2016
Volume 5, Issue 1
MHP NEWS & NOTES VALUABLE RESOURCES AWAIT YOU AT THE MHP SITE
Most of our readers are presumably aware that MHP has its own website (www.mhpdoctor.com). What they may not be
CONTENTS Valuable Resources Await You at the MHP Site . . . . . . . . 1 S.A.Y. Detroit Clinic Provides an Opportunity for MHP Members to Benefit People in Need . . . . . . . . . . 6 Welcome to MHP: Ayham Ashkar, The Division of Clinical Hematology and Medical Oncology of Oakland Medical Group . . . . . . . . . . . . . . . . . .8 Welcome to MHP: Oakland Macomb Surgical Group . . .10 Who’s Who at MHP: Brian Kirschner, Franklin Neurology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 MHP’s Sleep Disorder Clinic Receives Accreditation . . . .12
aware of is just how much material is there that can be very useful to them. This is especially true of the MHP Employee/ Supervisor portal. Think of the “website” itself as the public-facing portion, and the “portal” as the password-protected portion for MHP members. The number of our members logging in to the portal has increased over time, and the feedback from those who are using it has been overwhelmingly favorable. People love it. The problem is there are still a substantial number of MHPers who have never even been on the portal, including many of our physicians. They don’t know what they’re missing. This article is intended to rectify that. [Continued on Page 2]
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MHP SITE (CONTINUED) The Website First let’s talk about the website—the part that does not require a log in—and then we’ll move on to address the portal at greater length. The MHP website is more barebones than not. There are a few items of interest—including a list of the MHP imaging centers and their locations, and a section on our nurse navigator program—but really the “meat” of the website is the physician search, which can be accessed in multiple ways, including by clicking on “Find a Physician,” “Locate a Physician,” or “Specialties.” Gradually more content should be added to the website, but really it is intended to be primarily a gateway to content located elsewhere, including on the MHP portal and on the websites of the various practices and groups of practices within MHP. You can log into the portal from the website, and you can click through to other MHP practice sites in the physician search section of the website. Each MHP physician should have a page in the physician search section. These pages include a photo and short bio of the physician and the area(s) of medicine he or she specializes in, as well as his or her education, certifications, and gender. Also included are the address, phone number, and fax number of the office(s) where he or she works, the larger group his or her practice is a part of (e.g., Millennium Medical Group, Oakland Medical Group, etc.), and a link to his or her practice or group’s website. If you browse this section you’ll see that not every doctor’s page is fully filled out, and that some of our newer doctors might not even have a page yet. This is where you come in. Indeed, this is one of the purposes of running this article. A great deal of time and effort has been put into this section of the website, but to make it more complete requires some help from our members. If you are an MHP physician, we ask that you look yourself up in the physician search, check your page for accuracy and completeness, and then submit the necessary additional or corrective information. There is a form for this purpose available once you log in to the portal portion of the site. Or you can contact Amy Jenkins, whose contact information is provided at the end of this article. The Portal The first question is how to get onto the MHP portal. If you look at the top of the MHP website (www.mhpdoctor.com), you’ll see an “Employee Login” link
(next to the little icon of a character in scrubs). Clicking on this takes you to the Login page. In the center of that page is the Login button, and at the bottom is contact information if you experience a problem with this process. Click on the Login button. This will take you to the screen where you enter your username and password. Every MHPer should already have a username and password. The default username is your first initial of your first name and your complete last name (just like for your MHP e-mail), and the default password is the last four digits of your social security number. So if you are Dr. Richard Milhous and your social security number is 101-09-1913, then you would enter rmilhous as your username and 1913 as your password. If you experience any difficulty logging in, which can happen for instance if two doctors have the same first initial and last name, contact Amy Jenkins for assistance. The first time you log in the system will take you to a page where you can change your password to whatever you choose. You’ll also need to enter a valid e-mail address. Be sure to press “Submit.” OK, so now that you’re in, let’s take a look around. One thing to know is that in effect there are two different [Continued on Page 3]
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MHP SITE (CONTINUED) MHP portals. Which one you get into with your username and password will depend on how your account was set up. One type of account takes you to the “Supervisor” version of the portal. These are the accounts of our physicians, office managers, and certain administrators. The other type of account takes you to the “Employee” version of the portal. These are the accounts of all other MHPers. There is a great deal of overlap in the content of the two versions of the portal. The Employee version is a subset of the Supervisor version. That is, everything that is in the Employee version is also in the Supervisor version, but not everything that is in the Supervisor version is also in the Employee version. The content that is only in the Supervisor version will be labeled with “Supervisor” in parentheses. We’ll generally refer to the portal (singular) in this article, since there is so much overlap, and what is true of one version of the portal is usually true of the other. Once you’ve made whatever changes you wish to your password and e-mail, you should be at the home page of the portal. You will see a ribbon of headings, not quite at the top of the page, but there just below the MHP logo. From left to right the headings are a little house icon (to take you back to this home page at any time), News & Alerts, Benefits, Payroll, Forms, Policy, Uniforms & MHP Mart, Contact, Profile, and Logout (which of course is what you click to log out of your account). Let’s explore each of these a little more, other than the first and the last. [Continued on Page 4]
While you’re learning about the MHP site, wouldn’t this be a great time to finally get your MHP e-mail up and running and get in the habit of checking it? Far, far too many of our members are still not using their MHP e-mail, including the majority of our newer physicians. Everyone is assigned an e-mail account and told about the email program when they join, so you do have an account. Within the portal you can find all the information you need for setting up your account on your computer and other devices, including your phone. It’s in the Forms section on the Supervisor side of the portal. If you run into any problem at all, call Amy Jenkins at 248-851-3300. Why is it important? The MHP e-mail accounts are secure. As a matter of policy, MHP avoids sending internal communication to other e-mails, such as Gmail, Hotmail, Beaumont or other hospital e-mail, etc. (If you’re in a group that has its own secure e-mail server, such as Comprehensive Urology, you’re fine. Those are the exceptions.) You likely will not, for instance, be on the mailing list for the electronic copy of MHP News & Notes. Members who do finally get around to checking their MHP email after a long delay often discover that a lot of relevant news and material that they could have used has piled up. So to stay on top of everything MHP, 1. Log in to the MHP portal regularly, and 2. Check your MHP e-mail regularly. (Well, and of course read MHP News & Notes religiously.)
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MHP SITE (CONTINUED) News & Alerts: There are two sections within News & Alerts. The link that says News takes you to a kind of blog page of general MHP news and information. This is important news that is placed here because all MHP members need to see it. It starts with what has been posted most recently, and then as you scroll down you see the older entries. The link that says Newsletters takes you to a list of all the back issues of MHP News & Notes. If you click on one of them, it will take you to a pdf version of that issue. Benefits: Here you’ll find relevant links for all the employee benefits. From this page you can access B-Swift (health insurance and life insurance), Merrill Lynch (retirement accounts), and Comerica Bank (health savings accounts, for those who chose a health insurance plan that has an HSA). This page also has links to information about LegalShield’s Identity Theft Plan and a sample application, as well as several Employee Assistance Program documents. Payroll: The Payroll page has a link you can use to get to ADP, which issues MHP’s paychecks, and which is where you would go to see your pay stubs, W-2s, withholding, etc. The Payroll page of the MHP portal is also where you’ll find relevant information, instructions, and forms on topics such as using the ADP mobile app, direct depositing your paychecks, and getting your paycheck early (for a $50 fee—so this isn’t something you want to do unless it’s really an emergency). Forms: This is the section where there is the most difference between the Supervisor portal and the Employee portal. Both portals contain the New Hire forms and the Background Screening forms. The New Hire forms can be accessed and
printed individually, or all one hundred plus pages as a complete packet. The Supervisor portal also contains Employment & Record Keeping forms (e.g., Performance Appraisal forms, Separation Notice forms, and the various posters and notices that are required to be posted in the workplace), Benefit forms (e.g., Benefits Termination forms and the various Family Medical Leave Act forms), Accounts Payable forms (e.g., Refund Request forms), Health & Safety forms (e.g., Patient Accident Report forms, various HIPAA forms, and various OSHA and MIOSHA forms), and Email & Website forms (e.g., forms and information regarding your MHP e-mail account, and the aforementioned form for submitting the information for your physician bio page of the website). Under the Email and Website forms, you will also find a link to take you directly to your MHP e-mail account. This is a particularly important section of the portal. Human Resources Manager Deb Hurren keeps current on the everchanging laws and regulations to make sure that all the relevant forms and educational material are available on the portal to ensure that our practices remain in compliance with all health, safety, and labor requirements. Some groups and practices might be in the habit of using their own forms for many of these purposes, but once you are a part of MHP you are legally required to use MHP forms with the MHP logo and company information. Policy: Among the items you will find in this section are the MHP Employee Manual, dozens of compliance-related [Continued on Page 5]
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MHP SITE (CONTINUED) Key Takeaways From This Article
The URL for the MHP website is www.mhpdoctor.com.
There is a search function on the MHP website for MHP physicians. If you are a physician, you should look yourself up with the search, and submit any necessary corrections or additional information.
To get into the MHP portal, enter your username and password on the MHP website. Your default username is the first letter of your first name and your entire last name, all lower case. Your default password is the last four digits of your social security number.
Depending on the kind of account you have been set up with, you will either enter the Supervisor side of the portal (physicians, office managers, certain administrators) or the Employee side of the portal (all other MHP personnel).
Within the portal are the vast majority of the forms and documents necessary for running one of our practices.
Within the portal are useful links to relevant third parties, such B-Swift, Merrill Lynch, Comerica Bank, ADP, and Eagle and Associates.
Within the portal is the contact information for all key MHP administrators.
Within the portal is the archive of the past issues of MHP News & Notes.
Within the portal you can set up and access your MHP e-mail account.
The portal is frequently updated with announcements and other new material, including relevant forms and documents as laws and regulations change. You should check the portal regularly.
For help with the MHP website and portal, contact Amy Jenkins at 248-851-3300 or
[email protected].
documents, and the toll-free anonymous compliance hotline. This section also contains compliance training manuals, as well as a link to Eagle & Associates, which houses the monthly online compliance quizzes for employees. Uniforms & MHP Mart: Lab coats and scrubs and such with the MHP logo may be purchased through the portal. Contacts: In this section are phone number and e-mail contact information for dozens of MHP administrative personnel, including for billing, I.T., payroll, and much more. A directory of MHP’s physicians is here as well, as is a list of MHP’s hospitalists, organized by hospital, and a list of our diagnostic centers. Profile: At any time you can go to this section of the portal to change your e-mail and/or password. The portal contains a vast amount of resources that can be very helpful in the day-to-day running of MHP’s practices. It’s worth checking weekly if not daily, as it is one of the main ways MHP’s administrators get messages out to the community. If you need help with anything related to the website or portal, you can call on Amy Jenkins at 248-851-3300 or
[email protected].
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S.A .Y. DETROIT CLINIC PROVIDES AN OPPORTUNIT Y FOR MHP MEMBERS TO BENEFIT PEOPLE IN NEED As you know if you’ve been keeping up with MHP News & Notes, MHP surgeon Dr. Richard Keidan has been doing important work in Nepal for several years, to which MHP has provided valuable assistance. [See My Path to Social Justice by Richard Keidan, M.D. (Volume 1, Issue 2), and MHP Funds Construction of Clinic in Nepal by Richard Keidan, M.D. (Volume 4, Issue 1)] Now Dr. Keidan is also volunteering his time to a project which provides MHP members the opportunity to do good much closer to home. S.A.Y. Detroit Clinic S.A.Y. Detroit is an organization to help the homeless founded by the writer Mitch Albom. In 2008, S.A.Y. Detroit, in conjunction with the Detroit Rescue Mission Ministries, opened the S.A.Y. Detroit Family Health Clinic. The S.A.Y. Detroit Clinic is located at 211 Glendale Street in Highland Park. Its mission is to serve homeless and other underserved women and children who lack health insurance and access to quality health care. The clinic receives about 5,000 patient visits per year. Due to changes in health care laws in recent years, especially changes in Medicaid specifically, the bulk of the formerly uninsured children are now covered, so the S.A.Y. Detroit Clinic now serves primarily adult women. Under its medical director Dr. Peggy Richardson, the clinic’s approach is not just to deal with current health crises and get patients patched back up, but to provide holistic, long term health care that addresses underlying issues. So there is a stress on providing health education, immunizations, exercise and weight loss counseling, etc. Dr. Keidan became involved with the clinic as a result of working with Albom on another project involving bringing
Dr. Keidan at the S.A.Y. Clinic
underserved children from Third World countries to the United States for specialized medical treatment that they do not have access to in their own country. The S.A.Y. Detroit Clinic and its needs came up in conversation with Albom, and Dr. Keidan recognized it as something he would be interested in helping with. How You Can Help Until recently, the S.A.Y. Detroit Clinic was only able to offer primary care services. It has since expanded its services modestly, but has plans to expand more substantially if it can get the needed assistance to do so. Here are some of the areas where there is an opportunity to help:
Specialists: A small number of MHP and non-MHP specialists now volunteer their time to treat patients at the clinic. From MHP specifically, Dr. Keidan provides surgical services, and Dr. Debbie Charfoos and Dr. Hamid Banooni provide gynecological services. But there are plenty more needs. As examples, Dr. Keidan mentions rheumatology, endocrinology, gastro-intestinal, and diabetes. The clinic asks for a commitment of at least one bloc of four hours per month. It’s worth noting that MHP attorney David Rogers has arranged for a rider to our medical liability insurance such that all policies now cover work at the S.A.Y. Detroit Clinic. [Continued on Page 7]
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S.A .Y. DETROIT CLINI C (CONTINUED)
Medications, equipment, office furniture: Many physicians have extra items they are not using, perhaps after purchasing an upgrade, perhaps after changing offices. Here’s an opportunity to put anything like that that you might have in storage to good use.
Contacts: Even if you don’t have anything available yourself, perhaps you know someone, or know someone who knows someone, or have a lead or an idea. In addition to the aforementioned items, the clinic is also looking for help in such areas as establishing pathways to procedures and surgeries to be done in local hospitals, and social service assistance to help people navigate the
health care system. In many cases, there might be a way for a person to get health insurance or some form of relevant government assistance but not know it, or not know how to go about taking advantage of such an opportunity. The S.A.Y. Detroit Clinic does provide some help in matching people up with available resources, but would like to have the personnel to do a lot more in this area.
Money: Financial donations for a project like this are always needed, and always much appreciated.
To learn more, contact Dr.
[email protected] or 248-551-2414.
Keidan
at
Given the April 2015 massive earthquake in Nepal, readers might be wondering what may have happened to the Alex Graham Clinic being built with the help of MHP donations to provide much-needed health care to villagers in Nepal. Dr. Keidan reports that the clinic, which was about half done when the earthquake struck, was undamaged as it is being built according to earthquake-safe engineering. Also (see flyer below), Detroit2Nepal will have its “Over the Edge” fundraiser on May 6 and 7 this year. You can keep up with the news from Nepal at http://detroit2nepal.org.
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AYHAM ASHKAR, THE DIVISION OF CLINICAL HEMATOLOGY AND MEDICAL ONCOLOGY OF OAKLAND MEDICAL GROUP Dr. Ayham Ashkar’s path to a career in oncology has certainly not been a conventional one, but it has been an interesting and impressive one. The Pre-Oncology Years Born and raised in Syria, Dr. Ashkar spent most of his life in Damascus before coming to the United States as a young adult. He achieved sufficient success in school to make it realistic to pursue pretty much any career he wanted. Medicine, he says, was a natural choice. With a mother who was a nurse in Syria and an uncle who was a neurosurgeon at Baylor University Medical Center in Texas, medicine ran in the family. Within medicine, he knew from the beginning that oncology was where he wanted to end up. But circumstances didn’t make that easy. He completed medical school in Damascus, experiencing the first two years as dry and unenjoyable, but then liking the remainder considerably more as it became more clinical. He stuck around an extra year to get additional training in radiology before taking advantage of a chance to come to the United States in 2000, to Michigan where his girlfriend (eventual wife) lived. He accepted a position at William Beaumont Hospital as a resident in internal medicine. His residency started in July 2001. Unfortunately his uncle, who as noted was already practicing in the United States, died shortly after Dr. Ashkar’s arrival. This was a big loss, as his uncle had been a true inspiration to him, showing him that his dreams of a successful career in America could come true. And then, just a few months after he commenced his residency, came 9/11 and the Patriot Act. Suddenly Syrians (who had nothing to do with 9/11, but never mind) were a lot less welcome in the United States. He couldn’t travel back home, for fear that he’d not be allowed back into this country. He continued his residency, uncertain when or if he’d be forced to leave the United States. He found out that there was a way he could earn a green card, but that it would mean putting off his plans to be an oncologist for several years. It involved devoting three years to practicing in an underserved community. Michigan is one of the states that adds a further requirement, namely that one
practice primary care specifically. Other states would have accepted an oncologist practicing in an underserved area, but he wanted to stay in Michigan because his girlfriend loved Michigan (and loved the snow, as much as he hated it), so primary care it was. After completing his internal medicine residency in 2004, he stayed on at Beaumont for an additional year for a fellowship in geriatric medicine. At that point it was time to put in his three years toward his green card. He found himself at an inner city clinic in southwest Detroit, where he treated “whatever came through the door.” But though this could have easily been a negative or neutral experience, just putting his time in practicing a form of medicine he didn’t really want to practice in order to fulfill a requirement, as it turned out, he says, he “loved it.” He threw himself into the job with enthusiasm. He estimates the community the clinic served was about 40% Latino (and about 30% white and 30% African American). The bulk of the people were poor as expected, but a large number of the Latinos also spoke little or no English. He decided to devote [Continued on Page 9]
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ASHKAR (CONTINUED) his evenings after work to learning Spanish. He wasn’t required to, but he did it so that he could provide better patient care. He took a year of Spanish at Oakland Community College, and followed that with eight months of one-on-one sessions with a tutor until he became fluent in Spanish in a medical context (and nearly fluent in Spanish in general). It really helped him at the clinic, as he’d anticipated. Initially he had had to rely on having an interpreter—generally a medical assistant—when he had a patient who did not speak English. Once he was able to communicate directly with such patients himself, he discovered that his interpreters’ translations had not always been meticulously accurate. Just as one of many examples, he recalls a case when his medical assistant informed him that a patient was complaining of a “painful lesion.” By this time Dr. Ashkar could speak at least some Spanish, and when he examined the patient, the patient told him that the lesion was not in fact painful at all. This made it an importantly different symptom, and Dr. Ashkar was able to make an accurate diagnosis based on it, whereas he might have made a different diagnosis had he assumed the symptom was as it had been described to him by the medical assistant. Putting in his time at the clinic is not something he resented at all. He interprets it as a matter of paying his dues to be allowed to remain in the United States to practice medicine and raise a family. In the end he’s proud that he played by the rules, that he didn’t look for any short cuts. He didn’t enter or remain in the country illegally. He didn’t marry someone he didn’t want to marry just to get a green card. He earned his citizenship through his work, not marriage, and married who he wanted to. When he completed his three years at the clinic, he returned to Beaumont, where he became a hospital-employed internist for about two years. During this time he also was a part time teaching faculty member. Oncology He finally had his first taste of oncology from January 2010 to August 2011, serving as the hospitalist at Beaumont for Oakland Medical Group’s hematology and medical oncology practice. He had been seeking an opportunity to receive training in oncology, and it finally came in 2011, but with virtually no notice, as a fellowship position opened up at the last minute unexpectedly. He had to make an immediate decision whether to give up his job and grab the fellowship while he could. “No guts, no glory,” he decided, and, with the blessings of Beaumont and Oakland Medical Group, he left his hospitalist
position early and commenced a three year fellowship in hematology and oncology. The fellowship was mostly at Providence Hospital early, and mostly at the Barbara Ann Karmanos Cancer Institute later, with a short stint at Henry Ford Hospital as well. When he finished his fellowship, he knew where he wanted to practice. He sought a job back with Oakland Medical Group— by then a part of MHP—not applying anywhere else. He was thrilled when he was indeed accepted for an oncologist position with the same practice for which he had previously worked as a hospitalist. It’s a perfect fit, he says. He can work in a practice he’s familiar with, with people he’s comfortable with, and he can see patients at Beaumont, with which he also of course is very familiar, having spent many years there. (He also sees patients at the practice’s Tri-Atria office, as well as rounding on weekends at Botsford Hospital.) Rather than start from scratch in a new location with new people, he figured he could get off to a better start where he was already known and respected. He’s very happy to be a member of MHP, which he describes as “a very dynamic group that adjusts to the changes in health care and helps its members navigate a very complicated system.” He and his wife have two young children now, Samir Michael and Colette Marie. “They drive me crazy, and I love it.” Oncology turned out to be the right choice, as he knew it would. It is his passion. He describes it as “one of the last frontiers of medicine.” There was major stagnation in oncology for many years, he says, but now there’s explosive progress. With all the new chemotherapies, new targeted therapies, and new techniques, it’s an exciting time to be entering the field.
Dr. Ashkar is seeing patients at: 3577 West 13 Mile Road, Suite 204 Royal Oak, MI 48073 Phone: 248-551-2446 Fax: 248-551-1094 32255 Northwestern Highway, Suite 150 Farmington Hills, MI 48334 Phone: 248-419-3456 Fax: 248-419-3455 27900 Grand River Avenue, Suite 220 Farmington Hills, MI 48336 Phone: 248-477-0552 Fax: 248-477-0742
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OAKLAND MACOMB SURGICAL GROUP The three physicians of Oakland Macomb Surgical Group are Dr. David Siegel, Dr. Gary Katz, and Dr. Renee Villaluz. Dr. Siegel and Dr. Katz have been at the practice’s current location in Madison Heights for approximately 20 years. Dr. Villaluz is a more recent addition, having joined in 2014.
been performed safely in other countries for twenty years) that involves endoscopically inserting a gastric balloon. It is a simple, ten minute procedure that requires no overnight hospital stay—a welcome option for those who are candidates.
All three surgeons of Oakland Macomb Surgical Group perform all general surgeries, such as hernia surgery, colon surgery, gall bladder surgery, colonoscopy, breast surgery, and a variety of laparoscopic procedures. Their procedures are done at St. John Oakland Hospital in Madison Heights and St. John Macomb-Oakland Hospital in Warren.
Dr. Villaluz received her medical degree from the Lake Erie College of Osteopathic Medicine in Pennsylvania, and completed an internship and residency at St. John MacombOakland. She performs a variety of general surgeries, with some of her areas of expertise including breast, endoscopy, laparoscopic, gastrointestinal, and oncologic surgery.
Dr. Siegel received his medical degree from the University of Osteopathic Medicine and Health Sciences in Des Moines, followed by an internship and residency at Oakland General Hospital (now St. John Oakland). He is currently the ViceChief of Surgery and the Program Director of the General Surgery Residency at St. John Oakland, and a former Chief of Staff of the hospital.
She also specializes in advanced wound care using hyperbaric medicine, which is a method that uses oxygen at a level higher than atmospheric pressure to speed the healing of wounds.
He specializes in hernia surgery. He has perfected an inguinal hernia repair procedure with a sutureless mesh that has many advantages over conventional hernia surgery, including less short and long term post-operative pain, and a shorter recovery time before the patient can return to work and their normal activities. He also does a wide variety of breast and colon cancer surgeries. Dr. Katz, like Dr. Siegel, received his medical degree from the University of Osteopathic Medicine and Health Sciences in Des Moines, followed by an internship and residency at Oakland General Hospital. In addition to his general surgery, he is the medical director of the St. John Oakland weight loss program. He performs multiple types of weight loss procedures, most notably a procedure just approved by the FDA in 2015 (though it has
Dr. David Siegel
As with so many practices, the decision to join MHP was motivated in part by the way the deck is stacked against small private practices in the current health care system in the United States. Also, the surgeons note that they already knew many MHP physicians, including Dr. Harold Margolis, Dr. Stephen Hoffman, and Dr. Michael Laffer, and have great respect for both their patient care and business sense, which gave them confidence about the quality of MHP. Asked what they would most want to be sure to convey to the MHP community about their practice, they note that they are three hard-working general surgeons and are always available. They accept all insurances, and no patient will be turned away. Most importantly, they offer great patient care at Oakland Macomb Surgical Group. Oakland Macomb Surgical Group is located at: 27483 Dequindre Road, Suite 301 Madison Heights, MI 48071 Phone: 248-546-2600 Fax: 248-546-2604
Dr. Gary Katz
Dr. Renee Villaluz
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BRIAN KIRSCHNER, FRANKLIN NEUROLOGY electroencephalography (EEG), and evoked potential test. Another specialty of his is managing patients with intrathecal baclofen pumps. Baclofen is a drug to reduce spasticity or muscle stiffness. Administering it with the pump into the spinal fluid avoids most of the side effects it has as an oral medication. The pump is implanted under the skin of the abdomen, and needs to be refilled periodically.
Fascination With the Brain Dr. Brian Kirschner’s interest in medicine goes back to his childhood, and then his education and experiences encouraged him toward neurology specifically. He remembers particularly liking his psychology classes at Brown University as an undergraduate. He talked to one of his professor about doing some research and was guided to a colleague who was working in neurobiochemistry. He loved studying how the brain works. He did his senior thesis on the g protein coupling of rat brain sigma receptors. While a career as a neuroscientist was tempting, he was wary of it for at least two reasons. One, he’s a people person, and he was concerned life as a scientist would not be as fulfilling as working directly with people. “I like people, not rats.” Two, it seemed like scientists had to spend an unpleasantly large portion of their time begging the government for money. He decided to try medical school (at the University of Michigan) to see if the life of a physician might fit him better. His neurology rotation cinched for him not only that he wanted to be a doctor, but what kind of doctor. “Neurology is like putting the pieces of a puzzle together, trying to figure out where in the nervous system the problem is.” He continued on at the University of Michigan for a neurology residency, and then a fellowship in electromyography (EMG) and neuromuscular disorders. He also completed a one year internship at St. Joseph Mercy Hospital. He has been in private practice on his own and with others since completing his education. He and Dr. Richard Trosch joined Millennium Medical Group in 2007, and then became members of MHP when it was formed in 2011. Today he and Dr. Trosch continue to share an office, having moved into the MHP medical mall at the Tri-Atria building in 2014. Dr. Kirschner has been practicing general adult neurology in the community for 20 years. He specializes in electrodiagnostic testing, including EMG,
Most of his practice is office-based—perhaps 85%—but he’s also on staff at Beaumont Hospital in Royal Oak, Providence Hospital in Southfield, Providence Park Hospital in Novi, and Straith Hospital for Special Surgery in Southfield. Dr. Kirschner has found that one of the challenges of neurology is that almost everybody who goes into it does so because they find neuroscience so interesting, but they then discover that clinical neurology really isn’t about studying how the brain works. Even his research work as a neurologist is focused on therapy rather than neuroscience. But really it’s just a different set of puzzles to enjoyably wrestle with. It helps, he says, to have the variety you see when you practice general neurology, which is why he has chosen not to focus more narrowly. Not that there isn’t variety in the sub-specialties—as his own very specialized officemate Dr. Trosch will tell you, every Parkinson’s disease patient is fascinatingly different—but as a general neurologist he has an especially wide variety of cases to deal with. Then in the acute setting in the hospital he sees conditions very different from what he sees in the office. Certainly he’s happy having moved to the Tri-Atria. He appreciates the opportunity to easily consult with colleagues of different specialties. On the day we interviewed him, he had just returned from walking down the hall to consult with the pulmonologists at the Millennium Sleep Clinic, and to discuss with the therapists at Team Rehabilitation Physical Therapy the best treatment for one of his patients. Advances in Neurology Another challenge of neurology has always been that it was so limited what you could do for your patients. That’s changed in a big way in recent years though. Whereas neurology had long been basically a diagnostic discipline, it has now become more of a therapeutic discipline. Dr. Kirschner notes that just during his career the available medications for neurological conditions have increased at least fivefold, and the improvement in quality has been as great as the improvement in quantity. [Continued on Page 12]
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KIRSCHNER (CONTINUED) Just finding the right treatment can make a huge difference in a patient’s life. As one of countless examples, Dr. Kirschner cites the case of a patient recently referred to him by Dr. Richard Minkin of MHP practice Internal Medicine Physicians. The woman suffered from severe facial pain. Dr. Kirschner tried the medication he judged would have the best chance of helping her, and on this first try her pain was reduced by 75%. As he adjusts her medication moving forward, it will likely improve further. Every day, he says, he has cases like this. People Skills are Essential
rewarding for the physician. There can be a certain satisfaction in solving a puzzle involving spots on an X-ray, but that pales in comparison to making a genuine connection with a patient and knowing that you’re helping that patient and the patient’s family cope with a very difficult situation. Advocate for Patients Dr. Kirschner maintains that it is very important for neurologists to be organized on a state and national level, and he has made such work a significant part of his career.
But as a neurologist you still have to deal with the fact that even as neurology has become more therapeutic, it hasn’t become curative. Diseases like multiple sclerosis, Alzheimer’s disease, amyotrophic lateral sclerosis (Lou Gehrig’s disease), and many more are serious, debilitating, chronic, degenerative, and—in the short and probably intermediate future—incurable conditions.
He has been on the Michigan Neurological Association Board of Directors for nine years, and served as its president in 2013-2014. This is an organization that advocates for neurologists and its patients through activities such as negotiating with insurance companies over appropriate quality measures to grade neurologists and whether to cover certain medications for certain purposes, and lobbying at the state and federal level.
When you are managing conditions and providing palliation, Dr. Kirschner has found, people skills are just as important as medical judgment in deciding among treatment options. To be a good neurologist you not only have to have appropriate knowledge, but to use the right empathic approach. The palliation you provide comes in part from your manner.
Dr. Kirschner himself has traveled to Washington, D.C. to seek increased National Institutes of Health (NIH) funding from Congress for studying neurological disease. (So it turns out his career choice didn’t enable him to avoid trying to get money from the government for a worthy cause after all.)
The key, he says, is to always remember that you’re treating a patient, not an MRI result or blood test results. That means listening to how they describe what they’re experiencing and what their complaints are. That’s not only good for the patient, he notes, but makes the practice of medicine more
Dr. Kirschner is seeing patients at: 32255 Northwestern Highway, Suite 40 Farmington Hills, MI 48334 Phone: 248-355-3875 Fax: 248-355-3857
MHP’S SLEEP DISORDER CLINIC RECEIVES ACC REDITATION Sleep Disorder Clinic in Warren has received program accreditation from the American Academy of Sleep Medicine (AASM). “The American Academy of Sleep Medicine congratulates Sleep Disorder Clinic on meeting the high standards required for receiving accreditation as a sleep disorder center,” said Dr. Nathaniel Watson, AASM president. “Sleep Disorder Clinic is an important resource to the local medical community and will provide academic and scientific value in addition to the highest quality care for patients suffering from sleep disorders.” The AASM is a professional medical society for clinicians,
researchers, and other health care providers in the field of sleep medicine. To receive accreditation for a five-year period, a sleep center must meet or exceed all standards for professional health care as designated by the AASM. These standards address core areas such as personnel, facility and equipment, policies and procedures, data acquisition, patient care, and quality assurance. Also, the sleep center’s goals must be clearly stated and include plans for positively affecting the quality of medical care in the community it serves. Sleep Disorder Clinic is directed by Dr. Emid Alatassi and is located at 29245 Ryan Road, Suite 400, Warren, MI, 48092, 586-576-0106.
MHP News & Notes would like to hear from you. Please direct all questions, comments, suggestions, complaints, rumors, leaks, news, bouquets, brickbats, and other assorted contributions to: Craig Gabriel 248-677-0412
Cell: 248-766-7844
[email protected]
