The
OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCIATION
January/February 2014

It was the first note I ever got in crayon. “Thank you for making my daddy feel better.”
I keep it on my desk, where
I pore over patient records and cash flow statements. Because even if the medical field seems to be changing by the day, the reasons I practice never do.
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HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 3

4
OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCAITION
Executive Council
Christopher Pittman, MD,
President
Devanand Mangar, MD,
President Elect
Jose Jimenez, MD,
Vice President
Joel Silverfield, MD,
Treasurer
David Lubin, MD,
Secretary
Michael Wasylik, MD,
Chairman, Brd of Trustees
William Davison, MD,
Immed Past President
Husain Nagamia, MD,
Dist. 1 (2014)
Michael Levitt, MD,
Dist. 2 (2015)
Lori Slezak, MD,
Dist. 3 (2014)
Steven Barna, MD,
Dist. 4 (2015)
Stanley Dennison, MD,
At Large (2015)
Malcolm Root, MD,
At Large (2015)
Colin Beach, MD,
At Large (2014)
David Mason, MD,
At Large (2014)
Anthony Pidala, MD,
At Large (2014)
Richard Lockey, MD,
USF Dist. (2015)
Scott Anderson, MD,
Yng Phys (2015)
Karen Pittman,
Alliance President
*Fred Bearison, MD,
Board of Medicine
*Nishit Patel, MD,
Resident Phys. Rep.
*Douglas Holt, MD,
Health Dept. Rep.
*Rakesh Kumar, MD, FAPI
*Elizabeth Ciaravino,
Medical Student
*Stephen Klasko, MD,
USF COM Dean
*Barbara Bachman, MD,
Women Physicians
*Gabriel Gonzales, MD, TBLAMS
(* = ex-officio representatives)
Editor
David Lubin, MD
Editorial Board
Loren Bartels, MD
William Davison, MD
Rodolfo Eichberg, MD
Michael Foley, MD
James Hulls, MD
Rafael Miguel, MD
Executive Director
Debbie Zorian
Managing Editor
Elke Lubin
The Bulletin is the official publication of the Hills bor ough
County Medi cal Asso ciation,
Inc., 606 S. Boule vard, Tampa,
Florida 33606.
Advertising in The Bulletin does not imply approval or endorsement by the Hillsborough County Medical
Associa tion. The Bulletin assumes no responsibility for statements made by its contributors. For advertising rates and mechanical data, contact the HCMA.
Opinions expressed by the authors are their own, and not necessarily those of The
Bulletin or the HCMA. The
Bulletin reserves the right to edit all contributions for clarity and length as well as to reject any material submitted.
Board of Trustees
Michael Wasylik, MD, Chairman
Joel Silverfield, MD, Treasurer
Christopher Pittman, MD, President
Devanand Mangar, MD, President Elect
William Davison, MD,
Immed Past President
Bruce Shephard, MD, (2015)
Kenneth Louis, MD, (2015)
Fred Bearison, MD, (2016)
A dvertising
The Card Shop .............................................35
Classified Ads ...............................................34
Full Page Advertisers ..................................14
Index of Display Ads ....................................34
g ot
s omething to
s
Ay
?
To submit an article, letter to the editor, or a photograph for The Bulletin cover, please contact Elke Lubin,
Managing Editor, at the HCMA office. All submissions will be reviewed by Bulletin Editor, David Lubin, M.D. We encourage you to review The Bulletin’s “Article Guidelines” which can be faxed or emailed to you.
The Bulletin is YOUR publication. You can express your views and creativity by participating.
Elke Lubin
Managing Editor, The Bulletin
813.253.0471 Phone
813.253.3737 Fax
ELubin@hcma.net
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

A bout
t he
C over
:
“The photo was taken at the Londolozi game reserve, which is part of the Sabi Sands game reserve in South Africa on the western border of Kruger National Park. We were in an open land rover about 10 yards from the approximately 11-month-old male leopard.
“Equipment and settings: Canon 7D, Canon 70-200mm f/2.8 lens, shooting at 200mm,”
Anthony Goldman, M.D.
F
A
President’s Message ..........................................7
Christopher Pittman, M.D.
Editor’s Page ............................................... 9-10
David Lubin, M.D.
Executive Director’s Desk ........................ 11-12
Debbie Zorian
Medical/Legal ........................................... 13-14
Michael Wasylik, M.D.
Restaurant Review ..........................................15
Taste Bud
Legislative Session
. 22-23
........ 23
........................................ 24-25
............25
Board of Medicine ..................................... 27-28
Crystal A. Sanford, CPM
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
Poet’s Corner ..................................................31
James Hulls, M.D.
P
g
November 5, 2013
HCMA Dinner Meeting ..............................18-19
F
y
i
A
Benefit Providers .......................................16-17
Dinner Meeting Details ..................................21
New Members .................................................12
Personal News .................................................33
2014 HCMA Dues Renewals
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Thank you for your continued support of the
HCMA as we continue to serve as your local voice and advocate on your behalf.
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HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
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When we are no longer able to change a situation – we are challenged to change
ourselves. ~ Viktor Frankl
L ike me, I suspect many of you are bewildered by all the changes in medicine these last few years. After 20 years in practice, I have seen and experienced many things, but the medical maelstrom created by a perfect storm of legislation is nearly overwhelming. My friends and colleagues, it is nothing less than a tsunami.
Most of the changes are a direct result of legislation including the HITECH Act (a small part of the ARRA or “stimulus” plan) where HHS is spending approximately 30 billion dollars to promote and expand health information technology with the goal of creating a nationwide network of electronic health records. When enacted in 2009, it was considered the most important health care legislation in a generation; however, that recognition was supplanted by the passage of Obamacare in 2010.
Off the top of my head, here is a not all-inclusive list of mind-boggling acronyms that physicians should be familiar with: ONC, HIPAA, EMR,
EHR, PQRS, HIT, HIE, CPOE, HIX, MU Stages 1,
2 and 3; MOC, MOL, PPACA, CIN, ACO, VBP, SGR,
ICD-10.
(Similar to the editor’s challenge to us to identify the location of a picture, I will recognize all those who correctly identify all of the common health care acronyms used in this article.)
It is easy to see the changes swirling about us, including the inexorable consolidation of health care delivery, growing ranks of employed physicians, ever enlarging single specialty groups, retail medicine mushrooming within corporate pharmacies and the growing influence of hospital-based physician practice brokers, etc. No value judgment here, just the facts.
I was sharing my professional political experiences with a newly minted radiologist colleague who abruptly found himself without a job due to the politics of corporate medicine and I think I convinced him how valuable this seemingly negative experience will be to his future professional career. I started out by exclaiming, “They moved your cheese”! I was referring to the best-selling business book of all time: Who Moved My Cheese? by Spencer Johnson, M.D. Yes, that’s correct, the best-selling business book of all time was written by a physician!
Ladies and gentlemen, our cheese is being moved in a major way. The book’s message is summarized below:
The Handwriting On The Wall:
Change Happens
They Keep Moving The Cheese
Anticipate Change
Get Ready For The Cheese To Move
Monitor Change
Smell The Cheese Often So You Know When It
Is Getting Old
Adapt To Change Quickly
The Quicker You Let Go Of Old Cheese, The
Sooner You Can Enjoy New Cheese
Change
Move With The Cheese
Enjoy Change!
Savor The Adventure And Enjoy The Taste Of
New Cheese!
Be Ready To Change Quickly And Enjoy It
Again
They Keep Moving The Cheese.
So, how do we survive the tectonic shift in medicine and the resulting tsunami? We cannot turn back this huge wave of change, however, organized medicine and your HCMA is an ongoing source of life preservers and disaster relief.
We are going to get wet, possibly bruised and injured, but we will survive. And, for those willing to change, the sun will always be shining.
Christopher Pittman, MD cpittman@vein911.com
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 7

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HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

A s I write this on January 7, 2014, it probably
IS the first day of the rest of my life. I mean, technically, December 28 th was since I had retired travel, and family in retirement. You deserve the long missed “H” for good use of time.” {Editor’s the day before, but when you go to Key West for a
New Year’s vacation and both you and your spouse don’t have to work, that time really doesn’t feel like you’re “retired.” And then on Monday, Janu-
note: that makes up for the “U” I used to get in elementary school}
A number of pictures of Barry and his wife,
Rose, appear on the back of my calendar every ary 6 th , I had to get up early and take my diesel into the mechanic for some minor repair work, and go to the office to continue packing up stuff, so Monday didn’t count either.
year. We connected when he bought MAD magazines from me on eBay.
And then I heard from Steven Zheutlin, a psychologist and friend, who got me through two divorces over the past 30 years:
But on Tuesday, the 7 th , Elke’s alarm went off.
She got up, I slept another hour and a half and then got up myself. She went off to work. I finished reading the papers, eating breakfast, and at
“God Bless you boy! I have one issue with your
Bulletin article. You said that at the onset of your practice you found it “easier” to treat patients. It was not ever easy. My dad was a psychiatrist in
9:30 settled in front of the computer in my jammies, while avoiding going out on a sunny but very chilly morn-
New Jersey after serving in the Army for four years. He ing, to write my overdue column. Yes, it is the good life…so far.
was a Captain, chief of psychiatry in a hospital’s department of psychiatry in
Anchorage, Alaska. Three
By the way, if you haven’t been to Key
West for New Year’s, it’s a blast. It’s warm, anyone would like to contribute, let Elke or me know and we’d be glad to publish a guest column.
of his brothers, one also a serviceman in Germany, became physicians during a period when “quotas” exthe food is great, and even the drunks are laid back in typical Key
West style. Here’s a link to a video I made as Sushi descended in
Last patient: December 27, 2013 her red stiletto at the stroke of midnight: meeting all admission criteria. It was not easy. It took heart.
http://www.youtube.com/watch?v=6Hhnz1EcZT ber of Jews admitted to med schools was limited, despite
A&feature=youtu.be
I plan to keep writing as I have in the past, but not practicing might limit me just a bit, so if isted to insure “diversity,” as after the war, with the influx of Jews to the US from concentration camps, the num-
My sister is a radiologist, a product of Baylor
Medical by way of Brown University and UCLA.
She is licensed and works in Los Angeles as a disability “processor” where she is told for whom disability is to be “determined.” Again, it was not easier then. It took heart.
In the meantime, I’ve been getting some very nice comments from friends, colleagues, and patients and appreciate the comments very much.
Barry Marcovich from Australia sent me this note:
I got a Ph.D. in clinical psychology, after completing graduate work at the University of Vermont. I saw my first patient in Tampa the same year you saw your first patient. It was not easy.
It took heart.
David Lubin, MD
Dajalu@aol.com
“I liked your retirement epistle and I am sure you will have plenty to do with photography,
Giving your all for many years to help people who are in pain, to assume responsibility and
(continued)
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 9

10 liability for each and every patient is not easy. Helping some quickly, struggling harder and longer to help others, and not being able to help at all is not easy. It takes heart.
The “changes” in health care to which you refer are efforts by non-physician business people, with profit driven motives appropriate to nearly all services and businesses in a corporate global marketplace. That is not easy. But it takes NO heart.
But...helping nature “heal” sickness is not about running a faceless, nameless, eternal corporate entity that has no heart. It takes heart to do what you guys do. As an investor myself, I often overrule my heart and do what makes the most money. This is not easy, but
I am learning to function in the corporate global community. It is generally not “for the faint of heart.” It is not easy, but you do best when you leave your heart at home when you go to the office.
Say what? Bro...don’t put me out there...I was off that day...the notes must have been erased...the fax ran out of paper...your private medical information must have been hacked...oh well, that’s why corporations have law firms on retainer, built into their budgets, just another
‘cost of doing business.’”
And finally, I’ll leave you with a patient story, one I’ve been holding for a while:
I saw him first, the 82 year-old husband of the 73 year-old wife. He had some memory loss, as you would expect in an 82 year-old, but if you spoke with him, you would be fairly certain that he didn’t have Alzheimer’s.
His wife was very dominant in correcting him and often seemed “short-tempered” when he spoke. I asked him who was President and he couldn’t quite remember but did say that he was the “colored fellow.” When told it was President Obama, he easily remembered the President’s first name. He also thought it was August (only one month ahead) and that it was summer. His wife said he loves to play sudoku puzzles, those crazy number games that I have no intention of ever trying. Anyone who can play those certainly can’t be diagnosed with
Alzheimer’s, or probably any type of dementia.
I wrote his prescriptions and he swapped positions with his wife who now sat on the exam table. I examined her and as I was writing out her prescriptions, she sort of rambled on how they were moving, they were living in limbo, but her kids were going to come and help them.
Her husband, sitting on the chair in front of me, looked at his wife and said, “The doctor doesn’t care about it.”
Well, I did and didn’t. I certainly had no objection to his wife telling me what stress they might be under with moving, but yes, I probably didn’t REALLY care about what she was relating to me. I laughed and explained to them that what he was saying probably had some merit and that it certainly would indicate a thought process that, again, would rule out Alzheimer’s.
I told them that what he said was actually a very perceptive comment - to which he replied, “What comment?”
And as Ernest Hooper, Tampa Bay Times columnist says,
“That’s all I’m saying.”
For now.
“One man’s junk is another man’s treasure”
Contact Dr. Lubin: dajalu@aol.com
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

I
’m not very good at making New Year’s resolutions. And when I do, it is most often a futile effort. Instead of trying to accomplish an unrealistic or difficult goal, I decided to start with a small, but very important, behavior modification…learning how to listen better.
This past holiday season triggered my motivation to attempt this effort. Family and friends gathered together before, during, and after
Christmas at my home. Serving as hostess on three separate evenings gave me the opportunity to observe something I never paid much attention to before: nobody really listens!
“One of the most sincere forms of respect is actually listening to what another has to say.”
Bryant H. McGill
People changed subjects quickly, interrupted each other, and even talked over one another.
This is not unusual, even when a conversation is held between only two people. We (me included) are so busy making sure that people hear what we have to say that we forget to listen. We hear mostly what we want to hear, not necessarily what the other person is trying to communicate to us.
In researching online for effective strategies on how to develop better listening skills, I found the following data to be quite interesting…
Research indicates that we speak at a rate of about 125 words per minute, yet we have the capacity to listen to approximately 400 words per minute. So what are we doing with that extra space in our minds when someone else is talking? We spend about 80% of our waking hours communicating (speaking, reading and writing) and 45% to 50% of our day engaged in listening
(to people, music and television). Approximately
75% of that time we are forgetful, pre-occupied and not paying attention. One of the factors influencing this statistic is that the average attention span for an adult in our country is 22 seconds. Immediately after we hear someone speak, we remember about half of what they said and a few hours later we only remember about 10% to
20% of what they said.
“Most people do not listen with the intent to understand; they listen with the intent to reply.” Stephen R. Covey
A poor listener is abrupt, easily distracted, finishes the other person’s sentence, and changes the subject without even realizing it. A good listener makes eye contact, uses positive body language and verbal signals, does not change the subject too quickly, and focuses on what the speaker is saying and not his or her next statement.
And then there are those who never interrupt you or finish your sentence, because it’s impossible to do so when a one way conversation is taking place. Just recently, I ran into a former
HCMA employee while shopping. It has been several years since I have seen her. We hugged and said hello. She asked me how I was doing, but I never had the chance to reply as she immediately began telling me why she was there, what she was purchasing, and the cruise her and her family were taking the very next morning. I received details including the places they were planning to visit and for how long. It was an exhausting conversation, although I never said a word. All of a sudden she was off and running. I never did reply to her initial greeting…however, given the opportunity, I’m sure whatever I said would have fallen on deaf ears.
It’s common for people in the business world to take classes to improve their verbal skills.
They focus on how to give speeches and make presentations. There are those who spend hours preparing to speak, but seldom prepare to consciously listen. The listener’s role is as central to the communication process as the speaker’s role.
Of course, in the world of medicine, communication is vital in all aspects. Effective communication is paramount in building a viable and beneficial physician/patient relationship. It is also essential in order for the relationship to thrive.
As oftentimes discussed, technology is so dominating in the practice of medicine that patients sometimes feel their quality of care is declining due to perceived lack of attention or communication. I believe the ability for physicians to listen thoroughly is increasingly challenging as continued mandates are put upon them. Although I embrace technology and understand the tremendous benefits, I sometimes question the detached manner in which physicians are forced to care for their patients and the barriers that may interfere with the comprehensive communication needed between physician and patient.
“Without credible communication, and a lot of it, the hearts and minds of others are never captured.” John P. Kotter
(continued)
Debbie Zorian
DZorian@HCMA.net
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 11

12
The ability and need to communicate touches every area of our lives. In today’s high-tech, high-speed, highstress world, communication is more important than ever. Listening is an art that, when done well, delivers tremendous benefits. It creates win-win communication which fosters understanding and affirmation. It creates an atmosphere of trust and respect. Genuine listening helps to build and sustain relationships, solves problems, and improves accuracy. A better listener is a better decision-maker; therefore, saving time and money can oftentimes be the reward as well.
I believe I will master the art of listening as I consciously practice the strategies I’m learning. In the meantime, I vow to talk less and listen more.
“You’re short on ears and long on mouth.”
John Wayne
Jacques Abitbol, MD (ORS)
Chandra Bapna, MD (IM)
Catherine Carrubba, M.D. (PD)
Chintan Desai, M.D. (DR)
Mark Floudin, MD, FAAFP (FP)
Samantha Franco, MD (AN)
Anil Gupta, MD (ORS)
Patrick Horan, MD (ORS)
Sharon Ingram, MD (OBG)
Fouzia Khan, DO (PM)
Jeffrey Langmaid, MD - (ORS)
Christina Lee, MD (PD)
Katherine Macoul, MD – (OPH)
William McCoy, DO (AN)
Brian Palumbo, MD - (ORS)
Ioannis Pappou, MD - (ORS)
Scott Pautler, MD – (OPH)
Kristen Powell, MD – OBG)
David Reina, MD - (ORS)
Athena Richardson, MD (PD)
Jeff Sellman, MD - (ORS)
Ron Shemesh, MD (OBG)
Dien Vu, MD - (AN)
Samuel Weinstein, MD (NEP)
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

O n November 19, 2013 the HCMA Executive
Council unanimously approved the most recent update of the Hillsborough Medical Legal
Code, continuing a tradition of 30 years of cooperation between the HCMA and the Hillsborough
County Bar Association (HCBA).
The “Hillsborough Medical-Legal Code,” a guideline for physicians and attorneys to assist them in navigating the medical-legal system, was initially created in 1983 and revised in 1998. An update was well overdue. In 1983, I was the cochairman of the Medical/Legal Committee and attorney David Kydyk was my counterpart from the HCBA. The Committee was comprised of the finest physicians and attorneys in our county. At that time, there was an arbitration panel to decide disputes arising from physician/attorney complaints.
The prompting for the latest update was made by the HCBA, specifically Judge James Barton and attorney Kevin McLaughlin. Mr. McLaughlin, representing the HCBA, stated the purpose of updating the Code was to encourage better communication and understanding between physicians and attorneys, promote the welfare and well-being of patients and clients, and to establish guidelines that conform to the highest ethical standards for both professions. In March of
2013, a new committee was formed and chaired by Kevin McLaughlin, Esq., and John S. Curran,
MD. Committee members included, from the
HCBA: Judge James M. Barton of the 13th Judicial circuit, Todd Miller, Esq., Brandon Scheele,
Esq., Marc Semago, Esq., Alan Wagner, Esq., and
Robert V. Williams, Esq. HCMA members included: Fred Bearison, MD, Mathis Becker, MD
(Past President), William Davison, MD (Immediate President) Devanand Mangar, MD (President
Elect), and myself, an HCMA Past President.
After dialogue, from both sides, the new Medical/Legal Committee began their collaborative efforts to clarify several topics in the Code as well address issues not present in previous editions.
(continued)
Several of the committee members and HCMA staff gathered to celebrate the completion of the updated Hillsborough Medical-Legal Code: back row/L-R: Dr. John Curran, Dr. Devanand
Mangar, Todd Miller, Esq., Alan Wagner, Esq. Front/L-R: Rob Williams, Esq., Dr. Michael Wasylik,
Elke Lubin (HCMA Exec. Assistant), Dr. William Davison, Debbie Zorian (HCMA Exec. Director),
Honorable James Barton, Amy Farrior, Esq., and Kevin McLaughlin, Esq.
Michael Wasylik, MD wasyliksoffice@aol.
com
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 13

Several meetings were held for guidance; however the majority of the work was done in-between the meetings. Most procedural revisions were suggested by members of the HCBA and Dr. Curran did his usual fantastic job of proof reading to insure that all t’s were crossed and i’s dotted. Dr.
Curran also consulted with former FMA general counsel, Jeff Cohen.
The 2013 Hillsborough Medical Legal Code provides guidelines for both professions. It is intended to affirm the expectations between the medical and legal professions and clarify the physician/attorney relationship, as they pertain to depositions, medical exams, subpoenas, and fees, which are more clearly addressed.
It is felt that the Hillsborough Medical Legal
Code is an invaluable document for physicians and the Medical Legal Committee serves as a great member benefit. The document would also be useful to educate medical students and postgraduate physicians.
This edition of the Medical-Legal Code is a contemporary revision for 2013 and beyond. The
Code will be reviewed annually and updated as needed. A copy of the Code can be obtained by calling the HCMA office (813.253.0471).
Also, as a result of this collaborative effort, the
HCBA has implemented a “hotline” for HCMA members who have simple legal questions or are not clear on any item within the Code. Members can call the HCMA (813.253.0471), provide basic information, and a member of the HCBA will contact them.
Collaboration between the HCMA and the
HCBA continues to improve the relationship between the medical and legal communities. I would like to thank both organizations, especially the committee chairmen, for a job well done.
14
1. No rate increase for 2013
2. No hidden risk to employer
3. Guaranteed rates
4. Profit sharing feature
5. Common effective dates
6. No deficit carry forward & stop coverage for large claims
7. 5 employee plans
8. 3 physician plans
9. Florida Blue is carrier
10. In- and out-of-network benefits
Mark Thompson: 813.639.3066
Tell them you saw their ad in The Bulletin!
AMO Office Supply (30)
The Bank of Tampa (6)
Cherry Bekaert (8)
Florida Healthcare Law Firm (29)
ProAssurance (Back Cover)
SunTrust Bank (Inside Front Cover)
Ultimate Medical Academy (3)
Veteran’s Health Adm (26)
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

Copperfish restaurant, owned by the same people who own Boca and Ciro’s Speakeasy, is a welcome seafood addition to south Tampa.
There are two artful representations of the name Copperfish. On the outside of the restaurant is a large copper colored fish that greets you by the door and the second is an exquisite school of hundreds of copper fish by local welder/artist
Mark Wabol.
Copperfish is a rustic brick and wood casual eatery on Howard Avenue with upscale seafood offerings and a small smattering of food for the landlubber. good kettle chips.
Virtually all of their entrées are seafood. The swordfish was prepared well and had a fine tangy gremolata of lemon zest, herbs, and garlic. Capers topped off the fish and bright green thin haricot verts were on the side. The black grouper is their most popular entrée and rightfully so.
The thick and tender slab of fish was delicious as were the white truffle grits that accompanied it. A side of truffled French fries was also a good crisp accompaniment. There were three lobster offerings the night we were there, but the $45 and $55 price tags made us resist even though the lobster dishes passing by looked great.
Fresh oysters are the star starter here with a blackboard listing of what is available for the day. The appetizer of grilled oysters is their most popular offering. I usually am not a lover of raw oysters (I guess my medical fear of them subconsciously kicks in), but their grilled rendition is great. Well seasoned and firm but not tough; they are yummy. The Parmesan and Romano cheeses, the butter, the spices, and the herbs all blend together deliciously. They come in two offerings: half dozen and one dozen. Note: if anyone at the table is an oyster lover, you had better order the dozen.
Copperfish has a good sounding selection of desserts including key lime pie, a chocolate taco with fried ice cream, and Nutella s’mores, but we were too sated to try them.
There is a list of specialty cocktails, craft beers, and wines, mostly whites, available.
The Copperfish menu changes seasonally and some menu items may be unavailable depending what fresh seafood is available. They have a bloody Mary and mimosa Sunday brunch and reduced drink and appetizer prices for happy hour: 4-7 p.m. daily.
We also had the sushi “surf and turf” appetizer.
If you have never had tenderloin filet sushi, try it. The very tender small slice of filet on top of the mango, lobster, shallots, and rice, with a balsamic avocado teriyaki sauce, fuses into a delightful party for the tongue.
PLUSES
+ + +
For a salad course, the spinach with red onion, bacon, and candied walnuts dish is also tasty, and is large enough for two.
For those who want a sandwich, there is a fish sandwich, a burger, and a lobster roll on a brioche bun.
We tried the lobster roll which had a surprisingly large amount of tender lobster and was accompanied by their
MINUSES
- - -
CUISINE
1 /
2
AMBIENCE
1 1 /
• Carefully constructed dishes artistic and flavorful
• Casual rustic atmosphere— casual but still upscale
• All seafood is fresh
/
2 2
• The brick and wood look nice, but when crowded there is no noise dampening
SERVICE
1 /
2
• Professional and seemingly fans of the food offered
Copperfish, 1502 South Howard Avenue, 813-251-6789 www.tampacopperfish.com
Restaurants are rated from one to five stethoscopes.
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
Taste Bud
15

SPOTLIGHT ON SAVINGS
HCMA BENEFIT PROVIDERS
The Hillsborough County Medical Association’s Benefit Provider Program provides value to physicians with products, programs, and services that far exceed the cost of annual dues. If you have any questions, please contact Debbie Zorian, HCMA
Executive Director, at 813-253-0471 or dzorian@hcma.net.
Lowest prices on all office supplies...will meet or beat any office supply company.
Over 30,000 items and a full line of recycled products, free customized cost analysis (guaranteed minimum of
10% annual savings), order via website, email, fax, or phone. Free, next-day delivery with no minimum requirement. You will be assigned a designated account manager to handle every aspect of your practice’s needs. Call Brittany Bunnell at 800-420-6421 ext. 245 or bbunnell@goamo.com for more information.
Banking and Wealth Management Services
Specializing in services for medical practices and physicians for over 25 years. The Bank of Tampa has designed exclusive benefits for HCMA members including a personal relationship package, commercial banking services, and wealth management services; as well as discounts on Remote Deposit Capture, payroll, and merchant card services. Contact Anna
Ehrlich, Vice President, at 813-872-1271 or aehrlich@bankoftampa.com.
Specialized team of accounting, tax, and consulting professionals that focus on providing services to healthcare and medical clients. Members receive discounts on specialized services, in addition to one free hour of proactive consultation.
Contact Richard Hedley at 813-841-1953 or 813-251-
1010, rhedley@cbh.com or visit www.cbh.com.
- Providing legal services to members with the right pricing, responsiveness, and ethics. FHLF offers “Healthcare Attorney on Call,” an “ Online Store,” and free webinars for HCMA members. The Law Offices of Jeff Cohen, P.A. will answer your legal questions, at no cost. Contact the office, after hours, and you will receive a return call by noon the next business day and will obtain up to fifteen minutes of free legal advice from a Florida healthcare attorney.
Contact Jeff Cohen, Esq. at 888-455-
7702, 561-455-7700 . The FHLF Online Store offers free legal documents, available for instant download.
Audio/visual presentations are also available for purchase (HCMA members receive a 25% discount by using the discount code HCMA25).
Visit the innovative new resource center at www.FloridaHealthcareLawFirm.com or contact Jeff Cohen at JCohen@floridahealthcarelawfirm.com,
Looking for an increased patient base and bottom line? Full Circle PR is a local, strategic growth firm specializing in the medical practice industry. They offer HCMA members a complimentary consultation and create a customized public relations and marketing plan that will increase their patient base and ultimately their bottom line. HCMA members save 10% on all services.
Contact Michele Krohn at
813.887.FCPR (3277) or Michele@fullcircle-pr.com.
16 HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
- Offering Medical Professional Liability Insurance and Risk Management Services .
Choose HCMA’s exclusively endorsed medical professional liability insurer. Doing so rewards eligible HCMA members with a 5% discount on their premiums. You also receive fair treatment from professionals who are committed to making it easier for you to secure the coverage, services, and support you want. With PRA, you experience less uncertainty and more control, which your hard-earned professional identity deserves. Find out how you can benefit with steadfast protection from PRA – Rated A+ (Superior) by A.M. Best and serving
Florida physicians since 1975. For a no-obligation premium quotation, contact Barbara Daugherty, Account
Executive, at 863-324-2650 or bdaugherty@proassurance.com.
High security on-site document shredding. The ONLY certified company in this market. 15% discount for HCMA members.
Free HIPAA HITECH Compliance Toolkit and free training! Contact David Reed at 813-910-3300, dreed@shredquick.com, or visit www.shredquick.com.
Providing customized personal and business banking services exclusively for HCMA members, their practices, and staff.
For more than 100 years, SunTrust has been a leader in providing financial services to the medical community. They understand the complex financial needs of physicians and their practices. Working with your SunTrust Client Advisors, you’ll have access to a customized, comprehensive set of financial products and services delivered by an incredible depth of human resources; the kind of resources that can manage across the financial disciplines of banking, brokerage, trust, and more. Contact
Kathy Carr 813-224-2100, Kathy.Carr@Suntrust.com or David DeWeese 813-224-2119 regarding the exclusive offers available to HCMA physicians and their practices.
- Delivering progressive cash-flow solutions since 1970.
HCMA members receive a members’ only discount, on the already fixed-fee pricing, regardless of account balance. Medical practices receive 100% of all recovered money, as well as monthly reporting, on all accounts placed in any of the flat fee services. Transworld has assisted over 200,000 clients resolve $6 billion in accounts receivables in the past decade, helping them to eliminate their need for traditional collection agencies and attorneys.
Contact Gene Rodriguez at 727-432-5690 or gene.rodriguez@transworldsystems.com.
- Office personnel at no cost to HCMA members.
UMA is a dynamic career school committed to empowering students to excel in the health care field. As a part of their curriculum, UMA students are required to perform a clinical externship in a physician’s office. UMA will place their students in HCMA members’ offices, performing the support staff duties they were trained for, at no expense to you or your practice. Contact Star Aponte at UMA, 813-283-5152, saponte@ultimatemedical.edu, or visit www.hireuma.com for additional information.

SPOTLIGHT ON SAVINGS
HCMA BENEFIT PROVIDERS
The Hillsborough County Medical Association’s Benefit Provider Program provides value to physicians with products, programs, and services that far exceed the cost of annual dues. If you have any questions, please contact Debbie Zorian, HCMA
Executive Director, at 813-253-0471 or dzorian@hcma.net.
Lowest prices on all office supplies...will meet or beat any office supply company.
Over 30,000 items and a full line of recycled products, free customized cost analysis (guaranteed minimum of
10% annual savings), order via website, email, fax, or phone. Free, next-day delivery with no minimum requirement. You will be assigned a designated account manager to handle every aspect of your practice’s needs. Call Brittany Bunnell at 800-420-6421 ext. 245 or bbunnell@goamo.com for more information.
Banking and Wealth Management Services
Specializing in services for medical practices and physicians for over 25 years. The Bank of Tampa has designed exclusive benefits for HCMA members including a personal relationship package, commercial banking services, and wealth management services; as well as discounts on Remote Deposit Capture, payroll, and merchant card services. Contact Anna
Ehrlich, Vice President, at 813-872-1271 or aehrlich@bankoftampa.com.
Specialized team of accounting, tax, and consulting professionals that focus on providing services to healthcare and medical clients. Members receive discounts on specialized services, in addition to one free hour of proactive consultation.
Contact Richard Hedley at 813-841-1953 or 813-251-
1010, rhedley@cbh.com or visit www.cbh.com.
- Providing legal services to members with the right pricing, responsiveness, and ethics. FHLF offers “Healthcare Attorney on Call,” an “ Online Store,” and free webinars for HCMA members. The Law Offices of Jeff Cohen, P.A. will answer your legal questions, at no cost. Contact the office, after hours, and you will receive a return call by noon the next business day and will obtain up to fifteen minutes of free legal advice from a Florida healthcare attorney.
Contact Jeff Cohen, Esq. at 888-455-
7702, 561-455-7700 . The FHLF Online Store offers free legal documents, available for instant download.
Audio/visual presentations are also available for purchase (HCMA members receive a 25% discount by using the discount code HCMA25).
Visit the innovative new resource center at www.FloridaHealthcareLawFirm.com or contact Jeff Cohen at JCohen@floridahealthcarelawfirm.com,
Looking for an increased patient base and bottom line? Full Circle PR is a local, strategic growth firm specializing in the medical practice industry. They offer HCMA members a complimentary consultation and create a customized public relations and marketing plan that will increase their patient base and ultimately their bottom line. HCMA members save 10% on all services.
Contact Michele Krohn at
813.887.FCPR (3277) or Michele@fullcircle-pr.com.
- Offering Medical Professional Liability Insurance and Risk Management Services .
Choose HCMA’s exclusively endorsed medical professional liability insurer. Doing so rewards eligible HCMA members with a 5% discount on their premiums. You also receive fair treatment from professionals who are committed to making it easier for you to secure the coverage, services, and support you want. With PRA, you experience less uncertainty and more control, which your hard-earned professional identity deserves. Find out how you can benefit with steadfast protection from PRA – Rated A+ (Superior) by A.M. Best and serving
Florida physicians since 1975. For a no-obligation premium quotation, contact Barbara Daugherty, Account
Executive, at 863-324-2650 or bdaugherty@proassurance.com.
High security on-site document shredding. The ONLY certified company in this market. 15% discount for HCMA members.
Free HIPAA HITECH Compliance Toolkit and free training! Contact David Reed at 813-910-3300, dreed@shredquick.com, or visit www.shredquick.com.
Providing customized personal and business banking services exclusively for HCMA members, their practices, and staff.
For more than 100 years, SunTrust has been a leader in providing financial services to the medical community. They understand the complex financial needs of physicians and their practices. Working with your SunTrust Client Advisors, you’ll have access to a customized, comprehensive set of financial products and services delivered by an incredible depth of human resources; the kind of resources that can manage across the financial disciplines of banking, brokerage, trust, and more. Contact
Kathy Carr 813-224-2100, Kathy.Carr@Suntrust.com or David DeWeese 813-224-2119 regarding the exclusive offers available to HCMA physicians and their practices.
- Delivering progressive cash-flow solutions since 1970.
HCMA members receive a members’ only discount, on the already fixed-fee pricing, regardless of account balance. Medical practices receive 100% of all recovered money, as well as monthly reporting, on all accounts placed in any of the flat fee services. Transworld has assisted over 200,000 clients resolve $6 billion in accounts receivables in the past decade, helping them to eliminate their need for traditional collection agencies and attorneys.
Contact Gene Rodriguez at 727-432-5690 or gene.rodriguez@transworldsystems.com.
- Office personnel at no cost to HCMA members.
UMA is a dynamic career school committed to empowering students to excel in the health care field. As a part of their curriculum, UMA students are required to perform a clinical externship in a physician’s office. UMA will place their students in HCMA members’ offices, performing the support staff duties they were trained for, at no expense to you or your practice. Contact Star Aponte at UMA, 813-283-5152, saponte@ultimatemedical.edu, or visit www.hireuma.com for additional information.
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 17

HCMA Past Presidents: Drs. Gene Balis
(2007) and Kenneth Louis (2010).
Fred Dobbins (City President and Managing Director of SunTrust’s medical specialty group), Lorraine Lutton
(President, St. Joseph’s Hospitals), and Linda Weldon (Sr.
VP of Academics and Accreditation for Ultimate Medicine
Academy) representing the evening’s sponsors, welcomed attendees.
O n November 5th, HCMA members were given the opportunity to hear a presentation and participate in Q & A with Travis Good, M.D., MBA, MS, Cofounder of Catalyze.io and editor of HISTalk Connect. His presentation was entitled, “Why Concierge Medicine is the Future of Healthcare.” According to Dr. Good, concierge medicine, direct primary care, will represent 10-12% of practices in the next four years. Direct care physicians are forging ahead with services and technologies that patients want and are willing to pay for. These same services and technologies are necessary if the broader health system is to shift to value-based care. Dr. Travis Good discussed how EMRs are ill-equipped to enable either concierge or value-based models of care and how new technologies will displace EMRs as the hub of healthcare technology.
Prior to the social hour, HCMA Past Presidents were honored with a private reception, sponsored by Dr. Manuel
Rose/Rose Radiology.
Many thanks to the generosity and continued support of ProAssurance, St. Joseph’s Hospitals, SunTrust Bank,
Ultimate Medical Academy, and Rose Radiology for making the evening possible.
Drs. Jose Dominguez, Rodolfo Eichberg, and Jairo Parada.
18
Dr. Rebecca Johnson, HCMA Women in Medicine representative on the Executive
Council, mixes and mingles with the best medical student contingency in Florida!
Dr. Travis Good,
Cofounder of Catalyze.
io and editor of HISTalk
Connect.
David Goss (VP of Sales and Marketing) and Barbara Daugherty (Account
Representative) from HCMA’s newest
Benefit Provider, and dinner meeting sponsor, ProAssurance, flank Debbie
Zorian (HCMA Executive Director).
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

O n November 5th, HCMA members were given the opportunity to hear a presentation and participate in Q & A with Travis Good, M.D., MBA, MS, Cofounder of Catalyze.io and editor of HISTalk Connect. His presentation was entitled, “Why Concierge Medicine is the Future of Healthcare.” According to Dr. Good, concierge medicine, direct primary care, will represent 10-12% of practices in the next four years. Direct care physicians are forging ahead with services and technologies that patients want and are willing to pay for. These same services and technologies are necessary if the broader health system is to shift to value-based care. Dr. Travis Good discussed how EMRs are ill-equipped to enable either concierge or value-based models of care and how new technologies will displace EMRs as the hub of healthcare technology.
Prior to the social hour, HCMA Past Presidents were honored with a private reception, sponsored by Dr. Manuel
Rose/Rose Radiology.
Many thanks to the generosity and continued support of ProAssurance, St. Joseph’s Hospitals, SunTrust Bank,
Ultimate Medical Academy, and Rose Radiology for making the evening possible.
HCMA Presidents: Drs. Robert Isbell (1983), Humberto Coto (2009),
Michael Wasylik (2000), John Curran (2008), Hunter Eubanks (1992), and
Mathis Becker (2011).
HCMA Presidents: Drs. Ronald Seeley (1980), Luis Menendez (1998),
Hernan Leon (1991), Bruce Shephard (2006), William DeWeese (1989), and
Dennis Agliano (1995).
HCMA Presidents: Drs. Christopher Pittman (2013), William Davison
(2012), Edward Homan (1999), Frank Mastandrea (2004), Edward Farrior
(2003), and President Elect, Dr. Devanand Mangar.
David Goss (VP of Sales and Marketing) and Barbara Daugherty (Account
Representative) from HCMA’s newest
Benefit Provider, and dinner meeting sponsor, ProAssurance, flank Debbie
Zorian (HCMA Executive Director).
Drs. Christopher Nussbaum and
Sami Elchahal.
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
Drs. Michael O’Neal (Concierge Doctor of Osteopathic
Medicine Physician of the Year), Christopher Pittman
(HCMA President), and Travis Good (dinner meeting featured speaker).
19

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HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 21

22
March 4 –
May 2, 2014
INSURANCE REFORM/PRIOR
AUTHORIZATION
The FMA will seek legislation making it unlawful for an insurance company or other third party payer to interfere with a licensed MD/
DO’s valid order for a medical test or procedure; provide for the mandatory use of a standardized form by all insurance companies and managed care plans that require any type of prior authorization; and place strict limitations on the use of fail first protocols. Part of the Affordable
Care Act requires patients be given 90 days before their policy is non-renewed for non-payment of premium. During the first 30 days the insurer is on the hook for payment; after that there is no obligation for them to pay for services rendered.
Currently, physicians will have no way to know whether or not a patient has coverage until the end of that 90 day period. During that time if services are rendered, insurers will not be required to pay those claims if the premium continues to go unpaid. Insurers should be required to flag those policyholders that have not paid their premium so that doctors can choose whether or not to see them. Each different insurer can have dozens of different prior authorization forms doctors must complete depending on the type of insurance coverage the patient has. A recent survey of physicians reveals that reducing this type of red tape ranks as the highest priority for Florida’s physician community. Studies have shown that the burdensome prior authorization process is costing the health care system between $23-31 billion per year, which equates to about $85,000 per physician. Several states like Texas, California and Ohio have already passed legislation to create a standard prior authorization form.
by establishing uniform standards for physicians and maintain patient safety though four (4) key components: definition, accountability, education, and reimbursement.
Definition
Telemedicine is the health care delivery, diagnosis, consultation, treatment, monitoring, or the transfer of medical data via the use of telecommunications services to establish a physician-patient relationship, to evaluate a patient, or to treat a patient. Telecommuting should only be conducted with the appropriate technology and encryption to comply with HIPAA.
The physician practicing telemedicine must establish a physician-patient relationship and have the patient’s informed consent. Controlled substances shall not be prescribed without a face-to-face consult unless it is an emergency situation.
Accountability
Physicians entering Florida to practice via telecommunications must be licensed in Florida or hold a Florida telemedicine certificate. To ensure the safety of Florida’s patients, these physicians telecommuting into the state must meet uniform standards of care. The Board of
Medicine must have jurisdiction to credential and discipline these physicians.
Education
All physicians practicing telemedicine must comply with current laws and rules in
Florida. The most effective way to maintain this knowledge in an ever-changing technological climate is for physicians to complete continuing medical education.
Reimbursement
TELEMEDICINE
Telemedicine is the delivery of health care services by a physician to a patient in a remote location using technology when distance separates the two. The FMA supports telemedicine legislation that will modernize medical practice
Parity for face-to-face consults and telemedicine consults must apply in the private insurance market as well as in Medicaid. The physician expends the same amount of time, skill, and expertise when conducting a consult whether it be face-to-face or through telecommunications.
The physician shouldn’t be financially penalized
(continued)
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

for serving more patients outside of the traditional office setting.
TEAM-BASED HEALTH CARE / SCOPE OF PRACTICE
The FMA supports the use of patient-centered, team-based patient care and believes that increased use of the team based care model can have a positive impact on Florida’s primary care needs.
A team-based approach would include physicians and other health professionals working together, sharing decisions and information, for the benefit of the patient. Physicians, ARNPs, physician assistants (PAs), nurses and other professionals would work together, drawing on the specific strengths of each member. Some nursing groups argue that nurse practitioners (ARNPs) should be given the authority to practice independently to meet access to primary care needs. However, Florida’s current ARNP supervision laws have much greater reach and flexibility than are commonly understood as evidenced in these four facts:
There are no established limits on how many ARNPs a physician may supervise as Florida law currently allows a physician to supervise an unspecified number of ARNPs at up to four offsite locations, so long as the supervision is conducted under a written protocol.
There are no requirements in law that limit the distance between a primary care physician’s on-site office and the off-site, supervised offices. (Exception: dermatological satellite offices must be within 25 miles). The physician need only be reachable in person or by communication devices.
Under an ARNP protocol, the physician delegates which duties the ARNP may perform, and which medications the ARNP may prescribe. (Exception: controlled substances). These protocols are written to accommodate a broad range of patient needs.
Current law already permits ARNPs to own retail clinics. This means that an ARNP does not need to be employed by a supervising physician in order to set up a delegation protocol. The ARNP can go through the facility licensure process and set up shop as his or her own small business, just as they would in states that permit
“independent practice.”
Current Florida law is well-equipped to enable an increased role for ARNPs and PAs in patient care. An expansion of the ARNPs scope of practice would offer nothing new to patients than what is already possible, and adversely, could be to the detriment of patient safety and quality of care. It is in the patient’s best interest for physicians and ARNPs to work together as a team, with the patient at the center.
HOSPITAL OBSTETRIC DEPARTMENT CLOSURE
The FMA will seek legislation to require that when a hospital decides to close an obstetric department, that hospital must provide notice of 120 days to physicians with privileges at that facility to ensure patients are not left without needed medical care.
The 2014 legislative session begins March 4, 2014, and the Florida Office of Legislative Services is seeking volunteer physicians to participate in the Doctor of the Day program. Participating physicians spend a day in Tallahassee providing health care for members of the Legislature and legislative employees during session. This is an invaluable service that helps to strengthen physician-legislator relations. The Office of Legislative Services will schedule two physicians for each day of the legislative session, one for the House of Representatives and one for the Senate.
If you would like to be a Doctor of the Day, please contact Takeshia Stokes with the Office of Legislative Services at stokes.takeshia@leg.state.fl.us or (850) 717-0301. Session is scheduled to adjourn on May 2, 2014.
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 23

For additional information about Florida Government, visit On-Line Sunshine at: www.leg.state.fl.us
Information as of November 7, 2013
SENATOR
JOHN LEGG (R)
17th District
Hillsborough Legislative
DISTRICT OFFICE
813-909-9919
262 Crystal Grove Blvd.
Lutz, FL 33548
TALLAHASSEE OFFICE
850-487-5017
FAX: 888-263-3681
316 Senate Office Bldg.
STAFF
Rich Reidy
Spencer Pylant
Becky Zizzo
Delegation Vice Chair legg.john.web@flsenate.gov 404 S. Monroe St.
Tallahassee, FL 32399-1100
Committees: Education (Chair); Appropriations Subcommittee on Education, Appropriations Subcommittee on General Government; Ethics and Elections; Military
Affairs, Space, and Domestic Security; Regulated Industries; Select Committee on Patient Protection and Affordable Care Act.
ARTHENIA JOYNER (D)
19th District
813-233-4277
FAX: 813-233-4280
508 W. Dr. MLK Jr. Blvd., Ste. C
850-487-5019
202 Senate Office Bldg.
404 S. Monroe St.
Randi Rosete
Rosalie Smith
Rosalie Smith
Tampa, FL 33603-3402 joyner.arthenia.web@flsenate.gov
Tallahassee, FL 32399-1100
Committees: Joint Committee on Public Counsel Oversight (Alternating Chair); Appropriations Subcommittee on Criminal and Civil Justice (Vice Chair); Appropriations Subcommittee on General Government; Ethics and Elections; Health Policy; Judiciary; Transportation.
JEFF BRANDES (R)
22nd District
727-552-2745
3637 4th St. North, Suite 101
St. Petersburg, FL 33704 brandes.jeff.web@flsenate.gov
850-487-5022
318 Senate Office Bldg.
404 S. Monroe St.
Tallahassee, FL 32399-1100
Robert Combs
Chris Spencer
Committees: Transportation (Chair); Agriculture; Appropriations Subcommittee on Finance and Tax; Appropriations Subcommittee on Transportation, Tourism, and
Economic Development; Education; Health Policy; Select Committee on Patient Protection and Affordable Care Act.
TOM LEE (R)
24th District
813-653-7061
915 Oakfield Drive
Brandon, FL 33511 lee.tom.web@flsenate.gov
850-487-5024
418 Senate Office Bldg.
404 S. Monroe St.
Tallahassee, FL 32399-1100
Audie Canney
Cori Cuttler
Douglas Roberts
Committees: Judiciary (Chair); Appropriations Subcommittee on Health and Human Services; Appropriations Subcommittee on Transportation, Tourism, and
Economic Development; Banking and Insurance; Ethnics and Elections; Gaming; Rules; Transportation.
BILL GALVANO (R)
26th District
941-741-3401
1023 Manatee Ave. W., Ste. 201
404 S. Monroe St.
850-487-5026
326 Senate Office Bldg.
Tallahassee, FL 32399-1100
Kathy Galea
Allie Mattice
Whitney Deem
Bradenton, FL 34205 galvano.bill.web@flsenate.gov
Victoria Brill
Committees: Appropriations Subcommittee on Education (Chair); Agriculture; Appropriations; Appropriations Subcommittee on Health and Human Services;
Education; Gaming; Health Policy; Regulated Industries; Rules.
REPRESENTATIVE DISTRICT OFFICE TALLAHASSEE OFFICE STAFF
JAKE RABURN (R)
57th District
813-653-7079 or 813-653-7098
FAX: 813-653-7099
3618 Erindale Dr.
850-717-5057
1003 The Capitol
402 S. Monroe St.
Clay Barker
Mary LaFollette
Riverview, FL 33596-6311 jake.raburn@myfloridahouse.gov
Tallahassee, FL 32399-1300
Committees: State Affairs Committee; Education Appropriations Subcommittee; Transportation & Highway Safety Subcommittee; K-12 Subcommittee; Health
Innovation Subcommittee.
DAN RAULERSON (R)
58th District
813-757-9110
110 W. Reynolds St., Ste. 204
Plant City, FL 33563
850-717-5058
1002 The Capitol
402 S. Monroe St.
Amber Smith
Robyn Bryant dan.raulerson@myfloridahouse.gov Tallahassee, FL 32399-1300
Committees: Regulatory Affairs Committee; Finance & Tax Subcommittee; Health Qulaity Subcommittee; Government Operations Subcommittee; Joint Legislative
Auditing Committee.
ROSS SPANO (R)
59th District
Riverview, FL 33578-4267 ross.spano@myfloridahouse.gov
402 S. Monroe St.
Tallahassee, FL 32399-1300
Committees: Judiciary Committee; Choice & Innovation Subcommittee; Higher Education & Workforce Subcommittee; Health Quality Subcommittee; Civil Justice
Subcommittee.
813-655-3742
11256 Winthrop Main St., Unit A
850-717-5059
1002 The Capitol
Chris Dierlam
Gloria Perez
DANA YOUNG (R)
60th District
Hillsborough Legislative
Delegation Chair
813-835-2270
2909 W. Bay to Bay Blvd., Ste. 202
Tampa, FL 33629-8175 dan.young@myfloridahouse.gov
Committees: Rules & Calendar, Select Committee on Gaming.
850-717-5060
322 The Capitol
402 S. Monroe St.
Tallahassee, FL 32399-1300
Sydney Ridley
Melonie Hoyt
24 HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

REPRESENTATIVE DISTRICT OFFICE TALLAHASSEE OFFICE STAFF
BETTY REED (D)
61st District
813-241-8024
2109 E. Palm Ave., Ste. 201
Tampa, FL 33605-3909 betty.reed@myfloridahouse.gov
402 S. Monroe St.
Tallahassee, FL 32399-1300
Committees: Education Committee (Vice Chair); Rules & Calendar; Education Appropriations Subcommittee; Economic Development and Tourism Subcommittee;
Agriculture & Natural Resources Subcommittee.
850-717-5061
300 House Office Bldg.
Dewayne Mallory
Patricia Givens
JANET CRUZ (D)
62nd Distrtict
813-673-4673
2221 N. Himes Avenue, Ste. B
Tampa, FL 33607-3139 janet.cruz@myfloridahouse.gov
850-717-5062
218 House Office Bldg.
402 S. Monroe St.
Tallahassee, FL 32399-1300
Wendy Brill
Sarah Roberts
Committees: Health Care Appropriations Subcommittee (Vice Chair); Ethics & Elections Subcommittee (Vice Chair); Appropriations Committee; Energy & Utilities
Subcommittee; Select Committee on Gaming; Joint Committee on Public Counsel Oversight.
MARK DANISH (D)
63rd Distrtict
813-910-3269
3246 Cove Bend Drive
Tampa, FL 33613-2752
850-717-5063
1401 The Capitol
402 S. Monroe St.
Jennifer Gordon
Brian Mason mark.danish@myfloridahouse.gov Tallahassee, FL 32399-1300
Committees: Agriculture & Natural Resources Appropriations Subcommittee; Economic Affairs Committee; Government Operations Appropriations Committee;
Education Committee.
JAMES GRANT (R)
64th Distrtict
813-265-6280
12956 N. Dale Mabry Hwy.
850-717-5064
405 House Office Building
Samantha Harper
Tampa, FL 33618-2806 james.grant@myfloridahouse.gov
402 S. Monroe St.
Tallahassee, FL 32399-1300
Committees: Select Committee on Claim Bills (Chair); State Affairs Committee (Vice Chair); Higher Education & Workforce Subcommittee; Education Committee;
Criminal Justice Subcommittee; Joint Legislative Budget Commission.
DARRYL ROUSON (D)
70th Distrtict
727-906-3200
535 Central Ave., Ste. 312
St. Petersburg, FL 33701-3703
850-717-5070
212 The Capitol
402 S. Monroe St.
Barclay Harless
Tennille Mooore
Leila Wilson darryl.rouson@myfloridahouse.gov Tallahassee, FL 32399-1300
Committees: State Affairs Committee (Democratic Ranking Member); Justice Appropriations Subcommittee (Democratic Ranking Member); Business & Professional
Regulation Subcommittee (Democratic Ranking Member); Appropriations Committee; Regulatory Affairs Committee.
Gus Bilirakis (R)
Dist. 12
2313 Rayburn HOB
Washington, DC 20515
202.225.5755
202.225.4085 fax http://bilirakis.house.gov
District Office:
5901 Argerian Dr., #102
Wesley Chapel, 33545
813.501.4942
813.501.4944 fax
Bill Nelson (D)
716 Hart SOB
Washington, DC 20510
202.224.5274
Marco Rubio (R)
317 Hart SOB
Washington, DC 20510
202.224.3041
202.228.2183 fax www.billnelson.senate.gov
202.228.0285 fax http://rubio.senate.gov
Tampa Office: Tampa Office:
Sam Gibbons Federal Courthouse 3802 Spectrum Blvd., #106
801 N. Florida Ave., 4 th Floor
Tampa, 33602
813.225.7040
813.225.7050 fax
Tampa, 33612
813.977.6450
813.977.6593 fax
Kathy Castor (D)
Dist. 14
137 Cannon HOB
Washington, DC 20515
202.225.3376
202.225.5652 fax http://castor.house.gov
District Office:
4144 N. Armenia Ave., #300
Tampa, 33607
813.871.2817
813.871.2864 fax
Tom Rooney, (R)
Dist. 17
221 Cannon HOB
Washington, DC 20515
202.225.5792
202.225.3132 fax http://rooney.house.gov/
District Office:
11345 Big Bend Rd.
Riverview, 33579
863.402.9082 (Sebring ofc)
863.402.9084 fax (Sebring ofc)
Dennis Ross (R)
Dist. 15
229Cannon HOB
Washington, DC 20515
202.225.1252
202.226.0585 fax http://dennisross.house.gov
District Office:
170 Fitzgerald Rd., #1
Lakeland, 33813
863.644.8215
863.648.0749 fax
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 25

Small town care has
Small town care has big benefits.
With some of the most competitive benefits packages available, becoming a rural-based physician with the Veteran’s Health
Administration (VHA) is the change of pace you’ve been looking for.
From creating stronger relationships with your patients to having more advantage of having access to the largest, most technologically advanced integrated health care system in the United States. But
most importantly, you have the chance to be a driving force behind providing Veterans with the world-class health care benefits they deserve.
Please tell the advertiser you saw it in the HCMA Bulletin!
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 26

T he Florida Board of Medicine’s Surgical Care/
Quality Assurance Committee has been reviewing Rule 64B8-9.007, Florida Administrative Code – Standards of Practice in an effort to reduce the number of wrong patient, wrong site and/or wrong procedure disciplinary cases. This rule outlines requirements for taking a pause prior to beginning surgery to ensure you have the right patient, the right site, and are performing the right surgery as described in the Informed
Consent signed by the patient.
The Board continued to see disc iplinary cases in which the required “pause” is performed but surgery was still performed on the wrong patient, wrong site, or the wrong procedure is performed.
The Committee met three times and heard public testimony. During that testimony, it was determined the definition of surgery also needed to be clarified.
Changes to the rule include:
• Physicians are required to confirm the patient’s identity, confirm the procedure being performed, and confirm the correct surgical site with another healthcare practitioner.
• “Pause” must be performed again if the physician leaves the room at any time during the procedure or surgery.
• Clarification of the definition of surgery.
The changes have been effective for one year and are underlined in the rule language below:
64B8-9.007 Standards of Practice.
The Board of Medicine interprets the standard of care requirement of Section 458.331(1)(t),
F.S., and the delegation of duties restrictions of
Section 458.331(1)(w), F.S., with regard to surgery as follows:
(1) The ultimate responsibility for diagnosing and treating medical and surgical problems is that of the licensed doctor of medicine or osteopathy who is to perform the procedure. In addition, it is the responsibility of the treating physician or an equivalently trained doctor of medicine or osteopathy or a physician practicing within a Board approved postgraduate training program to ex-
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 plain the procedure to and obtain the informed consent of the patient. It is not necessary, however, that the treating physician obtain or witness the signature of the patient on the written form evidencing informed consent.
(2) This rule is intended to prevent wrong site, wrong side, wrong patient and wrong surgeries/ procedures by requiring the team to pause prior to the initiation of the surgery/procedure to confirm the side, site, patient identity, and surgery/ procedure.
(a) Definition of Surgery/Procedure. As used herein, “surgery/procedure” means the removal, incision or curettage of tissue or an organ, insertion of natural or artificial implants, electroconvulsive therapy, endoscopic procedure or other procedure requiring the administration of anesthesia or an anesthetic agent. Minor surgeries/procedures such as excision of skin lesions, moles, warts, cysts, lipomas and repair of lacerations or surgery limited to the skin and subcutaneous tissue performed under topical or local anesthesia not involving drug-induced alteration of consciousness other than minimal pre-operative tranquilization of the patient are exempt from the following requirements. Paracentesis, thoracentesis, ocular surgery, liposuction, lipoplasty, and Mohs, are not minor surgeries/procedures.
(b) Except in life-threatening emergencies requiring immediate resuscitative measures, once the patient has been prepared for the elective surgery/procedure and the team has been gathered and immediately prior to the initiation of any procedure, the team will pause and the physician(s) performing the procedure will verbally confirm the patient’s identification, the intended procedure and the correct surgical/procedure site. The operating physician shall not make any incision or perform any surgery or procedure prior to performing this required confirmation.
If the surgery/procedure is performed in a facility licensed pursuant to Chapter 395, F.S., or a level
II or III surgery/procedure is performed in an office surgery setting, the physician(s) performing the procedure and another Florida licensed health care practitioner shall verbally and simul-
Crystal A. Sanford,
CPM
Crystal_Sanford@ doh.state.fl.us
(continued)
27

28 taneously confirm the patient’s identification, the intended procedure and the correct surgical/procedure site prior to making any incision or initiating the procedure. The medical record shall specifically reflect when this confirmation procedure was completed and which personnel on the team confirmed each item.
(c) Confirmation of the patient’s identity shall be made by using two or more of the following corroborating patient identifiers:
1. Name.
2. Assigned identification number.
3. Telephone number.
4. Date of Birth.
5. Social security number.
6. Address.
7. Photograph.
(d) The provisions of paragraph (b) shall be applicable to anesthesia providers prior to administering anesthesia or anesthetic agents, or performing regional blocks at any time both within or outside a surgery setting.
(e) At any time after the pause is completed, but before the procedure is initiated, if the physician(s) leave(s) the room where the procedure is being performed, upon his or her return, the pause set forth in subsection (b) above must be performed again.
(3) Management of postsurgical care is the responsibility of the operating surgeon.
(4) The operating surgeon can delegate discretionary postoperative activities to equivalently trained licensed doctors of medicine or osteopathy or to physicians practicing within Board approved postgraduate training programs. Delegation to any health care practitioner is permitted only if the other practitioner is supervised by the operating surgeon or an equivalently trained licensed doctor of medicine or osteopathy or a physician practicing within a Board approved postgraduate training program.
Rulemaking Authority 458.309, 458.331(1)
(v) FS. Law Implemented 458.331(1)(v) FS. History–New 11-28-91, Formerly 21M-20.015, 21M-
27.007, 61F6-27.007, 59R-9.007, Amended 2-18-
04, 9-18-05, 4-25-06, 5-6-08, 1-29-13(2)(b), (c),
(e).
Ms. Sanford is currently a Program Operations
Administrator in the Board of Medicine and has worked in the Board for over 22 years. For more information, please visit: www.FLBoardofMedicine.
gov or email: info@FLBoardofMedicine.gov
The HCMA will no longer be mailing dinner meeting notices…all dinner meeting invitations and HCMA communications will be sent to members electronically (except HCMA’s bi-monthly publication, The Bulletin). Please contact the HCMA office ASAP to provide us with your preferred email address/es to guarantee you receive all important information and notices from the HCMA.
Contact Kay Mills, HCMA Membership Coordinator, to provide your email address/es. Kay can be reached by calling 813.253.0471 or via email: KMills@hcma.net.
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014
The Florida Healthcare Law Firm is proud to announce our partnership with HCMA.
Visit our innovative new resource center today, accessible through www.FloridaHealthcareLawFirm.com
or by www.NationalHealthcareLawFirm.com/store where you'll find:
FREE legal documents available for instant download covering everything from
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AND audio/visual presentations are also available for purchase on the following topics:
Buying a Medical Practice
Selling a Medical Practice
How to Hire a Physician
Physicians Getting Employed
Florida's Prompt Payment Laws
PIP Modifications & Regulations
MD/DC Business Arrangements
Visit us online at www.FloridaHealthcareLawFirm.com
Call Toll Free at 888-455-7702
Email Jeff Cohen jcohen@floridahealthcarelawfirm.com

The Florida Healthcare Law Firm is proud to announce our partnership with HCMA.
Visit our innovative new resource center today, accessible through www.FloridaHealthcareLawFirm.com
or by www.NationalHealthcareLawFirm.com/store where you'll find:
FREE legal documents available for instant download covering everything from
Confidentiality Agreements to Space Leases !
AND audio/visual presentations are also available for purchase on the following topics:
Buying a Medical Practice
Selling a Medical Practice
How to Hire a Physician
Physicians Getting Employed
Florida's Prompt Payment Laws
PIP Modifications & Regulations
MD/DC Business Arrangements
HCMA
BENEFIT
PROVIDER
Visit us online at www.FloridaHealthcareLawFirm.com
Call Toll Free at 888-455-7702
Email Jeff Cohen jcohen@floridahealthcarelawfirm.com
Please tell the advertiser you saw it in the HCMA Bulletin!
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 29
HCMA
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Over 30,000 Items & a full line of recycled products
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Order via our website, email, fax, or phone
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A designated account manager to handle every aspect of your company’s needs
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Call Brittany Bunnell at 800-420-6421 ext. 245 or bbunnell@goamo.com for more information.
Please tell the advertiser you saw it in the HCMA Bulletin!
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

It was a dark and still night.
Very still and silent.
Still, except for the path you have to take.
The path where the pine branches are low to the ground and touch across the path so that you have to push them away to get through. It’s the path you have to take.
Alone.
Then you see one the of the still branches ahead shake.
You know they’re in there.
Ready to pounce on you.
To scratch at you, hiss at you, claw you, bite at you.
Crawl over your head and the back of your neck.
You can scream but it won’t do any good.
There could be only one. But there could be two.
Or even twenty-two.
They are probably rodents.
But they could be something else.
Just like being a physician in two thousand and fourteen.
It was a very dark path.
And a very still and lonely night.
It’s very still ahead, except for the path you have to take.
James Hulls, MD jhulls@tampabay.
rr.com
HCMA
Hillsborough County Medical Association, Inc.
Call the HCMA office to receive more information concerning
HCMA benefits, upcoming events, and programs:
813.253.0471
HCMA Staff:
Debbie Zorian, Executive Director
Elke Lubin, Executive Assistant
Kay Mills, Event and Membership Coordinator
Martha Brooks, Accountant
HCMA Headquarters
606 S. Boulevard
Tampa, FL 33606 www.HCMA.net
Hillsborough County Medical Association physicians and their staff can take advantage of the following benefits:
• Legislative Advocacy
• HCMA Health Plan
• FREE Quarterly Dinner Meetings
• FREE Educational Seminars for Members &
Staff – many offering CME & CEU
• Networking Opportunities
• Benefit Provider Program/Discounts
• Bimonthly publication, The Bulletin
• Website & Directory Listings
The HCMA is here to protect the future of medicine and our physicians’ ability to practice it.
Please tell the advertiser you saw it in the HCMA Bulletin!
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 31

C O M P E T E N C E C O M M U N I C A T I O N C O M P A S S I O N
.
Bronchial Thermoplasty is the latest non-drug treatment for patients who have persistent and severe asthma. The procedure allows for the delivery of precise and controlled thermal energy to the airway walls, which heats the tissues and reduces the airway smooth muscle.
How Bronchial Thermoplasty works:
• The procedure is delivered by the
Alair® System, which consists of an
Alair® Catheter and Alair®
Radiofrequency (RF) Controller
• It is performed during a bronchoscopy,
an examination of the lungs using an
instrument called a bronchoscope, a
tube with a camera on one end
• The Alair® Catheter is inserted
into the desired area of the air ways via
the bronchoscope
• The Alair® Catheter expands the
airway walls and a pulmonologist
starts the Alair® RF Controller, which
transports low power energy through
the Alair® Catheter to the airway wall
• The Alair® RF Controller sends
temperature controlled heat to
the airway
• Each transmittal is 10 seconds long
• Three separate outpatient treatments
are performed on three different areas
of the lungs
• Treatments are typically scheduled
three weeks apart
• Procedures are performed under
moderate sedation or light anesthesia
• Patients usually go home the same day
A Joint Commission
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Please tell the advertiser you saw it in the HCMA Bulletin!
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

It is with much sadness that we report the following members of our medical family have passed away…
Mother of HCMA member Dr. Peter Donelan, Irene Martha Donelan, age 88, died December
25th, in Tampa. She was predeceased by her beloved husband Dr. Richard T. Donelan. She is also survived by her other children, Richard T. Donelan Jr. of Tallahassee, Stephen M. Donelan of
Tallahassee, and Therese Donelan Odell of Tampa; and eleven beautiful grandchildren. Memorial gifts may be made to St. Timothy Catholic Church Building Fund (www.sainttims.org). Condolences may be shared with the family by visiting www.gonzalezfuneral.com.
Dr. Gaspar R. Salvador, died December 3 rd , following a brave battle with cancer. He was 69 years old. Dr. Salvador was born October 23, 1944, in Camaguey, Cuba. He was a US Air Force veteran. Dr.
Salvador received his medical degree from the University of Seville, Spain. He was a family practice physician at Sunhill Medical Center and the medical director at Sun Terrace Rehabilitation Center for 34 years in Sun City Center. He is survived by his wife of forty-one years Judy Weidner Salvador.
He is also survived by his son Stan (Samantha), two grandchildren, a sister, and many other family members and friends. Dr Salvador had a lifelong passion for boating and deep-sea fishing. Donations may be made in his name to Wounded Warrior Project (http://support.woundedwarriorproject.org).
Our heartfelt condolences go out to the family and friends of Drs. Donelan and Salvador.
Dr. Miguel Rivera, of Tampa Bay E.N.T. was named 2013
Florida Otolaryngologist of the Year by the Network of
Florida Otolaryngologists, Inc. (NFO), “in recognition of his outstanding dedicated service to, and promotion of, the specialty of otolaryngology/head and neck surgery, in the state of Florida for his benefit of his colleagues and patients.”
For the ninth consecutive year, the NFO has recognized an otolaryngologist that has done an outstanding job promoting the specialty and helping others throughout the community.
Dr. Rivera is currently the President of FSO-HNS. For the past four years he has been the Chairman of the Department of Otolaryngology at St. Joseph’s Hospital. He is an Assistant
Professor at the University of South Florida’s Department of
Otolaryngology and teaches Otolaryngology residents while treating veterans at the James A. Haley Veterans’ Hospital in
Tampa.
In the January 5 th edition of the Tampa Tribune, columnist Michelle Bearden, wrote a piece entitled,
“Tampa doctor to retire, but local calendars to continue” announcing the retirement of Dr. David Lubin and celebrating his annual Tampa Bay Events Calendar. To view the article, as well as the photos that accompanied the article, visit TBO.com and search “Lubin.”
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 33

F or
L ease
3,000 SF available in 10,000 SF medical building.
Beautiful office, centrally located: 8011 N. Himes Ave.,
Tampa. Lease negotiable. Dr. Lopez 317-3501.
F or
L ease or
s aLe
Medical Office - Next to Brandon Hospital. 2100 SQ FT
- Newly renovated. Call Dr. Karp: 813-787-6972.
F or
s aLe
GYN OFFICE CLOSES – EVERYTHING GOES. EXAM
TABLES, FILE CABINETS, SCALES, MAYO STAND,
STERILIZERS, CULPOSCOPE, INSTRUMENTS, ETC.
813-362-1663.
5200 SF Retail Center, Apollo Beach. 4 miles from new
St Joes. One 2200SF space good for Doctor, 3 smaller spaces. Own building with income from tenants Hi traffic area. 400k. 304-614-6135.
P roFessionaL
s ervices
Thinking about…Selling a Practice? Buying a
Practice? Terry Flanagan Direct (877) 988-0911 t.flanagan@murphybusiness.com. Murphy Business and Financial Services.
34
INDEX OF ADVERTISERS
Please support YOUR advertisers!
Tell them you saw their ad in The Bulletin!
H indicates HCMA Benefit Provider!
H AMO Office Supply .................................................. 30
Arcade Professional Center ........................................ 20
H The Bank of Tampa ................................................. 6
H Cherry Bekaert/CPAs .............................................. 8
William Dudney, MD .................................................. Card Shop
H Florida Healthcare Law Firm ................................. 29
Gunster/Health Law ................................................... 20
David Lubin, MD/eBay ............................................... 10
Parthenon West/Web Design ..................................... Card Shop
H ProAssurance/Professional Liability Ins. .............. Back Cover
Pulmonary & Sleep of Tampa Bay ............................. 32
H SunTrust Bank ........................................................ Inside Front Cover
H Transworld Systems/Profit Recovery ..................... Card Shop
TriCom Business Systems ......................................... 32
H Ultimate Medical Academy ..................................... 3
Veteran’s Health Adm/Careers ................................... 26
H Card Shop ................................................. 35
HCMA BULLETIN, Vol 59, No. 5 – January/February 2014

Service Ads - Business Cards size…The perfect advertising opportunity for companies such as your favorite transcriptionist, electrician, plumber, A/C repairman, automotive repair shop, lawn maintenance business, restuarant, or office cleaning crew. Contact Elke
Lubin, Managing Editor, at 813/253-0471, to find out how to place a business card ad.
HCMA
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HCMA BULLETIN, Vol 59, No. 5 – January/February 2014 35

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