March/April 2012

The 

Bulletin 

OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCIATION 

March/April 2012

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HCMA BULLETIN, Vol. 57, No. 6 – March/April 2012 3

Bulletin 

The 

OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCIATION 

Executive Council 

Mathis Becker, MD, President 

William Davison, MD 

President Elect 

Christopher Pittman, MD 

Vice President 

Malcolm Root, MD, Treasurer 

David Lubin, MD 

Secretary 

Kenneth Louis, MD 

Chm/Brd of Trustees 

& Imm. Past President 

Husain Nagamia, MD 

Dist. 1 (2012) 

Martha Price, MD 

Dist. 2 (2013) 

Anthony Pidala, MD 

Dist. 3 (2012) 

Jose Jimenez, MD 

Dist. 4 (2013) 

Stanley Dennison, MD 

At Large (2013) 9 

Kimberly McIlwain-Smith, MD 

At Large (2013) 

Pamela Baines, MD 

At Large (2012) 

Devanand Mangar, MD 


Joe Whitaker, MD 


Catherine Lynch, MD 

USF Dist. (2013) 

Dominic Castellano, MD 

Young Phys (2011) 

Blanca Crespo, Alliance President 

*Krishan Batra, MD, FAPI 

*Fred Bearison, MD 

Board of Medicine 

*Brad Bjornstad, MD 

Board of Censors 

*Jill Hechtman, MD 

Women Phys. Rep. 

*Richard Hodges, MD 


*Douglas Holt, MD 

Health Dept. Rep. 

*Stephen Klasko, MD 

USF COM Dean 

*Stephen Kreitzer, MD 


*Rakesh Kumar, MD, FAPI 

*Karon LoCicero, MD, 


*Nishit Patel, MD, 

Resident Phys. Rep. 

*Michael Perrone, Medical Student 

*Enrique Urrutia, MD, TBLAMS 

*Zach Wetendorf, Medical Student 

(* = ex-officio representatives) 

Board of Trustees 

Kenneth Louis, MD, Chairman (2015) 

Malcolm Root, MD, Treasurer 

Mathis Becker, MD, President 

William Davison, MD, President Elect 

John Curran, MD, (2013) 

Michael Wasylik, MD, (2014) 

Humberto Coto, MD, (2014) 

Bruce Shephard, MD, (2015) 

Editor 

David Lubin, MD 

Editorial Board 

Loren Bartels, 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 Hillsborough 

County Medical Association, 

Inc., 606 S. Boulevard, 

Tampa, Florida 33606. 

Advertising in The Bulletin 

does not imply approval or 

endorsement by the Hillsborough 

County Medical 

Association. 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. 

Executive Council Meeting 

6:00 PM @ the HCMA Office 

May 22, 2012 

General Membership 

Dinner Meeting 

May 1, 2012 

HCMA President Installed 

& Election Results 

Intercontinental Hotel 

(see page 8 for details) 

ADVERTISING 

The Card Shop .............................................42 

Classified Ads................................................41 

Index of Display Ads.....................................26 

Full Page Advertisers...................................41 

GOT SOMETHING TO SAY? 

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 

4 HCMA BULLETIN, Vol. 57, No. 6 – March/April 2012

The Bulletin: March/April 2012 

ABOUT THE COVER 

This month’s cover photograph was taken by HCMA Executive Director, 

Debbie Zorian, while she was visiting the Museum of Fine Arts in Boston…her 

first experience seeing a Chihuly exhibit. 

Over the course of his career, Dale Chihuly has revolutionized the art of blown 

glass, moving into the realm of large-scale sculpture and establishing the use of 

glass as a vehicle for installation and environmental art. This exhibition of new 

and archival works represents the breadth and scope of the artist’s creative vision 

over the last four decades. 

The beautiful display was shot with a simple Canon point and shoot camera. 

FEATURES 

President’s Message ....................................7-8 

Times Flies 

Mathis Becker, M.D. 

Editor’s Page ...........................................11-12 

Hey, listen up! 

David Lubin, M.D. 

Executive Director’s Desk.......................13-14 

Coping with Suicide 

Debbie Zorian 

2012 Florida Legislative Session............15-16 

FMA Legislative Summary 

Neal Dunn, M.D., FMA Chairman on 

Legislation 

Restaurant Review..................................17-18 

Carmel Café – 

First Links in a Chain 

Taste Bud 

Medical/Legal Update..........................21 & 24 

Physician Owned 

Distributorships Make Waves 

Jeff Cohen, Esq. 

Practitioners’ Corner..............................25-26 

Traumatic Brain Injury: 

The Diagnosis Du Jour 

Reed Murtagh, M.D. & 

Ryan Murtagh, M.D. 

Alliance News ...............................................29 

Alliance on Heart Disease 

Awareness Month 

Blanca Crespo, MPH, Alliance President 

Board of Medicine Update......................30-31 

What’s New with the Florida 

Board of Medicine… 

Crystal A. Sanford 

PHOTO GALLERY 

February Dinner Meeting.......................24-25 

January/February Photo Contest Winners..40 

March/April Photo Contest..........................40 

COMMITTEE HAPPENINGS 

Nominating Committee.................................9 

Proposed Ballot & Announcements 

Executive Council ...............................27 & 29 

Meeting Highlights – 1/17/12 

FOR YOUR INFORMATION 

CME, Seminars, Workshops, & 

Conferences.........................................39-40 

Medical Briefs .........................................32-35 

New Members...............................................31 

Personal News.........................................36-37 


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Time 

Flies 

My year as your president will close out on 

May 1 with the installation of Dr. Bill 

Davison as our new HCMA leader. 

It's been a fast moving year, with much still in 

progress that I look forward to working with Dr. 

Davison to continue to move forward. Most 

notable is our ongoing effort to identify the 

issues that affect the ebb and flow of our membership 

numbers. Looking ahead to the changing 

demographics of our physician workforce 

(more employed physicians, whether in group 

practices or hospital owned; more women physicians 

often with competing commitments-medicine, 

child rearing; more part time physicians; a 

new generation of physicians seeking a better 

balance between their physician responsibilities 

and their quality of life), medical organizations 

will need to position themselves to be of value to 

the changing physician workforce. This need is 

obvious for a membership dues supported organization. 

To that end, we must reach out to 

those groups for their input if we are to understand 

what our future HCMA must offer to be of 

value in meeting organizational goals of our next 

generation(s) of physicians. 

Looking to provide “value added” programs 

that solidify membership, we are in the midst of 

developing our group insurance plan, participation 

in which requires ongoing HCMA membership. 

The response to this program has been 

excellent to date. We have begun what have been 

productive conversations in developing a Health 

Information Exchange (HIE), a fundamental 

requirement as the nation moves toward the ultimate 

goal of more efficient, cost effective use of 

the electronic health record (EHR/EMR). Again, 

a value added benefit of HCMA membership will 

be a reduced fee for any HCMA member participating 

in the sponsored HIE. 

As part of our effort to achieve greater visibility 

for the HCMA in our community, consideration 

is being given to the HCMA taking a more 

active role in local government health related 

issues. In response to a request for support by 

County Commissioner Kevin Buckner, your 

Executive Council voted to support a 

Hillsborough County ordinance aimed at clamping 

down on Personal Injury Protection (PIP) 

fraud, our county having become the center of 

the country for such fraud resulting from staged 

accidents. The ordinance passed unanimously. 

Similar legislation is being addressed in the 

Florida Legislature. 

In collaboration with the USF Morsani College 

of Medicine, College of Nursing, and College of 

Public Health, we are embarking on further collaborating 

with local interest groups to pursue a 

county ordinance intended to alert pregnant 

women to the potentially serious health hazards 

that alcohol consumption during pregnancy can 

cause, most notably, fetal alcohol syndrome. 

Your Executive Council voted to share its concern 

with the leadership and Board of the Florida 

Medical Association regarding the FMA’s decision 

to support legislation expanding the scope of 

practice for optometrists, thereby abandoning 

our profession’s long held opposition to the 

expansion of scope of practice by non-MD/DOs. 

We must continue to adhere to the basic principle 

that any individual who wants to practice 

medicine must complete the necessary pre-med 

requirements and be admitted to and successfully 

complete medical school and residency training. 

Then, and only then, can an individual contend 

that they are qualified to take on the serious 

responsibilities of caring for patients. 

Life would certainly be quite boring if we 

didn’t find ourselves facing new challenges. 

Certainly our profession faces unending challenges 

as we strive to provide the best care for 

our patients. We’ve been trained to deal with 

such challenges and we need to continue to train 

to become even better at what we do. What we 

haven’t been trained to do is deal with the ongoing 

challenges the government and other entities 

put on our platter. These are the challenges we 

look to our medical organizations and their collective 

expertise to take action on. It is incumbent 

upon each of us to understand that in the 

absence of the efforts of organized medicine, 

(continued) 

President’s Message 

Mathis 

Becker, M.D. 

mbecker1@health.usf.edu 


President’s Message (con’t.) 

often with certain positions we cannot all agree on, we 

will have no profession. Rather, we will become amalgamated 

into the pool of that new group increasingly 

referred to as “health care providers” sharing resources 

for our patients’ needs with the optometrists, chiropractors, 

podiatrists, naturopaths, massage therapists, 

and others, all of whom would have you believe they are 

better at doing what we have been so rigorously trained 

to do. 

Being recognized as the outstanding county medical 

organization it is, there are several individuals you must 

understand are devoted to making the HCMA the best it 

can possibly be. Our Executive Director, Debbie Zorian 

and her support staff Elke Johnston-Lubin, Martha 

Brooks and Kay Mills make it happen. Your Executive 

Council and Board of Trustees devote countless hours to 

the decision-making process that drives our goals. 

(Thank goodness for the Papa John’s pizza that nourishes 

us in the process.) We enthusiastically support 

our medical students as they learn about and get 

involved in our role as advocates for our profession and 

patients’ best interests and the health of our community. 

I marvel at the time and energy they find as they 

pursue their formal studies, while anxious to “learn the 

ropes” as future leaders for our profession. 

I look forward to continued participation in our 

HCMA and sincerely thank you for the privilege of having 

served our membership. In closing, I urge each of 

you to strongly consider active participation in our 

committees and activities and plead with you to encourage 

your non-member colleagues to join us at the 

HCMA as we diligently work to represent our profession. 

P.S. I almost forgot to mention the fantastic job Dr. 

David Lubin does in shepherding production of The 

Bulletin and his enviable patience in putting up 

with my tardiness in getting my President’s 

Message in by deadline. 

YOU ARE CORDIALLY INVITED! 

HILLSBOROUGH COUNTY MEDICAL ASSOCIATION’S 

ANNUAL INSTALLATION DINNER MEETING 

William Davison, M.D. 

will be installed as HCMA’s 2012-2013 President 

Tuesday, May 1, 2012 

InterContinental Hotel 

4860 W. Kennedy Boulevard 

(At the corner of Westshore and Kennedy Blvds – Tampa) 

Special Guest Speaker: 

Peter W. Carmel, M.D., President, 

American Medical Association 

6:00pm ~ Social Hour 

7:00pm ~ Dinner & Program 

To make reservations please contact Kay Mills at 813-253-0471 or email kmills@hcma.net. 

Guests: $35.00 

William Davison, M.D. 

HCMA President Elect 

Peter W. Carmel, M.D. 

AMA President 

Sponsored by: 

The Bank of Tampa 

Blue Cross Blue Shield of Florida 

HCMA Health Plan 

H. Lee Moffitt Cancer Center & Research Institute 

*All vegetarian meal requests & dinner cancellations must be received by April 26, 2012 



NOMINATING COMMITTEE REPORT 

2012 HCMA ELECTION OF OFFICERS & REPRESENTATIVES 

PROPOSED BALLOT & ANNOUNCEMENT 

THIS IS NOT YOUR BALLOT. ALL ACTIVE, AFFILIATE, LIFE, AND RETIRED PAST PRESIDENTS, 

WHO HAVE PAID THEIR 2012 HCMA DUES IN FULL, ARE ELIGIBLE TO VOTE AND WILL RECEIVE 

AN OFFICIAL BALLOT BY MAIL. 

The Nominating Committee of the Hillsborough County Medical Association has placed in nomination the following candidates 

for the 2012 election. Official ballots will be mailed by April 1st and winners will be announced at the May 1st 

Installation Dinner meeting (watch your mail for further information). In accordance with the By-Laws, any voting member 

has the right to make additional nominations for all offices, provided that he or she delivers to the Secretary of the 

Association at least 31 days prior to the Annual Membership Meeting, a written statement indicating the intention to nominate 

one or more additional persons with the signatures attached thereto of each intended nominee and at least 10% of the 

voting members of the Association. 

Respectfully Submitted, 

The Nominating Committee 

************************************************************************************************** 

EXECUTIVE COUNCIL/AT LARGE (2 yr. term) 

(vote for THREE) 

Dr. Colin Beach Dr. David Mason 

Dr. Antony Pidala Dr. Barbara Sanford 

Dr. Jason Wilson 

EXECUTIVE COUNCIL/District 3 (2 yr. term) 

(vote for ONE) 

Dr. Lori Slezak Dr. Stephen Szabo 

THE MEMBERS BELOW WILL SERVE THE HCMA 

IN THE FOLLOWING CAPACITIES: 

PRESIDENT-ELECT VICE-PRESIDENT SECRETARY TREASURER 

Dr. Christopher Pittman Dr. Devanand Mangar Dr. David Lubin Dr. Malcolm Root 

EXECUTIVE COUNCIL 

District 1 (2 yr. term) 

Dr. Husain Nagamia 

BOARD OF CENSORS (3 yr. term) 

Dr. Edward Farrior 

Dr. Deborah Trehy 

HILLPAC BOARD OF DIRECTORS 

(2 yr term: 1/1/13-12/31/14) 

Dr. William Davison Dr. Jose Jimenez Dr. Christopher Pittman 

Dr. Edward Homan Dr. Frank Mastandrea Dr. Michael Wasylik 

DELEGATES TO THE FMA (3 yr. term): 

Dr. Dennis Agliano Dr. Husain Nagamia Dr. Lori Slezak 

Dr. David Halpern Dr. Christopher Pittman Dr. Stephen Szabo 

Dr. Catherine Lynch Dr. Martha Price Dr. Deborah Trehy 

Dr. Devanand Mangar Dr. Malcolm Root Dr. Mark Vaaler 

Dr. David Mason Dr. Barbara Sanford Dr. Mani Vindhya 

Dr. Frank Mastandrea Dr. Bruce Shephard Dr. Jason Wilson 



PROVIDER 



Hey, 

listen up! 

In case you missed it, or even if you were 

there, the February dinner meeting of the 

HCMA was the fourth installment of the “USF 

medical students attempt to answer some questions 

and get a feel of what medicine is REALLY 

like.” With all due respect to Art Linkletter, the 

first installment 4 years ago was entitled “Med 

students say the darnedest things.” And you 

know what? They still do. 

I’m actually in awe of the USF medical students. 

They’re bright, good-looking, knowledgeable 

about the politics of medicine, and just good 

well-rounded kids, albeit they tend to chatter a 

bit much at dinner meetings. 

Med school is a LOT different 

today than it was 40 

years ago. My chairman of 

the cardiology department 

at Tulane, the renown 

George Burch, used to say, 

“Let the patient talk and 

90% of the time they’ll 

give you the diagnosis.” 

That quote was actually 

paraphrased from Dr. 

William Osler, the 

Canadian pathologist who 

was one of 4 founding 

physicians at Johns 

Hopkins and often considered the Father of 

Modern Medicine. 

Members of the HCMA were asked to submit 

questions for a panel of 4 students, one from 

each class. Mine wasn’t chosen; more on that 

later. The students were given the questions in 

advance and could research data to aid in discussing 

their answers. The problem was, the 

questions were rather complex for the most part 

and not within the purview of some of the students. 

The students were given 4 minutes each to 

discuss their answers. Unfortunately, many of the 

answers sounded similar to those of politicians 

answering questions in debates, that is, just 

somehow not focusing on the answer. The first 

question dealt with the possibility of discharging 

patients from a practice if the patients chose to 

“ignore advice” or were “difficult.” 

This is something that a med student cannot 

possibly answer, but only surmise. It can’t be 

taught in medical school; it’s a lesson to be 

learned along the way. I’ve discharged patients 

over my 35 years in practice due to non-compliance, 

clash of personalities, and of course, over 

office policies that they might not like. 

Sometimes it’s not an easy thing to do. I often 

feel that doctors should be able to put difficult 

patients on waivers. I’ll take your two difficult 

hypertensives for my one non-compliant 

diabetic. Maybe the change would help everyone 

involved. 

Other questions were similar, I thought, as 

just being outside the scope of the students’ 

grasp of medicine. The 

second question involved 

the use of extended 

providers, nurse practitioners 

and physician 

assistants. How could a 

med student, just barely 

starting his medical education, 

possibly have an 

educated answer when 

those of us in organized 

medicine are still debating 

the issue? 

The third question 

asked of them was what 

they thought about young physicians accepting 

employment in Government, insurance companies, 

or hospitals…those entities that those of us 

in organized medicine seem to be battling on a 

daily basis. I don’t think that young doctors are 

accepting those positions as often as those who 

have been in practice for years and have finally 

given up and joined the “enemy.” A good salary 

without the management hassles can be very 

inviting. 

The fourth, and final, question was a no-brainer: 

“Are future doctors willing to accept a salary 

of $60,000 to insure that all Americans receive 

healthcare regardless of their ability to pay?” It 

didn’t really matter what any of the students 

THOUGHT. As Dr. William Davison stated in the 

discussion, a salary of $60K was never going to 

be a reality. 

(continued) 

Editor’s Page 

David 

Lubin, M.D. 

Dajalu@aol.com 


Editor’s Page (continued) 

Today’s med students can look forward to the ability 

to diagnose patients with the most sophisticated technology 

available. When I started practice, CT and MRI 

scanners were in their infancy; today ultrasound 

machines are handheld at the bedside. We can gaze into 

our patients’ anatomy and make a diagnosis with only 

asking a chief complaint. But those demanding us to use 

EHR’s expect extended histories: past, family, social, etc., 

and record every detail. I still think we’d do better, as Dr. 

Osler said: just LISTEN to the patient to make the diagnosis. 

It’s been reported in previous studies that doctors 

interrupt patients within about 20 seconds. It’s no wonder 

patients complain that we don’t listen to them. 

The fifth and final question never made it to the floor. 

“What is one thing you would change about medicine 

today?” That’s one I really would like to have heard and 

discussed. My question never was considered: “What 

would you say to a patient as you took a history, while 

typing away on your computer next to the patient, and 

the patient asked you if you were really paying attention 

to what he said?” It seems to me that typing while taking 

a history, making corrections, etc., is analogous to 

texting while driving, just more or less a distraction to 

what’s going on. 

I think the current format has “jumped the shark,” a 

term familiar in the TV industry, meaning it “was once 

great (and) has reached a point where it will now decline 

in quality and popularity.” If we’re going to continue the 

student panel, then maybe we could change it to a different 

type of platform. The students could answer the 

questions how they THINK medicine is or should be, 

and then those of us who have been around awhile can 

counterpoint with how it REALLY is. Some of us have 

been there and done that. 

As Dr. Osler also said, “Medicine is learned by the bedside 

and not in the classroom. Let not your conceptions 

of disease come from words heard in the lecture room or 

read from the book. See, and then reason and compare 

and control. But see first.” 

And maybe just listen a bit more. 

Discount for HCMA members 

$49.95 per person 

Call Don Juceam at 813-600-3134 

to order tickets 

Questions about your 

HCMA membership? 

We have the answers… 

813.253.0471 

We Want to Hear from YOU! 

The HCMA Benefit Provider Program provides value to physicians with products, programs, and services that, when utilized, 

far exceeds the cost of annual dues. Discounted services available through the Benefit Provider Program include medical 

malpractice insurance, office supplies, document shredding, retirement plans, and banking services, to mention only a 

few. 

If you have taken advantage of the HCMA Benefit Provider Program, we want to hear from you. Please send us feedback 

regarding your experience/s with our benefit provider companies. Send an email to Debbie Zorian, HCMA Executive Director, 

(DZorian@hcma.net) and let her know which benefit provider/s you have used and the quality of the service you received. 

Ms. Zorian can also be reached by calling the HCMA office (813.253.0471). 



Coping With 

Suicide 

It is February 21st and I am one day late in 

submitting my article for the March/April 

issue of The Bulletin. I was going to write about 

something else all together, but my visit to my 

stepson’s gravesite on the way to the office this 

morning is what prompted me to change my 

mind. 

For those of you who have read my last few 

articles, you may remember that they were frivolous 

(although true) narratives. On occasion, my 

articles allow me to temporarily escape from the 

challenges and seriousness of my job serving as 

your Executive Director. This article, however, 

will be as solemn as the others were lighthearted. 

Today is an extremely sad day for me, my family, 

and all those who loved my stepson, Patrick. 

Patrick took his own life four months and 19 days 

ago. Today would have been his 45th birthday. I 

visited Patrick’s gravesite today for the first time 

since his burial. I left a Happy Birthday balloon 

tied around a beautiful Peace Lily plant which 

Patrick’s mother, Sandra, will take home in a few 

days. 

As stated in one of the many articles I have 

downloaded regarding this horrific topic…“Selfdeath 

is incomprehensible. The horror it embodies 

creates lasting trauma as survivors struggle 

to grasp how the person could have done it and 

are consumed with guilt for having failed to save 

their loved one’s life. The lasting legacy for suicide 

survivors is that the death of their loved one 

was preventable. This socially held belief implicitly 

makes those closest to the victim feel responsible 

for the death. At the same time, suicide is a 

fundamental betrayal and a profound form of 

desertion. Regardless of the victim’s state of 

mind, the act is an affront that leaves relationships 

forever unfinished and survivors to pick up 

the fragments of a shattered existence.” Sadly, 

the families of over 36,000 people per year, in the 

United States alone, are left to deal with the consequences 

of suicide…the unbearable pain, the 

immeasurable despair oftentimes followed by 

anger, the empty feelings of desertion, the meaningless 

void, and the relentless persistence of 

unanswerable questions. 

I was in North Carolina visiting my mother 

when I received the shocking phone call that 

Patrick had shot himself. He was instantly brain 

dead but his heart kept beating for over 28 hours. 

Patrick was pronounced legally dead on October 

2, 2011…just hours before I could make it back 

to Tampa. I went straight to TGH from the airport 

and spent hours with my husband, Jon, and 

our 19 year old son, Justin, as LifeLink performed 

numerous tests to determine which 

healthy organs they could harvest. I remember 

the horrific experience of seeing Patrick, the 

overwhelming heartache I felt for Jon, and my 

consuming worry for Justin. Not only was this 

his first experience with death…but a death as 

traumatic as his own brother’s suicide. The 25 

year age difference between them made Justin 

look up to his brother even more. Jon was 

almost 50 years old when Justin was born, so 

Justin always acknowledged him to be “older 

than most dads.” In reference to his dad’s many 

years involved in the racing circuit, Justin oftentimes 

referred to himself and his brother as the 

“Zorian team” and how they would always be 

together after “dad was gone.” Justin and Patrick 

spent many memorable times together throughout 

the years. I can’t imagine how abandoned 

my son must feel. Most of the time he doesn’t 

have too much to say about his brother’s suicide…but 

occasionally, when we are alone, he 

spews nonstop without allowing me to interject 

even a word. 

On Father’s Day in 2002, Patrick almost lost 

his life in a dirt bike accident. There was no 

doubt that wearing a helmet saved his life. He 

was airlifted to TGH where he spent 10 days in 

the intensive care unit. After numerous surgeries 

for his broken and crushed limbs, he 

endured months of physical therapy and had to 

wear a full leg brace from then on. Although it 

was necessary for a finger to be amputated, he 

was eventually able to use his hand again. 

Patrick was never the same after that accident. 

He was in constant pain, his moods were oftentimes 

intolerable, and he experienced depression 

that, caused him to withdraw from his family for 

months at a time. 

(continued) 

Director’s Desk 

Executive 

Debbie Zorian 

DZorian@HCMA.net 


Exec. Director’s Desk (continued) 

I feel that in Patrick’s case, his suicide was a decision 

made when he was distraught and intoxicated, and bears 

a statement on how he felt only at that moment. It was 

not a statement about his entire life, and I truly believe 

that no one is responsible for his decision, except for 

Patrick, in his time of stress. Some feel because suicide 

is an act of abomination, the person’s soul cannot be 

saved. Jon and I personally feel that the forgiveness, 

compassion, and the love that God offers, far outweighs 

any other factor. Our belief that Patrick is at peace 

brings us much needed comfort. Justin is having a very 

difficult time accepting his brother’s instant, spontaneous 

act and can’t think much beyond that right now. 

He often states that he believes Patrick didn’t “really” 

want to kill himself. He repeats, “If only he wasn’t intoxicated…if 

only he wasn’t upset and angry…if only he 

thought about it for one minute…if only he realized 

what he was really doing.” If only… 

I was out of the office the entire week after Patrick’s 

death, helping Jon and Sandra with the memorial service 

arrangements. I tried to be of comfort when possible, 

although I found myself simply going through the 

motions while feeling totally unemotional. The days 

ahead, specifically the holidays, proved to be overwhelming. 

We all felt the emptiness of not having 

Patrick’s smile and laughter amongst us as we celebrated 

what was always a cherished family gathering on 

Christmas Eve. Patrick’s death had started to become 

much more of a reality. 

Coping with suicide is different than other types of 

bereavement. I have been told that the grieving of a violent 

death such as murder or suicide takes three to five 

years. However, it’s true that we all grieve differently 

and there is no length of time that is standard. My husband 

is grieving silently, which is not surprising taking 

into account his personality traits. My son is grieving 

somewhat in the same fashion, although, his attitude 

and outlook have changed tremendously. I have seen a 

sense of futility surface and he often discusses his turmoil 

with mortality. I’m in hopes that his upbringing in 

a Christian school and future grief counseling will help 

him with his newfound confusion regarding the purpose 

of life. 

The immeasurable pain of losing a child at any age is 

the most difficult heartbreak a parent can endure. As I 

continue to try and make sense of it all, I pray that the 

journey to healing and acceptance is given to Jon and 

Sandra, although I realize that losing their only child 

has irrevocably changed their lives forever. I pray that 

the devastation Justin is feeling lessens as the years pass 

and warmhearted memories eventually take the place of 

his overwhelming anguish. I pray that I can learn to 

cope with my own heartache and loss and continue to be 

of support to my family. 

I thank those who have read this lengthy article in its 

entirety. Talking or writing about this tragedy, or suicide 

itself, helps me with my own healing process. Each 

time I’m able to address my feelings, a little of the shock 

effect dissipates and the intensity of my emotions 

decreases. 

Patrick will be in the hearts of his family and 

loved ones forever. We miss him so. 

Suicide Prevention and Support Groups: 

www.suicide.org 

www.HelpPromoteHope.com 

www.suicideforum.com 

www.survivorsofsuicide.com 

Crisis Center of Tampa Bay – Call 211 

www.crisiscenter.com 

813.964.1964 

Suicide Crisis Center – Call 211 

www.suicidecrisiscenter.com 

813.234.1234 

National Suicide Prevention 

www.nationalsuicideprevention.com 

800.273.8255 

HCMA Executive Council Tentative Meeting Schedule 

The HCMA Executive Council meets bi-monthly. The meetings are held at the HCMA office 

which is located at 606 S. Boulevard in South Tampa. The meetings begin promptly at 6:00. 

May 22, 2012 • July 24, 2012 • September 20 (Thursday), 2012 • November 20, 2012 

Please call the HCMA (813/253-0471) to confirm date and time, and to RSVP, before 

attending. 


FMA Legislative 

Summary 

The 2012 legislative session is now behind us, 

and the Florida Medical Association successfully 

played defense against harmful legislation 

while securing significant provisions that will 

protect Florida’s patients. The political climate 

during this election year unfortunately prevented 

movement on some major issues, but the 

overall outcome was positive for Florida physicians. 

This was not by chance. Without the FMA’s 

diligence and the work of our excellent governmental 

affairs staff, I assure you that the results 

would have been far less favorable. 

Following is a summary of some of the issues 

that the FMA was involved in and tracked: 

Personal Injury Protection 

HB 119 (Jim Boyd) revises provisions relating 

to mandatory Personal Injury Protection automobile 

insurance. It limits PIP coverage to treatment 

at a hospital within 14 days of an accident 

for an “emergency medical condition” and necessary 

follow-up care by specified professionals. 

PIP coverage for treatment for a non-emergency 

medical condition is capped at $2,500. Massage 

therapy and acupuncture services are not covered. 

The bill does not cap attorney fees for disputed 

payments or claims but does prohibit the 

use of “contingency risk multipliers” in calculating 

attorney fee awards. The bill does not authorize 

insurance companies to require physicians 

to submit to arbitrary and intrusive “examinations 

under oath.” 

Youth Athletes/Head Trauma 

HB 291 (Ronald “Doc” Renuart, D.O.) requires 

the Florida High School Athletic Association and 

independent youth sanctioning authorities to 

develop “return to play” policies for athletes who 

sustain a traumatic head injury. Further, the bill 

defines the membership of the sports medicine 

advisory committee of the Florida High School 

Athletic Association as follows: eight M.D.s or 

D.Os., one dentist, one podiatrist, one chiropractor, 

one retired coach, and three athletic trainers. 

Chiropractors’ efforts to amend the bill so that 

they would be authorized to clear athletes to 

return to play were unsuccessful. 

Pharmacists/Vaccines 

HB 509 (Ana Rivas Logan) authorizes pharmacists 

to administer the pneumonia vaccine to 

adults pursuant to a protocol with a physician, 

and to administer the shingles vaccine to adults 

pursuant to a prescription from a physician. 

Initial educational certification and continuing 

education is required. 

Pain Management “Glitch” 

Issues/Clinical Lab Personnel 

HB 787 (Carlos Trujillo) is a bill relating to 

nursing homes that was amended to include several 

provisions to fix some (but not all) glitches 

in last year’s pain clinic legislation. The bill 

addresses inadvertent uses of the term “physiatrist” 

(instead of “psychiatrist”). It clarifies definitions 

of “board-certified pain management 

physician” and “chronic non-malignant pain,” 

and adds a definition for “Board eligible.” It 

specifies that rheumatologists and specified 

“board-eligible” individuals are exempt from following 

the statutory standards of practice for 

prescribing controlled substances. Finally, a lateadded 

provision of the bill will prohibit a clinical 

laboratory from providing personnel to perform 

any functions or duties in a physician’s office 

unless the lab and office are owned by the same 

entity. 

Department of Health Reorganization 

HB 1263 (Matt Hudson) revises the purpose of 

the DOH and the duties of the Surgeon General. 

Provisions that would have decentralized the 

DOH to county health departments were 

removed from the bill. The bill modifies provisions 

relating to the Children’s Medical Services 

program, but the changes are significantly scaled 

back from the bill as originally filed. 

Background Screening 

HB 943 (Doug Holder) revises requirements 

for background screening of volunteers and 

licensees of various professions, and contains 

provisions that will ultimately allow fingerprints 

to be “shared” among state agencies to avoid 

duplicative screening requirements. The FMA 

was able to remove from the bill a provision that 

would have required all physicians to be re-fingerprinted 

upon renewal of their license. 

Medicaid/Budget 

HB 5301, a budget-implementing bill, limits 

(continued) 

Legislative Session 

2012 Florida 

Neal 

Dunn, M.D. 

Chairman, 

FMA Council on 

Legislation 


2012 FMA Legislative Agenda (continued) 

the number of covered ER visits to six per year and limits 

the number of primary care doctor visits to two per 

month. The Senate rejected a House proposal to eliminate 

Medipass. 

Did Not Pass 

License Suspension 

SB 594 (Ronda Storms) and HB 1143 (Frederick W. 

“Fred” Costello) would have authorized the Department 

of Health to suspend or revoke a physician’s license 

based solely on the physician being arrested or under 

investigation for violating specified criminal laws. 

Balance Billing 

HB 1329 (Richard Corcoran) and SPB 7186 (Health 

Regulation) would have limited the charges of a physician 

providing ER services to PPO patients to the 

amount set by the patient’s insurance plan and would 

have restricted physicians from recovering fees for nonemergency 

services provided in a hospital to PPO 

patients. 

Impaired Practitioners 

HB 1019 (Dr. Renuart) and SB 1286 (John Thrasher) 

would have made several clarifying and technical revisions 

to the statutes governing Florida’s impaired practitioners 

programs, Professionals Resource Network 

(PRN) and the Intervention Project for Nurses (IPN). 

Medical Liability Reform 

SB 1506 (Thrasher), SB 1316 (Don Gaetz), and HB 

385 (Matt Gaetz) would have extended the state's sovereign 

immunity protections to services rendered by 

physicians in an ER, allowed defendants in a medical liability 

case access to interview subsequent treating physicians, 

and increased the burden of proof in cases alleging 

failure to order supplemental diagnostic testing to a 

“clear and convincing” evidentiary standard. SB 1506 

and SB 1316 were later amended to include provisions 

that would have delineated conditions under which 

optometrists could prescribe specified oral medications. 

Optometrist Scope-of-Practice Expansion 

HB 261 (Matthew H. “Matt” Caldwell), SB 788 (Mike 

Bennett) and 718 (Bennett) would have authorized 

optometrists to prescribe an unlimited number and type 

of oral medications. 

ARNP Scope-of-Practice Expansion 

SB 1014 (Bennett) and HB 1267 (Charles Van Zant) 

would have authorized ARNPs to prescribe narcotics. 

Sen. Bennett also unsuccessfully attempted to amend 

these provisions into a budget bill on the Senate floor. 

Efforts to amend other bills to authorize ARNPs to 

release persons submitted for involuntary examinations 

under the Baker Act were defeated. 

Electrologist Scope-of-Practice Expansion 

HB 381 (Rivas Logan) and SB 1330 (Alan Hays) would 

have removed requirements in law for direct supervision 

of electrologists performing laser hair removal. 

Chiropractor Scope-of-Practice Expansion 

SB 948 (Dennis Jones) would have authorized chiropractors 

to be included in the list of medical professionals 

authorized to clear youth athletes to return to play 

following a traumatic head injury. HB 291, a related bill 

that did not contain provisions sought by chiropractors, 

did pass. 

Workers’ Compensation/Drug Repackaging 

HB 511 (Hudson) and SB 668 by (Hays) would have 

imposed restrictions on the price of repackaged or relabeled 

drugs. The bills contained FMA-supported language 

that ensured physicians would not be prohibited 

from dispensing medication to workers’ compensation 

patients. 

Pain Management Regulations 

SB 904 (Mike Fasano) and HB 915 (Trudi Williams) 

would have mandated physicians to check the prescription 

drug database prior to prescribing a controlled substance. 

SB 1198 (Bogdanoff) contained provisions to fix 

various “glitches” from pain clinic legislation passed in 

the 2011 legislative session. Note that portions of this 

bill were amended onto HB 787, which did pass. 

HMO “Bait & Switch” 

HB 1155 (Dennis Baxley) and SB 1418 (Ellyn 

Bogdanoff) would have required HMOs to allow the 

insured to continue to use the services of a network 

panel provider for a minimum period of time following 

enrollment. 

Booster Seats 

HB 151 (Richard Steinberg) and SB 196 (Thad 

Altman) would have required children of specified 

height and weight to use booster seats in automobiles. 

This is not a complete list of all the legislative issues 

the FMA tackled, and a more extensive overview will be 

available soon. In the meantime, if you have questions or 

need information about a specific bill not mentioned 

here, contact me or Vice President of Governmental 

Affairs Rebecca O’Hara at rohara@flmedical.org. 

The FMA worked extremely hard on your behalf this 

legislative session. I would like to thank all of you for 

your encouragement and constructive feedback during 

the past two months as we fought for physicians and 

patients. Though session is over, our work does not end 

here. The 2012 election cycle is well underway, and we 

must now engage in the political process to make sure 

pro-medicine candidates are elected to office. You can 

support these Friends of Medicine by joining the FMA 

PAC today. Now is the time to get involved. And, if you 

have colleagues who are not FMA members, 

please tell them about everything we do to help 

physicians practice medicine. 


Carmel Café — 

First Links in a Chain 

Whenever a new restaurant is started and 

then another added in a few months, and 

then another, watch out. Especially when the 

restaurant is started by Chris Sullivan, one of the 

original Outback founders (and Chris’ son we 

were told), you have to take notice. 

Carmel Café started in Clearwater, progressed 

to Carrollwood, and is opening soon in South 

Tampa. A very contemporary motif, accompanied 

by “order on the iPad” makes the Café a prototype 

for the new wave of modern restaurants. The 

café is located in a strip center - one advantage is 

you can drop the kids off next door at Chuck-E- 

Cheese. 

Carmel Café lends iPads to each patron with 

the full menu pictured. The iPad experience is 

not just a gimmick. It improves the ordering 

experience because there are photos of each 

choice; and we all know that the visual part of a 

meal is a good part of an enjoyable dining event. 

In addition, the orders go directly to the bar or 

the kitchen; no more waving for a waiter or wondering 

where they are. When we ordered drinks, 

the first ones actually arrived before the entire 

table had ordered. Note on ordering: there is a 

small red “minus sign” at the left on 

the screen to cancel an order, which 

didn’t seem obvious to us. 

Our group had a multitude of good 

tasting appetizers, soups, and salads. 

The most surprising were the 

“Chickpea Fries.” The fries were made 

into an oblong shape like a French fry 

or a child’s building block and had 

much more taste than the rather bland 

chickpeas. The accompanying curry 

aioli and tomato jam combined in a 

“sweet-savory” way to produce a 

favorite we will order again. “Nan’s 

Goat Cheese” was a large offering of 

crostinis with sun dried tomato, roasted 

garlic, pitted Greek olives, and, of 

course, goat cheese. Again, you get the 

feeling that these tastes were tried 

PLUSES 

MINUSES 

again and again to perfect and they have succeeded 

in developing popular tastes in a new way. 

The tomato basil soup was thick and robust, 

and the Caesar salad had a flavorful twist with a 

black olive dressing. 

For entrees, the “Lemon Moroccan Chicken 

with Quinoa Couscous” was a favorite. The 

quinoa was a multitude of tastes with dried apricots, 

pistachios, dried cranberries, parsley, and 

lime zest. The chicken was flavored with pine 

nuts, saffron, olives, and lemon. What a combination 

of flavors - and it worked nicely. 

The “Basil Grilled Salmon” was served with 

quinoa and a Kalamata olive tapenade that was 

slightly spicy. “Steak Frites” is a signature dish of 

tender Angus beef, classic Béarnaise, and spicy 

Carmel Fries. 

The “Braised Short Ribs with Asiago Creamy 

Polenta” were very “short,” served with the very 

moist and creamy polenta reminiscent of cheese 

grits. 

CUISINE AMBIENCE SERVICE 

1 

⁄2 

• Fun tasty 

offerings 

• Wide variety on 

the menu sure 

to please most 

people 

• Both “Small” 

and “Large” 

plates of most 

entrees 

• Contemporary 

with adequately 

spaced tables 

• iPad for 

ordering 

• For some the 

technology and 

rapid deliverance 

of orders may 

smack of a “fastfood” 

establishment 

Carmel Café • 14306 North Dale Mabry Hwy. 

813-265-1415 • www.carmelcafe.com 

Restaurants are rated from one to five stethoscopes. 

(continued) 

• Waiters have it 

easy-you tell the 

kitchen what you 

want, leaving 

time for good 

service by the 

wait staff 

• Service is fast if 

you want it to 

be, but they 

don’t rush you 

out 

Restaurant Review 

Taste Bud 


Restaurant Review (cont.) 

The “Four cheese Satchels” combined ricotta, 

Parmesan, Pecorino Romano, and mozzarella in a 

savory pomodoro sauce. We found out “satchels” 

are actually large “raviolis.” 

For dessert, we had a good but rather standard 

chocolate lava cake and a not-so-standard grilled 

pound cake that they coat with sugar and then 

press. It is presented with Kaffir lime scented strawberries 

and almond infused whipping cream for an 

excellent way to end the meal. 

On Sundays the café has a great deal for $25 for 

two people - a menu from which you can select one 

appetizer, two soups or salads, two small entrees, 

and one dessert. 

The café has a plethora of fine wines, most of 

which can be ordered by the 3 oz., 6 oz., and 

9 oz. size, or by the bottle. 

 

 

 

 

 

 

 

 

 




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Physician Owned 

Distributorships (PODs) 

Make Waves 

Physician owned distributorships (PODs) 

have been the source of considerable controversy 

for years, but now they’ve caught the 

attention of Congress! 

PODs distribute various things, most commonly 

surgical implants and devices, that are 

reimbursed by insurers. A patient needs a spinal 

rod, a surgical implant/device company makes it 

and a distributor rep distributed it. 

Device/implant companies usually contract with 

distributorships to sell their products. 

Distributorships contract with reps who are paid 

commissions for sales. Surgeons who actually 

order the devices sometimes think “Since I’m the 

one doing the surgery and ordering all this stuff, 

why don’t I make something from the selling it?” 

PODs are one way for physicians to financially 

benefit from the sales of devices and items their 

patients need, but they have never been more 

controversial than now. 

Conceptually speaking, PODs are controversial 

because government regulators think physicians 

who have an economic stake in health care 

items or services will tend to over utilize them. 

Moreover, there is a specific concern that allowing 

physicians to profit from the devices their 

patients need violates federal anti kickback laws 

or the Stark prohibition on compensation 

arrangements. 

In 2006, the Office of the Inspector General of 

HHS and CMS expressed major concerns about 

PODs, and cited concerns about “improper 

inducements.” At that time, the OIG stopped 

short of prohibiting them, but called for heightened 

scrutiny. CMS itself has stated that PODs 

“serve little purpose other than providing physicians 

the opportunity to earn economic benefits 

in exchange for nothing more than ordering 

medical devices or other products that the physician-investors 

use on their own patients.” 

Implantable medical devices are unusual in 

the way they come into use. Unlike DMEPOS, 

for instance, medical devices are not sold to distributors. 

They’re sold from the manufacture to 

the medical facility where the surgery will take 

place. So, the argument goes, physicians are not 

actually in a position to drive the sales volume of 

the implants. The counter: physicians invested 

in a POD can leverage their hospital admissions 

to influence the device choice of hospitals and 

surgery centers. 

The biggest legal hurdle for PODs is the federal 

Anti Kickback Statute, which carries both 

criminal and civil penalties. Simply put, if even 

one purpose of an arrangement is to pay for 

patient referrals, the law is violated. So, the law 

is arguably violated if one purpose of the POD is 

to induce physicians to order implants for their 

patients. Looked at another way, the law is violated 

if one purpose of a hospital doing business 

with a POD is to ensure patient referrals by the 

physician POD investors. 

A 1989 OIG Special Fraud Alert on fraudulent 

physician joint ventures is especially interesting 

on the fraud and abuse issues in pointing out 

that the following would indicate unlawful intent 

to induce patient referrals: 

Investor choice. If the only investors chosen 

are surgeons with an opportunity to refer and if 

they lack any business or management expertise, 

the arrangement appears to be a cloaked way to 

incentivize unlawful referrals (i.e. ordering 

implants). The key question is whether the business, 

in selecting investors, is looking to raise 

capital or to lock in referral sources. 

Risk. If the POD investment involves little or 

no financial risk, the OIG would likely take issue 

with it. 

The bottom line seems to be that if there isn’t 

a real business, with real financial risk and qualified 

investors, a POD will likely be viewed as a 

suspicious arrangement based on locking in 

(continued on page 24) 

Medical/Legal Update 

Jeffrey L. Cohen 

The Florida 

Healthcare Law 

Firm 

JCohen@floridahealthcarelawfirm.com 


Students Debated Medicine’s Future! 

On February 7th the Fourth Annual “Students Debate Medicine’s Future” was held in the ballroom of the 

InterContinental Hotel. A panel of four medical students, Kevin Cronin (MS I), Hershel Patel (MS II), 

Steven Dudick (MS III), and Alicia Billington (MD, PhD Candidate), debated current hot topic issues in healthcare. 

They also addressed questions and comments from some of the “seasoned” HCMA members. Nick DeVito 

(MS IV) was the debate moderator. 

Prior to the start of the debate, Jessica Deslauriers, was awarded the Cherry, Bekaert, & Holland medical student 

scholarship. The medical student scholarship is presented to a USF medical student chosen for their 

demonstration of leadership, participation, and citizenship thoughout medical school. The HCMA Foundation 

also provided Ms. Deslauriers a matching award. 

Many thanks to the generosity and continued support of Florida Hospital Tampa and Tower Radiology Centers 

for helping make the evening so enjoyable. 

Medical students Jacqueline Selbst, Robert Lorch, Sarah 

Williams, Kim Levitt, Loren Brown, and Candace Haddox. 

Dr. David Archibald, Dr. Edward Farrior, Blanca Crespo and her husband, 

Dr. Israel Crespo, and Dr. Jay Farrior 

The Tower Radiology Centers table…one of the evening’s 

sponsors. 

Mr. Bill Becker, representing Cherry, 

Bekaert, & Holland CPAs, awards 

Jessica Deslauriers the medical student 

scholarship. 

Dr. Hunter Eubanks, with his wife, 

Becky, displays his photo that graced 

the cover of the Jan/Feb 2012 issue of 

the Bulletin. 

Dr. Karen Slack, Dr. Anthony Pidala, Sonia Slack, and 

Michelle Blanco. 

Dinner Meeting 

Drs. Jeffrey White, Earl Pippin, and Wilfred 

Daily. 

Jessica Goldonowicz (MSIII), Nick DeVito (MSIV), Dr. Alicia Monroe, Dr. Mathis 

Becker, Dr. Barry Bercu, Sandy Bercu, and Linda Becker. 

Drs. Luis Menendez, Michael Wasylik, 

Prakit Jeerapaet, and David Lubin. 

John Harding, CEO and President of 

Florida Hospital Tampa, welcomed the 

attendees. Florida Hospital Tampa was 

one of the evening’s sponsors. 

The USF Medical Student Contingency – 

over 70 students were in attendance. 

The Medical Student Panel: Nick DeVito moderates, while Alicia Billington, Steven Dudick, Hershel 

Patel, and Kevin Cronin debate medicine’s issues and take questions from attendees. 

22 HCMA BULLETIN, Vol. 57, No. 6 – March/April 2012 


Medical/Legal Update (continued) 

patient referrals or physician admitting pressure by 

physician investors. 

In its June, 2011 Inquiry “Physician Owned 

Distributors (PODs): Overview of Key Issues and 

Potential Areas for Congressional Oversight,” the U.S. 

Senate Finance Committee Minority Staff, the 

Committee reports “A number of legal and ethical concerns 

have been identified as a result of this initial 

inquiry into the POD Models.” The Committee reviewed 

over 1,000 pages of documents and spoke with over 50 

people in preparing its report. The Committee cited 

long-held concerns regarding PODs, and leaned 

heavily on the 2006 Hogan Lovells (previously Hogan 

& Hartson) law firm’s anti-POD analysis. 

With the Committee’s call for greater OIG and 

CMS involvement, one thing seems clear: the future 

of PODs is uncertain. In this era of cost-cutting, it 

seems clear that PODs are gonna get a haircut and 

may even lose their head. 

About the author: With almost 25 years of healthcare 

law experience following his experience as legal 

counsel for the Florida Medical Association, Mr. 

Cohen is board certified by The Florida Bar as a specialist 

in healthcare law. With a strong background and 

expertise in transactional healthcare and corporate matters, 

particularly as they relate to physicians, Mr. 

Cohen’s practice involves him in regulatory, contract, 

corporate, compliance, and other healthcare law related 

matters. As Founder of the Florida Healthcare Law 

Firm, Mr. Cohen can be reached at 888-455-7702 or 

online at jcohen@floridahealthcarelawfirm.com. 

The Florida Healthcare Law Firm is an HCMA 

Benefit Provider. 



Traumatic Brain Injury: 

The Diagnosis Du Jour 

No matter what your specialty, you may have 

noticed a recent increase in patients in your 

practice complaining of loss of memory, mental 

fogginess, or persistent headaches. This is probably 

not because there is a spreading epidemic of 

Traumatic Brain Injury (TBI, and its sometime 

consequence, CTE, Chronic Traumatic 

Encephalopathy), but most likely the result of 

increasing public awareness of TBI involving 

current and former players in the National 

Football and National Hockey Leagues. Perhaps 

one of the more publicized examples of TBI/CTE 

involved retired Chicago Bears player Dave 

Duerson, who, sensing his own mental decline 

after many concussions, shot himself in the chest 

last year. In his will, he directed his brain to be 

sent to the National TBI Research Center at 

Boston University for examination. 

Not surprisingly, his brain autopsy showed 

neurofibrillary tangles and buildup of amyloid 

plaque typical for TBI and CTE-associated 

Alzheimer Disease. Not every case of TBI progresses 

toward CTE, and not every case of CTE 

ends up with AD, but there is a well-documented 

literature linking the three entities. Sadly, 

Duerson is not the only ex-NFL player in the 

same situation at the end of his career and the 

League has recently been moved to attempt to 

limit head-to-head impacts, develop safer helmets, 

and further define the problem. 

TBI is increasingly being recognized at all levels 

of athletics – not just the professional level. 

Concern for the long term effects of repeated 

bouts of unconsciousness extends to high school 

and college football as well as youth leagues. Nor 

are the effects of repeated brain injury confined 

to football and hockey. A study released at the 

Radiological Society of North America’s annual 

meeting in 2012 showed that players who repeatedly 

headed the ball performed worse on neuropsychological 

testing and had evidence of 

microscopic white matter injury on Diffusion 

Tensor Imaging (DTI). Safety issues in all contact 

sports at all levels now appropriately mandate 

rest time for brain healing after a bout of 

unconsciousness before returning to a game. 

While mainstream media has popularized 

traumatic brain injuries in professional athletes, 

perhaps the patient group that first brought this 

subject to national attention is the one that has 

had the most extensive and deadly exposure to 

head injury: active duty soldiers. The signature 

injury of the Iraq/Afganistan wars is TBI/CTE, 

usually in the form of blast injury. A large proportion 

of these patients are profoundly affected 

and, while many bear physical exterior scars of 

their injuries, a significant sub-set has no outward 

stigmata, and for them accurate diagnosis 

can difficult. 

For these patients with TBI, whether mild, 

severe, or progressing to CTE, MRI imaging has 

become the mainstay for objective neuroanatomical 

diagnosis. Coupled with highly accurate 

psychological testing and clinical psychiatric 

evaluation, MR imaging is indispensible. The 

stronger the magnetic field employed, the better 

the anatomical detail that can be demonstrated. 

Field strengths of 1.5 Tesla and 3.0 Tesla in the 

MRI scanner are necessary to produce the best 

possible structural images. Functional MRI 

(fMRI), available at some locations, is able to add 

important information to the routine diagnosis. 

Most importantly, high-field strength fMRI 

imaging has an increased ability to identify 

extremely small deposits of hemosiderin in brain 

parenchyma. Hemosiderin is the deposition of 

iron particles in the brain parenchyma that signifies 

an old bleeding site. Hemosiderin deposition 

is permanent and will be present in the brain 

or on the surface of the brain reliably (and unfortunately) 

forever, so that old bleeding sites can be 

identified many years or even decades after a 

hemorrhagic event. This old blood can be identified 

on MRI scans performed on any high or even 

some lower field strength units utilizing gradient 

echo recall (GRE) techniques. The higher the 

field strength, the greater will be the sensitivity, 

and the greater the conspicuity of the blood 

detection. BOLD SWI (Blood Oxygen Level 

Dependent, Susceptibility Weighted Imaging) 

fMRI techniques have been reported to be 4 – 6 

times more sensitive than GRE techniques performed 

at the same field strengths at depicting 

these tiny old bleeding sites. 

(continued) 

Corner 

Practitioners’ 

Reed 

Murtagh, M.D. 

rmurtagh@udimri.com 

Ryan 

Murtagh, M.D. 

rmurtagh13@gmail.com 


Practitioners’ Corner (continued) 

Fractional Anisotropy/Diffusion Tractography 

Imaging (FA/DTI) fMRI sequences are newer sequences 

that require considerable post-processing. These can 

produce truly impressive color images of the brain that 

highlight the integrity of myelinated white matter fiber 

tracts. These images depict brain white matter fiber 

tract anatomy at the microscopic level, and much work 

is being done to understand their significance and normal 

appearance with these new techniques. Absolute FA 

values taken from eloquent regions of brain have the 

potential to objectively evaluate the integrity of the 

white matter and are in the process of being formally 

investigated and reported in the peer-reviewed literature 

for validation. 

Expect to see these terms (TBI, CTE, DTI, fMRI, 

etc…) mentioned in the literature with increasing frequency 

in the future. Psychiatrists, Psychologists, and 

Neurologists will be the most important parts of the 

diagnostic workup in TBI/DTE, with physical assessment 

and psychological testing providing accurate, 

objective data. Detailed, high-field strength MR imaging 

will have an increasingly important role to play 

as research and experience improve the understanding 

and expand the applications of fMRI. 

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Executive Council 

Meeting Highlights 

An unabridged version of the January 17, 2012 

meeting minutes are available by calling the 

HCMA office: 813.253.0471. 

Call to Order 

The meeting was called to order at 6:15PM. 

Approval of Minutes 

MOTION MADE AND CARRIED TO 

APPROVE THE MINUTES OF THE 

NOVEMBER 15, 2011 EXECUTIVE COUN- 

CIL MEETING. 

HCMA/BCBSFL Health Insurance Benefit 

Trust Update 

Dr. Michael Wasylik, HCMA Past President, 

gave a brief update on the HCMA/BCBSFL 

Health Insurance Trust. The HCMA plan is progressing 

and will allow enrollment for another 

year to large groups. 

SGR Update 

Dr. Michael Wasylik updated the Council members 

on the Sustainable Growth Rate (SGR) 

issue. He reiterated that the SGR formula does 

not work and that an upcoming Medicare cut may 

be as high as 27.4%. Currently, physicians are 

seeing a two month “patch” on the SGR and a 

proposed two year patch is being considered. Dr. 

Wasylik stated the SGR must be repealed now in 

order to avoid further unnecessary and unfair 

costs. Dr. Wasylik encouraged the Council members 

to review the AMA’s SGR Repeal Talking 

Points. 

FMA Update 

Dr. Jose Jimenez, FMA District C Representative, 

reminded the Council members that 

2012 will be a big election year and encouraged 

membership in the FMA’s MD1000 Club, the 

FMA PAC, and HILLPAC. 

Dr. Jimenez also briefly reviewed the FMA’s 

Legislative Report. 

Membership Report 

Dr. Christopher Pittman, HCMA Vice President 

and Membership Chairman, updated the Council 

regarding membership. HCMA’s current membership 

count is 1481. The HCMA gained twenty-seven 

new Active members since the previous 

report. The third 2012 dues renewal statements 

were mailed January 2, 2012. As of January 9, 

2012, over 540 ACT members have paid their 

2012 dues. 

President’s Report 

Dr. Mathis Becker, HCMA President, reported 

that the sub-committee to investigate Health 

Information Exchange (HIE) options will meet 

again with representatives from HIE Networks 

(formerly Big Bend RHIO) for a detailed presentation. 

Dr. Becker gave a brief medical school 

update, reporting that due to a significant donation, 

the medical school will now be known as 

the Morsani College of Medicine. He also 

reported that the CAMLS facility will be opening 

in a few weeks. Dr. Becker reported the Annual 

Legislative Luncheon was well attended and continues 

to be a great opportunity to communicate 

with the Hillsborough County Legislative 

Delegation prior to the Session each year. Dr. 

Becker announced that the Nominating 

Committee will be meeting. He encouraged the 

Council members to talk with HCMA colleagues 

to determine who would be interested in being 

nominated to serve on the HCMA Executive 

Council, Board of Censors, Delegation, and or 

HILLPAC Board. Dr. Becker updated the 

Council on his attempt to include the HCMA in 

the recommendation of a local ordinance. Dr. 

Becker requested the Council members consider 

nominees for the HCMA’s Dr. Frederick A. 

Reddy Memorial Award. 

Executive Director’s Report 

Debbie Zorian, HCMA Executive Director, 

reported that the HCMA Benefit Provider Open 

House was held December 1st at the HCMA. 

Ms. Zorian reported that 56 HCMA members 

attended the December 7th FLDIC Risk 

Management CME Seminar. Ms. Zorian also 

notified the Council members that HCMA staff 

spent several days reminding members whose FL 

medical licenses were scheduled to expire 

January 31st, and had not been renewed yet. 

Several members thanked HCMA staff as their 

non-renewal was an oversight that would have 

resulted in major practice problems if not 

(continued on page 29) 

Committee Happenings 



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enewed on time. 

Board of Medicine Update 

Dr. Fred Bearison, Florida Board of Medicine representative, 

attempted to clarify the law pertaining to controlled 

substance prescribing. He stated that even if a physician 

does not work in a “pain clinic” but does write prescriptions 

for narcotics for chronic non-malignant pain (a Rx 

for more than 90 consecutive days) then the physicians 

MUST check “yes” on their BOM profile when prompted. 

Alliance Report 

Ms. Blanca Crespo, HCMA Alliance President, reported 

that fundraising for their Foundation has concluded and 

$2,500 has been raised through the Sharing Card program. 

Several funds will be used for Evelyn Shaver 

scholarships to be awarded in April. Other funds will be 

donated to the FMA Foundation. 

Medical Student Report 

Michael Perrone, HCMA medical student representative, 

reported that the USF Medical Student Section is striving 

to become the “AMA Medical Student Chapter of the 

Year.” 

Correspondence 

The Council was provided dates and times of upcoming 

events as well as correspondence from Ms. Zorian to the 

representative from Pharmacy Choice and Access Now 

Coalition (PCAN) advising her that the HCMA is unable 

to support PCAN’s legislative agenda. This correspondence 

was a follow-up from the last Executive Council 

meeting and for the Council’s information only. 

Adjournment 

The meeting was adjourned at 7:35PM. 

Comm. Happenings (con’t.) 

Alliance on Heart Disease 

Awareness Month 

February was Heart Disease Awareness month 

and the Alliance once again joined the effort 

by promoting this issue, especially to women 

with our third “Go Red for Women” program. 

We shared information regarding 

the previous year’s risks factors 

for awareness and promoted 

“Citizen CPR.” 

This year we also wanted to 

emphasize the exercise part of the 

heart health equation. We wanted 

to reach out not only to our members 

but also our friends, co-workers, 

and the great family of medicine. 

We chose Zumba as a unique 

and fun way to exercise. Under the 

direction of our Zumba instructor, 

Cyndi Eicholtz from “Rizing Star Dance 

Academy” in Tampa, we danced and enjoyed a 

good workout to a variety of Latin rhythms. The 

participants received, in addition to a great workout, 

goodies, raffle tickets, and educational materials 

from the American Heart Association. 

These materials included instructions on risk 

factor modification on topics such as cholesterol, 

glucose, waist size, and blood 

pressure. We also distributed Good 

Nutrition flyers which offered heart 

healthy nutritional alternatives. 

I am very proud to announce 

that in November the HCMA 

Alliance was awarded first place in 

the Healthy Living Award at the 

Southern Medical Association 

Alliance Convention in North 

Carolina for our “Go Red for 

Women” projects. Our entry highlighted 

our previous efforts as well as 

our current efforts to increase 

awareness. The prize awarded was in 

the category of counties under 50 

members. 

News 

Alliance 

Many thanks to all donors to our Evelyn Shaver Scholarship Fund 

The following families are additions to the previous list: 

Pam Arain, Bill E & Sherry Barry, and Edmund G. Grant, MD 

Member who contributed $100 or more: 

Dr. & Mrs. Jorge Leal 

Blanca Crespo, MPH 

HCMA Alliance 

President 

crespo04@aol.com 


Board of Medicine 

Update 

Crystal 

A. Sandord 

Crystal_Sanford@doh.state.fl.us 

What’s New with the Florida Board of Medicine: 

Introducing Changes to the Board’s Website 

In 2011, the Florida Board of Medicine underwent 

many changes. One of those changes 

was a complete overhaul of our website based on 

comments received from our licensees as well as 

the general public. This article will provide you 

with an overview of the website so you can find 

information when you need it. 

The web address for the Division of Medical 

Quality Assurance (MQA) is 

www.doh.state.fl.us/mqa. This site is the 

overview site applicable to all health care 

providers and from this site you can access many 

things: 

• Renew your license 

• Update your Practitioner Profile 

• Update your address 

• Designated yourself as a controlled substance 

prescriber 

• Create a relationship between yourself and a 

pain-management clinic 

• Request a duplicate license 

• Request a license verification 

• Access information on counterfeit-proof 

prescription pads and approved vendor list 

• New changes in law 

• And much more . . . 

Coming soon - The Board of Medicine’s licensure 

applications will soon be online. This will 

allow applicants to complete the application and 

submit the fee with the application online. 

The Board of Medicine web site can be 

accessed from the MQA site or by typing in the 

web address which is www.doh.state.fl.us/ 

mqa/medical. To access it from the MQA web 

site, simply click on Health Care Professions and 

select Medicine. 

Everything on this site is related to physicians. 

Below is a list of the categories available on this 

site and the types of documents that can be found 

under each category: 

Apply for License 

As mentioned earlier, this is where an applicant 

would go to access online applications. This 

section also contains information on licensure 

requirements, fees and other forms. 

Board Meeting Information 

This section includes meeting dates and locations, 

the actual agenda materials, minutes, and 

audio of the meetings. You can also find information 

on the Board Members in this section. 

Contact Information 

This section provides the Board of Medicine 

address, telephone number, fax, and email 

address. 

Continuing Education 

This section provides the continuing medical 

education requirements necessary for renewal of 

your license. 

Petitions for Declaratory Statements 

This section is a link to a searchable database 

of Final Orders on Petitions for Declaratory 

Statement. A Petition for Declaratory Statement 

is a legal mechanism for physicians to request 

clarification from the Board on a particular law 

as that law relates to that particular physician’s 

circumstances. 

Practitioners Recovery Network (PRN) 

This section provides contact and other information 

for PRN, Florida’s approved impairment 

program. 

Profession Updates 

This section contains alerts from the 

Department of Health, Board of Medicine, and 

DEA. Also available in this section are the current 

and previous versions of the Messages from 

the Chair and the Board’s Annual Reports. 

Registration/Inspection 

This section has links to the Office Surgery 

Registration and Inspection Program and the 

Pain-Management Registration and Inspection 

Program. All information related to these two 

programs can be found here. 

Renewal 

This section provides renewal dates. You can 

also link to MQA Services where you renew your 

license. There is also information about renewing 

through the mail instead of online. 

Remember that renewing online is faster and you 

can print confirmation of your renewal. 

(continued) 


NEWEST MEMBERS 

Sheryce Andrews, MD (PM) 

Craig Berger, MD (OPH) 

Jon Finan, MD (ATP) 

Timothy Floreth, MD (IM) 

Gabriel Gonzales-Portillo, MD (NS) 

Julie Guerrero-Vitko, MD (PTH) 

S. (Sivaselvi ) Gunasekaran, MD (ATP) 

Howard Heidenberg, DO (U) 

Karla Ledoux-Coton, DO (N) 

Tracy Martin, MD (PD) 

Ashley Maru, MD (R) 

Dan Mason, MD (PDO) 

Cynthia Mayer, DO (ID) 

John Merritt, MD (IM) 

Rajan Narula, D.O (IM) 

Yagneshvari Patel, DO (ID) 

Carmen Peden, MD (OBG) 

Tran Phung, MD (ID) 

Jayant Rao, MD (EM) 

Shanmugapriya Reddy, MD (RHU) 

Megan Selbst, MD (ATP) 

Brian Stiffler, M.D. (IM) 

Christopher Tappan, MD (PD) 

Marela Velez, MD (ID) 

Antionina Watkins, MD (OBG) 

Laws and Rules 

This section of the web site lists all pertinent laws 

and rules as well as links to access them. There are a 

few specific laws highlighted in this section as well. 

Forms/Information 

This section houses all of our forms except applications 

for licensure. This includes the financial responsibility 

form, relinquishment forms, address change 

forms, dispensing practitioner registration forms, and 

many more. All forms can be completed online, printed, 

and mailed to the Board Office. 

A great option, for physicians to receive information 

as it occurs, is to join our Interested Parties List 

(Mailman). Emails will be sent directly to you with 

information we are posting on our web site. By using 

this tool, your email address is not readily available for 

public viewing on your Practitioner Profile. You can 

join the Mailman by clicking on its link on the Medicine 

web page or by going to http://www.doh.state.fl.us/mqa/ 

medical/me_mailman.html. 

As always, if you cannot find the information you are 

looking for on our web site, we will be glad to assist you. 

You can send us an email at MQA_Medicine 

@doh.state.fl.us and we will respond within 24 hours. 

About the author: Ms. Sanford is currently a 

Program Operations Administrator at the Board 

of Medicine and has worked at the Board for 

over 20 years. 

Board of Mediciine (continued) 

2012 HCMA Dues Renewal Statements Have Been Mailed! 

Check your mailbox…2012 HCMA dues statements have been mailed! HCMA renewals were due January 1st, 

were past due after February 1st, and members will be dropped for non-payment on April 30th. If you have any 

questions concerning your membership category, dues amount, or to pay by credit card over the phone, please 

call the HCMA office: 813.253.0471. 

How About a 100% Discount on Dues? 

Yes, free membership! That’s up to $350 in savings! Just ask Dr. Malcom Root. He did not have to pay his 2012 

HCMA dues! What’s the catch? Dr. Root recruited three new members within one year. That’s all. If you encourage 

three of your colleagues to join the HCMA within a year, and they have never been HCMA members before, 

you too will have a zero balance on your next year’s HCMA dues statement.* 

$50 Credit Toward Dues 

You say recruiting three is too difficult? Recruit ONE or TWO new members* and you will receive a $50 credit 

(for each new member) toward your next year’s dues. For more information or recruitment materials, please contact 

Kay Mills at the HCMA office: 813.253.0471 or KMills@hcma.net. 

*New HCMA members must indicate on their application, on page 2, that you recruited them in order for you to 

receive credit. 


Medical Briefs 

Dr. Frank Farmer, 

Secretary of Health, Steps Down 

“This letter is to tender my resignation as 

Secretary of Health, effective March 9, 2012. The 

reason for my resignation is that my wife, Peggy, 

and I are faced with a life changing event in that 

she has recently been diagnosed with breast cancer. 

This occurred before Christmas but she and 

I both felt that I had to continue through the legislative 

session that will end on March 9. 

“She has had surgery and radiation and is continuing 

treatment. We are both confident that 

she will have a complete recovery and cure but it 

is time for me to retire and support her and our 

family through this time. 

“I am appreciative of the opportunity you gave 

me and proud of the accomplishments we have 

achieved, especially in the field of prescription 

drug abuse. There are now a little over 500 registered 

pain clinics in Florida compared with 

over 800 in 2010. The time for the DOH to take 

action on a practitioner’s license after an arrest 

has been reduced from an average of 120 days to 

about 19 days. Our office has issued Emergency 

Action Orders to over 300 entities for violations 

relating to prescription drug abuse, which is over 

60% more than the previous year. We have 

established a line of communications with law 

enforcement agencies with the results that they 

now trust us and know we are serious about 

removing the licenses of those who participate in 

illegal activities. 

“I leave knowing that Florida is a safer place 

for its citizens and a much more dangerous place 

for those who would prey on them with inappropriate 

prescription drug abuse,” Frank Farmer, 

M.D., Florida Secretary of Health; letter to 

Governor Rick Scott, March 5, 2012 

We look forward to hearing of Mrs. Farmer’s 

complete recovery! 

2012 E-Prescribing 

Penalty Update 

The information below has been forwarded by 

the FMA, regarding the 2012 E-Prescribing 

Penalty. If anyone has a question about the status 

of their request or they believe the request 

was denied in error, they need to contact CMS 

immediately. The number to contact CMS is 

below. 

If you have any questions concerning this 

FMA memorandum, please contact Susan Franz, 

FMA Medical Economic Specialist, at (850) 

224.6496. 

2012 E-Prescribing Penalty - Contact CMS 

Immediately for Possible Exemption: The FMA 

has recently been notified of an opportunity for 

more physicians to obtain an exemption from the 

2012 Medicare e-prescribing penalty. Even if you 

have already contacted CMS, contact CMS again. 

They are willing to hear your case. 

Concerns have been raised with CMS that the 

back-dating of the 2012 e-prescribing penalty 

program along with the multiple other quality 

and health IT programs underway left little time 

for a significant number of physicians to take the 

necessary steps to avoid the 2012 e-prescribing 

penalty. 

CMS has completed its review of all hardship 

exemption requests for the 2012 e-prescribing 

penalty program received via CMS’ 

Communication Support Page. If you have not 

already done so, please contact CMS’ Quality Net 

Help Desk immediately if you have not received a 

formal notice from CMS regarding the final status 

of your exemption request or if you believe 

you are receiving the 2012 e-prescribing penalty 

in error. The Quality Net Help Desk can be 

reached via telephone at 1-866-288-8912 or via 

email at Qnetsupport@sdps.org. 

We have heard from many physicians who 

believe that they received the 2012 Medicare e- 

prescribing penalty in error. Here are some 

examples of the hardships physicians faced: 

• You did e-prescribe in 2011 but due to 

errors or system/technical glitches (e.g., 

your billing vendor/clearinghouse removed 

the G8553 code from your Medicare Part B 

claims that you submitted), the G8553 code 

was removed from your Medicare Part B 

claims that you submitted to Medicare. You 

also have documentation that shows that 

you e-prescribed for your Medicare patients 

in 2011. 

• You reported the wrong G-code (e.g., a 2009 

e-prescribing G-code) on your Medicare 

Part B claims in 2011. You also have documentation 

that shows that you e-prescribed 

for your Medicare patients in 2011. 

• You filed for an exemption request but you 

included your group NPI rather than your 

individual NPI number on the exemption 

request form and your exemption request 

was denied. 

• You filed for an exemption request, but you 

have not yet heard from CMS regarding the 

status of your exemption request, or you 


elieve that your exemption request was denied in 

error. 

If you faced any of the hardships described above or 

faced another type of hardship please contact CMS to 

hear or reconsider your case. You must contact CMS’ 

Quality Net Help Desk as soon as possible via telephone 

at 1-866-288-8912 or via email at 

Qnetsupport@sdps.org 

Extension of Enforcement Discretion 

Period for Updated HIPAA Transaction 

Standards Through June 30, 2012 

(March 15, 2012) The Centers for Medicare & 

Medicaid Services’ Office of E-Health Standards and 

Services (OESS) is announcing that it will not initiate 

enforcement action for an additional three (3) months, 

through June 30, 2012, against any covered entity that 

is required to comply with the updated transactions 

standards adopted under the Health Insurance 

Portability and Accountability Act of 1996 (HIPAA): ASC 

X12 Version 5010 and NCPDP Versions D.0 and 3.0. 

On November 17, 2011, OESS announced that, for a 

90-day period, it would not initiate enforcement action 

against any covered entity that was not compliant with 

the updated versions of the standards by the January 1, 

2012 compliance date. This was referred to as enforcement 

discretion, and during this period, covered entities 

were encouraged to complete outstanding implementation 

activities including software installation, testing 

and training. 

Health plans, clearinghouses, providers and software 

vendors have been making steady progress: the 

Medicare Fee-for-Service (FFS) program is currently 

reporting successful receipt and processing of over 70 

percent of all Part A claims and over 90 percent of all 

Part B claims in the Version 5010 format. Commercial 

plans are reporting similar numbers. State Medicaid 

agencies are showing progress as well, and some have 

made a full transition to Version 5010. 

Covered entities are making similar progress with 

Version D.0. At the same time, OESS is aware that there 

are still a number of outstanding issues and challenges 

impeding full implementation. OESS believes that these 

remaining issues warrant an extension of enforcement 

discretion to ensure that all entities can complete the 

transition. OESS expects that transition statistics will 

reach 98 percent industry wide by the end of the 

enforcement discretion period. 

Given that OESS will not initiate enforcement 

actions through June 30, 2012, industry is urged to collaborate 

more closely on appropriate strategies to 

resolve remaining problems. OESS is stepping up its 

existing outreach to include more technical assistance 

for covered entities. 

OESS is also partnering with several industry groups 

as well as Medicare FFS and Medicaid to expand technical 

assistance opportunities and eliminate remaining 

barriers. Details will be provided in a separate communication. 

The Medicare FFS program will continue to host separate 

provider calls to address outstanding issues related 

to Medicare programs and systems. The Medicare 

Administrative Contractors (MAC) will continue to work 

closely with clearinghouses, billing vendors or health 

care providers requiring assistance in submitting and 

receiving Version 5010 compliant transactions. If any 

entity is experiencing difficulty reaching a MAC, please 

contact Karen Jackson at 

Karen.Jackson1@cms.hhs.gov. 

The Medicaid program staff at CMS will continue to 

work with individual States regarding their program 

readiness. Issues related to implementation problems 

with the States may be sent to 

Medicaid5010@cms.hhs.gov. 

OESS strongly encourages industry to come together 

in a collaborative, unified way to identify and resolve 

all outstanding issues that are impacting full compliance, 

and looks forward to seeing extensive engagement 

in the technical assistance initiative to be launched over 

the next few weeks. 

Judeo Christian Health Clinic (JCHC) 

Testimonial Dinner & 

Anniversary Celebration! 

On April 19th the Judeo Christian Health Clinic’s 

2012 Testimonial Dinner Honorees will be Bob Basham 

and Chris Sullivan of Outback Steakhouse fame! 

Support the Clinic by becoming a sponsor, purchasing 

dinner tickets, or volunteering at the Clinic. The silent 

auction and reception will begin at 6pm, followed by 

dinner at 7pm. Individual tickets are $95. The Judeo 

Christian Health Clinic is also celebrating its 40th 

Anniversary this year! Contact the clinic to reserve your 

tickets: 813.870.3231. 

More JCHC News – Sovereign Immunity 

for Health Care Volunteers 

The Clinic’s health care providers now have the 

opportunity to be covered by sovereign immunity. The 

Judeo Christian Health Clinic has been very successful 

in helping thousands of Tampa Bay residents each year. 

It is the Clinic’s hope that this opportunity will remove 

the barrier to volunteering for those licensed medical 

professionals who have liability insurance concerns. 

For additional information regarding sovereign immunity 

and the Judeo Christian Health Clinic, please contact 

the Clinic’s Executive Director, Kelly Bell at 

813.870.0395 extension 22 or Kelly@judeochc.org. 

(continued) 

Medical Briefs (continued) 



Advertise in the 

2012 HCMA Membership Directory 

HCMA members can take advantage of discounted 

rates to advertise in the 2012 Membership Directory. If 

you have any questions concerning the 2012 HCMA 

Membership Directory, please contact Elke Lubin at the 

HCMA office (813.253.0471 or ELubin@hcma.net) for 

details for “members only” rates. The deadline to submit 

your ad is May 28th. Members who have not paid their 

2012 HCMA dues in full with not be listed in the 

Membership Directory. 

Be a Famous Author 

… in the eyes of the HCMA Membership, anyway. Do 

you enjoy writing? Do you have great stories to tell or 

an unusual hobby that not many know about? Fancy 

yourself an advanced amateur photographer? Have 

unusual cases that would challenge even Dr. House? If 

so, The Bulletin’s Editorial Board is looking for you! If 

you are interested in serving on the Editorial Board, 

please contact Elke Lubin, Managing Editor, by calling 

the HCMA office: 813.253.0471 or via email: 

ELubin@hcma.net. Elke will give you more information 

about The Bulletin and the expectations of the Editorial 

Board members as well as provide The Bulletin’s “Article 

Guidelines,” to give you an idea of what style of writing 

works best with your publication. 

YOU NEED PHYSICIAN- 

FRIENDLY CANDIDATES 

ELECTED TO OFFICE! 

It is imperative that all physicians become pro-active 

and support “friends of medicine” in this upcoming election 

year. HILLPAC (Hillsborough Political Action 

Committee) conducts interviews and will support the 

campaigns of pro-medicine/pro-physician candidates. 

Please join HILLPAC today - HILLPAC DUES ARE ONLY 

$50! YOUR SUPPORT IS NEEDED AND GREATLY 

APPRECIATED. Send your contribution to: HILLPAC, 

c/o Hillsborough County Medical Association, Inc., 606 

S. Boulevard, Tampa, Florida 33606. Contact Debbie 

Zorian, Executive Director, for more information 

regarding HILLPAC: 813.253.0471 or 

DZorian@hcma.net. 

HCMA.NET – ALWAYS CHANGING 

Visit the HCMA website to find a host of information, 

including new advertisers, the latest issue of The 

Bulletin, the HCMA Benefit Providers, a list of the 

HCMA officers, or a list of upcoming CMEs. You can also 

check out the photos from the FMA Annual Meeting, the 

HCMA Foundation Charity Golf Classic, and recent dinner 

meetings, or look up a colleague’s contact information! 

Visit the site, www.HCMA.net – let us know what 

you think. 

HAVE YOUR 2012 HCMA DUES 

BEEN PAID? 

Dues statements for the upcoming year’s membership 

dues have been mailed. 2012 HCMA membership 

dues were due January 1st, past due after February 1st, 

and members are removed from membership after April 

30th. 

HCMA dues can be paid by check or credit card. 

Automatic renewals can be arranged – contact Kay Mills, 

HCMA Membership Coordinator, at the HCMA to find 

out how: 813.253.0471 or KMills@hcma.net. 

To those members who have already paid their 2012 

HCMA dues, thank you for your continued support of 

the HCMA! 

Members who have not paid their 2012 dues will not 

be included in the 2012 Directory. 

THE PRESCRIPTION DRUG 

MONITORING DATABASE IS “LIVE” 

Physicians and other health care professionals will 

be able to query the database for any indication a 

patient is engaging in the practice of doctor shopping 

for the expressed purpose of accumulating prescription 

drugs for illicit reasons. There is no requirement to 

query the database prior to writing a prescription. You 

can begin registering for query privileges at 

http://www.eforcse.com/ 

The database will be populated by mandatory reports 

from pharmacies and dispensing practitioners. 

Dispensing practitioners are authorized to write a prescription 

for controlled substances and fill prescriptions 

in his or her office. More information about Florida’s 

Prescription Drug Database can be found at 

http://www.eforcse.com/. 

2012 BOARD OF MEDICINE 

MEETING DATES/LOCATIONS 

April 12-14: Westin Tampa Harbour Island, 725 

South Harbour Island Blvd., Tampa, 33602, (813) 229- 

5000. May 31 - June 2: The Peabody Orlando, 9801 

International Drive, Orlando, 32819, (407) 352-4000. 

August 2-4: Wyndham Tampa Westshore, 700 N 

Westshore Blvd., Tampa, 33609, (813) 289-8200. 

October 4-6: TBA. November 29 - December 1: The 

Florida Hotel and Conference Center, 1500 Sand Lake 

Road, Orlando, 32809, (407) 859-1500. 

Visit the Board of Medicine website for details, possible 

CME opportunities, board meeting minutes, board 

member information, agenda materials, and audio files: 

http://www.doh.state.fl.us/mqa/medical/me_meeting.html 

Note from the BOM: All Full Board meetings commence 

at 8:00 am. Committee meetings begin with the 

first at 9:00 am and with each thereafter immediately 


following the end of the previous one. Dates and locations 

are subject to change. The board will notice applicants 

and licensees of a required appearance. Notice for 

Hurricane Cancellations - In the event of a natural disaster, 

such as a severe tropical storm or hurricane, in the 

local or general area of the scheduled Board of Medicine 

meeting, please call (850) 245-4131 for confirmation of 

meeting dates and/or cancellations. Notices concerning 

cancellations will also be placed on the web page. 

PAPERFREE FLORIDA – 

ASSISTANCE AT NO CHARGE! 

PaperFree Florida is part of a partnership between 

USF Health, the Florida Academy of Family Physicians 

and the Hillsborough County Medical Association. 

PaperFree Florida provides physicians like you, access to 

qualified assistance in achieving “Meaningful Use.” 

Currently, PaperFree Florida is able to offer their services 

to you, as a primary care physician, at no charge. 

PaperFree Florida is uniquely positioned to be your 

advocate in navigating through the process of migration 

to a certified Electronic Health Record (EHR) System. 

Through onsite analysis and the use of proven tools 

they’ll help identify specific requirements unique to 

your practice and what types of EHR systems would best 

benefit your practice. They’ll assist you in finding the 

right EHR options and in setting your timeline for system 

demonstrations. By streamlining the process, they 

keep you focused on the business of practicing medicine 

while improving the operation of your practice. They’ll 

help you achieve your goals towards Meaningful Use 

through all stages of implementation 

As the first step in accessing their services, you will 

need to enroll with PaperFree Florida. Please visit their 

website at www.paperfreeflorida.org and click the “membership 

agreement” link located in the center of the 

homepage. One click, that’s all it takes. Fill out the 

requested information and submit the agreement. A 

PaperFree Florida, eHealth Ambassador will then contact 

you to set up a convenient appointment with you 

and your practice management staff to outline how 

PaperFree Florida can help you. Please help them 

respond quickly to you by alerting your office staff that 

an eHealth Ambassador will be calling. PaperFree 

Florida is your direct, rapid and reliable access to key 

information on Health IT and Meaningful EHR Use. 

They are your physician support and resource team 

throughout EHR selection, migration and beyond 

If you have any questions, please contact Tom Lang, 

Project Manager at PaperFree Florida at (813) 974- 

7742 or via e-mail at tlang@health.usf.edu. 

THE ASSOCIATION’S STRENGTH 

If you would like to participate, get involved, voice your 

opinions and ideas, and speak out on behalf of organized 

medicine...this is the way: make a commitment to serve on 

an HCMA committee! 

The effectiveness of YOUR HCMA in meeting the needs 

of its members depends, to a great extent, on the vitality of 

its committees. Your support of and active participation in 

the HCMA is crucial to meeting the challenges faced by the 

medical profession. Please consider serving on an HCMA 

committee and/or participate in an HCMA program. 

Committees/Programs include: Charter & By-Laws, 

Mini-Internship Program, Editorial Board of The Bulletin, 

HCMA Foundation/Golf Tournament, Membership 

Development, Legislative, Managed Care, and Executive 

Council. If you are interested, or would like more information 

on any of the committees/programs listed here, 

please contact Elke at the HCMA (ELubin@hcma.net) or 

813.253.0471. 

We look forward to your participation! 

JUDEO CHRISTIAN HEALTH CLINIC 

NEEDS VOLUNTEER PHYSICIANS 

The Judeo Christian Health Clinic needs additional physicians 

to work in its general medical clinics on Monday, 

Tuesday and Thursday evenings. It also needs additional 

general surgeons and other specialists. Please contact 

the Clinic at 870-3231 if you can help. 


REMINDER: 

If your 2012 HCMA Dues are not paid, you will 

not receive a 2012 Ballot and you will not be 

listed in the 2012 Membership Directory. 


Personal News 

Owen Garrick, M.D., President, AMA Foundation, 

Jack Watters, M.D., Vice President of External Medical 

Affairs, Pfizer, and Ms. Alicia Billington receiving 

award from AMA President, Peter Carmel, M.D. 

NEW MEMBER – NEW CITIZEN 

An otherwise routine citizenship ceremony 

was extra special Wednesday, March 14th for a 

Florida immigration officer who presented a naturalization 

certificate to a doctor from Peru who 

saved her life with an emergency brain surgery. 

In front of 450 people from 75 countries gathered 

in the Tampa Convention Center, immigration 

services officer, Melissa Wingerd, presented new 

HCMA member, Dr. Gabriel Gonzales- 

Portillo, his naturalization certificate. 

Last year, Ms. Wingerd suffered a near-fatal 

brain hemorrhage. The neurosurgeon on call at 

the hospital was Dr. Gonzales-Portillo. He told 

Ms. Wingerd that she needed surgery immediately 

or she would die. Dr. Gonzales-Portillo performed 

the surgery, and within two weeks Ms. 

Wingerd’s life was nearly back to normal. On 

March 14th, Ms. Wingerd told her story to the 

hundreds of new citizens. “I wanted these 

people to see a different side of immigration officers. 

I wanted them to know that we see every 

day the value that they bring, not like the general 

public. We see it every day,” she said after the 

ceremony. “Immigrants bring a lot to this country 

on so many different levels. They bring a lot 

of value. They are this country.” Dr. Gonzales- 

Portillo, has been in the U.S. for about 20 years. 

He previously worked as an assistant professor at 

the University of Arizona’s department of neurosurgery 

in Tucson. He’s lived in Tampa for almost 

seven years with his wife and three children. “I’m 

very happy, very excited. It was a long road to 

become a citizen,” Dr. Gonzales-Portillo said. 

“I’m happy to know that I’m going to be able to 

HCMA’S OWN RECEIVES 

NATIONAL AWARD 

HCMA’s own medical student member, Alicia 

Billington, was recently awarded the AMA 

Foundation Excellence in Medicine in 

Washington, D.C. Ms. Billington is one of 22 students 

from around the country, and the only student 

from Florida, being recognized with this 

award. 

Each year the AMA Foundation honors a select 

group of physicians and medical students who 

exemplify the medical profession’s highest values: 

commitment to service, community involvement, 

altruism, leadership, and dedication to 

patient care. 

exercise my right to vote.” After singing the 

national anthem, taking the citizenship oath, 

and hugging Ms. Wingerd, Dr. Gonzales-Portillo 

had to leave. He had brain surgeries to perform. 

This email and any attached files are confidential 

and intended solely for the intended recipient(s). 

If you are not the named recipient you 

should not read, distribute, copy or alter this 

email. Any views or opinions expressed in this 

email are those of the author and do not represent 

those of the company. Warning: Although 

precautions have been taken to make sure no 

viruses are present in this email, the company 

cannot accept responsibility for any loss or damage 

that arise from the use of this email or 

attachments. 

Melissa Wingerd presents a naturalization certificate 

to Dr. Gonzales-Portillo 


A BULLETIN ROMANCE 

After a lengthy courtship and many hours of Bulletin 

article proofreading…HCMA’s Executive Assistant and 

Bulletin Managing Editor, the former Elke Johnston, and 

Dr. David Lubin were married poolside at their home on 

March 10th. Elke’s sister and daughter, Kendra and 

Samantha, stood up for her, while Dr. Lubin’s daughters, 

Leah and Sabrina, were his “Best Girls.” Congratulations 

to the newlyweds! 

IN MEMORIAM 

It is with much sadness that we report the following members of our medical family has passed away… 

Dr. Arthur Raymond Brooker, Jr., passed away January 14, 2012, after an almost 3-year battle with pancreatic 

cancer. Dr. Brooker, a radiologist, was 75. Known affectionately to all of his friends as Ray, he is survived by 

his wife, Donna and sons, Stephen, Brian, and Jason, as well as many other family members, friends, and colleagues. 

In 1968, he moved to Tampa and joined the Radiology practice of Drs. Sheer, Ahearn and Associates, 

becoming the fourth member of the group. In 2005, he began an affiliation with Radiology Associates of 

Tampa and continued to perform his medical duties with that practice until shortly before his death. 

Donations can be made in his honor to the Pancreatic Cancer Action Network, www.pancan.org, 1-877-272- 

6226. 

Personal News (continued) 

Our heartfelt condolences go out to the family and friends of Dr Raymond Brooker. 

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Visit the Department of Health’s Medical 

Quality Assurance (Board of Medicine) website 

for detail information on licensure requirements: 

WWW.DOH.STATE.FL.US/MQA 

Licensure Renewals 

In order to determine the expiration date of your 

license, look for the date on the actual paper 

license sent to you by the Board of 

Medicine/Osteopathic Medicine or go to: 

www.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP 

to search for information about your license. 

Continuing Medical Education (CME) coursework 

must be completed between February 1 of 

the even/odd year through January 31 of the next 

even/odd year for the license renewal. Licensees 

should not submit CME documentation unless 

audited. Physicians and/or spouses in the military 

are exempt from the CME requirements. 

All CME must be AMA approved category I, except 

for Domestic Violence. Domestic Violence courses 

offered by any State or Federal Government 

Agency or professional association including any 

provider of category I or II AMA continuing medical 

education will be acceptable. 

Below is a summary of Florida CME requirements 

for MDs only: 

Initial licensure: 

Two (2) credits in Prevention of Medical Errors 

First renewal: 

One (1) credit in HIV/AIDS 

Domestic Violence 

2 hours 

This course is required every 

third licensing biennium. 

You are encouraged to go 

online to determine if you 

are required to meet this 

requirement for renewal. 

Prevention of 2 hours 

Medical Errors This course has specific 

course content requirements 

that change every 2 years and 

are described in Rule 64B8- 

13.005, Florida 

Administrative Code (FAC). 

Go online to access the rule 

for more information. 

General CME 

If domestic violence is due, 

36 hours If no domestic 

violence is due, 38 hours. 

Two (2) credits in Prevention of Medical Errors 

Auditing 

The Florida Board of Medicine will audit at random 

a number of licensees as is necessary to 

assure that the continuing education requirements 

are met. Should he/she be one of the 3% 

who are audited, the documents must be notarized. 

(Note: If the physician has met these 

requirements under MECOP’s sponsorship, 

MECOP will provide & notarize the documents. 

In addition, and in order to give the physician a 

complete profile of hours earned, he may submit 

to MECOP proof of those hours earned under 

another accredited sponsor and it will be entered 

into MECOP’s tracking system. ALL hours will 

then be notarized for the audit.) 

The application for renewal shall include a form 

on which the licensee shall state that he has completed 

the required continuing education. The 

licensee must retain such receipts, vouchers, certificates, 

or other papers, such as the Physician’s 

Recognition Award issued by the AMA, as may be 

necessary to document completion of the continuing 

education listed on the renewal form for a 

period of not less than 4 years from the date the 

course was taken. 

April 

ACLS PROVIDER COURSE. April 6, 7, 2012, 

Tampa, Florida. Nationally recognized training 

and evaluation program in advanced life support. 

Certifications and Recertification available. 

Physician half day course available on April 7th. 

St. Joseph’s Hospital designates this educational 

activity for a maximum of (8) AMA PRA Category 

1 Credit(s). Physicians should claim credit 

commensurate with the extent of their participation 

in the activity. Course to be held at St. 

Joseph’s Hospital, Tampa, Florida. An FMA 

accredited program. Please call Emergency 

Medical Associates, 813-874-5707, for more 

information and registration. 

22nd Annual Advances in Urology. April 11-14, 

2012, Key West, FL. 15.0 AMA PRA Category 1 

Credits Please call (813) 974-4296 for further 

information or visit www.cme.hsc.usf.edu. 

Complication Avoidance in the Cervical Spine. 

April 13-14, 2012, Tampa, FL. 12.75 AMA PRA 

Category 1 Credits . Please call (813) 974-4296 

for further information or visit 

www.cme.hsc.usf.edu. 

Clinical Virology Symposium. April 22-25, 2012, 

Workshops, & Conferences 

CME, Seminars, 


CME, Seminars, etc (continued) 

Daytona Beach, FL. 16.5 AMA PRA Category 1 Credits 

Please call (813) 974-4296 for further information or 

visit www.cme.hsc.usf.edu. 

Dependency Mediation Certification Training. April 26- 

May 5, 2012, Tampa, FL. 40.0 AMA PRA Category 1 

Credits. Please call (813) 974-4296 for further information 

or visit www.cme.hsc.usf.edu. 

May 

Negotiating and Mediating Healthcare Disputes. May 17- 

18, 2012, Tampa, FL. 13.0 AMA PRA Category 1 

Credits. Please call (813) 974-4296 for further information 

or visit www.cme.hsc.usf.edu. 

13th Annual Dermatology for the Non-Dermatologist. 

May 30-June 2, 2012, Key West, FL. 19.0 AMA PRA 

Category 1 Credits. Please call (813) 974-4296 for further 

information or visit www.cme.hsc.usf.edu. 

3rd Annual National Women in Surgery Career 

Symposium. May 31-June 2, 2012, Baltimore, MD. 10.0 

AMA PRA Category 1 Credits Please call (813) 974- 

4296 for further information or visit 

www.cme.hsc.usf.edu. 

June 

Family Mediation Certification Training. June 14-23, 

2012, Tampa, FL. 40.0 AMA PRA Category 1 Credits. 

Please call (813) 974-4296 for further information or 

visit www.cme.hsc.usf.edu. 

August 

ACLS PROVIDER COURSE. August 24, 25, 2012, Tampa, 

Florida. Nationally recognized training and evaluation 

program in advanced life support. Certifications and 

Recertification available. Physician half day course 

available on August 25th. St. Joseph’s Hospital designates 

this educational activity for a maximum of (8) AMA 

PRA Category 1 Credit(s). Physicians should claim 

credit commensurate with the extent of their participation 

in the activity. Course to be held at St. Joseph’s 

Hospital, Tampa, Florida. An FMA accredited program. 

Please call Emergency Medical Associates, 813-874- 

5707, for more information and registration. 

Continuous 

FMA Online Education Center. Start your online 

education today through a combination of multimedia 

presentations and instructional tests and quizzes. 

It’s that easy. All course information is provided 

at www.fmaonline.org. 




813.253.0471 

And we have our winners… 

Where is this? 

Drs. Alan Cousin and Ed Shafii gave us the correct 

answers: The Starbucks used to be this Long John 

Silver’s at the corner of Dale Mabry Highway and 

Linebaugh Ave. Drs. Cousin and Shafii each received a 

gift certificate to Panera Bread. Congratulations! 

The first two HCMA members to guess the location of 

this photo will be recognized in the May/June issue of 

The Bulletin and, best of all, will win a gift certificate! 

Contact Elke Lubin at the HCMA with your guess: 

813.253.0471 or ELubin@hcma.net. Sorry, only one winner 

per household. 


FOR LEASE 

OFFICE FOR LEASE in well established professional 

building for physicians and surgeons. Centrally located 

to Mease Dunedin and Countryside Hospitals. 

2250 Sq Ft, with plumbing, wiring for x-ray and medical 

equipment, cabinets. Six exam/operating rooms, 

recovery room, labs, sterilization, large reception, 

staff and chart area. Well kept and ready to move in. 

Abundant parking. MUST SEE. Call 727-791-7299 for 

more information. 

Citrus Park – sublease, available on Tues, Thurs, Fri, 

and Sat. 1,000 to 1,700 square feet furnished. Day/s, 

footage, pricing, all negotiable. 813.971-9743 ext. 

109, Dona 

Palma Ceia South Tampa 3100 Sq. Ft. Medical Ofc. See 

photo this Bulletin Exc Visibility from Dale Mabry. 

(813) 286-0529. 

FOR LEASE OR SALE 

BRANDON MEDICAL OFFICE NEXT TO HOSPITAL. 

2050 sq ft. Newly Remodeled. Call Dr. Karp 813-787- 

6972. 

FOR RENT OR SALE 

Fully equipped medical office space, 2-3 days a week. 

Located at the LIFEHOPE Office Bldg adjacent to 

Florida Hospital Tampa and Pepin Heart Hospital. 

813-933-9666. 

FOR SALE 

Medical office for sale. South Tampa. 3000 sq. feet. 

2919 Swann Avenue. Fully equipped if needed. Call 

813-625-7808. No brokers commission paid. 

SHARING OF RENT/COMMON EXPENSES 

Orlando J. Castillo, MD, nephrologist, looking for 2 or 

3 other doctors any specialty to share with him his 

office. Good enough for 4 doctors. Located: 2810 W. 

St. Isabel St., #101, Tampa, 33607. Ph: 813-294-8002. 

CLASSIFIED 

ADS: 

$10 per line. 

Call 813.253.0471 

Ads 

Classified 

Happy Spring! 

INDEX OF ADVERTISERS 

Please support YOUR advertisers! 

Tell them you saw their ad in The Bulletin! 

AMO Office Supply ................................................19 

The Bank of Tampa................................................6 

Cherry Bekaert & Holland/CPAs...........................38 

Coverall Cleaning Concepts..................................Card Shop 

Cyberknife Centers................................................24 

Dajalu.com/Tampa Photography...........................24 

DeGuenther & Associates/Insurance....................Inside Back Cover 

Dry Ice Florida.......................................................Card Shop 

Florida Doctors Insurance Company/MedMal......Back Cover 

The Florida Healthcare Law Firm ........................20 

HCMA Installation Dinner Meeting......................8 

Heinz & Associates/Decorative Pavers..................Card Shop 

Don Juceam/Tampa’s Frank Sinatra.....................12 & Card Shop 

William Dudney, MD .............................................Card Shop 

MetLife/Disability Insurance.................................37 

Moffitt Cancer Center............................................18 

Palma Ceia Office for Lease ..................................18 

Parthenon West/Web Design.................................Card Shop 

Principal/Disability Insurance ..............................28 

ShredQuick............................................................26 

SunTrust Bank.......................................................Inside Front Cover 

Ultimate Medical Academy/Externs-Staffing........3 

Wasson & Associates/Workers’ Comp...................10 

Card Shop ...........................................42 



The 

Card Shop 

Service Ads - Business Card size...The perfect advertising opportunity for companies such 

as your favorite transcriptionist, electrician, plumber, A/C repairman, automotive repair 

shop, lawn maintenance business, restaurant, or office cleaning crew. Contact Elke 

Johnston, Managing Editor, at 813/253-0471, to find out how to place a business card ad. 

P.O. Box 2526 

Lutz, FL 33548 

Ph: (813) 909-4822 

www.parthenonwest.net 

kelly@parthenonwest.net 



Veronica DeGuenther 

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Insuring your future. 

Please call my office today for a free, in-person or telephone consultation 

regarding your medical malpractice coverage. 

Now insuring your fun. 

Whether you are a serious car collector, or have just one vehicle of particular 

interest and value – call me. DeGuenther & Associates is now an authorized agent 

for Hagerty – the gold standard for collectible and vintage automobile insurance. 

Call or email today for a free quote. 

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Please tell the advertiser you saw it in the HCMA Bulletin!

March/April 2012 - Hillsborough County Medical Association

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