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The Florida Internist

Fall, 2001

From the Governor

Frederick E. Turton, MD, FACP
Fturton@gate.net

Looks Like Rain
Florida's Malpractice Crisis

Internists and medical specialists have been relatively lucky when it comes to medical malpractice premiums. Other specialists have traditionally paid more for their profession liability insurance (PLI). The situation has changed.

Medical Malpractice Crisis
The PLI market place has evolved out of what the experts call a "soft cycle" and rates will rise again like they did in the mid-eighties. In the next one to two years expect 25 to 30 per cent increases. The reasons for the rising rates are several: (1) the insurance industry is normally cyclical and the economy has changed in a way that will inevitably drive rates up, (2) malpractice settlements have risen and (3) some insurers have undermined the market by charging inappropriately low premiums.

The effects of this crisis will be felt unequally. The hardest hit will be pulmonology and cardiology. Other specialties to see higher costs include radiology, vascular surgery, general internal medicine and general surgery roughly in that order. Interestingly, the traditionally hard hit specialties of OB-GYN and neurosurgery will be among the specialties relatively unaffected by rate increases.

What can you do to get through this tough time? Here is my four-part prescription.

First: buy a good insurance product
Make sure the money you are paying is worth it. Is the company you are purchasing coverage from able or willing to defend you should you be sued? What is that company's record when it comes to settling claims without cost to the doctor? How long has the company been in Florida and what are the chances it will stay in Florida? Buying a cheap policy from a transient, poorly run insurance company is not a bargain.

Second: avoid overbuying
Make an honest estimate of how high your liability limits really need to be. There are three important considerations. (1) How much of your personal assets are really at risk in the case of an adverse malpractice settlement? Consider spending a few dollars with your financial advisor and find out much protection you really need. (2) How litigious is your community? Practicing in an area like Miami/Dade bears more risk than working in rural areas in the panhandle. How risky is your community? (3) How much protection do you, as an individual, need to sleep well at night? Some of us need the big policy to be comfortable. If you are one, do yourself and your loved ones a favor and buy the $1,000,000 policy.

I recently discussed how much coverage a doctor needs with one of the state's most prominent medical malpractice defense attorneys. He admitted that he had begrudgingly come to the conclusion that the $250,000 policy is probably enough. He noted that the Florida legislature requires doctors to have $250K policies and there seems to be a gentleman's agreement among lawyers to sue the accused physician only up to the limits of his/her policy limits. He went on to say there are few (actually he was not aware of even one in Florida) settlements in excess of the doctor's liability limits. In his words: a $250K policy buys "90% of what you need at less money."

I would add that higher liability limits might actually increase your risk of being sued. Higher limits can be chum for the plaintiff attorney sharks.

Third: continuously review your risk

Make an honest assessment of your practice. Are the systems in your office designed to avoid risk? Are you and your staff treating your patients with respect and compassion? Are your charts maintained in a way that will serve you should be sued? Are you up to date with the state-of-the-art in your specialty? You must be honest with yourself and be willing to make changes. A medical malpractice suit can be a career-changing episode. Do not fail to alter your behavior and stay out of trouble in the first place.

Fourth: get involved

Make sure to join your chapter's key contact network. The Florida Chapter ACP-ASIM has initiated a grass-roots effort to influence the Florida legislature. By developing a personal relationship with your state Representative and local Senator you can be part of the tort reform process planned by your chapter. Call Dawn Moerings at 800-564-8461-12 and become part of the solution.

Hang tough. The skies will brighten.

From the President

Kenneth R. Ratzan, MD, FACP
Kratzan@aol.com

This past weekend I attended our annual regional meeting at the Renaissance Vinoy in St. Petersburg. It was a resounding success. Kudos to Phil Altus, M.D, Professor of Medicine University of South Florida and his faculty for superb and stimulating presentations. Even though we had almost 300 registrants attend the Scientific Meeting and the Office Management Seminar, those of you who chose not to come deprived yourself of an opportunity to experience an excellent scientific program and obtain 13 CME credits without cost as a member benefit; mingle with colleagues and friends throughout the state; and meet and speak with two of the leaders and stars of our national chapter, William Hall, MD, President of the American College of Physicians-American Society of Internal Medicine, and Robert Dougherty, Vice-President for Government Affairs and Public Policy. We are forever grateful to these two, not only for attending our meeting but also for sharing with us their expertise, counsel, and thoughtful presentations on the direction of the college, the impact of genetics on the future of geriatrics, and the political climate of the U.S. Congress and the legislative program of the College for 2001-2002. Among the most compelling presentations was that given by John Sinnot who changed his topic at the last minute to take to us about bioterrorism.

In the wake of the recent case of anthrax in Lantana, the terrorist attacks on the World Trade Center and the Pentagon, and raising of our consciousness by the media of the threat of bioterrorism, Dr. Sinnot's talk was compelling and gripping. The audience sat there spellbound listening to Dr. Sinnot delineate the biological agents which could potentially cause devastating loss of lives in the proper setting. As physicians, particularly primary care physicians, we will be first responders in a biological weapons incident. It is our role to become familiar with the signs and symptoms of diseases such as smallpox, anthrax, plague, and botulism; to identify and report an increased number of cases with a similar respiratory and/or flu-like illness which occur over a short period of time; and to understand the natural history of these diseases so we can reassure our patients and the public about the treatment and contagiousness of these illnesses. Early diagnosis of an etiologic agent in a biological terrorist attack is critical to allow the government to mobilize the proper supplies, vaccines, and anti-microbial agents to contain the epidemic and diminish loss of life. In addition, it is our responsibility to be familiar with the response plan of our hospitals and at least to make sure that our hospitals have developed such a plan. For those of you with e-mail addresses our chapter sent you a bioterrorism preparedness plan developed by the Association for Practitioners in Infection Control and the Centers for Disease Control. This plan identifies the signs and symptoms of the various potential biological agents, lists critical telephone numbers to call in the event of a suspected attack, and outlines a plan for hospitals to deal with potential casualties. The College has developed a website, http//www.acponline.org/bioterro/, which has excellent up to date information concerning bioterrorism and links to other critical sites on the web.

Indeed, these are difficult times filled with uncertainty and the expectation of retaliation, especially following our military strikes on Afghanistan. As internists we have always put our patients first and have served them with distinction and compassion. I would expect that we will continue to do so even in times of great stress.

October 5, A Good Day for the Florida Chapter, Compassion and Florida's Underserved Citizens

By James W. Stockwell, MD, FACP
Chair, Volunteerism Committee

Drs. Stockwell, McConnell and Hall

On October 5 The Council Of The Florida Chapter ACP/ASIM voted to partner with Volunteers In Health Care Institute in an effort to establish additional free medical clinics in the State of Florida to serve the growing numbers of medically indigent citizens. This joint project is in keeping with the chapter's goals of enhancing access to quality care and promoting physician volunteerism. The project is also in keeping with the spirit of many ACP/ASIM members who currently participate in free clinics, volunteer, or desire to improve access to care.

Dr. Jack McConnell, founder of the Hilton Head Island, South Carolina Free Clinic presented an informative and inspiring overview of the Free Clinic mission, development, and operations. Through the efforts of Governor Fred Turton and Dr. Chuck Duvall, former President of the American Society Of Internal Medicine, and a volunteer at the Hilton Head Clinic, Dr. McConnell developed an interest in partnering with the Florida Chapter to bring additional free clinics to Florida.

Dr. McConnell retired to Hilton Head Island after a successful medical career as a pharmaceutical medical director, scientist, and leader. In his retirement years his leadership, humanitarian efforts, and outstanding accomplishments have led to many well-deserved honors and awards.

In 1992 Dr. McConnell recognized that in the prosperous community of Hilton Head one-third of citizens were without medical care. He was motivated to find a solution, not only by the tremendous need for care, but also by his desire to help others and his belief, "that it is only in service to others that we find and begin to understand ourselves." Under Dr. McConnell's leadership, the Hilton Head Volunteers in Medicine Clinic was established.

The clinic is an attractive modern facility staffed largely by retired physicians and other volunteers. Excellent medical care is given in an atmosphere of dignity and genuine caring. The clinic is funded by grants and donations of every type, from monetary gifts, to building materials, to medical supplies.

Through his efforts to establish the Hilton Head Clinic, Dr. McConnell and his associates acquired great expertise in free clinic development. The Volunteers In Medicine Institute was created to provide that expertise to others throughout the United States who might desire to establish a free medical clinic. To date, Dr. McConnell and the Institute have assisted in the development of 36 free clinics in the United States. The establishment of local free clinics is made easier and much more time-efficient by utilization of Dr. McConnell's expertise and the resources of the Institute. A "start-up guide" is available that deals with all issues encountered in free clinic development. Also available is a "document manual" containing documents needed to start and operate a clinic. Issues that are addressed include: target population, malpractice liability, retired physicians' licensing, polices and procedures, job descriptions, public relations, grant requests, and sample forms used in the day-to-day operations. In addition, Dr. McConnell and his staff are willing to visit local sites and assist in the development.

All of the above assistance provides a wonderful opportunity to expand medical care to the underserved. The project also provides an opportunity for the Chapter to enhance access to care and encourage volunteerism with minimal, if any, monetary expense. The project is a volunteer effort giving the chapter and its members the opportunity to donate their enthusiasm, time, labors and expertise.

It should be emphasized that the establishment of free medical clinics is a local undertaking. Although the Chapter will partner with the Volunteers In Medicine Institute to encourage and facilitate development, the establishment of need, and leadership, and operation must be a local undertaking. Physicians who identify the need for a clinic in their area must lead the effort.

It should also be emphasized that the establishment of additional free clinics in Florida is in no way meant to compete or interfere with free clinics already in operation through the dedicated efforts of many Florida physicians. The need for access to quality medical care for the poor is so great that every effort to deliver care must be applauded, encouraged, and supported.

Establishment of additional free clinics will make many Floridians healthier. Their establishment will also contribute to the good health of The Florida ACP/ASIM and its member physicians. In these times of governmental interference, Medicare mandates, HMO's, malpractice risk, and interference with the doctor-patient relationship, our professional heritage, excellence, compassion, and the delivery of appropriate care is threatened. Physicians are therefore at risk for losing the joy of medical practice and becoming demoralized and cynical with feelings of helplessness. The Florida Chapter and its leadership work diligently and successfully in the legislature and public arenas to combat the forces that threaten our mission to care well for our patients, and to remain a healthy, economically viable, and powerful force for good.

The joint project with the Volunteers In Medicine Institute will also make The Florida Chapter and its member physicians healthier by rediscovering the joy of bringing excellent medical care to deserving patients. Many of the chapter's members already know the joy Dr. McConnell stated during his visit, "When I give, I always receive much more back than I have given". The chapter and its membership will also experience additional benefits as others recognize the commitment to health care access, our ability to be effective, and our unrelenting humanitarian spirit. The project will attract idealistic young physicians looking for an effective organization that will represent their interests. The project will put chapter members in contact with minority and disadvantaged citizens and their physicians. This will provide the opportunity to understand one another, work together, ensure improved health care access, and make the chapter stronger and more richly diverse. Contacts will be made through the project with other citizens and organizations interested in access to health care that will contribute to our mission and make the Chapter more visible and stronger. Legislators will take notice and see us as a valuable source of expertise. They will see internists as part of the solution to the health care problems. Internists will have a "seat at the table" when health care issues are discussed. More important, all will know "internists care for adults."

As the joint project with Volunteers In Medicine Institute moves forward, the next step is to find physicians who might want to establish a free clinic in their community. Please contact Volunteers In Medicine Institute for information and assistance (843-681-6612.) Dr. McConnell will also be happy to send you a copy of his book, "The Story Of The Volunteers In Health Care Clinics." As Chairman of the Volunteerism Committee, I will be happy to answer questions & assist (850-877-2105.)

The physicians that choose to participate will feel a renewal of the joy of medical practice. Dr. McConnell notes that, "One cannot create a health clinic for the medically underserved without being changed in the process. You will never be the same again. You will see the poor, and those who serve them, in a very different light. You will also see yourself and your previous work in a different light."

ACP-ASIM Florida Regional Meeting Associate Awards

By: Farzanna Haffizulla, MD, Cleveland Clinic Representative to the Florida Council of Associates

The Florida Regional Scientific meeting was held at the Renaissance Vinoy in St. Petersburg on October 5-7th. The experience for our Associate members was once again a rewarding one. The Local Council of Associates under the leadership of Dr. Max Brito hosted an "Associates' Hospitality Table" which was visited by the majority of residents and fellows attending the meeting. As always, there were some wonderful oral and written presentations four of which were recognized with awards.

The award for the oral presentation was given to Dr. Karen Haglof. Dr. Haglof attended medical school at the State University of New York and is currently a 3rd year resident at the University of Florida in Gainesville. She is an accomplished musician and chef and plans on pursuing a fellowship in Hematology/Oncology at NYU in July 2002. Her presentation was entitled "An Unusual Case of Shortness of Breath." This is a case of a 28yo Caucasian male who presented with shortness of breath. After an extensive work-up, a transbronchial biopsy disclosed birefringent particles within the vascular spaces consistent with the diagnosis of intravenous pulmonary talcosis.

There were three awards for poster presentations. In the clinical category the award was presented to Dr Sirpa Autio from Cleveland Clinic Florida. As her local Council representative , I am privileged to have more insight into this amazing young woman. Dr. Autio, a first year resident is originally from Finland but graduated from Mercer University School of Medicine in Georgia. She is versed in five languages and her love of volunteerism propelled her to participate in "Mercy Ships" and other organizations. She is an avid athlete and plans on pursuing a fellowship in Sports Medicine. Her poster was entitled "Atypical Parvovirus B19 Infection with Refractory Anemia and Membranoproliferative Glomerulonephritis in a 34 Year Old Female with Asymptomatic Hepatitis C Infection."

The second award in the clinical poster category was given to Dr Yoram Padeh, a 3rd year resident at Mount Sinai Medical Center. Dr Padeh will serve as chief resident at Mt Sinai in 2002. He plans on completing a fellowship in Allergy/Immunology thereafter. His presentation was entitled "The Increased Risk of Prolonged QT Syndrome and Polymorphic Ventricular Tachycardia (Torsades De Pointes) with Gatifloxacin."

Finally, one Research poster award was presented to Dr. Dawn Ferguson. She is a 3rd year resident at Mayo Clinic in Jacksonville. She graduated from the University of Colorado medical school and has also obtained a Masters in Public Health. Dr Ferguson plans on completing a Gastroenterology fellowship at the Mayo Clinic. Her poster was entitled "Serum Troponin Levels in Pulmonary Embolism: Association with CT Findings."

The exciting "Doctors Dilemma" Competition was won by Drs. Antonio Cano, Rafael Bravo and Jose Castillo from Mount Sinai Medical Center.

On behalf of the Council of Associates we offer our heartfelt congratulations to all awardees and invite you to submit your work for our upcoming Associates meeting in Orlando in the spring.

Patient Safety Compliance: The Missing Link to Medication Safety

All physicians know that care of the patient doesn't stop at the clinic door. In fact, most ambulatory patient-safety accidents happen outside the clinic, as a result of medication errors, including non-compliance. But you can know the risk factors associated with medication errors and non-compliance, and you can work to prevent them. Below are just a few of the factors associated with errors of non-compliance:

  • Advanced age
  • Multiple co-morbidities or medications
  • Depression
  • Perception of over-medication

For example, in a study of elderly primary-care patients, 86% misunderstood physician instructions regarding medication schedules. And patients with depression are three times more likely to be noncompliant with medical recommendations. For patients with noncompliance risk factors, take a little extra time to explain how to use the medication, and why it's important. If side effects are a possibility, let the patient know what to expect and what to do if the side effects are more than transitory. Working together, patients and physicians can promote safety beyond the clinic door.

The Scientific Policy Department of the ACP-ASIM is working to improve patient safety through its new CME series, Patient Safety: The Other Side of the Quality Equation. If you are interested in having this program presented at our next Chapter meeting, please contact your ACP-ASIM Governor for Florida, Dr. Frederick E. Turton (fturton@gate.net) or Alice Sutton (acpfl@onearrow.net.)

2001 Florida Award Recipients

Florida Chapter Laureate Awards

The Laureate Award honors those Fellows or Masters of the College who have demonstrated by their example and conduct an abiding commitment to excellence in medical care, education, or research, and in service to their community, their Chapter, and the American College of Physicians-American Society of Internal medicine.

Jamie S. Barkin, MD, FACP, MACG

Jamie Barkin graduated from the University of Miami School of Medicine in 1970. For the past 31 years he has taken the field of internal medicine and especially gastroenterology by storm. After completing an internship and residency in Internal Medicine and fellowship in Gastroenterology at the University of Miami, Jamie joined its faculty in 1975 and by 1987 rose to the rank of full Professor not only in the Department of Medicine, but also in the Departments of Oncology and Pediatrics. Academically he is recognized as an expert in the field of pancreatic disease and gastrointestinal endoscopy. His contributions to the literature in the field of pancreatic disease and gastrointestinal bleeding are legion and he has been widely recognized and honored by his colleagues. He served as President of the American College of Gastroenterology, the Council of Regional Endoscopic Societies, the Florida Society for Gastrointestinal Endoscopy, and the Bockus International Society of Gastroenterology.

It is hard to imagine that in addition to his involvement in the leadership position of these national societies Dr. Barkin has devoted thirty years to the United States Military. Indeed, in 1995 he was promoted to Brigadier General in the US Army Reserve and presently heads the 3rd Medical Command of the US Army, a position, which comes with a promotion to Lieutenant General. His service to the American College of Physicians has been outstanding. He served as Governor of the Florida Chapter from 1996 to 2000 and presided over the merger of the Florida Chapters of the American College of Physicians and American Society of Internal Medicine. Just this past year he was elected to serve as a Regent in the American College of Physicians -American Society of Internal Medicine. During his four years as Governor he served his constituents well. From 1996 to 1999 our chapter was awarded three Evergreen Awards for Chapter Management and a special award for Education and Information.

Dr. Barkin truly deserves to be recognized as a Laureate of the Florida Chapter. His accomplishments as an academician and teacher have been extraordinary, his leadership skills in directing national organizations and thousands of men in our armed services and his contributions to the ACP-ASIM have been outstanding. Throughout his years in leadership Dr. Barkin has been quick to recognize the accomplishments of others. It is only fitting that we recognize Jamie Barkin's accomplishments and award him with the Laureate Award of the Florida Chapter of the ACP-ASIM.

—Kenneth R. Ratzan, MD, FACP

Eugene Taylor Davidson, MD, FACP

Eugene Taylor Davidson was born in Birmingham, Alabama and went to medical school at Vanderbilt University. He did his post-graduate training at Barnes Hospital in St. Louis and his senior residency at Duke. This was followed by a fellowship in endocrinology and metabolism at Vanderbilt University and two years of service with the U.S. Army Medical Research Laboratory's Endocrine Division in Ft. Knox. When Gene was at Duke he became friends with many fellow residents who were from the Florida area and they suggested that he consider our state as a possible practice area. While serving in the Army, Gene heard of the Watson Clinic's desire to land a top-notch endocrinologist and he joined that prestigious organization following his military service and has been there until this day.

Dr. Davidson has been an icon in endocrinology and metabolism in Florida. He has served locally as Chairman of the Department of Medicine at the Lakeland Regional Medical Center, as well as Vice-President of that facility. He has been active in both state and national organizations serving as President of the Florida Society of Internal Medicine, Chairman of the Fish's Committee of Clinical Excellence as well as Chair of the Committee on Voluntary Health Agencies for the Florida Medical Association. He was President of the Florida Endocrine Society, Chairman of the Florida Diabetes Advisory Council, and President of the Florida Diabetes Association as well as serving on the Governor Advisory Council for the Florida Chapter ACP. As a member of the Florida Chapter ACP he developed and edited a manual for medical residents going out into practice, calling upon individuals from throughout the state to lend their expertise to help our residents during this transition.

Dr. David has also been active nationally. He has served as President of the American College of Endocrinology and was honored by that organization with a Mastership. He was elected a delegate-at-large to the American Diabetes Association and served as the second President in the history of the American Association of Clinical Endocrinologists. He has chaired numerous committees of that organization including the Organization & Operations Committee, Ethics Committee and Organization and Planning Committee. He has served on the National Osteoporosis Foundation and the Task Force on Diabetic Retinopathy.

Dr. Davidson has been honored by his peers and colleagues on numerous occasions. He is the recipient of the Hutton Traveling Scholarship in Endocrinology given by the American College of Physicians. He has received the Leadership in Medical Education Award from the Florida Medical Association, the Internist of the Year Award by the Florida Chapter ACP-ASIM, and has been voted to the top 100 physicians nationally in his field by a survey of other physicians. He was voted Outstanding Physician by the peer review committee in Polk County, receiving the top number of votes of all specialties. The American Association of Endocrinologist has developed an award entitled "The Eugene Taylor Davidson Outstanding Layman Award", established to be given to the outstanding layman who has contributed to the field of endocrinology and diabetes.

It is clear that Gene Davidson fits the description of a scholar and a gentleman. He is the type of physician we should all use as a role model. He is an outstanding clinician providing superior care to his patients while still volunteering his precious time to make medicine better locally, regionally and nationally. Dr. Davidson certainly deserves being named a Laureate of our organization. As a previous Laureate, I know I can speak for our entire group by saying we're honored to have him join our ranks.

—Philip Altus, MD, MACP

Charles E. Donegan Volunteerism Award

Donald Rosenberg, MD, FACP

Dr. Donald G. Rosenberg graduated from Emory Medical School and completed fellowship training under J.Willis Hurst in cardiology. He was in private practice from 1960 to 1988, serving as an attending at the University of Miami School of Medicine at the same time. In 1988, Dr. Rosenberg accepted a position as a full-time attending in cardiology at that institution and also became Director of Emergency Medical.Services training. As a hobby in the 1970's, he participated in the creation of Miami-Dade Fire Rescue.

In 1995, he was made Director of Miami-Dade County Fire Rescue. In addition to his full-time practice and teaching as a Professor of Cardiology at the University of Miami, his duties with Metro-Fire Rescue have included co-chairing a project with Robert J. Myerburg, M.D., Professor of Medicine and Physiology and Director of Cardiology at the University of Miami School of Medicine. This project included putting in 2,300 automatic external defibrillators in every police car of Miami-Dade County Police force. The result, so far, has been a doubling of the survival rate from cardiac arrest in the county. Besides a pilot study involving 67 cases, an additional 120 to 130 cases were done in TIMI 19, a study using Retavase pre-admission that was chaired by Eugene Braunwald of Harvard and directed by Dr. Elliot Atman of Harvard. This study was expanded to include Broward County and these results will be presented September 5, 2001 in Stockholm, Sweden to the European Society of Cardiology. The decreased mortality rate utilizing TIMI 19 is impressive; there is approximately a 96 percent survival rate for acute myocardial infarction. This study is now being expanded into TIMI 26 for non-Q myocardial infarction and unstable angina, and negotiations are ongoing with the University of Texas, Ford Foundation in Detroit, Cincinnati and Minnesota to institute a further project using Retavase and ReoPro, pre-hospital, for Q-wave MI.

As Medical Director Dr. Rosenberg rides rescue and rides the helicopter. Through the workings of a lieutenant, Miami-Dade Fire Rescue probably has the most extensive anti-venom bank in the world. Recently they were able to save a man who was taking a photograph of a cobra and was bitten. Miami Dade Fire Rescue had the only anti-venom in the country. The gentleman was flown to Miami, and he was stabilized with the anti-venom.

Dr. Rosenberg is also intermittently involved with the Ryder Trauma Center, the only Trauma Level 1 center in Miami-Dade County, which attempts to keep as up-to-date as possible in the investigation of hazardous materials and toxic warfare.

Outstanding Teacher Award

For outstanding leadership and dedication to medical education

Daniel L. Lichtstein, MD, FACP, University of Miami School of Medicine
Mark A. Gelbard, MD, University of Miami School of Medicine
Joseph C Chan, MD, FACP, Mount Sinai Medical Center
Richard Lottenberg, MD, FACP, University of Florida School of Medicine
Malcolm T. Foster, Jr., MD, FACP, UF Health Science Center - Jacksonville

Community Based Teacher Award

For contributions to the education of medical students, residents and fellows as an office-based internist

Allen T. Brasington, MD, FACP, Gainesville, Florida

Florida Chapter Internist of the Year Award

For outstanding dedication to the practice of internal medicine

Kay M. Mitchell, MD, FACP

Kay Mitchell's was born and raised in Albertville, Alabama and received a bachelor's degree in Medical Technology from Jacksonville State University in Jacksonville, Alabama. She earned a Master's Degree in Biology from Georgia State University and her Medical Degree from the University of Georgia. She served as an intern and resident at the University of Florida Health Science Center, Jacksonville, FL. In 1992, after working in the private practice of general internal medicine for 3 years, she joined the staff of the Mayo Clinic and the faculty of the Mayo Medical School where she is currently, Assistant Professor of Medicine. She is board certified in internal medicine with the special added qualification in geriatrics.

She has lectured widely in the areas of geriatrics, domestic abuse, obesity and women's health issues. At the Mayo Clinic, she has served as coordinator of the resident's geriatric experience.

Kay has a long list of awards and professional affiliations. She has worked tirelessly in organized medicine to help enhance the medical care of her patients, the training of her residents and the political environment for her physician colleagues. She currently serves as the chair of the FMA Council on Medical Education and as a delegate to the AMA. In addition, she is a board member of the Duval County Medical Society and a Regional Representative from Region A of the Florida Chapter ACP-ASIM. In June of this year, she was elected to the AMA Council on Medical Education.

In addition to her extensive professional activities she has remained a devoted wife and mother, raising two girls who are now practicing attorneys. She enjoys spending her spare time gardening and refurbishing old homes with her husband Alex.

Public Service Award

John Langdon, MD, FACP, Celebration, Florida

Chief Residents 2001-2002

Alissa Quin, MD, UF Health Science Center Jacksonville
Amarin Alexander, MD, ACP Associate, UF Health Science Center Jacksonville
Mario Cole, MD, ACP Associate, UF Health Science Center Jacksonville
Vafa Mansouri, MD, ACP Associate, UF Health Science Center Jacksonville
Elizabeth Araujo, MD, ACP Associate, University of Miami
Luis Caceres, D.O., ACP Associate, University of Miami
Loryn Feinberg, MD, ACP Associate, University of Miami
Wendel Moreira, MD, University of Miami
Sunil Joshi, MD, ACP Associate, Mayo Clinic Jacksonville
Sandra Williams, MD, ACP Associate, Mayo Clinic Jacksonville
Thomas George, MD, ACP Associate, University of Florida
Dennis Collins, MD, ACP Associate, University of Florida
Barbara Fare, MD, ACP Associate, Orlando Regional Medical Center
Lorna Pickles, MD, ACP Associate, Orlando Regional Medical Center
Brian Liebersbach, MD, ACP Associate, Orlando Regional Medical Center
Gustavo Cardenas, MD, ACP Associate, Cleveland Clinic Florida
Gerardo Valdes, MD, Cleveland Clinic Florida
Jennifer Orzano, MD, ACP Associate, Mount Sinai Medical Center