March - April 2013 - Hillsborough County Medical Association

The 

Bulletin 

OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCIATION 

March/April 2013

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HCMA BULLETIN, Vol 58, No. 6 – March/April 2013 3

The 

Bulletin 

OF THE HILLSBOROUGH COUNTY MEDICAL ASSOCAITION 

Executive Council 

William Davison, MD, President 

Chris Pittman, MD, 

President Elect 

Devanand Mangar, MD, 

Vice President 

Malcolm Root, MD, Treasurer 

David Lubin, MD, Secretary 

John Curran, MD, 

Chairman, Board of Trustees 

Mathis Becker, MD, 

Immed Past President 

Husain Nagamia, MD, 

Dist. 1 (2014) 

Martha Price, MD, 

Dist. 2 (2013) 

Lori Slezak, MD, 

Dist. 3 (2014) 

Jose Jimenez, MD, 

Dist. 4 (2013) 

Stanley Dennison, MD, 

At Large (2013) 

Kimberly Smith, MD, 

At Large (2013) 

Colin Beach, MD, 

At Large (2014) 

David Mason, MD, 


Anthony Pidala, MD, 


Catherine Lynch, MD, 

USF Dist. (2013) 

Dominic Castellano, MD, 

Yng Phys (2013) 

Karen Pittman, 

Alliance President 

*Barbara Bachman, MD, 

Women Physicians 

*Fred Bearison, MD, 

Board of Medicine 

*Gabriel Gonzales, MD, 

TBLAMS 

*Douglas Holt, MD, 

Health Dept. Rep. 

*Stephen Klasko, MD, 

USF COM Dean 

*Rakesh Kumar, MD, FAPI 

*Nishit Patel, MD, 

Resident Phys. Rep. 

*Alexandra Printz, 

Medical Student 

(* = ex-officio representatives) 

Board of Trustees 

John Curran, MD, Chairman 

Malcolm Root, MD, Treasurer 

William Davison, MD, President 

Chris Pittman, MD, 

President Elect 

Mathis Becker, MD, 

Immed Past President 

Michael Wasylik, MD, (2014) 

Bruce Shephard, MD, (2015) 

Kenneth Louis, 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 Hills bor ough 

County Medi cal Asso ciation, 

Inc., 606 S. Boule vard, Tampa, 

Florida 33606. 

Advertising in The Bulletin 

does not imply approval or 

endorsement by the Hillsborough 

County Medical 

Associa tion. The Bulletin 

assumes no responsibility for 

statements made by its contributors. 

For advertising rates 

and mechanical data, contact 

the HCMA. 

Opinions expressed by the 

authors are their own, and 

not necessarily those of The 

Bulletin or the HCMA. The 

Bulletin reserves the right 

to edit all contributions for 

clarity and length as well as to 

reject any material submitted. 

Executive Council Meeting 

6:00 PM @ the HCMA Office 

May 21, 2013 

HCMA Dinner Meeting 

Advertising 


Watch your email 

for more details 

The Card Shop.............................................46 

Classified Ads................................................45 

Full Page Advertisers...................................39 

Index of Display Ads.....................................45 

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 58, No. 6 – March/April 2013

The Bulletin: March/April 2013 

About the Cover 

This issue’s cover photo was taken by HCMA member, Dr. Bruce Shephard. These 

huge butterflies’ scientific name is Idea leuconoe. They are also known as the Giant 

Tree Nymph, Paper Kite, or Giant Wood Nymph Butterfly. The Idea leuconoe is known 

especially for its presence in butterfly greenhouses and live butterfly expositions. It is of 

Southeast Asian origin. 

Features 

President’s Message...........................................7 

A Luxury We Can’t Afford 

William Davison, M.D. 

Editor’s Page.................................................9-10 

In the words of John Tortorella... 

“Shut your yap!” 

David Lubin, M.D. 

Executive Director’s Desk..........................11-12 

Viva Las Vegas 

Debbie Zorian 

Legislative Session 

2013 FMA Legislative Agenda.17-19 

Hillsborough County 

Legislators’ Contact Info.......20-21 

Medical/Legal Update.................................27-28 

Split Fee Soup: 

A Recipe for Disaster 

David Hirshfeld, Esq. 

Practitioners’ Corner.................................31-32 

Why Now 

Robert Norman, DO 

Restaurant Review...........................................21 

Pearl in the Grove... 

Taste Bud 

Photo Gallery 

Photo Contest Answer....................................10 

Legislative Luncheon.....................................22 

February 5, 2013 Dinner Meeting............ 24-25 

Quarterly Social..............................................35 

Gasparilla Parade............................................36 

Committee Happenings 

Nominating Committee Report......................15 

Executive Council......................................29-30 

Meeting Highlights – 1/15/13 

For Your Information 

CME, Seminars, Workshops, & 

Conferences............................................42-44 

Medical Briefs.............................................37-38 

New Members..................................................14 

Personal News.................................................41 


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A Luxury 

We Can’t Afford 

Well, I’ve been waiting to hear whether 

Florida will become part of the Obamacare 

experiment. It appears that we are headed 

in that direction. Gov. Scott announced yesterday 

that Florida will expand Medicaid for the next 

three years as long as Washington pays for 100% 

of the costs. 

Although I am opposed to the un-Affordable 

Care Act, I can clearly see why this was the only 

way the governor could go - all Floridians will be 

paying taxes for it but not getting anything back if 

we did not go along with Washington’s plans. 

Doctors make up a large portion of the top 1% 

of American taxpayers and we will all be paying 

extra tax for the privilege of supporting our venture 

into subsidized medical care. Hospitals and 

other healthcare business were looking at lower 

reimbursements for services under Obamacare but 

now have huge potential with so many more people 

covered under Medicaid. I can hear big sighs 

of relief in the boardrooms of our healthcare related 

enterprises now that another 900,000 Floridians 

are covered by the Medicaid system. It remains to 

be seen the effects this will have on our free clinics, 

health departments, federally funded healthcare 

clinics, and our own Hillsborough County 

Health Plan. Primary care physicians are slated to 

be paid at Medicare rates and so those folks stand 

to benefit from this move as well. 

The possibilities to engage in large scale primary 

care practices have now been augmented with 

huge infusions of cash due to the ACA. Groups 

like Tampa General and the University of South 

Florida Practice Plan, as well as some of the other 

medical groups in town, appear to be poised for 

substantial improvement in their bottom lines 

thanks to the ACA. 

The increased demands of about one million 

newly insured patients have not been lost on those 

business minded professionals. I suspect we will 

be seeing big changes in the near future to service 

these new “customers.” Who knows, I may even 

want to get in on this myself! The dilemma, however, 

is how long can this cash-cow last Will it 

be sustainable for longer than the short run or will 

we discover what all of us are afraid of - that we 

cannot afford this luxury. 

Only time will tell - I am dying to know how 

all this will turn out. Too bad the crystal ball is so 

cloudy! 

The HCMA and FMA will be charged with 

helping our state through all this. We have incredible 

talent in these organizations but could always 

use some help. If you feel that you may be able 

to assist in this journey, please jump on the train 

and help us to help you practice medicine! We are 

looking for future leaders and members, and God 

knows, we could always use the help. 

This is my last “President’s Message,” as Dr. 

Chris Pittman will be installed as the HCMA President 

in May, and will take over this regular feature 

of The Bulletin. It’s been my honor to serve as 

your President. I plan to stick around for some 

time to participate in projects and events, and hope 

to see everyone soon. 

Bless you for what you do. 

President’s Message 

William Davison, MD 

DAVRAC4964@aol.com 


WMS 

HCMA Female Members, 

The newly established HCMA focus group, 

the Women in Medicine Section (WMS), is 

asking for your input. It is the goal of the 

WMS to reach out to the female member 

physicians of the HCMA, and in our county, 

who have been inconspicuous, albeit very 

important segments of our medical community. 

The goal of the WMS is to promote a 

forum for networking and continuing education, 

and solicit ideas and energy from these 

members to make the HCMA relevant and 

useful to them, their practices, and their 

families. 

The HCMA staff is in the beginning stages 

of planning the first WMS gathering and 

we’d appreciate your opinion. Before choosing 

a speaker, we’d like to ascertain what 

topics are pertinent to you. Your input is 

valued as we strive to serve the needs of our 

female members. 

Please do not hesitate to contact Executive 

D i r e c t o r , D e b b i e Z o r i a n , 

(DZorian@hcma.net) or Executive Assistant, 

Elke Lubin, (ELubin@hcma.net), if 

you have any questions or wish to discuss 

the HCMA’s WMS. 

Please take a few minutes to review and 

complete the short questionnaire below. 

Indicate all topics that appeal to you: 

___ Balancing your professional and personal lives 

___ Personal financing and investing 

___ Managing your practice 

___ Health and beauty 

___ Sexual health and intimacy 

Suggested Topics (please list additional topics that 

interest you): 

If you are interested in serving as a committee 

member of the WMS, please provide us with your 

name, email address, and the best way to contact 

you: 

Thanking you in advance for your response. 

Please complete the questionnaire and 

fax to: 813.253.3737. 



In the words of John Tortorella 


John Tortorella, the Tampa Bay Lightning 

coach during the successful run to winning 

the Stanley Cup in 2004, told the Philadelphia 

Flyers coach, Ken Hitchcock, to mind his own 

business and not talk to his players…in so many 

words. Well, three to be exact. 

And with all due respect to Torts, I’d like to say 

to HCMA members, spouses, significant others, 

guests, medical students, sponsors…and anyone 

else sitting at the dinner tables, please… 


I’ve been an officer of the HCMA for at least 10 

years and thus I sit at the head table, giving me 

an overview 

of the entire 

banquet 

room. It’s 

unbelievable, 

that when 

our president 

calls 

the meeting 

to order, and 

starts speaking, so does everyone else seated at 

tables. I’ve even had the person next to me at the 

head table try to carry on a conversation while 

the president was trying to address the audience. 

It’s just plain RUDE! 

Of course, when the magical silverware hits the 

glass of water, the crowd quiets down for a bit. It 

used to be just the med students who were guilty, 

but I looked around at the last dinner meeting 

and there was some conversation at almost every 

table. It’s embarrassing. If I were president and 

trying to talk, I wouldn’t until everyone gave me 

the courtesy and stopped talking. It’s bad enough 

we can’t let our phones out of sight for a few minutes, 

let alone hold our tongues for a brief period 

of time during the meeting. 

So I’m asking everyone who reads this to 

please keep quiet, just for a little while, while the 

meeting takes place, and if someone tries to start 

up a conversation, just politely ask them to hold 

their thought until the president and our speakers 

finish. 

Well, since I’ve started this column with a 

“bitch,” I guess I can continue with a “moan” or 

two since I haven’t written a “bitch and moan” 

column in a while. 

I had a female Humana patient who hadn’t 

had an eye exam in about three years, so I opted 

to test her with our tonometer, a screening test 

for glaucoma, which I thought was covered by 

almost every insurance company. The problem, 

obviously, is when I think. She came in with an 

EOB stating that she owed us a bit over $50 as 

the test was not covered. A test that could potentially 

prevent blindness was NOT covered. I love 

Humana… 

A prescription benefits manager denied a prescription 

for 

a young lady 

with anxiety 

and mild depression 

for 

generic Wellbutrin, 

that’s 

G E N E R I C 

W E L L 

BUTRIN. After 

a half an 

hour of wasting my time and speaking with three 

different people, I was asked if the drug was for 

weight control or smoking cessation. No, it was 

for anxiety and mild depression. It was authorized 

for a year. All they would have done was explain 

WHY it was denied in the original fax to me, but 

NOOOOOOOOO… 

I inherited a 59-year-old male from an internist 

who retired. The patient had slightly elevated 

blood pressure, but wasn’t on medication, had a 

family history of heart disease, and slightly elevated 

total cholesterol and LDL. The doctor’s 

notes stated that the patient was declining to take 

any cholesterol medication, despite the elevated 

levels and the strong family history of heart disease. 

That’s fine; I have no problem with a patient 

who decides he understands medicine better than 

I, as long as he initials my note that “he refuses 

treatment.” But I don’t understand why the doctor 

continued to get lipid levels if the patient declined 

treatment and each time the levels were 

about the same. I can understand maybe checking 

yearly or every two years, but not five times 

during a 19 month time period (see the table cen 

(continued) 

Editor’s Page 

David Lubin, MD 

Dajalu@aol.com 


Editor’s Page (continued) 

ter). No wonder the “cost of medicine” is going through 

the roof. 

I don’t know about you clinicians out there, but being 

rather blunt…I’m getting tired of severely overweight, 

ok, fat patients, who refuse to do anything 

for themselves to lose weight, especially the diabetics, 

patients with metabolic syndrome, or those with high 

lipid levels and elevated blood pressure. I don’t know 

how a patient who weighs over 300 pounds cannot lose 

weight with a reasonable diet. I’ve heard them all, numerous 

times…“I only eat one meal,” “I watch what I 

eat,” “I walk the dog every night,” “I joined the gym,” 

and now my new favorite, “The air is very humid here.” 

Yes it is, but I think that might only affect Sponge Bob 

Square Pants. 

I have a very nice female patient, 71 years old, who 

weighs 268 pounds, with a BMI of 45. She has type 2 

diabetes, hypertension, elevated lipids, hypothyroidism, 

rheumatoid arthritis, knee pain secondary to osteoarthritis, 

lower extremity edema, and, well, geez, that’s 

enough, don’t you think She sees a rheumatologist and 

between the two of us, we have her on maximum dosages 

of meds. Her numbers are ok: lipids, A1C, blood 

pressure, but she isn’t working on her weight, something 

that would greatly help her. I don’t know what 

else to do for her, but since I joined Weight Watchers 

and YES, finally fulfilled my New Year’s resolution from 

New Years past to lose 25 pounds, I can, having “talked 

the talk and walked the walk,” encourage my patients to 

join WW. The plan works, it’s simple, it’s not expensive, 

and there are NO Weight Watchers foods that you have 

to eat. There’s simply no reason not to join, but patients 

want a quick fix or someone else to do it for them, and 

not take the responsibility upon themselves. At our 

Weight Watchers meetings, we say it’s “accountability” 

that one must accept to be successful. If you don’t want 

to be accountable to yourself, then there’s not much I 

can do for you. I’m not your friend, I’m your doctor, and 

I’m your medical messenger, not your miracle worker. 

Accept that and don’t make excuses. 

And lastly, I’m a bit perplexed by this one. I was asked 

to evaluate an 80-year-old lady for eyelid surgery. She 

was diabetic with an A1C over 8, but that really didn’t 

concern me for the surgery. What did was a rather loud 

bruit over one of her carotids. An ultrasound showed 

between a 50-74% narrowing. I was concerned about 

her undergoing any type of general anesthesia, so suggested 

to the surgeon and patient that she see a vascular 

surgeon for clearance. I received a report from a cardiologist, 

whom the patient saw after her son made the 

appointment, which included an echocardiogram and 

exercise stress test. Both tests were essentially normal 

for her age. I wanted someone to evaluate her carotids, 

not her heart, and I was a bit confused. So I called 

the cardiologist for an explanation. He told me that, in 

his experience, blockage of a carotid, even in the 50- 

74% range, was not a problem if the patient was asymptomatic. 

I said, “Ok, that’s fine, but why did you do the 

echo and stress test” He couldn’t really say, but he did 

reiterate that the carotid blockage shouldn’t stop her 

from having the eyelid surgery. I never did get an 

explanation for why the tests were done. It still 

doesn’t make any $en$e. 

Photo Contest Answer…No One Guessed! 

This was a tough one! After publishing the photo in THREE issues of The Bulletin, no one was able to come up with 

the correct answer: The “Future Walk” sculpture at the HCC Ybor City Campus. 


Viva 

Las Vegas 

became a mother at a very young age. My 

I daughter, Charisse, was born in 1971. My 

second daughter, Gina, was born in 1978. I had 

no plans to have children after that, but low and 

behold, I gave birth to Justin in 1992. 

I quickly realized that having children 21 

years apart was not that unusual. I found that 

many experienced the same situation. In fact, 

it’s rather common when people remarry…especially 

if a parent was young at the time their first 

child was born. 

Charisse married her high school sweetheart 

in 1990 and in August of 1991, my first grandson, 

Austin, was born. I remember all the shopping 

and the excitement of helping decorate my 

grandson’s nursery. The thrill of his upcoming 

birth eluded the fact that I was going to become 

an unusually young grandmother. That soon became 

a nonissue when, 

much to my surprise, 

I found out that I was 

pregnant! 

So there I was, about 

to become a grandmother 

for the first time…and 

about to become a mother 

again for the third. 

Four months and eight 

days after my grandson 

was born, my son came 

into the world. Having 

the two of them grow 

up together has been fun, exciting, many times 

exhausting, and sweetly memorable. For many 

years, prior to my other grandchildren being 

born, it was just the four of us. We did everything 

and went everywhere together. From parks 

and beaches, to baseball games and the movies… 

we were inseparable. We spent every holiday together 

and on occasion my daughter and I even 

bought our sons the same Christmas gifts in order 

to avoid controversy. 

Everyone always thought that Justin and Austin 

were brothers; they didn’t look alike when 

they were younger, but the closeness between 

them was undeniable. I remember many times 

my grandson putting his arm around my son’s 

neck after being questioned only to brag, “Nope, 

this is my uncle and he’s younger than I am!” 

As my son and grandson were growing up, developing 

their own personalities, choosing different 

paths in sports and outside interests, they remained 

very close. Through thick and thin, they 

were always there for each other. I’m sure they 

have a few stories to tell that my daughter and I 

don’t necessarily need to hear. 

My daughter and I have never lived more than 

15 minutes apart so it was easy for our sons to 

spend much time together, including overnight 

stays on weekends. Our annual family vacation 

was spent in Boca Grande where the boys would 

play games, swim, fish, golf, and just hang out. 

When they became teenagers we would rent a 

golf cart for them so they could take off to roam 

and explore the island on their own. 

When our sons were 20 years old, my daughter 

and I started talking about taking them to Las 

Vegas to celebrate their 21 st birthdays together. 

They both have had somewhat sheltered lives 

when it comes to 

traveling. We knew 

the excitement of Vegas 

would certainly 

be an experience for 

them, plus they both 

enjoy playing poker. 

Most of the time they 

play with friends in 

a laid back environment…and 

with 

minimal money at 

stake. Occasionally, 

they will venture out 

to the Hard Rock in Tampa but never exceed the 

planned amount of money allotted for a possible 

loss. When they come back winners, even if by a 

slight margin, they are happy campers. 

When my grandson turned 21 he didn’t mind 

having to wait a few months to “celebrate” his 

birthday. They talked about the trip often, while 

I was planning behind the scenes. Of course a few 

months seemed like forever for both of them, but 

on January 8 my son turned 21 and two days later 

we were on our way! 

As soon as we boarded the plane in Tampa the 

excitement was abundant. It was difficult to hide 

my own excitement, as I had a few surprises waiting 

for them. One included a limo driver waiting 

for us at the airport in Vegas. He held a sign that 

read, “Justin & Austin.” When they first spotted 

him it took a minute for reality to sink in. They 

(continued) 

Director’s Desk 

Executive 

Debbie Zorian 

DZorian@HCMA.net 


Exec. Director’s Desk (continued) 

then turned, looked at my daughter and me, and said 

simultaneously, “No way!” 

Another surprise was staying at the Bellagio...what I 

consider to be one of the finer hotels in Vegas. As you 

enter the grand hotel lobby, a mirrored mosaic horse 

sculpture stands below an 18-foot coffer ceiling filled 

with the most extraordinary glass sculpture and chandelier. 

Brilliant Chihuly glass art sculptures also adorn 

the areas of the Conservatory and breathtaking Botanical 

Gardens. 

As we were ushered into VIP check-in I could hear the 

boys chattering with excitement. They were captivated 

by all the glamour, hustle and bustle, and sounds of slot 

machines pinging and roulette wheels spinning. We 

were then escorted to a beautiful suite, offering a spectacular 

view of the mountains. We could even see the 

mountain tops capped with snow. 

That evening, at the Bellagio’s Prime Steakhouse, 

we enjoyed dinner while sitting at a table by the window 

where we watched performances of the illustrious 

Bellagio fountains every 15 minutes. The fountains can 

rocket and dance up to 460 feet in the air and are illuminated 

by almost 5,000 lights. For those who have seen 

this aquatic extravaganza, I’m sure you will agree it is 

more than delightful. 

The next three days went by quickly as we crammed 

in as much as possible including a couple of wonderfully 

engaging Cirque du Soleil shows. We lounged in the 

morning after being up most the night, ate breakfast in 

the middle of the day, shopped while our sons gambled, 

and rarely looked at our watches except to check on dining 

and show reservations. On the last night, Justin and 

Austin left their moms behind to walk the strip and experience 

a bit of entertainment on their own. They fancied 

a show, where they enjoyed seats that touched the 

stage and were amused by all the glitz and glam. Against 

his will, my son even ended up on stage! I understand 

that he was quite a trooper as my grandson chuckled and 

needled him from their seats below. There is no doubt 

that Justin and Austin will always remember the experiences 

and fun of celebrating their 21 st birthdays together 

in Vegas. 

And I can’t end my personally joyful article without 

sharing the conclusion of our whirlwind but fabulous 

trip… 

While waiting at the airport to board the flight home, 

Austin walked over to a slot machine and on a whim, inserted 

a dollar bill. It was an unusual gesture as neither 

Austin nor Justin ever play the slots. All of a sudden we 

heard, “Ding…ding…ding…” along with Austin’s yells 

which could be heard throughout the airport. 262 dollars 

on the spot! Justin and Austin were laughing and 

high fiving each other as if Austin just won 262 thousand 

dollars! One lady nearby was watching them with 

amusement and asked, “Are you twins” A smile 

from ear to ear covered their faces as one of 

them said, “No, but we might as well be.” 


Hillsborough County Medical Association 

CORDIALLY INVITES YOU TO ATTEND THE 

ANNUAL INSTALLATION DINNER MEETING 

TUESDAY, MAY 7, 2013 

Organization 

Christopher Pittman, M.D., will be installed as HCMA’s 2013-2014 President 

Special Guest Speaker 

Jonathan D. Fleece 

“Practical Opportunities for Physicians to Prevail 

in the New Health Age” 

Jonathan Fleece is a leading health care attorney, with over 

15 years experience. He is an expert in Health Care Reform 

Laws and the Patient Protection and Affordable Care Act 

(PPACA). He is also an acclaimed co-author of The New 

Health Age: The Future of Health Care in America. 

InterContinental Hotel 

4860 W. Kennedy Boulevard 

6:00-7:00 PM ~ Social Hour 

7:00 PM ~ Dinner & Program 

Spouse/Guest $40.00 

All Reservations and Dinner Cancellations 

must be made by May 2, 2013 

Please RSVP to Kay Mills at 813. 253.0471 or KMills@HCMA.net 

Sponsored by: 

Bright House Networks Business Solutions—Enterprise 

Florida Blue 

HCMA Health Plan 

The Bank of Tampa 


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• cervical Disk Herniations 

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• Brain Tumors 

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• arteriovenous Malformations 

• aneurysms 

For physician profiles, office hours and 

other details, please visit us online: 

HealthPointMedicalGroup.com 

• Trigeminal neuralgia 

• stereotactic radiosurgery 

• carpal Tunnel syndrome 

• cubital Tunnel syndrome 

We accept most commercial 

health insurance. 

NEWEST 

MEMBERS 

Sara Ansari, DO (PD) 

Toinette Chin, MD (OBG) 

Kevin Donnelly, MD (OTO) 

Michael Flannery, MD (IM) 

Talal Hamdan, MD (CD) 

Jakub Kahl, MD (EM) 

Charles Nofsinger, MD (ORS) 

Nalin Patel, MD (OTO) 

Paul Pulcini, MD (FP) 

Michael Shereff, MD (ORS) 

Sherley ValdezArroyo, MD (N) 

Stephen Wagner, MD (OBG) 

Genelle Walters, DO (OBG) 

We Want to Hear 

from YOU! 

The HCMA Benefi t 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 Benefi 

t Provider Program include 

medical malpractice insurance, offi ce 

supplies, document shredding, retirement 

plans, and banking services, to 

mention only a few. 

If you have taken advantage of the HCMA 

Benefi t Provider Program, we want to 

hear from you. Please send us feedback 

regarding your experience/s with our 

benefi t provider companies. Send an 

email to Debbie Zorian, HCMA Executive 

Director, (DZorian@hcma.net) 

and let her know which benefi t 

provider/s you have used and 

the quality of the service you 

received. Ms. Zorian can also be 

reached by calling the HCMA offi ce 

(813.253.0471). 

Questions about your 

HCMA membership 

We have the answers… 

813.253.0471 



Nominating Committee Report 

ALL ACTIVE, AFFILIATE, LIFE, AND RETIRED PAST PRESIDENTS, WHO HAVE PAID THEIR 2013 

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 2013 election. Official ballots will be mailed in early April and winners will be 

announced at the May 7 th General Membership 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. 

The HCMA By-Laws established six District Representatives to the Executive Council and one Young Physicians 

Seat. District 2 (South Tampa), District 4 (NE Hillsborough County), At Large, Plant City, USF College 

of Medicine, and the Young Physician seats will be elected this year for two-year terms. Each member votes 

for the entire slate, except members whose principle office is located in the respective districts may vote for 

their district and At Large nominees; members whose principle office is located in the At Large Districts vote 

only for At Large nominees. 

PRESIDENT-ELECT VICE-PRESIDENT SECRETARY TREASURER 

(unopposed) (unopposed) (unopposed) (unopposed) 

Dr. Devanand Mangar Dr. Jose Jimenez Dr. David Lubin Dr. Joel Silverfield 

EXECUTIVE COUNCIL/AT LARGE (2 yr. term) 

(two will be elected) 

Dr. Stanley Dennison 

Dr. Malcolm Root 

Dr. David Orban 

Dr. Pedro Soler 

Dr. Radhakrishna Rao 

EXECUTIVE COUNCIL 

District 2 (2 yr. term) 

(one will be elected) 

Dr. Michael Levitt 

Dr. Jason Wilson 


USF District (2 year term) 

(unopposed) 

Dr. Richard Lockey 


District 4 (2 yr. term) 


Dr. Steven Barna 

Dr. Sarah Kline 


Plant City Dist. (2 year term) 

(unopposed) 

Dr. Dragos Zanchi 

BOARD OF CENSORS (3 yr. term) EXECUTIVE COUNCIL 

(unopposed) 

Young Phys. Seat (2 yr. term) 

Dr. Jayant Rao 


Dr. Bruce Shephard 

Dr. Scott Anderson (ENT) 

Dr. Pedro Soler 

Dr. Jayant Rao 

BOARD OF TRUSTEES (4 yr term) 

(unopposed) 

Dr. Fred Bearison 

DELEGATES TO THE FMA (3 yr. 

term) (unopposed): Drs. Gene Balis, 

Steven Barna, Stanley Dennison, Anthony 

Pidala, Jayant Rao, Joel Silverfield, 

Pedro Soler, Dragos Zanchi, 

Do not hesitate to contact the HCMA 

office (813/253-0471) if you have 

any questions concerning the 2013 

HCMA Nominating Committee 

Report. 

Respectfully Submitted, 

The HCMA Nominating Committee 

Mathis Becker, MD 

Humberto Coto, MD 

John Curran, MD 

Kenneth Louis, MD 

David Mason, MD 

Husain Nagamia, MD 

Lori Slezak, MD 

Committee Happenings 


We proudly 

HCMA 

BENEFIT 

PROVIDER 

support 

the HCMA 

HCMA 

BENEFIT 

PROVIDER 

 

 

 



2013 FMA 

Legislative Agenda 

ISSUES TO SUPPORT: 

TORT REFORM 

Support legislation that will permit defendant 

providers in a medical liability suit to discuss the 

case with the plaintiff’s other treating providers and 

that will increase the burden of proof for negligence 

in cases involving supplemental diagnostic testing 

in order to reduce costly and unnecessary testing for 

defensive purposes. 

MEDICAID TO MEDICARE 

Increase the reimbursement rate for Medicaid to that 

of Medicare. At the very least seek to ensure that physicians 

have the opportunity to control the disbursement 

of Medicaid funds in any type of capitated system. 

GRADUATE MEDICAL EDUCATION 

Increase state funding for graduate medical education 

programs in order to preserve access to care in Florida. 

PRN 

Support a PRN revisers bill that would: allow PRN to 

provide services to all health care professionals, ensure 

sovereign immunity coverage for all types of actions, 

clarify that licensure from DCF as a “treatment center” 

is not required, address the discoverability of PRN 

work product, and add first responders to PRN’s scope 

of service. 

CAT FUND 

Seek permanent exemption for medical malpractice 

insurance from any assessments levied on premiums 

for property and casualty insurance by the Florida 

Hurricane Catastrophe Fund. 

HOSPITAL DEPARTMENT CLOSURE 

Give the Agency for Health Care Administration the 

power to investigate decisions by a hospital to close 

a particular department and to take action to ensure 

patients are not left without needed medical care. 

TRANSPARENCY IN HEALTH INSURANCE CPT 

REIMBURSEMENT SCHEDULES 

Support legislation that would require all health insurance 

companies licensed in Florida to give all physicians 

access, on the company’s website, to the participating 

physician’s current complete fee schedule. 

PROHIBIT ARTIFICIAL PRICE CONTROLS OF 

NON-COVERED SERVICES 

Support legislation that would prohibit Florida insurance 

companies from forcing contract provisions on 

health care providers for services not covered by the 

plan. 

PREAUTHORIZATION FOR MEDICAL 

TESTING 

Support legislation making it unlawful for an insurance 

company or other third party payer to interfere 

with a licensed MD/DO’s valid order for a medical test 

or procedure. 

DETERMINATION OF MEDICAL BENEFITS 

Seek legislation that would require managed care organizations 

to provide “real time” eligibility for their 

subscribers and reimburse physicians for any patient 

services rendered whereby subscriber eligibility has 

been confirmed prior to the delivery of care. 

USE OF THE TERM “PHYSICIAN” 

Support legislation that would prohibit the use of the 

term “physician” by any person other than an M.D. or 

D.O. 

IMPLEMENTATION OF FEDERAL AFFORDABLE 

CARE ACT 

Support state implementation of a rate increase to 

Medicaid primary care providers pursuant to the Affordable 

Care Act in a manner that implements the increase 

uniformly and which ensures that primary care 

physicians receive the full increase, and continue to 

support an increase for all physicians. 

Support legislation which ensures that the governing 

body of any Health Insurance Exchange contains adequate 

physician representation and which prohibits 

restrictions on the ability of a physician to bill patients 

directly for the costs of care not fully covered by their 

insurance policy, and which does not weaken any existing 

physician protections in chapters 641 or 627, F.S. 

BOOSTER SEATS / CHILDREN 

Support legislation that requires all children 4 to 7 

years of age and 4’9” in height or less to be placed in 

a properly restrained booster seat when riding in an 

automobile. 

TANNING BEDS 

Support legislation that would prohibit minors from 

using tanning beds. 

NERVE CONDUCTION / EMG 

Seek legislation that would limit the performance of 

nerve conduction studies and needle EMGs in outpatient 

facilities to situations where the licensed 

allopathic or osteopathic physician who is interpreting 

the study is onsite at the time the study is performed. 

TEXTING WHILE DRIVING 

Support legislation banning drivers from manually 

texting or emailing while operating a motorized 

vehicle. 

APPROPRIATE PAYMENTS FOR VACCINES/ 

VACCINE ADMINISTRATION 

Seek legislation to ensure commercial insurance 

payment for all vaccines is not less than 25% above 

the vaccine cost on the CDC Vaccine Price List and 

that payment for each billed age-specific and non- 

(continued) 

Legislative Session 

March 5- 



Legislative Session (continued) 

age specific vaccine administration CPT code is not less than 

Medicare rates. 

TRUTH IN MEDICAL EDUCATION 

Seek legislation to make it unlawful for a nurse to represent 

him or herself as a physician (MD/DO), and include such 

activity under the definition of the unlicensed practice of 

medicine with felony-level penalties for such representation. 

PAIN CLINICS 

Seek legislation that allows state law regarding the standards of 

practice and registration of pain clinics to supersede any local 

ordinances and explicitly prohibits counties and municipalities 

from passing such laws. 

AUTOMATIC SUBSTITUTION OF BIOSIMILARS 

Support legislation that would enact statewide guidelines on 

the substitution of “biosimilars.” 

DEFINING EXPERT TESTIMONY 

Support legislation that would require Florida courts to interpret 

and apply principles of expert testimony in conformity 

with the Daubert standard, as set forth by the United States 

Supreme Court. 

ENSURING PAYMENT FOR NEWBORN CARE 

Support legislation so that a newborn’s medical care is covered 

under the mother’s health insurance for the first 30 days of life 

and that the newborn’s insurance be active at the time of birth 

with no additional costs for the policyholder during the first 30 

days and regardless of whether or not the child is registered. 

BENEFITS MANAGEMENT 

Seek legislation that would require the following: any physician 

who makes health insurance coverage recommendations 

regarding approval or disapproval of any patient care decisions 

be licensed in the state of Florida and be a member of the same 

specialty as the ordering physician; all benefits managers to 

be considered as “practicing medicine” when taking action to 

approve or disapprove a benefit for a patient; benefits managers 

to disclose, upon request, the guidelines used to make 

a negative recommendation; and that ordering physicians be 

compensated for their time at market value when interacting 

with benefits managers hired or engaged by any third party. 

PAYMENT FOR PREVENTATIVE SERVICES 

Seek or support legislation so that comprehensive preventive 

medicine CPT codes (99381-99387, 99391-99397) are paid at 

least at “Medicare” rates, as calculated by using RVU’s obtained 

from the Centers of Medicare and Medicaid Services (CMS); 

and also seek or support legislation so that vision screening, 

hearing screening, VEP (visual evoked potential), and recommended 

age-appropriate laboratory procedures and tests are 

required to be paid independently when performed along with 

a comprehensive preventive medicine CPT code (99381-99387, 

99391-99397). 

APPROPRIATE PAYMENTS BY AHCA FOR VACCINES / 

ADMINISTRATION 

Work with the Agency for Healthcare Administration (AHCA) 

or seek legislation to increase vaccine payments to at least 25% 

above the vaccine cost, as listed on the CDC Vaccine Price List, 

for patients with MediKids or Healthy Kids insurance; encourage 

AHCA to update its vaccine fee schedule for MediKids and 

Healthy Kids patients on the first day of every quarter on their 

website; and work with AHCA or seek legislation to increase 

vaccine administration payments for all patients covered by 

Florida KidCare (Medicaid, MediKids, Healthy Kids, Children’s 

Medical Services) to the Maximum Regional Charges for Florida 

($24.01) as established by the US Department of Health and 

Human Services. 

TIMELY AND APPROPRIATE PAYMENTS FOR NEW CPT 

CODES 

Seek or support legislation to ensure that, beginning January 

1 st of each year, health insurance companies recognize and pay 

physicians for all current-year CPT codes billed. 

APPROPRIATE PAYMENT FOR VACCINE PRICE 

INCREASES 

Seek or support legislation so that health insurance companies 

increase vaccine payments by an amount at least equal to the 

manufacturer vaccine price increase(s) beginning on the day 

the price increase(s) goes into effect. 

CMS VERBAL ORDER AUTHENTICATION 

REQUIREMENT 

Collaborate with the Florida Hospital Association and the Florida 

Society of Hospital Physician Executives to effect legislative 

change to FS 395.3025(12) as follows, “Verbal or telephone 

orders for hospital services must be authenticated within 30 

days from the date of patient discharge. The hospital must 

maintain the written authentication or documentation of the 

efforts made to obtain such authentication as part of the medical 

record.” 

IDENTIFY INTERVENTIONAL PAIN MEDICINE AS THE 

PRACTICE OF MEDICINE 

Support legislation that identifies interventional pain medicine 

as the practice of medicine by medical and osteopathic 

physicians and specifies that only physicians licensed under 

Chapter 458 or Chapter 459 may perform interventional pain 

medicine techniques. 

HMO’S BAIT AND SWITCH 

Support legislation that would require HMOs to allow any policyholder 

to continue to utilize the services of any physician 

who was on the list of preferred providers as of the date of the 

policyholder’s enrollment for no less than one year from the 

date of enrollment. 

LEGALIZING SYRINGE EXCHANGE PROGRAMS IN 

FLORIDA 

Seek legislation to amend Chapter 893, Florida Statutes, to legalize 

Syringe Exchange Programs in the state of Florida. 

PENALTIES FOR CARETAKERS WHO WITHHOLD 

INFORMATION 

Support legislation that would make it a crime for caretakers 

to purposely withhold information and/or provide false 

or misleading information to treating physicians/health care 

professionals regarding the true nature of a child’s injury or 

condition. 

NEONATAL PULSE OXIMETRY HEART DISEASE 

Support legislation to require that all Florida newborns be 

screened for critical congenital heart disease using pulse oximetry 

and that newborn pulse oximetry be added to list of 

mandated newborn screening tests. Such legislation will 

also direct Children’s Medical Services to develop and implement 

a screening program for critical congenital heart disease 

(CCHD) and track the results in all newborns. 

MUSCLE-BUILDING DRUGS 

Support legislation that transfers Somatropin (HGH), Sermolelin, 

Chorionic Ganodotropin (hCG), and other musclebuilding 

drugs, as necessary, to the list of Schedule III drugs. 


COMMERCIAL WEIGHT LOSS PROGRAMS AND 

UNLICENSED DIETETIC ACTIVITY 

Support legislation to amend the Florida Commercial Weight- 

Loss Practices Act (s. 501.073, F.S.) to require public disclosure 

of the name and license number of any licensee who reviews 

and approves a weight-loss program. 

RECOGNITION AND TREATMENT OF ANAPHYLAXIS 

Seek legislation to require that school personnel, including 

but not limited to teachers and nurses, be instructed to recognize 

and treat an individual experiencing an anaphylactic 

emergency, particularly through the administration of an epinephrine 

auto-injection, and also require all schools to have 

a non-student specific epinephrine auto-injector available on 

site for treatment purposes. 

PHYSICIAN ASSISTANTS ORDERING MEDICATIONS 

Support legislation that clarifies the authority of physician assistants 

to order medications for their supervising physician’s 

patient in a hospital setting. 

ISSUES TO OPPOSE: 

MEDICAID REFORM 

Oppose the statewide expansion of the Medicaid Pilot Project 

that would effectively move almost every Medicaid patient into 

a Medicaid HMO. Oppose any effort to mandate Medicaid participation 

as a condition of physician licensure. 

MANDATORY PARTICIPATION IN HEALTH NETWORKS 

Oppose legislation that requires the linkage of physician licensure 

to the acceptance of any government or private insurance, 

public health care system, forced public service initiatives or 

mandatory ER coverage. 

PRESCRIPTION DRUG MONITORING DATABASE 

Oppose mandates on physicians to check Florida’s prescription 

drug monitoring database before issuing a prescription. 

BALANCED BILLING 

Oppose the imposition of any new restrictions on the ability 

of a physician to bill patients directly for the costs of care not 

fully covered by their insurance policy. 

SCOPE OF PRACTICE EXPANSIONS 

Continue to oppose all scope of practice expansions including 

naturopaths, ARNPs, pharmacists, optometrists, psychologists, 

podiatrists, direct access to physical therapists, audiologists 

and speech language pathologists. 

AUTONOMY IN MEDICAL DECISION MAKING 

Oppose any legislation that would infringe on physician practice 

autonomy and the doctor/patient relationship. 

PROTECT ABILITY TO SELF INSURE 

Oppose legislation that will take away a physician’s ability to 

self insure or that will make it more difficult for a physician to 

meet the financial responsibility requirements for licensure. 

WRONGFUL DEATH 

Oppose any expansion of Florida’s Wrongful Death Act. 

VACCINATIONS 

Oppose any vaccine legislation that would deviate from evidence-based 

recommendations and guidelines of the Centers 

for Disease Control and Prevention, the Advisory Committee 

on Immunization Practices, the American Academy of Family 

Physicians, and the American Academy of Pediatrics. 

UNFUNDED MANDATES 

Oppose any legislation that imposes additional costs on physicians 

or their practices without remuneration or other mechanisms 

to offset the additional costs. 

FABRE CHANGES 

Oppose any legislation changing current law relating to the 

Fabre doctrine. 

PHYSICIAN SUPERVISION ISSUES 

Protect advances we have made relating to physician supervision 

of nurses and PAs. 

ARBITRATION 

Oppose any changes to the statutes/rules governing arbitration 

that would jeopardize the effectiveness of the FMA created 

physician-patient arbitration form. 

MANDATORY PARTICIPATION IN HEALTH NETWORKS 

Oppose legislation that would tie physician licensure to mandated 

participation in any health care network, insurance plan 

or public health care system, forced public service initiatives, 

mandated emergency room coverage, or affiliation with any 

public or private third party payor organization. 

LIMITS ON PHYSICIAN / PATIENT CONVERSATIONS 

Oppose any legislation that would seek to interfere with the 

scope of conversations a physician can have with their patients 

or patient’s guardian. 

PHYSICIAN DISPENSING 

Oppose legislation that would restrict, directly or indirectly, 

the ability of physicians to dispense repackaged medications 

and that would restrict the level of reimbursement necessary 

for physicians to continue point-of-care dispensing to workers 

compensation patients. 

Legislative Session (continued) 

Dr. David Lubin has published a 20 page book 

of what he considers his best photographic 

images, including many from his previous 

Tampa Bay Events Calendars. You can order 

for $35 each, delivery or shipping included, 

by sending a check to him at 508 S. Habana 

Ave, Suite 280, Tampa, FL 33609. 


HILLSBOROUGH LEGISATIVE DELEGATION 

For additional information about Florida Government, visit On-Line Sunshine at: www.leg.state.fl.us 

Information as of January 29, 2013 

SENATOR DISTRICT OFFICE TALLAHASSEE OFFICE STAFF 

JOHN LEGG (R) 813-909-9919 850-487-5017 Tim Couet 

17th District 262 Crystal Grove Blvd. FAX: 888-263-3681 Spencer Pylant 

Hillsborough Legislative Lutz, FL 33548 316 Senate Office Bldg. Becky Zizzo 

Delegation Vice Chair legg.john.web@flsenate.gov 404 S. Monroe St. 

Tallahassee, FL 32399-1100 

Committees: Education (Chair); Appropriations Subcommittee on Education, Appropriations Subcommittee on General Government; Ethics and Elections; Military 

Affairs, Space, and Domestic Security; Regulated Industries; Select Committee on Patient Protection and Affordable Care Act. 

ARTHENIA JOYNER (D) 813-233-4277 850-487-5019 Randi Rosete 

19th District FAX: 813-233-4280 202 Senate Office Bldg. Karen Skyers 

508 W. Dr. MLK Jr. Blvd., Ste. C 404 S. Monroe St. Rosalie Smith 

Tampa, FL 33603-3402 Tallahassee, FL 32399-1100 

joyner.arthenia.web@flsenate.gov 

Committees: Joint Committee on Public Counsel Oversight (Alternating Chair); Appropriations Subcommittee on Criminal and Civil Justice (Vice Chair); Appropriations 

Subcommittee on General Government; Ethics and Elections; Health Policy; Judiciary; Transportation. 

JEFF BRANDES (R) 727-552-2745 850-487-5022 Caitlin Murray 

22nd District 3637 4th St. North, Suite 101 318 Senate Office Bldg. Chris Spencer 

St. Petersburg, FL 33704 404 S. Monroe St. Robert Esposito 

brandes.jeff.web@flsenate.gov Tallahassee, FL 32399-1100 

Committees: Transportation (Chair); Agriculture; Appropriations Subcommittee on Finance and Tax; Appropriations Subcommittee on Transportation, Tourism, and 

Economic Development; Education; Health Policy; Select Committee on Patient Protection and Affordable Care Act. 

TOM LEE (R) 813-653-7061 850-487-5024 Audie Canney 

24th District TBA 418 Senate Office Bldg. Cori Cuttler 

915 Oakfield Drive 404 S. Monroe St. Kimberly Simon 

Brandon, FL 33511 Tallahassee, FL 32399-1100 

lee.tom.web@flsenate.gov 

Committees: Judiciary (Chair); Appropriations Subcommittee on Health and Human Services; Appropriations Subcommittee on Transportation, Tourism, and 

Economic Development; Banking and Insurance; Ethnics and Elections; Gaming; Rules; Transportation. 

BILL GALVANO (R) TBA 850-487-5026 Kathy Galea 

26th District TBA 326 Senate Office Bldg. Allie Mattice 

1023 Manatee Ave. W. Ste. 201 404 S. Monroe St. Whitney Deem 

Bradenton, FL 34205 Tallahassee, FL 32399-1100 

galvano.bill.web@flsenate.gov 

Committees: Appropriations Subcommittee on Education (Chair); Agriculture; Appropriations; Appropriations Subcommittee on Health and Human Services; 

Education; Gaming; Health Policy; Regulated Industries; Rules. 

REPRESENTATIVE DISTRICT OFFICE TALLAHASSEE OFFICE STAFF 

JAKE RABURN (R) 813-653-7079 or 813-653-7098 850-717-5057 Clay Barker 

57th District FAX: 813-653-7099 1003 The Capitol Mary LaFollette 

3618 Erindale Dr. 402 S. Monroe St. 

Riverview, FL 33596-6311 Tallahassee, FL 32399-1300 

jake.raburn@myfloridahouse.gov 

Committees: State Affairs Committee; Education Appropriations Subcommittee; Transportation & Highway Safety Subcommittee; K-12 Subcommittee; Health 

Innovation Subcommittee. 

DAN RAULERSON (R) 813-757-9110 850-717-5058 Amber Smith 

58th District 110 W. Reynolds St., Ste. 204 1002 The Capitol Robyn Bryant 

Plant City, FL 33563 

402 S. Monroe St. 

dan.raulerson@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Regulatory Affairs Committee; Finance & Tax Subcommittee; Health Qulaity Subcommittee; Government Operations Subcommittee; Joint Legislative 

Auditing Committee. 

ROSS SPANO (R) 813-655-3742 850-717-5059 Jonathan Rees 

59th District 11256 Winthrop Main St., Unit A 1002 The Capitol Carol Kolenda 

Riverview, FL 33578-4267 402 S. Monroe St. Gloria Perez 

ross.spano@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Judiciary Committee; Choice & Innovation Subcommittee; Higher Education & Workforce Subcommittee; Health Quality Subcommittee; Civil Justice 

Subcommittee. 

DANA YOUNG (R) 813-835-2270 850-717-5060 Sydney Ridley 

60th District 2909 W. Bay to Bay Blvd., Ste. 202 322 The Capitol Melonie Hoyt 

Hillsborough Legislative Tampa, FL 33629-8175 402 S. Monroe St. 

Delegation Chair dan.young@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Rules & Calendar, Select Committee on Gaming. 


REPRESENTATIVE DISTRICT OFFICE TALLAHASSEE OFFICE STAFF 

BETTY REED (D) 813-241-8024 850-717-5061 Dewayne Mallory 

61st District 2109 E. Palm Ave., Ste. 201 300 House Office Bldg. Patricia Givens 

Tampa, FL 33605-3909 


betty.reed@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Education Committee (Vice Chair); Rules & Calendar; Education Appropriations Subcommittee; Economic Development and Tourism Subcommittee; 

Agriculture & Natural Resources Subcommittee. 

JANET CRUZ (D) 813-673-4673 850-717-5062 Wendy Brill 

62nd Distrtict 2221 N. Himes Avenue, Ste. B 218 The Capitol Sarah Roberts 

Tampa, FL 33607-3139 


janet.cruz@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Health Care Appropriations Subcommittee (Vice Chair); Ethics & Elections Subcommittee (Vice Chair); Appropriations Committee; Energy & Utilities 

Subcommittee; Select Committee on Gaming; Joint Committee on Public Counsel Oversight. 

MARK DANISH (D) 813-910-3269 850-717-5063 Jennifer Gordon 

63rd Distrtict 3246 Cove Bend Drive 1401 The Capitol Brian Mason 

Tampa, FL 33613-2752 


mark.danish@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Agriculture & Natural Resources Appropriations Subcommittee; Economic Affairs Committee; Government Operations Appropriations Committee; 

Education Committee. 

JAMES GRANT (R) 813-265-6280 850-717-5064 James Taylor 

64th Distrtict 12956 N. Dale Mabry Hwy. 405 House Office Building Samantha Harper 

Tampa, FL 33618-2806 


james.grant@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: Select Committee on Claim Bills (Chair); State Affairs Committee (Vice Chair); Higher Education & Workforce Subcommittee; Education Committee; 

Criminal Justice Subcommittee; Joint Legislative Budget Commission. 

DARRYL ROUSON (D) 727-906-3200 850-717-5070 Barclay Harless 

70th Distrtict 6501 25th Way S., Ste. D 212 The Capitol Tennille Mooore 

St. Petersburg, FL 33712-5665 402 S. Monroe St. Leila Wilson 

darryl.rouson@myfloridahouse.gov Tallahassee, FL 32399-1300 

Committees: State Affairs Committee (Democratic Ranking Member); Justice Appropriations Subcommittee (Democratic Ranking Member); Business & Professional 

Regulation Subcommittee (Democratic Ranking Member); Appropriations Committee; Regulatory Affairs Committee. 

US Senate 

Bill Nelson (D) 

Marco Rubio (R) 

716 Hart SOB 317 Hart SOB 

Washington, DC 20510 Washington, DC 20510 

202.224.5274 202.224.3041 

202.228.2183 fax 202.228.0285 fax 

www.billnelson.senate.gov 

http://rubio.senate.gov 

Tampa Office: 

Tampa Office: 

Sam Gibbons Federal Courthouse 3802 Spectrum Blvd., #106 

801 N. Florida Ave., 4 th Floor Tampa, 33612 

Tampa, 33602 813.977.6450 

813.225.7040 813.977.6593 fax 

813.225.7050 fax 

US Congress 

Gus Bilirakis (R) Kathy Castor (D) Tom Rooney, (R) Dennis Ross (R) 

Dist. 12 Dist. 14 Dist. 17 Dist. 15 

2313 Rayburn HOB 137 Cannon HOB 221 Cannon HOB 229Cannon HOB 

Washington, DC 20515 Washington, DC 20515 Washington, DC 20515 Washington, DC 20515 

202.225.5755 202.225.3376 202.225.5792 202.225.1252 

202.225.4085 fax 202.225.5652 fax 202.225.3132 fax 202.226.0585 fax 

http://bilirakis.house.gov http://castor.house.gov http://rooney.house.gov/ http://dennisross.house.gov 

District Office: District Office: District Office: District Office: 

5901 Argerian Dr., #102 4144 N. Armenia Ave., #300 11345 Big Bend Rd. 170 Fitzgerald Rd., #1 

Wesley Chapel, 33545 Tampa, 33607 Riverview, 33579 Lakeland, 33813 

813.501.4942 813.871.2817 863.402.9082 (Sebring ofc) 863.644.8215 

813.501.4944 fax 813.871.2864 fax 863.402.9084 fax (Sebring ofc) 863.648.0749 fax 


HCMA Leaders Meet with Legislators 

and Legislative Assistants 

On February 1st members of the HCMA Leadership met 

with members of the Hillsborough County Legislative 

Delegation and their aides. 12 of the 14 members of the 

delegation (Senators and Representatives) were represented 

at the luncheon and discussed with HCMA leaders the issues 

affecting physicians, their practices, and their patients. 

This event has proven to be the most successful event that 

allows HCMA leaders and staff to discuss, one-on-one, with 

Legislators and their senior staff members the issues facing 

medicine and the citizens of Florida. Of the 34 people in 

attendance, 21 represented various House and Senate district 

offices. 

Attendees included: Clay Barker (Leg. Asst./Rep. Raburn), 

Dr. Brad Bjornstad, Robyn Bryant (Leg. Asst./Rep. Raulerson), 

Bill Butler, Dr. Madelyn Butler, Tim Couet (Leg. Asst./Sen. 

Legg), Dr. John Curran, Dr. William Davison, Robert Esposito 

(Leg. Asst./Sen. Brandes), Stephen Gately (Leg. Asst./Rep. 

Mike LaRosa), Patrica Givens (Leg. Asst./Rep. Reed), Jennifer 

Gordon (Leg. Asst./Rep. Danish), Rep. James Grant (HD#64), 

Dr. Ed Homan, Melonie Hoyt (Secretary/Rep. Young), Dr. Jose 

Jimenez, Sen. Tom Lee (SD#24), Elke Lubin (HCMA Executive 

Assistant), Dr. David Lubin, Dewayne Mallory (Leg. Asst./Rep. 

Reed), Gloria Perez (Dist. Asst./Rep. Spano), Karen Pittman, 

Dr. Christopher Pittman, Rep. Jake Raburn (HD#57), Rep. 

Betty Reed (HD#61), Selina Rice (Volunteer/Rep. Rouson), Dr. 

Bruce Shephard, Katen Skyer (Leg. Asst./Sen. Joyner), Amber 

Smith (Leg. Asst./Rep. Raulerson), Rosalie Smith (Leg. Asst./ 

Sen. Joyner), Jim Taylor (Leg. Asst./Rep. Grant), Leila Wilson 

(Leg. Asst./Rep. Rouson), Rep. Dana Young (HD#60), and 

Debbie Zorian (HCMA Executive Director). 


Hillsborough County Medical Association 

Health Plan 

Great News! 

NO RATE INCREASE FOR 2013! 

Based on the Plan’s first year claim experience, there is no rate increase for the new 2013 plan year! 

• HCMA Health Plan renews for 2013 with no rate increase AND fully insured by Florida Blue 

• All enrolled groups have remained on the Plan 

• Groups that did not enroll last year are now being given a “second chance” to enroll 

• Referrals to non-enrolled groups ARE appreciated, as the Plan will be 100% experience rated with 

1,000 subscribers 

• All groups enrolled for prior year Plan, with less than 50 employees, qualify for: (1) Small Group 

Medical Loss Rao Rebates AND (2) Florida Blue Profit Sharing 

• New Plan offering available January 1st, includes co-payments* for: 

1. Primary care office visits 

2. Specialists office visits 

3. Urgent care services 

4. Radiologist services 

5. Hospital emergency room 

• Prevenve Care, Well Care, and Diagnosc Lab services covered 100%* 

• Deducbles are WAIED for accident-related claims* 

*see policy for all condions and limitaons. 

Authorized Local Agent: 

Mark Thompson, HIA, RHU 

Wells Fargo Insurance Services USA, Inc. 

Mark.Thompson1@wellsfargo.com 

813.639.3066 



Medical student, 

Kanchi Batra, provided the 

invocation before the meal. 

Kanchi is the daughter of 

longtime HCMA member, 

Dr. Krishan Batra. 

John H. Armstrong, MD, 

FACS, FCCP, Florida 

Surgeon General and 

Secretary of Health was the 

guest speaker. 

Thank You… 

Florida Doctors Insurance Company 

Florida Hospital – Tampa Bay Division 

& 

Tower Radiology Centers 

On February 5th, HCMA members were given the opportunity to hear a presentation and participate in Q & A with Florida’s 

Surgeon General and Secretary of Health, Dr. John Armstrong. For the past 20 years, Dr. Armstrong has been a national 

leader in health policy and advocacy. He was previously the Chief Medical Officer of the University of South Florida Health Center 

for Advanced Medical Learning and Simulation, Surgical Director of the USF Health American College of Surgeons Accredited 

Education Institute, and Associate Professor of Surgery at the USF Morsani College of Medicine. Before his work at USF, he was the 

Trauma Medical Director at Shands at the University of Florida Medical Center in Gainesville, and a 2011 Exemplary Teacher at the 

University of Florida College of Medicine. His insights into the health of the citizens of Florida, and how we can strive for improvement 

in our state’s overall health, was motivating. It was an honor and a privilege to have Dr. John Armstrong as our guest speaker. 

Many thanks to the generosity and continued support of Florida Doctors Insurance Company, Florida Hospital, and Tower Radiology 

for making the evening possible. 

Dr. Michael Wasylik 

presents medical 

student Jessica 

Goldonowicz with an 

HCMA Foundation 

medical student 

scholarship. 

Richard Hedley (Cherry Bekaert & 

Holland CPAs) presents medical 

student William Pearce with the 

HCMA/Cherry Bekaert & Holland 

medical student scholarship. 

Dinner Meeting 

Drs. William Davison (HCMA President), John Armstrong 

(FL Surgeon General/Secretary of Health), Douglas Holt 

(Director, Hillsborough County Health Dept.), and Christopher 

Pittman (HCMA President Elect). 

Dr. Jairo Parada, Dr. Dario Grisales & Adriana 

Grisales, and Dr. Hernando Bernal & Ellen Bernal. 

Dr. Ailis Marrero and Dr. George Davis. 

Dinner meeting sponsors, Florida Doctors Insurance 

Company and Florida Hospital were represented by 

Lesa Kemp (VP of Marketing & Communications for 

FLDIC) and John Harding (President & CEO of Florida 

Hospital). 

A full house! 

Dr. Alexander Rosemurgy and Dr. 

Sharona Ross. 

24 HCMA BULLETIN, Vol 58, No. 6 – March/April 2013 HCMA BULLETIN, Vol 58, No. 6 – March/April 2013 25

Hillsborough County Medical Association Members, 

We Invite You to Celebrate the 

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The Florida Healthcare Law Firm is proud to announce our partnership with HCMA. 

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AND audio/visual presentations are also available for purchase on the following topics: 

Buying a Medical Practice 

Selling a Medical Practice 

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PIP Modifications & Regulations 

MD/DC Business Arrangements 

Members of the Hillsborough County 

Medical Association will receive 25% off 

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Use coupon code: HCMA25 

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Email Jeff Cohen jcohen@floridahealthcarelawfirm.com 



Split-Fee Soup: 

A Recipe for Disaster 

When people ask me what I do, I used to say 

“I’m a transactional health care attorney. 

I represent health care practitioners in their 

business deals. I don’t do malpractice.” That response 

does little to wipe the blank stare off my 

questioner’s face, and even I have to stifle the 

urge to yawn. My new and improved response 

is that “I spend a lot of time advising health care 

practitioners how they can share fees with people 

who refer them patients.” Now I get invited to all 

sorts of cocktail parties!! 

Practitioners split fees with one another for 

a variety of reasons; and they very often do not 

realize that a particular arrangement involves a 

split-fee arrangement, or that split-fee arrangements 

are often illegal in Florida. The purpose 

of this article is to provide practitioners with a 

general overview of the concepts underlying the 

prohibition against split-fee arrangements in 

Florida, in the context of three common business 

arrangements. 

Source of the Law 

Split-fee arrangements become problematic 

when the split is such that it constitutes the payment 

in exchange for the referral of a patient or 

health care service. Paying for referrals is professional 

misconduct and a criminal act in Florida. 

Unfortunately, it is not always easy to recognize 

that a particular situation constitutes a payment 

for referrals. The actual laws in this regard are 

vague. Florida’s Board of Medicine has published 

approximately twenty-five opinions on split-fee 

arrangements; but those opinions, although informative, 

only actually bind the parties who 

were before the Board. 

Common Arrangements Involving 

Split-Fees 

Percentage of Collections of the Independent 

Contractor 

Practices often desire to engage a professional 

as an independent contractor (i.e. on a 1099 basis), 

and to pay that contractor a percentage of 

the collections generated by that contractor. The 

motivation for this type of arrangement is obvious: 

the practice wants to incent the contractor 

to work hard, and the contractor wants to be 

rewarded for all of his hard work. The problem 

arises from the fact that when the practice assigns 

a patient to the contractor, that assignment 

of the patient constitutes a referral. Once you 

have a referral by the practice to the contractor, 

any revenue that flows from the contractor to the 

practice may constitute a payment for that referral. 

The decisive analysis is what percentage of 

the total fee for treating the patient is retained by 

the practice 

The general rule is that the portion of the fee 

retained by the practice must be based on the 

practice’s cost of providing items and services to 

the contractor and the patients (s)he treats, that 

are necessary for the episodes of care. If and to 

the extent that practice retains a fee that does not 

reflect its cost, the practice may be considered to 

be taking a fee from the contractor in exchange 

for referring the patient to the contractor. 

There is no bright line test with respect to 

what percentage of a fee the practice can safely 

retain, but there are certain factors that should 

be considered. The overhead of the practice is 

important. If the practice retains a percentage of 

the fee that far exceeds the practice’s overhead, 

then the arrangement is susceptible to challenge. 

In addition, if the contractor is to provide services 

on behalf of the practice both in the practice’s office 

and in hospitals and/or clinics, then the percentages 

ought to vary depending on the location 

of service. The practice’s costs associated with 

care rendered in its office are likely different from 

the costs associated with care rendered outside 

its office, so the percentage of fees retained from 

the various settings should likewise be different. 

Marketing Arrangements 

Practices often wish to hire companies to mar- 

(continued) 

Update 

Medical / Legal 

David W. Hirshfeld, Esq. 

david@ 

floridahealthcarelawfirm.com 

KEEP INFORMED…UPDATE YOUR EMAIL ADDRESS 

The HCMA will no longer send informal faxes – we will be sending only email correspondence. 

To insure you receive all up-to-date information, confirm your email address with us. Contact Kay Mills, 

HCMA Membership Coordinator, at 813.253.0471 or KMills@hcma.net. 


Medical / Legal Update (continued) 

ket the medical practice. The practice and the consultant 

understandably prefer for the consultant to be paid based 

on results; that is, that amount by which the practice 

has grown since the marketing consultant began work. 

Since the sole purpose of a marketing arrangement is to 

generate referrals to the practice, there is a strong prohibition 

against a medical practice paying a marketing 

consultant a percentage of the practice’s revenue in exchange 

for marketing the practice. 

Marketing arrangements are sometimes part of larger 

practice management arrangements, but are often 

stand-alone arrangements with professional consultants. 

The prohibition against percentage fees for marketing 

arrangements is so strong in Florida that I often 

advise my clients to isolate those arrangements from all 

percentage-based arrangements. I usually suggest that 

marketing services be specifically excluded from practice 

management and/or professional service agreements and 

dealt with separately. I am much more comfortable with 

a time-based marketing fee, such as an hourly or annual 

fee, that is owed by the practice regardless of any increase 

in patient flow. I recognize that a time-based marketing 

fee does not create direct incentive for the marketing 

consultant to perform but, depending on the nature of 

the practice and its marketing goals, there can be other 

tactics available to assure performance. 

Selling Receivables 

Practitioners with a large base of patients 

whose injuries have been caused by the negligence 

of others often have large accounts receivable 

on their books for years. The reason is 

that these “personal injury patients” sometimes 

do not have insurance, or do not submit their 

bills to their insurer. The theory is that patient’s 

medical care will be paid for if and when their 

negligence lawsuit is resolved, assuming there 

is enough money from the settlement or verdict 

to go around to all the health care practitioners 

and attorneys involved. Practitioners become 

financially squeezed because the underlying 

negligence lawsuits often take years to resolve. 

Practitioners with a large mix of personal 

injury patients, and other practitioners, sometimes 

desire to sell their accounts receivable. 

The practitioner agrees to accept a fraction of 

the receivable’s face value in exchange for immediate 

and certain payment. This sort of factoring 

arrangement is fine and safe unless the 

factor purchasing the receivables somehow 

has a hand in referring the underlying patient 

to the practice. If a factor brings a patient to 

a practice, purchases the receivable attributable 

to that patient at a discount, then collects more 

than it pays for that receivable; the arrangement 

may be challenged as a split-fee arrangement intended 

to compensate the factor for the referral. 

Split-fee arrangements are very common, and not always 

easy to recognize. Through this article I hope to develop 

practitioners’ intuitions with respect to prohibited 

split-fee arrangements in Florida. Practitioners should 

note that in addition to issues created by Florida law, 

Federal law also prohibits payments intended to induce 

referrals of patients or services that are reimbursed by 

Federal health insurance programs such as Medicare. In 

my experience, split-fee arrangements that pass muster 

under Florida law can usually be tweaked to fulfill the 

requirements of Federal law. 

Mr. Hirshfeld has dedicated the majority of his 18 

year legal career to a strong focus on the healthcare industry 

and has an exceptional reputation as a corporate 

attorney. He has structured, negotiated and documented 

many business transactions which include a variety of 

issues involving compliance, control and operational 

issues; and the impact of state and Federal legislation 

including anti-self-referral (e.g. “Stark”), anti-kickback 

and corporate practice of medicine laws; professional 

misconduct; managed care contracting guidelines; 

Medicare; HIPAA and tax laws. He can be reached at david@floridahealthcarelawfirm.com 

or by calling 

the Healthcare Law Firm, an HCMA Benefit Provider, 

at (888) 455-7702 

CCIM 

Individual Member 

Tampa Based Commercial Real Estate Firm 

Specializing in 

Medical & Dental Office 

Sales/Leasing/Build To Suit 

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Among our Current Offerings: 

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v North Tampa – LEASE Medical Ofc. 2,000, 3,000 or 

5,000 sf 

v St. Josephs Area – SALE/LEASE Medical Ofc.3,425 sf 

v Temple Terrace – LEASE Medical Ofc. space (from 500 

up to 7,483 SF & sizes in between) 

Contact: 

Amy Cox, CCIM 813.205.2426 acox@mahrcompany.com 

Cathy Sopher, MBA 813.508.4719 csopher@mahrcompany.com 

813.835.4888 



An unabridged version of the January 15, 2013 

meeting minutes are available by calling the 

HCMA office: 813.253.0471. 

Call to Order 

The meeting was called to order at 6:10PM by Dr. 

William Davison, HCMA President. 

Approval of Minutes 

MOTION MADE AND CARRIED TO APPROVE 

THE MINUTES OF THE NOVEMBER 27, 2012 

EXECUTIVE COUNCIL MEETING. 

HCMA/HCBA Medical-Legal Code Update 

On behalf of the Hillsborough County Bar 

Association (HCBA), Judge James Barton (Circuit 

Court Judge/13 th Judicial Circuit, Hillsborough), 

Attorney Jeffrey Goodis (Thompson/Goodis), and 

Attorney Kevin McLaughlin (Wagner, Vaughan & 

McLaughlin, P.A.), requested the HCMA consider 

re-establishing a Medical-Legal Committee to 

work in conjunction with an HCBA committee 

to update the antiquated HCMA/HCBA Medical- 

Legal Code. The last update to the code was made 

in 1998. 

MOTION MADE AND CARRIED TO RE- 

ESTABLISH AN HCMA MEDICAL-LEGAL 

COMMITTEE FOR THE PURPOSE 

OF WORKING TOGETHER WITH 

THE HILLSBOROUGH COUNTY BAR 

ASSOCIATION TO UPDATE THE 1998 

VERSION OF THE HCMA/HCBA MEDICAL- 

LEGAL CODE. 

Membership Report 

HCMA Vice President and Membership 

Chairman, Dr. Devanand Mangar, reported that 

HCMA’s current membership count is 1225 (266 

remain unpaid). 

Dr. Mangar, updated the Council regarding the 

Membership Task Force meeting which was held 

December 3, 2012. Completed tasks assigned by 

the Task Force include: Inaugural reception of 

the Women in Medicine Section (WMS), quarterly 

educational seminars for members, meetings with 

Full Circle PR to develop a marketing plan, and 

the list of FMA members in Hillsborough County 

who are not HCMA members was provided in 

order to develop a recruitment strategy. 

The Council members discussed the challenge 

with attempting to recruit and entice young 

physicians to become involved is that many 

have new practices, new families with young 

children, and are focusing their attention in 

those directions, and not in organized medicine. 

Council members pondered how to suggest to 

the young physician population the importance 

of supporting the HCMA now by paying dues, so 

those with the time and desire can work hard for 

the Association. When things change and time 

allows, they can participate accordingly. 

HIE Update 

Dr. Mathis Becker, Chairman of the HIE 

Subcommittee, reported that the Subcommittee 

and the HCMA Board of Trustees has severed ties 

with HIE Networks. At their upcoming meeting, 

the HCMA Board of Trustees will further discuss 

the termination of the HCMA/HIE Networks 

partnership as well as discuss the feasibility of 

pursuing an HIE option with another company. 

Dr. Chris Pittman will provide Debbie Zorian, 

HCMA Executive Director, with the contact 

person at the AT&T HIE division in the event 

the Board would like to examine the AT&T HIE 

option. 

FMA Update 

Dr. Jose Jimenez, FMA District C Representative, 

reported that the inaugural meeting of the 

new FMA Committee, the Committee on the 

Future, was held in December. The Committee 

is charged with determining how to demonstrate 

that FMA has relevance for its members. He 

reported that the FMA instructed that no reports 

of the meeting discussion be disseminated until 

the official report is presented at the FMA Board 

of Governor’s meeting in February. Dr. Jimenez 

will provide a report at the March Executive 

Council meeting. 

Pharmacy Mandates for Controlled Substances 

Dr. Colin Beach, Executive Council At Large 

representative, brought to the attention of the 

Council members that some pharmacies, such as 

CVS, are requiring that physicians can no longer 

pre-fill a prescription request. All information 

on the patient and the prescription must be 

entered manually on the form in lieu of allowing 

physicians to automatically fill in duplicate 

information. It was determined by Debbie 

Zorian, after asking the FMA legal department, 

that pharmacies can established their own 

policies; and that a DEA law may be the basis for 

the change in pharmacy policy. Dr. Beach will 

provide Ms. Zorian with the law referenced by the 

pharmacy and she will forward to the FMA legal 

department for clarification. 

President’s Report 

Dr. William Davison, President, encouraged 

the Council members to attend the Annual 

Legislative Luncheon and the February 5, 2013 

dinner meeting in which Dr. John Armstrong, 

Florida Surgeon General, is scheduled to be the 

guest speaker. 

(Continued) 

Meeting 

Executive Council 


Executive Council Meeting (continued) 

Dr. Davison asked Council members to consider, and 

to encourage HCMA member colleagues to consider, 

running for an HCMA seat in the 2013 HCMA Election 

of Officers & Representatives. 

Dr. Davison also reported that the HCMA/Florida Blue 

Health Plan is offering open enrollment. Subscribers 

to the Plan saw NO increase in their 2013 premiums. 

It was suggested that Mark Thompson, HCMA/Florida 

Blue Health Plan representative provide an update to 

the Council at the March meeting. 

Executive Director’s Report 

Debbie Zorian, HCMA Executive Director, reminded 

the Council of the following seminars and socials: 

Marketing Your Practice (January 29, 2013), 

Quarterly Social sponsored by Medtronic at Bonefish 

(January 31, 2013), Billing & Coding (April 11, 

2013), ICD-10 (July 2013) and Internal Audit & 

Compliance (October 2013). There will be no charge 

for the “HCMA members only” seminars. Another 

recent HCMA benefit included HCMA staff sending 

individual reminders to HCMA members who have 

not renewed their Florida medical license. Many 

physicians contacted the HCMA office to thank the 

staff for the reminders as the nonrenewal was an 

oversight that could have been quite costly. 

Adjournment 

The meeting was adjourned at 7:55PM. 

General Membership Dinner 

Meeting Policy for 

HCMA Members: 

Please be aware all Dinner Meeting cancellations, 

including guest registrations, must be received 3 

business days prior to the Dinner Meeting. 

Dinner Meeting “No Shows” and last minute 

cancellations have become a costly issue for the 

HCMA. The HCMA offers a discount to members 

for their guests’ meals of $40. If we do not receive 

cancellations in advance the HCMA is charged $50 

per plate. Please help us to keep our cost down by 

notifying the HCMA office as requested. 

Members will be charged $40 for all guest meals, 

including “No Shows,” not previously cancelled, 

in accordance with this policy. 

Also, please note vegetarian meal requests must 

be made 3 business days prior to the Dinner Meeting. 

We will be unable to honor your request once 

the food count has been confirmed to the hotel. 

We greatly appreciate your cooperation in following 

these policies. 

HCMA 

BENEFIT 

PROVIDER 

HCMA 

BENEFIT 

PROVIDER 



Why 

Now 

frail alabaster-skinned woman sat on my 

A exam room table, the last patient of the day 

late on a Friday afternoon. The woman in the 

corner introduced herself as the patient’s sister. 

The patient, whom I will call Priscilla, slowly 

opened her blouse. She revealed a growth about 

the size of a human heart, but outside the central 

chest instead of inside, as if her heart had somehow 

flipped outside like an everted starfish. 

“How long have you had that” 

“I don’t know.” 

“Approximately.” 

“More than 4 years.” 

I looked at the sister. “Is there a reason you 

waited so long” 

“I can‘t force her.” 

Priscilla spoke quietly. “I went to another doctor, 

a surgeon.” 

“And” 

“She was a bitch.” 

“What did she do” 

“She took a swab from it and sent me out. Said 

she would not remove it.” 

Priscilla had a medical insurance only rarely 

accepted by any dermatologist – Medicaid - and 

her choice of providers was severely limited. We 

talked and I emphasized that she needed to get 

this off of her ASAP. We checked her vital signs. 

Her blood pressure was elevated. Given her noncompliance 

with the tumor that had grown on 

her chest, I did not expect her to be taking care of 

herself, so having high blood pressure fell in line 

with her approach to health. 

In textbook medicine, I would have sent her 

out and made sure her blood pressure was lower 

and she had all the best options to decrease her 

risk factors, including perhaps a general surgery 

under anesthesia. But this was far from textbook. 

I knew that it was highly likely that if she 

left now, she would never get anything done, and 

this cancer would erode into her chest and kill 

her. Even now, I did not know if it had spread and 

would quickly be her demise. 

With some persuasion from her sister, she 

agreed to have the operation and the proper consents 

were signed. The surgical room was prepared 

and she was prepped. As she lay down on 

her back, she had the visage of a frightened child. 

I carefully explained to her what I was doing during 

each step of the surgical journey. I had to 

reach under the large mass and cut the pedicle 

that clung to her chest. As I performed the procedure, 

one blood-soaked sponge after another was 

used to mop up the profuse bleeding. 

Finally the giant growth gave up its hold on 

poor Priscilla. If this had been a fish, I would have 

had to toss it back in the water—it was far above 

the legal limit of size. 

Priscilla was shivering and seemed a bit more 

pale. I had her sit up and put pressure on her 

wound so the gravitational flow of blood would 

not result in more bleeding. In a few minutes the 

flow of blood subsided, and I began the onerous 

chore of sewing up the defect where the tumor 

had grown and spread. 

After the surgery she seemed to have a bit 

more color and I was hopeful that she would have 

a good recovery. 

“God sent me to you,” Priscilla said. 

“We have a ways to go,” I said. “We have to see 

what the biopsy shows. You need an MRI and your 

blood pressure controlled. You may need to see a 

general surgeon or plastic surgeon.” 

“I need something for pain.” 

I gave her a pain med, an oral and topical antibiotic, 

and complete instructions to her and 

her sister to head to the ER if she started having 

bleeding or any problems. When I checked her 

before she left, she appeared as if her burden had 

lightened; she had shifted from a scared child to 

someone who at least seemed to be able to stand 

up a little taller. 

The biopsy was reported as a 314 gram, 12.5 

cm x 8cm basal cell tumor, certainly the biggest 

one I had ever removed. I saw her again a couple 

weeks later, and her wound had started to heal. 

When I asked her about getting her blood pressure 

checked or a MRI, she replied, “I haven’t had 

time.” 

Why now Why do certain people wait so long 

to come see us when they must be aware they 

(continued) 

Practitioners’ Corner 

Robert Norman, DO 

skindrrob@aol.com 


Practitioners’ Corner (continued) 

have a problem that continues to get worse And then 

comes the great question of everyday life…What do we 

do next 

Here are other examples. A man came to see me who 

complained about a “growth on my arm.” When he was 

in the exam room, and my medical assistant gently pulled 

off his ragged home-rigged dressing, a profusely bleeding 

half-dollar sized skin cancer made its appearance. I 

mentioned the option to surgically remove it right then, 

and the patient agreed. But underneath the story of this 

nasty growth was a whole history of events that had occurred 

prior, in particular an extreme lack of money. 

I remember a woman who had waited over ten years 

to see a physician and when she showed up at my office, 

she had a basal cell cancer that covered almost her entire 

right cheek. “I didn’t have any money and just got insurance 

last month,” she said. 

I saw an eight-year old girl in my office with severe 

atopic dermatitis. She had been out of school for three 

weeks and the mother had been off of work due to lack 

of sleep and trying to care for her child during much of 

the three weeks. Why did the mother wait three weeks 

And the horrendous cases often gain purchase in my 

mind, such as the 41 year old man with AIDS that came 

to see me because he felt a bump on his buttocks and 

never did anything about it. When I examined him, he 

had a huge and irregular growth that I removed, a 12 

mm deep melanoma, that had already spread internally, 

and despite every effort, eventually claimed his life. 

Or the 50 year man that looked at least 70 years old 

and had smoked two packs a day since his teenage years, 

and showed me a nasty growth that everted his lower lip. 

During his examination I noticed a swelling on his neck, 

and later found out he had spread of the cancer to the 

cervical lymph nodes and beyond. 

A 32-year-old, Hispanic woman came to see me, 

accompanied by her parents. She asked about getting 

a growth taken off her lip. I asked how long it had been 

there, and she replied “ten years.” I performed a history 

and physical, and noted a raised red bump on her left 

upper lip, appearing as an irregular hematoma. The 

patient, who I will call Graciella, was mildly mentally 

retarded, and the family had moved to Tampa from a 

tough area in New York City about eight years ago. She 

remembered getting some rocks thrown at her one day 

by rowdy neighborhood kids. “I think one of them hit 

my lip,” she said, pointing to the raised bump. 

“Why after all this time did you want this off” I asked. 

“I don’t know,” she said. “I’m just tired of looking at 

it.” 

I had her sign a consent after reviewing the procedure 

with her and her parents. The mother appeared quite 

anxious, and the parents left the room prior to the procedure. 

I numbed up the area, and Graciella seemed to handle 

everything without much distress. I used a scalpel to 

open the lesion and explored it with a dissecting scissors. 

Within a short time, I probed and found a solid object 

that resembled a small hematoma. Using a pickup, I 

was ready to pluck it into the biopsy bottle when I noticed 

something shiny. While my nurse put pressure on 

the wound, I pressed on the object with my fingertips. 

The bloody covering slipped off, revealing a tiny copper 

ball. It was a B-B! I dropped it in the bottle, and it landed 

with a little kerplunk. 

“I don’t think you got hit by a rock ten years ago,” I 

said. “You got shot with a B-B gun.” 

“A B-B” she exclaimed. “Oh, my God! Momma, Pappa, 

come here!” 

I told my nurse to have the parents come in. The 

mother was a bit hysterical when she heard the news. 

“That’s a first,” I said. I just shook my head in amazement. 

After ten years, the mystery had been solved. 

All of us have these crazy stories. As physicians, we 

are often required to peel away other possibilities to get 

to the source of a patient’s medical problem and repair 

what has been disturbed or broken. And with each problem 

comes a whole story that has preceded the person’s 

appointment. Many reasons come to mind: fear, frustration, 

denial, feeling vulnerable, lack of trust, symptoms 

that did not interfere enough with daily life, a lack of 

funds, a perceived or real paucity of available and timely 

care, limited transportation. All can contribute to someone 

not seeking a remedy. A Priscilla type exists in every 

medical practice, and we need to be aware that, for whatever 

reason, sometimes now is the right time. 

Dr. Norman has written 25 books, including The Woman 

Who Lost Her Skin (And Other Dermatological Tales) primarily 

based on articles he has written in Discover magazine, and 

100 Questions and Answers on Aging Skin. He has been the 

editor of four textbooks on Geriatrics and Geriatric 

Dermatology, the first text on Preventive Dermatology, 

and published over 150 articles in various major 

media publications. 

HCMA 

Health Plan 

For HCMA members, 

their families, 

and their staff 

Call 800-622-9124 

for details 

www.trusthcma.com 


Pearl in the Grove... 

Drive North to Go South 

The Pearl in the Grove Restaurant is in the 

country - in more ways than one. If you are 

from the deep south, meaning not Florida” and 

you are homesick for some good old southern 

food, the Pearl is a good reminder of what you 

are missing. In the outskirts of Dade City, the 

Pearl in the Grove is in a converted house with 

a “homey,” country feel. The menu changes 

frequently, specials are on a blackboard, and local 

farms are used for many ingredients. The menu, 

while southern, seems predominantly taken from 

Louisiana cuisine. 

After a pleasant introduction about 

the restaurant from the hostess and the 

complimentary boiled peanuts at the table, we 

started our meal with a “snack” of very good Geeno 

Chips which are homemade sweet potato chips 

covered with melted blue cheese and balsamic 

vinegar. They were crisp and fried to a pleasant 

dark brown. The small plates include catfish 

beignets, red beans and “not rice” (meaning the 

beans are served over grit cakes), and a veggie 

plate. We tried the fresh underground 

salad consisting of fresh greens, goat 

cheese, and kumquats with a light 

Vidalia and kumquat dressing which 

was different and tasty. The onion pie 

with baked squash was a heavy dish 

with a dense good tart of caramelized 

onions on a flaky and cheesy crust. On 

the side were two delicious wedges of 

sweet baked acorn squash. 

Their most popular entrée is an 

authentic shrimp Creole, just like you 

will find in Louisiana and just as good. 

Tender shrimp over rice were bathed 

in a spicy thick Creole tomato sauce, 

just as in New Orleans. The shrimp 

are from Bon Secour, Alabama, an 

1800’s French fishing village with a 

population of less than a thousand, but 

home to many shrimp boats. 

PLUSES 

+ + + 

MINUSES 

- - - 

We also tried the southern fried chicken, a 

whole young poussin, which was breaded and 

crisp on the outside and moist and tender on the 

inside. It was served with bitter mustard greens, 

too bitter for our tastes, and red beans and rice. 

The Pappardelle Pearl, with homemade pasta, 

porkbelly, and caramelized onions also sounded 

good, but was gone for the evening. 

For dessert, we had a small slice of a rather 

dry chocolate cake with a smattering of chocolate 

icing. Next time we would go for the banana bread 

pudding or homemade pound cake. 

The Pearl offers a variety of simple inexpensive 

wines and a good craft beer list. 

The Pearl in the Grove is a bit of a drive from 

Tampa, but deep southern food is not plentiful 

around here, and the Pearl takes this 

cuisine to heart. So if you’ve been 

longing for a good taste of the South, 

make the trip. 

SUMMARY: 

cuisine 

½ 

• Southern country 

food hard 

to find around 

Tampa Bay 

• Quality dishes 

true to traditional 

Southern 

cuisine 

ambience 

• Converted 

country home 

with quaint 

decor 

service 

• The hostess 

and chef were 

friendly and 

accommodating 

• Our waiter 

seemed to want 

to be elsewhere 

• “Forgot” our 

wine 

• “Forgot” our 

dessert 

The Pearl in the Grove, 31936 St. Joe Road, Dade City, Florida 33525 

www.pearlinthegrove.com, 352-588-0008 

Restaurants are rated from one to five stethoscopes. 

Restaurant Review 

Taste Bud 


HCMA 

BENEFIT 

PROVIDER 

HCMA 

BENEFIT 

PROVIDER 



Quarterly Socials for 

HCMA Members 

Watch your emails for invitations to the HCMA 

Quarterly Socials. The social in January was held at 

the South Tampa Bonefish and was sponsored by Medtronic 

Neuromodulation. The socials are held in January, April, 

July, and October at various locations. Call the HCMA for 

details: 813.253.0471. 

(Front row) Drs. Ashley Maru, Steve Barna, David Lubin, and 

Mathis Becker enjoyed the generosity of Medtronics, represented 

by (back row) Skip Simmons, Lorie Montalvo, and Sam Cahill at 

the January 31 st HCMA Quarterly Social. 

RENEW YOUR 

MEMBERSHIP 

DUES TODAY! 

If 2013 HCMA membership dues are not paid in 

full 

• You WILL NOT receive a ballot for the 

2013-2014 HCMA Election 

• You WILL NOT be listed in the 2013 

HCMA Membership Directory 

• You and your staff WILL NOT be eligible 

to attend educational seminars 

• You WILL NOT be able to take advantage 

of the members only discounts offered 

through the Benefit Program 

Contact the HCMA office to confirm your dues 

have been paid in full: 813.253.0471. 

Serving Spring Hill 

Area Since 1999 

Nouvelle 

Cuisine 

Belgian 

& French 

Fine Dining 

While the restaurant is not 

surrounded with European 

Cathedrals, inside, proprietors 

Jan Kinds and his wife Isabelle 

Roos have gone the extra 

mile to bring a touch of Old 

Belgium right to your table. 

Enjoy Our Selection of Fine Wines & 

Portfolio of 14 Different Belgian Beers 

LUNCH Tue. - Fri. • 11:30-2:00 

DINNER Tue. - Sat. 4:30-9:00 • Sunday 4:30-8:00 

Call today for reservations 

(352)686-6860 

APPETIZER 

Seafood Crepes, 

Escargot 

Bourgogne, 

‘Paté Maison’ 

House Paté of Pork 

ENTREES 

Breast of Duck w/Blackberry Sauce 

Pork Tenderloin w/Bordelaise Sauce 

Filet Mignon 

Seafood Platter Florentine 

Veal w/Blue Crab topped 

with Roquefort Sauce 

Chateau Briand w/Bearnaise 

Coquille St-Jaques 

Dover Sole Meuniere 

Monk Fish w/Curry Sauce 

Rack of Lamb 

488915-01 

Quail w/ Tarragon 

10531 Spring Hill Dr. 1/4 mile W. of Mariner • www.thenouvellecuisine.com 



As Seen on the Boulevard… 

Bayshore Boulevard, that is! 

HCMA members were spotted during the festivities of the Gasparilla Parade in January! Many members were able 

to go unnoticed due to their elaborately fashioned pirate alter-egos. 

Dr. Joel Silverfield stops for a photo with HCMA’s Executive 

Assistant and photography assistant, Elke. 

HCMA member, Dr. Catherine Lynch opted not to don an eyepatch 

or a hook, but did still participate in the excitement of 

the parade with her husband Bob…Mayor Bob Buckhorn. 

Your Best CHanCe 

for Beating CanCer 

Moffitt Belongs to an elite group of CanCer Centers tHat Have aCHieveD 

DistinCtion froM tHe national CanCer institute. tHat Means aCCess to tHe 

latest treatMents, proMising researCH, More CliniCal trials anD DoCtors 

WHo proviDe tHe HigHest levels of patient Care. for You, it Means sHorter 

treatMent tiMes, reDuCeD Hospital staYs anD Better outCoMes – During 

anD after treatMent. anD Most iMportant, it Means Your Best CHanCe 

for Beating CanCer. learn More aBout our personalizeD approaCH to 

CanCer treatMent at eitHer of our tWo loCations at moffitt.org 

Moffitt CanCer Center 

12902 Magnolia Drive, taMpa, fl 

Moffitt CanCer Center at international plaza 

4101 JiM Walter BoulevarD, taMpa, fl 

H. lee Moffitt CanCer Center & researCH institute 

an nCi CoMpreHensive CanCer Center 

taMpa, fl | 1-888-Moffitt 

Closer to our patients. 

Closer to a Cure. ® 



HCMA Health Plan 

For HCMA members, their families, 

and their staff 

Call 800-622-9124 for details 

www.trusthcma.com 

THE 2013 LEGISLATIVE SESSION 

BEGINS MARCH 5 TH AND 

ADJOURNS MAY 3 RD . 

Contact your Legislators! – In this issue of The 

Bulletin you will find contact information for the 

Hillsborough Legislative Delegation as well as the 

2013 FMA Legislative Agenda. The FMA Legislative 

Agenda reviews issues organized medicine will 

support and oppose and includes brief facts that 

will assist you when contacting your senator and 

representative. 

Be “Doctor of the DAY” 

During the 2013 Florida 

Legislative Session! 

The Florida Office of Legislative Services will 

once again be coordinating the Doctor of the Day 

program. For those of you who might not be 

familiar with this program, since the 1960s, the 

Florida Legislature’s Doctor of the Day program 

has provided lawmakers with medical care during 

the legislative session while serving to strengthen 

physician-legislator relations. During each of 

the 60 days of session, 2 physicians (one for the 

House of Representatives and one for the Senate) 

provide any necessary care to legislators, their staff 

members, and others at the Capitol. HCMA member 

participation in the Doctor of the Day program 

not only provides a valuable service, but also 

continues a noble tradition. Mavis Knight with the 

Florida Office of Legislative Services coordinates 

the program. Please contact Ms. Knight directly 

to volunteer, or if you have any questions: Mavis 

Knight, Office of Legislative Services, Claude 

Pepper Building, Room 874, 111 West Madison 

Street, Tallahassee, Florida 32399-1400, (850) 717- 

0301, knight.mavis@leg.state.fl.us. 

HCMA Foundation’s 17 th 

Charity Golf Classic – 

DATE CONFIRMED! 

Thursday, October 17, 2013, Tournament Players 

Club – Tampa Bay. Mark your calendars and reserve 

your spot… sponsorship, golfing, and volunteer 

opportunities available. Contact Kay Mills or Elke 

Lubin at the HCMA office for details (813.253.0471). 

Guidelines for Social Media 

The Federation of State Medical Boards has 

created a comprehensive manual, “Guidelines for 

Social Media.” This 17 page document represents a 

model policy for the appropriate use of social media 

and social networking for medical practices. To 

download this policy, please visit: http://www.fsmb. 

org/pdf/pub-social-media-guidelines.pdf. 

HCMA Benefit Providers 

Could you use a 20% discount on your medical 

malpractice insurance Do you need a temporary 

or permanent staff member Or perhaps you need 

to take advantage of a healthcare attorney who is 

“on call” at no charge for HCMA members HCMA 

Benefit Providers can assist you with these needs, 

as well as many others, at HCMA members only 

rates! By utilizing the HCMA Benefit Providers 

you could save more than the cost of your HCMA 

annual membership dues. Call the HCMA office 

(813.253.0471), or visit www.HCMA.net, for a list of 

the current Benefit Providers. 

2013 Board of Medicine 

Meeting DATES & Locations 

Full Board of Medicine meetings are scheduled 

for: April 4-6 (Deerfield Beach), June 6-8 (Tampa), 

August 1-3 (Deerfield Beach), October 3-5 (Orlando), 

and December 5-7 (Orlando). Visit the Board of 

Medicine website to confirm dates and locations, for 

details, possible CME opportunities, board meeting 

minutes, board member information, agenda materials, 

and audio files: http://www.flboardofmedicine. 

gov/category/meetings/. 

Have an AMAZING 

PATIENT story 

Oftentimes, our members are the “unsung heroes” 

in so many patients’ lives. The HCMA wants 

to share your unique story with our community. If 

you have had an extraordinary experience with a patient, 

please let us know. We may use your story as a 

part of a future press release campaign. If your story 

is chosen, you will be contacted by the HCMA’s PR 

firm, Full Circle PR, for more details. Please email 

your submission to: Elke Lubin, HCMA Executive 

Assistant, ELubin@hcma.net. Include in your submission 

(500 words maximum): How you changed 

this patient’s life, how this patient changed your 

life, what makes this case/patient unique from others, 

and the best way to contact you (private phone, 

email, cell, etc). If you have any questions, please 

contact Elke at 813.253.0471. 

Like us on FACEBOOK and 

FOLLOW us on Twitter 

Facebook and Twitter pages have been created 

for the HCMA. Follow these links to join 

http://twitter.com/HCMADocs and http://www. 

facebook.com/HCMADocs 

(continued) 

Medical Briefs 


Medical Briefs (continued) 

Health Department’s 

Community Wellness 

Newsletter Online 

The Florida Department of Health - Hillsborough County 

Community Wellness Newsletter is now available by visiting 

the Hillsborough County Health Department website 

(www.hillscountyhealth.org). Go to: Community Programs 

> Health Education > Newsletter. For more information, 

please contact Cynthia A. Hardy, R.N., Community Health 

Nursing Manager, Ph (813) 307-8015 ext. 7102 or Cindy_ 

Hardy@DOH.state.fl.us. 

HCMA photo site 

The HCMA has created a website of photos taken during 

HCMA events. Please visit http://hcmaphotos.shutterfly. 

com/, and check back often for updates. A link to this site 

will also be posted on the HCMA Website. 

HCMA.net – Always Changing 

Visit www.HCMA.net to find a host of information, including 

new advertisers, the latest issue of The Bulletin, the 

HCMA Benefit Providers, a list of 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 colleagues’ 

contact information. 

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 Develop-ment, 

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. 



HCMA HEALTH PLAN 

Top 10 List 

1. No rate increase for 2013 

2. No hidden risk to employer 

3. Guaranteed rates 

4. Profit sharing feature 

5. Common effective dates 

6. No deficit carry forward & stop coverage for 

large claims 

7. 5 employee plans 

8. 3 physician plans 

9. Florida Blue is carrier 

10. In- and out-of-network benefits 

Mark Thompson: 813.639.3066 

SPECIAL THANKS TO 

OUR FULL PAGE 

ADVERTISERS: 

Tell them you saw their ad in The Bulletin! 

The Bank of Tampa (6) 

Cherry Bekaert & Holland, CPAs (16) 

DeGuenther & Associates (Inside Back Cover) 

Florida Doctors Insurance Company 

(Back Cover) 

Florida Healthcare Law Firm (26) 

SunTrust Banking Service (Inside Front Cover) 

Ultimate Medical Academy (3) 

Wasson & Associates/Workers Comp (34) 

C O M P E T E N C E • C O M M U N I C A T I O N • C O M P A S S I O N 

THE COMFORTS OF HOME, 

THE EXPERTISE OF PROFESSIONALS 

At Pulmonary & Sleep of Tampa Bay, our Sleep Labs offer 

comfy beds in a hotel-like evironment, compassionate staff 

and the latest technologies for the diagnosis, treatment and 

management of sleeping disorders. 

• Obstructive Sleep Apnea 

• Narcolepsy 

• Insomnia 

• Restless Leg Syndrome 

• Circadian Sleep Disorders 

• Excessive Sleepiness 

• Snoring 

• Consultation, screening and follow-ups with board certified 

sleep specialists 

• Diagnostic sleep studies in our lab or home monitoring 

• Cadwell Easy III – Full EEG qualified amplifier 

• Infrared Motion Detection Software to identify nocturnal 

limb movements 

• MPEG-4 video with proprietary Q-Video® technology 

A Joint Commission 

Accredited Practice 

Office Locations in Tampa, Brandon, Plant City, and Wesley Chapel to better serve you. Call today 

for an appointment 813.654.8100 or visit our website at www.pulmonaryandsleephealth.com 

TBSC HCMA Sleep Ad.indd 1 


2/21/13 3:11 PM 


WOW! 

Have an AMAZING 

patient story 

Please include in your submission 

(500 words maximum): 

•How you changed this patient’s life 

•How this patient changed your life 

•What makes this case/patient 

unique from others 

•The best way to contact you 

(private phone, email, cell, etc) 

Oftentimes, our members are the “unsung heroes” in 

so many patients’ lives. The HCMA wants to share your 

unique story with our community. If you have had an 

extraordinary experience with a patient, please let us 

know. We may use your story as a part of a future press 

release campaign. 

If your story is chosen, you will be 

contacted by the HCMA’s PR firm, 

Full Circle PR, for more details. 

Email your submission to: 

ELubin@HCMA.net 

If you have any questions, please contact Elke Lubin, Executive Assistant, 

813.253.0471 or ELubin@HCMA.net 

Advertise in the HCMA’s other publication, 

The Membership Directory 

Over the years, The HCMA Membership Directory has been an indispensable item on the desks of HCMA 

members and their office staff. All Active and Life members are listed, once, by their medical specialty, including 

their office address, phone number, fax number, medical school, and any board certifications. 

The HCMA Membership Directory is distributed to every member of the Hillsborough County Medical Association, 

with additional copies sent upon request, at no charge. The HCMA Directory is also sold to the public for a minimal 

fee. 

Advertising in The HCMA Membership Directory offers an opportunity to advertise your practice. 

We have limited space available, at discounted rates, for HCMA members. 

The deadline to submit your ad for the 2013-2014 HCMA Membership Directory is May 28th. ALL ADS ARE 

BLACK AND WHITE. 

Full page ad (w: 7 5/16” x h: 9 3/4”) 1/2 page ad (w: 7 5/16” x h: 4 13/16”) 

$880.00 25% Member discount: $660.00 $440.00 25% Member discount: $330.00 

1/4 page ad (w: 31/2” x h: 4 3/4”) 

$242.00 (new ad size for members only!) 

RESERVE YOUR SPACE TODAY – CONTACT ELKE LUBIN AT THE HCMA OFFICE! 

813/253-0471 or ELubin@hcma.net 


HCMA 

Member is 

PATIENTS’ 

Choice 

Among the select 

few physicians 

honored with the 

prestigious Patients’ 

Choice Award for 

2012 is Dr. Joseph 

Hirschfeld. Dr. Hirschfeld, a plastic surgeon, 

has been an HCMA member since 1984. Of the 

nation’s 780,000 active physicians and dentists, 

only five percent consistently received top 

scores from their patients, qualifying them for 

this honor in 2012. “I’m so honored to receive 

an award that’s based on how my patients view 

IN MEMORIAM 

the quality of care I provide. I strive each day to 

exceed my patients’ expectations and I’m grateful 

that they’ve recognized my efforts,” remarked Dr. 

Hirschfeld. Congratulations to Dr. Hirschfeld on 

this honor! 

Long Haul: 

(noun): a considerable 

period of time. 

Example: March 31 st 

marks HCMA’s 

Executive Director, 

Debbie Zorian’s, 

27 th year with the 

Association… “Debbie 

is in it for the long 

haul!” 

Thanks for all that you do - Happy Anniversary! 

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

away… 

Longtime HCMA member and one of the founding partners of the pathology group, Ruffolo, 

Hooper, and Associates, Dr. Eugene H. Ruffolo, passed away on January 9, 2013, he was 85 years 

old. Dr. Ruffolo is survived by his wife, Marina, their children: Dr. Robert Ruffolo, Dr. Eugene F. 

Ruffolo, and Marina Ruffolo, Esq., grandchildren, many more family members, close friends, and 

colleagues. Dr. Ruffolo’s sons, both HCMA members, followed in their father’s footsteps to also 

become pathologists. A small private service was held in January for relatives and close friends. 

Donations can be made in Dr. Ruffolo’ s memory to the American Cancer Society or the Humane 

Society, as the Ruffolos are avid “animal people.” 

Personal News 

Rose Freeman Verkauf, 100, mother of HCMA member Dr. Barry Verkauf, passed away on January 

15, 2013. She was preceded in death by her husband, Oscar Verkauf. She is also survived by 

her daughter, Elinor Turkel, three granddaughters, a grandson-in-law, and her sister-in-law and 

loving friend, Doris Verkauf; nine great-grandchildren; and many nieces and nephews. Memorial 

contributions may be made to Congregation Rodeph Sholom. Condolences may be expressed 

online at www.segalfuneralhome.com 

Our heartfelt condolences go out to the family and friends of Drs. Ruffolo and Verkauf. 

Questions about your 

HCMA membership 

We have the answers… 

813.253.0471 


CME, Seminars, 

Workshops, & Conferences 

The Florida Board of Medicine and the Florida 

Board of Osteopathic Medicine are responsible 

for setting the CME required for licensure 

and relicensure in Florida. Each Board specifies a 

certain number of hours, including some mandatory 

topics, that must be completed within each 

two year licensure term. 

Half of Florida allopathic licenses expire January 

31st of every even numbered year (2014, 2016, 

etc.) and the other half expire January 31st of 

every odd numbered year (2013, 2015, etc.). 

All osteopathic licenses expire March 31st of 

every even numbered year. 

To determine the expiration date of your license, 

look for the date on the physical license sent to you 

by the Board of Medicine/Osteopathic Medicine 

or visit the Florida Department of Health online 

site, www.FLhealthSource.com. Choose Licensee/ 

Provider then License Verification. 

A NEW APPROACH TO LICENSE REnewaL 

– the Department of Health, Division 

of Medical Quality Assurance, will now 

review your continuing education records in 

the electronic tracking system at the time of 

renewal. It will happen automatically when 

you renew your license, but it is important 

that you understand how this simple change 

will affect the way you renew your license in 

the future. Visit: www.CEatRenewal.com to 

learn more. 

MEDICAL DOCTORS (MDs) 

For Initial Licensure 

All applicants must have completed a minimum 

of two (2) hours of an approved prevention of 

medical errors course since June 1, 2002. 

For Licensure Renewal 

For first renewal, all physicians initially licensed 

within the biennium are exempt from the continuing 

medical education (CME) requirements 

for renewal with the exception of: 

• Two (2) hour course relating to prevention 

of medical errors 

• One (1) hour of HIV/AIDS. 

Otherwise, all physicians must complete: 



• Two hours of Domestic Violence as part of 

every third biennium renewal (or every six 

years) 

• 38 hours of general CME 

The requirements can be found by visiting: 

www.FLBoardofMedicine.gov 

DOCTORS OF OSTEOPATHIC MEDICINE 

(DOs) 

For Initial Licensure 

Licensees are required to submit proof of completion 

of the following continuing education (CE) 

prior to initial licensure: 



For Initial Licensure Renewal & 

For Licensure Renewal Following Initial Renewal 

Every licensee must complete 40 hours of approved 

CE within the biennium for which they 

are claimed. The requirements can be found by 

visiting: 

http://www.doh.state.fl.us/mqa/osteopath/os_ 

ceu.html 

Any licensee who is a member of the Armed 

Forces of the United States on active duty (and 

for a period of six (6) months after discharge from 

active duty) now has the option of obtaining all 

forty (40) hours of continuing education through 

home study, correspondence or on-line courses. 

Not all Prevention of Medical Errors courses 

will meet the criteria for renewal. It is important 

to make sure that the course you take includes 

the following information: a study of root-cause 

analysis, error reduction, prevention and patient 

safety and the five most misdiagnosed conditions 

during the previous biennium. 

Please remember to periodically refer to rule 

64B15-13.001, F.A.C. for the specific Prevention 

of Medical Errors course requirements as 

they may change every two years. 

April 

ACLS Course and recertification opportunity. 

This is nationally recognized training and 

evaluation program in advanced life support, 

sponsored by St. Joseph’s Hospital, for physicians 

and non-physicians. Designated for a maximum 

of 8 AMA PRA Category 1 Credits. Baycare 

employees receive a discounted registration fee. 

Courses are offered at SJH Main Campus and SJH 

North. Two day courses: April 5-6, and August 

2-3, 2013; Half day physician courses: April 6 

and August 3, 2013. Recertification only: April 

5, August 2, and September 25 (North campus 

only). Call 813.874.5707 for details. 

23nd Annual Advances in Urology. 4/16/2013 to 

4/21/2013. Key West, FL. 14.5 AMA PRA Category 


1 Credits. Sponsored by USF HEALTH Continuing 

Professional Development. For more information, or to 

register, please contact USF Health CPD: 813-224-7860 

or cpdsupport@health.usf.edu. 

7th Annual Educational Forum: Diabetes Treatment 

Strategies. 4/18/2013 to 4/19/2013. Tampa, FL. 6 AMA 

PRA Category 1 Credits. Sponsored by USF HEALTH 

Continuing Professional Development. For more 

information, or to register, please contact USF Health 

CPD: 813-224-7860 or cpdsupport@health.usf.edu. 

Improving Outcomes When Infection is More Than 

Skin Deep. 4/18/2013 to 6/30/2013. Online . 1 AMA 





Dependency Mediation Training. 4/18/2013 to 4/27/2013. 

Tampa, FL. 40 AMA PRA Category 1 Credits. Sponsored 

by USF HEALTH Continuing Professional Development. 

For more information, or to register, please contact USF 

Health CPD: 813-224-7860 or cpdsupport@health.usf. 

edu. 

2013 Rocky Mountain Metabolic Syndrome Symposium. 

4/25/2013. Aurora, CO. 7.25 AMA PRA Category 1 

Credits. Sponsored by USF HEALTH Continuing 




29th Annual Clinical Virology Symposium. 4/28/2013 to 

5/1/2013. Daytona Beach, FL. 16.5 AMA PRA Category 




or cpdsupport@health.usf.edu.edu. 

May 


Skin Deep. 4/18/2013 to 6/30/2013. Online. 1 AMA 





Negotiating and Mediating Healthcare Disputes. 

5/16/2013 to 5/17/2013. Tampa, FL. 13 AMA PRA Category 





Chemical Peeling for Skin Rejuvenation. 5/18/2013. 

Aventura, FL. 8.75 AMA PRA Category 1 Credits. 

Sponsored by USF HEALTH Continuing Professional 

Development. For more information, or to register, 

please contact USF Health CPD: 813-224-7860 or 

cpdsupport@health.usf.edu. 

Treatment of Unwanted Veins with Sclerotherapy. 

5/19/2013. Aventura, FL. 8.25 AMA PRA Category 1 





14th Annual Dermatology for the Non-Dermatologist. 

5/29/2013 to 6/2/2013. Key West, FL. 19 AMA PRA Category 


Professional Development. For more information, 

or to register, please contact USF Health CPD: 813-224- 

7860 or cpdsupport@health.usf.edu. 

June 


Skin Deep. 4/18/2013 to 6/30/2013. Online. 1 AMA 





Cosmetic Use of Botulinum Toxin Type A. 6/1/2013. 

Aventura, FL. 9 AMA PRA Category 1 Credits. Sponsored 

by USF HEALTH Continuing Professional Development. 



edu. 

Use of Facial Fillers for Aesthetic Enhancement. 

6/2/2013. Aventura, FL. 10.5 AMA PRA Category 1 





Use of Lasers and Light-Based Devices in Aesthetic 

Medicine. 6/3/2013 to 6/4/2013. Aventura, FL. 12 AMA 





Family Mediation Certification Training. 6/6/2013 

to 6/15/2013. Tampa, FL. 40 AMA PRA Category 1 





July 

Improving Outcomes When Infection is More Than Skin 

Deep. 7/1/2013 to 9/30/2013. Online. 1 AMA PRA Category 




(continued) 

CME, Seminars, Workshops, & Conferences (continued) 


CME, Seminars, Workshops, & Conferences (continued) 


An Integrated Approach for Improving Outcomes in 

Fibromyalgia. 7/1/2013 to 9/30/2013 

Online. 1 AMA PRA Category 1 Credits. Sponsored by 

USF HEALTH Continuing Professional Development. 



edu. 

August 












Health CPD: 813-224-7860 or cpdsupport@health.usf.edu. 

Parenting Coordination Training. 8/1/2013. Tampa, FL. 

23.5 AMA PRA Category 1 Credits. Sponsored by USF 

HEALTH Continuing Professional Development. For more 

information, or to register, please contact USF Health CPD: 

813-224-7860 or cpdsupport@health.usf.edu. 

ACLS Course and recertification opportunity. This is 

nationally recognized training and evaluation program 

in advanced life support, sponsored by St. Joseph’s 

Hospital, for physicians and non-physicians. Designated 

for a maximum of 8 AMA PRA 

Category 1 Credits. Baycare 

employees receive a discounted 

registration fee. Courses are 

offered at SJH Main Campus 

and SJH North. Two day 

course: August 2-3, 2013; Half 

day physician course: August 

3, 2013. Recertification only: 

August 2 and September 25 

(North campus only). 

813.874.5707 for details. 

Call 

Circuit Civil Mediation 

Training. 8/16/2013 to 

8/25/2013. Tampa, FL. 

40 AMA PRA Category 1 

Credits. Sponsored by 

USF HEALTH Continuing 

Professional Development. 

For more information, or to 

register, please contact USF 

Health CPD: 813-224-7860 or 

cpdsupport@health.usf.edu. 

September 













edu. 

ACLS Course and recertification opportunity. This is 

nationally recognized training and evaluation program 

in advanced life support, sponsored by St. Joseph’s 

Hospital, for physicians and non-physicians. Designated 

for a maximum of 8 AMA PRA Category 1 Credits. Baycare 

employees receive a discounted registration fee. Course 

offered at SJH North. Recertification only: September 

25. Call 813.874.5707 for details. 

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. 

MEDICAL OFFICE FOR LEASE 

Special Lease Rate! 

• 5,000 SF Divisible 

• Alternate 19 Frontage 

• No CAM Charges 

• First Floor 

• Handicap Accessible 

• Renovated Building 

• Flexible Terms 

• Great Frontage 

ARCADE PROFESSIONAL CENTER 

210 South Pinellas Avenue, Tarpon Springs, FL 


PAUL PELUSO (727) 638-9559 

BILL CLAYTON (813) 841-1329 


For Lease 

St. Joe’s Area – 2725 SF, Class A, New Bldg. Kevin 

Platt, Smith & Associates: 813-367-3458. 

For Lease or Sale 

Riverview Medical Office – 2250 SF available in 4500 

SF building. Busy dermatology practice occupies other 

half. Call John Doyle 813-376-5369. 

Nice office in the Medical Plaza building at 6101 Webb 

Road. See www.medicalofficetampa.com. Immediate 

occupancy. (813) 310-2452. 

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 

S. Tampa – Swann Ave., 2305 SF corner unit, $399K, 

Smith & Associates, Kevin Platt, 813-367-3458. 

Physician Wanted 

Doctor’s office available for rent Monday through Friday. 

Use our staff, one block North of USF. Call Bernice 

972-1654. 

Professional Services 

Thinking about…Selling a Practice Buying a 

Practice Terry Flanagan Direct (877) 988-0911 

t.flanagan@murphybusiness.com. Murphy Business 

and Financial Services. 

Ads 

Classified 

classified ads: 

$10 per line. 

Call 813.253.0471 

HCMA Dinner Meeting 

Sponorship Available 

Contact: Debbie Zorian, Executive Director 

DZorian@HCMA.net 

Please support YOUR advertisers! 

Tell them you saw their ad in The Bulletin! 

H indicates HCMA Benefit Provider! 

Arcade Professional Center....................................... 44 

HThe Bank of Tampa................................................ 6 

HCherry Bekaert & Holland, CPAs........................... 16 

Cyberknife Centers.................................................... 38 

Dajalu.com/Tampa Photography Book..................... 19 

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

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

HFlorida Doctors Insurance Company.................... Back Cover 

HFlorida Healthcare Law Firm................................ 26 

HCMA Dinner Meeting Invitation............................ 13 

HHCMA/FL Blue Health Plan................................... 23 & 39 

Index of advertisers 

HCMA Women in Medicine Section Survey............. 8 

Health Point Medical Group..................................... 14 

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

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

The Mahr Company/Real Estate............................... 28 

Moffitt Cancer Center............................................... 36 

MONALISA/Custom Framing................................... Card Shop 

Nouvelle Cuisine Restaurant.................................... 35 

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

Pulmonary & Sleep of Tampa Bay............................ 39 

HShredQuick............................................................ 30 

HSunTrust Banking Service..................................... Inside Front Cover 

HUltimate Medical Academy.................................... 3 

HWasson & Associates/Workers Comp.................... 34 

HCard Shop................................................46 


The Card Shop 

Service Ads - Business Cards size…The perfect advertising opportunity for companies 

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

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

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

Your 

Business Card 

Here… 

Call 813.253.0471 



Veronica DeGuenther 

Veronica DeGuenther 

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. 

Celebrating 30 Years of Insuring Your Future: 1983 - 2013 

DeGuenther & Associates 

813-818-9201 • Fax: 813-818-9401 • Veronica@MalpracticeInsurance.co • Toll-free: 888-711-1222 


HCMA BULLETIN, Vol 58, No. 64 – March/April January/February 2013 2013 47 43

The Bulletin of the HCMA 

606 S. Boulevard 

Tampa, Florida 33606 

prsrt std 

u.s. postage 

paid 

tampa fl 

permit 633 

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Medical Professional 

Liability Carrier is 

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www.FLDIC.com 

Endorsed carrier 

(members save 10%)

March - April 2013 - Hillsborough County Medical Association

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