NEWSLETTER NEW JERSEY CHAPTER AMERICAN COLLEGE OF SURGEONS PRESIDENT S MESSAGE. Volume 6; Issue 1 March, Fred Weber, M.D., J.D.

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1 NEW JERSEY CHAPTER AMERICAN COLLEGE OF SURGEONS NEWSLETTER Volume 6; Issue 1 But I am faint, my gashes cry for help. So well thy words become thee as thy wounds; They smack of honor both. Go get him surgeons. Macbeth William Shakespeare I, ii, Annual Meeting The 62 nd annual meeting of the New Jersey Chapter of the American College of Surgeons was held on December 14, 2013 at the Woodbridge Conference Center. There were twelve individual sessions in both the morning and afternoon. The Sheen Award presentation took place during the luncheon.. Individual conferences were held on all disciplines of surgery from General Surgery, the subspecialties and global surgery. A most popular session is Surgical Jeopardy presented by Dr. Ronald Chamberlain. Teams of residents competed in such categories as Name that Triad and La Leche League. The Sheen Award is given annually at the December Clinical Symposium. It was created in 1967 by philanthropist Thomas Sheen of Atlantic City to honor his brother, an early Roentgenologist. It is an honorarium of $25,000 and is given to further the study of medicine and to compensate an outstanding Doctor of Medicine Science in the United States. This year s Awardee was Ronald V. Maier, MD, FACS, the Jane and Donald D. Trunkey Endowed Chair in Trauma Surgery and vice-chairman, department of surgery, University of Washington (UW) School of Medicine, Seattle. He gave a fascinating talk on recent advances in the molecular basis of trauma resuscitation of the trauma victim which was most informative and very well received by those in attendance. More than two hundred surgeons and exhibitors were registered. Acute Care Surgery Symposium Mark Hirko, M.D., F.A.C.S. arranged the PRESIDENT S MESSAGE Acute Care Symposium hosted Saturday, March 8, 2014 at the Woodbridge Hotel & Conference Center. A lively and informative session with several perspectives on acute care surgery in the community and the urban academic settings were presented. A highlight was the lunch symposium with Ms. Lori Herndon, R.N, B.S.N., M.B.A., the President and CEO of Atlanticare Regional Medical Center speaking on Health Systems Plan for the Future. Registration begun at 7:30 AM and a Continental Breakfast and lunch was provided. YOUR ACTION IS NEEDED TODAY Call your Representative and Senators today, and tell them they must act now to permanently repeal Medicare's sustainable growth rate (SGR) formula by passing The SGR Repeal and Medicare Provider Payment Modernization Act of 2014, before a 23.7 percent pay cut goes into effect on April 1. Please find background information and specific instructions on page three. Chapter Pilgrimage A pilgrimage is a long journey especially one undertaken in search of moral or spiritual significance. A successful pilgrimage involves a commitment to leave behind one s problems and to focus instead on seeking to learn. The New Jersey Chapter of the American College of Surgeons makes an annual pilgrimage to visit with surgeons of other countries. Previous pilgrimages have journeyed to Barcelona, London, Lisbon, Edinburgh, and Dublin. This year the Chapter will make an Academic Pilgrimage to Sicily under the leadership of Michael Spedick. M.D., F.A.C.S. We will depart May 11, 2014 and fly to Catania. Tours will include Mt. Etna and Agrigento. An academic session will be held with the surgeons of Sicily followed by a gala dinner. This pilgrimage is a unique opportunity to interact with international surgeons, foster positive relations between medical systems and to have fun. Previous journeys have been a great success. We hope you will consider joining us for this exciting trip. Medical Student Loan Repayment Program Dr. Goldfarb has initiated an innovative program to help repay student loans for surgeons planning to practice in New Jersey. The original program was established with a $300,000 donation from Sallie Mae and was administered by Building Hope, a non-profit educational organization. Three awards were presented to Drs. Kevin Holzman, Imani Jackson Rosario and Raymond Green. Each received $100,000 to repay their medical student loans. Those payments ended in December Sallie Mae donated $250,000 for the current program with the Chapter contributing $50,000. The program is again being administered by Building Hope. The awardees this year are: Drs. Lloyd Brown, Joshua Hazelton and Jonathan Keith. (Continued on Page Nine) Fred Weber, M.D., J.D., FACS

2 Page 2 NEW JERSEY CHAPTER, AMERICAN COLLEGE OF SURGEONS Executive Office: 52 Elm Street, Morristown, NJ (973) FAX: (973) njsurgeons@aol.com Newsletter Editor: Frank T. Padberg, Jr., M.D. Managing Editor: Andrea Donelan Opinions expressed in this newsletter are not necessarily those of NJACS. Mention of products or services does not constitute endorsement. Clinical, legal, tax and other comments are offered for general guidance only. Professional counsel should be sought for specific situations. For reprint permission call (973) Chapter Officers President...Fred Weber, M.D., J.D. President-Elect..Michael J. Spedick, M.D. Vice-President..Adam M. Kopelan, M.D. Secretary...Michael L. Arvanitis, M.D. Treasurer...Justin T. Sambol, M.D. Executive Director...Andrea M. Donelan Immediate Past President..Michael A. Goldfarb, MD Chapter Councilors Arnold Baskies, M.D. Willingboro Howard M. Berger, M.D. Toms River Kai Bickenbach, M.D. Morristown Frank Borao, M.D. Eatontown Jeffrey P. Carpenter, M.D. Camden Joseph Cauda, M.D. Shrewsbury Joseph P. Costabile, M.D. Marlton Arno Fried, M.D. Hackensack James N. Gardner, M.D. Summit John Gatti, M.D. Cherry Hill Paul Haser, M.D. New Brunswick Mark Hirko, M.D. Long Branch Eric Lazar, M.D. Morristown Anne C. Mosenthal, M.D. Newark Robert Olson, M.D. New Brunswick Charles Prestigiacomo, M.D. Newark Rolando Rolandelli, M.D. Morristown Richard J. Scott, M.D. Little Silver Paul Starker, M.D. Summit Stanley Z. Trooskin, M.D. New Brunswick Governors Bruce Brenner, M.D. Mark W. Moritz, M.D. Frank T. Padberg, Jr., M.D. Fred Weber, M.D. Lewis Wetstein, M.D. Felix Garcia, M.D. Jarrod Kaufman, M.D. ACS Committees Past Presidents Michael A. Goldfarb, M.D. Committee on Trauma Cancer Commission Ronald S. Chamberlain, M.D. Frank T. Padberg, M.D. Paul J. Carniol, M.D. Lewis Wetstein, M.D. Mark Moritz, M.D. William Rough, M.D. Bruce Brenner, M.D. H. Stephen Fletcher, M.D. Paul LoVerme, M.D. J. Thomas Davidson, MD Robert W. Hobson, M.D. Robert C. Davies, M.D. James Alexander, M.D. Kathleen Kelly, M.D. John Donahue, M.D. Albert Frankel, M.D. Ralph S. Greco, M.D. William Hardesty, M.D. John Krause, M.D. Rudolph Camishion, M.D. George Saj. M.D. William Rainer, M.D. Cyril S. Arvanitis, M.D. Donald Brief, M.D. Ames Filippone, Jr., M.D. Roy Morrow, M.D. Anita Falla, M.D. Francis Barse, M.D. William Muir, M.D. James Mackenzie, M.D. Victor Parsonnet, M.D. Benjamin Rush, Jr., MD James Chandler, M.D.

3 Page 3 CALL TO ACTION!! On February 7, you received an update from the American College of Surgeons (ACS) that Congress reached a bipartisan, bicameral deal for the repeal of Medicare's sustainable growth rate (SGR) formula and to reform the Medicare physician payment system The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/S. 2000). This ACS-supported legislation is the product of a yearlong collaborative effort between Congress and key stakeholders, including the College. Unfortunately, some powerful interest groups are fighting against this legislation due to financial cuts that could be included to offset the cost of the bill upwards of $150 billion (over 10 years). Your participation is critical. It will take our strong collective effort to provide Representatives and Senators with the political will to put physicians and patients first. The opposition has already begun their efforts, and we must answer the call or we will lose this opportunity. We can't allow Congress to stall on this landmark legislation. The current deadline for Congress to repeal the SGR is March 31st. If no action is taken, Medicare physician payments will be slashed by 24 percent. Another patch is NOT the answer, it is time to pass H.R. 4015/S and put an end to the SGR. INSTRUCTIONS: Please call toll-free today. You will be asked to enter your zip code and will then be connected to your Representative and Senators' offices. Once you are connected, tell them you are a constituent and leave your name, phone number, and address, along with the suggested message below. PHONE MESSAGE: As a surgeon and as your constituent, I urge you to sign-on as a cosponsor of H.R. 4015/ S I also urge you to persuade congressional leadership to bring the bill to a vote before April 1st. ACS LEADERSHIP & ADVOCACY SUMMIT Registration is now open for the American College of Surgeons (ACS) third annual Leadership & Advocacy Summit, March 29 April 1, 2014, at the JW Marriott Hotel in Washington, DC. The Leadership Summit will convene on Sunday, March 30 and will focus on building leadership and mentoring skills, emotional intelligence, and chapter development. The Advocacy Summit will begin on Monday, March 31, and will focus on providing strategies specifically designed to accommodate the attendees varying levels of advocacy experience. On April 1, ACS members will meet with their elected officials or their health care policy staff on Capitol Hill. This portion of the program provides an opportunity to rally the surgical profession s collective grassroots advocacy voice on issues such as physician payment, professional liability, and physician workforce issues.

4 Page 4 A902- Munoz: This bill allows a health care provider to hold a homestead, as defined in the bill, exempt from attachment, execution, and forced sale in any judgment resulting from a medical malpractice action brought by a claimant for medical malpractice. A903- Munoz: This bill provides that an insurer shall not increase the premium of any medical malpractice liability insurance policy based on a claim of medical negligence or malpractice against an insured unless the claim, as defined in the bill, results in a medical malpractice claim settlement, judgment, or arbitration award against the insured. S884 Beck & Weinberg: The bill revises the law governing lawsuits and insurance coverage for medical malpractice. The bill provides that, notwithstanding any law or rule to the contrary, if an attorney representing a plaintiff in a medical malpractice action files a complaint using fictitious names for one or more persons who may be determined to be parties to the action but whose role is unknown at the time of the filing of the complaint, the attorney shall substitute the name of a person for a fictitious name for any person who may be determined to be a party to the action at least 120 days prior to the date on which the action is set for trial, after which time names of persons shall not be substituted for fictitious names. This bill also provides that a health care professional who volunteers to respond in good faith to an emergency at a hospital or health care facility has immunity for civil damages, if there is no current active provider-patient relationship with the patient. Currently, a health care provider, in order to have the benefit of immunity for such an emergency, could not have had a provider-patient relationship before the emergency, and could not have been provided any consideration for the service rendered. The bill further provides that an insurer shall not increase the premium of any medical malpractice liability insurance policy based on a claim of medical negligence or malpractice against an 2014 LEGISLATIVE UPDATE insured unless the claim, as defined in the bill, results in a medical malpractice claim settlement, judgment or arbitration award against the insured. Finally, the bill also prohibits an insurer from increasing medical malpractice insurance premiums, if the alleged malpractice occurred in certain charitable or emergency situations. A335 - Bramnick & Munoz : This bill prohibits insurers authorized to transact medical malpractice liability insurance in this State from increasing the premium of any medical malpractice liability insurance policy based on a claim of medical negligence or malpractice while the insured was a resident physician or nurse in training unless the claim results in a medical malpractice claim settlement, judgment, or arbitration award against the insured. This bill also prohibits employers from seeking to obtain or requiring a current or prospective employee to provide or consent as a condition of employment to the creation of information about claims of medical negligence or malpractice against the employee that occurred while the employee was a resident physician or nurse in training and that did not result in a settlement, judgment, or arbitration award against the employee. A906 Munoz & Jasey: This bill which is designated as the Consumer Access to Health Care Act, eliminates the requirement that a joint protocol be in place before an advanced practice nurse (APN) may prescribe medications, and sets forth the conditions under which an APN may prescribe medications. These conditions include use of the New Jersey Prescription Blank and satisfaction of continuing professional education requirements related to prescribing controlled substances. An APN with fewer than 24 months or 2,400 hours of licensed, active, advanced nursing practice in an initial role would be permitted to prescribe medication only if a formal collaborating agreement with a provider is in place. The bill also provides that any State law or regulation that requires the signature or similar endorsement of a physician would be deemed to require the same of an APN, to the extent consistent with an APN s scope of practice. The bill incorporates recommendations of the National Council of State Boards of Nursing, which also adopted a model act. The model act does not condition an APN s prescribing authority on a joint protocol with a collaborating physician, because collaboration with other health care professionals is currently a professional responsibility. This bill is consistent with the Institute of Medicine (IOM) recommendation that barriers to APN scope of practice be eliminated and that states adopt the model act. The IOM has suggested that federal funding for nursing education programs be limited to only those programs in states that adopt the model act, because it has found that restrictive collaboration requirements are barriers to nursing practices and to patient access to primary care. A593- Webber & McHose: This bill limits the liability of health care providers to an injured plaintiff for pain and suffering, also known as noneconomic damages, to $250,000. A606- Webber: This bill, which is designated the Medical Philanthropy Act, seeks to encourage physicians to provide their professional services without receiving compensation to more than 10% of their patients. In return for the provision of uncompensated care and treatment, the bill establishes a $250,000 cap on noneconomic damages for a physician s entire professional medical practice. With a limited malpractice liability risk, the physician will be subject to a reduced medical malpractice insurance premium. Specifically, the bill provides that a physician licensed to practice in this State who provides care or treatment to at least 10% of the physician s patients in a calendar year without receiving any compensation for that care or treatment, shall not be liable in any action for noneconomic damages alleging medical malpractice against that physician in an amount that exceeds $250,000.

5 Page 5 LEGISLATIVE UPDATE CONTINUED S958- Beck (R) : This bill would require that a voluntary survey developed by the Department of Health, in collaboration with the State Board of Medical Examiners (BME), be made available to physicians as part of the biennial registration process for physicians. The survey is to include questions relating to the physician s professional practice. The BME is to make the voluntary online survey available on the BME website to every physician licensed to practice in this State. The BME is prohibited from conditioning the physician s biennial registration on whether the physician completes the survey or on any response provided to a survey question. The BME is to compile, and serve as the repository of, the survey results. The information obtained from the survey is to be made available within 30 calendar days of a request from: other State entities and programs as appropriate for the performance of their duties under State or federal law or regulations, or as required to obtain federal funds available to the State for purposes that relate to the survey results; and medical professional societies, medical schools, and other organizations representing health care providers or that are involved with physician work force planning in the State. A325- Bramnick & Munoz : This bill provides physicians with the right to engage in joint negotiations over the terms and conditions of their contracts with health insurance carriers, that is, health, hospital and medical service corporations, commercial health insurers, and health maintenance organizations. The bill is based on legislation enacted in 2002 (P.L.2001, c.371) that authorized physicians and dentists to engage in joint negotiations with carriers, which legislation expired in The bill permits two or more independent physicians who are practicing in the geographic service area of a carrier to jointly negotiate with the carrier and engage in related joint activity over the terms and conditions of a proposed contract. The negotiations would be carried out through a joint negotiation representative selected by the physicians to act on their behalf. A115-McHose (R) :This bill renders the federal Patient Protection and Affordable Care Act, Pub.L , as amended by the federal Health Care and Education Reconciliation Act of 2010, Pub.L , and any federal rules and regulations adopted pursuant thereto, null and void and of no force and effect in the State of New Jersey. The bill further provides as follows: It is the duty of the Legislature to adopt and enact any measures necessary to prevent the enforcement of the federal act within the limits of this State. S364 Oroho: This bill revises certain provisions of statutory law concerning access to information maintained by the Prescription Monitoring Program (PMP), which was established in the Division of Consumer Affairs in the Department of Law and Public Safety pursuant to P.L.2007, c.244 (C.45:1-45) as an electronic system for monitoring controlled dangerous substances that are dispensed in or into the State by a pharmacist in an outpatient setting. The bill requires that the division review the prescription monitoring information provided by a pharmacy permit holder including, but not be limited to: a review to identify whether any person is obtaining prescriptions in a manner that may be indicative of misuse, abuse, or diversion of controlled dangerous substances; and a review to identify whether a violation of law or regulations or a breach of the applicable standards of practice by any person may have occurred. If the division determines that such a violation or breach may have occurred, the division is to notify the appropriate law enforcement agency or professional licensing board, and provide the prescription monitoring information required for an investigation. The bill also stipulates that when evaluation of the information reviewed by the division indicates that a person is obtaining prescriptions in a manner that appears to represent misuse, abuse, or diversion of controlled dangerous substances, by obtaining prescriptions for the same or similar drugs from multiple practitioners and pharmacists during the same time period, the division may provide prescription monitoring information about the person to practitioners and pharmacists. SCR 25 Oroho & Van Drew: This proposed constitutional amendment states that the Legislature may provide that a parent or legal guardian shall receive notice before his or her unemancipated minor or incompetent child undergoes any medical or surgical procedure or treatment relating to pregnancy, irrespective of any right or interest otherwise provided in the State Constitution. The Legislature enacted the "Parental Notification for Abortion Act," P.L.1999, c.145 (C.9:17A-1.1 et seq.) and the constitutionality of the act was challenged in court. The case came before the New Jersey Supreme Court and in Planned Parenthood of Central New Jersey v. Farmer, 165 N.J. 609 (2000), the court found the act unconstitutional. S596- Webber: This bill prohibits causes of action for wrongful life and birth lawsuits. It is modeled principally after Pennsylvania s statute. Eight other states have similar laws. The lawsuits prohibited by this bill violate the tenets of traditional tort law. For example, in traditional tort law, in order for one to be liable for the injuries of another, one s actions actually must cause the injuries. But in wrongful birth and life suits, the defendants have not caused any harm to the unborn child. Tort claims also require damages commensurate with the injury suffered. These lawsuits raise the unanswerable question of how to compare the value of a life with a disability to the alternative never having lived at all.

6 Page nd ANNUAL MEETING Dr. James Alexander, Lauren Maier, Drs. Ronald Maier, Fred Weber and Michael Goldfarb Drs. Mark Moritz, Michael Goldfarb and Frank Padberg Resident Abstract Winners: Drs. Aaron Klinger, Oliver Eng, Michael Goldfarb (President), Jason Lei, David Pham, Aram Jawed and Harry Agis (Committee Chair) Residents 2013 Sitting: Drs. Bogdan Protyniak, Ravi Kapadia, Shivang Patel, Kambiz Kamrani and Stephanis Scott. Standing: Drs. Samuel Hui, Dan Lavy, Javier Otero and Arpish Shah Drs. H. Stephen Fletcher and Michael A. Goldfarb Drs. Michael A. Goldfarb and Michael L. Arvanitis

7 Page nd ANNUAL MEETING Mr. Anthony Terracciano, Chairman of Sallie Mae and Michael A. Goldfarb, M.D., President Michael A. Goldfarb, M.D., Out-going President and Fred Weber, M.D., J.D., In-coming President 2013 Medical Student Loan Repayment Awardees Mr. Anthony Terracciano, Drs. Joshua Hazelton, Lloyd Brown, Jonathan Keith and Michael A. Goldfarb Drs. Alexander Abkin, Aram Jawed and Mr. Eric Abkin Ronald S. Maier, M.D., 2013 Sheen Award Recipient Michael A. Goldfarb, M.D. Fred Weber, M.D., J.D., FACS

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9 Page 9 (Continued from Page One) PRESIDENT S MESSAGE CONTINUED ACS Leadership & Advocacy Summit The American College of Surgeons, Division of Advocacy and Health Policy, will hold the 2014 Leadership and Advocacy Summit in Washington, D.C. beginning on March 29. The Leadership Summit will convene on Sunday, March 30 and will focus on building leadership and mentoring skills, emotional intelligence, and chapter development. The Advocacy Summit will begin on Monday, March 31, and will focus on providing strategies specifically designed to accommodate the attendees varying levels of advocacy experience. On April 1, ACS members will meet with their elected officials or their health care policy staff on Capitol Hill. This portion of the program provides an opportunity to rally the surgical profession s collective grassroots advocacy voice on issues such as physician payment, professional liability, and physician workforce issues. Several officers of the New Jersey Chapter will be attending and advocating for the practice of surgery. LEGISLATIVE REPORT A complete state legislative report can be found on pages four and five of this newsletter ACS FOUNDATION Finally, the American College of Surgeons has invited all chapters to make contributions to the Foundation to ensure the continued success of all surgical specialties in the United States. This proposal will be discussed at the council meeting on March 8, This is a very exciting year for the New Jersey Chapter with great enthusiasm for the future of surgery in our state. Please join me in support of our chapter. Respectfully submitted, Fred Weber, M.D., J.D., FACS President, GET WELL ART! We have been informed that Art Ellenberger, our previous Executive Director, hasn t been feeling well lately. Art was involved in a car accident in January which resulted in two fractured knee caps and several fractured ribs. Art underwent successful surgery and is now in a rehabilitation facility (with his wife Ann, who had suffered a stroke last year). Art can be contacted at Alaris Health at Belgrove, 195 Belgrove Drive, Kearny, 07032, (973) NEW MEMBERS WELCOMED! The following physicians are welcomed as members of the Chapter Michael Holman, MD, FACS, General Surgery, Princeton. Anish Nihalani, M.D., FACS, General Surgery-Bariatric Surgery, Edison. Franz Smith, MBBS, General Surgery, Livingston. Peter Thompson, M.D., FACS, General Surgery-Vascular Surgery, Atlantic City. DO WE HAVE YOUR CORRECT ADDRESS? Are we sending your mail to the correct address? Have you moved recently? Please notify the Chapter office of any changes in your address, telephone number, fax number or address. IN MEMORIAM FREDERICK L. PERL, M.D EUGENE PRINCIPATO, M.D ROBERT L. WEGRYN, M.D REMINDER The following certificates are required to practice medicine in New Jersey. NJ State BME Mr. William Roeder Executive Director P.O.Box 183 Trenton, NJ (609) CDS Registration Susan Gartland,Chief Drug Control Department of L& P Safety P.O. Box Halsey Street, 7th Floor, Newark, NJ (973) County Clerk Registration Certificate NJ SBME regulation 45:9.17 requires that you register your license with the County Clerk in the County in which you reside. Drug Enforcement Administration 80 Mulberry Street Newark, NJ (973) FAX: (973) (800)

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11 Page 11 SPONSORSHIP 63rd Annual Clinical Meeting Saturday, December 6, 2014 Sponsorship Opportunities Gold Sponsor Contribution of $3,500 Credit for sponsoring all meals provided and AV support. Gold sponsors will be given NJ-ACS website home page recognition and a link to their own website for one year. Acknowledgement of this level will appear in promotional materials, on site signage, and post -meeting communications. Gold sponsors also enjoy all the benefits of Bronze Sponsors (see below) and 4 representatives. Silver Sponsor Contribution of $2,500 Credit for sponsoring the membership luncheon. Silver sponsors will be given NJ-ACS website home page recognition and a link to their own website for one year. Acknowledgement of this level will appear in promotional materials, on site signage, and post-meeting communications. Silver sponsors also enjoy all the benefits of Bronze Sponsors (see below) and 3 representatives. Bronze Sponsor Contribution of $1,500 Bronze sponsors will enjoy the following benefits and privileges for 2 representatives: One 6 draped table display area and chairs Access to an electrical outlet Continental breakfast, morning break and luncheon Badges for company representatives Registration liist of conference attendees The exhibit hall will be open from 7:30 a.m. until 5:00 p.m. FEDERAL TAX ID # Company Contact Address City State Zip Phone Fax Company Website Make checks payable to: 52 Elm Street Morristown, NJ (973) FAX: (973) njsurgeons@aol.com

12 NEW JERSEY CHAPTER AMERICAN COLLEGE OF SURGEONS 52 ELM STREET MORRISTOWN, NJ 07960