Lexington Medical Society Physicians caring for the community since 1799 MAY 2014 NEWSLETTER (continued on page 2) There are ICD-10 codes for being bitten by a turkey, being burned by flam- ing water-skis, or being locked for too long in a freezer. There are over 13,000 codes in the ICD-9 and over 68,000 codes in the ICD-10, a five-fold increase. Current cost estimates of the implementation of ICD-10 are three times greater than it was thought to be in 2008, and there is no funding for implementation. This is an unfunded mandate! Briefly the ICD-10 (International Statistical Classification of Diseases and Related Health Problems – 10 th revision) is a medical classification owned by the World Health Organization (WHO). The code set allows for more than 14,400 different codes and can be expanded to over 18,000 codes by using optional sub-classifications. The international version of ICD-10 should not be confused with national Clinical Modifications of ICD which include more detail. For example, the US ICD-10-CM has 68,000 diagnostic codes and 76,000 procedure codes (ICD-10-PCS) not used by other countries. The Canadian version of ICD-10, introduced in 2000, uses about 18,000 codes; it is much less complex. Work on ICD-10 began in 1983 and was finished in 1992. It has been implemented in 25 coun- tries for tracking and resource allocation. It is not used for reimbursement. Australia adopted ICD-10 in 1998-1999, Canada in 2000, China 2002, France in 2005, Korea in 2008, etc. In the United States, ICD-10 required participation was announced in January 2009. The launch date was pushed back by two years. In March, 2012, Health and Human Services (HHS) announced another delay and in Sep- tember 2012 the Final Rule set a date of October 2013 for implementation. In February 2014, CMS stated that there would be no further delays and the deadline was set at October 2014. At the writing of this message the deadline for all HIPPA “covered entities” to make the change to ICD-10 has again been extended to October 2015. Why is there all this TENsion over implementation? Because it is cumbersome and cost- ly! According to a 2004 RAND (Research ANd Development) report prepared on behalf of HHS, the transition price tag was to be $425 million to $1.15 billion in one-time costs for system changes and training, plus up to an additional $40 million per year in lost productivity. In an address delivered by Barbara L. McAneny, M.D., chair person elect of the AMA Board of Trustees, at the 2014 National Advocacy Conference, she stated that her particular practice had secured a $4 million line of credit so they could “pay the bills” during any periods of payment delay or denial during the ICD-10-CM im- plementation. She also revealed a comparison of estimated practice costs to establish the system in 2008 vs 2014. Stratified by practice size they are as follows: Size 2008 2014 Small practice (3 doctors) $83,000 $56 -226,000 Medium practice (10 doctors) $285,000 $213-800,000 Large practice (over 20 doctors) $2.7 million up to $8 million President’s Message: ICD TENsion Thomas H. Waid, M.D.
Surgery on Sunday is Focused on “Why” By Chris Hickey, CEO Lexington Medical Society
“People don’t buy what you do; people buy why you do it.” That is the advice Simon Sinek, a professor at Columbia
University, imparts in one of the most watched Ted Talk videos* of all time with over 16.5 million views. By “why” he
means what is your purpose or cause. The key is to focus on “why” or purpose and like-minded people will, according to
Sinek, “…work for you with blood and sweat and tears.” Surgery On Sunday has cracked this code, and the results are
truly inspiring. If you are ever feeling down about society and where this world is going, you need to know about Sur-
gery on Sunday. I visited there not knowing what to expect, and came away really proud that there are people like this
who give freely of their talent and time in order to improve the quality of life and in many cases, alleviate suffering, of
members of our community who otherwise might not get care. I saw a medical all-star team made up of physicians, nurs-
es, PA’s, and other volunteers who were rewarded for their efforts not by money, but by fulfilling a higher, noble pur-
pose. The real story of Surgery on Sunday is not what they were doing, but why.
This “why” is hugely powerful, a combination of best-of-the-best talent infused with passion, enthusiasm and com-
mitment to their mission. Volunteers came from every major medical facility in the city, many private practices and as
far away as Nashville. It was a beautiful, Sunday morning, blue skies, 75 degrees, the horses were getting ready to race at
Keeneland, and this high-energy team couldn’t have been happier serving. Did you notice I didn’t say working? No one
I talked to said they were working. That is power. Tap this power, and you could accomplish anything.
Surgery On Sunday, Inc., according to its information pamphlet, “Is a non-profit organization that provides outpa-
tient surgical services for those who cannot afford insurance and are not eligible for federal or state programs. Patients
are referred from existing organizations in the community and receive much needed medical outpatient procedures.” The
facility is located at the Lexington Surgery Center, next to St. Joseph Hospital. It is a first of its kind program in the
United States that many other communities are trying to replicate. It has received national media attention and many ac-
Surgery On Sunday came into existence in 2005 and is the fulfillment of a long time vision of Dr. Andrew M.
Moore, II. Dr. Moore first started conceiving the vision back in the 1990’s when he was trying to figure out a way to pro-
vide much needed surgery to those in our community who did not have the means to afford it. Downing water, and phys-
ically drained after performing a three hour surgery, Dr. Moore said, “You don’t have to go to Africa or South America
to find poor people who need health care. You know you are changing their life, if you didn’t do it, it wasn’t going to
Dr. Moore will be the first to tell you it is not about him, but his team. This team has performed, since the program’s
inception, over 5,400 surgical procedures, saved local hospitals over 28 million and Medicaid over 20 million dollars.
These staggering figures are pale in comparison to the amount of lives they have improved. Dr. Moore and his team are
careful not to burn their volunteers out, so they have limited the program to once a month and conclude by early after-
noon on Sunday.
Supporting the volunteer team is a small staff consisting of Laura Ebert, Executive Director, and Terri Cline, MSW,
patient coordinator. Together they make a strong pair that keeps this high energy team running. Laura said, “I have the
best job in the world.” According to Terri, “It is so rewarding. It is not like working.” It is amazing what they can do
with a relatively small budget.
You know something is different about this place when you first walk in the door. You are greeted by the two nicest
people you’d ever want to meet. Mary Ellen Amato, RN, known as Nurse Podgi, is sort of a legend in Lexington having
worked for decades in operating rooms. Sitting with her is Peggy Moore, Dr. Andrew Moore’s mother. They handed me
off to Dr. J. Michael Moore, Andrew’s brother and fellow team member. This passion is a family affair and there were
more than one multiple generations of families serving together on this team. We exited the lobby and entered the surgi-
cal center to find over 80 volunteers separated in smaller teams in various stages of eight surgical procedures.
Preparing for a surgery, was Dr. Paul A. Kearney. He was Chief of Trauma Surgery at UK for over twenty-two years
and has been with Surgery On Sunday from the beginning. Asked why he serves here Dr. Kearney said, “It is an obliga-
tion if you have a talent you should use it (to help others). If everyone gave away 10% of their time we could take care of
the entire planet.” Dr. Kearney’s daughter was also volunteering that day.
Surgery On Sunday is supported by many generous organizations, including the Lexington Medical Society Founda-
tion. If you would like to become involved with this noble effort and tap into your passion to serve for a higher purpose,
you can contact Laura Ebert at (859) 246-0046 or [email protected]. If you would like to help this program finan-
cially go to surgeryonsunday.org or through the mail: Surgery On Sunday, Inc, 650 Newtown Pike, Lexington, KY
Dr. Andrew Moore’s vision is to expand this incredible capability to other facilities, communities, and states. Baptist
Health and Kentucky One Health created similar programs under the Surgery On Sunday template. A program has start-
ed in Louisville. Macon, Georgia and Omaha, Nebraska want to start programs. Dr. Moore wants to start an endowment
that would provide seed money for new programs to get off the ground. He’d like to get a Surgery On Sunday in every
sizable community in Kentucky and in every state. With the power I saw here, like-minded talented people focused on
“why” rather than “what”; dreams become reality.
* TED is a nonprofit devoted to spreading ideas, usually in the form of short, powerful talks (18 minutes or less). Ted has innovative speakers from all over the world. You can view Simon Sinek’s video at this link: http://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action
Members of the LMS answered phones for the 2014 KET Telefund. During our phone bank shift,
we raised $28,657 and our team raised an additional $800 with calls to friends, family & associates.
Thank you LMS volunteers:
Cheryl Broster, LMSA
Bruce Broudy, M.D.
Terry Clark, M.D.
W. Lisle Dalton, M.D.
Michael Hagen, M.D.
Betty Nolan, LMSA
Jessica Ragland, LMSA
Mike Ragland, M.D.
John White, M.D.
Lexington Medical Society
2628 Wilhite Court, Suite 201
Lexington, Kentucky 40503-3328
Address Service Requested
PERMIT NO. 14
Thank you to our May meeting sponsors:
Central Bank & Trust Company
Professionals’ Insurance Agency, Inc./Professionals’ Purchasing Group
For dinner reservations please call the Society office at 278-0569, fax this page to 277-3919 or email
[email protected] by Friday, May 9, 2014. Guest charge is $28.00. Please include the following:
Number attending: __________
Name of Member and Guest: ____________________________________________________
Please inform the LMS staff at the time reservations are made if you have any special dietary needs.
There will be a charge for guest reservations not cancelled prior to the meeting.
Payments to the Lexington Medical Society are not tax deductible as charitable contributions for federal income tax purposes. However, they may
be tax deductible under provisions of the Internal Revenue Service.
CME Credit: MRSA
By Daniel C. Rodrigue, M.D. Hilary J. Boone Center