Inside - American Association of Physicians of Indian Origin
Inside - American Association of Physicians of Indian Origin
Inside - American Association of Physicians of Indian Origin
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
<strong>Inside</strong><br />
Global Healthcare Summit –<br />
New Delhi, India . . . . . . . . . . . . .22<br />
HIPAA – What’s New<br />
This Year?<br />
by Peter Parvis,<br />
Healthcare Attorney . . . . . . . . . . . . .36<br />
AAPI Launches Political<br />
Action Committee<br />
Vinod K. Shah, MD, AAPI President<br />
Dino Teppara, Esq. , AAPI Director<br />
<strong>of</strong> Legislative Affairs . . . . . . . . . . . . . 26<br />
AAPI President Attends<br />
State Dinner . . . . . . . . . . . . . . . . . 35<br />
The U.S. Ayurveda<br />
Delegation Trip to India,<br />
January 28 to February 4, 2010<br />
by Dr. Navin Shah, Medical<br />
Education Director, Metropolitan<br />
Urologic Institute . . . . . . . . . . . . . . . .43
2 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
3
Contents<br />
aapi<br />
President<br />
Vinod K. Shah, M.D., F.A.C.C.<br />
600 Enterprise Drive, Suite #108<br />
Oakbrook, IL 60523<br />
Phone: (630) 990-2277<br />
Fax: (630) 990-2281<br />
www.aapiusa.org<br />
Editor<br />
Jayesh Kanuga, M.D.<br />
journal@aapiusa.net<br />
Co-Editor<br />
Prasad Srinivasan, M.D.<br />
prasads268@gmail.com<br />
Production & Design Coordinator<br />
Vipul Shah<br />
vipulshah.aapi@gmail.com<br />
Marketing Communications<br />
& Ad Sales<br />
Sam Fulambarker<br />
sam@aapiusa.net<br />
Accounts & Membership<br />
Vijaya Kodali<br />
vkodali@aapiusa.net<br />
Designed & Printed by<br />
GR Marketing & Graphic Design<br />
Phone: (813) 886-4500<br />
Fax: (813) 886-4501<br />
Copyright©2010 by<br />
<strong>American</strong> <strong>Association</strong> <strong>of</strong> <strong>Physicians</strong><br />
<strong>of</strong> <strong>Indian</strong> <strong>Origin</strong>.<br />
All rights reserved.<br />
Winter 2010 AAPI Journal<br />
About The Cover<br />
Counterclockwise: Official banner <strong>of</strong> the Global Healthcare Summit in New Dehli, India; Audience<br />
members sit mezmerized at the depth <strong>of</strong> topics at the Global Healthcare Summit; AAPI President, Dr.<br />
Vinod K. Shah and wife, Ila, smile proudly at President Obama's first <strong>of</strong>ficial State Dinner honoring<br />
Prime Minister Manmohan Singh; taken by Dr. VK Shah after a Lukemia & Lymphoma Society<br />
benefit, "Light the Night Walk", a beautiful picture <strong>of</strong> the U.S. Capitol Building on a cold, rainy night<br />
- despite the weather, thousands <strong>of</strong> people attended the LLS benefit; supporters <strong>of</strong> Team Ami-Ba are<br />
geared up and ready to walk the 2.5 mile "Light the Night Walk" to support the LLS - Team Ami-Ba<br />
raised over $32,000 (http://www.lightthenight.org/nca/localchapter/top_fundraisers)<br />
Executive Officers Reports<br />
President’s Report<br />
Vinod K. Shah, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6<br />
President’s Elect’s Report<br />
Ajeet Singhvi, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8<br />
Vice President’s Report<br />
Sunita Kanumury, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10<br />
Treasurer’s Report<br />
Jayesh Shah, MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12<br />
Secretary’s Report<br />
Narendra Kumar, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14<br />
Board <strong>of</strong> Trustees Report<br />
Sanat Gandhi, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14<br />
In The News<br />
AAPI President Attends State Dinner<br />
Dr. Vinod K. Shah, the only national president <strong>of</strong> an <strong>Indian</strong> <strong>American</strong><br />
community organization to attend the State dinner at the invitation<br />
<strong>of</strong> President Barack Obama, speaks about his experience. . . . . . . . . . . . . . . . . . . . . . . 35<br />
Dr. Sudhir M. Parikh Receives Padma Shri Award<br />
Dr. Sudhir M. Parikh, Publisher, India Advocate,<br />
Philanthropist, Physician<br />
<strong>Indian</strong> <strong>American</strong> physician, philanthropist and publisher, Dr. Sudhir M.<br />
Parikh, has been named a recipient <strong>of</strong> the 2010 Padma Shri award. . . . . . . . . . . . . . 27<br />
Dr. Onaly A. Kapasi Receives New England’s 2009<br />
Distinguished Humanitarian Service Award<br />
Onaly A. Kapasi, MD, a nominee for the <strong>American</strong> Academy <strong>of</strong> Orthopedic<br />
Surgery’s Humanitarian Service Award, recently received the Distinguished<br />
Humanitarian Service Award from the <strong>Indian</strong> Medical <strong>Association</strong> <strong>of</strong><br />
New England (IMANE) on November 21, 2009. . . . . . . . . . . . . . . . . . . . . . . . . . . . 33<br />
The AAPI Journal is published quarterly by the <strong>American</strong> <strong>Association</strong> <strong>of</strong> <strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong> <strong>Origin</strong> (AAPI). This publication may not be reproduced<br />
in whole or in part without the express written permission <strong>of</strong> AAPI. All articles published including editorials, letters and book reviews represent the<br />
opinions <strong>of</strong> the authors and do not reflect the <strong>of</strong>ficial policy <strong>of</strong> AAPI.<br />
4 www. aapiusa.org Winter 2010 AAPI Journal
Featured Articles<br />
AAPI Launches Political Action Committee<br />
Vinod K. Shah, MD, AAPI President<br />
Dino Teppara, Esq. , AAPI Director <strong>of</strong> Legislative Affairs<br />
<strong>Physicians</strong> are the key players in providing quality health care to the <strong>American</strong> people.<br />
However, they are not a large nationwide constituency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26<br />
AAPI Clinic launches HIV, Hepatitis and Mother-Child<br />
programs and conducts health camp<br />
by Jagan Ailinani, MD, Past President,<br />
Board <strong>of</strong> Director AAPI-Charitable Foundation<br />
The AAPI Preventive Health Clinic, initiated several<br />
projects in rural Andhra Pradesh this year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30<br />
HIPAA – What’s New This Year?<br />
by Peter Parvis, Healthcare Attorney<br />
HIPAA (Health Insurance Portability and Accountability Act <strong>of</strong> 1996)<br />
affects everyone who uses, provides, or pays for health care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36<br />
Special Articles<br />
MSRF: Year to Date<br />
by Chirag Parghi, MD<br />
The AAPI-MSRF (Medical Student, Resident, Fellow) section has<br />
had a busy year with a focus on increasing awareness nationwide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15<br />
NRIs and Globalization<br />
The following is the summary <strong>of</strong> the invited talk given before<br />
the AP Medical and Dental College’s Management <strong>Association</strong> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16<br />
Process <strong>of</strong> Progress<br />
Onaly A. Kapasi, MD<br />
To analyze and comprehend progress we must understand<br />
and establish the process <strong>of</strong> measuring progress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18<br />
Global Healthcare Summit – New Delhi, India<br />
The <strong>American</strong> Associate <strong>of</strong> <strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong> <strong>Origin</strong> (AAPI) was proud to host a<br />
Global Healthcare Summit at Modia Sheraton Hotel in New Delhi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22<br />
Book Review: ‘CHEATING DEATH’<br />
by M. P. Ravindra Nathan, MD, Brooksville, FL<br />
Anyone who is frustrated by the failure <strong>of</strong> standard approaches for treating critically ill<br />
patients will be amazed at what Dr. Sanjay Gupta has to say in his latest book,<br />
‘Cheating Death,’ a New York Times best seller. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28<br />
The U.S. Ayurveda Delegation Trip to India, January 28 to February 4, 2010<br />
by Dr. Navin Shah, Medical Education Director, Metropolitan Urologic Institute<br />
Delegation: Seven delegates including six Complementary Alternative Medicine<br />
(CAM) directors <strong>of</strong> six major United States medical schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
5
President’s Report<br />
Dear Friends,<br />
As your President, I have been regularly sending<br />
you a monthly e-newsletter to keep you abreast with<br />
the activities <strong>of</strong> our organization. This monthly<br />
communication has been very well received and I<br />
would like to express my gratitude for the many<br />
compliments you have sent to me and to the AAPI<br />
<strong>of</strong>fice.<br />
Fall Governing Body<br />
We had an exciting and very well attended Fall<br />
Governing Body meeting in San Antonio, TX. The<br />
Texas Indo <strong>American</strong> Physician Society SW<br />
Chapter (TIPS-SW) did a great job in organizing<br />
the event. The AAPI Charitable Foundation dinner<br />
generated $15,000.<br />
White House State Dinner<br />
I am honored that President Obama provided me<br />
with an opportunity to join 300 guests in welcoming<br />
Prime Minister Dr. Manmohan Singh. This was<br />
truly a memorable event recognizing the global<br />
presence <strong>of</strong> the world’s largest democracy.<br />
Reception in Honor <strong>of</strong> Prime Minister<br />
Dr. Manmohan Singh<br />
On November 25th, along with other AAPI<br />
members, I attended a reception in Washington,<br />
D.C. to honor <strong>Indian</strong> Prime Minister Dr.<br />
Manmohan Singh hosted by India’s Ambassador to<br />
the United States, Hon. Ambassador Meera<br />
Shankar.<br />
AAPI/AKMG Dubai Annual Convention<br />
and CME Program<br />
AAPI/AKMG Dubai CME meeting was well<br />
attended by over 600 physicians. The AKMG<br />
leaders were outstanding hosts and arranged<br />
excellent CME topics and speakers in addition to<br />
the gala dinner event cruise on New Year’s Eve.<br />
Vinod K. Shah, MD<br />
President<br />
AAPI Global Healthcare Summit -<br />
New Delhi, India<br />
AAPI Global Healthcare Summit was great a<br />
success and was well attended by physicians from<br />
around the world. The Summit shared the best<br />
practices and experience from leading experts around<br />
the world to develop actionable plans for launching<br />
demonstration projects with focus on prevention,<br />
treatment and management <strong>of</strong> priority disease states<br />
in India with define measurable metrics to ensure<br />
that action plans are economically viable.<br />
3C Conference in Ahmedabad<br />
Attended 3C Conference in Ahmedabad and gave<br />
a talk on “The Role <strong>of</strong> AAPI and US <strong>Physicians</strong> in<br />
Building the Bridge”.<br />
Spring Governing Body<br />
Meeting/Women’s Forum<br />
AAPI’s Spring Governing Body Meeting will be<br />
held in Washington, D.C. from April 17-18, 2010<br />
along with the Women’s Forum. AAPI delegates will<br />
have a private meeting with former President <strong>of</strong><br />
India Dr. Abdul Kalam.<br />
AAPI Convention 2010<br />
The 28th Annual AAPI Convention will be held<br />
at the Gaylord National Hotel and Convention<br />
Center from Wednesday through Sunday, June 23-<br />
27, 2010. Registration opened on Sunday, February<br />
28th. As we received several requests from our<br />
Continued on page 7<br />
6 www. aapiusa.org Winter 2010 AAPI Journal
President’s Report...continued<br />
Continued from page 6<br />
members, we introduced kick <strong>of</strong>f and advanced<br />
pricing for the initial 2 weeks.<br />
AAPI Bylaws<br />
AAPI Bylaws were extensively deliberated by the<br />
Bylaws Committee, Executive Committee, and<br />
approved unanimously at the Fall Governing Body<br />
meeting in San Antonio, TX. The changes <strong>of</strong> the<br />
Bylaws were mailed to the entire membership and<br />
the ballots were counted. I am pleased to inform you<br />
that 955 out <strong>of</strong> the 1,026 ballots that were returned<br />
showed unanimous approval <strong>of</strong> all changes<br />
presented. The new AAPI Bylaws will come into<br />
effect immediately.<br />
Opportunity for an existing Patron member<br />
to nominate a new Patron member<br />
The AAPI <strong>of</strong>fice has received 295 applications for<br />
the $100 Patron Nomination initiative. We are<br />
working on these applications and will present them<br />
to the Spring Governing Body for its final approval.<br />
I would like to express my gratitude for your<br />
friendship and trust and look forward to working<br />
with you in the coming years.<br />
Sincerely yours,<br />
Vinod K. Shah, MD, F.A.C.C.<br />
AAPI Executive Officers<br />
Vinod K. Shah, MD<br />
President<br />
Ajeet Singhvi, MD<br />
President Elect<br />
Sunita Kanumury, MD<br />
Vice President<br />
Narendra Kumar, MD<br />
Secretary<br />
Jayesh Shah, MD<br />
Treasurer<br />
Sanku Rao, MD<br />
Past President<br />
Sanat Gandhi, MD<br />
Chair, BOT<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
7
President-Elect’s Report<br />
As the President-Elect <strong>of</strong> the <strong>American</strong> <strong>Association</strong> <strong>of</strong><br />
<strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong> <strong>Origin</strong> (AAPI), it is my privilege to<br />
present the President-Elect’s report.<br />
Ajeet Singhvi, MD<br />
President Elect<br />
I would like to thank the Constitution & Bylaws<br />
committee, for having deliberated and gone through the<br />
Bylaws extensively this year. The committee members are<br />
as follows:<br />
Advisors: Drs. S. Jay Jayasankar, MA & Krishan K.<br />
Aggarwal, WV<br />
Members: Drs. Madhu Aggarwal, WV Anuj Chandra,<br />
TN, Ashok Fulambarker, IL, Ashok Jain, MI, Narinder<br />
Kukar, NY, Arun Narang, IL, Nidhi Mehta, NV,<br />
Rajendra Mehta, NY, Jyotin Patel, CA, Velugubanti<br />
Prasadarao, VA, Manju Sachdev, TX, Lalit Savla, MA,<br />
Harnath Singh, AZ, Jawahar Tank, FL, Ram Upadhyay,<br />
MA, Priya Kundra, MD, Mamta Singhvi, CA<br />
We are working to update the Convention Manual<br />
which has been a guide for the convention committees for<br />
smooth execution <strong>of</strong> AAPI Conventions. In view <strong>of</strong> the<br />
fast evolving technology, a lot <strong>of</strong> information in the<br />
manual has become outdated. Lessons learned from past<br />
conventions also need to be incorporated. Senior leaders<br />
<strong>of</strong> AAPI have been devoting their valuable time in<br />
assisting us in this project.<br />
Since this year I did not need to spend time in<br />
campaigning for the AAPI elections which incidentally<br />
takes a lot <strong>of</strong> Officers’ time, I have had time at hand to<br />
help our President, Dr. Vinod Shah, Board <strong>of</strong> Trustee’s<br />
Chairman, Dr. Sanat Gandhi, Vice President, Dr. Sunita<br />
Kanumury, Secretary, Dr. Narendra Kumar,Treasurer, Dr.<br />
Jayesh Shah and various Committee Chairs in whatever<br />
capacity they have needed my help.<br />
Many members are willing to serve our organization in<br />
various committees. Please call me or the AAPI <strong>of</strong>fice at<br />
630-990-2277 and let us know if you would like to serve<br />
on any <strong>of</strong> next year’s Standing or Ad Hoc Committees.<br />
We are also planning a calendar <strong>of</strong> events for the year<br />
2010-2011. Please call us for any suggestions. We request<br />
you to join us in as many AAPI sponsored programs as<br />
possible.The 29th Annual AAPI Convention will be held<br />
in New York City from June 22-26, 2011 at The Hilton<br />
Hotel, at Avenue <strong>of</strong> Americas. The previous Convention<br />
held in New York City was in the year 2000.<br />
Vijaya and Sam have been very efficient and have been<br />
working tirelessly to catch-up with the extra work.<br />
Telephone calls are being personally answered and<br />
individual logs <strong>of</strong> outgoing and incoming calls are being<br />
kept. Any complaints or grief <strong>of</strong> AAPI members or<br />
vendors should be referred to an <strong>of</strong>ficer for swift<br />
resolution.<br />
I hope to see some you at the AAPI Governing Body<br />
meeting in April and many <strong>of</strong> you in Washington, D.C.<br />
for the 28th Annual AAPI Convention. The Convention<br />
committee under the leadership <strong>of</strong> Dr. Nayan Shah is<br />
planning a very good event and I you to join us for what<br />
will undoubtedly be a memorable event.<br />
I have been fortunate to have the full support and<br />
confidence <strong>of</strong> the Executive Committee, which has made<br />
my job easy and pleasurable. It has been my honor in<br />
serving the AAPI membership as your Treasurer,<br />
Secretary, Vice President and President-Elect.<br />
I will be happy to receive and respond to your<br />
comments.<br />
Respectfully Submitted,<br />
Ajeet R. Singhvi, M.D., F.A.C.G<br />
President-Elect, AAPI<br />
O: 951-929-0124<br />
H: 951-927-7177<br />
asinghvi@aol.com<br />
8 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
9
Vice-President’s Report<br />
Dear Colleagues,<br />
Thank you for supporting me and I am honored<br />
to serve as your Vice President in 2009-2010. In my<br />
90-day report, I had chalked out my agenda for my<br />
Year and I now present you my Semi Annual<br />
Report.<br />
Continuing on my Mantra about sound<br />
Membership, I am crediting my success to the<br />
concept <strong>of</strong> TEAM WORK.<br />
Having participated with the day to day workings<br />
<strong>of</strong> AAPI, I have attended The Governing Body<br />
Meeting, Indo-US Healthcare Summit and other<br />
AAPI related activities I have worked on towards<br />
membership issues.<br />
Membership Numbers as<br />
<strong>of</strong> February 28, 2010<br />
Chapter Patron Member – Three<br />
- <strong>American</strong> <strong>Association</strong> for Emergency<br />
Medicine in India (AAEMI)<br />
- Georgia <strong>Association</strong> <strong>of</strong> <strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong><br />
<strong>Origin</strong> (GAPI)<br />
- Knoxville Region <strong>of</strong> <strong>Indian</strong> <strong>Physicians</strong><br />
<strong>Association</strong> (KRIPA)<br />
Sunita Kanumury, MD<br />
Vice President<br />
Reaching out to Membership<br />
I executed an initiative to vet Young <strong>Physicians</strong> to<br />
be Patron Members <strong>of</strong> AAPI by Launching “AAPI<br />
CONNECTS! Enhance Your Pr<strong>of</strong>ession, Advance<br />
Your Career, and Enrich Your Community...........”<br />
My Membership Strategies, Database and<br />
Program Execution Teams have helped me perform<br />
with distinction in reaching out to Members. I<br />
brought awareness with a potential to grow the<br />
number <strong>of</strong> members by personally traveling to more<br />
than 18 events held by Local Chapters and Alumni<br />
Organizations across United States.<br />
We have designed an initiative to <strong>of</strong>fer dual<br />
membership to members <strong>of</strong> Sister Organizations.<br />
This initiative was on the floor <strong>of</strong> the Governing<br />
Body in the Fall but was put for further discussion<br />
Continued on page 11<br />
*Annual members from July 1, 2008 to June 15, 2009<br />
As <strong>of</strong> June 15, 2009 As <strong>of</strong> February 28, 2010<br />
From June 16 to<br />
February 28, 2010<br />
Patron – Life member 6583 6631 48<br />
MSRF – Our Future 7439 7888 449<br />
YPS – Our Youth 94 127 33<br />
Annual – Our Strength 157* 199 42<br />
Total 14273 14845 572<br />
10 www. aapiusa.org Winter 2010 AAPI Journal
Vice-President’s Report...continued<br />
Continued from page 10<br />
in the Spring Governing Body <strong>of</strong> 2010. I have been<br />
working with the local chapter committees to come<br />
forward with proposals so that our committee can<br />
review the needs <strong>of</strong> our members before discussion<br />
and being formalized into a bylaw in future.<br />
My journey across America has helped me<br />
understand the concerns and challenges AAPI faces<br />
as an organization. As a result I have come across<br />
many physicians who excel in their work,<br />
community and charitable activities.<br />
I have requested many to participate in National<br />
AAPI events and have tried to showcase their<br />
activities on the AAPI website to inspire and help<br />
our members and younger physicians.<br />
Marketing and Promoting AAPI:<br />
To increase awareness about National AAPI<br />
issues, AAPI marketing materials and slides that are<br />
more informative and attractive have been<br />
distributed to chapter members in areas that I have<br />
traveled.<br />
The continuously monitored and updated AAPI<br />
website is a result <strong>of</strong> successful coordination<br />
between various committees in AAPI.<br />
Database Correction:<br />
My Vice Presidency had its Challenges which<br />
still remain when it come to the fact that significant<br />
portion <strong>of</strong> addresses and emails in our database are<br />
incorrect. I continue to strive to get this done and I<br />
am hopeful that my successor will do the same. I<br />
request all members to visit our new interactive<br />
website www.aapiusa.org to update their contact<br />
details. Our committee is working on a short term<br />
and long term plan on correcting the database.<br />
In the short term with the help <strong>of</strong> couple <strong>of</strong> my<br />
committee members and AAPI personnel we were<br />
able to correct about 500 addresses and some<br />
duplicates as <strong>of</strong> date and the process is ongoing.<br />
In the long term with the help <strong>of</strong> committee<br />
members and IT committee, working to come up<br />
with a plan to develop local chapter websites and<br />
integrate local chapter database with the National<br />
database, so that we can maintain accuracy. Working<br />
towards electronic database.<br />
I request all members to participate in AAPI.<br />
They can take pride in participating in an<br />
organization that can speak out on the issues<br />
affecting the field <strong>of</strong> medicine in communities<br />
nationwide. Join us and add your voice to ours on<br />
behalf <strong>of</strong> the future we will share.<br />
Please contact me at anytime, all the time.<br />
I am your Vice President and I am here to serve.<br />
Sincerely,<br />
Sunita Kanumury, M.D.<br />
Vice President, AAPI<br />
Chairperson, AAPI Membership Committee<br />
Office: 973-627-1000<br />
Email: sunitakanumury@yahoo.com<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
11
Treasurer’s Report<br />
It is my privilege and honor to serve you as your<br />
Treasurer and I am happy to provide you with the<br />
updated financial status <strong>of</strong> our organization. I have<br />
done everything I could do to keep close tabs on<br />
expenses. The financial activities are monitored<br />
closely at the AAPI National Executive Office by<br />
a weekly teleconference with the AAPI <strong>of</strong>fice and<br />
Dr. Vinod Shah, and a monthly Treasurer’s Report<br />
is sent to the entire Executive Committee before<br />
scheduled teleconferences.<br />
• As Chair <strong>of</strong> the AAPI Resource Committee, I<br />
was able to secure funds to keep the AAPI<br />
Journal budget neutral.<br />
Jayesh Shah, MD<br />
Treasurer<br />
• A detailed Treasurer’s report was presented at<br />
the Governing Body Meeting in San Antonio in<br />
October and I look forward to presenting an<br />
updated report at the Washington, D.C.<br />
Governing Body Meeting.<br />
• This year, in order to bring consistency and to<br />
consolidate our financial positions, the YPS,<br />
MSRF, and AAPI convention account holders<br />
were requested to bring their accounts to the<br />
AAPI central <strong>of</strong>fice.<br />
This year, besides keeping tabs on expenses and<br />
keeping books in order, I actively worked to:<br />
1. Increase involvement <strong>of</strong> young physicians and<br />
enhance their participation at all levels <strong>of</strong><br />
Cash Balances as <strong>of</strong> February 28, 2010<br />
Expenses<br />
Operating Account $368,548.13 Bank Fees $2,156<br />
Healthcare Summit Account $9,169.64 Computer Related $17,450<br />
Women’s Forum Account $2,768.72 Condo Fee $4,739<br />
AAPI YPS Account $8,071.00 Office/Other Expenses $12,338<br />
AAPI MSRF Account $2,485.00 Storage $1,680<br />
AAPI ACCME Account $16,010.00 Legislative Director $23,000<br />
Washington DC Convention Account $993.04 Real Estate Taxes $1,727<br />
Orlando Convention Account $5,033.19 Postage $4,193<br />
Income Printing $52,486<br />
Orlando Convention Income $221,868 Salaries/Benefits $114,318<br />
Patron 5% $112,899 Travel $8,559<br />
Sponsorships $178,000 Audit $4,800<br />
Journal Ads $61,500 Insurance $3,133<br />
Membership Dues $6,850 Governing Body $2,607<br />
Election Nomination Fee $7,500 Legislative Expenses $2,584<br />
Royalties $4,027 YPS/MSRF Support $5,000<br />
AAPI CME $1,231 Texas A&M $35,000<br />
Website Ads $900 Media $7,500<br />
Miscellaneous $198<br />
Continued on page 13<br />
12 www. aapiusa.org Winter 2010 AAPI Journal
Treasurer’s Report...continued<br />
Continued from page 12<br />
AAPI. With the help <strong>of</strong> Dr. Vinod Shah,<br />
President, we were able to secure a grant to do a<br />
leadership and YPS conference for young<br />
physicians throughout the country.<br />
2. Develop and expand externship programs in<br />
the U.S. As the AAPI liaison <strong>of</strong>ficer for the<br />
Observership Committee, we have opened up an<br />
Observership Co-coordinator Position, which is<br />
an Internship position for a physician awaiting<br />
residency. At the main <strong>of</strong>fice, this physician will<br />
be responsible for coordinating matching<br />
observers with proctors.<br />
3. Strengthen the base <strong>of</strong> AAPI by empowering<br />
local chapters. As your representative, I<br />
attended a Chirag Fundraiser at Cleveland, an<br />
AKMG meeting in Chicago, an IMA meeting<br />
in Southern California, a MAPI meeting in<br />
Michigan, and a Queens and Long Island<br />
annual meeting.<br />
4. Further the goal to improve quality <strong>of</strong> healthcare<br />
in India. With the help <strong>of</strong> TIPS SW Chapter, a<br />
fund raiser event for the AAPI Charitable<br />
Foundation was organized and $20,000 was<br />
donated to the AAPI Charitable Foundation.<br />
Actively participated in the Global Healthcare<br />
Summit and worked on pocket cards for diabetes,<br />
which were distributed locally in India.<br />
5. Closely work with organized medicine at state,<br />
national and subspecialty levels. I will remain the<br />
AAPI liaison to AMA and will continue to<br />
advocate on behalf <strong>of</strong> IMG’s and other physicians.<br />
While concluding, I want to thank you for<br />
electing me as your next Secretary. I am humbled<br />
with your confidence in my abilities to bring this<br />
great organization to greater heights.<br />
With kind regards,<br />
Jayesh Shah, MD<br />
Treasurer, AAPI<br />
1st & Business Class Airline Tickets<br />
SAVE UP TO 70% OFF<br />
India, Europe, Middle East,<br />
Africa, Canada & USA<br />
DELHI - $3695, BOMBAY - $3795<br />
MADRAS - $3995<br />
• All Major Airlines<br />
• Guaranteed Reservations<br />
• No Restrictions<br />
• 15 Years Experience<br />
No Economy<br />
1-877-744-8444<br />
Class Ticket Please!<br />
Serious<br />
Inquiries Only<br />
www.firstclasstickets.com • info@firstclasstickets.com<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
13
Secretary’s Report<br />
It has been a distinct pleasure working as your<br />
Secretary under the able leadership <strong>of</strong> our President<br />
Dr. Vinod K. Shah, President-Elect Dr. Ajeet<br />
Singhvi, BOT chair Dr. Sanat Gandhi and the entire<br />
Executive Committee. We all have been working<br />
together for the good <strong>of</strong> our organization, although at<br />
times we have to respectfully disagree on certain<br />
major decisions. It has been a humbling and learning<br />
experience for me to be your Treasurer and Secretary.<br />
As Secretary, I have tried to fulfill my duties to the<br />
best <strong>of</strong> my ability in keeping the AAPI <strong>of</strong>fice and our<br />
records in proper order. Our <strong>of</strong>fice staff Vijaya Kodali<br />
and Sam Fulambarker are doing a fantastic job and<br />
they are truly committed and devoted to our<br />
organization. We are in the process <strong>of</strong> filling a<br />
temporary <strong>of</strong>fice staff position during the busy<br />
Convention season. Hopefully one <strong>of</strong> these days we<br />
may be able to fulfill our goal <strong>of</strong> finding an Executive<br />
Director for our AAPI <strong>of</strong>fice. We are keeping proper<br />
records <strong>of</strong> all Executive Committee minutes,<br />
Governing Body minutes and General Body<br />
minutes. We also keep copies <strong>of</strong> all major contract<br />
negotiations. Our tax returns and Convention<br />
financial reports are up to date. We have been<br />
constantly trying to update our database and need<br />
Narendra Kumar, MD<br />
Secretary<br />
your continued help in this matter. With the<br />
changing times, we also have tried to upgrade and<br />
update our AAPI web site. In preparation for the<br />
2010 election, I have certified the voters list and the<br />
ballots. I am closely working with Dr. Vinod Shah<br />
and Dr. Nayan Shah (Convention Chair) on all<br />
matters relating to 2010 Spring Governing Body<br />
Meeting and Annual Convention. Hope to see you<br />
all in our Nation's Capitol.<br />
Thank you once again for your continued<br />
confidence and giving me another opportunity to<br />
serve as your next Vice President.<br />
Respectfully Submitted,<br />
Narendra R. Kumar, M.D.<br />
AAPI Secretary<br />
Board <strong>of</strong> Trustees Report<br />
Thanks to improving the stock market. Trust<br />
account has done well.<br />
Our Trust account is managed by Glad Kurian and<br />
Kamesh Nagarajan <strong>of</strong> Smith Barney. Our exposure to<br />
the stock market is about 48%, with about 10% in<br />
Gold and rest in the fixed income. Our total net<br />
stands at $2,406,241.46 as <strong>of</strong> February 28, 2010.<br />
Let us hope the stock market remains in a recovery<br />
phase.<br />
Sanat Gandhi, MD<br />
Chair, BOT<br />
Respectfully submitted,<br />
Sanat Gandhi, MD<br />
Chairman<br />
AAPI Board <strong>of</strong> Trustees<br />
14 www. aapiusa.org Winter 2010 AAPI Journal
MSRF: Year to Date<br />
by Chirag Parghi, MD<br />
The AAPI-MSRF (Medical Student, Resident,<br />
Fellow) section has had a busy year with a focus on<br />
increasing awareness nationwide. We have hosted<br />
charity networking socials in eight cities aimed at<br />
mobilizing <strong>Indian</strong> physicians in training.<br />
Contributions have been used towards earthquake<br />
relief in Haiti, building schools in India, and even<br />
funding charitable cataract surgeries in rural India.<br />
By linking our social and pr<strong>of</strong>essional networking<br />
ability with these wonderful causes, we have been<br />
able to make a difference. This is an initiative that I<br />
am quite proud <strong>of</strong> and would like to see grow in the<br />
years to come as we have limitless ability to unite<br />
towards charitable endeavors.<br />
As this year’s match day approaches, another<br />
round <strong>of</strong> applicants will soon discover if and where<br />
they will be training. This application process is quite<br />
rigorous and <strong>of</strong>ten is controlled by random<br />
circumstances such as personal contacts or through a<br />
lucky meeting. Meeting a single advocate in your<br />
field can be the single-most important factor in<br />
securing a residency spot, or a desired residency<br />
position. In order to facilitate these encounters,<br />
MSRF has created a national database <strong>of</strong> our<br />
membership that can be sorted by specialty and<br />
location. Our members are already using it to get<br />
sage advice or find mentors in the different<br />
specialties. Career advancement in our stage <strong>of</strong> the<br />
game is a difficult process in medicine with its own<br />
rules; we <strong>of</strong>fer our membership to help with this<br />
process.<br />
Lastly, I would like to encourage all <strong>of</strong> you to<br />
come to our annual convention in Washington, DC<br />
from June 23rd to 27th. My board and I have been<br />
enthusiastically planning what I am sure will be the<br />
most memorable MSRF convention to date. We<br />
have exciting daytime events including a research<br />
contest among our general membership, elegant<br />
evening galas utilizing the rich canvas <strong>of</strong> Washington<br />
DC, and a signature political twist that could only be<br />
done in our nations capital. Please check your<br />
calendars and register at www.aapiconvention.com.<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
15
NRIs and Globalization<br />
A Non-Resident <strong>Indian</strong>’s Thoughts on Effects <strong>of</strong> Globalization and<br />
Market Economy on Medicine and Health Care<br />
The following is the summary <strong>of</strong> the invited talk<br />
given before the AP Medical and Dental College’s<br />
Management <strong>Association</strong> during the Platinum<br />
Jubilee Celebrations <strong>of</strong> the Medical Council <strong>of</strong> India<br />
at Hyderabad in December 2008.<br />
The benefits <strong>of</strong> globalization are potentially<br />
enormous and include increased sharing <strong>of</strong>:<br />
• Ideas and cultures<br />
• Lifesaving technologies<br />
• New infrastructures<br />
• Resources to breach disparities and lessen threat<br />
Yet, according to the United Nations Development<br />
Program, over the past 30 years, the gap in per capita<br />
income between wealthy and poor nations has tripled.<br />
More than 1.2 billion <strong>of</strong> the world’s people live on<br />
less than one dollar a day. Life expectancy in the 48<br />
least developed countries is just 51 years, and the<br />
infant mortality rate (IMR) averages 100/1000.<br />
WHEN ANYONE SNEEZES, EVERYONE<br />
CATCHES COLD – gist <strong>of</strong> globalization.<br />
One <strong>of</strong> the most predictable accompaniments to<br />
globalization is the emergence <strong>of</strong> new diseases and the<br />
re-emergence <strong>of</strong> old ones. In 1865, it took 365 days to<br />
circumnavigate the globe—now it takes 36 hours.<br />
Disease also migrates. The share <strong>of</strong> TB cases in the<br />
US’s foreign-born population increased from 30% <strong>of</strong><br />
all US TB cases in 1992, to 46% in 2000.<br />
The share <strong>of</strong> multi-drug resistant cases occurring in<br />
the foreign-born US population increased from 31%<br />
to 72%.<br />
Four Globalization Gaps:<br />
1. Research 10/90<br />
2. Pharmaceutical research and development (R&D)<br />
for neglected diseases<br />
3. Internet<br />
4. Gender<br />
1. Research 10/90 gap<br />
Research 10/90 is a term that illustrates the fact<br />
that only 10% <strong>of</strong> the biomedical research funding is<br />
targeted to the diseases that account for 90% <strong>of</strong> the<br />
global burden <strong>of</strong> disease.<br />
According to the Commission on Macroeconomics<br />
and Health, at least $3 billion /year should be<br />
allocated to the R & D <strong>of</strong> the health priorities <strong>of</strong> the<br />
poor. Half <strong>of</strong> this $3 billion is proposed to go to a<br />
newly created international version <strong>of</strong> the National<br />
Institutes <strong>of</strong> Health (NIH), called the Global Health<br />
Research Fund.<br />
Yet the entire budget <strong>of</strong> tropical disease research at<br />
the World Health Organization (WHO) directed at<br />
the 8 major tropical diseases is only $30 Million.<br />
It is estimated that worldwide, countries annually<br />
spend more than $800 Billion on weapons and<br />
military resources.<br />
What India can do to reduce the 10/90 gap<br />
History has shown that excellent scientific research<br />
has not always translated into solutions.<br />
The stunning discoveries <strong>of</strong> the causes and<br />
treatment <strong>of</strong> tuberculosis and malaria have resulted in<br />
three Nobel Prizes but had not translated into general<br />
accessibility for the global populations.<br />
Continued on page 17<br />
16 www. aapiusa.org Winter 2010 AAPI Journal
NRIs and Globalization...continued<br />
Continued from page 16<br />
50 years later the incidence <strong>of</strong> tuberculosis is still at<br />
eight million cases per year—and it kills two million<br />
annually.<br />
The story <strong>of</strong> yellow fever is equally sad.<br />
Clinicians and researchers <strong>of</strong> India who can stand<br />
in the interface between the laboratory bench and<br />
global public health issues are vital to this process.<br />
2. Pharmaceutical R&D Gap<br />
The small part <strong>of</strong> the globe accounting for 15% <strong>of</strong><br />
the earth’s population provides nearly all <strong>of</strong> the world’s<br />
technology innovation. North America, Europe, and<br />
Japan accounted for 80% <strong>of</strong> the world pharmaceutical<br />
markets in 2002 (total value $406 billion), while<br />
Africa, Asia, Latin America, and the Middle East<br />
accounted for 20% <strong>of</strong> the market, despite representing<br />
80% <strong>of</strong> the world population.<br />
Even when effective drugs are available, patent<br />
protection and WTO agreements on trade-related<br />
aspects <strong>of</strong> intellectual property rights (TRIPS) can<br />
hinder availability <strong>of</strong> drugs to those with the most<br />
need.<br />
3. Globalization and the Internet Gap<br />
The past two decades have seen dramatic advances<br />
in independent media and global communication<br />
with the dramatic expansion <strong>of</strong> the internet. It has<br />
been the internet that <strong>of</strong>fers the most potential for<br />
scientific exchanges and unfettered management <strong>of</strong><br />
scientific data.<br />
There is enormous internet gap between rich and<br />
poor countries.<br />
4. Gender Gap<br />
Recent studies <strong>of</strong> malaria have demonstrated that<br />
biological immunity is compromised in pregnancy<br />
and in the early post partum period. A recent study in<br />
Nigeria showed that the prevalence <strong>of</strong> Schistosomiasis<br />
in girls is highest at the age <strong>of</strong> 15, when they are most<br />
likely to be involved in domestic work that involves<br />
water.<br />
Access to hospitalization and drugs for tropical<br />
diseases <strong>of</strong>ten is limited to the male child in some<br />
developing countries.<br />
India and the Globalized World<br />
India can contribute greatly in the globalization <strong>of</strong><br />
medicine. There should be some ground rules which<br />
nurture the positive aspects <strong>of</strong> globalization.<br />
1. Integrity <strong>of</strong> big corporations and government<br />
2. Effective and efficient legal system<br />
3. Regulation and supervision (quality control)<br />
India is in a unique position with it multitudes <strong>of</strong><br />
educated people. It can excel in implementing and<br />
improving health delivery systems by telemedicine.<br />
As Nani Palkhivala said in his book “We the People”<br />
(in 1977) – if we “stop being foolish collectively in spite<br />
<strong>of</strong> being highly intelligent individually” the educated<br />
throngs can accomplish a world <strong>of</strong> good.<br />
"Money is not the measure <strong>of</strong> man, but it is <strong>of</strong>ten<br />
the means <strong>of</strong> finding out how small he is."<br />
~ Disraeli<br />
VK Raju, M.D., F.R.C.S., F.A.C.S.<br />
3140 Collins Ferry Road<br />
Morgantown, West Virginia 26505<br />
vkr@vkraju.com<br />
www.eyefoundation<strong>of</strong>america.org<br />
www.goutami.org<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
17
To analyze and comprehend progress we must<br />
understand and establish the process <strong>of</strong> measuring<br />
progress. I believe that we <strong>of</strong>ten confuse change with<br />
progress simply because we fail to understand the<br />
difference between the two entities.<br />
In the past thirty–nine years I have attended a fair<br />
share <strong>of</strong> medical meetings and heard as many<br />
presidential addresses exalting progress made in their<br />
term in <strong>of</strong>fice. Initially such notations were what I<br />
wanted to hear, even though far from reality, as it gave<br />
me a sense <strong>of</strong> identity in a country where I was<br />
searching for my own identity. As I have matured my<br />
ability to differentiate reality from gloss, my sense <strong>of</strong><br />
identity comes from within myself rather than from<br />
the collective that I associate with. Has that made me<br />
cynical? I believe not but a hair more, a realist.<br />
Webster’s dictionary defines “change” as “to<br />
become transformed or different.” Change therefore<br />
covers a wide spectrum <strong>of</strong> entities between good at<br />
one end and bad at the other end. “Progress” on the<br />
other hand is defined as, “the development <strong>of</strong> an<br />
individual or group in a direction considered more<br />
beneficial than and superior to the previous level”. To<br />
be able to establish that a group has benefited or<br />
established superiority we must have a measure for<br />
progress that is reproducible and verifiable even<br />
though progress has abstract dimensions. The famous<br />
wartime British Prime Minister was asked, “How is<br />
your wife?” And he responded, “Compared to whom?”<br />
Similarity, to measure progress we must have a<br />
measure <strong>of</strong> the present and an ability to extrapolate<br />
the future.<br />
To illustrate by example, a drop in membership <strong>of</strong><br />
an organization even though denotes a change it<br />
cannot be slated as progress. Gandhijee with his “quit<br />
India” movement made a remarkable and lasting<br />
change in the status quo that was undeniably a<br />
progress as it was superior and beneficial to all<br />
<strong>Indian</strong>s.<br />
Process <strong>of</strong> Progress<br />
Onaly A. Kapasi, MD<br />
New England AAPI Rep.<br />
Now that we have established the difference<br />
between change and progress we have to establish a<br />
verifiable and reproducible criteria to measure<br />
progress. I have observed progress measured either<br />
qualitatively or quantitatively or a combination <strong>of</strong> the<br />
two.<br />
A qualitative measure <strong>of</strong> progress has a built in<br />
personal bias and may not be reproducible. It may<br />
also be marred by personal state <strong>of</strong> the observer. Each<br />
year we hear anecdotal individual assertions <strong>of</strong><br />
progress <strong>of</strong> a group or association. Conversely, when<br />
viewed objectively a decline in membership numbers,<br />
and a precarious financial structure may become<br />
apparent. Therefore I believe that a qualitative<br />
measure cannot truly depict progress.<br />
Quantitative measure on the other hand uses<br />
verifiable and reproducible criteria to measure<br />
progress. A quantitative analysis <strong>of</strong> a group or<br />
association removes personal bias to a great extent.<br />
Of course there is a remote possibility <strong>of</strong> people<br />
fudging and manipulating data to edify their term in<br />
<strong>of</strong>fice. I have suggested some basic parameters that<br />
may be utilized to measure progress <strong>of</strong> a group or an<br />
association. Other parameters may be added as the<br />
process matures. Let us look into each <strong>of</strong> the<br />
suggested parameters in detail.<br />
Continued on page 20<br />
18<br />
www. aapiusa.org Winter 2010 AAPI Journal
A N E XCLUSIVE O PPORTUNITY<br />
FOR M EDICAL P ROFESSIONALS<br />
B EARA C APITAL SPECIALIZES IN PROVIDING<br />
INNOVATIVE FINANCING SOLUTIONS AND<br />
UNBEATABLE PRICING FOR MEDICAL<br />
I invite you to set up an appointment to<br />
learn more about the many ways I can be<br />
<strong>of</strong> help to you and your growing business.<br />
PROFESSIONALS LIKE YOURSELF. WE CAN<br />
HELP YOU SAVE MILLIONS OF DOLLARS<br />
IN DEBT REPAYMENTS AND TAKE CASH<br />
OUT OF YOUR PROPERTIES THROUGH OUR<br />
WALL S TREET DIRECT PRICING MODELS<br />
My direct line is<br />
401-641-1190<br />
Sincerely,<br />
Dev Singh<br />
AND SOPHISTICATED DEAL STRUCTURES.<br />
www.bearacapital.com<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
19
Process <strong>of</strong> Progress...continued<br />
Continued from page 18<br />
Membership<br />
The number <strong>of</strong> active members and a crosssectional<br />
diversity is a good measure <strong>of</strong> the continued<br />
viability <strong>of</strong> any group or association. Member<br />
satisfaction is also very important and year after year<br />
loyalty greatly signifies satisfaction. An increase in<br />
membership <strong>of</strong> a group or an association is a fair<br />
measure <strong>of</strong> the continued participation, need and<br />
interest <strong>of</strong> the group or association. Member loyalty<br />
is multifactorial. Mostly it is related to the net returns<br />
that the member derives from the association, which<br />
may be camaraderie, need for continuing medical<br />
education, political clout, participation in charitable<br />
projects within the country or outside, and other<br />
tangible and non-tangible gains derived from<br />
collective bargaining power <strong>of</strong> the group and an<br />
additional draw <strong>of</strong> meeting like minded people with<br />
similar goals and aspirations.<br />
Financial Viability<br />
In the bygone days the medical industry assisted in<br />
financing medical conferences, continued medical<br />
education activities and some other nonmedical<br />
activities. However with the advent <strong>of</strong> stringent<br />
regulations both state and local and multiple lawsuits<br />
filed against the medical industry that venue has<br />
dwindled away. Therefore the financial viability <strong>of</strong> a<br />
group or association is now directly contingent on its<br />
collections from its membership dues. Obviously a<br />
financially sound association or group has the<br />
advantage and the potential <strong>of</strong> achieving its<br />
charitable goals and initiating programs to improve<br />
membership participation and satisfaction. In the<br />
present scenario where many associations are trying<br />
their best to get a share <strong>of</strong> the pie providing<br />
membership benefits is an added incentive. Ethnic<br />
organizations uniquely bring like-minded people<br />
together to share their values and exchange ideas. A<br />
home away from home concept. For the young<br />
physicians additionally it may be a venue to meet and<br />
interact with their ethnic counterparts.<br />
Charitable and Educational Goals<br />
Medical associations are known for their charitable<br />
and educational projects as physicians share a<br />
compelling need to foster charitable projects. It is<br />
part and parcel <strong>of</strong> our culture <strong>of</strong> global giving. The<br />
association’s progress may therefore be measured by<br />
its attainment <strong>of</strong> charitable goals. Most ethnic<br />
organizations contribute extensively to alleviate<br />
healthcare conditions within the country <strong>of</strong> their<br />
origin and also in the U.S. Most <strong>of</strong> our continued<br />
medical education requirements are easily fulfilled<br />
with our attendance <strong>of</strong> specialty conferences and<br />
hospital grand rounds however funding <strong>of</strong> research in<br />
diseases prevalent in the ethnic socioeconomic group<br />
and its medical education is a definite draw as seen<br />
with our continued interest in CADI and diabetes<br />
mellitus studies.<br />
I used some <strong>of</strong> the parameters mentioned above to<br />
reflect the performance <strong>of</strong> a small ethnic medical<br />
organization that was in the doldrums in the the<br />
years 2002-2003 and to help revitalize it.<br />
The bar graph <strong>of</strong> the year-end financial balances<br />
from 2000 to 2003 clearly illustrates a dismal future<br />
Ending balances from yrs. 2000-2003<br />
Continued on page 21<br />
20 www. aapiusa.org Winter 2010 AAPI Journal
Process <strong>of</strong> Progress...continued<br />
Continued from page 20<br />
for the organization. The analysis helped the 2004<br />
executive committee to tighten its shoestrings, and to<br />
explore alternative financing and to work relentlessly<br />
to replenish its c<strong>of</strong>fers without compromising the<br />
quality <strong>of</strong> its meetings. Quantifying performance<br />
helped strategize future performance <strong>of</strong> the said<br />
organization, which managed to rebound in 2004<br />
leaving behind a financially secure association.<br />
members. Not discounting the fact that life<br />
membership was an expression <strong>of</strong> continued loyalty<br />
and a sense <strong>of</strong> belonging therefore looked with that<br />
perspective during data compilation.<br />
Increase in membership<br />
Seven-fold increase in CME<br />
During the year 2004 the organization managed to<br />
increase its CME activity seven folds as seen in the<br />
comparative pie chart. Each CME activity was<br />
planned and structured to be financially independent.<br />
Audience targeted CME programs brought in<br />
prospective new members and left surplus balance to<br />
finance other activities such as free clinics, free<br />
vaccination projects and also finance local health<br />
fairs. The apparent belief that less was more was<br />
dispelled by the reciprocal financial growth <strong>of</strong> the<br />
group.<br />
Realizing the fact that active yearly membership<br />
was a lifeline for the organization as active<br />
membership fee was recurring each year as opposed<br />
to life membership that was a one-time commitment<br />
the group made an effort to draw in active yearly<br />
In summary a comparative analysis that quantifies<br />
the performance <strong>of</strong> an organization may <strong>of</strong>fer a means<br />
<strong>of</strong> measuring its performance in a verifiable and<br />
reproducible manner that is credible. It may give the<br />
Chief Executive Officer a means <strong>of</strong> substantiating<br />
his/her claim for success and <strong>of</strong>fer direction and<br />
foresight to an incoming executive committee.<br />
I believe that photo opportunities are generally<br />
great as they give additional gloss and it also looks<br />
good in scrapbooks and periodicals and it may also<br />
help with establishing a public image but a<br />
meaningful true measure <strong>of</strong> performance can only be<br />
derived from substantiating performance utilizing<br />
verifiable and reproducible quantitative data.<br />
Onaly A. Kapasi, MD, FAAOS<br />
Boston, MA<br />
New England AAPI Rep.<br />
www. MassOrtho.com<br />
www.orthodoc.aaos.org/KapasiAssociates<br />
email: arthroscopy@live.com<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
21
Global Healthcare Summit – New Delhi, India<br />
The <strong>American</strong> Associate <strong>of</strong> <strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong><br />
<strong>Origin</strong> (AAPI) was proud to host a Global Healthcare<br />
Summit at Modia Sheraton Hotel in New Delhi. The<br />
summit was a great success and was well attended by<br />
physicians from from Great Britain, Canada, Saudi<br />
Arabia, Australia, New Zealand, India, and all around<br />
the world.<br />
AAPI teamed up with British <strong>Association</strong> <strong>of</strong><br />
<strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong> <strong>Origin</strong> (BAPIO) and top-notch<br />
<strong>Indian</strong> Medical Pr<strong>of</strong>essional <strong>Association</strong>s: <strong>Indian</strong><br />
Medical <strong>Association</strong> (IMA), AmeriCares India,<br />
Federation <strong>of</strong> Obstetric & Gynecological Societies <strong>of</strong><br />
India (FOGSI), <strong>Indian</strong> Academy <strong>of</strong> Pediatrics (IAP),<br />
<strong>Association</strong> <strong>of</strong> Surgeons <strong>of</strong> India (ASI), <strong>Indian</strong> Society<br />
<strong>of</strong> Medical and Pediatric Oncology (ISMPO) ICON<br />
and Urogynacology and Reconstructive Pelvic Surgery<br />
Society <strong>of</strong> India to make it truly a global summit.<br />
Healthcare companies like Johnson & Johnson and<br />
Pfizer are the global sponsors for the summit.<br />
It was our pleasure to have Union Minister <strong>of</strong> State<br />
for Health and Family Welfare, Honorable Dinesh<br />
Trivedi, to give the summit inaugural address.<br />
The Summit brought together some <strong>of</strong> the world's<br />
most renowned experts to focus on priority disease states<br />
such as Allergy & Immunology, Cardiovascular Disease,<br />
Diabetes, Infectious Diseases (HIV/AIDS), Emergency<br />
Medicine, Mental Health and Maternal & Child<br />
Health. For the first time in this 3rd Summit, we<br />
introduced four new tracks that are necessary elements<br />
<strong>of</strong> 21st century medicine; Applications <strong>of</strong> Health<br />
Information Technology, Innovative Surgical<br />
Techniques in Healthcare and The Growing<br />
Engagement <strong>of</strong> Consumers, Oncology, and Medical<br />
Tourism. This year's summit had a wider global<br />
perspective with the addition <strong>of</strong> Medical Tourism and<br />
Health Information Technology.<br />
The summit shared best practices and experiences<br />
from the leading experts from around the world to<br />
develop actionable plans for launching demonstration<br />
projects with focus on prevention, treatment, and<br />
management <strong>of</strong> priority<br />
disease states in India with<br />
defined measurable metrics to<br />
ensure that action plans are<br />
economically viable.<br />
The following pictures<br />
highlight some <strong>of</strong> the<br />
activities during this enjoyable<br />
and intriguing summit.<br />
22 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
23
24 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
25
AAPI Launches Political Action Committee<br />
Why we need a PAC on Capitol Hill<br />
Vinod K. Shah, MD<br />
AAPI President<br />
Dino Teppara, Esq.<br />
AAPI Director <strong>of</strong><br />
Legislative Affairs<br />
<strong>Physicians</strong> are the key players in providing quality<br />
health care to the <strong>American</strong> people. However, they are<br />
not a large nationwide constituency. According to U.S.<br />
Department <strong>of</strong> Labor statistics, there were <strong>of</strong>ficially<br />
661,400 jobs held by physicians and surgeons in 2008.<br />
This works out to approximately 1,500 doctors for each<br />
congressional district. Out <strong>of</strong> nearly 700,000<br />
constituents, this means that less than 1% <strong>of</strong> any one<br />
Congressman’s constituents are physicians.<br />
On Capitol Hill, physicians are sometimes<br />
stereotyped as making many demands on politicians but<br />
doing very little politically to aid the reelection efforts <strong>of</strong><br />
Members <strong>of</strong> Congress. Considering the small size and<br />
influence <strong>of</strong> physicians in the political process, the even<br />
smaller number <strong>of</strong> <strong>Indian</strong> <strong>American</strong>s (only 3 million<br />
people out <strong>of</strong> a national population <strong>of</strong> more than 300<br />
million), and the even smaller number still <strong>of</strong> <strong>Indian</strong><br />
<strong>American</strong> physicians, AAPI members must be<br />
cognizant <strong>of</strong> the enormous challenges facing the<br />
organization to increase its influence in the political<br />
arena.<br />
Frankly, politicians do not care that AAPI is the<br />
largest ethnic medical association in the United States.<br />
The fact is that <strong>Indian</strong> <strong>American</strong>s will never be a large<br />
voting bloc equivalent to labor unions, African<br />
<strong>American</strong>s or Hispanics in our nation. Therefore,<br />
AAPI must make up for its lack <strong>of</strong> size by gaining<br />
prominence through a political action committee,<br />
because politicians WILL care that AAPI has the<br />
largest PAC in the <strong>Indian</strong> <strong>American</strong> community.<br />
Mainstream corporations such as Pfizer that have<br />
PACs will be impressed by AAPI’s savviness in building<br />
up a PAC. AAPI will be successful in gaining<br />
sponsorships for its national conventions as<br />
corporations will see a benefit for them in joining forces<br />
with AAPI when they realize we have extensive<br />
political clout. This clout cannot be won any other way<br />
but through financial resources.<br />
First, AAPI as a nonpr<strong>of</strong>it 501(c)(3) organization is<br />
permitted to have an unconnected political action<br />
committee. We will be establishing a separate legal<br />
entity entirely with a separate website and set aside<br />
approximately $200-$300 per month out <strong>of</strong> PAC funds<br />
to pay for a political consultant to file the necessary<br />
paperwork with the Federal Election Commission<br />
(FEC). The primary focus would be to raise funds in<br />
2010, as this is an election year. As the Asian <strong>American</strong><br />
Hotel Owners <strong>Association</strong> (AAHOA) has $250,000 in<br />
its PAC, AAPI would have to raise at least $300,000<br />
this year to claim the mantle <strong>of</strong> having the largest PAC<br />
in the <strong>Indian</strong> <strong>American</strong> community. It is entirely an<br />
achievable goal and we must work together to do it.<br />
We are establishing a benefits package for Gold,<br />
Silver and Bronze donors. Gold donors are those who<br />
give the maximum allowable amount this year under<br />
federal law, which is $5,000. These donors will be<br />
invited to every exclusive event we do with senior<br />
politicians, will be publicly recognized in the media for<br />
Continued on page 34<br />
26 www. aapiusa.org Winter 2010 AAPI Journal
IN THE NEWS<br />
Dr. Sudhir M. Parikh Receives Padma Shri Award<br />
<strong>Indian</strong> <strong>American</strong> physician, philanthropist and<br />
publisher, Dr. Sudhir M. Parikh, has been named a<br />
recipient <strong>of</strong> the 2010 Padma Shri award. The New<br />
Jersey-based doctor made the President <strong>of</strong> India’s<br />
honoree’s list released on Jan. 25th, the eve <strong>of</strong> the<br />
country’s 60th Republic Day.<br />
Dr. Sudhir M. Parikh<br />
Publisher, India Advocate,<br />
Philanthropist, Physician<br />
With this honor, Dr. Parikh now joins the ranks <strong>of</strong><br />
most honored <strong>Indian</strong> <strong>American</strong>s and the only one to<br />
receive all three much coveted awards: the Ellis Island<br />
Award, the highest honor conferred on U.S. immigrants<br />
for their lifetime <strong>of</strong> community service; the Pravasi<br />
Bharatiya Samman, a special award given by the<br />
Government <strong>of</strong> India to select non-resident <strong>Indian</strong>s for<br />
their individual accomplishments and contributions to<br />
India, and ; the Padma Shri, which is awarded to<br />
distinguished <strong>Indian</strong>s and people <strong>of</strong> <strong>Indian</strong> origin for<br />
their contribution in various speres <strong>of</strong> activity including<br />
the arts, education, industry, literature, science, sports,<br />
social service and public life.The award will be presented<br />
by President Pratibha Patil at a ceremony in New Delhi<br />
in March.<br />
“I’m deeply honored and humbled by the honor<br />
conferred on me by the President <strong>of</strong> India,” Dr. Parikh<br />
said in a statement, adding, “but I also recognize the<br />
responsibility <strong>of</strong> living up to this honor by redoubling my<br />
efforts to further U.S.–India relations, and making<br />
greater efforts at community service on both sides <strong>of</strong> the<br />
Atlantic.”<br />
Dr. Parikh, who is a noted allergist and an acclaimed<br />
authority n the field <strong>of</strong> allergy, asthma and immunology,<br />
is also the chairman and publisher <strong>of</strong> New York-based<br />
Parikh Worldwide Media, Inc., which publishes three<br />
periodicals – “News India Times, “Desi Talk” and “The<br />
<strong>Indian</strong> <strong>American</strong>.” (Please see the detailed resume<br />
attached.)<br />
Apart from medical practice and publishing, Dr.<br />
Parikh is actively involved in a number <strong>of</strong> charitable<br />
causes in the U.S. and in India. He was recently in New<br />
Delhi to attend the Pravasi Bharatiya Divas, where he<br />
was invited to speak about philanthropy as part <strong>of</strong> the<br />
PBD lecture series.<br />
Dr. Sudhir M. Parikh<br />
Publisher, India Advocate, Philanthropist, Physician<br />
Congratulations, Sudhir!<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
27
Book Review: ‘CHEATING DEATH’<br />
by M. P. Ravindra Nathan, MD, Brooksville, FL<br />
Anyone who is frustrated by the failure <strong>of</strong> standard<br />
approaches for treating critically ill patients will be<br />
amazed at what Dr. Sanjay Gupta has to say in his<br />
latest book, ‘Cheating Death,’ a New York Times best<br />
seller. The book is all about ‘medical miracles’ in<br />
which seemingly dead patients are revived back to<br />
real life. In other words, stopping death in its own<br />
tracks! Yes, a new breed <strong>of</strong> audacious and pioneering<br />
physicians and researchers using simple to complex<br />
innovations are doing just that, pushing the frontiers<br />
in medicine!<br />
Here are a few tantalizing stories you will read in this<br />
wonderful book:<br />
• A young medical resident in Sweden takes a<br />
tumble during skiing, gets trapped under the<br />
frozen fjords <strong>of</strong> Norway for 40 minutes and is<br />
practically dead but survives with proper<br />
treatment and is a practicing radiologist now.<br />
• A 59 year old sustains a sudden cardiac arrest<br />
while driving, crashes his car, but was resuscitated<br />
using a new version <strong>of</strong> CPR that involves<br />
nothing more than chest thumps and a few<br />
shocks, without giving a single breath.<br />
• A comatose brain surgery patient declared as<br />
‘vegetable’ by doctors is ‘chilled’ for several days<br />
and is slowly revived, recovers fully and goes<br />
home.<br />
• An unborn child with a serious heart disease who<br />
has no chance <strong>of</strong> being born alive undergoes<br />
intrauterine surgery to fix a heart defect and is<br />
born healthy and lives a normal life.<br />
• A 33 yr old man with the one <strong>of</strong> the deadliest<br />
cancers, ‘glioblastoma’ in the brain, beats the odds<br />
with a combination <strong>of</strong> treatments - a new drug,<br />
radiation and a newly developed vaccine CDX-<br />
110 by Duke.<br />
A few years ago, such feats would be simply the<br />
stuff <strong>of</strong> sci-fi novels or movies. But believe it or not,<br />
they are about to become<br />
common place in the<br />
medical field. Every story<br />
and every chapter in this<br />
book is yet another<br />
example <strong>of</strong> “man cheating<br />
death,” beating all odds<br />
through new scientific<br />
methods or innovations<br />
used deliberately and<br />
successfully. Some <strong>of</strong> these<br />
Published by<br />
Wellness Center<br />
Hatchette Book Group,<br />
282 pages 2009<br />
treatments are even low cost, low tech and can be<br />
achieved anywhere in the world.<br />
“Death is a complicated thing. It is not a single<br />
event, but the process could be reversed,” says the<br />
author. Dr. Gupta, CNN’s Chief Medical<br />
correspondent, a famous neurosurgeon and a best<br />
selling author, visits several countries and talks to<br />
many research scientists in his quest to understand<br />
the mechanisms leading to death and how it can be<br />
avoided or reversed. Human beings cannot survive<br />
even a few minutes without oxygen since ‘hypoxemia’<br />
as occurs in cardiac arrests, severe trauma etc., can<br />
trigger a devastating cycle <strong>of</strong> inflammation and<br />
metabolic chaos in the body leading to death.<br />
Reducing the oxygen requirements during these<br />
critical times will be the key to survival.<br />
Lance Becker, Director <strong>of</strong> ER in U. Penn<br />
Hospitals says, “The chemical chaos in the death<br />
pathways seems to take place at the cellular level,<br />
mitochondria specifically, the part that produces<br />
energy.” Fred Roth at Fred Huntchinson Cancer<br />
Center studying molecular basis for immortality,<br />
agrees. “It is all about manipulating oxygen. Lack <strong>of</strong><br />
oxygen or too much <strong>of</strong> it can injure the cells,<br />
especially if already damaged after a cardiac arrest.”<br />
By reducing concentration in the cells, you can put<br />
Continued on page 29<br />
28 www. aapiusa.org Winter 2010 AAPI Journal
Book Review...continued<br />
Continued from page 28<br />
them in ‘suspended animation’- a sort <strong>of</strong> hibernationwhich<br />
reduces the metabolic and energy demands.<br />
We learned about ‘suspended animation and<br />
hibernation’ as two approaches that can save human<br />
lives from animal models. Many animals go into<br />
hibernation in winter to conserve energy demands<br />
that aid in their long term survival. The painted<br />
turtles <strong>of</strong>ten burrow in the mud, without breathing<br />
for as long as four months, during a rough winter. An<br />
un-acclimatized first time climber <strong>of</strong> Mount Everest<br />
is likely to go into pulmonary edema which could be<br />
fatal, and yet a seasoned, well trained climber can<br />
scale high altitudes without much difficulty. The key<br />
word is ‘adaptation.’ In the case <strong>of</strong> patients, it means<br />
buying time to reduce body’s oxygen demands which<br />
in turn will reduce organ injury during the recovery<br />
process. Hypothermia using a variety <strong>of</strong> methods<br />
seems to be very beneficial.<br />
Dr. Gupta’s book teaches us, that the power <strong>of</strong><br />
modern medicine continues to unfold revealing an<br />
amazing array <strong>of</strong> new treatment modalities and<br />
innovations which are helping us to cheat death and<br />
live longer. Thanks to these major breakthroughs, the<br />
mysterious line between life and death is being<br />
shifted in our favor. As Woody Allen says (quoted by<br />
Gupta) “I don’t want to achieve immortality through<br />
my work. I want to achieve it through not dying.”<br />
Don’t we all? Read this book and you will know how.<br />
CALL FOR<br />
YOUR FREE<br />
TOURIST<br />
GUIDE<br />
Safari Ventures organized a most<br />
unforgettable trip to south and East<br />
Africa for three couples which included<br />
my husband and me”. We are taking<br />
another trip with Safari Ventures to see the Tiger<br />
sanctuary in India. It promises to be as memorable<br />
as the tour we took seven years ago.<br />
Nalini Juthani, MD<br />
Life Member, AAPI<br />
ST-35254<br />
Ask about our 2010 special<br />
AAPI departures<br />
Call now TOLL FREE 1 888 341 7771<br />
Visit www.safariventures.com<br />
The Wild Of Africa – Within Your Reach…<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
29
AAPI Clinic launches HIV, Hepatitis and Mother-Child<br />
programs and conducts health camp<br />
The AAPI Preventive Health Clinic,<br />
initiated several projects in rural Andhra<br />
Pradesh this year. Today, India has an<br />
infant mortality rate <strong>of</strong> 6.8%, almost fifty<br />
percent <strong>of</strong> children who survive are severely<br />
and chronically malnourished, and as they<br />
grow in to the rural population only 31% <strong>of</strong><br />
them have access to potable water. As a<br />
result <strong>of</strong> poor nutrition and poor<br />
sanitation, infectious diseases are still a<br />
major cause <strong>of</strong> death in rural India. The<br />
current healthcare delivery system has not<br />
served the rural population well.<br />
AAPI preventive health clinic <strong>of</strong> Jagtial<br />
partnered with SHARE Health and has<br />
initiated many programs to rectify the<br />
health disparities in rural Telangana region <strong>of</strong><br />
Andhra Pradesh by working with local and state<br />
by Jagan Ailinani, MD<br />
Past President, AAPI<br />
Board <strong>of</strong> Director, AAPI-Charitable Foundation<br />
(l-r) Dr. Jagan Ailinani, L. Ramana, Madhu Yaskhi, Jeevan Reddy, and Dr.Vijay Yel-dandi<br />
at the opening <strong>of</strong> the clinic.<br />
Dr. Vijay Yeldandi addressing the the gathering at the opening <strong>of</strong> the clinic. Dr. Jagan<br />
Ail-inani, L.Ramana, MLA, Madhu Yaskhi, Chief guest Member <strong>of</strong> Parliament, and<br />
Jeevan Reddy, Former minister, attended.<br />
governments to increase access to care. SHARE is<br />
providing technical support to the AAPI Preventive<br />
Health Clinic, which serves the Jagtial<br />
municipality as well as the 60 villages in<br />
three rural mandals <strong>of</strong> Jagtial, Raikal and<br />
Sarangpur located in Andhra Pradesh.<br />
This area has a high incidence <strong>of</strong><br />
hepatitis and various water born diseases<br />
and is also has the highest number <strong>of</strong><br />
HIV positive and full-blown AIDS cases<br />
in the state. In addition, Andhra Pradesh<br />
ranks third in <strong>Indian</strong> states in the<br />
incidence <strong>of</strong> AIDS and has the highest<br />
maternal and infant mortality rate in<br />
India. Funding for these will be raised<br />
through AAPI members from the Jagtial<br />
area and we will seek additional<br />
government funding.<br />
Continued on page 31<br />
30 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Clinic launches...continued<br />
Continued from page 30<br />
The Hepatitis, HIV and motherchild<br />
program was inaugurated on<br />
August 9, 2009 by Dr. Vijay Yeldandi,<br />
Chair, AAPI HIV-AIDS Committee.<br />
Dr. Yeldandi is a infectious disease<br />
specialist, a pr<strong>of</strong>essor <strong>of</strong> medicine at the<br />
University <strong>of</strong> Illinois, and program<br />
director at Resurrection Hospital,<br />
Chicago, Illinois. He secured a $5<br />
million grant from the Centers for<br />
Disease Control (CDC) for an<br />
HIV/AIDS awareness and education<br />
program in Andhra Pradesh. Chief<br />
guest Madhu Yaskhi, member <strong>of</strong><br />
Parliament, commended the work <strong>of</strong> the<br />
clinic in promoting the health <strong>of</strong> the rural population<br />
<strong>of</strong> his district, and promised matching funds for this<br />
project and for conducting health camps. Other<br />
guests at the inauguration included Madhu Yakshi,<br />
MP L., Ramana Local MLA, and Jeevan Reddy,<br />
former minister.<br />
Administration <strong>of</strong> Hepatitis B vaccinations to school children.<br />
mandals. Group and one-on-one sessions clarify<br />
myths and misconceptions surrounding HIV while<br />
imparting knowledge about HIV and STIs, and the<br />
use <strong>of</strong> condoms, which are distributed free. Sexual<br />
matters are still considered a taboo, and therefore easy<br />
accessibility is very important. Nutrional support will<br />
be provided for children infected with HIV/AIDS.<br />
Mother-Child Program<br />
Dr. Dharmapuri Vidyasagar, past chair <strong>of</strong> the<br />
AAPI Board <strong>of</strong> Trustees and pr<strong>of</strong>essor <strong>of</strong> pediatrics<br />
at the University <strong>of</strong> Illinois, Chicago will be<br />
overseeing the Mother-Child program to reduce<br />
maternal and infant mortality in these rural mandals<br />
<strong>of</strong> A.P. Dr. Vidyasagar has recently visited the area<br />
and is working on establishing educational and skill<br />
training programs in maternal and neonatal care.<br />
Distribution <strong>of</strong> nutritional food/supplements to HIV infected children.<br />
Hepatitis and HIV Program<br />
Periodic awareness education about HIV/AIDS<br />
will be conducted in all the villages <strong>of</strong> the three<br />
Both the Mother-Child and Hepatitis/HIV<br />
programs will be implemented in 60 villages in 3<br />
mandals <strong>of</strong> the Jagtial Constituency in the<br />
Karimnagar district <strong>of</strong> Andhra Pradesh. Our goal is<br />
to vaccinate all school children including for hepatitis<br />
B (HBV) and typhoid.<br />
Continued on page 32<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
31
AAPI Clinic launches...continued<br />
Continued from page 31<br />
The prevalence rates for Typhoid and Hepatitis B<br />
is elevated in the covered mandals. To combat this,<br />
the clinic is conducting in-school immunizations as a<br />
preventive measure. In its first year, the project will<br />
cover 2,500 children and expand to all 120 schools in<br />
the coming years. Periodic eye camps will be<br />
conducted in these schools that each has about 300<br />
students and children with vision problems will be<br />
provided with eye glasses.<br />
Health Camp<br />
The Clinic conducted a health camp in Jagtiyal on<br />
August 9, 2009 with support from SHARE Health<br />
and Yashoda Hospital. Nearly 1,000 patients from<br />
Jagtiyal and the surrounding villages took advantage<br />
<strong>of</strong> the free camp, and about 20 doctors <strong>of</strong> various<br />
specialties participated.<br />
Yashoda Hospital <strong>of</strong> Hyderabad cosponsored the<br />
camp and provided specialists and a large mobile<br />
truck equipped to perform X-ray, ultrasound, EKG,<br />
and echo studies. Free labs were provided, including<br />
blood sugar and cholesterol testing. Education was an<br />
important part <strong>of</strong> the camp with Padmini Balagopal,<br />
a diabetic educator, participating, and staff<br />
distributed heart disease and diabetes education<br />
brochures developed by Dr. Purusotham Kotha, a<br />
cardiologist from San Diego, California.<br />
About the AAPI Preventive Health<br />
Clinic <strong>of</strong> Jagtial<br />
The AAPI Preventive Health Clinic was<br />
established in December 2005 with the mission to<br />
improve the health and wellness <strong>of</strong> villagers focusing<br />
on ABCD’S, AIDS, blindness prevention, Child-<br />
Mother health, deafness prevention, diabetes<br />
screening and education, safe drinking water, and<br />
sanitation.<br />
This Clinic conducts periodic<br />
health camps which include<br />
general medical, diabetic, eye,<br />
ENT, cancer, cleft lip palate and<br />
rehabilitation/artificial limb<br />
distribution camps. The Clinic<br />
also conducts annual physical<br />
exams for school children<br />
including vision, hearing and<br />
dental check ups and provides<br />
free eye glasses. The clinic also<br />
provides free ambulance to<br />
transport patients from villages<br />
to Karimnagar district<br />
headquarters or Hyderabad. Two<br />
safe drinking water plants were<br />
established in two villages in this<br />
region which were sponsored by<br />
two AAPI members. Villagers were educated about<br />
safe drinking water and sanitation.<br />
32 www. aapiusa.org Winter 2010 AAPI Journal
IN THE NEWS<br />
Dr. Onaly A. Kapasi Receives New England’s 2009<br />
Distinguished Humanitarian Service Award<br />
Onaly A. Kapasi, MD a nominee<br />
for the <strong>American</strong> Academy <strong>of</strong><br />
Orthopedic Surgery’s Humanitarian<br />
Service Award recently received the<br />
Distinguished Humanitarian Service<br />
Award from the <strong>Indian</strong> Medical<br />
<strong>Association</strong> <strong>of</strong> New England<br />
(IMANE) on November 21, 2009.<br />
In recognition <strong>of</strong> his humanitarian<br />
services in Boston, India and Africa.<br />
He is also a recipient <strong>of</strong> the 2004<br />
Leadership Award from IMANE.<br />
Dr. Kapasi came to Boston as a<br />
pediatric orthopedic fellow at the<br />
Harvard affiliated Children’s Hospital Medical<br />
Center in 1975.<br />
Whilst in Kenya his puritan streak came to the<br />
forefront in August 1972 as he organized relief efforts<br />
for the 60,000 plus <strong>Indian</strong> refugees fleeing Idi Amin’s<br />
Uganda.<br />
This passion to assist the less fortunate resurfaced<br />
in 1980 when he and a fellow surgeon delivered very<br />
large bags containing a few hundred loaves <strong>of</strong> bread<br />
each Friday to a shelter for the homeless in Boston.<br />
He received a humanitarian service award from the<br />
Himalayan International Institute in 1998 for<br />
dedicated services to the indigent Himalayan<br />
community where he has continued to serve in<br />
person, kind and money for the past fifteen years. In<br />
Himachel he is fondly referred to as the Dhamad <strong>of</strong><br />
Mandi.<br />
He received a dedicated service award in 2000 from<br />
his peers at the <strong>American</strong> <strong>Association</strong> <strong>of</strong> <strong>Physicians</strong> <strong>of</strong><br />
<strong>Indian</strong> <strong>Origin</strong> (AAPI) for assisting <strong>Indian</strong> <strong>American</strong><br />
<strong>Physicians</strong> practicing medicine in the U.S.A.<br />
Again in 2001 he received a<br />
special presidential award from the<br />
AAPI president, Dr. Naik, for<br />
assisting <strong>Indian</strong> physicians fighting<br />
peer review abuse.<br />
He has traveled to India where<br />
he has carried out free orthopedic<br />
surgeries in Bombay and Pune,<br />
conducted orthopedic camps, given<br />
continuing medical education<br />
courses in Patiala at the National<br />
Sports Academy, presented papers<br />
at orthopedic meetings in India<br />
and also traveled to East Africa on<br />
medical missions. He collects surplus medical<br />
equipment from the Boston hospitals that he<br />
repatriates to needy countries.<br />
He received the coveted Ethicon prize for<br />
meritorious academic performance in the Master <strong>of</strong><br />
Medicine in Surgery program in Kenya, his research<br />
paper; “Psoriatic Hands” was acclaimed as the best<br />
paper <strong>of</strong> the year at the <strong>American</strong> Hand Society<br />
Meeting in September 1980. He was appointed to the<br />
Massachusetts Board <strong>of</strong> Registration in Medicine in<br />
1991 where he served as the chairman <strong>of</strong> the licensing<br />
committee and Joint Committee on Graduate<br />
Medical Education. He has also served as a physician<br />
member <strong>of</strong> the Massachusetts Acupuncture and<br />
Alternative Medicine Board. He has served as the<br />
chair <strong>of</strong> the AAPI Federation <strong>of</strong> Licensing Boards,<br />
Ethics and Grievances Committee, for two<br />
consecutive terms, and Awards Committee and<br />
member <strong>of</strong> many key committees. He is an appointed<br />
member <strong>of</strong> the <strong>American</strong> Academy <strong>of</strong> Orthopedic<br />
Surgeon’s Ethics Committee.<br />
His passion for humanitarian work resounds also in<br />
his personal poetries some <strong>of</strong> which are published.<br />
Continued on page 34<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
33
AAPI Launches Political...continued<br />
Continued from page 26<br />
their contribution and will receive a prominent pr<strong>of</strong>ile<br />
and picture on the PAC website. Silver donors are those<br />
who give $2,500 this year. They will receive invitations<br />
to two events this year and their name and picture will<br />
be placed on our website for their support. Bronze<br />
donors are those who give $1,000 this year. They will<br />
receive an invitation to one event and their name will be<br />
placed online as a supporter. Our PAC will be fully<br />
transparent with our FEC filings placed online.<br />
Dr. Vinod K. Shah is the President <strong>of</strong> Shah<br />
Associates, the largest medical practice in<br />
southern Maryland and is a Board Certified<br />
Internist and Board Certified Cardiologist.<br />
In order to make the maximum impact, we need as<br />
many donors to step forward and assist us in this<br />
endeavor. To show our commitment, a number <strong>of</strong><br />
AAPI <strong>of</strong>ficers have already taken the initiative by<br />
contributing $5,000 each.The donors do not need to be<br />
<strong>Indian</strong> <strong>American</strong>, AAPI members or even doctors. As<br />
the PAC is a separate legal entity, it is unconnected to<br />
AAPI and can accept funds from anyone in any<br />
industry.<br />
We will establish a smart political process to allow<br />
local AAPI chapters the opportunity to present PAC<br />
checks to their own Congressman or Senator. This is a<br />
great way to build the AAPI brand name in the<br />
community, build our membership at the local and<br />
national level simultaneously and give our physicians<br />
more political clout.<br />
Dino Teppara is an attorney and the only <strong>Indian</strong><br />
<strong>American</strong> to ever serve as Chief <strong>of</strong> Staff and<br />
Counsel to a Member <strong>of</strong> Congress. He will receive<br />
an Officer Commission later this year, making him<br />
the only <strong>Indian</strong> <strong>American</strong> Public Affairs Officer in<br />
the United States Navy.<br />
We would not give away all the money we raise this<br />
year. We will keep funds in the bank so we have a base<br />
to build upon when we begin fundraising in earnest for<br />
the 2012 national election. Lastly, our PAC will be<br />
completely bipartisan, with a plan <strong>of</strong> giving 50-50 to<br />
both Democrats and Republicans.This political balance<br />
will best serve the interests <strong>of</strong> <strong>Indian</strong> <strong>American</strong><br />
physicians.<br />
We firmly believe that this new opportunity will<br />
greatly enable AAPI to take the organization to the<br />
next level in terms <strong>of</strong> membership, corporate sponsors<br />
and influence. But more importantly, it gives us the<br />
opportunity to have a seat at the table when politicians<br />
attempt to pass laws that affect us, our practices and<br />
families.<br />
Dr. Onaly A. Kapasi,...continued<br />
Continued from page 33<br />
And he states that he is planning to publish a book <strong>of</strong><br />
his personal poems some day.<br />
When asked about his passion he is quick to<br />
mention that he derives an inner strength from a<br />
family that is very supportive and also very giving. His<br />
brother a physician in the U. K. is a recipient <strong>of</strong><br />
M.B.E. (Member <strong>of</strong> the British Empire) that was<br />
bestowed by the Queen <strong>of</strong> England for his services to<br />
the British Health Care. He believes that the need for<br />
giving was ingrained by his parents who also lived by<br />
an example <strong>of</strong> giving.<br />
Congratulations, Onaly!<br />
34 www. aapiusa.org Winter 2010 AAPI Journal
IN THE NEWS<br />
AAPI President Attends State Dinner<br />
Dr. Vinod K. Shah, the only national president <strong>of</strong><br />
an <strong>Indian</strong> <strong>American</strong> community organization to<br />
attend the State dinner at the invitation <strong>of</strong> President<br />
Barack Obama, speaks about his experience.<br />
“I am honored that President Obama provided<br />
me with the opportunity to join 300 guests in<br />
welcoming Prime Minister Dr. Manmohan Singh<br />
and his wife Gursharan Kaur back to<br />
Washington, D.C. at the White House's first<br />
<strong>of</strong>ficial state dinner. This was truly a memorable<br />
event recognizing the global presence <strong>of</strong> the<br />
world's largest democracy and I will never forget<br />
the evening my wife Ila and I had last night.<br />
President Obama's comments were very well<br />
received and he stated that the contributions <strong>of</strong><br />
2.6 million <strong>Indian</strong> <strong>American</strong>s were significant,<br />
and that he is looking forward to his visit to India<br />
with the First Lady and his two beautiful<br />
daughters in the near future.<br />
The Prime Minister spoke from his heart in a<br />
very passionate speech, moving the audience to<br />
applaud on many occasions when he<br />
acknowledged the wisdom and commitment <strong>of</strong><br />
our President. During this difficult time, he noted<br />
that President Obama's leadership is important<br />
not only to the United States but globally and that<br />
India as the largest democracy has a role to play<br />
beyond our bilateral relationship to better the<br />
world.<br />
I am also pleased to announce that AAPI is<br />
tackling the challenges <strong>of</strong> public health<br />
mentioned in the joint statement issued by<br />
President Obama and Prime Minister Singh, and<br />
will be focusing on this very issue during our<br />
upcoming global health summit from January 2-<br />
3, 2010 in New Delhi.<br />
On behalf <strong>of</strong> AAPI's 15,000 members, we want to<br />
thank President Obama and Prime Minister Singh<br />
for their leadership in continuing the U.S.-India<br />
strategic relationship.”<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
35
HIPAA – What’s New This Year?<br />
HIPAA (Health Insurance Portability and<br />
Accountability Act <strong>of</strong> 1996) affects everyone who<br />
uses, provides, or pays for health care. The HIPAA<br />
Privacy Rule, effective April 14, 2003, sets forth the<br />
standard for use and disclosure <strong>of</strong> protected health<br />
information. The HIPAA Electronic Transactions<br />
Rule, extended effective date October 16, 2003,<br />
establishes ten standardized electronic transaction<br />
formats that entities subject to HIPAA (called<br />
“Covered Entities”) must use in communicating with<br />
other Covered Entities. The HIPAA Security Rule<br />
established standards for securing protected health<br />
information. <strong>Physicians</strong> and other Covered Entities<br />
under the HIPAA rules spent a great deal <strong>of</strong> time<br />
and money to prepare for HIPAA. Many mistakes<br />
were made, but after five years most physicians had<br />
at least made peace with the rules and learned to live<br />
with them. They may have even made the mistake <strong>of</strong><br />
thinking that was all they had to do. Wrong again.<br />
Welcome to the High Tech Act, part <strong>of</strong> the Recovery<br />
Act passed at the beginning <strong>of</strong> 2009 (ARRA) and its<br />
implementing regulations. This brief article will give<br />
you the high points <strong>of</strong> what you should do to comply<br />
with this latest round <strong>of</strong> HIPAA changes. We will<br />
start with a very brief description <strong>of</strong> the major points<br />
<strong>of</strong> HIPAA as we have known it and discuss the<br />
changes.<br />
1) Are you a Covered Entity?<br />
YES if you 1) are a health care provider that uses<br />
any <strong>of</strong> the ten specified electronic transmissions<br />
(“Provider”); 2) operate a health plan that pays or<br />
reimburses for health care (“Plan”); or 3) are a<br />
clearinghouse, such as a billing company. Some in<br />
house and occupational health clinics, many school<br />
health programs, and small providers may escape<br />
HIPAA if they only use paper in billing for the<br />
health care they provide. Medicare will require use <strong>of</strong><br />
the electronic transmission standards. Almost every<br />
health plan will be a Covered Entity, including fully<br />
insured plans, governmental plans, and self-insured<br />
plans that either 1) use a third party administrator<br />
Peter Parvis<br />
Healthcare Attorney<br />
(“TPA”) or 2) have 50 or more participants. The<br />
employer (and its employment records) isn’t directly<br />
affected by HIPAA since it is not a Covered Entity,<br />
but HIPAA affects employers indirectly through the<br />
Plans they sponsor. Workers compensation and auto,<br />
disability and life policies are outside HIPAA.<br />
The High Tech Act does not change these<br />
definitions.<br />
2) What does HIPAA require?<br />
Privacy Rule<br />
The heart <strong>of</strong> HIPAA is the HIPAA Privacy Rule,<br />
effect which limits what you can do with health care<br />
information (called protected health information or<br />
“PHI”) that could identify the affected individual.<br />
PHI is protected in the hands <strong>of</strong> a Covered Entity or<br />
its “Business Associate”, defined as anyone with<br />
whom a Covered Entity contracts to perform any<br />
function involving PHI. In the list <strong>of</strong> things you<br />
already must have, we have identified with an<br />
asterisk points that are affected by the new rules. You<br />
already have to have:<br />
• Developed, posted and distributed the Notice <strong>of</strong><br />
Privacy Practices (“Notice”) that describes what<br />
you will do with PHI and informs individuals<br />
about their rights under HIPAA.<br />
• Have a privacy <strong>of</strong>ficer.<br />
• Have policies and procedures regulating your use<br />
Continued on page 37<br />
36 www. aapiusa.org Winter 2010 AAPI Journal
HIPAA – What’s new...continued<br />
Continued from page 36<br />
and disclosure <strong>of</strong> PHI, and identifying by job<br />
description permitted internal and external uses<br />
and flow <strong>of</strong> PHI.*<br />
• Trained your workforce members, including unpaid<br />
volunteers, and each new employee, with access to<br />
PHI in your HIPAA policies.*<br />
• Have a complaint and sanction procedure.<br />
• Implemented reasonable technical and physical<br />
safeguards for your PHI. See the discussion <strong>of</strong> the<br />
Security Rule below.*<br />
• Established document retention procedures<br />
(everything needs to be kept for six years).<br />
• Honor the individual’s new federal right to inspect,<br />
request an amendment to, and obtain an<br />
accounting <strong>of</strong> unauthorized disclosures <strong>of</strong>, their<br />
own PHI.*<br />
• Have written contracts with, your Business<br />
Associates to make them protect PHI in their<br />
possession.*<br />
• If you sponsor a Plan for your employees, as<br />
opposed to purchasing coverage for them, and want<br />
more than very limited PHI from your Plan, you<br />
must amend your Plan to permit and protect such<br />
disclosures.<br />
Electronic Transactions<br />
If you are a Covered Entity, you must be able to<br />
use the 10 Electronic Transaction standards when<br />
communicating with other Covered.i The<br />
transactions all deal with payment for health care or<br />
insurance information, and were not directly affected<br />
by the ARRA provisions.<br />
Security Rule:<br />
The Security Rule governs the security <strong>of</strong><br />
Electronic PHI (“ePHI”), defined as PHI<br />
transmitted by or maintained in an electronic media<br />
• Including hard drive, disk, CD and Internet<br />
• Excluding paper fax<br />
The security procedures adopted by a Covered<br />
Entity must ensure confidentiality <strong>of</strong> ePHI and<br />
protect against reasonably anticipated threats. A<br />
hospital is held to a higher standard than a small<br />
physician practice, but every Covered Entity must<br />
comply. The Security Rule contains:<br />
• 18 Standards (i.e., safeguards): administrative,<br />
physical, technical; and 36 Implementation<br />
specifications: some <strong>of</strong> these are mandatory, others<br />
are “addressable”, meaning the practice can come<br />
up with a solution designed for its size and unique<br />
problems.<br />
3) What can a Covered Entity do with PHI?<br />
You can use or disclose PHI for treatment <strong>of</strong> the<br />
individual, for payment (to bill or pay/get<br />
paid/coordinate benefits for the treatment), or for<br />
defined elements <strong>of</strong> your internal operations<br />
(“TPO”). You must describe your uses and<br />
disclosures in your Notice <strong>of</strong> Privacy Practices. For<br />
payment or operations, you can only use or disclose<br />
the minimally necessary information* for the task at<br />
hand. The minimum necessary requirement did not<br />
apply to disclosures for treatment, in response to<br />
provider’s legitimate concerns that treatment could<br />
be compromised if providers had to stop and<br />
question the necessity <strong>of</strong> using each piece <strong>of</strong> patient<br />
information when providing care.<br />
You can also disclose PHI pursuant to a specific,<br />
signed and time limited authorization from the<br />
patient. Limited other disclosures (such as those<br />
required by law, or in response to subpoena, or<br />
incidental disclosures) are also permitted. Any<br />
disclosure that is not listed is forbidden. This piece is<br />
too short to include all <strong>of</strong> the more specific<br />
disclosures permitted under HIPAA.<br />
The regulations are complex, but the intent is<br />
simple. Patient information is confidential and<br />
Continued on page 38<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
37
HIPAA – What’s new...continued<br />
Continued from page 37<br />
should be treated accordingly. Employees who don’t<br />
need PHI shouldn’t have access to it, and those who<br />
need it should only have access to the PHI they<br />
need. Only you know which <strong>of</strong> your employees,<br />
broken down by job title, actually require PHI to do<br />
their job. You must therefore adopt and periodically<br />
review policies that describe reasonable limitations<br />
on the flow <strong>of</strong> PHI within your workforce, train your<br />
workforce on your policies, and enforce compliance.<br />
4) What rights do patients have?<br />
Patients are afforded significant rights under<br />
HIPAA, and have many new rights under the High<br />
Tech rules. Again using an asterisk to identify areas<br />
<strong>of</strong> change, each patient has right to:<br />
• Review their health information*<br />
• Request changes or corrections in that information<br />
• Request an accounting <strong>of</strong> disclosures*<br />
• Designate persons to (or not to) receive<br />
information<br />
• Request restrictions in use <strong>of</strong> their health<br />
information*<br />
• Withdraw authorization at any time for any reason<br />
5) What about enforcement?<br />
The concern was that the penalties under HIPAA<br />
were too weak and enforcement too lax. The old<br />
penalty was $100/violation with a $25,000 annual<br />
cap. Civil monetary penalties for a HIPAA violation<br />
have greatly increased under the ARRA, both for a<br />
single violation and for the annual cap on violations<br />
<strong>of</strong> the same sort, up to a 60 fold increase in the<br />
annual cap:<br />
• Unknown violation: $100 - $50,000*<br />
• Violation due to reasonable cause:<br />
$1,000 - $50,000*<br />
• Violation due to willful neglect, corrected:<br />
$10,000 - $50,000*<br />
• Violation due to willful neglect, not corrected:<br />
$50,000*<br />
• New Annual Cap per calendar year - $1,500,000<br />
Criminal penalties were also added, and state’s<br />
attorney generals were given authority to enforce<br />
violations. HHS audit authority was also increased.<br />
Last, but most certainly not least, the penalties can<br />
now be imposed on business associates. Under the<br />
prior law, only a Covered Entity could be assessed a<br />
penalty under federal law for violations <strong>of</strong> HIPAA.<br />
Business associate agreements should be reviewed<br />
and amended to reflect this and other changes.<br />
6) What do you have to do when you<br />
discover a breach?<br />
The new rules place significant new duties on<br />
Covered Entities, and for the first time on Business<br />
Associates, when a breach occurs. The new breach<br />
rules cover “unsecured protected health<br />
information”. For now, “Unsecured” means any<br />
information not secured through encryption or<br />
destruction. Until further guidance is released, these<br />
are the only two safe harbors for PHI. “Protected<br />
health information” (PHI) retains same meaning as<br />
under HIPAA. If all your PHI is encrypted, the<br />
breach rules don’t apply. For almost everyone, that is<br />
not currently feasible. You need to inform your<br />
employees about the breach rules and develop<br />
policies for how to respond to any potential breach.<br />
What is a breach?<br />
Any unauthorized acquisition, access, use or<br />
disclosure <strong>of</strong> PHI that compromises security or<br />
privacy <strong>of</strong> PHI. “Unauthorized” means any use not<br />
permitted by HIPAA Privacy Rule. “Compromises<br />
security or privacy” means that unauthorized action<br />
poses significant risk <strong>of</strong> financial, reputational or<br />
other harm to the patient. This may not be<br />
immediately apparent, but you have a duty to<br />
determine whether there is significant risk whenever<br />
you discover that an unauthorized use or disclosure<br />
<strong>of</strong> PHI occurred.<br />
Continued on page 40<br />
38 www. aapiusa.org Winter 2010 AAPI Journal
Job No: <br />
Our Job is Making Sure<br />
Investment Managers<br />
Do Their Job.<br />
There is no substitute for objective, pr<strong>of</strong>essional investment advice. For<br />
more than 35 years, we have provided investors with access to independent<br />
investment firms that pass our rigorous evaluation standards and ongoing<br />
reviews.<br />
We use a disciplined evaluation process applied consistently to every<br />
investment firm we approve or recommend. We focus on identifying:<br />
> Experienced portfolio management teams<br />
> Depth <strong>of</strong> investment research capabilities<br />
> A consistently applied investment philosophy<br />
> Ability to help deliver value over the long-term<br />
For more information on our investment manager research<br />
capabilities and recommendations, call:<br />
Kamesh Nagarajan<br />
First Vice President – Wealth Management<br />
Senior Investment Management Consultant<br />
Financial Planning Specialist<br />
Financial Advisor<br />
787 Seventh Avenue, 36th Floor<br />
New York, NY 10019<br />
(212) 492-6750<br />
kamesh.nagarajan@smithbarney.com<br />
© 2009 Morgan Stanley Smith Barney LLC. Member SIPC.<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
39<br />
<br />
Morgan Stanley
HIPAA – What’s new...continued<br />
Continued from page 38<br />
Some mistakes do not constitute a breach. If deidentified<br />
information is disclosed, there is no breach<br />
since de-identified information is not PHI. If you<br />
believe, in good faith, that the unauthorized person<br />
who obtained the PHI could not reasonably have<br />
retained or further disclosed the information, it may<br />
not be a breach. Similarly, if workforce member<br />
accessed information without permission but in good<br />
faith, there is no breach as long as there is no further<br />
unauthorized action occurred. Or if workforce<br />
member reveals information to an unauthorized<br />
colleague, there is no breach as long as there is no<br />
further unauthorized action. This is not to say that<br />
action should not be taken if any but the first <strong>of</strong> these<br />
occurs. However, there is no breach so you don’t have<br />
to go on to the disclosure and notice requirements.<br />
What do you have to do if a breach<br />
occurred?<br />
If your investigation reveals that a breach<br />
occurred, many requirements apply. You have the<br />
duty to notify without unreasonable delay all affected<br />
individuals <strong>of</strong> the breach, and may have to notify the<br />
Secretary <strong>of</strong> Health and Human Services (HHS) or<br />
local media. You should <strong>of</strong> course investigate, but you<br />
only have a maximum <strong>of</strong> 60 days to notify, so the<br />
investigation should begin promptly. Mailed notice<br />
to the individuals will suffice if you have contact<br />
information. If you don’t, or can’t reach the<br />
individuals, telephone or personal notice works if<br />
there are fewer than 10, but if there are a significant<br />
number you have to either notify media outlets or<br />
post the information on your website for at least 90<br />
days. If the breach involves more than 499<br />
individuals, you also have to notify the Secretary <strong>of</strong><br />
HHS, and media in any state if there are more than<br />
499 affected individuals in the state. You have to<br />
maintain a log <strong>of</strong> all breaches regardless <strong>of</strong> the<br />
number <strong>of</strong> individuals involved. There may be<br />
circumstances where you don’t know the exact<br />
number <strong>of</strong> individuals, but you are expected to have<br />
systems in place that will allow you to track and<br />
identify individuals when a breach occurs. There are<br />
requirements for the information that must be<br />
included in each notification.<br />
Your HIPAA policies must permit you to discover<br />
breaches and impose the duty on every employee and<br />
business associate the duty to notify you promptly <strong>of</strong><br />
any potential breach. You should consider whether to<br />
impose the notice duty or cost <strong>of</strong> notice on your<br />
business associate if they are responsible for the<br />
breach. In any event, every possible breach must be<br />
investigated, logged and documented. This includes<br />
a detailed result <strong>of</strong> any investigation, even if the<br />
result was a determination that no breach occurred.<br />
You should get your attorney’s help in conducting<br />
the investigation and formulating a response if you<br />
discover any potential breach.<br />
What else changed?<br />
Patient’s Right to Request Restrictions on<br />
Disclosure<br />
Individuals can request that Covered Entities<br />
restrict disclosure <strong>of</strong> the individual’s PHI.<br />
- Pre-ARRA: Covered Entities were not required to<br />
comply with requested restrictions<br />
- Post-ARRA: Covered Entities are still not required<br />
to comply with requested restrictions, except where<br />
an individual requests a restriction on:<br />
• disclosure <strong>of</strong> PHI to a health plan for purposes<br />
<strong>of</strong> payment or operations (not treatment)<br />
• where the PHI relates to an item/service for<br />
which the provider has been paid in full out-<strong>of</strong>pocket<br />
How much PHI can be used, disclosed or<br />
requested?<br />
- Pre-ARRA: Reasonable efforts to limit PHI to the<br />
minimum necessary to accomplish intended<br />
purpose<br />
Continued on page 41<br />
40 www. aapiusa.org Winter 2010 AAPI Journal
HIPAA – What’s new...continued<br />
Continued from page 40<br />
- Post-ARRA:<br />
• By August 17, 2010, HHS must issue guidance<br />
on what constitutes “minimum necessary”<br />
• In the meantime, a Covered Entity is deemed<br />
compliant with the minimum necessary standard<br />
if PHI is limited to:<br />
• The limited data set; or<br />
• if needed, the minimum necessary PHI (the pre-<br />
ARRA standard)<br />
Patient’s Rights to an Accounting <strong>of</strong><br />
disclosures have increased.<br />
Generally, an individual has a right to an<br />
Accounting <strong>of</strong> PHI disclosures by a Covered Entity<br />
going back six years, subject to various exceptions.<br />
- Pre-ARRA: Covered Entities were not required to<br />
provide an accounting <strong>of</strong> disclosures made to carry<br />
out treatment, payment or operations<br />
- Post-ARRA:<br />
• Treatment/payment/operations exception is not<br />
available with respect to disclosures made<br />
through an electronic health record by the<br />
covered entity that<br />
Date<br />
uses/maintains it<br />
• But, an individual can September 2009<br />
only request an accounting February 2010<br />
<strong>of</strong> such disclosures in the<br />
previous three (not six)<br />
years<br />
If disclosures were made to a January 2011<br />
business associate, the Covered<br />
February 2011<br />
Entity can elect to provide<br />
disclosure to the individual on<br />
behalf <strong>of</strong> business associates, or give the individual a<br />
list <strong>of</strong> Business Associates. If the latter, the business<br />
associate agreement should include the requirement to<br />
provide a response to individuals who request an<br />
accounting. This may be difficult.<br />
Access in Electronic Format<br />
An individual has the right to inspect and obtain<br />
a copy <strong>of</strong> the individual’s PHI. State laws also apply<br />
here, and the more stringent rule applies.<br />
Under ARRA, if a Covered Entity uses or<br />
maintains an Electronic Health Record:<br />
• An individual has a right to:<br />
• Obtain his/her PHI in an electronic format<br />
• Direct the Covered Entity to transmit a copy <strong>of</strong> the<br />
electronic PHI to a person or entity designated by<br />
the individual<br />
- Must be “clear, conspicuous and specific”<br />
• The Covered Entity may charge a fee, not to exceed<br />
actual labor cost<br />
The effective date <strong>of</strong> an individual’s the right to<br />
accounting and disclosure <strong>of</strong> electronic PHI varies<br />
with the date the Covered Entity acquired an EHR<br />
system:<br />
• January 1, 2014 – for Covered Entities that<br />
acquired an EHR on or before January 1, 2009<br />
• January 1, 2011 – for Covered Entities that acquire<br />
an EHR after January 1, 2009<br />
What applies?<br />
New notice <strong>of</strong> breach rule<br />
New business associate requirements<br />
New minimum necessary rule<br />
New individual access rules<br />
New restrictions on marketing<br />
Enforcement <strong>of</strong> breach rule sanctions<br />
New disclosure accounting rules begin<br />
New restrictions on unauthorized sale <strong>of</strong> EHR/PHI<br />
Penalties for noncompliance by willful neglect<br />
HHS may extend these effective dates, but not<br />
later than 2016 and 2013, respectively. We would<br />
simply add that at this time we don’t know how this<br />
Continued on page 42<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
41
HIPAA – What’s new...continued<br />
Continued from page 41<br />
will really work, what an electronic format for<br />
disclosure means, or how exactly you can charge for<br />
it in the face <strong>of</strong> state laws that limit what can be<br />
charged on a per page basis.<br />
When does all this become effective?<br />
What should you do?<br />
Greater enforcement, greater penalties, new<br />
requirements and new patient rights present a<br />
challenge which should be addressed by a review <strong>of</strong><br />
your HIPAA Policies and Procedures, followed by<br />
amendments where necessary and training <strong>of</strong> all<br />
personnel in the changes. As a brief summary, we list<br />
the issues and policies to be reviewed below.<br />
1. Minimum necessary use and disclosure<br />
2. Security, as affected by the new notice <strong>of</strong> breach<br />
requirements<br />
3. Individual’s Right to request restrictions on use<br />
or disclosure<br />
4. Individual’s Right to access or inspect PHI<br />
5. Individual’s Right to request an accounting <strong>of</strong><br />
disclosures<br />
6. Mitigation and security incidents<br />
7. Sanction, complaint, audit and enforcement<br />
8. Business Associate relationships and contracts<br />
9. Notice <strong>of</strong> breach responses<br />
10. Prohibiting sale <strong>of</strong> PHI<br />
A last word. This is important. Patient<br />
information should be protected, and the greater use<br />
<strong>of</strong> electronic communication poses additional risks.<br />
Get help if you need it and come up with an<br />
approach that your practice can make work. As with<br />
compliance, words alone are not sufficient. Get staff<br />
and physicians to buy in to the new approach and<br />
understand what they need to do to make it work.<br />
This article was taken from a webinar sponsored<br />
by Venable for its friends and clients. It is a brief<br />
summary, and should not be relied on as legal advice.<br />
I would like to thank my colleagues in the webinar<br />
for their kind assistance- Thora Johnson, Emilio<br />
Cividanes, Mike Pedone, Martha Jo Wagner and<br />
Davis Sherman, all <strong>of</strong> Venable LLP.<br />
Michigan Chapter Raises $10,000 for Haiti Disaster Relief<br />
Dr. Yash Shah<br />
In the wake <strong>of</strong> the recent tragedy in<br />
Haiti, MAPI President Dr. Yash Shah<br />
and the Foundation <strong>of</strong> MAPI<br />
(FOMAPI) Chairperson Dr. Dinesh<br />
Shah quickly mobilized their membership<br />
to raise over $10,000 for the international medical<br />
humanitarian organization, "Doctors Without Borders". A<br />
special thank you goes out to all the members who have<br />
contributed and donated to the effort. To learn more about<br />
how you can help please visit www.mapiusa.org and<br />
www.doctorswithoutborders.org<br />
Dr. Dinesh Shah<br />
42 www. aapiusa.org Winter 2010 AAPI Journal
The U.S. Ayurveda Delegation Trip to India<br />
January 28 to February 4, 2010<br />
Delegation: Seven delegates including six<br />
Complementary Alternative Medicine (CAM)<br />
directors <strong>of</strong> six major United States medical schools:<br />
1 – Dr. Navin Shah – Leader<br />
2 – Dr. Aviad Haramati – Coordinator, Georgetown<br />
University Medical School<br />
3 – Dr. David Eisenberg – Harvard University<br />
Medical School<br />
4 – Dr. Anastasia Rowland-Seymour – Johns<br />
Hopkins University Medical School<br />
5 – Dr. Victoria Maizes – University <strong>of</strong> Arizona<br />
Medical School<br />
6 – Dr. Anne Nedrow – Oregon Health & Science<br />
University<br />
7 – Dr. Benjamin Kligler – Albert Einstein College<br />
<strong>of</strong> Medicine<br />
This delegation visited New Delhi and Jaipur at the<br />
invitation <strong>of</strong> the Government <strong>of</strong> India, Ministry <strong>of</strong><br />
Health – AYUSH (Ayurveda, Yoga, Unani, Siddha,<br />
and Homeopathy). The purpose <strong>of</strong> the U.S. delegation<br />
was to learn about evidence based Ayurveda, Yoga,<br />
meditation, and oil massage treatments, and also to<br />
discuss ten <strong>Indian</strong> proposals for joint Indo-U.S.<br />
research under NIH funding. This visit was also to<br />
explore possibilities <strong>of</strong> introducing evidence-based<br />
Ayurveda, Yoga, meditation, and oil massage<br />
treatments in the U.S. medical education, research, and<br />
patient care areas under CAM.<br />
The visit included:<br />
1 - AYUSH selected 10 evidence-based presentations<br />
on various diseases and drugs<br />
2 - AYUSH selected 10 proposals for joint Indo-U.S.<br />
Ayurveda research for consideration under the<br />
NIH funding<br />
3 - AYUSH selected site visits to:<br />
Navin Shah, MD<br />
Medical Education<br />
Director, Metropolitan<br />
Urologic Institute<br />
a. National Institution <strong>of</strong> Ayurveda at Jaipur,<br />
b. National Institute <strong>of</strong> Yoga at New Delhi,<br />
c. Maharishi Ayurveda Pharma Factory at New<br />
Delhi,<br />
d. Arya Vaidya Sala (Ayurveda hospital and<br />
outpatient clinic) at New Delhi<br />
These visits were arranged to educate the U.S.<br />
delegates on various facets <strong>of</strong> Ayurveda, Yoga,<br />
meditation, and oil massage treatments – teaching,<br />
training, practice, patient care (inpatient and<br />
outpatient), and complete process <strong>of</strong> drug<br />
manufacturing.<br />
4 – Meetings with ten AYUSH selected Ayurveda<br />
pharmaceutical companies <strong>of</strong>ficials,<br />
5 – Presentation by Dr. B. Kligler on “Research<br />
Methodology and publication in the U.S.<br />
Journals”,<br />
6 – Presentation by Dr. D. Eisenberg on “Evaluation<br />
<strong>of</strong> Medicinal Plants” (especially from China),<br />
7 – Presentations by Dr. A. Haramati on involvement<br />
<strong>of</strong> AYUSH in the Global CAM and Integrative<br />
Medicine arena.<br />
The delegates heard and interacted with over sixty<br />
different <strong>Indian</strong> experts on the above-mentioned<br />
Continued on page 44<br />
AAPI Journal Winter 2010 www. aapiusa.org<br />
43
The U.S. Ayurveda Delegation...continued<br />
Continued from page 43<br />
subjects and visits. They met the following<br />
Government <strong>of</strong>ficials and conducted detailed<br />
discussions on various facets <strong>of</strong> the visits and future<br />
plans: Honorable Health Minister Mr. Ghulan Nabi<br />
Azad, Honorable Minister <strong>of</strong> State Health Mr.<br />
Gandhiselvan, Principal Secretary to the Prime<br />
Minister Mr. T.K.A. Nair, Health Secretary Mrs.<br />
Sujata Rao, AYUSH Secretary Mrs. S.<br />
Jalaja, AYUSH Joint Secretary Mr. B.<br />
Anand, and Foreign Secretary Mrs.<br />
Nirupama Rao.<br />
weeks course in Ayurveda in various <strong>Indian</strong><br />
Ayurveda Institutes.<br />
5 – US institutions to invite the AYUSH selected<br />
Ayurveda faculty members for 2-4 weeks exchange<br />
visits to CAM departments <strong>of</strong> the US Medical<br />
Schools.<br />
6 – The delegates will study the nine joint proposals<br />
presented by the AYUSHA selected experts for<br />
joint research for further actions.<br />
On the last day, the delegates and<br />
participants discussed the future actions and<br />
road map to further the understanding and<br />
utilization <strong>of</strong> evidence-based Ayurveda and<br />
its research. The following few areas <strong>of</strong><br />
mutual interest emerged.<br />
1 – Two Ayurveda Pr<strong>of</strong>essors to visit Six US<br />
Medical Schools (as represented by six<br />
delegates) to teach evidence based<br />
Ayurveda to medical students, residents,<br />
faculty members & practicing<br />
physicians & also discuss joint Indo-US<br />
research projects. Each institution will<br />
host the visiting Ayurveda Pr<strong>of</strong>essors for<br />
3 days. Hopefully, their interaction will<br />
promote Ayurveda teaching & its<br />
research in the U.S.<br />
2 – Consider a project to study <strong>Indian</strong><br />
Medicinal Plants collection & research with Dr.<br />
David Eisenberg <strong>of</strong> Harvard University. (Harvard<br />
is conducting Chinese medicinal plant project for<br />
last ten years).<br />
3 – The US medical institution will consider positions<br />
for AYUSH selected candidates for two year<br />
masters program in clinical research.<br />
4 – Inviting the US (CAM) faculty members for 2<br />
7 – A separate funding for AYUSH by the Health<br />
ministry to conduct joint research by <strong>Indian</strong><br />
Allopath and Ayurveda community. This will<br />
provide the foundation for the joint Indo-U.S.<br />
research proposals for consideration under NIH<br />
grants. This will also help the U.S. consortium <strong>of</strong><br />
CAM and Integrative Medicine members to<br />
Continued on page 46<br />
44 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
45
The U.S. Ayurveda Delegation...continued<br />
Continued from page 44<br />
integrate evidence based Ayurveda in the U.S.<br />
mainstream medicine and research.<br />
8 – AYUSH to work with Dr. A. Haramati for<br />
participation and presentations in the Global<br />
CAM conference (in 2011, at Denver).<br />
All the mutually accepted proposals and activities<br />
will be coordinated by Dr. A. Haramati. The<br />
delegation will submit a final report on March 30,<br />
2010 to the Health Secretary, AYUSH, Mrs. S. Jalaja,<br />
Health Minister Mr. G.N. Azad, and the Principal<br />
Secretary to the Prime Minister, Mr. T.K.A. Nair.<br />
Respectfully,<br />
Navin Shah<br />
Medical Education Director, Metropolitan Urologic<br />
Institute<br />
Treasurer, Mid Atlantic Urology Associates<br />
Past president <strong>of</strong> Medical Staff, Doctors Community<br />
Hospital, Washington DC area<br />
Former Trustee, The Maryland State Medical<br />
Society<br />
Co-Founder and Past President, The <strong>American</strong><br />
<strong>Association</strong> <strong>Physicians</strong> <strong>of</strong> <strong>Indian</strong> <strong>Origin</strong> (AAPI)<br />
Past President, The <strong>American</strong> College <strong>of</strong><br />
International <strong>Physicians</strong> (ACIP)<br />
DR. MOHAN DURVE PRESENTS CME PROGRAMS FOR YEAR 2010-2011<br />
*trips Dr. Durve will be escorting. WEBsite: CMETravels.com<br />
• Alaska Cruise (Seattle to Seattle) July 13 – 20, 2010 Balcony from $990<br />
• Antarctica (15 days) December 29, 2010 From $6999<br />
• Australia/New Zealand (15 days) 4/12, 5/3, 10/4, 10/25/ 2010 From $2499<br />
• *Caribbean Cruise<br />
(Norwegian’s brand new EPIC) December 11-18, 2010 From $469 + taxes<br />
• China w/Yangtze cruise July 16 – 31 From $2049<br />
or Sept 10 - 25, 2010 From $2349 + Internal air $700<br />
• Egypt Smithsonian (11 days) Sept 9, Oct 6, Nov 3, Nov 10, 2010 From $2099 + Internal Air $400<br />
• S. France (train & Riviera (10 days) October 14, 2010 From $2599<br />
• Iceland Smithsonian (7 days) June 20, July 25, Aug 15, Sept 19, 2010 From $1849<br />
• *Indonesia May 9 – 17, 2010 $2995 including air LAX<br />
• Italian Lakes/Greek Islands w/7 night<br />
E. Mediterranean cruise (12 days) May 21 From $1699<br />
• Maan Sarovar & Kailash May 30, June 11, June 23,<br />
July 11, Sept 7 & Sept 19 From $4200<br />
• *Mediterranean Cruise (Black Sea) Aug 24 – Sept 6, 2010 From $1549<br />
• *Russian River Cruise<br />
(St. Petersburg to Moscow) (11 days) July 7 or Sept 21, 2010 From $1799<br />
• *Scotland August 4-14, 2010 From $1799<br />
• South Africa (13 days) November 4, 2010 From $2199 + Internal Air $320<br />
• Spain October 28, 2010 From $1899<br />
• Turkey (12 days) September 23, 2010 From $2249<br />
Call Dr. Mohan Durve at 888-794-1995 or 440-845-7272 E-mail at: mjdurve@yahoo.com or mjdurve@sbcglobal.net.<br />
We organize family/group vacations to your dream destination anywhere in the world on your dates <strong>of</strong> choice!<br />
ALL rates are for land only. Call for Air prices. We will help book your air for you.<br />
46 www. aapiusa.org Winter 2010 AAPI Journal
AAPI Journal Winter 2010 www. aapiusa.org<br />
47
AAPI Executive Office<br />
600 Enterprise Drive, Suite 108<br />
Oakbrook, IL 60523<br />
PRSRTD STD<br />
U.S. POSTAGE<br />
PAID<br />
TAMPA, FL<br />
PERMIT No. 4309