouraged to contact Dr. Tim Silegy at 562-496-1978 or by e-mail [email protected].

OMSA, We are on the right track with afull head of steam. Make sure your assis-

tants get on board

Donations can be made on behalf of Don Dana and his familyto the following Organization:National Heart, Lung, and Blood Institute

NHLBI Health Information CenterP.O. Box 30105Bethesda, MD 20824-0105Dr. Donald S. Dana Memorial

Note on the bottom of the checkIdiopathic Pulmonary Fibrosis ResearchIn memory of Dr. Donald Dana

20


AAOMS District VIUpdate

Richard A. Crinzi, D.D.S., M.S.AAOMS District VI Trustee

As part of my Trustee update Ithought I would highlightseveral topics and provide youwith information about some ofthe ongoing issues within our

specialty. On 2/4/03, Drs. Tim Shahbazian,John Bond and myself attended a FoundationAAOMS Network meeting in Rosemont to“rally the troops” and help coordinate oursolicitations in District 6. As you are aware,your contributions and financial support of thespecialty’s research and education programbenefit the specialty and the public we serve.Examples of such programs are theMulticenter study of patients undergoing thesurgical removal of wisdom teeth and clinicalsurgery fellowships the results of which willsignificantly improve patient care and addscientific documentation to what we all“understand” from a clinical perspective. Atthe present time, approximately 410 membershave given to the Campaign and it is at 54%of its stated goal of $2,500,000. As leadersin our specialty, it is CRITICAL for all of usto participate. PLEASE CONSIDER ACONTRIBUTION. A five-year contribution of$1,000.00 a year will go a long way to helpwith this important specialty project. Pleasecontact Dr. Jim Kelly at 866-278-9221 toassist you with your contribution.

Many states including California are in themidst of OMS “battles” related to Scope ofPractice and anesthesia delivery. Several ofthese events have affected OMS efforts toadvance the ADA Definition of Dentistry andother favorable legislation to supportcontemporary Scope of Practice. For example:in the past, the American College of Surgeons(ACS) had “strongly supported” the conceptthat surgeons should be credentialed for

operative procedures in their own specificspecialty based on their training andexperience. However, in July of 2002 the ACShave begun distributing a “Scope of Practice”kit which targets efforts by single degree oralsurgeons (DDS) to expand their scope intocosmetic surgery of the head and neck bylegislatively redefining the Practice ofDentistry. The kit includes sample letters tostate dental boards and also a statement bythe Montana Medical Association and theASPS urging states to adopt the “New York”Definition of Dentistry, which does notsupport the ADA Definition of Dentistry andessentially limits one to a non-expansive/intra-oral scope for OMS practice. Please seethe website at http://www.facs.org/dept/hpa/scopeofpractice.html. AAOMS officers andstaff are attempting to meet with the ACS todiscuss this change in position and stress OMStraining and education as an essential part ofany credentialing process and that cosmeticsurgery can be a subspecialty of many surgicalspecialties with appropriate training.

Testimony has been given in New Hampshireand South Carolina, which also dealt withScope of Practice issues and while theirtestimony went well, they are in a “wait andsee” period regarding their Dental PracticeActs. It appears that in Colorado the COMedical Association may be rethinking itsagreement with the CO Dental Associationthat it would not oppose a new ADA definitionin CO. As many of you are aware there areongoing discussions between the DentalBoard of California with CALAOMS and theCDA regarding Scope of Practice issues andenteral sedation. While others will underscorethese issues for you, AAOMS is committedto working with the officers of CALAOMSand others for the betterment of our specialtyin California. For the most up to dateinformation and critical issues please contactMs. Jeannie O’Brien at AAOMS/OMSPACGovernment Relations Staff at 800-822-6637Ext. 4351 and have your name included onthe Capital Advocacy E-News Letter or visitthe AAOMS website at www.aaoms.org.

The Board of Trustees met on 02/08/03 inRosemont for a 2-hour information/instructional session on OMSVision a stateof the art comprehensive practice managementsoftware that will combine exceptionaltraining and customer service. Beta testingwill begin in early March with the final

product ready for distribution by the AAOMS85th Annual Meeting in September. I mustsay that the Task Force involved in this projecthas done an excellent job, and I was veryimpressed with the software. Pre-orders willbe taken at the Boston AO Implant Conferenceor you may contact Brad Schrat at 800-422-9448 Ext 8733.

The Board also reviewed the ongoing dialoguebetween AAOMS and the Joint Commissionon Accreditation of Healthcare Organizations.JCAHO is in the process of making revisionsto the Medical Staff Chapter, as well asproposed revisions to standards that addressthe use of clinical practice guidelines andtelemedicine services of the ComprehensiveAccreditation Manual for Hospitals.Concerns were expressed, however, that aslicensed independent practitioners (LIPs) thenew wording, which eliminates specificlanguage relative to issues such as history andphysicals may allow hospitals to deny theseprivileges to qualified OMS’s. AAOMS isworking diligently with Joint Commission tomaintain current language in the 2004standards and strengthen the OMS positionon organized medical staff.

I would also like to remind you that the 2003Day on the Hill will be in Washington DC onMarch 25th and 26th, 2003. It has become anannual event, and assists OMS in deliveringour legislative message while participating inthe political process for our profession. Pleasetry to attend. This event is sponsored in partby OMSPAC, and again, your contribution andsupport of this needed political effort isnecessary. If you have any questions pleasecontact your OMSPAC representative, Dr.Gerald Gelfand and also consider acontribution.

I would encourage you to contact the AAOMSoffice to assist you with media andcommunications or legal and litigation supportas well as providing you with a myriad ofinsurance reimbursement and coding servicesall available through the central office. AHIPAA interactive web cast for AAOMSmembers and their staff will take place onlineon March 5th, 2003 and will assist withcompliancy issues. I would again like to thankyou for the opportunity to represent you on anational level. Please feel free to contact meif you have any issues that I may help youwith.

Richard A. Crinzi, D.D.S., M.S.

21


Teaching Centers

Presenting Residents from Left to Right: Dr. Rodger Grissett, Highland Hospital (UOP); Dr. Albert Ouellette,David Grant USAF Medical Center; Dr. Robin Reisz, University Medical Center; Dr. Alex Tomaich, UCSF.

Art Curley, legal counsel for our society and noteddefense lawyer for our profession.

Resident’s Presentations

On February 8, 2003 North Area Resident Presenta-tions were held at the Embassy Suites in Walnut Creek.This meeting was very well attended. There is always ininterest in the latest medical techniques presented bysome of our newest, OMS in the field.

Art Curly, Legal Counsel for CALAOMS also presented.His topics covered HIPAA rules and regulations, andInformed consent, which was received well by bothResidents and Members.

Special thanks needs to be given to Dr. Philip Merrill ofUOP for his pathology insight on each case. Also to Dr.Vince Farhood for chairing the resident’s courses forCALAOMS, and for providing the photos shown here.

We hope to see you at the next South Area Resident’sNight Presentations later this year!

22


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Having problems logging into the mem-bers section fo the web site? Do you haveother technical quesiton? Call our Direc-tor of Information Systems, SteveKrantzman for help and answers to yourquesitons @ (800) 500-1332 or (916) 783-4518. Questions can also be emailed [email protected].

NEW MRL AEDs for sale. Take advan-tage of CALAOMS bulk buying power andpruchase a Jumpstart or Lifequest AED atunbeatable prices fom $800-$1000 belowMSRP. Each Unit ships with extra battery,carrying case, wall mounting rack, extrapads, and in-service video at no additonalcost.

Our prices on Jumpstart including extrasis $1,775.00. Our price on the Lifequestincluding extras is $2,825.00Orders are place through CALAOMS andneed to be in by March 31, 2003.

Please Call the central office and requestan order form if you do not already haveone. Spcifications can be downloaded fromthe members area of our web siteCalaoms.org or can be faxed to you uponrequest. Call (916) 783-1332

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1888 Century Park East, Suite 800 • Los Angeles, CA 90067-1712 • 800/ 717-5333 • www.scpie.com

A relationship of real trust can take years to develop. ThatÕs one reason the trust between the members of CALAOMS and The SCPIE Companies is genuine: It has been developing since 1987.

When the rest of the professional liability insurance industry lost interest in insuringCaliforniaÕs oral and maxillofacial surgeons, SCPIE stepped in to help solve the problem. SCPIEimproved the level of available protection and service, while dramatically reducing insurance costsfor CALAOMS members.

Although much has changed for CaliforniaÕs oral and maxillofacial surgeons since 1987, onething has remained constant: SCPIEÕs commitment to providing CALAOMS members withsolid liability protection.

We understand the liability issues in oral and maxillofacial surgery, and we know how to defendoral and maxillofacial surgeons against malpractice claims. WeÕre also experts at helping preventclaims in the first place.

SCPIE has established an industry standard for servicing the unique liability insurance needs oforal and maxillofacial surgeons. ThatÕs why CALAOMS has continued to endorse SCPIEyear in and year outÑ and why you should put your trust in SCPIE.

To learn more and receive a free, no-obligation premium estimate, call 800 / 717-5333.

n the compass 2003.pdfthe compass official publication of the california association of oral and...

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