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1992:
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see "Ruminations" page 38
stacks
so In This Issue:
ow to compete under managed competition Leigh Truitt , MD, President , CMS
pdate on Health Care Reform Bill Pierson , Managing Editor
lections/Legislative Reports Alan Rapp , Chairman , Council on Legislation
Doctor, Doctor! Come Quick! There’s a Process Server
in the Waiting Room!
An unlikely scenario? Unfortunately, no. Colorado physicians are on the receiving end of malpractice suits on the average of once every seven years.
$ The right response? Accept the summons or subpoena, then pick up your phone and call Copic Insurance Company Headquarters, which is right here in Colorado. The damage control will start immediately, and you’ll feel better in the morning. ❖ But, you say, what if the targeted physician is one of the minority in Colorado who didn’t choose Copic?
♦♦♦ Well, maybe he or she won’t feel better in the morning.
The Copic Bottom Line. It’s more than just competitive rates.
Copic Insurance Company
EO. Box 17540 • Denver, CO 80217-0540 * (303) 779-0044 • 1-800-421-1834
Colorado Medicine
January, 1993 Volume 90, Number 1
Cover Story
It's anybody's guess what 1993 will hold for health care professionals, but a look back may help. Check out Ruminations on page 38.
On This
7 How to compete under managed competition
Leigh Truitt , MD President, 1992-1993
10 Update: Health Care Reform
Bill Pierson Managing Editor
1 1 1992 Election success
COMP AC
20 The Interview (Part 3 of 3)
Joe Batuello, MSI
Departments
7 President's Letter 9 Copic Comment 1 2 The Lobby 1 5 Letters
16 Health Care Financing 18 Committee Update 21 Board Highlights 24 Medical News 26 New Members
31 In Memory
32 New Officers
36 Classified Advertising 38 Ruminations
22 Introducing your Board of Directors
Colorado Medical Society
COLORADO MEDICAL SOCIETY OFFICERS, BOARD MEMBERS and AMA DELEGATES
1992/1993 Officers Leigh Truitt, M.D.
President
Wm. Carl Bailey, MD
President-elect Terrance J. Sullivan, M.D.
Treasurer
Stuart O. Silverberg, M.D.
Speaker of the House
David C. Martz, M.D.
Vice-speaker of the House
Sandra L. Maloney
Secretary/Executive Director
Harrison G. Butler, Ml, M.D.
(Immediate Past President)
|
Board of Directors |
Board of Directors |
|
Thomas J. Allen, MD |
Dieter W. Schneider, MD |
|
Stephen G. Batuello, MD |
David Shander, MD |
|
John O. Cletcher, Jr., MD |
W. George Shanks, MD |
|
Donald G. Eckhoff, MD |
Susan A. Shermas, MD |
|
John E. Elliff, MD |
Gary D. VanderArk, MD |
|
Jonathan C. Feeney, MD |
Denis J. Winder, MD |
|
David C. S. Franklin, MD Joel M. Karlin, MD |
M. Robert Yakely, MD |
|
George M. Kreye, MD Muryl L. Laman, MD |
AMA Delegates |
|
Ted T. Lewis, MD |
M. Ray Painter, Jr., MD |
|
Maura J. Lofaro, MS IV |
Richert E. Quinn, Jr., MD |
|
Louise L. McDonald, MD Robert R. Montgomery, |
Mark A. Levine, MD |
|
Legal Counsel Robert A. Nathan, MD |
Alternate Delegates |
|
Kenneth M. Olds, MD |
Robert D. McCartney, MD |
|
Lothar K. Roller, MD |
Robert M. Bogin, MD Joel M. Karlin, MD |
COLORADO MEDICAL SOCIETY STAFF
Executive Office
Sandra L. Maloney, Executive Director Mary Lee Johnston, Executive Admin. Asst. Nancy L. Deter, Manager, Accounting
Western Slope Office
Dolores M. Bennett, Executive Secretary
Division of Membership Information Services
Timothy H. Roberts, Director Diane L. LeHew, Manager, Support Services Debra M. Jones, Membership Coordinator Beth M. Crusha, Administrative Assistant
Division of Professional Services
Sandra M. Finney, Director Lorraine H. Heth, Program Manager Kirsten E. Regalado, Secretary
Division of Health Care Policy
Ellen J. Stein, Director
Marilyn P. Barton, Program Manager
Lynn R. Livingston, Administrative Assistant
Division of Health Care Financing
Edie K. Register, Director
Marijo M. Parkin, Program Manager
Division of Government Relations
Sue Ellen Quam, Director
Lorraine L. Koehn, Program Manager/Lobbyist
K. Suzanne Hamilton, Administrative Assistant
Division of Communications
William S. Pierson, Director
Michael P. Thompson, Communications Spec.
Gil Maestas II, Communications Staff
COLORADO MEDICINE (ISSN-01 99-7343) is published monthly as the official journal of the Colorado Medical Society, 7800 E. Dorado PI., Englewood, CO 801 1 1 . Telephone (303) 779-5455. Outside Denver area, call 1 -800-654-5653. Second Class postage paid at Englewood, Colorado, and at additional mailing offices. POSTMASTER, send address changes to COLORADO MEDICINE, P. O. BOX 1 7550, Denver, CO 80217-0550. Address all correspondence relating to subscriptions, advertising or address changes, manuscripts, organizational and other news items regarding the editorial content to the editorial and business office. Subscriptions are available for $30 per year, paid in advance.
COLORADO MEDICINE magazine is the official journal of the Colorado Medical Society, but as such is also authorized to carry general advertising. Publication of any advertisement in COLORADO MEDICINE does not imply an endorsement or sponsorship by the Colorado Medical Society of the product or service advertised. Published articles represent opinions of the authors and do not necessarily reflect the official policy of the Colorado Medical Society unless clearly specified.
Sandra L. Maloney, Executive Editor; William S. Pierson, Managing Editor; Michael Thompson, Asst. Managing Editor Member, Colorado Press Association, Member, Colorado Broadcasters Association
4
Colorado Medicine for January, 1993
Photo by Rocky Mountain News
Leigh Truitt , MD President, 1992-1993
President's
How to compete under managed competition
We do not yet have a definitive health care reform proposal from President-elect Clinton. In Colorado, however, we are already studying ColoradoCare, a managed competi- tion approach. In this model, a single payer, the State of Colorado, would give a managed care network a predetermined, capitated amount to provide care for those citizens who chose that particular network.
Most observers believe that the best way to compete under such conditions is a health maintenance organization. Studies have shown that staff model HMOs are currently more cost effective than their independent practice association counterparts. Salaries can change incentives from providing more services to providing less.
Does this mean that a vertically integrated health care network - with all components such as hospitals, specialists, primary care physicians, etc., under common ownership - is the most efficient model? Recent observations in other industries suggest that the opposite is true.
Japanese manufacturing indus- tries have typically been organized in keiretsu, "distributed produc- tion" networks of many separately owned suppliers with one core manufacturer who coordinates the final assembly of a motor vehicle or some similar product. The latest thinking is that, if these networks become too closely bound together, the relationship can become "stale".
As a subcontractor is drawn ever closer to the core company, it can become over-specialized and unable to compete in markets outside the network. Worse, it may lose the innovative edge it gained from working for several, equally demanding customers.’
A further problem with the traditional pyramid-type coalition, with suppliers working exclusively with one core manufacturer, is that total dependence on one network only works if demand for the core product is expanding. During times of market contraction, suppliers need to insure their own survival by working with other manufacturers and by selling original products.
These structural changes . . . will shortly make pyramid-type keiretsu an old-fashioned scheme. Instead, a distributed production system - optimizing networking among manufactur- ers and parts markets - will become the norm.2
The fastest-growing type of physician organization is the single specialty group. The most rapidly expanding type of HMO is the IPA model. This development speaks for the desire of physicians to maintain their individualism even in the face of pressures for greater economic integration.
If single specialty groups and individual economic incentives are desirable as opposed to full vertical integration, how can we attain these
//... keiretsu, 'distributed production 1 networks of many separately owned suppliers ..."
Colorado Medicine for January, 1993
7
President's Letter (Continued)
How to compete under managed competition
" People want to identify with something closer to them and of human scale."
' Organizations need to be both big and small at the same time , be they corporations or nations/
objectives and still remain cost effective? Must we create a tradi- tional pyramid-type keiretsu under the domination of an insurer or a hospital system? Or do we need a horizontal network of distributed production under some other paradigm?
We must resolve the following paradox:
[Organizations need to be both big and small at the same time, be they corporations or nations. On the one hand, the economies of scale still apply. The discovery and development of new sources of oil and gas require resources that no small niche player could contemplate. Big is essential as well for pharmaceutical compa- nies if they are to finance the massive research programs on which their future depends. Bigness also makes an organiza- tion less dependent on a few crucial people or on outside expertise.
At the same time, businesses and nations need to be small. Every- where small nation states and regions are flexing their muscles and demanding more autonomy. People want to identify with something closer to them and of human scale. We want villages, even in the midst of our cities. It is no different in organizations. Small may not always be beauti- ful, but it is more comfortable. It is also more flexible and more likely to be innovative.3
Such a solution requires understand- ing, cooperation and effort on the part of all the different providers of health care. We can learn from looking at other models of political and industrial organization.
Ownership isn't always the best strategy.
' "Why networks fail" The Economist, October 10, 1992, p. 83
2 Ikuo Umebavashi, "New Trends in the Keiretsu
System" The Wali Street Journal, November 16, 1992, p. A12
3 Charles Handy, "Balancing Corporate Power:
A New Federalist Paper Harvard Business Review, November-December, 1992, p. 61
Legal Representation before the Colorado State Board of Medical Examiners
Jeffrey M. La ski Attorney at Law 337-1400
8
Colorado Medicine for January, 1993
Comment
Distribution
At its meeting of December 1 6- 1 7, the Copic Board received encouraging news from its actuaries: Losses in prior years are developing more favorably than predicted, producing for Copic insureds a profitable 1992 — and the surplus needed to fund a 1993 policyholder dividend of $6,000,000. As you view your expenses for the new year, each policyholder may plan on profes- sional liability insurance costs approximately 14% less than you expected.
The 1993 distribution will bring to a total of $18.3 million the funds returned to policyholders in 1990-
93, sound evidence of our basic corporate policy — that any and all "profits" are returned to those who are paying the premium.
Payment will be made as two equal premium credits, which you will see on invoices at May 1 5th and September 15th, 1993.
HIV benefit
In a separate mailing to all policyholders, early in 1993, you will receive details regarding a policy enhancement for insureds faced with the professional and financial disaster of acquiring infection with HIV.
At no additional premium cost, all Copic policyholders will be eligible for a one-time benefit payment of $ 1 00,000 upon provision of proof of having converted to an HIV positive serology, or being diagnosed as having AIDS. Any insured physician so unfortunate will also be counseled regarding existing statutory or regulatory requirements for practice modification, and will remain eligible for continuation of their professional liability insurance coverage if they practice within the parameters of such requirements.
Watch your incoming mail for details; if you have questions on any aspect of these policy amendments, contact your own policyholder representative at Copic.
CompHealth, the nation's premier locum tenens organization, now provides local primary care coverage and flexible, part-time opportunities lor physicians in the greater Denver area. Call today to discuss daily, weekly, weekend, evening, or monthly coverage for your practice, or to find out more about building a tlexible locum tenens practice right here in the greater Denver area.
303-777-8002
P.O. Box 100218, Denver, CO 80250
CompHeallh/Denver
Local Staffing Network
Copic '93 distribution set at $6,000,000...
Policy amendments provide HIV benefit
Colorado Medicine tor January, 1993
9
Update: Health Care Reform
Health care reform is in an
There is probably no person or thing which can retrieve health care reform from this bottomless political chasm for at least the next 1 20 days.
The abyss is the fault that opens in the earth crust immediately after presidential elections in which the incumbent is unseated. Those campaign promises, those critical electoral issues which were para- mount throughout the campaign year suddenly disappear until the "first hundred day priorities" are set by the new administration, or until some enterprising curmudgeon (certainly, in the case of health care) reminds the public that nothing has hap- pened.
At this moment in political evolution the abyss is largest.
What were the last words on the new administration's "health re- form"?
The Clinton Proposal*
Key Access Mechanism
• Require phase-in of employer- provided health coverage for employees
• Implement managed competition: all small businesses (with up to
1 000 employees under Conserva- tive Democratic Forum [CDF] proposal) must buy health insur- ance through state health insur- ance purchasing cooperatives (HIPCs), which must contract with accountable health plans (AHPs) — networks that may include provid- ers and insurers — to provide coverage based on a standard premium for each class in an AHP
• Probable phase-in of program as funds become available due to cost savings.
abyss.
Secondary Mechanism
• Under managed competition, poor and low-income given subsidies to buy insurance through HIPCs
Insurance
• Require community rating
• Under CDF managed competition proposal, AHPs must
* provide uniform set of effective benefits
* require cost-sharing
* arrange low-income assistance
* not discriminate based on health status
* limit pre-existing conditions to 6 months; no exclusion for new- borns/pregnant women
* set standard premium for each class
Cost Containment
• Managed competition** rather than price controls intended; price controls used only in transition where AHPs have not developed
• Federal health board establishes annual health budget targets nationally and by state, guides expenditures in public and private sectors, and establishes core benefit package insurers must provide, including ambulatory MD, inpatient hospital, prescrip- tion drugs, basic mental health, and preventive care
•Reduce drug prices by eliminating tax breaks for drug companies raising prices faster than American income; limit deductibility of drug company marketing/lobbying costs
• Control unnecessary use of tech- nology through federal health board's recommendations/incen- tives for sensible capital budgets, including shared use of technology
• Provide updated medical practice guidelines
by Bill Pierson , Managing Editor
• Intensify health education in home/school/workplace/senior centers to help change behaviors
Financing
• All Americans can be covered with money now spent on health care
Medicare Reform
Long-Term Care
•Access to comprehensive LTC from Medicare for disabled and elderly, with affordable/equitable cost sharing and case managers; phased-in, beginning with home/ community based care; respite care to help relieve families; remove disincentives for commu- nity care, making nursing home care funding available for home health, adult day care, transporta- tion
• Through new National Service Corps, provide college loans to be paid back through service, includ- ing labor in LTC
Liability Reform
• Alternative dispute resolution mechanisms should be available in every state
• Medical practice guidelines can help establish better guidelines on what constitutes medical malprac- tice
Other
•Accelerate FDA approval process
• Provide adequate inner city/rural primary/preventive care clinics
• Carry out NGA recommendations to provide incentives for students/ health professionals to provide primary care in underserved areas; expand NHSC; increase support for graduate training for mid-level health professionals like CNMs/ NPs
• AMA Division of Federal Legislation Group on Legislative Activities
** See President's Letter - this issue
10
Colorado Medicine for January, 1993
1992 elections a success
C0MR\C
COMPAC was involved in 69 State and Federal general election cam- paigns, contributing $43,400 at the state level. COMPAC also made recommendations for AMPAC to contribute $35,000 at the federal level (excluding independent expenditures.) With $78,400 contributed to Colorado candidates, COMPAC finished on November 3rd with a success rate of 81 %. With the redistricting that took place in 1992, this is quite an achievement. Here is how it all breaks down:
Congressional Races:
Recommendations were made by COMPAC to support 1 Demo- cratic campaign and 3 Republican campaigns. All 4 recommendations were carried out by AMPAC and all 4 campaigns were successful. COMPAC has also recommended $10,000.00 in debt retirement for Democratic Senator-elect Ben Nighthorse Campbell. AMPAC is currently processing this recommen- dation.
State Senate Races:
COMPAC supported 4 Demo- cratic senate campaigns, ail of which were successful, and 7 Republican senate campaigns, 5 of which were successful. COMPAC also supported an additional 6 senators who ran unopposed for their senate seats, providing assistance in mailing to constituents. Of these 6 senators, 2 were Democrats and 4 were Repub- licans.
State House of Representatives:
In the I louse, COMPAC sup- ported 17 Democratic campaigns, 15 being successful, and 23 Republican
campaigns, 18 of which were successful. COMPAC, again sup- ported an additional group of representatives running unopposed. This group is made up of 4 Demo- crats and 2 Republicans.
C. U. Board of Regents:
COMPAC supported one Republican candidate for the C. U. Board of Regents, a physician and member of the Colorado Medical Society. This campaign was unsuc- cessful, but a tight race to the end.
"...a success rate of 81%f/
Access to Food Constitutes a Human Right
World hunger is an ever-present scourge that claims 35,000 lives each day.
Access to food constitutes a human right. In 1 976, the United States Congress passed a Right to Food Resolution which declared the sense of the congress to be "that all people have a right to a nutritionally adequate diet'.'
Physicians Against World Hunger (PAWH), a non-profit, tax-exempt organization was founded so that physicians could collectively defend this human right by raising funds to support well-recognized, reputable organizations that are directly engaged in working with the poor primarily for the purpose of ending death by starvation.
Please join us — together physicians must help bring an end to world hunger.
Physicians Against World Hunger
#2 Stowe Road, Peek ski II, NY 1 0566
□ YES I wish to join PAWH in the struggle to end world hunger - enclosed is my contribution.
□ $50 O$100 □ $250 Ll $500 flOther
NAME PLEASE PRINT
ADDRESS CITY STATE ZIP
SIGNATURE
Please forward your tax deductible contribution to Physicians Against World Hunger *2 Stowe Road, Peekskill, NY 10566
Colorado Medicine for January, 1993
The Lobby
What's in
it for me?
Alan Rapp, MD, Chairman Council on Legislation
Colorado 59th General Assembly Committees
Listed here and on the following pages are all of the legislative committees, members and leadership for the 1 993 session. We recommend that you keep these pages for reference throughout the session.
House Health, Environment, Welfare and Institutions Committee
Representative Debbie Allen (R)
923 S. Ouray St., Aurora, CO 8001 7 695-4920 Capitol 866-2936
Representative Mary Blue (D)
37 Princeton Cir., Longmont, CO 80503 772-3890 Capitol 866-2925
Representative Mary Ellen Epps, Vice-Chairman (R)
21 7 Dexter St., Colorado Springs, CO 8091 1 (719)392-3861 Capitol 866-2946
Representative Daphne Greenwood (D)
315 N. Prospect St., Colorado Springs, CO 80903 (719)444-0115 Capitol 866-3069
Representative Rob Hernandez (D)
4600 W. 36th Ave., Denver, CO 80212 458-101 1 Capitol 866-2954
Representative Martha Kreutz (R)
6023 S. Bellaire Way, Littleton, CO 80121 741-4681 Capitol 866-2904
Representative Michelle Lawrence (R)
6362 Depew St., Arvada, CO 80003 420-7654 Capitol 866-2950
Representative Marcy Morrison (R)
302 Sutherland PL, Manitou Springs, CO 80829 (719)685-5929 Capitol 866-2904
Representative Alice Nichol (D)
891 E. 71 st Ave., Denver, CO 80229 287-7742 Capitol 866-2904
Representative Phil Pankey, Chairman (R)
5763 Shasta Cir., Littleton, CO 801 23 798-5873 Capitol 866-2953
Representative Dan Prinster (D)
P. O. Box 3884, Grand Junction, CO 81 502 241-5015 Capitol 866-2908
Senate Health, Environment, Welfare and Institutions Committee (HEWI)
Senator Lloyd Casey
10434 Carmela Ln., Northglenn, CO 80234 452-8515 Capitol 866-4865
Senator Sally Hopper, Chairman
21649 Cabrini Blvd., Golden, CO 80401 526-0785 Capitol 866-4873
Senator Elsie Lacy, Vice-Chairman
1 1 637 E. Mexico Ave., Aurora, CO 8001 2 750-5943 Capitol 866-4866
Senator Donald Mares
2441 Perry St., Denver, CO 80212 433-3559 Capitol 866-4865
Senator Dick Mutzebaugh
9965 S. Wyecliff Dr., Highlands Ranch, CO 80126
791-4063 Capitol 866-4866
Senator Paul Weissmann
822 LaFarge Ave., Louisville, CO 80027
673-0191 Capitol 866-4865
Senator Dottie Wham
2790 S. High St., Denver, CO 80210
757-0615 Capitol 866-4866
House Judiciary Committee
Representative Jeanne Adkins, Chairman (R)
6517 N. Pinewood Dr., Parker, CO 80134 841-8829 Capitol 866-2936
Representative Celina Benavidez (D)
2825 W. 34th Ave., Denver, CO 8021 1 477-2867 Capitol 866-2925
Representative Diana DeGette (D)
290 Elm St., Denver, CO 80220 Capitol 866-2904
Representative Mary Ellen Epps (R)
21 7 Dexter St., Colorado Springs, CO 8091 1 (719)392-3861 Capitol 866-2946
Representative Doug Friednash (D)
3371 S. Magnolia St., Denver, CO 80224 832-1900 Capitol 866-2904
12
Colorado Medicine for January, 1993
House Judiciary Committee (Continued)
Representative Russ George (R)
1300 E. 7th St., Rifle, CO 81650 625-3778 Capitol 866-2904
Representative Moe Keller (D)
4325 Iris St., Wheat Ridge, CO 80033 425-01 30 Capitol 866-2904
Representative Wayne Knox (D)
761 S. Tejon St., Denver, CO 80223 934-8707 Capitol 866-2921
Representative Martha Kreutz (R)
6023 S. Bellaire Way, Littleton, CO 80121 741-4681 Capitol 866-2904
Representative Marcy Morrison (R)
302 Sutherland PI., Manitou Springs, CO 80829 (719)685-5929 Capitol 866-2904
Representative Dorothy Rupert (D)
680 Yale Rd., Boulder, CO 80303 494-0568 Capitol 866-291 5
Representative Pat Sullivan (R)
241 1 1 9th Ave., Greeley, CO 80631 352-5066 Capitol 866-2929
Representative Shirleen Tucker, Vice-Chairman (R)
615 S. Eldridge St., Lakewood, CO 80228 988-01 1 8 Capitol 866-2923
Senate Judiciary Committee
Senator Tom Blickensderfer, Vice Chairman
9 Parkway Dr., Englewood, CO 801 10 758-0146 Capitol 866-4866
Senator Sam Cassidy
P. O. Box 1 29, Pagosa Springs, CO 81 1 47 Capitol 866-4865
Senator Regis Groff
2079 Albion St., Denver, CO 80207 320-0495 Capitol 866-4865
Senator Sally Hopper
21649 Cabrini Blvd., Golden, CO 80401 526-0785 Capitol 866-4873
Senator Elsie Lacy
1 1 637 E. Mexico Ave., Aurora, CO 8001 2 750-5943 Capitol 866-4866
Senator Dick Mutzebaugh
9965 S. Wyecliff Dr., Highlands Ranch, CO 80126 791-4063 Capitol 866-4866
Senator Bob Pastore
536 Swede Lane, Monte Vista, CO 81 144 (719)852-2795 Capitol 866-4853
Senator Linda Powers
P. O. Box 2300, Crested Butte, CO 81224 349-5798 Capitol 866-4865
Senator Dottie Wham, Chairman
2790 S. High St., Denver, CO 80210 757-0615 Capitol 866-4866
House Appropriations Committee
Representative Vickie Agler
1 0289 W. Burgandy Ave., Littleton, CO 801 27 973-1987 Capitol 866-2939
Representative Ken Gordon
2323 S. Jackson, Denver, CO 80209 753-1383 Capitol 866-2904
Representative Tony Grampsas, Chairman
3237 S. Hiwan Dr., Evergreen, CO 80439 674-7883 Capitol 866-2957
Representative Tony Hernandez
I 285 S. Clay St., Denver, CO 80219 922-4388 Capitol 866-291 1
Representative Bill Jerke
23003 WCR 39, LaSalle, CO 80645 284-6061 Capitol 866-2907
Representative Bill Martin
3110 Lees Lane, Colorado Springs, CO 80909 (719)634-8729 Capitol 866-2965
Representative David Owen, Vice-Chairman
2722 Buena Vista Dr., Greeley, CO 80631 330-9600 Capitol 866-2943
Representative Phil Pankey
5763 Shasta Cir., Littleton, CO 801 23 7 98-5873 Capitol 866-2953
Representative Gil Romero
II 28 Catalpa St., Pueblo, CO 81001 (719)544-2420 Capitol 866-258 7
Representative Gloria Tanner
2150 Monaco Pky., Denver, CO 80207 355-7288 Capitol 866-2909
Representative Bill Thiebaut
P. O. Box 262, Pueblo, CO 81002 (719)544-3822 Capitol 866-2922
Senate Appropriations Committee
Senator Mike Bird, Chairman
5810 Spurwood Ct., Colorado Springs, CO 80918 (719)594-9206 Capitol 866-4866
Senator Tilman Bishop
2697 G Road, Grand Junction, CO 81506 242-9230 Capitol 866-4866
Senator Sam Cassidy
P. O. Box 1 29, Pagosa Springs, CO 81147
Capitol 866-4865
Senator Joan Johnson
7951 York St. #3, Denver, CO 80229
288-923 7 Capitol 866-4865
Senator Jana Wells Mendez
P. O. Box 1 1 26, Boulder, CO 80306
442-71 10 Capitol 866-4865
Senator Jim Rizzuto
Box 215, La Junta, CO 81050
(719)384-4465 Capitol 866-4865
Senator Jim Roberts
633 W. 6th St., Loveland, CO 80537
663-1737 Capitol 866-4866
Colorado Medicine for January, 1993
13
Senate Appropriations Committee (Continued)
House Leadership
Senator MaryAnn Tebedo
1916 Snyder Ave., Colorado Springs, CO 80909 (719)471-2561 Capitol 866-4880
Senator Claire Traylor, Vice-Chairman
4045 Field Dr., Wheat Ridge, CO 80033 424-1 737 Capitol 866-4866
Joint Budget Committee
Senator Mike Bird, Chairman
581 0 Spurwood Ct., Colorado Springs, CO 8091 8
(719)594-9206 JBC 866-2587
Representative Tony Grampsas
3237 S. FJiwan Dr., Evergreen, CO 80439
674-7883 |BC 866-2061
Representative David Owen
2722 Buena Vista Dr., Greeley, CO 80631
330-9600 JBC 866-2061
Senator Jim Rizzuto
Box 21 5, La Junta, CO 81050
(719)384-8388 JBC 866-2587
Representative Gil Romero
1 1 28 Catalpa St., Pueblo, CO 81001
(719)544-2420 JBC 866-2061
Senator Claire Traylor
4045 Field Dr., Wheat Ridge, CO 80033
424-1737 JBC 866-2587
Senate Leadership
President of the Senate - Senator Tom Norton
1 204 50th Ave., Greeley, CO 80634 353-5360 Capitol 866-4866
President Pro Tern - Senator Tilman Bishop
2697 G Road, Grand Junction, CO 81506 242-9230 Capitol 866-4866
Majority Leader - Senator Jeffrey Wells
524 S. Cascade, Suite No. 1 , Colo. Springs, CO 80903 Capitol 866-3341
Assistant Majority Leader - Senator Ray Powers
5 N. Marksheffel Rd., Colorado Springs, CO 80929 (719)596-1055 Capitol 866-4866
Majority Caucus Chairman - Senator Bill Schroeder
4420 S. Braun Ct., Morrison, CO 80465 697-8321 Capitol 866-4866
Minority Leader - Senator Larry Trujillo, Sr.
Suite 425 United Bank Bldg., Pueblo, CO 81003 (719)542-6912 Capitol 866-2318
Assistant Minority Leader - Senator Jana Wells Mendez
P. O. Box 1126 Boulder, CO 80306 442-71 10 Capitol 866-4865
Minority Caucus Chairman - Senator Bob Martinez
6462 E. 63rd Ave., Commerce City, CO 80022 287-81 1 1 Capitol 866-4865
Speaker of the House - Representative Chuck Berry
314 Pine Ave., Colorado Springs, CO 80906 (719)634-6328 Capitol 866-2346
Majority Leader - Representative Tim Foster
593 Village Way, Grand Junction, CO 81 503 245-8440 Capitol 866-2348
Assistant Majority Leader - Representative Jeanne Faatz
2903 S. Quitman St., Denver, CO 80236 935-6915 Capitol 866-2966
Majority Caucus Chairman - Vacant due to the death of
Representative John Irwin
Majority Whip - Representative Vickie Agler
10289 W. Burgandy Ave., Littleton, CO 80127 973-1987 Capitol 866-2939
Minority Leader - Representative Sam Williams
Box 21 59 0982 FHigh Point Dr., Breckenridge, CO 80424 453-1586 Capitol 866-2920
Assistant Minority Leader - Representative Peggy Kerns
1 1 24 S. Oakland St., Aurora, CO 8001 2 696-7178 Capitol 866-2919
Minority Caucus Chairman - Representative Carol Snyder
1 1 756 Elati Ct., Northglenn, CO 80234 452-7043 Capitol 866-4667
Minority Whip - Representative Vi June
7500 Wilson Ct., Westminster, CO 80030 429-1 161 Capitol 866-2843
Assistant Whip - Representative Wayne Knox
761 S. Tejon St., Denver, CO 80223 934-8707 Capitol 866-2921
Address At the Capitol:
The Colorado Senate (or Flouse of Representatives)
State Capitol Denver, CO 80203
KeyContacts are the right combination
With many new faces at the state capitol, physicians have a chance to make even more of an impact on legislation that affects medicine. A personal phone call or visit from a physician can make a dramatic difference in a legislator's opinion and actions, especially if that physician is a constituent.
| That is the reason behind the KeyContact program. Each legislator is assigned one or more physician/constitutents who will contact that law- maker on critical issues. CMS staff provides the physician with the name and phone number of his or her representative and alerts the physicians when a critical issue is about to be discussed.
Take this opportunity to become involved in one of the most effective grass roots lobbying efforts going. Call (303) 779-5455 or 1-800-654-5653, extension 427 to find out more.
14
Colorado Medicine for January, 1993
An Open letter to the members of the
Fifty Ninth Session of the Colorado General Assembly
We know the Colorado legisla- tors have been subjected to a great deal of pressure from special interest groups to legalize lay midwifery. The Colorado Gynecologic and Obstetric Society is opposed to this action and urges you to stand against it.
Home delivery in 1992 was at best archaic. Physicians and hospi- tals who oppose lay midwifery have been falsely characterized as being interested only in the business aspect. In truth, with the present shortage of physicians, there is no lack of obstetric patients. The real issue is that mothers and babies will be harmed by this practice. In the past a leading cause of death in women was childbirth complica- tions, and the newborn death rates were extremely high. Modern medicine has changed that, and legalizing lay midwifery would be a gigantic step backward for our society.
There are many deliveries which are accomplished with no problems, but the risk is great. There are countless documented examples of sudden development of complica- tions when the results would be a tragic death or irreversible damage for the mother or fetus in labor not in hospital. Since the law is so stringent regarding abuse and injury of children, should not they also be protected at birth? Why should untrained persons be allowed to put these citizens at risk? The Colorado Gyn/OB Society is unalterably opposed to passage of such a bill. This is not a question of choice or access. There are countless choices, and access is available to the community. Please remember the
maternal mortality rate in the United States was over 1 per 100 births and it is now less than 2 per 10,000. If this issue is enabled by law passed through your legislture it will have inevitible adverse maternal and newborn outcomes. There are standards by the World Health Organization and the American College of Nurse Midwives concern- ing the education of nurse midwives which the American College of Obstetricians and Gynecologists endorses. The certified nurse mid- wife meets these standards. Lower standards are unacceptable for care of women in the United States. The American College of Obstetricians and Gynecologists has issued a statement of policy, "supporting those actions that improve the experience of the family while continuing to provide the mother and her infant with accepted stan- dards of safety available only in hospitals. Labor and delivery, while a physiologic process, clearly presents potential hazards to both mother and fetus before and after birth. These hazards require stan- dards of safety which are provided in the hospital setting and cannot be matched in the home situation".
If you do pass this legislation, please enact another bureaucracy which requires reporting of disasters that come through the Emergency Rooms of the State of Colorado so that you can keep a tally on the maternal and fetal deaths that you have enabled.
Sincerely,
Bruce C. Richards, MD
"If this issue is enabled by law ...it will have inevitible adverse maternal and newborn outcomes. "
Colorado Medicine for January, 1993
15
by Edie K. Register, Director Jo Parkin, Program Manager
Health Care
Financing
The following are responses to questions received by the Health Care Financing Administration concerning implementation of the new payment policies for surgical procedures as published in the Medicare Bulletin dated December 1 , 1 992. Some of the questions and answers refer to the rebundling initiative and columns I and II. This information was published in the Medicare Bulletin dated December 31 , 1991.
Endoscopy Procedures
Q: Please clarify the proper billing of endoscopies performed with multiple biopsies and/or polyp- ectomies. For example, should the code for colonoscopy with biopsy (45380) be billed for each specimen taken for a biopsy? Should the code for colonoscopy with removal of polypoid lesions (45385) be billed for each lesion removed in conjunc- tion with a colonoscopy? If so, how should payment be calculated if multiple biopsies and multiple polypoid lesions are removed during a colonoscopy?
A: Code 45380 should be billed only once for all specimens collected and biopsied during a single colon- oscopy. This code represents either a single or multiple biopsy. Similarly, 45385 designates the removal of a lesion or lesions during a colon- oscopy. Even if multiple specimens or lesions are removed during the colonoscopy, the physician should bill the appropriate code only once.
If both 45380 and 45385 are billed, the carrier should calculate payment according to the multiple endoscopy rules.
Q: In multiple endoscopy situations, carriers are instructed to pay the full value of the highest value procedure plus the difference between the next highest and the base endoscopy.
How should carriers apply the multiple endoscopy rules if a physi- cian bills only for the base procedure and another procedure in the same endoscopic series (e.g., 43235, upper gastrointestinal (Gl) endos-
copy, billed with 43251 , upper Gl endoscopy for removal of polypoid lesions)?
A: In this situation, the carrier should pay only the value of the highest valued procedure (43251 ) since this procedure includes the base (43235). Phase II of the rebundling initiative includes base procedures in Column II for a number of endoscopies. Other endoscopies, such as the example cited in this question, did not meet the monetary threshold for inclusion in Phase II. However, even if the endoscopies in question are not included in the mandatory rebundl- ing edits, carriers should not pay twice for the same base procedure.
Q: Some endoscopies other than base procedures appear in Column II for another endoscopy in the same series. For example, codes 29874 (arthroscopy, knee, for removal of loose body or foreign body) and 29875 (arthroscopy, knee, synov- ectomy, limited) are Column II codes for 29876 (arthroscopy, knee, synovectomy, major). Ail Three codes represent knee arthroscopies with the same base procedure 29870 (arthroscopy, knee, diagnostic, with or without synovial biopsy). How do the rebundling edits affect the multiple endoscopy rules?
A: Carriers must first apply the rebundling edits to determine if payment for any procedures reported by the physician must be denied. For example, if a physician reports codes 29874 and 29876, the carrier may pay only for code 29876. In this case, the multiple endoscopy rules
16
Colorado Medicine for January, 1993
would not be a factor. If a physician reports only codes 29874 and 29875, payment would be based on the full value of the higher valued procedure 29874 plus the difference between 29875 and the base proce- dure (29870).
Ophthalmology
Q: Retinal specialists are concerned about payment for laser eye surgery (e.g., code 67141) when the surgery is done in phases. Should carriers pay for codes which describe multiple sessions only once during a 90-day global period?
A: Where a descriptor states that the code represents one or more sessions of a procedure, carriers may pay for that service only once during the established global period. The work relative values (WRVs) for these codes were established for one or more sessions. Examples of such procedures are contained in the CPT- 4 range 67141-67228.
Q: The Ophthalmological services in the CPT-4 range 92002-92499 were assigned bilateral indicators of "0". Should the correct indicator be "1 " so that carriers can adjust payment when a service is per- formed on both eyes?
A: The correct bilateral indicator is "0" since the WRVs were established on the assumption that the codes describe bilateral services. Physi- cians should use the reduced service modifier if the procedure is per- formed on only one eye.
Health Care
F
I N A N C I N G
Multiple Surgery
Q: Do the multiple surgery or co- surgeon rules apply if two physicians each perform separate procedures during the same operative session (e.g., a general surgeon performs a hernia repair, and a urologist per- forms prostate surgery)?
A: Neither the multiple procedure nor co-surgeon adjustments apply if two physicians each perform dis- tinctly different surgeries (with specific CPT codes) on the same patient on the same day. Modifier-51 should not be reported for these surgeries unless one of the physi- cians individually performs multiple surgeries.
Q: A physician may attempt to correct a problem and avoid a risky, extensive surgery by performing a less extensive procedure. Occasion- ally, the less extensive procedure is unsuccessful, and the surgeon must perform the more difficult procedure within the postoperative period of the original surgery. Is payment for the second surgery limited to the intraoperative percentage?
A: The carriers should make full payment for a surgery performed during postoperative period of an unsuccessful lesser procedure. This means, the payment rules for the treatment of complications do not apply to this situation. The physician should bill for the second surgery with modifier-79. A new global period commences with the second surgery.
Q: Anesthesiologists may be paid separately for insertion of Swan- Ganz catheters and other specialized procedures. When an anesthesiolo- gist bills for providing the anesthesi- ology services and insertion of the Swan-Ganz catheter (or other procedure) on the same day, do the multiple surgery rules apply?
A: The multiple surgery rules apply only if the anesthesiologist furnishes two or more specialized procedures on the same day. If the anesthesiolo- gist provides only the anesthesiology services and insertion of a catheter, the multiple surgery rules do not apply to the insertion of the catheter.
NOTE: Modifiers -24, -25,-78, -79 were established to facilitate physi- cian billing and carrier processing. Services provided that meet the criteria for these modifiers should be submitted with the appropriate modifiers. In general, carriers have been instructed to not suspend services reported without a modifier to review for additional documenta- tion. To avoid delays and possible denials, please utilize the modifiers when appropriate. Please see Medicare Bulletin dated January 2,
1 992 for explanation of use of these modifiers for Medicare claims.
Colorado Medicine for January, 1993
17
y urni/, ^
5
a
©* S
a
/\ monthly report of current and on-going ctivities of the Councils , Committees and Sections of the Colorado Medical Society. None of the information herein is meant to indicate a policy or position statement of the Colorado Medical Society. This report is designed only to inform CMS members of their organization's activities and study projects at the Council \ Committee or Section level.
Council on Community Health Issues:
The Council reviewed the Poison Control Center's ongoing funding problem and agreed to support the concept of maintaining the Center as it now stands, recognizing that Denver should not have to support the full burden of the Center's operating costs. The Council also reviewed and supported the HIV Committee's recommendations regarding anonymous test sites. The Council reviewed and approved The Guide to Nursing Home Medical Director's Job Description which was an attachment to Res-9-A: Standards for Medical Directors of Nursing Homes as adopted at the Annual Meeting in 1 991 . Plans for dissemi- nation of these guidelines were developed for implementation after House of Delegates approval in March. Also reviewed was Res-54- P: Study Approaches to Reforming Nursing Home Care.
Following lengthy discussions it was determined that the Council does not have the expertise to analyze the issues proposed in this resolution. It was suggested that an ad hoc committee be created for the sole purpose of responding to this resolution.
HIV Committee:
The Council is providing input to the CMS Council on Ethical and judicial Affairs regarding Res-48-P: Treatment of HIV Infections. Res 48 was referred to the Council at the 1 992 Annual Meeting. The next meeting of the HIV Committee is scheduled for January.
Family Violence Task Force:
The November meeting was cancelled due to inclement weather. The next meeting is scheduled for January 12, 1992. A subcommittee is in the process of planning a multidisciplinary forum to 1 ) identify and clarify each agency's role, 2) clarify the existing reporting statute for domestic violence, 3) identify problems with the current system for dealing with domestic violence, and 4) problem solve.
Medical Service Council:
At the December meeting of the Council members reviewed the proposed rules for unlicensed x-ray operators. Their comments were referred to the Government Affairs Division. The Council also began developing an action plan for the implementation of Res-68-P: Creden- tialling and Peer Review.
Members outlined initial infor- mation to be gathered from hospitals, COPIC and CFMC prior to the next meeting. The Council approved the draft guidelines for the locum tenens project. The guidelines will be forwarded to legal counsel for review. The Council also recom- mended disbanding the pharmacy committee suggesting that future pharmacy issues can be addressed by the Council or an ad hoc commit- tee.
In addition, a multidisciplinary task force has begun meeting in response to Res-47-P: Non-physician Medical Care Providers. PAs, Nurse Practitioners and physicians are meeting to discuss the roles, scope of practice and supervisory requ ire-
18
Colorado Medicine for January, 1993
merits for mid-level providers and how these issues impact access to quality care.
Colorado Health Data Commission Task Force:
The task force has been reconsti- tuted to include the CMS executive committee as well as Drs. John Farrington, Ned Calonge and Vern Smith. The task force has met once and will continue to meet as needed to monitor the activities of the Colorado Health Data Commission.
Additional Department Activities:
Codman Small Area Analysis Project:
The first report which focuses on medical backs and back and neck procedures is complete. A study committee is being convened to review this report and determine the questions raised by the data. This information will then be provided to the medical community to assist them in understanding and utilizing the data.
Hospital Medical Staff Section:
The HMSS Section will hold its next meeting in January.
Women in Medicine Section:
The Section continues to work on sample parental policies. They will be mailing a questionnaire to all women physicians in the state to inquire about what the Section can do for them. A mentor program for medical students is being developed. A ski day is planned for January 27. The Section's Interim Business
Meeting is scheduled for April 2 in Colorado Springs in conjunction with the CMS Interim Meeting. Dr. Mary Ann Neifert is the scheduled speaker. The next meeting of the Governing Council is scheduled for January 28th.
"...a good number of complaints from health care workers about non- compliance in medical offices' '
Important OHSA Update
A recently completed AMA survey of the OSHA regional offices and state programs reinforced our information that enforcement authorities do not plan to perform random physician office surveys to determine compliance with the standards for bloodborne patho- gens. They will do inspections in response to complaints. However, staff at a local OSHA offices stated that they were receiving a good number of complaints from health care workers about non-compliance in medical offices which will be followed up with inspections. Complaints about non-compliance are frequent in the following areas:
1 ) Lack of appropriate personal protective equipment (i.e. gloves, gowns, masks, etc.)
2) No provision for Hepatitis B vaccines for staff
3) Lack of an exposure control
plan
4) Lack of training for office staff in areas pertaining to the bloodborne pathogen standard and office policies regarding such
One additional caution. Physicians offices often hire person- nel from temp services but do not complete an exposure determina- tion for them (job classification regarding potential for exposure to bloodborne pathogens) and do not determine whether or not these staff have received Hep B vaccinations. Be aware of what jobs you are hiring temps for and whether or not they are in a job classification with the potential for exposure. If so and if they will be with your office for any length of time, consider making appropriate arrangements for training and vaccination. Check with the local OSHA offices (844- 5285 or 843-4500) if you have questions.
Colorado Medicine for January, 1993
19
The Interview
A short story (Part III of three parts)
by Joe Batuello, MSI
Denver, Colorado
" I'm not dead yet."
"You will be. You'll be stone cold in a moment."
"I think I'm getting better
"You're not fooling anyone, you know."
" What a drag it is
getting old. . . "
When last we saw Alex Bookman, in Part II, he had just concluded his in- terview with Dr. Zyklon considering the residency in thanatology. Alex was on a tour of the California facility, and was aware of a room labeled the " Pro- cedure Room". Just out- side the room was a Nor- man Rockwell portrait of the boy with his bare backside fin the face of the doctor, who is about to administer a shot.
"Interesting," thought Alex "that a person's dying image be of getting mooned by an artist's depiction of a trusting patient."
Alex also wondered to himself what would be an appropriate soundtrack forone'sfinal exit. Maybe "The End" by The Doors? Or anything by Sinead O'Connor so you would want to be dead that much more?
Alex peered into the procedure room. There a table in the center, with a cabinet against the wall. A couch and some wooden chairs were clustered at one end of the room, presumably for the family. The walls were bare.
A hospital maintenance employee swabbed the tile floor, whilea portable radio played in the background. Alex surveyed the room thoughtfully, trying to imagine what it was like while the "procedure" was being performed. The music from the radio drifted slowly into Alex's consciousness: it was Pink Floyd's "Comfortably Numb." At that moment, the gestalt was almost over- powering and Alex thought he would swoon.
He turned back into the hallway, experiencing some disorientation. From one of the rooms his attention was taken by a familiar dialogue, though he couldn't quite place it. The unmistakable culture of British accents flavored the conversation:
"I'm not dead yet."
"You will be. You'll be stone cold in a moment."
"I think I'm getting better." "You're not fooling anyone, you know."
Alex peeked into the room to see a scene from "Monty Python and the Holy Grail" on the television. He re- membered the scene: a man is drawing a cart in a medieval village collecting victims from the plague. A citizen approaches him with a "not quite dead" victim and tries to get the cart bearer to accept the cargo. "I can't take 'em like that," explains the cart-bearer, "it's against regulations." After some per- suading the cart man agrees to help the reluctant cargo is clubbed over the head and piled onto the cart.
"Hmmm," reflected Alex. "Maybe Dr. Zyklon's program isn't so innova- tive after all."
As Alex headed down the elevator and out of the building, he was still confused about his residency. Hedidn't think he would like thanatology.
He loosened his tie, slid into his rented car and started the engine. The radiocameon with a melodic observa- tion from the Rolling Stones: "What a drag it is getting old..."
20
Colorado Medicine for January, 1993
Board Highlights
Highlights of the CMS Board of Directors meeting November 22, 1992
CMSA:
Medical Student Society:
Executive Committee:
Finance Committee:
Board of Directors:
Mrs. Pam Laman, President, reported that the Denver Medical Society Auxiliary had distributed over 10,000 pamphlets on Domestic Violence and that Otero County was developing an awareness program on the same subject.
Maura Lofaro, MSIV, reported that the MSS had held its first meeting and elected officers.
The Board ratified the actions of the Executive Committee in deciding to hold both an Interim Meeting and a Leadership Conference. Also, Ms. Maloney has been directed to negotiate with the Colorado Dept, of Health for CMS to be the facilitator for the distribution of Do Not Resuscitate forms.
The Board ratified the actions of the Finance Committee in approving requests for distribution of monies from the Colorado Medical Foundation Trust to the Colorado Physician Health Program, the Colorado Personalized Education Program and to CMSERF.
The Board approved Dr. Truitt's recommendation to create a Task Force for the purpose of study and monitoring the ongoing health care reform activities, both on a state and federal level.
It was announced that Dr. Don Parsons, a long-time active member of CMS had accepted a position in the legislative division of Kaiser Permamente in Washington, D.C. His expertise in this arena in Colorado will be missed.
Volunteer Doctors
The Salvation Army Adult Rehabilitation Center at 4751 North Broadway (1-25 to 49th Avenue exit to Broadway and right to 4751 ) is looking for retired physicians who are interested in volunteering some time and medical services.
If you or any retired physician you know is interested, please call
Connie Schranz Salvation Army Adult Rehabilitation Center in Denver at 294-0827.
Jo Parkin
CMS is pleased to introduce a new employee in the Health Care Financing Department.
Jo Parkin comes to us from Blue Cross Blue Shield of Colorado where she was a Network Administrator for Colorado, New Mexico and Nevada.
Jo has ten years experience in the health care field. She has recently received her masters degree in health care systems, lo's responsibility at CMS will be to deal with third party payer issues. She will be assisting CMS physicians members with Workers' Compensation, Auto No- Fault and private Insurance issues.
Jo will also be responsible for disseminating information and advice to the membership pertaining to current and new laws, regulations and policies emanating from federal, state and local agencies and third party payers.
Colorado Medicine for January, 1993
Introducing
1992-1993 Board of Directors
Photos by Gill Maestas, II, except for Dr. Truitt, photo by Rocky Mountain News
Dr. Leigh Truitt, 1993 President of the Colo- rado Medical Society has been a member for the past 22 years. He earned his MD degree in 1964 from Johns Hopkins Medical School and specializes in Internal medicine and Pulmonary Dis- eases.
Wm. Carl Bailey, MD currently serves as President-Elect of 1 992-93 oftheColorado Medical So- ciety. Dr. Bailey recieved his Medical Degree in 1952 from the Wayne State Universtiy Medical College in DetroitMichigan. He has been a member of CMS for the past 34 years and spe- cializes in Pediatric Surgery.
Dr. Harrison G. Butler III is the Immediate i Past President of CMS. He
years. Dr. Butler recieved
Dr. Terrance Sullivan has
been a member of CMS for the past 8 years. He serves as treasurer for the Colo- rado Medical Society Board of Directors. Dr. Sullivan specializes in Occupa- tional Medicine.
Thomas J. Allen, MD has been a member of TheColorado Medical So- ciety forthe past 18 years. He recieved his Medical Degree in 1972 from In- diana University and spe- cializes in Family Prac- tice, Emergency Medicine and Occupational Medi- cine.
John O. Cletcher Jr, MD has been a mem- ber of CMS for the past 28 years. He recieved his Medi- cal Degree in 1 955 from the University of Illinois. Dr.
Cletcher practices Orthope- dic Surgery and is based in Longmont CO.
Donald G. Eckhoff, MD
is a Denver physician who specializes in Or- thopedic Surgery. Dr.
Eckhoff has been a CMS member for 1 5 years. He recieved his Medical De- gree from the University of Minnesota and served his internship at Saint Lukes Hospital in Denver.
Dr John E. Elliff has been a Member of the Colo- rado Medical Society for the past 38 years. He stud- ied at and earned his Medical Degree from the University of Colorado School of Medicine in 1 956. He currently practices Ophthalmol- ogy in Sterling CO.
Vail Colorado is the home Feeney, MD. Dr. Feeney specializes in Family Prac- tice and has been a mem- ber of CMS for 9 years. He recieved his Medical De- gree in 1 977 and served his internship and residency at St. Paul Ramsey Hospital in Minnesota.
Dr. David C.S. Franklin earned his Medical Degree ^in South Africa at
‘ where he practices Anes- thesiology.
In addition to a thriving adult and pediatric allergy and asthma prac- tice, Joel M. Karlin, MD is an alternate delegate to the American Medical Asso- ciation from Colorado and represents the Clear Creek Valley Medical Society on the CMS Board of Direc-
George M. Kreye, MD received his Medi- cal Degree from the Uni- versity of Kansas Medical School in 1 962 and com- pleted an internship at Fitzsimons General Hos- pital in Aurora CO. He has been a member of the CMS for 26 years. Dr. Kreye specializes in
Dermatology.
Muryl L. Laman received h is h i s Doctorate of Med i- cine from the University of Kansas. In addition to serving as the Pueblo County representative to the CMS Board of Direc- tors, Dr. Laman practices Cardiology, Internal Medicine and Aero- space Medicine in Pueblo. His wife, Pam, is currently President of the CMS Alliance, a physician spouse organization.
Dr. Ted T. Lewis is a Rheumatologist from Colorado Springs, Colo- rado. Dr. Lewis received his medical degree from the State University of Virginia, but has done all his post-doctorate work at he University of Colo- rado. He represents El Paso County Medical Society on the CMS Board of Directors.
Robert A. Nathan, MD has been a member of the Colorado Medical Society for fifteen years. He represents the El Paso County Medical Society on the CMS Board of Di- rectors. Dr. Nathan spe- cializes in Allergy & Im- munology in Colorado Springs. He received his MD from the University of Miami.
Dr. Kenneth M. Olds is a
ner from Greeley, Colo- rado. He represents the Weld County Medical Society on the CMS Board of Directors. Dr. Olds has been a member of the Colorado Medical Soci- ety for 1 9 years.
Lothar K. Roller, MD came to Colorado after earning a Medical Degree at the University of Heidelberg in Ger- many. He has been a CMS member for 29 years. Dr. Roilerpractices in Canon City CO. where he spe- cializes in Radiology and Nuclear Medicine. David Shander, MD is a Denver physician who specializes in Car- diovascular Diseases. Dr.
Shander received his Medical Degree from the University of Rochester in New York and has been a member of CMS for 1 7 years.
Photo not available
of Jonathan C.
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Family Practitio-
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22
Colorado Medicine for January, 1993
1992-1993 Board of Directors
I has lx vn ,i ( MS member . iS f°r ' ^ years. After receiv- ing a Medical Degree from Temple University in Phila- del phi,i, Dr. Shanks came j^iPI to Denver and completed a residenecy at St. loseph Hospital. He lives in Grand junction CO. where he practices General Surgery.
Susan A. Sherman, MD is
sician who specializes in Internal Medicine, Endo- crinology & Metabolism, and Diabetes. Dr. Sher- man earned her Medical Degree in 1973 from the University of North Caro- lina and completed her internship and residency at Presbyterian University Medical Center in Pennsylvania. She has been a member of CMS for 1 6 years.
Denis J. Winder, MD is a Durango CO. 1 3 years.
M. Robert Yakely, MD has been a member ofCMSforthepast21 years.
After receiving his Medical Degree Dr. Yakely com- pleted an internship at the Ohio State University Hos- pital followed by his resi- dency at the University of Colorado School of Medi- cine. He currently practices in Denver where he is a specialist of Uro- logical Surgery. Dr. Yakely is a past chair- man of the CMS Council on Legislation.
Cardiologist Dieter W. Schneider, MD has
been a member of the Colorado Medical Soci- ety since 1 983. Dr. Schneider graduated from the University of Colorado School of Medi- cine and served as an in- tern and resident at St. Luke's Hospital in Den- ver. He represents the Young Physicians Section of CMS on the Board of Directors.
Dr. Gary D. VanderArk is
proud of his work at the Colorado Neurological In- stitute in Denver, but is also concerned with organized medicine. That is why he represents the Hospital Medical Staff Section on the CMS Board of Directors. Dr. VanderArk was awarded the Doctor of Medicine by the University of Michigan in Ann Arbor and received the Robins Award for Com- munity Service by a Physician from the Colorado Medical Society.
Louise L. McDonald was granted the de- greeof Medical Doctor by Georgetown University School of Medicine in Washington DC. She did her internship and resi- dency training at Harbor General Hospital in Tor- rance California and cur- rently is a practicing Pediatrician in Den- ver. She works at the University of Denver Student Health Service. Dr. McDonald rep- resents the Women in Medicine Section on the Board of Directors.
Stephen G. Batuello became active in or- ganized medicine as a student at the University of Colorado School of Medicine and served as the student representative to the Board of Directors until his graduation last spring. Currently under- taking a surgical residency, he stayed on the Board as the representative of the Resi- dent Physicians Section.
Maura J. Lofaro is currently a senior medi- cal student at the Uni- versity of Colorado. She plans to specialize in Obstetrics and Gynecol- ogy when she graduates this spring. Until then, she will continue to serve as the Medical Stu- dent Component repre- sentative on the CMS Board of Directors. M. Ray Painter, MD has been a member of the Colorado Medical Soci- ety for 22 years. Specializ- ing in Urological Surgery,
Dr. Painter did his intern- ship and residency work at Triplet Army Hospital in Hawaii. Currently practic- ing in Glenwood Springs,
Dr. Painter is a member in good standing in the Mt. Sopris County Medical Society. He is a delegate to the American Medical Association from Colo- rado.
In addition to representing Colorado at the American Medical Asso- ^ H ciation meetings. Dr.
■ Richert E. Quinn, Jr. is a I member of the Board of I Directors of Copic Insur- HH ance and a Past President of the Colorado Medical Society. In his free time, Dr. Quinn operates a gen- eral surgery practice in Greeley. He has been a CMS member for 22 years.
After receiving his medical degree from Temple University School of Medicine in Pennsyl- vania, Mark A. Levine served an internship atthe University Hospital there before coming to Colo- rado for a residency atthe CU School of Medicine.
He currently practices In- ternal Medicine and Allergy & Immunol- ogy in Englewood and represents the Colo- rado Medical Society in the AMA House of Delegates. Dr. Levine has been a member of the CMS for 20 years.
In addition to his duties as an alternate delegate to the AMA from Colorado, Dr. Robert D. McCartney Chairs the Council on Physician/Pa- tient Advocacy of the CMS, where he has been a cham- pion of the elderly patient. He does much community work in this area and is a specialist in Internal Medicine and Geriat- rics in Denver. Dr. McCartney's education, including internship and residency was completed at the University of Colorado, he joined the Colorado Medical Society in 1981.
Dr. Robert M. Bogin has been active in the Young Physicians Section on both national and state levels. He currently is an alternate delegate to the American Medical Asso- ciation from the CMS and specializes in Internal Medicine and Pulmonary Diseases in Denver. Dr.
Bogin was awarded the MD degree from Cornell University in New York and served his internship and residency at the Univer- sity of Michican Hospital in Ann Arbor.
a Colorado phy-
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Colorado Medicine for January, 1993
23
Medical
News
Cancer Help Available
In today's world of modern medi- cine, a diagnosis of cancer is no longer a reason to despair. Recent advances in science have enabled physicians not only to treat but in some cases cure many forms of cancer
Since cancer will strike three out of four American families every year, the Cancer Research Institute would like to ask you to lend your support to an organization and a publication that figure importantly in the ongoing effort to control the disease.
The Institute is a not-for-profit corporation, founded in 1953 to support research in the field of cancer immunology. Known for its scientific excellence and fiscal integrity, this farsighted organization offers the Help Book as its first venture into the outpatient services area.
The HelpBook is a 44-page booklet intended to assist cancer patients and their families in coping with their illness. It is an exception- ally valuable guide that presents an eight-step plan for patients to follow from diagnosis through recovery. The booklet gives clear, concise, easy-to- read advice on getting the best medical care, how to obtain a second opinion, how to seek out sources of needed treatment, how to obtain ancillary services and even gives information on financial considerations.
Dr. lill O'Donnell-Tormey, co- author of the HelpBook, sought advice from leading oncologists
drawn from the Institute's Scientific Advisory Council that includes four Nobel laureates and 17 members of the National Academy of Sciences to assure the validity of the booklet.
The Institute will make these book- lets available to physicians to distribute in their offices for a small shipping and handling charge. To order, call the Institute at 1-800- 99CANCER.
National Physician Group Enters Colorado Politics
The American Association of Physi- cians for Human Rights (AAPHR), a group of lesbian and gay physicians and supporters based in California, has announced that it will join other groups in a boycott of Colorado over the passage of Amendment 2. The association canceled their plans to hold their annual convention in Denver in August and called for other organizations to boycott Colorado as well.
The group said this is the first time in their history that a major meeting has been rescheduled in response to a political decision. Larry Prater, MD, AAPHR President, said "We cannot in good conscience bring our members and our dollars to a state that would so willingly deny basic civil rights to lesbian and gay people."
Amendment 2, supported by over 800,000 Colorado voters November 3, prohibits government entities from adding "sexual orienta- tion" to the list of classes of people who receive special protection from
discrimination. The list presently includes such groups as women, racial minorities, and natives of other countries, all of whom have required protection from a history of past discrimination.
Cheryl Clark, MD, a Denver psychiatrist who serves on the board of AAPHR, said, "It's a shame that the citizens of my state gave in to pressure from the religious right. This will adversely affect the health and well-being of thousands of Colorad- ans."
Local columnist Al Knight, writing in the Denver Post, disagreed with this prediction of disastrous effects, saying that, in practical terms, all that changed was the elimination of three local ordinances and one executive order prohibiting discrimination against people on the basis of their sex lives. Knight discounted the contention that passage of this amendment signals an era of hate against homosexuals, "It is said that Coloradans want to discriminate against homosexuals. It is much more likely that hundreds of thousands of them did not want to be taken on a guilt trip. Many know nothing of homosexuality and are unaware of any action on their part that would in any way affect the lives of homosexuals. Many others simply reject the notion that sexual orienta- tion should be considered in the same legal class with race and ethnicity."
24
Colorado Medicine for January, 1993
Child Abuse Training
The Denver Osteopathic Foundation and Presbyterian/St. Luke's Family Medicine Program will offer a one day training session for family physicians on Child Sexual Abuse and Neglect February 27. Dr. Carole Jenny of the Children's Hospital will be conducting the program at Denver Presbyterian Hospital Auditorium. Call 364-2273 for more information.
Colorado Trust Begins $4.5 Million Community Health Initiative.
Thirteen communities across Colo- rado have been selected to begin a five year project called Colorado Healthy Communities Initiative. Begun by the Trust in response to the findings of the Choices for Colo- rado's Future study, the Initiative responds to a desire for local action and participation to respond to community needs through commu- nity-based approaches to problem solving.
The Trust has contracted with the National Civic League to manage the program in Commerce City,
Delta and Montrose counties, Gilpin County and the Nederland mountain area, Globeville, Gunnison basis, La Plata, San Juan and Archuleta counties, Las Animas County, Mesa County, Montezuma County (includ- ing the Ute Mountain Tribe), North- east Colorado (Logan, Morgan,
Medical
News
Phillips, Sedgwick, Washington and Yuma counties), Pueblo County, (Roaring Fork Forum (Aspen to Parachute), and the Telluride region. Up to 30 communities will ulti- mately be selected for the project over the next two years. Contact the Colorado Trust for more information at (303) 837-1200.
Feds Consider Electronic Records Requirement
Bills introduced at this past session of the U.S. Congress included provi- sions to require all Medicare provid- ers to have computerized patient record systems Observers expect the Clinton administration to accelerate efforts toward electronic patient record systems.
To help physicians cope with these changes, the Medical Records Institute is sponsoring TOWARD AN ELECTRONIC PATIENT RECORD - 1993, to be be held April 21-24,
1993 in San Antonio, Texas. Call Shirley Tow at (61 7) 964-3923.
New Hope in Anti- Trust Arena
A recent court decision in the much publicized case of three Florida dentists accused of criminal price fixing gives some hope to belea- guered health professionals.
Currently, even "getting together to discuss this miserable situation" can be considered criminal con- spiracy in violation of federal anti- trust laws and any kind of concerted action on the part of health care professionals is viewed as price
fixing. This means physicians and others have very little ability to bargain effectively with large health care organizations, insurance companies and third party payors.
Now the Ninth Federal Circuit Court of Appeals has recognized this imbalance and, in an opinion issued in the case of the dentists, has opened the door for more collective action on the part of physicians. According to the court, "individual health care providers are entitled to take some joint action (short of price fixing or a group boycott) to level the bargaining imbalance created by the Plans and provide meaningful input into the setting of the fee schedules."
Actions that would not constitute price fixing, according to the court, would include, "commiserating over the low fee schedules; or impugning the motivations of the Plans; even sabre-rattling about economic regtribution at some indefinite time in the future if their grievances remain unaddressed. Some such activity, like clamoring for govern- mental protection of their interests, vis-a-vis their antagonists or competi- tors, would even be constitutionally protected."
This case may signal an opening of the door for physicians to take collective action in certain cases without violating anti-trust laws, but it is only one court's opinion. Watch for possible changes in anti-trust laws and be certain to consult with an attorney before undertaking any collective action with other health care professionals!
Colorado Medicine for January, 1993
25
New
Members
ARAPAHOE MEDICAL SOCIETY
Norman O Aarestad, MD 799 E Hampden Ave #1001 Englewood, CO 801 1 0 Elected 08/1 9/92
Judy Baack, MD 5161 E Arapahoe Rd Littleton, CO 80122 Elected 08/1 9/92
Clifford A Bloch, MD 850 E Harvard Ave #465 Denver, CO 80210 Elected 10/01/92
L Michelle Booth, MD 7720 S Broadway #330 Littleton, CO 80122 Elected 10/20/92
Mary Ann Buesing, MD 1 91 9 S University Blvcl Denver, CO 80210 Elected 08/1 9/92
Diana M DeSantis, MD 7720 S Broadway #200 Littleton, CO 80123 Elected 09/1 5/92
John B Ebens, MD 799 E Hampden Ave #400 Englewood, CO 801 10 Elected 08/1 9/92
Edward B Eigner, MD 850 E Harvard Ave #525 Denver, CO 80210 Elected 09/1 5/92
Hope R Engsberg-Rauzi, MD 333 W Hampden Ave #600 Englewood, CO 801 10 Elected 09/1 5/92
Martha C S Hepparc), MD 200 W Littleton Blvd Littleton, CO 80121 Elected 09/30/92
Charles H Kay Jr, MD 71 80 E Orchard Rd #202 Englewood, CO 801 1 1 Elected 08/19/92
Eric O Kortz, MD 601 E Hampden Ave #470 Englewood, CO 801 1 0 Elected 08/19/92
Alan S Lidsky, MD 799 E Hampden Ave #400 Englewood, CO 801 1 1 Elected 08/1 9/92
Robert J Miner, MD 950 E Harvard Ave #660 Denver, CO 80210 Elected 07/23/92
Charlotte D Scanlon, MD 6169 S Balsam Way #240 Littleton, CO 80123 Elected 1 0/20/92
Mitchell D Seemann, MD 1 805 Kipling St Lakewood, CO 8021 5 Elected 09/1 5/92
AURORA-ADAMS COUNTY MEDICAL SOCIETY
Carolyn Burkhardt, MD 1601 E 19th Ave #4400 Denver, CO 80218 Elected 10/01/92
Michael Charney, MD 4545 E 9th Ave #510 Denver, CO 80220 Elected 08/1 1/92
Raphael J d'Angelo, MD 14991 E Hampden Ave #210 Aurora, CO 80014 Elected 08/04/92
Joel P Karasek, MD 3483 W 101st PI Westminster, CO 80030 Elected 09/01/92
Thomas P McDonough, MD 14991 E Hampden Ave #280 Aurora, CO 80014 Elected 10/01/92
Brian D Ryals, MD 5206 S Flanders St Aurora, CO 80015 Elected 10/01/92
Jonathan J Seidlin, MD 730 Potomac St #1 24 Aurora, CO 8001 1 Elected 10/01/92
BOULDER COUNTY MEDICAL SOCIETY
Robert H Levine, MD 2750 Broadway Boulder, CO 80304 Elected 08/01/92
John S O'Hearne, MD 90 Health Park Dr #290 Louisville, CO 80027 Elected 11/01/92
Carolyn S Schaffter, MD 90 Health Pk Dr #300 Louisville, CO 80027 Elected 08/1 2/92
Michael VonGortler, MD 4649 Apple Way Boulder, CO 80301 Elected 08/1 2/92
CLEAR CREEK VALLEY MEDICAL SOCIETY
Mark J Conklin, MD 3550 Lutheran Pkwy West #201 Wheat Ridge, CO 80033 Elected 09/29/92
Patrick S Freeman, MD 5730 Ward Rd #102 Arvada, CO 80002 Elected 09/24/92
26
Colorado Medicine for January, 1993
James A Hopfenbeck, MD 8300 W 38th Ave Wheat Ridge, CO 80033 Elected 09/24/92
David A Landy, MD 3329 E Bayaud Ave #1316 Denver, CO 80209 Elected 09/1 6/92
Lucien T Megna, MD 8770 Wadsworth Blvcl Arvada, CO 80003 Elected 08/1 3/92
Grant C Olson, MD 8074 S Quince Way Englewood, CO 801 1 2 Elected 08/1 9/92
Kirk T Shamley, MD 8300 Alcott St #300 Westminster, CO 80030 Elected 09/08/92
Steve M Volin, MD 8300 N Alcott St #300 Westminster, CO 80030 Elected 09/24/92
Carlton L Wallis Jr, MD 8300 W 38th Ave Wheat Ridge, CO 80033 Elected 09/24/92
DELTA COUNTY MEDICAL SOCIETY
Kenneth J Eckstein, MD PO Box 10100 Delta, CO 81416 Elected 09/08/92
DENVER MEDICAL SOCIETY
Bruce E Andrea, MD 101 S Downing St #6 Denver, CO 80209 Elected 12/01/92
Tanya S Argo, MD 3467 W 97th Ave #23 Westminster, CO 80030 Elected 12/01/92
New
Paul S Asmar, MD 9891 E Jewell Ave Denver, CO 80231 Elected 09/04/92
Ronald N Baxter, MD 11 50 Syracuse St #8-145 Denver, CO 80220 Elected 09/04/92
John N Beattie, MD 4640 Greenbriar Ct Boulder, CO 80303 Elected 09/04/92
|ohn D Bender, DO 1 2061 Tejon St Westminster, CO 80234 Elected 11/01/92
Andrew T Blair, MD 7557 E Warren Ave ##5-303 Denver, CO 80231 Elected 12/01/92
Rosalie A Bondi, DO 6573 Benton Cir Arvada, CO 80003 Elected 09/04/92
Steve Carstens, DO 3433 Lowell Blvd Denver, CO 8021 1 Elected 09/04/92
Gregory D Denzel, DO 1 738 S Franklin St Denver, CO 80210 Elected 09/04/92
Avninder Singh Dhaliwal, MD 1 939 S Quebec Way H-822
Denver, CO 80231 Elected 1 2/01/92
Eleanor M Diss, MD 1601 E 19th Ave #6500 Denver, CO 80218 Elected 08/01/92
James C Duke, MD 4200 E 9th Ave #B-1 13 Denver, CO 80262 Elected 1 1/01/92
Alexandra A Fortner, MD 1820 Gilpin St #210 Denver, CO 80218 Elected 12/01/92
Gayle A Frazzetta, MD 9085 E Mississippi Ave #M-20 7 Denver, CO 80231 Elected 09/04/92
Perry L Haney, MD PO Box 24344 Denver, CO 80224 Elected 09/04/92
Karen Faye Higgins, MD 4200 E 9th Ave Box 270-C Denver, CO 80262 Elected 12/01/92
Karen L Hord, MD 645 Bannock St Denver, CO 80204 Elected 12/01/92
Ronnie S Horowitz, MD 645 Bannock St Denver, CO 80204 Elected 08/01/92
Elizabeth L Horvath, DO 1 357 Williams St #305 Denver, CO 80218 Elected 09/04/92
Annie Y Johnson, DO 1250 S Kline Way Lakewood, CO 80226 Elected 09/04/92
Timothy B Judd, DO 1801 E Girard PI #247 Englewood, CO 801 1 0 Elected 09/04/92
Corby S Kessler, MD 900 Potomac St Aurora, CO 8001 1 Elected 09/01/92
Robert E Khoo, MD 4500 E 9th Ave #340 Denver, CO 80220 Elected 12/01/92
Colorado Medicine for January, 1993
27
New Members
|
Anita J Klaus, MD 7359-B W Kentucky Dr Lakewood, CO 80226 Elected 09/04/92 |
Douglas A Milligan, MD 4500 E 9th Ave #220-S Denver, CO 80220 Elected 07/28/92 |
Steven C Posson, DO 4923 S Carson St #1 -1 03 Aurora, CO 80015 Elected 09/04/92 |
|
James D Kriseman, DO 480 S Joplin St #2-102 Aurora, CO 80017 Elected 12/01/92 |
Thomas D Mino, DO 3655 S Verbena St #C-202 Denver, CO 80237 Elected 09/04/92 |
Cynthia M Ruggero, MD 653 Marion St Denver, CO 80218 Elected 08/01/92 |
|
Laurie M Vande Krol, MD 3032 S King St Denver, CO 80236 Elected 08/01/92 |
Judy M Mouchawar, MD 4860 Meredith Way #1 30 Boulder, CO 80303 Elected 09/04/92 |
Susan L Sant i 1 1 i , MD 500 W 123rd Ave #3332 Westminster, CO 80234 Elected 10/01/92 |
|
Frank R Lansville, DO 12806 W 61st PI Arvada, CO 80004 Elected 09/04/92 |
Dilsher Nawaz, MD 17033 E Greenwood Cir Aurora, CO 8001 3 Elected 10/24/86 |
John W Schultz, MD 1721 E 19th Ave #468 Denver, CO 80218 Elected 08/01/92 |
|
Joon Hak E Lee, MD 4862 B E Kentucky Ave Denver, CO 80222 Elected 09/04/92 |
Daniel H Nguyen, MD 4801 S Wadsworth Blvd #8-304 Littleton, CO 801 23 Elected 09/04/92 |
Eduardo Seda, MD 1820 Gilpin St #210 Denver, CO 80218 Elected 12/01/92 |
|
Joseph H Lock Jr, MD 8965 E Florida Ave #11 -302 Denver, CO 80231 Elected 1 1/01/92 |
Patricia Nolan, MD 4300 Cherry Creek Dr S Denver, CO 80222 Elected 0 |
Andrew A Shultz, MD 1 5068 E Mexico Dr Aurora, CO 80012 Elected 12/01/92 |
|
Elizabeth A Loudon, MD 1 1 1 1 Ash St #704 Denver, CO 80220 Elected 08/01/92 |
Norman | Novel ly, DO 1601 E 19th Ave #5500 Denver, CO 80218 Elected 1 1/01/92 |
John L Smith, MD 1601 E 19th Ave #5200 Denver, CO 80218 Elected 08/01/92 |
|
Liesel E A Lowell, MD 991 1 E Colorado Ave #624 Denver, CO 80231 Elected 09/04/92 |
Calvin J Okey, DO 12150 Race St #L-201 Northglenn, CO 80241 Elected 09/04/92 |
Michael D Smith, MD 1 001 E Bayaud Ave #1 007 Denver, CO 80205 Elected 09/01/92 |
|
Dale F Mabe, DO 51 5 Lost Angel Rd Boulder, CO 80302 Elected 09/04/92 |
Rebekah K Owen, MD 1 470 S Quebec Way #1 74 Denver, CO 80231 Elected 10/01/92 |
Arthur R Snyder, MD 360 S Garfield St #630 Denver, CO 80209 Elected 12/01/92 |
|
Nola A MacDonald, DO 3100 Cherry Creek Dr S #202 Denver, CO 80209 Elected 09/04/92 |
Andrew W Parker, MD 4500 E 9th Ave #450S Denver, CO 80220 Elected 10/01/92 |
Glen N Villanueva, DO 817 27th St Denver, CO 80205 Elected 1 1/01/92 |
|
Andrew J Michael, MD 850 E Harvard Ave Denver, CO 80210 Elected 10/01/92 |
John G Petty, MD 1616 Olive St Denver, CO 80220 Elected 09/04/92 |
Anna M Wegleitner, MD 2020 S Oneida St #100 Denver, CO 80224 Elected 10/01/92 |
28
Colorado Medicine tor January, 1993
Lawrence S Wilner, DO 601 E 19th Ave Denver, CO 80203 Elected 09/04/92
Sandra L Wootton, MD 1056 E 19th Ave Dept of Rad Denver, CO 80218 Elected 09/01/92
EL PASO COUNTY MEDICAL SOCIETY
Peter E Anderson, MD 825 E Pikes Peak Ave Colorado Springs, CO 80903 Elected 09/08/92
Laurence J Cohen, DO 2835 Hunters Glenn Rd Monument, CO 801 32 Elected 09/08/92
Brian Cole, MD 1901 N Union Blvd #102 Colorado Springs, CO 80909 Elected 10/07/92
Richard E Collister, MD 1 660 Stoney Point Ct Colorado Springs, CO 80919 Elected 09/08/92
Matthew M Cooper, MD 1 725 E Boulder St #104 Colorado Springs, CO 80909 Elected 09/09/92
Robert L Fritz, MD 209 S Nevada Ave Colorado Springs, CO 80903 Elected 1 1/18/92
Mitchell L Goldblum, MD 325 Parkside Dr Colorado Springs, CO 80910 Elected 10/21/92
Susan M McMaster, DO 4760 Flintridge Dr #200 Colorado Springs, CO 8091 8 Elected 09/08/92
New
Joseph M Pruitt, MD 3205 N Academy Blvd Colorado Springs, CO 8091 7 Elected 1 1/18/92
Dennis C Raphael, MD 2131 N Tejon St #L-2 Colorado Springs, CO 80907 Elected 09/01/82
Pamela K Richards, MD 1725 E Boulder St #201 Colorado Springs, CO 80909 Elected 09/09/92
David W Ross, DO 825 E Pikes Peak Ave Colorado Springs, CO 80903 Elected 09/23/92
Steven E Ryan, MD 7750 N Union Blvd Colorado Springs, CO 80920 Elected 09/09/92
Patrick W Schmitt, DO 2233 Academy PI #200 Colorado Springs, CO 80909 Elected 09/09/92
John L Sherman, MD 21 1 5 E LaSalle St Colorado Springs, CO 80909 Elected 08/1 3/92
Jon F Snider, MD 1465 N Union Blvd #200 Colorado Springs, CO 80909 Elected 1 1/18/92
Terri B Weber, MD 7608 N Union Blvd #E Colorado Springs, CO 80920 Elected 09/08/92
Robert A Whiteford, DO 31 1 N Union Blvd Colorado Springs, CO 80909 Elected 1 1/18/92
INTERMOUNTAIN MEDICAL SOCIETY
Patricia A Duletsky, MD 1 01 W Main St PO Box 653 Frisco, CO 80443 Elected 09/1 3/92
LARIMER COUNTY MEDICAL SOCIETY
Kendrick M Adnan, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Douglas W Beard, MD 2500 E Prospect Ave Fort Collins, CO 80525 Elected 07/1 5/92
Hans C Coester, MD 1313 Riverside Ave Fort Collins, CO 80524 Elected 07/1 5/92
Winfield M Craven, MD 1 024 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Gary M Garner, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Mark W Hoenig, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Stephen G Horne, MD 1 024 Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Christina L Kuroiwa, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Harvey J Navrkal, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Colorado Medicine for January, 1993
29
Tim P Podhajsky, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Matthew J Robinson, MD 1017 Robertson St Fort Collins, CO 80524 Elected 07/1 5/92
Robert L Sancetta, MD 1 500 S Lemay Ave Fort Collins, CO 80524 Elected 07/1 5/92
Norma J Stiglich, MD 1 224 E Elizabeth St Fort Collins, CO 80524 Elected 07/1 5/92
MEDICAL STUDENT COMPONENT MEDICAL SOCIETY
Mary L Bowman 7536 E Warren Dr #1 5-305 Denver, CO 80231 Elected 08/1 5/92
Craig L Brown 61 1 Harrison St Denver, CO 80206 Elected 09/02/92
Lesli S DeBord 880 Dexter St #204 Denver, CO 80220 Elected 09/02/92
Sam Ferszt 2246 S Corona St Denver, CO 80210 Elected 08/24/92
Angela R Hahn 1 01 1 Milwaukee St Denver, CO 80206 Elected 09/02/92
Anne E Harper 889 Eudora St Denver, CO 80220 Elected 08/24/92
30
|
Christine Hopper |
Nick Slenkovich |
|
6491 Barnacle Ct |
4225 E 7th Ave |
|
Boulder, CO 80301 |
Denver, CO 80220 |
|
Elected 08/1 5/92 |
Elected 10/24/92 |
|
David L Kirschman |
Peter N Toensing |
|
1175 Albion St #410 |
860 Clermont St #503 |
|
Denver, CO 80220 |
Denver, CO 80220 |
|
Elected 08/24/92 |
Elected 1 0/24/92 |
|
Lillian Klancar |
Judith D R Wilson |
|
476 S Logan St |
PO Box 3912 |
|
Denver, CO 80209 |
Littleton, CO 801 61 |
|
Elected 09/23/92 |
Elected 08/24/92 |
|
Sarah Leisenring 860 Clermont St #603 |
MESA COUNTY MEDICAL SOCIETY |
|
Denver, CO 80220 |
Sigma Alpha, MD |
|
Elected 09/23/92 |
1 1 20 Wellington Ave #206 Grand Junction, CO 81501 |
|
Saurabh Mangalik 1 260 Ivanhoe St |
Elected 11/03/92 |
|
Denver, CO 80220 |
Michael E Holt, MD |
|
Elected 10/09/92 |
2530 N 8th St #101 Grand Junction, CO 81501 |
|
Abilio Munoz 955 Harrison St |
Elected 1 0/06/92 |
|
Denver, CO 80206 |
Daniel P Sullivan, MD |
|
Elected 08/24/92 |
729 Bookcliff Ave Grand lunction, CO 81501 |
|
Jenny Riggs 794 Cherry St |
Elected 11/03/92 |
|
Denver, CO 80220 |
MORGAN COUNTY MEDICAL |
|
Elected 09/02/92 |
SOCIETY |
|
lennifer A Roller |
|
|
860 Clermont St #602 |
Andrew John Saueracker, MD |
|
Denver, CO 80220 |
625 W Platte |
|
Elected 08/24/92 |
Fort Morgan, CO 80701 Elected 10/09/92 |
|
lason Roth |
|
|
61 1 Harrison St |
Robert A Thiel, MD |
|
Denver, CO 80206 |
102 W 9th Ave |
|
Elected 09/23/92 |
Fort Morgan, CO 80701 Elected 10/21/92 |
|
William Rumace |
|
|
61 1 Harrison St |
MT. SOPRIS COUNTY MEDICAL |
|
Denver, CO 80206 Elected 09/23/92 |
SOCIETY Matthew L Goodstein, MD |
|
Kimberly M Simons |
1905 Blake Ave #201 |
|
1175 Albion St #104 |
Glenwood Springs, CO 81601 |
|
Denver, CO 80220 Elected 08/24/92 |
Elected 07/1 5/92 |
Colorado Medicine for January, 1993
N ew Members/I n
Kimball | Spence, DO 1340 Hwy 133 Carbondale, CO 81623 Elected 07/1 5/92
NORTHEAST COLORADO MEDICAL SOCIETY
Joseph E Bonelli, MD 61 5 Fairhurst Sterling, CO 80751 Elected 09/1 5/92
PUEBLO COUNTY MEDICAL SOCIETY
Isabel Bertran, MD 1008 Minnequa Ave Pueblo, CO 81004 Elected 10/13/92
Thomas W Dorrell, MD 1 008 Minnequa Ave Pueblo, CO 81004 Elected 1 0/1 3/92
Imran U Khan, MD 1 925 E Orman Ave #G-1 2 Pueblo, CO 81004 Elected 09/1 6/92
John | Kunstle, MD 1008 Minnequa Ave Pueblo, CO 81004 Elected 10/13/92
David M Oba, MD 1 9 Fordham Cir Pueblo, CO 81005 Elected 08/11/92
Craig J Panos, MD 1008 Minnequa Ave Pueblo, CO 81004 Elected 10/13/92
Jennifer A Pentecost, MD 1008 Minnequa Ave Pueblo, CO 81004 Elected 1 2/07/92
Joni K Salmon, MD 1008 Minnequa Ave Pueblo, CO 81004 Elected 1 0/1 3/92
In Memory
Osmyn W. McFarland MD. died on April 22, 1991. Ernest Wittenberg, MD. died in April of 1 991 .
Clarence L. Ross, MD. died on June 23, 1991.
Ann Thron, MD. died on July 30, 1 991 .
Frank L. Garner, MD. died in August of 1991.
Rollin L. Thompson, MD. died September 9, 1991 James Robert Blair, MD. died on September 13, 1991. Dorothy C. Campbell, MD. died in October of 1991. Robert W. Sherwood, MD. died on October 3, 1991. Thomas K. Kobayashi, MD. died on October 5, 1991.
J. Harvey Johnston, MD. died on October 12, 1991. William L. Halseth, MD. died on October 28, 1991. Wallace H. Livingston, MD. died on November 1, 1991. John Douglas Carson, MD.died on November 7, 1991. John Kanas, MD. died on November 1 1, 1991 William L Waldrop, MD. died on November 28,1 991 Roscoe Hope Ackerly, MD. died on December 4, 1991. Harvey S. Rusk, MD. died on December 6, 1991. Rodney H. Jones, MD. died on December 16, 1991 Mark L Apling, MD. died on December 21 , 1991.
Ernest Forman, MD. died on January 4,1992.
Jearl F. Frye, MD. died on February 22, 1992.
Vincent A. Lagerborg, MD. died on July 7, 1 992.
James D. Stewart, MD. died.
James M. Myers MD. died on March 4, 1992.
Gary H. Fletcher, MD. died in March 7, 1992.
William Martin MD. died on April 27, 1992.
Leonard W. Levisohn died in April of 1992.
Ruth B. Howard, MD. died on May 1, 1992.
Robert Chandler, MD. died May 8, I 992.
Raymond H. Smith , MD. died on June 13, 1992. Demosthenes A. Manolis, MD. died on June 23, 1 992. Vincent A. Lagerborg, MD. died on July 7, 1992.
Isamu Ozamoto,MD. died on December 28, 1992.
Colorado Medicine for January, 1993
31
New Officers
ARAPAHOE MEDICAL SOCIETY TERM EXPIRES 4/93
PRESIDENT
Robert L. Kurse, M.D.
501 E. Hampden Avenue Englewood, Colorado 801 1 0 761-5325 PRESIDENT-ELECT Janice Benneman, M.D.
3333 S. Bannock StreetEnglewood,
Colorado 801 1 0
No phone listed
TREASURER
Arthur P. Heller, M. D.
601 East Hampden Avenue Englewood, Colorado 801 10 778-6446
ASSOCIATE DIRECTOR
Anne Wooley
777 East Girard Avenue
Englewood, Colorado 801 10
761-2887
SECRETARY
Robert j. Gillesby, M.D.
701 E. Hampden Ave.
Englewood, Colorado 801 10 788-4250
BOULDER COUNTY MEDICAL SOCIETY TERM EXPIRES 10/93
PRESIDENT
Kevin R. Berg, M.D.
1925 W. Mountain View Avenue Longmont, Colorado 80501 776-1234
PRESIDENT-ELECT
None elected EXECUTIVE DIRECTOR
Joan Ladley 6560 Gunpark Drive Boulder, Colorado 80301 530-3635
SECRETARY/TREASURER
Alan E. Benson, M.D.
1950 W. Mountain View Avenue P.O. Box 1659 Longmont, Colorado 80501 651-5085
CHAFFEE COUNTY MEDICAL SOCIETY TERM EXPIRES 4/93
PRESIDENT
Donald W. Cline, M.D.
P.O. Box 3129
Buena Vista, Colorado 81211
719-395-8632
Because this information is supplied by the component societies, we are not responsible for its timeliness or accuracy.
CLEAR CREEK VALLEY MEDICAL SOCIETY
TERM EXPIRES 10/93
PRESIDENT
Howard E. Netz, M.;D.
801 5 West Alameda Avenue Lakewood, Colorado 80226 232-8383 PRESIDENT-ELECT Harold A. Yocum, M.D.
4200 West Conejos Place Denver, Colorado 80204 893-2228 VICE PRESIDENT Harold A. Yocum, M.D.
4200 West Conejos Place Denver, Colorado 80204 893-2228
EXECUTIVE DIRECTOR
Rene Hawthorne-Shriver 7536 West 1 7th Avenue Lakewood, Colorado 8021 5 232-1428
SECRETARY/TREASURER
John A. Santoro Jr., M.D.
10001 Washington Street Thornton, Colorado 80229 252-9981
CURECANTI MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Paul D. Wiesner, M.D.
231 South Nevada Avenue Montrose, Colorado 81401 249-1210
VICE-PRESIDENT
Jay W. McMurren, M.D.
Box 1 849
Gunnison, Colorado 81230 641-021 1
SECRETARY/TREASURER
Lynwood M. Hopple, M.D.
3 Columbia Way Montrose, Colorado 81401 249-2205
EXECUTIVE SECRETARY
Kathy Holman 61120 Vernal Road Montrose, Colorado 81401 249-221 1 x397
DELTA COUNTY MEDICAL SOCIETY TERM EXPIRES 1/93
PRESIDENT
Jerry S. Driessner, M.D.
100 Stafford Lane Delta, Colorado 81416 874-7681 x284 VICE-PRESIDENT Doug K. Speedie, M.D.
70 Stafford Lane Delta, Colorado 8141 6 874-7681
SECRETARY/TREASURER
Patrick W. Donahue, M.D. 2 555 Meeker Street Delta, Colorado 8141 6 No phone listed EXECUTIVE SECRETARY Fran Cranor 1 00 Stafford Lane Delta, Colorado 81416 874-7681 x281
DENVER MEDICAL SOCIETY TERM EXPIRES 10/92
PRESIDENT
A. Lee Anneberg, M.D.
1901 East 20th Avenue Denver, Colorado 80205 377-2759 PRESIDENT-ELECT Terrance J. Sullivan M.D.
700 Broadway, 5th Floor Denver, Colorado 80273 831-3259
CHAIRMAN OF THE BOARD
Wm. Carl Bailey, M.D.
1 950 Ogden Street Denver, Colorado 8021 8 861-4871
EXECUTIVE DIRECTOR
Kathy Lindqu ist-Kleissler
1 850 Williams Street
Denver, Colorado 80218
377-1850
TREASURER
Barbara R. Reed, M.D.
2200 East 1 8th Avenue Denver, Colorado 80206 322-7789
32
Colorado Medicine for January, 1993
EASTERN COLORADO MEDICAL SOCIETY
TERM EXPIRES 9/92
PRESIDENT
Jerome L. Keefe, M.D.
Box 98
Cheyenne Wells, Colorado 80810
719-767-5669
SECRETARY
Mark R. Olson, M.D.
1612 6th Street Linton, Colorado 80828 719-775-2367
EL PASO COUNTY MEDICAL SOCIETY TERM EXPIRES 9/93
PRESIDENT
Robert A. Nathan, M.D.
2709 North Tejon Street Colorado Springs, Colorado 80907 719-473-0872 PRESIDENT-ELECT Marilyn J. Gifford, M.D.
1400 East Boulder Street Emergency Dept Memorial Hospital Colorado Springs, Colorado 80909 719-471-2311 VICE PRESIDENT Paul M. Wall, M.D.
2131 North Tejon Street
Colorado Springs, Colorado 80907
719-636-3701
SECRETARY
Frank J. Barry, M.D.
21 30 Hollowbrook Drive
Colorado Springs, Colorado 80918
719-590-7007
TREASURER
Laura L. Feldman, D.O.
730 W. Cheyenne Blvd Colorado Springs, Colorado 80906 7 19-632-0324
ADMINISTRATIVE DIRECTOR
Carol Walker
2760 N. Academy Blvd.
Colorado Springs, Colorado 80907 719-591-2424
FREMONT COUNTY MEDICAL SOCIETY
TERM EXPIRES 6/93
PRESIDENT
Gary A. Mohr, M.D.
730 Macon Avenue
Canon City, Colorado 81212
719-275-1618
New
Offi
VICE-PRESIDENT
Eric Carlson, M.D. 3
61 6 Yale Place
Canon City, Colorado 81212
719-275-2301
SECRETARY
Helen M. Danahey, M.D.
1 335 Phay Avenue
Canon city, Colorado 81212
719-269-1727
LAKE COUNTY MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Wayne Callen, M.D.
825 West Sixth Street Leadville, Colorado 80461 719-486-1264 PRESIDENT-ELECT John Perna, M.D.
825 West Sixth Street Leadville, Colorado 80461 719-486-1264 SECRETARY/TREASURER Clifford Field, M.D.
825 West Sixth Street Leadville, Colorado 80416 719-486-1264
LA PLATA COUNTY MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Mark R. Walters, M.D.
33 Lewis Mountain Lane Durango, Colorado 81 301 No phone listed.
SECRETARY
None elected
LARIMER COUNTY MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Jerry A. Chase, M.D.
1 808 Boise Avenue
Fort Collins, Colorado 80537
669-6660
PRESIDENT-ELECT
William W. Ezell, M.D.
1 337 Riverside Avenue Fort Collins, Colorado 80524 221-9545
SECRETARY/TREASURER
Richard F. Giansiracusa, M.D.
1 808 Boise Avenue
Fort Collins, Colorado 80537
669-6660
EXECUTIVE DIRECTOR
Tammy Nelson 1 024 Lemay Avenue Fort Collins, Colorado 80524 490-4105
LAS ANIMAS COUNTY MEDICAL SOCIETY
TERM EXPIRES 12/92 PRESIDENT
Joseph P. Jimenez, M.D.
410 Benedicta, Suite A Trinidad, Colorado 81082-2005 719-846-2206
VICE-PRESIDENT
Donald P. Ferrell, M.D.
P.O. Box 930 Trinidad, Colorado 81082
SECRETARY
Guilebaldo E. Jimenez, M.D.
Box 1 42
Trinidad, Colorado 81082 719-846-7787
MESA COUNTY MEDICAL SOCIETY TERM EXPIRES 9/93
PRESIDENT
Bronwen J. Magraw, M.D.
P.O. Box 920 107 W. 6th Street Palisade, Colorado 81 526 464-561 1
PRESIDENT-ELECT
John H. Dorank, D.O.
249 N. Plum Street Fruita, Colorado 81 521 858-9894
SECRETARY/TREASURER
Paul B. Jones, M.D.
2525 N. 8th Street
Grand Junction, Colorado 81 501
245-1168
EXECUTIVE SECRETARY
Dolores Bennett 1 1 20 Wellington Avenue Grand Junction, Colorado 81501 243-2808
MORGAN COUNTY MEDICAL SOCIETY
TERM EXPIRES 9/92
PRESIDENT
James A. Miller, M.D.
231 Prospect Avenue
Fort Morgan, Colorado 80701
867-4823
Colorado Medicine for January, 1993
33
New Officers
Because this information is supplied by the component societies, we are not responsible for its timeliness or accuracy.
PRESIDENT-ELECT
Kevin V. Lindell, M.D.
220 East Beaver Avenue P.O. Box 370
Fort Morgan, Colorado 80701 SECRETARY/TREASURER
Kevin V. Lindell, M.D.
220 East Beaver Avenue P.O. Box 370
Fort Morgan, Colorado 80701
MOUNT EVANS MEDICAL SOCIETY TERM EXPIRES 5/93
PRESIDENT
Rik Santaguida, M.D.
P.O. Box 1930
Idaho Springs, Colorado 80452 567-4316 VICE-PRESIDENT John P. Moyer, M.D.
P.O. Box 2530
Evergreen, Colorado 80439
674-6671
SECRETARY/TREASURER
Fred Buchwald, M.D.
29029 Upper Bear Creek Road Evergreen, Colorado 80439 674-3370
MOUNT SOPRIS COUNTY MEDICAL SOCIETY
TERM EXPIRES 12/92
PRESIDENT
Mark S. Lea, M.D.
401 23 rd Street
Glenwood Springs, Colorado 81 601
No phone listed
EXECUTIVE SECRETARY
Dolores Bennett
1 1 20 Wellington
Grand Junction, Colorado 81 501
243-2808
SECRETARY/TREASURER
Teresa L. Platt, M.D.
1 905 Blake Avenue
Glenwood Springs, Colorado 81601
945-0554
NORTHEAST COLORADO MEDICAL SOCIETY
TERM EXPIRES 5/93
PRESIDENT
Richard C. Lamb, M.D.
620 Iris Drive
Sterling, Colorado 80751
522-7266
STAFF SUPPORT (CONTACT FIRST)
LaVonne Bilyeu Plains Radiology 1430 South 7th Avenue Sterling, Colorado 80751 522-6386 SECRETARY
Thomas M. Pickard, M.D.
507 Pawnee Drive, Rt 4 Sterling, Colorado 80751 522-5610 (unlisted)
NORTHWESTERN COLORADO MEDICAL SOCIETY TERM EXPIRES 9/93
PRESIDENT
Laura E. Rathe, M.D. 2 785 Russel Street Craig, Colorado 81625 824-3556
SECRETARY
None elected
OTERO COUNTY MEDICAL SOCIETY TERM EXPIRES 9/93
PRESIDENT
Jeffrey Morse, M.D.
245 Vine Avenue
Las Animas, Colorado 81054
(719) 456-1243
SECRETARY
Howard E. Stutzman, M.D.
2201 San Juan Avenue La Junta, Colorado 81050 (719) 384-8181 Attn: Martha Vasquez
PUEBLO COUNTY MEDICAL SOCIETY TERM EXPIRES 11/93
PRESIDENT
Jarvis D. Ryals, M.D.
400 West 1 7th Street Pueblo, Colorado 81 003 719-543-4040 PRESIDENT-ELECT Charles E. Snyder, M.D.
371 5 Thatcher Avenue
Pueblo, Colorado 81005
719-561-8480
SECRETARY
Roger W. Miller, M.D.
1 925 East Orman Avenue Pueblo, Colorado 81004 719-561-0383
EXECUTIVE SECRETARY
Peggy Fogel
1 925 East Orman Avenue Pueblo, Colorado 81004 719-564-9109 (office)
719-542-01 06 (answering service)
TREASURER
Christopher ). Smith, M.D.
51 7 Colorado Avenue Pueblo, Colorado 81004 719-543-4016
SAN LUIS VALLEY MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Phillip J. Bogner, M.D.
17228 W. Highway 160 Del Norte, Colorado 81 132 719-657-3342 VICE-PRESIDENT Grant Allen Hurley Jr, M.D.
404 Morris Street
Monte Vista, Colorado 81 1 44
719-852-4073
SECRETARY/TREASURER
Lonnie S. Vickers, M.D.
1 7228 W. Highway 1 60 Del Norte, Colorado 81 1 32 719-657-3342
SOUTHEASTERN COLORADO MEDICAL SOCIETY TERM EXPIRES 10/92
PRESIDENT
Donald F. Benton, M.D.
200 Kendall Drive Lamar, Colorado 81052 719-336-9068 VICE-PRESIDENT Ousama Ghaibeh, M.D.
P.O. Box 1 1 72 Lamar, Colorado 81052 719-336-2798 SECRETARY Michael J. Lee, M.D.
200 Kendall Drive Lamar, Colorado 81052 719-336-3247
UCMC STUDENT MEDICAL SOCIETY TERM EXPIRES 9/93
PRESIDENT
Anthony Nagorka 753 1/2 Ash Street Denver, Colorado 80220 399-4686
34
Colorado Medicine for January, 1993
New Officers
VICE-PRESIDENT
Paul D. Bonacci
955 Eudora Street
Denver, Colorado 80220
388-3852
SECRETARY
Theresa Scholz
6039 Wright Street
Arvada, Colorado 80004
No phone listed
TREASURER
Kelli Lambert
9085 E. Mississippi Ave
Denver, Colorado 80231
No phone listed
WASHINGTON-YUMA COUNTY MEDICAL SOCIETY TERM EXPIRES 12/92
PRESIDENT
Robert D. Buchanan, M.D.
Wray Clinic
P.O. Box 216
Wray, Colorado 80758
322-4895
SECRETARY
Robert G. Loyd, M.D.
Wray Clinic P.O. Box 216 Wray, Colorado 80758 332-4895
WELD COUNTY MEDICAL SOCIETY TERM EXPIRES 9/94
“I have never gotten used to people dying. And I don’t want to get used to it.”
Dr. Aliza Lifshitz, Internist, Los Angeles, California,
Member, American Medical Association
PRESIDENT
lames H. Peterson, M.D.
2528 16th Street Greeley, Colorado 80631 356-4646 PRESIDENT-ELECT Robert C. Bradley, M.D.
1 230 West Ash Street Windsor, Colorado 80550 686-5646
TREASURER/SECRETARY
Jeffrey B. Weeks, M.D.
3400 1 6th Streeteeley, Colorado 356-4040
EXECUTIVE SECRETARY
Pennie Joseph
North Colorado Medical Center 1801 1 6th Street Greeley, Colorado 80631 353-2596
Patients come to physicians for many reasons. Beyond relief from pain, they seek compassion, empa- thy and support,. AIDS patients receive all of these and more from Dr. Aliza Lifshitz.
Bom and raised in Mexico and educated at one of Mexico City’s finest medical schools, Dr. Lifshitz now serves the Hispanic community in Southern California. Over a third of her patients have tested HIV positive.
Most live below the poverty level. Many are illegal aliens.
“I never forget what it means to be a doctor, and what it means is embodied in the Principles of Medical Ethics of the American Medical Association (AMA),” states Dr. Lifshitz.
You are invited to join Dr. Lifshitz and to join with her in her efforts to bring quality health care to those in need. Become a member of the AMA today.
Members of the AMA are encouraged to join their state, county and specialty societies.
American Medical Association
Physicians dedicated to the health of America
Colorado Medicine for January, 1993
35
Classified Advertising
Publication of any advertisement in Colorado Medicine is not an endorsement by the Colorado Medical Society of the product or service. Colorado Medicine magazine is the official journal of the Colorado Medical Society, and is authorized to carry General Advertising.
♦ PROFESSIONAL OPPORTUNITIES
BC/BE DIAGNOSTIC RADIOLOGY— Immediate opening for Diagnostic Radi- ologist with skills in MRI & Interventional. Join a growing 3-4 physician practice in 1 00 bed community hospital 45 miles north of Denver. Attractive compensation package with track to partnership. Send CV to Donald Cornforth, MD, PO Box 238, Loveland, CO 80539 or contact Sharon at (303)669-7916. 4/1192
GENERAL SURGEON needed to join compatible staff, small VA medical center in Cheyenne, WY. Laparoscopic, vascular/ thoracic surgery beneficial. Competitive salary/benefits. Ideal location with varied recreational activities — hunting, fishing, skiing and campint. 2 hrs from Denver CME opportunities, theater, arts and professional sports. Affiliation with U of Colorado possible. Local community college. U of Wyoming only 1 hr away. Excellent public education system, low crime, low cost living — no state income tax. Send CV/resume to Mike Lee (11 A), VA Medical Center, 2360 E Pershing Blvd, Cheyenne WY 82001, or call (307) 778- 7307. 4/1192
LOCUM TENENS COVERAGE and Op- portunities in the greater Denver area: CompHealth, the nation's premier locum tenens organization, now provides daily, weekly, weekend, evening, or monthly coverage for your practice with physicians from the local area. Or we offer you the opportunity to build a flexible practice right in the Denver area. Call today for more information, (303) 777-8002, or write, P.O. Box 1 00218, Denver CO 80250.1 2/ 1092
EMERGENT/URGENT CARE PHYSICIAN Full and part time position in Lafayette. Flexible scheduling. Send CV or Contact Dr. Coryell, Community Medical Center, 2000 W. S. Boulder Rd., Lafayette, CO 80206, (303) 666-4357. 1 2/0892
FAMILY PRACTICE OPPORTUNITY IN CANON CITY
We need one family physician to practice in the Climate Capital of Colorado. Privileges at St. Thomas More Hospital, obstetric services desirable but not required. Unlimited opportunities for recreation. Growingcommunity. Formore information, please call or write Gary Alan Mohr, MD, FAAFP, 730 Macon Avenue, Canon City, CO 81212, (719) 275-1618 Tfn/0892
LOCUM TENENS It is not what it used
to be. As a client, your practice goes uninterrupted. As a locum tenens, you have the freedom and flexibility to work as often or as little as you like. Physician managed since 1982. Call for details — Interim Physicians 1 -800-669-071 8 or (303) 691 - 0718. 12/0192
FAMILY PRACTICE— HOSPITAL SPON- SORED CLIN 1C OPPORTUNITY. Dynamic, growth oriented hospital in beautiful North Central Wisconsin is seeking Family Physicians to respond to growing com- munity demand. The administrative burdens of medical practice will be minimized in this hospital managed clinic. The hospital has committed to an income and benefit package which is significantly higher than similar opportunities. Package includes base income, incentive bonus, malpractice, disability, signing bonus and student loan reduction/forgiveness program. All re- location costs will be borne by the hospital. Please contact Kari Wangsness, Associate, The Chancellor Group, Inc., France Place, Suite 920, 3601 Minnesota Drive, Bloomington, Minnesota, 55435, (612) 835-5123. tfn/1190
FAMILY PHYSICIAN needed full time to practice in great Lakewood location. Duties includefamily practice medicineexcluding OB and inpatient hospital work. Four physician call group. Excellent com- pensation package. Please contact Shirley Lewis, Porter Hospital, (303) 778-5691.2/ 1292
EXPERIENCED ANESTHESIOLOGIST preparing for oral board exam in April 1993. Desires part time or low-volume practice or Locum Tenens. Contact David Murphy, MD. 4 Middle Rd. Englewood, CO 801 1 0. (303) 753-1819. 3/1 292
LOCUM TENENS... new adventures, free from administrative tasks, flexibility, and high earnings. Assignments vary: one day, one week, one month, long term, OR, time off with peace of mind, knowing that your practice goes uninterrupted. Qualified physicians are ready to assist. Ten years experience; physician-managed company. Call INTERIM PHYSICIANS today for details. — Denver 691 -071 8, or 1 -800-669- 0718 12/1292
UROLOGY PRACTICE OPPORTUNITY in South Central Colorado. Western com- munity at edge of Rocky Mountains offers clean environment, quality of life, easy access to larger communities. Group Practice. Hospital pays interview and relocation expenses. Offers financial support for selected candidate for a period of time. Call collect: Willim Foster, CEO (719) 269-2021 or 269-9305. 2/1292
COLORADO MTN. RESORT PRACTICE FOR SALE. Busy OB. GYN. practice in the ski/summer resort of Steamboat Springs. Available to BC/BE physician. Retiring physician will transition practice which offers excellentfinancial return in a beautiful mountain community. Good OB. and GYN .call coverage. Please send C.V. to : Box T. C/O Colorado Medical Society, P.O. Box 1 7550, Denver, CO. 80217-0550 3/01 93
TIRED OF THE DAY TO DAY HASSLE of
HMO's, Medicare, discounted insurance and being on call ? Then consider a position with corrections. Before you say "No Way," call us and find out more. Contact Roderic Gottula, MD, 10900 Smith Road, Denver CO 80239 or call (303) 375-21 1 0.6/01 93
WANTED: OPEN-MINDED GENERAL PRACTITIONER to perform evaluations in multi-specialty office. Part time, flexible hours, hourly rate. Call: 721 -7947 and ask for Dr. K.
36
Colorado Medicine for January, 1993
Classified
♦ PROPERTIES FOR SALE OR LEASE
MAUI, HAWAII. Luxurious 2BR/2BA, 2,100 sf condominium in Kaanapali Beach Resort, 1 00 yards from beach. Everything's new! Pool, Jacuzzi, Sauna, Lighted Tennis Courts, Maids. On 16th fairway Royal Kaanapali Golf Club. Special Fall/Winter Rates. Call 985-9531 . 6/0892
Professional Office Space
Excellent location in Wash Park/DU area. Share common pt. waiting room w/ 2 internists and 1 DDS. Three 1 O' X 1 O' ops, reception area. Very reasonable. Call Russ, 688-8976. 12/0792
YOU OWE ITTO YOURSELF! Winter Park, very plush 2 BR Condo with all amenities including sauna, athletic club, door to ski area transportation. For sale by owner. Call Werner or Ruth, 399-8919.12/0491
EAGLE/VAIL fully equipped luxury townhouse on golf course, 4 bedrooms, 3 baths, reasonable summer-winter rates. Peter Gehret, MD (303) 771-0456.
1 2/0492
EAST VAIL CONDO 2 BR + loft. Sleeps 6, 3 full baths, fully equipped kitchen — TV VCR fireplace- excellent condition great view, free shuttle to slopes weekly winter rentals. Arthur Waldbaum MD.. (303) 298- 0222 4/0992
VAIL FOR SALE- 50% interest in 3500 sq.foot vacation home above the Westin Hotel. 5 bedrooms, 3.5 baths, 4-cargarage, jacuzzi, large decks, walk to Westin lift. Call Doug Kirkpatrick. Evenings (303) 762- 9050. 4/0193
♦ EQUIPMENT FOR SALE OR LEASE
X-RAY MACHINE, Three years old, barely used, excellent condition. Model: Cont- inental 300 MA, 1 25 KVP, elevating table, wall bucky; Kodak auto processor M35A. Contact John Lynn MD. at 80 1 N. Cascade Ave., CS, CO, 80903, or call (719) 636- 2388. tfn/01 93
♦ PRACTICES FOR SALE
FAMILY PRACTICE FOR SALE- S. Central Aurora, CO- 30 patient volume per day. Grossed $ 230,000 last year-Hospital assistance with setup. Current practitioner must leave July 1993. Call 3-Minute Reader — 1-800-848-4912, ext. 4410 or metro Denver (303) 756-6108. 2/1292
Aurora, Colorado. Large Family Practice for sale. Could be excellent opportunity for internist as well. Substantial gross income with potential for much more. Doctor retiring. Call Marvin N. Cameron, M.D. 1- 303-364-4553 3/1192
♦ SERVICES
MEDICAL LITERATURE RESEARCH - Want to review literature for clinical or legal problem, presentation or publication? Experienced physician/author/educator will do customized multiple database search at reasonable rates. Call: Bill Milburn, MD at 823-5083; 1-800-828-9259 (outside Boulder/Longmont). 12/0792
HOME MORTGAGE LOANS LOW DOC PROGRAM available for physicians and other health professionals. Purchase and refinance. Call Milt, a mortgage bankerwith 1 8 years experience. 753-6262. 12/1292
LOCUM TENENS SERVICE RADIOLOGISTS AVAILABLE Since 1979, Western Physicians Registry has been providing radiologists throughout the Western States. For locum tenens or permanent positions, please call Jim Ellis, Director. 1-800-437-7676. 6/0992
INOVATIONS SHOULD BE PATENTED if
marketable. For more information call Brian D Smith of Fields, Lewis, Pittenger & Rost. Colo's leading patent law firm. Mr. Smith specializes in the medical arts. (303) 758- 8400. 12/1192
Cash Crunch?
Overhead Rising?
Revenue Dropping?
Let us help lower your costs. YOU specialize in patient care. WE specialize in insurance billing. We work with Medicare, Medicaid, HMO's, PPO's, and other third party carriers.
We don't get paid until you get paid.
For more information call Advanced Professional Services (303) 341-1008.
tfn/0492
MEDICAL TRANSCRIPTION SERVICE- Guaranteed quality and accuracy. Cust- omized serviced 5 years experience. Free pickup and delivery in the metro area. Member AAMT. Call Lesa at 693-6652.2/ 0193
♦ MISCELLANEOUS
EXPERIENCED SECRETARIAL SERVICESfor the medical professional. Dictation, manuscripts, insurance reports, large or small projects. Computer and laser equipped. Confidential and reliable. SE Metro area. Call Administrative Support Personnel (303) 770-4948. 2/1092
STOP
DOMESTIC
VIOLENCE
>
J
Check The Box On Your Colorado Tax Return
Domestic Abuse Assistance Programs Help Support
■ Prevention Programs
■ Safe Homes
■ Counseling
■ Intervention
Colorado Medicine for January, 1993
Ruminations
(def: to chew again what has been chewed slightly and swallowed; to REFLECT)
by Bill Pierson , Managing Editor
The Year in Medicine - 1 982 (January, 1 983 AMA summary reprinted from Colorado Medicine)
• In January, 1 983, we looked back proudly on a year filled with headline-making medical achievements.
• In January, 1 993, historian jurors are still out on the medical notability of 1992.
• It may be best remem- bered as the year the U.S population, politician and commoner alike, finally conceded that somehow all Americans must receive health care.
AIDS: That is the acronym for acquired immune deficiency syndrome, the official name for a peculiar mixture of diseases that was first detected in 1981. AIDS has reached epidemic proportions in the 18 months since it was recognized as a new disease entity. It is known to have killed more than 300 people, making it more deadly than Legionnaires' disease or toxic shock syndrome combined.
Artificial Heart: The surgery to implant the polyurethane plastic and alumi- num ]arvik-7 heart into Barney Clark began late on the night of December 1 , but it was not until early the next day that the mechanical pump was empowered by compressed air to support a human life. The historic event came one day short of the 1 5th anniversary of the first human heart transplantation. Cyclosporin: Much of the credit for the improvement in survival after organ transplantation and the resurgence of transplantation surgery is due to this drug, which was originally isolated from fungi in soil samples from Wisconsin and Norway.
Genetically Engineered Human Insulin: Human insulin made with recombinant DNA technology by genetically modified bacteria won the Food and Drug Administration's approval for marketing this year. ... the bioengineered insulin is the first such product made by gene splicing to be marketed for use in humans.
Hazards of Salt: A coalition of health organizations, federal agencies and food processors joined forces and found a voluntary way in which reliable information about the sodium content of packaged foods could be made available to physicians and to their patients whose daily sodium intake must be limited because of high blood pressure.
Lyme Disease: The mystery of an illness that came to light in the summer of 1 975 and was named after the
Connecticut town where the first known outbreak occurred has been traced to a bacterium transmitted by the bite of a tick.
Medical Lasers: From their original use by ophthalmologists to weld detached retinas and seal leaking blood vessels in the eye, lasers continue to make inroads to areas of the body only the scalpel went before. A new type of laser, pioneered in Europe and called the YAG laser (for neodymium yttrium aluminum garnet), is being used more and more for sealing bleeding ulcers.
Nuclear Magnetic Resonance: Called NMR for short, this technology and the machinery designed to apply it have the potential to revolutionize the way physicians look inside the body and the view they get.
Oncogenes: A revival of a 10-year-old hypothesis with a startling "cart before the horse" twist is producing some of the most promising research ever into the mechanism of cancer. The hypothesis and the related origin of the term oncogene (for cancer-causing gene) goes back to work done in the 1960s and early 1970s when certain viruses were found to have genes that cause cancer.
Synthetic Human Interferon: Gene- splicing techniques have led to the preparation of what promises to be an ample supply of interferon. In early clinical use, the synthetic variety has shown anticancer activity in patients with non-Hodgkin's lymphoma, breast cancer, chronic lymphocytic leukemia, Hodgkin's disease and melanoma.
Streptokinase: This clot-dissolving enzyme was approved by the Food and Drug Administration this year for use in treating heart attacks. Given to appropriate patients in the early stages of a heart attack, the drug holds the potential for restoring circulation to a choked-off section of heart muscle and for preserving the vitality of the cells that would otherwise die.
38
Colorado Medicine for January, 1993
WEALTH SCIENCES LIBRARY
^Advocatingi^^jjj^^e ®!PJhl44ffii®C#ssion of medicine"
I'uary, 1993
Volume 90, Number 2
Which train will it be? stacks
Health Care Reform; Medicaid; Workers Comp
Can you run fast enough, doctor, to stay out of its way?
Attend the CMS Interim Meeting to help you see what is coming down the track fSee pg 53 and following J.
This Issue:
orporate Practice of Medicine .
ealth Care Reform
iterim Meeting Information
MS Targeted by Demonstrators
Leigh Truitt , MD, President , CMS
Page 49
Page 53ff
Page 66
Can you imagine a physician who would run a classified advertisement like that?
♦♦♦ Of course not And yet, some Colorado physicians choose their malpractice insurance carrier that way. Unfortunately, when they sort through the fine print of their policy they often discover that Brand X wasn’t even the low bidder, let alone the most competent to avoid or defend malpractice suits, or to provide vital services to policyholders and the Colorado physician community. By all means, comparison shop if you’re in the market for malpractice insurance. But when you do, be certain that you make your choice based on all the facts and figures. ♦♦♦ We are confident that you will choose Copic. More often than not, we will be the low bidder, once you reach the real bottom line.
The Copic Bottom Line.
It’s more than just competitive rates.
Opic
Copic Insurance Company
RO. Box 17540 • Denver, CO 80217-0540 • (303) 779-0044 • 1-800-421-1834
Colorado Medicine
February, 1993 Volume 90, Number 2
Cover Story
Health Care Reform, Medic- aid, Worker's Compensa- tion...They're all moving ahead. But can we get them all on a track that won't run over physicians?
n This Issue...
47 Corporate Practice of Medicine — What is our future?
Leigh Truitt ; MD, President Colorado Medical Society
48 Not 'Business As Usual' at CMS
Sandra L. Maloney , Executive Director, CMS
49 The Future of Health Care in Colorado
Michael P. Thompson, Ass't Managing Editor
51 Governor Romer Addresses Health Care Issues
53 Special Interim Meeting Section
Who serves and who selects
Departments
Stuart O. Silverberg, MD
Schedule of Events Registration Form List of Area Restaurants
60 Planning for Retirement
Michael P. Thompson, Ass't Managing Editor
64 Book Review "AIDS in the World"
Thomas H. Coleman, MD
47 President's Letter
48 Executive Director's Update 58 The Lobby
62 Committee Update
63 Letters
69 Medical News 71 Classified Advertising 74 Ruminations
66 Demonstrators Come to CMS Offices
74 Corporate Practice of Medicine — Not a new question
Bill Pierson, Managing Editor
Colorado Medical Society
COLORADO MEDICAL SOCIETY OFFICERS, BOARD MEMBERS and AMA DELEGATES
1992/1993 Officers Leigh Truitt, M.D.
President
Wm. Carl Bailey, MD
President-elect
Terrance J. Sullivan, M.D.
Treasurer
Stuart O. Silverberg, M.D.
Speaker of the House
David C. Martz, M.D.
Vice-speaker of the House
Sandra L. Maloney
Secretary/Executive Director
Harrison G. Butler, III, M.D.
(Immediate Past President)
|
Board of Directors |
Board of Directors |
|
Thomas J. Allen, MD |
Dieter W. Schneider, MD |
|
Stephen G. Batuello, MD |
David Shander, MD |
|
John O. Cletcher, Jr., MD |
W. George Shanks, MD |
|
Donald G. Eckhoff, MD |
Susan A. Sherman, MD |
|
John E. Ell iff, MD |
Gary D. VanderArk, MD |
|
Jonathan C. Feeney, MD |
Denis J. Winder, MD |
|
David C. S. Franklin, MD Joel M. Karlin, MD |
M. Robert Yakely, MD |
|
George M. Kreye, MD Muryl L. Laman, MD |
AMA Delegates |
|
Ted T. Lewis, MD |
M. Ray Painter, Jr., MD |
|
Maura J. Lofaro, MS IV |
Richert E. Quinn, Jr., MD |
|
Louise L. McDonald, MD Robert R. Montgomery, |
Mark A. Levine, MD |
|
Legal Counsel Robert A. Nathan, MD |
Alternate Delegates |
|
Kenneth M. Olds, MD |
Robert D. McCartney, MD |
|
Lothar K. Roller, MD |
Robert M. Bogin, MD Joel M. Karlin, MD |
COLORADO MEDICAL SOCIETY STAFF
Executive Office
Sandra L. Maloney, Executive Director Mary Lee Johnston, Executive Admin. Asst. Nancy L. Deter, Manager, Accounting
Western Slope Office
Dolores M. Bennett, Executive Secretary
Division of Membership Information Services
Timothy H. Roberts, Director Diane L. LeHew, Manager, Support Services Debra M. Jones, Membership Coordinator Beth M. Crusha, Administrative Assistant
Division of Professional Services
Sandra M. Finney, Director Lorraine H. Heth, Program Manager Kirsten E. Regalado, Secretary
Division of Health Care Policy
Ellen J. Stein, Director
Marilyn P. Barton, Program Manager
Lynn R. Livingston, Administrative Assistant
Division of Health Care Financing
Edie K. Register, Director Marijo M. Parkin, Program Manager
Division of Government Relations
Sue Ellen Quam, Director
Lorraine L. Koehn, Program Manager/Lobbyist
K. Suzanne Hamilton, Administrative Assistant
Division of Communications
William S. Pierson, Director
Michael P. Thompson, Communications Spec.
Gil Maestas II, Communications Staff
COLORADO MEDICINE (ISSN-01 99-7343) is published monthly as the official journal of the Colorado Medical Society, 7800 E. Dorado PI., Englewood, CO 801 1 1 . Telephone (303) 779-5455. Outside Denver area, call 1 -800-654-5653. Second Class postage paid at Englewood, Colorado, and at additional mailing offices. POSTMASTER, send address changes to COLORADO MEDICINE, P. O. BOX 1 7550, Denver, CO 8021 7-0550. Address all correspondence relating to subscriptions, advertising or address changes, manuscripts, organizational and other news items regarding the editorial content to the editorial and business office. Subscriptions are available for $30 per year, paid in advance.
COLORADO MEDICINE magazine is the official journal of the Colorado Medical Society, but as such is also authorized to carry general advertising. Publication of any advertisement in COLORADO MEDICINE does not imply an endorsement or sponsorship by the Colorado Medical Society of the product or service advertised. Published articles represent opinions of the authors and do not necessarily reflect the official policy of the Colorado Medical Society unless clearly specified.
Sandra L. Maloney, Executive Editor; William S. Pierson, Managing Editor; Michael Thompson, Asst. Managing Editor
Member, Colorado Press Association,
Member, Colorado Broadcasters Association
44
Colorado Medicine for February, 1993
Photo by Rocky Mountain News
Leigh Truitt, MD President, 1992-1993
President's
A bill will be proposed this year to repeal or modify Colorado Revised Statutes §12-36-11 7(1 )(m) of the Medical Practice Act which prohibits the "corporate practice of medicine":
Practicing medicine as the part- ner, agent, or employee of, or in joint adventure with, any person who does not hold a license to practice medicine within this state, or practicing medicine as an employee of, or in joint ad- venture with, any partnership or association any of whose part- ners or associates do not hold a license to practice medicine within this state, or practicing medicine as an employee of or in joint adventure with any corpo- ration other than a professional service corporation for the prac- tice of medicine as defined in §12-36-134.
Colorado Medical Society policy has been to support this prohibition so that physicians cannot be directly employed by hospitals, insurers, or similar entities. We are surveying our membership through the component and specialty societies to determine current thinking in this regard. Many of us believe that overturning this ban will lead to a loss of professional autonomy, thereby compromising patient care.
In 1 988 I first became aware of the term "decapitalization, which can be defined as reduction in the capital of a business unit relative to the unit's capacity to generate value".1 Since then, we have seen the trend toward less vertical integra-
tion and more independence of manufacturers and suppliers. The least successful auto and computer makers of today are those who produce most of their product components in house, such as General Motors, IBM and Digital. On the other hand, Toyota, Dell Com- puter, and others, who coordinate many different suppliers, deliver high quality, innovative, low-cost prod- ucts.
First, we should determine where we can add the most value to the system. For a hospital, this is certainly capitalizing and managing inpatient beds, not practicing medicine; for a specialist, pursuing his/her specialty in the hospital, operating room or office, not owning hospital beds or other capital equipment; for a primary care physician, managing the overall care of his/her patients in many different settings with the aid of consultants, not selling pharmaceuticals or medical equipment.
Next, we must decide if the systems and assets necessary to provide these services need to be fully owned to be controlled ad- equately.
• How much control is neces- sary or desirable?
• How much ownership is essential to attain or retain that much control?
For example, must a radiologist own an MRI scanner in order to practice radiology? Is the maximum value owning the machine or reading the scans?
Third, "are [there] alternative owners of an asset [or service] to whom the asset [or service] might be
worth more[?] This could be a matter of another [entity's] having a tax position that it can exploit, a greater debt capacity, a different risk profile or a greater ability to manage risks because of a naturally hedged position or special skill".
Finally, how do we achieve an organization, a commonality of purpose, that permits us local ownership and autonomy while still providing a high degree of economic coordination? This is the challenge of our times.
We will not attain it by insisting upon control through ownership, confrontation, or demanding profes- sional autonomy without financial responsibility. Physicians, hospitals and insurers must look to new models of cooperation so that all can do what they do best — thereby creating maximum value in the health care system.
Please let us know your thoughts on the corporate practice of medi- cine issue. At a time when most other industries have given up on total vertical integration, there are many parts of the health care system who would like to own the entirety.
'This discussion is based on Peter Bisson, "Manager's Journal: Ownership Isn't Always the Best Strategy," The Wall Street Journal, P. A1 4, December 5, '88.
Colorado Medicine for February, 1993
47
XECUTI VE
Director's U pdate
Sandra L. Maloney Executive Director Colorado Medical Society
It is not 'business as usual' at CMS
On Friday, January 15th, my cellular phone rang. Nothing un- usual. It was one of our CMS staff members on the line. "You'd better get back to the office, we have an emergency. There are people in wheelchairs protesting." This was stated with excitement and deep concern. Well, this was unusual.
As I made the short drive back to CMS headquarters, my head was reeling. I tried to figure out what policies we had that would be upsetting these folks. I arrived at CMS much too quickly — I now had to face the protesters. I knew that Dr. Bill Bailey, President-elect lived close by so I made phone contact with him and asked that he, too,
return to CMS.
I opened the back door to our office and immediately heard the commotion. There were strangers up and down the halls of CMS. I recognized one of the individuals. I remembered that this person and I had met before on two separate occasions. Both prior instances were while I was employed at BCBS of Colorado. At that point in time, these folks were protesting the medical policies on reimbursement for electric wheelchairs. I went up to the fellow and re-introduced myself and told him that this was the third time he and I had been involved in this type of situation. FHe just grinned.
I asked them to all gather in the lobby so that we could talk as a group. They identified themselves as the "American Disabled for Atten- dant Programs Today (ADAPT)". As I stood in the middle of this large group, I could now read the signs they were carrying. Some of the signs read, "AMA Kills", "Abolish Apartheid," "Destroy Nursing F-lomes", etc. I was handed a piece of paper that outlined their "de- mands". (Actually, their demands are of the AMA more so than CMS.) The spokesperson detailed these de- mands. In short, they want the AMA to 1 ) direct members to reduce nursing home referrals by 50% the first year, 2) require all member physicians to make full disclosure of their financial interests in long term care facilities, 3) mandate that members divest themselves of all financial interests in nursing homes and institutions, and 4) invite ADAPT to present at the next national AMA conference. They also reported that
ADAPT had scheduled protests at 14 other state medical societies across the nation. I wondered what they would ask of CMS.
The subject they became most emotional about was nursing home placement. They want alternatives. Their cry is that institutionalization will limit independence, dignity, self- determination, community participa- tion, productivity, property owner- ship, human and civil rights. As this was being talked about, I vividly remembered going through the agony of placing my mother in a nursing home. Probably one of the most difficult decisions I have ever made. My mother died in that nursing home two years later. I have wondered if I could have extended her life by providing some alternative living arrangement. This I believe is what ADAPT is asking for - alterna- tives.
It did not appear that the protest- ers were going to leave anytime soon. Doctor Bailey and 1 offered to provide a representative of ADAPT the opportunity to present their concerns and ideas to a CMS committee. They seemed openly surprised by our offer. They de- manded that I immediately call the AMA and tell them that ADAPT was at CMS. I did.
Was it wrong for ADAPT to invade a private office? Yes. Are they wrong to identify their con- cerns? No.
Using a reasonable approach, let's hear what they have to say. Perhaps we all will learn.
48
Colorado Medicine for February, 1993
of Health Care in Colorado
Michael P. Thompson Assistant Managing Editor
Universal Health Care Reform
Colorado Governor Roy Romer and the Department of Regulatory Agencies (DORA), unveiled the preliminary format of their ideas for health care reform in Colorado, called CoioradoCare. The program is intended to replace all existing health care insurance coverage for Colorado citizens, including Medic- aid (but not Medicare) with a state funded, managed care program.
The development of the Coio- radoCare plan was mandated by Colorado Senate Bill 92-4, passed last year. The bill required a prelimi- nary report which was studied by a special commission at their meeting January 7. Following this meeting, Governor Romer addressed health care reform at a meeting of the Denver Forum (see Romer Addresses Health Care, in this issue). Coio- radoCare is in the formative stages at this time, and staff have recom- mended against a previously planned county demonstration.
A Three Part Plan
According to documents re- leased by DORA, CoioradoCare has three basic parts. "First, the state collects through a broad-based tax, such as a payroll tax, a large portion of the money spent on health care in the State of Colorado. Second, the state contracts with a limited number of carriers, such as FHMOs and insurance companies, to provide health care to the residents of the state. These carriers must offer at least a basic package of health care benefits, but they may supplement
this package if they are able to deliver health care in a more cost-effective manner. Third, every resident of Colorado selects one of the carriers as their insurer. Each person may select any carrier without respect to family income, health status, or employ- ment.
Where Do We Get the Money?
CoioradoCare would be paid for by redirecting funds already spent for health care in other arenas. Each employer and employee would be required to pay a head tax to the state, in place of current health insurance expenditures. All employ- ees previously covered under plans at work would receive benefits through CoioradoCare. State and Federal Medicaid funds would be diverted into CoioradoCare and all Medicaid patients would be covered under the program.
Getting employees and Medicaid recipients into the program covers the majority of Colorado citizens. In order to cover those under the federal poverty level, but not eligible for Medicaid, a 25# cigarette tax would be imposed. College students would pay a head tax similar to that paid by employees. Non-working non-poor (such as retirees living on investment income, for example) would pay a percentage of their income. The state income tax would be raised from 5% to 5.25% to cover additional gaps in funding.
Governor Roy Romer has convened people from all walks of life and all parts of the state to help finalize "CoioradoCare", the most comprehensive restructuring of health care financing and delivery ever attempted in Colorado.
continued on following page...
Colorado Medicine for February, 1993
49
Photo by Gil Maestas, II
"I am respectful enough of the difficulty and the complexity of the problem that we have to have the very best minds of Colorado on it, and we must include all those who are critical to its execution: those of you who are providing these services."
Governor Roy Romer to the CMS House of Delegates
September 13 , 1992
Following the first meeting of the commission examining ColoradoCare, the Governor addressed the Denver Forum on the rising costs of Medicaid and how they illustrate the need for comprehensive health care reform. (See following page.)
Why
ColoradoCare?
Impetus for ColoradoCare comes largely from growth in health care expenditures and an apparent lack of access by an estimated 514,000 Coloradans without health insur- ance. Health care costs are estimated to be increasing at a rate 1 .5 times that of inflation. The aim of the program will be to bring health care expenditures in line with the overall growth of the economy, provide universal preventive and primary care to all Coloradans and to capi- tate the amount received by the insurers administering the program.
It is being undertaken at this time, despite incoming President Clinton's promise to introduce health care reform legislation within 100 days of taking office. Any nation- wide plan will likely be administered by states, so Colorado would have experience already. In addition, the enactment of Senate Bill 92-4 brings
Colorado to the cutting edge of the health care reform movement nationwide. Third, Governor Romer, as head of the National Governor's Council, will have significant input to the process of formulating a national health care plan. Besides, despite the best intentions, it is possible that national health care reform will not be accomplished this year.
How Does It Work?
Under the original concept of ColoradoCare (to be modified by study and public input), a State Health Authority would define a basic set of benefits (yes, that is health care rationing) for which all citizens would be eligible. The state authority would gather all health care money into a pool, from which a group of insurers would be paid a set premium to provide the care.
Coloradans would have their choice of the approved plans. Each insurer could compete with the others by offering additional benefits or other plan enhancements for the same money. ("Managed Competi- tion") The advantage would go to the firm which can provide the best package for the premium amount.
No resident could be excluded because of age, sex, medical or employment status, or pre-existing conditions. There would be a uniform billing form, and all pay- ments, utilization review and cost reporting would be standardized.
In order to have input to the process, write: Health Care Reform Initiative, Office of the Governor,
1 36 State Capitol, Denver CO 80203.
50
Colorado Medicine for February, 1993
Romer Addresses Health Care
"This is the most important policy question in the United States, and that is, 'What are we going to do about health care costs?'" That was part of Colorado Governor Roy Romer's remarks to the Denver Forum )anuary 6, after unveiling ColoradoCare, his vision for health care reform in Colorado. Governor Romer told the group about Medic- aid, currently the biggest health care expenditure in Colorado at a billion dollars per year, and how it fits into the overall picture of health care financing and reform.
"I'm convinced that, next to comprehensive national reform, turning Medicaid into a managed care system holds the most hope for restraining costs," the governor told the group. "Competitive bidding, which I propose would begin immediately, is a step toward the ultimate goal of managed care contracting for Medicaid."
The governor called upon health care providers to accept assignment for Medicaid patients. FHe said he sees Medicaid as a part of a national managed care program in the future and that expenditure targets are likely to be used by the Clinton administration, in connection with health care rationing, as basic tools for constraining health care costs.
Governor Romer said he sees Medicaid reform as only a part of the larger picture, "The solution to the Federal Deficit problem hinges upon controlling health care costs," said the Governor, "I tell you, there is really no greater threat to the wealth of the nation, the competitiveness of our business and the fiscal stability of our families and our governments
than the current state of health care in America."
"We're kind of at a crossroads today on the issue of health care," he said, "One road is the one we're on. It is a road of steadily increasing costs, and steadily increasing burdens on families, businesses and governments. It's a road where health care costs rise faster than the growth of our economy, and as a result, the health care benefits available to people shrink each year. Government shifts costs to private businesses, and it cuts services to the poor. And the businesses shift the costs to their employees, and individuals pick up more of the health care tab, or go without care. That's one road.
"The other road requires a sharp turn in our thinking. It's the road of a comprehensive health care reform. It's the road of ColoradoCare, which we have been discussing this morn- ing. And hopefully, it's the road of the new administration's health care plan.
It's on this road, if we can change the structure of the health care system, first, we can constrain the growth in health care costs, so that the benefits aren't shrinking each year, and second, we can make sure that everyone has coverage so the system gains some stability.
Now in my mind, the choice of those roads is clear. The tough
Prominent Denver attorney Donald Hoagland and CMS member Fred Abrams, MD are among those listening as the governor describes his proposals.
Colorado Medicine for February, 1993
51
"What we have here is universal coverage, absolute portability, and community rated programs."
choices we face today in Medicaid will only get worse unless we change the road we're on."
Governor Romer told the group that Colorado and the nation face similar problems in deciding how to pay for the higher costs of obtaining medical care, "Now at the core of both the President-elect's proposal and the ColoradoCare proposal is a central idea. It's called 'managed competition'. That means restructur- ing the marketplace to encourage more cost conscious decisions by health care providers and purchas- ers. Now for Medicaid, that means we need to move more toward managed care."
Under ColoradoCare, Medicaid would be only one part of a total state-administered health care program, said the Governor, "What we have here is universal coverage, absolute portability, and community rated programs. ...Some would say there's already enough cost in this system to cover everybody, you don't need to add any more dollars. My own view is that if that's not true, it's close to being true and with a little bit more we could make it true, because we are now shifting so much cost to others."
During the meeting, the Gover- nor was questioned on the responsi- bility of physicians in controlling health care costs, "I don't think we ought to single out doctors as over against other providers. I think we all have a responsibility to try to find a system that does the job at less cost."
The governor said that physi- cians are forced to practice too much defensive medicine, "We have forced doctors to use many more
tests than you really need to practice good medicine. We forced that by several incentives that are screwed up. One is the whole litigation system of this country. ...Secondly there are some doctors who may have an incentive to do tests because they own a piece of the action. I think we've got to get rid of that."
"Doctors have a responsibility to be a part of this action," said the Governor, "but also, all of us have got to be a part of this." He put some of the blame for high health care costs on unsophisticated consumer- ism. As an example, he mentioned the Denver Public Schools/Class- room Teachers Union feud he mediated a few years ago. According to Romer, when he pointed out that there were several options, some more expensive than others, but no incentive to choose the less expen- sive option, he was told by both sides that it was unimportant. In other words, neither side considered prudent use of health care dollars as important enough to discuss.
The governor said this disparity also happens in society at large, though physicians are often blamed for high costs, "In terms of just doctors, I think that their practices are not any more of a problem sometimes than the people who buy this stuff. I mean, we have got the wrong incentives working here to hold the price down, and I think that's the bottom line of this whole change. We've got to get the right incentives to work or the free market isn't going to work, and if the free market doesn't work, folks, you're going to have a solution that you may not like."
52
Colorado Medicine for February, 1993
Who serves and who selects
by Stuart O. Silverberg, M.D.
Speaker of the House of Delegates Colorado Medical Society
The direction, role and legislative policies of the Colorado Medical Society, its Board of Directors and Executive Committee is established every six months by the House of Delegates.
Any organization of decisive, independent minded, and strong- willed physicians must have referees to keep the process on course.
Reference Committees provide this role. They hear testimony - some articulate, some passionate, some emotional - but all committed and significant. Once testimony is complete, the committee has the thankless task of consolidating this wide diversity of thought and opinion into a single position on which the House of Delegates can vote... Referees are never beloved - but they are important!
To insure that every delegate has an equal chance to serve on a Reference Committee, the Speaker of the House is requesting that each Component Society poll their Delegates for those members inter- ested in serving on a specific Refer- ence Committee and submit their
"Referees are never beloved - but they are important !"
nominees in order of preference to the Speaker by February, 1993.
The Speaker intends to appoint all nominees by order of preference to the Reference Committees - one delegate from each Component Society. In the event of the primary Delegate's absence, the Component Society's second preference will be appointed.
Any CMS member interested in serving on a Reference Committee is urged to contact his/her Component Society's leadership.
CompHealth, the nation s premier locum tenens organization, now provides local primary care coverage and flexible, part-time opportunities for physicians in the greater Denver area. Call today to discuss daily, weekly, weekend, evening, or monthly coverage for your practice, or to find out more about building a flexible locum tenens practice right here in the greater Denver area.
303-777-8002
P.O. Box 100218, Denver, CO 80250
CompHealth/Denver
Local Staffing Network
\ou didn’t spend umpteen years in school in order to become a
bill
collector.
Collecting money from slow paying patients is critical to your practice. But you didn’t spend all those years in school to become a bill collector.
And that’s where I.C. System can help.
First of all, we have the resources and expertise to do the job. And while we’re tenacious, we treat your delinquent patients with courtesy and respect.
In fact, our work is en- dorsed by over 1,200 profes- sional associations and societ- ies, including the Colorado Medical Society. And no matter where you’re located or where your debtors live, we have local representatives to service your account.
But most important, we guarantee results, by collect- ing at least ten times the amount of our retainer.
To find how the I.C.
System approach can work for you, call toll free (800) 824- 9469, ext. 330.
fftl.C. System
The SvMcni J W<irk^
Colorado Medicine for February, 1993
53
Colorado Medical Society Interim Meeting— April 3-4, 1993
Friday, April 2, 1 993
|
1 1 :30 am - 1 :00 pm |
Finance Committee |
12:00 N |
— 1 :30 pm |
Lunchieon |
|
1 :00 pm — 4:00 pm |
Board of Directors |
1 :30 pm |
— 4:00 pm |
Reference Committee |
|
3:00 pm — 5:00 pm |
FHealthi Care Reform — |
1 :30 pm |
— 4:00 pm |
Reference Committee |
|
Medicaid |
3:30 pm |
— 6:00 pm |
Reference Committee |
|
|
3:00 pm — 5:00 pm |
FHealthi Care Reform — Worker's Compensation |
3:30 pm |
— 6:00 pm |
Reference Committee |
|
5:00 pm — 7:00 pm |
Registration |
Sunday, April 4, 1993 |
||
|
5:30 pm — 7:00 pm |
Welcome reception |
7:00 am |
-- 1 1 :00 am |
Registration |
|
sponsored by El Paso County Medical Society |
7:00 am |
— 8:30 am |
Arapahoe Medical Society caucus |
|
|
6:30 pm — 9:30 pm |
Women in Medicine Section Dinner and Business Meeting |
7:00 am 7 :00 am |
— 8:30 am — 8:30 am |
AuroraAdams County Medical Society caucus Boulder County Medical Society caucus |
|
Saturday, April 3, 1993 7:00 am — 5:00 pm |
Registration |
7 :00 am |
— 8:30 am |
Denver Medical Society caucus |
|
7:00 am — 9:00 am |
Reference Committee Breakfast |
7 :00 am |
— 8:30 am |
El Paso County Medical Society caucus |
|
7:00 am — 8:30 am |
Nominating Committee Open Forum |
7:00 am |
— 8:30 am |
Larimer /Weld County Medical Societies caucus |
|
7:00 am —8:45 am |
Congress of Medical Specialties |
7:00 am |
— 8:30 am |
Pueblo/Western Slope Medical Societies caucus |
|
8:30 am — 9:00 am |
Credentials Committee |
8:00 am |
— 8:30 am |
Credentials Committee |
|
9:00 am — 9:30 am 9:30 am — 1 1 :45 am |
FHouse of Delegates Opening Session General Membershiip Meeting |
8:30 am |
— 12:00 N |
FHouse of Delegates Concluding Session |
54
Colorado Medicine for February, 1993
INTERIM MEETING REGISTRATION
1993 Interim Meeting of the Colorado Medical Society, April 3-4, 1993, Sheraton Colorado Springs Hotel
Name (please type or print)
Name of Spouse/Guest (if attending)
Component Society Office Phone
Please check all that apply
|
□ Women in Medicine Section |
□ Young Physicians Section |
□ Resident Physicians Section |
□ Hospital Medical Staff Section |
|
■ □ Component Society Executive |
□ Program Speaker |
□ Press |
□ Other |
If you are not a member of CMS, please provide the following: Company/Organization
Title
Be sure to complete both sides of the form.
Hotel Reservation form below Send directly to hotel, not to CMS
Sheraton Colorado Springs Hotel 2886 South Circle Drive Colorado Springs, CO 80906-4199 (7 19)576-5900 FAX (71 9) 576-7695
Advance Reservation Request
Reservations are accepted on a guaranteed basis only (Please complete and remit early.)
Guaranteed Reservations
• Send a deposit of one night's room charge plus tax (8.6%)
• Include your credit card number (AMEX/DC/MCAdsa/CB)
If you do not cancel with hotel 48 hours prior to arrival, you will be billed by the credit card company for one night's lodging, plus tax.
Cancellations
Please don't be a "NO SHOW." If you cannot stay with us, cancel your reservation by calling the hotel directly at least 48 hours prior to arrival and obtain a Cancellation Number.
Check-Out
Check-out time is 1 1 :00 a.m.
Check-In
Check-in is not guaranteed prior to 3:00 p.m.
Special Note
Reservation deadline is March 1, 1993. The preferred rate will be extended to CMS members on a space available basis after March 1 .
For additional information or
group reservations - call 719-576-5900.
Colorado Medicine for February, 1993
55
Reservations for Events and Meetings
(Reservation deadline is March 19, 1993. Reservations accepted on a first-come, first-served basis.)
Number of Reservations
Friday, April 2, 1993
3:00-5:00 pm Health Care Reform — Medicaid
3:00-5:00 pm Health Care Reform — Worker's
Compensation
5:30-7:00 pm Welcome Reception sponsored by
El Paso County Medical Society
Amount
Enclosed
Complimentary
Complimentary
Complimentary
Saturday, April 3, 1993
1 2 Noon-1 :30 pm Luncheon Complimentary
Hotel Reservations
Please use the hotel reservation form in this issue of Colorado Medicine to make your reservations directly with the Sheraton Colorado Springs Hotel. The deadline for room reservations is March 1, 1993. The preferred rate will be extended to CMS members on a space available basis after March 1 .
Meeting Registration
Please submit a registration form by March 19, 1993, if you plan to attend this Interim Meeting. We're delighted to receive it by mail, fax, or phone. We can check you in more quickly and efficiently if you've pre-registered, in addition to providing more accurate and therefore cost-saving guarantees for our food functions. Thanks!
Messages
For your convenience, a message board will be provided at the CMS registration desk. The hotel's phone number is 719-576-5900. (You may want to leave this number with someone). If you need to be contacted, ask the hotel operator to transfer the call to the CMS registration desk or CMS office.
What To Do
Complete and return to Colorado Medical Society, PO Box 1 7550, Denver, CO 8021 7 (303-779-5455 or
1-800-654-5653), or FAX to 303-771-8657.
Hotel Reservation Information
Name of Group: Colorado Medical Society
Last Name First Middle
Company Name Co. Phone
Address
City State Zip
Home Address _ _ Phone
City
State
Zip.
Share with: Last Name.
First
Last Name
First
Group Code
□ No Smoking Room
Rate Check Type
_ _ _ Requested
|
Single |
$58.00 |
|
|
Double |
$68.00 |
|
|
Triple |
$78.00 |
|
|
Quad |
$88.00 |
Guest rooms are held by the hotel for your group as listed below. Any variation is subiect to availability.
Meeting Dates April 2-4, 1993
Please make my reservation for the following dates:
ARRIVAL
DEPARTURE
(We must have this information in order to make your reservation.)
Guaranteed Reservation
□ Deposit included
□ AM/Ex □ DC □ MC □ VISA QCB
Credit card No.
Expiration date
Signature
56
Colorado Medicine for February, 1993
Dear CMS member,
The 1 993 interim meeting will be taking place in Colorado Springs on April 2-4. If you are not familiar with Colorado Springs area and would like to dine out while in town, the following list may be useful.
Hatch Cover
576-5223 Steak & Seafood Moderate to Expensive
Bell's Deli
154 Cheyenne Mountain Blvd. 576-8633
Casual Neighborhood Dining Inexpensive to Moderate
Luigi's
947 S. Tejon Street
632- 0700 Italian Moderate
Izzi's
1731 Mount Washington Ave. 473-5308
Italian & Continental Moderate
Peppino's
919 Arcturus Drive 475-1077
New Orleans Cuisine Moderate
Ritz Grill
1 5 S. Tejon 635-8484 Nouvelle Cuisine Moderate
Edelweiss
34 E. Ramona Ave.
633- 2220 German Moderate
Mekong
3219 S. Academy Blvd.
390-4223
Vietnamese
Inexpensive to Moderate
Howard's Pit Barbecue
2814 E. Fountain Blvd.- 473-1 390 301 9 W. Colorado Ave.- 473-7427 Colorado & Fountain — Inexpensive
Estela's
925 S. 8th Street
575-0244
Mexican
Inexpensive to Moderate
Papagyos
301 Manitou Ave.
685-9458
Mexican
Moderate
Zeb's
945 S. 8th Street 473-9999
Fish & the best ribs anywhere Moderate
Imperial Wok
5674 N. Academy Blvd.
548-0300
Chinese
Moderate
Craftwood Inn
404 El Paso Blvd.
685-9000 Colorado Game Moderate to Expensive
La Petite Maison
1015 W. Colorado Ave.
632-4887 Country French Expensive
The Peppertree
888 W. Moreno Ave.
471-4888
Continental with the best pepper
steak around
Expensive
Charles Court
Broadmoor Hotel 1 Lake Circle 577-5733 American
Very Expensive
Penrose Room
Broadmoor Hotel 1 Lake Circle 577-5733
Continental & Nouvelle Very Expensive
The Tavern
Broadmoor Hotel 1 Lake Circle 577-5733
Steak/Prime Rib/Seafood Moderate
Remington's
3225 Broadmoor Valley Road
576-4600
Continental
Expensive
Maxi's
Red Lion Hotel 1 775 Cheyenne Mtn. Blvd.
576- 8900 American Moderate
Golden Bee
I Lake Circle
577- 5776
for Drinks and Fun
Colorado Medicine for February, 1993
57
■
Lobby
Alan Rapp, MD Chairman Council on Legislation
" ... act more like an HMO — pay our provid- ers a flat amount and give them responsibility
Roy Romer, Governor State of Colorado
Our state leaders will be working during this legislative session to promote their vision of how health care services should be delivered in Colorado. Finding adequate funding for the state's public health care programs has always been a chal- lenge for the Governor and legisla- tors. Under the Amendment 1 provisions, enacted by Coioradans in November's election, this challenge has grown even harder to meet.
We believe you should know, first hand, what solutions leadership is offering . We quote directly from Governor Romer's "State of the State," Senator Norton's "State of the Senate" and Representative Berry's "State of the House" messages.
CMS must be involved in these discussions. Our leadership will be charged with setting and critiquing the goals of the Medicaid program, and how best we can achieve them, while still providing quality care to the Medicaid patients. We will need your advice and assistance in this effort.
On Medicaid Reform - Colorado Governor Romer
"To be bold, we must overhaul the structure of Medicaid by: 1 ) immediately beginning competitive bidding for services, and 2) moving from the current system to a system that takes advantage of the benefits of managed care, like and FHMO.
This year, we will spend $1 billion in state and federal Medicaid funds to provide medical care for Colorado's poor, nursing home care for the elderly, and long-term care for the disabled. These Medicaid
costs are growing at 20% per year.
If we're going to be bold in redefining government, we must fundamentally change Colorado's Medicaid program. We have to stop paying providers for each individual service to a Medicaid enrollee. Instead, we must act more like an HMO — pay our providers a flat amount and give them responsibility for delivering all necessary health care within their own budget.
It's the best way to hold down costs throughout the system.
At the current rate of growth, Medicaid is the single greatest threat to the stability of our state budget.
The problem we face with Medicaid is closely tied to the problems of our nation's health care system.
In Washington, the incoming administration has made health care a top priority. As chairman of the 50 governors (National Governor's Conference), I and others are work- ing with the transition team to craft that reform proposal. In Colorado, we're moving ahead with our own statewide reform proposal called ColoradoCare. If there is no national solution, we will submit legislation for ColoradoCare as early as 1 994.
But we must start right now by authorizing the Medicaid program to begin competitive bidding for services. It's the first step in our reform. With competitive bidding, we will be able to seek our low cost, high quality providers of health care and give them contracts to provide services to people on Medicaid.
Now, I know some providers rely upon Medicaid for much of their income. They will need to demon-
58
Colorado Medicine for February, 1993
"At the current rate of growth, Medicaid is the single greatest threat to the stability of our state budget."
Roy Romer, Governor State of Colorado
strate that they are cost-efficient if they want to keep doing business with us. And Medicaid enrollees will lose some of the choice they cur- rently have.
We need to be sensitive, but fair and firm, in making these changes. We also need to be sensitive to the availability of services in different geographic regions within the state when begin competitive bidding. Medicaid competitive bidding is the right thing to do, and we must begin it immediately."
President of the Senate - Senator Tom Norton:
Another topic of major concern this session is health care — specifi- cally Medicaid. As you'll recall, we passed a bill last year that would have allowed us to work toward the replacement of Medicaid with an innovative, cost effective approach to providing medical assistance to low income people.
The governor disagreed and vetoed the bill voicing what was termed a "grave concern" over the possibility of Colorado losing funding for the medically indigent. Now, we are in a position of not only dealing with runaway Medicaid costs, but pressure for a national health care system which will create similar problems. Therefore, we must find a state solution which eliminates the need for further intervention.
Speaker of the House - Representative Chuck Berry:
No challenge Colorado faces is more important than health care for our citizens Yet the future of this issue may be less in our hands than in those of decision-makers in Washington. Federal mandates cause spiraling increases in Medicaid and deny us the discretion we should have in state budgeting. We must work with the Governor to seek more flexibility from the federal government in the operation of our Medicaid system. In addition, the new President has promised America a program of national health insur- ance, and we must recognize that congressional action on this initiative could pre-empt anything we do here at the state level.
//. . . pressure for a national health care system which will create similar problems. "
Senator Tom Norton President of the Senate
"... congressional action ... could pre-empt any- thing we do here at the state level."
Representative Chuck Berry Speaker of the House
Colorado Medicine for February, 1993
59
lanning for Retirement
by Michael P. Thompson Assistant Managing Editor
" The Real Mid-Life Crisis "
As you drift into your middle years, you begin to have those feelings of doubt. Oh, I'm not talking about the question of whether you've still "got it." No, this is the question Duane D. Freese calls "The Real Mid-Life Crisis." That's the question, "Am I really prepared for retirement?"
Unlike an employee of a corpo- ration, the physician often has to plan and work for his or her own retirement benefits. How would you like a knowledgeable friend to step you through your retirement plan- ning? The next best thing may be Retirement Planning: The Real Mid- Life Crisis by Duane D. Freese.
Now before you begin com- plaining that you haven't got the time to plan for retirement, consider the alternative. Oh, right. That's not the brightest version of your golden years, is it? Just because you've made a few smart investments doesn't necessarily mean you'll have enough to sustain your desired lifestyle without working.
Ftow do you know you're really ready? Well, the answer is not that simple or that easy. Mr. Freese says, "If it was so simple, you wouldn't need a book. If it was so simple, all the advice you would need would be available on a three-by-five index card." But that is not the case. "You want me to tell you not to worry about it," says Mr. Freese, "That there's some simple way to handle your retirement. Tough."
Those comments tell you something about his writing style, don't they? He's not going to give you some get rich quick and easy scheme. That's not to say it's too difficult for a competent professional
such as you, but you do need to put in the effort. He also isn't going to give you a bunch of professional gobbledygook or some scary stories. You can do it if you want.
This book is very practical. Chapter One advises you to figure out where you are. "Budgeting is boring," he says, "but it is also basic. It makes everything else easier."
From the worksheet that shows you your present financial status, he takes you through the ever more pleasant countryside of figuring your net worth and what kind of income you want when you retire.
Now, how are you going to pay for it? Many people are drastically overinsured. Others have bought the myth that term insurance is "one size fits all." How can you improve your present income status? One way is a weekly food menu. You'll have to read the book to find out how.
Basic investment strategies are covered next, such as, saving the cash to start the process. Then you have to keep track of it. (You always loved to count your money anyway, didn't you?) You even have to face the final curtain, deciding who will get what and how to provide for your loved ones after you're gone. (You were planning on leaving, weren't you?)
If you want a book of magic answers and pots of gold, you haven't found it here. If you want a good, practical guide to getting ready for retirement, pick up a copy of Retirement Planning: The Real Mid- Life Crisis by Duane D. Freese, ©1990, International Publishing Corporation, 625 N. Michigan Ave, Chicago, IL 60611.
60
Colorado Medicine for February, 1993
Defined Benefit Plans
Time for a closer look
A recent change in the position of the IRS on early retirement ages has brought renewed life to Defined Benefit Plans. As a result of Tax Court developments, Congressional input, and testimony from retirement professionals, it appears the use of
early retirement ages between 60-65 will no longer be challenged by the IRS, provided proper plan design.
This change in the position of the IRS together with current Cost of Living Adjustments (COLA) for retirement benefits opens the door
for younger physician owners who wish to accumulate assets quickly and retire earlier. As you can see from the numbers below, the De- fined Benefit Plan can once again be an important retirement and tax planning alternative.
Defined Benefit Plan Contributions at Selected Ages
|
43 |
44 |
45 |
46 |
47 |
48 |
49 |
50 |
51 |
52 |
53 |
|
|
$30,000 |
27,500 |
29,135 |
30,990 |
33,094 |
35,506 |
38,302 |
41,588 |
45,510 |
50,281 |
56,220 |
63,827 |
|
$40,000 |
30,800 |
34,330 |
38,341 |
42,992 |
47,341 |
51,069 |
55,451 |
60,680 |
67,042 |
74,960 |
81,670 |
|
$50,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$60,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$70,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$80,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$90,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$100,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
|
$1 10,000 |
30,800 |
34,330 |
38,341 |
42,992 |
48,431 |
54,858 |
62,542 |
71,863 |
75,030 |
78,299 |
81,670 |
The chart assumes no other prior plans or contributions. Actuarial Assumptions: Normal Retirement Age = 60; Pre-Retirement Interest = 8%; Post Retirement Interest = 5%; Mortality Table = Fern 83A; Salary Scale = 5%; COLA = 4%.
For many years the Defined Benefit Plan had been one of the most attractive tax shelters for physician business owners. The Defined Benefit Plan can provide high levels of deductible contribu- tions and primarily benefits older employees. However, changes in the tax law limited the level of benefits from these plans which lowered the level of contributions permitted and in turn diminished the appeal of these plans.
Now that the use of earlier retirement ages appears to have successfully passed IRS scrutiny, the Defined Benefit plan will once again make sense for the younger Physi- cian owner. For example, for a 45 year old physician owner who has never had a plan and who wants to retire at age 60, the projected accumulation (assuming COLA increases) is more than $1 .8 million.
Furthermore, changes in the IRS position on plan amendment now provides additional flexibility should the physician objectives change.
Despite the bad press over the last few years, the Defined Benefit Plan remains an important and effective tax planning strategy for physician small business. With the proper design, physicians can receive high tax deductions while controlling the cost of contributions for other employees.
Our thanks to Pete Bernardis and Benetech for supplying us with this information. For further details contact John K. Weisert, Program Director, Colorado Medical Society Physician's Financial Program, Chase Manhattan Investment Services, Inc., 2000 S Colorado Blvd #8500,
Denver CO 80222, (303) 782-8000 or 1-800-223-2140.
Colorado Medicine for February, 1993
61
A monthly report of current and on-going activities of the Councils , Committees and Sections of the Colorado Medical Society. None of the information herein is meant to indicate a policy or position statement of the Colorado Medical Society. This report is designed only to inform CMS members of their organization's activities and study projects at the Council , Committee or Section level.
The Committee on Accreditation, chaired by L. H. Stahlgren, MD, will
meet on February 4 at 4 p.m. at the CMS offices.
The Council on Professional Education, chaired by Richard Bakemeier, MD, will meet on February 1 8 at 4 p.m. at the CMS offices.
The Physician Health Issues Committee, chaired by Bonita Carson, MD, will meet February 1 1 at 5:30 p.m. at the CMS offices.
The Organizational Study Committee, chaired by John A. Sbarbaro, MD, MPH, will meet February 9 at 5:30 p.m. at the CMS offices.
The CMS Education and Research Foundation met January 1 1 and took the following actions: ratified $5000 donation from ERF to CMS in support of the 1992 Educational Program; recommended two proposed bylaws changes to be presented to the CMS Board for approval; approved continued support of the Colorado State Science Fair with a $500 donation. The next meeting will be held April 19 at Dr. Rainer's office.
The Coalition on Senior Issues, chaired by Muryl Laman, MD, will meet March 1 6 at 2:00 p.m. at the CMS offices.
60 Minutes an "excellent show"
On Sunday, January 24, 1993, "60 Minutes" produced what the American Medical Association called an "excellent show" on Dr. Michael Carey's research at Louisiana State University that was halted through the efforts of what they called "animal 'rights' extrem- ists".
The AM A expressed their encour- agement to anyone who saw the program to write "60 Minutes" with comments. They said, "This is the first time a major television program has exposed the damage caused by animal extremists."
If you wish to comment on the program, write, Don Flewitt, "60 Minutes", 524 W. 57th St, New York, NY 10019-6101.
For another perspective on animal research, see page 63.
Reminder to all Colorado physicians:
The State Board of FHealth Regula- tions say that Hepatitis A — con- firmed or suspected — is a manda- tory reportable condition and must be reported within 24 hours of clini- cal diagnosis, regardless of whether or not supporting laboratory data are available.
All physicians, health care provid- ers and hospitals are subject to these regulations.
62
Colorado Medicine for February, 1993
A letter to Colorado physicians
I attended the November 1 6th conference concerning animal research sponsored by the American Medical Association, Colorado Medical Society, and the University of Colorado Health Sciences Center. The conference was entitled "A Miracle at Risk". I was extremely disappointed in the program. It was an unscientific presentation unwor- thy of a professional organization.
This was not an intellectual discussion on the pros and cons of the use of animals in research. There was no mention of the fact that there are countless examples of useless experiments that employ animals. There was no mention of the fact that many animal experiments are useless duplications of previous experiments and that many experiments use animals when other methods could be used sometimes with even greater accuracy. There was no mention of experiments where unanesthetized animals are burned to death, muti- lated, electrocuted, or drugged and often left to die a slow death over several days and all of this frequently in experiments without scientific merit. There was mention of the fact that there is an Animal Welfare Act to protect experimental animals, but no mention of the fact that it does not even apply to most animals and even when it does apply covers the animals only before and after the experiment but does nothing to protect them from the horrible abuse during the experiment itself.
Instead the AMA chose to say that animal research has been responsible for medical progress and
chose to say this without giving any facts to support this controversial statement. They chose to portray animal rights activists as unscientific lunatics and chose to present animal research as always necessary when done and seldom causing any pain or discomfort. They chose to dwell on the few examples where those concerned with animal welfare have broken into labs without mentioning that these events are rare and are often last resort attempts by those who have been frustrated with the inability and disinterest of the scientific and legal communities in stopping experiments that are gross examples of animal torture in unnecessary experiments.
One of the speakers at the conference was Adrian Morrisson who was involved with defending those accused of animal cruelty in the Silver Springs monkey experi- ments. For those who are not familiar with this legal case, these experi- ments were conducted by a behav- ioral psychologist, Edwin Taub, who cut the nerves to one arm of each monkey in an attempt to duplicate the effects of a stroke. After the operation the monkeys were pre- vented from using their good limb to see how they managed with the other arm. The lab itself was a hell on earth with rusty cages with moldy excrement and the monkeys left with draining wounds and limbs with stumps where there had once been fingers. I would seriously question the ethics of anyone who would defend these experiments.
Another speaker was Nora Rumpf who presented the story of her son who she said was cured because of a procedure developed by animal researchers. There was no
discussion of exactly how the animals had helped to developed this procedure. Most importantly a personal testimonial of one case by a medically untrained person does not have a place in any supposedly scientific meeting.
The next speaker was James Stevens, DVM who is the Director of Laboratory Animal Resources at the University of Colorado. His topic was animal rights in Colorado. He listed the animal rights groups in this state. He also gave out the names of the heads of two of the organizations both of whom I know personally and can attest to their kind nature and tireless work to lessen animal cruelty in this community. Dr. Stevens continued by listing other what he felt were ridiculous things that the animal rights groups were working on such as veal farming, the fur industry, and conditions in slaughter houses. I question the ability of anyone to head up the animal labs at the University of Colorado who does not know about or have compassion for the animal abuse involved in these industries.
Overall I found the conference to be a one-sided unscientific propaganda show. There was no serious discussion of any of the crucial issues involved with the topic of animal use in research. The conference was an insult to anyone of intelligence and a devastation to anyone with compassion. As long as the medical profession continues to turn its back on animals who suffer needlessly then the public will view the medical profession with mistrust and misgivings.
Peggy Carlson, M D
St. Anthony North Hospital
Colorado Medicine for February, 1993
63
Book Review
"Aids in the World, A Global Report"
Harvard University Press 1992. 843 pages. $19.95 (U.S.)
By Thomas H. Coleman , MD.
Denver
" The behavior of nations invites the virus , the behavior of people does not change
This book is a tremendous accomplishment. It is required reading for anyone who is not afraid of realities and professes to have more than a superficial understand- ing of the AIDS epidemic. It collects in one place the facts about the worldwide behavior of the AIDS virus while it is infiltrating and killing the human race. As a story it is fascinating and frightening. As a primary reference it is indispensable to an understanding of what the medical professions and the people of the world are facing.
The book has unusual scientific credentials. It is not the child of political prejudice or money. It is privately funded by the Francois- Xavier Bagnoud Foundation. In 1991 the Foundation organized the Global AIDS Policy Coalition, committed to tracking and evaluating the AIDS pandemic. This book is the Coalition's first report. Its editors, advisors and contributors come from the medical schools of Michigan, FHarvard, Yale, and from other experts on the scene in seventeen nations, Australia to Zimbabwe. The report brings a message too grave for review as just another medical book. Some of the particulars:
In fewer than twenty years of the world epidemic HIV has infected about 13 million people. It has killed two and a half million. By 1 995 it will have infected about 7 million more. Nearly 20 percent of those will be children.
In the five years between 1 995 and 2000 the virus will infect six times more adults than it did in its first twenty years. A conservative projection for the year 2000 sees a
total of at least 38 million adults infected. A more realistic figure is probably near 100 million.
The virus is riding high on mindless sexual drives, thriving on international complacency, igno- rance, superstition, misinformation., discrimination, and denial. Individu- als, societies and nations think AIDS is a sexual disease of "other people", other groups and nations. Since they don't "belong" to those groups they think they're not at risk whilethey are easily the next victims.
The virus is constantly shifting among all classes of world society regardless of geography. It is growing in the "low intensity" wars of Yugoslavia, Angola, Liberia. The people, especially children, flee their villages for the refugee camps and the streets of cities where they have no money, no food, and no protec- tion against drugs, prostitution and abuse.
The behavior of nations invites the virus, the behavior of people does not change. In the late 1970s Tanzania dosed its borders, attract- ing young Tanzanian smugglers.
They were infected by the virus from Uganda. As they began to die they blamed the disease on a fast-selling red shirt smuggled from other countries. Tanzanian men decided that the shirts, printed with an eagle and the word "Juliana", must be cursed by witchcraft. They named the disease Juliana. When Juliana's victims lost weight and became slim, they called it "slim". This caused a "logical" change in behavior. The men avoided thin prostitutes. They thought the plump ones would be "safe".
64
Colorado Medicine for February, 1993
"In Mexico City in 1 984 only one woman was infected for every 25 men.
By 1990 the ratio was 1 in 4."
"No nation is without ignorance
This worldwide holocaust has not been arrested by provincial programs crippled by politicians and bureaucrats. Out of fear and denial the heads of state in 1 3 of 35 coun- tries still have made no public mention of AIDS as a problem. Thirteen others had never mentioned it until 1 989. In some of those countries twenty to thirty percent of the people already are infected, waiting to die.
Prevention by education is the only hope for slowing the rate. The most vulnerable groups are also the most unreachable, both intellectually and logistical ly. Money has not done it. Money spent per capita for prevention in North America, Europe and Australian Oceania averages about $2. In sub-Saharan Africa, with 68 percent of the world's HIV infection, it is about five cents. In England some of the first educational literature was censored and sup- pressed as "obscene". In the United States about 8 percent of the people at risk could not read well enough to understand the literature.
Industrialized nations don't fund prevention worldwide because they see AIDS as a "problem of the developing countries". The Coalition calls upon world leaders for a "global ethic of caring", in the name of self-protection and national survival.
As the infection rises, world response weakens. In 1991 the world cost of care for people with AIDS was $3.5 billion, twice the cost estimated for prevention. In several nations the cost of care for people with AIDS will eventually equal the gross national product.
Meanwhile, infected travelers fly the world, with their AIDS and tuberculosis "carry-on", to start little epidemics in every island, every nation. Infected commercial sex workers welcome travelers who are not yet infected. ("CSWs" is the new acronym for prostitutes). The virus comes home to towns and families where it probes into every vulnerable person, every innocent group.
This brings cries for selective testing, or closure of international borders. There are too many false tests, too many threats to privacy, freedom and tourism to make programs of massive testing practi- cable. An Illinois law requiring premarital testing was followed by a decline of 22 percent in marriage license applications. Among 1 55,000 applicants tested, Illinois discovered the virus in 26 people at a cost of $208,000 each.
The virus is equalizing men and women. In Mexico City in 1984 only one woman was infected for every 25 men. By 1990 the ratio was 1 in 4.
During 1989-90 in Bombay's sexual disease clinics the HIV infection rate was 4.3 percent. By 1991 it was 32 percent.
HIV is slowly killing young families, robbing their countries of entire generations, destroying the workers, converting them to a human loss and a financial burden.
AIDS is potentially worse than the plague that swept away most of the labor force of Europe in the fourteenth century, worse than the influenza pandemic that killed millions in a few months of 191 8-1 9. A vaccine may be on the horizon in
scientific laboratories, but testing, approval and distribution would take years. Small groups of volunteers, (ASOs or AIDS Service Organiza- tions) and straightforward dramas in the mass media are slowly influenc- ing the sexual customs of people at risk, beginning to educate govern- ments about prevention.
At the same time the press in one industrialized country quotes a notorious personality who says AIDS is a racial conspiracy designed intentionally to decimate minorities. No nation is without ignorance.
We await the Coalition's report for 1993.
Colorado Medicine for February, 1993
65
Colorado Medical Society offices were the site of a brief demonstration by a group representing ADAPT (Americans Disabled for Attendant Programs Today) on January 1 5th. ADAPT spokesperson, Wade Blank, said the group was mainly con- cerned that the American Medical Association know of its protest to Colorado doctors over current funding of nursing homes. Blank said ADAPT is asking "for no new funding. We are asking that 25% of the Medicaid funding which now goes to nursing homes be redirected to fund a national community- based attendant service pro- gram." Blank added that ADAPT came to CMS because it mainly wanted input into a group representing a majority of Colorado's doctors. Blank also said his group wants the AMA to
• direct its members to reduce nursing home referrals by 50% in the first year
• require all member physicians to make full disclosure of their financial interests in nursing homes and institutions
• mandate that AMA members divest themselves of all financial interests in nursing homes and institutions, and
• invite ADAPT to present at the next
national AMA conference and vote on ADAPT's resolution.
CMS President-elect Wm. Carl Bailey, MD, was the officer on location this particular day. He and Executive Director Sandi Maloney conferred with the group, first listening to their requests and their demands, then responding with a reasoned approach of inviting ADAPT representatives to present their points before CMS councils or committees.. Wade Blank asked if CMS had a committee or task force studying the Governor's health care reform proposals and, if so, could ADAPT have input to that group? Dr. Bailey said he felt that was a reason- able request and one which could be arranged. Sandi Maloney said she would act as the liaison for CMS and would set such an agenda.
Bailey asked if there were any other points and a spokesperson said the group wanted someone in the CMS office to call the AMA (now) and tell them what was taking place here in Denver and what their (ADAPT's) requests were, because Colorado was only one of 1 5 state societies that were being visited by ADAPT demonstrators on January 1 5th. Wade Blank said his group had a meeting with AMA representatives at the Interim Meeting in Nashville, telling them they wanted positive answers to the ADAPT demands by this date or demonstrations were in the offing.
When a CMS staffer began taking video pictures of the group, a number of demonstrators said they did not want pictures because they were afraid they would be used against the individuals. Sandi
66
Colorado Medicine for February, 1993
Demonstrators come to CMS offices
Maloney replied that it was a CMS employee taking the pictures. Dr. Bailey was quick to remind the demonstrators that if they wanted a fair representation to the entire CMS organization, then they had better allow the video recording.
The group continued to protest the picture-taking, saying that television news men had not been allowed into the building to take pictures for the public news media, so CMS should not be allowed to either. Dr. Bailey was quick to pick up on the issue, replying: "Wait a minute. You came here unan- nounced and marched into our offices and, I can say, disrupted things. When we try to explain this to our members, I think the recording and pictures will be helpful." ADAPT then replied: "It would have been nice if Channel 4 could have come up and filmed it for the general public." Dr. Bailey replied, "Well, now I didn't think Channel 4 was the
issue here today. If it is, then we have no more to talk about."
The demon- stration lasted for a little less that two hours. Both sides went away feeling they had a better perspective of one another's position. CMS will follow up on its pledge to open communi- cation channels and allow input from the group.
Dr. Bailey said to CMS staff later, "There's no doubt this kind of protest will occur more frequently as the health care question becomes more the focal point of public concerns. CMS will remain on the front line and be
targeted by other such demon- strations."
Photos captured from videotape with Macintosh llsi computer and MacVision image capturing hardware and software.
Colorado Medicine for February, 1993
67
* mi
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Colorado Medicine for February, 1993
M E L
Dr. John C. Seiner elected ACAI President
In December of 1 992 the American College of Allergy and Immunology (ACAI) elected John C. Seiner, MD. as President. Dr. Seiner has been a member of the Colorado Medical Society for the past 27 years.
In addition to private practice in Allergy/Respiratory, Dr. Seiner is Director of the Allergy Respiratory Institute of Colorado, Clinical Professor in the Department of Medicine, at Children's Hospital, Denver, 1976-92, and Founder and Director of the Environmental Care Unit at Presbyterian Hospital, 1979- 82.
Dr. Seiner has authored numer- ous articles in the medical literature and contributed chapters in several medical text books. He is a contrib- uting editor to several medical journals, including Annals of Allergy, New England and Regional Allergy Proceedings, Pediatric Allergy, and Rhinology.
The Colorado Medical Society wishes success to Dr. Seiner as President of ACAI.
Three Public Health Scholars
Randy Gordon, MD, director of the Weld County Health Department,
Christine Nevin-Woods, MD,
director of the Pueblo City-County Health Department and John Muth, MD, Director of the El Paso County Department of Health and Environ- ment, have been selected to serve as Scholars for the second annual national Public Health Leadership Institute.
The institute is funded by the Centers for Disease Control and serves to strengthen America's public health system by enhancing the leadership capacities of city, county and state health officials.
"Being chosen an Institute Scholar is certainly a tremendous honor." said each of the three physicians. Each spoke of a commit- ment to using this opportunity to further their work in addressing the complex health challenges in their local health departments and in the nation.
Veterans Alert
Veterans who served in China, Burma, and India in World War II are invited to a reunion, August 1 1- 1 5, 1 993, in Salt Lake City, Utah.
This 46th annual reunion is being organized by the China-Burma-India Veterans Association, which has over 7000 members.
As stated by Homer C. Cooper, Organizer of the CBI annual re- unions, "Although the national China-Burma-India Veterans Asso- ciation has over 7,000 members and has held reunions annually since I 948. I can't help but feel that we have failed to find thousands of CBI veterans who would enjoy our reunions if they knew about them."
If you are a CBI veteran, please
send your name, address, and phone number to Homer C. Cooper, 145 Pendleton Drive, Athens, Georgia 30606, so they can send you infor- mation about the reunion. Please also tell them the name of your CBI unit and the locations where you served overseas.
If you cannot attend the Salt Lake City reunion, they would still like to hear from you so we can notify you of future CBI programs, including those of local CBIVA units in your state.
Recognizing
Inventors
The American College of Physician Inventors (ACPI) proudly announces its incorporation with the motto "Creatrex Medicus Pro Ingenio Suo Noscatur" Let the Creative Physician Inventor be Recognized for His Genius.
ACPI is a new organization that has been formed by a prestigious group of physician inventors to establish a forum for creative profes- sionals and to assist in the inventing, patenting and marketing process of ideas applicable to the medical profession. They also acts as a liaison between physician inventors, the medical community, industry and the government regulatory agencies.
The ACPI was founded this past spring of 1992 by Leo Rubin, MD , Herb Dardik, MD , Frank Deber- nardis and Charles Klieman, MD.
For further information contact: Frank Debernardis at 352 Hillcrest Road , Ridgewood, N.J. 07450, phone (201 ) 447-6926 or Charles Klieman, MD at (310) 698-0271 .
Colorado Medicine for February, 1993
69
Medical
News
HEALTH
WORKBOOK
The Colorado Department of Health STD/AIDS Section has compiled a free resource workbook for persons with HIV infection. The workbook is designed to help health care professionals provide better HIV risk-reduction counseling, emotional support and referral to community resources. The workbook's aim is to empower individuals to take and active role in their health care, stay healthier longer and prevent the transmission of HIV infection. The workbook, adapted from materials developed by the Seattle-King County AIDS program, has chapters on such topics as emotional reac- tions to HIV infection, disclosure and partner notification, stress, nutrition, safer sex, HIV infection in women, drugs and alcohol, TB and hepatitis B and legal and financial assistance. Attachments include listings of clinical, dental and mental health referrals, community support ser- vices, social services and social security offices, local health depart- ments and community nursing services. The free workbook can be obtained by contacting Judith Schwartz at (303) 692-2707 or writing to:
Colorado Department of Health
DCEED-STD-A3
4300 Cherry Creek Drive South
Denver, CO 80222-1530
New DEA Numbers
During the past year, the Drug Enforcement Administration has undergone relocation. The new local
as well as national address and telephone numbers are as follows:
1 1 5 Inverness Drive East Englewood, Co. 801 1 2 (303) 784-6300 For registration information:
(303) 784-6323 National:
Drug Enforcement Administration 700 Army Navy Drive Arlington, VA 22102 (202) 307-1000
Diabetes Patients Needed
The International Diabetes Center of Colorado (IDC) is seeking volunteers for a research study Participants will help test a new insulin. This new insulin may act more quickly in lowering blood sugar with less risk of low blood glucose reactions. The study will last one year.
Volunteers for the study must: