The Tumor of Jim Alain

50 Pages·2015·3.8 MB·English

PAGE 8 PAGE 14 PAGE 22
Meeting the candidates for AAOMS officer The 2015 Day on the Hill was another Treloar and Heisel offers food for thought on
positions. advocacy success. portfolio diversification.
MAY/JUNE 2015
VOLUME 13, ISSUE 3
A publication of the American Association
of Oral and Maxillofacial Surgeons
The Tumor of Jim Alain
AAOMS fellow Tim Bartholomew, DDS,
and his wife, Huyen, an anesthesiologist,
spend the majority of each year in Africa caring
for those in need. Dr. Bartholomew provides
periodic updates on their work to AAOMS
and other interested parties, in which he
highlights unusual and intriguing cases. One
such case is that of Cameroonian Jim Alain,
whom the Bartholomews encountered in
October 2014.
W
e met Pastor Thomas during
our time in Cameroon
several years ago and have
Clockwise from top
kept in touch since then. He wrote us
left: X-ray of the
before we left for Chad last October for
tumor; pre-operative
our cleft lip and palate trip asking if we
photo of Mr. Alain;
could operate on Jim Alain, a friend of his
left to right, Dr.
from church who had a jaw tumor since
Bartholomew, Dr.
he was 17 years old.
Osee, Mr. Alain,
and Pastor Thomas.
After seeing Jim’s pictures, there was no
possible way we weren’t going to try. So,
we took every imaginable piece of surgical
and anesthesia equipment we normally
use for these difficult cases that would fit
in our suitcases.
We arrived in Chad on a Thursday night,
did our greetings and such Friday, then JOMS Seeks Nominations for Section Editor Positions
continued on page 18 The 5-year terms of the seven Section Editors of the JOMS expire at the end of 2015. The
JOMS is now accepting nominations for these 5-year term positions. Section editors have
several important responsibilities that require some work most days of the year. Their chief
duty is to take submissions to their section and determine if peer review is in order, and for
In This Issue those articles qualifying for peer review, invite expert reviewers. Section editors then use the
peer review results to make recommendations to the editor-in-chief and associate editor.
Section editors are also expected to help advise journal leadership on matters related to the
AAOMS President’s Column ...................2 journal and attend a once a year editorial board meeting. Those interested in nominating
Treasurer’s Account ..............................16 someone or themselves must send an email making the nomination, signifying the section
Coding Corner .......................................26 for which the nomination is being made, and discuss the nominee’s expertise in the section
for which they are being nominated. The nominee’s curriculum vitae must be attached to
Practice Management Matters ............33
the email and be sent to [email protected]. Nominations are open until September 1, 2015.
Calendar ................................................48 T
Final decisions on Section Editor positions are made by the AAOMS Board of Trustees.
AAOMS TODAY
MAY/JUNE 2015
VOLUME 13, ISSUE 3
AAOMS Today is published six times a year by
the American Association of Oral and Maxillofacial William J. Nelson, DDS, AAOMS President
Surgeons. Unless specifically stated otherwise,
the opinions expressed and statements made in AAOMS
Today do not imply endorsements by, nor official policy IN MY VIEW
of, AAOMS.
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endorsement has been grantede.xt. 4334
2 AAOMS Today | aaoms.org
MAY/JUNE 2015 | VOLUME 13, ISSUE 3
AAOMS has been able to accomplish many of its goals for the specialty through a
philosophy guided by teamwork and collaborative ventures with allied organizations
William J. Nelson, DDS, AAOMS President
and partners that share our vision and value our input.
IN MY VIEW
In other areas, AAOMS is working abusing their medications. Karin In today’s busy and sometimes chaotic
with federal agencies to advance several Wittich, AAOMS associate executive healthcare environment, it may
drug-related initiatives. We support director, Practice Management be difficult for dental and medical
the National Take Back Initiative & Government Affairs, and I had specialties to break through the
developed by the Drug Enforcement an excellent meeting with NIDA clutter and advance their message.
Agency’s Office of Diversion Control, officials in Washington, DC in April. At AAOMS, we have found that
which seeks to educate the public I will report on this exchange in an collaboration with organizations of
upcoming issue of AAOMS Today. good will and similar objectives may
circumvent the noise and achieve a
T
These are a sample of the collaborative successful outcome.
“We maintain our seats at a
activities in which AAOMS engages
number of tables where the
every day to advance the specialty of
training and practice of health-
oral and maxillofacial surgery and its
care providers are debated and
member practices. We maintain our
decided.”
seat at a number of tables where the
training and
practice of health-
about the potential for medication care providers
NEWLY REVISED!
abuse while providing options for are debated and
the safe, convenient, and responsible decided.
disposal of prescription drugs. Later
this year, AAOMS will make available
for member download and purchase
a patient-focused flyer that discusses
the proper disposal of prescription
medications.
We have also joined a coalition of
All-New PIPs and PEGs!
groups working with the National
Institute on Drug Abuse (NIDA) Introducing updated and redesigned Patient
on a series of continuing education Information Pamphlets (PIPs) and Patient Education
programs designed to help clinicians Guides (PEGs) that complement the AAOMS public
screen patients for substance use Web site, MyOMS.org.
disorder risk factors before prescribing, Great for your waiting room, referrals and community
and identify patients who may be presentations, the PIPs and PEGs feature:
• High-impact graphics
• Patient-friendly language
• Important facts about the conditions you
• tSrpeaact ea nodn tthhee pbraoccke odfu ereasc hyo fou rp yeorufo trom PPREORPSMROOANCTATEL IYICZOEE U&R
imprint your name and office information
Order now at AAOMSSTORE.com!
AAOMS Today | aaoms.org 3
OMS FOUNDATION NEWS
Applying for OMSF Funding? OMSF Announces New
Online Award Application System
T
he Oral and Maxillofacial The online application system also
Surgery Foundation (OMSF) facilitates application collection,
has launched a new online review, and progress reports by OMSF
application process for research staff and application reviewers.
awards and fellowships, including
Research Support Grants, Student It is very important to read the
Research Training Awards and guidelines for each award, which have
Clinical Surgery Fellowships. The new been revised since the last application
system’s improved functionality allows cycle.
applicants to log into the system and The deadline to apply for research
complete the application process all at For Clinical Surgery Fellowships, awards and fellowships is July 15,
once or over several visits to the Web go to: www.omsfoundation.org/ 2015 at 11:59 p.m. CDT. If you
site. The new system will also store fellowships have any questions about the new
applicants’ information, making it application procedure, please contact
easier to apply for funding in For Research Support Grants and Patti Gillespie, program and project
future years. Student Research Training Awards, go manager, at 847/233-4363 or via
T
to: www.omsfoundation.org/research e-mail at [email protected].
Staff Employment Anniversaries Recognized
At a special board-staff 15 YEARS
luncheon on April 13,
Cristina Iosup, senior
AAOMS recognized 11
finance associate
staff members celebrating
employment anniversaries Gary Low, senior membership
ranging from 5 to 25 years. associate
Debbie Skrzypek, senior
5 YEARS
exhibition associate
Adam Brenman,
Government Affairs associate 25 YEARS
Julie Carr, senior design and
10 YEARS
production associate
Dick Berry, staff attorney
Janie Dunham, editorial
Cory Breeden, network manager
Seated, left to right: Adam Brenman, Lisa Marino, Janie Dunham,
support technician
Julie Carr and Richard Berry. Standing, left to right: Kyle Smith, Lisa Marino, senior
Debbie Skrzypek, Ron Skiba, Cory Breeden, Cristina Iosup and Kyle Smith, senior associate, accounting associate
Gary Low. Advanced Education and
Ron Skiba, human resources
Professional Affairs
director
4 AAOMS Today | aaoms.org
MAY/JUNE 2015 | VOLUME 13, ISSUE 3
AAOMS Today | aaoms.org 5
CAPITOL
CONNECTION
Legislative and Regulatory Update
FEDERAL ISSUES n On April 14, the Senate approved Loan Interest Deduction Act (HR
legislation (HR 2) to permanently 509), the RAISE Health Benefits Act
n On March 4, the US Supreme
repeal the sustainable growth (HR 1185), the Indian Health Services
Court finished hearing oral arguments
rate (SGR) formula for physician Health Professional Tax Fairness
in King v. Burwell, the case brought
reimbursement under Medicare. The Act (S 536), the Competitive Health
by challengers to the healthcare law’s
legislation, which passed in the House Insurance Reform Act (HR 494), and
system of distributing insurance
on March 26, was signed into law by the Dental Insurance Fairness Act (HR
subsidies. The court appeared divided
President Obama on April 16. The 1677).
as the justices heard almost 90 minutes
measure replaces the SGR with an
of arguments in the case, which will be
increase of 0.5% in Medicare physician STATE ISSUES
decided by the end of June. A ruling
reimbursement starting in July 2015
against the government could upend n The North Carolina Board of
through December 2015, and then
the nation’s health insurance system Dental Examiners isn’t entitled to
annual 0.5% increases through 2019.
and make coverage unaffordable for invoke state-action antitrust immunity
It also consolidates various reporting
millions of Americans in the 34 states from potential liability under federal
programs, such as the Meaningful
without a state-run exchange. antitrust laws because the board is
Use program for electronic health
controlled by dentists who are active
records and several quality reporting
n On March 26, US Health and market participants and because the
programs, into a new, merit-based
Human Services Secretary Sylvia M. board isn’t subject to active supervision
incentive payment system, and would
Burwell announced a targeted initiative by the state, the US Supreme Court
incentivize physicians to participate
aimed at reducing prescription opioid ruled Feb. 25. The Supreme Court in
in alternative payment models such as
and heroin-related overdose, death a 6-3 decision made it clear that state
accountable care organizations (ACOs).
and dependence. She noted that the occupational boards controlled by
While the bill retains some aspect of
president’s FY 2016 budget includes members of the same occupation are
Medicare’s fee-for-service model for
critical investments to intensify efforts subject to federal antitrust laws unless
those who choose not to participate in
to reduce opioid misuse and abuse, the state actively supervises the board’s
an alternative payment model, the bill’s
including $133 million in new funding decisions.
impact on this reimbursement model
to address the issue. Among other
remains uncertain.
things, the initiative will focus on n New York Governor Andrew
providing training and educational Cuomo (D) signed legislation (SB
n Since the last edition of the AAOMS
resources, including updated prescriber 2486) that delays the electronic
Today, AAOMS has either sent or
guidelines, to assist health professionals prescribing requirement in the state
signed onto six comment letters to
in making informed prescribing until March 27, 2016. Legislation
Congress on the following issues:
decisions and address the over- enacted in 2013 required all
support for the Action for Dental
prescribing of opioids. practitioners to electronically prescribe
Health Act (HR 539), the Student
all prescriptions as of March 27, 2015.
6 AAOMS Today | aaoms.org
MAY/JUNE 2015 | VOLUME 13, ISSUE 3
Reports leading up to the deadline,
however, indicated that less than
2% of prescribers had the ability to
HEALTH IT
transmit the prescriptions through
Highlighting health information
required DEA certified software,
BYTES technology (health IT) issues
necessitating the delay.
affecting OMS practices
n In a 5-4 decision, the US
Supreme Court ruled that healthcare
providers may not sue states to raise
n The Joint Commission has final stage of the federal incentive
Medicaid reimbursement rates. The
issued a sentinel event alert program developed to encourage
case originated when a provider in
regarding inherent risks found in practitioners to adopt and utilize
Idaho filed a lawsuit against the state’s
health information technology. electronic health records (EHRs). In
Health and Welfare Department for
In the document, the Joint addition to increased thresholds for
holding Medicaid reimbursement
Commission cautions, “incorrect the utilization of functions found in
rates at 2006 levels despite rising
or miscommunicated information EHRs, the proposal will require all
costs. In 2011, a US district judge
entered into health IT systems may Medicare practitioners to operate at
agreed with the providers and
result in adverse events.” According the Stage 3 level by 2018, regardless
ordered the state to raise Medicaid
to information submitted by of prior participation in the program.
rates, a decision that was also upheld
participating hospitals, more than The proposed regulations will also
by the 9th US Circuit Court of
120 health IT-related sentinel events require a new version of certified
Appeals in 2013. The US Supreme
were reported between January 1, EHRs to be offered, requiring
Court Justices ultimately sided with
2010 and June 30, 2010, stemming currently certified programs to be re-
the state during the appeals process,
from issues such as usability issues, certified to the revised criteria. The
noting that only federal agencies
workflow and communication, and comment period on these regulations
have the ability to determine if states
clinical decision-making support. runs until May 29, 2015, with final
comply with federal Medicaid statutes.
regulations expected before the end
The ruling will have implications on T
n CMS has released proposed rules of the year.
whether private parties can bring such
for Stage 3 of Meaningful Use, the
suits in the future.
OMSPAC
n As of March, OMSPAC raised
YOU
$489,492 in contributions from
AAOMS members. Additionally, What is OMSPAC Doing to
OMSPAC had contributed $72,500
to federal candidates as of March 31, Protect the Specialty?
2015. For additional information on
contribution totals or for a list
of candidates to whom OMSPAC
has contributed, please visit
YOU ARE
T
www.omspac.org.
OMSPAC!
Oral and maxillofacial surgeons’ voice in national politics for over 40 years.
9700 West Bryn Mawr | Rosemont, Illinois 60018 | 800/822-6637 | www.omspac.org
AAOMS Today | aaoms.org 7
MEET
THE
CANDIDATES
AAOMS officer elections Dr. Ferguson is completing his second, two- addition, Dr. Ferguson is a past president of
will be held during the 2015 year term as AAOMS Treasurer. A Kansas the Rinehart Foundation, the endowment of
annual meeting on Wednesday, City, MO, native, he received his DDS UMKC School of Dentistry.
September 30, immediately from the University of Missouri–Kansas
preceding the third session of City (UMKC) School of Dentistry with STATEMENT
the House of Delegates. At press honors in 1981, and subsequently entered
It has been a distinct pleasure and a
time, Douglas W. Fain, DDS, full time academics at the UMKC School of
privilege to represent you as AAOMS
MD, FACS, Prairie Village, KS, Dentistry. He then completed a fellowship
treasurer for the last three and a half
and Steven R. Nelson, DDS, year in general anesthesia under the tutelage
years. I am happy to report that your
MS, Denver, CO are running of Dr. Nina Beatty at Truman Medical
association is in an excellent financial
unopposed for the offices of Center.
position. During my two terms as
president-elect and speaker of the
treasurer we have maintained balanced
House of Delegates, respectively. Dr. Ferguson is program director of the
budgets that have resulted in a positive
Two candidates, AAOMS UMKC OMS Graduate Training Program,
revenue-over-expense ratio. And,
Treasurer Brett Ferguson, DDS, and chairman of OMS at Truman Medical
while we raised member dues in 2013,
Kansas City, MO, and District Center and of Hospital Dentistry at the
we significantly increased the level
III Trustee J. David Johnson, UMKC School of Dentistry. In January
of member services with the addition
DDS, are completing their terms 2006, he was appointed chairman of OMS
of a clinical research program that
of office this year and seeking at the UMKC School of Dentistry as well.
will provide evidence-based data to
election to new positions. Dr.
support the scope of the specialty;
Ferguson is running unopposed Prior to serving as AAOMS Treasurer, Dr.
the Informational Campaign, which
for the office of vice president. Dr. Ferguson chaired the AAOMS Committee
promotes OMS training and skills
Johnson is running unopposed for on Residency Education and Training, and
to the public, the dental and medical
the office of treasurer. served on the AAOMS Faculty Recruitment
professions, insurance and third party
and Retention Committee and the
providers, legislators and regulators,
To better acquaint fellows and Committee on Hospital and Interprofessional
and other communities of interest; and
members with the candidates Affairs. Additionally, he was appointed
our new award-winning public Web
and their positions, AAOMS to the AO/ASIF maxillofacial trauma
site, MyOMS.org, and the redesigned
asked Drs. Ferguson and Johnson educators of North America and served on
member site, AAOMS.org.
to provide a platform statement the Examiner Committee of the ABOMS.
to AAOMS Today. In addition
We have also increased our educational
to the material presented here, Dr. Ferguson is a diplomate of the
offerings through onsite meetings
members are encouraged to meet American Board of Oral and Maxillofacial
like the new three-part Research
the candidates at their state and Surgery, and a member of the International
and Education Conference, which
regional society meetings, and at Association of OMS, American College
was held May 6-9, in Rosemont,
the annual meeting open forum of Dentists, Midwest Society of OMS,
Illinois; issue-focused webinars led
on Tuesday, September 29, from Missouri Society of OMS, American Dental
by renowned experts in the topic
4:30 to 5:30 pm, at the Marriott Association, Missouri Dental Association,
area; and innovative print and online
Marquis Washington, DC. and Greater Kansas City Dental Society.
publications, including the Web-based
He is a past-president of the Greater Kansas
Office Anesthesia Evaluation program.
City Society of OMS, and a former member
of the Fifth District Caucus and delegate
to the AAOMS House of Delegates. In
8 AAOMS Today | aaoms.org
MAY/JUNE 2015 | VOLUME 13, ISSUE 3
Brett Ferguson, DDS
Candidate for
Vice President
Having been a key participant in the planning and
Join the thousands of
development of these specialty-altering projects, I believe
I am armed with the necessary background, knowledge members who receive
and experience to offer my services as your vice president.
year-end rebate checks!
Moreover, as a practicing surgeon and chairman of the
Department of Oral and Maxillofacial Surgery at the
UMKC School of Dentistry, I am in a unique position to With just $10,000 in annual purchases from SAS,
appreciate all sides of the issues confronting the association your practice will receive a 3% year-end rebate.
and our membership. In recent years we have witnessed a That is money coming right back into YOUR
number of challenges with the potential to gain traction and practice each year. Remember to factor in all of the
affect the specialty. discounts you receive from SAS when comparing
prices on sedation and surgical supplies.
For example, we are all aware of the current OMS faculty
shortage. Not only is this a concern in our OMS residency
programs, it also affects the dental schools where many of Are you prepared for a
our nation’s more than 20,000 dental students graduate with
little interaction with an oral and maxillofacial surgeon DEA Inspection?
faculty member. As a result, they may be unfamiliar with
the breadth of procedures offered by the specialty. Once in Be Compliant | Be Prepared
practice, they may prefer to send patients to those specialties
they know from dental school.
SAS brings you a powerful combination of online
compliance video training, matched with an all-purpose
AAOMS is working diligently to address this problem.
compliance policy template that can be easily adapted
We are evaluating the recommendations made by our
to your office.
Task Force on Faculty Workforce, beefing up our Faculty
Educator Development Awards program to encourage
more OMSs to commit to an academic career, and
offering opportunities that encourage surgeons who may
Call for info $350.00 yearly Train yourself
be reducing their practice load to consider a second career & set up subscription and your staff
in academia. Additionally, we are utilizing the power of
the AAOMS Informational Campaign to acquaint dental
Call today for access!
students with oral and maxillofacial surgery and how our
surgeons may assist them in their future practices. As an
1.800.624.5926
AAOMS officer, I have been involved in the development
of these strategies and, as your vice president, I will
$350 could save you
continue these efforts and seek opportunities to expand on
their success. $10,000 in fines.
For information and current promotions
continued on page 10
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AAOMS Today | aaoms.org 9
Candidate:
educational venue, the Informational
Dr. Ferguson Campaign, or the clinical research
initiative, no AAOMS program is
Continued from page 9
exempt from this board evaluation.
It is my firm belief that this rolling
The Affordable Care Act and its oversight keeps our programs fresh,
accompanying regulatory and relevant and cost-effective.
legislative initiatives are reinventing
dental and medical practice in the Before I close, please allow me to
US. Evidence-based data gleaned express my sincere appreciation
from solid PBRN-sanctioned for the support you have given me
James David Johnson, Jr., DDS, earned
research is the key to reimbursement over the last four years as AAOMS
a BS Degree from Rhodes College and
and the future of specialty practice. treasurer. I believe my collaborations
graduated with highest honors from
Last year AAOMS launched a with AAOMS CFO Scott Farrell
the University of Tennessee College of
clinical research project to obtain have helped solidify the association’s
Dentistry. He completed his residency
the necessary data to support the financial independence and enabled
in oral and maxillofacial surgery at the
procedures performed in the OMS us to pursue new and exciting
University of Tennessee Medical Center
operatory. With the launch of our initiatives that will keep AAOMS
at Knoxville in 1990. Dr. Johnson was
initial research study on third molar and its fellows and members at the
certified by the American Board of Oral
surgery last fall, we became the forefront of dentistry and medicine.
& Maxillofacial Surgery (ABOMS)
first dental specialty to establish a I humbly ask for your continued
in 1992. He recertified in 2002 and
Practice-based Research Network, support as I seek election to the
2012, and has served on the ABOMS
or PBRN. We expect to have position of AAOMS vice president
Examination Committee. Dr. Johnson is
preliminary data from this study at the 2015 annual meeting. With
an associate professor at the University of
later this summer. I fully support your help, I pledge to continue the
Tennessee Graduate School of Medicine
AAOMS’s entry into the clinical dedication and commitment of
and has served as chair of the AAOMS
research arena. It is good for our the last four years and to take our
Committee on Public and Professional
association and even better for our association and specialty to even
T Communication (CPPC) and as a
specialty. As vice president, I will higher levels of greatness.
member of numerous other AAOMS
continue the association’s efforts
committees including the Faculty Educator
in this area and encourage future
Development Awards Committee, the
projects that speak to the needs of our
Special Committee on Implant Dentistry,
members’ practices.
the Special Committee on Cosmetic
Surgery, the Special Committee on
As treasurer, I am keenly aware
Priorities and Strategic Plan, and the
of the need to balance our budget
Committee on Practice Management. He
and monitor expenditures in order
is a past president of both the Southeastern
to ensure that AAOMS remains a
Society of Oral and Maxillofacial
strong and vital advocate for the
Surgeons (SSOMS) and the Tennessee
specialty in the decades to come. I
Society of Oral and Maxillofacial
am particularly appreciative of the
Surgeons (TSOMS). Dr. Johnson
board’s determination that all major
currently serves as AAOMS District III
projects be regularly evaluated in
trustee. He is the recipient of the 2003
terms of their performance, value to
AAOMS Presidential Achievement
the membership and financial results.
Award, the 2003 TSOMS Outstanding
Whether it is an annual meeting,
Service Award, the 2004 Tennessee
dental implant conference or other
Dental Association Fellowship Award,
and the 2004 Second District Dental
Society Dentist of the Year Award. He
is a fellow of the American College of
Dentists and the International College of
Dentists.
10 AAOMS Today | aaoms.org