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This blog is written by Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) team members, with special guest blog entries provided by members. To submit a guest blog entry, email Thank you!


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Top tags: advocacy  opioid crisis  PDMP  Physician Burnout  Self-care  Staying Focused 

*Prescription Drug Monitoring Programs (PDMP): The Pros and Cons

Posted By Brian Bowles, Executive Director, Monday, March 6, 2017

I want to let you know both sides of the issue, and provide some education on why forty-nine states have statute establishing a PDMP, and Missouri does not.


Yes, Missouri is the only state without a Prescription Drug Monitoring Program.


 What you usually don’t hear is that not all states with PDMP statutes have truly functional PDMPs, either due to lack of funding or burdensome  requirements.  Missouri  legislators  have  been  criticized  for  lack   of action, and rightly so.    In our most recent survey, almost 95% were in support of a state PDMP and 75% even supported mandatory physician use.


Physicians across the state overwhelmingly agree that a PDMP would make their jobs easier by allowing them to more easily determine if a patient is doctor-shopping or using prescription drugs inappropriately.


 Many physicians have told me that they simply will not prescribe pain medications to patients due to fear of what may happen to those drugs after the patient visits the pharmacy. Physicians should be able to make informed decisions about their patients’ care without this worry. While a PDMP may not totally solve the problem, it would serve as an additional tool.


 So why does it seem like legislators are ignoring your voice?  Good question, but the answer may surprise you.


Some legislators point out that forty-nine states have PDMPs, but the overdose death rate in every state continue to rise. Shouldn’t we see a decline? And, because we have no PDMP, why is Missouri not first on the list of deaths rather than 22nd? Data does not always support the effectiveness of those PDMPs that are currently in place. Again, these are valid points. But, we all know evidence can be found for either way we want to spin the issue.


 I  have  been  in  countless  meetings on the opioid/PDMP issue, and hear over and over about this being a physician-created problem. Right or wrong, many in

positions of power feel that to fix the problem a physician (not patient) crack-down is needed. A PDMP is looked at as a tool to help the powers-that-be (DEA, BNDD) do this, rather than as a tool to ensure patients who need the drugs get them. MAOPS disagrees.


So, maybe it’s time to educate leaders and citizens in your communities about the benefits of a PDMP?!


 As physicians, MAOPS members provide some of the most trusted voices in their communities. If you have influence in your county, this is an opportunity to educate the county commission about this issue. Go to the MAOPS website at, click on the 2017 Legislative Update link, and download the @ Issue Brief on PDMP. Use this brief as a tool to start the conversation with city and county leaders, our colleagues, and your patients. You can also download all of the Legislative Updates on what MAOPS has been doing as your advocate at the Capitol since the beginning of the 2017 legislative session.


If you have questions, need further information or want to participate in advocacy at the State Capitol, please contact me at  Together, we can do so much!


*This blog was taken from the original editorial Straight Talk - Prescription Drug Monitoring Programs: A Look at the Pros and Cons, featured in the March 2017 issues of the Prognosis newsletter. Click here to read the entire article.

Tags:  advocacy  opioid crisis  PDMP 

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MAOPS President’s Message

Posted By Administration, Tuesday, December 27, 2016


You Are Not Alone: Avoiding "Burnout" 

 Jeff Davis, D.O., MAOPS 2016 - 2017 President

A member recently forwarded me an article from titled, “Half of Physicians Demoralized, Dissatisfied.” The study, commissioned by the Physicians Foundation, found that a majority of the over 17,000 physicians surveyed described their morale as either somewhat or very negative:

  • 63% said they were "pessimistic about the future of medicine"
  • 49% stated that they would not recommend the practice of medicine to their children!    

We all probably know what this study cited as the reasons for this “burnout:”  regulatory and paperwork burdens and loss of clinical autonomy. While we will often feel overwhelmed and “demoralized,” we need to keep the reason we got into medicine in clear focus. That’s difficult sometimes.


As Jim Wieberg and Heather Johns, the Directors of the MAOPS Physician Health Program, point out in the article in this issue of the Prognosis, physician burnout is real, and it must not be ignored or downplayed. Click here to read the article by Jim and Heather in the December/January issue of Prognosis. MAOPS Physician Health Program is here for you. I'd also like to remind you that another way to help feelings of burnout is to interact with our peers outside of work.


I find great satisfaction in  being able to meet with others, discuss issues, and take steps to help solve problems through my volunteer role with MAOPS. The Missouri Osteopathic Annual Convention (MOAC) is also a fantastic way to network with peers and enjoy the collegiality of the profession.


This year’s conference is specifically geared towards reminding each of us why we got  into medicine. I hope you will join me and over 300 other D.O.s to hear nationally renowned keynote speakers  (see last month’s issue of the Prognosis) that will leave you feeling rejuvenated, ready to take the best care of your  patients possible, and realize that you are not alone!


Click here to visit the 2017 MOAC page and register!

I am not one of those physicians who will steer my daughters away from a career in medicine. However, I would advise them that practicing medicine is only part of their job. They will need to be responsive to change, and remember to take care of their own physical and mental health in order to continue to provide the best care for their patients.


Have a wonderful Holiday season and see you in 2017!

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Tags:  Physician Burnout  Self-care  Staying Focused 

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A Breakdown of Federal Loan Repayment Options for Medical Trainees

Posted By Administration, Monday, August 8, 2016

By Jesse Richards, D.O. – PGY-1 University of Kansas Internal Medicine
Edited by Caleb Scheckel, D.O. – PGY-1 Mayo Clinic Internal Medicine

With median education debt for medical residents over $200,000, we have reached the point where managing student loans effectively as a resident or new attending is a decision that can save tens of thousands of dollars or more. The magnitude of this decision, compounded by the arcane and confusing variety of loan repayment plans can lead to confusion and paralysis. However, with a little time investment, you can learn the system and figure out what options will work best for you.

The goal of this article is to break down and classify the different options for repaying student loans.  In addition, Public Service Loan Forgiveness (PSLF) is briefly discussed, because it can change the calculations for certain plans.

PSLF is a current government program that is designed to incentivize a wide range of professionals to work for non-profit and government organizations. Specifically, it states that if you make 120 payments (they do not have to be consecutive) while working at a qualifying 501c organization, the remainder of your student loans will be forgiven. There is a lot of debate about the program and whether or not it will be around in the future, but that is how it stands at this time.

For the purposes of this article, I am assuming you are a typical graduate, with $200,000 in loans at 6.5% interest, who will be in residency/fellowship for 3-6 years, making roughly $55,000 per year. Your situation may be different. To start with, let’s look at the repayment calculator on

I will divide these plans into two categories: plans that qualify for PSLF and plans that don’t.

Qualifying Plans

Standard Repayment
This is a simple plan where your loan repayment is amortized over 10 years. There is no change in your monthly payment; you simply pay down the loan. This option is good for people with relatively low student loans, but a monthly payment of $2,271 is a large financial burden for most residents. This is a qualifying plan for PSLF, however if you stay in it for 10 years, there won’t be any remaining balance to forgive.

Income Driven Repayment Plans (IDRP)
This is not specifically a plan, but rather an umbrella term that encompasses all of the plans where your monthly payment depends on your income instead of your loan amount. One term that needs to be defined for IDRP is discretionary income, which the government defines as “the difference between your Adjusted Gross Income and 150% of the federal poverty level for your household.” Now onto the specific plans.

Income Based Repayment (IBR)
IBR is the first and least restrictive of the income driven plans. Your monthly payments are capped at 15% of discretionary income. The requirements are that your loan monthly payments constitute a “financial hardship,” which virtually all residents qualify for, but few attendings do based on the ratio of loan balance to income. This plan allows you to only take your AGI into consideration if you are married and file taxes separately. If you make 25 years of repayments under the plan, the remaining balance on your loans will be forgiven, though this forgiveness will count as taxable income. Finally, the maximum payment under is capped at the standard repayment.

Pay As You Earn (PAYE)
Similar to IBR, but only available for people who did not take loans out before 2007.  It uses 10% of discretionary income rather than 15% of IBR, resulting in lower monthly payments. Like IBR, you can also separate your income from your spouses if you files taxes separately. Payment is also capped at the standard repayment amount. If not going for PSLF, forgiveness occurs after 20 years.

Revised Pay As You Earn (REPAYE)

Identical to PAYE, with for 4 key changes. First, you cannot separate your income from your spouse, even if you file taxes separately. Second, you can enroll in the plan even if you have loans from before 2007. Third, there is no cap on the maximum payment. Fourth, if your payments do not cover all of the accruing interest on your loans, the federal government will forgive half of the interest. The fourth change is the largest difference. For the typical resident above, repayment will be around $250 a month on REPAYE, while their loans accrue $13,000 a year in interest. Since that leaves $10,000 in additional interest, forgiveness of half of that saves the resident $5,000. This lowers the effective interest rate in residency to 4% ($8,000 total interest on $200,000 in loans). Finally, if you’re not participating in PSLF, the plan will forgive any remaining balance of your loans after 25 years of payments.

Income Contingent Repayment (ICR)
ICR requires you to pay 20% of your discretionary income, though it is capped at payments that would pay your loans off in 12 years instead of the standard 10-year repayment. This leads to higher minimum, but lower maximum payments than other options. However, there are no restrictions on qualifying for the program. If you make 25 years of payments, the remainder of your loans will be forgiven.

Plans that Do Not Qualify for PSLF

A plan where your payments start out low and increase every two years until you have paid off your loans in 10 years.  While there are lower initial payments than the standard plan, it ends up paying off in the same time period and paying more interest.

Extended and Extended Graduated
These plans are similar to the standard and graduated loan repayment programs, but they are amortized over 25 years. Essentially, you pay interest only in the beginning and slowly pay down the balance. These are not great choices for physicians, because the high interest rates on student loans would end up costing hundreds of thousands of extra dollars before payoff.

Now that all of the federal loan plans have been covered, let’s wrap up with a discussion of private loan refinancing. There has been a recent growth in the student loan refinancing industry. Five years ago, there were a few scattered locations, and now there are dozens of companies that are willing to refinance education debt for medical trainees. The decrease in interest rates can save tens of thousands of dollars, however there are several caveats to refinancing.

First, not all lenders will refinance residents. At the writing of this document (July 2016) there are only two lenders that will refinance during residency: Damien Rowan Bank (DRB) and Link Capital. DRB offers no capitalization of interest and $100 a month payments during residency. Link Capital offers no payments until after you graduate from residency.

Second, the interest rates that you can receive on your student loans are very dependent on your personal situation. Lender terms can vary, and the higher your income and credit score, the lower an interest rate you will probably be offered. Keep in mind that even if the rates that you are offered as a resident are not worth refinancing for, once you become an attending that may change. It is worth noting that some people may opt for private financing due to “teaser” interest rates that are attractive but also flexible. While interest rates are at generational lows, it’s worth remembering that there is only one direction the Federal Reserve can move interest rates – up! So, flexible rates that are attractively low now could become a real pain in later years of repayment.

Wrap Up

To finish this discussion up, here are suggestions for two good pay off strategies for different career paths. This obviously doesn’t cover every person’s situation, but it does address the situations of a good majority.

Fellowship/academic career: Go for PSLF
In this case, the most important thing is to get into REPAYE as soon as possible if you are single, and either REPAYE or PAYE if you are married to an income-earning spouse. Take advantage of the interest subsidy, and pay the minimum monthly payments. Stay in REPAYE throughout residency and fellowship, then switch to IBR two months before you graduate and start working to take advantage of the capped maximum payment. Continue to work for a nonprofit institution, and once you have made 120 payments, have the remainder of your loan balance forgiven. (Hint: skip the mandatory six-month “grace period” by consolidating your loans.) Upon approval, you can start making those first 12 qualifying payments based upon last year’s income as a medical student. For many of you, that will be $0 a month.

Private Practice and Refinance Route
Once you start residency, look at private refinancing. If the rate is better than what you would get with REPAYE, then refinance. If not, enter REPAYE for the duration of residency and get the interest subsidy. After you graduate, refinance privately with whoever will offer you the lowest interest rate, and then aggressively pay your loans off with your attending salary.

I hope this article helps explain the options for student loan repayment. If you have additional questions or would like to see a specific financial topic addressed in a future article, please feel free to contact the authors at or For further reading, click here.

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Director's Feature: The Power of Gratitude

Posted By Administration, Monday, January 11, 2016

Have You Thanked Your Patients Lately?

By MAOPS Executive Director Brian Bowles

I recently read an interesting editorial in Medical Economics entitled, “The last words you should say to any patient,” by Joseph Sidari, M.D. Dr. Sidari emphasized the importance of saying “thank you” to patients. In an effort to increase patient satisfaction scores, he would simply thank his patient for coming in to see him or even for taking medications as prescribed. What he found was that his patient satisfaction scores sky-rocketed from making this simple change.

As I thought about this, I realized that in most industries (fast food, grocery, etc.), a customer is always thanked for their patronage. However, in the medical industry, the customer (patient) is often the one who thanks the provider of the service (physician). Patients are so grateful for the physician and for their ability to make them feel better, they thank YOU!

While it is always nice to be thanked for your work, it is also easy in the physician-patient relationship to forget that the patient has a lot of choices for their health care. This “competition” for services grows every day with the variety of non-physician providers available and now online health care.

Physician rating sites like make it very easy for a physician’s reputation to be tarnished very publicly. It is important that physicians understand that they are providing a service for which their clients (patients) have many choices. The more you do to make the patient’s experience a good one, the better it is for you in the long run.

Saying “thank youis a simple way to let your patients know you appreciate their business and their confidence in you. Why not make this one of your New Year’s resolutions for 2016? Try thanking your patients more often and see what happens!

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Covering Your Back

Posted By Administration , Tuesday, November 17, 2015

Top Tips About Medical Malpractice Tail Coverage

By: Brian Bowles, MAOPS Executive Director

The following information is not provided as legal advice. It is simply a guide to assist you and make you aware of some issues you may face regarding medical liability insurance and tail coverage. You should always consult with an attorney with expertise in this area before making final decisions.

A major consideration for physicians who are retiring or changing employment situations is protection from medical liability claims that occurred in the past. When you switch jobs, your new coverage may not necessarily cover you for your prior acts. When you retire, protection from claims that might come back to haunt you from the past is necessary. Those contemplating retirement, or changes in employment, need to be aware of the type of medical liability insurance they have and some caveats regarding tail coverage. It is also extremely important to be proactive when initially purchasing malpractice insurance as it can save you tremendous frustration later on. The following is not an exhaustive list of questions to think about, rather it’s a starting point for necessary conversations with liability insurance carriers when purchasing insurance, retiring or changing employers.

Question: Do medical liability polices include tail coverage?

Answer: Most do not. Two types of policies exist: 1) occurrence-made; and 2) claim-made. Occurrence-made polices are rarely offered (by employers or medical malpractice insurance companies) these days, but they are still available. These polices are expensive, because they cover the insured for any malpractice claim that occurs while the claimant was covered by that insurer, regardless of if they are still with the insurer at the time of the claim. In short, tail coverage is “built in” to these policies. A claim-made policy (the most common type today) has the advantage of being lower in cost, but only covers the insured while they are an active policy-holder. Therefore, if you switch employers, or retire on Jan. 1, and drop your coverage with company A, you are not protected from any prior acts occurring while you were under that coverage. This is why you need to purchase tail coverage. Basically it’s a “pay now or pay later” scenario.

Question: My medical liability offers free tail coverage when I retire. I’m covered, right?

Answer: Maybe. The free tail coverage many companies provide covers you if you stay retired. If you go back to work, many companies have a provision which terminates the tail coverage leaving you unprotected. Some companies say they provide permanent tail coverage to policy holders, so even if you go back to work, you will be covered. If you are told this, be sure it is in writing and be sure an attorney verifies this for you.

Question: If I am changing jobs, won’t my new employer-provided policy cover me for tail occurrences?

Answer: Probably not. Your new coverage is for events during your employment with the new employer. Why would they want to pay for coverage for you with a past employer? They probably won’t assume that responsibility, so while you are covered for incidents while working for them, you may not be covered for prior acts. However, it never hurts to try and negotiate this into your employment contract.

Question: How do I know if I am covered for events associated with my previous employer?

Answer: Ask them before you retire or leave. Often, hospitals have provisions in place to protect them and their employees. But, it is your responsibility to know the policy and ask the right questions. Be sure to get the answer in writing, and it would be wise to have a trusted attorney assist you in reviewing the provisions in your policy.

Question: What if I am self-employed? Am I covered when I retire?

Answer: If you, by chance, had occurrence-based insurance, tail occurrences will be covered. If you privately purchased claim-made medical liability coverage (the most likely scenario), you may very well be offered free tail coverage when you retire. Be sure to ask about this when you BUY the policy. Also, ask if the coverage is terminated if you decide to go back to work. This is a common and problematic practice of medical liability companies. You are fine if you stay retired, but the second you go back to work (as a physician), you are unprotected from any previous claims and must purchase tail insurance. This could also include charity work, consulting, etc.

Question: What if I want to provide charity care for no compensation during my retirement? Will I lose my tail coverage?

Answer: First, regardless of the type of care you provide, you need to protect yourself from lawsuits. You can still be sued even though you were providing free care. Check with your insurance provider and see what they recommend. Chances are you can have your old policy reactivated, or they may simply allow you to keep the free tail coverage. It will depend on the company you are dealing with and your specific situation. But, have the conversation BEFORE you provide the charity care.

Question: What good is free tail coverage when I retire if they terminate it if I go back to work?

Answer: For one, it is free. Tail coverage is very expensive to purchase (220% to 350% of the current malpractice premium). So, if you stay retired, it is a very nice benefit for being a loyal customer. However, many physicians never fully retire. They often provide services for free for charities or work part-time at an urgent care facility or fill in occasionally as a locum tenens. Any of these situations require medical malpractice insurance, because you are at risk of a lawsuit. If it is purchased from the same company you have always used, chances are you can negotiate with them to keep the tail coverage they have provided you. However, if you switch companies or are employed by a business that uses another company, in essence, you have “switched allegiance” and are no longer a customer of your original provider. Remember, the free tail insurance was provided for being a loyal customer. Once you go back to work and are a customer of another company, the original company really has no incentive to protect you for free. Sound unfair? Maybe. But, you have to remember that insurance companies, like all businesses, need to make a profit. It doesn’t make good business sense to provide free protection for another company’s customer. This is also where good research early in your career pays off. If you had occurrence-made insurance, your tail is covered, but you paid the price throughout your career. If you had claim-made insurance, you saved money throughout your career, and have to pay the price now.

Question: So how do I protect myself for past occurrences if I decide to go back to work, even part-time?

Answer: It depends on the situation. Let’s look at four scenarios, assuming you had claim-based insurance.

1) Retired private physician returning as a private physician (part-time or full-time)
Answer: Simply approach your former malpractice provider and explain your specific situation. Negotiate a rate that fits your situation (if you are part-time, the rate shouldn’t be the same as if you are full-time). Also, be sure to ask about tail coverage. A reputable company will keep the free tail coverage for you or will simply convert your old policy back to an active policy with the same tail coverage provision for when you retire.

2) Retired private physician returning as an employed physician
Answer: Most likely your employer is using another malpractice provider, especially if it is a hospital system. Most private malpractice companies will terminate your free tail coverage once you go back to work. This means you either have to purchase the tail coverage at great expense or be left unprotected. You may be able to negotiate with your employer to pay for the tail coverage. You may also be able to negotiate with your previous provider. But, most likely, this will be your financial responsibility. Also, don’t assume that “if they don’t know I am working, I still have tail coverage.” Not true! If a claim is filed, the insurer will find out you were employed and termination of the tail coverage will still occur from the time you went back to work.

3) Employed physician returning as an employed physician
Answer: Most employers have policies for employees that provide tail coverage after the employee leaves. This is as much to protect the employer as the employee, but none-the-less, you are covered. Be sure to ask about this and get the answer in writing. If not covered, you will have to purchase tail coverage from a reputable company.

4) Employed physician returning as a private physician (or becoming a private physician)
Answer: This scenario is similar to the one above. Your previous employer probably has tail coverage for you. Still, get it in writing. When you purchase liability insurance for your private practice, be proactive and ask the right questions about tail coverage. Chances are, if you have retired and are coming back, you may truly retire in the near future, so it is very important that you have a policy that protects you in retirement. Take care of the tail coverage issue while you have this new opportunity.

One last thing to consider: “retired” means you are no longer working and deriving income as a physician. Be careful not to confuse this with “cutting back.” Many physicians feel that the one day of the week they work is more like a hobby to “stay in the game” and keep their skills fresh. BUT, when it comes to medical malpractice insurance, you are still working. You still need coverage, including tail coverage.

In summary, while Missouri does not require all physicians to carry medical liability insurance, it is not a wise decision to be unprotected. While claim-made insurance is usually cheaper initially, it does not include tail coverage. With the mobility in today’s physicians, frequent job changes could result in several periods where the physician is not covered by medical malpractice. It is recommended that tail coverage be purchased in order to protect your assets.

Occurrence-made insurance is more expensive, but it does offer the peace of mind of protection regardless of circumstance. It is less readily available than claim-made insurance, but there are companies that do offer it. It would be wise for the physician to look at both types of insurance from reputable, financially sound companies and determine what coverage best fits their situation. And remember, its either “pay now or pay later,” and tail coverage is basically an added endorsement to convert a claim-made policy into an occurrence policy.

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Director's Feature: Debunking the Regulatory Process

Posted By Administration, Monday, October 5, 2015

A Guide to Getting a Firm Grip on the Details

 By MAOPS Executive Director Brian Bowles

For the past several years, I have tried to educate MAOPS members about the regulatory process. This is the mysterious process that usually leads to the question all of us ask at some point, "Where did that idea come from?" The regulatory process is such a mystery, because it happens behind closed doors in rooms filled with governor appointees who think they know what is best for us. Whereas, legislation is difficult to pass, having to traverse the two chambers of the state legislature (the House and Senate), the regulatory process is far less transparent. The good news is that there is transparency. The bad news is that it's difficult to follow and most citizens are unaware of the process or that they can have a major impact if the process is used. Even more so, they can have a major impact if they SUPPORT organizations that follow the regulatory process closely, like we do at MAOPS.


The Regulatory Process in Action

  • Regulatory Boards – The governor appoints folks to sit on various regulatory boards, like the Missouri Board of Healing Arts (BoHA), your licensing board.
  • Comment Period – When BoHA wants to change a regulation, such as how a physician and a nurse must collaborate, they are required to propose the rule changes and post them in the Missouri Register for a 30-day comment period. Every Missouri citizen can comment on any proposed rule. However, hardly any do. The reason is that most people don't know about it. Additionally, the volume of rules can be quite intimidating and very difficult to follow. The Federal Register is even more cumbersome.
  • Missouri Register – The publication comes out twice per month. (The Federal Register comes out at least once per day.) MAOPS reads the Missouri Register and submits comments on items impacting the profession. Comments are based on MAOPS policy, which is developed by you, the members! Usually a letter from MAOPS representing all of our members is all that is needed. Occasionally, we ask for individual members to help by submitting their own comments as well.
  • Final Rules – Commonly, MAOPS comments are considered and implemented into the final rules, so this is an effective process for those who choose to participate. This is why MAOPS membership is so important. We do the things for you that you: 1) don’t have time to do; and 2) don’t want to do! Keep this in mind later this fall when you consider whether or not to renew your investment in MAOPS membership for 2016. We hope you will see the value in this, and all the other things we do for the profession.

MAOPS is always looking for people to help monitor the government. For those interested in following the regulatory process, click here to access the Missouri Register. You can register to receive email updates when rules are proposed by agencies. You can even filter the agencies most applicable or of most interest to you. For physicians, the following agencies are good ones to follow:

  • The Missouri Department of Mental Health;
  • The Missouri Department of Social Services;
  • The Missouri Department of Health and Senior Services;
  • The Missouri Department of Insurance; and
  • The Missouri Office of Administration.

If you have any questions about the regulatory process, how to get move involved or anything in between, I'd be happy to visit with you at your convenience. Please call the MAOPS Central Office Team at (573) 634-3415, or email me at you!

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MAOPS President's Blog

Posted By Administration, Thursday, June 11, 2015

MAOPS President Mark Pelikan, D.O., Calls on All Leaders - Past, Present and Future

During the 2015 Missouri Osteopathic Annual Convention in April, newly installed MAOPS President Mark Pelikan, D.O., of St. Louis delivered a powerful speech to his colleagues.

He challenged his osteopathic family, who listened intently as his passionate and invigorating words filled the banquet room at the Chateau on the Lake in Branson, to join him and “help fight the good fight on behalf of all of us, our patients and our profession.

“To be a leader, you may have to struggle. You may have to go above, up and over many roadblocks,” Dr. Pelikan declared, lightheartedly adding, “Remember medical school?”

If you didn’t have the opportunity to listen to Dr. Pelikan’s speech firsthand in Branson, you’re in luck, because his sister-in-law had her cell phone handy just in time to capture the moment. Enjoy!

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MAOPS President Calls for Member Unity

Posted By Administration, Monday, April 13, 2015

Bringing the Profession Together Today for a Stronger Tomorrow

By Lee Parks, D.O., MAOPS 2014-2015 President

As I end my tenure as MAOPS President in a few weeks, I wanted to thank each of you for your support through your membership and volunteer time. It is our members who make our organization strong. I also wanted to inform you about some issues that need resolution and invite you to participate in developing a solution.

MAOPS district osteopathic associations (we have 13 active ones) were originally formed to allow members of certain geographic areas to meet, discuss pertinent professional issues, and submit policy ideas to the state organization. However, for quite a few years now, the MAOPS Board has struggled with trying to help districts be more active, engaged and functional. Districts are meeting less frequently, and when they do meet, attendance is low. Physicians are busier now than they ever have been with other priorities and interests, and evening meetings just don’t seem to work any longer. We have realized that we are not the only professional organization to be looking at this issue, so we’ve been researching ways to progress. I believe it’s time to consider a new way to meet member needs, and that is where each of you come in.

You have seen some of the results of our efforts. For example, we have tightened our mission and goals, sharpened our strategic plan and discarded some of the time-honored, but unnecessary and unproductive, committees and activities. The House of Delegates is no more. Standing committees have largely been replaced by fast action teams with distinct, limited mandates for problem solving. We have stopped trying to force inactive districts to meet. We are offering members more opportunities to be better and more conveniently informed that do not involve district meetings. Some of these methods include social media, a state-of-the-art website, a weekly Legislative Journal during the legislative session, a twice-monthly electronic Prognosis eNewsletter and an annual hard copy of the Health Care Legislative Rundown magazine. We are putting resources into publicizing the role and scope of osteopathic medicine in Missouri through awareness campaigns and news releases.  We are also actively seeking to identify and mentor new leaders for the future. If you haven't been noticing these changes, that fact only underscores the need to address the problem of making organized osteopathic medicine powerful, relevant and responsive to today’s and tomorrow’s physicians.

MAOPS Annual Membership meeting will be held on Wed., April 29 at 5 p.m. at the Chateau on the Lake in Branson, Missouri. This will be the first meeting since dissolution of the House of Delegates. It’s vital that every member of this Association makes a valiant effort to be in attendance, as the Board of Trustees will be forming a plan for the future of MAOPS and our districts. The primary purpose of the meeting is to receive direction from our members regarding the next steps of the organization. We need to know what issues are most important to you and your practice now and what you foresee as needs in the future.

I encourage you to send your thoughts to MAOPS Executive Director Brian Bowles for consideration on the agenda. We need to know what kind of organization you want, what you need and what you expect from a professional organization representing YOU. Additionally, we need your input on the future of our osteopathic districts. We know what we have now is not functioning as it should. We have an opportunity to shape the structure of our organization to become more responsive to member needs and more efficient in accomplishing that task.

We want to kick start a real discussion about the future of MAOPS and its governance, and we need your input. During the meeting, we’ll discuss some options we’ve developed after researching how other organizations maintain a foothold on the unique needs of their membership bases. The Board of Trustees has to make some difficult decisions regarding our districts’ futures. We cannot continue to provide support (both time and financial) to keep districts on life support when most serve so few members in a meaningful way, as is evident by the extremely low turnout out a majority of district meetings. I suspect we will see some dramatic changes in our district structure in the near future in order to better meet the needs of a majority of our members. The annual membership meeting is your opportunity to have input about what that structure will look like.

I hope to see everyone at the Annual Membership Meeting on April 29, so together, we can discuss how planning today can help shape the MAOPS of tomorrow. The general Board meeting will begin at 5 p.m., with the conclusion of business by 6:15 p.m. Reports will be given from the American Osteopathic Association, Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons, American College of Osteopathic Family Physicians, our Executive Director Brian Bowles and myself. The meeting will conclude with a discussion about the future of our districts and a general membership forum where your ideas and issues can be addressed. Following the forum, all attendees are invited to a reception hosted by the Board.

Please choose to be involved in our future. Thank you!

RSVP to the Membership Meeting Now

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Taking the Osteopathic Oath to Heart

Posted By Administration, Wednesday, March 25, 2015

Mentoring the Next Generation... If Not You, Then Who?

By Bruce Williams, D.O., FACOFP


To have been given the opportunity to practice medicine is an honor and a privilege. With that privilege comes responsibility. We all realize that. We understand the responsibility to our patients, families, hospitals, etc. However, I’m wondering if we’ve all considered the responsibility we have to our colleagues and the profession? Are we looking out for each other? Because, if we are not looking out for each other, who is looking out for us? Who is considering our best interests? Who is advocating for us or our hospitals and patients? How about the insurance plans? Do they lose sleep at night worrying about the physicians? Are they concerned if the physicians get a fair deal? I submit that physicians need to look after physicians.

We all took the Osteopathic Oath. The very first sentence states, “I do hereby affirm my loyalty to the profession I am about to enter.” Have we all taken the time to really consider what that statement means? To me, it means that I will do everything in my power to protect, preserve and defend the profession and those who practice osteopathic medicine. What mechanism do we have to do that? We have our osteopathic organizations. We each have our local, state and national organizations and our corresponding specialty organizations. At the very least, every physician should be a member. So why is this not the case? I have heard various reasons, including: “I’m too busy.” “I don’t want to go to another meeting.” “I have too many other commitments.” “I’m not into politics.”

I can relate, and I suspect that we all can identify with at least one of these reasons. So what has been the result of physicians avoiding meetings, being too busy or having too many other commitments? Well, immediately, the Affordable Care Act comes to mind. We have also been blessed with mid-level providers helping out with our busy daily lives and helping to ease our burden by taking over our patients because after all, they can provide the same care we do. They also don’t shy away from politics, so they have solved that problem for us as well. And of course, we are all aware of the big pay raises we have been blessed with because our government and hospitals are looking out for our best interests. When we talk to our legislators, they all remark about the huge numbers of physicians they see at the Capitol every day. Sure they do.

It saddens me to see the apathy among physicians, especially at a time when we need each other the most. Our profession was made strong by iron-willed physicians fighting and clawing for practice rights, payment and speaking up on behalf of our patients. We had true mentors that stood up and were proud to be physician leaders. They commanded the respect of their colleagues, legislators, community leaders, hospital administrators and insurance companies. It was an honor to be asked to be on the board of your local or state medical organization or society. Even to be asked to sit on a committee, meant your opinion was sought after and respected. And by no means were you expected to always agree. In fact, quite the opposite was encouraged. Progress is made by injecting new thoughts and opinions.

Today, it is still an honor to be asked to be on a board or committee of a medical organization. Your opinion is still sought after and respected. And we do need differences of opinion to progress. We need committed leaders in our profession. We need youth. We need direction. We need mentors. We need you! And we need you now before the next “Affordable Care Act.” We need you to join us as a mentor and leader before the next pharmacist, optometrist, nurse, physician assistant, chiropractor or midwife states they can do everything we do. We need your participation before the next legislation further restricts our ability to provide the care for our patients we are trained to provide, or before it’s made so difficult to practice that it is easier to retire or go into a different line of work.

We are training the next generation of physicians in our schools. These students are the best and brightest there have ever been. They will also be OUR physicians as we age. We need to provide the example to them, just as we had the example of what it was to be a physician when we were getting started. They need to be encouraged. They are eager and energized. When I started my career, I had a physician approach me and ask me to be on the board of the Jackson County Osteopathic Association. Later, I was approached by another to consider being on a committee for the Missouri Association of Osteopathic Physicians and Surgeons (MAOPS). These physicians are my mentors. I was extremely honored that they considered me to be a physician who had something to offer. I didn’t want to let them down, because I knew of their passion for the profession and their patients. These physicians were pioneers who made our profession what it is because of their persistence and dedication.

We have leaders in our profession who continue to fight the battles for our profession and our patients. These are the leaders our students and young physicians will look up to as mentors. Next time you’re asked to serve as a district president, trustee or make a trip to the Missouri State Capitol for a day to talk to legislators, I hope you will see this as an honorable request and not a chore. I hope you will see this as a privilege and not an obligation. I hope you will step into this role with commitment and passion. I hope you will be eager to be counted among the leaders and mentors of our profession. I hope that when your dues statement arrives for your district, state, national and specialty organizations, you will willingly write that check because you remember the first line in the Osteopathic Oath you took to “affirm your loyalty to the profession you have entered.”

I’m proud of my profession, the physicians, students and each and every member of MAOPS. Let’s continue to set good examples and support one another. Together, we’re strong, and I believe there is no limit to what we can accomplish. Thank you all for your dedication to the profession and each other.

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President’s Final Plea to Membership

Posted By Administration, Wednesday, March 18, 2015
Updated: Wednesday, March 18, 2015

Take the Time to Tend to Your Needs

By MAOPS President Lee Parks, D.O.

As I near the end of my term as president of the Missouri Association of Osteopathic Physicians and Surgeons, I find myself with too many things to do in the time allotted. However, before moving onto the next chapter of my life, I feel inclined to pause, and share some advice with each of you that I often give to my patients, but sometimes fail to follow in my own life (as I suspect many of you also do). To the young single moms, the grandmothers raising grandkids and the breadwinners burdened by the demands of supporting a growing family on the wages of two part-time jobs, neither of which pay a living wage, my message is the same. I tell them this: “If you don’t take care of YOURSELF, you can’t take care of everything else.”

If we put off doing the things that keep us healthy and sane because, “It doesn’t matter, it’s only for me,” we’ll eventually LOSE our health and maybe our sanity. Not only are our bodies, as physicians, just as subject to the laws of nature as every other body, but the subliminal message we send to ourselves is that we don’t matter. To feel that one does not matter leads to depression, ineffectiveness, inability to sleep well and anger. As I think about the people I see at various meetings around the state, I know that many of them are at least as saddled by their workload, family and community responsibilities as I am. We are doers, givers, and we all work hard every day.

What concerns me is seeing and knowing how easy it is to become so busy that we forget to take care of ourselves. We, as physicians, easily become preoccupied with treating patients, and we often neglect our own needs. Instead of constantly treating patients with little regard for our needs, we need to carve out the time to actually be a patient. It’s imperative that we pay attention to our own risk factors for disease. We must set an example for our families, patients and colleagues of what a healthy life looks like, and display how to balance that life so we continue to be the kind of resource for improving the world that we have been in the past.

As I end my term as MAOPS President, I have one final request of the incredible members of this Association. I ask that you take a step back from your hectic schedules and make a commitment with me. Resolve to treat yourselves better, because you matter to everyone around you, even if you lose sight of that because you’re too busy caring for everyone else. Let’s do it together. Let’s agree that we’ll make a conscious effort to eat three well-balanced, unhurried meals a day, lose that extra weight, take time to exercise regularly, make memories with our families and friends and stop putting off those hobbies we use to make a priority.  Perhaps, most important of all, let’s commit to growing our spiritual side, whatever we each interpret that to be. I urge you all to please cast aside the notion that taking time for ourselves is selfish. As a profession, we spend our entire lives caring for the needs of others. We need to lead by example. Nobody should ever feel guilty about taking the time to tend to their needs. We owe it to ourselves and those whose lives we touch as physicians, friends, family members and as a member of our communities, to be the best version of ourselves we can be. This is possible if we take the time to stop, listen to our bodies, and realize that we matter as much as the next person. If we take good care of ourselves, we’ll become stronger, fresher physicians better equipped to help everyone else in our lives.

With love to my osteopathic family,


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