Update September 2012

           Update, September 2012                              Vol. 27, No. 8
IN THIS ISSUE:                                                      FOLLOW US:

Eva Chalas, Chair's Report
     Raising Cancer Awareness in September
  Facebook   YouTube
Spotlight on the Annual District II Meeting
Breakfast at Tiffany's
Special Contributor - Scott Hayworth, MD, FACOG
District II Supports Medicaid Waiver
Governor Signs Telemedicine Legislation
Doctors Across New York - More than $2 Million Awarded
D2 EFM Initiative Highlighted in Publication  
Exciting News from Mercy & Sisters of Charity Hospitals  
Live Webinars | Managing Obstetrical Risk Efficiently

CMS: ICD-10 2014 Final Rule  
Mechanical Bowel Prep: Take a Brief Survey
Humana Claim Processing Edits
Pub Sells Pregnancy Tests to Curb Birth Defects

Eva Chalas, MD, FACOG, FACS

Raising Cancer Awareness in September
September is Gynecologic Cancer Awareness Month as well as Prostate Cancer Awareness Month. Both observances are aimed at increasing public understanding of these cancers. By speaking with women about both issues, we have an opportunity to make a lasting impression - for the sake of their health and the health of the men in their lives. You may want to make a note of the following talking points to share with your patients. Since many of the organizations which work diligently to educate, raise awareness and support research are not-for-profit, volunteer-based groups, you may wish to consider donating and encouraging our patients to invest in their mission on the occasion of these observances. I would suggest Foundation for Women's Cancer and American Cancer Society.

Gynecologic Cancer
Gynecologic cancers originate in the female reproductive organs, including the cervix, ovaries, uterus, fallopian tubes, vagina and vulva. It is estimated that about 80,000 women will be diagnosed in the U.S. in 2012. Increasing awareness of gynecologic cancers enables early detection, appropriate treatment, and a greater chance for recovery.

  • Risk Factors: Age, Family history, obesity, failure to receive regular pap tests, or vaccines for Human papillomavirus (HPV), smoking, HNPCC ,BRCA1 or BRCA2 gene, hypertension, diabetes, tamoxifen or unopposed estrogen use.
  • Symptoms: Abnormal vaginal bleeding or discharge, bleeding after intercourse, bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, change in bathroom habits, itching, burning or bleeding on the vulva.
  • Prevention: Adhere to screening guidelines, perform self-examinations, maintain a healthy weight, exercise regularly, do not smoke, practice safe sex, visit your doctor regularly for pap tests, get vaccinated against Human papillomavirus (HPV), be aware of the increased risk due to family history.

For more about gynecologic cancer and other women’s health issues, please visit the ACOG website.

Prostate Cancer
Prostate cancer is the most common cancer diagnosed in men in the United States. The American Cancer Society's most recent estimates for prostate cancer in the United States are for 2012 about 241,740 new cases of prostate cancer. Overall, the lifetime risk of developing prostate cancer is one in six men. Prostate cancer is the second leading cause of cancer-related death in the US. It is expected to cause about 28,170 deaths during 2012. Fortunately, the death rate has been dropping over the last 20 years. Screening allows more men with prostate cancer to be found earlier when the disease is easier to cure. Treatment for prostate cancer has improved over the last several years. As a result there are over 2 million survivors of prostate cancer in the United States.

What are the risk factors for Prostate Cancer?
Age, history of prostatitis (inflammation of the prostate gland), and family history of prostate cancer. People of African-American descent and men who live in North America and Northwestern Europe have a greater incidence of prostate cancer. Lifestyle-related factors: A diet that is high in red meats and processed meats, physical inactivity, obesity, smoking, heavy alcohol use, history of sexually transmitted diseases. The American Cancer Society recommends screening begins at age 50 for those at average risk. Please speak to your physician if you think you may be at high risk or have questions about screening. To learn more about prostate cancer, visit the American Cancer Society website.


  The Door is Closing on ADM Deals!
2012 ADM
  3 days of clinical content for $495

 $299/Night at the luxurious Grant Hyatt

 Printed copy of meeting syllabus for $20
(Pre-order only. No copies
purchased on site)

Join us October 19-21 at the Grand Hyatt

Preliminary Program - Click here
On-Line Registration - Click here

Ancillary Meetings at the ADM

Residency Program Directors Meeting
Friday, October 19, 2012  |  3:30pm - 5:30pm
Grand Hyatt New York
Click here for RSVP registration

Breakfast at Tiffany’s at the ADM!
To Benefit Ob-GynPAC
Saturday, October 20, 2012  |  7:00am
Grand Hyatt New York
One lucky attendee will go home with a Tiffany & Co. door prize!
Click here for more


Scott Hayworth, MDScott Hayworth, MD, FACOG
With the many changes in physician practice that have taken place over the past few years and many more to come, it is a wonder that we are able to stay in practice at all.

Our District II office has been approached with financial questions regarding a variety of topics such as: evaluating a practice’s benefits (ie. Disability or 401k) or analyzing the economic viability of merging a practice or joining another organization. Topics such as these affect physicians in different ways. I believe it’s impossible to make general or broad conclusions about whether a benefit or transaction is “good” or “bad.” Rather, it really comes down to the demographics of the entity as well as the goal & objectives.

Given my experience as an ob-gyn in many practice environments, I have been asked to provide information to our members who may be considering changing their current practice and are thinking about their long & short term financial strategy.

These matters are very complicated and often there are competing interests even among partners. We’ve seen situations where the decision to work for a large entity can be a good deal for some and a bad proposition for others. We believe the key takeaway is that anytime you are faced with a situation such as securing benefits, or joining, merging or collapsing a practice you evaluate the pros & cons both individually as well as in concert with your partners.

As is true with life, anytime you make a major professional change certain things are improved and other things can be worse. The key thing is to understand these issues before you make a change - rather than being naively optimistic that “things will work out.”

My group, Mount Kisco Medical Group, has engaged Andy Schwartz, CFP of Bleakley, Schwartz, Cooney & Finney LLC. With Andy and his capable staff, I will be co-authoring newsletter articles to offer you free information on areas of focus that are critically important should you contemplate (now or in the future) a change to your practice environment. Please click here to answer 3 questions to help me get a basic understanding of where to start. During the next several months, please don’t hesitate to contact me or Andy. Andy can be reached directly at 973-244-4202 or andy.schwartz@nmfn.com


District II Supports Medicaid Waiver
The Cuomo Administration has applied for a waiver that would enable New York to use up to $10 billion of Medicaid Redesign Team savings to revamp the health care system by improving primary health care for poorer New Yorkers. Click here to read the governor’s press release.

District II sent a letter on August 22, 2012 (click here) to Jason Helgerson, the New York State Medicaid Director, thanking Governor Cuomo for his dedication to ensure that all New York women received adequate health insurance coverage. However, District II remains committed to making meaningful medical liability reform part of the discussion in order to have true health care reform in New York State.

Governor Signs Telemedicine Legislation
Governor Andrew Cuomo signed S.6970,Young / A.9834,Gunther to streamline the process to credential health care practitioners providing telemedicine services to patients in New York State. The law, which is now in effect, allows a hospital that wishes to contract for practitioner services via telemedicine to also arrange for the sharing of credentials verification paperwork used for granting hospital privileges. It also allows the hospital receiving the telemedicine services to rely on the hospital providing the services for peer review and quality assurance activities.

Doctors Across New York - More than $2 Million Awarded
NYS Health Commissioner Dr. Nirav Shah has announced more than $2 million in awards to 21 hospitals, health centers, medical practices, and physicians to address the need for qualified health care providers in underserved communities. (Click here)

The grants were awarded under the Doctors Across New York (DANY) program, which assists in the training and placement of physicians in rural and inner-city areas where a shortage of health care providers has been identified.

District II will continue to work with the Department of Health to ensure that funding continues for our physicians. Please contact our office is you are interested in more information.  


District II EFM Initiative Highlighted in Publication
Partnership Improves OB Safety in New York State was published in the July/August edition of Patient Safety & Quality Healthcare, which highlights the success of a joint initiative between the Healthcare Association of New York State (HANYS), ACOG District II and the New York State Department of Health (NYSDOH). The article discusses key aspects of the statewide partnership and features the success stories from two hospitals who participated in the initiative.

Through regional train-the-trainer programs conducted in 2009 and ongoing support, the Obstetric Safety Initiative: Providing Excellence in Electronic Fetal Monitoring (EFM) set out to improve fetal outcomes and reduce liability exposure by providing multidisciplinary hospital obstetric teams with vital training on how to interpret, communicate, and effectively respond to fetal heart rate (FHR) tracings. The program was presented by nationally renowned faculty in EFM education and legal implications, David Miller, MD, FACOG and Lisa Miller, CNM, JD.

For more information about this initiative and to review notable successes, see HANYS’ final report and District II’s web-based EFM provider toolkit.


Exciting News from Mercy Hospital & Sisters of Charity Hospital in Buffalo
Mercy Hospital, Buffalo and Sisters of Charity Hospital, Buffalo, both members of the Catholic Health System, kicked off the three-year comprehensive patient safety program, MOREOB (Managing Obstetrical Risk Efficiently) in April and May of this year. More than 60 Ob/Gyns, 100 nurses, anesthesiologists, certified nurse midwives, residents as well as administration and staff educators are participating in the program. The short term results of the education benefits and increased respect for the knowledge between the physicians and the nurses has been evident in the skills drills and preparation of patients for procedures.

"I attended a core team meeting at one of our sites and there was a great exchange between nursing and anesthesia about the management of twins," shared Aimee Gomlak, Vice President for Women's Services for Catholic Health. “In the meeting our nurse shared that but not for the MOREOB program, the conversation might not have been that open and solution focused. The conversation was about how much safer she and her nurses would feel with a second anesthesiologist on call when it came to the management of the second twin who was about to be born and the physician left with the first baby. The lead anesthesiologist for OB agreed and the staffing policy for the physicians was immediately addressed. I was so impressed to see that communication and solution between two professionals who are equally invested in the quality outcomes of the patients we serve.”

Both hospitals have mentoring teams set up to complete the chapters. All staff is encouraged to participate in skills drills and many of the physicians found them to be both fun and informative once they started. There are small prizes for staff that complete chapters and team awards for the mentoring teams completing the work and personal learning projects. "When the fall comes all staff will be participating in workshops run by the core teams and everyone is looking forward to the improved outcomes as a result," shared the Core Team leadership from both locations.

For both hospitals, the MOREOB project was sponsored in part by the John R. Oishei Foundation as well as Catholic Medical Partners and Catholic Health.

Rochester General Health System and Newark-Wayne Community Hospital have also embarked on this wonderful new journey in patient safety. District II will continue to bring you highlights from each of the participating hospitals as they move forward through the program modules. If you are interested in learning more about the program, please contact Kelly Gilchrist, ACOG District II Patient Safety Manager at kgilchrist@ny.acog.org

Live Webinars
Please join ACOG District II as we host a webinar series on Managing Obstetrical Risk Efficiently.

Save the Dates

  • Tuesday, October 9th
  • Thursday, November 15th
  • Thursday, December 13th

*Live webinars are presented from 12:00pm-1:30pm Eastern Time.

To register for October 9th, click here. More detailed information about each presentation, including topics will be available in the coming weeks on the ACOG District II website www.acogny.org.  


CMS: ICD-10 2014 Final Rule
The Centers for Medicare and Medicaid Services (CMS) issued a final rule announcing that it would delay the implementation of the International Classification of Diseases, 10th Edition (ICD-10) coding systems used in administrative health care transactions. The use of ICD-10 diagnosis and procedure codes will begin instead on October 1, 2014. The rule, which also sets dates for health plan and provider identifiers, emphasizes that providers and payers must adopt the code set by the 2014 date, which is a one-year delay from the previous implementation date. The rule explains the postponed date allows providers and payers additional time to implement the new code set. CMS’s final rule will be published in the Federal Register on September 5.


Dear colleague,

The Division of Gynecologic Oncology at North Shore LIJ Health System is investigating the use of mechanical bowel preparation in patients undergoing gynecologic surgery. The purpose of the survey is to determine the standard of care across our specialty as it relates to use of bowel preparation. As a member of the American College of Obstetricians and Gynecologists, we would greatly value your participation in this research study. Click here to take the survey.

The survey was IRB approved at the North Shore LIJ Health System. Participation in the study is voluntary and involves completing a brief online questionnaire. The survey is anonymous, but will include demographic information. The survey will take approximately 5 minutes to complete. You will not be able to save your responses, so please complete all questions in one sitting.

This survey is not being conducted by ACOG.

If you have any questions or additional comments regarding the questionnaire please contact us at 516-562-4438 or the IRB office at the North Shore LIJ Health system at 516-719-3100.

Thank you very much for your participation.

Jill S. Whyte, MD, FACOG
Assistant Professor of Obstetrics and Gynecology
Hofstra North Shore LIJ School of Medicine
Division of Gynecologic Oncology

Andrew W. Menzin, MD, FACOG
Professor of Obstetrics and Gynecology
Hofstra North Shore LIJ School of Medicine
Associate Chief of Gynecologic Oncology
North Shore LIJ Health System


If you treat patients who have their coverage through Humana, you might want to share this link with your billing staff.


Pub Sells Pregnancy Tests to Curb Birth Defects 
Click here to read the story - which quotes David Garry, DO, FACOG




ACOG District II:
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American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998