Peter Dipasco, MD Cer—But No Insurance Or Ability to Pay for Care—Contacted the Kansas City Medical Society Foundation’S Wy Jo Care Program Tissue

FOURTH QUARTER 2019

JOURNAL OF THE NEW KANSAS CITY MEDICAL SOCIETY

annual meeting 2019 highlights Recent HHS Official Speaks on Pain Management Charles B. Wheeler, Jr., MD, JD, Honored Scenes from the 2019 Annual Meeting advocacy Physicians Serving in State Government Advocacy Tips Ten Things You Can Do Our Commitments to You. • Highest level of customer service and expert care • Doctors will always be informed of the patient's status & progress • Quick results and happy patients Blue ValleyFeel Physical Better. Therapy NEW LOCATION! 4 LOCATIONS BLUE VALLEY PHYSICAL THERAPY & SPORTS MEDICINE

K1010396 & SouthRidgeview Ridgeview Fast Results Services Olathe, KS 66061 • Physical Therapy 913-599-4600913-599-4600 FF 913-599-4605913-599-4605 Hands-on Therapy • Occupational Therapy I-35 • Certified Hand Therapy State of the Art AmenitiesQuirvira • Certified Dry Needling 11940 W. 119th St. 119th St 119th & Quivira • Women’s Health Program Overland Park, KS 66213 Friendly, Warm and Welcoming Place to Rehab 913-563-5500913-563-5500 • Vestibular Rehabilitation FF 913-563-5174913-563-5174 5 Star Google Review Rating • Aquatic Rehabilitation • Graston Certified • Post-Operative Rehabilitation 6885 W. 151st St. 151stSuite 102 & Metcalf • Sports47th Medicine & Rainbow 913-897-1100Overland Park, KS 66223 Don't let pain or injury get in the way • Specialists913-789-0888 in Spine Rehabilitation F913-897-1100 913-897-9696 of your patients living their life to the fullest. • CertifiedF 913-789-0887 Titlelist Performance Institute F 913-897-9696 Refer now so your patients can FEEL BETTER. • FMS Testing & Training • Licensed Oriental Medicine & Acupuncture • Comprehensive Total Joint Replacement Program Thank you for your support. Feelwww.bluevalleypt.com Better. bluevalleypt.com

OVER 400Appointments FIVE STAR available from 6am until 7pm Monday through Friday. Don’t let pain or injury get in the way of your patients living their life to the fullest. GOOGLE REVIEWS Refer now so your patients can FEEL BETTER.

2 fourth quarter 2019 — fourth quarter 2019 —

from the Editor 2019 kcms Awards 03 Recognition and Advocacy 14 Physician and Public Servant saluting the recipients of the medical society’s awards and lifetime achievement award: charles b. wheeler, jr., md, jd those who advocate for medicine By Jim Braibish, Kansas City Medicine By Michael L. O’Dell, MD, Editor, Kansas City Medicine 16 An Outstanding Educator of Physicians and the speaking Community Editorially friend of medicine award: patrick b. “rusty” ryan, pharmd 05 Suprise Medical Bills By Jim Braibish, Kansas City Medicine insurance plans’ narrow provider networks and the search for legislative solutions 18 Taking on Leadership Roles at Hospital and With KCMS By Charles W. Van Way, III, MD, Editor Emeritus, Kansas City Medicine rising star award: carole e. freiberger-o’keefe, do

19 Stepping Up to Provide Care to a Patient in Need 2019 kcms patient & community advocate award: leland graves, iii, md Annual Meeting & peter j. dipasco, md 08 Speakers, Awards Highlight 2019 Annual Meeting 20 Building Independent Practice Organizations Individualized, Multidisciplinary Approach to Pain 09 innovation award: nathan d. granger, md, mba Management Is Needed keynote address by vanila m. singh, md, macm 21 Student-Run Clinic Cares for Underserved Population community service award: jaydoc free clinic 10 Scenes from the 2019 Annual Meeting 22 Contributing to Patient Care, Teaching and Research Thank You to Annual Meeting Sponsors 13 in Cardiology exemplary leadership award: james l. vacek, md, ms

Advocacy 24 Bringing the Physician Voice to State Elected Office profiles of former gov. jeff colyer, md; state sen. barbara bollier, md; and state rep. jonathan patterson, md By Jim Braibish, Kansas City Medicine

28 Advocacy Tips Presented at “Medicine’s Muscle”

29 Ten Things You Can Do to Get Involved That Don’t Require Money

By State Rep. Jonathan Patterson, MD

ON THE COVER: Vanila Singh, MD, MACM, of Stanford University and the chair of a federal multi‐agency task force on pain management, speaks to the 2019 Kansas City Medical Society Annual Meeting. (photo by Mike Curtis)

kansas city medicine 1 Vol. V, No. 4 Fourth Quarter 2019 Official publication of the new Kansas City Medical Society www.kcmedicine.org

Kansas City Medicine (ISSN 2473-327X) (USPS 227-680) is published quarterly by the Kansas City Medical Society, 300 E. 39th St., Kansas City, MO 64111, phone (816) 315-0164. Sub- scription price $10.00 per year to physicians and $50.00 per year to all others. Periodicals postage paid at Kansas City, MO, and additional mailing offices. POSTMASTER: Send address changes to Kansas City Medical Society, 300 E. 39th St., Kansas Editor City, MO 64111. Copyright © 2019 Kansas City Medical Society. Michael L. O’Dell, MD Editor Emeritus Charles W. Van Way, III, MD The Kansas City Medical Society in no way endorses opinions or statements contained in this publication except those that Associate Editors accurately reflect official action of the Society. Acceptance of ad- John C. Hagan, III, MD vertising in this publication in no way constitutes professional John Sheldon, MD approval or endorsement of products or services which may be Karl Stark, MD advertised. The Kansas City Medical Society reserves the right to reject any advertising material submitted for publication. Managing Editor James Braibish All communication should be sent to: Kansas City Medical Soci- ety, 300 E. 39th St., Kansas City, MO 64111, or 10000 Marshall Medical Society Staff Dr., Lenexa, KS 66215. Angela Broderick-Bedell, CAE, Executive Director Emily Whalen, Director, Membership & Special Events Karole Bradford, Foundation Chief Program Officer

Send all advertising inquiries to: Angela Broderick-Bedell [email protected]

The New Kansas City Medical Society Board of Directors 2019

Mark Brady, MD, President Joshua Mammen, MD, PhD, Past President John Hagan, III, MD, Chair, Governance Betty Drees, MD, President-Elect Scott Kujath, MD, Chair, Patient Advocacy Carole Freiberger-O’Keefe, DO, Secretary Jim Wetzel, MD, Chair, Strategic Planning Gregory Unruh, MD, Treasurer Michael O’Dell, MD, Editor, Kansas City Medicine Chris Dixon, MD, At Large Sheila McGreevy, MD, At Large Joseph Reuben, MD, At Large Stephen Salanski, MD, At Large from the Editor Recognition and Advocacy saluting the recipients of the medical society’s 2019 awards and those who advocate for medicine By Michael L. O’Dell, MD, MSHA, FAAFP, Editor, Kansas City Medicine

At our September 26 Kansas City than to recognize. Our awardees seemed present. Would you also prefer to speak for Medical Society Annual Meeting, we preternatural in their assumption of the yourself in choosing your professional life’s came together to recognize our honorees behaviors of humility. direction? Most likely that answer is yes and support our advocates. We celebrated Another complex behavior extolled as well, but doing so would substantially some of the best in medicine and in the description of our honorees is that interfere with the time needed for that encouraged those who support our work. of compassion. Our senses recognize same professional life. compassion in a warm touch and a soft We, physicians, are few, and our care RECOGNITION voice. But more importantly, it is the remains in high demand. There is a need One of the enduring questions of pattern of elevating the care of another to be present with our patients, which cognition is, How do we as humans limits our time available to advocate for recognize each other? our profession. Given this, we rely on our And further, what is our response What we saw in our friends to promote us. to recognition? Beyond personal Thankfully, we have several friends identification, just what did we recognize honorees are the working on our behalf. Recognized in in our honorees for this year? attributes of health this issue of Kansas City Medicine are Recognition is mostly a sensory a special group of physicians who give experience, bolstered by the expectation care ... a person generously of their time to serve as elected of a set of patterns associated with visibly with others in representatives in our state legislatures individuals and events. Given this and executive branch offices. Besides their sensory experience, what sort of sensory their time of need. work, we are grateful to our state medical stimulation precipitated identifying our associations that testify and lobby on our awardees? And what patterns did we behalf routinely. We also appreciate our detect? to such importance as to be described as practicing colleagues who support these What we saw in our honorees are the selfless. We did not hear tales of personal efforts. attributes of health care. Someone who is struggles; only stories of the repeated help As the start of the 2020 legislative with others. A person visibly with others given to others came to light. sessions nears, I encourage you to become in their time of need. Someone who is seen We celebrated our awardees’ acts as informed about the issues and join in by those in need as essential to be near. seen by those in need. We heard about being an advocate for medicine. Beyond a given moment, history let us them from the voices of patients. We � Michael O’Dell, MD, MSHA, FAAFP, is chair know that our honorees were repeatedly, learned from their touching presence, of the Department of Community and Family seemingly always, seen with those in need. memorably lessening suffering. We honor Medicine at the University of Missouri-Kansas What we heard from our honored was and recognize them to the fullest sense. City School of Medicine, and associate chief often very little. We heard for the many medical officer for the Truman Medical Centers Lakewood campus. He can be reached at mi- others whose experiences extolled their ADVOCACY chael.o’[email protected]. appreciation of the awardees. A pattern of Who would you choose to select the healing experiences emerged from those perfect gift for you? Would it be a stranger many in the honorees’ presences over or a friend, or would you choose it? time. Humility is a behavior pattern that Most of us know what we might like and takes longer for the individual to develop would nominate ourselves to pick out the

kansas city medicine 3 speaking Editorially Surprise Medical Bills insurance plans’ narrow provider networks and the search for legislative solutions By Charles W. Van Way, III, MD, Editor Emeritus, Kansas City Medicine

Among the many reasons to despair haven’t been paid. The insurance compa- ance company gets to pay even less than over our collective ability to reform the ny is somewhat happy, because they’ve it would if the doc was in network. And health care system, the phenomenon of improved their “cost ratio.” But they’ve the docs ... they aren’t happy. That plastic “surprise billing” is perhaps the most acquired a really unhappy client. surgeon isn’t going to rush to the ED next discouraging. It’s sometimes been in the time. And the neurologist is going to be news, but it is still under-reported and LEGISLATION: A WORK IN PROGRESS a little more selective in the consults she under-appreciated. Except, to its victims, It gets worse. Turns out that Jennifer is sees. And the hospital? They may turn over our patients. the sister-in-law of a state representative. more of the specialized services to their An explanation is necessary. Let’s tell a She complains. The rep’s office has a couple ED physicians, something which patients story. Jennifer is driving through an inter- are not going to appreciate. section, and another car crashes into hers. This isn’t far-fetched. A law just passed She is taken to the emergency department, Whatever the cause, in California dealt with surprise billing in with facial and scalp lacerations and a a similar manner. And it’s creating havoc. broken left arm. But all ends (reasonably) networks are leaving To nobody’s surprise, other states have happily. Her lacerations are repaired by a more physicians done much better. In 2015, New York dealt plastic surgeon, her arm by an orthopedic with this problem in a more even-handed surgeon, and she is discharged from the outside. It is increas- manner. But now we have action at the hospital the next day. Since she has excel- national level. Bills have been introduced lent health insurance, she assumes that her ingly likely that a in Congress to control surprise billing. Are bills will be paid. Except for copays, cost hospitalization or ED they any good? Let’s just say, it’s a work in shares and the like. progress. We may not have legislation this Imagine her surprise when she gets visit will involve a year, but it’s likely soon. a bill for $2,000 from doctors she hasn’t physician who is not ever heard of. What has happened? The NARROW NETWORKS orthopedic surgeon who fixed her arm was in the network. The problem stems from how insur- in her health plan, as was the ED doc, the ance companies deal with their physician hospitalist and the anesthesiologist. But networks. These networks are becoming the plastic surgeon who spent two hours of dozen other similar complaints on file. more and more narrow. Some blame the wasn’t. Nor was the radiologist who did Sensing an issue, the rep looks around a bit Affordable Care Act. But this problem her (normal) CT. Nor the neurologist who and finds that this is a fairly common prob- has been around longer than the ACA. consulted on that funny tingling feeling in lem. So, she puts a bill in the legislature Whatever the cause, networks are leaving her left hand. So, all three of them sent bills to ban surprise billing. The law will force more physicians outside. It is increasingly to the insurance company. the insurance company to pay out-of-net- likely that a hospitalization or ED visit The insurance company said they are work charges, but it caps the amount. The will involve a physician who is not in the “out of network’” and wouldn’t pay them. law now allows the insurance company to network. Insurance plans are notoriously They sent “balance bills” to the patient. By pay out a much lower charge, say Medi- reluctant to pay out-of-network charges, this time, a couple of months have passed. care-level reimbursement. either paying a small amount or denying Nobody’s happy. The patient is facing big Now almost everyone is happy. The the bill entirely. So, what’s to be done? The and unexpected medical bills. The doctors patient has her charges paid. The insur- physician, having provided a service, has

4 fourth quarter 2019 speaking Editorially a legitimate claim. And he or she has no alternative but to bill the patient directly. The problem is made worse because the Any legislation must be a balance between the insurance plans often don’t maintain ac- interests of the insurance plans and those of the curate and accessible lists of their covered doctors. Why should they? It’s an extra doctors. expense and provides no benefit. After all, if patients knew just how limited is their coverage, they might complain. Or they might insist that any physician they see be average in-network reimbursement. Either is doing, legislation won’t be passed until actually in network. To be sure, that’s hard way, the doctor is going to get stiffed. 2020, if then. Still, write your Congressper- to do in an emergency. Rep. Sharice Davids More importantly, the plans will have son!! And don’t forget HR 5144 mentioned of Kansas has introduced a bill to require a strong incentive to make their networks earlier. With an election coming up, Con- accurate listing of in-network physicians even narrower, since they will pay out- gress will be paying attention. And this is by health plans (HR 5144).1 of-network bills at a bargain rate. On the truly a bipartisan issue. It’s important to us To fix the surprise billing problem is other hand, physicians would like “usual and to our patients. It should be important complicated. The easy legislative fix is to and customary charges.” That probably to Congress. ban balance billing. At least one bill was isn’t going to happen either. Physicians � introduced into the Senate to do just that. will have to settle for some reduction in Charles W. Van Way, III, MD, is editor emeritus of Kansas City Medicine and is emeritus fees in return for getting paid reasonably But then what? Even Congress can see the professor of surgery at the University of Missou- unfairness of simply requiring doctors to promptly. ri-Kansas City. He can be reached at cvanway@ write off their bills, and such a law would Crafting this sort of compromise is well kc.rr.com. face constitutional challenge. Hospitals within the capacity of Congress or state REFERENCES would be in a situation in which specialists legislatures. The best example is New York. will choose which patients they’ll care for, In 2015, New York passed a law using a 1. HR 5144, To amend the Patient Protection and Affordable Care Act to require group health plans and health based on insurance coverage. framework based on Independent Dispute insurance coverage to have in place a process to self-audit While Congress can do pretty much Resolution (IDR). This encourages use of information listed in publicly accessible provider directories anything they like, any practical legislative moderate charges, together with a reso- of such plans and coverage. https://www.congress.gov/ fix will have to provide for at least some lution process which kicks in for charges bill/116th-congress/house-bill/5144?s=1&r=9 payment to out-of-network physicians. over a certain level. Their system has 2. O’Reilly, KB. Surprise medical bills: Physicians want mar- As noted, California tied the rate to just worked well for patients, physicians, hos- ket-based fixes. AMA website, October 17, 2019. https:// www.ama-assn.org/delivering-care/patient-support-advoca- above Medicare reimbursement, which pitals and health plans. New York patients cy/surprise-medical-bills-physicians-want-market-based-fixes is inadequate. Other suggestions have in- have saved some $400 million on emergen- 3. HR 3502, Protecting People from Surprise Medical Bills cluded fee schedules and tables of regional cy care alone. According to the New York Act. https://www.congress.gov/bill/116th-congress/ or nationwide average fees, compiled by a Department of Financial Services, out-of- house-bill/3502?s=1&r=9 third party. network billing has fallen 34% since the 4. Surprise Medical Bills. Doctor-Patient Unity website. 2 law was begun in 2015. https://www.stopsurprisemedicalbills.com/issues FINDING SOLUTIONS Looking at Congress, the Ruiz-Roe bill Any legislation must be a balance be- (HR 3502) is based on the 2015 New York tween the interests of the insurance plans law.3 It has 105 sponsors from both parties. and those of the doctors. The insurance It’s a pretty good bill, although there are plans don’t want to pay anything, but will things which could be improved. But it’s be forced to pay something. They want that based on IDR and is definitely workable.4 to be as low as possible. As noted, Medi- However, prospects for passage this session care or 110% of Medicare have been used. seem poor. Or, the insurance plan could just use their Given all the other things that Congress

kansas city medicine 5 News Jay Rapley, MD, Named 2019 Lee’s Summit Citizen of the Year; Overcame Paralysis to Continue Medical Practice

Jay Rapley, MD, therapy and re-learning how to live life. Six an orthopedic months after his accident, Dr. Rapley was surgeon with back at work. Two months after that, he Rockhill was back in the operating room. Kansas Health Orthopaedic Dr. Rapley specializes in knees, shoul- Specialists in ders and sports medicine. The accident has Foundation Grant Lee’s Summit, given him a new perspective as a doctor on to KCMS Foundation was honored as the what his patients might be going through as 2019 Lee’s Summit Citizen of the Year for they deal with injuries, surgeries and pain. The Kansas City Medical Society Founda- his perseverance and strength in overcom- In addition to his practice, Dr. Rapley tion recently received a $25,000 grant from ing a 2017 accident that left the KCMS is active in the community. He serves as the Kansas Health Foundation to support member paralyzed. team physician for the football team at a quality and capacity initiative. Pictured “Despite a devastating and life-chang- Lee’s Summit West High School. He is also above, at the check presentation, from left, ing injury, Jay never wavered in his deter- active in his church along with his wife, KCMS Foundation Referral Coordinator mination to return to giving his talents Ashley, and their four daughters. Maria Valencia, Referral Manager Steph- to serve others,” said Lee’s Summit Mayor The prestigious Citizen of the Year anie Lopata, and Kansas Health Founda- Bill Baird. “His inspiring journey is one of award recognizes exceptional citizens tion Program Officer Natalie Olmsted. courage, perseverance, focus and faith.” whose work and service to the community The KCMS Foundation operates the Wy In the accident, a truck hit Dr. Rapley have significantly enhanced the quality Jo Care and Metro Care programs that as he was walking his dog, resulting in of life for citizens of Lee’s Summit. The arrange specialty care for uninsured area multiple fractures and a spinal cord injury. City has been recognizing its outstanding residents, through the donation of ser- Losing the use of his legs, he endured citizens since 1996. vices by Kansas City physicians, hospitals months of surgeries, grueling physical and other partners. Based in Topeka, the Kansas Health Foundation supports access to care, healthy behaviors, civic and Medical Mission community engagement, and educational attainment in Kansas. KCMS president Mark D. Brady, MD, left, recently served on a medical mission to Peru. He is pictured with other medical staff and a family they have just assisted. Dr. Brady is a staff anesthesiologist with AdventHealth Shawnee Mission.

6 fourth quarter 2019 healthy vitals ProAssurance has been monitoring risk and protecting healthcare industry professionals for more than 40 years, with key specialists on duty to diagnose complex risk exposures.

Work with a team that understands the importance of delivering flexible healthcare professional liability solutions.

Healthcare Professional Liability Insurance & Risk Resource Services

800.282.6242 • ProAssurance.com When you are treated fairly you are confident in your coverage. kansas city medicine 7

Kansas City Med Soc_full page bleed 3.19.indd 1 3/27/19 12:24 PM 2019 annual meeting

Speakers, Awards Highlight 2019 Annual Meeting

Over 250 Medical Society physicians accompanying summary on page 9. Former Kansas City Mayor Charles B. and partners attended the KCMS 2019 Wesley Hamilton, founder of the Wheeler, Jr, MD, JD, received the Lifetime Annual Meeting on September 26 at the Disabled But Not Really Foundation of Achievement Award. Patrick B. “Rusty” Marriott Kansas City Overland Park. Kansas City, also spoke to the Annual Ryan, PharmD, received the Friend of Keynote speaker was Vanila M. Meeting for the second consecutive year. Medicine Award. See profiles of the 2019 Singh, MD, MACM, Stanford University He described the challenge of mistrust honorees starting on page 14. professor and immediate past chief that outsiders must overcome in trying to Thanks to our premier sponsor Blue medical officer in the U.S. Department deliver help to persons in disadvantaged Cross and Blue Shield of Kansas City of Health and Human Services. She communities. Overcoming paralysis from and all of our sponsors. See sponsor described the findings of the federal a 2012 gunshot wound, Hamilton has recognition on page 13. inter-agency task force on opioids and become an adaptive athlete and inspiration � pain management that she chaired. See to other persons with disabilities.

Students from Mission Trail Elementary School sang the national anthem. Wesley Hamilton from the Disabled But Not Really Foundation spoke.

Medical Society Executive Director Angela Bedell, CAE. Medical Society President Mark Brady, MD.

8 fourth quarter 2019 2019 annual meeting

Individualized, Multidisciplinary Approach to Pain Management Is Needed, HHS Task Force Chair Tells KCMS Annual Meeting

Treatment of chronic and acute pain incorporate interventional procedures, should take into account the patient’s restorative therapies, behavioral health, individual needs and draw from a full and complementary and integrative health range of interventions, Vanila M. Singh, approaches. The report details options in MD, MACM, told over 250 physicians each of these areas. and health care partners at the Kansas “This pain management model places City Medical Society Annual Meeting on even greater priority on the physician- September 26. patient relationship,” Dr. Singh said. Dr. Singh chaired the federal Pain “Together they can arrive at a treatment Management Best Practices Inter-Agency plan that best suits the patient’s individual Task Force that released its report needs and circumstances.” on pain management best practices The task force had 29 members in May. She chaired the task force including representatives of federal as part of her work as chief medical agencies, hospital associations, officer for the Office of the Assistant medical organizations, patient Secretary for Health, U.S. Department advocacy organizations and of Health & Human Services, from others, along with experts in pain June 2017 through July 2019. Dr. management, substance use disorder, Singh also has served at Stanford primary care, pharmacy and other University School of Medicine areas. The report was the result of for the past 13 years as clinical broad stakeholder input including associate professor of anesthesiology, Model for individualized patient care developed by the federal more than 10,000 public comments, perioperative and pain medicine. pain management task force that Dr. Singh chaired. she said. The report has been “Pain matters. Addressing it endorsed by the American Medical matters. How we address pain is what more powerful and damaging fentanyl. Association, the Association of American enables people to recover and return to Dr. Singh presented the model for pain Physicians and Surgeons and many other society. It has to remain at the forefront of management proposed by the task force. organizations. what we do,” Dr. Singh said. In assessing the patient, the task force � Data from the Centers for Disease calls for a biopsychosocial approach. LEARN MORE Control and Prevention show that some The physician should consider three Final Task Force Report 50 million American adults suffer from components: biological factors (age, injury, http://bit.ly/pain-report chronic pain daily or almost daily, and 19.6 diagnosis, general health), psychological HHS Q&A Blog million American adults have high-impact factors (mood, stress, trauma) and social http://bit.ly/pain-report-qa chronic pain that significantly affects factors (culture, education, spirituality). Dr. Vanila Singh Twitter their quality of life, she quoted from the This provides a complete, holistic view of https://twitter.com/vanilasingh?lang=e task force report. This in turn has led to the patient. the opioid crisis where people become Treatment should be individualized, addicted to prescription painkillers, and multimodal and multidisciplinary, she then end up obtaining substitutes on the said. The mix available to the physician street that often are laced with the much includes not just medications, but also can

kansas city medicine 9 scenes from the 2019 annual meeting Photos by Mike Curtis

Front row: Medical Society President Mark Brady, MD; keynote speaker and former U.S. Patrick O’Keefe, MD; Carole Freiberger-O’Keefe, DO; Jennifer Bernard, MD; Chris Department of Health and Human Services official Vanila Singh, MD, MACM; Aaron LacKamp, MD, Perryman, MD. Kansas Society of Anesthesiologists. Back row: Tim Krause, MD; Kathy MacNaughton Hance, MD.

Mark Steele, MD; Joshua Petrikin, MD; Matt Gratton, MD; Mitzi Cardenas; Nancy Lewis; Richard Hellman, MD; Peggy Schmitt and James Stewart, MD. Todd Clayman.

Mahoua Ray, MD; Charles Wheeler, Jr., MD, JD; Vanila Singh, MD, MACM; Jamila Murga; David Smith, Karen Johnson, Kathy Ripley-Hake and Jill Warren of Blue KC with, center, Michael Weaver, MD; Jean O’Brien. Hugh Doran of UnitedHealthcare.

10 fourth quarter 2019 scenes from the 2019 annual meeting

Keith Ratzlaff, MD; Darren Odum; Tracy Ellenz. Sarada Kataaragadda; Sukumar Ehthirajan, MD; Gregg Laiben, MD.

Chris Guenther; Dana Evans, MD; Blake Cooper, MD. From Clay-Platte Family Medicine: Risa and Christopher Kafka, DO; Heather Bollinger, DO; Duana Meseyton, DO; Josh Zeplin.

From JayDoc: Christina Hermanns, Leah Dionisi, Jasmine Hitt, Jackson Knappen, Megan Jack Erkmann, MD; Aaron LacKamp, MD; Mark Brady, MD; Gregory Unruh, MD. Kohman, Rachel Jenkins. (continued)

kansas city medicine 11 scenes from the 2019 annual meeting

Mark Taormina, MD; Stephanie Taormina; Richard Hellman, MD. Guest speaker Wesley Hamilton, seated, with Dennis Pyszczynski, MD, left, and Carole Freiberger-O’Keefe, DO.

Joseph Barry, MD; Sheila McGreevy, MD. Jennifer Ashby, MD; Cheryl Douglas; James DiRenna, Jr., DO.

Kokobe Ambaye and Abebe Abebe, MD. Former Health and Human Services official Vanila Singh, MD, MACM, presents a copy of the report of the inter-agency task force she chaired on opioid abuse and pain management to Medical Society President Mark Brady, MD. 12 fourth quarter 2019 To Our Kansas City Medical Society 2019 Annual Meeting Supporters

Premier Sponsor

Gold Sponsors

Silver Sponsor

Bronze Sponsors

Medical Society Partners Thank you for your year-round support in 2019! Thank You

kansas city medicine 13 2019 kcms awards

lifetime achievement award: Charles B. Wh eeler, Jr., md, jd Physician and Public Servant By Jim Braibish, Kansas City Medicine

Charles B. Wheeler, Jr., MD, JD, is an icon in Kansas City for his nearly 70 years of service to the community. He is best known for eight years as mayor of Kansas City during the 1970s. It was a proud time for our city, as he oversaw the opening of Kansas City International Air- port, the Truman Sports Complex, Crown (Above) Dr. Wheeler’s portrait photo as mayor.; (Above right) At the 1972 dedication of Kansas City Interna- Center, Kemper Arena and Worlds of Fun. tional Airport, Dr. Wheeler is seated at left, behind the speaker, Vice President Spiro Agnew. (Kansas City Public Dr. Wheeler was honored for his Library) achievements with the Medical Society’s 2019 Lifetime Achievement Award. A third generation physician, Dr. “I grew up with politics and feel others should, Wheeler was born in Kansas City on August 10, 1926. He graduated from too. I think children develop an awareness of the Westport High School in 1942. He earned his bachelor’s degree from the University importance of having a conviction and sticking of Louisville while also serving in the U.S. to it. Politics gets them out into the mainstream Navy from 1944 to 1946. He obtained his medical degree from the University where they learn the amount of income a person of Kansas in 1950. After an internship makes is not the most important thing, but rather at Charity Hospital in New Orleans, he joined the U.S. Air Force and served until the courage of conviction.” 1953 as a captain and flight surgeon to the ~ Charles B. Wheeler, Jr., MD, JD, quoted in the Kansas City Star in 1966 original Thunderbirds, the Air Force aerial acrobatic team. He completed his pathology residen- Dr. Wheeler’s first political victory decades. He was elected to the Missouri cy at Saint Luke’s Hospital from 1953 to occurred in 1964 when he was elected Senate in 2002 and served one term. 1955. He also attended evening classes at Jackson County coroner, serving in office “It’s important for doctors to get in- the University of Kansas City Law School from 1965 to 1967. He was elected to the volved in elective office,” Dr. Wheeler said. and earned his J.D. degree in 1959. In Jackson County governing body (then “They are very busy and prone to stay out 1957, he became director of laboratories at called the County Court) in 1967, and was of election races. But when they do go into Kansas City General Hospital. He founded elected mayor of Kansas City in 1971. He politics, they have some remarkable contri- Wheeler Medical Laboratories in 1963. He served until 1979. butions to make. So I encourage them to is board certified in pathological anatomy, He returned to his private sector run for office.” clinical pathology and forensic pathology. work with Wheeler Laboratories for two His wife of nearly 70 years, Marjorie,

14 fourth quarter 2019 2019 kcms awards

(Above) Dr. Wheeler, right, in 1966 with his family following his election to the Jackson County Court, which was the county legislative body at the time. Back row from left: daughter Marion, then 12; wife Marjorie; sons Mark, 15, and Gordon, 16. Front: Nina, then 7, and Graham, 9. (Above right) Throughout his two terms as mayor, Dr. Wheeler continued his pathology practice with Wheeler Medical Laboratories. He began each day with a supervisory stop at the laboratory. (news clippings from the Kansas City Star courtesy Nina Wheeler Yoakum)

“When (physicians) go into politics, they have some remarkable contribu- tions to make. I encourage them to run for office.”

says she “grew up ued commitment to helping others was knocking on doors” displayed in January 2014 when he came in Dr. Wheeler’s to the aid of a young woman who had an campaigns. Her epileptic seizure at a Saint Luke’s medical campaign website building. He checked her condition and is https://www.nin- calmed her until the seizure ended. Dr. Wheeler speaks to media at the 2010 dedication of a hangar at Wheeler aforflorida.com. “The Society is honored to present Downtown Airport. (photo courtesy Kansas City Department of Aviation) Dr. Wheeler has this award to Dr. Wheeler,” said KCMS passed away on July 3, 2019. They have five been honored with the American Medi- past president and awards committee children, including son Graham Wheel- cal Association Benjamin Rush Award in chair Joshua M.V. Mammen, MD, PhD. er and daughter Marion Wheeler who 1971, the University of Missouri-Kansas “Through his long career in public service currently reside in Kansas City, along with City Lifetime Achievement Award in 1984 as mayor, state senator and other offices, daughter Nina Wheeler Yoakum of Orlan- and the University of Kansas Medical Dis- he has left a strong mark on Kansas City. do, Florida. Two other sons predeceased tinguished Alumnus Award in 1997. He has set a tremendous example of how Mrs. Wheeler. There are six grandchildren. The Kansas City downtown airport was a physician can serve the public, not only Following in her father’s footsteps, Nina rededicated as the Charles B. Wheeler, Jr., through clinical care, but by advocacy and Wheeler Yoakum in July announced her Downtown Airport in October 2002 in engagement in the political sphere.” candidacy for the Florida House of Repre- honor of his service to Kansas City and the � sentatives in the 2020 election. This is her development of airport facilities. first run for elective office, although she Evidence of Dr. Wheeler’s contin-

kansas city medicine 15 2019 kcms awards

friend of medicine award: Patrick B. ‘Rusty’ Ryan, pharmd An Outstanding Educator of Physicians and the Community By Jim Braibish, Kansas City Medicine

Patrick B. “Rusty” Ryan, PharmD, was “Rusty is an ultimate professional and taught honored with the Medical our residents many of the intangibles of the Society’s practice of medicine—such as how to function 2019 Friend of Medicine Award on an interdisciplinary team, the joy of being given to a non-physician in recognition of inquisitive and asking questions and just outstanding service to medicine. Throughout his career as a PharmD, enjoying our work. Truly a part of our Family Dr. Ryan worked alongside physicians and ~ Beth Rosemergey, DO helped train physicians as a faculty mem- Medicine family.” ber at the University of Missouri-Kansas City School of Medicine in a unique partnership relationship. Now retired, he “We’ve developed quite a following. education of the residents over the years. continues this valued partnership. Many groups ask us to return every year,” They attended rounds on a daily basis, Several years after retiring, in 2011 he Dr. Ryan said. greatly improving patient care by improv- joined the Kansas City Medical Society Besides the speakers bureau, Dr. Ryan ing pharmacotherapeutics. They also gave Retired Physicians Organization. He took also is involved in the other Retired Phy- meaningful didactic lectures regularly, and the lead in organizing a speakers bureau sicians activities including social events were available all the time for consulta- for the retired physicians. They give and mentoring of medical students and tion about patient care in outpatient and talks on health care topics to community residents. inpatient arena. The quality of physician groups, primarily older adults at church- Dr. Ryan served for 33 years in the graduates of our program was better due to es, community centers and retirement Department of Community and Family their efforts.” communities. The talks are informal and Medicine at UMKC and Truman Medical Added Beth Rosemergey, DO, director involve a lot of dialogue with the audience. Center. Most of those 33 years were on the of the Community and Family Medicine “People love to hear a physician who Lakewood campus. There, he trained resi- Residency Program: “Rusty is an ultimate is very personable. They may never have dents in applied therapeutics. He was part professional and taught our residents been able to approach a physician like this of a team of 15-20 family practice residents many of the intangibles of the practice of before. Interaction is the top draw of what and medical students. He also trained medicine—such as how to function on an we do,” Dr. Ryan said. Goppert Family Medicine residents at the interdisciplinary team, the joy of being And the retired physicians get as much former Baptist Medical Center. inquisitive and asking questions and just satisfaction out of giving the talks as the R. Stephen Griffith, MD, who chaired enjoying our work. Truly a part of our audience does in hearing them, he added. the Department of Community and Family Medicine family!” The speakers bureau currently involves Family Medicine during much of the time Stephen Salanski, MD, who trained more than 10 physicians who together when Dr. Ryan was there, said: “Rusty and under Dr. Ryan in the early 1980s, said: give some 50 talks a year that reach over a his partner Dave Rush were an invaluable “Rusty knew a lot about pharmacology, but thousand attendees. part of our residency program and the he also knew a lot about clinical medicine

16 fourth quarter 2019 2019 kcms awards and taking care of patients. I learned a dation, the Upjohn Pharmacy Research been done with the help of many others— tremendous amount of medicine from Award from the Missouri Society of Hospi- including our patients, other physicians, Rusty Ryan.” tal Pharmacists, the Innovative Pharmacy my wife Nancy, our family, and my long- Dr. Ryan is a Fellow of the American Practice Award from the Kansas Phar- time practice partner Dr. Dave Rush.” College of Clinical Pharmacy and is a macists Association, and the Teacher of � board-certified pharmacotherapy special- the Year Award from the former Goppert ist. He obtained his B.S. in pharmacy from Family Care Center at Baptist Medical Samford University in Birmingham, Ala., Center. and completed a pharmacy internship at He has served for many years on the Carraway Methodist Hospital in Birming- board of trustees of Shepherd’s Centers of ham. After serving as a pharmacy officer America, an interfaith volunteer organi- in the U.S. Navy for four years, he obtained zation that provides volunteers to support his Doctor of Pharmacy from the Univer- life enrichment, lifelong learning and sity of Kentucky. He completed a hospital mental-physical-spiritual programs to and clinical pharmacy residency at A.B. older adults. Shepherd’s Center originated Chandler Medical Center at the University in Kansas City and continues to be based of Kentucky. He joined UMKC and Tru- here. Dr. Ryan first became involved as a man Medical Center in 1974. volunteer. Today, Shepherd’s Centers of Among the other honors he has American has 55 centers in 15 states. received are the Thomas Garrison Award On receiving the award, Dr. Ryan said, in Hospital Pharmacy from the Missouri “I’m honored to be recognized. At the Society of Hospital Pharmacists Foun- same time, what I’ve accomplished has

You Are Invited!

A Physician Wellness Program

(Being held in conjunction with the 2020 Winter Family Medicine Update)

Featuring a Film Screening of Registration is FREE for this program. CME is available for a small fee.

Followed by: Saturday, January 25, 2020 • A panel discussion regarding 1:30 - 5:00 pm Program issues raised in the film. 5:00 - 6:30 pm Social • A session on “Prioritizing Physician Wellness.” The Hilton Garden Inn • Mix & Mingle Social Time 19677 E. Jackson Dr. Independence, MO 64057 816-350-3000

Missouri Society of the American College of Osteopathic Family Physicians PO Box 105077 • Jefferson City, MO 65110-5077 • PH 573-634-4667

kansas city medicine 17 2019 kcms member awards

rising star award: Carole E. Freiberger-O’Keefe, do Taking On Leadership Roles at Hospital and with KCMS

Carole E. Freiberger-O’Keefe, DO, has taken on “Having KCMS is important because it unifies leadership roles at both Saint Luke’s physicians and helps us work toward our com- Hospital of Kansas mon goals of betterment of the profession and City, where she is a critical care physician, and with the Kansas advancing the health of the community.” City Medical Society. At Saint Luke’s, she is an intensivist in the cardiovascular ICU. She also carries a teaching role as a clinical assistant professor in the Department of ber of the evidence-based protocol team Dr. Freiberger-O’Keefe obtained her Anesthesiology at the University of Mis- in the critical care department at Saint medical degree from the Kirksville Col- souri-Kansas City. Luke’s. Since 2012, she has chaired the lege of Osteopathic Medicine. She com- For her achievements, Dr. Freiberg- hospital Code Blue Committee overseeing pleted her residency in internal medicine er-O’Keefe was chosen to receive the Med- improvements in the handling of code blue and pediatrics at Children’s Mercy Hospi- ical Society’s 2019 Rising Star Award. events. tal, then held a critical care fellowship at She has led the rejuvenation of the She has been a member of the Medi- Saint Luke’s Hospital. She is board-certified Saint Luke’s Donor Advisory Council cal Society Board of Directors since 2012 in critical care. which identifies ways to further excellence and has held the office of board secretary About physician involvement in orga- in organ donation at the hospital. After since 2018. During that time she has been nized medicine, she said: “We all have busy the group had disbanded, Dr. Freiberg- part of the discussions that completed the lives. I think it is a physician’s responsibili- er-O’Keefe brought together physicians merger of the former Kansas City Medi- ty to work not only at their job but to make and hospital staff from various depart- cal Society with the Wyandotte-Johnson the medical field better. Physicians have a ments to form a new council in 2015. County Medical Society. unique perspective for what patients need. Under her leadership, the council has Dr. Freiberger-O’Keefe said, “Having Through leadership, physicians can effect identified a number of process improve- KCMS is important because it unifies those changes.” ments. She continues to chair the council physicians and helps us work toward � in partnership with the regional Midwest our common goals of betterment of the Transplant Network. profession and advancing the health of the “Several years ago, the council dis- community. KCMS is an extension of what solved for variety of reasons. We saw our we do at our hospitals.” organ donation practices suffer as a result,” She continued, “I love the community Dr. Freiberger-O’Keefe recalled. “I then aspect of KCMS. Our Leadership Council agreed to chair those efforts. We now have brings together many physicians from the a wonderful and thriving Donor Advi- different hospitals across Kansas City. They sory Council. As a result, we’ve seen our offer many great ideas. This can produce numbers and our organ donation practices much change and improvement in our improve tremendously.” community both on the physician side and Dr. Freiberger-O’Keefe also is a mem- the patient side.”

18 fourth quarter 2019 2019 kcms member awards patient & community advocate award: LeLand Gra ves, 111, md & Peter J. DiPasco, md Stepping Up to Provide Care to a Patient in Need

“We as physicians and surgeons are privileged to do this work. I look at this as a gift I have been given. Every day it is my responsibility to A patient with a history of thyroid can- use that gift.”~ Peter DiPasco, MD cer—but no insurance or ability to pay for care—contacted the Kansas City Medical Society Foundation’s Wy Jo Care program tissue. The actual surgery was booked 2019 Community Service Award. for assistance. Since Wy Jo Care did not for six hours, but it stretched over seven Dr. McGreevy, who is a clinical associ- have any endocrinology providers at the hours. There was much work to be done ate professor of internal medicine at KU, time, staff asked Foundation board chair to remove all of the disease that was still said, “When our physician leaders such Sheila M. McGreevy, MD, for assistance in present.” as Dr. Graves and Dr. DiPasco say ‘yes’ to identifying a provider. Currently, the patient is preparing for prioritizing the care of the most vulnera- Dr. McGreevy reached out to two of radioactive iodine treatment which will ble people in our community, even when, her University of Kansas Medical Center begin soon. especially when, saying ‘yes’ is difficult colleagues to help this patient. First was Dr. Graves and Dr. DiPasco credit the and is time consuming and challenging, endocrinologist Leland Graves, III, MD, University of Kansas Medical Center for that sends a strong message to the rest professor of medicine and director of the stepping up to provide the hospital facili- of us in health care and in health policy Division of Metabolism, Endocrinology ties and staff needed to complete the treat- about priorities and the future direction of and Genetics. He agreed to see the patient. ment, including surgical suite, radiation health care.” Imaging showed a large mass remaining therapy, lab work, medications and more. � on the thyroid. “We could not have cared for this patient “When Dr. McGreevy called, I was without KU’s help,” Dr. Graves said. very excited to help. She’s a wonderful “I agreed to take on this patient be- person who has organized a lot of care for cause it’s the right thing to do,” Dr. Graves patients who can’t get the care they need,” continued. “People need to be taken care Dr. Graves said. of. If they’re in a situation where they can’t Imaging showed a large mass remain- get access to the care they need, this is ing on the thyroid. A second surgery what we do. We take care of people who would be needed to remove the cancer- need help. I would urge all my colleagues ous growth which had spread to the area to participate in programs like this.” around the gland and the lymph nodes. Dr. DiPasco added, “We as physicians Radioactive iodine had to be put off. Peter and surgeons are privileged to do this J. DiPasco, MD, associate professor of work. I look at this as a gift I have been surgery, agreed to take the case. given. Every day it is my responsibility to He described the surgery, which was use that gift.” completed in June. “It was a lengthy For their service, Dr. Graves and Dr. surgery. There was quite a bit of scar DiPasco were honored by KCMS with the

kansas city medicine 19 2019 kcms member awards

innovation award: Nathan D. Granger, md, mba Building Independent Practice Organizations

For over 20 years, Nathan D. Granger, MD, MBA, has “Maintaining independent physicians is im- been providing portant to the future of our profession. This leadership to help advance and support gives physicians and patients more choices... independent practice physicians. He was recognized with the Most importantly it gives them more of a voice 2019 KCMS Innovation Award. in the future of the health care system.” In 1995, he and Richard Ortiz, MD, formed Clay-Platte Family Medicine Clinic, now one of the largest independent primary care clinics in the metropolitan cifically designed for independent practic- cian-led quality and value network which area. It is recognized by the National es,” he said. has responsibility for more than $800 Committee for Quality Assurance for The KCMPA Accountable Care Orga- million in medical expenses for 105,000 excellence in the care of diabetes, heart, nization was formed as a result. It was the patients. stroke and hypertension. It also started the first Medicare Shared Savings Program The KCMPA is represented on the first patient-centered medical home in the in the Kansas City region. The program board of directors of Centrus and Dr. Kansas City area. provided funding to hire care coordinators Granger chairs the payment transforma- In late 2011, as the Affordable Care Act who worked with practices on quality im- tion and finance committee. was being implemented, Dr. Granger and provement. The patient-centered medical Dr. Granger obtained both his under- his colleagues saw many changes on the home model was implemented in many graduate and medical degrees from the horizon that would promote consolidation. practices. University of Kansas. He completed his “What will our practice need to do to sur- Through its four years of operation, the residency at St. Francis Regional Medical vive?” Dr. Granger recalled. “We decided ACO provided care transformation and fi- Center through KU. He also holds an MBA the best strategy for us moving forward nancial support to nearly 100 primary care in health care leadership from Rockhurst would be to associate with other indepen- providers serving nearly 26,000 Medicare University. dent physicians.” patients, many in impoverished areas of “Maintaining independent physicians is They reached out to other independent Kansas City. The KCMPA-ACO achieved important to the future of our profession,” physicians around the area to join with nearly $8.4 million in Medicare savings in Dr. Granger said. “This gives physicians them. The result was formation of the 2016, and distributed more than $2 million and patients more choices in the range of Kansas City Metropolitan Physician As- to KCMPA-ACO participants. hospitals and services they can utilize. New sociation. Today, KCMPA has 52 practices In 2017, Dr. Granger again was on physicians coming out of residency have and 250 providers encompassing not just the forefront of innovation when he was the option of working for another physi- primary care, but a full range of specialties. integral in establishing Centrus Health of cian or starting their own practice. At the same time, the Innovation Cen- Kansas City. This clinically integrated net- “Most importantly, it gives physicians ter at the Centers for Medicare & Medicaid work joins members of KCMPA with the and patients more of a voice in the future Services was rolling out new innovation area’s three largest independent hospitals— of the health care system.” programs including the Medicare Shared The University of Kansas Health System, � Savings Program. “Within that program AdventHealth Shawnee Mission and North there was an advance payment model spe- Kansas City Hospital—to create a physi-

20 fourth quarter 2019 2019 kcms member awards community service award: JayDoc Free Clinic Student-Run Clinic Cares for Underserved Patients

JayDoc Free Clinic, recipient of the physician, also a volunteer, signs off on “JayDoc not only acts as a pillar of 2019 KCMS Community Service Award, the treatment plan. In addition, there are safety net care in the Kansas City area, but was started in 2003 by students at the three co-executive directors, each of whom also helps provide the next generation of University of Kansas School of Medicine manages the clinic one night a week. doctors with unique experiences that will as a way to provide care to low-income, Undergraduate student volunteers, mostly forever shape their medical careers,” said underserved people. It is managed and pre-med, work at the front desk and help Allen Greiner, MD, MPH, faculty advisor staffed by medical students with the help patients fill out intake forms. A social ser- to JayDoc, and family medicine research of supervising volunteer physicians. vice unit helps link patient with additional director and professor at the University of Located in Kansas City, Kan., JayDoc is community resources. Clinical laboratory Kansas Medical Center. open three nights a week starting at 5 p.m. science students operate a point-of-care Added KU student Jackson Knappen, On Mondays and Wednesdays, primary lab during clinic hours. one of three 2019-2020 JayDoc co-execu- care is provided on a walk-in basis, triaged In 2018, JayDoc served 1,193 patient tive directors, “JayDoc sees special group according to need. Tuesdays are devoted encounters. About 140 medical student of patients; a lot of them have barriers to to specialty care which is delivered by volunteers work at the clinic each year, health. This is important for students to appointment only. The clinic uses the along with approximately 65 volunteer experience. As we go through our profes- Sharon Lee Family Health Care facility on supervising physicians. JayDoc serves pa- sional careers, we are going to see patients Southwest Boulevard at Rainbow Road. tients from all over Kansas City, but most from all backgrounds.” Medical students see patients first to are from Wyandotte County. Around half � obtain a history, perform a physical and are Hispanic and their primary language is develop a treatment plan. A supervising Spanish.

(Above) JayDoc board members were on hand with KCMS President Mark Brady, MD, front left, to accept the award at the Annual Meeting. To the right of Dr. Brady are 2019-2020 JayDoc co-executive directors Rachel Jenkins (holding award), Megan Kohman and Jackson Knappen. (photo by Mike Curtis); (Above right) Students at work in the clinic. (photos by Michael Coy)

kansas city medicine 21 2019 kcms member awards

community service award: Jam es L. Vacek, md, ms, facp, facc, faha Contributing to Patient Care, Teaching and Research in Cardiology

For over 30 years, James L. Vacek, MD, MS, FACP, “Dr. Vacek’s work spans continents and he re- FACC, FAHA, has been a leader in mains a true pioneer and an influential thought patient care, teach- leader in cardiology. He has brought innova- ing and research in the field of cardiology in Kansas City. He was tion, scientific rigor, dynamism, visibility and recognized with the 2019 KCMS Exempla- honor to the field of electrophysiology.” ry Leadership Award. He has been a professor of medicine at ~ Former Colleague the University of Kansas Medical Center since 2008 and was a clinical professor there from 2001-2008. He previously was a professor of medicine at the University Teaching medical students and resi- A former colleague at KU, Dhanunjaya of Missouri-Kansas City from 1989-2001, dents over the years has been a source of Lakkireddy, MD, now of HCA Midwest and was on the KU faculty from 1986- great satisfaction. He first gained his love Health, said: “Dr. Vacek’s work spans con- 1989. for teaching while serving in the U.S. Air tinents and he remains a true pioneer and Among his accomplishments in Force in Biloxi, Miss., where he was in- an influential thought leader in cardiology. research has been the development of the volved in managing patients and teaching He has brought innovation, scientific rigor, hot-tip catheter in the 1980s, during a at several local hospitals. dynamism, visibility and honor to the field time when opening up occluded arteries “For the people who trained us, we of electrophysiology.” was still considered revolutionary. This have to pass this gift on to the next gen- � patented technology was licensed to eration and inspire them not only to take Boston Scientific, and it contributed to excellent care of patients, but also teach the development of today’s radiofrequen- the next wave of trainees coming through,” cy ablation catheters used to treat heart Dr. Vacek said. “We also must stay alert for arrhythmias. Other focuses of his research innovation with which we may help in ad- have been investigating the role of vitamin vancing the state of the art. It’s been a great D in cardiovascular disease, managing honor to have the opportunity to work in a myocardial infarction, comparing catheter teaching environment at the University of techniques vs. thrombolytic drugs, and Kansas Medical Center.” analyzing the impact of risk factors on Dr. Vacek obtained his undergraduate coronary artery disease. and medical degrees from Creighton Uni- Dr. Vacek practiced with Mid-America versity. He completed internship, residency Cardiology at the University of Kansas and cardiology fellowship at Washington Medical Center until his retirement from University School of Medicine in St. Louis. clinical work at the end of 2017. He con- He obtained an M.S. in clinical research tinues to teach and conduct research. from the University of Kansas School of Medicine.

22 fourth quarter 2019 Advocacy

making the physician voice heard on legislative and policy issues that are shaping the future of medicine

“Either you’re at the table or on the menu,” says Missourir State Sen. Bob Onder, MD, on the importance of physicians being involved in advocacy issues.

More than ever, there are issues being decided in legislative chambers and regulatory offices that determine the environment in which physicians practice and impact the health of the public. These range from scope of practice, to insurance matters, to legal and tort reforms, public health issues and more.

In this special section of Kansas City Medicine, we share the stories of three physicians who are serving or have recently served in elected office in Kansas and Missouri, including former Kansas Gov. Jeff Colyer, MD; Kansas State Sen. Barbara Bollier, MD; and Missouri State Rep. Jonathan Patterson, MD. Besides these three, other physicians are serving in appointed offices in state government, including Kansas Secretary of Health and Environment Lee Norman, MD, and various physicians on the state boards of regulation of the healing arts. Other physicians are active in advocacy through their national specialty societies, such as Mark Brady, MD, in the American Society of Anesthesiology, and Stephen Salanski, MD, in local public health advocacy in the Kansas City area. As the start of the 2020 legislative sessions nears, we offer advocacy tips from the Missouri State Medical Association and Rep. Patterson.

�

kansas city medicine 23 Advocacy Bringing the Physician Voice to State Elected Office the kansas city region is privileged to have three physicians who are serving or recently served in elected positions in state government By Jim Braibish, Kansas City Medicine

For a physician, serving in elected office involves tremendous sacrifices in time away from family and medical practice. But these Kansas City-area physician public servants each feel the sacrifice is important, because they are bringing the physician voice to state government.

JEFF COLYER, MD

Governor of Kansas, 2018 Dr. Colyer in the governor’s office making an official announcement. (Dr. Colyer Facebook page) Lieutenant Governor, 2011-2018 State Senator, 2009-2011 politics and medicine. “As a kid, I wanted at the University of Missouri-Kansas City State Representative, 2007-2009 to help people,” he recalled. “Being a doc- from 1991-1993 followed by a fellow- tor was a way to serve their physical needs. ship in craniofacial and pediatric plastic “It was the honor of a lifetime to serve I saw public policy as a way to help people surgery at the International Craniofacial as lieutenant governor and then governor in their community environment. So I Institute in Dallas. In 1994, he established of Kansas,” states Jeff Colyer, MD, a cra- deliberately decided to do both.” his practice in Kansas City and Overland niofacial and plastic surgeon practicing in A native of Hays, Kan., and the son of Park. Overland Park. a dentist, Dr. Colyer obtained his under- Over the past 25 years, Dr. Colyer also “The first governor of Kansas, Charles graduate degree from Georgetown Univer- has volunteered as a surgeon through L. Robinson, was a physician. He served sity. Indicative of his dual interest in policy the International Medical Corps. He has during the Civil War right after Kansas and medicine, he earned his master’s in served in dangerous war zones such as was admitted as a state. As doctors, we are international relations from Cambridge Afghanistan, Iraq, the Balkans, Libya and uniquely qualified to serve Kansas.” University in 1982 and then his medical Africa. He was the only surgeon in south- Dr. Colyer was elected lieutenant degree in 1986 from the University of ern Rwanda during the 1994 genocide that governor in 2010 as the running mate of Kansas. He completed his residency in killed 800,000 people. He was featured on former Gov. Sam Brownback. On January general surgery and trauma at Washington the “60 Minutes” episode, “Scars of War,” 31, 2018, Dr. Colyer was sworn in as the Hospital Center in Washington, D.C. in in 2002. 47th governor of Kansas after Brownback 1986-1988 and 1988-1991. He took a year Dr. Colyer ran successfully for the Kan- was appointed United States ambassador at away from residency to serve as a White sas House of Representatives from the 48th large for international religious freedom by House Fellow in international affairs under district in 2006 and the Senate 37th district President Donald Trump. He was narrowly President Ronald Reagan and President in 2008. “At the time, I was the only prac- defeated in the 2018 Republican primary. George H.W. Bush. ticing surgeon in the House and Senate. Dr. Colyer grew up interested in both He completed plastic surgery residency It was a way to help on a lot of issues and

24 fourth quarter 2019 Advocacy bring a physician perspective,” he noted. In his first year in the House, he was appointed chair of the 2007 Legislative “Get involved in Health Reform Task Force that oversaw a campaigns and policy. revamping of the state Medicaid program into KanCare. The reforms helped the state It’s tough and some- BARBARA BOLLIER, MD save $2.5 billion while improving out- Kansas State Senator, 2017-present comes for more than 400,000 patients. times frustrating, but State Representative, 2011-2017 As governor, he made an impact in a it is important to our Candidate for U.S. Senate short year. Overseeing a $17 billion budget and 40,000 employees, he helped Kansas f utu re .” Barbara Bollier, MD, learned from her earn its first credit outlook upgrade in 10 parents a passion for advocating for good ~ Jeff Colyer, MD years by implementing a stable budget, health. consolidating agencies, and making tech- Her father, Robert Goolsbee, MD, was nology and workforce improvements. a Kansas City anesthesiologist who started Dr. Colyer and his wife, Ruth, have reformed Medicaid, expanded services, the Surgicenter of Kansas City in 1977. It been married since 1991 and have three increased the number of medical and was one of the nation’s first free-standing daughters. nursing students, and started measuring ambulatory surgical centers. outcomes. Through KanCare we saved $2.5 “It was illegal to do surgery outside Question & Answer billion by increasing physician visits and of a hospital. They had to get the laws Sacrifices made to serve in government? pharmacy while decreasing ER visits and changed,” Dr. Bollier recalled. “So, I grew My family made tremendous sacrifices in the number of days in the hospital. Out- up around advocacy.” time and resources. I cut my practice about comes have improved but there is more to She described how she was influenced: 90% but still did on-call trauma surgery as do and continually improve. “I’ve always been engaged in the public governor. That made me a better governor policy side of medicine. It is important and a better doctor. Do you have any plans to run for office to make sure have we have a health care again? system that is accessible, affordable and of How did your practice manage in your I believe in service and we will see where the highest quality.” absence? that leads. As health care became an increasingly I chose not to give up medicine. I had to important public issue, Dr. Bollier ran for shrink my staff and my practice but they Why is it important for physicians to be the Kansas House of Representatives in the focused on great care. Often, my patients involved in advocacy in government? 21st district in 2010. in the ER had no idea I was governor. But Physicians are great advocates for their Dr. Bollier explained. “As the Afford- when they figured it out, they liked it and patients. Its hard work but their voice is able Care Act was being debated and en- they gave me the best advice and insight. valuable. acted, it became clear that we needed more people at the legislative table who were Biggest surprise in government? What can and should physicians do to familiar with the practice of medicine.” Being lieutenant governor was really like make their voices heard? In addition, she felt she could bring the being chief resident again. Government Get involved in campaigns and policy. It’s unique attributes of a physician. “My goal as needs more people with medical exper- tough and sometimes frustrating, but it is a physician is to bring people together. The tise and a physicians’ commitment to get important to our future. physician is a listener, a collaborator and a things done. https://www.jeffcolyer.com doer. It’s of huge importance that we make decisions on fact rather than ideology.” Biggest accomplishments in health care? An anesthesiologist, Dr. Bollier prac- We were able to positively change the tone ticed with her father at the Surgicenter and economic direction of the state. We (continued)

kansas city medicine 25 Advocacy

of Kansas City from 1987 through 1999, Issues working on this year? when she retired to raise a family. She Medicaid expansion has a good chance. served a term as president of the Missouri “The very practice of The challenge will be resisting attempts Society of Anesthesiologists in the 1990s. medicine is determined to insert waivers. It will take a bipartisan Her husband is family medicine physician group to get this passed. Other issues René Bollier, MD, with St. Joseph Family by what is legislated. include the budget and revenue stream, Medical Care and a KCMS member. along with regulating step therapy and During her years raising their two chil- To effectively care for maintaining supervision requirements for dren, she continued her interest in health our patients, physicians nurse practitioners and other professions. care issues by working with the Center for It’s concerning that President Trump Practical Bioethics. She also taught in the must be engaged.” recently asked CMS to develop a proposed bioethics master’s program at the rule eliminating supervision requirements ~ Sen. Barbara Bollier, MD Kansas City University of Medicine and in Medicare. Bioscienses. In 2010, the Center honored her with its Vision to Action Award. In Why is it important for physicians to be addition, she served on the board of the cy for the U.S. Senate. She has received involved in advocacy in government? Shawnee Mission Education Foundation endorsements from Gov. Laura Kelly and The very practice of medicine is deter- and tutored students at Ruston Elementary former Gov. Kathleen Sebelius. mined by what is legislated. To effectively School in the district. care for our patients, physicians must be Dr. Bollier earned both her under- Question & Answer engaged. If there is no one at the table who graduate and medical degrees from the Sacrifices made to serve in government? knows about the practice of medicine, University of Kansas. The reality is, that as physicians, we com- the parameters will be changed and not Her father Dr. Goolsbee also helped mit fully to whatever we do. Serving as a in favor of the physician. Scope of prac- found the Society for the Advancement of legislator takes a lot of time. There is the tice, for example, has huge public health Freestanding Ambulatory Surgery Care sacrifice of time away from family, and the implications. and was active in the former Jackson pay is not commensurate with a physician’s County Medical Society and its successor, education level. However, I thoroughly What can and should physicians do to the former Metropolitan Medical Society enjoy helping people. make their voices heard? of Kansas City, now part of the Kansas City Pay attention to what is happening in Medical Society. He passed away in 2015. Biggest surprise in government? the legislature. Join your local, state and “My dad had huge influence on me as to That others were not as interested in national societies. Get to know your rep- the importance of engaging in policy side coming together as I was. I am used to resentatives at the state and federal levels. of medicine. It determines how you can working as a team for the best outcome for Offer to become a resource, someone practice and what you can and can’t do for the patient. whom the legislator can call for answers. patients. He also was an entrepreneur and Participate in campaigns financially. Ulti- taught me the importance of innovation,” Biggest accomplishments in health care? mately, this will make a difference for our Dr. Bollier said. First of all, it’s important to note that patients. In December 2018, she made waves by one legislator alone does not make a bill https://bollierforkansas.com announcing she was changing her party pass. That being said, my favorite public affiliation from Republican to Democrat; health bill is the clean indoor air act which two other Kansas Republican state senators stopped indoor smoking in public places. switched their affiliations shortly thereafter. This is a huge help to people with pulmo- “Morally, the party is not going where my nary health issues. Also, it was a great ac- compass resides,” she was quoted at the time. complishment to pass Medicaid expansion This fall, she announced her candida- even though it was vetoed by the governor.

26 fourth quarter 2019 Advocacy

Issues working on this year? I am going to be focusing on transporta- “Email your tion, including finding ways to optimize representative and funding for our roads and bridges. Also, on health care issues such as scope of JONATHAN PATTERSON, MD senator. Have a rela- practice. Missouri State Representative, 2019-present tionship with them. Why is it important for physicians to be Jonathan Patterson, MD, was elected in Meet them in person. involved in advocacy in government? 2018 to the Missouri House of Representa- It is important that physicians be involved tives. A Republican, he represents the 30th Let them know why because so much of what is decided in district comprising the eastern Kansas you feel a certain way Jefferson City directly affects the practice City suburbs of Lee’s Summit, Indepen- of medicine. There are a lot of special dence and Blue Springs. He is a general about an issue. They interests trying to have things their way. surgeon with United Surgical Associates in will listen to you.” Physicians need to be involved so patients’ Lee’s Summit. interests are equally represented. Like Drs. Colyer and Bollier, he has ~ Rep. Jonathan Patterson, MD always had an interest in politics. “I knew What can and should physicians do to that I wanted to have a career in medicine make their voices heard? but I always kept my eye on the politics ri-Columbia. He completed his residency The easiest thing to do is email your repre- and policy,” Dr. Patterson said. in general surgery at Truman Medical sentative and senator. Have a relationship He fulfilled that ambition by run- Center. Dr. Patterson is board-certified in with them. Meet them in person. Let them ning for the legislature. “I decided to run general surgery. know why you feel a certain way about an because I believe that we need all kinds of He and his wife, Jennifer, have two issue. They will listen to you. They want people in our government, not just attor- children. advice from experts. One more thing: neys,” Dr. Patterson explained. Missouri physicians, be sure to sign up to He added: “I also felt that I could be the MSMA Physician of the Day at the help in a positive way and make a differ- SacrificesQuestion &made Answer to serve in government? Capitol. Come on down and see for your- ence. There is a lot that the legislature does The sacrifice is time. Time away from my self what is going on in Jefferson City! that affects health care directly and I think family and from my practice. But I think it https://www.pattersonformo.com � my experience adds to the discussion and is worth it. helps us make better policy.” In his first year, Dr. Patterson achieved Biggest surprise in government? passage of a bill he sponsored to exempt The biggest surprise was how much of medication-assisted treatment (MAT) the work of the legislature has to do with pharmacological services for opioid use health care. It affects all of us—patients disorder from insurance prior authori- and doctors—so it’s important that we zation requirements. The legislation also have legislators who have first-hand ex- provides that the medications prescribed perience in health care. Also, I’ve learned for MAT will not be subject to step ther- that even first-year legislators can make a apy protocols, and they must be in the difference! We were able to pass legislation insurer’s lowest cost-sharing tier. removing insurance prior authorization A native of Blue Springs, Dr. Patterson requirements on medically assisted treat- earned his undergraduate and medical ment (MAT) for opioid use disorder. degrees from the University of Missou-

kansas city medicine 27 Advocacy Advocacy Tips Presented at “Medicine’s Muscle”

Advocacy leaders from the Missouri • Offer to be a resource on health care conducting these meetings. State Medical Association presented tips issues. She offered tips on giving legislative on legislative advocacy and gave an update She also described using phone calls testimony: on current legislative issues at “Medicine’s to reach legislators. “Be prepared to speak • Prepare notes and practice before you Muscle” on August 27 at the KCMS office with legislative staff. They are more often testify. in Kansas City. A large group of KCMS able to devote the time necessary to talk • Keep the testimony brief and con- members attended. about your topic. If you are calling about cise—under three minutes. The key to success in grassroots lobby- legislation, make sure to have the bill num- • Share personal experiences and ing is to build relationships with legisla- ber on hand. Keep your message clear and perspectives on how the issue affects tors, said Heidi Geisbuhler Sutherland, concise. Offer to send a follow-up email.” you. MSMA director of legislative affairs. Face-to-face meetings can be scheduled • Try to not read directly from a piece Physicians should determine, if they at the Capitol or in your home district, she of paper. haven’t already, who are the state represen- said. Contact the legislator’s office. Before tative and senators for the districts where the meeting, note the bill number if you • Contact MSMA legislative staff to let they live and where they practice. The Mis- will be speaking about specific legislation. them know of your interest in testify- souri House and Senate websites each have Prepare an outline of what you are going ing on a particular topic. a “legislator lookup” tool. to say. If possible, you can develop a fact Two more actions that physicians can take: In contacting a legislator by email, you sheet or handout summarizing the topic. • Sign up for the MSMA Physician of should “make sure to note that you are a Be prepared to meet with a staff member the Day program. Volunteer physi- physician who lives or practices in their During the meeting, be informative cians serve in the Capitol from 9 a.m. district,” Geisbuhler Sutherland said. If and non-confrontational, she advised. to 2 p.m. as the on-call physician for you are following a form letter, be sure to Thank the legislator for his or her time and legislators and staff. Contact MSMA. add personal details. offer your assistance with future health • Make plans to attend White Coat Day She suggested that email can serve a care issues. at the Capitol on Tuesday, March 3, variety of purposes: After the meeting, send a brief thank- 2020. See accompanying article. • Ask your legislator’s position on a bill you note or email. You also can post a “One contact from a ‘doc back home’ is • Urge your legislator to act on a bill photo of yourself with the legislator on worth 100 visits from us lobbyists. That’s social media. • Thank your legislator for supporting why we encourage members to establish a The MSMA legislative staff can provide physicians and patients. rapport and reach out,” MSMA wrote in a support to physicians in setting up and recent weekly legislative briefing.

�

Missouri “White Coat Day” Set for March 3, 2020

Physicians and medical students from rotunda with legislators and MSMA lead- there may be additional meetings and pre- across Missouri are urged to attend White ers delivering brief remarks on health care sentations participants want to attend. Coat Day on Tuesday, March 3, 2020, at issues. Throughout the rest of the day, at- Registration is open at https://www. the state Capitol in Jefferson City. Or- tendees are encouraged to meet with their msma.org/white-coat-day.html. For more ganized by the Missouri State Medical local legislators, attend legislative sessions information, contact Heidi Geisbuhler Association, the event is an opportunity to and network with fellow physicians. Lunch Sutherland, MSMA legislative affairs direc- network and advocate on behalf of physi- will be provided. tor, at [email protected]. cians and patients in the state. Some state medical specialty societies The day begins at 9 a.m. in the Capitol are planning to join the rally that day, so

28 fourth quarter 2019 Advocacy Ten Things You Can Do to Get Involved That Don’t Require Money By State Rep. Jonathan Patterson, MD

Reprinted with permission from Progress This doesn’t mean you have to become with. Legislators receive dozens of Notes, the newsletter of the Missouri State hunting buddies. Just don’t make the emails and letters a week, mostly from Medical Association first time you meet your legislator be constituents that are unhappy with During my first year in the Missouri the time you call her to encourage her their vote. Be the bright spot in their House of Representatives in 2019, I to vote one way on a certain bill. day. learned quickly about how things get done 4. Sign up to be MSMA Physician of 9. Get your colleagues involved. Talk in Jefferson City. It’s not complicated. It the Day at the Capitol. Both your with people in your specialty about is 197 elected members who are trying representative and senator will go out issues that affect you directly. If it’s to learn about all the issues that are put of their way to meet with you. You’ll a really important issue, get a group before them and then vote in a way that be introduced and thanked on both together for coffee and invite your would best serve their constituents. the House and Senate floor. You’ll representative. There’s no way to know everything be providing a public service. There 10. Actively participate in your local about every one of the thousand bills that will be little to no actual doctoring medical society. They have people who are filed each year. That is why advocacy required. are tied in politically and will get you matters. Ten people emailing their 5. Take time to learn about issues that more involved if you want. representative about a specific issue might affect physicians in Missouri. Read the be the only thing the representative hears Recently the House passed a certain weekly update emails from MSMA. about on that particular subject. Physicians piece of legislation. We gave it a first-round Read the brief bill summaries online. need to advocate for medicine in Missouri. vote and then left for the weekend. By the All the bills have one-page summaries Here are ten easy ways to get politically next week when it was time to take a final that are written in non-legalese and involved: vote on the bill and send it over to the posted on the House and Senate 1. Look up your legislators at www. Senate, eight members had changed their websites. house.mo.gov and www.senate. “yes” votes to “no.” Why? Because over mo.gov. Know their names. Write 6. Go to your legislator’s official the weekend they received emails from down their email addresses. Write website and sign up for their Capitol constituents telling them they disagreed down their phone numbers. reports. They’ll email you every week with their vote. Political advocacy matters. about the issues that they are working It’s not hard. Get involved. 2. Email your representative about an on. � issue that you care about. Write your 7. Get upset sometimes. It’s okay to Jonathan Patterson, MD, was elected to the phone number and address on the Missouri House of Representatives in 2018. disagree. If you strongly disagree email so that they know you are a He represents the 30th District comprising the with your representative about an eastern Kansas City suburbs of Lee’s Summit, constituent. They should at least read important issue, let them know. Independence and Blue Springs. He is a general and respond to your email. Respectfully tell them you’re a surgeon with United Surgical Associates in Lee’s Summit. He can be reached at jon.patterson. 3. Meet your representative back constituent and you disagree with [email protected]. in your district. Go to one of the them, and tell them why. They are representative’s town halls. Call and paid to represent you. It’s part of the ask him or her to come speak to a job to hear from their voters. group of doctors at your office or 8. Take time to write your legislator hospital. Build relationships with your thanking them for a vote you agree state legislators. Politicians are human.

kansas city medicine 29 “It is important to have a local program for people who do not have the means for medical care. There are The Kansas City Medical Society Foun- dation recognizes Bruce B. Snider, MD, many great people who volunteer for serving as a volunteer physician with Wy Jo Care since its beginning in 2007. their time to make this wonderful or- A board-certified ob-gyn, Dr. Snider ganization, and I am blessed to be part has been practicing since 1990. He earned his undergraduate degree from of it, caring for those in need. I am Wichita State University and attend- grateful to give back to the community ed medical school at the University of Kansas before completing his residency as a provider for WyJo Care.” at the University of Kansas Medical Center. He carries out his dedication to serve the less fortunate through the patients he accepts through Wy Jo Care.

Join the KCMS Foundation in our mission to provide care to the uninsured.

~ Bruce B. Snider, MD Olathe Women’s Center Supporter, Wy Jo Care and Metro Care

contact natalie lynch, metro care and wy jo care director of provider relations 913-526-8231 | [email protected]