Project Access receives $12,500 grant

In Affiliates, Community Health by admin

Project-Access-cmykThe Project Access program has received a $12,500 grant to coordinate care for uninsured Sedgwick County residents who are experiencing serious gynecological health issues.

Through the Wichita Community Foundation, the George R. Tiller, M.D. Memorial Fund for the Advancement of Women’s Health gives grants to nonprofits to “provide comprehensive health services, support, and compassion to vulnerable women to enhance their ability to realize their dreams.” Dr. Tiller, a MSSC member, was slain in 2009.

“This grant will help us coordinate donated health care for many women with critical health issues,” said Shelley Duncan, executive director of Central Plains Health Care Partnership, a nonprofit affiliate of the MSSC. “It will help us connect women most in need of care to doctors, other providers and services.”

Reddy part of breast cancer chemo study

In Feature by admin

Dr. Reddy

Dr. Reddy

MSSC member Dr. Pavan Reddy, an oncologist/hematologist with Cancer Center of Kansas, is among authors of a study that determined that many women diagnosed with early stage breast cancer do not need chemotherapy.

The study of more than 10,000 women found that those who had midrange scores on a 21-gene test, the Oncotype DX Breast Cancer Assay, had similar outcomes with endocrine therapy, including tamoxifen and related medicines, as they did with a combination of endocrine therapy and chemotherapy. Women in the category had recurrent scores of 11 to 25 and their cancer had not spread to lymph nodes, among other factors. The study appeared in the New England Journal of Medicine and can be found at www.nejm.org/doi/full/10.1056/NEJMoa1804710.

Melhorn awarded for child abuse work

In Community Health by admin

Dr. Melhorn

Dr. Melhorn

MSSC member Dr. Katherine Melhorn recently was honored with the 2018 Volunteer Leadership Award from the National Children’s Alliance, recognizing her decades of work in investigating and preventing child abuse.

The alliance is a national organization that helps communities provide a coordinated response to investigating and supporting victims of child abuse and accredits Child Advocacy Centers such as the one in Sedgwick County.

Dr. Melhorn, a pediatrician and clinical professor with KU Wichita Pediatrics, received the award June 10 in Washington, D.C. She was the first child-abuse pediatrician in the state and was integral in creating the Child Advocacy Center of Sedgwick County in 2008.

Earl Mills scholarships available

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The Earl L. Mills Educational Trust is accepting applications from practicing physicians for scholarship funds to support additional study in medicine lasting 4-12 months at an approved institution or to attend local educational seminars offering postgraduate opportunities.

Applicants must have practiced in Kansas for at least five years and be a member of a medical group no larger than five. The deadline is Aug. 31, 2018. To request an application, call Stephanie Clausen with Intrust Bank at 383-1912.

Brown to lead KUSM-Wichita psychiatry

In KUSM-Wichita by admin

KU School of Medicine-Wichita has appointed Rachel Brown as chair of its Department of Psychiatry and Behavioral Sciences.

Brown, who begins her duties July 2, most recently served as associate dean for student affairs, diversity and inclusion officer and professor of psychiatry at Central Michigan University College of Medicine. At KUSM-Wichita, Brown will lead 27 faculty and staff. She succeeds Lyle Baade, who is retiring after 40 years.

Discussing opioids with top doctor

In Community Health, Feature by admin

MSSC member Dr. John Gallagher, Wichita/Sedgwick County EMS System medical director, was in Washington, D.C., May 23 and had the opportunity to speak with U.S. Surgeon General Vice Admiral Jerome Adams about the opioid crisis and steps needed to manage the issue.

MSSC member Dr. John Gallagher, Wichita/Sedgwick County EMS System medical director, was in Washington, D.C., May 23 and had the opportunity to speak with U.S. Surgeon General Vice Admiral Jerome Adams about the opioid crisis and steps needed to manage the issue.

In rush to act on opioids, don’t overlook those in pain

In Feature by admin

By Dr. Jed Delmore, Reprinted from Kansas.com, May 11, 2018

Opioids are all over the news these days. Insurers and regulators are discussing limits on prescriptions, and politicians are pointing fingers.

Though action is needed to curb the misuse of opioids and help those struggling with addictions, we also need to respect and care for people in real pain. And to realize that one-size-fits-all solutions can do harm.

The Medical Society of Sedgwick County recently held a panel discussion for its members on opioid use in Kansas. Panelists were Greg Lakin, an addiction specialist and the state’s chief medical officer; Joe Davison, a Wichita family physician and member of the advisory board of K-TRACS, the state’s prescription-monitoring program; and Daniel Warren, a faculty member at the KU School of Medicine-Wichita specializing in substance abuse.

The panelists noted how Kansas has not experienced the same level of opioid abuse and overdoses as many other states, including several of our neighbors. The drug overdose death rate in Kansas was 11.1 per 100,000 people in 2016, according to the Centers for Disease Control. That was among the lowest rates in the nation.

Opioid overdose deaths in Kansas also have declined in recent years, as has the percentage of prescriptions that are opioids.

It’s also important to note that most of the opioid overdose deaths in the past few years were caused by synthetic opioids, such as fentanyl. And the vast majority of the people abusing opioids don’t get them from their physician.

That’s not to say that the problem isn’t serious. The misuse of opioids is destroying lives and wrecking families.

And contrary to what some may assume, those dying from opioid and heroin overdoses include many people in their 50s and 60s who hold jobs.

“It’s not just the young, careless and wild,” Lakin told Medical Society members.

But in the rush to act, we must not overlook or dismiss those who need help with pain.

As a gynecologic oncologist, I have many patients who experience severe pain, particularly as they recover from major surgery. Family physicians also have patients struggling with chronic, sometimes debilitating pain.

For some surgeries and patients, alternative medications – such as a combination of Tylenol and ibuprofen — can be just as effective as opioids. But for other patients, arbitrary limits on medications can make their difficult lives even harder.

I’m grateful that our state lawmakers and Gov. Jeff Colyer have been proactive in working with physicians and others on policies that make sense for Kansas.

The governor formed a task force, headed by Lakin, to address substance abuse disorders. The Kansas Medical Society and the Kansas Hospital Association also created a joint task force on opioid use.

These groups are carefully studying the opioid issue and are seeking evidence-based solutions.

Action is needed. But it needs to be help patients not harm them.

ProviDRs Care launching doctor-designed NexUS insurance July 1

In Affiliates, Feature by admin

nexus-logo-01webMSSC affiliate WPPA ProviDRs Care is launching a new value-based insurance product, NexUS, on July 1 that is designed to appeal to both physicians and employers.

“NexUS will apply a commonsense approach to the delivery of health care. By encouraging activities shown to create value, we will create an excellent product at a favorable cost,” said WPPA board member Dr. Joe Davison.

“NexUS is primary-care-centric,” said Justin Leitzen, director of network innovations, and has been designed with valuable input from MSSC members, with Drs. Davison, John Lohnes and Dennis Knight leading the effort.

NexUS will allow both employed and independent physicians to participate in a value-based delivery model. It aims to lower health care costs by aligning provider and employer incentives, said Karen Cox, CEO of ProviDRs Care.

“Medicine works best when the physician and the patient work together. NexUS offers a methodology to encourage those relationships and in doing so also brings a benefit for employers,” Dr. Lohnes said.

NexUS is one of several products offered by ProviDRs Care, the only physician-owned PPO in Kansas and one of the few in the country. “Employers have been asking for something like this for years,” Cox said. “It is the direction the industry is going.”

NexUS is not intended to replace fee-for-service, but in addition offers financial incentives in five broader areas – or domains – and providers will be rewarded for their performance.

“Physicians are often worried about accepting downside risk in their practice,” Dr. Davison said. “NexUS will continue to reimburse with their usual fee schedule, but those efficient physicians will receive additional incentives on a per member per month basis.”

The five incentive focus areas are access, utilization, referrals, quality and place of service. A quick way to think of it is making sure members receive the right care at the right time in the right place.

“We are also going to be helping the primary care providers manage their higher-risk patients by providing nurse navigators hired by the network,” Leitzen said. Higher-risk patients are often the major cost drivers in a health care plan.

“By using a carrot instead of a stick approach, we believe significant savings for the health care system can be achieved,” Dr. Davison said. “This very special endeavor by the physicians of Sedgwick County just might be a game changer for our medical practices, patients, and the economic viability of our city’s employers.”

ProviDRs Care has sent letters about NexUS to practice managers and will soon begin contracting with primary care physicians. It will also soon reach out to insurance brokers, consultants and employers to participate in NexUS, which would replace their current health plan.

A strength of NexUS is that KHIN, the Kansas Health Information Network, will provide the clinical data. Because of that robust connection, taking part in NexUS will not burden physicians with additional reporting requirements. Doctors will regularly receive reports including clinical and claims data that will provide a 360-degree view of their patients.

“The intent is to improve care and decrease costs while increasing doctor satisfaction,” Cox said. “Physicians will be able to focus on what they really want to do: helping patients stay healthy.

June President’s Message: Suicide is difficult to talk about and impossible to ignore

In President's Message by admin

delmore-mug-bigby Jed Delmore, MD —

This article cannot start with my usual attempt at being witty. The past few weeks have brought suicide to the forefront for me and, I suspect, all in the community.

While attending the funeral and celebration of life for the child of good friends, I couldn’t help the constriction in my chest and tears of sorrow for the loss of such a wonderful, talented person and the lasting impact that loss would have on her family and all she touched.

Just weeks ago, a front-page article in the Wichita Eagle reported that the Kansas suicide rate had risen 45 percent since 1999, exceeding the U.S. rate. Only four other states exceeded that degree of increase. Within days, news outlets were reporting the deaths of fashion designer Kate Spade and then celebrity chef and author Anthony Bourdain, both reportedly by suicide. Next came the apparent suicide in Wichita of Emily Glass, the stepmother of the little boy, Lucas Hernandez, whose body was found after going missing three months ago.

I suspect that most of us have an impression or notion of what factors would lead someone to be sufficiently desperate to end his or her own life. Those notions are likely overly simplistic.

Within the past year we have been informed, warned and educated regarding the opioid epidemic. These reports have resulted in proposed state and federal legislation, in addition to restrictions placed by third-party and government payers on prescription narcotics. The Centers for Disease Control reported 42,249 opioid-related deaths in the U.S., with an incidence of 10.4 per 100,000 population for all narcotics and 4.7 per 100,000 for prescription ones.

Allow me to put these statistics in perspective. Data from the CDC shows 44,965 suicides in 2016, making it the nation’s 10th-leading cause of death. The incidence of suicide is 13.4 per 100,000 population. For every death from suicide, there are 25 attempts. Men die by suicide 3.5 times more often than women, with males accounting for 7 in 10 suicide deaths in 2016.

In Kansas, 514 suicides were reported in 2016, an incidence of 19.9 per 100,000, placing us 15th in the nation. Suicide in Kansas is the second-leading cause of death for ages 15-44, and the fourth-leading cause of death for ages 45-54. It seems that opioid misuse is an epidemic, while an equal or bigger problem, suicide, doesn’t receive the same attention.

The factors and causes leading to death by suicide are complex. There is no single cause or etiology. A combination of emotional and physical stressors may produce hopelessness, despair and the ultimate decision to end one’s life. Although mental health conditions including depression, bipolar disorder, anxiety disorders, substance abuse and schizophrenia may be risk factors, almost 50 percent of deaths by suicide occur in those without a documented mental health disorder.

What can we do? As physicians, health care providers and members of the human race, we should be observant and caring regarding those around us. There are multiple organizations, websites and helplines with lists of actions, behavior and changes in personality that raise concern.

Perhaps of greatest help is the ability to mention the word “suicide.” Asking about suicide does not precipitate the action. If someone we know or care for appears to be barely holding it together, asking if they have considered suicide may result in a call for help and action on our part.

Young doctors group kicking off with mixer at Third Place Brewing

In Feature, Meetings/Events by admin

juneyoungdocmixerThe MSSC’s new young physicians group will go public with a June 19 mixer at Old Town’s Third Place Brewing.

The new group is spurred by MSSC members Drs. Chuck Coffey, Braden Foster and Katie Rosell, and is intended to provide an avenue for young physicians to network and become involved as they navigate the practice and business of medicine early in their careers.

“I like the idea of just getting out and seeing other physicians,” said Dr. Rosell, who went into practice with Neurology Consultants of Kansas last summer.

The June 19 mixer is at Third Place Brewing, where Dr. Tom Kryzer is a co-owner. Dr. Kryzer will tell about brewing and provide a tour as part of the event, which features free beer, of course. Future events will include a joint mixer with the Wichita Bar Association’s Young Lawyers group in September.

This year, Dr. Foster is the recipient of the MSSC’s Dr. Joe Meek Award and is engaging in leadership-building opportunities. He sees both collegial and professional benefits from the group and the MSSC at large.

Dr. Coffey

Dr. Coffey

Dr. Foster

Dr. Foster

Dr. Rosell

Dr. Rosell

“Something I realized when I got out of residency was that medicine involved an ever-changing path. You either need to be part of that, or you’re going to be left behind,” he said.

As the father of two young children and the spouse of a physician, Dr. Foster knows that finding time is challenging. “The most beneficial thing is the networking, not only in your specialty but in other subspecialties as well. You can learn about insurance trends, medical legal issues and hospital matters, for example.”

“I have friends who are general surgeons, who are obstetricians, who are in other specialties. There is power in numbers. If we are able to get outside the natural environment, on a personal level, it helps strengthen the bonds,” Dr. Foster says. In an age of hospitalists and specialty clinics, some traditional venues for meeting colleagues have been lost. “We are trying to re-establish some of that, the
commonality of physicians. That’s kind of what we are trying to achieve in the group.”

Dr. Rosell said she, understandably, is likely more familiar with the MSSC than other doctors her age, as her father, Dr. Bart Grelinger, is a past president and her father-in-law, Jon Rosell, used to be executive director. She appreciates the mix of MSSC programs, advocacy and opportunities to meet other doctors, and thinks other young physicians might as well once they learn more. And that’s a goal of the group and events like the June 19 one.

“The Medical Society has always been very receptive to members suggesting programs and initiatives,” said Dr. Rosell, a mother of two. “Physicians have a voice in that, but you have to be there telling them what you need.”

Wyatt-Harris chosen 2019 president-elect

In Affiliates by admin

Dr. Wyatt-Harris

Dr. Wyatt-Harris

MSSC members elected Dr. Patricia Wyatt-Harris as the society’s president-elect for 2019, with results announced at the May 1 members meeting. Others elected for 2019 are:

Secretary: Christina Nicholas

Treasurer: Fadi Joudi

Board of Directors (three-year terms): Nicholas Brown, Jennifer Jackson, Zachary Kuhlmann

Membership & Ethics: Thomas Moore, Krista Shackelford

Opioids panel discussion draws big crowd

In Community Health, Feature by admin

Drs. Greg Lakin, left, and Joe Davison were among panel members.

Drs. Greg Lakin, left, and Joe Davison were among panel members.

Reflecting the concern about the opioids issue and the difficulties physicians encounter wrestling with it, about 140 doctors and others came out May 1 to hear a panel of MSSC members share their expertise at “Opioids: A Closer Look.”

During the program at Distillery
244 in Old Town, MSSC President Dr. Jed Delmore moderated a panel discussion by Drs. Greg Lakin, an addiction specialist and the state’s chief medical officer; Dr. Joe Davison, who has served on the K-TRACS advisory board since its inception; and Dr. Daniel Warren, a faculty member at KUSM-Wichita specializing in substance abuse.

Dr. Delmore shared how pain medications are a fact of life in his gynecological oncology practice and gave an overview of the opioid crisis in Kansas and nationally. He shared statistics on deaths, addiction and how addicts obtain drugs, with the intent of establishing “where we fit into the big picture.”

Dr. Lakin elaborated on where Kansas stood nationally, noting “Kansas has avoided the crisis to a certain extent. Our overdose deaths have actually gone down.” Still, he said, drug poisonings are the leading cause of unintentional death. Addiction, he said, is “not just a poor man’s disease.” Overdose deaths come among people in their 30s, 40s and 50s, ones holding jobs and functioning to some extent. “It’s not just the young, careless and wild.”

The state and other entities, such as a joint KMS-KHA task force, are pursuing strategies to contend with the issue, and Dr. Lakin said physician involvement in the matter was essential.

Dr. Davison explained how the K-TRACS monitoring program came about, noting a local “pill factory” heightened awareness and “this community of physicians said something had to be done.”

K-TRACS has been increasingly effective in finding “threshold patients” who visit multiple doctors and pharmacies. Now, K-TRACS is planning to provide physicians with a scorecard of dosages, frequency and other factors. It’s a work in progress but worthwhile, he said. “We do not look into your offices and your charts,” he said.

When abuse concerns arise, Dr. Davison urged colleagues to help patients find treatment or otherwise work to manage the situation. “Don’t just dispose of that patient,” he said.

Dr. Warren expounded on that point. By the time a patient arrives in treatment, they have often lost nearly all their healthy connections – job, family, friends – so the specialist’s focus is to help them
reconnect. “Our patients come expecting to have a road forward offered,” he said. A lack of treatment options is a challenge, he said, with many Kansas counties lacking programs and methadone programs available only in just Wichita and a few other cities.

The evening concluded with audience questions. Queries included whether midlevels should prescribe narcotics (depends on practice focus, Dr. Davison said); whether fentanyl deaths were specifically tracked (working to improve, Dr. Lakin said) and whether chronic pain was real and if opioids were necessary to treat it. The chronic pain issue brought forth a range of opinions on that point, with panelists largely agreeing that in many cases it was valid.

Dr. Lakin urged physicians to stay involved in policy matters. Lawmakers “want to do something,” and if doctors do not lead, there’s the chance the void could be “filled with things we don’t like.”

 

Opioid treatment training May 24

In Community Health, Meetings/Events by admin

Dr. Warren

Dr. Warren

KUSM-Wichita faculty member Dr. Daniel Warren is among the presenters at a May 24 seminar providing Medication-Assisted Treatment Training.

The free seminar is sponsored by KUSM-Wichita and the Substance Abuse Center of Kansas. Other presenters are Dr. Tim Scanlan and Chad Harmon, clinical care manager at SACK. The seminar has morning and afternoon sessions, with lunch provided.

The morning session, 8 to 11:30 a.m., will focus on the opioid epidemic in Kansas, as well as models for treatment. The emphasis for the afternoon session, 12:30 to 5:30, is on treating addiction with buprenorphine. The sessions will be in Roberts Amphitheater at the medical school, 1010 N. Kansas. Parking will be available in the lot at the northeast corner of 10th and Minnesota.

Application for up to 7 hours of CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

Signup for the morning and afternoon sessions is separate. For the morning one, go to SACKSEMINAR.eventbrite.com. For the afternoon, go to SACKBUPRENORPHINE.eventbrite.com.