Editorial Pg 12 a Public Health Approach to Gun Control

VOLUME CXXVI ISSUE 9 • INDIANAPOLIS, INDIANA SEPTEMBER 2019 BULLETIN

editorial pg 12 A Public Health Approach to Gun Control

by RICHARD D. FELDMAN, MD

IMS Board Member, Family Physician, Former Indiana State Health Commissioner

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VOLUME CXXVI • ISSUE 9 INDIANAPOLIS, INDIANA TABLE OF CONTENTS BULLETIN IN THIS ISSUE OFFICIAL MONTHLY PUBLICATION OF THE SPECIAL FEATURES Indianapolis Medical Society President’s Page...... 04 125 West Market Street, Suite 300 Indianapolis, IN 46204 “The all-cause mortality rate among participants who consumed 2 or more glasses per day of total soft drinks was higher than that ph: 317-639-3406 www.indymedicalsociety.org among participants who consumed less than 1 glass per month.”

Editorial: Childhood Sex Abuse...... 06 President CHRISTOPHER D. BOJRAB Special Feature: 2019 Sachem Recepient...... 08 President-Elect ERIC E. TIBESAR Editorial: A Public Health Approach to Gun Control ...... 12

Board Chair LINDA FEIWELL ABELS ANNOUNCEMENTS Editor/Executive Vice President MORGAN E. PERRILL New Members ...... 15 Direct copy for publication and inquiries regarding advertising to: [email protected] Bulletin Board ...... 17

The Bulletin invites news from and about members of the Indianapolis CME ...... Medical Society. Copy deadline: First of the month preceding month of 18 publication. IMS Leadership ...... 19 Advertising: Rates available upon request. Advertisers should provide electronic files by the first of the month preceding publication. Placement of advertisements, except for premium spaces, will be throughout the publication at the discretion of the editor. LETTER FROM THE EDITOR: Board Certification Policy: IMS publishes board certifications approved by the American Board of Medical Specialties, American Osteopathic Thank you for your readership! And thank you to those of you who Association, and Royal College of Surgeons. Physician members wishing to designate an area of special interest in which their boards have been submitting articles! The Bulletin is your magazine. If you are not ABMS-, AOA-, or RCS-approved may use the following wording: have an idea or opinion you’d like to share, or an article you have “Specializing in.” written, please email me at [email protected]. We Statements and conclusions of authors that are published in The Bulletin are solely those of the authors and do not necessarily reflect would love to publish it. Indianapolis Medical Society policy or position. The Indianapolis Medical We have several thought-provoking articles to share with you this Society makes no representation or warranty as to their accuracy or reliability. Advertisements published in The Bulletin do not imply month. In our October edition, we will have an update for you from approval or endorsement by the Indianapolis Medical Society, but the ISMA Annual Convention so be sure to watch for represent solely the viewpoint of the advertiser or their agent. next month.

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IMS BULLETIN • SEPTEMBER 2019 PAGE 3 THE PRESIDENT’S PAGE CHRISTOPHER D. BOJRAB, MD

The Beverage Wars and the Sick-User Effect

ecently at a meeting, I had an exchange with a respected colleague about the potential risks associated with sodas and products sweetened with Rsugar substitutes. He expressed concern about these potential risks which was contrary to my under- standing of the topic. It prompted me to spend some time doing a review of some of the more recent data.

There has been more interest again in this topic lately due to a recent article in JAMA Internal Medicine published September 3, 2019 titled Association Between ened drinks and deaths from digestive diseases with Soft Drink Consumption and Mortality in 10 European a hazard ratio of 1.59 (95% CI 1.1.24-2.05). A significant Countries by Amy Mulee, PhD, Dora Romaguera, PhD, difference in mortality rates were not observed for Jonathan Pearson-Stuttard, BMMCh, et. al. This was cancer or neurodegenerative diseases. an observational study looking at over 520,000 sub- jects from 10 countries in Europe The confidence intervals of evaluating the consumption of most of the outcomes are sugar-sweetened and artificial- “I believe that if we consider what largely overlapping, so it ly sweetened soft drinks and is hard to draw solid con- all-cause mortality between 1992 we have learned about these pos- clusions. Also, the study and 2000. They looked at total sible differences as mentioned did not look at 2 or more mortality and cause-specific mor- above, we should explore these glasses consumed per day tality. Of the total group, over new hypotheses both vigorously vs. 1 or less glasses con- 450,000 were included in the and rigorously. To be sure, there sumed per day, but rather study (86.7%) with an average are some fascinating findings 1 or less glasses consumed age of 50.8 years (roughly 71% per MONTH. I would have female and 29% male). early on, but they are still early and almost exclusively limited to been interested to see what animal studies at this point.” many would consider to be The mean follow-up period was an “average” consumption 16.4 years during which time of around 2 glasses per day, there were just under 41,693 deaths. The all-cause a very low consumption of mortality rate among participants who consumed less than 1 glass per month (both of which they did) 2 or more glasses per day of total soft drinks was but then also a very high consumption group (perhaps higher than that among participants who consumed those individuals consuming on average 6 or more per less than 1 glass per month. The hazard ratio for total day?). soft drinks was 1.17 (95% CI 1.11-1.22), sugar-sweetened drinks was 1.08 (95% CI 1.01-1.16), and artificially sweet- The study did attempt to adjust for the role of BMI as ened drinks was 1.26 (95% CI 1.16-1.35). Subgroup anal- the degree of adiposity could be a confounding vari- ysis showed a positive association between artificially able in many ways, but the results were unchanged sweetened soft drinks and deaths from circulatory with or without BMI adjustment. (in a separate review diseases with a hazard ratio of 1.52 ((95% CI 1.30-1.78), of related articles, 3 of 7 studies pointed to a possible as well as a positive association between sugar-sweet-

IMS BULLETIN • SEPTEMBER 2019 PAGE 4 THE PRESIDENT’S PAGE CHRISTOPHER D. BOJRAB, MD

increase in hepatic lipogenesis associated with the use of fructose and 4 of 7 studies pointed to possible increases in insulin resistance associated with the use of fructose). (J Hepatol. 2018 May; 68(5): 1063–1075.)

Complicating this type of observational study is the fact that people who are overweight and who are at greater risk of cardiovascular disease are more likely to avoid sugar-sweetened drinks, so while this may strengthen the association, it does not speak to the degree of causation. This is an example of the sick-user effect. This is also seen in the association between the use of a daily multivitamin and an increased risk of mortality (people who are sick or recently diag- nosed with a potentially life-threatening illness are gradually declined over the course of observation more likely to take multivitamins than are the gener- following NNS consumption. The glycemic impact of al public). NNS consumption did not differ by type of NNS but to some extent varied by participants’ age, body weight, and diabetic status.” And concluded, “NNS consump- Other reviews of the association between artificial tion was not found to elevate blood glucose level. sweeteners or low calorie sweeteners (AS/LCS) and Future studies are warranted to assess the health im- sugar have pointed to similar associations, but have plications of frequent and chronic NNS consumption also pointed out that the use of these AS/LCS may and elucidate the underlying biological mechanisms.” be more likely the result of these other health issues (Eur J Clin Nutr. 2018 Jun;72(6):796-804. doi: 10.1038/ rather than the cause. s41430-018-0170-6. Epub 2018 May 15.)

There have been some animal (rat and mice) studies As a side note, doing a little reading for this article that have suggested a correlation between the use of dramatically pointed out the ways in which there are AS/LCS and weight gain, but many of these studies often times difference between theory, basic bench used what appear to be unrealistically high levels/ science, animal studies, and human studies. It made amounts of AS/LCS compared to what would be seen me think of some of the information coming out re- in actual dietary consumption. To be sure, the ani- garding the impact of our gut microbiome on a vari- mal data is a good reason to address the question in ety of health concerns (obesity, diabetes, autoimmune human studies, which has been done. Larger scale disease, autism, depression, etc.). I believe that if we reviews of the impact of AS/LCS have found that consider what we have learned about these possible “Low-calorie sweeteners provide a means to reduce differences as mentioned above, we should explore energy density while largely preserving food or bev- these new hypotheses both vigorously and rigorously. erage reward value. Consistent with this, consump- To be sure, there are some fascinating findings early tion of low-calorie sweeteners compared with con- on, but they are still early and almost exclusively sumption of sugars has been found to reduce energy limited to animal studies at this point. This may turn intake and body weight.” (Obesity (Silver Spring). 2018 out to be the basis of some useful and important treat- Oct;26 Suppl 3:S18-S24. doi: 10.1002/oby.22280.) ment interventions for patients, but I am concerned that some people are rushing headlong into making treatment recommendations to patients prematurely. There have also been concerns that there may be harmful effects on glycemic control caused by AS/ LCS. One of the largest and most recent reviews from last year evaluating the glycemic impact of these products (also referred to as nonnutritive sweeteners Chris Bojrab, MD, DFAPA or NNSs) found that “NNS consumption was not found President to increase blood glucose level, and its concentration Indianapolis Medical Society

IMS BULLETIN • SEPTEMBER 2019 PAGE 5 EDITORIAL Childhood Sex Abuse: A Pre-Existing Condition Under Attack A Case Study on Sexual Trauma and Disordered Eating

by CAROLINA VOGEL, BS, OMS-III & THERESA ROHR-KIRCHGRABER, MD

A forty year old female presents for treatment of “rating up” and can also result from a patient taking anorexia with purging behaviors. She described a certain medications or having other minor and com- history of sexual abuse by her father from the age of mon medical conditions like acne or menstrual irreg- 3-18. Her mother had died when she was very young ularities (Assistant). When the ACA was enacted in and the sexual abuse began soon afterward. She has 2014 it offered protections from pre-existing conditions had intermittent treatment for her ED but only recent- (Assistant, Sovereign). These protections enabled pa- ly disclosed the history of sexual abuse. She currently tients with pre-existing conditions to obtain coverage has a BMI of 15 kg/m^2 and purges daily. that they may have previously been denied or unable to afford due to rating up. Adverse Childhood Events (ACE) such as childhood abuse and trauma, especially that of a sexual nature, Starting in 2017, the Trump administration has pro- create a powerful predilection for development of an posed changes to the ACA, the American Healthcare eating disorder (ED) even years Act (AHCA/”Trumpcare”). later (Holzer, Victims). Compared Versions of the AHCA cur- with women who reported no “Adverse Childhood Events rently proposed could strip abuse, women who reported a many patients of the insur- history of ACE have twice the (ACE) such as childhood ance coverage protections odds of suffering from subclinical abuse and trauma, especially that the ACA afforded them ED symptoms or meeting crite- that of a sexual nature, cre- (Rovner). Therefore, it would ria for an ED (Rayworth). Addi- ate a powerful predilection also negatively impact those tionally, 94% of women who are for development of an eating ED sufferers who have a raped experience Post Traumatic disorder (ED) even years lat- history of ACE from procur- Stress Disorder (PTSD) in the two ing affordable care for their weeks following the attack and er (Holzer, Victims).” illnesses. 30% report symptoms after nine months (Victims). Women dispro- If the AHCA were to move portionately suffer from ED’s and sexual trauma when forward as proposed in 2017 or amended in 2018 this compared to their male counterparts (Victims). patient and hundreds of women with similar histories will not have the same opportunity to obtain recovery When seeking treatment for an ED many patients due to their history of ACE, PTSD, sexual abuse, or have found coverage and financial protection un- even rape (Assistant, Sovereign). Because these con- der the Affordable Care Act (ACA). Prior to the ACA ditions are disproportionately suffered by women the many medical conditions could prevent a person from AHCA has the potential to perpetuate gender dispari- obtaining coverage or result in the patient being ties in healthcare access. charged a higher premium (Fehr). This is known as

IMS BULLETIN • SEPTEMBER 2019 PAGE 6 Note from the Editor: Opinions expressed in this piece (and all pieces) are those of the author(s)’s and are not made on behalf of the society or any employer and specif- ically in this case on behalf of Indiana University.

This case supports that pre-existing conditions such as abuse can lead to significant disease later in life and highlights the imperative of a thorough history that does not preclude treatment. Addendums have been proposed to the AHCA that may help alleviate this potential discrepancy in care. Experts disagree if the currently proposed addendums would truly expand coverage to those most disadvantaged (Kodiak, Christopherson). The legislation and proposed amendments continue to be debated in the public and political spheres, but it is clear that the public is in favor of protections for patients with pre-existing conditions (Rovner). This case further demonstrates the importance of advocacy in support of disadvantaged patient populations and the need for protection for those with pre-existing conditions.

Sources:

Assistant Secretary for Public Affairs. (2017, January 31). About the ACA: Pre-Existing Conditions. Retrieved from: https:// www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html

Christopherson, Sarah. (2017, May 18). Trumpcare and the turn of Rape and Domestic Violence as Pre-existing Conditions. https://rewire.news/article/2017/05/18/trumpcare-return-rape-domestic-violence-pre-existing-conditions/

Fehr, R, et al. 2018. Mapping Pre-existing Conditions across the U.S. Health Reform.

Holzer, S, et al. 2008. Mediational significance of PTSD in the relationship of sexual trauma and eating disorders. Child Abuse & Neglect. Issue 5: 561-566.

Kodjak, Alison. (2017, May 11). Is Rape a Pre-Existing Condition? Not Exactly. https://www.npr.org/sections/health- shots/2017/05/11/527938951/is-rape-a-pre-existing-condition-not-exactly

Rayworth, BB, Wise, LA, Harlow, BL. 2004. Childhood abuse and risk of eating disorders in women. Epidemiology. 15(3):271-8.

Rovner, Julie. (2018, October 11). Fact Check: Who’s Right On Protections For Preexisting Conditions? It’s Complicated. Re- trieved from: https://www.kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-june-2018-campaigns-pre-existing-conditions-prescription-drug-ads/

Sovereign Health of Arizona. (2017, May 8). Under Trumpcare, PTSD, PPD can be pre-existing conditions. Retrieved from https://www.sovarizona.com/trauma/trumpcare-ptsd-ppd-can-pre-existing-conditions/

Victims of Sexual Violence: Statistics. (2018). Retrieved from https://www.rainn.org/statistics/victims-sexual-violence

IMS BULLETIN • SEPTEMBER2019 PAGE 7 SPECIAL FEATURE 2019 Sachem Recipient Dr. George F. Rapp

by Bernard J. Emkes, MD IMS Member and Past President

On August 27th, 2019, Dr George F Rapp It is quite an honor for Dr Rapp and Peggy, received from Governor Holcomb the high- his lifetime partner. Their children, grand- est honor anyone can receive from Indiana children and great-grandchildren were state government. Most of us are familiar all in attendance. An estimated 200 people with the Sagamore of the Wabash, which is attended the event, held at the State Muse- routinely given to deserving citizens. The um. Congratulations to Dr Rapp from his St Sachem (Say-chem -hard CH) Award is given Vincent family. to “at most” one person per year and sym- bolizes a lifetime of service and excellence. SACHEM SCULPTURE Achievement as well as virtue are required to be considered for this award. The Sachem sculpture was created by Dr Rapp exemplifies the virtues needed Jeffery L. Fearin, Jr. Born in Knightstown, as he has worked and continues to work Indiana, he served three years in the U.S. tirelessly in retirement for New Harmony, Army before attending Herron School of his birthplace – both the town and the Arts Art and Design. He graduated in May of Community, the medical field and the India- 2006 with a bachelor’s degree in Fine Arts. napolis Art Community. His ongoing support Jeffery found inspiration for the Sachem of the Hoosier Salon is incredible. His ser- sculpture from two sources relating to the vice on innumerable Boards was also con- Treaty of Greenville of 1795 between the sidered in the nomination process. United States and Native American tribes in the region, including the Miamis. The Sachem was first implemented as a “business thought leader group” by Gover- The scroll represents the treaty itself and nor Ed Whitcomb in 1970, but Gov. Mitch the pipeline tomahawk represents the one Daniels resurrected the award with a dif- given to Chief Little Turtle by General ferent twist in 2005 – to reflect individual Anthony Wayne as a gesture of peace when service and excellence. Since that date one the treaty was signed. In addition to Gener- award has been given yearly except for al Wayne, General William Henry Harrison 2016. of Indiana was also present at the signing; Indiana’s second largest city was named for Past recipients include John Wooden (2005), General Wayne, and General Harrison later Father Theodore Hesburgh (2006), Bill Cook became the ninth President of the United (2011) and Eva Kor (2017). These are all States. names we easily recognize, but there are many other well-deserving recipients.

IMS BULLETIN • SEPTEMBER 2019 PAGE 8 Sachem Award Recipients

2005 2012 John Wooden Ian M. Rolland

2006 2013 Rev. Theodore Hesburgh Don Wolf

2007 2014 Jane Blaffer Owen P.E. MacAllister

2008 2015 Bill & Gloria Gaither Amos C, Brown, III

2009 2017 Donald C. “Danny” Danielson Eva Mozes Kor

2010 2018 Carl D. Erskine Sammy Davis, Jr.

2011 2019 William A. “Bill” Cook George F. Rapp, M.D.

IMS BULLETIN • SEPTEMBER 2019 PAGE 9 SPEICAL FEATURE continued

THE HISTORY OF THE SACHEM AWARD

In 1970, Governor Whitcomb introduced the “Con- federacy of Indiana Sachems” - a group of business, industry, publishing, banking, and legal leaders - who would serve as state hosts, welcoming visitors to Indiana and promoting the state’s culture and economy. The organization’s name came from the Algonquin term given to village leaders, implying wisdom, judgment, and grace. Such Native leaders were consulted on matters that required these virtues, and their guidance and experience accorded them a special place in Native societies.

Following Governor Whitcomb’s term, the Sachem project was not pursed further during the 1980s and 1990s and the organization dissolved. However, in 2005, Governor Whitcomb visited Governor Daniels to acquaint him with the concept, leading Governor Daniels to recreate the Sachem as a recognition to be awarded to our State’s finest citizens.

Today, Indiana’s Sachem honorees are selected by the Governor on the basis of a lifetime of excellence and integrity. Achievement alone, without extraor- dinary virtue, does not qualify a person for this recognition - rather, the honor serves to underscore the importance of moral example. Along with the des- ignation, each Sachem honoree receives a specially designed sculpture that captures the Native Ameri- can heritage of the Sachem, and his or her name is placed on a plaque in the Statehouse rotunda.

IMS BULLETIN • SEPTEMBER 2019 PAGE 10

EDITORIAL A Public Health Approach to Gun Control

by RICHARD D. FELDMAN, MD IMS Board Member, Family Physician, Former Indiana State Health Commissioner

olumbine. Sandy Hook. Las Vegas. Pitts- assault-like weapon and high capacity magazine burg. Parkland. El Paso. Dayton. Odessa. bans, enhanced mental illness intervention, fede- Certainly not an all-inclusive list of high-pro- ral gun registration, safe gun storage, and “red Cfile mass-shooting tragedies. Mass shootings flag” laws allowing the temporary confiscation of are becoming more frequent. During 2018 in the firearms from high-risk individuals until a court U.S., there were 340 mass shoo- can rule. tings (defined as 4 or more shot) with 1346 people wounded and I am a gun owner. I believe in 373 killed. That’s just the tip of “There are 80,000 in- the right to defend myself in my the iceberg. While mass shoo- juries from firearms home, and that the American tings are horrific, the firearm each year in the U.S. public should not be disarmed. death toll from homicides, with 39,000 fatalities.” It is a necessary defense to a ty- accidents, and suicides is also of rannical and demagogic govern- great concern. There are 80,000 ment, if that should ever occur injuries from firearms each year in the U.S. with in America. But reasonable gun 39,000 fatalities. Sixty percent of firearm deaths control is warranted. What is occurring in our are from suicide. country is outrageous. The vast majority of Ame- ricans support reasonable gun-control measures. Presidential candidates and gun-control activists have promoted various ideas to curb the violence. So, what can a physician add to this discussion? They include universal background checks, A public health approach. It has been successful-

IMS BULLETIN • SEPTEMBER 2019 PAGE 12 EDITORIAL continued ly utilized for other public health issues. Take motor vehicle deaths. We didn’t do away with automo- biles, but rather researched the issues that gave us answers to making motor vehicles safer. The public health approach has been used to battle tobacco use, obesity, the opioid epidemic, HIV/AIDS, and heart disease.

The approach recognizes that although behavioral change is important, it’s usually more effective to change the environment. It recognizes that garne- ring common ground between those with opposing perspectives is essential.

“A public health Public health professionals, joined by health-care approach offers a providers, add the health perspective to what is ordinarily a criminal justice and legislative process. methodical, com- Indeed, seven physician and public health organi- prehensive, and zations just released a position statement regarding firearm-related injury and death published in the scientific method Annals of Internal Medicine. It endorses some of the for finding solu- measures listed above. It adds a call for systematic research on gun injury and violence as well as pro- tions to cultural, tection of confidential, unrestricted patient-physician social, economic, communication regarding gun ownership and gun and mental-heal- safety. th factors; and for A public health approach offers a methodical, com- prehensive, and scientific method for finding solu- researching the tions to cultural, social, economic, and mental-health agents that deliver factors; and for researching the agents that deliver the injuries. It involves the entire community inclu- the injuries. ” ding government, law enforcement, public health and health-care organizations, and religious, educa- RICHARD D. FELDMAN, MD tional, and business entities working together to find solutions.

The public health approach involves epidemiological research and the rigorous scientific evaluation of suggested constitutionally-consistent changes in re- gulations, policies, and laws; investigating perpetra- tor risk factors and factors that may protect against violence and injury; testing the effectiveness of proposed strategies; and implementing proven solutions and best practices. We are currently entertaining changes in policy that sound good or intuitive but not necessarily data-driven and evidenced-based.

But there is a serious lack of necessary federal- ly-funded research on gun violence that may lead to gun control measures since a Congressional ban was enacted in 1996. Although there has been some Presidential and Congressional affirmation for the research of gun violence, the research has never recovered.

Inordinate gun violence is preventable and should not be considered acceptable collateral damage for the right of gun ownership.

IMS BULLETIN • SEPTEMBER 2019 PAGE 13

WELCOME NEW MEMBERS

Kara Wools-Kaloustian, MD Amy Hanson, MD Indiana University School of Medicine Resident 545 Barnhill Drive, Emerson Hall, Suite 421 Pediatrics Indianapolis, IN 46202 Iowa University School of Medicine, 2019 Infectious Disease Indiana University School of Medicine, 1988 Cody Hillin, MD Resident Raja Ramaswamy, MD Orthopedic Surgery Radiology of Indiana P.C. Baylor College of Medicine, 2014 7340 Shadeland Station, Suite 200 Indianapolis, IN 46265 Lauren Karbach, MD 317-579-2150 Resident Diagnostic Radiology Orthopedic Surgery Chicago Medical School at Rosalind Franklin University, Baylor College of Medicine, 2013 2009 Elise Miller, MD Ruby Benn, MD Resident Resident Diagnostic Radiology OBGYN Indiana University School of Medicine, 2013 Indiana University School of Medicine, 2019 Ravitet Bommu, MD Mohsin Mukhtar, MD Resident Resident Pathology Radiology Indiana University School of Medicine, 2019 Indiana University School of Medicine, 2019 Darrian Bost, MD Kristin Ploetz, MD Resident Resident Pediatrics Orthopedic Surgery Indiana University School of Medicine, 2019 Vanderbilt University School of Medicine, 2014 Farah Bshesh, MD Wahida Rahman, MD Resident Resident Pediatrics Diagnostic Radiology Weill Cornell Medicine-Qatar, 2019 Indiana University School of Medicine, 2013 Brock Reiter, MD Brian Bussey, MD Resident Resident Orthopedic Surgery Diagnostic Radiology Chicago Medical School at Rosalind Franklin University, University of Cincinnati College of Medicine, 2013 2014 Sara Takacs, MD Kristin Buterbaugh, MD Resident Resident Neurology Orthopedic Surgery Indiana University School of Medicine, 2016 Mt. Sinai School of Medicine, 2014 William Warrender, MD Andrew Carlisle, MD Resident Orthopedic Surgery Resident Sidney Kimmel Medical College at Thomas Jefferson Anesthesiology University, 2014 Ross University School of Medicine, 2017

IMS BULLETIN • SEPTEMBER 2019 PAGE 15

THE BULLETIN BOARD

THERESA ROHR-KRICHGRABER, MD RICK C. SASSO, MD

Theresa Rohr-Kirchgraber, MD re- Dr. Rick Sasso was involved with a cently presented to the Resource and manuscript published in the Inter- Adoptive Parent Training (RAPT) national Journal of Spine Surgery attendees on To “REAP” Success: first and describes a novel non-operative care for ourselves. Her presentation treatment for low back pain that just to the group in Noblesville was well completed a multi-center FDA pro- received. spective trial.

Fischgrund JS, Rhyne A, Franke J, Sasso R, Kitchel S, Bae H, Yeung C. Truumees E, Schaufele M, Yuan P, Vajkoczy P, Depalma M, Anderson DG, Thibodeau L, Meyer B: Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 2-Year results from a prospective randomized double-blind sham-controlled multicenter study. Int J Spine Surg 13: 110-119, 2019.

Justin Miller, M.D., Joseph D. Smucker, M.D., Rick Sasso, M.D. and Ryan Snowden, M.D. were published in the Journal of Neurosurgery Spine. It is a prospective clinical study assessing adjacent level disc degeneration after anterior cervical fusion surgical procedures.

Snowden R, Miller J, Saidon T, Smucker JD, Riew KD, Sasso R: Does index level sagittal alignment de- termine adjacent level disc height loss? J Neurosurg Spine 2019.

Please submit Bulletin Board Information to [email protected]. Your photo in the IMS files will be used unless an updated picture is submitted with your material.

IMS BULLETIN • AUGUST 2019 PAGE 17 CME & CONFERENCES MONTHLY EVENTS TUESDAY WEDNESDAY THURSDAY FRIDAY

1st Week of the Month Community North: Breast Community East: CHE Admin Community North: Forum Cancer Conf. 7-8 am Conf. 12-1 pm 7-8 am Community North: Psychiatry Community South: South Case GR 12:30-1:30 pm Presentations 12-1 pm Community North: Chest Cancer Conf. 7-8 am Community Heart & Vascular: Imaging Conf. 7-8 am

Community North: GI/Oncol- St. Vincent: Echocardiography Community North: Gynecolog- 2nd Week of the Month Community East: Medical GR ogy Conf. 7-8 am Conf. 7-8 am ical/Oncology Conf. 7-8 am 1-2 pm Community Heart & Vascular: Community South General M&M Conf. 7-8 am CHS 12-1 pm Community South: Breast Cancer Conf. 8-9 am St. Vincent Simulation Center: Pediatric GR 12-1 pm St. Vincent Womens: Neonatol- ogy GR 12-1 pm

Community North: Breast Community North: Psychiatry St. Vincent Heart Center: Car- Community North: GU Conf. 3rd Week of the Month Cancer Conf. 7-8 am GR 12:30-1:30 pm diac, Medical, Surgery 7-8 am 7-8 am Community South: South Community North: Melanoma Community South: South Case Thoracic 8-9 am 7:30-8:30 am Presentations 12-1 pm Community South: South Community Heart & Vascular: Molecular 5-6 pm CV Conf. 7-8 am

Community East: Breast Can- Community North: GI/Oncol- 4th Week of the Month cer Conf. 7-8 am ogy Conf. 7-8 am Community Heart & Vascular: Disease Manage Conf. 7-8 am St. Vincent Womens: Perinatal Case 7-8 am St. Vincent Womens: MFM Ultra Sound Series Quarterly 1-4 pm Annual St. Vincent Simulation Center: Sim Debriefing Essentials 12x/Year St. Vincent Simulation Center: PMCH Crisis Management 12x/Year

WEEKLY EVENTS ONLINE EVENTS

Day of the Week Event Indiana University School of Medicine HPV Documentary, Someone You Love: The HPV Epidemic Monday St. Vincent: General Cardiology 7-8 am http://cme.medicine.iu.edu/hpvdocumentary Opioid TeleECHO Clinic Providers and Prescribers Webinar Tuesday St. Vincent: Trauma Case 12-1 pm https://iu.cloud-cme.com/opioidecho

St. Vincent Womens: Neonatology Journal Club (every other month) 12-1 pm OCTOBER EVENTS

Wednesday St. Vincent: CCEP 7-8 am Oct 8-11 Tobacco Treatment Specialists Core Training, Evansville St. Vincent Heart Center: Interventional Cardiol Oct 18 Emergency Medicine Basic Ultrasound Workshop, IU Health Methodist ogy 7-8 am Oct 19 AMWA Learn to Identify & Fight Trafficking Training, Tallahassee, FL St. Vincent: Advanced Heart Failure 7-8 am Oct 20-23 Collaborating Across Borders, JW Marriott, Indianapolis, IN St. Vincent: Surgery Didactics 7:30-8:30 am Oct 24-25 Fundamental Critical Care Support, IU Health Methodist Hospital St. Vincent: Surgery M&M 6:30-7:30 am Oct 29 HPV Medical Provider, Top Golf, Fishers Oct 29-31 Agile Implementation Boot Camp, Indianapolis Thursday St. Vincent PMCH: Pediatric Cardiothoracic Oct 30 IU Health Pharmacology for Advanced Practice Providers, IU Health Surgery & Cardiology Conf. 12-1 pm Methodist Hospital, Indianapolis St. Vincent OrthoIndy: Fractures 8-9 am

Friday For more detailed information, please visit the events page on our web- site at www.indymedicalsociety.org/imsevents

To submit articles, Bulletin Board items, CME & events, opinions or information, email [email protected]. Deadline is the first of the month preceding publication.

IMS BULLETIN • SEPTEMBER 2019 PAGE 18 125 West Market Street, Suite 300, Indianapolis, IN 46204 ph: 317-639-3406 | www.IndyMedicalSociety.org officers 2019 President Secretary/Treasurer At-Large Vice Board Chair CHRISTOPHER D. BOJRAB JODI L. SMITH SCOTT E. PHILLIPS RAMANA S. MOORTHY

President-Elect/Vice President Immediate Past President Board Chair ISMA Liaison (non-voting) ERIC E. TIBESAR MARY IAN MCATEER LINDA FEIWELL ABELS SUSAN K. MAISEL board of directors 2019 Terms End with Year in Parentheses

Linda Feiwell Abels, Chair and Ramana S. Moorthy, Vice Chair

Rania Abbasi (2021) Richard D. Feldman (2019) Chad R. Kauffman (2019) Thomas R. Mote (2019) Linda Feiwell Abels (2019) Ann Marie Hake (2020) Jeffrey J. Kellams (2021) Mercy O. Obeime (2021) Mary Pell Abernathy (2021) Mark M. Hamilton (2021) Stephen R. Klapper (2019) Scott E. Phillips (2020) Ann C. Collins (2021) Tod C. Huntley (2019) John E. Krol (2020) Taha Z. Shipchandler (2020) Julie A. Daftari (2019) David A. Josephson (2020) Ramana S. Moorthy (2020) H. Jeffrey Whitaker (2020) past presidents’ council 2019 * Indicates Voting Board Members, Term Ends with Year in Parentheses

Carolyn A. Cunningham Bernard J. Emkes Jon D. Marhenke John J. Wernert David R. Diaz Bruce M. Goens John P. McGoff* (2019) Marc E. Duerden Paula A. Hall* (2020) Stephen W. Perkins John C. Ellis Susan K. Maisel* (2021) Richard H. Rhodes delegates Delegates to the Annual State Convention The year shown in parentheses indicates year in which the term expires following the conclusion of the ISMA Annual Convention.

Linda Feiwell Abels (2021) Darrell D. Davidson (2021) Mark M. Hamilton (2019) Ramana S. Moorthy (2020) Michael Rothbaum (2021) Mary Pell Abernathy (2021) Marc E. Duerden (2020) C. William Hanke (2021) Thomas R. Mote (2021) Jodi L. Smith (2021) Christopher D. Bojrab (2021) Robert S. Flint (2021) Chad R. Kauffman (2020) Mercy O. Obeime (2020) Eric E. Tibesar (2020) Ann C. Collins (2020) Bruce M. Goens (2020) Jeffrey J. Kellams (2019) Robert M. Pascuzzi (2020) John J. Wernert (2020) Carolyn A. Cunningham (2019) Paula A. Hall (2020) Susan K. Maisel (2019) J. Scott Pittman (2019) H. Jeffrey Whitaker (2020) Julie A. Daftari (2020) Ronda A. Hamaker (2019) Mary Ian McAteer (2020) David M. Ratzman (2021) Steven L. Wise (2021) alternate delegates Delegates to the Annual State Convention The year shown in parentheses indicates year in which the term expires following the conclusion of the ISMA Annual Convention. Ranai Abbasi (2021) Ann Marie Hake (2019) Stephen R. Klapper (2019) Ingrida I. Ozols (2021) Taha Shipchandler (2019) Jeffrey L. Amodeo (2021) Brian S. Hart (2020) John E. Krol (2020) Stephen W. Perkins (2020) Jason K. Sprunger (2019) Nicholas M. Barbaro (2019) Tod C. Huntley (2019) David E. Lehman (2020) Scott E. Phillips (2019) Richard M. Storm (2021) Daniel J. Beckman (2019) Kyle Jamison (2021) David Mandelbaum (2019) Richard H. Rhodes (2020) Glenn A. Tuckman (2021) Brian D. Clarke (2020) David A. Josephson (2020) Christopher Mernitz (2021) Dale A. Rouch (2019) John H. Ditsler (2019) Penny W. Kallmyer (2020) Martina F. Mutone (2021) Amy D. Shapiro (2019) indiana state medical association Seventh District Past Presidents Executive Committee Trustees David R. Diaz (2020) John P. McGoff Peter L. Winters John D. MacDougall Immediate Past President John C. Ellis (2021) 2017-2018 1997-1998 1987-1988 John P. McGoff Alternate Trustees Jon D. Marhenke William H. Beeson George T. Lukemeyer Susan K. Maisel (2022) 2007-2008 1992-1993 1983-1984 At-Large Richard H. Rhodes (2021) David R. Diaz Bernard J. Emkes George H. Rawls Alvin J. Haley President 2000-2001 1989-1990 1980-1981 Robert Flint (2020)

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