Pathways to Building and Sustaining a Medical Toxicology Practice

Pathways to Building and Sustaining a Medical Toxicology Practice

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Overview

Pathways to Building and Sustaining a Medical Toxicology Practice is a one-day (8-hour) virtual workshop on the variety of pathways available for establishing and maintaining a satisfying career in the field of medical toxicology.

Led by experienced active medical toxicologists from a variety of practice settings, this workshop features panel discussions comparing the most common hospital-based, non-hospital-based, and non-clinical practice models, plus presentations on additional topics of interest, including adding addiction medicine services to a medical toxicology practice, hints and tips for contract negotiation, the basics of medical billing and coding, and the need for additional research on medical toxicology practice.

Target Audience: Medical toxicologists, including fellows, recent graduates, and others with an interest in expanding their medical toxicology practice.

Learning Objectives

  • Outline opportunities for a lifelong career practicing medical toxicology
  • Identify revenue streams for working as a medical toxicologist
  • Understand how to get out of the emergency department and earn a living as a medical toxicology subspecialist
  • Describe additional pathways to expand current medical toxicology practice
  • Identify new and emerging roles for medical toxicologists in the field of addiction medicine, telehealth, government/public health, and industry
  • Illustrate techniques for negotiating your time (FTE) with your Chair and Administrators
  • Describe how to incorporate forensic consulting into your medical toxicology practice

What People Are Saying

  • "It was very helpful to see the different revenue and funding streams and the arguments that have to be made to continue the service."
  • "Hearing about the journey to getting a younger service on the ground was exceptionally helpful"
  • "This will be a great course to take before another national meeting such as ACMT, ASM, or NACCT"

 All lectures will be recorded and made available on-demand after the live-streamed event.

Please note that CME is not available for this content.

Agenda | May 4, 2023

10:00 - 10:10 AM ET      Welcome & Opening Remarks

                                         Anthony Pizon, MD, FACMT
                                         Chief of Division of Medical Toxicology, Department of Emergency Medicine
                                         University of Pittsburgh, Pittsburgh, PA

                                         President, American College of Medical Toxicology

                                         Paul Wax, MD, FACMT
                                         Executive Director, American College of Medical Toxicology                                         

                                         Christina Hantsch, MD, FACEP, FACMT, FAACT
                                         Chair, Practice Committee, American College of Medical Toxicology
                                         Board Member, American College of Medical Toxicology                                      


Panel Presentation: Hospital-Based Medical Toxicology Practice
Co-Moderators: Christina Hantsch, MD, FACEP, FACMT, FAACT and Timothy Wiegand, MD, FACMT, FAACT, DFASAM

10:10 - 10:29 AM ET      "Phoenix Model" Admitting Service
                                           Anne-Michelle Ruha, MD, FACMT
                                           Chair, Department of Medical Toxicology
                                           Banner University Medical Center, Phoenix, AZ
  

10:30 - 10:45 AM ET      "Pittsburgh Model" Admitting Service
                                           Anthony Pizon, MD, FACMT
                                           Chief of Division of Medical Toxicology, Department of Emergency Medicine
                                           University of Pittsburgh, Pittsburgh, PA

10:46 - 11:01 AM ET      Consult Service in an Academic Setting
                                           Joshua Radke, MD
                                           Medical Toxicologist, Clinical Associate Professor, Department of Emergency Medicine
                                           University of Iowa Carver College of Medicine, Iowa City, IA

11:02 - 11:22 AM ET      Consult Service in the Community Setting
                                           Michelle Hieger, DO
                                           Emergency Physician, Medical Toxicologist, Addiction Medicine Physician
                                           WellSpan Health, York, PA

                                           Bryan Judge, MD, FAAEM, FACMT
                                           Emergency Physician, Medical Toxicologist
                                           Spectrum Health, Grand Rapids, MI

11:23 - 11:43 AM ET      Discussion / Q&A


11:43 - 12:00 PM ET        Break - 17 min


Panel Presentation: Medical Toxicology Practice in Other Clinical Settings
Co-Moderators: Jerrold Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM and Anthony Pizon, MD, FACMT

12:00 - 12:15 PM ET      Virtual Consultation Service
                                           Steven Offerman, MD, FACMT, FACEP
                                           Medical Director, KPNC Regional Toxicology Consultation Service
                                           Kaiser Permanente Northern California, Sacramento, CA

12:16 - 12:34 PM ET      "Money Talks for Med Tox" Outpatient Services
                                           Jerrold Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM
                                           Adjunct Clinical Professor, Division of Environmental and Occupational Health Sciences
                                           University of Illinois - Chicago, Chicago, IL
                                           Professor of Medicine
                                           Rosalind Franklin University of Medicine & Science, North Chicago, IL

12:35 - 1:00 PM ET        Telehealth Experience in Medical Toxicology 
                                           Timothy Wiegand, MD, FACMT, FAACT, DFASAM
                                           Associate Professor, Emergency Medicine; Director of Toxicology and Toxicology/Addiction Consult Service
                                           Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY

1:01 - 1:15 PM ET          Interprofessional Consults
                                           Kristine Nanagas, MD, FACMT
                                           Associate Professor of Clinical Emergency Medicine; Chief, Medical Toxicology Division
                                           Indiana University School of Medicine, Indianapolis, IN

1:16 - 1:36 PM ET          Discussion / Q&A


1:36 - 1:45 PM ET            Break - 9 min


1:45 - 2:32 PM ET         Addiction Medicine Clinical and Academic Practice
                                         Ashley Haynes, MD, FACEP
                                         Ascension Via Christi Hospitals, Wichita, KS

                                         Leslie Dye, MD, FACMT, FASAM, FAACT
                                         Clinical Professor, Emergency Medicine; Assistant Medical Director
                                         Wright State University/Boonshoft School of Medicine; OneFifteen, Dayton, OH

                                         Moderator: Joshua Radke, MD


Panel Presentation: Non-Clinical Practice Models
Moderator: Ashley Haynes, MD, FACEP

2:32 - 2:48 PM ET         Government Careers for Medical Toxicologists
                                         Stephanie Weiss, MD, PhD
                                         Staff Clinician, Translational Addiction Medicine Branch
                                         National Institute on Drug Abuse

2:49 - 3:02 PM ET         Pathways to Industry
                                         Sarah Eliza Dunn (Halcomb), MD, FACMT
                                         Medical Affairs Lead, Senior Science Fellow
                                         Bayer U.S. Crop Science

3:03 - 3:22 PM ET         How to Set up a Forensic Toxicology Practice
                                         Jerrold Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM
                                         Adjunct Clinical Professor, Division of Environmental and Occupational Health Sciences
                                         University of Illinois - Chicago, Chicago, IL
                                         Professor of Medicine
                                         Rosalind Franklin University of Medicine & Science, North Chicago, IL

3:23 - 3:43 PM ET         Discussion / Q&A


3:43 - 3:55 PM ET           Break - 12 min


Practical Sessions: Contracts, Billing, and Practice-Based Research

3:55 - 4:50 PM ET        Negotiating 101
                                        Azeem Ahmed, MD, MBA
                                        Clinical Professor of Emergency Medicine; Executive Vice Chair, Department of Emergency Medicine
                                        University of Iowa Carver College of Medicine, Iowa City, IA
                                        Adjunct Clinical Professor of Management and Entrepreneurship
                                        University of Iowa, Iowa City, IA

                                        Moderator: Joshua Radke, MD

4:51 - 5:25 PM ET        Understanding Medical Insurers and Medical Billing & Coding 101
                                        Tracey Loveland, CMBS
                                        University of Rochester, Rochester, NY

                                        Moderator: Timothy Wiegand, MD, FACMT, FAACT, DFASAM

5:26 - 5:53 PM ET        Practice Based Research: Can We Overcome the Challenges?
                                        Shooshan Danagoulian, PhD
                                        Associate Professor, Department of Economics
                                        Wayne State University

                                        Moderator: Paul Wax, MD, FACMT 


5:54 - 6:00 PM ET        Closing Remarks / Adjourn
                                       Paul Wax, MD, FACMT
                                       Executive Director, American College of Medical Toxicology

Azeemuddin Ahmed, MD, MBA

Clinical Professor of Emergency Medicine; Executive Vice Chair, Department of Emergency Medicine

University of Iowa Carver College of Medicine

Azeemuddin Ahmed, MD, MBA is a Clinical Professor of Emergency Medicine and Adjunct Clinical Professor of Management and Entrepreneurship at the University of Iowa. He practices and teaches Emergency Medicine at the University of Iowa Carver College of Medicine and the University of Iowa Hospitals and Clinics. Serving as Executive Vice Chair, he works closely with the department chair in all aspects of departmental administration with added focus on faculty recruitment, faculty development, faculty practice plan, faculty compensation, clinical innovation as well as strategic planning. Dr. Ahmed is board certified in Emergency Medicine and sub-specialty board certified in Emergency Medical Services by the American Board of Emergency Medicine.

His area of clinical expertise is pre-hospital care, and Dr. Ahmed serves as the Division and Fellowship Program Director for Emergency Medical Services in the Department of Emergency Medicine. In the realm of medical direction, he is Medical Director of Kinnick Stadium and Carver Hawkeye Arena as well as the Medical Director for the Bureau of Emergency Medical and Trauma Services, Iowa Department of Health and Human Services. Dr. Ahmed is an active researcher with projects involving health services, pre-hospital care, and continues to publish case reports, book chapters, research abstracts and manuscripts in a variety of academic media. He presents didactic lectures both locally and nationally and is a member of several professional organizations devoted to the advancement of Emergency Medicine care, education and research. He has received numerous teaching awards from his trainees in recognition of his education efforts.

Dr. Ahmed brings his education, enthusiasm, and real-world experience in conducting negotiations to the Dynamics of Negotiations class at the University of Iowa Tippie College of Business. He has proficiency in negotiating in a variety of situations within the health care system, between organizational units, human resources and business development. He provides seminars on negotiation strategies and tactics to a variety of business and health care organizations regionally and nationally. He was recognized by the Tippie Executive MBA – Iowa City Classes of 2015, 2018, 2019 and 2020 as a GREAT Instructor of the Year. In 2017, Dr. Ahmed was selected by the Tippie Executive MBA – Des Moines cohort as a GREAT Instructor of the Year and they also nominated him for the President and Provost Teaching Award.

In his free time, Dr. Ahmed is an endurance athlete having completed 21 half marathons and 5 marathons (including the New York City Marathon).

Shooshan Danagoulian, PhD

Associate Professor, Department of Economics

Wayne State University

Dr. Shooshan Danagoulian is an associate professor of economics at Wayne State University. As a health economist, Dr. Danagoulian’s research focuses on health insurance utilization and delivery of care, emergency department care and environmental health outcomes.

Sarah Eliza Dunn (Halcomb), MD, FACMT

Medical Affairs Lead, Senior Science Fellow

Bayer U.S. Crop Science

Dr. S. Eliza Dunn (Halcomb) is an emergency medicine physician and medical toxicologist with a long-standing interest in global health.

After completing her toxicology fellowship at NYU in 2006, Dr. Dunn returned to Washington University in St. Louis and started an ACGME accredited fellowship in Medical Toxicology.
Over the following ten years, Dr. Dunn became increasingly involved with global health and humanitarian relief projects. She organized a relief mission to Haiti after the 2010 earthquake, started the scholar track in Global Health for the Washington University Division of Emergency Medicine, and is one of the Global Health Scholars for the Department of Internal Medicine.

Over the years, Dr. Dunn began to realize that in order to have a sustainable impact in global health, there needed to be an effort to focus on creative ways of addressing malnutrition and insect-borne illness, two of the most commonly encountered public health problems in developing countries. With that in mind, Dr. Dunn started working as the Medical Affairs Lead for Bayer, a global seed and chemical company with innovative technology that has great potential to remediate malnutrition.

Dr. Dunn has lectured nationally and internationally on a diverse range of topics in medical toxicology and global health.

Leslie R. Dye, MD, FACMT, FASAM, FACCT

Clinical Professor, Emergency Medicine, Assistant Medical Director

Wright State University/Boonshoft School of Medicine, OneFifteen

Leslie R. Dye, MD is triple board certified in emergency medicine, medical toxicology, and addiction medicine. She has worked in the fields of medical toxicology and addiction medicine for 30 years. In addition to her clinical expertise, she has academic and business content expertise from experiences as an editor-in-chief (EIC) of a peer-reviewed medical journal (Journal of Medical Toxicology) and EIC of physician and pharmacist content production for a leading international medical digital content provider. Her deep subject matter expertise is demonstrated in her role as senior editor of the textbook, Case Studies in Medical Toxicology, author of 18 peer reviewed publications and 16 textbook chapters, 66 national and 11 international presentations, 10 various commentaries, interviews, and podcasts. Her leadership skills have been proven in both corporate and academic environments, as professor at a medical school, long-term board member and past president of the American College of Medical Toxicology, Chair of the Addiction Medicine Committee, former co-chair, and co-moderator of the AACT Acute and Intensive Care Symposium, and as the manager of as many as 30 team members at an international corporation. She received a funded grant that enabled her to start the first poison control center in mainland China and trained 6 Chinese physicians in the field of medical toxicology over 3 years in the US. Dr. Dye is experienced in and continues to provide medical care in remote polar regions with no access to advanced medical facilities.

Ashley Haynes, MD, FACEP

Medical Toxicologist, Addiction Medicine Specialist

Ascension Via Christi Hospitals

Dr. Ashley Haynes completed her medical training at the University of Kansas, followed by a combined emergency-internal medicine training program at East Carolina University. She completed a toxicology fellowship at University of Texas Southwestern in 2016, remaining as faculty for a few years after while engaging in a faculty development project in addiction medicine. She moved to Kansas in 2019 and now provides bedside toxicology and addiction medicine consultations at Ascension Via Christi hospitals in Wichita and periodically provides on-call support for the Kansas Poison Control Center. Additionally, she is a program physician for an outpatient addiction treatment center, and provides medication assisted therapy services to an inpatient residential treatment facility.

Michelle Hieger, DO

Emergency Physician, Medical Toxicologist, and Addiction Medicine Physician

Wellspan Health, York, PA

I am a board-certified Medical Toxicologist, Addictionologist, and Emergency Medicine physician. I completed my residency at Memorial Hospital in York, PA. My fellowship was completed at Virginia Commonwealth University in Richmond, VA. I currently work at WellSpan York Hospital in York, PA, as an Emergency Physician, Medical Toxicologist, and working with in-patients starting treatment for addiction. I initiated the toxicology service at York Hospital and now I am the Medical Director for Medical Toxicology. I am interested in treating the poisoned patients at bedside, and especially interested in the antidotal therapy with physostigmine (if it returns) and flumazenil. I enjoy professional engagement with ACMT.

Bryan S. Judge, MD, FACMT

Professor of Emergency Medicine; Medical Toxicologist

Michigan State University College of Medicine; Spectrum Health - Grand Rapids

Jerrold Blair Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM

Adjunct Clinical Professor Division of Environmental and Occupational Health Sciences & Professor of Medicine

University of Illinois Chicago and Rosalind Franklin University of Medicine & Science

I am a currently Adjunct Clinical Professor on the Division of Environmental and Occupational Health Sciences and the Occupational and Environmental Medicine Service of UI Health at the University of Illinois at Chicago and Professor of Medicine at Rosalind Franklin University of Medicine & Science in North Chicago, Ill.

In 1980, I received my medical degree from the Chicago Medical School.  I then completed a combined residency in Internal Medicine and Emergency Medicine at Northwestern University (1984) followed by a three-year preceptorship/fellowship training in Medical Toxicology at Cook County Hospital and University of Illinois Hospital in Chicago, Illinois. I am Board Certified in Internal Medicine, Emergency Medicine, Medical Toxicology and Addiction Medicine. 

I served as the Associate Director of the Emergency Department at Rush Presbyterian-St. Luke’s Medical Center in Chicago from 1998-2001.  During this time, I was also the Medical Director of the Rush Poison Control Center and served as Medical Director of the United States Drug Testing Laboratory (from 1991 -1996).  I was also the Medical Director of PROSAR (located in St. Paul, MN); a national call center devoted to industrial exposures and product safety issues, up until December 2013.

I have presented over 200 research abstracts at national meetings (primarily to the North American Congress of Clinical Toxicology) and have published over 200 articles in peer-reviewed medical journals.  I am the co-editor of the Poisoning and Toxicology Handbook (now in its fourth edition), published by CRC Press, and the American Medical Association Handbook of First Aid and Emergency Care, and published by Random House (New York).  I am also the co-editor with Dr. Robin McFee for the Toxico-terrorism book (McGraw Hill) and the Handbook of Nuclear, Biological and Chemical Agent Exposure (CRC Press) both published in 2007.  I was also the co-editor of the American Medical Association Complete Medical Encyclopedia, published by Random House in 2003.  I am presently the Editor-in-Chief of the primary care journal, Disease-a-Month, published by Elsevier.  I was on the Illinois State Board of Health from 2016 – 2019.

Kristine Nanagas, MD

Associate Professor of Clinical Emergency Medicine; Chief, Medical Toxicology Division

Indiana University School of Medicine

Dr. Nanagas graduated from The Ohio State University School of Medicine and Public Health in 1999 before completing her Emergency Medicine residency at Methodist/Indiana University in 2002. She was inspired to do the Medical Toxicology fellowship (also at IU) after her resident rotation on the toxicology service. After negotiating cat visitation rights in exchange for cooperation with medical therapy from a particularly difficult patient and learning a whole new vocabulary of swear words from her colorful patients that month, she knew this was the specialty for her. She completed her Medical Toxicology fellowship in 2004 and has been a member of the IUSOM faculty since then. In addition to working in the IUH Methodist Emergency Department, she is the Division Chief for Medical Toxicology.  The Medical Toxicology consult service performs inpatient consults at the IUH Academic Health Center, the Riley Hospital for Children, and Eskenazi Health, in addition to providing medical backup for the Indiana Poison Center.  Her interests include clinical operations, deprescribing, and mentoring.  Her scholarly work focuses on the care of poisoned patients. Kris dearly loves her husband and three children- who all relish living near Eagle Creek Park and enjoying the outdoors there. She shares her home with numerous animals- some of whom are invited and some are merely invading and hard to eradicate.

Steven R. Offerman, MD, FACMT, FACEP

Medical Director, KPNC Regional Toxicology Consultation Service

Kaiser Permanente Northern California

Anthony Pizon, MD, FACMT

Chief of Medical Toxicology Division, Professor of Emergency Medicine

University of Pittsburgh

Dr. Anthony (Tony) Pizon received his medical degree from the University of Toledo School of Medicine in 2001.  He then completed his Emergency Medicine Residency at the University of Pittsburgh Medical Center in 2004 and his Medical Toxicology Fellowship at Banner Good Samaritan Medical Center in Phoenix, Arizona in 2006. Dr. Pizon is currently a Professor in the Department of Emergency Medicine, Division of Medical Toxicology at the University of Pittsburgh, School of Medicine. He serves as Chief of the Division of Medical Toxicology and Director of the Medical Toxicology Fellowship at UPMC. He is also Assistant Medical Director of both the Pittsburgh and West Virginia Poison Centers. Yet, most importantly, he is blessed with amazing wife, Caryn, and four wonderful children (Benjamin, Elizabeth, Gabriela, and Seraphina).

Joshua Radke, MD

Clinical Assistant Professor of Emergency Medicine

University of Iowa Hospitals & Clinics

Michelle Ruha, MD, FACMT

Professor of Emergency Medicine and Internal Medicine; Chair, Department of Medical Toxicology; Chief, Section of Addiction Medicine (Department of Medical Toxicology)

Banner - University Medical Center Phoenix

Paul M. Wax, MD, FACMT

Executive Director

American College of Medical Toxicology (ACMT)

Dr. Wax is the Executive Director of the American College of Medical Toxicology. He received his B.A from Dartmouth College, his M.D. from the Mount Sinai School of Medicine, his Emergency Medicine training at the UCLA Hospitals, and his Medical Toxicology training at Bellevue Medicine Center / New York University. He is Board-certified in both Medical Toxicology and Emergency Medicine, and is a Fellow of the American College of Medical Toxicology.

Stephanie Weiss, MD, PhD

Staff Clinician, Translational Addiction Medicine Branch

National Institute on Drug Abuse

Dr. Stephanie Weiss is the Staff Research Physician serving the Translational Addiction Medicine Branch of the National Institute on Drug Abuse’s Intramural Research Program. After earning a Ph.D. in pharmaceutical chemistry, Dr. Weiss received her medical degree in 2011.  She is board certified in emergency medicine, addiction medicine, and medical toxicology and was selected to participate in the Boston University Research in Addiction Medicine Scholars Program prior to joining NIDA.  Dr. Weiss is responsible for providing optimal, safe, and ethical care to study participants and clinical support toward the TAMB mission conducting inpatient and outpatient proof-of-concept human laboratory studies. Her research interests include novel psychoactive substances, medication misuse, and improving interpretation of urine drug testing.

Timothy Wiegand, MD, DFASAM, FACMT, FAACT

Director of Addiction Medicine and Addiction Medicine Consults

University of Rochester Medical Center

Timothy J. Wiegand, MD, FACMT, FAACT, DFASAM is an Associate Professor of Emergency Medicine and Public Health Sciences at the University of Rochester Medical Center in Rochester New York.  He is Board Certified in Medical Toxicology and Addiction Medicine and practices in Addiction Toxicology with a mix of clinical,  research, teaching, and other professional work.  Dr. Wiegand has served two terms on the Board of Directors for the American College of Medical Toxicology (ACMT) and he is currently serving on the Board of Directors for the American Society of Addiction Medicine (ASAM) completing a term on the Executive Counsel as Vice President of ASAM.  He begins a two-year term as Treasurer of ASAM in April 2023.  Dr. Wiegand founded and led the Toxicology service at URMC until 2022 when he became Director of Addiction Medicine and Director of Addiction Medicine Consults also at URMC in the Department of Emergency Medicine.  Dr. Wiegand has served as Fellowship Director for the URMC Combined Addiction Medicine Fellowship and he is the Fellowship Director for the URMC Medical Toxicology fellowship expecting to formally begin once accredited, in July of 2023.

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Pathways to Building and Sustaining a Medical Toxicology Practice
05/04/2023 at 10:00 AM (EDT)  |  480 minutes
05/04/2023 at 10:00 AM (EDT)  |  480 minutes
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