August 25, 2023
Interested in a Leadership Role with the Capital Medical Society?
The CMS Board of Governors and the CMS Delegates to the FMA Annual Meeting serve essential roles in guiding the Capital Medical Society and the Florida Medical Association in the practice of medicine for the benefit of the patient. In October, the CMS Nominating Committee will be reviewing vacancies to fill for 2024. Would you like to be considered for a seat on the CMS Board of Governors or as a Delegate or Alternate to the FMA Annual Meeting? Terms are two-years. If so, please contact Pam Irwin at pirwin@capmed.org or 850.559.8611 or submit your application by September 30.


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FDA OKs Pfizer's RSV Vaccine to Protect Babies
Abrysvo, given in the third trimester, allows moms-to-be to develop virus-fighting antibodies that pass to the fetus. RSV is a cold-like nuisance for most people but can be deadly for the very young. RSV season typically peaks in the winter, but activity has already begun in Florida. The CDC must still sign off.


Source: Health News Florida
'Flesh-Eating' Vibrio Kills 5 in Tampa Area This Year
The health department says 26 cases are confirmed statewide, with two deaths in Hillsborough and one each in Pasco, Polk and Sarasota counties.


Source: Health News Florida
Venous Insufficiency and Acrocyanosis in Long COVID: Dysautonomia
A 33-year-old man with long COVID presented with rapid discoloration of legs on standing; he said his legs felt heavy and numb, and he reported an itchy sensation and purpureal, petechial rash in feet. What is the most likely diagnosis?


Source: The Lancet
CDC announces hospital sepsis guidelines to improve survival rates
The Centers for Disease Control and Prevention on Thursday released “core elements” for hospitals to improve the diagnose and treatment of sepsis guideline, a serious condition that kills at least 350,000 people annually.

Sepsis occurs when the body responds improperly to an infection and causes organs to work poorly. More than 1.7 million Americans develop sepsis each year.

Many hospitals don’t have the proper programs in place to rapidly respond to sepsis, according to a 2022 survey of hospitals in the CDC’s Morbidity and Mortality Weekly Report.

Source: Health News Florida
What is Stockholm syndrome? It all started with a bank robbery 50 years ago
This week marks 50 years since a failed bank robbery that gave rise to Stockholm syndrome, a term used to describe the bond that victims of kidnappings or hostage situations sometimes develop with their captors.

It's a common term these days, deployed to describe the bond that victims of kidnappings or hostage situations sometimes develop with their captors: “Stockholm syndrome.” And it got its name 50 years ago this week, during a failed bank robbery in Sweden's capital.

Source: Health News Florida
New flame retardants found in breast milk years after similar chemicals were banned
In the early 2000s, researchers tested breast milk samples from U.S. mothers and found high levels of toxic compounds used as a common flame retardant in household items.

The compounds, polybrominated diphenyl ethers (PBDEs), were gradually phased out after a link was found with certain health risks. It sounds like a public health success story, but new research suggests it may not be quite that simple.

This summer, scientists detected a new set of similar flame retardants in the breast milk of 50 U.S. women.
Source: Health News Florida
Some Florida doctors hope new golf cart law will curb a rise in youth injuries
Starting Oct. 1, teens in Florida won't be allowed to drive golf carts on public roads without a valid driver’s license or learner’s permit, according to a new state law passed during the legislative session this year.

Doctors like Meghan Martin at Johns Hopkins All Children's Hospital in St. Petersburg applaud the move and hope it will improve golf cart safety.

“A couple years ago we'd see golf cart injuries intermittently, but honestly over the last three years they have only been continually increasing," Martin said. "We're seeing them fairly regularly now and some of the injuries are more significant.”

Source: Health News Florida
Why Blue Shield of California is Shaking Up its Prescription Drug Model
Blue Shield of California is cutting many of its ties with CVS Caremark (though not all) and adding four additional partners for its prescription drug benefits. These partners include Mark Cuban Cost Plus Drug Company and Amazon Pharmacy. The changes are needed to disrupt the current broken system, said Salina Wong, senior director of clinical pharmacy programs at Blue Shield of California.


Source: MedCity News
Timing, cost of new vaccines vary by virus and health insurance status
Flu. COVID. RSV. When and how to get vaccinated against them can be confusing. Here are some of the most important things to know.

As summer edges toward fall, thoughts turn to, well, vaccines.
Yes, inevitably, it’s time to think about the usual suspects — influenza and COVID-19 shots — but also the new kid in town: recently approved vaccines for RSV, short for respiratory syncytial virus.

But who should get the various vaccines, and when?

Source: Health News Florida
Unbelievable Things Doctors Used To Recommend
To view a video from Doctor Mike on "Unbelievable Things Doctors Used to Recommend", click here.

Source: YouTube
Capital Health Plan - Walk with a Doc Program in Tallahassee - Next Walk: Saturday, August 26 at 9:00 AM
Save the Date - Adolescent Mental Health in the Post-Covid Era - September 25, 2023
New DEA Requirement CME Available
The Florida Medical Association (FMA) has announced they will be providing the 8-hour, required DEA continuing education requirement through their CME portal: www.flmedical.org.
 
Here is the clickable link to the FMA site for further information and courses. Signing in is required, membership is not required.
 
Course fees apply: Member $200 / Non-Member $300 for the one-time requirement.
Are You Prepared This Hurricane Season?
Hurricane Preparedness Guide 2023

Know Your Flood Zone - FEMA
Learn the Health Risks of Gas Stoves - My Green Doctor
Gas stoves are a health risk. This is true especially for children and the elderly. People who live in homes with gas stoves have more asthma, lung disease, and cardiovascular disease. This month, the Society’s My Green Doctor provides a short article (visit https://mygreendoctor.org/learn-the-health-risks-of-gas-stoves/) on this vital topic (reading time: 5 mins).
DEA Extends Telehealth Flexibilities Until November 11, 2023
The ability to prescribe controlled substances based on telehealth patient visits was set to expire when the COVID-19 Public Health Emergency ends on Thursday, May 11th. The U.S. Drug Enforcement Administration (DEA) initially issued two proposed rules establishing new policies for controlled substance prescriptions based on telehealth visits, one for buprenorphine and one for other controlled substances. After receiving more than 38,000 comment letters, however, the DEA has decided to extend [federalregister.gov] the same policies that have been in place during COVID for an additional 6 months, until November 11, 2023.

DEA-Registered Practitioners' Training Requirement
On December 29, 2022, the Consolidated Appropriations Act of 2023 enacted a new one-time, eight-hour training requirement for all Drug Enforcement Administration (DEA)-registered practitioners on the treatment and management of patients with opioid or other substance use disorders. Below is information on this new requirement.
 
Who is responsible for satisfying this new training requirement?
 
• All DEA-registered practitioners, with the exception of practitioners that are solely veterinarians.
How will practitioners be asked to report satisfying this new training requirement?
• Beginning on June 27, 2023, practitioners will be required to check a box on their online DEA registration form—regardless of whether a registrant is completing their initial registration application or renewing their registration—affirming that they have completed the new training requirement.
What is the deadline for satisfying this new training requirement?

·    The deadline for satisfying this new training requirement is the date of a practitioner’s next scheduled DEA registration submission—regardless of whether it is an initial registration or a renewal registration—on or after June 27, 2023.
·    This one-time training requirement affirmation will not be a part of future registration renewals.
·    How can practitioners satisfy this new training requirement?
·    There are multiple ways that practitioners can satisfy this new training requirement.
 
• First, the following groups of practitioners are deemed to have satisfied this training:
 
1.Group 1: All practitioners that are board certified in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, the American Board of Addiction Medicine, or the American Osteopathic Association.
2.Group 2: All practitioners that graduated in good standing from a medical (allopathic or osteopathic), dental, physician assistant, or advanced practice nursing school in the United States within five years of June 27, 2023, and successfully completed a comprehensive curriculum that included at least eight hours of training on:
 
·    Treating and managing patients with opioid or other substance use disorders, including the appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of a substance use disorder; or
·    Safe pharmacological management of dental pain and screening, brief intervention, and referral for appropriate treatment of patients with or at risk of developing opioid and other substance use disorders.
 
• Second, practitioners can satisfy this training by engaging in a total of eight hours of training on treatment and management of patients with opioid or other substance use disorders from the groups listed below. A few key points related to this training:
 
1.The training does not have to occur in one session. It can be cumulative across multiple sessions that equal eight hours of training.
2.Past trainings on the treatment and management of patients with opioid or other substance use disorders can count towards a practitioner meeting this requirement. In other words, if you received a relevant training from one of the groups listed below— prior to the enactment of this new training obligation on December 29, 2022—that training counts towards the eight-hour requirement.
3.Past DATA-Waived trainings count towards a DEA registrant’s 8-hour training requirement.
4.Trainings can occur in a variety of formats, including classroom settings, seminars at professional society meetings, or virtual offerings.
5. What accredited groups may provide trainings that meet this new requirement?
 
·    The American Society of Addiction Medicine (ASAM)
·    The American Academy of Addiction Psychiatry (AAAP)
·    American Medical Association (AMA)
·    The American Osteopathic Association (AOA), or any organizations accredited by the AOA to provide continuing medical education
·    The American Dental Association (ADA)
·    The American Association of Oral and Maxillofacial Surgeons (AAOMS)
·    The American Psychiatric Association (APA)
·    The American Association of Nurse Practitioners (AANP)
·    The American Academy of Physician Associates (AAPA)
·    The American Nurses Credentialing Center (ANCC)
·    Any other organization accredited by the Accreditation Council for Continuing Medical
Education (AACCME) or the Commission for Continuing Education Provider Recognition (CCEPR), whether directly or through an organization accredited by a State medical society that is recognized by the ACCME or CCEPR
·    Any other organization approved or accredited by the Assistant Secretary for Mental Health and Substance Use, the ACCME, or the CCEPR
 
We hope this information is helpful. For information regarding the DEA Diversion Control Division, please visit www.DEAdiversion.usdoj.gov. If you have any additional questions on this issue, please contact the Diversion Control Division Policy Section at (571) 362-3260.

Sincerely,
Thomas W. Prevoznik
Acting Assistant Administrator Diversion Control Division

Source: U.S Department of Justice Drug Enforcement Administration (DEA)
About Exception Applications PY 2023
There are 2 exception applications available to clinicians:



Source: U.S Centers for Medicare & Medicaid Services
CMS Foundation Physician Wellness Program is Here for Physicians and TMH Residents
Overloaded? Stressed? You're Not Alone.

Does your workday start before dawn and end well after dusk? Do you go to bed tired and wake up the same way? Maybe it’s time you talk to someone who can help you make positive changes for a healthier, happier life and lifestyle. The CMS has six professional counselors who are available to you - free of charge - free of worry. This program remains one of the few in the state that serves all local practicing physicians and TMH Residents, without cost, without question. Six sessions annually are completely confidential and autonomous. 
 
WELLNESS COACHES: 
Paul Deitchman, Ph.D.
313 Williams St., #5
Tallahassee, FL 32303
850-878-3571
UNIVERSITY: FLORIDA STATE UNIVERSITY
Tracey Morse, Ph.D.
1114 E. Tennessee St.
Tallahassee, FL 32308
850-556-7944 
UNIVERSITY: SOUTHERN ILLINOIS UNIVERSITY – CARBONDALE
Stephen Wright, Ph.D.
313 Williams St., #7
Tallahassee, FL 32303
850-222-3045
UNIVERSITY: FLORIDA STATE UNIVERSITY
SPECIALTY AREA WELLNESS COACHES:
Family, Marriage, and Trauma
Kenneth Fowler, Ph.D., LMHC & Certified Traumatologist
1028 E. Park Ave.
Tallahassee, FL 32301
850-212-6873
UNIVERSITY: FLORIDA STATE UNIVERSITY
CERTIFICATE: FSU TRAUMATOLOGY INSTITUTE
Dr. Fowler is a licensed mental health counselor (LMHC) and an Approved Supervisor for mental health counselors, marriage and family therapists and social workers. As a result of his expertise in psychological trauma, Dr. Fowler was called to respond in New York City following the 9/11 attacks. As a leader in his field, he was able to help with this national tragedy. His work with natural disasters led to him being called to assist with the Hurricane Katrina disaster by debriefing first responders who were exposed to the aftermath of the trauma. Currently, he consults with the Southcom Command of the United States Armed Forces to help returning soldiers and their families deal with the effects of war as well as post-traumatic stress disorder. 
Family and Marriage
Jane Marks, LFMT, LMHC
3325-C Thomasville Road
Tallahassee, FL 32308
850-385-8222
 UNIVERSITY: FLORIDA STATE UNIVERSITY

For five decades, Jane Marks has helped countless families navigate the challenges in life. As a Licensed Family & Marriage Therapist, she will bring a thoughtful approach to wellness for those seeking individual, family or marriage coaching through the CMS Foundation’s Physician Wellness Program.
Grief, Loss, and Trauma
Brenda Rabalais, Ph.D.
216 Lake Ella Drive
Tallahassee, FL  32303
850-841-7733 
UNIVERSITY: FLORIDA STATE UNIVERSITY

Brenda Rabalais, Ph.D., specializes in providing counseling services to those who are struggling with a loss or a trauma. Examples include; divorce, abandonment (foster care, adoption, service families), abuse, suicide, homicide, crime, loss of functionality, loss of home or job, long-term illnesses, other life transitions, as well as death. Brenda founded Lee's Place, a grief, loss and trauma counseling center, in 2000 and has been a practicing therapist as well as the Executive Director for those 21 years.
Special thanks to the MagMutual Foundation and the TMH Medical Staff for helping the CMS fund this program.

African-American Alzheimer's Caregivers Training and Support (ACTS 2) Project
Informational Correspondence with the Capital Medical Society
In this digital era, we strive to keep you updated with the latest in information. Please let us know when your emails and contact information change. We want you to be part of this Society and be active in your practice networking. Patients seeking provider referrals and providers seeking provider referrals keep your practice flourishing. If your membership information is old and you would like to contact us about relocating, new staff changes, or if you haven’t heard from us in a while, your information may not be current. Your personal contact information is kept confidential but is our way of reaching out to you about meetings, medical updates, license requirements, legalities in medicine and patient privacy and care, Journals, newsletters and more.
Pam Irwin, Executive Director, 850-559-8611, pirwin@capmed.org
Are You One of our Members on the Move?
If you can answer "yes" to any of these questions, we want to know more!
·    Is your practice expanding? Are you adding staff members?
·    Do you have a new practice administrator/office manager?
·    Have you changed or added locations?
·    Have you changed your email/phone/fax?
·    Have you added a new specialty or passed your Board Certification(s)?
·    Have you retired within the last six months?
 
Send your updates to rcarlin@capmed.org.
Subject line: Member Updates
Updated Physician Headshots
The CMS website is your link to our physician member database. The CMS has been actively working on each provider search. Please take the time to search the listing. If you find there is any inaccurate information or an outdated headshot, please reach out to CMS to update your information. Let us know as soon as possible to make sure your information is current.
CMS | (850) 877-9018 | rcarlin@capmed.org
Electronic Version of August 2023 Cap Scan
Click here to view the August 2023 Cap Scan.
Free Monthly Webinars: "The Business Side of Medicine"
Each webinar is on the third Tuesday of every month at 6:30 PM.

For more information and to register, click here.

Source: MIRZA, Healthcare Law Partners
Medicare Revalidations
Medicare Revalidations are back in full force after a brief pause during the height of the COVID-19 Pandemic. All healthcare providers and suppliers are required to revalidate their Medicare enrollment every 3-5 years per CMS’ request. Medicare has implemented new revalidation screening criteria that you will need to be aware of. Missing this important deadline will have significant financial consequences on your medical practice! This link is to a tool to a searchable database that allows you to look up the revalidation due date for Medicare providers who must revalidate their enrollment record information every three or five years.

Your Dose of Medical Humor
Save the Date for Upcoming CMS Meetings/Events
Here's Another Connection for CMS Members: Healthcare Lawyer On Call
The CMS has had a long-standing relationship with Jeff Cohen and The Florida Healthcare Law Firm. Did you know that you can tap into a program called Healthcare Lawyer On Call through Jeff and his firm? That's right! On-Call is different than what you may be used to and doesn't mean that you'll find an attorney at 3 AM to answer a question, but what it does mean is that you can call and speak with someone at The Florida Healthcare Law Firm for 15 minutes at no charge! Please remember that any purely verbal discussion on legal matters is simply the lawyer’s best (and unconfirmed) understanding. Another benefit of being a CMS member!
CME Resources
Accredited Education Courses to Meet DEA Training Requirement
The Doctors Company offers 6.75 hrs. that meet the DEA requirement for free. These hours can be combined with previous opioid education the physician may have completed to achieve the 8 hr. requirement. This, and all The Doctors Company CME, is available for free to any physician. They do not have to be a The Doctors Company insured.

2023 Medical-Dental Integration Symposium - Virtual
September 13, 2023
2:00-6:00 pm
Free

Easy to use web portal makes it easy to find courses and track credits. Accredited activities for over 30 medical specialties; Over 100 active courses at any given time; Activity accreditations include ACCME, ANCC, AANP, ACPE, and more; Content is always current, and always free.

Free 1-hour online CME opportunity!
University of Florida's Department of Epidemiology
Raising awareness for Alzheimer's disease and increasing screening for cognitive impairment. This CME has a focus on primary care physicians but is applicable to all physicians who may encounter patients with cognitive impairments.

On-Demand CME by The Doctors Company
Diagnostic error continues to be a top patient safety concern, a global burden, and cause patient harm from treatment delay, testing, or misdiagnosis. “Prevention of Diagnostic Error in Primary Care” is an on-demand CME activity that features patient safety expert Jeffrey A. Gold, MD, professor of medicine, vice chair for quality and safety, for the department of medicine at the Oregon Health and Science University. This program highlights major contributing factors of diagnostic error along with the diagnostic process of care framework with additional focus on strategies to mitigate risk of patient harm in the primary care setting.

On-Demand CME by The Doctors Company
1.25 AMA PRA Category 1 Credits™
Explore the challenges and risks associated with telehealth. Concerns regarding privacy, security, licensure, and technology that might instigate a malpractice claim are discussed.

On-Demand CME by The Doctors Company
2.5 AMA PRA Category 1 Credits or 2.5 ADA CE Credits
Opioids play an important role in pain management—both in acute and chronic care settings—but overuse, misuse, and diversion have contributed to an opioid-related epidemic leading to addiction and death. Our on-demand program provides a useful and informative examination of the epidemic’s prevalence and effects.
National Human Trafficking Hotline
If you suspect human trafficking, please call:
  
National Human Trafficking Hotline
1 (888) 373-7888
Suicide Prevention Hotline
Reach the National Suicide Prevention Lifeline and Veterans Crisis Line by Phone and Text

By Phone:
Call 1-800-273-8255 to reach the National Suicide Prevention Lifeline today. 988 is not a nationwide calling code right now.
Veterans should Press 1 to be connected with the Veterans Crisis Line.

By Text:
The National Suicide Prevention Lifeline is also available today through online chats. 988 is not a nationwide texting code right now.
Service members, Veterans, and their families can reach the Veterans Crisis Line by texting 838255, and through online chats at veteranscrisisline.net.


Source: Federal Communications Commission
Florida E-Prescribing
Electronic Prescribing Requirements (Florida Board of Medicine)
House Bill 831 (2019), Electronic Prescribing, was signed into law by Governor DeSantis. The effective date is January 1, 2020. The bill provides important new requirements for prescribers to generate and transmit all prescriptions electronically upon licensure renewal or by July 1, 2021, whichever is earlier.

Florida ePrescribing Clearinghouse (Agency for Healthcare Administration)
The purpose of the Florida ePrescribing Clearinghouse is to provide information that contributes to the promotion and implementation of electronic prescribing by health care practitioners, health care facilities, and pharmacies in order to prevent prescription drug abuse, improve patient safety, and reduce unnecessary prescriptions. This Clearinghouse contains information on the advantages, processes, products, rules, and laws of ePrescribing as well as Florida ePrescribing reports.
PAP Machine Donations Needed!
A PAP (Positive Airway Pressure) machine is an electronic respiratory ventilation device used to treat obstructive sleep apnea. Capital Medical Society Foundation, Inc.'s We Care Network program assists low-income, uninsured adults, whose income is at or below 150% of the Federal Poverty Level, with obtaining these potentially life-saving medical devices, when prescribed by a pulmonologist. Thanks to our partners at Desloge Home Oxygen and Medical Equipment, Inc., we are able to provide refurbished CPAP, AutoPAP, and BPAP machines for eligible We Care Network patients in Leon, Gadsden, Jefferson, and Wakulla Counties. We Care Network also accepts unused, unopened supplies for PAP machines, such as masks, nasal cannulas, and tubing. We Care Network coordinates over $5,000,000 in donated specialty medical and dental care annually.
 
Machine donations can be dropped off at Capital Medical Society Foundation's office at 1204 Miccosukee Road, Tallahassee, FL 32308. Donations to Capital Medical Society Foundation are tax-deductible within IRS guidelines Federal Tax I.D. #: 59-2104510. For additional information, please call 850-942-5215 or email dbixler@capmed.org.
Check Out the Latest CMS Member Benefits