Issuu

Volum e L X X IV, No . 4 • W in te r 2 0 1 7

Se r ving the Gr e ate r M e tr opolitan Knoxvi l l e Area

HOLIDAY ISSUE

FOLLOW UP -A DAY AT THE RACES, LEGISLATIVE DINNER, LMU’S GRILLIN’ AND CHILLIN’, & A SPECIAL HOLIDAY MESSAGE FROM ELISE DENNENY, MD

KAM KNOXVILLE ACADEMY OF MEDICINE

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Friday, April 27, 2018 6:30 pm Knoxville Marriott

KAPA’s Boot Scootin’ Ball is quickly becoming one of Knoxville’s most talked about charity events. The evening will be packed with great country music by Montgomery Gentry, line dancing, signature drinks, a stick to your bones mouth-watering western-themed dinner, and a variety of beers in your own bottomless souvenir glass. A large silent auction will complete this special event with all of the proceeds to benefit Knoxville Area Project Access (KAPA). The Boot Scootin’ Ball is a high-end event that requires casual attire--what could be better than that? For more info & tickets visit kapabootscootin.com or call (865) 531-2766

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MERRY CHRISTMAS

Academy Officers Neil Coleman, MD PRESIDENT

Tim Wilson, MD PRESIDENT ELECT

Daniel Bustamante, MD SECRETARY

Jeff Ollis, MD TREASURER

Thomas Pollard, MD

IMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees Michael Brunson, MD Brian Daley, MD David Harris, MD Zac Jumper, MD Ceeccy Yang, MD

Ex- Officio Board Members Richard Briggs, MD Debbie Christiansen, MD Randal Dabbs, MD Elise Denneny, MD Richard DePersio, MD Jerry Epps, MD Barbara Crist -KAMA Mike Maggart, MD Patrick McFarland, MD Robert Page, MD Max Keeling -LMU

Publisher Kim Weaver, PhD

Editor Jonathan Weaver

Production Coordinator

KAM KNOXVILLE ACADEMY OF MEDICINE

Merry Christmas and Happy New Year from the board and staff of the Knoxville Academy of Medicine!! This year has been a great year for KAM and we are excited to see what 2018 will bring for organized medicine here in East Tennessee! Here are just few of the highlights of 2017: • The KAM membership rolls hit an all-time high in 2017 and at press time we currently have 1271 Knox County members. As of November, 359 new members joined the KAM this year. • KAM leadership is continually evaluating membership benefits and has added a KAM Lump-Sum, Specialty-Specific, Disability Plan; a legal and identity theft plan through LegalShield, and a member discount with London and Amburn Associates, Attorneys at Law. Stay tune for more membership benefits! • KAM members successfully elected UT physician, Dr. Matt Mancini, to the position of TMA President-Elect. • Two KAM physicians, Drs. John W. Lacey and Clif Tennison received awards from TMA for their service in medicine. • Physician delegates from Region 7 (Knox, Blount, Roane, Anderson and Monroe) showed up in force at the 2017 TMA House of Delegates to effect improvements in the way medicine is practiced. • Knoxville Area Project Access (KAPA) reached over $210 million dollars in donated health care to help our neighbors in need. This was done by a network of over 1450

physicians, area hospitals and physicianextenders. • KAPA expanded services offered to lowincome, uninsured patients through a new pilot, KAPA Connects, which addresses the socio-economic barriers to good health. This project was funded by the Humana Foundation (KAPA received one of Humana’s largest grants awarded in the USA!) • KAM leadership is currently exploring the possibility of beginning a building program due to the increasing size of staff and a need to provide more space for physician functions. • KAM members are pleased to welcome Monroe County Medical Society to the area medical associations which our staff provides services. • KAM staff organized and hosted 24 special events for members not including board and committee meetings. • KAM members were pleased to welcome TMA President, Dr. Nita Shumaker, to Knoxville while she spent several days visiting local physicians to discuss opportunities to improve the health of all Tennesseans. While in East TN, Dr. Shumaker spoke to more than 400 medical students at LMU on addressing the opioid crisis in Tennessee (pictured below). If you have a colleague who is not currently a member of the Knoxville Academy of Medicine, please encourage him or her to join. We are better and stronger when physicians unite to improve patient care!

Margaret Maddox

Advertising David Caudill

ADVERTISING: For advertising information, call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be referred to in collateral advertising. The KAM

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reserves the right to accept or reject any advertising in the publication.

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ACADEMY NEWS New Members A big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine. JENNIFER LAIRD BRANTLEY, MD

BLAKE MOORE, MD

________________________________________________

GURPREET BULLEN, MD

WILLIAM OLIVER, MD

________________________________________________

MARC A. CAMPBELL, DO

MAYA RAIMAN, MD

________________________________________________

JENNIFER CASTELBUONO, MD

KELLY ROUSE, DO

________________________________________________

J. TRENT ELLENBURG, DO

AMAR PARIKH, MD

________________________________________________

PAUL HATCHER, MD

RHONDA SIVLEY, MD

________________________________________________

WILLIAM LINDSAY, MD

JOSEPH THURMAN, MD

OBSTETRICS AND GYNECOLOGY Contemporary Womenâ€™s Health PLLC 10031 Sherrill Blvd Knoxville, TN 37932

KAM

KNOXVILLE ACADEMY OF MEDICINE No Picture Available

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PEDIATRICS Shults Pediatrics 1225 E. Weisgarber Rd Ste N-200 Knoxville, TN 37909

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy. #U-109 Knoxville, TN 37920

PATHOLOGY, FORENSIC Knox County Regional Forensic Center 2761 Sullivan Street Knoxville, TN 37919

SURGICAL CRITICAL CARE University General Surgeons 1932 Alcoa Hwy. Bldg. C Suite 270 Knoxville, TN 37920

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy. #U-109 Knoxville, TN 37920

DERMATOLOGY Dermatology Associates of Knoxville 1928 Alcoa Hwy. Bldg. B Suite 209 Knoxville, TN 37920

INTERNAL MEDICINE Summit Medical Group 1225 E Weisgarber Rd Ste N-200 Knoxville, TN 37909

KNOXVILLE ACADEMY OF MEDICINE No Picture Available

PEDIATRIC ALLERGY Allergy and Asthma Affiliates 2121 Highland Ave Knoxville, TN 37916

UROLOGIC SURGERY University Urology 1932 Alcoa Hwy Ste C475 Knoxville, TN 37920

Left Column Top to Bottom: Jennifer Laird Brantley, MD; Gurpreet Bullen, MD; Marc A. Campbell, DO; Jennifer Castelbuono, MD; J. Trent Ellenburg, DO. Center Column Top to Bottom: Paul Hatcher, MD; William Lindsay, MD; Blake Moore, MD; William Oliver, MD; Maya Raiman, MD.

INTERNAL MEDICINE Summit Healthcare 1225 E. Weisgarber Rd Ste N-200 Knoxville, TN 37909

INTERNAL MEDICINE Summit Medical Group 1225 E Weisgarber Rd Ste N-200 Knoxville, TN 37909

CARDIOLOGY East Tennessee Heart Consultants 8975 Executive Park Dr, Ste 200 Knoxville, TN 37923

GENERAL SURGERY Premier Surgical Associates 1819 Clinch Avenue, Suite 200 Knoxville, TN 37916

Right Column Top to Bottom: Kelly Rouse, DO; Amar Parikh, MD; Rhonda Sivley, MD; Joseph Thurman, MD.

University Anesthesiologists

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Address: 1924 Alcoa Hwy U - 109 Knoxville, TN 37920

Phone: (865) 588-0880

KAM KNOXVILLE ACADEMY OF MEDICINE

Additionally, we would like to welcome the following new KAM Resident and Students Members: Residents: Dennis Van Dorp, MD Madeleine Garren, MD Robert Tonks, MD Students: Mary Alexander Mandy Alhajj Grant Allbritten Chinedu Amah Evan Amonett Alexandra Anderson Zachary Anderson Miranda Anderson Adnan Ansari Zara Ashraf Vidya Attaluri Jordan Austin Sandeep Bains Jordynn Baldwin Christopher Barron Andrew Barty Jesse Bell

Zachary Bondranko Michael Bridges Jesse Brookner James Brown Megan Bruinius Justin Buck Stanley Budzinski Sandra Bugariu Aaron Bush Katelyn Butler William Callicott Austin Carrier Jessica Case Johnny Cebak Anthony Cecchini John Chacko Lou-Ren Chang Steven Chapman Mafaz Choudhary Elizabeth Cipparrone Kasey Cook Mary Copeland Adam Crandell

Dustin Cundiff Dakota Dalton Gabe Davidson Matthew "Gabe" Davidson Lindsay Davis Warren Dean IV Allison Debusk Megan Dick James Dolbow Alec Donohue Trevor Elswick Theresa Ferguson Diane Fernandes Neal Fischer Alec Fletcher Benjamin Fogelson Justin Foreman Emily Friedl Ferrukh Ghavri Tiffany Gillion Rachel Gilson Jordan Glass Jonathan Go

Josephine Gomes Tatyana Gurina Luke Hall Kenneth Haynes Sean Hill Skyler Hill-Norby Justin Horner Chelsea Ingle Andrew James Katielynn Johnson James Luong Meghna Kataky Robert Kennedy Awab Khan Ian Kinder Scott Lallier Jordan Lee Marisela Loera Maryann Mahmood Melanie McCann Rachel McCoy Mary McDowell Christopher Medley Robert Minas Andreas Montano Matthew Moore Andrew Moser Wittmann Murphy Ali Naqvi Erin Nichols Oluwaseun Olusanya Ankita Patel Sejal Patel Krupa Patel Hardik Patel Darshan Patel Harshana Patel Joseph Perry

Azabelle Peters Tay Peters Linda Pham Victoria Pigg Sean Porter Deepa Ramaswamy Megan Rauch Randall Reagan Sara Reed Hassnain Rizvi Dakota Robertson Nicholas Roberts Zachary Robinson Noah Russell Kaywan Saed Michael Schoeller Sumaira Shakir Katyayini Sharma Corey Smith Kelcie Smith Abigail Sy Thomas Tchir Sheena Tran Henry Tsang Miranda Valleroy Stephanie Vass Krishna Vellanki Pascal Vo Irfan Vora Julie Vuu Abdul Ward Chin Wells Austin White Michael Wu Ali Yazback Jessika Young Xinyan Yu

Calendar of Events DECEMBER Monroe County Medical Society Holiday 1 Party, Club LeConte, 6:30 pm

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CME Saturday Blitz, Morrison’s Conference Center at UT Medical Center, 8 am

Blount County Medical Society Holiday Party, Calhoun’s on the River, 6:30 pm

Emeritus Club Christmas Luncheon, Naples Italian Restaurant, 11:30 am

Young Physicians’ Christmas Party, Main Event Entertainment, 6:30 pm

JANUARY Doc Rock for Health, The International 19

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ACADEMY NEWS Right out of the gateâ€Ś The KAM Keeneland trip never disappoints, and guests this year enjoyed it being on opening weekend! Thanks to our sponsor Capital Financial, KAM was able to provide an event that those in attendance will not soon forget. KAM members and their guests boarded a chartered bus and enjoyed muffins and mimosas as they earned 1 hour CME provided by Dale Amburn, JD with London and Amburn, Attorneys at Law on the way to Keeneland. Dale educated all on contract negotiations, a topic that everyone on the bus learned from. Upon arrival a buffet meal was provided in the private dining room that overlooked the paddock. Guests enjoyed the exclusive betting windows and strolling the grounds as the races continued throughout the day of the sold out event. On the return trip KAM members and their guests were served Panera boxed meals and refreshments as they enjoyed a movie and learned of some of the upcoming KAM events.

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ACADEMY NEWS Annual Legislative Dinner

KAM KNOXVILLE ACADEMY OF MEDICINE

This year’s Legislative Dinner was held at the Gettysvue Country Club and gave members an opportunity to speak with many of the area legislators including: Senator Becky Duncan Massey, Representatives Roger Kane, John Ragan, Eddie Smith and Martin Daniel. The legislators expressed their gratitude for a community of experts that they can rely on as they review legislation. KAM members heard from Dr. Elise Denneny who sits on the TMA Legislative Committee as she spoke of some of the items that could be impacting the house of medicine this year. Local physician and TMA President Elect, Dr. Matthew Mancini, also spoke regarding Episodes of Care for which he will be addressing throughout his TMA Presidency next year. The importance of being a part of organized medicine was something that was repeated throughout the evening. We look forward to attending the “Day on the Hill” event that will take place on Tuesday March 6, 2018 and encourage all our members to mark their calendars and plan on joining us on the bus trip to Nashville!

LMU Medical Students Grillin’ and Chillin’ Many medical students enjoyed some time together as they kicked off the academic year with Grillin’ and Chillin’. LMU Knoxville Academy of Medicine student members came together at the University Club for hamburgers and hot dogs and some great fellowship as they settled in to campus life. Capital Financial sponsored the evening’s event to welcome the students back to a new year at LMU. The current LMU AMA-MSS chapter President, Max Keeling, along with many members of his board were present to get to know the students and encourage them to join and take an active role in organized medicine.

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ACADEMY NEWS It’s the holiday season! I am reminded of a simple common theme celebrated by all the winter holidays and customs... we celebrate being there for each other....as families... as colleagues. Despite the egregious intrusions into the practice of medicine we are still blessed by sharing its intellectual curiosity and goal of curing patients. Despite physician burnout threatening escalating retirement we enjoy collegiality and shared care of patients. I wish for each of you the following this holiday season: Happy Holidays and a healthy prosperous New Year! Elise Denneny, MD

Twelve exponentially decreased EHR mouse clicks, Eleven rolled back episodes of care, Ten approved prior authorization, Nine protected OR block times, Eight less bureaucratic tasks per clinic, Seven more grants for health care research, Six less MIPS measures, Five gold star ratings, Four successful claw back appeals, Three days per week to exercise, Two hours daily quality family time, One physician led team based health care model

KAPA Expand Services through KAPA Connects Since the Knoxville Academy of Medicine Foundation first introduced Knoxville Area Project Access (KAPA), the program has successfully served as the health care safety net for our community, coordinating vital medical services for over 22,000 low-income, uninsured residents in Knox County. KAPA’s extensive volunteer network of over 1,450 physicians, physician extenders, and all Knox area hospitals have donated an estimated $210 million dollars in healthcare services to those in need. Last year alone, KAPA coordinated over 45,000 medical encounters for its patient base. Over the years, our case managers and staff have documented the many socioeconomic barriers that influence the healthcare of our patients. Barriers such as access to food and proper nutrition, housing, transportation and health literacy lay the foundation for good health. As a result of these barriers, KAPA Connects, a pilot funded by the Humana Foundation, was recently launched and has been growing exponentially. KAPA Connects expands the health care services already offered by our network of physicians and hospitals to include social service agencies that can address other 8

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barriers to good health. Additionally, the program uses volunteers to act as Community Connectors to refer individuals to KAPA for services. To date, over 60 volunteers have been trained as Community Care Connectors. An important component of the program is provided through etHIN, as these interventions will be documented in the medical record, giving physicians access to barriers addressed. The synergy of expansion of KAPA services can be felt when reading this synopsis of a conversation between one of our Case Managers and a patient; a reflection of many such daily interactions: KAPA has been the “biggest blessing [they’ve had] for over six years”. Their household was one that fell through the cracks of being able to qualify for Indigent care and federal assistance. KAPA was the only agency that didn’t tell them “We can’t help you.” They were also able to receive additional food assistance and medical education through KAPA and had food delivered free from FISH’s delivery program the same day it was requested. They graciously thanked the staff at KAPA: “Bless you people.” We would like to extend those blessings on to all of those who offer up their time, expertise, and financial assistance to make KAPA possible. Thank you!

KAM Opioid Epidemic Update

By: Patrick McFarland, MD Resident Physician, PGY-4 Department of Anesthesiology University of Tennessee Graduate School of Medicine As the opioid epidemic wreaks havoc across the country, Tennessee remains a top offender, and the numbers are rising. The Tennessee Department of Health recently released data from 2016, showing a state record of 1,631 Tennesseans died from overdoses last year, a 12% increase from 2015.1 This number equates to 4.5 deaths per day due to opioids, over 30 deaths per week. Although the number of deaths reached a record high, the rate of increase is lower than in years past, giving hope to optimists across the state. Hardly a new problem, this epidemic is decades in the making, and most numbers are not as encouraging. Fentanyl overdose deaths jumped 74% in 2016, with the biggest increase in those aged 25-34 years old.1 Heroin abuse is also up 26%, suggesting users may be turning to recreational drugs as the clamp tightens on prescription medications.1 Overall, most overdose deaths involve a combination of substances, as demonstrated by increases in methamphetamine, benzodiazepine, and buprenorphine overdoses as well. The increasing appearance of fentanyl in these overdoses remains a focal point of this epidemic, and deserves special attention. Fifty to one hundred times more potent than morphine; fentanyl is a powerful synthetic opioid capable of rapidly inducing life-threatening respiratory depression, particularly when counterfeit and mixed with other substances. In 2015, the Tennessee Bureau of Investigation seized what they thought was prescription oxycodone, complete with pill signature stamps; however, analysis indicated the pills were counterfeit, not containing oxycodone, but fentanyl.2 Yikes. Furthermore, the Tennessee Department of Health released an advisory earlier this year after a study showed fentanyl was present in 89% of seized counterfeit medications.2 Even carfentanil, a more potent analogue of fentanyl seen used in ele-

Patients for Fair Compensation Has Been Defeated

A three-year push by an out-of-state group to dismantle Tennessee’s medical liability system has ended. Since 2015 a Georgia-based group called Patients for Fair Compensation has lobbied the Tennessee General Assembly to shift physician liability cases from the civil court system to a government-run administrative system. The proposal was strongly opposed by physicians across the state. TMA worked with medical malpractice insurance carrier State Volunteer Mutual Insurance Company and others in the medical community to convince lawmakers that Tennessee’s current system is working well and needs no reform. “The Patients for Fair Compensation proposal would have adversely affected our healthcare system without any guaranteed benefits,” said Nita W. Shumaker, MD, a Chattanooga pediatrician and 2017-2018 TMA President. “We are relieved that this unproven concept will not

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KNOXVILLE ACADEMY OF MEDICINE

phants, has been isolated in these recreational drug combinations. This is an ominous, and deadly, trend. How can we reverse these developments? While awareness is a good start, strong, collaborative efforts are needed. The United States Department of Health and Human Services has announced $485 million in grants to help states combat opioid addiction.3 Ideally, these grants will help support research for decreasing opioid use and increasing patient access to multimodal and multidisciplinary pain management. Considering 70% of opioid abusers obtain them from family and friends, enhancing education on safe and effective opioid prescribing practices seems prudent, as well as increasing the availability of naloxone, the opioid antidote.3 Similarly, encouraging safe storage and disposal of opioid medication remains paramount. Professional societies recommend, in addition to the above, making “take back” programs and drop boxes more available.3 Tennessee currently has the “Count It! Lock It! Drop It!” program, originally developed by the Coffee County Anti-Drug Coalition, to help achieve this aim. These recommendations are a good place to start; however, for those hoping to curb this lethal epidemic, I say we can do more. We can address rural access to care, where most overdoses occur. We can better address addiction and mental health. Regardless, as the data shows, we must strengthen our efforts in combating this terrible disease. 1. Tennessee Department of Health. “Increasing Number of Tennesseans Dying from Drug Overdoses.” 18 September 2017. <www. tn.gov/health/news/53332>. 2. Fentanyl Public Health Advisory. TN Dept of Health. TN Dept of Mental Health and Substance Abuse Services. TN Dept of Safety and Homeland Security. Accessed 17 October 2017. <www.tn.gov/ health/article/health-advisories>. 3. Strategies to Address the Opioid Epidemic in the United States. American Society of Anesthesiologists. Accessed 17 October 2017. <www.asahq.org/advocacy/federal-activities>. be tested in Tennessee and applaud our legislature for its common sense response to the debate. Tennessee should not be a trial balloon state for any exploratory program that directly affects our doctors and patients.” Doctors successfully raised fundamental concerns about verifying proponents’ claims that their plan would save the state money, and preserving medical liability insurance in the event a patient compensation system did not work. The opposition could not resolve fundamental issues, and Patients for Fair Compensation has stated that it does not plan to introduce any related bills in the 2018 legislative session. TMA and SVMIC were instrumental in tort reforms enacted in 2008 and 2011 that have resulted in a 40% drop in volume of health care liability cases filed against physicians and a 37% drop in claims as a result of cases against physicians. A favorable medical liability climate is one of the many reasons why Tennessee has been named as one of the best places to practice medicine. Preserving tort reforms is critical to attracting and retaining the best physicians who help provide access to safe, quality healthcare in the state.

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LEGAL NEWS

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MIPS Score Will Follow Providers Performance By: Luke Ihnen, London & Amburn, P.C.

A lesser-known provision of the Medicare Access and CHIP Reauthorization Act (“MACRA”) will have major implications for physicians and practices in the future. Under the Quality Payment Program, eligible physicians must choose to participate in the Merit-Based Incentive Payment System (“MIPS”) or an Advanced Alternative Payment Model (“APM”). Both programs impact Medicare payments to physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified nurse anesthetists. MIPS is the default payment system for providers billing Medicare Part B and requires providers to submit data on four performance categories: Quality, Cost, Improvement Activities, and Advancing Care Information. Each provider will receive a MIPS “score” that will affect their Medicare payments in a future year. Data submitted for the performance year 2017 will affect payments in 2019. MIPS scores are applied at the individual National Provider Identifier (“NPI”) regardless of whether group or individual data are submitted. As result, the practice employing the provider in the payment year must accept the provider’s payment adjustment based on their MIPS score from the performance year, whether at the same practice or a new one. The result is that performance this year (2017) will follow the provider to a new practice and affect their payments in 2019. Consider the following example from the Final Rule: If a MIPS eligible clinician worked in one practice (A) in the performance period, but is working at a new practice (B) during the

payment year, then we would use the final score for the old practice (A/NPI) to apply the MIPS payment adjustment for the NPI in the new practice (B/NPI). The rational is two-fold. According to CMS, some practices will have providers that do not qualify for MIPS and some that do, and the NPI is the only way to track individual provider performance because each NPI is unique and is expected to remain unchanged, even where a provider leaves a practice. Secondly, the goal of MACRA is to track provider performance and ensure accountability. According to CMS, the NPI is the only way to tie performance to an individual provider. CMS believes that applying MIPS scores to an individual NPI “most closely” links a provider’s performance to the MIPS payment adjustment. It ensures that providers that qualify for a positive payment adjustment are able to keep it even if they change practices. For providers that will receive a negative adjustment, it is way to ensure accountability. The provision could have far-reaching ramifications to the employment of providers and acquisition of practice groups. Practices should make a provider’s 2017 MIPS performance a topic of discussion during the hiring process or transaction, and should consider protecting against a possible negative adjustment by inserting language in the employment or purchase agreement. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

Blount County Medical Society Quarterly Update By: Jerome Heiny, MD This year has gone by fast. I was very appreciative of TMA president Dr.Nita Shumacker visiting our society in September and presenting an update on the opioid crisis in the state of Tennessee. This was very timely and informative. On December 5, we will have our annual holiday dinner for members and guests. This year we will be holding the event at Calhoun’s on the River in Knoxville. Our guest speaker

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will be Sam Venable. Mr. Venable has spoken to our society in the past. I am sure his talk will be very entertaining. It has been my honor to serve as your president for the last 2 years. At our December dinner we will also have our annual election. Positions up for election include president and 2 delegates to the TMA house delegates. The president serves as the third delegate. I hope everybody has a happy and safe holiday season.

KNOXVILLE MED CINE | 11

KAM KNOXVILLE ACADEMY OF MEDICINE www.knoxvillemedicine.org

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KAMA CORNER By: Tina Callicutt KAMA President, 2017-2018 Hello KAM friends! The Knoxville Academy of Medicine Alliance is having an amazing start to the year. We already have two meetings behind us including our October breast cancer centered meeting at Tennova North. Dr. Vinsant gave an enlightening presentation on breast cancer through a surgical view. We have also completed one of our major fundraisers, Fashiondrama, which met all of our set goals for this event. We have been lucky to receive multiple grants that have helped our fight against opioid abuse. We also enjoyed a fun-filled membership event at Maple Hall bowling. It is so hard to believe that we have been able to accomplish so much in such a short time. As the holidays approach, I would like to reflect on how thankful I am to be a part of this organization filled with such incredible people. KAMA is thankful as well to have a great partner in KAM. We are blessed to have this medical community in Knoxville that has such a heart for service. Not only do we all support one another, but we have a key role in both the health and enrichment of our community. On a lighter note, we are thankful for a hardworking Doc Rock committee who is working on creating another spectacular fundraiser this January 19th at the International. The

Tina Callicutt, KAMA President

committee is hoping for the best Doc Rock yet! We are so thankful for all of our committee leaders that take time out of their lives to make KAMA what it is. As we are around our Thanksgiving tables, let us all reflect on how fortunate we all are. With Christmas coming, we are reminded how happy we feel in giving and with the fellowship of the season. The act of giving fills us with tremendous joy, and not only is that what the holiday season embodies but our organizations as well. We have the great pleasure of being with our colleagues and friends while working to give to our local communities. We also reflect on the year and its ups and downs while planning for our upcoming year. My favorite holiday movie is It’s a Wonderful Life. The quote at the end of the movie is something like this “No man is a failure who has friends.” I absolutely love this quote for many reasons. When we are a friend to one another, our toughest times aren’t so tough, and our good times are even more special. As organizations, we are friends to each other and our community, so we will always be a success. If you would like any information about KAMA, please check our website, kamalliance.org, and our Facebook page: Knoxville Academy of Medicine Alliance. Soon to come Instagram! Happy Holidays!

Jenny Bushkell

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Delay Delay plays plays rightright into into the IRS's the IRS's hands. hands. January January 1, 2017, 1, 2017 ma months months away. away. TheThe clock clock is ticking. is ticking. Of course, Of course, therethere is a chance is a chance thatt immediately immediately sincesince the IRS the IRS will will holdhold a public a public hearing hearing and and there's there's at l delay delay worth worth the risk? the risk? My answer My answer is “no.” is “no.” Implementing Implementing a plan a plan now discounts discounts and and using using the current the current $5.45M $5.45M exemption exemption is the is best the best option op

Everyone needs protection what you don’t know can hurt you Philip Philip J. Bryce, J. Bryce, P.C. P.C.

We are We available are available to assist to assist youryour clients clients withwith the immediate the immedia im Remember, Remember, Godhave God gave gave you assets you assets as a blessing, as a blessing, don’t don’t lose current current law. law. If you If you have clients clients or prospective or prospective clients clients that that arelose motiv are m them them tosteps Satan’s to Satan’s minions, also also mayyour may be attorneys! be attorneys! discuss discuss the steps the you you need need tominions, take towho take to who protect to protect your client's client's wealth. wealth Sincerely, Sincerely,

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PhilPhil Bryce Bryce (phil@brycelawof�ces.com) Mr.voted Bryce was voted best in : Mr. (phil@brycelawof�ces.com) Bryce Mr. Bryce was was voted best best in Estate in Estate Planning/ Planning/

Planning/ Trustsfor: Wills/ Trusts Trusts and Income andEstate Income Tax/IRS Tax/IRS Resolutions Resolutions for Probate : Income Tax/IRS Cityview’s Cityview’s Top Attorneys Top Attorneys for 2015 for 2015 & 2016 & 2016

When When youyou leave leave your your house, house, do do youyou locklock your your doors? doors?

Resolutions : Elder law

Certifications Certifications of Specialization of Specialization are available are available to Tennessee to Tennessee lawyers lawyers in all areas in all areas of praco

Trial, Business Trial, Business Bankruptcy, Bankruptcy, Consumer Consumer Bankruptcy, Bankruptcy, Creditor’s Creditor’s Rights,Rights, Medical Medical Malpractic Malp

Planning Planning and Family and Family Law. Listing Law. Listing of related of related or included or included practice practice areas areas hereinherein does not does con

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Everyone needs to protect their assets Tennessee is One of the Top States for Asset Protection Trusts!! Do you have anything that if you lost it, you would cry, “Ouch!” or something worse?

Do you own a house? Rental properties? Do you drive a car? Do your children drive? Do you have a business or income stream? Do you have investments other than 401k’s, IRA’s, etc.? Contact my office for a free brochure and to find out when my next free seminar is to be given

Law Offices of Philip J. Bryce, P.C

865-690-5566

Phil@brycelawoffices.com V.A. Accredited Attorney Remember, God gave you assets as a blessing, don’t lose them to Satan’s minions, who also may be attorneys!