Broward County Physicians Leader Carries Busy Agenda into New Year

South Florida Hospital News
January 2006 - Volume 2 - Issue 7
by Ron Paglia

It didn't take long for Ronald F. Giffler, M.D., to move into high gear in his new role as president of the Broward County Medical Association. And his ambitious agenda includes issues involving physicians, hospitals and health care facilities, and consumers.

"There are more than enough issues to keep us busy," Giffler, president of FirstPath Laboratories, Inc. in Fort Lauderdale, said. "We have been for many years in Florida devoting our energy to problems with existing malpractice litigation and the high costs of medical liability insurance. Those issues certainly remain critical, but we also need to direct our attention to other areas."

Like Medicaid reform, for instance.

Giffler, a pathologist, was installed as president of BCMA on November 12 and less than a month later was headed for Tallahassee and a special session of the Florida Legislature to address the future of Medicaid. Other officers of the Broward County group for 2006 are Mark S. Grenitz, M.D., immediate past president; Michael Weston, M.D., president elect; Nigel Spier, M.D., vice president; Tony Prieto, M.D., treasurer, and Alberto Casaretto, M.D., secretary.

"Medicaid problems certainly are not unique to Florida," Giffler said. "It is a national issue, one that significantly impacts physicians and hospitals in economic terms. Reduced (Medicaid) payments certainly don't help counter the rising expenses confronting us. Our (state) government is making a concentrated effort to come up with changes that will rectify the situation and perhaps set a standard for other states to follow."

Giffler, a physician since 1973, said Medicaid accounts for the largest single item in Florida's state budget. Medicaid in Florida covers some 2-million people, and approximately 40 percent of the state financial plan will fund the Medicaid program in the coming year. That figure, according to a WebMemo by Nina Owcharenko, senior policy analyst in the Center for Health Policy Studies at The Heritage Foundation, is expected by climb to 60 percent by 2015.

According to Florida Senate President Tom Lee and House Speaker Allan Bense, the legislature is considering ideas to address the future of Medicaid with the goal of "ensuring quality of care, improving efficiency in the delivery of services, and facilitating sustainable growth in Medicare expenditures." Under the reform plan proposed by Gov. Jeb Bush and currently being weighed by the Florida House and Senate, Medicaid recipients would be enrolled in some type of HMO (health maintenance organization) instead of the existing fee schedule formula. They would be required to enroll in an HMO, Giffler said. "That would be a real challenge in Broward County," Giffler admitted. "We have a large urban population with some 150,000 Medicaid patients."

Giffler said the Florida reform proposal would provide Medicaid recipients with counseling regarding the HMO plans available to them.

"The basic tenet is to educate the Medicaid recipients on what might best serve their needs," he said. "The plans vary in basic coverage to special individual needs. Counselors would be available to help the prospective enrollees determine their needs and choose a plan best suited for them. If it works here, it could be a model across the country."

Another feature of the proposed Florida reform, Giffler said, is that it creates incentives to the enrollees. "It is designed to make them more aware of the healthy lifestyles that can help them," he said. "It prompts them to make good choices, to create a mind-set encouraging them to take better control of their lives. We want them to understand what it means (to their health) to stop smoking or using tobacco products or get serious about choosing healthier diets to reduce their risks for heart disease, cancer and other illnesses." Giffler said Gov. Bush has been receptive to health care issues – physician related, regulatory measure, patient protection – throughout his tenure. And he remains encouraged that policy will continue.

"We face a lot of challenges in Broward County because of the demographics of lower income people and retirees," Giffler said. "The population is continuing to grow but the physician population isn't growing fast enough to meet the needs of those people. The malpractice situation certainly is taking its toll throughout Florida. Many physicians hold licenses here but don't practice here, and others are cutting back on their practices. They are not taking high-risk procedures or treating the sickest patients for fear of being sued, and many of our most experienced physicians are choosing to retire early, again creating a shortage of physicians. It's very difficult to get a handle on curbing this trend."

While these issues will continue to dominate the agenda for Giffler and his BCMA colleagues, they'll also move forward with programs to educate residents of their community on ways to improve their health.

"We have worked for a long time and will continue to work with hospitals in providing public forums for medical information that is beneficial to the consumer," Giffler said. "Our Association provides public services speakers, we sponsor charitable events, we are involved, in partnership with the Salvation Army, in clinics for the homeless, and we work with the Broward Partnership for the Homeless."

These advocacy roles are not new for Giffler, 57, a 1973 graduate of the Medical College of Virginia in Richmond who is board certified in anatomic and clinical pathology. He has been in practice in Broward County since 1982 and is recognized as a prominent leader in the South Florida medical community. He is a member of the Board of Directors of the Florida Medical Foundation, and as a former board member and secretary of the Board of Women in Distress of Broward County, he frequently addresses audiences of physicians on domestic violence awareness issues.

As president of FirstPath Laboratories, he is credited with modeling care, competence and professionalism in serving his clients and their patients as well as the community. FirstPath provides levels one through six surgical pathology, along with frozen sections, Pap smears and other non-gynecological pathology procedures.

"We provide services to hospitals and health care facilities and doctors," Giffler said. "We offer consulting services to help them determine how they can enhance their pathology and laboratory services. There has been a tremendous advance in technology over the years I've been in this profession. There is more information available and the use of computers has increased so much. It becomes more expensive, of course, to keep up with this technology but you have to do it to continue playing on an even field. "We can do things now that I never expected to see done when I was in medical school," Giffler continued. "Some of those things didn't even exist then – interventional procedures, sophisticated treatments. I hope it will continue."

In addition to earning his Medical Degree, Giffler also holds a law degree (J.D.) from the University of Miami and an MBA from Nova Southeastern University. He no longer practices law but his experiences in that field – representing physicians on legal issues – will serve him well as president of the Broward County Medical Association, he said.

"I think it will give us an advantage when we are involved in lobbying, studying legislation and laws, and taking our causes to our legislators," he said. "You can never be too well prepared."

At A Glance
Ronald F. Giffler, M.D., J.D.

President of First Path, Fort Lauderdale
President, Broward County Medical Association, 2005-2006

Professional Activities

President, Broward County Medical Association, 2005-2006.
Board of Directors, Florida Physicians Association, 2005.
Board of Directors, Florida Medical Foundation, 2002-Present.
President, Florida Physicians Association, 2004-2005.
Member, committee chair and officer of Broward County Medical Association since 1994.
In addition to this service to the community, Dr. Giffler also serves as a major in the Medical Corps of the United States Army Reserve.
As a Florida-licensed HealthCare Risk Manager, he has written and lectured extensively on risk management and medical-legal issues in defense of Florida physicians and their patients.

Dr. Giffler's wife Diane chairs the central branch of the Broward County Medical Association Alliance, and their daughter, Sara, is a veterinarian in Virginia Beach, VA.

--------------------------------------------------------------------------------
For further information contact:
Ronald F. Giffler, M.D., J.D., can be reached at (954) 202-4863 or ronaldgiffler@firstpathlab.com. For more information about the Broward County Medical Association, contact Cynthia S. Peterson, Executive Director, at (954) 714-9477 or bcma1@msn.com