Archive for January, 2017

The Medical Association Is On Call For You

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The Medical Association Is On Call For You

The Medical Association’s Board of Censors met and approved the Association’s 2017 State and Federal Agendas. These agendas were developed with guidance from the House of Delegates and input from individual physician members. As the Alabama Legislature and Congress begin their work for 2017, additional items affecting physicians, medical practices and patients may be added to this list.

2017 STATE AGENDA

The Medical Association supports:

  • Ensuring legislation “first do[es] no harm”
  • Increasing Medicaid payments for all physicians
  • Recruiting and retaining more physicians for Alabama
  • Eliminating the health insurance-coverage gap for the working poor
  • Ensuring adequate payment for patient care
  • Reducing administrative burdens on practices
  • Strengthening existing tort reforms and ensuring liability system stability
  • Empowering patients and their doctors in medical decisions
  • Continued physician compounding, dispensing of drugs
  • Emerging practice models that restore physician autonomy
  • Same standards and reimbursements for telehealth and face-to-face visits
  • Training, education and licensing transparency of health professionals

The Medical Association opposes:

  • The radical Patient Compensation System legislation
  • Legislation/initiatives encouraging lawsuits against physicians
  • Non-physicians setting standards of care
  • Legalizing physician-assisted suicide
  • Tax increases disproportionately affecting physicians
  • Expanding access to the Prescription Drug Monitoring Program (PDMP) for law enforcement
  • Sale of PDMP data to third parties
  • Further expansion of Maintenance of Certification (MOC) requirements
  • Changes to Workers’ Compensation laws that negatively affect treatment of injured workers

2017 FEDERAL AGENDA

The Medical Association supports:

  • Repeal of the Affordable Care Act and replacement with a system that:
  1. Includes meaningful tort reforms that maintain existing state protections
  2. Preserves employer-based health insurance
  3. Protects coverage for patients with pre-existing conditions
  4. Protects coverage for dependents under age 26
  5. With proper oversight, allows the sale of health insurance across state lines
  6. Allows for deducting individual health insurance expenses on tax returns
  7. Increases allowed contributions to health savings accounts
  8. Ensures access for vulnerable populations
  9. Ensures universal, catastrophic coverage
  10. Does not increase uncompensated care
  11. Does not require adherence with insurance requirements until insurance reimbursement begins
  12. Reduces administrative and regulatory burdens

 

  • Overhauling federal fraud and abuse programs
  • Reforming the RAC program
  • Prescription drug abuse education, prevention and treatment initiatives
  • Allowing patient private contracting in Medicare
  • Expanding veterans’ access to non-VA physicians
  • Reducing escalating prescription drug costs
  • A patient-centered MACRA framework, including non-punitive and flexible implementation of new MIPS, PQRS and MU requirements
  • Congressional reauthorization of CHIP (Children’s Health Insurance Program)
  • Better interstate PDMP connectivity
  • Eliminating “pain” as the fifth vital sign
  • Repealing the “language interpreters” rule
  • Repealing the recent “overtime” rule
  • Requiring VA facilities, methadone clinics and suboxone clinics to input prescription data into state PDMPs

The Medical Association opposes:

  • Non-physicians setting standards of care
  • Publication of Medicare physician payment data
  • National medical licensure to supersede state licensure
  • Legislation/initiatives encouraging lawsuits against physicians
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CVS Out of BCBS Alabama Network but Does Not Affect PIPA Policies

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CVS Out of BCBS Alabama Network but Does Not Affect PIPA Policies

While some Blue Cross and Blue Shield customers in Alabama will no longer be able to use CVS for their prescription drugs, the Medical Association members who have PIPA policies will not be affected.

CVS is no longer in the Blue Cross and Blue Shield Alabama preferred network for certain plans, and according to the company, the change will affect some 13 percent (about 390,000), of the 2.69 million Blue Cross customers in Alabama. The change was made through the insurer and its pharmacy benefit manager, Prime Therapeutics.

Blue Cross spokeswoman Koko Mackin said the change was made to help offset the continuous rise in prescription drug costs and provide customers with the best price.

CVS has responded to the change noting that it was not the company’s “desire or decision” to be excluded from any pharmacy network.

“CVS Pharmacy continues to accept all commercial plans offered by BCBS Alabama, which are typically through large employers and other groups of over 50 participants,” said Gary Serby, Director of Corporate Communications for CVS. “CVS Pharmacy also continues to accept all BCBS Alabama Medicare Part D plans.”

The change does not affect Medicare members who have drug coverage through Blue Cross. The Medical Association’s PIPA policyholders are also unaffected by the change.

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Alabama Medicaid Pushes RCO Start Date to October 2017

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Alabama Medicaid Pushes RCO Start Date to October 2017

The State of Alabama’s shift to managed care has been long in the works, and it looks as though the wait will be a little longer before the regional care organizations will be officially operational, according to the Alabama Medicaid Agency.

While Gov. Robert Bentley has said repeatedly that he remains committed to moving forward with the RCO system, earlier this week he admitted that there are too many questions and not enough answers to allow the system to become effective this summer as originally planned.

“The election changed things, but I think long-term funding is the real issue,” Gov. Bentley said. “I believe a managed care system based on outcomes rather than on fee-for-service is the best way to go for our Medicaid patients.”

Alabama has been working since 2013 toward a managed care system that would shift some of the state’s 1 million Medicaid patients to care through the RCO system, ensuring patients receive check-ups and preventive care while limiting expensive ER visits later on.

Also earlier this week, Alabama Medicaid issued clarification regarding reimbursement by RCOs for services provided to RCO Enrollees by out-of-network providers. This guidance only applies to the populations and the services included in the RCOs. For a listing of the populations and services included in the RCO please visit the Medicaid website.

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The Cost of Non-Compliance with HIPAA Regulations Can Cripple Your Practice

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The Cost of Non-Compliance with HIPAA Regulations Can Cripple Your Practice

The Basics of HIPAA Privacy and Security

The Health Insurance Portability and Accountability Act (HIPAA) mandates that covered entities comply with the HIPAA Privacy Rule, Security Rule and Breach Notification Standards set out by the Department of Health and Human Services (HHS) Office of Civil Rights (OCR). These covered entities include health plans, health care clearinghouses, health care providers who transmit health information in electronic form and business associates. Affectionately known as the “HIPAA Police,” this agency is responsible for protecting patients’ health information privacy rights.

The Privacy Rule dictates how protected health information (PHI) shall be used and disclosed. It strikes an appropriate balance of ensuring that patient information is maintained in a confidential manner while not hindering disclosures that would account for the treatment and payment of health care services.

The Security Rule has the same overall goal of protecting PHI with a specific focus on electronically created, maintained or transmitted PHI. Thus, the Security Rule protects electronic PHI (ePHI).

At a minimum, a covered health care entity is required to complete the following tasks to comply with the Privacy and Security Rules:

  • Designate a Privacy Officer;
  • Designate a Security Officer;
  • Perform a Risk Analysis;
  • Publish and Make Available a Notice of Privacy Practices;
  • Adopt Policies and Procedures;
  • Perform and Document Workforce Training;
  • Develop and Implement Mitigation Procedures;
  • Adhere to Administrative, Technical and Physical Safeguards of PHI;
  • Adhere to Administrative, Technical and Physical Safeguards of ePHI;
  • Develop and Implement Mechanisms to Receive and Handle Complaints and Breaches; and
  • Perform Periodic Assessments and Audits

The HIPAA Breach Notification Rule specifically dictates how covered entities and their business associates must handle impermissible uses or disclosures of PHI, also known as breaches. This rule dictates the content of the notice, to whom notice must be given, timeliness of the notice and other appropriate deadlines. Breaches must be assessed to determine the number of individuals affected and the possibility of mitigation, both of which affect how the breach should be ultimately handled. For example, breaches affecting less than 500 people require individual notice, whereas breaches affecting 500 people or more require individual notice, notice to specific news outlets and notice to the Secretary of HHS. Due to the complexity of the breach notification standards, it is paramount that your privacy and security officers know and understand the breach notification requirements.

How much could non-compliance cost you?

Not complying with HIPAA regulations can be expensive. The fines can range from $100 to $50,000 per violation, with a maximum of $1.5 million in a calendar year for repeat violations. The categories of violations are based upon the level of negligence demonstrated by the individual/entity that caused the breach. Penalties are based on the nature of the breach and the extent of harm caused by the breach.

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The HHS Office of Civil rights has collected tens of millions of dollars in settlements. These settlement funds are then funneled back into the enforcement program to further strengthen their auditing efforts and oversight. This practice makes the program self-sustaining and will continue to grow and develop making it that much more likely that you or a health care provider that you know will be audited.

In August of 2016, Advocate Health Care Network settled with the HHS Office of Civil Rights for $5.5 million after it was determined that they failed to do the following:

  • Conduct accurate and thorough risk assessments of ePHI;
  • Implement policies and procedures to limit physical access to ePHI;
  • Obtain business associate agreements assuring that business associates would appropriately safeguard PHI; and
  • Safeguard an unencrypted laptop that was left in an unlocked vehicle overnight

In July of 2016, the University of Mississippi Medical Center reached a $2.75 million dollar settlement after numerous issues of non-compliance were discovered, including:

  • Failure to implement policies procedures relating to security violations;
  • Failure to implement physical safeguards of workstations that access ePHI and restrict access to authorized users;
  • Failure to assign a unique name and/or number for identifying and tracking user identity in information systems containing ePHI; and
  • Failure to notify individuals and follow breach notification standards after information was believed to be inappropriately accessed, acquired or disclosed.

Business associates were also fined, highlighting the importance of health care entities identifying their business associates and executing appropriate business associate agreements. In April of 2016, Raleigh Orthopedic Clinic, P.A. in North Carolina entered into a resolution agreement with a monetary payment of $750,000. It was determined that this entity turned over x-ray films and PHI to a company that would then harvest the silver from the x-ray films.

“HIPAA’s obligation on covered entities to obtain business associate agreements is more than a mere check-the-box paperwork exercise,” said Jocelyn Samuels, Director of the HHS Office of  Civil Rights. “It is critical for entities to know to whom they are handing PHI and to obtain assurances that the information will be protected.”

On January 9, 2017, HHS announced a settlement with Presence Health for $475,000. This represented the first settlement based on the untimely reporting of breaches of unsecured PHI.

“Covered entities need to have a clear policy and procedures in place to respond to the Breach Notification Rule’s timeliness requirements,” said Director Samuels. “Individuals need prompt notice of a breach of their unsecured PHI so they can take action that could help mitigate any potential harm caused by the breach.”

Resolution agreements can go beyond requiring entities to pay fines. They may also require an entity to take specific corrective action and report their activities to HHS Office of Civil Rights for a designated time. Often this probationary period lasts from one to three years. Additional information on fines and resolution agreements are available on the OCR website.

In addition to steep fines, an equally threatening issue is damage to your reputation. There is no doubt that media coverage of publicized breaches can have a chilling effect on patients who are already on heightened alert to issues like identity theft. Last year alone, OCR publicized settlements ranging from $25,000 to $5.5 million. They also maintain a scrolling section on their web page, affectionately known to compliance professionals as the “Wall of Shame.”

Should your organization receive the unpleasant honor of being highlighted on this website, you should know that it details information on the underlying offense and OCR has no intention of removing past offenders, regardless of how long ago their misdeeds occurred. A quick glance at the Wall of Shame contains breach information on over 1,798 separate incidents dating all the way back to 2009.  https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf

The covered entities hit the hardest by enforcement action are listed below based on frequency:

  • Private Practices
  • General Hospitals
  • Outpatient Facilities
  • Pharmacies; and
  • Health Plans

According to OCR, issues investigated most are, compiled cumulatively, in order of frequency:

  • Impermissible uses and disclosures of PHI;
  • Lack of safeguards of PHI;
  • Lack of patient access to their PHI;
  • Lack of administrative safeguards of electronic PHI; and
  • Use or disclosure of more than the minimum necessary PHI

But where might health care entities be most vulnerable? According to Jerome Meites, a Chief Regional Counsel for the Office of Civil Rights, “Portable media is the bane of existence for covered entities. It causes an enormous number of the complaints that OCR deals with.” Portable media includes laptops, cellphones, hard drives and flashdrives. While these instruments are vital to communicating information in the health care setting, the amount of data contained on these devices makes their security a primary focus for Privacy and Security Officers.

Threats to medical practices and other covered entities exist and the consequences of enforcement actions and private litigation can be devastating.  Covered entities must address these issues on the front end. Covered entities should assess the strengths and weaknesses of their compliance programs to protect themselves and their patients.

Samarria Dunson (samarria@dunsongroup.com) is attorney/principal of Dunson Group, LLC, a health care compliance consulting and law firm in Montgomery, Alabama.  www.dunsongroup.com

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Understanding MACRA: New MACRA Lectures Announced

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Understanding MACRA: New MACRA Lectures Announced

The Medical Association of the State of Alabama and Warren Averett CPAs and Advisors in conjunction with the several county medical societies will be hosting an in-depth education session on MACRA.

CMS has outlined phases for MACRA’s payment models to go into effect, and the first proposed performance reporting period began Jan. 1. This is just the beginning.

This is an educational opportunity for physicians and staff to learn details regarding the new MACRA law and how it will affect your practice. The session will provide physicians with important information you need to know to be in compliance with new MACRA requirements so your practice can maximize your Medicare reimbursement potential and avoid penalties.

Below is a list of the dates for the Understanding MACRA series:

  • Baldwin County – February 21
  • Houston County – March 9
  • Covington County – March 14
  • Jefferson County – March 16
  • Lee County – March 21
  • Montgomery County – April 18
  • Colbert County – April 20
  • Huntsville – April 25
  • Fayette – May 2
  • Gadsden – May 4
  • Mobile – TBA
  • Anniston – May 23

If other county societies would like to host an Understanding MACRA series, please contact Mark Jackson for more information.

The Medical Foundation of Alabama designates this live activity for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Medical Association of the State of Alabama through the joint providership of the Medical Foundation of Alabama and the Medical Association of the State of Alabama. The Medical Foundation of Alabama is accredited by the Medical Association of the State of Alabama to provide continuing medical education for physicians.

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Opinion: All Americans Need Access to Affordable, Quality Care

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meigsEditorial contributed by John Meigs Jr., M.D., president of the American Academy of Family Physicians, member of the Medical Association Board of Censors, and a family physician in Centreville, Ala. Editorial reprinted by permission.

Since Election Day, health care analysts have tried to forecast the fate of our health care system. Much remains uncertain, but what is undisputed is the goal that all Americans must be able to obtain affordable, high-quality and efficient health care. This must be at the center of any national health care strategy. That’s why America’s family doctors are starting this new year by encouraging the Trump administration and the 115th Congress to focus on this essential priority.

The American Academy of Family Physicians has long supported and advocated for meaningful patient-centered health care for all, an underlying tenet of many health care reform proposals, including the 2010 Affordable Care Act. We recognize that our current health care system is not perfect and new approaches can certainly improve the law. However, the nearly 200 million Americans who currently have health care coverage through the individual, small group and employer-based markets — as well as Medicaid — should not have their coverage and insurance protections jerked out from underneath them.

Within any changes, the overarching policy must ensure everyone has access to health care. Because America’s family doctors see more than half a million patients a day, we know what policies and programs ensure access to consistent, comprehensive and preventive care, particularly for low-income individuals and families. Financial barriers to care have crumbled as a result of Medicaid, the Children’s Health Insurance Program and Medicare. Medicaid and CHIP currently enroll nearly 73 million children and low-income Americans. Medicare preserves access to care for nearly 56 million elderly and disabled people. Equally important, patients who have privately purchased health insurance — particularly those with high-deductible plans — must not have to overcome financial obstacles to receive care.

Patient-centered care is at the heart of health care reform, which is why we must have a payment system that rewards the value of care over the volume of services provided. Our nation’s policy must build on the Medicare Access and CHIP Reauthorization Act — or MACRA — to ensure family physicians in all practice settings can continue to practice patient-centered care.

Our lawmakers also must commit to building a physician workforce that can meet the growing demand for primary care. They must support efforts to maintain a steady pipeline of primary care physicians through graduate medical education reforms and extension of the community-based Teaching Health Center program that attracts students to family medicine.

Health care is a personal matter, which is why primary care is the foundation of our health care system. Time and time again, primary care physicians have been counted on to provide care to millions of Americans from all parts of the country — for they have proven their expertise to improve health outcomes while lowering costs.

It is imperative that we have national health policies that ensure all Americans can sustain a continuous relationship with their primary care physicians. The only way we can do this is with legislation and regulations that ensure all Americans, regardless of health or financial status, can get needed health care in a timely, efficient, affordable and personalized manner. America’s family doctors pledge our support in helping to achieve this vision.

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Scale Back Alabama Kicks Off 11th Year

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Scale Back Alabama Kicks Off 11th Year

A new year is the perfect time to shed those extra pounds, and the state’s largest weight loss and physical activity competition can help you do that.

Scale Back Alabama is an 8-week statewide program that encourages Alabamians to eat healthier, exercise, and have fun while doing it. Cash prize drawings are held for teams and individuals that lose at least 10 pounds, and participants receive weekly tips on ways they can improve their health.

This year’s contest began with a kickoff today in Montgomery and a challenge from the city of Montgomery. Michael Briddell, director of public information and external affairs for the city, called out fellow city administrators and mayors to join Montgomery in participating in the contest.

“In Montgomery, we are not only concerned about roads and buildings, but also about the health of our citizens,” said Briddell. “We have participated in this exciting program for many years; it’s a fun way to develop some healthy habits, and the results have been amazing. I urge all cities to encourage their staff and their citizens to participate.”

The contest that began with a challenge from American Idol winner Ruben Studdard in 2006 has continued to be a staple in many companies, hospitals, health departments and other organizations, with millions of pounds lost over the 11-year history.

Last year, 10,826 teams of two participated, a total of 21,652 people. More than 1,000 of those teams had each team member lose 10 pounds, and there was a total of 76,485 pounds lost.

The program is free, and two-member teams can register to participate at scalebackalabama.com. Participants must be 18 years of age, live or work in Alabama, and must weigh in during the week of January 11–18 at an official weigh-in site. Public weigh-in sites are listed on the Scale Back Alabama website.

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Managing Your Practice: Is Your Practice Cyber Secure?

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Managing Your Practice: Is Your Practice Cyber Secure?

With the increased use of technology in health care comes the increased risk of cyber attacks and cyber liability, as well as regulatory investigations, fines and penalties. Anything created, stored or transmitted electronically is at risk of being compromised by an innocent mistake or – worse yet – maliciously stolen by a criminal.

According to a compilation of data breach statistics, there were 1,673 reported data security breach incidents worldwide in 2015, and 1,222 of those occurred in the United States. Of that total, 374 – approximately 22 percent – were breaches of medical or health care information. This equated to more than 134 million individual health care data records being accessed or stolen by cyberattacks just in calendar year 2015 alone.1

Many people don’t believe — or understand why — medical information is valuable or at risk.

Medical records are targeted because they contain a wide variety of a patient’s personal information: social security number, financial, health, demographic and family information. This gives criminals many potential uses for the stolen information, including identity theft and applying for credit cards, store accounts, or other lines of credit. But they also use the information to purchase medical equipment and pharmaceuticals that can be resold, or to fraudulently bill health insurers or the government for fictitious medical care by masquerading as health care providers. One cybersecurity expert estimates that a medical record can fetch up to $50 on the black market, while a credit card number may go for as little as $5.2

Big or small, all health care organizations are at risk.

Large health care systems, hospitals, group practices and individual health care providers have all been attacked, but the size of the entity is no clear indication of the size of the breach. One need only reference the HIPAA data breach “wall of shame” to bear out the truth of this assertion. Data breach incidents at very large organizations have exposed anywhere from several hundred to several million patient records. Likewise, cyber attacks on small solo practices — though frequently in the range of several hundred to several thousand — have exposed tens of thousands of patient records with a single breach.

Transition to EHRs, dated systems, and weak security measures pave the way for cyberattacks.

The transition to electronic health records has given criminal hackers more opportunities to steal medical records. The chief information officer for a hospital system in Utah estimates his hospital’s EHR system fends off thousands of attempts to penetrate its network each week.3

Another reason is ease of access. Many hospitals and physician practices are using EHR systems that have not been updated in more than 10 years. While hospitals and physician practices grappled with more urgent matters like ICD-10 implementation and Meaningful Use, robust cybersecurity measures fell down the priority list. Once a hacker penetrates whatever security the system does have, the exposed information is there for the taking.4

Cyberattacks on EHR systems take many forms.

In addition to outright theft of medical information, emerging cyber threats also include various forms of cyber terrorism and cyber extortion. Recent reports of ransomware attacks are particularly troublesome. Sophisticated hackers launch malicious codes (typically via entry through email) that crawl through a target’s computer system, encrypting and locking up data files, and then demand payment (ransom) in exchange for providing the decryption key. Cybersecurity experts believe health care providers make good targets for ransomware attacks because they do not typically have the advanced backup systems and other resilience measures in place that are typical of other types of organizations.5

What can you do to safeguard EHRs and protect patient information?

Patient trust in your practice’s ability to protect medical information is critical. To maintain that trust, it is important to have safeguards in place that help prevent data breaches. When implementing or updating an EHR system for your practice, talk to your vendor about cybersecurity. Ask whether the stored information is encrypted. It is also a good idea to determine if or when the vendor will provide security updates for your EHR software.

You may need to invest more resources in shoring up the walls around your electronically stored and transmitted data. Cybersecurity is a highly specialized area that requires a certain degree of expertise and experience. Your EHR vendor may be able to provide some assistance in this area, but remember their expertise is more about creation and functionality and less about security. Hiring an in-house cybersecurity expert or contracting with a cybersecurity firm specializing in this area may be the best option to protect your practice and your patients.

ProAssurance also helps protect you against cyber liability threats.

ProAssurance is also committed to helping you reduce uncertainty and increase the control you have over cybersecurity — it’s only fair. That’s why we partnered with NAS Insurance Services to provide coverage for certain types of cyber liability risk exposures. This coverage, called CyberAssurance Plus®, is now embedded in your existing ProAssurance professional liability insurance policy and is provided at no cost to you. Through CyberAssurance Plus® you have coverage for Network Asset Protection, Privacy Breach Response Costs and Patient Notification Expenses, Patient Support and Credit Monitoring Expenses, Privacy and Security Liability, as well as coverage for Regulatory Defense Costs and certain Fines and Penalties. This embedded coverage was recently enhanced to also include coverage for Multimedia Liability, Cyber Extortion and Cyber Terrorism, PCI DSS Assessments, and a unique coverage feature called BrandGuard® for lost revenue as a result of an adverse media report or customer notification of a security or privacy breach. Your CyberAssurance Plus® coverage is limited to $50,000 per claim and subject to an annual aggregate limit (determined by group size) for all claims in a single policy year. You may, however, purchase higher coverage limits for cyber liability threats through ProSecure®, which is a co-branded insurance program with NAS Insurance Services that is exclusive to ProAssurance insureds. Through ProSecure® you can purchase an additional $1 million in cyber liability coverage that is designed to work seamlessly with CyberAssurance Plus® coverage already embedded in your ProAssurance policy.

As a ProAssurance insured, you and your staff also have access to webinars, toolkits, bulletins, posters, FAQs, and online training programs to help you address cyber liability risks. For example, you can access:

  • Summaries of major changes to the HIPAA/HITECH Rules (effective September 2013), including required changes to your Notice of Privacy Practices; the expanded definition of Business Associates (with updated sample Business Associate and Vendor Agreements); and patients’ ability to request medical records in electronic form
  • Webinars, tool kits, and sample documents, including basic data privacy/security, encryption, and destruction practices; sample HIPAA Privacy/Security Rule policies and procedures; social media training tools; sample mobile and personal device user policies, procedures, and agreements; and how to implement a data security plan
  • Breach notification requirements under federal and state laws (where applicable); sample HIPAA Breach/Risk Assessment Worksheets; examples of incidents to report, how to report data security incidents, and more

You can access these resources from NAS Insurance Services’ Data Security Risk Resource Website through your proassurance.com account. Please Note: Content on the NAS Insurance Services’ Data Security Risk Resource Website is provided by third party sources. ProAssurance is not responsible for the content and does not consider it to be legal advice.

For more information about cyber liability, cybersecurity, risk management, CyberAssurance Plus® and ProSecure®, contact your ProAssurance representative. Article by ProAssurance, a Platinum Partner with the Association. ProAssurance insured physicians and their practice managers may contact Risk Resource for prompt answers to liability questions by calling (844) 223-9648 or email riskadvisor@proassurance.com.

SOURCES

1   2015 The Year Data Breaches Got Personal: Findings from the 2015 Breach Level Index. Gemalto website. http://www.gemalto.com/press/Pages/Gemalto-releases-findings-of-2015-Breach-Level-Index.aspx. February 23, 2016. Accessed September 8, 2016.

2   Murphy T., Bailey B. Hackers mine for gold in medical records. The Boston Globe website. https://www.bostonglobe.com/business/2015/02/06/why-hackers-are-targeting-medical-sector/xxjFN6G3cFJZ8Fh3mF3XhN/story.html. February 6, 2015. Accessed September 1, 2016.

3   Humer C., Finkle J. Your medical record is worth more to hackers than your credit card. Reuters website. http://www.reuters.com/article/2014/09/24/us-cybersecurity-hospitals-idUSKCN0HJ21I20140924. September 24, 2014. Accessed September 1, 2016.

4   Radcliffe S. Patients beware: hackers are targeting your medical information. Healthline News website. http://www.healthline.com/health-news/hackers-are-targeting-your-medical-information-010715#1. January 7, 2015. Accessed September 1, 2016.

5   Conn J. Hospital pays hackers $17,000 to unlock EHRs frozen in ‘ransomware’ attack. Modern Healthcare website. http://www.modernhealthcare.com/article/20160217/NEWS/160219920. February 18, 2016. Accessed September 1, 2016.

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From the Treatment Room to the Classroom with Wick Many, M.D.

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From the Treatment Room to the Classroom with Wick Many, M.D.

MONTGOMERY — He jokes about it now, but Wick Many, M.D., said he was a sickly child who spent a lot of time in his pediatrician’s office. For those times when he was too sick, his doctor would make house calls…an experience he did not look forward to.

“Back then, in the 1950s, pediatricians would come out to your house at the end of the day. They would spend all day in their clinics seeing children, but then for those who were really sick, they would make house calls. I was scared to death!” Dr. Many laughed. “The doctor would come in with his big brown doctor’s bag, and that usually meant I was going to get a shot of something. That was my first recollection of medicine.”

Dr. Many grew up around medicine. A native of New Orleans, his mother was the paging operator at what was then the Southern Baptist Hospital of New Orleans. Because she worked night or evening shifts and couldn’t come home for dinner, family dinners were often taken on the ER ramp.

“No one in my family had a medical background, but at some point in high school, I decided this was what I wanted to do. I didn’t have an A-HA moment or an epiphany, it’s just what I knew I wanted to do,” Dr. Many said.

Although he went to LSU for his undergraduate degree, he intended to stay close to home for medical school until a friend who was accepted to UAB talked him into joining him in Birmingham. Once convinced of UAB’s credibility as a medical school, he had to convince his colleagues back home in Louisiana.

“This was the late 1960s, and my colleagues who were at LSU just didn’t understand,” Dr. Many explained. “Alabama? Birmingham? What? They just didn’t get it. I stayed at UAB for the rest of my time except for a year when I went to Dallas. I’ve been affiliated with UAB in some way, shape or form since 1980.”

Although trained in infectious disease, there came a time when Dr. Many’s marketing skills were put to the test when he was approached with an opportunity to step into the spotlight and bring some publicity to the UAB School of Medicine Montgomery Regional Medical Campus.

WSFA-12 had run a syndicated medical segment for years with Houston’s Dr. James “Red” Duke, Jr. When that syndication ended, Dr. Many stepped in, not only to provide helpful medical information to viewers but also for the sake of the Montgomery UAB campus.

“Even to this day – TO THIS DAY – there are a lot of people who do not know there is a residency program and a branch campus here in Montgomery,” Dr. Many said. “I can still go to the bank or the post office and folks will ask me if I drive down from Birmingham every day, and I have to tell them no, no, no. UAB has been in Montgomery since 1978, but the majority of the people here in the region still don’t know that. We haven’t done a lot of advertising or marketing because we haven’t had the funding for it.”

As dean of medicine for the UAB School of Medicine Montgomery Regional Medical Campus, Dr. Many is responsible for about 40 medical students, roughly 20 third-year and 20 fourth-year students. There’s still much room to grow, but Dr. Many said the Montgomery campus is unique considering the resources he and his staff utilize to give the students a well-rounded medical education. For example, in the eight weeks students spend working in the family medicine “block,” four of those weeks are spent in Montgomery with another four in Selma. Part of the time spent in Selma is then spent in Marion with the idea that each step further removes the students from what they have become accustomed to in medical school.

“The purpose of that is to give them an appreciation of not only the opportunities of practicing in a rural setting but also the challenges so that in the future if they decide not to do that they have a better appreciation for what family physicians in that position actually do. I call it ‘intellectual isolation.’ Everyone likes to share stories. If you’re a solo practitioner in a very small town, and you have a patient that comes to you with something weird that you haven’t seen since medical school, who do you talk to? Physicians in more metropolitan areas are fortunate because we have grand rounds, lectures, and of course the Internet has made a difference, but in the most rural of our communities, we don’t have these things,” Dr. Many said.

The Montgomery campus also utilizes resources unique to Montgomery for special teaching opportunities. Representatives from the Medical Association of the State of Alabama, the Alabama Board of Medical Examiners, the Alabama Department of Public Health, the state forensics lab, military physicians and representatives from the Montgomery Police Department all have a special take on medicine that can’t be taught in the classroom but aspects of medicine that new physicians need to understand.

Considering all his contributions to the medical landscape in the River Region and to UAB, it’s difficult to picture medicine without Dr. Many. But in his junior year in college, he also took a different path.

“I came very close to changing my major to history my junior year in college,” Dr. Many said. “If I wasn’t a physician, I’d be a college history professor. I love to read, but I don’t read fiction. I read biographies of our presidents and historical figures. My favorite book is the biography of Alexander Hamilton. He has to this day had an impact on our country. He created the financial system of the United States yet he had so many flaws. Fascinating!”

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