Curriculum VitaeofTHEODORE WILLIAM SHIVELY, DO, MHSAdHOME41693 Chesterfield CT.Novi, MI48375(248) 449-8226Fax: 248-449-8227OFFICEPrimeCare of Novi, PLLC39555 West Ten Mile RoadSuite #302Novi, MI48375OBJECTIVETo be a good steward: to use my talents wisely and to their fullest for the betterment of all.I strive to make the best possible use of my clinical and teaching skills and use myenergy, academic research,clinical and leadership interests for the betterment of all organizations with which I become affiliated.CLINICAL BACKGROUNDJuly 2011 – Present Appointed Unites States Aviation Medical Examiner, Federal Aviation AdministrationJuly 2010 - Present Appointed United States Civil SurgeonJuly 2009 – Present Hospitalist, ProvidenceHospital and MedicalCenters, Southfield, MIJuly 2003 – June 2005 Osteopathic Program Director – Family Practice, ProvidenceHospitalandMedicalCenters, Southfield, MIOctober 2003 – Assistant Clinical Professor, MichiganStateUniversityPresent College of Osteopathic MedicineOctober 2003 – Assistant Clinical Professor, WayneStateUniversityCollege of MedicinePresentJanuary 2005 – President, Department of Family Medicine, ProvidenceHospital andJanuary 2008 MedicalCenters, Southfield, MIJanuary 2003 – Secretary, Department of Family Practice, ProvidenceHospital and Medical January2005 Centers, Southfield, MIApril 2003 –Present Staff Physician, Angela Hospice, Livonia, MichiganOctober 8, 2000 – Co-founder, PrimeCare of Novi, a multi-physician family practice in Novi, MIPresent
June. 1997 – Moonlighting work- ProvidenceHospital and. Medical Centers.October 6. 2000 Urgent Care PhysicianNovember 2001- Clinical faculty, Department of Family Medicine, Botsford GeneralHospital,Present Farmington Hills, MI. Duties involve teaching and precepting Family Practiceand Internal Medicine residents.January -1997 – Private (employed) group practice. Specialist in Family -Practice,October 8,, 2000 ProvidenceHospital and Medical Centers47601 Grand River Avenue, Suite C-106Novi, MI48374Memberships: Managed Care, Quality Assurance, Medical PracticeManagement Group (Electronic medical records)October, 1998 – Lecturer, MichiganState Medical Society. Adult ImmunizationMarch, 1999 State representative to national ACP/NIH convention on immunization policies andpractices.February, 1996 – Faculty, Family Practice Residency. Mission Health, Southfield, Mi.February, 1997 Duties involve in-patient and out-patient teaching, of residents.in-patient and out-patient clinical care. "Teacher of the Year"awarded by the residents. June 1996, "Outstanding Faculty of the Year"awarded by the Department of Family Practice, June 1996.Committee memberships: Patient Education, Geriatrics-, Physician Compensation andBenefits, Primary Care Council. I was responsible for the Geriatrics teaching componentof the Family Practice Residency.July 1. 1981 – Extensive clinical experience in primary rural health care. ContinuousFe6ary, 1996 self-employed, self-administered private medical practice in Cassville,Pennsylvania (Pop. 300). The practice grew to the point where I hadto restrict new patients in 1988. At that time, there were 7000 active patients.From 1992 through 1994, 1 employed a second physician.Cassville is located 17 miles south into the mountains from theMixed staff 110 bed community hospital. Active staff privilegesatJ.C.BlairHospital included nursery, ICU, pediatrics, medicine and theEmergency Room. Committee members*: P&T, QC, credentials, medical records and ICU.July 1, 1979 – National Health Service Corps physician, BroadtopMedicalCenter, BroadtopJune 30., 1981 PA. This was a community-board administered general practice. Hospitalprivileges were maintained as above.EDUCATIONDecember, 1997 Master of Science, Concentration in Health Science AdministrationCentralMichiganUniversityJuly 1,1978– Rotating internship, Detroit Osteopathic Hospital CorporationJune 30, 1979 Detroit, Michigan.July 1, 1974 – MedicalSchool, PhiladelphiaCollege of Osteopathic MedicineJune 30, 1978 Philadelphia, Pennsylvania. Doctor of Osteopathy grantedJune 4, 1978.September 1970 – College, LehighUniversity~ Bethlehem, Pennsylvania. GrantedMay 1974 B.S. in Fundamental Sciences. This program was designedto accommodate students with double science majors.
September 1966 – High School , Salutatorian, BishopMcDevittHigh School,May 1970 Harrisburg, Pennsylvania. Extra-curricular activities includedHonor Society, Drama Club, Latin Club, Yearbook (sportseditor), Projection Club, Forensics Club and Swimming Team(Varsity letter 3 years).LICENSUREJuly 7, 1979 Unrestricted license to practice osteopathic medicine.Granted by the State Board of Osteopathic Medical Examinersof the Commonwealth of Pennsylvania, License # OS-004262-L.August 2., 1979 Unrestricted license to practice osteopathic medicine.Granted by the State Board of Osteopathic Medical Examinersof the State of Michigan, License # B-7518. (Now 51017588)CERTIFICATIONJanuary 12, 1995 Recertified in Family Practice. This was a voluntary recertificationand was the first tune the Osteopathic profession sponsored suchan examination. Certificate # 3397.Expires December 31, 2005.February 14, 1992 Certificate of Added Qualification in Geriatrics.Certificate # 3397.July 28, 1988 Certified in General Practice by the American Osteopathic Boardof General Practitioners and Surgeons, Certificate # 3397.July 1, 1979 Passed the National Board of Examiners for OsteopathicPhysicians and Surgeons., USA.Certificate # 5422.MEMBERSHIPSProfessional American Osteopathic AssociationAmericanCollege of General PractitionersBotsfordHospital, Farmington, MI, Inactive medical staffMichigan Osteopathic AssociationPennsylvania Osteopathic Medical AssociationProvidenceHospital and MedicalCenters, active medical staffAWARDS AND APPOINTMENTSSecretary, Department of Medicine, I C. BlairMemorialHospital1986-1987"Teacher of the Year" awarded by the residents, June 1996"Outstanding Faculty of the Year" awarded by theDepartment of Family Practice, June 1996PERSONALDate of Birth August 15, 1952Place of Birth Harrisburg, PennsylvaniaMarital Status MarriedRace CaucasianCitizenship USATEACHING AND RESEARCH
Teaching is what I do as a practicing physician! I have distilled over my career a unique style of analogy in order toillustrate medical points to patients. I have extensive experience in public speaking to civic groups, ambulance corps,religious and medical organizations.1996-97 Responsible for the Geriatrics component of the Family PracticeResidency. Duties included weekly in-patient teaching rounds, regularlectures on practice management and weekly lectures in the nursinghome on topics in geriatric medicine.1982 Course Director, Emergency Medical Technician 11985 Course Director, Emergency Medical Technician 11987-1988 Clinical researcher, Loratadine Study, Schering CorporationSeptember 1987- Clinical researcher, Omeprazole open label study, MSD,May 1990 This study involved setting up an IRB and compliance withextensive study protocols for development of data ultimatelyincluded in MSD`s data base. This was done for the benefitof one of my patients with a MEN-l syndrome in order toobtain the drug under the compassionate use program beforeit was commercially available.1989 Course director, EKG interpretationMay 199 1 -June 1992 Clinical researcher, Isradapine Study, Sandoz CorporationJune 1996 "Teacher of the Year". Department of Family Practice,ProvidenceHospital and MedicalCenter.Schwartzberg Award for teaching excellence, Family Practice.November, 1997 Masters Thesis: MEDICARE RISK CONTRACTS: CASE STUDYIN THEIR IMPLEMENTATION AND A PROSPECTIVE COSTBENEFIT ANALYSIS FOR THE CREATION OF A CASEMANAGEMENT POSITIONREFERENCES AND FURTHER DATA ON REQUEST