ACOInformation March 2022

The March issue of ACOInfo is features important government relations updates, highlights from our 3 upcoming CME meetings, Healthcare Hero Dr. Packer, and more!


Ma r ch 2022

American College of Osteopathic Internists • Stay True to Why You Pursued Medicine

Importance of Osteopathic Research Funding Recognized by Congress

Duquesne University COM Groundbreaking Ceremony

2022 Virtual Spring Meetings

ACOI Healthcare Heroes

inside: ACOI info March 2022

2020-2021 OFFICERS Robert L. DiGiovanni, DO, FACOI President

STAFF Karen C. Caruth, MBA

Executive Director Timothy W. McNichol, JD Deputy Executive Director Susan B. Stacy, FACOI Director of Administration and Meetings Keisha L. Oglesby Director of Finance and

Joanne Kaiser-Smith, DO, FACOI President-Ele ct

Letter From Our President 3 From Robert L. DiGiovanni, DO, FACOI Read

Coding Corner 10 New ICD-10 Clinical Modification (CM) Codes Read

Robert T. Hasty, DO, FACOI


Michael A. Adornetto, DO, MBA, FACOI Imme diat ePast President

Docs off the Clock 11 Dr. Laura Rosch discusses heart care and lifestyle choices for physicians Read

Member Services

2022 ACOI Virtual Spring Meetings 4 Choose the CME opportunity that meets your needs! Read

Samuel K. Snyder, DO, FACOI Past President

Erin Ross, MS Director of Marketing and Communications Kara Kerns Post-Doctoral Training Specialist Claudette Jones Membership Services Specialist Katie Allen Digital Media Manager Meg O’Rourke


Community and Member News 12 Groundbreaking ceremony on a new COM; Remembering Dr. Gadowski Read

Healthcare Heroes 5-6 Dr. Packer Responds to Patients, Community, and Family as COVID Hits Home Read

Robert A. Cain, DO, FACOI

Watson Ducatel, DO, MPH, FACOI

Hints With Hermann 13 Incorporating OMM into Your Practice Read

Susan M. Enright, DO, FACOI

Government Relations 7-8 • $1.5 Trillion Spending Bill Signed into Law • Top Health Care Watchdog Confirmed • COVID-19 National Emergency Extended • ... and more! Read Importance of Osteopathic Research Funding Recognized by Congress 9 A significant step forward Read

Charlene A. LePane, DO, FACOI

CME Specialist

Important Dates 14 Upcoming ACOI Meeting and AOBIM Examinations dates Read

C. Clark Milton, DO, FACOI

Neena J. Kuruvilla Administrative Assistant

Laura Rosch, DO, FACOI

David L. Tolentino, DO, FACOI

75th Anniversary Circle Members 15 Thank you for your support! Read

Connect with us:

Amita Vasoya, DO, FACOI

Robert Aran, DO




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3 • American College of Osteopathic Internists

ACOI Info • March 2022

A Letter From Our President Happy Women’s History Month. I’ve been blessed to be associated over my life and career with many bright and talented women. I’ve attached a photograph from the 1982 “Osteoblast”

Our daughter, Rachel Duffy, earned her DMD and MPH degrees at the Arizona School of Dentistry and Oral Health ATSU in 2013. Now she works there in the Comprehensive Care Unit and is an Assistant Professor at ATSU. She was elected by her peers to the Faculty Congress. On top of that, she is a loving mother to Clara and Layla Duffy. I hope each and every one of us takes the time to honor all the women in our lives this month and always. Let’s include a prayer for Ukraine as well. O Robert L. DiGiovanni, DO, FACOI

which was the Kirksville College of Osteopathic Medicine (KCOM) yearbook. Pictured are the fifteen

women who graduated my year in a class of about 130. All went on to have active careers in medicine. One of them, Margaret Wilson, DO, is now the Dean at KCOM. That was 40 years ago. I’m pretty sure the number of men and women in Colleges of Osteopathic Medicine is closer to fairly even these days. Of the twenty graduates from my rheumatology fellowship, 13 have been women. Two of these women stayed on as faculty: Rubaiya Mallay, DO, FACOI, as my partner and now director of our TY program and Priyanka Murali, DO, FACOI, who is Chief of Rheumatology at the Bay Pines VA Medical Center in St. Pete, FL. I met my wife in 1975 at the Johns Hopkins University in Baltimore, MD. Monica was in the second class of women to be allowed admittance to Hopkins in 1972. After earning her bachelor’s and master’s degree in business, she taught business administration at Northeast Missouri State University in Kirksville for four years. After raising our two children, Ernie and Rachel, she went back into the workplace about 20 years ago. Currently, she is an Assistant Executive Director for Israel Bonds.

1982 Women Graduates of the Kirksville College of Osteopathic Medicine. Margaret Wilson, DO, current Dean of KCOM, is pictured top left.


4 • American College of Osteopathic Internists

ACOI Info • March 2022

2022 Virtual Spring Meetings

It’s easy to use the virtual platform and plan out your experience at home or at the office. Plus, join in on Q&As after each session to connect with the speaker and fellow members.

For Residents and Physicians Looking for a CME Refresher

Geared Towards Hospitalists

Perfect for Cardiologists, Pulmonologists, Critical Care, and Infectious Disease Physicians

Approximately 25.75 AOA Category 1A / AMA PRA Category 1 Credits™

Approximately 45 AOA Category 1A / AMA PRA Category 1 Credits™

Approximately 19.75 AOA Category 1A / AMA PRA Category 1 Credits™

This course will provide hospital-based internists (generalists and subspecialists) and other health care professionals clinical updates to empower them to advance their knowledge and competence, integrate best practices for patient care, and to optimize their practice management.

Residents can now prepare for both the AOBIM and the ABIM initial certification exams with the ACOI’s Internal Medicine Board Review Course. It also is a great refresher course for general internists and internal medicine subspecialists who are looking to stay up to date on their day-to-day knowledge of osteopathic internal medicine. The course covers general medicine and the internal medicine subspecialties of hematology, oncology, gastroenterology, rheumatology, infectious diseases, allergy/immunology, pulmonary diseases, endocrinology, cardiology, and nephrology.

This meeting will focus on case-driven presentations, and the shared clinical experiences within the subspecialties of cardiology, pulmonology, critical care, and infectious disease. Featured sessions include: • Untangling COVID and Pneumococcal Vaccine Recommendations • TikTok Doc? Using Social Media to Reach our Patients • The Pandemic of Physician Burnout – Striking a Work/Life Balance Plus, we’ll feature an interactive Specialty Grand Rounds—Challenging Inpatient and Outpatient Cases.

Featured sessions include: • What is the Hospitalist’s Role in Avoiding Readmissions?

• Avoiding and Justifying Unnecessary Testing • Hematologic Considerations in the COVID-19 Pandemic • Split-Shared Billing: What You Need to Know • Fireside Chat: What’s Next in Hospital Medicine • Hospital at Home

View Agenda


View Agenda


View Agenda



5 • American College of Osteopathic Internists

ACOI Info • March 2022 ACOI Info •

ACOI Healthcare Heroes Facing COVID-19

by Gina Kilker Dr. Jeffrey Packer Responds to Patients, Community, and Family as COVID Hits Home Thank You ACOI Healthcare Heroes

Jeffrey Packer, DO, FACOI, FASN, FASDIN, is a nephrologist who subspecializes in dialysis access for patients. Working in Phoenix, at Arizona Kidney Disease & Hypertension Centers (AKDHC), the largest kidney disease and hypertension practice in the nation, Dr. Packer’s

But the new virus posed uncertainty for Dr. Packer’s patients since there simply wasn’t enough knowledge of COVID’s effects and its potential complications. When the vaccine became available, Dr. Packer and his practice joined a concerted national effort to get kidney patients vaccinated. He estimates that today around 70% of dialysis patients are vaccinated. Pitching in to Provide N95 Masks Before there were vaccines, Dr. Packer jumped in and became active within his community to aid Phoenix area hospitals which, like others in the nation, were experiencing N95 mask shortages. Becoming a part of a grassroots effort to supply hospitals with homemade masks, he and his wife were part of a group working with unemployed seamstresses to make masks meant to simulate the medical-grade N95s that were in short supply. “I spent many evenings on our back porch cutting out air conditioner filters to stuff into the masks.” Since hospitals weren’t allowing outside masks to be brought in, he said the work felt akin to an underground operation as they met with staff members in Circle K parking lots to drop off the desperately needed PPE. Even before that, he and his wife found themselves going door-to-door in their neighborhood asking their neighbors if they had N95 masks or equivalents to donate.

For two years, we have been featuring members’ COVID-19 experiences. We have shared heart- wrenching stories from the frontlines as they faced the historic health calamity head on. We have also heard their professional and personal challenges as the uncertainties of the virus came to dominate their lives. During these last 24 months, the healthcare community has had to endure the confusion, the ever-changing CDC protocols and guidelines, and the widespread politicization of science, which has exacerbated the difficulty of doing your jobs as physicians. We know that many have felt alone and isolated. Our hope is that through these series of stories, there has been some relief and a demonstration that the ACOI is a community of support. As we shift our focus to moving forward, Dr. Jeffrey Packer’s story will be the last COVID-19 Heroes story ACOI Information will publish. In future newsletters we will continue to share member stories, highlighting the broad range of ways our members are supporting their communities. We have only been able to feature some of our members, but we consider all of you healthcare heroes. We salute our ACOI community as a remarkable, dedicated, and brave group. We are proud to have shared your stories. To read back on any past stories from previous issues, visit our newsletter archive. O

subspecialty prepares patients to successfully receive and continue life-saving hemodialysis treatments. Early in the pandemic, it quickly became obvious to Dr. Packer and his team that making space in healthcare facilities for patients contracting the new virus needed to be a priority. That meant that elective surgeries were canceled and, consequently, some specialties and practices saw a drop in their workload or shifted their focus as all-hands-on-deck were required in COVID wards. But patients depend upon dialysis to live, so Dr. Packer continued caring for patients as usual, just with an extra layer of caution. Typically, individuals who experience kidney failure and who depend upon the process of dialysis to act as a replacement for functioning kidneys already need to be extra cautious.



6 • American College of Osteopathic Internists

ACOI Info • March 2022 ACOI Info •

ACOI Healthcare Heroes Facing COVID-19


They were desperate to help a family member who was an ER doctor in New York and couldn’t get PPE to be sufficiently protected. Personally, he and his family took precautions, and still exercise care to wear masks in public places. “While we are not going to lock ourselves in a hermetically sealed room every day, we’re not going to be stupid either,” he says. COVID Strikes and Creates Rare Complication For all the care he and his family took, three months after getting a booster shot, a member of his family contracted COVID. While she had no pulmonary manifestations and no fever, she developed an auto- immune mediated post infectious dysautonomia known as autoimmune SARS-CoV-2-induced DNS. “The autonomic nervous system is what helps control keeping your blood pressure at a fairly steady range and your heart at a fairly steady rate. It went totally out of whack, where her blood pressure would go from extremely high to extremely low in just a few minutes. And when it goes extremely high, she developed stroke-like symptoms,” he recalls. After three hospitalizations, a plethora of medications to steady blood pressure, and immunologic therapies including intravenous immunoglobulin therapy (IVIG) and plasma exchange therapy, he describes the past few months as a “nightmare” for him and his family. His family member also has had significant and varying mental status changes and brain fog.

The IVIG immune therapy is working for now, but because the condition is considered rare, Dr. Packer doesn’t know what to expect and despite reaching out to contacts around the country, “nobody is quite sure how to even deal with it.” While the hope is for 100% recovery, Dr. Packer can’t help but feel frustrated that precautions could have minimized the opportunity for the virus to mutate into variants and continue to pose a threat. He doesn’t understand patients questioning the efficacy of a vaccine that has been given to hundreds of millions of people. “The logic defies me when somebody says, ‘I don’t want something in my body that’s experimental.’ I am confused at how you say that after how many doses of vaccine have been given throughout the world. But at the same time, they’re willing to get IV antibody infusions or some of these newer antiviral agents that have not been as extensively tested. I don’t understand.” As the COVID numbers in Arizona and throughout the country decrease, his practice continues to be vigilant. “We must do it because this is how you take care of people. This is our job. This is what we do.” O

Editor’s Note: The views expressed by the Healthcare Heroes in this series are their own and do not necessarily represent those of the ACOI. Throughout this series of Healthcare Heroes stories published in this newsletter, our goal has been to reflect the realities and truths as seen through the eyes of our members. We’ve heard numerous stories of how our members are managing the stress of being at the epicenter of healthcare during an historic pandemic. We know there are likely many of you who can relate to the sincerity of this story as well as others we have featured. We are an organization that has been built on listening and support. Contact Susan Stacy at susan@ to let us know how we can help.



7 • American College of Osteopathic Internists

ACOI Info • March 2022

Timothy McNichol, JD RELATIONS

As previously noted, the final package did not include $15.6 billion in additional funds to respond to the COVID-19 pandemic. This issue will be monitored closely as negotiations continue. Top Health Care Watchdog Confirmed The Senate recently confirmed Christi A. Grimm as Inspector General for the Department of Health and Human Services (HHS). She will oversee 1,600 auditors, law enforcement agents, and management experts tasked with rooting out fraud, waste, and abuse within HHS. With a $1.3 trillion budget for HHS, oversight is essential. Ms. Grimm is a longtime civil servant who came under attack by the previous Administration for a released survey that recognized the challenges faced by hospitals in the early days of the COVID-19 pandemic. Her nomination was approved by voice vote without opposition. She has served in both Democratic and Republican Administrations since 1999. COVID-19 National Emergency Extended The Administration recently extended the COVID-19 national emergency declaration that was set to expire on March 1.

Included in the package is $108.3 billion in discretionary funds for the Department of Health and Human Services (HHS). Mandatory spending for Medicare and Medicaid brings HHS funding to a total of $1.3 trillion for fiscal year 2022. A few health-related highlights of the funding package include the following: • $3.3 billion in discretionary funds for the Food and Drug Administration (FDA) • Regulatory authority provided to the FDA to regulate synthetic nicotine • Funds to address the opioid crisis • Funds provided to enhance medical supply chain surveillance • $1 billion to establish the Advanced Research Projects Agency for Health (ARPA-H) under HHS • $1.3 billion to address the health care workforce shortage • A 151-day blanket extension of pandemic telehealth waivers after the Public Health Emergency (PHE) expires; and • Prohibits the use of funds to block states from implementing their medical marijuana laws.

Washington in Brief Activity continues to increase in Washington. President Biden delivered his State of the Union address where he called for efforts to reduce the cost of prescription medications and nursing home reforms, among other things. The House and Senate approved, and the President signed into law, a $1.5 trillion spending package that funds the government through September 30. Prior to approval of the package, negotiations led to the removal of $15.6 billion in additional emergency funds to develop and buy coronavirus products. Negotiations continue to explore additional funds to respond to the pandemic through a stand- alone package. The ACOI will continue to monitor any legislative action that impacts you and the patients for who you provide care. $1.5 Trillion Spending Bill Signed into Law The President signed into law a $1.5 trillion omnibus spending package that funds the federal government through September 30, 2022. The omnibus package includes 12 regular spending bills and ends more than five months of short-term patches used to keep the government open.



8 • American College of Osteopathic Internists

ACOI Info • March 2022


RELATIONS (Continued)

Extension of the national health emergency allows the Secretary of Health and Human Services (HHS) to continue pandemic-related Medicare, Medicaid, CHIP and Health Insurance Portability and Accountability Act (HIPAA) flexibilities, among other things. This includes an extension of the telehealth waivers put in place in response to the pandemic. With no end date included in the extension, the national emergency appears likely to remain in place until at least July 2022. The national emergency was first declared on March 13, 2020 and has now spanned two Administrations.

In 2022 and 2023, CBO plans to hire additional staff who will increase the agency’s expertise and modeling capability in the areas of health care, climate change, and energy policy--areas in which CBO expects the Congress to show increased interest.” Health care already has the most analysts of any subject area reviewed by the CBO. The CBO is a non-partisan body that is tasked with producing independent analyses of budgetary and economic issues to support the legislative process. O

Washington Tidbits A First... The University of Pennsylvania at Philadelphia graduated its first medical class in 1769. Included in that class was Jonathan Elmer. Following his graduation, he went on to practice medicine in Bridgeton, New Jersey, and became a member of the Continental Congress. He served as president of the state medical society in 1787. In 1789 he accomplished one more first – Dr. Jonathan Elmer became the first of 54 physicians to serve in the US Senate.

Additional Health Bills Likely to be Considered by Congress

The Congressional Budget Office (CBO) recently requested an additional $64.6 million for fiscal year 2023 to, in part, expand its health care staff. The increased funds would allow for the additional analyses of health care, climate change, and energy policies. The request for increased funding reflects an anticipated increase in legislative activity in these areas. According to the request, “The budgetary increase that CBO is requesting would allow it to maintain its efforts to be responsive, particularly in two important areas of analysis.


9 • American College of Osteopathic Internists

ACOI Info • March 2022

Importance of Osteopathic Research Funding Recognized by Congress

The American Association of Colleges of Osteopathic Medicine (AACOM) recently announced that its efforts to expand osteopathic research at the National Institutes of Health (NIH) were successful with the approval by Congress of the fiscal year 2022 omnibus appropriations package. The report language that accompanied passage of the 2022 spending bill included the following:

Osteopathic Medical Schools—The agreement recognizes that increased access to research funding for the osteopathic profession will significantly bolster NIH’s capacity to support robust recovery from the COVID-19 pandemic, address health disparities in rural and medically- underserved populations, and advance research in primary care, prevention, and treatment. The agreement requests an update on the current status of NIH funding to colleges of osteopathic medicine and representation of doctors of osteopathic medicine on NIH National Advisory Councils and standing study sections in the fiscal year 2023 Congressional Justification.

Inclusion of this language in the report that accompanied the fiscal year 2022 spending package is a significant step towards the appropriate recognition of the critical role osteopathic medicine plays in the healthcare delivery system. O


10 • American College of Osteopathic Internists

ACOI Info • March 2022


New ICD-10 Clinical Modification (CM) Codes

Jill M. Young, CPC, CEDC, CIMC

Diagnosis codes are traditionally released once a year in the fall with an effective date of January 1 of the following year. The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS), due to the ongoing national COVID-19 emergency, recently released three new diagnosis codes that you should know. The codes are listed in a new sub-section titled “Under-immunization for COVID-19 Status.” The new codes are effective April 1, 2022. ICD-10-CM Guidelines indicate that when a patient has not received at least one dose of any COVID-19 vaccine, code Z28.310 —Under-immunization for COVID-19 Status, should be assigned.

When a patient has received at least one dose of a multi-dose COVID-19 vaccine regimen but has not received the full set of vaccinations to meet the CDC’s definition of “fully vaccinated” at the time of the encounter, code Z28.311 —Partially vaccinated for COVID-19, should be assigned. The last of the three new codes is Z28.39 —Other under-immunization Status, is for use when the information in the medical record provides detail for which a specific code does not exist. It is the opposite of a code that reads “unspecified.” If you have additional information about the under- immunized status of the patient that is not reflected in a specific code, use the Z28.39 code.

A detailed description of the codes is available here.

These codes are not primary codes and should not be listed first in a patient’s diagnostic list. A note within the new codes additionally indicates that “These codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the healthcare provider.” O


11 • American College of Osteopathic Internists

ACOI Info • March 2022

Getting Heart Healthy

Dr. Laura Rosch discusses heart care and lifestyle choices for physicians

On the ACOI’s podcast series, Docs off the Clock, Laura Rosch, DO, FACOI, CS, MPH, shares thoughts and tips on the importance of heart health and how busy physicians can make smart lifestyle choices. While Dr. Rosch believes that it is easy for physicians

Too many times, signs of a heart attack in women are mistaken for menopause symptoms. She shares a story about a friend who experienced a major coronary event and how women present with symptoms that are sometimes atypical and can be easily missed. Tune into this latest podcast as Dr. Rosch shares her wellness tips and the five things that can make the biggest impact toward good health for busy physicians.

What is Docs off the Clock?

Discover the ACOI’s podcast series where our members and other experts share their knowledge on a variety of topics relevant for physicians today. Made for busy doctors who may only have a few minutes to listen in the car, on a jog, or even on a lunch break between patients, each podcast episode is designed to enrich members with information especially for them. Spend a few minutes with Docs off the Clock and get some quick tips from our guests who share their thoughts on subjects like practice management, physician wellness, specialty medicine geared toward internists, updates on the COVID-19 pandemic, CME attainment, and more. It will soon become your favorite podcast!

Don’t forget to check out our previous episodes, available wherever you get podcasts! O

to sometimes ignore their own health as they focus on their patients, she is also encouraged. She says that recent studies have revealed positive trends in physician health. Data has found that compared to the general public, physicians and medical students are less likely to smoke, drink, or take risks that could adversely affect their health, which is crucial in providing the best patient care. In her observations she has found that a physician’s own health practice strongly influences their patients’ health practices. “If physicians smoke,” she says, “they’re not going to talk to their patients about smoking because this is what they do. So, promoting your own healthy lifestyle really leads to significant influence on your patient’s health habits.” During the podcast, she discusses the prevalence of heart disease in women as the National Institutes of Health reports that it is the number one cause of death in women in the U.S.


12 • American College of Osteopathic Internists

ACOI Info • March 2022

Community and Member News

New COM Opening Fall 2024 The Duquesne University College of Osteopathic Medicine held their

In Memoriam

We have received word of the passing of Raymond F. Gadowski, DO, FACOI, of Farmington Hills, MI. Dr. Gadowski first joined ACOI as a student in 1969 and remained a member of the college until his passing in February 2022. He was an alumnus of the Chicago College of Osteopathic Medicine and went on to complete his cardiology fellowship in 1978. Dr. Gadowski practiced cardiology for 44 years in the Greater Detroit area. He was known for his passion for teaching and never retired due to his dedication to his

groundbreaking ceremony March 1, 2022, in Pittsburgh, PA. ACOI member John M. Kauffman, DO, FACOI, is serving as the Dean of the new COM. Duquesne University hopes to help fill a shortage of primary-care physicians locally. “Communities with stronger primary care services have better health outcomes, improved quality of care, lower costs and higher patient satisfaction,” Kauffman said. “Our doctors will be trained to very high standards of medical excellence and will understand and meet the healthcare needs of their patients, including those living in underserved regions.” Listen to the full interview with Dr. Kauffman at the groundbreaking ceremony here. The college will enroll 85 students when it launches in fall 2024 and plans to grow annual enrollment to 170 students beginning in 2026. The college intends to enroll 680 students over all four years by the 2029-2030 school year. O

patients. Dr. Gadowski is survived by his wife Marvelyn, his children Gregory, Jennifer, Andrea, and Aaron, and many grandchildren, nieces, nephews, and friends. O

Dr. Kauffman at the groundbreaking ceremony on March 1.


13 • American College of Osteopathic Internists

ACOI Info • March 2022

Jodie Hermann, DO, FACOI ACOI Osteopathic Manipulative Medicine Committee HERMANN Hints From Incorporating OMM Into Your Practice

My hands go to the lower left side of her chest near the sternum. Left hand on anterior aspect. Right hand on posterior aspect. I hold the heart between my hands. My R hand does a quick assessment of her thoracal costal junction with hypertonicity and limited respiratory movement. The heart does truly feel like a bag o’ worms. I console the heart into letting me hold it. Not tight. Not loose. Just right. It allows me to begin to get to know it, trusting my hands. It’s flailing wildly. My inner self grounds, centers and calmness ensues. My hands find her hearts path of least resistance. Or known to DOs as the position of ease. It’s rotated left, the medial aspect is superior, the inferior apex is posteromedial. The mid-section has torsion. She begins to respond. Her heart begins to nestle into my hands. Less flailing. Similar to a wild dog who doesn’t know you or trust you now deciding to take a leap of faith/gamble to begin to respond to your because somehow on some level it knows it will help. As she beings to settle in my hands, my R fingertips begin to release the costal vertebral attachment therefore releasing some of the sympathetic chain ganglia.

Short and Sweet.

We hold it together for a moment. My patient notices right away. The tense fearful body position eases up. Her breathing is no longer through pursed lips. The fear begins to drain from her face. Without being stimulated she voluntarily states she ‘felt that’ and ‘feels calmer’ now. Thank you. The nurse returns with the metoprolol. We give her half the dose now. The patient is becoming more comfortable. As time ticks by we do give the full dose and transfer her to the CCU to keep an eye on her. She again thanks me for not letting her take a shower.

I’m standing next to the bedside of my patient who came in for shortness of breath. Real simple: tele, rate control, O2 sat >88% in patient with COPD exacerbation. She is much improved from yesterday’s admission with the exception of that new acute onset of HR > 200. She’s 75 years old, looks 55 years old. She’s five feet tall and 120 pounds soaking wet. She’s talking to me letting me know that she’s happy I didn’t let her take a shower this morning even though her daughter was more than adamant that the “shower must be today.” My patient is smiling at me frozen in her supine position now starting to get lightheaded and somewhat short of breath. She is noting a ‘chest discomfort’ and palpitations feeling like a ‘racing heart’ now. We are not in the CCU but a regular med surg floor. Her last BP was 200/110, HR 210. I sent my nurse out for IV metoprolol STAT. Standing at the side of the bed seeing her heart gallop under her ribs, feeling her frozen position out of fear, hearing her strained but calm voice as recognition of her condition dawns on her – it feels like the nurse (who is doing her due diligence) is taking F-O-R-E-V- E-R. I know she is not.

Don’t forget we can always do something. The tools are ALWAYS with us. We just have to choose to use them. O

Believe me – it takes seconds – but feels like minutes.

I’m standing right in front of the vitals screen.

The monitor slows down. HR 130’s. BP 160/76.

Watching her. Watching it.

Health & Wellness

14 • American College of Osteopathic Internists

ACOI Info • March 2022

2022 Certifying Examination Dates & Deadlines

ACOI National Meetings

AOBIM Initial Subspecialty Certification Exams Remote Online Proctoring August 18-20, 2022 Application Period: February 21 - July 18, 2022 First Application Deadline: June 18, 2022 Final Application Deadline: July 18, 2022 AOBIM Subspecialty OCC (Recertification) Exams Remote Online Proctoring August 18-20, 2022 Application Period: February 21 - July 18, 2022 First Application Deadline: June 18, 2022 Final Application Deadline: July 18, 2022 AOBIM Initial Certification Exam Remote Online Proctoring September 20-22, 2022 Application Period: March 18 - August 18, 2022 First Application Deadline: June 18, 2022 Final Application Deadline: August 18, 2022

Click here to register for ACOI’s 2022 Virtual Spring Meetings! Upcoming Conventions—Save the Date! 2022 Annual Convention & Scientific Sessions October 19-23

Baltimore Marriott Waterfront Hotel, Baltimore, MD 2023 Annual Convention & Scientific Sessions October 11-15 Tampa Marriott Waterside Hotel, Tampa, FL 2024 Annual Convention & Scientific Sessions October 9-13 Kierland Resort, Phoenix, AZ

Application materials are available on the AOBIM’s website. Contact the AOBIM at for additional information.

Please note: It is an ACOI membership requirement that Active Members attend an ACOI-sponsored continuing education program at least once every three years. Information on any meeting listed here may be obtained from ACOI Headquarters at 800 327-5183, or from our website at


15 • American College of Osteopathic Internists

ACOI Info • March 2022

75th Anniversary Circle

The ACOI Board of Director wishes to thank all ACOI members for their annual support for the College. The generous support from 75th Anniversary Circle members is of the utmost importance as we seek to maintain an osteopathic approach to internal medicine for future generations of patients.

$1,000 - $2,499 Gary A. Agia, DO, FACOI Barbara A. Atkinson, DO, FACOI Mark D. Baldwin, DO, FACOI Jay Beckwith, DO, MACOI and Beth Beckwith Robert H. Biggs, DO, FACOI Gerald W. Blackburn, DO, MACOI Francis X. Blais, DO, MACOI Robert E. Bulow, DO, FACOI Kimberly A. Burch, DO Boyd R. Buser, DO Terry Bushnell, DO, FACOI Christian T. Cable, MD, MHPE, FACP Kenneth E. Calabrese, DO, MACOI Thomas A. Cavalieri, DO, MACOI Humayun Chaudhry, DO, MS, MACOI David Chesney, DO, FACOI Barbara L. Ciconte, Donor Strategies David V. Condoluci, DO, MACOI Sharolyn Cook, DO, FACOI Lawrence Cowsill, DO, FACOI Carmella D’Addezio, DO, FACOI Margaret Davenport, DO, FACOI David DePutron, DO, FACOI MarkAlain Dery, DO, MPH, FACOI Kenneth P. Dizon, DO

Jeffrey A. Ranalli, DO and Trina A. Poretta, DO Laura Rosch, DO, FACOI for her mentor George Caleel, DO, MACOI Laura M. Rosch, DO, FACOI Craig M. Rundbaken, DO, FACOI Christine M. Samsa, DO, FACOI and Nathan P. Samsa, DO, FACOI Roy J. Sartori, DO, FACOI and Christine Sartori Thomas Schneider, DO, FACOI Martin W. Schwarze, DO, MACOI Suzanne Shenk, DO, FACOI and Scott Siegal, DO, FACOI Laura Smith, DO, FACOI Duane Sossong, DO Susan B. Stacy, FACOI David G. Stainbrook, Jr., DO, FACOI Christina A. Stasiuk, DO and George M. Farion, Esq. W. W. Stoever, DO, MACOI Brad Suprenant, DO, FACOI David Susser, DO, MACOI John R. Sutton, DO, FACOI Richard R. Thacker, DO, FACOI Kenneth Trinidad, DO Gordon P. Tussing, Jr., DO Wilfred VanderRoest, DO, FACOI William H. Voss, DO, MACOI Ronald L. Walsh, DO, MACOI

David J. Greathouse, DO, FACOI Adam J. Grunbaum, DO, FACOI Robert T. Hasty, DO, FACOI Dory Jarzabkowski, DO, FACOI G. Michael Johnston, DO, MACOI Robert S. Juhasz, DO, MACOI Joanne Kaiser-Smith, DO, FACOI and Kevin P. Smith Michael Keefe, DO, MACOI Marc M. Kesselman, DO, FACOI and Robin Kesselman, DO Teresa M. Kilgore, DO, FACOI Janice A. Knebl, DO, MACOI Andrew Kotis, DO, FACOI Cheryl Kovalski, DO, FACOI Paul Kudelko, DO, MACOI Nathan J. Landesman, DO, FACOI Alexander “Sandy” Macnab Daniel L. Maxwell, DO, FACOI Timothy W. McNichol, JD Michael J. Menolasino, III, DO, FACOI Nathan Miller, DO, FACOI Jo Ann Mitchell, DO, FACOI David J. Mohlman, DO, FACOI Rizwan K. Moinuddin, DO, FACOI and Mahnaz Ali, DO Cyrus Dean Motazedi, DO, FACOI Joseph Namey, Jr., DO, MACOI Donald S. Nelinson, PhD V. Kim Newsome, DO, FACOI and Tim Stainbrook, RN, BSN Ryan Norman, DO Herbert Pasternak, DO, FACOI

$75,000 Lawrence U. Haspel, DO, MACOI $45,000 Martin C. Burke, DO, FACOI $25,000 - $44,999 Rick A. Greco, DO, MACOI and Carol A. Greco, DO Robert J. Stomel, DO, MACOI $15,000 - $24,999 John B. Bulger, DO, MBA, FACOI and Michele Neff Bulger, DO Robert G. Good, DO, MACOI and Brenda Good David F. Hitzeman, DO, MACOI and Rita Hitzeman Judith A. Lightfoot, DO, FACOI and Alvin Banks $10,000 - $14,999 Jack D. Bragg, DO, MACOI and Jocelyn Bragg Robert A. Cain, DO, FACOI and Gina Eversole-Cain Michael B. Clearfield, DO, MACOI and Susan Clearfield James C. Clouse, DO, MACOI Robert L. DiGiovanni, DO, FACOI and Monica DiGiovanni

$2,500 - $4,999 Michael A. Adornetto, DO, MBA, FACOI and Laurel Adornetto Steven B. Calkin, DO, FACOI Janet E. Cheek, DO, FACOI Pamela R. Gardner, DO, FACOI Bonita J. Krempel-Portier, DO, FACOI and Bill Portier, PhD Sara Liter-Kuester, DO, FACOI Daniel J. Peasley, DO, FACOI and Marti Peasley Keith A. Reich, DO, FACOI Morvarid Rezaie, DO, FACOI Scott Spradlin, DO, FACOI Troy A. Tyner, DO, FACOI and Ingrid M. Brown, DO, FACOI

Kevin P. Hubbard, DO, MACOI and Roxanne Hubbard C. Clark Milton, DO, FACOI and Elaine D. Milton Susan M. O’Neal, DO, FACOI Michael I. Opipari, DO, MACOI and Susan Opipari Anthony N. Ottaviani, DO, MPH, MACOI and Catherine Ottaviani Frederick A. Schaller, DO, MACOI and Amy Schaller James H. Wells, DO, PhD, FACOI Larry A. Wickless, DO, MACOI $5,000 - $7,499 Damon L. Baker, DO, FACOI Lee Peter Bee, DO, FACOI Annette T. Carron, DO, FACOI and Everett Greenleaf Brian J. Donadio, FACOI and Ellen Donadio Scott L. Girard, DO, FACOI and Laura J. Girard James C. Giudice, DO, MACOI Karen J. Nichols, DO, MA, MACOI, CS

John F. Uslick, DO, MACOI Amita Vasoya, DO, FACOI Winter Wilson, DO, FACOI and Tina Wilson Randal Worth, DO, FACOI

Kathleen J. Drinan, DO, FACOI Bruce D. Dubin, DO, MACOI Susan E. Duke, DO, FACOI Susan M. Enright, DO, FACOI Ira Epstein, DO, FACOI J. Michael Finley, DO, FACOI Mitchell D. Forman, DO, FACOI Eric D. Good, DO, FACOI Debora Goodrich DO, FACOI and John Goodrich

Thomas Waltz, DO, FACOI R. Colin Wetz, DO, FACOI

Mark L. Woodard, DO, FACOI William Zipperer, Jr., DO, FACOI

Joanna Pease, DO, MACOI William Peppo, DO, FACOI Daniel K. Peshka, DO John Prior, DO, FACOI Bennet Radford, DO, FACOI

Eugene A. Oliveri, DO, MACOI Samuel K. Snyder, DO, FACOI and Pamela Snyder Ruben Tenorio, DO, FACOI Alan W. Wan, DO, FACOI

Thank You!


MISSION The mission of ACOI is to promote high quality, distinctive osteopathic care of the adult.

VISION ACOI seeks to be the organization that osteopathic internists think of first for education, information, representation and service to the profession.

VALUES To accomplish its vision and mission, ACOI will base its decisions and actions on the following core values:

LEADERSHIP for the advancement of osteopathic medicine

11400 Rockville Pike

EXCELLENCE in programs and services

Suite 801 • Rockville MD 20852

INTEGRITY in decision-making and actions

301 231-8877 • 800 327-5183 • Fax 301 231-6099

PROFESSIONALISM in all interactions •

SERVICE to meet member needs

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