Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
150 Y EARS OF LEADERSHIP & ADVOCACY FOR PATIENTS AND PHYSICIANS 1865-2015 150 YEARS 2015 ACMS EXECUTIVE COMMITTEE ACMS ADMINISTRATIVE STAFF President Executive Director John P. Williams, MD John G. Krah President-elect Assistant to the Director Lawrence R. John, MD Dorothy S. Hostovich Vice President Bookkeeper David J. Deitrick, DO Susan L. Brown Secretary Bulletin Managing Editor Robert C. Cicco, MD Meagan Welling Treasurer Assistant Executive Director, Adele L. Towers, MD Director of Member Relations James D. Ireland Board Chair Kevin O. Garrett, MD Member Relations Manager Nadine M. Popovich BOARD OF DIRECTORS 2015 2016 2017 Vijay K. Bahl, MD David L. Blinn, MD Peter G. Ellis, MD Patricia L. Bononi, MD Robert W. Bragdon, MD David A. Logan, MD M. Sabina Daroski, MD Thomas B. Campbell, MD Jan W. Madison, MD Sharon L. Goldstein, MD Douglas F. Clough, MD Matthew B. Straka, MD Karl R. Olsen, MD Jason J. Lamb, MD Angela M. Stupi, MD 150 I YEARS t is hard to comprehend that the roots of the Allegheny County Medical Society extend back to the Civil War. Physicians practiced against a backdrop of circumstances almost unimaginable today. Minutes of Society meetings are replete with concerns for public health issues including clean water, air, milk and communicable diseases. Early Society members came to ACMS to hear the latest on smallpox and tuberculosis. The Society continues to be a leader in community efforts targeting today’s health threats — substance abuse, AIDS, infant mortality, obesity, and early childhood development. Over the years, the Society and its members joined forces with likeminded organizations to encourage medical and nursing education, to initiate emergency medical services, health planning, utilization review, and shared computer services. The ACMS Foundation, born of a community immunization drive, returns that investment in the form of grants for local charitable, educational, and scientific projects in the interest of better health. Numbered in the ACMS ranks are nationally and internationally known medical pioneers in fields of radiology, immunology and transplantation. Of equal importance is the commitment of time and expertise on committees and task forces that affect change. Virgin Alley (now Oliver Avenue and Wood Street) was the site of the first ACMS meeting. From hospital to hospital, organization to organization, member to member, ACMS bridges the thinking of individual constituencies, combines the energies of many for a stronger, common good, and meets with friends as well as adversaries to achieve mutual goals. The Society provides the means to connect and to make a difference. A Legacy of Caring 1 150 YEARS In the Beginning... 1865: Nineteen physicians and surgeons gather at Pittsburgh’s Board of Trade on the corner of Wood Street and Virgin Alley to form the Allegheny County Medical Society with $57 from member initiation fees. 1871: Pittsburgh has a difficult year with outbreaks of smallpox and cholera infantum. 1874: Drs. James McCann and S.N. Benham speak out against the prevalent practice of immediately amputating badly fractured limbs. 1876: Dr. McCann reports on the antiseptic treatment of wounds and surgical incisions, as recommended by Dr. Joseph Lister. He is ahead of his time; Lister’s work is still largely rejected in England, Scotland, France and Italy. 1885: The Society adopts a resolution urging the state to create a board of medical examiners. Dr. James C. Dunn warns members of the habit-forming effects of cocaine, previously welcomed as a great boon to medicine. 1886: The Western Pennsylvania Medical College opens on Brereton and 30th streets with 55 students and staffed almost entirely by Society members, usually paid little or nothing. Allegheny General Hospital opens with 76 beds and an average per patient maintenance cost of 97 cents per day. 1867: The Society’s first scientific meeting is held. The germ theory is still virtually unknown. Dr. James King makes front-page news by presenting the dangers of drinking river water polluted “by the percolations and overflow of innumerable cesspools and privies” and connects typhoid fever outbreaks to the polluted water. 1869: A state committee on medical education raises standards of medical schools. 1870: Dr. E.A. Wood presents a paper on placenta previa, and is brusquely reminded by a fellow physician that the Society’s scientific meetings are for “only cases, not theory.” Tracking Pittsburgh’s vital statistics dates back to this year. 2 1888: Dr. W.T. Burleigh analyzes a South Side typhoid epidemic of 1,351 cases in eight months, demonstrating that it and a parallel epidemic in Allegheny are due to water pollution. Pittsburgh moves its water intake up the Allegheny River and has no epidemic, while towns pumping water from inside the city limits suffer greatly. 150 1890s: Tuberculosis is dubbed “the master killer.” 1891: There is “considerable merriment” over a “lady doctor” who has opened an office on Arch Street. YEARS 1892: Dr. C. Jane Vincent is the Society’s first female member. Dr. Adolph Koenig’s paper “The Medication of the Future” suggests many improvements including legally set standards of purity, dating containers of perishable medicines, government inspection, and government grants for pharmaceutical research. 1896: Dr. E.B. Haworth demonstrates the newly discovered Roentgen Ray’s usefulness for surgery. The Society plans to provide such equipment to all city hospitals. Combatting Communicable Diseases In the early 20th century communicable diseases were considered more important than other diseases that were deemed “the order of nature.” It wasn’t until the mid-1900s when acute infectious diseases were considered under control that a shift to problems of the aged – arthritis, heart disease, cancer, diabetes and mental illness – came into sharper focus. 1900: The Society believes the greatest health threats to Pittsburgh and its environs are polluted water and air. 1911: The ACMS BULLETIN is founded, with Dr. W.H. Cameron as first editor. (The BULLETIN has had uninterrupted publication ever since.) 1915: 1904: The Society continues to do battle against quacks and other illegal practitioners. One “doctor” with neither license nor diploma is warned to desist. A Society report states, “The ‘Doctor’ thereupon ceased practicing and disappeared by the light of the moon.” 1907: The Society becomes convinced that the area’s milk supply needs supervision and forms a Milk Commission that certifies clean dairies until governmental entities take over the job. University of Pittsburgh, in which the visionary doctor lays the groundwork for modern blood vessel surgery and transplants. 1912: A London publisher issues “Blood Vessel Surgery” by Dr. Charles C. Guthrie of the The Society celebrates its 50th anniversary. The BULLETIN comments favorably on a resolution of the Schuylkill County Medical Society, which says in part, “The largest problem facing the medical profession today is that of getting their services to the sick person of average means. All medical services should be available to any citizen at public expense; and not as charity, but as a right given him by his citizenship.” 1917: Narcotic drug control is an issue. 3 150 YEARS 1918: Nearly half the Society’s membership enters military service. Along with civilian colleagues they cope with the terrible influenza epidemic, which peaks the week of October 26 with reports of more than 5,500 cases and 576 deaths. By December 17, there were more than 3,000 deaths. 1936: Society members respond in force to a disastrous flood. A local newspaper says, “In such crises the doctors are always in the first line of defense, working unselfishly, heroically. . .” 1937: Iron lungs are still the treatment for polio in 1937. 1919: Physicians who served in the military return with an infusion of new knowledge. Dr. J.W. Robinson presents a paper on treatment of shock for war wounds and using methods previously little known, e.g., spinal anesthesia and the intravenous administration of glucose and saline solutions. 1922: Dr. Walter F. Donaldson becomes Society president. He is regarded by many as a medical statesman and a mainstay of organized medicine: for 35 years permanent secretary of the State Medical Society, an ACMS director for more than 30 years, and BULLETIN editor from 1928-1947. 1925: The ACMS Auxiliary is established to support Society goals through medical education and charitable projects. 1928: Penicillin is introduced. 1930: Dr. T. Lyle Hazlett gives the first public demonstration of a portable electrocardiograph, which he and Dr. A.P. D’Zmura helped Westinghouse engineers design. 1931: The Depression is at its worst. A group of physicians and nurses volunteers free medical services to penniless men at the Helping Hand Association, set up to accommodate thousands passing through Pittsburgh in search of work. 4 1941: Pearl Harbor spurs America’s entry into war. Over time more than 700 Society members answer the call. Dr. John McAleese, stationed in New Guinea, replaces the prevailing “pressure” treatment of burns with the “kleenex-penicillin” approach. The results are so positive that the Surgeon General adopts the method as standard practice. 1944: Dr. Allison Johnston becomes the first woman to head the Society. In 1936, she was the first woman to head the American Radiological Society. Members Mark Medical Milestones 150 YEARS Society members make international medical news over the new decade: Dr. Jonas P. Salk and his coworkers develop the first successful vaccine against poliomyelitis, Dr. Benjamin Spock teaches at the Pitt Medical School, Dr. William McD. Hammon demonstrates that gamma globulin will provide temporary immunity against many diseases, Dr. Edward Rynearson becomes a world-famous endocrinologist, and Dr. Jessie S. Wright is honored by the Argentine government for her work during an epidemic there. 1958: The first local intensive care department opens at the Western Pennsylvania Hospital. 1960: The Allegheny County Medical Society Foundation is established to provide grants for educational, scientific and charitable projects. 1964: The Society sponsors a campaign in which more than a million persons receive Sabin polio vaccine free. 1965: During its centennial year, Society membership totals more than 2,000, a far cry from the 19 who founded it a century before. 1968: Issues of informed consent are on the ACMS agenda. The Allegheny County Council on Emergency Medical and Health Services and the Hospital Planning Association are established. 1969: Courses in management and control of tuberculosis are offered. The Comprehensive Health Planning Association of Western Pennsylvania evolves. Montefiore Hospital joins the University Health Center. National health insurance proposals surface. H. David Moore, Jr. is named ACMS executive director, serving nearly 20 years in this role. 1970: The Society moves from downtown’s Jenkins Arcade to current North Side headquarters. Professional Standards Review Organizations (PSROs) are proposed by Sen. Wallace Bennett (D-Utah). 1966: The Department of Public Welfare increases fees to $4 for an office visit and $5 for a house call. 1967: Dr. Francis S. Cheever becomes Vice Chancellor of Health Professions at the University of Pittsburgh. 5 150 YEARS 1971: ACMS conducts a survey on non-physician assistants in private practice. 1972: The AMA proposes “Medicredit” national health plan. 1973: Pre-disposition Utilization Review (PDUR) is established by the Department of Public Welfare. The ACMS Public Relations Committee drafts press guidelines for physicians. 1974: Local physician director proclaims “PSRO is our last, best hope.” 1975: The Auxiliary celebrates its 50th anniversary. A BULLETIN editorial comments on the Karen Ann Quinlan case regarding withdrawal of life support. The Health Systems Agency is born via the National Health Planning Resources Development Act of 1974. Act Ill, establishing a malpractice arbitration panel, is enacted in Pennsylvania. 1976: ACMS marks the nation’s Bicentennial with a patriotic theme for its installation of Dr. Lawrence D. Ellis as president. The Federal Trade Commission sues the AMA, the Connecticut State Medical Association and the New Haven Medical Society for restraint of trade relative to physician advertising. The Pennsylvania Medical Society Liability Insurance Company (PMSLIC), a physician-run insurance program, is organized in response to the state professional 6 liability crisis. The Thyroid Irradiation Project attempts to find persons who received a childhood radiation treatment, which though acceptable at the time may cause future health problems. Swine flu is a public health issue. The ACMS Friends of Medicine Committee is established to address issues of impaired physicians. 1977: St. John’s Hospital proposal is the first to go before the Health Systems Agency. ACMS and the Allegheny County Bar Association develop the Interprofessional Code. A spate of weight loss programs prompts ACMS to issue a statement on bariatrics. Allan Bakke’s reverse discrimination suit is editorialized in the BULLETIN. 1978: Health Maintenance Organizations and Independent Practice Associations are topics of discussion. The Voluntary Effort, an AMA/American Hospital Association plan, addresses health care cost containment. ACMS issues statements on second surgical opinions and in-vitro fertilization. Hospice care gains attention. 1979: Dr. Howard Mermelstein, a pediatrician, is Society president when ACMS joins local pediatric groups for projects marking the International Year of the Child. The Society co-hosts dialogue on health care priorities with the United Steelworkers. ACMS member Dr. Gordon K. MacLeod becomes state Secretary of Health and deals with the Three Mile Island Accident. The New Medical Marketplace 150 YEARS The fee-for-service model gradually erodes as alternative insurance plans purported to contain costs and provide better quality medicine. Preservation of that quality care continued to be the common bond of members while the marketplace widened the margins of employed physicians and those in fee for service, each with unique perspectives about the future of medicine. 1980: Corporate and health care leaders form the Health Policy Institute to objectively evaluate health care issues as they affect cost. ACMS joins WPXI-TV and other groups for “Health Spirit ’80” providing free medical screenings. The ACMS Foundation conducts “Patient’s Perceptions of Medical Care” survey. 1985: Under the leadership of Society President Dr. Daniel Brooks, ACMS is the catalyst for the Physicians Health Plan (PHP) of Western Pennsylvania, which over the years evolves into the Partners Health Plan. 1981: CAT scanners are the hot topic. ACMS and the Allegheny County Health Department provide the “Envelope of Life” home emergency medical record. 1982: Cardiac transplantation articles appear in the BULLETIN. ACMS President Dr. Abraham Twerski is a proponent of substance abuse diagnosis and prevention. 1983: Unemployment waves hit Pittsburgh as the steel industry declines. ACMS urges members to treat patients with sensitivity to their financial needs. Tax Equity and Fiscal Responsibility Act (TEFRA) changes the system of Medicare hospital reimbursement. Diagnosis Related Groups (DRGs) and case mix methodology become buzz words. The Society starts to “fight city hall” to re-zone its property for expansion. 1984: Dr. H. Lee Dameshek makes “caring” his presidential theme. ACMS and WTAE-TV team for “4 Your Good Health.” Medicare Mandated Assignment is proposed. 1986: The BULLETIN celebrates its diamond jubilee. Dr. Ralph Gaudio, Jr., succeeds Dr. Macy I. Levine as editor. 1987: Medical care at the jail is re-examined and policy developed. ACMS and its Foundation sponsor “Medicine in Action,” a hands-on health exhibit to bring medicine closer to the public. Act 89, the Health Care Cost Containment Act, is passed. Acquired Immune Deficiency Syndrome (AIDS) headlines the news. 1988: New Medicare regulations are part of the Omnibus Budget Reconciliation Act. House Bills 1828-1834 prompt major PAMED tort reform efforts. The Journal of the American Medical Association publishes “It’s over, Debbie” raising questions about physician-assisted suicide. 1989: Substance abuse is the focus of “Diagnosis ’89,” a multi-disciplinary symposium to raise awareness and build cooperation in dealing with alcohol and other drug problems. The Hippocrates Society is established to tap the knowledge and experience of ACMS past presidents. 7 150 YEARS An Explosion of Clinical Knowledge and Medical Advances The period of 1991-2015 is marked by an explosion in clinical knowledge and medical advances – laparoscopy, robotics, imaging, bioengineering, telemedicine, joint replacements and remarkable drugs. Transplantation, neurosurgery, oncology, and the treatment and management of HIV stand out. But with these medical miracles comes the ongoing challenge – how to pay for care and make it accessible to all. 1990: The Allegheny County Medical Society celebrates its 125th year. The ACMS Foundation turned 30 and the Society marked 20 years at its North Side location. The National Committee for Quality Assurance (NCQA), a private, not-forprofit organization, is founded to elevate the issue of health care quality on the national agenda, developing quality standards and performance measures for a broad range of health care entities. real validation in the Institute of Medicine’s (IOM) 1991 report “The Computer-Based Patient Record: An Essential Technology for Health Care.” 1992: Medicare’s Resource Based Relative Value Scale (RBRVS) is implemented in January. The ACMS Medical Exchange brings together a broad range of medical, insurance, business, legal and community leaders to provide insights into challenges facing physicians and their patients. 1991: Medicare reimbursements, hospital/HMO negotiations and physician joint ventures were among the topics of the time. The National Practitioner Data Bank is established for credentialing. The “Confidentiality of HIVrelated Information Act” goes into effect. Blue Cross of Western Pennsylvania announces its Medicenters. Physicians enter the Persian Gulf conflict. The AMA released results of its Health Access America survey: 58 percent support a system to cover uninsured; 80 percent feel employers should provide coverage; and 68 percent feel the poor are unable to access health care. The Electronic Medical Record (EMR) received its first 8 Abuse and others – champion issues that impact physicians and patient care. The Bio-Ethics Advisory Committee institutes discussions about HIV/AIDS. The Third Party Reimbursement Committee works with the PAMED Council on Medical Economics, medical specialty societies and Management Professionals in Healthcare to address members’ third party reimbursement issues. 1995: The ACMS Managed Care Committee is formed to assess the evolution of managed care, develop relationships with stakeholders and focus on the cost/ quality relationship. Allegheny MedCare offers group purchasing and other services to members. 1996: 1993: Healthcare reform resurfaces with the introduction of the Healthcare Security Act on October 27. Physicians reacted in an AMA survey: 44 percent of physicians voted “negative” while 22 percent reported a positive reaction, which helped form the AMA Position on Healthcare Reform. 1994: The work of ACMS Committees – Occupational and Environmental Health, Substance ACMS President Dr. Richard Harris says, “While national healthcare issues are important, local and regional issues now have the biggest impact on the everyday practice of medicine. . . .Help us win one victory at a time and not get overwhelmed by the big picture.” The consolidation of Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield is approved by the Pennsylvania Insurance Department on November 27, resulting in a new 150 YEARS company – Highmark Inc. AMA House of Delegates opposes physician-aided suicide and creates an International Medical Graduates section. Dr. Judith Black warns that when/if to withhold treatment in geriatric care will be a major issue of the 21st century as Allegheny County’s senior population grows in the 1990s – citing a 21 percent rise in the over-85 population. An Assurance of Quality The insurance industry introduces capitation, outcome measures, quality reports, referrals, pre-authorization, valued-based medicine, and pay for performance (P4P or PFP). Various regulatory agencies – PHC4, AHQRS, JCAHO, CMS -- attempt to develop quality measures. EHR (electronic health records) and e-prescriptions are part of the “paperless office.” Health care reform, tort reform, managed care, physician reimbursement and quality of care are recurrent themes. The Pennsylvania Medical Society honors Dr. George J. Magovern for 50 years in medicine Dr. Magovern, the cardiovascular surgeon who pioneered artificial heart valves and helped establish Allegheny General Hospital as a leader in open-heart surgery, is widely regarded as one of Pittsburgh’s medical icons, in the company of polio vaccine maker Dr. Jonas Salk and transplant great Dr. Thomas Starzl. Dr. Abraham J. Twerski, founder of Gateway Rehabilitation Center and an internationally respected authority on the treatment of alcohol and other drug dependencies, received the Pennsylvania Medical Society’s Distinguished Service Award for his work in treating chemical dependency. 1997: As a member benefit, ACMS introduced a credentials verification service to comply with JCAHO and other requirements. Highmark BCBS capitation for primary care physicians is among topics tackled at ACMS member workshops. HCFA restructure of Medicare payments provoked a letter writing campaign by ACMS members. PAMED Education and Scientific Trust’s Physicians’ Health Programs medical director Thomas Hobbs, Ph.D., M.D., exhorts, “It’s more convenient to believe that a physician’s addiction is none of our business but we all have a responsibility to help a colleague in need. We owe it to ourselves, our colleagues and our patients to deal with physician impairment as early as possible.” 1998: The $1.3 billion bankruptcy of the Allegheny Health, Education, and Research Foundation (AHERF) in July was the nation’s largest nonprofit health care failure. ACMS offers assistance to physicians affected by the AHERF crisis. Dr. Alvin Shapiro called the passing of ACMS member Dr. Jack D. Myers “an end to an era in Pittsburgh medicine and the discipline of internal medicine in this country which will not be seen again.” Dr. Myers, who developed one of the first computer programs to help doctors diagnose complex cases, was widely regarded as one of the nation’s premier diagnosticians. Physician unions is the spring ACMS Business Meeting topic. 9 150 YEARS 1999: Dr. John G. Kokales echoes the sentiments of many in a BULLETIN article: “Is there nothing we physicians can do these days that is not questioned, changed, denied, altered, corrected, or subject to possible criminal prosecution?” With pressure to provide health care at a lower cost, legislation to expand the role of limited license practitioners is introduced. ACMS joins the “Working Together Coalition,” a group of physicians and business leaders focusing on quality of care. ACMS President Dennis Hurwitz calls on members to contact legislators in support of the Quality Health Care Coalition Act of 1999, allowing physicians to act collectively on behalf of their patients. The New Millennium This is the era of Y2K, 9/11, myriad pieces of legislation, unrest in the middle east, an influx of tsunami and hurricane refugees, the aftermath of the collapse of AHERF and the merger of Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield, and the clash of Highmark and UPMC. HIV, tobacco and opiate use, medical marijuana, end-of-life decisions, obesity, domestic and gun violence, and an aging population weave in and out of the headlines. The pace at which changes occurred saw physicians turning more and more to the Allegheny County Medical Society for help to sort it all out. 2000: Y2K preparations avert computer chaos as the world transitions to a new millennium. An active Speakers Bureau and initiatives such as the “Straight Talk about Health Care” radio commercials and “Dear Doctor” column in the Pittsburgh Post-Gazette involve dozens of members. 2001: Tort reform and the privatization of the CAT fund ignite discussion at the Pennsylvania Medical Society sessions across the state, with 100 local doctors attending a meeting in Cranberry. BULLETIN Editor Dr. Jack Wilberger warns: “Many outside of medicine dismiss this (malpractice) crisis as the selfish plaints of physicians. However, this issue is driving good physicians away from our state.” UPMC purchases Children’s Hospital, announcing plans to 10 build a new hospital at the site of the former St. Francis Health System in Lawrenceville with financial support from Highmark. Domestic violence is the focus of the Spring Business Meeting. The aftermath of 9/11 results in calling up of troops, including physicians, and anthrax scares. Dr. Carol E. Rose becomes the Pennsylvania Medical Society’s first female president. 2002: The Pennsylvania Medical Care Availability and Reduction of Error Fund (Mcare), the successor to the Medical Professional Liability Catastrophe Loss (CAT) Fund, is signed into law on March 20. Mcare is designed to ensure compensation for persons injured due to medical negligence among other provisions. The nursing work force shortage is predicted to intensify as baby boomers age and the need for health care grows. 2003: A Pittsburgh Post-Gazette headline in December asks: “Is the collapse of employmentbased health insurance inevitable?” ACMS President Dr. Alan Yeasted terms the times “The Age of Medical Activism,” calling on members to unite for change in the interest of patients. ACMS and more than 35 coalition partners – including insurers, specialty 150 societies and other regional medical societies – unite for “Code Blue Week,” attracting more than 3,000 doctors to Harrisburg to continue to rally for tort reform and visit legislators. Health Savings Accounts are proposed as an alternative to insurance. 2004: The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) is called “the most dramatic and innovative changes to the Medicare program since its inception in 1965.” ACMS supports Tobacco Free Allegheny, a smoking cessation program funded by the state “cigarette tax.” 2005: Sen. Jane Orie warns of a potential Medicaid crisis in Pennsylvania with statistics from The Congressional Research Service estimating that the state ranks fourth in state tax revenue spent on Medicaid (19.2 percent in 2004). The position of coroner in Allegheny County was abolished and retitled Medical Examiner. Longtime coroner and nationally renowned forensic pathologist Dr. Cyril H. Wecht has the distinction of serving as coroner and medical examiner in one term as a result. Members of A C M S , along with the Pennsylvania YEARS Medical Society and many specialty societies, are successful in their appeal to have Highmark withdraw its plan for Security Blue capitation of specialty care. 2006: The proposed merger of Highmark and Independence Blue Cross prompts the passage of Senate Bill 550, giving the Pennsylvania Department of Insurance greater oversight of nonprofit health insurers. Hospitals revise policies to use cell phones in lieu of pagers. The “Donut Hole,” the portion of Medicare Part D sandwiched between the Initial Coverage Limitation (ICL) and Catastrophic Coverage, causes confusion and concern for physicians and seniors alike. The Western Pennsylvania Diversity Initiative brought together ACMS and a broad spectrum of civic groups to promote diverse working environments. 2007: Roger Mecum, Pennsylvania Medical Society executive vice president, updated the ACMS board on Governor Ed Rendell’s health care reform proposal. The plan includes accessibility, affordability, quality and lifestyles, executive orders, and Mcare. 2008: ACMS President Dr. Krishnan Gopal in his 2008 inaugural address aptly stated: “. . . many of the administrative and financial changes began in the days of President Lyndon Johnson. Medicare and Diagnosis Related Groups (DRGs) were thrust on us. Under President Bill Clinton, ‘managed care’ accelerated, as did the various acronyms -- HMO, PPO, IPO and IPA. Paradoxically, methods designed to increase access to medical services often result in attendant financial cost increases that limit access. Again, physicians are left to manage within these systems and are often cast as the problem rather than being asked to help in designing health care plans.” 2009: ACMS President Dr. Douglas Clough reports growing interest in the diagnosis and treatment of post-traumatic stress disorder (PTSD) since the terror attacks on the World Trade Center in 2001: “Devastating natural disasters, wars, accidents and personal assaults are a few of the traumas witnessed over the past 10 years. Somewhere between 10 and 25 percent of people exposed to such traumatic events will develop ongoing difficulties meeting the criterion for post-traumatic stress disorder.” The Allegheny County Medical Reserve Corps (MRC) seeks volunteers from the medical and allied health professions to strengthen the emergency response. 11 150 YEARS 2010: “. . .Most of us are referred to as Dr. Bruce W. Dixon passes away at age 74 in 2013. Dr. Dixon, head of the Allegheny County Health Department for 20 years, instituted a number of innovative programs in disaster planning and preparedness, inmate medical services at the county jail, and the Pennsylvania smallpox vaccination program. He also was a nationally recognized authority on public health and infectious diseases, which he taught at the University of Pittsburgh. 2012: On June 28, a sharply divided United States Supreme Court ruled that The Patient Protection and Affordable Care Act (PPACA) is constitutional. The Allegheny County Medical Society’s Primary Care Coalition conveys concern about the primary care shortage to large audiences in meetings with medical school administrators, insurance providers, governmental representatives, medical students, lobbyists, representatives from organized medicine, and leaders in primary care. As UPMC and Highmark contract issues impact patients and members on both sides, ACMS President Dr. Rajiv Varma advocates for patient access and open dialogue among parties. 12 health care providers and not physicians. Perhaps we are seen as just that: a device that delivers care, and not the physician who knows the science of medicine as well as the art of medicine, and also has learned to apply it to people,” ACMS President Dr. John Delaney notes in his inaugural address. He also says: “The decision by Highmark and the approval by the Pennsylvania Department of Insurance to move business from the non-profit Highmark entity to a wholly-owned, for-profit subsidiary (Highmark Health Insurance Company) has resulted in premium increases that are startling in the percentage of the increase and the actual dollar amounts.” The ACMS Foundation marks its 50th anniversary! 2011: ACMS President Dr. Leo McCafferty writes: “The stalemate involving the region’s three major corporate health care organizations— Highmark, UPMC and West Penn Allegheny Health System —is a looming problem for the community, patients and physicians. These large corporate enterprises have a huge economic impact, and patients want to know how current negotiations and corporate relationships among these entities will affect their accessibility to health care.” Dr. Frank Vertosick offers this perspective on the rising concern about concussions in youth sports: “... the mother frankly admits she’s letting her son electively play a sport that carries the risks of a car crash.” 2013: While most major causes of preventable death are declining, overdose deaths are an exception, taking a life every 19 seconds, prompting public health experts to characterize Opioid Use Disorder (OUD) as an epidemic. With expanding telemedicine and mobile health applications usage, the FDA considers guidance on the standards and usage of mobile devices. 2014: Dr. Antoine Douaihy, medical director of Addiction Medicine Services at Western Psychiatric Institute and Clinic, writes in a BULLETIN article: “Research at both individual and societal levels is needed to better understand the consequences of marijuana use, the effects of various types of policy change on rates of problematic marijuana use, and its medicinal applications.” A bill legalizing marijuana for medicinal purposes in Pennsylvania passed the State Senate in October. Concerns about e-cigarette advertising surface. The Pennsylvania Medical Society and the Hospital Association of Pennsylvania settle litigation with the Commonwealth regarding the Mcare Fund, appealing prior assessments and challenging the transfer of $100 million to the general fund from Mcare in 2009. This resulted in a return of $164 million in insurance premiums for physicians and hospitals. 150 YEARS 2015: Congress passes legislation to prevent a 21 percent pay cut to Medicare physicians. The Medicare Access and CHIP Reauthorization Act (MACRA – dubbed the “SGR fix”) addresses physician reimbursement problems of the last 18 years, eliminating yearly negotiations triggered by drastic cuts in Medicare’s physician reimbursement rates. The Medicare Sustainable Growth Rate (SGR) system is a means to regulate spending on Medicare physician services. Without MACRA, many physicians could have been forced to leave the Medicare system, causing a significant gap in patient care. Beyond Office and Operating Room Dr. Terrence Starz, 2006 ACMS president, believes “health is impacted by our environmental experience.” Healthy living, diversity and mentoring mark the Society’s ongoing community outreach projects, engaging medical students and partnering with the University of Pittsburgh’s Graduate School of Public Health, the Allegheny County Health Department, Carnegie Mellon University and many others. Throughout the years, ACMS members stay connected with the community through participation in the “HealthLine” call-in program and the “Straight Talk about Health Care” campaign on KQV radio (1999), “Healthy 4 Life” on WTAE-TV, and the “Dear Doctor” column in the Pittsburgh Post-Gazette (1997). The “POWER of Prevention” initiative was introduced. “Health Capsules” on KDKA-TV provided tips to stay healthy with brochures available at local drug stores. ACMS became a founding partner of Mayor Sophie Masloff’s Pittsburgh Community Health Challenge. Dozens of physicians participated in Days of Caring, filled hundreds of community speaking engagements, and relaxed at Kennywood family picnics. Memorable to 2002 ACMS President Dr. Gerald Pifer was building an accessible playground at the YMCA’s Camp Kon-O-Kwee. For 55 years, the ACMS Foundation has extended the reach of physicians into the community through $2.3 million in grants for an extraordinary array of programs and projects, enabling hundreds of nonprofit organizations to fulfill the Foundation’s mission of “supporting home and community environments that nurture and develop healthy children and families for a healthy Allegheny County.” The tireless efforts of the ACMS Auxiliary, now the ACMS Alliance, contribute to the work of ACMS and its Foundation. Leadership and Advocacy for Patients and Physicians “Leadership and Advocacy for Patients and Physicians” is not just a catch phrase, it is a call to action! ACMS and its members initiate, respond, collaborate and fight for essential issues like public health, access to care, appropriate reimbursement and tort reform, keeping the patient at the center of their efforts. Reminisce about all you have experienced, supported and accomplished through your ACMS membership in these 150 years and be proud! A Legacy of Caring “Among the changing medical landscape of hundreds of insurers, exchanges and other issues, ACMS provides one clear, focused voice. Otherwise it’s all just noise – people complaining. I’m so excited about medicine and I’d recommend it to anyone. It is a gift.” Dr. Amelia Paré, 2013 ACMS President 13 150 YEARS Past Presidents A.H. Gross 1865-66 C.B. King 1885 J.E. Rigg 1903 Walter F. Donaldson 1922-23 R.B. Mowry 1867 J.B. Batten 1886 T.M.T. McKennan 1904 E.W. Willetts 1923-24 A.M. Pollock 1868 Thomas Mabon 1887 E.B. Heckel 1905 H.A. Miller 1924-25 H.T. Coffee 1869 W.M. Brinton 1888 E.W. Day 1906 H.A. Mayer 1925-26 Thos. J. Gallaher 1870 W.V. Knox 1889 R.W. Stewart 1907 Hugh E. McGuire 1926-27 E.A. Wood 1871 W.S. Foster 1890 L. Litchfield 1908 Charles H. Henninger 1927-28 G.D. Bruce 1872 T.D. Davis 1891 X.O. Werder 1909 Robert H. Anderson 1928-29 J.C. Maginni 1873 J.C. Lange 1892 M.C. Cameron 1910 James I. Johnston 1929 M.O. Jones 1874 W.S. Huselton 1893 J.D. Heard 1911 James McCann 1875 J.J. Green 1894 Theodore Diller 1912 Thomas W. Shaw 1876 J.M. Duff 1895 John W. Boyce 1913 N. McDonald 1877 F. Lemoyne 1896 John A. Hawkins 1914 A. Flamming 1878 Adolph Koenig 1897 E.B. Haworth 1915 S.N. Benham 1879 George W. McNeil 1898 W.W. Jones 1916 James King 1880 J.A. Lippincott 1899 J.M. Thorne 1917 William H. Daly 1881 Charles S. Shaw 1900 E.S. Montgomery 1918 J.M. Stevenson 1882 J.D. Thomas 1883 J.B. Murdoch 1884 14 (Died before installation) J.W. McFarlane 1900 J.S. Mabon 1901 J.C. Dunn 1902 J.P. McKelvy 1919 J.J. Buchanan 1920 C.J. Vaux 1921-22 (Died before installation) Thomas C. Grieg 1929-30 Alexander H. Colwell 1930-31 I. Hope Alexander 1931-32 Thomas B. Carroll 1932-33 George W. Grier 1933-34 Wilton W. Robinson 1934-35 R.J. Behan 1935-36 Sidney A. Chalfant 1936-37 William H. Guy 1937-38 C.L. Palmer 1938-39 Henry T. Price 1939-40 150 YEARS Past Presidents Continued Frederick M. Jacob 1940-41 William F. Brennan 1958-59 Joseph V. Caliguiri 1978 Alan A. Axelson 1997 John R. Griffith 1941-42 John S. Donaldson 1960 Howard A. Mermelstein 1979 David S. Zorub 1998 Samuel R. Haythorn 1942-43 William A. Barrett 1961 Harold E. Swensen 1980 Dennis J. Hurwitz 1999 Charles C. Rinard 1943-44 J. Everett McClenahan 1962 James R. Dornenburg 1981 Jitendra M. Desai 2000 Zoe Allison Johnston 1944-45 C. William Weisser 1963 Abraham J. Twerski 1982 Paul W. Dishart 2001 Harold B. Gardner 1945-46 William R. Hunt 1964 Ralph Gaudio, Jr. 1983 Gerald W. Pifer 2002 George Lang 1946-47 William R. Kelly 1965 H. Lee Dameshek 1984 G. Alan Yeasted 2003 T. R. Helmbold 1947-48 Gilmore M. Sanes 1966 Daniel H. Brooks 1985 Edward Teeple, Jr. 2004 Thos J. Sheppard 1948 Matthew R. Marshall, Jr. 1967 Phillip R. Levine 1986 Mark A. Goodman 2005 Eugene A. Conti 1968 Gilbert A. Friday 1987 Terence W. Starz 2006 Robert J. Carroll 1969 Richard E. Deitrick 1988 Krishnan A. Gopal 2007 William F. Donaldson 1970 Daniel H. Gregory 1989 Adam J. Gordon 2008 Fred C. Brady 1971 George F. Buerger, Jr. 1990 Douglas F. Clough 2009 Ralph C. Wilde 1972 Stanley M. Marks 1991 John F. Delaney, Jr. 2010 Ralph J. Stalter 1973 John A. Burkholder 1992 Leo R. McCafferty 2011 David W. Clare 1974 George J. Gerneth 1993 Rajiv R. Varma 2012 Michael P. Levis 1975 Lee H. McCormick 1994 Amelia A. Paré 2013 Lawrence D. Ellis 1976 Nancy S. Nieland-Fisher 1995 Kevin O. Garrett 2014 A. Linn Weigel 1977 Richard N.Harris 1996 John P. Williams 2015 (Died before installation) Thomas McC. Mabon 1948-49 Paul G. Bovard 1949-50 N.C. Ochsenhirt 1950-51 William A. Bradshaw 1951-52 John A. O’Donnell 1952-53 John W. Shirer 1953-54 John W. Fredette 1954-55 Wendell B. Gordon 1955-56 Leo R. Sheedy 1956-57 David Katz 1957-58 15 150 YEARS Pennsylvania Medical Society Presidents from Allegheny County James King 1866 Thomas C. Simonton 1928 William J. Kelly 1977 A.M. Pollock 1872 William H. Mayer 1931 Matthew Marshall, Jr. 1980 Robert B. Mowry 1876 Alexander H. Colwell 1935 Michael P. Levis 1983 E.A. Wood 1885 Charles J. Henninger 1939 Gordon K. MacLeod 1991 J.B. Murdoch 1888-89 Robert L. Anderson 1942 Donald G. Ferguson 1993 William S. Foster 1895 Harold B. Gardner 1950 Lee H. McCormick 1998 Thomas D. Davis 1900 John W. Shirer 1957 Carol E. Rose 2001 Adolph Koenig 1904 J. Everett McClenahan 1966 Jitendra M. Desai 2004 Edward B. Heckel 1913-14 William A. Barrett 1969 Ralph Schmeltz 2011 Lawrence Litchfield 1922 Ralph C. Wilde 1973 Bruce A. MacLeod 2014 ACMS Past Presidents with 1995 ACMS President Nancy Nieland-Fisher 16 ACMS Board of Directors - 2015 150 YEARS Affiliated with the Pennsylvania Medical Society (PAMED) and the American Medical Association (AMA) The 150th Anniversary History combines the previously published 125 years with additions to complete the 150-year legacy of ACMS. Credits reflect contributors to the past and present editions. WRITERS Susan Cosgrove - 125 years Diane C. Wuycheck - 125 and 150 years REFERENCES BULLETIN of the Allegheny County Medical Society Carnegie Library of Pittsburgh Pennsylvania Department “The First One Hundred Years,” George Swetnam, Ph.D. “Milestones to Health in Pennsylvania,” B.W. Kunkel, Ph.D., Sc.D. “The People of Progress: The Sesquicentennial History of the Western Pennsylvania Hospital, 1848-1998,” Hax McCullough PHOTOS ACMS and the Western Pennsylvania Hospital Archives BULLETIN of the Allegheny County Medical Society Carnegie Library of Pittsburgh Gerald F. Ellson Ric Evans DESIGN Steve Schwartz Associates, Inc. SPECIAL THANKS ACMS Past Presidents John G. Krah, James D. Ireland and Meagan K. Welling, ACMS staff Mary Beth Green, former ACMS Communications Assistant Robert C. Grom . 17