Bulletin Volume 11 • Issue No

The Medical Society of the County of Queens and The Academy of Medicine of Queens County Bulletin Volume 11 • Issue No. 1 Over 200 Years of Service to the Medical Community of Queens County Fall 2019 t Inside This Issue From the President’s Desk 1 President’s Message Dear Friends and Colleagues, The core of our Society is our mem bership. 2 Upcoming Meetings Over the next year, I invite all of you to bring in Programs/Events Happy Autumn! at least ONE new member who will participate 3 Epithelial Ovarian Cancer I hope that all of you had a in our activities. Secondly, during this year, I wonderful summer and that 4 Managing Negative en courage all of you to serve our Society in at Online Reviews this message finds you and least ONE new way --in an activity that you feel your loved ones well. 5 Protecting Your Medical passionate about. Practice from Employment- Related Liability in Autumn represents for me a time of significant I extend a warm invitation to all of our new New York State change: colder weather, colorful foliage, the busy physi cian members from Northwell Health who 6 ACF’S Corner start of school, and the reconvening of our New have joined us earlier this year. I also invite all of York State Assembly. This past summer, we saw our members to play a more active role in our 7 Do Women with Dense Breasts Need many developments in healthcare policy and Medical Society: Supplemental Imaging public health: the end of our national measles to Screen for outbreak after over 1200 cases, removal of the • Attend our monthly Comitia Minora meetings (members/non-members welcome) Breast Cancer? religious exemption for vaccines in our state, 8 Main Street Radiology hundreds of lung injury cases from vaping, • Participate in our professional and/or social events physi cian response to address surprise bill Join one of our Standing or Special Committees 9 TD Bank • leg is lation, blocked implementation of a 90-day • Organize a professional or social event 10 The Ralph E. ban on most flavored e-cigarettes in our state, etc. Schlossman, MD Award for our Society • Contribute to our quarterly Society newsletter 11 Brandeis- Executive MBA As members of one of 60 county medical societies for Physicians which comprise the Medical Society of the State • Meet with legislators to advocate for physicians 12 The Origin of NYC of New York, we all have an important role and patients in March 2020 in Albany on Physician Lobby Day Health+Hospitals/Queens advo cating for ourselves as physicians and for 13 The Boulevard Hospital our patients. As I mentioned in my inaugural Through participation and service, you will find 14 NYC Commissioner of ad dress in May 2019 at Russo's on the Bay, we colleagues, role models, mentors, and friends. Health Memorandum can seize on ample opportunities to learn about They will broaden your perspective and inspire important healthcare policies a ffecting us and you to return again and again. Additionally, you 15 Just What the Doctor Ordered/Recipe our patients, increase our medical knowledge, will improve the health of your patients and and meet other skilled and compassionate other Queens residents. In so doing, you will Executive MBA/MS in col leagues through our Medical Society. make your Queens community a healthier and Healthcare Leadership Cornell University more enjoyable place to live and work. Over We are blessed to live in the most ethnically time, you will find higher meaning and greater 16 Symposium: diverse county in America: Queens has 2.3 “Health Matters joy in your professional and personal lives. for Women” mil lion residents who come from more than 190 countries and speak more than 130 languages. It is my privilege to serve all of you. Our Medical 17 Film Screening: As a proud native of Queens, I have lived here “To Err is Human” Society looks forward to providing unique for 30 years and cared for patients as a pri mary op portu nities for professional education, 18 Symposium: care physician for the past 15 years. networking, and socialization this year. We “Spotlight on Elder Abuse” wel come your ideas and participation. Please As President of our Medical Society: I have contact me anytime at [email protected] 19 2019-2020 two goals this year --to strengthen our Society or by cell at 347-635-5233. MSCQ O fficers ■ by in creasing our membership of over 1400 Contact Information physicians and by deepening our engagement Best regards, in Queens. Liana Leung, MD, MPH, FACP, President

www.MSCQ.org | BULLETIN 1 Upcoming Meetings Date • Time • Speaker Need the perfect space MSCQ for your meeting? Board of Trustees Meetings November 12, 2019 • 6:00 pm Call or e-mail us. Meetings are held on the 1st Tuesday of December 3, 2019 • 6:00 pm the month, unless otherwise notiﬁed.

Comitia Minora November 12, 2019 • 7:30 pm Leadership Meetings • “OPMC 101” Meetings are held on the 1st Tuesday of Paula Breen, Acting Director the month, unless otherwise notified. NYS DOH Oﬃce of Professional Medical Conduct December 3, 2019 • 7:30 pm Ning Lin, MD, Neurological Surgery NYP Queens/Weill Cornell Medicine

MEETINGS First District Meetings November 21, 2019 • 7:00 pm / TBA Refer to e-mails from this organization for details MSSNY Council Meeting November 7, 2019 • 8:00 am MSSNY House of Delegates 2020 April 24-26, 2020 / Tarrytown, NY Upcoming Programs / Events w Symposium on Women’s Health - ”Health Matters for Women” Saturday, November 2, 2019 • 7:30 am - 12:30 pm [CME - accredited activity] Location: NYC Health+Hospitals/Queens, Conference Room A-540 82-68 164 Street, Jamaica, NY To Register https://docs.google.com/forms/d/e/1FAIpQLSe9zloLYo7LUNcgpV8bEx3Xn4tQlnzhwTX PZRBO1cde04QfMw/viewform w Effects of Dapagliflozin Beyond Glycemia: Implications for Prevention of Hospitalization for Heart Failure in Type 2 Diabetes Wednesday, December 4, 2019 • 6:00 pm Presenter: Hillary Bell, PA-C, Cardiometabolic Clinical Science Liaison Location: Mythos Authentic Greek Cuisine w Programs & 19629 Northern Blvd., Flushing, NY events details RSVP to attend See pages [email protected] 16, 17, 18 w A Patient Safety Documentary - ”To Err is Human” Tuesday, December 10, 2019 • 7:00 pm- 8:45 pm [Not a CME - accredited activity] Location: Medical Society of the County of Queens 112-25 Queens Blvd., 4th Floor, Queens, NY RSVP to attend by 12/06/2019 718-268-7300 or E-mail to: [email protected]

PROGRAMS / EVENTS w 9th Annual Geriatrics & Palliative Care Symposium Spotlight on Elder Abuse: Now is the Time for Multidisciplinary Collaboration and Intervention Across the Care Continuum Tuesday, January 14, 2020 • 7:30 am- 12:45 pm [CME - accredited activity] For information about Location: NewYork-Presbyterian Queens • Theresa and Eugene M. Lang Center placing a CME program for Research and Education, 56-45 Main Street, Flushing, NY listing, please contact To Register 718.268.7300. 718-670-1419 • www.nypqcme.org www.MSCQ.org | BULLETIN 2 MEDICAL Epithelial Ovarian Cancer David A. Fishman, MD

Epithelial ovarian cancer (EOC) is the most diagnosed with EOC regardless of age or lethal gynecologic malignancy, with an family history should have formal genetic es timated 140,000 annual deaths globally. Inheritance of high-penetrance testing. Germline and somatic testing is The majority of women are diagnosed in cancer susceptibility genes now avail able to help identify those that advanced stage (III-IV), and despite advances places women at greatly are in herited and acquired which opens in therapy, this figure remains unchanged increased risk of developing EOC. new venues to optimize patient care. Iden - over five decades. The prognosis of advanced tifying women with genetic predisposition stage EOC is poor, with a 5-year survival for EOC is the first step toward risk assess - rate of 12-15%. In contrast, the 5-year ment and prevention. sur vival rate of early stage (I) EOC approx - imates 90%. Current modalities of bi- Biomarkers man ual exam, CA125, and transvaginal Biomarkers have long played a role in sonogram together allow us to detect at the management of EOC. CA125 is a best only 30% of women with early stage glycoprotein antigen that is the most disease, and this is more often due to the com monly known and measured tumor tumor biology rather than clinical acumen. marker. It is found in 85-90% of cases of Ideally, identification of at-risk individuals over 592 genes are associated with inherited EOC. However, it is only present in 47% of would lead to prevention or possibly the cancers. In heritance of high-penetrance those women with early stage EOC. There - detection of early stage disease when cancer susceptibility genes places women fore, using CA125 as the single marker in sub sequent treatment would improve at greatly increased risk of developing screening may miss more than 50% of prognosis. We believe identification and EOC. Several of the more recognized cases of early stage ovarian cancer. Multi - intervention of at-risk individuals will shift genes include BRCA1, BRCA2 and those ple publications have identified potential the paradigm of the treatment of EOC Lynch syndrome-associated mutations. biomarkers for detecting ovarian cancer in analogous to the role of cervical dysplasia Women who have inherited a BRCA1 or addition to CA125. Human epididymis in cervical cancer. BRCA2 gene mutation have a 35-70% and protein 4 (HE4), trasthyretin (TTR), 10-30% respective lifetime risk of develop - apolipoprotein A1 (ApoA1) and transferrin Genetics ing EOC. Those with Lynch syndrome as - are examples of protein biomarkers, that, All cancers have a genetic basis but not all sociated mutations (MLH1MSH2, MSH6, in combination with CA125, have been cancers are hereditary. Approximately 20 % PMS2, EPCAM) have an estimated 9-12% used in panels with encouraging results in of ovarian cancers are associated with an lifetime risk of developing EOC. However, early stage EOC detection. Anderson et al. inherited mutation. Diagnosis of genetic there have been an increasing number proposed a panel of biomarkers including predisposition involves risk assessment of genes identi fied which have been CA 125, HE4, and mesothelin. The multi - based on the patient’s family history of asso ciated with a higher risk in developing variate index assay OVA1 has been FDA cancers and components such as family EOC: BRIP1, RAD51D, RAD51C, PALB2 and approved for triage of pelvic masses since pedi gree, age, and personal history of BARD1. Women of Eastern European or 2009. The test consists of CA125, beta2- cancer. Management includes testing for Ashkenazi Jewish de scent, are at higher mi croglobulin, transferrin, apolipoprotein known genetic mutations and extensive risk of being positive carriers of BRCA1 or A1, and transthyretin. OVA1 score ranging pre-and post-test counseling performed BRCA2 mutations. In fact, a family history from 0 to 10 with cutoffs set as 5.0 for by a multidisciplinary team involving of ovarian cancer in a first-degree relative premenopausal women and 4.4 for post - ge netic counselors and for ovarian cancer triples a woman’s lifetime risk of develop - menopausal women. Pelvic masses with gynecologic oncologists to aid the patient ing ovarian cancer. A number of familial scores higher than these thresholds are in understanding the implications of ovarian cancer syndromes have also been considered likely cancerous. The sensitivity their condition and available treatments. identified such as Cowden disease, a.k.a. of the test is initially reported to be greater Because the total number and type of multiple hamartoma syndrome, and Li- than 90% with a negative predictive value gene mutations associated with hereditary Fraumeni syndrome. Al though a positive of greater than 90%. A recent study on ovarian cancer continue to rapidly expand patient history with risk factors is currently 516 women yielded an improvement of from the initial two (BRCA1 and BRCA2), a recommended prior to initiating work-up sensitivity and negative predictive value negative work-up for a genetic mutation for inherited genes, almost one-third of while decreasing specificity and positive does not preclude management in the women where hereditary ovarian carci - predictive value when replacing the CA presence of a positive family pedigree. noma have no close relatives and 35% are 125 with the multivariate index assay (121). Presently, over 300 hereditary cancer greater than 60 years of age at diagnosis. These results, while requiring validation, syn dromes have been recognized and There is new consensus that any women -continued on page 4

www.MSCQ.org | BULLETIN 3 INSURANCE Advertorial Epithelial Ovarian Cancer Managing Negative continued from page 3 Online Reviews suggest that combinations of biomarkers Healthcare providers recognize that along media, use a standard response that also may provide improved detection as the with their practice websites, public web- serves as a marketing opportunity for your first step in a multimodal screening protocol. sites such as Yelp, Healthgrades, and Rate practice. MDs, and social media sites like Facebook and Twitter, can be used as marketing Some examples include: tools to inform the public of their services. a. “[Insert name] Medical Group is proud The online community, however, is then to have been providing comprehensive afforded an opportunity to respond, rate, and compassionate care in the community and, at times, complain about those services. since [insert year] and takes our treatment These statements and reviews are readily of its patients and their privacy seriously. accessible to anyone with an internet- Because federal privacy laws govern ready device to open and read. While patients’ protected health information, it there is a basic instinct to immediately is not the policy of [insert name] Medical respond to negative online reviews, Group to substantively respond to nega- healthcare providers must remember that tive reviews on “ratings” websites, even Imaging Studies privacy rules make a complete response if they provide misleading, unfair or in- Transvaginal ultrasound is the initial diag- via social media inappropriate, and re- accurate information. We welcome all our nostic modality of choice for the evalua- sponding directly to an online post puts patients and their families to address any tion of the adnexa but likewise has proven the healthcare provider at risk of disclos- concerns/requests or information about ineffective as a primary screening method ing protected health information (PHI). their care with us directly, as we strive to for the detection of early stage EOC. In Your response may not contain any iden- continue to provide individualized care in order to improve the efficacy of sonogra- tifying statements, but the mere recogni- our community.” phy, several new techniques have been tion of a patient-provider relationship is a combined with gray scale morphologic potential HIPAA violation. b.“At our medical practice, we strive for assessment. Three-dimensional ultrasound patient satisfaction. However, we cannot with power Doppler and microvascular The following tips will help you success- discuss specific situations due to patient contrast-enhancement are examples of fully and appropriately respond to nega- privacy regulations. We encourage those techniques that have improved ovarian tive online reviews: with questions or concerns to contact us lesion characterization in sonography. directly at [insert phone number].” Results in several studies show that 1. Critically review all social media posts these advanced techniques can be used for accuracy and authenticity. While 5. If you feel the patient’s complaint has to differentiate benign and malignant some negative statements regarding the disrupted the physician-patient relation- adnexal masses. performance of you or your staff may be ship, consider discharging the patient difficult to read, evaluate these reviews to from your practice. This action may be Conclusion determine if there is any opportunity for viewed as retaliatory by the patient and EOC continues to be a lethal disease despite learning or process change. may set off a new series of negative advances in genetics, imaging and treat- posts. Attorneys at Fager Amsler Keller & ment of ovarian cancer. The key to changing 2. Do not become engaged in online Schoppmann, LLP are available to assist outcomes in EOC requires a paradigm shift arguments or retaliation--especially if the you to make this decision. using genetics to identify those at-risk comments made are particularly negative women for prevention and ultimately and potentially detrimental to the reputa- 6. Notify your local authorities if you feel shifting treatment to early-rather than tion of the facility or physician. at any time that your safety, the safety of advanced-stage ovarian cancer. ■ your staff or your family is threatened or 3. According to federal and state confi- at risk. ■ About the Author dentiality and privacy laws, providers are David A. Fishman, MD, Secretary precluded from identifying patients on This article has been reprinted with permission from: MLMIC Dateline® (Spring 2019), published by MLMIC Insurance Company, 2 Park Avenue, Medical Society of the County of Queens social media. In order to protect patient Room 2500, New York, NY 10016. Copyright ©2019 by MLMIC Insurance Director, Cancer Center privacy, all patient concerns and com- Company. All Rights Reserved. No part of this article may be reproduced or Director, Gynecologic Oncology plaints should be resolved by the practice transmitted in any form or Vice Chair, Obstetrics and Gynecology by contacting the patient directly and not by any means, electronic, NewYork-Presbyterian Queens through social media. photocopying, or otherwise, Professor, Obstetrics and Gynecology without the written Weill Cornell Medicine 4. If you do choose to respond via social permission of MLMIC.

www.MSCQ.org | BULLETIN 4 INSURANCE Advertorial Protecting Your Medical Practice from Employment - Related Liability in New York State Kathleen Sellers, JD, CLU

It’s now been about two years since the #MeToo movement exploded. It’s clear that all employers and supervisor y em ployees have to work to prevent and address sexual harassment, which has ex isted for too long in many workplace cultures. While being mindful of these re sponsibilities, business owners and managers also need to consider the po tential financial ramifications for our own businesses and workplaces. This is es pecially true in New York, where new laws addressing sexual harassment and discrimination in the workplace have made it easier for employers to be sued, and training for employees by October 9, 2019 settlement (if there is one). Coverage for harder for them to defend themselves. and annually thereafter. More legislation, these types of claims is excluded from signed into law in August 2019, made Workers Compensation and standard Healthcare businesses need to be aware of ad ditional significant changes. For exam - Business Owners Policies (although some the potential for employment-related claims. ple, effective October 11, 2019, an employee Business Owners Policies may include According to the US Liability Insurance suing for sexual harassment does not need or add on some Employment Practices Group, a medical practice is more likely to to prove that the harassment is “severe Li ability coverage). Employment Practices have an employment claim brought or pervasive,” which is the current legal Liability coverage can be purchased on a against it than a general liability claim. standard for a claim of hostile work envi - stand-alone basis, or as part of a manage - Small practices aren’t immune -- over 40% ronment. Certain defenses, long relied ment liability package that can include of all employment claims are brought upon by attorneys defending employers, Di rectors & Officers Liability coverage (for against businesses with less than 1 00 will no longer be permitted. For successful claims brought in connection with other em ployees. The typical power structure in employee claimants, punitive damages wrongful acts or omissions by manage - many medical practices – with mostly and attorneys’ fees will now be available. ment) and/or Fiduciary Liability coverage male physician owners and mostly female And, effective February 8, 2020, the New (for claims against fiduciaries of employee staff – results in a heightened risk of actual York Human Rights Law’s prohibitions benefit plans). EPLI policies can also in - or alleged wrongful conduct in medical against discrimination and harassment in clude coverage for claims of harassment practices. Employment claims can include the workplace will apply to all employers or discrimination brought by third parties, allegations of wrongful termination, (currently, these apply to employers with such as patients or customers and ven dors breach of an employment contract, four or more employees). (for example, a pharmaceutical represen - failure to promote, violation of anti- tative who vis its a medical practice). This dis crimination and harassment laws, Medical practices, like other businesses, coverage is more important than ever wrongful demotion, and retaliation for need to take action to establish a fair and for businesses in New York. The 2018 making a claim of an illegal employment safe workplace culture, by making sure budget legislation provided that employ - practice. And while sexual harassment that anti-harassment and discrimination ers may be liable to (non-employee) third scenarios are dominating headlines now, policies and practices are in place, and parties, if the employer knew or should employees may bring claims of discrimi - that all managers and staff are trained to have known that the third party was being nation or ha rassment on the basis of race, prevent and address improper workplace harassed and did not take corrective national origin, religion, pregnancy, age, conduct. But even the best policies and ac tion. disability, and sexual orientation, as well. procedures can’t prevent all employment practices claims, which is where Employ - US Liability Insurance Group offers a policy New York State has responded to the ment Practices Liability Insurance (EPLI) that we have put in place for many of our #MeToo movement with legislation aimed comes into play. This insurance covers the customers that is specifically designed at preventing sexual discrimination and cost of a judgment or settlement in an for medical practices, and it can include harassment. Legislation passed in April em ployment-related claim, up to the pol - coverage for defense costs for claims 2018 required all New York employers to icy limit, as well as paying defense costs, of patient molestation (availability of this establish a written sexual harassment policy which in many employment-related coverage varies by medical specialty). and to provide anti-sexual harassment claims, exceed the eventual judgment or -continued on page 6

www.MSCQ.org | BULLETIN 5 Protecting Your ACF’s CORNER Medical Practice continued from page 5 As a valuable add-on, most EPLI policies %%%%%%%%%%%%%%%% also provide access to services to help a business prevent or mitigate loss from an employment practices claim. These include sample employment policies, online anti-sexual harassment prevention training, a set amount of free consultation with a lawyer or human resources professional, and other smart hiring resources, such as discounts on background checks for job applicants.

When purchasing an EPLI policy, a business should consider what limits to purchase (many of our customers purchase a $1,000,000 limit), as well as the deductible and premium oﬀered by the insurance company. In some policies, the costs of defending the claim are sub- tracted from the overall limit available for a judgment or settlement (this is referred to as defense “within” or “inside” the limit), while with others, defense costs are covered in addition to the limit (referred to as “outside” the limit). EPLI policies are written on a claims-made basis, which means that they cover claims made during the policy period, subject to the retroactive date. Claims based on acts that took place before the retroactive MSSNY President Dr. Arthur C. Fougner (right) date, are not covered. If coverage is of- talks Surprise Bills on WRHU FM’s Well Said with Dr. Ira Nash (left). fered on a “Full Prior Acts” basis, there is no retroactive date, which means that more claims may be covered.

EPLI coverage is now more important than ever for the ﬁnancial protection of medical practices, with the increased attention being brought to harassment in the workplace and changes in state law. Even if these issues aren’t occurring in your practice, a disgruntled employee can sue your practice, alleging discrimination or harassment. An EPLI policy can help your practice survive the ﬁnancial impact of such a claim. ■

About the Author Kathleen Sellers, JD, CLU To preview the video, click below. Vice President, Charles J. Sellers & Co., Inc. %%%%%%%%%%%%%%%%

www.MSCQ.org | BULLETIN 6 MEDICAL Do Women with Dense Breasts Need Supplemental Imaging to Screen for Breast Cancer? Ravali Kondaveeti, PGY-2

In clinical practice, breast cancer screening notification law that has been implemented is recommended in asymptomatic women in many states (currently 38 states and the aged 40-74 years annually to biennially District of Columbia). As per the New York based on guidelines from different med - State Department of Health, the physician ical associations and expert groups. In or the facility that provides the mammo - the population at or above age 75 years, gram must notify women if they are found it is ad vised to discuss the potential risks to have dense breasts. and benefits with the patient to reach a shared decision whether to continue or In the presentation given by Bobbi Ring, stop screening. Women who are at in - MD, Co-Section Chief for Breast Imaging creased risk of breast cancer benefit from Section at Main Street Radiology at the early screening from age 40 years with Medical Society’s Comitia Minora meeting an nual mammogram and/or additional on September 10, 2019, she discussed testing (genetic testing, MRI). According to sev eral cases where ultrasound identified the United State Preventive Services Task the abnormal tissue which was later Force, in the population of women with deter mined to be breast cancer; this dense breasts irrespective of age group, can cer was missed by the prior annual risks of using ultrasound as additional current evidence is insufficient to recom - mammogram in women with dense im aging along with annual mammogram mend for or against additional breast breasts. Additional testing with breast in women with dense breasts. However, can cer screening (breast ultrasound, MRI, ul trasound has increased cancer detection patients and healthcare professionals or other methods). rates. This discussion highlighted the pos - should discuss breast density, its associa - sible need for additional testing in certain tion with increased risk of breast cancer Dense breasts increase the risk of breast populations of women with dense breasts. and the lim itations of mammography cancer and decrease sensitivity of the It also focused on digital breast tomosyn - in early de tection of breast cancer in mammogram to detect breast cancer. thesis (DBT) which overcomes some of these women. In this manner, patients Ap proximately 43% of women in the the limi tations faced with a traditional 2D can be knowledgeable and then weigh United States who are undergoing breast mammogram alone as DBT views thin sec - appropriately the risks and benefits and cancer screening have dense breasts. As tions and decreases the lesion masking make an informed decision if they would the breast density increases, the sensitivity and overlapping effect. DBT has also de - want to proceed with additional tests. ■ of the mammogram decreases. Density creased recall rates. DBT can be of much About the Author in mammogram is reported as one of help in detecting cancer, especially in Ravali Kondaveeti, PGY-2 four breast imaging reporting and data women with dense breasts. Icahn School of Medicine at Mount Sinai: system (BI-RADS) categories. The first two Internal Medicine Residency Program categories of entirely fatty and scattered Supplementing mammography with New York City Health+Hospitals/Queens areas of fibroglandular density are consid - breast ultrasound in women with dense ered nondense. The last two categories of breasts increases the cancer detection Edited by Bobbi Ring, MD heterogeneously dense and extremely rate, but it also increases the false positive Co-Section Chief for Breast Imaging dense breast tissue are considered dense rates and follow up recommendations. So Section at Main Street Radiology, and are now required to be reported in the far, there has been no evidence or studies and Liana Leung, MD, MPH, President, radiological result as per the dense breast to support that the benefits outweigh the Medical Society of the County of Queens

References 3. Kerlikowske, Karla; Miglioretti, Diana L., Vachon, 5. “Final Recommendation Statement: Celine. “Discussions of Dense Breasts, Breast Cancer Breast Cancer: Screening.” 1. “Breast Cancer Screening Guidelines for Women.” Risk, and Screening Choices.” U.S. Preventive Services Task Force, May 2019. Centers for Disease Control and Prevention, JAMA. 2019;322(1): 69-70, https://www.uspreventiveservicestaskforce.org/ https://www.cdc.gov/cancer/breast/pdf/Breast/ https://jamanetwork.com/journals/jama/ Page/Document/RecommendationStatement CancerScreeningGuidelines.pdf fullarticle/2735405 Final/breast-cancer-screening. Accessed 20 September 2019. Accessed 20 September 2019. Accessed 20 September 2019.

2. “About Dense Breasts.” 4. Keating, Nancy L; Pace, Lydia. “New Federal 6. “Legislation and Regulation: New York State Department of Health, Requirements to Inform Patients About Breast Density. Noti fication required by state.” https://www.health.ny.gov/diseases/cancer/ Will They Help Patients?” JAMA. 2019;321(23):2275- DenseBreast-info.org breast/dense_breasts.htm. 2276. doi:10.1001/jama.2019.5919. https://densebreast-info.org/legislation.aspx Accessed 20 September 20, 2019. Accessed 20 September 2019. Accessed 20 September 2019.

www.MSCQ.org | BULLETIN 7 www.MSCQ.org | BULLETIN 8 Visit or call our South Flushing Store at 1-718-888-0129 to open an account or to find out if your existing TD Bank account is eligible to participate today!

www.MSCQ.org | BULLETIN 9 The Ralph E. Schlossman , MD Humanism in Medicine Award

The Ralph E. Schlossman, MD Humanism in Medicine Award was created this year to commemorate and honor Dr. Schlossman who departed from us in January. A family physician, he cared for generations of patients for over half a century. He was deeply admired by his colleagues who elected him as President of our County Medical Society as well as our State Medical S ociety. He also loved to teach medical students and residents. We will always remember him with love as a man of leadership, dignity, and integrity.

This Award will be given to one outstanding physician annually who has cared for patients in the County of Queens and has taught residents and/or medical students with compassion, dedication, and professionalism. Presentation of the Award will begin in 2020.

Commemorative plaque displayed in the office of the Board of Trustees at the MSCQ headquarters.

www.MSCQ.org | BULLETIN 10 www.MSCQ.org | BULLETIN 11 A WALK DOWN MEMORY LANE The Origin of NYC Health+Hospitals/Queens Liana Leung, MD, MPH

Did you know that one of the two municipal hospitals in Queens owes its existence in part to the Medical Society of the County of Queens?

In 1928, our Medical Society (then known as the Queens County Medical Society) began petitioning the New York City Board of Es timate and Mayor Jimmy Walker for a free public hospital in Queens. Because there were no municipal general hospitals in Queens at that time, people were required to use Kings County Hospi tal in Brooklyn or Bellevue Hospital in lower Manhattan. Queens General Hospital was proposed by the city in 1929; it was also referred to as the new Queensboro NYC Health+Hospitals/Queens Hospital. Construction was approved in 1930 and took place over the next two years. In 1997, after his attempt to sell Queens and southeastern Queens. Its mission is to General Hospital failed, Mayor Rudolph pro vide quality, comprehensive care to all Due to its many buildings including a Giuliani announced plans to build a new members of the public regardless of their power plant, a heating plant, and the hospital on the campus. Construction ability to pay. Medical services are provided laun dry building, the new Queens General began in 1998 and was finally completed through an affiliation agreement with its Hospital was referred to as a "miniature in 2001 at a cost of $147 million. The academic partner, the Mount Sinai School city." It contained specialized X-ray mod ern, state-of-the-art facility opened in of Medicine. The hospital offers res idency equipment, radium for the treatment of January of 2002. The new Ambulatory training in Dental Medicine, In ternal cancer (no longer in practice), and an iron Care Pavilion building across from the Medicine, OB-GYN, and Ophthalmology . ■ lung --medical innovations at the time. main hospital opened in January 2007 Only patients who could not afford to and pro vides primary care and sub - References pay were allowed to be ad mitted as in - spe cialty services. 1. “About Queens.” The City of patients; those who could afford to pay New York, 2019, were re quired to use one of the private Today, NYC Health + Hospitals/Queens https://www.nychealthandhospitals.org/ hospitals in the borough. Over the years, is a major healthcare provider and an queens/about-us/ Queens General Hospital merged with affil iate of Mount Sinai School of Medicine Accessed 10 October 2019. Queensboro Hospital, Triboro Hospital, that serves the communities of central 2. “Queens Hospital Center.” Wikipedia, and many other healthcare facilities in https://en.wikipedia.org/wiki/ Queens. Queens_Hospital_Center NYC Health + Hospitals/Queens Accessed 10 October 2019. In July 1964, Queens Hospital Center Statistics be came a ffiliated with the Long Island About the Author Jewish Medical Center, the Hillside Hospital • Beds in Service: 271 Liana Leung, MD, MPH has served as in Glen Oaks, and the Mary Immaculate the Associate Director of the Hospital in downtown Jamaica. It faced • Clinic Visits: 314,042 Department of Ambulatory Care and overcrowding, shortages of equipment, • Emergency Room (ER) Associate Program Director of the and many financial challenges. In 1992, the Visits: 91,295 Internal Medicine Residency Program Long Island Jewish Medical Center ended at NYC Health+Hospitals/Queens its 25-year-long contract to provide medical • Discharges: 13,673 for the past six years. residents for rotation at the hospital. Later • Births: 1,743 that year, Mount Sinai Medical Center agreed to supply doctors to the hospital.

www.MSCQ.org | BULLETIN 12 A WALK DOWN MEMORY LANE Advertisement for The Boulevard Hospital in this 1929 publication from the Medical Society of the County of Queens.

Illustration: Louis W. Burch

www.MSCQ.org | BULLETIN 13 A WALK DOWN MEMORY LANE Memorandum from the NYC Commissioner of Health – circa 1929

www.MSCQ.org | BULLETIN 14 VIEWPOINT Just What the Doctor Ordered Joseph D’Amore, MD

Influences CASSOULET D’AMORE

My Jewish and Italian families conditioned Ingredients sPREHEAT oven to 400 degrees me from birth to equate home cooking 8 cloves of garlic, 1 onion, sSauté sausage meat in butter and with love of family and friends. No one 1 green bell pepper, chopped oil for 4 minutes, medium high heat who came to our apartment in East New 1 and 1/4 pound of bulk hot Italian sAdd bell pepper and onion and York, Brooklyn ever went home hungry. To sausage meat, chopped continue to sauté another 4 minutes me, there is no greater satisfaction than Add in beans, spices and tomatoes people enjoying your culinary eﬀorts and 1/2 teaspoon EACH of salt, pepper, s and mix well for another 4 minutes asking for the recipe! oregano, thyme, rosemary sPour mixture into an oven proof Career 2 tablespoons EACH of butter and casserole dish and bake uncovered olive oil for 20 minutes I started out loading industrial dish- washers at age 15 and worked myself 2 (1 pound) cans of drained sGarnish with fresh chopped basil or up over the next 9 years to bus boy- white kidney beans a dollop of pesto! waiter-dessert chef and then sous chef sSERVE HOT with crusty Italian bread at various places in Long Island. I ﬂipped 16 ounce can of diced tomatoes and ENJOY! a coin at age 24 to see if I wanted the FYI… An allergist at Medex, Dr. D’Amore now uses his culinary passion for charity CULINARY INSTITUTE of AMERICA or events, including the Susan G. Komen Breast Cancer Foundation’s “Cook for the Cure” program medical school. ■ and the Great Chefs event, raising thousands of dollars for the endeavors. He spends anywhere from 25 to 50 hours each month volunteering, on top of a 60-hour work week.

Executive MBA/MS in Healthcare Leadership at Cornell University

Earn an MBA in General Management and an MS in Healthcare Leadership in 22 months in New York City. The curriculum combines the breadth of business and depth of the healthcare industry to equip leaders with the tools they need to lead innovation and transformation in the industry.

Contact us to learn more, including details about an exclusive scholarship opportunity for Medical Society of Queens members. johnson.cornell.edu/mba-ms

www.MSCQ.org | BULLETIN 15 Sponsored by the Medical Society of the State of New York & the Academy of Medicine of Queens County

When: November 2, 2019 7:30 am - 12:30 pm Where: NYC Health + Hospitals/Queens u 82-68 164 Street To Register A-540 Conference Room Click Here Jamaica, NY 11432 Schedule w 7:30 - 8:30 am Registration and Breakfast w 10:30 - 11:30 am w 8:30 - 9:30 am Health Matters for Women: * Health Matters for Women: Endometriosis* Fibromyalgia and Myalgic Encephalomyelitis Faculty: Lisa Eng, DO Faculty: Florence Shum, DO Educational Objectives: Educational Objectives: Review potential causes of chronic diffused pain and fatigue Review potential causes of pelvic pain and discuss how to identify endometriosis Discuss how to accurately diagnose fibromyalgic and myalgic encephalomyelitis Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for Discuss treatment options for fibromyalgia and long-term treatment of endometriosis myalgic encephalomyelitis Discuss implementation of individualized w11:30 - 12:30 pm endometriosis treatment plans and options Genetic Profiling of Breast Cancer and Its w 9:30 - 10:30 am Implication for Staging, Prognosis Ovarian Cancer and Genetic Risk** and Treatment** Faculty: David Fishman, MD Faculty: Louis Auguste, MD Educational Objectives: Educational Objectives: Identify who is at risk for cancer Describe different cellular proteins that can Explain what a genetic counselor is help predict the outcome of breast cancer Review cancer genes and cancer susceptibility Discuss how genetic profiling is Describe future applications for new cancer treatments a better prognosticator

Funding provided by the New York State Legislative Grant ** The Academy of Medicine of Queens County is accredited *The Medical Society of the State of New York is accredited by by the Medical Society of the State of New York (MSSNY) the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education for physicians. (ACCME) to provide medical education for physicians. The Academy of Medicine of Queens County designates The Medical Society of the State of New York designates this each of these live activities for a maximum of 1.0 AMA PRA TM live activity for a maximum of 1.0 AMA PRA Category 1 credit TM. Category 1 credit . Physicians should claim only the credit Physicians should claim only the credit commensurate commensurate with the extent of their participation in with the extent of their participation in the activity. the activity.

www.MSCQ.org | BULLETIN 16 Medical Society of the County of Queens, Inc. Academy of Medicine of Queens County

Save the Date for this important event sponsored by the Medical Society of the County of Queens

To Err Is Human is an in-depth documentary about medical mistakes and those working behind the scenes to create a new age of patient safety. “To Err Is Human ” Through interviews with leaders in healthcare, A Patient Safety Documentary footage of real-world efforts leading to safer care, Director: Mike Eisenberg and one family’s compelling journey from victim to Duration: 77 minutes empowered patient advocate, the film provides a unique look at our health care system’s ongoing Tuesday, th fight against preventable harm. December 10 , 2019 Target Audience 7:00 pm - 8:45 pm Attendings, physicians, physician assistants, 7:00 pm nurse practitioners and residents Networking & Refreshments Location 7:30 pm - 8:45 pm Medical Society of the County of Queens Film Screening 112-25 Queens Blvd., 4th Floor Forest Hills, New York,11375 uRSVP by 12/06/2019 tel: Parking 718-268-7300 $10 Reduced parking fee for event attendees at or by E-mail to: the parking garage next to the Medical Society [email protected] Free street parking in the area after 7:00 pm This is not a CME-accredited activity

www.MSCQ.org | BULLETIN 17 Register early !

9th Annual Geriatrics & Palliative Care Symposium Spotlight on Elder Abuse: Now is the Time for Multidisciplinary Collaboration and Intervention Across the Care Continuum This Symposium is Tuesday, presented collaboratively by: January 14, 2020 NewYork-Presbyterian Queens 7:30 a.m. - 12 :45 p.m. Division of Geriatrics NewYork-Presbyterian Queens & Palliative Care Medicine Theresa and Eugene M. Lang Center Weill Cornell Medicine for Research and Education Division of Geriatrics 56-45 Main Street, Flushing, NY 11355 & Palliative Medicine Symposium Moderators NYC Elder Abuse Center Cynthia X. Pan, MD, FACP, AGSF Academy of Medicine of Queens County Jane Morris, MS, RN, ACHPN KEYNOTE SPEAKERS Credit Risa Breckman, LCSW Maximum o f 4.25 AMA PRA Veronica LoFaso, MD ™ Category 1 Credit(s ) Click here to register Nursing: 4.25 contact hours 718-67 0-141 9 • www.nypqcme.org

Professionals serving older adults

www.MSCQ.org | BULLETIN 18 CONTACT 2019 - 2020 MSCQ Officers

Board of Trustees President Lorraine M. Giordano, MD, FACEP, FAADM, Chair Liana H. Leung, MD, MPH, FACP 212th ANNUAL DINNER President’s Recognition Event Louis-Joseph Auguste, MD, MPH, FACS, Secretary President-Elect Fred S. Fensterer, MD & Physician Expo David Vilabrera, MD May 13, 2019 Cornelius J. Foley, MD Arthur C. Fougner, MD Immediate Past President With heartfelt Gary J. Guarnaccia, MD Allen C. Small, MD, FACP gratitude. .. Sandhya Malhotra, MD Secretary We wish to thank all of Michael L. Richter, MD David A. Fishman, MD our generous James E. Satterﬁeld, MD Assistant Secretary Sponsors Physician Expo Exhibitors Emeriti Board of Trustees Joseph D’Amore, MD Leah S. McCormack, MD Advertisers and Contributors Ralph E. Schlossman, MD * Treasurer Joseph T. Cooke, MD for your commitment Emeriti Executive Director to the health of our Karolyn J. Burbige * Assistant Treasurer communities. Janine Regosin* Ayman Z. Attia, MD Your continued annual support helps to make our public Historian *Deceased health initiatives, Leah S. McCormack, MD Executive Director continuing medical educational Evangeline Rosad o-Tripp, BA Directing Librarian programs, and special Saulius J. Skeivys, MD, FAAFP professional and community Accounting Specialist & events possible. Workers’ Comp. Coordinator MSSNY Councilor Thank you. Gina Burgos, MPS-ATR Saulius J. Skeivys, MD, FAAFP

BULLETIN The Karolyn (Lynn) is published 3x/year for the membership of EDITORIAL BOARD Burbige Legacy Tree the Medical Society of the County of Queens David A. Fishman, MD, Editor and The Academy of Medicine Secretary of the Medical Society of Queens County. of the County of Queens For information about membership, PUBLICATION COMMITTEE advertising, tax deductible inquiries, article submission, CME listings and • David A. Fishman, MD letters to the editor, please contact: Chair Make a Donation to Honor a Friend, Colleague or Loved One. • Liana H. Leung, MD, MPH, FACP The Medical Society of the County of Queens Have your special message President 2019-20 112-25 Queens Boulevard, 4th Floor engraved on a brass leaf. Forest Hills, NY 11375 • Evangeline Rosado-Tripp Levels of $25, $75 & $150 tel: 718.268.7300 Executive Director Please contact: fax: 718.268.7301 & Managing Editor Gina Burgos, MPS-ATR Att: ERTripp @QueensMedicalSociety.org 718.268.7300 www.MSCQ.org Design: JBRH 917.399.8440 [email protected]