Summer magazine 2016

1 | KNOXVILLE MED CINE

Serving the Greater Metropolitan Knoxvil le AreaVolume LXXIII, No. 2 • Summer 2016

KAMKNOXVILLE ACADEMY OF MEDICINE

KAPA’S BOOT SCOOTIN’ BALLFEATURING RODNEY ATKINS

perfectserve.com | 866.844.5484 | @PerfectServe

You decide how and when to handle calls. Our unified clinical communication and collaboration platform provides after-hours or 24/7 call management—with customized call routing based on workflow, call schedules and personal preferences.

● Easily change call schedules via the mobile app or the web. ● Secure all messages to protect patient information and ensure

HIPAA compliance. ● Connect coordinating provider sites to your service group. ● Return patient calls without exposing your personal phone number. ● Avoid the unpredictable costs of traditional answering services.

Gain control with customized communications management at your practice.

of PerfectServe Synchrony

Schedule a demo

866.844.5484

PerfectServe Synchrony™ gives you morecontrol.

1 | KNOXVILLE MED CINE KNOXVILLE MED CINE | 3

By: Thomas Pollard, MD

“Doctor”. For as long as we can remember, this word has been associated with feelings of trust, pro-fessionalism, and respect. Your doctor always took care of you and your fam-ily. Your doctor could be reached at any time to allay your fears and to address your healthcare needs. Your doctor was the pri-mary decision-maker re-garding the medical needs of the community.

Over the years, the term “doctor” has lost some of its mystique. The term applies to any individual who has an ad-vanced degree in his or her given field, not just medicine. In the health-care community, doctors of pharmacy, nursing, and ad-ministration, just to name a few, all play a vital role in our medical community. It is not the dilution of the term “doctor” that should garner our attention, but rather, the attack on our role as the primary supervisor of the health care needs of our patients. Government, third-party payors, and an-cillary institutions have all issued challenges to our role, disguised as improvements in access to care and cost-cutting.

At the Tennessee Medical Association delegates meeting this past month, maintaining our profes-sional integrity was a theme of several resolutions. These actions encouraged our lawmakers to forbid the continued use of the term “medical” in advertise-ment particularly as it relates to “medical“ spas and salons unless a licensed physician is directly involved in the supervision of these businesses. In order to pro-tect our patients further, the delegates asked that the State support legislation to forbid the sale of tanning services to minors at these establishments.

All of us have also been effected by the efforts of our respective medical specialty societies to impose maintenance of certification (MOC) on our practice. Although the intent of these mandates is to improve quality of patient care, there is no good evidence that MOC is any better at achieving this goal over the quality initiatives of individual practices and hospi-tals. As the cost of MOC has become burdensome to the physician, the TMA has asked the State to no longer use MOC as a qualifier for state licensure and hospital privileging.

These are just a few examples of how the Knox-ville Academy of Medicine and TMA are working on your behalf to maintain our professional integrity

as doctors. I cannot thank you enough as members for your continued support of our legislative efforts!

Tommy

K N O X V I L L E A C A D E M YO F M E D I C I N E

Academy OfficersThomas Pollard, MDPRESIDENT

Neil Coleman, MDPRESIDENT ELECT

Ceeccy Yang, MDSECRETARY

Tim Wilson, MDTREASURER

Pat O’Brien, MDIMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhDCEO

Board of TrusteesClif Tennison, MDJeff Ollis, MDDavid Harris, MDMichael Brunson, MDDaniel Bustamante, MD

Ex- Officio Board MembersRandal Dabbs, MDElise Denneny, MDRichard DePersio, MDJerry Epps, MDRobert Page, MDLorraine Johnson -KAMA

PublisherKim Weaver, PhD

EditorJonathan Weaver

Production CoordinatorMargaret Maddox

AdvertisingDavid Caudill

ADVERTISING: For advertising information, call the

Academy offices at (865) 531-2766. The magazine is

published four times per year by the Knoxville Acad-

emy of Medicine (KAM). All rights reserved. This

publication or any part thereof may not be reproduced

without the expressed written consent of the KAM.

The appearance of advertising in KAM publications is

not a KAM guarantee/endorsement of the product or

the claims made for the product by the manufacturer.

The fact that an advertisement for a product, service,

or company has appeared in a KAM publication shall

not be referred to in collateral advertising. The KAM

reserves the right to accept or reject any advertising in

the publication.

P R E S I D E N T ’ S M E S S A G EKNOXVILLEMEDICINE.ORG KAM

KNOXVILLE ACADEMY OF MEDICINE

Calendar of EventsJUNE20 Texas Hold’em Poker Tournament

Casual Pint - Farrgut, 6:30 pm

24 KAM Family Fun Night with theSmokies, Smokies Stadium, 6:30 pm

JULY27 TMA/KAM Payment Reform Roadshow,

UTMCK Heart Hospital Conference Room, 8:00 am

AUGUST19 KAM/KAMA Family Picnic, Gettysvue

pavilion, 5:00 pm

20 Blount County Medical Society PicnicRoyal Oaks Country Club, 5:30 pm

A C A D E M Y N E W S

KNOXVILLE MED CINE | 5KNOXVILLEMEDICINE.ORG


National Doctors’ Day CelebratedEach year on March 30, National Doctor’s Day is celebrated to recog-

nize physicians and their contributions to our communi-ty. The holiday was officially signed into U.S. law in the early 1990s by President George H.W. Bush, however, the history of Doctors’ Day dates back to the early 1930s.

It is believed that the idea of the holiday was first conceived by a physician’s wife, Eudora Brown Almond of Georgia. The very first Doctors’ Day in 1933 consisted of a few doctors’ wives putting together a luncheon for the local physicians in Winder Georgia, northeast of At-lanta. The date of March 30th was eventually chosen to celebrate Doctors’ Day because it is the anniversary of the day that anesthesia was first administered to a patient.

The Knoxville Academy of Medicine Alliance (KAMA) keeps the tradition alive of hosting an annual luncheon for lo-cal physicians. This year, KAMA hosted the Annual Doctors’ Day Luncheon on March 28th at Lakeside Tavern. This year’s guest speaker was KAM mem-ber, Sister Mariana Koonce, MD. Many people are aware of the “Truck Driving Nun” that makes it her mission to go to the rural areas and offer medical as-sistance through the St. Mary’s Legacy Clinic; how-ever, guests at the luncheon were offered insight into how this group was founded, as well as, the history of the area that inspired the project. All that were in attendance enjoyed her visit and were grateful for the presentation.

Region 7 Represented at House of DelegatesThe Tennessee Medical Association recently held the 181st Annual

House of Delegates meeting. Physicians from around the state came together in Murfreesboro, Tennessee to discuss issues important to the practice of medicine. Delegates from the Knoxville Academy of Medi-cine submitted a resolution that would expectantly limit the number of babies born with Neonatal Abstinence Syndrome (NAS) by supporting efforts to require women of childbearing age taking opioids to also use birth control. KAM Member Debbie Christiansen, MD, presented the resolution which was adopted the House of Delegates. KAM Resident Member, Patrick McFarland, MD also addressed the House of Delegates in support of a resolution, which was also adopted, that would increase funding of Graduate Medical Education in an effort to increase the num-ber of resident positions available in the future.

Many thanks to this year’s delegates who represented the Knoxville Academy of Medicine, Blount County Medical Society and the Roane Anderson County Medical Society. This year’s regional delegates included:Knoxville Academy of Medicine:

Debbie Christiansen, MD; James Choo, MD; Elise Denneny, MD; Jeffrey Ollis, MD; Leonard Brabson, MD; Matt Mancini, MD; Neil Coleman, MD; Thomas Pollard, MD; Patrick McFarland, MD; Timothy Wilson, MD; David Gerkin, MD; Richard Briggs, MD; and Richard De-Persio, MD. Blount County Medical Society:

Aaron Bussey, MD and Robert Proffitt, MDRoane Anderson County Medical Society:

Edward Capparelli, MD, George Smith, MD and Kenneth Luck-mann, MD

KAM Member Patrick McFarland, MD addresses the TMA House of Delegates Debbie Christiansen, MD discussess the NAS epidemic


Julia Arana, MD

New MembersA big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine.

JULIA ARANA, MD PEDIATRICSChildren’s Pediatric Group at ETCH2018 W. Clinch AveKnoxville, TN 37916

FARRELL PIERSON, MDCARDIOLOGYGE Health2330 Southern Shade Blvd.Knoxville, TN 37932


No Picture Available

Farrell Pierson, MD

Additionally, we would like to welcome the following new transferred KAM Resident Members: Matthew Allison, MD, Jonathan J. Allred, MD

The Knoxville Academy of Medicinemourns the recent loss of this physician member.

Joseph Delozier, MD4/4/1930 – 4/8/2016Retired from Baptist HospitalInterfaith Health Clinic Volunteer

John Wall, MD 5/13/1937 – 4/1/201647 year memberRetired fromKnoxville Pediatric Associates

The KAM Poker Tournament Continues On...In April, several poker players turned out to enjoy an evening of cards, BBQ and brew at the Casual Pint of Farragut. The evening winners were Dr.

Jeff Fuqua (First Place) whose efforts were rewarded with a gift card to Fleming’s Steakhouse. Second place went to Dr. Mile Wilson who enjoyed a large bottle of Gentleman Jack. The third place winner also received a bottle of Gentleman Jack. Many thanks to the players and, of course, our Texas Hold’em sponsor, Capitol Financial.

Mark your calendar now, sign up online and join us for our next tournament play on June 20th! Beginning poker players are encouraged to attend! Dr. Pollard happily supplies “cheat sheets” upon request. For more information on the Poker Tournament, contact Margaret Maddox, KAM Member Services Director at [email protected] or at (865) 531-2766.

UT Medical Center Names Dr. Jerry Epps Chief Medical OfficerThe University of Tennessee Medical Center recently named KAM member, Jerry Epps, MD, as Senior

Vice President and Chief Medical Officer. Dr. Epps has previously served as Chair of the Department of Anesthesiology with the medical center and UT Graduate School of Medicine. He has more than three decades of experience as an anesthesiologist and also in physician leadership. Dr. Epps will continue to practice anesthesiology at the medical center, in a reduced schedule, so that he may continue to further un-derstand the evolving needs of patients and clinicians. Dr. Epps also currently serves on the KAM Founda-tion Endocarditis Project, as well as maintaining a hospital liaison position on the KAM Board of Trustees. Congratulations Dr. Epps!


Robert Avery, MD 6/14/1938 – 5/24/201645 year member



BME UpdateBy: Reeves Johnson, MD

This past April, 28-30, I served as the delegate from the Tennessee Board of Medical Examiners to the Federation of State Medical Boards Annual Meeting in San Diego. The FSMB as it is called, is made up of 70 state medical boards, both medical and osteopathic in all 50 states, D.C., Puerto Rico, the Virgin Islands and other US territories. It serves as the national resource for the state medical boards in assisting them to promote excellence in medical practice, licensure and regulation.

The Keynote speaker was Vice Admiral Vivek Murthy, our current Surgeon General. Three of the issues he is addressing are opioid abuse, mental health access and physician burnout.

Also discussed was the Interstate Compact, developed by the FSMB, which allows licensed physicians meeting strict qualifications from a member state to be easily licensed in another member state. This will become important as Telemedicine becomes more wide spread as generally, you must be licensed in the state where the patient is located. In 2013, there were an estimated 350,000 telemedicine encounters. It is projected to rise to 7 million by 2018.

To be a member state, that particular state’s legislature has to pass a law incorporating the Compact’s Rules and Policies. So far, 16 states have joined the Compact and several others are in the process. At this point, Tennessee has not begun the process. One concern is that some of the medical practice act would have to be amended. Also, it would

require changing some of the rules of our Board and could allow licensed physicians who have been out of clinical practice for several years to now be able to obtain an unrestricted license.

Regarding this last issue, at the FSMB meeting, I spoke of this con-cern and was told it had been overlooked during the development of the compact and was assured that it will be addressed.

Here in Tennessee, KAM Debbie Christiansen, MD, Melanie Blake, MD (a Chattanooga internist) and I have been appointed to a task force to draft and recommend a policy to the Board outlining possible path-ways for physicians who have been out of clinical practice for a certain length of time to demonstrate or regain competency to resume active clinical practice.

The FSMB is also working to develop a single graduate medical education accreditation system such that MDs and DOs will be able to train in either program and there only be one “Match”.

Another important issue we must deal with in Tennessee has to do with interprofessional collaboration. This is not just pertaining to pri-mary care by replacing an expensive provider with a less expensive one, but much broader addressing issues such as population health manage-ment, community health programs, access quality and cost.

Finally, I was honored by Governor Haslam to be reappointed to the Board for a 5 year term. I certainly appreciate the support of the Knoxville Academy of Medicine and the TMA.

VA Gives Full Practice Authority to APRNsAs anticipated, on May 25th, the Veterans Health Administration

published a Proposed Rule that would give full practice authority to four categories of APRNs: Certified Nurse Practitioner (CNP), Certi-fied Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), or Certified Nurse-Midwife (CNM). The Proposed Rule defines “full practice authority” to mean that an APRN working within the scope of VA employment would be authorized to provide services with-out the clinical oversight of a physician, regardless of State or local law restrictions on that authority. APRNs working outside of VA facilities would remain subject to state laws on APRN scope of practice. Federal preemption will be used to side-step state medical licensure laws such that APRNs who work for the VA will have full authority inside the VA.

It is common knowledge that the VA is under tremendous pressure to reduce the wait times for appointments that veterans are experienc-ing. Consequently, this Proposed Rule was anticipated, and was the subject of many conversations with VA and AMA physician leadership, including AMA Board Members David Barbe, MD and Jesse Ehrenfeld, MD.

At press time, the Knoxville Academy of Medicine has been in-formed that a press release from the AMA to express disappointment in the direction the VA has proposed will be forthcoming. AMA has had a longstanding policy opposing APRN independent practice and intends to comment on the Proposed Rule consistent to that policy. This move by the VA is being applauded by many nursing associations. KAM, Blount, Roane, and Anderson members are encouraged to communicate to the VA with their opposition, as well. The deadline to submit com-ments on the Proposed Rule is Monday, July 25. Written comments may be submitted to http://www/regulations.gov or by mail to:

DirectorRegulations Management (02REG)Department of Veterans Affairs810 Vermont Avenue, NWRoom 1068Washington, CC 20420Faxes are also accepted at (202) 273-9026. Comments should indi-

cate that they are submitted in response to “RIN 2900-AP44-Advance Practice Registered Nurses”

In a medical emergency, every minute matters. So, at Tennova Healthcare, you’ll find faster care in the emergency room. We work diligently to have you initially seen by a medical professional* in 30 minutes – or less. And, with a team of dedicated medical specialists, we can provide a lot more care, if you need it.

Less waiting for emergency care (and a lot more care, if you need it).

*Medical professionals may include physicians, physician assistants and nurse practitioners. If you are experiencing a medical emergency, call 911.

Tennova.com

The 30-Minutes-Or-Less E.R. Service Pledge at Tennova Healthcare.

Trust the team I trust.

91633_PRMC_ER30_8_75x11_25c.indd 1 5/18/16 2:01 PM


A C A D E M Y N E W SKAMKNOXVILLE ACADEMY OF MEDICINE

KAPA’s Boot Scootin’ Ball April 8, 2016

Rodney Atkins comes home for KAPA’s Boot Scootin’ BallOn April 8, country artist and Knoxville area native, Rodney Atkins, performed for KAPA’s Boot

Scootin’ Ball, held at the Knoxville Marriott. The annual event is hosted by the Knoxville Academy of Medicine Foundation and all proceeds benefit Knoxville Area Project Access, also known as KAPA. The event included a private concert by Rodney Atkins, in addition to a southern buffet and bottomless beverages. The silent auction was also a highlight of the evening as this year’s auction boasted of more than 83 packages from which to choose.

The KAPA’s Boot Scootin’ Ball helps continue the work of a much needed program in our area. Since 2006, KAPA has coordinated more than $175 million in donated care to low income individu-als that have no any other access to health care through either government programs or employer-sponsored insurance. KAPA is always looking for physicians to join the fight to serve our neighbors in need. If you are not currently participating in KAPA, contact the KAPA office today at 531-2766.

THANK YOU!Diamond Sponsors

• Covenant Health• Tennova Healthcare• UT Medical Center • SouthEast Bank

Media Sponsors• Bandit Lites• WBIR• WIVK

Gold Sponsors• Alphagraphics• Ole Smoky Tennessee Moonshine• Stages West

Silver Sponsors• Capital Financial Group• East TN Children’s Hospital• Contemporary Women’s Health• Law offices of Ogle, Elrod, and Baril• First Tennessee Bank• Knoxville Comprehensive Breast Center


My Reflection on ResidencyBy: Niva Misra-Sammons, MDPGY3 (Third Post-graduate Year) IM ResidentUT Graduate School of Medicine, Dept. of Medicine

It is hard to believe that the last three years of my life as an Internal Medicine resident will be coming to a close in one month. Graduation is a day I have long awaited over this journey.

Being at the end of my training takes me back to my inspiration to be-come a physician. My late father was a physician and passed away when I was 15. His presence in my life inspired me to go forward and pursue my dream to become a doctor. Although my mom is not a physician, she continually encouraged me throughout my life to work hard in order to reach my goals. In addition, my sister’s determination to be a physician motivated me. I have had physician mentors throughout my life who have encouraged me. I am thankful for these people.

I was fortunate to be accepted to James H. Quillen College of Medi-cine- my first choice medical school. I was blessed to match residency at UT Knoxville Internal Medicine which was also my first choice. My husband, Brandon, also matched at UT and is now an upcoming third year Medicine resident. It has been wonderful to have him by my side to moti-vate me during this challenging time in training.

Residency has not only trained me to become a doctor-It has taught

me much more. I have had three years to work on communication with patients and with medical staff. This practice seems to have paid off, and I am finally feeling confident. Along with good communication, I have learned to be empathetic. I see that anger and anxiety is often coming from a threatened individual and being considerate helps. This same concept has also taught me to be more patient and relaxed. I have seen patience will pay off on a busy day.

One must also be patient when learning the skills of medicine. Internal Medicine, for example, is a wide subject that requires continual studying and practice to gain medical knowledge. I have promised myself that I will work every day for the rest of my career to increase my knowledge. In learning the knowledge, one must develop the characteristic of dedica-tion. Being dedicated takes strength-the strength to work 24 hour shifts and endure the unknown at times. Being strong teaches you that negative feedback sometimes makes you a better person. Strength inspires other people around you which I hope I have done.

Finally, I have learned to be proud of myself. I take good care of my-self with a healthy diet and exercise. I am proud of what I have accom-plished and will continue to work hard to be the best physician I can be.

I will be starting in a hospitalist position with StatCare Hospitalists in September and am very excited to start the next phase of my career serving Knoxville alongside wonderful physicians. I have enjoyed the opportunity to write this column and am thankful to KAM for giving me the opportu-nity.

Here for YOU since 1983

30th P R E S E N T S T H EAnnual Alzheimer’s Disease Management & Research Symposium

Strategies for managing DEMENTIA CARE

For more information please call

865.544.6288 Statewide Toll-free: 888.326.988

Online registration NOW OPEN: www.alzTennessee.org/symposium2016Alzheimer’s Tennessee is offering a special rate of two day’s admission for the price of one for

Knoxville Academy of Medicine members.

at The Clayton Center, Maryville College

Gregory A. Jicha, MD, PhD, is a professor in the Department of Neurology and Sanders-Brown Center on Aging at the University of Kentucky (UK). He holds the Robert T. & Nyles Y. McCowan Endowed

Chair in Alzheimer’s research at UK and is the Director of the Clinical Core of the UK, NIA-funded Alzheimer’s Disease Center. He also serves as the Medical Director for KY Telecare and directs the Telemedicine Cognitive Clinic at UK. He is the principle investigator at UK for the National Alzheimer’s Disease Cooperative Study Group and also serves on the Clinical Task Force and Steering Committee for the National Institute of Aging Alzheimer’s Disease Center Program.

Gregory A. Jicha, MD, PhD Monica Crane, MD

ACCME & CNE Credits Available. Call for details.JUNE 23 & 24

2016

Monica Crane, M.D. is the Associate Director of the Senior Assessment Clinic at Cole Neuroscience Center, UT Medical Center, in Knoxville where she is focused on clinical care, Alzheimer’s disease and related

dementias research and management. She serves on the Board of Directors of Alzheimer’s Tennessee. Dr. Crane completed her residency, fellowship training and research fellowship in Geriatric Medicine at the Hospital of the University of Pennsylvania in Philadelphia where she later held a faculty position. Dr. Crane was the director of the Memory Health Clinic in Charlotte, NC. She has been recognized by the National Institute of Mental Health for New Investigators in dementia research.

UT Chief Medical Officer, Dr. Lacey, Retires

KAM Member, John “Jack” Lacey, III, MD, Senior Vice President and Chief Medical Officer of The University of Tennessee Medical Cen-ter retired recently after nearly four decades of service with UTMCK. Dr. Lacey is a past president of the Knoxville Academy of Medicine and 2011 Recipient of the TMA Outstanding Physician Award.

“Dr. Lacey is not only one of the best doctors and most skilled phy-sicians I’ve known, but he’s also one of the finest individuals I’ve ever had the pleasure of meeting,” said Joseph R. Landsman, Jr., President and CEO of The University of Tennessee Medical Center. “Jack’s com-passion, as well as, his dedication to his patients and our community, is demonstrative of the leadership he has provided to our team members and this campus for nearly forty years.”

In addition to his position with UTMCK, Dr. Lacey was instrumen-tal in the formation of Knoxville Area Project Access (KAPA), a pro-gram of the KAM Foundation, in which he has been the medical direc-tor since its inception in 2006. Dr. Lacey will continue his efforts with KAPA, though retired.

Congratulations on your retirement, Dr. Lacey!


Do you know about these KAMF projects?Knoxville Area Project Access (KAPA) – This program helps to

serve the uninsured of Knox County and is the largest Project Access in the nation. KAPA has a staff that screen potential patients and case manages medical care to those enrolled. This program covers the truly needy who have no other access to care through either government-sponsored or employer-sponsored health programs. Patients are re-evaluated every 90 days to ensure they still meet the guidelines. KAPA also employs the only federally-certified Navigators in a 15 county re-gion to assist the community in finding health insurance for those who qualify for a federal subsidy. KAPA has shown a decrease in emer-gency room visits and provided patient education, thus changing lives and impacting our community. To date, we have facilitated over $175 million dollars in donated health care. Are you a KAPA provider? All KAPA patients can be seen right in your office, eliminating the need to take off work to volunteer. We provide a way that you can give back to the community, help pre-determine your giving goals, and ensure the patient need is valid by screening all applicants. If you would like to participate as a KAPA volunteer, contact Sonnie Campbell at [email protected] or call (865) 531-2766.

East Tennessee Quality Alliance (ETQA) – One of the Founda-tion’s most recent programs is partnering with the University of Ten-nessee Medical Center Knoxville, Covenant Health System, Tennova Healthcare, Children’s Hospital, Blount Medical Center and the Knox County Health Department in a group called East Tennessee Quality Al-liance (ETQA). The ETQA provides a vital forum for healthcare orga-nizations and professionals to collaborate and address health challenges of East Tennessee communities. Successful past projects have includ-ed a Hand-Washing Campaign in Knox County Schools to eradicate MRSA, Hospital Rapid Response Teams, and a Ventilator-associated Pneumonia Project. Currently, the ETQA is working on two important

projects. These projects are Conversation Ready and a new Endocarditis Project.

Conversation Ready - In 2014, the Knoxville Academy of Medi-cine Foundation enrolled with the Institute for Healthcare Improvement (IHI) as one out of 23 pilot sites across the U.S engaging in Conversation Ready. The collaborative project involves area hospitals, providers and other institutions. The IHI is very data driven, so the project includes frequent evaluations of current state and interventions for improvement. The physicians and staff involved are also heavily involved in education oriented towards the providers, the community and patients. The goal is to make advance care plans as much a part of the medical record as allergies. Conversation Ready is also collaborating with etHIN to work towards ensuring advance directives show up in community medical records. In Lacrosse, Wisconsin, where a very similar project has been running for 25+ years, the effort shows results that include close to 90% of the community having advance directives. Nationally, a patient av-erages over 30 days in the hospital in their final two years of life, in Lacrosse, the number is 13 days. Spearheaded by the Gundersen Clinic, the protocol there calls for three “asks.” Once when the patient is young and healthy, again with age > 55 or onset of chronic illness and a third time when a potentially life ending illness is encountered. The Knox-ville Academy of Medicine is very pleased to be part of this national pilot program.

The Endocarditis Project (NEW) – This group has recently begun the task of addressing the drug-related endocarditis cases that are steadi-ly rising. This group realizes that the problem is deeper than a costly heart valve replacement and seeks to find a solution that will increase the success rate. KAM physicians have brought together area hospital administration, Helen Ross McNabb, Metropolitan Drug Commission, and recovery centers to tackle this issue and impact the community.

If you are interested in participating in either of these projects, please contact the KAM office at (865) 531-2766.


©2016 First Tennessee Bank National Association. Member FDIC. www.firsttennessee.com

Medical Private Banking

GIVE YOUR FINANCES THE SAME CARE AS YOU DO YOUR PATIENTSIn today’s uncertain markets, having a bank that tends to your financial health is vital. First Tennessee Medical Private Banking can help with today’s needs and tomorrow’s goals. Our Relationship Managers offer guidance and solutions tailored to medical professionals. So you can focus on your priority: your patients.

To make an appointment with a Relationship Manager, please contact:

Robin Thomas Vice President Medical Private Banking ph: 865-971-2128 email: [email protected]

Michelle Hardin Senior Vice President and Manager Medical Private Banking ph: 865-971-2117 email: [email protected]

Rick Rushing Senior Vice President Medical Private Banking ph: 865-971-2570 email: [email protected]

FTB_WEA_0324_07316_2016_MPB_Print_Prep_Trafficking_8.5x11_4c_DoctorAndChild.indd 1 5/24/16 12:27 PM


Legislative UpdateBy: Elise Denneny, MD

The Tennessee General Assembly has adjourned for 2016 and KAM/TMA was successful on several fronts. Some of these successes included preserving the ability of physicians to provide in-office dis-pensing; relieving physicians of regulatory licensure as a medi-spa for minor cosmetic procedures; establishing reasonable conditions for licensure of pain clinics and addiction treatment centers; heading off the nurse independent practice bill and diverting it into a summer task force; amending over-the-counter oral contraceptives; giving TAG teams in the Tennessee Payment Reform plan a voice in the general as-sembly; and the defeat of Patients for Fair Compensation Bill. Other successes can be found on the TMA website.

Payor Accountability (also known as the Provider Stability Act) almost passed falling short by only a handful of votes. If you recall, this bill was introduced three years ago as an attempt to hold payors accountable to their contractual agreements. Reform was iterated on several fronts. It met severe resistance from the insurance industry to the extent that “exaggerated” actuarial data were promulgated to the legislators. TMA was able to educate legislators to the excessive bar-riers payors present to physicians and their patients and inaccuracies misrepresented by the insurance industry.

Remember success is not always defined as the passage of spon-sored bills. Our voiced opposition to several bills introduced this year prevented further intrusion into the practice of medicine. Specifically I would bring attention to the Patient for Fair Compensation bill.

This bill is the brainchild of Mr. Rick Jackson of Jackson Healthcare (Healthcare staffing) based in Alpharetta, Georgia. He introduced this as a solution to what he perceives as a failed tort system. His proposal is to reinvent reform through a system loosely based on the Workman’s Compensation model. Under this model, patient compensation for neg-ative outcomes will not be measured by “negligence” but rather be mea-

sured by was it “avoidable”? How does one truly define “avoidable” as physicians have less control over the delivery of healthcare than ever before? With each regulatory mandate on physicians and healthcare, comes the inevi-tability of yet another metric or “click” that must be satisfied to payors. At the risk of alarmism, envision the day when the simple task of us-ing a 4x4 sponge will require documenting where it was manufactured, distributed, stored, sterilized, opened, utilized, disposed, etc. With each step there is the element of human error over which the physician has no control. So…was the outcome “avoidable”?

Mr. Jackson’s argument for the need for tort reform is based on the belief that the cost of defensive medicine is a hidden driver, raising the cost of healthcare. This is wrong. Since 2011, with the passage of Ten-nessee tort reform bill, malpractice premiums have dropped 30-40%.

Rising health care costs are at best, only marginally driven by mal-practice premium and defensive medical practice of ordering tests. Larger drivers include, expensive technology, high patient expectation, uncoordinated care, high cost of drugs, unhealthy behaviors (we are get-ting older, sicker and fatter) and expensive end of life care costs.

Finally, Jackson argues his proposal for medical malpractice could create thousands of jobs. That prophesizes yet another administrative layer of bureaucracy… nightmare of red tape that we have already seen realized in Workers Compensation. This would increase the system’s complexity.

Patient for Fair Compensation was opposed by the Georgia Medical Society. Likewise, the TMA and SVMIC believe there is a better way. Physicians should strive to implement systems to protect our patients and value-based care.

The bill has gone to summer study and I encourage you to remind your legislators that Patient for Fair Compensation, as presently con-ceived, will harm efforts to deliver quality value-based care to our pa-tients. If only legislation, as in medicine, be guided by “primum non nocere”.



All KAM Physicians and invitational guests are welcome to join us for a Texas Holdem Poker Tournament.Tournament slots are limited so reserve your slot today!

Entry fee is $50.00 and will benefit Knoxville Area Project Access (KAPA),with the top 3 tournament players receiving prize winnings!

Dinner starts at 6:30 pmTournament starts at 7:00 pm

Register at knoxvillemedicine.org or email Margaret Maddox at [email protected]

Monday, June 20, 20166:30 pm

Casual Pint - Farragut$50 Entry fee


K A M A C O R N E R

By: Barbara Crist, KAMA President

KAMA had good representation at the 88th TMAA Annual Meeting and Convention held in Murfreesboro April 28th - May 1st. KAMA mem-bers Jo Terry, Robin Hutchins, Sandra Huddleston, Cynthia Gash, Jacque Prince, Sheila Barnett, and Barbara Crist attended. KAMA’s own Gail Brabson, TMAA President for the 2015-2016 year, presided over the meet-ing.

Our Philanthropic meeting was held in April and we are very proud that our hard work this past year has enabled us to give $200,000.00 to our com-munity! Health grants and Nursing School Scholarships were recipients of some of these funds. Endowed Nursing Scholarships were established for the UT School of Nursing and TN Wesleyan College Fort Sanders Nursing Dept, as well as one Endowed Medical Scholarship for a UT Medical Stu-dent, thus creating a lasting legacy for KAMA. The funds used to establish the endowments came from the KAMA Philanthropic Endowment Fund at the East TN Foundation (formerly the KAMA Health Discovery Fund).

Our KAMA membership has grown by 15% this year! This was due to a team effort which included several enjoyable membership events throughout the year, as well as members reaching out one on one to friends and acquaintances.

Our May 5th KAMA meeting was a very festive event at the Chero-kee Country Club. It included a Past President’s Luncheon to honor for-mer KAMA presidents for their service and the installation of new offi-cers. Newly installed officers are: Barbara Crist, President; Tina Callicutt, President-Elect; Sharon Griffin, 1st Vice-President; Michele Maves, 2nd Vice-President; Paula Kelley, Recording Secretary; Kirstin Kropilak, Cor-responding Secretary; Sheila Barnett, Treasurer; Swannee Sexton, Asst.

Treasurer; and Sandy Ange, Historian. Presentation of KAMA’s new en-dowed scholarships were given to representatives of the respective nursing schools.

KAMA had a very successful booth at the 5th “Let’s Move Knoxville” event at Victor Ashe Park. Our booth theme, “I Can Be Healthy,” included a game used to teach children about how to be healthy. Juliann Chavez, KAMA Health Promotions Chairperson, designed the activity. KAMA members who participated were Jacque Prince, Poonam Harsh, Michelle Bishop and Barbara Crist.

Looking toward the next few months, KAMA will have several mem-bers attending the annual AMAA Meeting June 12-14th in Chicago. Ad-ditionally, the Third Annual Summer Welcome Picnic, hosted jointly by KAMA and KAM, will be held August 19th (with a rain date scheduled for August 26th) at the lower pool area of Gettysvue Country Club. It’s been a very popular event the past two years, with an excellent turnout! The picnic is open to young physicians and their families in addition to physi-cian families who are new to town. However, if you know of a physician family who you’d like to introduce them to KAMA and KAM, please con-tact Andrea Brown at [email protected] or (865) 531-2766. KAM will be sending out invitations with more details later this summer.

If you would like to learn more about KAMA, visit us on Facebook, follow us on Twitter (KAM_Alliance), Pinterest and on our website www.kamalliance.org

Barbara J. CristKAMA President 2016-2017

Alliance OfficersPoonam Harsh, Barbara Crist, and Juliann Chavez


etHIN’s Clinical Portal...Soon to be Better Than EverAdditional functionality available this summerby: Leigh SterlingetHIN Executive Director

East Tennessee Health Information Network’s (etHIN) clinical por-tal is getting a new name and will offer enhanced functionality to users this summer. etHIN is currently upgrading its core system and expects the improvements to be available to users in July. The clinical portal, currently called the Virtual Health Record or VHR, will now be known as the etHIN Health Information Portal, or eHIP for short.

etHIN continues to respond to its healthcare community’s needs as they have changed during the past several years, driven by evolving patient needs as well as Federal initiatives. We listened to input from the community during our search for system enhancements, and with the upgrade, we will now be able to offer a system that includes Natural Language Processing, analytics, more robust reporting capabilities, and identification for potential gaps in care.

Natural Language Processing, or NLP, is the ability of a computer program to understand human speech as it is written or spoken. In this instance, etHIN’s core system will be able to identify the contents of a

transcribed narrative report, for example, allowing users to search by keyword for information that is in the body of the report. This capability will greatly increase the ability of etHIN users to more easily locate specific data they need without having to search through all the contents of numer-ous reports.

The upgraded system also features fully integrated analytics and enhanced reporting capabilities. With these enhancements, etHIN will begin to offer more reporting options including stronger Quality, eMea-sures, HEDIS and Star reporting to participants that use etHIN.

Analysis for potential gaps in care is another new feature that will be available in the upgraded system that leverages the Natural Language Processing feature within the software. The potential gaps in care list is created as a talking points guideline for providers during a patient’s visit. The list is based on information that has been reported to etHIN; therefore, it is not a definitive list nor does it predict or exclude other patient problems or diagnoses.

The new features offered in the etHIN Health Information Portal could be useful in your daily practice as well as supporting your qual-ity reporting requirements. Contact etHIN at 865-691-8433 for more information or a demonstration.

.

T E C H N O L O G Y N E W SKAMKNOXVILLE ACADEMY OF MEDICINE

Blount County Medical Society Quarterly UpdateDr. Jerome Heiny

We are pleased to welcome the following 18 new members to our group:James D Briggs, MD-East Tennessee Medical Group, David K. Calvert, MD-Blount Memorial Occupational

Health Center At Springbrook, Veronica M Gubatan, MD-Parkway Psychiatric Service, Paul Warrick Miller, MD-Parkway Psychiatric Service, Lee Ellen Naramore, MD-Parkway Psychiatric Service, Stephen Earl Pacifico, MD-East Tennessee Medical Group , Melissa Joy Rodgers, MD-East Tennessee Medical Group, Karen Sawabini Mullins, DO-East Tennessee Medical Group, Bryan Brooks Thompson, MD-Blount Memorial Occupational Health Center At Springbrook, Julia Kristina Wood, MD-Parkway Psychiatric Service, Kristen O. Broadhead, DO-East Tennessee Medical Group, Bruce M. Hairston, MD-East Tennessee Medical Group, Ravindra Narayana Murthy, MD-Smoky Mountain Gastroenterology, James Allen Rigell, MD-Parkway Psychiatric Service, Justin A Bennett, MD-East Tennessee Medical Group, Brett L. Smith, DO-East Tennessee Medical Group, Leonard Scott Sole, MD-East Tennessee Medical Group, Sarah E. Smith, MD-Blount Memorial Weight Management Center

As our membership continues to grow we look forward to a more active medical society. Please join us for a family friendly Summer Cook Out on Saturday August 20th! Save the date and plan on attending as details will follow shortly!

We believe it is essential to understand our clients’ investment goals and provide them the best in financial services.We offer our clients services for:

• Wealth Management• Retirement Strategies• Tax Reduction & Investment Strategies• Investment Strategies

• Business Strategies• Life & Disability Income Strategies• Qualified Retirement Plans• Asset Protection Strategies

Travis S. McCurryPhone: 865.246.1697Cell: 865.556.5873

Travis S. McCurry is a Registered Representative of and offers Securities, Investment Advisory, and Financial Planning Services through MML Investors Services, LLC, Member SIPC, 8 Cadillac

Drive, Suite 150, Brentwood, TN 37027 (615) 309-6300.

ContactJ. Todd Williams

Phone: 865.246.2955Cell: 865.368.1945

J. Todd Williams is a Registered Representative of and offers Se-curities, through MML Investors Services, LLC, Member SIPC, 8 Cadillac Drive, Suite 150, Brentwood, TN 37027 (615) 309-6300.

www.capitalfinancialgroup.net8320 E. Walker Springs Lane, Suite 100 Knoxville, TN 37923

CRN201411-166573


CMS Proposes New Changes to the Provider Enrollment ProcessBy: Jeremy Goolsby, London Amburn, P.C.

On March 1, 2016, Centers for Medicare and Medicaid Services (CMS) proposed new regulations implementing sections of the Afford-able Care Act that would require “Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) providers and suppliers to disclose certain current and previous affiliations with other providers and sup-pliers.” If finalized, the proposed regulations would allow CMS to remove or prevent the enrollment of healthcare providers and suppliers that have attempted “to circumvent Medicare’s enrollment requirements through name and identity changes as well as through elaborate, inter-provider relationships.” The proposed provisions also address other program integrity issues and vulnerabilities, including instances where providers and suppliers avoid paying Medicare debts by re-enrolling as a different entity.

Under the proposed regulations, Medicare, Medicaid, and CHIP providers and suppliers would have to disclose affiliations with provid-ers or suppliers that: (1) currently have uncollected debt to Medicare, Medicaid, or CHIP; (2) have been or are subject to a payment suspen-sion under a federal healthcare program or subject to an Office of In-spector General exclusion; or (3) have had their Medicare, Medicaid, or CHIP enrollment revoked. CMS would then have the authority to deny or revoke billing privileges based on an affiliation determined to pose an “undue risk of fraud, waste, or abuse.” The disclosure of affiliations has a proposed look-back period of five years, and affiliation is defined very broadly to include owning or managing individuals or directors.

Furthermore, CMS would require that physicians or eligible profes-sionals who order, certify, refer, or prescribe any Part A or B service, item, or drug be enrolled in or validly opted out of Medicare. The

documentation of any such orders must be kept and maintained for a period of seven years and the physician must furnish access to such documenta-tion upon request. If this information reveals a pattern or practice of improper ordering, certifying, or prescribing of Medicare Part A or B services, items, or drugs, enrollment may be revoked.

The proposed regulations also place an even higher significance on filing Changes of Information (CHOI). CMS proposes expanded re-vocation authority for failure to report. It would apply to all types of providers and suppliers who fail to submit required CHOI filings, and to all types of enrollment reporting requirements. Providers would be required to submit an 855 CHOI to report new or changed information regarding existing affiliations. Currently, CMS may revoke enrollment if the provider/supplier fails to report a change in its practice location or a final adverse legal action status within 30 days of the change. Un-der the proposed regulations, the revocation authority would apply to failure to report all types of enrollment reporting requirements, not just changes of address and adverse legal actions.

Essentially, the proposed rule seeks to enable CMS “to take action against unqualified and potentially fraudulent entities and individuals” in hopes of deterring other parties from engaging in the same behavior. The rule would go into effect on January 1, 2018. Providers and suppli-ers are encouraged to seek the advice of counsel in regards to how this proposed rule may affect their practice.

Jeremey Goolsby is an attorney with London Amburn, a law firm based in Knoxville, Tennessee, which represents providers in the area of healthcare law, including regulatory, compliance, HIPAA, malprac-tice and nursing home defense, employment, mergers and acquisitions, corporate and business matters. For more information, you may contact Mr. Goolsby at (865) 637-0203 or visit www.londonamburn.com.

Disclaimer: The information contained herein is strictly informa-tional; it is not to be construed as legal advice.

L E G A L N E W SKAMKNOXVILLE ACADEMY OF MEDICINE

HomeFederalBankTN.com

KAM Family Fun Night with the Smokies

Friday, June 24, 20166:30 PM

The Smokies play the Pensacola Blue Wahoos(Cincinnati Reds Double A team)

Tickets Include:• One ticket good for access to the Calhoun’s at the Yard Pavilion• An all-you-can-eat buffet provided by Calhoun’s served 30 min-utes before first pitch

• Smokies baseball cap

Register at Knoxvillemedicine.org

$10 adult$5 children


There are no good reasons for not getting your annual screening mammogram...

But there are plenty of good reasons why you should.

Give us a call at 865-584-0291

www.Knoxvillebreastcenter.com 1400 Dowell Springs Blvd, Knoxville, TN

(865) 540-1650

Robin ThomasVice President

Medical Private Banking 865-971-2128 • [email protected]

©2016 First Tennessee Bank National Association. Member FDIC. www.firsttennessee.com

A BIG Thank You to the Sponsors of KAPA’s Boot Scootin’ Ball!

Dr. Roland Gray Speaks at RACMS MeetingOn May 17th, Roland Gray, MD gave a presentation to the Roane An-

derson County Medical Society and their guests from Region 7 regarding the “Distressed Physician.” The meeting was held at the Event Center at Calhoun’s in Oak Ridge.

Dr. Gray is the Medical Director of the Tennessee Medical Founda-tion’s Physicians’ Health Program and has had extensive experience work-ing with physicians who are burdened by the stresses of the profession. In his presentation, Dr. Gray pointed out that all physicians must deal with the pressures of the position and it is imperative to ask for help when it becomes overwhelming. Many times, manifestations of uncontrolled emo-

tion can range from outbursts within the office to burnout, depression, mar-ital problems, substance abuse, and in extreme cases, even suicide. Often, just the inability to “get-along” with colleagues and the nursing staff can jeopardize hospital privileges which effects our livelihood.

The next meeting of the Roane Anderson County Medical Society will be held in August and will feature special guest speaker, Tommy Farmer, of the TBI. Officer Farmer will discuss ways to stay in compliance with controlled substance prescriptions guidelines and prevent a possible inves-tigation of a medical practice. Time and location details are forth coming.

For more information about RACMS meetings, contact Andrea Brown via email at [email protected] or by calling the KAM at (865) 531-2766.

Edward Capparelli, MD Roland Gray, MD

Medical ProfessionalLiability InsuranceAs we proudly celebrate 40 years of insuring physicians, our commitment to you is stronger than ever.

• Claims handling expertise

• Highly acclaimed policyholder service

• Patient safety education

• Risk evaluation services

• Practice management consulting

800.342.2239 SVMIC.com [email protected]

SVMIC_KnoxAcadMed_Spring2016.indd 1 2/22/2016 2:38:44 PM

* Excludes all options, taxes, title registration, $925 transportation charge and dealer preparation fees. **Available for qualified customers only.

2016 GLE350 SUVstarting at

$51,100 MSRP*

Where brains meet brawn.The 2016 GLE350 SUV. The GLE is more than a luxury SUV – it’s oneof the most intellegent SUVs we’ve ever made, and it’s also a 2016 IIHS Top Safety Pick.

Discover affordable luxury.

Conveniently located at 10131 Parkside Drive.(865) 777-2222 or online at mercedesofknoxville.com.

A 2016 IIHS TopSafety Pick

Membership has itsrewards. Ask us aboutFleet Incentives at

Mercedes-Benz of Knoxville.**

Documents

Summer magazine 2016