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Florida Derm News
An Official Publication of the Florida Society of Dermatology & Dermatologic Surgery Winter 2009
The 2009 Annual Meeting that I hope will make it even a of the Florida Society of more memorable experience in this issue.
Dermatology & Dermatologic for all attendees.
Rules & Regulations . 2
Surgery is scheduled for Memorial Day weekend at the First, there will be a special pre- Market Watch . 3
Boca Raton Resort and Club in conference session entitled Risk Boca Raton, Florida. (See back Management/Medical Errors. Board of Medicine Update . 5
page.) This annual meeting This 2-hour session will satisfy James M. Spencer, MD
is our Society's main activity the mandatory requirement FSDDS News . 8
FSDDS President of the year and we strongly needed for re-licensure in the urge you to attend. We have State of Florida and is a must Board of Directors . 10
assembled an outstanding for all licensed physicians in faculty who represent the the state. The course will be The Final Word . 11
best in medical, surgical, and taught by Chris Nuland, Esq., cosmetic dermatology. They the FSDDS General Counsel will be bringing us cutting- and Steven Rosenberg, MD, edge knowledge and new past FSDDS president and developments in our field. In Board member. Together they addition, this year's meeting will bring useful and practical will have some new features legal and medical perspectives continued on page 6 2009 Legislative Update
With the campaign season than $300 million from various behind us, the 2009 Legislative other trust funds to fill the gap. Session is quickly ramping The Legislature also set aside up. At the time of this writing a reported $400 million to fill we are completing Special future shortfalls between now Session 2009 A. This session and the end of the year. Florida Derm News is was called to address the published quarterly by $2.4 billion dollar hole in the Unfortunately, this is just the the Florida Society of Jon Johnson
current 2008–2009 Fiscal Year. beginning of the budget cuts. Dermatologic Surgery FSDDS Governmental The two sides agreed to $1.2 Economists are predicting an 6816 Southpoint Pkwy billion in spending cuts, as over $4 billion shortfall for the well as spending $400 million 2009–2010 Fiscal Year budget, Jacksonville, FL 32216 from the budget stabilization which the legislature will be fund, $700 million from the passing during the regular 2009 All rights reserved.
Lawton Chiles Endowment Legislative Session. The bottom Fund, $190 million from the line is that there is not an end in housing trust fund, and more sight to the budget cutting. continued on page 6 Visit us online at www.fsdds.org

Rules & Regulations
Do You Need a Health Care Clinic Establishment Permit?
Many physicians were drugs in their personal names.
taken aback this December when they received notices According to Rebecca Poston, the Executive demanding that they pay Director of the Florida Board of Pharmacy, $225 for a "Health Care Clinic "Health care practitioners or veterinarians who Establishment Permit." Under are personally purchasing prescription drugs the new law, the permit is through the use of their professional license required for all professional number do not need to apply for this permit… Chris Nuland, Esq.
associations and professional The Department does not intend (sic) to enforce FSDDS General Counsel limited liability companies that an interpretation of the law that would prohibit purchase prescription drugs, even if the physicians the use of prescription drugs by practitioners at are not registered as dispensing practitioners, and a an establishment in a group practice that were separate permit is required for each office. However, purchased by another member of the group members should be aware that they may not be practice at that establishment.
required to purchase such a permit if they order the continued on page 7 Winter 2009 • 2
Market Watch
The New World We Live In
As I sit here at my desk all of you realized what was really important in once again doing my daily 2008. If you are reading this, then something good research, I see a plethora has happened in your life today! "You woke up of new research coming this morning!" As for the rest of the stuff going across my e-mails. Will on, we will get through this. Tomorrow we will I once again find myself pay more attention to our debt ratio. The broker wasting precious time will actually have to keep up with the changing on what will be a moot environment instead of just handing money over to point when I read the mutual fund companies or third party investment next e-mail? What is the platforms. More brokers will utilize more indexing government up to today? with exchange-traded funds that offer currencies, This is my new theme until buy-write strategies and many more. Ratings on things return back to normal. By the way, what insurance companies will become the first question is normal in today's world? Normal for me will a client asks. Some lessons learned from 2008 will be to go home tonight, get a good night's sleep, make us better prepared moving forward. Although and do it all over again tomorrow. it seems never ending, this will end. * An investor with a system knows that research Margaux Fiori has worked in the investment and never stops. Even when there is no buying financial services industry since 1997. She is an going on, the preparation for buying has to investment advisor representative for Lincoln Financial continue. A correction of this magnitude is Securities Corporation, member of SIPC, offering a extraordinary, and while the trend could extend comprehensive range of investments, in addition further south before a new bull market emerges, to retirement and financial planning services. Her this would be a good time to survey the areas of expertise include financial planning, wealth damage. Some of the bear market's casualties, preservation, estate planning, supplemental retirement i.e. collaterally damaged stocks, will survive income, asset protection and corporate planning. the current economic down cycle and be all the stronger and more profitable for it. Not all * As with any investment, international investing sectors will emerge together. However, following carries some risks, including but not limited to the money of the spender (the government), political risk and currency fluctuation risk. To would be a good place to start. Investors who determine if international investing is appropriate can identify the potential survivors and are for your circumstances and to learn more about patient and financially solvent enough to delay the risks and potential rewards associated with this immediate gratification for longer-term gains, strategy and if you would like to learn more about stand to be rewarded. Warren Buffet says he likes these areas of investment, please do not hesitate to buy when other people are selling. However, to contact Margaux Fiori through the office of Larry this market is not like any other, is it? This market Share at 800-329-5011. is full of surprises and revelations. Now let us fast forward! What has changed? How about life as we know it! We go back to basics like our parents and grandparents. (Who by the way did very well for themselves.) But, first let me say to all of you readers: I hope that Winter 2009 • 3
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Board of Medicine Update
What's New with the Florida Board of Medicine
1. Federation of State Medical Boards (FSMB)
5. Recent Legislation
The FSMB is conducting research on demonstrating 2008 legislation: competence as a condition of continued licensure. • expanded the authority of the Physician Referred to as Maintenance of Licensure, the Assistant Council to expand PA Board discussed this at their annual meeting and prescribing to include anti-psychotics determined there is not enough evidence at this and parenteral medications. Nothing has time to make any changes to Florida's re-licensure changed yet in the current PA formulary.
laws, although they do support FSMB's continued • expanded availability of Practitioners research in this area. Resource Network (PRN) to medical students 2. Workforce Survey
• USF and FIU Schools of Medicine authorized to use Medical Faculty The Board is looking forward to a Department Certificates to allow out-of-state Report on the recent surveys conducted by physicians to practice as part of their physicians during 2007 (voluntary) and 2008 teaching duties. (mandatory) renewals. Data from these surveys will be used by the Board and the Department of If you have any questions about recent Health to make decisions about the future of health Legislation or rules and laws that may affect care in Florida. Speaking of renewal, due to sound your practice, you may email us at fiscal handling of the budget, the Board voted to [email protected] and we'll do reduce the renewal fee to $360 last year. our best to assist you. 3. Licensure Process
6. Top Ten Tips To Avoid Problems With
Your License
The application process has been streamlined to reduce application processing time from 120 to 97 There are a few laws and rules that every days thanks to changes in the approval process and physician practicing in Florida should know electronically filing fingerprint cards. The newest and knowing these things will help physicians licensure advancement is the online application avoid unnecessary disciplinary action.
status check system which allows applicants to 1. Physicians must update their profile check the status of their application online at any within 15 days of any change. [s. 456.042, 2. Physicians must notify the Board prior 4. Communication with Physicians
to relocating a practice. [s. 456.035, 458.319(3), s. 458.327(2)(e), F.S. & Rule If the Board has your e-mail address, you have been receiving quarterly messages from Robert 3. Do not pre-sign prescription pads. Cline, MD, and you have had the opportunity to [s. 458.331(1)(aa), F.S.] provide input on what is important to you and your 4. Know the rules on advertising. [s. practice. So, please update your practitioner profile 456.002, F.S. & Rule 64B8-11, FAC] and provide an email address. 5. If you treat your family, friends and employees, you must maintain medical records. [s. 458.331(1)(r) & (m), F.S.] 6. Know patient boundaries: a prescription creates a physician/patient relationship. continued on page 9 Winter 2009 • 5
President's Message continued from page 1 Legislative Update continued from page 1 to this important topic. This session will be held on To date, there are several legislative issues relating to Friday, May 22, from 3:00 to 5:00 pm and is included hospitals and doctors that we are closely following. at no extra charge for those registered for our annual This of course is just a sampling of bills that have meeting. Following the educational session we will been filed to date. be holding an opening reception with our exhibitors to officially begin the meeting.
HB 11 Cigarette Tax by Rep. Waldman
Another change worth noting is that the format of This legislation would increase the cigarette tax and the meeting has been expanded slightly to provide designate where the increased general revenue an even better educational and social weekend. should be spent.
In addition to an outstanding line of nationally prominent speakers, we are going to hold some HB 243 and SB 416 Health Care Management by
smaller group breakout sessions, allowing members Rep. Patronis and Sen. Fasano
to pursue their individual interests in medical, surgical, or cosmetic dermatology in depth with the This managed care reform legislation addresses three experts. You will be able to tailor your experience issues: (1) Payment denials, after covered medical at the meeting to best fit your needs. We will also services have been rendered to patients with private feature live demonstrations of the latest cosmetic health insurance, for one of two reasons – prior techniques as well as laser and light devices.
authorization was inadvertently not obtained for a medically necessary service or because the health We are also adding some sessions where we can plan mistakenly verified the patient's eligibility learn from one another. There will be a member's under the plan; (2) Policy and procedural changes pearls session on Sunday, May 24. Any member that impact terms of a provider contract that are may submit a 10 minute pearls presentation they implemented after a contract is signed between would like to share with their colleagues. If you a provider and the health plan; and (3) Efforts by are interested in presenting your techniques, health plans to discourage collection of patient observations, or ideas, just send me an e-mail with financial requirements at the point of service. The your proposed topic to [email protected] legislation also creates a study group to recommend for consideration. We are also sponsoring a poster more efficient and cost-effective approaches to competition with a cash prize. Posters on clinical or collecting deductibles, co-pays and co-insurance. research topics are most welcome, so please consider sharing your expertise with your colleagues.
HB 263 and SB 558 Prescription Drug Coverage
by Rep. Hayes and Sen. Fasano
The weekend offers ample opportunity to socialize and reconnect with friends and colleagues. The Boca This legislation prohibits health insurance policies Raton Resort and Club is truly a beautiful property or medical service plan contracts from limiting, with outstanding restaurants, beach, pool, tennis reducing, or denying coverage for drugs under and golf, and spa among the many amenities. After a hiatus of several years, we have reinstituted a Gala Dinner for the membership and this will take place SB 462 Controlled Substances/ Prescription
Sunday evening, May 24. Remember, our meeting Monitoring by Sen. Fasano
is about education, professional development, friendship and collegiality. A strong attendance This legislation requires AHCA to establish a makes for a great meeting, and I look forward to statewide comprehensive electronic system to seeing you there! monitor the prescribing and dispensing of controlled substances listed in Schedule II, Schedule III, or Schedule IV.
Winter 2009 • 6
Rules and Regulations continued from page 2 SB 556 and HB 285 Medicaid Program/ Low-
"If the professional limited liability company Income Pool Plan by Sen. Gaetz and Rep.
wishes to purchase prescription drugs in the name of the company, then it would need a permit." However, groups may pay for the This legislation requires AHCA to make and prescription drugs with a corporate check submit recommendations to the Governor and so long as the medications are delivered in the Legislature regarding the financing of and the name of individual physician, using that distribution of funds for the low-income pool physician's professional license number.
plan. This legislation would abolish the Medicaid Low-Income Pool Council.
For more information, contact the FSDDS General Counsel's office at [email protected].
As always we will be watching closely for any legislation that undoes any of the important patient safety provisions that we have been successful in implementing in the past by stalling efforts of non-physician providers from gaining more unsupervised practices particularly in the area of laser hair removal. Winter 2009 • 7
FSDDS News
THE COSTS OF DERMATOLOGIC PRESCRIPTIONS
How often do we have drug reps in our office touting their companies' new formulation of a 30-year-old antibiotic and being advised that with the rebate forms it will cost your patient less than a generic? A few hours later the patient calls complaining about the exorbitant cost. The rebates may be a saving for some patients, but all too often the cost of the rebate is just tacked on to the final cost with the anticipation that the insurer will be paying for the medication. Now that more patients have high deductible policies or prescription plans with limited formularies Steven P. Rosenberg, MD
we should anticipate greater scrutiny of prescription costs by our patients.
FSDDS Past President and Member, Florida The following data was collected by the listed pharmacies in the West Palm Beach Board of Medicine area during the month of September 2008.
VANOS CREAM 60GMS VERDESO FOAM 100GMS DESONATE GEL 60GMS CLOBEX LOTION 4OZ OLUX E FOAM 100GMS TACLONEX OINT 60GMS DIFFERIN GEL 0.1% 50GMS ATRALIN GEL 45GMS RETINA MICRO 0.1% GMS PUMP TAZORAC CREAM 0.1% 60GMS METROGEL 1% 60GMS BENZACLIN PUMP 50GMS OXISTAT CREAM 30GMS ROSULA NS PADS 1 BOX ATOPICLAIR 100 GMS HYLIRA GEL LARGE BOTTLE EFUDEX 5% CREAM 40 GMS OXSORALEN ULTRA 10MG #50 PLEXION CLOTHS #30 Winter 2009 • 8
Board of Medicine Update continued from page 5 [s. 458.331(1)(j) & s. 458.329, F.S.] 7. Stay in Touch
7. Avoid wrong site/patient surgery: Make the right incision, on the right patient, at the Never be left in the dark. You can access the correct site. [s. 456.072(1)(bb)] Board of Medicine's web site 24 hours a day at 8. Prescribing without a history and physical is www.doh.state.fl.us/mqa/medical. From this a standard of care violation and a violation of site you can access information regarding the Board Rule: Do not prescribe on the Internet. laws and rules, frequently requested forms, [Rule 64B8-9.014, FAC] profession updates, current events, renewal 9. Know the rules about reproduction of medical information, FDA/DEA alerts and much more. records and know what you can and cannot You can also join our web board from this site charge. Also, consider providing your patient and receive information as soon as it is released. with one (1) complimentary set of his/her medical records upon request, free of charge. —Crystal A. Sanford, CPM [Rule 64B8-10.003, FAC] Program Operations Administrator 10. Minor offenses are handled through a citation Florida Board of Medicine process. The first citation issued for an offense, although public record, is not considered disciplinary action. [Rule 64B8-8.017, FAC] SBS FEATURED FACULTY LAST CHANCE TO REGISTER!
Glynis R. Ablon, MD
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Kenneth Beer, MD
B. Kent Remington, MD
Brian Berman, MD, PhD
Marta I. Rendon, MD
2009 South Beach SympoSium Roger I. Ceilley, MD
Darrell S. Rigel, MD
Clay J. Cockerell, MD
Lawrence A. Schachner, MD
SOUTH BEACH CLINICAL DERMATOLOGY SYMPOSIUM
David E. Cohen, MD, MPH Ava T. Shamban, MD
SOUTH BEACH AESTHETICS SYMPOSIUM
Joel L. Cohen, MD
Daniel M. Siegel, MD, MS
Doris J. Day, MD, MA
Nowell Solish, MD, FRCP
James Q. Del Rosso, DO
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NOW for a $300
Michael H. Gold, MD
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February 12-16, 2009 Larry Harmon, PhD
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David L. Wagener, MBA, CPA
Bruce E. Katz, MD
Guy F. Webster, MD, PhD
LoewS Miami Beach Hotel - Miami, Florida Mark G. Lebwohl, MD
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Stephen H. Mandy, MD
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Gary D. Monheit, MD
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Hosted by the Florida Society of Dermatology and Dermatologic Surgery
Symposium Chair – Register online today for the
Jointly sponsored by Creative Educational Concepts, Inc. and SBS Medical Education, LLC
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Session Directors – • Clinical, Aesthetic and Dermatology Practice • Advanced Certification Workshops Brian Berman, MD, PhD
New in 2009. Management Sessions – All Under One Roof featuring a new Type A Botulinum Toxin James Q. Del Rosso, DO
• 37+ hours of AMA PRA Category 1 and • New Practice Management Sessions Zoe D. Draelos, MD
• More Hands-on, Live Patient Training • Hot Topics in Clinical and Cosmetic • Interactive Poster Sessions Michael H. Gold, MD
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Winter 2009 • 9
Board Member-at-large (2010)
Past President Ex Officio
James M. Spencer, MD Laertes A. Manuelidis, MD Robert S. Kirsner, MD, PhD 900 Carillon Parkway, Ste 404 8381 Riverwalk Park Blvd, Ste 101 University of Miami Miller School of St. Petersburg, FL 33716 Fort Myers, FL 33919 727-572-1333 phone 239-936-5425 phone 1600 NW 10th Ave. RMSB RM 2023-A Miami, FL 33136305-243-4472 phone Board Member-at-large (2011)
Albert J. Nemeth, MD Susan Weinkle, MD 3165 N. McMullen Booth Rd, C-2 5601 B 21st Ave W.
Past President Ex Officio
Clearwater, FL 33761 Bradenton, FL, 34209 Steven P. Rosenberg, MD 727-799-5273 phone 941-794-5432 phone 470 Columbia Drive, Suite 102A West Palm Beach, FL 33409561-640-4400 phone Vice President and Public
FSDDS Representative to the AAD
Craig J. Eichler, MD Douglas Robins, MD 6101 Pine Ridge Rd, FSDDS General Counsel
Christopher L. Nuland, Esquire Ponte Vedra Beach, FL 32082 239-348-4335 phone 904-354-4488 phone FSDDS Governmental Consultant
Managed Care Committee Chair
Jon Johnson & Travis Blanton William I. Roth, MD 537 East Park Avenue Kristin Smallwood, MD 10075 Jog Rd, Ste 206 Tallahassee, FL 32301 1980 N. Atlantic Ave, Ste 722 Boynton Beach, FL 33437 850-224-1900 phone Cocoa Beach, FL 32931-3275 561-731-4900 phone 321-784-8811 phone FSDDS Executive Director
Surgical Care Committee Chair
(FSDS Board Liason)
6816 Southpoint Parkway, Suite 1000 J. Rob Hamill, MD Jacksonville, FL 32216 12901 Bruce B Downs Boulevard # 79 904-309-6240 phone 727-862-8561 phone 813-974-2188 phone 813-974-4272 fax Associate Director of Programs
Colleen Filbert
Immediate Past President
FSDDS Representative to the FMA
6816 Southpoint Parkway, Suite 1000 Glenn L. Zellman, MD and Socioeconomic Chair
Jacksonville, FL 32216 7301 N. University Dr, Ste 102 Clifford W. Lober, MD, JD 904-309-6240 phone Tamarac, FL 33321 505 West Oak St, #201 954-726-2000 phone Kissimmee, FL 34741 407-846-7166 phone Legislative Committee Chair
6816 Southpoint Parkway, Suite 1000 South Beach Symposium
Jacksonville, FL 32216 1 West Sample Rd, Ste 302 904-309-6240 phone Pompano Beach, FL 33064 Mark S. Nestor, MD, PhD 954-782-7701 phone 2925 Aventura Blvd, Ste 205 Aventura, FL 33180 305-933-6716 phone Board Member-at-large (2009)
Oren H. Lifshitz, MD4477 Medical Center Way, Ste AWest Palm Beach, FL 33407561-840-7977 phone 561-842-9521 fax Winter 2009 • 10
The Final Word
"Membership begins with me." I'm sure you have heard that a
hundred times but it always rings true!
Congratulations if you are The Top Ten Reasons to be a Member of
receiving this newsletter! FSDDS. Yes—it is "Letterman-esque," but it
You and approximately 33% should give you the ammunition you need when of your colleagues in Florida discussing membership with a colleague. Pick are members of the FSDDS. a few bullet points that best explain why you Thank you for your support of support FSDDS, and use them when you talk to a the FSDDS, your professional fellow dermatologist who is not (yet) a member. advocacy organization on behalf We produced many of these cards here at the of the practice of dermatology head office that reflect these messages, so please Brian O. Foy in Florida! Your financial support, let us know if you'd like some to distribute.
FSDDS Executive Director time commitment and service on behalf of your colleagues is truly appreciated. The FSDDS will soon be sending a membership However, the downside is that nearly two-thirds of appeal to non-members. The Florida Legislative your fellow dermatologists are not members. They Session is approaching and your Board and staff do not pay dues, they do not support the activities team will be closely monitoring the process. of the FSDDS, yet they benefit from the collective Collectively, we are your eyes and ears for work and support you do on their behalf in so many preserving the practice of dermatology in Florida, areas. Sure—they may support what FSDDS does for but we need your help! Please take a moment to them in spirit, but they do not walk the talk. This must talk to a colleague soon and urge them to join the change, and it will take some work on your behalf.
team. Your encouragement may be all it takes.
From my perspective, in terms of membership Happy New Year to all of you and best wishes for a recruitment, nothing is more effective than peer- prosperous and healthy 2009! to-peer contact and mentorship. Every one of you knows a dermatologist (or several) in this state who Top 10 Reasons to Be a Member of FSDDS
is not a member of the FSDDS. When was the last 1. Advocate for your profession in time you asked a colleague or a partner, "Are you Tallahassee on legislative issues a member of the FSDDS?" If they are not, ask them "Why not?" If you or they are not sure, please contact 2. Support legislators who support your FSDDS staff team and we will verify their membership status. 3. Represent dermatologists and patients at the national level (AAD) FSDDS is working on your behalf. We have strong 4. Promote collegiality and professionalism in and engaged physician leaders who understand what is important to practicing dermatologists. They 5. Support maximum reimbursement for participate and are active in the AAD. They lobby in quality dermatologic care Tallahassee. One of our Board members serves on the Florida Board of Medicine and gives us insight 6. Maintain direct access to dermatologists for into regulatory and licensure issues that impact the Florida's citizens practice of medicine. They support Pac-Y-Derm and, 7. Attend educational programs that enhance in turn, support legislators who understand our issues. They give much of their spare time. And much, 8. Promote dermatologists as THE experts in 9. Exclusive member benefits like discounted We have a good team, but to be stronger and liability insurance more effective, our team must grow! We need your help. Below is a marketing piece your FSDDS Board 10. Access to legal information and discounted developed to assist members in recruiting non- rates for counsel Winter 2009 • 11
Save the Date for the 2009 Annual Meeting!
Spend your Memorial Day weekend, May 22–25, 2009 with the FSDDS! Enjoy world-class accommodations and a relaxing weekend with colleagues and friends. FSDDS room rates start at $163/night for a Cloister room. Rates vary depending on accommodation preference. Please note: There is an additional $20/night charge for the resort fee and applicable room taxes. Call early – the discounted FSDDS room rates cannot be guaranteed after April 21, 2009.
W in 2009
The 2009 Annual Meeting will feature new and exciting scientific programs to spark your interest. New additions include a poster session for attendees, specialty breakout sessions and an administrator's program for your office staff. Stay tuned for more details on the FSDDS Annual Meeting. You can always visit the newly designed website at www.fsdds.org for updates on the meeting.
The Florida Society of Dermatology
& Dermatologic Surgery
6816 Southpoint Pkwy., Suite 1000 Jacksonville, FL 32216 Fall 2008 • 12

Source: https://www.fsdds.org/downloads/pdf/fsdds_winter2009newsletter.pdf