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President's Message: Terrific Symposium concludes, AAMA proceeds with exciting plans for 2011
By Richard F. Hobbs, III, MD, FAAMA
President, AAMA
This being my first contribution to the AAMA Newsletter as president, let me first say that it is a great honor to represent you. I pledge to work diligently over this next year to address the concerns and the needs of academy members, to promote medical acupuncture as a specialty and to strengthen our role as stakeholder in the evolving healthcare system. This work, of course, cannot be accomplished by one person alone, and I am pleased to recognize your Board of Directors. Richard Niemtzow remains on the board as Immediate Past President; Rey Ximenes was elected Vice-President; Sandi Amoils, Secretary; Claudia Harsh ,Treasurer; Jay Abel-Horowitz, Director-at-Large; Tom Burgoon, Director-at-Large; Paras Mehta, Director-at-Large; and Marshall Sager, Director-at-Large. What an amazing group! Each one brings to bear tremendous talent and deep commitment to working for the benefit of the Academy.
We are in a good position to accomplish our goals now and, for this, we have Richard Niemtzow to thank. His leadership over these past two years has brought us out of a difficult period and enabled us to move forward.
2011 Academy Plans
You will hear more in future issues of the newsletter, but I want to share with you some of the steps we are currently taking to broaden our services to members and to improve the quality of what we have to offer.
First, we are well into the process of building a new website. This effort is being led by Jay Abel-Horowitz, Sandi Amoils and Paras Mehta. I am confident that, once we go live, you will like what you see. Our current website is out of date and lacks the functionality to support social media, on-line educational programs and the like. Our new one will do all of these things plus will make accessing all Academy services much easier.
Reimbursement
Reimbursement is a major issue for the membership. Marshall Sager and Rey Ximenes are now prepared to provide consultations on reimbursement issues. (See related article in this issue.) Marshall had the great idea of providing this service. He and Rey both have tremendous experience and expertise in dealing with billing and coding and will work together to help you find your way through the “puckerbrush” of third party payers.
We have just had a marvelous symposium in San Diego. Our Symposium Committee for 2012, under the leadership of Anna Kelly as Chair and Jay Sandweiss as Vice-Chair, got an early start and is well along in planning our next symposium. The group of speakers lined up, thus far, is amazing. Please plan to join us in Atlanta, GA, April 26-29, 2012.
Survey Results
In our last survey, we received a clear message that, in addition to the Symposium, the membership is interested in affordable, year-round educational opportunities. Claudia Harsh, working with the Education Committee is in the process of planning a new series of educational DVDs. In addition, once our website is completed, Claudia is planning for the Academy to offer webinars and other on-line learning experiences.
We are not letting Richard Niemtzow off the hook, just yet. As Immediate Past President and a member of the AAAOM Board of Directors, he is our liaison with the AAAOM and is working with them on some important issues of mutual interest.
Finally, Tom Burgoon is spearheading our efforts to increase membership. Why is this important? First, we need to maintain a dynamic state of being. Without new members, we become stagnant and members will drift away. Secondly, it is through membership dues that we have the resources to develop a new website, to provide educational programs and to have the administrative services we need for a vibrant, volunteer organization. Tom will be contacting the directors of the various physician acupuncture courses to arrange for their graduates to receive information about the AAMA and its benefits. He will also be overseeing contact with former members to let them know that we value their past participation and hope that they will return.
Diverse Membership
One of our greatest assets is our diversity. We represent many medical specialties and also many schools of thought and clinical approaches in the practice of medical acupuncture. This poses some challenges when it comes time to develop educational programs, like the Symposium, that will meet everyone’s needs. However, this rich diversity also provides the opportunity for us to constantly be learning new things which we can use for the benefit of our patients. For me, personally, this is perhaps the greatest benefit of belonging to the academy, and I have all of you to thank.
We, as a board, welcome your concerns and your ideas about how we can improve the AAMA. My e-mail address is drhobbs@plumblossomacupuncture.com. Please feel free to get in touch.
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AAMA 23rd Annual Symposium
New Board, turn around, goals, recertification & CPT Coding Sheet outlined
More than 300 healthcare practitioners and exhibitors enjoyed the 23rd Annual AAMA Symposium with informative sessions, presenters, a Dinner Dance and more in San Diego, where a revitalized spirit was felt among those studying medical acupuncture.
“We should feel good about the AAMA. I do believe the spirit is back and will serve us well in years ahead,” said outgoing President Richard C. Niemtzow, MD, PhD, MPH. “This has been a year of turn-around after three years of membership going down. We have 1,350 members, which is flat but better than the decline.” He then led members in a moment of silence to remember damage from the earthquake in Japan.
“We began planning this Symposium a year ago,” Dr. Niemtzow said, “and Dr. Anna C. Kelly is already planning the next Symposium, April 26-29, 2012 at the Grand Hyatt Atlanta in Atlanta, GA.” Symposium 2011 sessions on CDs and syllabus for Pre-Symposium and Symposium can be ordered online. Dr. Niemtzow added that leaders are looking into loading Symposium sessions onto DVDs and granting CME for them.
Treasurer Rey Ximenes, MD, FAAMA, reported money has been tight for AAMA the past few years but now is looking better and is in the black. He noted that revenue and attendance for this Symposium is higher than for the past five years.
New Leadership
In San Diego, the 2011-’12 AAMA Board of Directors was elected:
President Richard F. Hobbs, III, MD, DABMA
Vice President Rey Ximenes, MD, FAAMA
Secretary Sandi Amoils, MD
Treasurer Claudia E. Harsh, MD
Directors now include: Jay Abel-Horowitz (continuing), MD; Thomas S. Burgoon, MD, DABMA; Paras Mehta, MD and Marshall H. Sager, DO, FAAMA. Dr. Niemtzow remains as immediate past president. Retiring Board member Hiroshi Nakazawa, MD, FAAMA, was honored for many years of service to AAMA, as was Executive Administrator C. James Dowden, commemorating his 20th Symposium. Dr. Nakazawa received a standing ovation, and Dowden was called “the glue that keeps us together.”
Outgoing President Remarks
“It’s been an honor to serve you for two years, and I know Rick Hobbs will do a tremendous job,” said Dr. Niemtzow, passing on the flashlight that Dr. Nakazawa gave him two years earlier to light the way. “Medical acupuncture is moving forward rapidly. We should be a beacon in the night – and we are.”
Dr. Niemtzow added that AAMA “needs to be aggressive in the way we present our profession. There’s a lot of respect for us for what we do, and we should do this openly and proudly.” The 14-year editor of AAMA’s Medical Acupuncture added that members can get published and earn $1,000 by submitting a comprehensive review to that journal.
Incoming President Remarks
“This is indeed an honor, but I may be shining this flashlight in the sky for help, like Batman did with his Bat Signal,” Dr. Hobbs said. “AAMA was in a state of crisis when I joined, but now things are turning around. A survey has been tabulated with your needs and desires. So some of the issues we will be focusing on include: reimbursement, low-cost educational opportunities and ensuring our medical acupuncture profession is recognized and promoted.”
Recertification
DABMA Committee Chair Robert J. Gross, DABMA, noted this is the first year that renewal is required for those nearing the end of the 10-year mark of their Board Certification. Requirements have been sent (and posted online) to those who need to recertify. An automatic three-year extension will be granted to those who are unable to complete the process by the deadline. For specific information on recertification, contact Executive Administrator Jim Dowden at the AAMA offices.
Medical Acupuncturists & LAc's
Dr. Niemtzow brought up the issue of Academy members working with licensed acupuncturists: “We met with the American Association of Acupuncture and Oriental Medicine for the first time and had a handshake. We now have a completely different situation in this country. We’re having a dialogue with a group that wasn’t too nice to us at times in the past. They want to talk about some of their problems, like licensing challenges.”
Now on the AAMA Board, Marshall H. Sager, DO, FAAMA, advised the membership to proceed cautiously and be thorough: “To see what’s in it for us.”
“No one has a license on healing,” Ann Robb, MD, DABMA, said. “I’d like to see us working together.” Lowell E. Kobrin, MD, FAAMA, also suggested AAMA move forward in these talks.
Bradley J. Williams, MD, FAAMA, noted any change to the bylaws would require a majority approval vote by the membership.
“We haven’t set a policy, made any decisions or decided goals,” Dr. Niemtzow responded. “We just had a discussion with the AAAOM, which represents 32,000 people in the US.”
CPT Coding Sheet
The Position Statement of the AAMA Regarding CPT and E/M Coding and Billing for Acupuncture Services was presented at the Academy’s Annual Membership Meeting. “We’re trying to get you paid for what you do,” Dr. Ximenes told members,” and the first step of that is this paper.” Dowden added that AAMA is “building a framework to make a case for charging Evaluation & Management services for every visit. So as the professional society representing physician acupuncturists, we need to set standards and criteria to make these charges. It’s our basis for charging E&M specific to physicians.” For a copy of the Coding Reference Sheet, click here. For a copy of the Position Statement on E/M Coding and Billing, click here.
Poster Competition Winners
1st Place ($750) -- Josne Carla Paterno, MsC
“Attenuation of Progression of Renal Disease in Rats by Electroacupuncture and Moxibustion is Linked to Decrease of Symphatetic Nerve Activity and Increase Nitric Oxide Levels”
2nd Place (tie -- $375) -- Lynn A. Gershan, MD
“Successful Acupuncture Treatment of Headache Associated with Pseudotumor Cerebri and Concurrent Migraine in an Adolescent Female”
Lawrence Taw, MD
“Integrative Medical Therapy for Dumping Syndrome”
Online Symposium Coverage
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Committee on Reimbursement forms to review medical acupuncture billing services
By Marshall H. Sager, DO, FAAMA
Member, AAMA Board of Directors
Are you having problems with billing, coding or reimbursement for your medical acupuncture services? Have you been denied adequate reimbursement? Have your claims been rejected?
A recent AAMA Board of Directors meeting reviewed membership needs, and, in response, established a Committee on Reimbursement. The Committee consists of Rey Ximenes MD, FAAMA, and me as chair. Both of us spoke at the recent Symposium concerning these subjects. The purpose of the Committee is to assist members in matters of coding, billing and reimbursement for medical acupuncture.
The Committee is working on a detailed survey to be distributed to our members. The purpose of this survey is to identify your various coding, billing and reimbursement insurance problems and your attempts, successful or otherwise, at resolution. Once that data is gathered, compiled and analyzed, we will begin to codify appropriate responses for members to utilize to help them effectively deal with a wide range of billing, coding and/or reimbursement situations.
Check back in the next AAMA Newsletter for up-to-date progress with this project.
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NIH launches site offering evidence-based information on acupuncture, CAM
A new online resource, designed to give medical acupuncturists easy access to evidence-based information on complementary and alternative medicine (CAM), was recently unveiled by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health.
With this new resource, AAMA members will have the tools necessary to learn about the various CAM practices and products and be better able to discuss the safety and effectiveness of complementary and alternative medicine with their patients. Acupuncture links and services can be found here.
The portal on the NCCAM Web site includes information on the safety and efficacy of a range of common health practices that lie outside of mainstream medicine— mind-body practices such as acupuncture, meditation, chiropractic, and massage, as well as natural products, such as dietary supplements, herbs and probiotics.
More details here.
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Medical acupuncturists earn DABMA certification
The following physicians recently met the stringent requirements of the American Board of Medical Acupuncture (ABMA) and have achieved Board Certification in medical acupuncture. They have earned the designation DABMA (Diplomate, American Board of Medical Acupuncture):
Kimberly A. Levitt, MD, of Princeton, NJ; R. Ivan Iriarte, MD, of Coto Laurel, Puerto Rico; William E. McDougall, DO, of Brookings, OR; Carolyn R. Olson, MD, of Bark River, MI, and James Won, MD of Brandon, FL.
The Academy has posted a list online of physicians who are Board Certified. Diplomates (DABMA) are listed alphabetically by last name, along with their location, and dates of expiration.
Click here for more on the Board Certification process.
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ABMA recertification process forms posted online
The ABMA Board of Trustees has posted the recertification application form and case report guidelines for designees approaching the 10-year recertification deadline.
Each candidate for recertification will be required to submit the following:
· Application for recertification.
· Copy of current active medical license.
· Documentation of 150 hours of continuing education credits in medical acupuncture since certification. CME credit is preferred. Topics must be primarily acupuncture. Independently awarded CEU credits may be acceptable, at the discretion of the Board.
· Submission of two written Case Reports on actual cases treated to demonstrate continued knowledge and proficiency in the discipline. Specific Case Report Guidelines will be provided.
· Payment of a recertification fee of $250.
There will be no written examination required for recertification.
Applications for recertification should be submitted at least 60 days prior to the expiration of the original certification to assure sufficient time for Board review and approval. Each submission will be submitted to the Board for review to confirm the adequacy of the Case Reports and to confirm that the continuing education requirements are met. If all requirements are met, the Board will grant a new 10-year certification. For those designees unable to complete the process by the expiration date, an automatic extension of up to three years will be provided.
The first designees will be up for recertification by June 30, 2011. Click here for those forms.
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Medical Acupuncture Research News
The following is a review of reported research results and related news recently announced or released through Internet outlets:
·The abstract, "Acupuncture for the alleviation of hot flashes in men treated with Androgen Ablation therapy," was published in the International Journal of Radiation Oncology/Biology/Physics (April 2011), a journal of the American Society for Radiation Oncology (April 2011). Researchers evaluated men experiencing hot flashes due to hormone therapy for prostate cancer. They concluded that acupuncture provides long-lasting relief to hot flashes, heart palpitations and anxiety due to side effects of the hormone given to counteract testosterone, the hormone that induces prostate cancer.
More details
·The abstract, “Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: Additional therapy to standard medication,” was published in Evidence-Based Complementary and Alternative Medicine (March 7, 2011). It’s believed this is the first report on hemodynamic change in retrobulbar vessels related to acupuncture in OAG eyes. Findings suggest that acupuncture can alter vessel resistance in the SPCA. The vessel resistance in the SPCA and IOP level were decreased by acupuncture in OAG eyes. Acupuncture can affect retrobulbar circulation and IOP despite standard medication. Researches concluded that acupuncture is effective for OAG with standard medication.
More details
·The abstract, “Acupuncture stimulation causes bilaterally different microcirculatory effects in stroke patients,” was published in Microvascular Research (May 2011, Vol. 81, Issue 3). The study documented the therapeutic effects of acupuncture on Taiwanese patients who had suffered strokes. All in the rehabilitation stage, patients received acupuncture in certain areas associated with improved blood flow and were later tested for changes. Results showed that acupuncture can decrease blood flow resistance and increase microcirculatory blood flow, a situation that is deemed helpful for the recovery of stroke patients.
More details (or type abstract name in the search engine at www.sciencedirect.com).
·The abstract, “Laser acupuncture therapy for primary monosymptomatic nocturnal enuresis,” was published in the Journal of Urology (online March 18, 2011). The study involved 91 children (mean age of 8.6 years) with primary monosymptomatic nocturnal enuresis. They were randomized into two groups: Laser acupuncture therapy was significantly more beneficial compared to placebo in terms of complete dryness, partial improvement and a decrease in the number of weekly bed-wetting episodes. Researchers concluded that laser acupuncture therapy can be considered as an alternative therapy for these patients.
More details
·The abstract, “Acupuncture to Danzhong but not to Zhongting increases the cardiac vagal component of heart rate variability,” was published in Autonomic Neuroscience (April 26, 2011, Vol. 161, Issue 1). The study involved acupuncture points CV17 (Shanzhong) and CV16 (Zhongting). CV16 did not produce therapeutic results, but CV17 worked. Researchers concluded that that acupuncture controls the heart rate and increases the strength of cardiac autonomic function. This indicates that specific acupuncture points may help to prevent heart attacks (myocardial infarctions) and arrhythmias.
More details
·The abstract, “The Physiological Basis of Complementary and Alternative Medicine for Polycystic Ovary Syndrome (PCOS),” was published in the American Journal of Physiology-Endocrinology and Metabolism (April 2011). The study measured if electro-acupuncture improved menstrual regularity in women with PCOS. Acupuncture was administered in 14 treatments over 16 weeks. Researchers concluded that low frequency electro-acupuncture improved menstrual frequency and balanced sex steroid levels in these patients.
More details
Please send information you find on research involving the effectiveness of medical acupuncture to bart.ortberg@dowdenmanagement.com.
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AAMA Member News
AAMA’s 24TH Annual Symposium will be April 26-29, 2012. The Review Course will be on April 24-25, 2012, the Pre-Symposium Workshops on April 26, 2012 and the ABMA Certification Exam on April 29, 2012. The location will be at Grand Hyatt Atlanta in Atlanta, GA. For the AAMA discounted room rate of $159/night (sgl/dbl) pending availability, call the hotel by April 1, 2012 at 404/237-1234 and be sure to mention the AAMA Symposium.
Check out Global Mission Partner opportunities in 2011: Join Bryan L Frank, MD, FAAMA, past president of AAMA (1999-2001) for some travel with a purpose. Projects in 2011 include Ecuador in June, Kenya in July, Mexico in September and India in November. Plan in advance; click here for an application. Click here for photos from 2010. GMP encourages physicians, dentists, therapists, nurses and non-medical general volunteers to help those with little or no access to health care. Dr. Frank says this may be the most fun you’ve had in medicine in years.
Five Element Acupuncture for Physicians will be taught Oct. 20-23, 2011 in San Diego, CA by Drs. Charles A. Moss and Ron Puhky. Sponsored by Five Element Acupuncture Physician Training Program, this course has been approved for 30 Category 1 CME hours by Palomar Medical Center. Visit www.FiveElementTraining.com for details.
The Medical Acupuncture Review Course is available on DVD. Visit the AAMA Store to purchase this valuable learning tool.
Members participating in AAMA's referral program will be happy to hear that there were 2,273 unique visits to the website referral page in February, 3,214 in March and 2,173 in April from patients seeking medical acupuncturists in their area. Members interested in participating in the Patient Referral Program should visit the physician listings online to verify that they are listed. Only Practice level members are eligible to participate, and the Academy staff needs explicit notice to include a member in the program.
The following Fellows were elected at AAMA’s 24th Annual Symposium: Howard Chen, MD, DABMA; Jordan Goetz, MD, DABMA; Richard F. Hobbs, MD, DABMA; R. Ivan Iriarte, MD, DABMA; Edward S. Lee, MD, DABMA; Mitsuru Nakatsuka, MD, DABMA; Eric H. Schindler, MD, DABMA; Carlos A. Suarez, MD, DABMA, and Rosalie Tassone, MD, DABMA.
AAMA reminds members who meet special qualifications in Medical Acupuncture about the certification mark to convey their accomplishments. The certification mark is available only to Full Members and Fellows of the AAMA who are currently Board Certified by the ABMA. See the image of logo posted online. An application has been submitted to the US Patent Office to register this Certification Mark so that it is available for the exclusive use of those who meet the specified credentials. See the Certification Mark Guidelines posted online for standards on how the mark should be used in printed materials including acceptable type face, size, color, etc. For an electronic copy of a reproducible jpeg copy of the logo to provide your printer, Full Members and Fellows who are currently Board Certified through the ABMA may send a request to administrator@medicalacupuncture.org. Upon verification of your status, a jpg file will be sent to you.
Jay Sandweiss, DO, FAAMA, will lead, Integrative Manual Approach to Cervical Spine Pain and Dysfunction, Oct. 8-9 at Covenant HealthCare Physical Medicine & Rehabilitation in Saginaw, MI. An algorithm of treatment will be presented, which includes manual muscle testing, tender point analysis, trigger point analysis, motion testing, anatomical positional analysis and more. Call 734/995-1880 or visit doctorjaysandweiss.com.
A Suffield, CT doctor accused of improperly billing Medicare has agreed to pay more than $375,000 to the government to resolve the allegations against him. Involving Medicare for activity from 2002 to 2009, the physician was charged with billing Medicare for osteopathic manipulative treatment and for office visit the same day, which is not normally allowed. More details.
Editor-in-Chief Dr. Richard Niemtzow of the journal, Medical Acupuncture, is seeking volunteer reviewers to review manuscripts. Reviewers will access manuscripts online. Reviews must be completed and returned within one business week. Reviewers successfully completing a series of timely, high-quality reviews may be invited to join the Editorial Board (at the discretion of the editor in chief). Please send brief qualifications and contact information to n5ev@aol.com.
IRGOVAS (International Research Group on VAS) is a research and study group on the science and application of the VAS (Vascular Autonomic Signal) and its use and applications in auricular medicine/energetic medicine. IRGOVAS is joined by auricular medicine practitioners within the USA and Europe, many of whom AAMA members have met or trained with over the last decades. IRGOVAS has a multi-centered trial established and is inviting others to consider joining the project. Contact Drs. Bryan Frank (bfrankmd@hotmail.com) or John M. Ackerman (jma439@gmail.com) for details and let them know if you are interested to join these unique clinical trials.
As part of AAMA membership, practice members are being offered access to more than 400 journal articles categorized by disease/health application which promote the efficacy of Acupuncture. Contact Karyn Scurti at mafp@hmieducation.com to obtain your unique password to access this information anytime. Then go to www.hmiacupuncture.com and click on "LINKS."
Please send news items and photos to bart.ortberg@dowdenmanagement.com.
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AAMA Chapter News
Arizona
Arizona Chapter meetings are held at 9 am the second Saturday of the month at Dr. Martha Grout’s office, Arizona Center for Advanced Medicine, 9328 E. Raintree Drive, Scottsdale, AZ 85260. For details, call 480/240-2600 or e-mail drmartha@arizonaadvancedmedicine.com. There are monthly speakers on topics related to medical acupuncture, as well as Chinese and Functional/Integrative medicine. E-mail Dr. Grout to get on the e-mail list for meeting announcements.
California
Chapter officers are working hard to come up with innovative ideas for CME credits. They are continuing their membership drive to make the Chapter stronger. Academy members interested in joining the California Chapter are encouraged to contact President Haleh Sheikholeslami, MD, at calchapaama@hotmail.com.
Georgia
The Georgia Association of Medical Acupuncturists had a very successful CME meeting in April, hosting Lonny Jarrett. There were 40 attendees, half physicians and half licensed acupuncturists, for the three-day event.
After 10 years of service to GAMA as president, Anna Kelly, MD, will be passing the position on to Carlos Parrado, MD. His first order of business was to host a journal club, "Acupuncture for Facial Rejuvenation," in May.
The next annual CME event for GAMA will be held this fall.
GAMA invites everyone to visit their website to learn more about their organization’s philosophy, mission, events and much more. Their site includes a “Member” page, which includes contact information for each GAMA member. For information regarding membership and seminars, contact GAMA President Carlos Parrado, MD, at parrado.pena@att.net.
Illinois
The goal of President Lorene Wu, MD, DiplAc, and Secretary/Treasurer Anthony DeLorenzo, DO is to provide education and support to members. They plan to interface more with the wider acupuncture community by serving on the Illinois Acupuncture Board and by attending meetings of the local acupuncture society.
Meetings are held every other month at Memorial Hospital in LaGrange, IL.
Maryland
Joan Ordman, MD, FAAMA, is the president of the Maryland Society of Medical Acupuncturists (MSMA). Dr. Ordman is board certified in Internal Medicine, Holistic Medicine, and Medical Acupuncture. She works at the National Naval Medical Center in Bethesda, MD.
The Maryland Society of Medical Acupuncturists offers educational programs and wants to increase participation. Treat yourself to a nice evening. It is free, and members whose dues are paid receive a nice free meal. The lecture is on the Chapter. Contact Chapter President Joan Ordman, MD, FAAMA, at jordman@aol.com to join MSMA.
Ohio
Ohio Chapter members would love to see more active participation of the current membership. Please join them and invite medical acupuncture colleagues. For more information or questions, contact Dr. Steve Amoils, president of the Ohio Chapter, at
Steve.Amoils@myhealingpartner.com.
New Jersey & Pennsylvania
John Kohler, MD, FAAMA, is the president of the Pennsylvania Chapter. Visit www.pamedicalacupuncture.com/ for details on this chapter.
Washington State
“We are encouraging you to instill a little new blood and energy into our Washington State Chapter,” said J. Kimber Rotchford, MD FAAMA. “Is anyone out there willing to be an officer and take over the reins? There is a little bit of money in our bank account, and we do need to figure out how best to spend it? You can best contact me at JKRotchford@gmail.com.”
Click here for an up-to-date listing of AAMA Regional Chapter officers, their contact information, Websites and members. Think about joining a Chapter to learn more about medical acupuncture specific to your area. And if there’s not a Chapter in your region, please consider forming one by contacting Jim Dowden, AAMA executive administrator, at administrator@medicalacupuncture.org. Chapters provide fellowship, professional camaraderie, education and curbside consults.
Chapter representatives, please send your news and photos for the AAMA Newsletter via e-mail to bart.ortberg@dowdenmanagement.com.
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