Georgia Obstetrical and OBGyn News Gynecological Society, Inc. PROMOTING EXCELLENCE IN WOMEN’S HEALTHCARE in GEORGIA APRIL 2015 • VOLUME 9, NUMBER 2

GA Legislation Gives OBGyns study committee. The committee will meet between now and the 2016 session to review a number of components that First Medicaid Increase in 14 Years are leading to diminishing care for women Anne Patterson, in Georgia. This includes low Medicaid GOGS President, Atlanta reimbursement, concerning maternal and infant mortality rates, high repeat t the same meet, leading to increased closures teen pregnancy, inadequate numbers and time as throughout the state. funding of OBGyn residency education AEmanuel Having been warned for a number slots and intimidating political climate and Medical Center of years that other factors. in Swainsboro, not only were Codes Targeted for Medicaid increase: The Society GA announced maternal Possible Approx. will support Procedure Code w/ closure of its labor and delivery unit health statistics Fee Increase the committee description for June 2015, the Georgia Legislature worsening, Amount by identifying budgeted the first Medicaid increase for but access to experts to speak obstetrical care in 14 years. Fees for OB care was 59400 - Obstetrical Care $330 on various topics and to educate six commonly used obstetrical codes are declining, 59425 - Antepartum Care only $180 approved for increase in 2015. the Georgia the committee. Closure of the Swainsboro OB Legislature 59426 - Antepartum Care Only $350 Hopefully, this unit will make the 32nd labor and has finally will lead to delivery unit closure in Georgia. Most taken heed. 59510 - Cesarean Delivery $220 improved health are in rural Georgia, leaving large In addition to 59610 - VBAC Delivery $360 policy making geographic areas of the state without the Medicaid and renew focus access to obstetrical care. With 60% increase, which 59618 - Attempted VBAC Delivery $260 on the important of deliveries covered by Medicaid, hopefully will be issues needing both OBGyns and hospital OB units one of several over the next few years, the to be addressed in women’s health. are having difficulty making ends Senate has proposed a women’s health While the Legislature has approved additional fees for obstetrical care, Governor Deal must still approve the budget and the CMOs must process the new reimbursement levels; so, it may be a while before physicians will see the increase implemented.

in this issue GA Legislation Gives OBGyns Medicaid Increase ...... 1 An Obstetrician’s Greatest Fear...... 2 Robot MIS Surgeries...... 3 Legislative Day at the Capitol Highlights...... 4 2015 Winter Symposium Highlights...... 5 Third Trimester Testing for HIV and Syphilis in Georgia...... 6-7 LARC Trainings Ramp Up in 2015...... 8 News from Around the State...... 10-11 Administrative Office 2925 Premiere Parkway, Suite 100 Duluth, GA 30097 Telephone: 770 904-0719 After many trips to the Capitol by Society members, testimony before various committees, Fax: 770 904-5251 and distributing pages of facts, figures and maps documenting the decline of OBGyn care, www.gaobgyn.org the Georgia Legislature approved a Medicaid fee increase for OB care. OBGyn NEWS, April 2015 OBGyn NEWS, April 2015 www.davincisurgerycommunity.com offers a wealth of information from Robot MIS Surgeries the manufacturer. Editor’s Column In summary, robot assisted surgery is a welcomed innovation for my practice. Cyril Spann, MD Those performing more challenging benign An Obstetrician’s Greatest Fear Guest Columnist, Atlanta, GA hysterectomy, endometriosis, pelvic reconstructive, or myomectomy cases will or me, the single most unnerving pounded, my chest tightened, and he past 20 years have witnessed a procedures with all instrumentation can particularly find this technology useful. For aspect of practicing medicine is sweat moistened my hands and brow. rapid surge in the use of minimally be performed through one small 3cm peri- best surgeon satisfaction, be certain to the possibility of being sued. While Based on the origination of each letter, I invasive surgery (MIS) to perform umbilical incision. The improved single F T maintain a critical volume, attend courses I have learned how to best manage anticipated no good news. abdominal gynecologic procedures. site technology for the new platform is and participate in discussions with both myself during the process, I still Holding my breath, I ripped open the Abdominal MIS includes laparoscopic due out later this year. experienced and novice surgeons. It is also cringe when I think of medical liability. first letter. It was a letter requesting approaches to perform myomectomy, For those in practice, the extremely beneficial if multiple specialties Although I have been counseled records from a patient who had been hysterectomy, adnexal procedures or decision to pursue robot training is at your hospital have a vested interest in repeatedly not to do so, I absolutely in an automobile accident. Whew, reconstructive surgery. MIS provides dependent on several factors. The maintaining a lively, viable robotic program. take it personally. It is a horrific event one down, two to go. The malpractice patients a shorter recovery time, less American Association of Gynecologic The Intuitive Surgical representatives are that you often never see coming. carrier’s letter included the annual wound infection, less blood loss and Laparoscopists (AAGL) published a friendly, approachable and always willing And, the last person that you might delivery of my Certificate of Insurance better cosmesis. special article outlining guidelines for Al Sermons, MD to facilitate your development as a robotic forms. Excellent! The Robot assisted privileging Robotic- Editor surgeon. As a GOGS member, please feel free final letter from the surgery has gained Assisted Gynecologic Atlanta, GA Training Requirements to reach out to me if you have any questions IRS was requesting sustained traction Laparoscopy. • Complete online training module related to robotic surgery. I look forward to additional information as an innovative Prerequisites include • Observe a live robotic assisted seeing you at our May Golf Tournament or from a previous year’s alternative to that the surgeon surgical procedure August Annual Meeting. tax return. I exhaled! thereof of similar letters. Perhaps others standard “straight should perform ______I sat down, shaken have not received such notices as stick” laparoscopy. Its • Complete 2 hours of bedside at least 20 major References and relieved that I had simultaneously as I have, but certainly advantages include training by a qualified trainer for gynecologic cases American Association of Gynecologic Laparoscopists. docking and bedside assisting Guidelines for privileging for robotic-assisted dodged three bullets. with equal impact. The feeling of better articulation per year competently gynecologic laparoscopy. J Min Inv Gyn. 2014; My sense of dread lifted, impending doom and utter physical pain (wristing) of the • At least one hour of dry lab in and complete several 21(2):157-67. DOI: http://dx.doi.org/10.1016/j. but I was perturbed by following the “notice” is life-changing. It instruments, 3-D inanimate training aids requirements. jmig.2014.01.024. Madhuri TK, et al. Robot-assisted surgery in my physical reaction to instills a fear that never goes away…fear viewing, elimination • Live animal laboratory course These include gynaecologic oncology-starting a program and initial “what might have been.” of another notice…fear that lingers, and of tremor and better • Robot simulator proficiency case observation, learning curve from a UK tertiary referral centre: The Guildford perspective. Int j Med Robotics What if it had been which can be ignited by the mere sight control by the Source: J Min Inv Gyn. 2014; 21(2) privileges to perform notification of another of what appears to be official letters. surgeon. Potential the procedures the Comput Assist Surg. 2012; 8:496-503. Iavazzo C, Gkegkes ID. Single-site port robotic- lawsuit? What if my Yes, the probability of a malpractice disadvantages are the learning curve surgeon is hoping to perform with assisted hysterectomy: A systematic review. Arch malpractice premium suit is most likely the greatest fear any for surgeon, anesthesia, and nursing the robot, and a Gynecol Obstet. 2014; 289:725-31 had escalated, or even practicing physician experiences during staffs, and, additionally, the initial good standing on have expected is almost always the worse, been canceled? How would I his professional career. outlay of fixed costs to purchase the the medical staff initiator. Accusations of malpractice manage another malpractice suit, when Recognizing the need for professional technology and maintenance contract. (see box). Most are painful. Medical liability suits hurt. my response to the mere possibility of peer support, most malpractice carriers Variable costs are incurred with importantly, the The litigation process intrudes on every such had just sent me into a tailspin? have established programs to support instrument use per case. surgeon must aspect of the physician’s life, and can My heart rate decelerated, and I doctors who are going through the The robot is thought to further reduce realize the training cause public humiliation, negative took a few minutes to reflect on the litigation process. The emotional post-op pain and blood loss when is a long-term publicity, self-doubt and outright past three decades of my medical impact of a lawsuit on one physician compared to standard laparoscopy. It commitment, and Physician led, physical pain. career. I recalled past incidents (much can be lessened by involvement with is particularly useful when the patient AAGL recommends peer-to-peer Recently, I slipped into the doctor’s like today’s) that had resulted in my another physician who has been is obese, has altered anatomy or a minimum of 20-25 lounge at the hospital for a quiet personal involvement with lawsuits. there and experienced that. One adhesions, or when exact technique is cases per year to education in moment of relaxation during a I remembered how the incidents such program is the Doctor2Doctor required for dissection in the case of maintain proficiency. busy day. I was barely seated when compelled fear to patrol my innermost Peer Support program created by advanced endometriosis or cancer. It is probably best your office I overheard a colleague (from a thoughts and concerns for the practice Mag Mutual. Similar programs are Surgeons who utilize robot technology to have a “buddy”  Breastfeeding different specialty) cursing to another of medicine. I allowed my breathing to established by most insurance carriers, also cite the ergonomic advantages of to learn with, Program physician about a recent malpractice return to normal. Then, I recalled the and physicians should check with their sitting instead of standing. Protracted thereby expanding suit. Even though I was not personally most important thing. I remembered individual carriers for more information. standard laparoscopy procedures often case exposure over  Immunizations included in the conversation, my the positive, life-changing outcomes Regardless of what the attorneys tell require the surgeon to stand in awkward a short period of Program stomach lurched at the mention of experienced by numerous families you, it is indeed personal! positions, sometimes leading to back time and improving the word malpractice. because of my decision to practice ______or neck discomfort. The assistant can the learning curve. Earn CME & contact hours Later that afternoon, I stopped by medicine. I reconfirmed (to myself) that References also sit at the bedside. The procedure Continued proficiency American College of Obstetricians and To schedule a program for your office call my office to pick up the weekend I am very good at what I do! And, then Gynecologists. Coping with the stress of medical I perform primarily is staging for is documented by mail. The stack of letters was small, I let the rivers wash over me, flooding professional liability litigation. Committee Opinion endometrial cancer, and the patients simulator training EPIC Breastfeeding: 404-881-5068 consisting mostly of advertisements me with a total sense of rapture, as I No. 551 (replaces Opinion No. 497). Obstet tend to have BMI greater than 35. The and patient EPIC Immunizations: 404-881-5054 with only three pieces that appeared fully embraced the fact that “I make Gynecol 2013:121;220–2. robot greatly facilitates these procedures outcomes. There is Kane CK. Medical liability claim frequency: A 2007- or visit www.GAepic.org important. The sender’s return address a difference” in more ways than not. 2008 snapshot of physicians. American Medical in comparison to standard laparoscopy a web resource at on the first letter was from a local law Neither an adverse outcome nor a Association, http://asts.org/docs/default-source/ and recovery is impressive. I often www.robotictraining. to complete a request form. firm, McKormick, Milfort, and Jackson, malpractice suit can erase that fact. legislative/medical-liability-claim-frequency---a- discharge patients home the same day. org. It is well 2007-08-snapshot-of-physicians.pdf?sfvrsn=4. This program is available to your practice free of charge. LLP. The second envelope was sent While the larger majority (98.5%) Intuitive Surgical rolled out a new balanced and offers Economic and Health Policy Research, August The Georgia Chapter of the American Academy of Pediatrics is accredited by the Medical Associ- by my malpractice carrier, and the of all medicine is practiced safely and 2010. Accessed March 30, 2015. robot system in 2014 which allows easy recommendations ation of Georgia to offer continuing medical education to physicians. The Georgia Chapter of the third was from the Internal Revenue effectively, that statistic does little Sermons A. Doctor 2 doctor peer support program. access to both the upper and lower for training and American Academy of Pediatrics designates this Live Activity for a maximum of AMA PRA Service (IRS). The perfect trifecta! The to lessen the prospect of malpractice Georgia Obstetrical and Gynecological Society. abdomen with improved technology becoming proficient Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of OBGyn News. 2012;6(3);4. their participation in the activity. room became uncomfortably warm as litigation for physicians. As practitioners, for single site use. Single site surgery with robot assisted This continuing nursing education activity was approved by the Georgia Nurses Association, an I fumbled through the mail. My heart we have all gotten “the notice” or hints diminishes trocar injury because the surgery. In addition, accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

2 3 OBGyn NEWS, April 2015 OBGyn NEWS, April 2015 Legislative Day at the Capitol Highlights 2015 Winter Symposium Thank you to all the OBGyn physicians who attended Legislative Day at the Capitol on The joint Winter Symposium of the Georgia OBGyn Society and the Georgia Chapter American Academy of Pediatrics March 5, 2015. Many Georgia representatives attended the event and it was was held February 21, 2015 at the Atlanta Airport Marriott. Seminar highlights included presentations on the state of maternal and child health in Georgia; LARCs in preventing teen pregnancy; neonatal withdrawal syndrome; a tremendous opportunity to advocate for OBGyns and women’s healthcare. HIV/AIDS in women, newborns and children; and HPV vaccine successes and failure.

Dr. Nancy Cook talked with Dr. John Moore advocates for OBGyns Dr. Cathy Bonk spoke about the GA Dr. Cyril Spann and Drs. Rana Chakraborty and Dr. Atul Khurana presented information Rep. Margaret Kaiser. with Rep. Chuck Martin. Perinatal Quality Collaborative. Dr. Jane Ellis visit during a break. Martina Badell spoke about HIV/AIDS. on neonatal withdrawal syndrome.

Dr. Roland Matthews was ready to talk with legislators at the Capitol.

WinSym presenters Dr. David A. Levine and Dr. Cathy Bonk, Dr. Eveline Johnson, GOGS President Anne Patterson and GA DPH Dr. Melissa Kottke Dr. Anne Patterson, Pat Cota, Commissioner Brenda Fitzgerald answered Drs. Eugene and Mardi Schaufler Dr. David Byck brought several residents talked about LARCs. Dr. Robert Wiskind and Rick Ward. questions at Winter Symposium. talked with legislators at the Capitol. from Memorial Health UMC in Savannah. SAVE THE DATE 2015 GOGS Annual Golf Tournament Dr. Ruth Cline talked with Dr. Byck visited with Rep. Matt Dollar discussed Rep. Chuck Williams. Rep. Butch Parrish. women’s health care with Dr. Winifred Soufi. Wednesday, May 13, 2015

Bear’s Best, Suwanee, GA String hole and mulligan funds will benefit the new GOGS Foundation. If you would like to be assigned to a team, or if you have additional questions, contact the Society,

Leadership of primary care physician groups Dr. Hugh Smith visited with Reps Drs. Carla Roberts and Andy Toledo pose with Governor Nathan Deal Johnnie Caldwell and Harry Geisinger had lunch with Rep. Sharon Cooper. 770-904-5293 (front row center). during lunch.

4 5 OBGyn NEWS, April 2015 OBGyn NEWS, April 2015

as early as possible during each pregnancy unless they specifically Third Trimester Testing for HIV and Syphilis decline. ACOG also recommends repeat third trimester and/ in Georgia – Better Late than Never! oGr rapid HIV testing at labor and delivery in areas with high Rana Chakraborty, MD, PhD, FAAP, Atlanta, GA HIV prevalence, in women known to be at high risk for HIV arly diagnosis and treatment of feeding with premasticated food. the nation for the total number of acquisition, and in women who human immunodeficiency virus Guidelines addressing these specific new HIV diagnoses. Among all races/ previously declined testing earlier E(HIV) reduces associated morbidity interventions are updated annually ethnicities, African-American/non- in pregnancy. Rapid testing is and improves individual survival. In the by The Department of Health and Hispanics accounted for the majority recommended for women in labor mother-infant dyad, early detection of Human Services Panel on Treatment of these diagnoses: 55% of new HIV with undocumented HIV status.9 maternal HIV infection and treatment of HIV-Infected Pregnant Women and infections and 70% of Stage 3 (AIDS). An area with high HIV prevalence with antiretrovirals (ARVs) antenatally Prevention of Perinatal Transmission, Seventy-two percent (26,735) of HIV is a jurisdiction in which prenatal significantly reduces vertical a working group of the Office of AIDS cases among males were attributed to screening identifies at lest one transmission. Research Advisory Council.2 These the MSM transmission category and 72% HIV-infected pregnant woman per Recommendations for HIV screening, evidence-based guidelines reflect the (8,929) of cases among females were 1,000 women screened.6 Georgia treatment of pregnant women and standard of care for the U.S. and are attributed to heterosexual contact. The is a high prevalence jurisdiction. prophylaxis to prevent perinatal available from the AIDSinfo website overwhelming majority of females were of Pregnant women at high risk for transmission of HIV have evolved in (http://aidsinfo.nih.gov). childbearing age. HIV acquisition include those the United States over the last three This article examines the pivotal role diagnosed with another STI within decades, so the rate of perinatal of universal prenatal HIV counseling Routine HIV Screening the last year, injection drug use transmission has dramatically and testing in this care continuum and The CDC recommends screening all or the exchange of sex for money decreased from 25% in 1992 to a Georgia bill that has recently been subjects aged 13–64 years in health or drugs, a new sex partner less than 2% today.1 Interventions passed by the state General Assembly care settings to identify those with or more than one sex partner testing. Additionally, every physician University School of Medicine and is include universal prenatal HIV relating to HIV and syphilis screening undiagnosed HIV infection.6 In May 2014, during the current pregnancy, or sex and health care provider who provides Medical Director of the Pediatric center at counseling and testing; antiretroviral during pregnancy. the Committee on Gynecologic Practice partner(s) known to be HIV positive or prenatal care of a pregnant woman the Grady Infectious Disease Program. chemoprophylaxis antenatally, during at the American College of Obstetricians at high risk. during the third trimester of gestation ______labor and delivery and postnatally; The Epidemiology of HIV Infection and Gynecologists (ACOG) updated their shall offer to test such pregnant women References scheduled cesarean delivery, and in the U.S. and Georgia recommendations on HIV screening.7 Prenatal and Perinatal HIV for HIV and syphilis at the time of first 1. Nesheim S, Taylor A, Lampe MA, et al. A framework Management for elimination of perinatal transmission of HIV in avoidance of breastfeeding and infant Between the years 2006-2009, In line with CDC guidelines, the first examination during that trimester or as the United States. Pediatrics. 2012;130(4):738- the Centers for recommendation the Committee made In the event of a positive rapid test soon as possible thereafter, regardless 744. Available at http://www.ncbi.nlm.nih.gov/ Disease Control was for routine HIV screening of females during labor, ARV prophylaxis should of whether such testing was performed pubmed/22945404. and Prevention age 13–64 years at least once in their be initiated immediately with oral ARVs during the first two trimesters of 2. Public Health Service Task Force. Recommendations for use of antiretroviral drugs in pregnant (CDC) estimated lifetime and annually thereafter based on (if possible), parenteral zidovudine, her pregnancy.” HIV-infected women for maternal health and approximately factors related to risk. The College joined and neonatal prophylaxis with oral In addition, the bill states, “If at the interventions to reduce perinatal HIV transmission 40,000–50,000 the Institute of Medicine in endorsing ziodvudine and nevirapine, without time of delivery there is no written in the United States, 2014. Committee on The new HIV infections opt-out screening where the patient is waiting for the results of confirmatory DHHS Panel on Treatment of HIV-Infected Pregnant evidence that an HIV test or a syphilis Women and Prevention of Perinatal Transmission, occurred notified that HIV testing will be performed HIV testing. A positive HIV test during test has been performed, the physician U.S.A. http://aidsinfo.nih.gov/contentfiles/ annually in the as a routine part of (most often) obstetric routine clinic screening should be or other health care provider in lvguidelines/perinatalgl.pdf United States.3 care without the requirement for written followed up by additional testing, attendance at the delivery shall order 3. Prejean J, Song R, Hernandez A, Ziebell R, Green Worryingly, 18% consent. HIV testing was previously including CD4+ T cell count, HIV T, Walker F, et al. Estimated HIV incidence in that a sample of the woman’s blood the United States, 2006–2009. HIV Incidence of all infected performed using enzyme immunoassay viral load and resistance testing, and be taken or a rapid oral test for HIV or Surveillance Group. PLoS One 2011;6:e17502. individuals are followed by confirmatory Western blot or screening tests for hepatitis C antibody, syphilis be administered at the time of 4. Centers for Disease Control and Prevention. unaware of their immunofluorescence testing with results hepatitis B surface antigen, syphilis, the delivery except in cases where the Monitoring selected national HIV prevention and underlying HIV not available for 24–48 hours post- complete blood count and baseline woman refuses the testing.” care objectives by using HIV surveillance data— 4 United States and 6 U.S. dependent areas—2010. status. This figure testing. A rapid HIV test is a screening chemistries with liver function tests HIV Surveillance Supplemental Report. 2012;17(No. includes <200 test commonly used in many settings and before prescribing appropriate ARVs.2 Comment 3, part A). Atlanta, GA. Available at: http://www. infants infected by centers because of a rapid turnaround This bill is to be welcomed and cdc.gov/hiv/pdf/statistics_2010_HIV_Surveillance_ Report_vol_17_no_3.pdf. mother-to-child time for results, ideally within an hour. Georgia Assembly Changes Office supported by the medical community in 5. Centers for Disease Control and Prevention. HIV 1 Code Regarding HIV Testing transmission. Rapid tests include those performed Georgia. It reflects recommendations surveillance report. 2011; vol.23. http://www.cdc. HIV infection is outside a laboratory like an oral swab test The 2015 Georgia legislative General of ACOG and other national medical gov/hiv/topics/surveillance/resources/reports/. a significant public obtained in an outpatient setting. The Assembly amended Chapter 17 of Title organizations, including the Institute of Published February 2013. health concern tests currently approved by the United 31 of the Official Code of Georgia so Medicine, and has been the standard of 6. Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised recommendations in Georgia. As of States Food and Drug Administration it now reads, “relating to control of care for most other states in the U.S. for HIV testing of adults, adolescents, and pregnant December 31, 2012, range in specificity from 93% to 100% venereal disease, so as to require that for a number of years. By identifying women in health-care settings. Centers for Disease the HIV prevalence with a sensitivity of 98.6–100%.8 A physicians and health care providers HIV-infection in a pregnant woman Control and Prevention (CDC). MMWR Recomm Rep 2006;55(RR-14):1–17; quiz CE1–4. rate in the state positive rapid test result must be offer HIV and syphilis testing of during her third trimester, not only can 7. American College of Obstetricians and (508 per 100,000) confirmed with additional testing. A pregnant women in their third trimester the mother receive treatment for HIV Gynecologists. Routine human immunodeficiency was almost twice negative rapid test result does not require of pregnancy.” infection with life-saving combination virus screening. Committee opinion No. 596. Obstet the national rate any additional testing. Obstetricians/ The wording from the bill further antiretroviral therapy, but infection can Gynecol. 2014;123:1137–9. (285 per 100,000 gynecologists using these tests must be states, “Every physician and health care be prevented in the infant. Two lives can 8. Greenwald JL, Burstein GR, Pincus J, Branson B. A rapid review of rapid HIV antibody tests. Curr Infect population, year- prepared to provide counseling to women provider who assumes responsibility for potentially be saved through one rapid Dis Rep 2006;8:125–31. 5 7 end, 2010). with positive test results. the prenatal care of pregnant women test. Nothing in medicine is simpler and 9. American College of Obstetricians and Among adults during gestation and at delivery shall yet so effective. Gynecologists. Committee opinion No. 418: and adolescents, Prenatal and Perinatal HIV Testing be required to test such pregnant Dr. Chakraborty is Associate Professor Prenatal and perinatal human immunodeficiency virus testing: expanded recommendations. Obstet Georgia ranked Routine HIV opt-out screening is women for HIV and syphilis except in in the Division of Infectious Disease, Gynecol. 2008;112(3):739-42. doi: 10.1097/ fifth highest in recommended for all pregnant women cases where the woman refuses the Department of Pediatrics at Emory AOG.0b013e318188d29c.

6 7 OBGyn NEWS, April 2015 OBGyn NEWS, April 2015 Immediate Postpartum LARC Trainings Ramp Up in 2015

Immediate Postpartum LARC trainings have kicked into high gear in 2015, with training sessions The Georgia Obstetrical and already occurring at Memorial UMC, Columbus Regional, Piedmont, Morehouse School of Medicine, DeKalb Medical, Navicent Medical Center and Georgia Regents University. Dr. Melissa Kottke of Emory Gynecological Society’s and Dr. Alan Joffe of Peach State have conducted the trainings. More trainings are planned for 2015. These trainings are made possible by a grant from Peach State. If you would like to attend an upcoming training or schedule training for your practice or hospital, please contact Kaprice Welsh at [email protected]. 64th64th AnnualAnnual MeetingMeeting Thursday, August 27 – Sunday, August 30, 2015

Faculty includes: Ronald Adams, MD, Kaiser Permanente Medical Center, Ohio Linda Bradley, MD, Cleveland Clinic, Ohio Regina M. Benjamin, MD, MBA, Former U.S. Surgeon General, Massachusetts Paul Dale, MD, Mercer University School of Medicine, Georgia Michael Duchowny, MD, University of Miami, Florida Brenda Fitzgerald, MD, Commissioner, GA Dept. of Public Health Anne Drapkin Lyerly, MD, UNC School of Medicine, North Carolina

Dr. Kottke teaches immediate postpartum IUD placement at Columbus Regional in Columbus, GA Make your hotel reservations at the Ritz-Carlton soon! and Navicent Medical Center in Macon in February. Hotel Room Rates: Prices range from $199 to $329/night, single or double occupancy. Please register early as the Society has a limited room block. Reserve by calling 1-888-239-1217. Ask for the GA OBGyn 2015 Annual Conference room block. Deadline: Special negotiated room rate is available until Monday, July 23, 2015 or until room block is full. For additional information on the Annual Meeting, contact the Society office at 770-904-0719.

Dr. Alan Joffe of Peach State demonstrates immediate postpartum LARC placement at Dekalb Medical in March. 8 9 OBGyn NEWS, April 2015 OBGyn NEWS, April 2015 News from Around the State

Our Journey toward Building Learning and the conference has been approved Golf Tournament Brochure at http:// Remembering Council, an advisory committee to Communities with Partners and Across and meets AAPC guidelines for 8.0 gaobgyn.org/resources/meeting-events/ the Governor. While on the Council, States,” on April 17, 2015 at The Carter continuing education units. Register for for details or call the Society office at Charlotte Wilen consensus emerged that Georgia Center in Atlanta. The conference will the conference at www.gmgma.com. 770-904-5293. Charlotte Wilen, needed a private, non-partisan, address questions such as does the founder of what non-profit organization dedicated to current healthcare system structure GOGS Annual Meeting is now known as continuing the public-private dialogue meet the needs of today’s woman, 2015 ACOG Annual Healthy Mothers, on Georgia’s maternal and infant Make your hotel reservations soon April Health are there other ways that women’s Clinical Meeting Healthy Babies health issues. In 1974, the “Georgia and register with the Society for the Awareness Campaigns healthcare can be facilitated and what Registration Coalition Continuum Alliance for Human GOGS 2015 Annual Meeting at the • STD Awareness Month – Statistics are women telling us? This interactive is open for of Georgia Development” was incorporated with Ritz-Carlton, Amelia Island, Thursday, show that one in two young people conference will take a closer look at the the 2015 (HMHB), passed Wilen as one of the founding board August 27-Sunday, August 30, 2015. will contract a sexually transmitted CenteringPregnancy® model of care and ACOG Annual away on March members. In 1992, Continuum Hotel reservations can be made by disease (STD) by age 25 because participate in discussions around health Clinical and 27, 2015 at the Alliance changed its name to “Healthy calling 1-888-239-1217. Ask for the GA of uneducated decisions regarding policy, patient engagement, Centering® Scientific age of 93. Wilen’s Mothers, Healthy Babies Coalition OBGyn 2015 Annual Conference room their sexual health. April marks the statewide collaboratives and much Meeting in San work in maternal of Georgia,” which has continued to block. See the Annual Meeting ad on annual observance of STD Awareness more. To register, visit http://www. Francisco, CA, and infant health fulfill the original promise of working page 9 for additional information. Month. Health care providers should unitedwayatlanta.org/events/. May 2-6. This had a huge impact on to improve access to healthcare for use the momentum gained during year’s theme Georgia and began in the late 1960s Georgia’s women and children. this month-long observance to bring NASPAG 29th Annual is “Teaming Up National Sexual Health when, as a member of the Jewish Highlights of her work with a renewed sense of enthusiasm and for Women’s Women International, she collaborated Continuum Alliance include leading Clinical & Research Conference focus to their STD awareness and Health.” For Registration is now open for the National with a consortium of other women’s the federal effort to ensure that no prevention efforts. This year, the Meeting additional Sexual Health Conference, which will be organizations, to address issues woman in labor could be turned away CDC’s Division of STD Prevention information and registration, visit held July 13-14, 2015, at the Keystone associated with inadequate or absent from a hospital. She also worked (DSTDP) will promote a theme of http://www.acog.org/About-ACOG/ Resort in Keystone, Colorado. The prenatal care. with HMHB to create state legislation Know the Facts! GYT: Get Yourself ACOG-Departments/Annual-Meeting. conference aims to create opportunities With Wilen at the helm, and backed preventing “drive-through” deliveries. Tested during STD Awareness Month. to share information, efforts, and best by the sound counsel of Dr. Dan Most recently, Wilen was working with To learn more, visit http://wwwn. The Million Hearts practices around sexual health across Thompson and the late Dr. Newton HMHB in its efforts to license lactation cdc.gov/pubs/CDCInfoOnDemand. Long of Emory/Grady, the consortium consultants, having just sent a letter Assembly the lifespan by bridging the disciplines of aspx?ProgramID=126. education, advocacy, and clinical care, established “Better Infant Births,” to Governor Deal days before her The Million Hearts Assembly will • National Minority Cancer among others. The conference is targeted which then led to the legislatively passing. She never quit working for be held May 12, 2015 from 9 am to 4 Awareness Month – The This year’s North American Society to individuals across the range of sexual created Maternal and Infant Health the women and children of Georgia! pm at the Macon Marriott City Center, American Cancer Society and other for Pediatric and Adolescent Gynecology health including those involved in clinical 240 Coliseum Dr., Macon, GA 31217. organizations work together to raise (NASPAG) is hosting its 29th Annual care, education, reproductive health, HIV, At the conclusion of this program, awareness about cancer among Clinical & Research Meeting April STDs, LGBT healthcare, advocacy, policy 2015 CPT Coding participants will be able to describe minorities in honor of National 16-18, 2015 at the Hyatt Regency development, hepatitis, and sexuality Minority Health Month. http://www. Grand Cypress in Orlando, Florida. the burden of hypertension; review for OBGyn ® from birth to death. cancer.org/. This meeting is a forum for education, the key components of Million Hearts • Cesarean Awareness Month – This research and communication among in the clinical and community arenas; Practices awareness campaign supports a health professionals who provide describe what support is needed from Wiant Appointed GA reduction in the number of cesareans gynecologic care and/or consultation to both the public and private sectors; and Medicaid Director Friday, May 1, 2015 in mothers who do not really need children and adolescents. To view the be challenged to consider what actions The Department or who will not benefit from this meeting program, visit http://c.ymcdn. will be taken to contribute to preventing of Community Macon Marriott City Center, procedure when compared to a com/sites/www.naspag.org/resource/ heart attacks and strokes. There is no Health has tapped Macon, GA vaginal birth. http://icanofnova.org/. resmgr/NASPAG_-_ACRM_2015_-_ registration fee and funding is provided a current official to Agenda_.pdf. For registration by the Department of Public Health become the state’s information, visit http://naspag. through the Association of State and new Medicaid Topics Include: CenteringPregnancy site-ym.com/events/event_details. Territorial Health Officials Million Hearts chief. Linda Wiant Conference asp?id=583625#. Grant. For additional information, contact has served as • ICD-10 for OB Services Britney Smith with the Georgia Hospital pharmacy director Association at 770-249-4500 or bsmith@ • OBGyn Coding Updates for 2015 GMGMA 2015 Annual for Georgia Medicaid since August 2011 gha.org. and she began her new appointment • ICD-10-CM for Genitourinary and Other Primary Conference March 16. She replaces Jerry Dubberly, Care Services GMGMA 2015 Annual Spring GOGS 2015 Annual who left the position of Georgia Medicaid Conference, April 26-28 at the Grove director in January to take a job in the Park Inn, is entitled “Roaring Into The New Golf Tournament private sector. As pharmacy director, • Social Media’s Impact on a Medical Practice Horizons Of Healthcare Management.” Wednesday, May Wiant has had daily responsibilities The packed agenda features education, 13, 2015 is the next including oversight of the pharmacy claims • Effective Team Work Stategies networking, and resource tools. Speakers Georgia OBGyn processing system, the Pharmacy Benefit United Way, in partnership with the include: Jody Urquart; Mary Kelly, PhD; Society’s Annual Golf Manager, and a drug rebate program. As The seminar is approved for 4 CEU credits. Centering Healthcare Institute, The Debra Wiggs, FACMPE; Adrienne Baker; Tournament at Bears’ Medicaid chief, Wiant will oversee services To register, visit http://gaobgyn.org/resources/meeting-events/ Best in Suwanee, GA. March of Dimes and Grady Health and Cameron Cox, III. for about 1.9 million Georgians in Medicaid or call the Society office at Systems, has coordinated a one-day Attendees can receive up to 11.75 Line up your team and and PeachCare, with a state budget of conference entitled “CenteringGeorgia: continuing education units for ACMPE, register soon. View the more than $2.5 billion. 770-904-5293. 10 11 Presorted Standard U.S. POSTAGE PAID Permit # 6264 Atlanta, GA

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