AMA Wire® http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page Thu, 02 Jul 2015 17:12:00 GMT How payments, penalties will change post-SGR http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_payments-penalties-will-change-post-sgr Thu, 02 Jul 2015 17:12:00 GMT <p> With the <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repeal of the sustainable growth rate</a> (SGR) formula comes a new, consolidated quality reporting program for Medicare. Learn how bonus payments and financial penalties you may face will be affected under the merit-based incentive payment system (MIPS).</p> <p> The Medicare Access and CHIP Reauthorization Act (MACRA), the law that eliminated the SGR, has a variety of provisions, including medical liability protections and incentives for physicians who participate in alternative payment models. This first post in a series that examines what physicians need to know about MACRA looks at a major provision that deals with alignment of quality reporting and value purchasing programs.</p> <p> These pay-for-performance programs—the Physician Quality Reporting System (PQRS), the value-based payment modifier and the meaningful use electronic health record incentive program—currently require physicians to separately report various metrics for each program. The competing programs would leave many physicians facing a <a href="http://www.ama-assn.org/ama/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">tsunami of regulatory penalties</a>.</p> <p> Under the MIPS, physicians will have the chance to earn bonuses if they score above average performance thresholds and avoid penalties if they meet those thresholds. The MIPS also will give physicians the chance to score better and receive more credit for more quality improvement efforts—including a new category of clinical practice improvement activities—than under current programs.</p> <p> Adjustment factors for performance assessment under the MIPS will be according to a “sliding scale”—versus the current “all or nothing” approaches used in PQRS and meaningful use. Credit will be provided to those who partially meet the performance metrics and for improvement as well as achievement.</p> <p> Solo and small practices can join together in “virtual groups” and combine their MIPS reporting. The composite MIPS score will generally reflect four categories, which when fully implemented, will be weighted in these ways:</p> <ul> <li style="margin-left:0.25in;"> PQRS and quality: 30 percent</li> <li style="margin-left:0.25in;"> Value-based payment modifier and resource use: 30 percent</li> <li style="margin-left:0.25in;"> Meaningful use: 25 percent</li> <li style="margin-left:0.25in;"> Clinical practice improvement: 15 percent</li> </ul> <p> CMS could adjust these percentages for physicians with limited measures and activities that are relevant to their practice. Starting in 2016, group practices also will be allowed to use qualified clinical data registries for PQRS and MIPS reporting. </p> <p> <strong>Penalties before MACRA:</strong></p> <p> Under the current three quality reporting programs, physicians face maximum total penalties that increase each year:</p> <ul> <li style="margin-left:0.25in;"> 2015: 4.5 percent</li> <li style="margin-left:0.25in;"> 2016: 6 percent</li> <li style="margin-left:0.25in;"> 2017: 9 percent</li> <li style="margin-left:0.25in;"> 2018: 10 percent</li> </ul> <p> By 2019 and beyond, physicians’ penalties could be 11 percent or more.</p> <p> <strong>Bonuses and penalties under MACRA:</strong></p> <p> The three quality reporting programs continue through 2018, and then the MIPS will take effect in 2019. That same year, the secretary of the U.S. Department of Health and Human Services must inform physicians of their upcoming MIPS payment adjustment, whether it is a penalty or a bonus.</p> <p> Here’s how MIPS penalties and bonuses play out through 2022:</p> <ul> <li style="margin-left:0.25in;"> 2019: Maximum penalties and bonuses are 4 percent.</li> <li style="margin-left:0.25in;"> 2020: Maximum penalties and bonuses are 5 percent.</li> <li style="margin-left:0.25in;"> 2021: Maximum penalties and bonuses are 7 percent.</li> <li style="margin-left:0.25in;"> 2022 and after: Maximum penalties and bonuses are 9 percent.</li> </ul> <p> MIPS bonuses and penalties must balance out, and bonuses for the very best performers could be adjusted to go even higher—up to three times these amounts. Physicians also may earn “exceptional performance” bonuses of up to 10 percent from 2019 through 2024.</p> <p> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/understanding-medicare-physician-payment-reform.page" target="_blank">Learn more</a> about MACRA, and access <a href="http://www.ama-assn.org/resources/doc/washington/hr2-myth-fact.pdf" target="_blank">FAQs</a> (log in) about the new legislation. While MIPS will offer more flexibility, lower total penalties, and more opportunities for bonuses, it is only as good as the existing quality reporting programs. The AMA continues its advocacy to improve the current programs.</p> <p> Watch <em>AMA Wire</em>® for future posts on the many facets of MACRA and how they’ll affect how physicians practice in years to come.</p> <p>  </p> <p align="right"> <em>By AMA staff writer </em><a href="https://twitter.com/Lauren_AMAWire" target="_blank" rel="nofollow"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ec499f1-2b20-4f24-a848-204cebbf02da The ICD-10 countdown continues--make sure you’re ready http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_icd-10-countdown-continues-sure-ready Wed, 01 Jul 2015 21:51:00 GMT <p> Less than 100 days remain before the ICD-10 code set implementation deadline. <a href="http://www.ama-assn.org/ama/ama-wire/post/doctors-call-two-year-grace-period-icd-10-penalties" target="_blank">Physicians are asking</a> for a transition period for ICD-10, but you still should make sure your practice is as prepared as possible to minimize disruptions.</p> <p> If you haven’t checked them out yet, here are some practical resources from the Centers for Medicare & Medicaid Services (CMS):</p> <ul> <li style="margin-left:0.25in;"> <strong>Interactive case studies</strong>. Use <a href="http://www.roadto10.org/ics/" rel="nofollow" target="_blank">sample medical cases</a> from CMS to determine proper documentation and coding with ICD-10. After completing the questions, you can view your results in comparison to your peers and the correct way to code the case in ICD-9 and ICD-10. New scenarios will be released weekly.</li> <li style="margin-left:0.25in;"> <strong>In-person trainings.</strong> Physicians and practice managers in small and rural practices can participate in CMS’ <a href="http://www.roadto10.org/events/" rel="nofollow" target="_blank">free trainings</a> that will use customizable action plans, clinical scenarios and resources. The latest trainings are scheduled for Alaska, Arizona and Nebraska.</li> <li style="margin-left:0.25in;"> <strong>Updated fact sheets. </strong>CMS just updated much of its ICD-10 material, including <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1435.pdf" rel="nofollow" target="_blank">FAQs</a>, guidance about <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN901743.html" rel="nofollow" target="_blank">how to convert</a> ICD-9 codes to ICD-10,  an <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN901044.html" rel="nofollow" target="_blank">overview</a> of ICD-10, a description of <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN903187.html" rel="nofollow" target="_blank">classification enhancements</a> and information about how to use ICD-10 new technology <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1519.pdf" rel="nofollow" target="_blank">Section X codes</a>.</li> </ul> <p> Whether you’re a beginner or an expert, you can use an <a href="http://www.ama-assn.org/ama/ama-wire/post/beginner-experts-guide-icd-10-prep-steps-july" target="_blank"><em>AMA Wire</em>® series</a> to prep for ICD-10. Also, take the time now to learn what your practice should do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially</a> for ICD-10.</p> <p> Looking for more? An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> is an essential transition tool. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> <p>  </p> <p align="right"> <em>By AMA staff writer </em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" target="_blank"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3c3a7167-3e09-4519-84f5-b67b0fc77407 10 must-read articles if you want to be a medical educator http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_10-must-read-articles-want-medical-educator Wed, 01 Jul 2015 21:18:00 GMT <p> Pursuing a career in medical education? Whether you’re a resident, fellow or an established physician considering your career options, this must-read list of articles is for you. See which resources one expert in the medical education field recommends to boost your med-ed abilities. </p> <p> <em>Journal of Graduate Medical Education </em>editor-in-chief Gail M. Sullivan, MD, said that in the early years of her career very few educators held degrees tied to the educational side of medicine. But in the last 40 years, that trend has changed.</p> <p> “Now, there are increasing numbers of medical school and residency program faculty with formal training in education,” Dr. Sullivan wrote in a <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-15-00098.1" rel="nofollow">recent editorial</a>.</p> <p> While such training can broaden employment opportunities, she contends that there’s no cookie-cutter path to developing educational expertise. </p> <p> “Many current program directors, medical school teachers and other clinic educators did not major in education in college, nor will they have the finances and time to obtain an additional degree,” she said.  </p> <p> Physicians and trainees can launch a med ed career without necessarily pursuing additional costly degrees: “Fortunately, it is not the initials after one’s name that are essential but the skill,” she said. “Although experimental learning is among the most powerful ways to learn, there are many terrific articles that can enhance one’s knowledge, and if translated into practice, one’s skills as a teacher, program director or educational researcher.”</p> <p> Here are some of the top articles she recommends to improve your skills as a medical educator:</p> <p> <strong>Multimedia and online instruction</strong></p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-05-01-32" rel="nofollow">“To play or not to play: Leveraging video in medical education”</a>: <em>Journal of Graduate Medical Education </em></li> <li style="margin-left:0.25in;">  “<a href="http://medicine.fiu.edu/_assets/docs/learning-and-teaching/applying-the-science-of-learning-by-mayer.pdf" rel="nofollow">Applying the science of learning to medical education</a>”: <em>Medical Education</em></li> </ul> <p> <strong>Learning styles and theories</strong></p> <ul> <li style="margin-left:0.25in;"> <a href="http://pdfs.journals.lww.com/academicmedicine/1999/08000/The_adult_learner__a_mythical_species_.11.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1435675751036;payload|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;hash|FdxIFkWFoEeQxhxHEFrXiQ==" rel="nofollow">“The adult learner: A mythical species”: <em>A</em></a><em>cademic Medicine  </em></li> <li style="margin-left:0.25in;"> <a href="http://www.tandfonline.com/doi/pdf/10.1080/00461520.2013.804395" rel="nofollow">“Do learners really know best? Urban legends in education”</a>: <em>Educational Psychologist</em></li> </ul> <p> <strong>Mentoring</strong></p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.jpeds.com/article/S0022-3476(07)00987-0/pdf" rel="nofollow">“Anatomy of mentoring”</a>: <em>The Journal of Pediatrics</em></li> <li style="margin-left:0.25in;"> <a href="http://download.springer.com/static/pdf/553/art%253A10.1007%252Fs11606-009-1165-8.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs11606-009-1165-8&token2=exp=1435588986~acl=%2Fstatic%2Fpdf%2F553%2Fart%25253A10.1007%25252Fs11606-009-1165-8.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs11606-009-1165-8*~hmac=e6f24e81c47e94e831d96e12e4dad48a145d072da899e3acac05b0e9c54c56d1" rel="nofollow">“A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine”</a>: <em>Journal of General Internal Medicine</em></li> </ul> <p> <strong>Teaching</strong></p> <ul> <li style="margin-left:0.25in;"> “<a href="http://www.nejm.org/doi/full/10.1056/NEJMra054782" rel="nofollow">Educational strategies to promote clinical diagnostic reasoning</a>”: <em>The New England Journal of Medicine </em></li> <li style="margin-left:0.25in;"> “<a href="http://www.ncbi.nlm.nih.gov/pubmed/14996338" rel="nofollow">Student perceptions of effective small group teaching</a>”:  <em>Medical Education</em></li> </ul> <p> <strong>Writing</strong></p> <ul> <li style="margin-left:0.25in;"> “<a href="http://download.springer.com/static/pdf/887/art%253A10.1007%252Fs10459-014-9494-8.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs10459-014-9494-8&token2=exp=1435590359~acl=%2Fstatic%2Fpdf%2F887%2Fart%25253A10.1007%25252Fs10459-014-9494-8.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs10459-014-9494-8*~hmac=502a3ccdcfa139ff05021cefeb57753a924d29aa37b70043c402fd65e86d0057" rel="nofollow">Data dredging, salami-slicing and other successful strategies to ensure rejection: 12 tips on how to not get your paper published</a>”: <em>Advances in Health Sciences Education</em></li> <li style="margin-left:0.25in;"> “<a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-12-00044.1" rel="nofollow">Writing education studies for publication</a>”: <em>Journal of Graduate Medical Education</em></li> </ul> <p> For additional reading recommendations, view Dr. Sullivan’s <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-15-00098.1" rel="nofollow">full reading list</a>. </p> <p> <em>                                                                                                                                                             By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0a2f68a4-d14c-4629-8c7c-ed3c3a6c7fd3 What it’s like to be in interventional radiology: Shadowing Dr. Ding http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-interventional-radiology-shadowing-dr-ding Tue, 30 Jun 2015 21:25:00 GMT <p> As a medical student, do you ever wonder what it’s like to specialize in interventional radiology? Here’s your chance to find out.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/f2f1ca58-9122-4afe-9079-cc4f6f299c2b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/f2f1ca58-9122-4afe-9079-cc4f6f299c2b.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> Meet Alex Ding, MD, a radiologist and featured physician in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read Dr. Ding’s insights to help determine whether a career in interventional radiology is a good fit for you.</p> <p> <strong>“Shadowing” Dr. Ding</strong></p> <p> <strong>Specialty:</strong> Interventional radiology (IR)</p> <p> <strong>Practice type:</strong> Hospital-based, large single specialty group practice.</p> <p> <strong>A typical week in my practice:</strong></p> <p> A typical day includes arriving to work at 7:30 a.m. to review the schedule and [do a] workup [of] the patients for the day. First case starts at 8 a.m. A usual day [involves] about six to eight cases, which include multiple types of procedures using multiple technologies. </p> <p> Some cases include biopsies, drainages, paracentesis, thoracentesis, joint injections, nephrostomy tubes, gastrostomy tubes, biliary drains, tumor ablations,<strike>,</strike> bleed embolization and multiple others.</p> <p> One of the best aspects of this specialty is the breadth of different procedures you can perform. Between cases, I call back referring physicians and consults regarding future procedures and complete EMR notes. I usually finish the day at about 5:30 pm.</p> <p> My typical week [includes] four days [of] clinical and one  day off for administrative or personal tasks. I also rotate between three different hospitals in the county.</p> <p> <strong>The most challenging and rewarding aspects of caring for patients in interventional radiology:</strong></p> <p> Catering to a broad panoply of specialists, understanding their specialty well enough to speak the same dialect of medicine, and understanding their treatments and how I can be an adjunct for their patients [can be challenging].</p> <p> The most rewarding aspect is that as a radiologist, I still maintain regular contact with patients and take care of them face-to-face. I have many patients who see me for a number of different problems, and establishing long-term relationships is wonderful.</p> <p> <strong>Three adjectives that describe the typical physician in interventional radiology:</strong></p> <p> Visual.  Problem-solving. Creative.</p> <p> <strong>What my lifestyle is like in interventional radiology:</strong></p> <p> The lifestyle is significantly better than expected, especially for a proceduralist. My call schedule, work hours and workload are all very well balanced.</p> <p> <strong>The main skills every physician in training should have for interventional radiology but won’t be tested for on the board exam:</strong></p> <p> Manual dexterity, anatomic understanding, procedural planning and execution. (The board exam is very heavily focused on the diagnostics of imaging rather than the procedural aspect.)</p> <p> <strong>Three books every medical student interested in interventional radiology should read:</strong></p> <ul> <li> <em>House of God </em>by Samuel Shem (This book is not IR-specific but is a must-read for all trainees. Good humor is needed these days in medicine.)</li> <li> <em>Redefining Health Care</em> by Michael Porte (it’s important for young IRs to think about proving value in health care as we move forward.)</li> <li> <em>Handbook of Interventional Radiologic Procedures</em> by Krishna Kandarpa.(This is a quick and easy way to understand a wide range of IR procedures, including the step-by-step technical aspects.)</li> </ul> <p> <strong>Two online resources students interested in my specialty should follow:</strong></p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.sirweb.org/patients/" target="_blank" rel="nofollow">Society of Interventional Radiology</a></li> <li style="margin-left:0.25in;"> <a href="http://www.radiologyinfo.org/" target="_blank" rel="nofollow">Radiology Info</a></li> </ul> <p> <strong>Additional advice for students considering interventional radiology:</strong></p> <p> IR recently became recognized as its own specialty. There are now two routes to practicing IR. One is the traditional route through a residency in diagnostic radiology and a fellowship in IR.  The other is the new direct IR pathway, which is a residency and fellowship combined [that] is more heavily clinical. There are plusses and minuses to each way, but read up on those differences and understand what works better for you.</p> <p> <strong>Want to learn more about your specialty options? </strong></p> <p> Follow <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank">this series</a> and read additional advice from physicians in these specialties:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-like-pediatrician-shadowing-dr-berkowitz" target="_blank">Carol Berkowitz, MD, in pediatrics</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-like-palliative-care-shadowing-dr-edmonds" target="_blank">Kyle P. Edmonds, MD, in palliative care</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-orthopedic-surgeon-shadowing-dr-dangles" target="_blank">Chris Dangles, MD, in orthopedic surgery</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-pediatrics-shadowing-dr-meade" target="_blank">Elizabeth Meade, MD, in pediatrics</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-sports-medicine-shadowing-dr-vasudevan" target="_blank">John Vasudevan, MD, in physical medicine and rehabilitation</a> (emphasis in sports medicine)</li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-family-medicine-shadowing-dr-wergin" target="_blank">Robert Wergin, MD, in family medicine </a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe" target="_blank">Claire Wolfe, MD, in physical medicine and rehabilitation</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:979f6862-6379-4218-ab0b-379de4b54eac Get ready for ICD-10-sale on new coding resources http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ready-icd-10-sale-new-coding-resources Tue, 30 Jun 2015 21:20:00 GMT <p> The countdown to implement the ICD-10 code set Oct. 1 continues. Get your practice ready with the latest coding resources.</p> <p> Save 20 percent at the AMA Store on <a href="https://commerce.ama-assn.org/store/content/icd-10-resources?node_id=icd-10-resources" target="_blank">2016 annual resources</a>. The most recent ICD-10 resources include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610008&navAction=push" target="_blank">ICD-10-PCS 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610007&navAction=push" target="_blank">ICD-10-CM 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610024&navAction=push" target="_blank">ICD-10-CM Documentation 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610009&navAction=push" target="_blank">ICD-10-CM Mappings 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank">Pocket Guide to Understanding ICD-10-CM Documentation</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610022&navAction=push" target="_blank">Advanced Anatomy and Physiology for ICD-10-CM/PCS 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620029&navAction=push" target="_blank">ICD-10-CM 2016 Snapshot Coding Cards</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620026&navAction=push" target="_blank">ICD-10-CM 2016 Mapping Cards</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620030&navAction=push" target="_blank">ICD-10-PCS 2016 Snapshot Coding Card Collection</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430005&navAction=push" target="_blank">Principles of ICD-10-CM Coding</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430006&navAction=push" target="_blank">Principles of ICD-10-CM Coding Workbook</a></li> </ul> <p> AMA members receive an additional discount on these products. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p> The sale is available for customers that purchase from the AMA directly (excludes wholesalers, resellers and bookstores) and expires July 31.</p> <p> <strong>Get more help: </strong>Whether you’re a beginner or an expert, you can use an <a href="http://www.ama-assn.org/ama/ama-wire/post/beginner-experts-guide-icd-10-prep-steps-july" target="_blank"><em>AMA Wire</em>® series</a> to prep for ICD-10. Also, take the time now to learn what your practice should do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially</a> for ICD-10.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:34eb123f-4e2e-4bed-a2b2-aaca7b7f405a Diabetes risks and solutions may lie in patients’ communities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_diabetes-risks-solutions-may-lie-patients-communities Tue, 30 Jun 2015 21:17:00 GMT <p> The future outcomes of chronic disease could be affected not by a lab or hospital but by the local park or corner store, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=2337256" target="_blank" rel="nofollow">new study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Neighborhood risk factors</strong></p> <p> The study found that neighborhood resources to support greater physical activity and healthy diets appear to be associated with a lower incidence of type 2 diabetes. Researchers investigated whether the physical and social environments of patients’ neighborhoods—including the availability of healthy foods, physical activity resources, and levels of social cohesion and safety—were associated with the development of type 2 diabetes during a 10-year period.</p> <p> “Our results suggest that modifying specific features of neighborhood environments, including increasing the availability of healthy foods and [physical activity] resources, may help to mitigate the risk for [type 2 diabetes,] although additional intervention studies with measures of multiple neighborhood features are needed,” the study said.</p> <p> While environmental factors are important in curbing the development of chronic disease, they are not the only answer, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=2337252" target="_blank" rel="nofollow">related commentary</a> in <em>JAMA Internal Medicine.</em></p> <p> “Having markets and recreational facilities located nearby may be necessary but not sufficient to enable healthy behaviors,” the commentary said. “Building more facilities in neighborhoods that lack them is a component of an overall strategy to address the national rise in obesity, but this strategy needs to be informed by an understanding of when such facilities are actually used and the characteristics of the individuals who use them.”</p> <p> <strong>A community solution</strong></p> <p> Every year the number of people who develop prediabetes, the precursor to type 2 diabetes, increases. Between 2007 and 2012 alone, prevalence of the disease rose by about 51 percent, according to a December <a href="http://care.diabetesjournals.org/content/37/12/3172.abstract" target="_blank" rel="nofollow">study</a> published in <em>Diabetes Care</em>.</p> <p> Because patients’ environments have such a big influence on their health, helping patients make healthy lifestyle changes within their communities is an especially effective way to help prevent the onset of chronic diseases such as type 2 diabetes.</p> <p> That’s one of the reasons the evidence-based National Diabetes Prevention Program, launched by the Centers for Disease Control and Prevention (CDC) in 2012, is gaining momentum. The program is based on <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa012512" target="_blank" rel="nofollow">research</a> led by the National Institutes of Health, which showed that individuals at high risk of developing type 2 diabetes who participated in structured lifestyle change programs saw a significant reduction in the incidence of the disease.</p> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the AMA <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-physician-helping-stop-diabetes-among-her-patients" target="_blank">worked with the YMCA of the USA</a> and 11 physician practice pilot sites in four states over the past year to develop tools and resources to increase physician screening and testing for prediabetes. The practices then referred their patients with prediabetes to diabetes prevention programs offered by local YMCAs, which use the CDC’s program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.</p> <p> Now physicians across the country can join in this work. The AMA and the CDC have teamed up to <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-03-12-ama-cdc-initiative-aims-to-prevent-diabetes-stat.page" target="_blank">issue a call</a> to take urgent action with <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act–Today™</a>. This multi-year initiative will help physicians refer adults who have prediabetes to diabetes prevention programs in their communities and online.</p> <p> Join this initiative in your practice: Access the <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/toolkit.html" target="_blank">toolkit</a> to get started. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:baddff0e-a625-4fd6-8b2e-7588a67a46b5 New governing council officers elected for AMA-IMG Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-governing-council-officers-elected-ama-img-section Mon, 29 Jun 2015 18:00:00 GMT <p> The AMA International Medical Graduate (IMG) Section at its 18th annual meeting in June elected the following new officers to the section’s governing council for the 2015-2016 year:</p> <ul> <li> June-Anne Gold, MD, chair</li> <li> Bhushan Pandya, MD, chair-elect</li> <li> Lt. Col. Ronit Katz, MD, immediate past chair</li> <li> Ved Gossain, MD, delegate</li> <li> Giovanni Campanile, MD, alternate delegate</li> <li> Rashi Aggarwal, MD, member at large</li> <li> Sumir Sahgal, MD, member at large</li> <li> Subhash Chandra, MD, resident/fellow</li> </ul> <p> Read more about the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates/about-us/img-governing-council.page" target="_blank">AMA-IMG Section Governing Council</a>. Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page" target="_blank">section’s Web page</a> to review more June meeting results. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:253f627c-0f3b-492c-9f70-ab9dbf36dc8f It’s about saving lives: Increasing access to naloxone http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-saving-lives-increasing-access-naloxone Mon, 29 Jun 2015 15:26:00 GMT <p> <em>An</em> <a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a> <em>post by</em> <em>Patrice A. Harris, MD, chair-elect of the AMA Board of Trustees</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/14/dd7e788b-6583-4d11-aee4-ca40de46103b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/14/dd7e788b-6583-4d11-aee4-ca40de46103b.Large.jpg?1" style="margin:15px;float:left;height:210px;width:150px;" /></a>As our nation suffers from a prescription opioid and heroin overdose epidemic, the U.S. Food and Drug Administration (FDA) is holding a <a href="http://www.fda.gov/Drugs/NewsEvents/ucm442236.htm" rel="nofollow" target="_blank">public hearing</a> this week to explore the uptake and use of naloxone, a lifesaving medication that can reverse opioid overdoses.</p> <p> More than 16,000 deaths in 2013 involved prescription opioids, and another 8,000 involved heroin. America’s physicians must do a better job of using all available tools to help stop this epidemic. Among the powerful tools in our arsenal that we must regularly use are prescription drug monitoring programs, enhanced education and naloxone.</p> <p> From 1996 to 2014, community-based organizations reported more than 26,000 overdose reversals based on the use of to this medication, <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm?s_cid=mm6423a2_w" rel="nofollow" target="_blank">according</a> to the Centers for Disease Control and Prevention.</p> <p> The AMA and many community, state and national groups—including professional organizations, government bodies and industry organizations—have supported co-prescribing naloxone to patients who are taking opioids as a critical part of the solution to the rising epidemic of opioid-overdose related deaths.</p> <p> Co-prescribing naloxone likely will be a part of the FDA hearing this week and will be a part of the AMA’s testimony at this event. The AMA encourages physicians to co-prescribe naloxone to their patients at-risk who are taking opioid analgesics.</p> <p> I recently had the honor of <a href="http://www.ama-assn.org/resources/doc/washington/opioid-abuse-testimony-23april2015.pdf" target="_blank">testifying</a> (log in) before the U.S. House of Representatives Energy and Commerce Oversight and Investigations Subcommittee in support of new state laws to put naloxone into the hands of appropriately trained first responders and friends and family members who may be in a position to help save lives.</p> <p> The AMA also has supported nearly 20 such new state laws in the past two years and emphasized the importance of these laws to many key stakeholders, including the National Governors Association (log in to read a <a href="http://www.ama-assn.org/resources/doc/arc/x-pub/nga-sign-on-letter-prescription-drug-diversion-19feb2015.pdf" target="_blank">recent letter</a> we sent).</p> <p> What we need now is to ensure all physicians have the information and education they need to fully understand the barriers to access and the benefits of naloxone. An AMA <a href="http://www.ama-assn.org/resources/doc/arc/x-pub/enhancing-access-naloxone-issue-brief.pdf" target="_blank">issue brief</a> (log in) provides additional information about this medication.</p> <p> Recent activities that have paved the way for more effective use of naloxone include:</p> <ul> <li> <strong>A Kaiser Permanente </strong><a href="http://www.ncbi.nlm.nih.gov/pubmed/26055224" rel="nofollow" target="_blank"><strong>study</strong></a><strong>,</strong> which recommends a universal prescribing method, in which naloxone would be indicated for all patients prescribed chronic opioids. The study revealed a need for increased awareness and dialogue surrounding the prescription of naloxone in conjunction with opioids.<br /> <br /> Clinicians who were surveyed were reluctant to prescribe naloxone because they did not want to offend patients by talking to them about a risk of overdose and because there hasn’t been consensus over who should be prescribed the drug.</li> </ul> <ul> <li> <a href="http://prescribetoprevent.org/wp2015/wp-content/uploads/1naloxone-rev-8-14.pdf" rel="nofollow" target="_blank"><strong>Guidelines</strong></a><strong> issued last month by the American Society of Addiction Medicine,</strong> which recommend the establishment of a co-prescription program for patients prescribed high-potency, long-acting opioids.</li> </ul> <ul> <li> <strong>FDA approval of the </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/new-fda-approval-expected-reduce-opioid-overdose-deaths" target="_blank"><strong>EVZIO® (naloxone HCl injection) auto-injector</strong></a><strong>,</strong> which can be prescribed by physicians. We have commended the FDA for expediting the approval process to quickly increase access to this medicine, which undoubtedly will save lives by reducing death from opioid-related overdose.</li> </ul> <ul> <li> <strong>The Veterans Health Administration’s </strong><a href="http://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/868-notes.pdf" rel="nofollow" target="_blank"><strong>Overdose Education and Naloxone Distribution program</strong></a> for all veterans in treatment for a substance use disorder or taking opioids chronically.</li> </ul> <ul> <li> <strong>Legislation in the Commonwealth of Virginia</strong> that requires risk mitigation <a href="http://lis.virginia.gov/cgi-bin/legp604.exe?151+bud+21-288" rel="nofollow" target="_blank">guidelines</a> on the prescription of extended-release and long-acting opioid analgesics to include co-prescription of naloxone for administration by family members or caregivers in a non-medically supervised environment.</li> </ul> <p> Increased access to naloxone is a key element of a comprehensive public health approach to decrease prescription drug overdose. The AMA believes that co-prescription of naloxone and enhanced access to this medication in community-based programs—coupled with increased use of prescription drug monitoring programs and enhanced education and awareness about the number of opioid emergencies—are critical next steps in reversing the growing epidemic of opioid-related morbidity and mortality.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5625074f-675a-4236-a32e-17f1c82503c0 Medical liability damages cap upheld http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-liability-damages-cap-upheld Fri, 26 Jun 2015 22:08:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/3/35eac3d7-4e94-440e-b3e0-4104328347da.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/3/35eac3d7-4e94-440e-b3e0-4104328347da.Large.jpg?1" style="margin:15px;float:right;" /></a>The nation’s leading medical liability reform law has been upheld yet again in a California court of appeal, with the court finding that the state’s cap on noneconomic damages is constitutional. It’s another victory to ensure physicians can afford to stay in practice and continue to provide care to the patients in their communities.</p> <p> In <em>Chan v. Curran</em>, the plaintiff attempted to prove that the non-economic damages cap under Medical Injury Compensation Reform Act (MICRA), California’s historic tort reform law, should be struck down. The cap is set at $250,000.</p> <p> The plaintiff claimed the MICRA cap was unconstitutional for a few reasons:</p> <ul> <li> MICRA was put in place to tamp down California’s medical liability insurance crisis in the 1970s, but times have changed and the crisis no longer exists. The court rejected this argument, noting that the Supreme Court of the United States rejected a similar argument.</li> <li> The noneconomic damages cap discourages attorneys from taking cases on contingency, so it limits access to the courts. The court held that parties in civil cases are not guaranteed the right to counsel.</li> <li> MICRA interferes with the right to jury trial. The court rejected this argument based on previous cases that held the same.</li> </ul> <p> “All of [Chan’s] arguments … are ultimately grounded on the assertion she is entitled to seek noneconomic damages sufficient to cover attorney fees,” the court said in its <a href="http://www.courts.ca.gov/opinions/documents/A138234.DOC" rel="nofollow">opinion</a>. “No California court has ever endorsed such a proposition … it is contrary to many well-established legal principles.”</p> <p> The <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page" target="_blank">Litigation Center of the AMA and State Medical Societies</a>, along with the California Medical Association, California Hospital Association and California Dental Association, backed the defense of MICRA and filed an <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/chan-v-curran.pdf" target="_blank">amicus brief </a>(log in) last year.</p> <p> “The noneconomic damages cap … is rationally related to the legitimate state interest of ensuring access to affordable health care,” the brief said. “The importance of MICRA has by no means waned over time.”</p> <p> Visit the AMA Litigation Center’s Web page to learn more about this case and others related to <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/professional-liability.page?" target="_blank">professional liability</a> and <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/tort-reform.page" target="_blank">tort reform</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:78259805-9e13-45ad-a4a7-1622b157abd7 Don’t miss your chance to help shape the future of med ed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dont-miss-chance-shape-future-of-med-ed-1 Fri, 26 Jun 2015 21:53:00 GMT <p> What if you could design the medical school of the future or turn med ed completely on its head? What would you do? As broad as these questions seem, they’re the exact focus of the AMA’s <a href="http://www.changemeded2015.org/" target="_blank" rel="nofollow">ChangeMedEd 2015 Conference</a>—and we want to hear from you. Learn more about the conference and <a href="http://www.changemeded2015.org/Attend" rel="nofollow" target="_blank">how to apply to</a> attend.</p> <p> Hosted by the AMA’s Accelerating Change in Medical Education initiative, the conference will take place Oct. 1-3 in Chicago. This highly interactive conference will be focused on innovation in medical education, bringing together leaders from across the medical education continuum and related fields to continue the transformation of how future physicians are trained.</p> <p> This conference provides leaders in medical education and health care opportunities to:</p> <ul> <li> Adopt innovations and emerging concepts from leading medical schools that are working together to envision the medical school of the future</li> <li> Engage and network with leaders who have unique and complementary innovations in curricula, educational redesign and technology to share successes and lessons learned</li> <li> Gain insights from representatives across the continuum of medical education, health care systems and learning technology</li> </ul> <p> To attend, <a href="http://www.changemeded2015.org/Attend" rel="nofollow" target="_blank">submit an application</a> for consideration.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:df401d6b-ffe4-42d2-b344-b4dc876511cf 3 answers to know about Sunshine Act data going public http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-answers-before-sunshine-act-data-goes-public Fri, 26 Jun 2015 21:32:00 GMT <p> The second release of physicians’ financial data under the Physician Payments Sunshine Act, also known as the <a href="http://www.cms.gov/OpenPayments/index.html" rel="nofollow">Open Payments</a> program, was June 30. Learn the three questions patients or others may ask you about your 2014 financial data and how to answer them.</p> <p> The program is the Center for Medicare & Medicaid’s (CMS) attempt to increase transparency and accountability in health care, but the program’s inaugural year was plagued with <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/time-running-out-review-sunshine-data-isnt-very-accurate" target="_blank">inaccurate data</a> and a prohibitive registration and review process. </p> <p> Here are three questions you’ll most likely hear and sample talking points for giving a thoughtful response:</p> <p style="margin-left:.5in;"> <strong>1. Why do physicians get money or items of value from the industry?</strong><br /> Physicians interact with the industry in many ways, including as consultants, speakers, researchers and recipients of “items of value.” These interactions generally benefit patients. For instance, items of value physicians often receive are medical journal reprints and certain patient education materials.</p> <p style="margin-left:.5in;"> <strong>2. Don’t relationships with the industry influence physicians’ decisions and recommendations?</strong><br /> The medical profession always is aware of the potential for conflicts of interest. But a relationship with the industry doesn’t automatically mean that a physician’s judgment has been influenced inappropriately. Industry support for research and development has been essential for developing new interventions and technologies to improve patient care and reduce health care costs.</p> <p style="margin-left:.5in;"> <strong>3. How could individual physicians be justified in accepting large sums of money from the industry?</strong><br /> While there probably are some instances when physicians received money that, in retrospect, they should not have accepted, there are legitimate reasons that a physician could be listed as having accepted a large sum of money. For instance, many physicians receive funds to support clinical trials, an essential component of advancing medical knowledge around specific conditions and treatments.</p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page">AMA’s Open Payments Web page</a> for additional resources, including detailed <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/sunshine-act-talking-points.pdf" target="_blank">talking points</a> (log in) to help explain the June 30 data release to your patients and step-by-step instructions for how to register to review and dispute your data.</p> <p> If you weren’t able to <a href="http://www.ama-assn.org/ama/ama-wire/post/review-financial-data-before-goes-public-june">review and dispute</a> your financial data by May 20, you may see inaccuracies. However, you still can review and dispute errors, and corrections will be reflected in the next scheduled update of the database.<br /> <br /> <strong>Want to know what the AMA has been doing about this issue?</strong> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-advocated-sunshine-act-implementation-overhaul" target="_blank">Read</a> how the AMA has been advocating for an overhaul of how the Sunshine Act has been implemented. In addition, the AMA issued a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-30-media-guide-for-reporting-open-payments-data.page" target="_blank">media guide</a> ahead of the program’s initial data release and is encouraging the media to make sure their reports about this data are presented in an accurate and informative way.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fa743622-be05-4fc5-99d3-ffb5c01eb431 3 things the Supreme Court’s ACA ruling means for physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-things-supreme-courts-aca-ruling-means-physicians Thu, 25 Jun 2015 21:52:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/1/caca7e5f-1c48-47b4-81fd-c9e600d6d0f3.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/1/caca7e5f-1c48-47b4-81fd-c9e600d6d0f3.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Steven J. Stack, MD.</em></p> <p> The Supreme Court of the United States delivered an historic <a href="http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf" rel="nofollow" target="_blank">decision</a> Thursday morning in <em>King v. Burwell</em>.</p> <p> In a 6-3 decision, the justices ruled that subsidies should remain available for lower-income people who purchase their health insurance through the Affordable Care Act (ACA) marketplaces, regardless of whether their marketplace is maintained by the federal or state government.</p> <p> This ruling affects physicians in three ways I’d like to highlight:</p> <p> <strong>1. The decision supports our chief goal of helping patients stay healthy.</strong></p> <p> The Supreme Court’s ruling means that about 6.4 million people in the 34 states that did not create their own marketplaces will retain their ability to purchase coverage going forward. This is particularly important for low-income patients in states that did not expand their Medicaid programs. Without the subsidies, many of them could never afford health insurance.</p> <p> As an emergency physician, I regularly see how important insurance coverage is to facilitate patients getting the medical care they need to recover from unexpected injury or illness. It also enables them to lead healthier, happier lives through better care of chronic diseases that can be devastating for them and their families.</p> <p> The decision also means that insurance premiums will remain more affordable for most patients than would have otherwise been the case. A <a href="http://www.rand.org/pubs/research_reports/RR980.html" rel="nofollow" target="_blank">recent RAND study</a> estimated that eliminating subsidies for patients who purchase their insurance through the federally run marketplace would result in a 47 percent increase in premiums. In such a scenario, a 40-year-old nonsmoker who purchased an unsubsidized silver-level plan would have needed to pay $1,610 more next year.</p> <p> <strong>2. The decision lets us move forward.</strong></p> <p> With this case behind us, we as a profession and as a nation now must focus on the issue at the heart of health care reform: Ensuring every American has access to high-quality, affordable health care.</p> <p> Regardless of differing opinions, access to high-quality, affordable health care is an issue we can all support. And by continuing to work together toward this end—whether through refining individual elements of the ACA, such as <a href="http://www.ama-assn.org/ama/ama-wire/post/ipab-repeal-bill-moves-forward-house" target="_blank">repealing the Independent Payment Advisory Board</a>, or making changes to the current health care system—we can improve the health of all Americans.</p> <p> <strong>3. The decision means we can turn our attention to improving the practice environment. </strong></p> <p> In moving forward, we must also devote our attention to transforming the practice environment so that both patients and physicians are healthier and more satisfied.</p> <p> At the AMA, we’re working to enhance <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">professional satisfaction and practice sustainability</a> by pressing for relief from the <a href="http://www.ama-assn.org/ama/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">tsunami of regulatory burdens</a> that gets in the way of providing the highest-quality care for our patients. Among those burdens are the electronic health record meaningful use program, implementation of ICD-10 and the value-based payment modifier. Lawmakers, too, are now able to turn their attention to these pressing topics.</p> <p> We’re also providing the tools physicians need to minimize professional stress and overcome barriers to providing the best possible care. Our newly launched <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward website</a> offers a free online series of proven solutions that are developed by physicians to make practices thrive. We’ll be adding more modules over the coming months, so be sure to explore the website often.</p> <p> Also, on the STEPS Forward website, we invite you to submit your own innovative solutions to clinical challenges to win $10,000 and help us create more modules to help physicians.</p> <p> Even in these early years of health care reform, implementation of the ACA has affected much of the health care system. To examine this issue further, I encourage you to check out the July issue of the <a href="http://journalofethics.ama-assn.org/site/current.html" target="_blank"><em>AMA Journal of Ethics</em></a>, which takes a look at how patient care has changed in the era of health care reform. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4572d597-327b-4d68-9e45-f61683a70b59 How residents really feel about peer-to-peer feedback http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-really-feel-peer-peer-feedback Wed, 24 Jun 2015 22:30:00 GMT <p> Residency may be set up for trainees to learn primarily from attending physicians, but a <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00388.1" target="_blank" rel="nofollow">new study</a> from the <em>Journal of Graduate Medical Education</em> reveals that residents also look to their peers for helpful feedback and guidance. Find out what residents really want in peer evaluations and how residency programs can improve their peer feedback processes.</p> <p> The study is based on data from a survey of 30 family medicine residents at the University of Michigan, who were piloting an online peer assessment tool. Researchers conducted a brief survey and 60-minute focus groups with residents regarding their perceptions of giving and receiving peer feedback. Of the 30 residents in the study, 28 provided survey responses about the peer feedback process, and 21 participated in focus group discussions.</p> <p> <strong>What residents want in peer evaluations</strong></p> <p> In the study, 89 percent of residents said that they found information on peer evaluations useful. Survey responses also revealed residents’ unique perceptions of the value of peer feedback and drivers to their professional development. These included:</p> <ul> <li style="margin-left:0.25in;"> Residents value the “authenticity of peer feedback,” with 89 percent of participants reporting that peer evaluations provided “unique information.” Residents also noted that “peers often provide feedback on situations that otherwise go unnoticed or unaddressed by attending [physicians].”</li> <li style="margin-left:0.25in;"> 92.6 percent of residents said they would change their behavior based on negative peer feedback, while only 81.5 percent of residents said they’d change their behavior based on positive peer feedback.</li> <li style="margin-left:0.25in;"> Although more than 85 percent of residents said they consider peer feedback helpful in assessing such competencies as communication skills and professionalism, only 59 percent reported that it benefited their training.</li> <li style="margin-left:0.25in;"> Participants found peer evaluations most helpful in assessing work ethics, team-building and interpersonal skills. They found peer evaluations least helpful in assessing medical knowledge.</li> </ul> <p> Contrary to a previous study that suggests residents may not feel responsible for their colleagues’ performance or find peer reviews helpful, residents in this study “regarded the ability to engage in peer-to-peer feedback delivery as a critical professional skill requiring professional accountability and interdependence that would benefit them in their future careers,” the study authors said.</p> <p> <strong>Understanding the limitations of peer feedback: How residency programs can improve </strong></p> <p> In the focus group discussions, the need for more structure in the peer assessment process garnered the most attention from residents. Instead of conducting online peer assessments, residents generally agreed that “frequent, informal verbal feedback would allow them to make more meaningful practice-based changes,” according to the study.</p> <p> Some barriers residents identified to providing quality feedback included:</p> <ul> <li style="margin-left:0.25in;"> A lack of time to provide substantial feedback</li> <li style="margin-left:0.25in;"> Concerns about feedback negatively affecting interpersonal relationships</li> <li style="margin-left:0.25in;"> A fear of providing “uphill” feedback to senior or chief residents</li> <li style="margin-left:0.25in;"> Concerns about guaranteed anonymity, especially in smaller institutions</li> </ul> <p> Solutions residents identified for programs to accomplish this included:</p> <ul> <li style="margin-left:0.25in;"> Structurally integrating peer evaluations into the formative feedback process that typically is provided only by attending physicians</li> <li style="margin-left:0.25in;"> Tailoring peer feedback goals and evaluation content to residents’ specific years in training and rotations</li> <li style="margin-left:0.25in;"> Offering residency preparatory training on how to adequately evaluate peers</li> <li style="margin-left:0.25in;"> Forming a residency committee of peers (not faculty) to establish specific guidelines, goals and objectives for peer evaluations</li> <li style="margin-left:0.25in;"> Prioritizing more time for peer feedback to help cultivate a “feedback culture” for self-improvement among residents</li> </ul> <p> Although the study authors acknowledged the constraints of using such a small sample of residents, they noted that the insights residents shared can help “residency programs interested in refining an existing approach or initiating a peer-to-peer feedback process.” </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:764364e3-1998-4fb4-ba0e-c0555c71811b The beginner and expert’s guide to ICD-10 prep: Steps for July http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_beginner-experts-guide-icd-10-prep-steps-july Wed, 24 Jun 2015 20:20:00 GMT <p> As the clock ticks down to the Oct. 1 deadline to implement the ICD-10 code set, physicians should be prepping their practices. In Month Three of our ICD-10 primer, learn the next steps you should take.</p> <p> <strong>What to tackle in June</strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/1/718f488d-1dab-4df5-a12e-f4c64843222f.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/1/718f488d-1dab-4df5-a12e-f4c64843222f.Large.png?1" style="margin:15px;float:right;" /></a><br /> Use these <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank">tips from the AMA</a> and the Centers for Medicare & Medicaid Services’ <a href="http://cdn.roadto10.org/wp-uploads/2014/02/Road_To_10_Implementation_Guide.pdf" rel="nofollow" target="_blank">Road to 10 Implementation Guide</a> to bring your practice up to speed for the new code set.</p> <p style="margin-left:.5in;"> <strong>Just getting started?</strong><br /> If you’re still in the early stages of preparation, spend your time next month completing <a href="http://www.ama-assn.org/ama/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">updates you identified</a> a few months ago. For example, finish updating your systems, forms and work flow processes. Use a <a href="http://www.cms.gov/eHealth/downloads/eHealthU_SmallMedPracChecklist.pdf" rel="nofollow" target="_blank">transition checklist</a> to guide you.</p> <p style="margin-left:.5in;"> This also is when you should finish your documentation assessment. Decide whether you want to perform the documentation assessment yourself or get outside expertise. Organizations exist that can provide feedback on your current situation and whether it will be sufficient for ICD-10. You also can conduct your own assessment with resources, such as this <a href="http://www.ama-assn.org/resources/doc/washington/icd10-assess-your-documentation.pdf" target="_blank">tip sheet</a> (log in) and a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/guide-icd-10-documentation" target="_blank">how-to guide</a> from the AMA.</p> <p style="margin-left:.5in;"> <strong>Already on your way?</strong></p> <p style="margin-left:.5in;"> Anyone in your practice who works with ICD-9 codes today will need to be trained for ICD-10. Not all staff will need the same level of training, so use <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-determine-your-training-needs.pdf" target="_blank">this guide</a> (log in) to determine who needs which type of training.</p> <p style="margin-left:.5in;"> Work with your staff to identify the best time for them to receive training. Keep in mind that staff will be unavailable to do their normal workload when they are in training, so training may need to occur after hours or on the weekend. If that is not possible, expect a decrease in the practice’s normal productivity.</p> <p style="margin-left:.5in;"> Physician practices have a variety of ICD-10 training options available. Check with your professional organizations, any hospital systems with which you are affiliated, medical societies, payers and clearinghouse to see what types of training they offer. Look at how the training is provided (for instance, in-person conferences, online modules, written materials, etc.) and consider which method will work best for your staff.</p> <p> <strong>Easing the transition</strong></p> <p> AMA efforts to ease the burden of ICD-10 implementation on physicians continue. Physicians at the 2015 AMA Annual Meeting <a href="http://www.ama-assn.org/ama/ama-wire/post/doctors-call-two-year-grace-period-icd-10-penalties">voted to urge CMS</a> not to withhold claim payments based on coding errors, mistakes or malfunctions in the system for two years directly following implementation.</p> <p> Visit the AMA ICD-10 Web page to access additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help you prepare. An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> also is an essential resource.</p> <p> <strong>Editor’s note:</strong> This post is the third part of a monthly series that will provide timely transition tips and resources as the Oct. 1 ICD-10 implementation deadline approaches. <a href="http://www.ama-assn.org/ama/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">See the first</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/beginner-experts-guide-icd-10-prep-steps-june" target="_blank">second</a> posts, and learn what your practice should do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially</a> for ICD-10.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/0/1cc50114-48a9-4fee-9016-17621964fc4f.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/0/1cc50114-48a9-4fee-9016-17621964fc4f.Full.png?1" style="width:850px;height:136px;margin:15px;float:left;" /></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d86d88cd-caf1-4b0c-867b-080b61a8b55e IOM releases report on cognitive aging http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_iom-releases-report-cognitive-aging Wed, 24 Jun 2015 14:17:00 GMT <p> The Institute of Medicine (IOM) in April <a href="http://iom.nationalacademies.org/Reports/2015/Cognitive-Aging.aspx" target="_blank" rel="nofollow">released a report</a> on cognitive aging. The study examines cognitive aging, a natural process associated with advancing years. The IOM committee was charged with assessing the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education.</p> <p> Included with the study are:</p> <ul> <li> An action guide for clinicians caring for elderly patients</li> <li> A summary of core competencies for health care professionals who treat older adults</li> <li> A list of assessment, practice guideline and patient education resources </li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e354d681-5058-4071-9d1e-fc3b5322f2a3 Submit your abstract for the Nov. 13 research symposium http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_submit-abstract-nov-13-research-symposium Wed, 24 Jun 2015 14:13:00 GMT <p style="font-size:11.9999990463257px;"> <span style="font-size:11.9999990463257px;">If you’re an AMA member who is ECFMG-certified and awaiting residency, come showcase your research at the 13th annual AMA Research Symposium.</span></p> <p style="font-size:11.9999990463257px;"> Abstracts will be considered for any of the three categories:</p> <ul style="font-size:11.9999990463257px;"> <li> Clinical vignette</li> <li> Clinical medicine</li> <li> Improving health outcomes (cardiovascular disease, diabetes)</li> </ul> <p style="font-size:11.9999990463257px;"> All abstracts must be <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/research-symposium.page" target="_blank">submitted online</a> by Aug. 19 for consideration.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8a903150-1801-498e-8391-eda49562517f CDC report highlights “Hispanic paradox” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-report-highlights-hispanic-paradox Wed, 24 Jun 2015 14:10:00 GMT <h3>  </h3> <p> <span style="font-family:arial,helvetica,sans-serif;">The Center for Disease Control and Prevention (CDC) in May released its <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6417a5.htm?s_cid=mm6417a5_whttp://www.elabs10.com/c.html?ufl=8&rtr=on&s=x8pbgr,29rnu,2kep,9fes,2l6q,cmwb,ld8r" target="_blank" rel="nofollow">first report on Hispanic health</a>. Four national data sets were analyzed to compare Hispanics overall, non-Hispanic whites and Hispanic origin subgroups for morbidity, disease prevalence and associated risk factors, and use of health services.</span></p> <p> <span style="font-family:arial,helvetica,sans-serif;">Consistent with previous research references to the “<a href="http://www.elabs10.com/c.html?ufl=8&rtr=on&s=x8pbgr,29rnu,2kep,c3lc,lwvc,cmwb,ld8r" target="_blank" rel="nofollow">Hispanic paradox</a>,” the CDC report highlights longer life expectancy and lower mortality, despite potential barriers to good health and worse profiles for some social determinants of health among Latinos.</span></p> <p> <span style="font-family:arial,helvetica,sans-serif;">The report also notes substantial differences among Hispanics by origin, nativity and sex. The <a href="http://www.elabs10.com/c.html?ufl=8&rtr=on&s=x8pbgr,29rnu,2kep,g8n4,5zex,cmwb,ld8r" target="_blank" rel="nofollow">full report</a> and a <a href="http://www.cdc.gov/vitalsigns/pdf/2015-05-vitalsigns.pdf" target="_blank" rel="nofollow">series of infographics</a> that summarize its findings are available on the CDC website.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:047b9b89-4f0c-4b60-8e10-1d254f34d782 Are you getting all the AMA-related news you want? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_getting-ama-related-news-want Wed, 24 Jun 2015 14:05:00 GMT <p> Make sure you’re receiving the full selection of AMA-related news in your email. Login to the <a href="https://apps.ama-assn.org/profile/user/email-preferences" target="_blank">AMA Email Preference Center</a> to see samples and select news of your choice, including:</p> <ul> <li style="margin-left:0.25in;"> Updates from the JAMA Network</li> <li style="margin-left:0.25in;"> <em>AMA Journal of Ethics</em> alerts</li> <li style="margin-left:0.25in;"> <em>AMA MedEd Update</em></li> <li style="margin-left:0.25in;"> PCPI announcements</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7a477408-a35a-484c-9f7d-8a08612e7e89 AMA-SPS elects new officers to governing council http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-sps-elects-new-officers-governing-council Wed, 24 Jun 2015 14:00:00 GMT <p> The new officers of the 2015-2016 AMA Senior Physician Section (SPS) Governing Council are Barbara A. Hummel, MD, who will serve as chair, and Barbara S. Schneidman, MD, who will serve as chair-elect.</p> <p> Dr. Hummel is a family physician in private practice in Milwaukee and is president-elect of the Wisconsin Medical Society. She also serves as an AMA delegate for the Wisconsin Medical Society and is secretary of the Private Practice Physicians Congress.</p> <p> Dr. Schneidman holds the position of clinical professor of psychiatry and behavioral sciences at the University of Washington School of Medicine and also serves as an AMA alternate delegate for the American Psychiatric Association.</p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">AMA-SPS Web page</a> for more information about the section and its initiatives, or call Alice Reed of the AMA at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:03ebd89b-c5da-4142-8830-bd9b48989926 Competency and retirement: Evaluating the senior physician http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_competency-retirement-evaluating-senior-physician Tue, 23 Jun 2015 22:00:00 GMT <p> For older physicians, deciding when to leave practice is about more than just clinical competency—it also comes with emotional internal struggles. Physicians examined this issue from both angles at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> and agreed to convene a special group of professional organizations to develop guidelines that will help older physicians continue to provide high quality care throughout their practice careers.</p> <p> About one in four U.S. physicians is older than 65, and the number of physicians in this age bracket more than quadrupled between 1975 and 2013. While research shows cognitive dysfunction is more prevalent among older adults, aging doesn’t necessarily result in cognitive impairment. An AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">Council on Medical Education</a> report took a deeper look at assessing senior physicians’ ability to provide safe and effective patient care.</p> <p> <strong>Safety and patient care</strong></p> <p> Several factors associated with aging may impact physicians’ analytical processes, such as decreasing working memory, declining visual acuity and slowing speed of mental operations.</p> <p> Published physician assessment data show important differences in performance may become apparent after age 60. Research also shows that older physicians are less likely to acquire new knowledge over time. For example, older primary care physicians are less likely to incorporate new treatment strategies into their practices, according to the report.</p> <p> Still, the effect of age on any individual physician’s competence can be highly variable. While age is one factor in predicting potential competence, other factors such as practice setting, clinical volume, specialty and stress also can contribute.</p> <p> <strong>What this means for older physicians</strong></p> <p> Physicians are professionally obligated to continually assess their own physical and mental health, even though there is no national standard for screening physicians who have reached a certain age. But a number of other professions that can impact public safety do have age-related cutoffs in place. Commercial airline pilots, for instance, must be regularly screened beginning at age 40 and must retire at 65.</p> <p> But the report pointed out that moving into retirement can be a difficult change for many physicians.</p> <p> “Some physicians are glad to move into a different phase of their lives when they reach age 70,” the report said. “For others, however, this transition is not easy, and it may require the guidance and support of peers. … Physicians with decades of experience and contribution deserve the same sensitivity and respect afforded their patients as they experience health changes that may or may not allow continued clinical practice.”</p> <p> This shift from practice to retirement was the focus of a special education session at the meeting, led by Glen Gabbard, MD, a clinical professor of psychiatry at Baylor College of Medicine and an expert in physician health and professionalism.</p> <p> “For most of us, the practice isn’t a job: It’s more of a calling,” Dr. Gabbard said. “One of the things that’s unique about physicians is that who we are—our identity—is so wrapped up in being a physician. … There are certain psychological characteristics that make for a good physician, but [they] also [make] for someone who is going to struggle with slowing down or not practicing.”</p> <p> For physicians who do want to slow down, the report suggests that the following steps may be beneficial:</p> <ul> <li style="margin-left:0.25in;"> Simplified documentation forms</li> <li style="margin-left:0.25in;"> Decreased case load or time demands</li> <li style="margin-left:0.25in;"> Narrowing or limiting the scope of practice</li> </ul> <p> “Whatever you do, you have to make time for living, and we [physicians] are not necessarily good at that,” he said. “Retirement should not be about leaving something—it should be about <em>going to</em> something.”</p> <p> <strong>Taking the lead in professionalism</strong></p> <p> Regulators and policymakers are considering some form of age-based competency screening, according to the report. Some hospitals and health systems already require such screenings.</p> <p> To ensure physicians can continue to practice as long as patient safety is not at risk, physicians approved policy at the 2015 AMA Annual Meeting to develop preliminary assessment guidelines.</p> <p> “Formal guidelines on the timing and content of testing of competence may be appropriate and may head off a call for mandatory retirement ages or imposition of guidelines by others,” the report said.</p> <p> Testing could include an evaluation of physicians’ mental health and a review of their treatments of patients. But figuring out such guidelines will be difficult, “especially in view of the limited and conflicting data available on this topic,” the report said.</p> <p> For physicians who want help moving into the next phase of their careers, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">Senior Physicians Section</a> offers resources and support. The section is for physicians age 65 or older and offers ways for senior physicians to remain active after retirement through <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/physician-volunteers.page" target="_blank">volunteer opportunities</a>.</p> <p> For more on opportunities and challenges for aging physicians, watch a <a href="https://cme.ama-assn.org/Activity/2531154/Detail.aspx" target="_blank">webinar</a> that focuses on understanding impairment in older physicians and developing prevention strategies. Also visit the AMA Store for <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/products-services/ama-bookstore-items.page" target="_blank">titles of interest for seniors</a> who are easing into retirement, starting a new career or who are curious about their retirement choices. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e597bfcf-2d5e-46f2-8379-b199d86f8ade Get everything you need to know about CPT® changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_everything-need-cpt-changes Tue, 23 Jun 2015 20:16:00 GMT <p> Learn all about the upcoming CPT® code changes so you can reduce claim denials using a newly updated resource—and gain access to a free webinar for insights from the CPT experts.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610006&navAction=push" target="_blank"><em>CPT® Changes</em> <em>2016: An Insider’s View</em></a> explains next year’s changes throughout the entire code set, including those areas with some of the most noteworthy changes: cardiovascular, prolonged office services, digestive, radiation oncology, vaccines and pathology/laboratory testing.</p> <p> The new edition has been completely redesigned and features:</p> <ul> <li style="margin-left:0.25in;"> Enhanced rationales to communicate the reasons for and implications of changes</li> <li style="margin-left:0.25in;"> New subject-code index for quick search</li> <li style="margin-left:0.25in;"> New headings and tabs for easier navigation</li> <li style="margin-left:0.25in;"> Larger page size and spiral binding</li> <li style="margin-left:0.25in;"> Four-color printing</li> <li style="margin-left:0.25in;"> Two-column page layout for easier reading</li> </ul> <p> Purchase of this book also gives you access to the CPT Changes <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610006&navAction=push#download-tab" target="_blank">webinar</a>, which features CPT Editorial Panel experts discussing the latest code changes and the rationales behind them.</p> <p> For even more inside knowledge, get the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620013&navAction=push" target="_blank">CPT package</a>, which includes <em>CPT® 2016 Professional Edition </em>and <em>CPT® Changes 2016: An Insider’s View</em>.</p> <p> AMA members receive a discount on these products. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fbd26915-f2a1-4bd7-9c73-1e20d87426f2 I want to hear from you about improving our practice environment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_want-hear-improving-practice-environment Tue, 23 Jun 2015 20:09:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/13/64151a0b-940e-46d1-ad83-357d7b96db49.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/13/64151a0b-940e-46d1-ad83-357d7b96db49.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Steven J. Stack, MD.</em></p> <p> This is my first Viewpoints post as AMA president and I want you to know how important it is to me that I engage with you—my colleagues all over the country—as we face the challenges of providing high-quality care in an increasingly burdensome environment.</p> <p> I am a student of the Classics and frequently turn to them for their timeless insight into human behavior. In my inaugural address, I drew on the great orator Cicero who said, “We were born to unite with our fellow men, and to join in community with the human race.” </p> <p> That is my goal for the upcoming year: To join with you, to toil alongside you, on behalf of this nation’s physicians and patients.</p> <p> As an emergency physician, I am fortunate to witness amazing moments with my patients—priceless experiences that have left indelible impressions on me as I know you, too, have had with your own patients. These moments are the reason we went to medical school, and they inspire us to do our best every day despite the challenges we face. </p> <p> Those challenges, the daily trials we face navigating the health system, all too often overshadow the joys of medicine. That simply has to change, and I am committed to working with you through the AMA to ease these burdens wherever possible and to restore some of the lost joy to the practice of medicine.</p> <p> Here are just a few of the important issues we will tackle this year to make it easier for physicians to enjoy the life-changing moments of medicine:</p> <ul> <li style="margin-left:0.25in;"> <strong>Increasing physician satisfaction and practice sustainability. </strong>We’ve just launched our <a href="http://stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a> website, a fantastic free resource developed for physicians by physicians. The modules on STEPS Forward offer proven ways to make your practice more efficient so you can devote more time to patient care. We have a lot more exciting things to come this year from this <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">AMA focus area</a>, and I look forward to sharing them with you in the months ahead.  We also are awarding $10,000 for <a href="http://www.innovatewithama.com/" rel="nofollow" target="_blank">solutions to clinical challenges</a>—I hope you'll submit your ideas and be a part of this effort to make things better for all of us.</li> <li style="margin-left:0.25in;"> <strong>Unraveling the web of regulatory requirements we face each day.</strong> The <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repeal of the sustainable growth rate (SGR) formula</a> brought with it a new merit-based incentive payment system (often referred to as “MIPS”). The current web of financial penalties under the Physician Quality Reporting System, electronic health record (EHR) meaningful use and the value-based payment modifier will expire at the end of 2018 and will be replaced by the MIPS. We will be working to ensure that its effect on physicians is positive, both in the short- and long-term.</li> <li style="margin-left:0.25in;"> <strong>Improving EHR systems.</strong> We all know that the current state of EHRs is intolerable. Current EHRs routinely turn us into typists, degrade our efficiency, interfere with effective communication and crowd out quality time spent with our patients. We’re hard at work on all levels to increase interoperability, improve usability and make sure physicians have a voice in the future of these systems.</li> </ul> <p> These all are big issues and they require big solutions. I need your help. Every one of us has a part to play.  Each one of us has something to contribute that another cannot. When it comes to something as important as shaping a better, healthier future, it will take every single one of us.</p> <p> When I stood in the ballroom during the 2015 AMA Annual Meeting earlier this month and delivered <a href="http://www.ama-assn.org/ama/ama-wire/post/story-of-hope-new-ama-president-points-power-of-physicians" target="_blank">my inaugural address</a>, I was inspired by what I saw. A room full of students and physicians, our peers, who came together to overcome challenges and to enjoy the friendship and camaraderie that is the special joy of this profession.</p> <p> We’ll do it together, but I need your help. Please share your thoughts with me in the comment section below. This is an important conversation and I look forward to learning from you in the year ahead.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9bbe3ce0-145e-4129-a09a-ecb66c7be4bc 6 simple ways to master patient communication http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-simple-ways-master-patient-communication Mon, 22 Jun 2015 21:27:00 GMT <p> Although the first two years of medical school require students to study intensively, learning how to effectively talk to patients is equally important as you begin clinical rotations. No matter what year you are in training, take this time to brush up on your communication skills so you can make the best connections with your patients.</p> <p> As a physician in training, you’re highly educated and accustomed to consuming dense information. But just because physicians in training understand medical jargon doesn’t mean they know how to effectively explain it to their patient, Randa Zalman, chief strategy officer and partner at marketing-communications firm Redstone, said during a presentation at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>.</p> <p> Zalman has devised an easy way to help students remember the communication skills they need for practice, summed up in a catchy acronym: RESPECT. Here are the 6 things you need to know in this acronym:</p> <p> <strong>R</strong>—<strong>Rapport.</strong> “This is imperative,” Zalman said, noting that the smallest details—such as physical appearance, your level of eye contact with patients or how often you use their names in conversation—can shape your relationships with patients.</p> <p> When it comes to treatment, you want patients to feel that “we’re in this together,” Zalman said. To boost team morale, she recommends students give patients their “full, undivided attention,” listen carefully and “hear their stories.”</p> <p> <strong>E—Explain.</strong> Ask patients a variety of questions that encourage them to explain more about their health and habits outside their appointments, Zalman recommended. Questions such as, “Can you tell me more about yourself? What is important to you? And what can I do to help you?” can incite patients to fully engage in conversation.</p> <p> <strong>S—Show.</strong> Regardless of your specialty or practice setting, you will have to deliver constructive criticism during your career. In those instances, it’s best to show patients “collaborative thinking, and work with them in an active way rather than telling them what to do,” Zalman said.</p> <p> With the proper approach, a critique can become an opportunity to bond with your patient. For instance, try a “7:1 compliment ratio.” Give your patients seven compliments for every one statement of criticism, Zalman said.</p> <p> She also suggests students show<strong>—</strong>not tell—how supportive they are by giving patients educational materials, websites, resources and information about support groups that may help them better understand medical terms or issues that apply to their treatment.</p> <p> <strong>P—Practice.</strong> The old adage rings true for a reason. Practice may not always “make perfect,” but it certainly can help physicians in training get ahead of tough conversations with patients.</p> <p> Practice good communication as much as possible. Ask patients for raw feedback, identify communication roadblocks and review communication techniques with others, Zalman said.</p> <p> <strong>E—Empathy.</strong> Avoid being judgmental by providing encouragement to your patients. This can be expressed through verbal and non-verbal cues, Zalman said.</p> <p> <strong>C—Collaboration.</strong> Partner with your patients, Zalman said, noting that people are far more likely to positively respond to recommendations and questions in collaborative settings. “Explain your recommendations, what you’re doing and how you’re doing it,” she said.</p> <p> She also recommended that students identify potential “barriers”—such as an overbearing spouse or a hearing difficulty<strong>—</strong>that may interfere with patients’ communication.</p> <p> <strong>T—Technology.</strong> Because technology gives students so many ways to communicate with patients, it’s a particularly important consideration. But don’t overdo it, Zalman cautioned. Instead of inundating patients with messages from multiple platforms, “choose no more than three communication channels, and [use] them well,” she said.</p> <p> Also, communicating through technology is no excuse to use vague language or lazily fire off emoticons in place of real conversation. She says physicians who wish to really connect with patients should do just the opposite: “Set appropriate expectations and communicate them. Be clear; be direct,” she said. </p> <p> <strong>Want to learn more about the patient-physician relationship? </strong>Learn how physicians treat patients in their own practices through <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series">AMA Wire’s “Shadow Me” Specialty Series</a>, which features advice directly from physicians about life and work with patients in their specialties. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cdcf7bcf-2c9a-42ca-aadb-1122b41503d9 Court to weigh physicians’ right to payments, recourse http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_court-weigh-physicians-right-payments-recourse Mon, 22 Jun 2015 21:11:00 GMT <p> Should physicians be left holding the bag when a private insurer retroactively denies a medical claim or recoups a payment? A federal appeals court is considering a case that could determine whether medical providers have recourse in such situations to ensure that their practices remain financially stable so they can continue caring for their patients.</p> <p> At issue in <em>Pennsylvania Chiropractic Association v. Independence Hospital Indemnity Plan, Inc.</em>, is the payer retroactively denying benefits or taking back payments without explaining why the action was taken or how the medical provider can appeal the decision.</p> <p> “The decades-long dispute continues between medical providers and the … third-party payers … of Employee Retirement Income Security Act (ERISA)-regulated health plans over whether providers should be paid for their services, and how providers can assert their right to receive payment,” the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page" target="_blank">Litigation Center of the AMA and State Medical Societies</a> and the Illinois State Medical Society said in an amicus brief recently filed with the court.</p> <p> “Unsurprisingly, the position Independence Hospital Indemnity Plan takes would result in … medical professionals performing necessary medical services and then being left ‘holding the bag,’” the brief states.</p> <p> The plaintiffs are seeking to make the payer bring its post-payment protocols in line with ERISA, a federal law that sets minimum standards for private health insurance plans. Under ERISA, plans must provide important benefits information and appeals processes for beneficiaries.</p> <p> Lower courts concluded that in-network health care providers can be treated as ERISA beneficiaries because the health plan pays them directly—and those payments constitute benefits. The case is one of the first times a court has had to address whether direct payment to a provider makes the provider a beneficiary.</p> <p> “Since retroactive denials of claims and recoupments are functionally identical to an ‘adverse benefit determination,’ ERISA entitle[s] plaintiffs to notice of the reasons for those denials and the right to a ‘full and fair review’ of those denials,” the brief argues.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/physician-payment-issues.page">Read more</a> about this case and other cases related to physician payment on the Litigation Center Web page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ec953b0e-9507-4ed3-b8b9-384e2c038d76 Get the financial advice women physicians really need http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_financial-advice-women-physicians-really-need Fri, 19 Jun 2015 19:01:00 GMT <p> Do you have the six traits of a financially prepared physician? Find out by participating in a free webinar from 1 p.m. to 1:30 p.m. Eastern time June 25. Participants will hear expert advice on personal financial planning, how to launch a retirement plan and getting back on track if you’ve fallen behind schedule. Don’t miss your chance to get ahead of the curve. <a href="https://cc.readytalk.com/r/x5qlwz57r9f3&eom" rel="nofollow" target="_blank">Register today</a>.</p> <p> Robin Robertson, a senior wealth advisor for the Millennium Brokerage Group, will share the roadmap for achieving a secure retirement. By the end of the webinar, you will learn:</p> <ul> <li> The six traits financially prepared physicians share and the attitudes and behaviors that will keep you on the path to financial success</li> <li> How to get on track with your retirement plan—and stay there</li> <li> Practical tips if you’re behind where you’d like to be</li> </ul> <p> Participants will be able to participate in a question-and-answer period at the end of the webinar as well.</p> <p> <a href="http://www.ama-assn.org/ama/ama-wire/post/6-traits-of-financially-prepared-physician" target="_blank">Read more</a> about physician financial preparedness at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2756c52e-4f0f-4d42-8879-deb8b9e80b6f 3 ways physicians are prepping for telemedicine’s success http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-ways-physicians-prepping-telemedicines-success Thu, 18 Jun 2015 20:40:00 GMT <p> More than one-half of the country now has laws in place <a href="http://www.americantelemed.org/news-landing/2015/05/27/milestone-most-states-now-have-telehealth-parity-laws#.VYLilflViko" target="_blank" rel="nofollow">enforcing coverage</a> for telemedicine services, pointing to a growing trend in care delivery—but physicians still must navigate gray areas. Learn some of the things physicians are doing now to pave the way for telemedicine to succeed.</p> <p> <strong>1. Getting up to speed</strong></p> <p> Physicians have taken a leading role in <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">issuing policy to govern telemedicine</a> and ensuring its safety and effectiveness for patients. They’re also making sure their colleagues have the resources they need to get up to speed on this recent delivery method, whether they just want to understand it better or are planning to participate in it.</p> <p> Resources offered through the AMA include:</p> <ul> <li> A <a href="http://www.himss.org/library/podcasts/innovation-that-sticks" target="_blank" rel="nofollow">brief podcast</a> with telemedicine expert Karen Rheuban, MD, director of the University of Virginia Center for Telehealth., on the current state of telemedicine and potential paths in the future. Produced with the Healthcare Information and Management Systems Society, this podcast explains the <a href="http://www.ama-assn.org/ama/ama-wire/post/definitions-of-digital-health-differ" target="_blank">difference between telemedicine and telehealth</a> and offers examples of how telemedicine is improving patient care.</li> <li> A <a href="http://journalofethics.ama-assn.org/2014/12/toc-1412.html" target="_blank">recent issue</a> of the <em>AMA Journal of Ethics</em> examines telemedicine’s challenges for the medical profession.</li> <li> Information about <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/telemedicine.page?" target="_blank">state telemedicine advocacy </a>and <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/digital-health.page" target="_blank">federal digital health advocacy</a>.</li> </ul> <p> <strong>2. Coding telemedicine services and getting paid</strong></p> <p> Leaders in technology and patient care are meeting Monday to discuss how to adapt CPT® codes to the modern telemedicine environment. The meeting—which will include representatives from medical specialty societies, industry, the AMA and the CPT Editorial Panel— will discuss unmet needs for reporting current telehealth services and potential solutions for anticipated future coding needs.</p> <p> After the meeting, it is likely that work groups of physicians and other telehealth experts also will convene to create applications for code set adaptations and to provide appropriate recommendations to ensure physicians can report telemedicine services and get paid so they can continue providing those services.</p> <p> Learn more about the <a href="https://download.ama-assn.org/resources/doc/cpt/x-pub/telehealth-services-invitation.pdf?cb=1434641348&retrieve=yes" target="_blank">meeting</a> (log in) and <a href="http://www.ama-assn.org/resources/doc/cpt/x-pub/telehealth-webinar.mp4" target="_blank">watch a webinar</a> that explains the current CPT telehealth codes.</p> <p> <strong>3. Expediting multistate medical licensure</strong></p> <p> Physicians who treat patients via telemedicine in multiple states, must have a medical license from each state. That process will be easier now that the <a href="http://www.ama-assn.org/ama/ama-wire/post/new-commission-streamline-medical-licensure" target="_blank">Interstate Medical Licensure Compact</a> is in effect. The compact will facilitate a speedier process with fewer administrative burdens for physicians seeking licensure in multiple states. Alabama became the ninth state to join the compact just last month.</p> <p> <strong>Want to learn more?</strong> <a href="http://www.ama-assn.org/ama/ama-wire/post/questions-telemedicine-answered" target="_blank">Get answers to your questions</a> about telemedicine.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d70c9a56-1e35-466c-9e9b-3e618afde1c8 How to equip new doctors for the digital health frontier http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_equip-new-doctors-digital-health-frontier Thu, 18 Jun 2015 20:37:00 GMT <p> As health technology booms, medical schools must prepare students for the associated complex cultural change and increasing physician demands. But new technology doesn’t necessitate a departure from patient-centered care—technological innovations can advance this kind of care. Here’s how <a href="http://community.the-hospitalist.org/bobs-bio/" rel="nofollow" target="_blank">Bob Wachter</a>, MD, author of <em>New York Times</em> science bestseller <em>The Digital Doctor</em>, recommends schools help students chart this new digital health frontier.</p> <p> From the pervasive use of <a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">electronic health records</a> to <a href="http://www.ama-assn.org/ama/ama-wire/post/tablet-can-treat-diabetes-watch-this-film-out" target="_blank">tablets</a> that monitor patient outcomes from afar, health care technology is a pillar of practice that is here to stay. These platforms have both ushered in advancements in modern health care and spurred new expectations that physicians deliver “the highest quality of care at the lowest available cost,” Dr. Wachter (pictured right) said during a special med ed session Sunday.</p> <p> The session was part of a collaborative design shop during which medical educators and informatics experts worked on plans for the future digital curriculum for med schools. Hosted by the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative and the <a href="https://medschool.ucsf.edu/" rel="nofollow" target="_blank">University of California, San Francisco School of Medicine</a>, participants included representatives from the 11 U.S. medical schools the AMA awarded $1 million grants to reshape the way physicians are trained.  </p> <table align="right" border="0" cellpadding="1" cellspacing="0" style="width:365px;"> <tbody> <tr> <td style="text-align:right;"> <br /> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/3/ef2a7487-0c88-4802-b3a2-9374d104e7ce.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/3/ef2a7487-0c88-4802-b3a2-9374d104e7ce.Large.jpg?1" style="float:right;margin-right:15px;margin-left:15px;" /></a></td> <td style="text-align:right;"> <br />  </td> </tr> <tr> <td style="text-align:right;"> <br /> <em style="font-family:arial, helvetica, sans-serif;font-size:10px;">Photo courtesy of Mark Wooding/ University of California, San Francisco      <br /> <br />  </em><span style="font-family:arial, helvetica, sans-serif;font-size:10px;"> </span></td> <td> <br />   </td> </tr> </tbody> </table> <p> <strong>Navigating pressures</strong><br /> Dr. Wachter said today’s tech-savvy students must navigate considerable expectations that weren’t at-play during his training: Imminent pressures to meet accreditation competencies, an increased need for transparency in practice and rapidly changing payment models that place more value on physician performance.</p> <p> Still, educators must prepare physicians in training to overcome these demands while using technology to keep patients at the center of care.</p> <p> And the road to implementing this isn’t necessarily a linear one, Dr. Wachter explained.</p> <p> “You can’t just make this all happen by rules and edicts and checklists and embedding standards in your IT system,” he said. “You actually need people to understand these issues and get engaged, and the only way that will happen is by starting this at the trainee stage.”</p> <p> This is where the work of innovative educators and medical schools like those in the AMA consortium becomes essential, he said. Instead of molding students into “informatics experts,” he advises educators to “train [students] to use all digital tools [and know] how to diagnose when these tools are not working or give misleading information.”<br /> <br /> “We have to use these tools, but we have to reimagine how they’re positioned in the larger geography of team-based care, health systems and practice work flows,” he said.</p> <p> <strong>Developing new skills</strong><br /> Dr. Wachter realized the crucial need for such adaptive skills while conducting research for his book <em>The Digital Doctor</em>, which required him to interview physicians, health care innovators and care teams about their most honest observations using technology in practice.</p> <p> Through his research, he learned of instances when patient care teams admitted to giving patients fatal prescription dosages or physicians failed to properly treat patients as the result of an over-reliance on technology instead of their own medical know-how.</p> <p> Considering these digital entrapments, Dr. Wachter recommended schools take a critical approach to creating informatics curricula that will streamline health systems without displacing patients.<br /> <br /> Educators have to ask, “How does the work flow change with digital tools, and how do we use those tools to create or reestablish relationships with [care teams]?” This isn’t for the sake of nostalgia, Dr. Wachter noted, but to spur the “reimagining” of health care technology in the modern era.</p> <table align="right" cellspacing="0"> <tbody> <tr> <td> <br />  </td> <td> <br /> <a href="http://jama.jamanetwork.com/article.aspx?articleid=1187932" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/2/9c8ce7a2-1ed8-46d3-9232-1c2232fb2fc3.Large.png?1" style="height:281px;width:365px;float:right;" /></a><br /> <br />  </td> </tr> <tr> <td> <br />   </td> <td style="text-align:right;"> <br /> <em><span style="font-size:10px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color:rgb(51, 51, 51);line-height:14.625px;">© 2011 Thomas G. Murphy, MD / The JAMA Network<br /> <br />  </span></span></span></em></td> </tr> </tbody> </table> <p> <strong>Making it all about the patient</strong><br /> A 2012 <em><a href="http://jama.jamanetwork.com/article.aspx?articleid=1187932" rel="nofollow" target="_blank">JAMA op-ed</a></em> underscores the importance of this issue and the impact of technology on the patient perspective. When asked to draw her pediatrician, a seven-year-old’s depiction resulted in a colorful mesh of squiggly lines all pointing to a physician who appears more engrossed in his computer than the actual patient seated on the bed behind him.</p> <p> This is the very perception of physicians that schools must teach students to avoid, Dr. Wachter said. To mitigate this issue, he urged educators to mold students into adaptive learners who are nimble enough to use technology in practice without compromising <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion1001.page?" target="_blank">the fundamental elements</a> of an effective patient-physician relationship.<br /> <br /> He said schools can accomplish this by educating students about emerging issues that will change the culture of medicine and clinical practice as health care continues to modernize. Some of these ever-evolving issues include:</p> <ul> <li> The potential risk of “de-skilling,” or becoming overly reliant on computers for patient diagnosis and treatment<br />  </li> <li> Managing “big data” to advance patient care or potentially work with new care team members who specifically analyze data for physicians</li> </ul> <ul> <li> Teaching students how to effectively avoid “alert fatigue” from copious automated alerts in practice<br />  </li> <li> Educating students about the use of technology in health care delivery science, and its impact on work flows, specialty culture and patient communication</li> </ul> <p> No matter the technology, Dr. Wachter said the goal of medical educators should invariably stay the same: “It’s up to all of us to figure out how to socialize and professionalize our trainees so they know that even though they’re getting data off a computer, that’s not who they’re treating. They’re treating a real person.”</p> <p> <strong>Want to learn more about this new curriculum? </strong>Stay tuned for a special informatics series from <em>AMA Wire</em>®, in which experts will break down the top competencies, tools and assessment strategies every educator needs to effectively create an informatics curriculum for physicians in training. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a90bd502-811e-4083-a132-a3955efcad98 2015 Conley Ethics Essay Contest http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_special-accommodations-med-school-fair Thu, 18 Jun 2015 17:57:00 GMT <p> <strong><em>Note:</em> </strong><em>The previously posted contest scenario has been withdrawn by the AMA Journal of Ethics editors. A new essay contest question/scenario will be posted within the next two weeks.</em></p> <p> The John Conley Ethics Essay Contest, hosted by the <a href="http://journalofethics.ama-assn.org/" target="_blank"><em>AMA Journal of Ethics</em></a>, will be open for submissions from current U.S. medical students beginning in July. Essays can be up to 2,000 words in response to a selected question dealing with medical ethics and professionalism.</p> <p> The author of the best essay receives $5,000, and authors of up to three runner-up essays could receive $1,000 prizes. Winning essays are published in the <em>AMA Journal of Ethics</em>.</p> <p> <a href="http://journalofethics.ama-assn.org/site/conleywinners.html" target="_blank">Read past winning essays</a> at the <em>AMA Journal of Ethics</em> Web page.</p> <p> The annual ethics essay contest is supported by the John Conley Foundation for Ethics and Philosophy in Medicine. John J. Conley, MD, was an otolaryngologist and head and neck surgeon with a passion for medicine’s ethical practice. In addition to establishing the student ethics essay contest, Dr. Conley endowed an annual ethics and philosophy lectureship at the Columbia University College of Physicians and Surgeons, where he was clinical professor of otolaryngology for many years.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2ad5ff0e-94a6-4db7-9e60-af83995f43b4 How residents, programs tackle wellness: 4 solutions to know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-programs-tackle-wellness-4-solutions Wed, 17 Jun 2015 22:33:00 GMT <p> While the burnout woes of residency are familiar to many physicians in training, concrete strategies to combat the problem can be more elusive. That’s why experts in the field put resident wellness top-of-mind during a panel discussion at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>, sharing some innovative solutions.</p> <p> Here are a few creative ways medical communities in the United States and abroad have developed to empower residents to better care for themselves and colleagues:</p> <p> <strong>1. Making wellness an accreditation requirement for residency programs</strong></p> <p> Jeff Blackmer, MD, an associate professor of medicine at University of Ottawa and executive director of the office of ethics, professionalism and international affairs at the Canadian Medical Association, spoke about how physician health, wellness and sustainability are recognized as critical components of medical education and training in Canada.</p> <p> The Royal College of Physicians and Surgeons of Canada, the country’s governing accreditation association, has made resident wellness a key part of “professionalism,” Dr. Blackmer said. Professionalism is a required competency on the <a href="http://www.royalcollege.ca/portal/page/portal/rc/resources/aboutcanmeds" rel="nofollow" target="_blank">CanMEDS</a> system, a national competency-based framework that describes the core knowledge, skills and abilities Canadian residents must fulfill in training.</p> <p> “This is a pretty big step for an organization like the Royal College to take since all residency programs will actually have to help residents meet this standard in order to gain accreditation,” Dr. Blackmer said.</p> <p> “At the University of Ottawa, we have a very innovative program in mindfulness that our university staff developed along with a corresponding book,” he said. “So every student who goes through the University of Ottawa has to take a mindfulness course and do reflective journaling as part of the curriculum, which has already proven beneficial.”</p> <p> <strong>2. Researching wellness solutions of the future</strong></p> <div> <p> “There has been a considerable amount of data documenting fatigue and stress as significant issues among residents, but interventions to combat these slowly lag behind,” said Olufunso W. Odunukan, MD, a cardiovascular disease fellow at the Mayo Clinic in Jacksonville, Fla.</p> <p> To address this issue, Dr. Olufunso and his colleagues created the Fellows and Residents’ Health and Wellness Initiative, which consists of developing evidence-based research and wellness strategies for programs to implement.</p> <p> In 2014, the initiative launched a pilot study of 45 residents who were asked to replace an hour in their day with art therapy or meditation over a three-month period.</p> <p> “We found that the art therapy and meditation intervention group reported significant reductions in stress and fatigue levels compared to their cohort of colleagues,” Dr. Olufunso said.</p> <p> During a second phase of the study in 2015, he also found that rates of stress and fatigue didn’t vary greatly based on activity. Both the art therapy and meditation activities fostered positive behaviors in residents, including team bonding and improved communication.</p> <p> While he acknowledges the limitations of a pilot study, Dr. Olufunso said he plans to expand his research and hopes it will incite other residency programs to explore wellness solutions.</p> <p> “We wanted to pass the message on to residents and fellows that their well-being is just as important as caring for patients,” he said. “And that it’s not always physical. In surveys I’ve done of residents, 80 percent of them can exercise and still report levels of fatigue, so just going to the gym isn’t going to solve it. We have to explore other solutions that also address our spiritual and mental health.”</p> </div> <div> <p> <strong>3. Prioritizing small changes for long-term improvements</strong></p> <p> Jane Shersher, a medical social worker and occupational therapist, consults practicing physicians and hospitals about burnout prevention.</p> <p> While organizations have to address infrastructural problems that augment physician burnout—such as unorganized clinical rotations or inefficient electronic health records—Shersher said residents still have control over lifestyle factors that can improve resiliency in training.</p> <p> “Studies show that making small behavior changes can really impact how you look at your day and treat your patients,” she said.</p> <p> For instance, Shersher said that doing something as simple as journaling for five minutes a day or taking deep breaths has proven to keep stress at bay. She also advises residents to incorporate vegetables and natural energizing supplements into their diets.</p> <p> “My passion is specifically for young physicians in the early stages of their careers because if you learn self-care early on, you will not only be more productive for your patients, you will be a much better asset to your employer,” she said.</p> </div> <p> <strong>4. Taking wellness around the globe </strong></p> <p> <a href="http://www.wma.net/en/80junior_doctors/10about_us/index.html" rel="nofollow" target="_blank">The Junior Doctors Network</a> (JDN), which was founded in 2010 as a platform for young physicians within the World Medical Association (WMA), hosts annual conferences to discuss public health, advocacy, human rights and health system issues that impact physicians around the world. </p> <p> “[The network] now includes hundreds of junior doctors from more than 70 countries and not surprisingly, physician well-being, specifically the well-being of junior [physicians], was identified early on within the organization as an issue that all of us grapple with,” said Elizabeth Wiley, MD, socio-medical affairs officer for the JDN.</p> <p> Dr. Wiley said the JDN hosted a wellness meeting in Durham, South Africa, a few years ago. From that meeting, several themes emerged around common issues that impact physician well-being worldwide, which included:</p> <ul> <li style="margin-left:0.25in;"> Excessive working hours</li> <li style="margin-left:0.25in;"> Poor working environments and conditions</li> <li style="margin-left:0.25in;"> Insufficient facilities, which span from a lack of adequate supplies to a lack of electricity in practice facilities</li> <li style="margin-left:0.25in;"> A culture of harassment and bullying in medicine, including verbal and physician abuse, gender discrimination, and inadequate supervision during rotations</li> </ul> <p> “This resulted in the formation of an expert working group, chaired by AMA [Immediate-Past] President Dr. Wah, and has ultimately produced a final policy statement on physician well-being that will establish a global norm and expectation around wellness,” Dr. Wiley said.</p> <p> <strong>For additional well-being solutions and tips for residents:</strong></p> <ul> <li style="margin-left:0.25in;"> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/acgme-seeks-transform-residency-foster-wellness" target="_blank">how the ACGME plans</a> to foster resident wellness.</li> <li style="margin-left:0.25in;"> Educate yourself on <a href="http://www.ama-assn.org/ama/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">the signs of burnout</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/burnout-busters-boost-satisfaction-personal-life-practice" target="_blank">how to avoid them.</a></li> <li style="margin-left:0.25in;"> Review <a href="http://www.ama-assn.org/ama/ama-wire/post/5-things-institutions-can-prevent-resident-burnout" target="_blank">5 things institutions can do</a> to prevent resident burnout.</li> <li style="margin-left:0.25in;"> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/ways-residents-found-conquer-burnout" target="_blank">how other residents have conquered</a> burnout in training. </li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:58d5fc07-008f-480d-9944-586e07607197 PM&R: A look at ethics in the “quality-of-life specialty” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_pmr-look-ethics-quality-of-life-specialty-1 Wed, 17 Jun 2015 20:37:00 GMT <p> Helping patients manage serious medical and life issues—such as severe disability, depression and barriers to independent living—is a primary concern for physicians practicing in the field of physical medicine and rehabilitation (PM&R). The <a href="http://journalofethics.ama-assn.org/site/current.html" target="_blank">June issue</a> of the <em>AMA Journal of Ethics</em> takes a close look at ethical issues in the “quality-of-life specialty.”</p> <p> The physical medicine and rehabilitation specialty aims to improve movement and reduce psychological, emotional, family and vocational stresses that often accompany temporary or permanent loss of motor function. Patients receiving this care can have congenital or acquired conditions that range from spina bifida to traumatic injury to Parkinson’s disease.</p> <p> Contributors to this month’s issue of the <em>AMA Journal of Ethics</em> tackle the serious ethical questions physiatrists confront as they offer patients encouragement tempered by realistic expectations, arrange safe discharge and follow-up, manage long-term pain, and fight for access to the best rehab care for everyone who needs it. Articles include:</p> <ul> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/06/ecas1-1506.html" target="_blank">Physician paternalism and severe disability: Strengthening autonomy through therapeutic engagement</a>”: Kristi L. Kirschner, MD, examines how one physician helps patients who are depressed, grieving or angry after a severe injury or illness image possible narratives for the next chapter of their lives.</li> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/06/ecas2-1506.html" target="_blank">Safety and ethical decisions in discharging patients to suboptimal living situations</a>”: James Hill, MD, and William Filer, MD, look at critical considerations in discharge planning that include caregiver trustworthiness and a competent patient’s decision-making prerogative.</li> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/06/msoc1-1506.html" target="_blank">The disability movement’s critique of rehabilitation’s medical model: A rebuttal</a>”: John D. Banja, PhD, writes that critiques of the “normalization” goals of the medical model of rehabilitation can be dismissive of efforts to remediate oppressive functional deficits.</li> </ul> <p> <strong>Ethics poll: Your chance to weigh in</strong></p> <p> Do research and treatment aimed at improving physical impairments send a message that a life lived with impairments is less valuable than a life lived without impairments? <a href="http://journalofethics.ama-assn.org/site/poll.html" target="_blank">Share your response</a> in this month’s ethics poll.</p> <p> <strong>Learn more about the physical medicine and rehabilitation specialty</strong></p> <p> For medical students who are deciding on a specialty to pursue after graduation, <em>AMA Wire</em>® offers the <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank">“Shadow Me” Specialty Series</a>, which gives honest advice, observations and resources from physicians in different specialties.</p> <p> The latest physician profiles in this series are from two physicians who practice physical medicine and rehabilitation:</p> <ul> <li style="margin-left:0.25in;"> Claire Wolfe, MD</li> <li style="margin-left:0.25in;"> John Vasudevan, MD</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:596b2545-dae1-47d1-a28e-570dd958d26a What it’s like to be in sports medicine: Shadowing Dr. Vasudevan http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-sports-medicine-shadowing-dr-vasudevan Wed, 17 Jun 2015 17:31:00 GMT <p> As a medical student, do you ever wonder what it’s like to specialize in physical medicine and rehabilitation (PM&R)? Here’s your chance to find out.</p> <p> Meet John Vasudevan, MD, a physiatrist and featured physician in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read Dr. Vasudevan’s insights to help determine whether a career in PM&R is a good fit for you.</p> <p> <strong>“Shadowing” Dr. Vasudevan</strong></p> <p> <strong>Specialty:</strong> PM&R, with a sub-specialty of sports medicine</p> <p> <strong>Practice type:</strong> Academic and employed</p> <p> <strong>A typical week in my practice:</strong></p> <p> My practice is essentially an outpatient, non-operative musculoskeletal and sports medicine practice. I typically work 40-50 hours per week. I usually see patients from 8 a.m. to 4 p.m., finish documentation and calls by 5-5:30 p.m. and return home by 6 p.m. I take three weekends of inpatient call (at an acute rehabilitation hospital) per year.</p> <p> <strong>The most challenging and rewarding aspects of caring for patients as a physiatrist:</strong></p> <p> The most challenging part is not much different from the most rewarding part. It can be very challenging when many of my patients either have chronic or overuse conditions with no easy “fix.” At the same time, it is rewarding to work in a specialty that is better prepared than any other to treat that which can be improved, manage that which cannot, and even prevent recurrent or progressive injury. Physiatrists (specialists in physical medicine and rehabilitation) maximize the functional ability of patients, regardless of their activity level.</p> <p> <strong>Three adjectives that describe the typical physician in PM&R:</strong></p> <p> Comprehensive. Open-minded. Collaborative.</p> <p> <strong>What my lifestyle is like in </strong><strong>PM&R</strong><strong>:</strong></p> <p> Some people joke that PM&R stands for “plenty of money and relaxation,” which assumes that the relatively good work-life balance the specialty provides means that it is easy. But that is far from the truth. Physiatrists must work diligently to ensure that our patients get the most benefit with a minimal amount of medical intervention. In our current health care environment, this is a very valuable skill set to have.</p> <p> <strong>The main skills every physician in training should have for PM&R but won’t be tested for on the board exam:</strong></p> <p> Almost everyone in medical school is excited to make decisions and have authority in determining the best treatment for a patient. Board exams are focused on the doctor making the decision for the patient. Physiatry is relatively unique in that it demands physicians to lead a team of many different disciplines (physical, occupational, speech, psychological therapies and nursing, at the least) and to embrace the collaborative decision-making of a group. A physiatrist has to be smart enough to make the right decision but humble enough to respect the expertise of those who contribute to that decision.</p> <p> <strong>One question every physician in training should ask themselves before pursuing PM&R:</strong></p> <p> Are you comfortable with treating people with disability? Disability can be as stark as those with spinal cord injury, stroke, brain injury or cerebral palsy, but as subtle as those who struggle with chronic and slowly progressive osteoarthritis. Managing disability is not easy, but to do so is very powerful to those who benefit from proper treatment. All medial disciplines encounter disability, but physiatry is best prepared to handle it.</p> <p> <strong>Three books every medical student interested in PM&R should read:</strong></p> <ul> <li> The definitive text on PM&R is <em>Physical Medicine and Rehabilitation: Expert Consult</em> by Randall Braddom.</li> <li> For ready reference on the wards and in clinics, grab a <em>Physical Medicine and Rehabilitation Pocketpedia</em> by Matthew Shatzer.</li> <li> For anyone interested in doing a proper musculoskeletal examination, I recommend the <em>3-Minute Musculoskeletal and Peripheral Nerve Exam</em> by Alan Miller, MD, Kimberly DiCuccio Heckert, MD, and Brian A. Davis, MD.</li> </ul> <p> <strong>An online resource students interested in my specialty should follow:</strong></p> <p> The <a href="http://www.aapmr.org/" rel="nofollow" target="_blank">Academy of Physical Medicine and Rehabilitation</a> the best starting point for anyone interested in PM&R (including a section for interested medical students). The site and association are instrumental throughout a career in psychiatry. </p> <p> <strong>Additional advice for students considering my specialty:</strong></p> <p> We all go into medical school to help people and (hopefully) save lives. Even though a beating heart and breathing lungs keep a person alive, they do not a guarantee that a person can satisfactorily “live” their lives. In other words, quantity of life does not equal quality of life. If your interest is in maximizing the comfort and ability of those who suffer from chronic disease, or even enhancing performance of an active and healthy population (as I do in a sports medicine practice), then you should strongly consider a career in PM&R.</p> <p> <strong>If I had a mantra or song to describe my life in this specialty, it would be:</strong></p> <p> Theme from the movie <em>Rocky.</em> (Just imagine the song playing as you work out in the physical therapy gym … or maybe I picked it because I practice in Philadelphia!)</p> <p> <strong>Want to learn more about life in PM&R? </strong></p> <ul> <li> Hear what it’s like to practice in the field from <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe">Dr. Wolfe</a>, another physical medicine and rehabilitation specialist featured in AMA Wire’s Shadow Me Specialty Series</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/pmr-look-ethics-quality-of-life-specialty-1">Check out</a> the June issue of the <em>AMA Journal of Ethics, which</em> takes a close look at ethical issues in this “quality-of-life specialty.”</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f6f73f31-e1fd-44e9-9f04-f8a67344f9db What it’s like to be in physical medicine and rehabilitation: Shadowing Dr. Wolfe http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe Wed, 17 Jun 2015 17:30:00 GMT <p> As a medical student, do you ever wonder what it’s like to specialize in physical medicine and rehabilitation (PM&R)? Here’s your chance to find out.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/6/2a7ef06b-b3d8-4c30-b609-5c00cf1ffe83.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/6/2a7ef06b-b3d8-4c30-b609-5c00cf1ffe83.Full.jpg?1" style="float:right;margin:15px;width:365px;height:250px;" /></a></p> <p> Meet Claire Wolfe, MD, a physiatrist and featured physician in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read Dr. Wolfe’s insights to help determine whether a career in PM&R is a good fit for you.</p> <p> <strong>“Shadowing” Dr. Wolfe</strong></p> <p> <strong>Specialty:</strong> PM&R</p> <p> <strong>Practice type:</strong> Group practice in orthopedics, physical medicine and sports medicine</p> <p> <strong>My typical day:</strong></p> <p> I’m semi-retired, so I work two days a week, now doing mostly EMGs and seeing some of my long-time patients. When I worked full time, I had no night/hospital call, and I usually was in the office from 9 a.m. to 3 p.m. when my kids were small.</p> <p> <strong>The most challenging and rewarding aspects of caring for patients as a physiatrist:</strong></p> <p> Challenging: You’re dealing with patients who have chronic problems, from benign muscular conditions and arthritis to spinal cord injuries, multiple sclerosis, stoke and amputations.</p> <p> Rewarding: the gratitude of the patient for helping them make their lives a little easier and their ability to function with their disability better.</p> <p> <strong>Three adjectives that describe the typical physician in PM&R:</strong></p> <p> Happy. Fulfilled. Unstressed.</p> <p> <strong>What my lifestyle is like in PM&R:</strong></p> <p> <span style="font-size:12px;">I picked my specialty in medical school because of the lifestyle it offered: Flexible hours, no night calls, patients who rarely were in medical crises and the ability to make a difference for a population of people often overlooked. I liked the people in the specialty. [They were] very holistic and team-oriented (physical therapy, occupational therapy, social work, vocational, psychiatry), [even] before “team” was such a popular term. I’ve never regretted [choosing] the specialty.</span></p> <p> <strong>The main skills every physician in training should have for PM&R but won’t be tested for on the board exam:</strong></p> <ul> <li> The ability to communicate hope for folks with chronic illness.</li> <li> To be able to counsel not only the patient but their families.</li> <li> Often to interface with employers or (in the case of young people) their schools.</li> <li> To work for accommodations with government, business and education.</li> </ul> <p> <strong>One question every physician in training should ask themselves before pursuing this specialty:</strong></p> <p> Do you want to have long-term relationships with patients, help those patients with long-term disabilities and help make them more functional in their lives, rather than “curing” them?</p> <p> <strong>Three books every medical student interested in PM&R should read:</strong></p> <ul> <li style="margin-left:0.25in;"> <em>The Anatomy of Hope</em> by Jerome Groopman, MD</li> <li style="margin-left:0.25in;"> <em>Tuesdays with Morrie</em> by Mitch Albom</li> <li style="margin-left:0.25in;"> <em>Anatomy of an Illness</em> <em>as Perceived by the Patient</em> by Norman Cousins</li> </ul> <p> <strong>An online resource students interested in my specialty should follow:</strong></p> <p> <a href="http://www.aapmr.org/" rel="nofollow" target="_blank">American Academy of Physical Medicine and Rehabilitation</a></p> <div> <p> <strong>Additional advice for students considering my specialty:</strong></p> <p> Hopefully, [your] school will have PM&R practitioners. Seek them out, especially if there’s no rotation or other introduction to the specialty. Find a couple of folks to shadow. Most PM&R physicians practice primarily rehabilitation (e.g., spinal cord, stroke, head injury) <strong>or</strong> physical medicine (e.g., sports, arthritis, diagnostic EMG). Try some of each.</p> <p> <strong>Want to learn more about life in PM&R? </strong></p> <ul> <li style="margin-left:0.25in;"> Hear what it’s like to practice in the field from <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-sports-medicine-shadowing-dr-vasudevan" target="_blank">Dr. Vasudevan</a>, another physical medicine and rehabilitation specialist featured in AMA Wire’s Shadow Me Series</li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/pmr-look-ethics-quality-of-life-specialty-1" target="_blank">Check out</a> the June issue of the <em>AMA Journal of Ethics,</em><em> which</em> takes a close look at ethical issues in this “quality-of-life specialty.”</li> </ul> </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a03fa6a7-6ee6-4f3f-9a7f-d9a5aa0160b7 Physicians take on MOC debate http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-moc-debate Wed, 17 Jun 2015 13:00:00 GMT <p> The maintenance of certification (MOC) process was an important topic for physicians attending the 2015 AMA Annual Meeting last week. Academic physicians had a chance to hear updates on MOC before the AMA House of Delegates considered policy to urge changes to MOC to make it more transparent and physician-friendly.</p> <p> While MOC has been a controversial topic for practicing physicians, it also is an impending reality for medical students and residents. The AMA Academic Physicians Section (APS)—previously the AMA Section on Medical Schools—hosted an education session to help its members understand the data and viewpoints on MOC as they mentor future physicians.</p> <p> The discussion centered on physician professionalism and the importance of physicians being involved in setting the profession’s standards as a key element of medicine’s responsibility to patients and society.</p> <p> “A profession is a very important and unique social construct that has elements around a social contract,” Lois Margaret Nora, MD, president and CEO of the American Board of Medical Specialties (ABMS), said during the session. “Medicine … demands special knowledge and skills that are not available to all. We profess that we will maintain the necessary skills and knowledge. … This privilege [to be recognized as a profession] is very dependent upon society’s confidence.”</p> <p> <strong>Hearing physicians’ concerns</strong></p> <p> Many physicians argue that MOC may present an additional administrative burden on top of an already heavy load of regulatory requirements that can divert time away from patient care.</p> <p> In an effort to address these concerns and collaborate with physicians, the ABMS in January released refined MOC standards that better reflect educational and practice environments. The <a href="http://www.abms.org/media/1109/standards-for-the-abms-program-for-moc-final.pdf" rel="nofollow">new standards</a> include elements common to MOC for all ABMS member boards, place greater emphasis on professionalism and patient safety and include a requirement that examinations assess physicians’ judgment as well as knowledge.</p> <p> But these new standards will need to be continuously revisited, Dr. Nora said.</p> <p> “We need more research, and we are involved in and encouraging outside research about MOC,” Dr. Nora said. She added a plea to medical educators: “Become involved. You can be some of our most passionate and knowledgeable constructive critics.”</p> <p> <strong>Encouraging transparency</strong></p> <p> Through its House of Delegates, the AMA is playing a role as a constructive critic as well. Physicians passed policy based on an <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a> report that asks the ABMS to develop “fiduciary standards” for its member boards. The new policy also asks the ABMS to urge full transparency related to the costs of preparing, administering, scoring and reporting MOC exams and seeks to ensure that MOC “doesn’t lead to unintentional economic hardships.”</p> <p> <a href="http://www.ama-assn.org/ama/ama-wire/post/transparent-physician-friendly-moc-focus-of-new-policy">Read more</a> about the AMA’s new policies on MOC at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2d7d185a-aeed-4ea5-8b1b-f6fb986591b1 Academic physicians have a new home in the AMA http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_academic-physicians-new-home-ama Wed, 17 Jun 2015 13:00:00 GMT <p> The AMA Section on Medical Schools (SMS) changed its name and refined its focus to better meet the needs of today’s academic physicians, medical educators and faculty.</p> <p> Through action of the AMA House of Delegates at the 2015 AMA Annual Meeting in Chicago, the section is now the Academic Physicians Section (APS).</p> <p> Since its founding in 1976, the section has represented the voice of academic medicine to the House. Strategic planning reviews and surveys of academic physicians nationwide, however, revealed that the name “Section on Medical Schools” has inhibited the interest and involvement of academic physicians outside the leadership and administration of medical schools including those who serve as faculty at our nation’s non-medical school affiliated medical centers and residency programs.</p> <p> The name connoted an exclusive focus on undergraduate medical education, even though the section welcomes academic physicians interested in graduate medical education and continuing medical education, as well as those who serve in a clinical/research capacity with an academic medical center, community hospital or other health care setting.</p> <p> Finally, the focus on the physician’s institution (i.e., medical school) versus what that physician does/is (i.e., an academic physician) was seen as a barrier to expanded membership in the section. Current membership is less than 600 physicians, including about 350 academic physicians appointed to the AMA-SMS by their respective institutions’ deans, even though data show upwards of 20,000 individuals as academic physicians—many of whom are AMA members and could become members of the section.</p> <p> “For all these reasons, the moniker ‘Section on Medical Schools’ was ready for retirement,” says Alma B. Littles, MD, current chair of the AMA-APS Governing Council and senior associate dean for medical education and academic affairs at the Florida State University College of Medicine in Tallahassee. “We believe this change will help the AMA-APS expand its engagement with academic physicians nationwide and help address the key challenge we all face—how best to educate the next generation of physicians.”</p> <p> Physicians at the meeting also approved changes to streamline the membership categories and processes of the former SMS. AMA member academic physicians can seek membership in the AMA-APS through three routes:</p> <ol> <li> Appointment by the dean of their allopathic or osteopathic medical school.</li> <li> Self-designation as an academic physician for those with a current faculty appointment at a U.S. medical school.</li> <li> Self-nomination as a physician who does not hold a medical school faculty appointment but has an active role in student (undergraduate), resident/fellow (graduate), and/or continuing medical education or serves in a clinical/research capacity with an academic medical center, community hospital, or other health care setting.</li> </ol> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page">Learn more</a> about the AMA-APS.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c598e1bb-d6f0-4a82-8aa7-4063c14b5914 How to talk to your patients about melanoma http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_talk-patients-melanoma Tue, 16 Jun 2015 20:43:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/10/6d610b6a-9ec2-4ed4-8a02-7aeeb4b2e6de.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/10/6d610b6a-9ec2-4ed4-8a02-7aeeb4b2e6de.Large.jpg?1" style="margin:15px;float:right;" /></a>The rate of new cases of melanoma in the United States has doubled over the last three decades, reaching 9,000 each year, according to a <a href="http://www.cdc.gov/vitalsigns/melanoma/index.html" rel="nofollow" target="_blank">new data release</a> from the Centers for Disease Control and Prevention (CDC).</p> <p> In light of this startling announcement as the summer begins, now is an important time to talk to your patients and answer their questions about appropriate prevention and screening measures for skin cancer.</p> <p> Here are essential resources from expert sources to help you and your patients.</p> <p> <strong>Patient resources:</strong></p> <ul> <li> <a href="http://jama.jamanetwork.com/article.aspx?articleid=900735&resultClick=3" rel="nofollow" target="_blank">Melanoma <em>JAMA</em> Patient Page</a>, which includes causes, symptoms, diagnosis and photo examples (from the JAMA Network)</li> <li> <a href="https://www.aad.org/spot-skin-cancer" rel="nofollow" target="_blank">SPOT™ Skin Cancer education</a>, which helps patients understand sun protection methods, learn how to apply sunscreen correctly and find a skin cancer screening (from the American Academy of Dermatology)</li> <li> <a href="https://www.aad.org/spot-skin-cancer/free-resources" rel="nofollow" target="_blank">Downloadable resources</a>, including a body mole map, infographic and sun safety FAQs (from the American Academy of Dermatology)</li> <li> <a href="http://www.cdc.gov/cancer/skin/index.htm" rel="nofollow" target="_blank">Skin cancer prevention tactics and FAQs</a> (from the CDC)</li> </ul> <p> <strong>Physician resources:</strong></p> <ul> <li> <a href="http://www.cdc.gov/vitalsigns/melanoma/index.html" rel="nofollow" target="_blank">Latest melanoma data</a>, including community prevention strategies (from the CDC)</li> <li> <a href="http://archderm.jamanetwork.com/article.aspx?articleid=2301157" rel="nofollow" target="_blank">Google search trends and skin cancer</a>: Evaluating the U.S. population’s interest in skin cancer and its association with melanoma outcomes (from the JAMA Network)</li> <li> <a href="http://archderm.jamanetwork.com/article.aspx?articleid=2301153&resultClick=1" rel="nofollow" target="_blank">Comparison of efficacy of differing partner-assisted skin examination interventions for melanoma patients</a> (from the JAMA Network)</li> <li> <a href="http://jama.jamanetwork.com/article.aspx?articleid=2108872&resultClick=3" rel="nofollow" target="_blank">Risk-stratified screening for detection of melanoma</a> (from the JAMA Network)</li> <li> <a href="http://jama.jamanetwork.com/article.aspx?articleid=2300343&resultClick=1" rel="nofollow" target="_blank">FDA regulation of indoor tanning devices and opportunities for skin cancer prevention</a> (from the JAMA Network)</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8a920129-2c3e-40f2-a5b0-46ad8a7e4402 6 ways your practice can save by using electronic transactions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-ways-practice-can-save-using-electronic-transactions Tue, 16 Jun 2015 19:57:00 GMT <p> Is your practice bogged down with paper processes? Whether you’ve already made the transition from a paper to an electronic claims revenue cycle or you’re still in the early stages of that process, a <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/remittance-advice.page" target="_blank">newly updated toolkit</a> from the AMA offers the insights you need.</p> <p> More practices are improving their revenue cycle by accepting electronic remittance advice (ERA), an electronic version of a paper explanation of payment.</p> <p> Here are the benefits to using ERAs:</p> <ul> <li style="margin-left:0.5in;"> Many payers pay more quickly when physicians interact with them electronically.</li> <li style="margin-left:0.5in;"> Secondary claims and patient bills can be created faster.</li> <li style="margin-left:0.5in;"> You won’t worry about misplacing paper explanations of benefits.</li> <li style="margin-left:0.5in;"> You’ll spend less time on administrative processes, such as opening mail, filing, posting payments and calling insurers.</li> <li style="margin-left:0.5in;"> Your staff will be able to better manage claim adjustments by using standardized code sets.</li> <li style="margin-left:0.5in;"> Your staff will have time for higher-value, revenue-enhancing functions, such as ensuring correct payment and appealing inappropriate denials.</li> </ul> <p> <strong>Here’s what you need</strong></p> <ul> <li style="margin-left:0.25in;"> The AMA’s newly updated <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/remittance-advice.page" target="_blank">ERA toolkit</a> gives insight into questions you should ask insurers, billing services and practice management system vendors before making the switch from paper explanations of payment.</li> <li style="margin-left:0.25in;"> Use the AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/insurers-not-paying-correctly-tool-helps-address-denials" target="_blank">Claims Workflow Assistant</a> to understand your ERA transactions and determine whether your claim has been properly processed by insurers. If you determine that there is an issue with a claim, you should consider submitting an appeal letter. AMA members can use these <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/appeal-your-claim/appealing-claims-payment-issues.page" target="_blank">sample appeal letters</a> to get started.</li> <li style="margin-left:0.25in;"> Access <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives.page?" target="_blank">additional resources</a> for assistance in navigating the claims process, from selecting a practice management system to dealing with overpayment disputes.</li> </ul> <p> Looking for more tips? <em>AMA Wire</em>® has you covered:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-things-must-overpayment-recovery" target="_blank">How to handle overpayment recovery requests</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-tips-providing-point-of-care-pricing" target="_blank">Tips for providing point-of-care pricing</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/refine-patient-payment-management-process-tips" target="_blank">Ways to refine your patient payment management process</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/learn-electronic-payments-work-practice" target="_blank">How to make electronic payments work for your practice</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2215a5a0-71ff-4021-8c06-6c6286cb100c PM&R: A look at ethics in the “quality-of-life specialty” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_pmr-look-ethics-quality-of-life-specialty Tue, 16 Jun 2015 16:00:00 GMT <p> Helping patients manage serious medical and life issues—such as severe disability, depression and barriers to independent living—is a primary concern for physicians practicing in the field of physical medicine and rehabilitation (PM&R). The <a href="http://journalofethics.ama-assn.org/site/current.html" target="_blank">June issue</a> of the <em>AMA Journal of Ethics</em> takes a close look at ethical issues in the “quality-of-life specialty.”</p> <p> The physical medicine and rehabilitation specialty aims to improve movement and reduce psychological, emotional, family and vocational stresses that often accompany temporary or permanent loss of motor function. Patients receiving this care can have congenital or acquired conditions that range from spina bifida to traumatic injury to Parkinson’s disease.</p> <p> Contributors to this month’s issue of the <em>AMA Journal of Ethics</em> tackle the serious ethical questions physiatrists confront as they offer patients encouragement tempered by realistic expectations, arrange safe discharge and follow-up, manage long-term pain, and fight for access to the best rehab care for everyone who needs it. Articles include:</p> <ul> <li> “<a href="http://journalofethics.ama-assn.org/2015/06/ecas1-1506.html">Physician paternalism and severe disability: Strengthening autonomy through therapeutic engagement</a>”: Kristi L. Kirschner, MD, examines how one physician helps patients who are depressed, grieving or angry after a severe injury or illness image possible narratives for the next chapter of their lives.</li> <li> “<a href="http://journalofethics.ama-assn.org/2015/06/ecas2-1506.html">Safety and ethical decisions in discharging patients to suboptimal living situations</a>”: James Hill, MD, and William Filer, MD, look at critical considerations in discharge planning that include caregiver trustworthiness and a competent patient’s decision-making prerogative.</li> <li> “<a href="http://journalofethics.ama-assn.org/2015/06/msoc1-1506.html">The disability movement’s critique of rehabilitation’s medical model: A rebuttal</a>”: John D. Banja, PhD, writes that critiques of the “normalization” goals of the medical model of rehabilitation can be dismissive of efforts to remediate oppressive functional deficits.</li> </ul> <p> <strong>Ethics poll: Your chance to weigh in</strong><br /> <span style="font-size:12px;">Do research and treatment aimed at improving physical impairments send a message that a life lived with impairments is less valuable than a life lived without impairments? </span><a href="http://journalofethics.ama-assn.org/site/poll.html" style="font-size:12px;">Share your response</a><span style="font-size:12px;"> in this month’s ethics poll.</span></p> <p> <strong>Learn more about the physical medicine and rehabilitation specialty</strong><br /> <span style="font-size:12px;">For medical students who are deciding on a specialty to pursue after graduation, </span><em style="font-size:12px;">AMA Wire</em><span style="font-size:12px;">® offers the </span><a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" style="font-size:12px;">“Shadow Me” Specialty Series</a><span style="font-size:12px;">, which gives honest advice, observations and resources from physicians in different specialties.</span></p> <p> The latest physician profiles in this series are from two physicians who practice physical medicine and rehabilitation:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe" target="_blank">Claire Wolfe, MD</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-sports-medicine-shadowing-dr-vasudevan" target="_blank">John Vasudevan, MD</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8f3fc6e7-ed1c-4e31-8497-1ac1b59b50a6 Virtual credit cards could be costing you 5% of your payments http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_virtual-credit-cards-could-costing-5-of-payments Mon, 15 Jun 2015 18:45:00 GMT <p> More health plans are paying claims with virtual credit cards (VCC), but physicians might not be aware of hidden fees associated with this payment method. New policy passed at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a> helps shine light on ways physicians can get paid fairly.</p> <p> If your practice accepts VCC payments, you may be losing a significant amount of your contractual payments to high interchange fees charged by the credit card company. These payments often offer health insurers significant financial rewards while sticking physicians with all the associated fees and extra work.</p> <p> For each of these payments, physicians are charged fees that typically amount to 3-5 percent of the total payment—and that adds up. If a physician contractually is owed $5,000, for instance, he or she could have to shell out up to $250 of that in fees.</p> <p> An informal survey of more than 1,100 participants showed that more than two-thirds of respondents have received VCC payments, with 86 percent reporting that VCC payments have increased over the past year. More than 40 percent of respondents said they were unaware of practice revenue being lost to VCCs.</p> <p> The results of this survey, conducted by the AMA, American Dental Association and Medical Group Management Association, point to physicians’ need for more information about this type of payment. That’s just what physicians called for in new AMA policy adopted last week.</p> <p> The AMA will advocate for transparency in VCC payments. This would include advanced disclosure by third-party payers of  transaction fees associated with VCCs and any rebates or other incentives awarded to payers for using this payment method.</p> <p> Meanwhile, some states are taking on VCC payments with legislation. In Oregon, physicians must “opt in” before payers can use VCCs under a newly enacted bill. Two other states have attempted to pass VCC bills this year as well.</p> <p> Learn the <a href="http://www.ama-assn.org/ama/ama-wire/post/3-things-physicians-can-avoid-high-virtual-credit-card-fees">three things physicians can do</a> to avoid high VCC fees, and access a free AMA <a href="https://download.ama-assn.org/resources/doc/psa/x-pub/virtual-cards.pdf?cb=1399650477&retrieve=yes">resource</a> (log in) to help your practice with this type of payment.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c5109b76-c6c9-4d3c-a278-0b76706b9ce8 New AMA board officers elected http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-ama-board-officers-elected Mon, 15 Jun 2015 18:42:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/3/2216121d-8f7c-4892-b39e-123a46b5aab1.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/3/2216121d-8f7c-4892-b39e-123a46b5aab1.Large.jpg?1" style="float:right;margin:15px;" /></a>Eight physicians were chosen last week as executive officers for the AMA Board of Trustees, representing a wide range of specialties, practice settings and regions of the country.</p> <p> Board members who will be officers for 2015-2016 are as follows:</p> <ul> <li> President: Steven J. Stack, MD (pictured upper left), an emergency physician in Lexington, Ky.</li> <li> President-elect: Andrew W. Gurman, MD, an orthopaedic hand surgeon in Hollidaysburg, Pa.</li> <li> Chair: Stephen R. Permut, MD (pictured lower right), a family physician in Wilmington, Del.</li> <li> Chair-elect: Patrice A. Harris, MD (pictured upper right), a psychiatrist and public health administrator in Atlanta, Ga.</li> <li> Speaker: Susan R. Bailey, MD (pictured lower left), an allergist in Fort Worth, Texas</li> <li> Vice speaker: Bruce A. Scott, MD, an otolaryngologist in Louisville, Ky.</li> <li> Secretary: Gerald E. Harmon, MD, a family physician in Pawleys Island, S.C.</li> <li> Immediate past chair: Barbara L. McAneny, MD, a medical oncologist/hematologist in Albuquerque, N.M.</li> </ul> <p> See the entire 21-member <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members.page?">AMA Board of Trustees</a>.</p> <p> Members of the board are elected by physicians and medical students representing more than 180 state and specialty medical societies, who gathered in Chicago this week for the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>. The mission of the AMA Board of Trustees is to foster the promotion of the art and science of medicine and the betterment of public health.</p> <p> <a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Meeting/1">Read news</a> from the meeting at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e886b67a-1c1a-488e-990a-7077fc8c2997 House votes to eliminate Medicare cuts from trade legislation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_house-votes-eliminate-medicare-cuts-trade-legislation Fri, 12 Jun 2015 19:02:00 GMT <p> Medicare payment cuts exceeding $700 million were eliminated from legislation that sought to redirect this funding to an unrelated trade program, following an overwhelming vote in the U.S. House of Representatives last week. Now the U.S. Senate must take action.</p> <p> The success of Thursday’s House vote—397 to 32—largely can be attributed to efforts by the AMA and other health care groups and the bipartisan collaboration among members of the House, including the Doctors’ Caucus.</p> <p> In the Senate version of the legislation, passed May 22, Medicare funding would be redirected to the trade program by extending Medicare sequestration cuts in current law through 2024 and adding an additional 0.25 percent cut. The additional cut would reduce $700 million in Medicare payments to physicians, hospitals and other health care providers in 2024.</p> <p> “Reductions to Medicare reimbursements significantly impact patients and providers and can reduce access to care,” AMA President Steven J. Stack, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-11-house-vote-eliminate-medicare-cuts.page" target="_blank">statement</a> following the House vote. “Medicare should not be used as a piggybank to fund other programs.”</p> <p> The trade legislation package advancing in Congress continues to involve several complicated procedural maneuvers in the both the House and Senate. The AMA now is strongly urging the Senate to remove the provisions that use Medicare cuts to help fund this unrelated legislation.</p> <p> “We encourage the U.S. Senate to move expeditiously to ensure that any final trade package does not include harmful Medicare cuts,” Dr. Stack said.   </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fb757446-82a7-4ec0-b162-7daa4abd04fe Preventive health campaign seeks to empower patients http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_preventive-health-campaign-seeks-empower-patients Thu, 11 Jun 2015 21:12:00 GMT <p> A new campaign launched Thursday by the U.S. Department of Health and Human Services (HHS) is galvanizing patients to take control of their health by taking advantage of covered preventive services. You can use this opportunity to talk to your patients about improving their health outcomes as well.</p> <p> The <a href="https://www.whitehouse.gov/blog/2015/06/10/invest-your-healthy-self-and-post-healthyselfie-while-you-re-it" target="_blank" rel="nofollow">“Healthy Self” campaign</a>, a joint effort between the White House and HHS, seeks to make patients aware of the preventive services that are covered by their health plans under the Affordable Care Act. There are 17 <a href="https://www.healthcare.gov/preventive-care-benefits/" target="_blank" rel="nofollow">preventive care benefits</a> for adults, including screenings for <a href="http://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-blood-pressure-checked" target="_blank" rel="nofollow">high blood pressure</a> and <a href="http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/diabetes/take-steps-to-prevent-type-2-diabetes" target="_blank" rel="nofollow">type 2 diabetes</a>, <a href="http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/diabetes/eat-healthy" target="_blank" rel="nofollow">diet counseling</a> for patients at higher risk for chronic disease, and <a href="http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/diabetes/watch-your-weight" target="_blank" rel="nofollow">obesity screening and counseling</a>.</p> <p> The campaign also is asking patients to commit to making their health a priority by posting a #HealthySelfie on social media. Suggested shots include getting exercise, choosing healthy food options and heading to their doctor’s office for preventive care. The White House will share these photos on its <a href="https://www.whitehouse.gov/health-care-in-america" target="_blank" rel="nofollow">Health Care in America Web page</a>.</p> <p> Help your patients take control of their health and <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">improve their health outcomes</a> by using physician-tested tools in your practice.</p> <p> <strong>Tools you can use</strong></p> <p> <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act–Today<em>™</em></a>, a joint initiative of the AMA and the Centers for Disease Control and prevention, can assist your practice in identifying patients with prediabetes and working with them to prevent the onset of type 2 diabetes. Prevent Diabetes STAT™ includes practical information on how to use electronic health record systems to pull information about patients with prediabetes, patient-facing resources, and sample telephone scripts and referral forms.</p> <p> For patients with hypertension, the M.A.P. framework from the AMA and Johns Hopkins can help you get their high blood pressure under control:</p> <ul> <li style="margin-left:0.25in;"> <strong>M</strong>easuring blood pressure accurately every time it’s measured</li> <li style="margin-left:0.25in;"> <strong>A</strong>cting rapidly to address high blood pressure readings</li> <li style="margin-left:0.25in;"> <strong>P</strong>artnering with patients, families and communities to promote self-management of high blood pressure</li> </ul> <p> Get the <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf" target="_blank">three checklists</a> (log in) that make up the M.A.P. framework for use in your practice.</p> <p> Additional resources to help you improve your practice’s hypertension management efforts include:</p> <ul> <li style="margin-left:0.25in;"> The <a href="http://www.ama-assn.org/ama/ama-wire/post/one-graphic-patients-need-accurate-blood-pressure-reading" target="_blank">one infographic you need</a> for an accurate blood pressure reading</li> <li style="margin-left:0.25in;"> Everything you need to know about <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring" target="_blank">self-measured blood pressure monitoring</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">3 questions you should ask patients</a> when measuring their blood pressure</li> <li style="margin-left:0.25in;"> How physicians can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">manage blood pressure outside of office visits</a></li> </ul> <p> The AMA’s newly launched STEPS Forward website also offers an <a href="https://www.stepsforward.org/modules/prevent-type-2-diabetes" target="_blank" rel="nofollow">interactive educational module</a> to address preventing type 2 diabetes in your practice. Earn continuing medical education (CME) credit and see how to make these tools work for you. <a href="https://www.stepsforward.org/modules/hypertension-blood-pressure-control" target="_blank" rel="nofollow">Another module</a>  shows how to apply the M.A.P. framework to help get your patients’ blood pressures under control.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f1ef79b9-e807-4201-89fc-aa3dc93db0e6 Resolutions due by Sept. 8 for AMA-SPS Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_resolutions-due-sept-8-ama-sps-interim-meeting Thu, 11 Jun 2015 16:00:00 GMT <p> Are you submitting a resolution for the 2015 AMA Senior Physicians Section (SPS) Interim Meeting? They’re due Sept. 8.</p> <p> Any AMA-SPS member may submit a resolution for governing council review and approval. By authoring a resolution, you can raise awareness of issues that are important for senior physicians.</p> <p> Resolutions must be <a href="mailto:sps@ama-assn.org" rel="nofollow">emailed to the section</a>. Resolution guidelines are available on the section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/meetings/meeting-timeline.page?" target="_blank">meeting timeline Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a0668da2-8617-4ecb-8e3c-393994504e6c Senior physicians: Get ready for amazing travels http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_senior-physicians-ready-amazing-travels Thu, 11 Jun 2015 15:58:00 GMT <p> The <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program.page" target="_blank">AMA MVP Program</a> is pleased to offer 22 new trips in 2016 to international travel destinations, sponsored through AHI Travel. Travelers have the opportunity to spend time with fellow physicians on land- and cruise-based travel excursions to such countries as Portugal, Spain and Italy.</p> <p> Next year’s cruises will explore China and the Yangtze River, the waterways and canals of Holland and Belgium, and the Grand Danube through Europe. Tours range from eight to 14 days and include optional excursions to add in at your leisure.</p> <p> Sign up today: Trips can sell out six months in advance of the departure date. Visit the AMA’s <a href="http://www.ahitravel.com/AMA" target="_blank" rel="nofollow">travel website</a> to learn more about AHI’s educational and leisure travel destinations.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:91bd8add-1989-47ec-81fe-032984b30755 How physicians are helping rethink EHRs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-helping-rethink-ehrs Thu, 11 Jun 2015 13:19:00 GMT <p> Dreaming of a day when your electronic health record (EHR) system actually communicates with other systems? You’re not alone—<a href="http://www.ama-assn.org/ama/ama-wire/post/journey-bemidji-doctors-views-of-ehrs-regulatory-burdens" target="_blank">doctors across the country</a> are frustrated. Physician involvement in a special group of heath IT leaders could help solve the problem.</p> <p> With its recent involvement in the Substitutable Medical Applications and Reusable Technology (SMART) Platforms project, the AMA is embedding the voice of physicians in efforts to make EHRs work better for physicians and patients.</p> <p> <strong>Improving technology</strong></p> <p> A key component of the <a href="http://smarthealthit.org/" target="_blank" rel="nofollow">SMART project</a> is the development of an infrastructure that allows for free, open development of plug-and-play apps. Such apps are intended to increase cost-effective interoperability between health technology, including EHRs.</p> <p> “It is important that physicians are involved throughout the development process to ensure new health technologies fully live up to their potential to enhance care and increase safety and efficiency," said <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-09-coverage-access-patients-multiple-health-care-needs.page" target="_blank">Jesse M. Ehrenfeld, MD</a>, member of the AMA Board of Trustees and newly named member of the SMART project advisory committee.</p> <p> “The SMART project has the potential to improve technology usability and utility for both patients and physicians, which would improve health outcomes and quality while driving down costs,” Dr. Ehrenfeld said.</p> <p> <strong>A fundamental shift in health IT</strong></p> <p> The project began after a <a href="http://www.nejm.org/doi/pdf/10.1056/NEJMp0900411" target="_blank" rel="nofollow">2009 paper</a> in the <em>New England Journal of Medicine</em> proposed a fundamental shift in the health IT marketplace—reimagining health IT as a smartphone-like platform that can run substitutable apps. This approach has the ability to accelerate innovation that can accommodate differences in care work flow, drive down health tech costs and foster competition in the marketplace.</p> <p> If an EHR vendor used some of the SMART project's suggestions, it would help that system achieve many of the functionalities included in the AMA’s framework for <a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">improving EHR usability</a>. Priorities in that framework include improving care coordination, increasing product modularity and configurability, facilitating digital and mobile patient engagement, and promoting data liquidity.</p> <p> Involvement in the SMART project is just one way the AMA is working to make physicians heard when it comes to health IT. The association’s recent collaboration with <a href="file:///Z:/Communications%20Documents/Morning%20Rounds%20Daily/Week%20of%2006_08_2015/Final/06_12_2015%20DRAFT%20MRD%20smart%20project.docx" target="_blank" rel="nofollow">MATTER</a>, a Chicago-based health tech incubator, gives physicians and tech entrepreneurs a space to interact. Future collaborations between physicians and patients at MATTER will include workshops, simulations and the “exam room of the future,” which will be built in the AMA’s Interaction Studio at the facility.</p> <p> Improved health IT is a piece of the AMA’s initiative on <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">professional satisfaction and practice sustainability</a>. Through this initiative, physicians are calling for overhauled EHRs. It’s also the basis for <a href="https://www.stepsforward.org/" target="_blank" rel="nofollow">STEPS Forward</a>, a new online series of proven solutions developed by physicians to help practices thrive. Educational modules help doctors address a range of common practice challenges, including <a href="https://www.stepsforward.org/modules/ehr-software-vendor-selection" target="_blank" rel="nofollow">selecting an EHR vendor</a> and <a href="https://www.stepsforward.org/modules/ehr-implementation" target="_blank" rel="nofollow">implementing an EHR system</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:986b89ba-7d24-40bf-9b01-3485cf10f22d From MOC to vaccines: Top 10 stories from AMA Annual Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_moc-vaccines-top-10-stories-ama-annual-meeting Wed, 10 Jun 2015 20:51:00 GMT <div> <span style="font-size:12px;">The <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a> took place this week. See <a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Meeting/1">full coverage</a> of the meeting at <em>AMA Wire</em>®.</span></div> <div>  </div> <div> <span style="font-size:12px;"><strong>1. <a href="http://www.ama-assn.org/ama/ama-wire/post/transparent-physician-friendly-moc-focus-of-new-policy">More transparent, physician-friendly MOC focus of new policy</a></strong></span></div> <div> <span style="font-size:12px;">Physicians took on the maintenance of certification (MOC) process at the 2015 AMA Annual Meeting Monday, calling for more transparency and education surrounding the process.</span><br />  </div> <p> <span style="font-size:12px;"><a href="http://youtu.be/pH9rmKqfd_8" rel="nofollow" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/6/b31aca8c-4519-42e5-860b-4a2fd18ea4b9.Large.jpg?1" style="float:right;margin:10px;height:100px;width:180px;" /></a><strong>2. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/creativity-united-voice-will-improve-nations-health-ama-ceo"><strong>“Innovation ecosystem” shaping medicine’s future</strong></a><br /> The AMA is improving the health of the nation by crafting an “innovation ecosystem,” AMA Executive Vice President and CEO James L. Madara, MD, said in his address. This includes the <a href="http://www.ama-assn.org/ama/ama-wire/post/real-physicians-making-their-practices-thrive" target="_blank">launch of the AMA’s STEPS Forward</a> website, which offers a free series of physician-developed, proven solutions to make physician practices thrive.</span></p> <p> <span style="font-size:12px;"><strong>3. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/doctors-call-two-year-grace-period-icd-10-penalties" target="_blank"><strong>Doctors call for two-year grace period for ICD-10 implementation</strong></a><br /> With less than four months to go before the deadline for implementing the ICD-10 code set, physicians agreed to seek a two-year grace period to avoid financial disruptions, facilitating a smoother transition that would allow them to continue providing quality care to their patients.</span></p> <p> <span style="font-size:12px;"><strong>4. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/rx-monitoring-treatment-solutions-overdose-epidemic"><strong>From Rx monitoring to treatment: Solutions for overdose epidemic</strong></a><br /> As the nation continues to grapple with its epidemic of opioid misuse, overdose and death, physicians supported additional steps to address this pressing public health issue.</span></p> <p> <span style="font-size:12px;"><a href="http://youtu.be/_pQHXUNBOXg" rel="nofollow" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/3/6174444b-c21d-4028-83a9-2f18dc43f69c.Large.jpg?1" style="margin:10px;float:right;height:100px;width:180px;" /></a><strong>5. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/facing-challenges-strengthens-physician-patient-bond-ama-president" target="_blank"><strong>Facing challenges strengthens physician-patient bond: AMA president</strong></a><br /> In his final address as AMA president, Robert M. Wah, MD, congratulated physicians on undertaking numerous challenges this year, including <a href="http://www.ama-assn.org/ama/ama-wire/post/new-third-science-bedrock-transforming-med-ed" target="_blank">accelerating change in medical education</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/physician-tested-tools-can-improve-patients-health" target="_blank">improving health outcomes</a> for patients with prediabetes and high blood pressure.</span></p> <div> <span style="font-size:12px;"><strong>6. <a href="http://www.ama-assn.org/ama/ama-wire/post/9-new-ama-policies-patients-need">New public health policies patients need to know—and why</a></strong></span></div> <div> <span style="font-size:12px;">Many of today’s precautions for public health and safety had their start with physicians at the AMA. Public health issues that doctors want to tackle next range from barring people younger than 21 from purchasing e-cigarettes to protecting youths with concussions.</span><br />  </div> <p> <span style="font-size:12px;"><strong>7. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/gme-funding-doc-shortage-tackled-new-policy" target="_blank"><strong>GME funding, doc shortage tackled in new policy</strong></a><br /> Physicians passed policy to address insufficient funding for graduate medical education (GME) ahead of a predicted shortage of 46,000-90,000 physicians over the next decade.</span></p> <p> <span style="font-size:12px;"><a href="https://youtu.be/y_Ka148J1-E" rel="nofollow" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/7/60e1ff88-b6a9-4e56-a765-ff5ee2049181.Large.jpg?1" style="float:right;margin:10px;height:100px;width:180px;" /></a><strong>8. </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/story-of-hope-new-ama-president-points-power-of-physicians" target="_blank"><strong>A story of hope: New AMA president points to power of physicians</strong></a><br /> For each story of frustration in the medical profession, “there is a story of vision, perseverance and success,” AMA President Steven J. Stack, MD, said in his inaugural address. “When it comes to something as important as shaping a better, healthier future, it will take every single one of us.”</span></p> <div> <span style="font-size:12px;"><strong>9. <a href="http://www.ama-assn.org/ama/ama-wire/post/medical-reasons-should-only-exemptions-vaccinations" target="_blank">Medical reasons should be the only exemptions from vaccinations</a></strong></span></div> <div> <span style="font-size:12px;">As the debate around vaccinations continues to rage in the public, outbreaks of dangerous preventable diseases have continued to increase. For public health experts, the question has become, “Should individuals be given exemptions from required immunizations for non-medical reasons?” Physicians provided some answers with policy passed Monday.</span><br />  </div> <p> <span style="font-size:12px;">10. <a href="http://www.ama-assn.org/ama/ama-wire/post/new-ama-policy-calls-research-violence-against-physicians" target="_blank"><strong>New AMA policy calls for research on violence against physicians</strong></a><br /> Policy adopted Tuesday supports a new study on methods that will prevent violence against health care professionals while in the workplace. Attacks at hospital and social service settings account for almost 70 percent of nonfatal workplace assaults.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e683a601-2a70-4336-a7ff-96e41ec7a5e7 A story of hope: New AMA president points to power of physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_story-of-hope-new-ama-president-points-power-of-physicians Wed, 10 Jun 2015 15:19:00 GMT <p> Kentucky physician <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/steven-stack.page?" target="_blank">Steven J. Stack, MD</a>, assumed the AMA presidency Tuesday night, the first emergency physician to hold the post and the youngest president in 160 years.</p> <p> <object align="right" data="http://www.youtube.com/v/y_Ka148J1-E" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/y_Ka148J1-E" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/y_Ka148J1-E" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="15" quality="best" src="http://www.youtube.com/v/y_Ka148J1-E" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object>Dr. Stack’s emergency medicine experience has given him the opportunity to witness many life-changing moments—“the moments we went to medical school for …. the moments for which we forego nights with our families,” he said during his <a href="http://www.ama-assn.org/ama/pub/news/speeches/2015-06-09-stack-inaugural-address.page" target="_blank">inaugural address</a>. “These are the moments that sustain us.”</p> <p> However, physicians often find that day-to-day challenges overshadow these moments, from government regulations and health system changes made without physician input to payers questioning procedures and medical liability concerns.</p> <p> “But for each story of frustration, there is a story of vision, perseverance and success,” he said. “There is a story of hope.”</p> <p> That hope comes from joining together, similar to how lives are saved in the emergency department.</p> <p> “Above all, it takes a team,” Dr. Stack said. “Each one of us has a role to play. Each one of us contributes something the other cannot. The same can be said of health care in this country. When it comes to something as important as shaping a better, healthier future, it will take every single one of us.”</p> <p> A Classics scholar, Dr. Stack points out that history offers valuable insight. He reflected on challenges in the AMA’s history—“medical quackery, insufficient standards in medical education, ethical dilemmas, the perils of smoking”—that physicians overcame together.</p> <p> “Rather than waiting for tomorrow, we’re creating the future of health care today,” he said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:51887fec-a6c0-4235-93e2-d3e000d21c62 New “third science” a bedrock for transforming med ed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-third-science-bedrock-transforming-med-ed Tue, 09 Jun 2015 21:00:00 GMT <p> Medicine historically has prioritized basic and clinical sciences as the core for medical school curriculum, but will an emerging “third science” shape the future of medical education? This question was top of mind for educators at a recent panel discussion during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>. Learn how schools are adopting innovations around this new science.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>  </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/6/c4316670-4041-4b67-86fd-9037ac8e65f4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/6/c4316670-4041-4b67-86fd-9037ac8e65f4.Large.jpg?1" style="margin:15px;float:right;" /></a></td> </tr> <tr> <td>  </td> <td>  </td> </tr> </tbody> </table> <p> “Medicine is founded upon two sciences: basic science and clinical science. But arguably, there is a third science schools need to incorporate,” said George Mejicano, MD, senior associate dean of medicine at Oregon Health and Sciences University. Dr. Mejicano also is a member of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative consortium, which consists of 11 U.S. medical schools that received $1 million grants to reshape the way physicians are trained.</p> <p> “This ‘third science’ is a health care delivery science, which [focuses on] the actual ability to work in our health systems to produce excellent patient care. Health policy, economics, the use of evidence-based medicine and team work are really important new content areas,” he said.</p> <p> David Savage (pictured right), a MD/PhD student at the University of Texas at Houston and member of the AMA initiative’s national advisory panel, agrees that schools should equally prioritize system-based care just as much as traditional medical education content.</p> <p> He said that for most medical students, the first two years of school revolve around lengthy spells of studying and memorizing disease patterns in preparation for step 1 of the United States Medical Licensing Examination, which often breeds a “passive learning” style among students.</p> <p> But then by the third year, students enter clinical rotations and are unprepared for complex team-based care. This abrupt transition to participating actively in team-based practice requires schools to take additional action to teach students about health care delivery systems, Savage said.</p> <p> Savage said he and peers wish to learn more.</p> <p> To address this need, the 11 schools in the AMA’s Accelerating Change in Medical Education initiative have developed a multifaceted approach to identify a core curriculum for health care delivery science. Embracing this third science of health care delivery, the consortium is focusing on teaching the following content:</p> <ul> <li> Structures, processes and individuals</li> <li> Health care policy and economics</li> <li> Clinical informatics and health information technology</li> <li> Population and public health</li> <li> Socio-ecological determinants of health</li> <li> Value-based care</li> <li> Health system improvement</li> </ul> <p> <strong>Med school changes already underway</strong></p> <p> From teaching students <a href="http://www.ama-assn.org/ama/ama-wire/post/health-used-school-investigates-competencies" target="_blank">how to maximize technology</a> in practice to researching cost-effective payment models, many schools already have launched innovative programs to strengthen competencies in health care delivery sciences.</p> <p> For instance, the Mayo Clinic’s Science of Healthcare Delivery program teaches students the <a href="http://www.ama-assn.org/ama/ama-wire/post/pivoting-new-way-of-training-future-physicians-mayo-clinic" target="_blank">nuances of team-based care</a>, including delivery systems and population surveillance to improve health outcomes.</p> <p> The Warren Alpert Medical School of Brown University offers a Primary Care-Population Medicine <a href="http://www.ama-assn.org/ama/ama-wire/post/dual-degree-program-targets-new-type-of-physician" target="_blank">program</a>, which allows students to pursue a dual MD/ScM degree in population medicine and earn substantive training in health disparities, social determinants of health, health systems, health policy, biostatistics and leadership skills.</p> <p> Pennsylvania State University College of Medicine also launched its <a href="http://www.ama-assn.org/ama/ama-wire/post/two-schools-embracing-new-science-medical-education" target="_blank">new systems navigation curriculum</a> last year. Designed for first-year students, the two-pronged curriculum incorporates systems-based practice topics over a 19-month period, beginning in students’ first month of medical school.</p> <p>  But the work of educators and the consortium is far from over. As schools continue to implement similar programs, “We need to think about how we can actually expand the consortium in thought and in action, so that these best practices can actually be propagated,” Dr. Mejicano said. “Through this, we will collectively create the medical school of the future.” </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2ffd65b7-e82c-4bca-85df-8e0abde650cc 9 new AMA policies patients need to know--and why http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_9-new-ama-policies-patients-need Tue, 09 Jun 2015 21:00:00 GMT <p> You might not know where important public health laws come from, but you know what they are—a minimum age to drink alcohol, restrictions on smoking and purchasing tobacco, and seatbelt safety requirements. You may be surprised to learn that many of today’s precautions for public health and safety have their start with physicians at the AMA. Read on to learn which issues physicians want to tackle next.</p> <p> When the physicians that make up the AMA’s House of Delegates come together, they debate and adopt policies to improve the health of the nation. Many of these policies have eventually become law as the AMA has advocated for their enactment. Here are a handful of such policies that no doubt have impacted you:</p> <ul> <li style="margin-left:0.25in;"> The legal drinking age was raised from 18 to 21 in all states by 1988.</li> <li style="margin-left:0.25in;"> Tobacco companies admitted their products were deadly in 2012.</li> <li style="margin-left:0.25in;"> Handicap accessibility became a requirement for public spaces in 1990.</li> <li style="margin-left:0.25in;"> Seatbelts became a requirement for automobiles in 1968.</li> </ul> <p> At the 2015 AMA Annual Meeting this week, physicians approved a variety of public health policies that could influence how patients stay healthy in the years to come. Doctors are seeking these changes:</p> <ol> <li style="margin-left:0.25in;"> Ensuring energy drinks have child-resistant packaging to prevent hospitalizations and deaths.</li> <li style="margin-left:0.25in;"> Requiring written consent from a physician or member of a physician-led care team for youth athletes suspected of having sustained a concussion to be allowed to return to a sport.</li> <li style="margin-left:0.25in;"> Securing labels on sunglasses that state the percentage of UVA and UVB radiation protection of the product to ensure consumers are aware of the extent to which their eyes would be protected.</li> <li style="margin-left:0.25in;"> Requiring hand-held electronic devices that use headphones and earbuds to include warning labels about the dangers of headphones use in public because they impede hearing.</li> <li style="margin-left:0.25in;"> Developing a list of best practices guiding the development of mobile medical applications to help ensure their efficiency and trustworthiness. The policy follows the release of a report on the subject by the AMA Council on Science and Public Health, <a href="http://www.ama-assn.org/ama/ama-wire/post/mobile-health-app-harmful-helpful" target="_blank">adopted</a> at the 2014 AMA Annual Meeting.</li> <li style="margin-left:0.25in;"> Setting the minimum age for purchasing electronic cigarettes to 21 and packaging liquid nicotine in child-resistant containers.</li> <li style="margin-left:0.25in;"> Addressing the prescription overdose epidemic. <a href="http://www.ama-assn.org/ama/ama-wire/post/rx-monitoring-treatment-solutions-overdose-epidemic" target="_blank">Read more</a> about ways physicians are planning to do this.</li> <li style="margin-left:0.25in;"> Increasing what patients can contribute to flexible spending accounts by a reasonable amount to help overcome financial barriers to receiving the care they need.</li> <li style="margin-left:0.25in;"> Banning the use of artificial trans fat in food.</li> </ol> <p> <a href="http://www.ama-assn.org/sub/at-a-glance/" target="_blank">Learn more</a> about how the AMA is improving the health of the nation. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:03a55a40-175e-4044-abe1-d9e03e7f062f From Rx monitoring to treatment: Solutions for overdose epidemic http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_rx-monitoring-treatment-solutions-overdose-epidemic Tue, 09 Jun 2015 20:52:00 GMT <p> As the nation continues to grapple with its epidemic of opioid misuse, overdose and death, physicians gathered in Chicago for the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> supported additional steps to address this pressing public health issue.</p> <p> <a href="http://www.cdc.gov/drugoverdose/data/index.html" target="_blank" rel="nofollow">More than 16,000 deaths</a> in the United States annually involve prescription opioids, and more than 8,000 additional deaths involved heroin-related causes in 2013 (the most recent year of data), <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6339a1.htm" target="_blank" rel="nofollow">according</a> to the Centers for Disease Control and Prevention. Total drug overdose deaths in 2013 stood at nearly 44,000.</p> <p> Physicians at the AMA meeting underscored their commitment to reverse the overdose epidemic. Among the policies adopted to this end were ones that called for increased reliance on prescribing data, more robust education and adequate coverage for addiction treatment. Doctors directed the AMA to pursue the following solutions:</p> <p> Encourage physicians to use state-based prescription drug monitoring programs (PDMP).</p> <ul> <li> Urge states to implement modernized PDMPs that seamlessly integrate into physicians’ work flows and provide clinically relevant, reliable information at the point of care. The policy also calls for sharing access to PDMP data across state lines under appropriate safeguards for protected health information and using uniform data standards to facilitate this information sharing.</li> <li> Work with the National Alliance for Model State Drug Laws and other national organizations to enhance physicians’ ability to review their own prescribing information in PDMPs.</li> <li> Intensify collaborations with public and private stakeholders to reduce harm from inappropriate use of opioids and other controlled substances, increase awareness that substance use disorders are chronic diseases and must be treated accordingly, and reduce the stigma associated with patients who suffer from persistent pain or substance use disorders.</li> <li> Advocate for an increased focus on comprehensive, multidisciplinary pain management approaches that are physician-led and support health insurance coverage that gives patients with a legitimate need for chronic pain management access to the full range of evidence-based modalities.</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Learn more</a> about the AMA’s ongoing efforts to combat prescription drug abuse and diversion.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c34434fc-66f4-4739-bb96-530b4e4c5888 New AMA policy urges better coverage for behavioral health care services http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-ama-policy-urges-better-coverage-behavioral-health-care-services Tue, 09 Jun 2015 20:49:00 GMT <p> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> Tuesday called for increased access and coverage of integrated medical and behavioral health care services.</p> <p> The new policy, outlined in a report from the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-service.page?" target="_blank">AMA Council on Medical Service</a>, directs the AMA to urge Medicaid and private health insurers to pay for physical and behavioral health care services provided on the same day. The AMA also will encourage state Medicaid programs to amend plans as needed to include payment for behavioral health care services in school settings in order to identify and treat behavioral health conditions as early as possible.</p> <p> Finally, the AMA will promote developing sustainable payment models to assist programs that currently rely on short-term funding to continue integrating behavioral health care services into primary care settings.</p> <p> More than 40 million adults have a mental illness, and 6 million children suffer from an emotional, behavioral or developmental issue. Data shows fewer than one-half of these people receive treatment.</p> <p> “There is an increased recognition that the health of an individual includes both physical and behavioral components that should be treated holistically,” said Mary Anne McCaffree, MD, member of the AMA Board of Trustees, in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-09-coverage-access-patients-multiple-health-care-needs.page">press release</a>. “Since a high prevalence of people with behavioral health disorders are seen by primary care physicians, it’s imperative that we remove any barriers that impede patient access to integrated care services on the same day or in the same setting if they need it.”</p> <p> “We also want practicing physicians to seek out continuing medical education opportunities on integrated physical and behavioral care,” said Dr. McCaffree. “We believe that with knowledge of these various approaches, physician practices will be better positioned to choose the best integrated treatment options to meet the needs of their patients.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a333b4b1-31d3-4cdb-9160-39ef4b787846 Physicians outline ways to improve veterans’ health care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-outline-ways-improve-veterans-health-care Tue, 09 Jun 2015 20:47:00 GMT <p> Policy adopted this week at the 2015 AMA Annual Meeting is aimed at increasing access to care for the nation’s veterans.</p> <p> New policies include:</p> <ul> <li> Continue advocating for improved veterans’ health care legislation to ensure timely access to care</li> <li> Monitoring implementation of and changes to the Veterans Choice Program’s “choice card,” which allows veterans to seek care outside of the U.S. Department of Veterans Affairs (VA)</li> <li> Calling for a study of the VA health care system to address access to care issues</li> <li> Advocating for the VA to pay private physicians Medicare rates and hire additional physicians</li> </ul> <p> At the 2014 AMA Interim Meeting in November, VA Secretary Robert McDonald <a href="http://www.ama-assn.org/ama/ama-wire/post/va-secretary-need-physicians" target="_blank">asked for help</a> with improving access to care for veterans. At the same meeting, physicians voted to create directories of private practice doctors who would see veterans.</p> <p> Physicians can participate in the VA’s <a href="http://www.ama-assn.org/ama/ama-wire/post/va-program-needs-physicians-provide-veterans-care" target="_blank">Veterans Choice Program</a>, which enables the VA enter into provider agreements with non-VA physicians to deliver care to veterans who are either unable to receive timely care, defined as wait times of more than 30 days, or who live too far from a VA facility, defined as more than 40 miles.</p> <p> The program is the result of the Veterans Access, Choice and Accountability Act of 2014, a <a href="http://www.ama-assn.org/ama/ama-wire/post/physician-voice-helps-shape-veterans-health-care-reform-law" target="_blank">law the AMA helped shape</a>, which offers funding and other tools to better serve veterans in the short term as the demand for VA care greatly outpaces the number of clinicians.</p> <p> Learn more about the program and get additional resources at the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/joining-forces.page" target="_blank">Web page on veterans' health</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3ae62ae8-e27d-4ced-abe3-e82337c35451 AMA trustees, council members elected http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-trustees-council-members-elected-1 Tue, 09 Jun 2015 20:04:00 GMT <p> Physicians were elected during the <a href="http://www.ama-assn.org/sub/meeting/" target="_blank">2015 AMA Annual Meeting</a> to open seats on the AMA Board of Trustees and six AMA councils.</p> <p> Of the four candidates vying for the three open positions on the AMA Board of Trustees, the AMA House of Delegates elected <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-harris.page" target="_blank">Patrice Harris, MD</a>, a private psychiatrist in Atlanta, <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-osbahr.page" target="_blank">Albert Osbahr, MD</a>, a family physician in Hickory, North Carolina, and <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-tuttle.page" target="_blank">Georgia A. Tuttle, MD</a>, a dermatologist in Lebanon, N.H. Delegates also re-elected <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-babu.page" target="_blank">Maya A. Babu, MD</a>, a neurosurgery resident in Rochester, Minn., as the resident member of the board.</p> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-gurman.page" target="_blank">Andrew W. Gurman, MD</a>, was elected by acclamation to the position of AMA president-elect. Dr. Gurman, a speaker and vice speaker of the AMA House of Delegates for the last eight years, is a hand surgeon in Altoona, Pa.</p> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/susan-bailey.page" target="_blank">Susan R. Bailey, MD</a>, an allergist in Fort Worth, Texas, was elected by acclamation as speaker. Delegates also elected <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/candidates/2015-scott.page" target="_blank">Bruce A. Scott</a>, MD, a Louisville, Ky. otolaryngologist, as vice speaker. </p> <p> <strong>Council elections</strong></p> <p> Here are results for elections to the various AMA councils.</p> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-constitution-bylaws.page" target="_blank">Council on Constitution and Bylaws</a>:  </p> <ul> <li> Colette R. Willins, MD</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page" target="_blank">Council on Medical Education</a><u>:</u></p> <ul> <li> Carol Berkowitz, MD</li> <li> Lynne M. Kirk, MD</li> <li> Patricia Turner, MD</li> <li> John Williams, MD</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-service.page" target="_blank">Council on Medical Service</a></p> <ul> <li> James G. Hinsdale, MD</li> <li> Thomas J. Madejski, MD</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-science-public-health.page" target="_blank">Council on Science and Public Health</a></p> <ul> <li> Robyn F. Chatman, MD</li> <li> Noel N. Deep, MD</li> <li> Bruce M. Smoller, MD</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7df52dec-831e-4b04-8541-840976000403 New AMA policy calls for research on violence against physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-ama-policy-calls-research-violence-against-physicians Tue, 09 Jun 2015 20:00:00 GMT <p> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> passed policy Tuesday to support a new study on methods that will prevent violence against physicians and other health care professionals while in the workplace.</p> <p> This policy arrives less than six months after a Boston cardiac surgeon was fatally shot by a man suspected to have a grudge, underscoring the need for more stringent policies that protect physicians.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/11/fb9263d9-169c-4873-ab9e-a222be135977.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/11/fb9263d9-169c-4873-ab9e-a222be135977.Full.jpg?1" style="margin:15px;float:right;" /></a></p> <p> “It’s imperative that health care providers feel safe and secure while caring for their patients,” AMA Board Chair Stephen R. Permut, MD, said in a news release. “Given that there are currently no clear interventions proposed to ensure a safer and more secure health care environment for providers, the AMA is committed to taking the necessary steps to shed light on the various protocols, procedures and mechanisms that can be put in place to do so.”</p> <p> Health care workers experience the most nonfatal workplace violence compared to other professions, with attacks at hospital and social service settings accounting for almost 70 percent of nonfatal workplace assaults, according to data from the Bureau of Labor Statistics.</p> <p> There also have been more than 150 shootings in health care facilities in the past decade, which has prompted some states to adopt legislation banning guns in hospital settings, according to a <a href="http://www.ncbi.nlm.nih.gov/pubmed/22998757" rel="nofollow" target="_blank">study</a> in the <em>Annals of Emergency Medicine.</em></p> <p> “It’s clear that we need to explore more ways to curb the incidence of violence against America’s health care providers, and this new policy puts us on the path to finding new ways to protect these individuals who devote their lives to maintaining the health and well-being of their patients,” Dr. Permut said. </p> <p> <strong>For more information about preventing workplace violence against physicians:</strong> Take a look at the U.S. Department of Labor Occupational Safety <a href="https://www.osha.gov/Publications/osha3148.pdf" rel="nofollow" target="_blank">guidelines</a>, which feature recommendations on launching workplace violence prevention programs in health care settings. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ac4ed9dc-f11a-4758-a676-0ad23c7c35e2 Physicians move to lower generic prescription drug costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-move-lower-generic-prescription-drug-costs Tue, 09 Jun 2015 19:22:00 GMT <p> Physicians at the 2015 AMA Annual Meeting voted to take action to address generic prescription drug increases.</p> <p> Delegates at the meeting passed policy calling on the AMA to:</p> <ul> <li> Advocate for legislation that will ensure fair and appropriate pricing</li> <li> Work collaboratively with federal and state agencies, policymakers and stakeholders to promote policies to address the already high and escalating costs of generic prescription drugs</li> <li> Encourage the development of methods that increase choice and competition in generic prescription drug creation and pricing</li> <li> Support measures that increase price transparency for generic prescription drugs</li> </ul> <p> The AMA Council on Medical Service is expected to release a report at the 2015 AMA Interim Meeting in November that examines both brand name and generic price increases.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5babdd40-578c-4e9e-87dd-6cd821723f17 Doctors give state boards MOL guidance http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-give-state-boards-mol-guidance Tue, 09 Jun 2015 16:08:00 GMT <p> <a href="http://www.ama-assn.org/ama/ama-wire/post/transparent-physician-friendly-moc-focus-of-new-policy" target="_blank">Maintenance of certification</a> (MOC) and maintenance of licensure (MOL) often are tied together in discussion, yet are distinctly different processes. Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> voted on policy to clarify the differences between MOL and MOC and set guidelines for state medical boards around the MOL process.</p> <p> MOC describes programs that address continued specialty certification. MOL principles, meanwhile, are meant to define the process by which physicians should meet requirements for renewing their medical license, which is overseen by state medical boards.</p> <p> Based on a report from the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a>, the new policy outlines how the MOL process has evolved. New York was the first state, in 1971, to pass a regulation requiring physicians to uphold specific continuing medical education (CME) requirements. Today, all but five states have CME requirements physicians must meet to maintain their state licenses.</p> <p> “Thus, while the process of MOL that is evolving may be new, physician demonstration of activities to maintain competence to practice has long been part of states’ licensure renewal processes,” the report said.</p> <p> In 2004, the Federation of State Medical Boards (FSMB) passed policy stating that state medical boards have a responsibility to the public to ensure the ongoing competence of physicians seeking licensure. Following this policy, the FSMB and other stakeholders, including the AMA, defined the three components of MOL:</p> <ul> <li style="margin-left:0.25in;"> Reflective self-assessment</li> <li style="margin-left:0.25in;"> Assessment of knowledge and skills</li> <li style="margin-left:0.25in;"> Performance in practice</li> </ul> <p> The proposed MOL process is relatively new—the FSMB issued its recommendations in 2011—so no state has implemented the MOL framework yet. The new AMA policy passed at the meeting makes it clear that the AMA can work with state medical societies and medical boards to implement MOL in their states and for their specialties.</p> <p> According to the policy, state medical boards developing MOL programs should use the following guidelines:</p> <ul> <li style="margin-left:0.25in;"> Any MOL activity should be capable of integration into the existing infrastructure of the health care environment.</li> <li style="margin-left:0.25in;"> Any proposed MOL educational activity should be developed in collaboration with physicians. It also should be evidence-based and practice-specific.</li> <li style="margin-left:0.25in;"> Any proposed MOL activity should undergo an in-depth analysis of the direct and indirect costs, including physicians’ time and the impact on patient access to care. It also should undergo a risk/benefit analysis, with particular attention to unintended consequences.</li> <li style="margin-left:0.25in;"> Any MOL activity should be flexible and offer a variety of compliance options for all physicians, practicing or non-practicing. The activity may vary depending on physicians’ roles, such as clinical care versus research.</li> <li style="margin-left:0.25in;"> Any MOL activity should be designed for quality improvement and lifelong learning.</li> <li style="margin-left:0.25in;"> Participation in quality improvement activities, such as chart review, should be an option as an MOL activity.</li> </ul> <p> State medical boards also should use the FSMB’s <a href="http://library.fsmb.org/pdf/mol-guiding-principles.pdf" target="_blank" rel="nofollow">guiding principles for MOL</a> (current as of June 2015) in developing programs, the policy stated.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b4f0a415-0138-484a-9f3c-5503a5a16152 Why medical reasons should be the only exemptions from vaccinations http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-reasons-should-only-exemptions-vaccinations Tue, 09 Jun 2015 16:00:00 GMT <p> As the debate around vaccinations continues to rage in the public, outbreaks of dangerous preventable diseases have continued to increase. For public health experts, the question has become, “Should individuals be given exemptions from required immunizations for non-medical reasons?” Physicians provided some answers with policy passed at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>.</p> <p> Immunization programs in the Unites States are credited with having controlled or eliminated the spread of epidemic diseases, including smallpox, measles, mumps, rubella, diphtheria and polio. Immunization requirements vary from state to state, but only two states bar non-medical exemptions based on personal beliefs.</p> <p> “When people are immunized they also help prevent the spread of disease to others," AMA Board of Trustees Member Patrice A. Harris, MD, said in a news release. “As evident from the recent measles outbreak at Disneyland, protecting community health in today’s mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience.”</p> <p> Policies adopted at the meeting call for immunization of the population—absent a medical reason for not being vaccinated—because disease exposure, importation, infections and outbreaks can occur without warning in communities, particularly those that do not have high rates of immunization. That begins with health care professionals involved in direct patient care, who have an obligation to accept vaccinations to prevent the spread of infectious disease and ensure the availability of the medical workforce.</p> <p> Other policies include:</p> <ul> <li> Supporting the development and evaluation of educational efforts, based on scientific evidence and in collaboration with health care providers, that support parents who want to help educate and encourage their peers who are reluctant to vaccinate their children</li> <li> Disseminating materials about the effectiveness of vaccines to states</li> <li> Encouraging states to eliminate philosophical and religious exemptions from state immunization requirements</li> <li> Recommending that states have an established decision mechanism that involves qualified public health physicians to determine which vaccines will be mandatory for admission to school and other identified public venues</li> </ul> <p> These policies aim to minimize the risk of outbreaks and protect vulnerable individuals from acquiring preventable but serious diseases.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:680f4c39-42a8-48af-a7c5-22164f60bbfa More transparent, physician-friendly MOC focus of new policy http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_transparent-physician-friendly-moc-focus-of-new-policy Tue, 09 Jun 2015 15:57:00 GMT <p> Physicians took on the maintenance of certification (MOC) process at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> Monday, calling for more transparency and education surrounding the process.</p> <p> One new policy, based on an <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a> report, asks the American Board of Medical Specialties to develop “fiduciary standards” for its member boards. The policy asks the ABMS to urge full transparency related to the costs of preparing, administering, scoring and reporting MOC exams. It also seeks to ensure MOC “doesn’t lead to unintentional economic hardships.”</p> <p> Other new policies direct the AMA to work with the ABMS toward the following changes:</p> <ul> <li style="margin-left:0.25in;"> Any assessment should be used to guide physicians’ self-directed CME study.</li> <li style="margin-left:0.25in;"> Specific content-based feedback after any assessment should be provided to physicians in a timely manner.</li> <li style="margin-left:0.25in;"> Multiple options should be available for how an assessment could be structured to accommodate different learning styles.</li> <li style="margin-left:0.25in;"> Physicians need to know what their specific MOC requirements are and the timing around when they must complete those requirements. The policy directs the AMA to ask the ABMS and its member boards to develop a system to alert physicians to the due dates of the multi-stage requirements of MOC.</li> <li style="margin-left:0.25in;"> Part III of the MOC exam, typically known as the high-stakes exam, should be streamlined and improved. The policy also calls for exploring alternative formats.</li> </ul> <p> In addition, physicians voted to work with the ABMS to ensure that its member boards “avoid attempts at restricting the legitimate scope of practice of board-certified physicians.” The policy is in response to a situation in 2013 when the American Board of Obstetrics and Gynecology (ABOG) posted on its website a new definition of an OB-GYN, including a limitation on the amount of time physicians spend performing non-gynecologic procedures. The board also stated that ABOG-certified physicians, with few exceptions, should treat female patients only, and that physicians who treated male patients could lose their ABOG certification.</p> <p> While ABOG retracted its policy, physicians felt the AMA’s new MOC policy, based on another Council on Medical Education report, would protect against any future attempts by medical specialty boards to restrict legitimate scope of practice.</p> <p> Related policy on MOC asks the <a href="http://www.ama-assn.org/ama/ama-wire/post/new-commission-streamline-medical-licensure" target="_blank">newly launched</a> Interstate Medical Licensure Compact commission to clarify that the intent of the compact’s model legislation requiring that a physician “holds” specialty certification refers only to initial certification and not MOC.</p> <p> Get <a href="http://www.ama-assn.org/ama/ama-wire/post/everything-need-moc" target="_blank">your questions about MOC answered</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:acbbc1aa-1ab8-4d40-8db2-d6c18e6fef64 Doctors uniquely suited to help human trafficking victims http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-uniquely-suited-human-trafficking-victims Tue, 09 Jun 2015 15:53:00 GMT <p> Physicians during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> identified a major global human rights and health issue they believe can be partially addressed in the health care setting: human trafficking.</p> <p> A staggering 12.3 million adults and children are enslaved in human trafficking around the world at any given time, according to the United Nations’ International Labor Organization. The AMA Monday adopted policy to help address this growing epidemic.</p> <p> The policy calls for physician education so they can identify and report suspected cases of human trafficking to the appropriate authorities while ensuring victims have the medical, legal and social resources they need.</p> <p> “We must do everything we can to help get victims of human trafficking to safety,” AMA Board of Trustees Member William E. Kobler, MD, said in a statement. “Since we know that victims of human trafficking rarely seek help out of fear of their captors or law enforcement, we believe that the health care setting is an ideal way to engage with suspected victims and get them the help and resources they so desperately need.” </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fb1be902-57ff-429b-8f91-073977a2daa6 GME funding, doc shortage tackled in new policy http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gme-funding-doc-shortage-tackled-new-policy Tue, 09 Jun 2015 15:47:00 GMT <p> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> passed policy to address insufficient funding for graduate medical education (GME) ahead of a <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" rel="nofollow" target="_blank">predicted shortage</a> of 46,000-90,000 physicians over the next decade.</p> <p> Part of the new policy is based on a report from the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a>, which stresses the need for increased medical residency slots and expanded funding sources for GME. The policy calls for the AMA to advocate for continued and expanded GME funding from federal, state, local and private sources.</p> <p> Specifically, the AMA will push for federal funding for the National Health Care Workforce Commission, which is charged with identifying barriers limiting health care workforce production and encouraging innovations that can address the current and future personnel requirements of the health care system. The policy asks the commission to provide the nation with data and policy that supports the value of GME.</p> <p> Related policy on GME funding also adopted at the meeting includes:</p> <ol> <li style="margin-left:0.25in;"> Collaborating with the Association of American Medical Colleges, the National Resident Matching Program, the American Osteopathic Association and other stakeholders to study the common reasons medical students fail to match to residency slots</li> <li style="margin-left:0.25in;"> Directing the AMA to study and report back on potential pathways to reengage in medicine for those who do not match.</li> <li style="margin-left:0.25in;"> Urging Congress to reauthorize the Teaching Health Center Graduate Medical Education Program to its full and ongoing funding needs. The program currently supports 60 training centers with 550 primary care physicians and dentists in underserved areas.</li> </ol> <p> The new policies are timely, considering the recent <a href="http://www.ama-assn.org/ama/ama-wire/post/record-breaking-match-sees-higher-percentage-of-unmatched-seniors" target="_blank">record-breaking number of unmatched students</a> who have graduated from medical school without securing a place to complete their training. </p> <p> The AMA recently supported both the <u><a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill">Resident P</a><a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill" target="_blank">hysician Shortage Reduction Act</a></u>, which would increase Medicare-funded residency positions, and the <a href="http://www.ama-assn.org/ama/ama-wire/post/bill-would-fund-residency-slots-underserved-areas" target="_blank">Creating Access to Residency Education Act</a>, which would create grants for GME positions in states with low rates of residents relative to the general population.</p> <p> <u><a href="http://www.ama-assn.org/ama/ama-wire/post/students-residents-saving-gme">S</a><a href="http://www.ama-assn.org/ama/ama-wire/post/students-residents-saving-gme" target="_blank">tudents and residents continue to advocate</a></u> for expanded GME programs, using social media and other tools that call on Congress to <u><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/students-residents-saving-gme">#</a><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/students-residents-saving-gme" target="_blank">SaveGME</a></u>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bdf9f1ae-edb6-4f52-8630-11432e47371a ACGME survey reveals concerning data on resident wellness http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_acgme-survey-reveals-concerning-data-resident-wellness-1 Mon, 08 Jun 2015 23:54:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/9/6041a1ac-491c-42d2-99ab-ffd30389e91e.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/9/6041a1ac-491c-42d2-99ab-ffd30389e91e.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> While research confirms the pervasiveness of burnout in residency, how do residents actually feel about their own well-being? A recent survey by the Accreditation Council on Graduate Medical Education (ACGME) asked 22,500 residents that same question, and the results, which were discussed for the first time last week during the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>, revealed an unusual trend. Read on for the results to see how you compare.</p> <p> After completing an annual survey from the ACGME in May 2013, residents also were asked to complete a voluntary wellness survey. Of those who received the survey, 22,500—roughly 1 in 6 people—responded. Researchers compared data from resident responses to that of their peers in the general population using the 2006 and 2011 Behavior Risk Factor Surveillance System, a yearly survey of the general population conducted by the Centers for Disease Control and Prevention.</p> <p> The ACGME plans to present the survey results at its 2015 wellness conference, which will summon roughly 120 people from medical and non-medical industries to discuss the current state of resident well-being and wellness solutions for residency programs to <a href="http://www.ama-assn.org/ama/ama-wire/post/acgme-seeks-transform-residency-foster-wellness">explore</a>.</p> <p> “At the ACGME level, we really consider ourselves conveners and facilitators on the issue of resident wellness,” Nick Yaghmour (pictured above), a research analyst for the ACGME’s department of education, said. “We want to bring people together to discuss this [issue]. In the most ideal situation, institutions and programs get together, respond through discussions and then begin creating wellness programs of their own.”</p> <p> Despite results from a Canadian <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-real-reason-residents-burn-out-tell">study</a> demonstrating the poor mental and emotional health of residents in training, participants in the ACGME’s wellness survey actually reported a fairly positive state of well-being among residents compared to the general population. Of the residents surveyed, 41.6 percent described their general health as “very good,” only one point lower than the 42.7 percent of their non-resident peers who reported the same favorable perspective.</p> <p> However, when assessing their health across individual lifestyle factors—such as sleep disturbances, low energy levels and depression— residents reported lower overall rates of well-being compared to the general population. For instance, responses about the number of days they “felt down, depressed or hopeless” during a two-week period were:</p> <ul> <li> 24.5 percent of residents reported feeling down 1-2 days (compared to 15.9 percent of the general population)</li> <li> 13.0 percent of residents reported feeling down 3-5 days (compared to 5.5 percent of the general population).</li> <li> 5.6 percent of residents reported feeling down 6-8 days (compared to 1.7 percent of the general population).</li> <li> 3.3 percent of residents reported feeling down 9-11 days (compared to 0.7 percent of the general population).</li> <li> 3.1 percent of residents reported feeling down 12-14 days (compared to 1.3 percent of the general population)</li> </ul> <p> This discrepancy between residents’ positive perceptions of health versus the reality of their well-being aligns with previous findings from other investigators that demonstrated physicians’ difficulties in assessing their own wellness.</p> <p> In a 2013 <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333681/" rel="nofollow" target="_blank">study</a>  of 1,150 surgeons, 89 percent of respondents believed their well-being was at or above average, including 70.5 percent with scores in the bottom 30 percent relative to national norms. But after receiving objective, individualized feedback based on the Mayo Clinic Physician Well-Being Index score, 46.6 percent of these surgeons indicated that they intended to make specific life changes to improve their wellness.  </p> <p> <strong>Tell us:</strong> Do you think residents also struggle to properly evaluate their well-being? If so, how can programs help address this issue? Share your thoughts in the comments below or on the <a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow">AMA-RFS Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e439c902-0787-4dfd-8ac2-5994ff0ee9f0 Physician-tested tools can improve patients’ health http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-tested-tools-can-improve-patients-health Mon, 08 Jun 2015 23:40:00 GMT <p> Medical practices are trying to keep up with large numbers of patients who have type 2 diabetes and hypertension, and the numbers are expected to continue to grow. Fortunately, free turnkey tools are available for physicians to immediately use in their practices to help prevent and address these conditions in their patients.</p> <p> Experts from the AMA's <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">Improving Health Outcomes</a> initiative explained how physicians can use these tools during a panel discussion at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>. These resources are ready to be used today and can help practices improve practice workflow, meet regulatory requirements and earn continuing medical education (CME) credits.</p> <p> <strong>Type 2 diabetes</strong></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/8/c0c9356f-7ff8-4e9d-882a-5f39b704d106.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/8/c0c9356f-7ff8-4e9d-882a-5f39b704d106.Large.jpg?1" style="margin:15px;float:right;" /></a>Every year, the number of people who develop prediabetes—the precursor to type 2 diabetes—increases. Prevalence of the condition rose by about 51 percent between 2007 and 2012, according to a December <a href="http://care.diabetesjournals.org/content/37/12/3172.abstract" rel="nofollow" target="_blank">study</a> published in <em>Diabetes Care</em>.</p> <p> “For patients and physicians, prediabetes should be a wakeup call,” said Namratha Kandula, MD (pictured right),  director of physician and patient engagement for the AMA’s Improving Health Outcomes initiative.</p> <p> In 2012, the Centers for Disease Control and Prevention (CDC) launched the <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a> based on <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa012512" rel="nofollow" target="_blank">research</a> led by the National Institutes of Health, which showed that individuals at high risk of developing type 2 diabetes who participated in structured lifestyle change programs saw a significant reduction in the incidence of the disease.  </p> <p> The AMA spent the past year <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-physician-helping-stop-diabetes-among-her-patients" target="_blank">working with the YMCA of the USA</a> and 11 physician practice pilot sites in four states to increase physician screening and testing for prediabetes, and referral of patients with prediabetes to diabetes prevention programs offered by local YMCAs, which use the CDC’s program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.</p> <p> This work helped inform <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act – Today<em>™</em></a>, a multi-year AMA and CDC initiative that helps physicians refer patients to diabetes prevention programs in their communities and online. Prevent Diabetes STAT™ includes practical information on how to use an electronic health record (EHR) system to pull information on patients with prediabetes, patient-facing resources and sample telephone scripts and referral forms..</p> <p> The AMA’s newly launched STEPS Forward website offers an <a href="https://www.stepsforward.org/modules/prevent-type-2-diabetes" rel="nofollow">interactive educational module</a> to address preventing type 2 diabetes in your practice—earn CME credit and see how to make these tools work for you.</p> <p> <strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/12/51940543-13c0-4caf-9c76-88496d7a3c0c.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/12/51940543-13c0-4caf-9c76-88496d7a3c0c.Large.jpg?1" style="float:left;margin:15px;" /></a>Hypertension</strong></p> <p> The number of hypertension-related deaths in the United States <a href="http://www.ama-assn.org/ama/ama-wire/post/hypertension-related-deaths-climb-upward-heres-can">increased by 66 percent</a> over the past decade, according to the CDC. To put that in perspective, the number of deaths from all other causes combined increased only 3.5 percent during that period.</p> <p> “There has never been a more important time to improve blood pressure control,” said Michael Rakotz, MD (pictured left), director of chronic disease prevention for the AMA Improving Health Outcomes initiative.</p> <p> Through this initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices. The basis of this research led to a framework called the M.A.P. for achieving optimal hypertension control:</p> <ul> <li> <strong>M</strong>easuring blood pressure accurately every time it’s measured</li> <li> <strong>A</strong>cting rapidly to address high blood pressure readings</li> <li> <strong>P</strong>artnering with patients, families and communities to promote self-management of high blood pressure</li> </ul> <p> Get the <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf">three checklists</a> (log in) that make up the M.A.P. framework for use in your practice.</p> <p> Here are some additional resources to help you improve your practice’s hypertension management:</p> <ul> <li> Get the <a href="http://www.ama-assn.org/ama/ama-wire/post/one-graphic-patients-need-accurate-blood-pressure-reading">one infographic you need</a> for an accurate blood pressure reading.</li> <li> Learn everything you need to know about <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring">self-measured blood pressure monitoring</a>.</li> <li> Read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">three questions you should ask patients</a> when measuring their blood pressure.</li> <li> Hear <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-saying-doing-control-hypertension" target="_blank">what other physicians are doing</a> to control hypertension in their practices.</li> <li> See how physicians can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">manage blood pressure outside of office visits</a>.</li> </ul> <p> <a href="https://www.stepsforward.org/modules/hypertension-blood-pressure-control" rel="nofollow">Another module</a> on the AMA STEPS Forward website also offers CME and shows how to apply the M.A.P. framework to help get your patients’ blood pressures under control.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ce602f94-84f4-4946-acb2-a6052638e496 Doctors vote for improved data, price transparency measures http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-vote-improved-data-price-transparency-measures Mon, 08 Jun 2015 23:35:00 GMT <p> Physicians at the 2015 AMA Annual Meeting voted Monday to adopt new policies to improve data and price transparency.</p> <p> A report from the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees.page?">AMA Board of Trustees</a> outlines resources physicians need to benefit from ongoing data transparency efforts, including:</p> <ul> <li> Increased physician engagement in transparency efforts, such as leading the development of quality measures</li> <li> Improved access to timely data that can inform choices at the point of care</li> <li> Fewer barriers to accessing information from other payers and care settings</li> <li> Developing user interfaces and analytics that allow physicians or their staff to ask simple queries and get actionable reports</li> </ul> <p> The principles will help the AMA improve the quality of patient care and promote new payment and delivery models. See the full list of principles at the bottom of the page.</p> <p> Another report, this one from the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-service.page?">AMA Council on Medical Service</a>, included new policies to help physicians engage in price transparency efforts to assist patients in making informed health care decisions. The report calls for:</p> <ul> <li> Encouraging physicians to communicate cost information to individual patients, taking into account insurance status and other mitigating factors</li> <li> Facilitating price and quality transparency</li> <li> Creating safeguards to ensure accuracy and relevance of pricing information</li> <li> Requesting the Centers for Medicare & Medicaid Services (CMS) expand its Medicare Physician Fee Schedule Look-Up Tool to include hospital outpatient payments</li> </ul> <p> The new policies strengthen the AMA’s existing work on transparency issues. Following CMS’ release of Medicare claims data in 2014, the AMA <a href="http://www.ama-assn.org/ama/ama-wire/post/better-data-needed-patients-physicians-ama-tells-cms">urged the agency</a> to <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-need-cost-outcomes-data-not-medicare-claims-data">develop and refine a more selective, actionable data set</a>. Earlier this month when CMS again released data on the medical services physicians provide, the AMA provided context to <a href="http://www.ama-assn.org/ama/ama-wire/post/6-things-medicares-claim-data-release">physicians</a> and the <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-01-ama-guide-media-reporting-cms-medicare-data.page">media</a>.</p> <p>  </p> <p> <strong>Data transparency principles</strong></p> <ul> <li> Increase physician engagement in transparency efforts, such as leading development of quality measures.</li> <li> Secure funding and support that can ensure the availability of data to inform new payment and delivery models and don’t impose additional costs or burdens on physician participants.</li> <li> Make sure data are presented appropriately, depending on the objective and end-user. This should include transparently identifying what information is provided, for what purpose, and how it can or cannot be used to influence care choices.</li> <li> Develop user interfaces that allow physicians or their staff to ask simple queries and get actionable reports for specific patients, peer comparisons, provider-level resource use, practice patterns and other information.</li> <li> Encourage patients to consult with physicians to understand and navigate health care transparency and data efforts.</li> <li> Inform other consumers about proactive use of health care data through physician involvement with other stakeholders.</li> <li> Remove barriers to accessing more information from other payers and care settings.</li> <li> Use and increase access to timely data. For example, government reports should be made available from the previous quarter.</li> <li> Support proper oversight of entities that access and use health care data, including more stringent safeguards for public reporting.</li> <li> Use quality data, including definitions of quality that come from evidence-based guidelines, specialty society-developed measures and physician-developed metrics that focus on patient outcomes and engagement.</li> <li> Increase data utility by assisting clinical data registries, regional collaborations and specialty societies to work together.</li> <li> Improve electronic health records and other technology that can capture and access data in standardized formats.</li> <li> Reduce burdens on physicians by limiting data reporting requirements to information proven to improve clinical practice.</li> <li> Avoid attribution errors in data, a current problem that should be addressed at the system level.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6fe7679d-e6e1-4248-a290-94c98197fc10 Doctors call for two-year grace period for ICD-10 implementation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-call-two-year-grace-period-icd-10-penalties Mon, 08 Jun 2015 23:05:00 GMT <div> With less than four months to go before the deadline for implementing the ICD-10 code set, physicians Monday agreed to seek a two-year grace period for physicians to avoid financial disruptions to facilitate a smoother transition that would allow physicians to continue providing quality care to their patients.</div> <div>  </div> <div> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> passed policy calling on the Centers for Medicare & Medicaid Services (CMS) not to withhold claim payments based on coding errors, mistakes or malfunctions in the system for two years directly following implementation. </div> <div>  </div> <div> Related policy pushes the AMA to advocate for physician voices to be part of the group that manages the International Classification of Diseases (ICD). Currently, the four cooperating parties that manage ICD code sets are the Centers for Disease Control National Centers for Health Statistics, CMS, the American Hospital Association and the American Health Information Management Association. A physician group is necessary in these conversations because none of the current groups “represent providers who have licensed authority to define, diagnose, describe and document patient conditions and treatments.”</div> <div>  </div> <div> The new policy also directs the AMA to seek data on how ICD-10 implementation has affected patients and changed physician practice patterns, such as physician retirement or moving to all-cash practices.</div> <div>  </div> <div> “The bottom line is that ICD-10 will significantly overwhelm physician practices with a 400 percent increase in the number of codes physicians must use for diagnosis, which will take time away from the valuable one-on-one patient-physician interface that is the hallmark of taking the best care of patients,” said AMA Russell W.H. Kridel, MD, member of the AMA Board of Trustees. “We continue to press both Congress and the administration to take necessary steps to avoid widespread disruption to physician practices created by this overly complex and burdensome mandate. Coding and billing protocols should never get in the way of patients receiving high quality care.”  </div> <div>  </div> <div> CMS has acknowledged that the transition to ICD-10 will have an impact on physician payment processes. The agency estimates that “in the early stages of implementation, denial rates will rise by 100-200 percent,” according to a 2013 <a href="http://www.hfma.org/denialsmanagementicd-10/" rel="nofollow" target="_blank">report</a> from the Healthcare Financial Management Association. </div> <div>  </div> <div> A 2014 <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/icd-10-costs-for-physician-practices-study.pdf" target="_blank">AMA study</a> (log in) conducted by Nachisom Advisors on the cost of implementing ICD-10 estimated that a small practice could see payment disruptions ranging from $22,579 to $100,349 during the first year of ICD-10 implementation. The study also estimates that a small practice could incur a 5 percent drop in revenue because of productivity loss during and after the change.</div> <div>  </div> <div> While the AMA continues to urge regulators to ease the burden of ICD-10 implementation on physicians, you should act now to make sure your practice is prepared.</div> <div>  </div> <div> Looking for resources? An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> is an essential tool. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</div> <div>  </div> <div> Check out a <a href="http://www.ama-assn.org/ama/ama-wire/post/beginner-experts-guide-icd-10-prep-steps-june" target="_blank">series</a> at <em>AMA Wire</em>® that offers timely transition tips and resources, and find out <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">what your practice should do to prepare financially</a> for ICD-10.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:05623a53-1215-44b4-91cc-1c37bd149804 How real physicians are making their practices thrive http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_real-physicians-making-their-practices-thrive Mon, 08 Jun 2015 15:01:00 GMT <p> Seemingly countless frustrations and bureaucratic hurdles stand in the way of physicians experiencing the fulfillment of what led them to the practice of medicine—spending time with their patients and providing the highest quality care. Learn how physicians across the country are working smarter in their practices and delivering big results. </p> <p> “When I was a young physician, only a few years into my practice, I realized that if I was going to stay in practice and thrive, I needed to change the way I organized my work,” said Christine Sinsky, MD, an internist in Dubuque, Iowa, and vice president of <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">professional satisfaction</a> at the AMA. “I realized that I needed to spend much less time documenting the visit and chasing after results and find a way to spend more time really focused on the patient. Otherwise, I wasn’t going to be able to stay in practice.”</p> <p> Dr. Sinsky’s experience reflects that of many physicians. In a <a href="http://www.ama-assn.org/ama/ama-wire/post/quality-of-patient-care-primary-driver-of-physician-satisfaction-rand-study" target="_blank">2013 AMA study</a> with the RAND Corporation, physicians nationwide said that providing high-quality care was the primary driver of their professional satisfaction. Obstacles to providing that care, meanwhile, were found to be major sources of stress.</p> <p> “Taking great care of our patients is why we get up in the morning—it is not to enter into this vortex of frustration,” Dr. Sinsky said. “We need to improve the efficiency of the practice, and by doing so, to create the time to do the work we know is most valuable.”</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/11/d4e64493-b4d8-45f5-bb7a-97e2ee0ce76b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/11/d4e64493-b4d8-45f5-bb7a-97e2ee0ce76b.Large.jpg?1" style="float:right;margin:15px;" /></a><strong>Reducing administrative frustrations, increasing time with patients</strong><br /> Now physicians have found a way to minimize stress and overcome barriers to providing the best care: A free online series of proven solutions developed by physicians that can make your practice thrive.</p> <p> The AMA’s newly launched <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a> website offers a collection of interactive educational modules that help physicians address common practice challenges while earning continuing medical education credit. The modules include steps for implementation, case studies, and downloadable tools and resources.</p> <p> Physicians who already have used the practice transformation series have seen positive changes.</p> <p> “Before, there wasn't enough time in the office visit to get it all done,” one physician said.</p> <p> Another physician noted that using these solutions led to a rediscovery of the “beauty of reconnecting with my patients.”  </p> <p> The 16 <a href="https://www.stepsforward.org/modules" rel="nofollow" target="_blank">modules</a> help you and your practice team improve practice efficiencies, including:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/modules/synchronized-prescription-renewal" rel="nofollow" target="_blank">Synchronizing prescription renewal</a></li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/modules/medication-adherence" rel="nofollow" target="_blank">Encouraging medication adherence</a></li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/modules/ehr-implementation" rel="nofollow" target="_blank">Implementing EHRs</a></li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/modules/physician-burnout" rel="nofollow" target="_blank">Avoiding burnout</a></li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/modules/hypertension-blood-pressure-control" rel="nofollow" target="_blank">Helping patients control blood pressure</a></li> </ul> <p> “These are tools that will help you save time,” Dr. Sinsky said. “Patients will get better care if the people they rely on no longer feel beaten down and overwhelmed by the clerical tasks of the day.” In addition, these tools will help physicians reclaim some of their personal time. “Many physicians are taking one to two hours of documentation and other computer home each night. One of our goals is to help physicians spend more time with their families.”</p> <p> <strong>Submit your ideas: Practice Innovation Challenge</strong><br /> The 16 modules available on the STEPS Forward website are only the beginning. The AMA and the Medical Group Management Association are partnering to conduct the <a href="http://www.innovatewithama.com/" rel="nofollow" target="_blank">Practice Innovation Challenge</a>, which seeks the best proposals from physicians and entrepreneurs.</p> <p> If you’re an out-of-the-box thinker, submit your ideas, experiences and learnings by Sept. 1. Submissions that are selected as high-value, easy-to-adopt, transformative medical practice solutions will be developed into future STEPS Forward modules and will be eligible to win one of several $10,000 prizes.</p> <p> More than 25 modules are expected to be available by the end of the year.</p> <p> Here’s how to learn more:</p> <ul> <li style="margin-left:0.25in;"> Visit the STEPS Forward website to see the <a href="https://www.stepsforward.org/modules" rel="nofollow" target="_blank">current modules</a></li> <li style="margin-left:0.25in;"> Check out upcoming <a href="https://www.stepsforward.org/events" rel="nofollow" target="_blank">live STEPS Forward events</a></li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/get-updates" rel="nofollow" target="_blank">Sign up</a> to be notified when new modules and events are available</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ea44c81-ee59-468a-beb5-87f0edfbbd0c How to reduce health disparities, unite physician efforts: Rep. Robin Kelly http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_reduce-health-disparities-unite-physician-efforts-rep-robin-kelly Sun, 07 Jun 2015 20:32:00 GMT <p> Leveraging strategic partnerships will empower physicians and medical students to close the nation’s health care equity gap, Rep. Robin Kelly, D-Ill., said Friday during an address at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>. </p> <p> Her remarks were part of a special reception to honor recipients of the 2015 <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/minority-scholars-award.page?">AMA Minority Scholars Award</a>, which gives 10,000 scholarships to exceptional students of color. The reception was hosted by the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page">Minority Affairs Section</a> and the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page">AMA Foundation</a>.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/13/215e2e87-0186-4520-bd6c-80e8b4e79798.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/13/215e2e87-0186-4520-bd6c-80e8b4e79798.Large.jpg?1" style="float:right;margin:15px;" /></a>Kelly (pictured right) is the chair of the <a href="http://www.cbcfinc.org/who-we-are/visionandmission.html" rel="nofollow">Congressional Black Caucus (CBC) Health Braintrust,</a> which aims  to advance African-American health and communities by developing leaders, informing policy and educating the public.</p> <p> During her address, Kelly reminded <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/2015-minority-scholars-award-recipients.page">this year’s scholars</a> that as promising physicians in training, they hold an important role in the nation’s fight to reduce health disparities.</p> <p> “The theme for [our caucus] this Congress is ‘The March Toward Health Equity,’ in honor of the 50th anniversary of the voting rights march from Selma to Montgomery,” Kelly said.</p> <p> She quoted a statement by Martin Luther King, Jr.: “‘Of all the forms of inequality, injustices in health care are the most shocking and inhumane.’ I couldn’t agree more Like the right to vote, health care is a fundamental civil right that must be promoted, protected and supported. Your zip code, ethnicity and bank balance shouldn’t determine your health.”</p> <p> This is precisely why the CBC Health Braintrust has developed key initiatives to help defend patients’ access to care and improve health outcomes in at-risk communities, Kelly said. These initiatives include:</p> <ul> <li> Calling on Congress to commission a greater body of research on social factors and determinants that impact health care.  </li> <li> Increasing engagement among health policy experts, community advocates and elected officials to discuss strategies for improving health outcomes in vulnerable communities.</li> <li> Continuing the CBC Health Braintrust’s national tour to spotlight key health issues affecting multicultural communities.</li> <li> Introducing health legislation that addresses pressing national health concerns while “keeping health equity and disparity reduction at the forefront of the national agenda,” Kelly said. “In particular, I’m gearing up to introduce the 2016 Health Equity and Accountability Act … Congress’ signature health disparities legislation.”</li> <li> Releasing the 2015 Kelly Report on Health Equity in America, an official congressional report examining the root causes and impact of health disparities in America. The report, to be released in September, also will provide a comprehensive set of legislative and policy recommendations to reverse these issues.  </li> </ul> <p> “With these steps, we begin the march toward a healthier future, laying the foundation for achieving health equity in a generation …. And I’m enlisting all of you in that pursuit,” she said.</p> <p> For additional information about national and local efforts to address health disparities:</p> <ul> <li> Visit the AMA-MAS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/about-us.page?">Web page</a><u>,</u> which features the latest on AMA policies, news and events to promote diversity in medicine and public health.</li> <li> Learn more about the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities.page">Commission to End Health Disparities</a><u>.</u></li> <li> Review the CBC Health Braintrusts’<a href="http://www.cbcfinc.org/mediacenter/cbcf-publications.html" rel="nofollow"> publications</a> on key policy issues that impact the health of African-American communities.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:160c6553-db3e-4e07-8df4-5a463db48fec Why medical students aren't matching--and what happens next? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_arent-medical-students-matching-happens-next Sun, 07 Jun 2015 17:28:00 GMT <p> More than 250 of this year’s graduating seniors from U.S. allopathic schools did not match to a residency position, which has medical educators troubled amid growing concerns of a <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" rel="nofollow" target="_blank">physician shortage</a>. During a discussion at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>, experts examined where these unmatched students are going and strategies for making sure they get to use their MDs.</p> <p> According to the Association of American Medical Colleges (AAMC), the top seven reasons this year’s seniors failed to match were:</p> <ol> <li> Had low scores on a United States Medical Licensing Exam (USMLE)</li> <li> Weren’t competitive for their first choice specialty</li> <li> Didn’t have an appropriate backup/alternative plan</li> <li> Didn’t follow guidance from their faculty adviser or dean’s office</li> <li> Had poor interviewing/interpersonal skills</li> <li> Did not rank enough programs</li> <li> Failed a USMLE exam</li> </ol> <p> Of these unmatched students, nearly one-half had been discussed in promotions committees at their schools, indicating they had performance problems, said Geoffrey Young, senior director of student affairs and programs at AAMC.</p> <p> “The issue becomes, ‘How do you counsel students to think more realistically [about their options]?’” Young said.</p> <p> AAMC data show most students who don’t match either re-enter the Match the following year or continue to seek a residency position. Others re-enter with a different specialty or take a research year.</p> <p> Schools should explore how to better advise and counsel students for the Match, Young said. They also may need to re-examine their promotions standards, which may be a tough discussion.</p> <p> “At some point, you need to help a student make an exit plan [from medical school],” he said.</p> <p> But it’s important to remember how each of the 254 students who didn’t match this year felt when they got the news, said Kathleen Kashima, senior associate dean of students at the University of Illinois College of Medicine.</p> <p> <strong>How one school is taking action</strong><br /> When a student has trained for years to be a physician, then sees a message on Match Day that says, “We are sorry, you did not match to any position,” they feel shocked, embarrassed and betrayed, Kashima said.</p> <p> “They think, ‘Is my career over?’” she said.</p> <p> Kashima’s institution decided to take action and ensure its students were as prepared as possible to match. To start, the dean of the University of Illinois College of Medicine started a residency preparedness initiative.</p> <p> Part of the initiative is a course all medical students must take on career development, which requires them to develop a strategic plan for the Match or alternate career paths.</p> <p> The school also started a loan assistance program. If a student graduates with medical school debt, has participated in the residency preparedness initiative and hasn’t secured a residency position through the Match, the college will assume the interest of the student’s medical school loans for up to one year.</p> <p> These two initiatives demonstrate how committed the school is to ensuring its students go on to become physicians, Kashima said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6f7c5f48-f10c-4f8f-9353-5019c5b942ac Physician who contracted Ebola among award winners http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-contracted-ebola-among-award-winners Sun, 07 Jun 2015 15:04:00 GMT <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> As medical director of the only Ebola treatment unit in southern Liberia, Kent Brantly, MD, knew he was putting himself at risk—but the need for care was too great.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> Dr. Brantly, a medical missions advisor for Samaritan’s Purse in Texas, treated patients in Monrovia, Liberia, from October 2013 to August 2014. When he was diagnosed with Ebola in July, he became the first American evacuated for treatment, which he received at Emory University Hospital. Dr. Brantly donated plasma to help others recover from the disease, including Dallas nurse Nina Pham, a fellow physician with Samaritan’s Purse and a cameraman.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> The AMA Foundation will recognize Dr. Brantly, the recipient of the Dr. Nathan Davis International Award in Medicine, during the Foundation’s Excellence in Medicine awards program Friday. The award recognizes him for his outstanding international service, and Samaritan’s Purse will receive a $2,500 grant.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> The <a href="https://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards.page" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);">Excellence in Medicine Awards</span></a> recognize physicians who exemplify medicine’s highest values: leadership, community service and dedication to treating underserved patients. Three other physicians received awards alongside Dr. Brantly:</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     New York physician<span class="List_0020Paragraph__Char" style="font-size:10pt;font-weight:bold;"> Mark Lachs, MD,</span> received the Dr. Debasish Mridha Spirit of Medicine Award, which recognizes the work of a U.S. physician who has demonstrated altruism, compassion, integrity, leadership and personal sacrifice while providing care to a destitute, distressed or marginalized population.  <br />  <br /> An internationally recognized expert in the field of elder mistreatment and the disenfranchised elderly, Dr. Lachs has published and lectured widely on elder abuse and neglect, adult protective services, measurement of functional status, ethics and health care finance. The award comes with a $2,500 grant to the New York Weill Cornell Medical Center, where Dr. Lachs is co-chief of the division of geriatrics and palliative medicine.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-size:10pt;font-weight:bold;">Sean G. Palfrey, MD,</span> a professor of pediatrics and public health at Boston University, received the Jack B. McConnell, MD, Award for Excellence in Volunteerism. Dr. Palfrey has dedicated his life’s work to improving and advocating for children’s health. He wrote and advocated for a state bill to create a public-private trust to fund the purchase, administration and management of all vaccines for the children of Massachusetts, as well as the maintenance of a state vaccine registry.  <br />  <br /> He also has worked with underserved and immigrant populations and children with special health care needs. The award comes with a $2,500 grant to the Judy and Sean Palfrey Advocacy Fund.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-size:10pt;font-weight:bold;">J. Emilio Carrillo, MD,</span> associate professor at Weill Cornell Medical College of Cornell University, received the Pride in the Profession Award, which honors physicians who aid underserved populations in the United States. At New York-Presbyterian Hospital, where he is vice president of community, Dr. Carrillo leads a population-based program that addresses the health care needs of a large urban immigrant community. His research and collaborations have laid the foundation for patient-based, cross-cultural health care.  <br />  <br /> Dr. Carrillo also is an original founder of the Latino Medical Student Association, the <span class="List_0020Paragraph__Char" style="font-size:10pt;font-style:italic;">Journal of Latin Community Health</span> and the <span class="List_0020Paragraph__Char" style="font-size:10pt;font-style:italic;">Journal of Multicultural Community Health</span>. The award comes with a $2,500 grant to the Weill Cornell Medical College Chapter of the Latino Medical Student Association.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <a href="https://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards/2015-major-award-recipients.page" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);">Read more</span></a> about the winners.</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> The AMA Foundation also presented 10 medical students, two residents, one fellow and two early-career physicians with its Leadership Awards. These awards recognize strong leadership skills in advocacy, community service, public health or education. The winners are:</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Mitra Daneshvar, second-year medical student at Cooper Medical School of Rowan University</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Patrick Davis, fourth-year medical student at Indiana University School of Medicine</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Erick A. Eiting, MD, assistant professor of clinical emergency medicine at Keck School of Medicine of the University of Southern California and medical director of USC Correctional Health</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Latha Ganti, MD, emergency medicine physician at North Florida South Georgia Veterans Affairs Medical Center</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Kristy Lynn Hawley, fourth-year medical student at the George Washington University School of Medicine and Health Sciences</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Harrison Hayward, second-year medical student at the University of Connecticut School of Medicine</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Nikan H. Khatabi, DO, interventional pain fellow at Loma Linda University Medical Center</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Jay I. Kumar, third-year medical student at Harvard Medical School</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Jillian Wong Millsop, MD, dermatology resident at the University of California Davis Medical Center</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Peter N. Mittwede, seventh-year MD/PhD student at the University of Mississippi School of Medicine</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Vinod E. Nambudiri, MD, internal medicine and dermatology resident at Brigham and Women’s Hospital</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Christian A. Pean, third-year medical student at Icahn School of Medicine at Mount Sinai</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Kushyup Shah, fourth-year medical student at Rutgers New Jersey Medical School</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Divya Sharma, third-year medical student at Rutgers New Jersey Medical School</p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     Christos Theophanous, a third-year medical student at the Keck School of Medicine of the University of Southern California</p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 0);"> <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards/2015-excellence-in-medicine-winners.page" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);">Read more</span></a> about the Leadership Awards winners.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6f316a68-d8b7-4490-b98e-85b59d5b7d6f Facing challenges strengthens physician-patient bond: AMA president http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_facing-challenges-strengthens-physician-patient-bond-ama-president Sun, 07 Jun 2015 00:59:00 GMT <p> <object align="right" data="http://www.youtube.com/v/_pQHXUNBOXg" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/_pQHXUNBOXg" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/_pQHXUNBOXg" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /></object></p> <p> In an address during Saturday’s opening session of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>, AMA President Robert M. Wah, MD, congratulated physicians on undertaking numerous challenges that, once solved, will strengthen the physician-patient relationship and make the practice of medicine better.</p> <p> The most important victory for physicians over the past year was undoubtedly the <a href="http://www.ama-assn.org/ama/ama-wire/post/overcame-sgr-hurdle" target="_blank">elimination of Medicare’s sustainable growth rate</a> (SGR) formula, a perennial threat of steep payment cuts and instability.</p> <p> “Working together, we finally ended an era of uncertainty for Medicare patients and their physicians and opened new avenues to provide better care at a lower cost,” he said. “It wasn’t a ‘doc fix’ …. It was Medicare that needed fixing—not doctors.”</p> <p> Physicians tackled many other issues this year, too, including:</p> <ul> <li> Calming the <a href="http://www.ama-assn.org/ama/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">“tsunami” of regulatory penalties</a> physicians will face over the next decade, specifically meaningful use. “Harness technology to improve care—don’t let it harness us,” Dr. Wah said. “The same goes for those who write regulations. Learn from mistakes and act accordingly. If something isn’t working, fix it.”</li> <li> Shaping regulations such as the Independent Payment Advisory Board (IPAB), or as Dr. Wah called it, “the SGR on steroids.” The AMA joined more than 500 organizations to <a href="http://www.ama-assn.org/ama/ama-wire/post/law-could-repeal-arbitrary-federal-panel" target="_blank">call on Congress to repeal the IPAB</a>, and a bill to do so has been <a href="http://www.ama-assn.org/ama/ama-wire/post/ipab-repeal-bill-moves-forward-house" target="_blank">approved</a> by the U.S. House of Representatives’ Ways and Means Committee.</li> <li> Improving outcomes around chronic diseases. The recent launch of the <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act–Today™</a> initiative between the AMA and the Centers for Disease Control and Prevention is a step in this direction.</li> <li> <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating change in medical education</a>. By listening to students’ interests and needs, harnessing technology and working on innovative ideas, the AMA and medical schools in its learning consortium are transforming medical education for the first time in a century.</li> </ul> <p> "The challenge of changes swirls all around us,” he said. “We need to see it as an opportunity to maximize those opportunities. It will take hard work, imagination and creativity.”</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7d7d8b44-21cc-4c51-9020-9402e8e8be0c Creativity, united voice will improve nation’s health: AMA CEO http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_creativity-united-voice-will-improve-nations-health-ama-ceo Sun, 07 Jun 2015 00:55:00 GMT <p> <object align="right" data="http://www.youtube.com/v/pH9rmKqfd_8" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/pH9rmKqfd_8" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/pH9rmKqfd_8" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="15" quality="best" src="http://www.youtube.com/v/pH9rmKqfd_8" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object></p> <p> Crafting a “culture of innovation and collaboration” across all aspects of health care—from medical education to patient care to advocacy—will propel physicians to continue shaping the future of medicine, AMA Executive Vice President and CEO <a href="http://www.ama-assn.org/resources/doc/about-ama/bio-madara.pdf" target="_blank">James L. Madara, MD</a>, said in his address Saturday at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>. </p> <p> “When we work together as a profession, we can accomplish incredible things. <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">The SGR win</a> is proof of the importance and of the effectiveness of aligning our efforts and aligning our voices,” Dr. Madara said. “Dealing with change, one has to have the mentality of a marathon runner—quick out of the gate, measured in approach.”</p> <p> The AMA has already begun partnering with physicians, residents and students to create these new approaches for health care, including:</p> <ul> <li> A new multi-year partnership with the Centers for Disease Control and Prevention: <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act—Today<em>™</em></a>, which will develop tools to help physicians across different specialties and practices treat patients with diabetes.</li> <li> A <a href="http://www.ama-assn.org/ama/ama-wire/post/innovators-tap-physicians-technology-insights" target="_blank">technology hub</a> dedicated to improving <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">professional satisfaction and practice sustainability</a> through research, data and analytics.</li> <li> The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative, which has awarded 11 medical schools $1 million grants to develop innovative changes in medical education. For instance, Oregon Health and Science University is establishing key competencies for medical students interested in <a href="http://www.ama-assn.org/ama/ama-wire/post/student-interest-informatics-outpaces-opportunities-study" target="_blank">clinical informatics</a>.</li> </ul> <p> “All of these efforts—from preventing diabetes to enhancing practice satisfaction to  creating the med school of the future … —create what I call the AMA innovation ecosystem,” he said.  </p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6a59dded-ec9b-486a-9e93-242321c44b20 Value-based payment isn’t about skyrocketing costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_value-based-payment-isnt-skyrocketing-costs Sun, 07 Jun 2015 00:47:00 GMT <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">Patient care is poised to change dramatically as new models of payment overtake traditional arrangements. But according to physician leaders from some of the nation’s cutting-edge health systems, this shift in the health care environment will be a “game changer” for reasons that go far beyond economic considerations.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;"><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/5/bf78ce6d-8f65-488b-a591-538063afb495.Full.jpg?1" style="font-family:Arial, Verdana, sans-serif;font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/5/bf78ce6d-8f65-488b-a591-538063afb495.Large.jpg?1" style="margin:15px;float:left;" /></a>As high as health care costs have risen—more than 17 percent of the nation’s gross domestic product—patients are eating up most of the costs, with employee cost shares rising 50 percent faster than the rate of overall premium increases, Charles Kennedy, MD (pictured left), said during a panel discussion Saturday at the </span><a href="https://www.ama-assn.org/sub/meeting/index.html" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);"><span class="Hyperlink__Char" style="font-family:Arial;font-size:10pt;">2015 AMA Annual Meeting</span></span></a><span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">Dr. Kennedy is chief population health officer at Healthagen, where he is working toward a more patient-centered system of care. He spoke about how value-based payment is more than a business issue—it’s a paradigm shift.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Placing the patient at the center</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">The existing model of payment places “profitability” with episodic treatment of sick people, which contributes to rising costs and makes care transactional, Dr. Kennedy said. The value-based system of the future will be about holistic care for the entire population, with an emphasis on keeping healthy people well and effectively managing diseases among those who are sick.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">Other panelists agreed that value will only come with overall changes to the system of care.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">“You can’t just change the way that you pay and have it amount to anything,” Grace Terrell, MD, president and CEO of Cornerstone Healthcare in Highpoint, N.C., said. “We actually have to change the way we take care of our patients. We ought to be able to get back to what it’s all about … with the patient at the center of all of it.”</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">For Dr. Terrell’s practice, “value” isn’t a term restricted to finances. Her practice reorganized to become a “population health management hub” to provide better care and simultaneously allow physicians to thrive. The changes they made were based on the question, “How can we take back medicine in a way that’s valuable for all of us?”</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Essential elements for moving to value-based care</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;">In talking about changes that have been made so far and what the future could hold, panelists noted several elements that will be essential to achieving a high-value system of care:</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Data.</span><span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;"> Dr. Kennedy noted that “proof points” of successes will be essential to making broader system changes, and practical data—such as the actual cost of care—should guide decisions.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Collaboration.</span><span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;"> “This is a time of change,” Dr. Terrell said. “For us as a profession, this could be a game changer in a very positive way. It will be a time of collaboration as opposed to a time of competition to get this done right.”</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Patient engagement.</span><span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;"> “You can’t be a reactive organization anymore and wait for [patients] to come in when there’s a problem,” panelist Donald Fisher, Phd, president of the American Medical Group Association, said. “If we can’t figure out a way to get patients engaged [in their own health], we will fail.”</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="List_0020Paragraph" style="margin-top:0pt;margin-bottom:0pt;margin-left:36pt;text-indent:-18pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="List_0020Paragraph__Char" style="font-family:Symbol, Arial;font-size:10pt;">·</span>     <span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Remembering the ultimate goal.</span><span class="List_0020Paragraph__Char" style="font-family:Arial, Arial;font-size:10pt;"> Dr. Terrell emphasized that the key thing to keep in mind about any health care changes is that “it’s about taking care of patients again.”</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Support for physicians in new models of care</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;color:rgb(26, 20, 20);">The AMA’s </span><a href="https://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);"><span class="Hyperlink__Char" style="color:rgb(0, 102, 204);font-family:Helvetica, Arial;font-size:10pt;">Professional Satisfaction and Practice Sustainability </span></span></a><span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;">initiative aims to ensure that physicians can thrive in their practices, resulting in improved health outcomes and greater professional satisfaction. </span><span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;color:rgb(26, 20, 20);"> </span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;">Key components of reaching that goal are promoting successful care delivery and payment models in the public and private sectors, and creating tools that will enable physicians to adopt proven models that fit with their practices.</span></p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Normal" style="margin-top:0pt;margin-bottom:0pt;line-height:13pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;">Visit the AMA’s </span><a href="https://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/payment-model-resources.page" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);"><span class="Hyperlink__Char" style="font-family:Helvetica, Arial;font-size:10pt;">Web page on next generation models</span></span></a><span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;color:rgb(26, 20, 20);"> </span><span class="Normal__Char" style="font-family:Helvetica, Arial;font-size:10pt;">to access existing resources for physicians who are pursuing new models of care and payment.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c3ee5a98-ba48-4a99-9118-132b7a470342 Three ways to improve physicians’ professional satisfaction http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_three-ways-improve-physicians-professional-satisfaction Sun, 07 Jun 2015 00:45:00 GMT <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">When you get home after a day of practicing medicine, how do you feel?</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/12/3401c266-85fb-4128-acb3-5a676421bf25.Full.jpg?1" style="font-family:Arial, Verdana, sans-serif;font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/12/3401c266-85fb-4128-acb3-5a676421bf25.Large.jpg?1" style="float:right;margin:15px;" /></a>Physicians spend their days doing extraordinary things providing patient care and should feel wonderful as a result. Instead, they often feel exhausted and overburdened, Michael Tutty, PhD, AMA group vice president for </span><a href="https://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">professional satisfaction and practice sustainability</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">, said during a presentation at the </span><a href="https://www.ama-assn.org/sub/meeting/index.html" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">2015 AMA Annual Meeting</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">So what's causing these pressures?</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Default__Char" style="font-size:10pt;">“</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">It's everything that takes them away from doing those amazing activities,</span><span class="Default__Char" style="font-size:10pt;">”</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> Tutty said</span>.</p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">Here are three ways the AMA is working to make it easier for physicians to practice so they can focus on patients and relieve some of that stress:</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;text-indent:-18pt;line-height:12pt;font-size:medium;color:rgb(0, 0, 0);margin-left:36pt;"> <span class="Default__Char" style="font-size:10pt;font-weight:bold;"><font face="Times New Roman, Arial">1. </font></span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Improved technology</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">It's no secret that electronic health record (EHR) systems are a huge frustration for physicians, from the technology itself to the regulatory requirements around it, such as the meaningful use program.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">To mitigate these problems, the AMA is pushing for better EHR usability, based on a </span><a href="https://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">framework</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> it developed with practicing physicians and health IT experts. The AMA also has urged the government to make </span><a href="https://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-outline-improvements-ehr-certification-process" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">three key changes</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> to improve the EHR certification process to make the technology easier to use.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">It also is aggressively advocating for </span><a href="https://www.ama-assn.org/ama/ama-wire/post/cms-should-stop-stage-3-of-meaningful-use" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">changes to meaningful use</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> and was successful in </span><a href="https://www.ama-assn.org/ama/ama-wire/post/good-news-meaningful-use-realistic-requirements" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">securing more flexibility</span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> for physicians in Stages 1 and 2.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;text-indent:-18pt;line-height:12pt;font-size:medium;color:rgb(0, 0, 0);margin-left:36pt;"> <span class="Default__Char" style="font-size:10pt;font-weight:bold;"><font face="Times New Roman, Arial">2. </font></span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Help with payment models</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">New models, such as accountable care organizations, <a name="_GoBack"></a>appear to be succeeding, but it depends on how you measure success, Tutty said. How are practicing physicians actually handling these new models?</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">To find out, the AMA and the RAND Corporation studied physician practices undertaking these new models. The results of that study revealed physicians need help managing and responding to the many quality programs and metrics from payers to ensure long-term sustainability. </span><a href="https://www.ama-assn.org/ama/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank"><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;color:rgb(0, 0, 128);">Read the details</span></a> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">of the study at <span class="Default__Char" style="font-size:10pt;font-style:italic;">AMA Wir</span>e®.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">The report's findings will guide the AMA's work in improving alternative payment models and securing the help physicians need to make them successful.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-size:10pt;">“</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">The lessons learned [from the study] are clear: Changing payment models alone will not get physicians' desired outcomes,</span><span class="Default__Char" style="font-size:10pt;">”</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> Tutty said.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;text-indent:-18pt;line-height:12pt;font-size:medium;color:rgb(0, 0, 0);margin-left:36pt;"> <span class="Default__Char" style="font-size:10pt;font-weight:bold;"><font face="Times New Roman, Arial">3. </font></span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;font-weight:bold;">Guidance for professional relationships</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">In some areas, physicians and hospitals may be feeling pulled</span><span class="Default__Char" style="font-size:10pt;">—</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">or pushed</span><span class="Default__Char" style="font-size:10pt;">—</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">together, said J. James Rohack, MD, a Texas cardiologist and former AMA president who is an advisor for the AMA</span><span class="Default__Char" style="font-size:10pt;">’</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">s Professional Satisfaction and Practice Sustainability initiative.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">To make it a smoother integration, the AMA and the American Hospital Association developed </span><a href="http://www.ama-assn.org/ama/ama-wire/post/6-characteristics-of-successful-physician-hospital-relationships" target="_blank"><span class="Hyperlink__Char" style="color:rgb(0, 0, 255);"><span class="Hyperlink__Char" style="font-family:Arial;font-size:10pt;">guidelines</span></span></a><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> on how to bring clinical skills and business insights together at the leadership level.</span></p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);">  </p> <p class="Default" style="margin-top:0pt;margin-bottom:0pt;line-height:12pt;font-family:'Times New Roman', Arial;font-size:medium;color:rgb(0, 0, 0);margin-left:18pt;"> <span class="Default__Char" style="font-size:10pt;">“</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">[Integration] is not for all practices or all places in the country,</span><span class="Default__Char" style="font-size:10pt;">”</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;"> Dr. Rohack said. </span><span class="Default__Char" style="font-size:10pt;">“</span><span class="Default__Char" style="font-family:Arial, Arial;font-size:10pt;">But there are some that would like to come together and just don't know where to start.</span>”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e9143e76-c06e-435b-b1c7-9e9dd4b70c83 Meeting highlights of the AMA Minority Affairs Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-of-ama-minority-affairs-section Sun, 07 Jun 2015 00:07:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page?">Minority Affairs Section</a> (MAS) kicked off its annual meeting with Doctors Back to School Improving Health Outcomes visits to two schools on Chicago’s South Side. The visits were part of a collaborative effort with the AMA Medical Student Section.</p> <p> A group of 50 physicians and medical student volunteers spoke with 277 students at Daniel Hale Williams Preparatory High School for Medicine and Kozminski Elementary Community Academy. Physicians spoke with students about careers in medicine, while medical students engaged them in interactive stations about healthy food options, hypertension, and mental health and bullying.</p> <p> The AMA-MAS held its business meeting Friday evening. The keynote speaker, U.S. Rep. Robin Kelly, chair of the Congressional Black Caucus Health Braintrust, <a href="http://www.ama-assn.org/ama/ama-wire/post/reduce-health-disparities-unite-physician-efforts-rep-robin-kelly">gave an overview of legislative priorities</a> to reduce health and health care disparities. The meeting also featured an open forum on AMA House of Delegates reports and resolutions that impact minority physicians and patients.</p> <p> An awards presentation honored 21 medical students who received the 2015 <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/minority-scholars-award.page?">Minority Scholars Awards</a>. Recipients won $10,000 scholarships from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page?">AMA Foundation</a>, made possible by the Pfizer Humanities Initiative, and one student received a $5,000 scholarship, made possible by Richard Allen Williams, MD, Ms. Genita Johnson and the Association of Black Cardiologists.</p> <p> These scholarships recognize scholastic achievement, financial need and personal commitment to improving health care disparities among students in groups defined as historically underrepresented in the medical profession.</p> <p> The AMA-MAS hosted an education program titled, “The new science of unconscious bias,” presented by diversity and cultural competency expert David Hunt, CEO of Critical Measures LLC. This evocative session explored how personal and systemic bias can impact clinicians’ objective evaluation and treatment of others based upon factors such as race, gender, religion, culture and language.</p> <p> Finally, the AMA-MAS Governing Council re-elected Niva Lubin-Johnson, MD, as chair and Frank Clark, MD, as vice chair for 2015-2016. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page?">Learn more</a> about the AMA-MAS.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ec345d8e-3379-4ac4-8665-52e04dfe05bc Meeting highlights of the AMA Section on Medical Schools http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-of-ama-section-medical-schools Sun, 07 Jun 2015 00:06:00 GMT <p> AMA policy review, education sessions and networking opportunities with academic physician colleagues were part of the 2015 AMA Section on Medical Schools (SMS) Annual Meeting, June 5-6 in Chicago.</p> <p> Meeting participants, comprised of deans and faculty from a wide range of medical schools nationwide, voiced their opinions and reached decisions on several reports and resolutions to be acted upon by delegates at the 2015 AMA Annual Meeting, June 6-10. Their work guides the section’s delegate and alternate delegate in the discussions and voting.</p> <p> Issues covered included obesity education for future physicians, the value of resident physicians to the health care system, transparency in medical education and access to training in settings affiliated with religious health care organizations, and human trafficking reporting and education.</p> <p> Other items covered such topics as how to expand residency programs, selecting resident physicians to better reflect patient diversity, including military history as part of standard history taking, and reducing the financial and educational costs of residency interviews.</p> <p> In addition, AMA-SMS members voted in favor of a resolution that would update the section’s bylaws. Among other revisions, this resolution, if passed by the AMA House of Delegates, would change the section’s name to the AMA Academic Physicians Section.</p> <p> <strong>Election of 2015-2016 AMA-SMS Governing Council</strong></p> <p> For the annual elections to the nine-member AMA-SMS Governing Council, members elected the slate put forward by the nomination committee as follows:</p> <p> <strong>AMA-SMS chair-elect:</strong> John Roberts, MD, associate dean for graduate medical education, ACGME-designated official, University of Louisville School of Medicine</p> <p> <strong>Liaison to the AMA Council on Medical Education:</strong> Surendra K. Varma, MD, executive associate dean for graduate medical education and resident affairs, Texas Tech University Health Sciences Center School of Medicine</p> <p> <strong>AMA-SMS members-at-large:</strong></p> <ul> <li> Jose Manuel de la Rosa, MD, provost and vice president for academic affairs, founding dean, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine (new AMA-SMS governing council member)</li> <li> George Mejicano, MD, senior associate dean for education, Oregon Health and Science University School of Medicine</li> <li> Capt. Mark B. Stephens, MD, Medical Corps of the U.S. Navy, professor and chair of the department of family medicine, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine (new AMA-SMS governing council member)</li> </ul> <p> The AMA-SMS also bade farewell to past chair John P. Fogarty, MD, dean at Florida State University College of Medicine. Cynda Ann Johnson, MD, president and founding dean at Virginia Tech Carilion School of Medicine and Research Institute, takes his place. In addition, Betty Drees, MD, former dean at the University of Missouri–Kansas City School of Medicine, completed her service as AMA-SMS liaison to the AMA Council on Medical Education.</p> <p> <strong>Updates on key nationwide medical education activities</strong></p> <p> After welcome and introductions from Alma Littles, MD, AMA-SMS chair for 2015-2016 and senior associate dean for medical education and academic affairs at Florida State University College of Medicine, a number of speakers covered key issues affecting academic physicians. Thomas A. Deutsch, MD, dean of the meeting’s host medical school, Rush Medical College of Rush University, provided a synopsis of his institution’s work in preparing future physicians for practice in the health care environment of tomorrow, and outlined some of the key disruptions and challenges that medical education needs to foresee and address.</p> <p> In addition, Susan Skochelak, MD, AMA group vice president of medical education, provided an update on the work of the AMA’s Accelerating Change in Medical Education initiative to advance and disseminate innovations to all U.S. medical schools. Barbara Barzansky, PhD, co-secretary of the Liaison Committee on Medical Education, provided an update on the committee’s activities related to medical school accreditation and its work to streamline the accreditation process.</p> <p> Other highlights included a review of the AMA-SMS role in developing and reviewing AMA policy, a legislative update, an AMA academic physician membership update, a review of the work of the AMA Council on Medical Education, and an update on the activities of the AMA Alliance and AMA Foundation.</p> <p> Also during the meeting, a representative of the AMA Medical Student Section presented the award for the 2014-2015 AMA Section Involvement Grant Event of the Year, which went to the AMA medical student section at the Rutgers Robert Wood Johnson Medical School for its Community Health Fair. Through the SIG program, the AMA Medical Student Section provides an opportunity for local AMA medical student sections to educate students about the AMA and provide an opportunity for students to get more involved, help put AMA policy into action by providing a service to medical school campuses or communities, and engage in activities that focus on the AMA’s top priorities. </p> <p> <strong>Educational focus on MOC, unmatched medical students</strong></p> <p> The education component of the meeting focused on two topics of interest to physicians and medical students alike. The first session covered maintenance of certification (MOC) and featured Lois M. Nora, MD, president and chief executive officer of the American Board of Medical Specialties.</p> <p> A reactor panel followed with Richard J. Baron, MD, president and chief executive officer of the American Board of Internal Medicine, and Joshua M. Cohen, MD, director of education at Mount Sinai Beth Israel, Roosevelt and St. Luke's hospitals and chair of the AMA Young Physicians Section Committee on Maintenance of Certification and Maintenance of Licensure.</p> <p> An interactive discussion followed, with a number of meeting participants weighing in on the best ways to measure and assess the continued competence of physicians. In addition, Dr. Nora specifically called on academic physicians to play a larger role in MOC and its continued refinement.</p> <p> The topic of unmatched medical school graduates was covered in a second educational session featuring Geoffrey Young, PhD, program leader for the Association of American Medical College’s group on student affairs. Dr. Young presented data on recent trends in Match rates.</p> <p> Two reactors followed: Kathleen Kashima, PhD, senior associate dean of students at the University of Illinois College of Medicine, and Betty Drees, MD, AMA-SMS liaison to the AMA Council on Medical Education. The session highlighted ways to identify and mentor students at risk for not matching, assist students who do not successfully match and consider how holistic medical school admissions processes may ultimately help improve Match rates.</p> <p> The next meeting of the AMA-SMS is Nov. 13-14 in Atlanta, Georgia, in conjunction with the 2015 AMA Interim Meeting.</p> <p> The AMA-SMS is the AMA member section that represents all academic physicians, educators and faculty/leadership of U.S. medical schools. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page">Learn more</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:af03788f-3704-4f9e-8a32-e2e2e02537ee Meeting highlights from the AMA Senior Physicians Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-ama-senior-physicians-section Sun, 07 Jun 2015 00:06:00 GMT <p> The AMA Senior Physicians Section (SPS) sponsored an education program titled “The aging physician: Possibilities and perils” June 6 as part of its annual meeting in Chicago.</p> <p> The well-attended program featured Glen O. Gabbard, MD, clinical professor of psychiatry at Baylor College of Medicine. The moderator for the session was Barbara S. Schneidman, MD, from the AMA-SPS Governing Council, along with three reaction panelists: Louis J. Kraus, MD, from the AMA Council on Science and Public Health; David J. Welsh, MD, from the AMA Organized Medical Staff Section; and Lt. Col. Ronit B. Katz, MD, from the AMA International Medical Graduates Section. </p> <p> The program was facilitated by Nancy W. Dickey, MD, former AMA president and professor in the Department of Family and Community Medicine and the Department of Medical Humanities in the College of Medicine and professor in the Department of Health Policy and Management in the School of Public Health at Texas A&M’s Health Science Center.  </p> <p> Recent surveys of physicians indicate that late-career physicians, compared to those in early- or mid-career, are generally the most satisfied and have the lowest rates of distress. This education session explored the difficulties and gratifications of the golden years. Research on successful aging was considered and recommendations were offered.</p> <p> The AMA-SPS Governing Council also met June 5 to review resolutions and reports related to senior physician issues, including the AMA Council on Medical Education Report 5, “Competency and the aging physician.” The governing council also completed interviews of board candidates.</p> <p> During this year’s meeting, elections of committee officers were announced for the two officer-at-large positions: Angus M. McBryde, Jr., MD, from Columbia, S.C., and Barbara S. Schneidman, MD, from Seattle, Wash., were reelected.  Additionally, the AMA-SPS Governing Council held a roundtable discussion with the AMA Medical Student Section titled, “Medical student debt: If I knew then, what I know now,” which had topics chosen in advance by the medical students.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a170553d-454a-4046-aa09-f3e8dfc4aa67 Meeting Highlights from the AMA Resident and Fellow Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-ama-resident-fellow-section Sun, 07 Jun 2015 00:05:00 GMT <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section.page">AMA Resident and Fellow Section</a> (RFS) kicked off its meeting with a welcome reception, with more than 200 residents, fellows and medical students attending. Medical students had opportunities to ask residents and fellows about the transition to residency and becoming members of the section.</p> <p> The section hosted four educational sessions:</p> <ul> <li> A session on payment models and post-residency and fellowship plans, presented by the AMA-RFS Committee for Business and Economics, discussed the various payment models available after residency and fellowship, including reimbursement channels.</li> <li> The AMA-RFS Membership Committee gave a session on the benefits of AMA membership and highlighted involvement and leadership opportunities.</li> <li> Nicholas Yaghmour, a research associate with the Accreditation Council for Graduate Medical Education, presented an interactive session focused on the determinants of resident well-being and shared data from the 2013-2014 national survey on resident wellness.</li> <li> A panel discussion on physician well-being brought together a number of physicians in training and experts.</li> </ul> <p> The AMA-RFS Assembly passed 16 resolutions and four reports at its business meeting on June 6. One item on balloting procedures was referred for study. The section immediately forwarded four resolutions to the AMA House of Delegates:</p> <ul> <li> Resolution 6: Evaluation of Resident and Fellow Compensation Levels</li> <li> Resolution 16: Telemedicine in Graduate Medical Education</li> <li> Resolution 20: Principles of GME Funding Reform</li> <li> Resolution 21: Ethical Physician Conduct in the Media</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6d8b939e-4ba8-442b-ba72-7a05dad26dcf Meeting highlights from the AMA IMG Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-img-section Sun, 07 Jun 2015 00:05:00 GMT <p> The International Medical Graduates (IMG) Section celebrated its 18th year of the section’s annual meetings, beginning with a joint AMA-IMG Section and Minority Affairs Section Board of Trustees Candidates Forum on Friday.</p> <p> The section meeting on Saturday featured two excellent speakers. First, Lisa Cover, vice president of business operations at the Educational Commission on Foreign Medical Graduates (ECFMG), provided an update on the commission’s work.</p> <p> Next, Gamini Soori, MD, vice chair of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-long-range-planning-development.page">AMA Council on Long Range Planning and Development</a> gave a talk on a very timely topic: Graduate medical education in crisis. Members also discussed various AMA House of Delegates reports and resolutions, and several AMA-IMG Section representatives gave organizational reports.</p> <p> Members ratified the 2015-2016 AMA-IMG Governing Council, including:</p> <ul> <li> June-Anne Gold, MD, chair</li> <li> Lt. Colonel Ronit Katz, MD, immediate past chair</li> <li> Bhushan Pandya, MD, chair-elect</li> <li> Ved Gossain, MD, delegate</li> <li> Giovanni Campanile, MD, alternate delegate</li> <li> Rashi Aggarwal, MD, member at large</li> <li> Sumir Sahgal, MD, member at large</li> <li> Subhash Chandra, MD, resident/fellow member</li> </ul> <p> On Saturday evening, the section hosted its 9th Annual Desserts From Around the World Reception, which attracted more 400 attendees who enjoyed various international desserts and an energized performance by the Borozda dancers, a Chicago-based Hungarian dance troupe.</p> <p> On Monday, the meeting culminated with the Busharat Ahmad, MD, Leadership Development Program on “Loss of Physician Leadership in our Changing Health Care Environment and How to Increase Physician Satisfaction.” The three speakers included Christine Sinsky, MD, AMA vice president of <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">professional satisfaction</a> and two speakers from Evolent Health: Lisa Shah, MD, senior vice president of practice optimization and Lisa Sasko, vice president of physician alignment and program innovation.   </p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page?">AMA-IMG Section Web page</a> for more information or <a href="mailto:img@ama-assn.org" rel="nofollow">email the section</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:67a3008e-b6a6-427c-9687-fc6dcfd490ec Meeting highlights from LGBT Advisory Committee http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meeting-highlights-lgbt-advisory-committee Sun, 07 Jun 2015 00:05:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page" target="_blank">Advisory Committee on Lesbian, Gay, Bisexual and Transgender (LGBT) Issues</a> hosted a well-attended caucus and reception Friday evening in conjunction with the 2015 AMA Annual Meeting. </p> <p> After the networking reception, Gregory Blaschke, MD, chair of the committee, provided a brief update about the committee's activities and work, including:</p> <ul> <li> Securing renewal of the committee’s charter for another four years from the AMA Board of Trustees</li> <li> Providing input and comments on current health care issues such as opposing the lifetime blood donation ban for men who have sex with men, patient discrimination based on their LGBT status and the need to capture LGBT patient data within electronic health records</li> <li> Ensuring the AMA signing an amicus curiae related to the current Supreme Court of the United States same-sex marriage case </li> <li> Participating as commissioners in the Commission to End Health Care Disparities</li> </ul> <p> On the policy front, attendees discussed a resolution on military medical policies affecting transgender individuals. The event concluded with a lively educational session on what physicians and medical students need to know about the Association of American Medical Colleges’ core competencies on LGBT health, presented by Kristen Eckstrand, MD, and Brian Hurley, MD. To access resources about LGBT health and health care, visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page">LGBT Advisory Committee's Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:82f646b9-6e9d-47fc-8c7e-c464b259b4c8 Meeting highlights from the AMA Integrated Physician Practice Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_highlights-integrated-physician-practice-section-meeting-1 Sun, 07 Jun 2015 00:00:00 GMT <p> With record high attendance, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/integrated-physician-practice-section/about-us.page" target="_blank">Integrated Physician Practice Section</a> elected two new governing council members at its meeting:</p> <ul> <li> AMA-IPPS Delegate: Susan Pike, MD, Baylor Scott & White Health in Texas</li> <li> AMA-IPPS Alternate Delegate: Michael Glenn, MD, Virginia Mason Medical Center in Washington</li> <li> AMA-IPPS Chair: Tom Eppes, Jr., MD, Central Virginia Family Physicians</li> <li> AMA-IPPS Vice Chair: Peter Rutherford, MD, Confluence Health in Washington</li> </ul> <p> Members heard a <a href="http://www.ama-assn.org/ama/ama-wire/post/value-based-payment-isnt-skyrocketing-costs">discussion</a> focused on the move from fee-for-service to value-based payment with physician executive from Aetna, Charles Kennedy, MD, and a physician executive from a physician-led multispecialty group, Grace Terrell, MD.</p> <p> James L. Madara, MD, AMA executive vice president and CEO, and Donald Fisher, PhD, president and CEO of the American Medical Group Association, moderated the discussion.</p> <p> The AMA-IPPS sent a resolution to the AMA House of Delegates supporting value-based payments with the caveat that implementation timetables for these types of payment models take into account the physician community’s readiness to assume two-sided risk.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9eab2aaa-631e-471d-9837-39343d787720 Meeting highlights from the AMA Medical Student Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_highlights-medical-student-section Sun, 07 Jun 2015 00:00:00 GMT <p> Nearly 600 medical students attended this year’s National Medical Student Meeting, which took place June 4-6 in Chicago.</p> <p> The AMA Medical Student Section (MSS) meeting had something for medical students in each year of medical school, including a residency program director panel, mock residency interviews and discussions on student loans.  The section welcomed Raymond Urbanski, MD, founder and chief medical officer for BioPharma Consulting, for a presentation on why new pharmaceutical drugs are so costly. Students also heard from Vin Capone, development executive at Apple, for a talk on technology and medicine.</p> <p> At the 12th annual AMA-MSS Medical Specialty Showcase on Saturday, 43 specialty societies, 7 other medical fields, and 4 modes of practice represented in the AMA House of Delegates participated. Students received an introduction to these specialties and materials to help them make informed decisions about their careers.</p> <p> For the first time, the section hosted a clinical skills workshop, including airway management training, blood pressure checks, ultrasounds and suturing. </p> <p> The AMA-MSS considered 60 items of business and drafted a final reference committee report using testimony presented online via its Virtual Reference Committee.  This year’s meeting represented the third implementation of completely virtual testimony. The Virtual Reference Committee received more than 6,500 views and offered the opportunity for all medical student members to provide testimony on the items of business, regardless of whether they were able to attend the meeting.</p> <p> Finally, on Friday, nearly 50 medical students and physicians participate in a Doctors Back to School™ health and wellness event at Kozminski Community Academy and Daniel Hale Williams Preparatory School as part of the AMA-MSS national service project. Medical students and physicians educated Chicago-area students in fourth through eighth grade about entering the medical profession and making healthy lifestyle choices through fun, interactive games and activities.</p> <p> <strong>2015–2016 AMA-MSS Governing Council members:</strong></p> <ul> <li> William Pearce, University of South Florida, chair</li> <li> Jessica Peterson, Medical College of Wisconsin, vice chair</li> <li> Cameron Paterson, University of South Florida, delegate</li> <li> Kilby Osborn, Indiana University, alternate delegate</li> <li> Poornima Oruganti, Northeast Ohio Medical University, at-large officer</li> <li> Trishna Narula, Stanford University, speaker</li> <li> Theresa Phan, Texas Tech University, vice speaker</li> </ul> <p> Dina Marie Pitta, University of Wisconsin, will begin her term as medical student representative on the AMA Board of Trustees at the close of the 2015 AMA Annual Meeting.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6144add3-11a3-4145-bd4c-33d1d017d7a2 Meeting highlights from the AMA Organized Medical Staff Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_highlights-organized-medical-staff-section Sun, 07 Jun 2015 00:00:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section.page" target="_blank">Organized Medical Staff Section</a> (OMSS) held its 32st Annual Assembly Meeting June 4-6 in Chicago with more than 150 attendees. The section hosted five <em>AMA PRA Category 1 Credit™</em> education programs during the meeting:</p> <ul> <li> How physicians are leading for quality and safety</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-need-integrating-hospitals">Challenges when integrating</a> employed and independent physicians</li> <li> How to develop a robust medical staff <a href="http://www.ama-assn.org/ama/ama-wire/post/burnout-busters-boost-satisfaction-personal-life-practice">wellness program</a></li> <li> Ways that AMA advocacy efforts are giving physicians a voice in Washington</li> <li> An update on an AMA <a href="http://www.ama-assn.org/ama/ama-wire/post/three-ways-improve-physicians-professional-satisfaction">focus area</a>: Enhancing professional satisfaction and practice sustainability</li> </ul> <p> AMA President Robert M. Wah, MD, addressed the section Friday afternoon, where he thanked AMA-OMSS leadership for their role in crafting the AMA and American Hospital Association’s jointly developed “<a href="http://www.ama-assn.org/ama/ama-wire/post/6-characteristics-of-successful-physician-hospital-relationships">Principles of Integrated Leadership for Hospitals and Health Systems</a>.”  </p> <p> The AMA-OMSS Assembly considered 19 items of business, prompting robust discussion on a range of issues, including:</p> <ul> <li> The role of community physicians in medical staff governance</li> <li> Credentialing and privileging at critical access hospitals</li> <li> Physician-led team-based care</li> </ul> <p> The Section sent seven resolutions to the AMA House of Delegates for consideration at the 2015 Annual Meeting and issued 22 instructions to its delegate as to the positions the section should take on various items of interest to medical staff leaders and members.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e19a37c8-e204-4b8d-bc6b-a76d08198902 Meeting highlights from the AMA Women Physicians Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_highlights-women-physicians-section Sun, 07 Jun 2015 00:00:00 GMT <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section.page" target="_blank">AMA Women Physicians Section</a> (WPS) hosted its business meeting and reception, which featured a talk by Heidi Stensmyren, MD, president of the Swedish Medical Association.</p> <p> Dr. Stensmyren shared insights on issues related to women physicians and women’s health in Sweden. In addition, Carrie Butt, assistant editor of <em>JAMA</em>, gave a very informative talk on art in <em>JAMA</em>.</p> <p> The business meeting concluded with a review of the AMA House of Delegates Handbook and AMA-WPS items of business. The AMA-WPS Governing Council reviewed its positions on various items of business before the House of Delegates that focus on issues of concern to women physicians, medical students and patients.</p> <p> The AMA-WPS sponsored three resolutions that are being considered at this meeting. These include:</p> <ul> <li> Resolution 313: Human Trafficking Reporting and Education</li> <li> Resolution 512: Off-Label Use of Hormone Therapy</li> <li> Resolution 604: A New Definition of “Women’s Health”</li> </ul> <p> The AMA-WPS looks forward to its liaison meeting from 7-8 a.m. on Monday, June 8 in Skyway 269. Highly regarded by past attendees, this event will feature updates from around the country about what state and specialty medical societies are doing to address important issues related to women physicians.</p> <p> The WPS governing council also held elections for its officers. Josephine C. Nguyen, MD, was re-elected as chair and Ami A. Shah, MD was elected as vice chair.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fe16c91e-26dd-4d10-a641-7d6aab84c499 Meeting highlights from the AMA Young Physicians Section http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_highlights-young-physicians-section Sun, 07 Jun 2015 00:00:00 GMT <p> Young physicians from across the country discussed priority issues and worked on shaping AMA policy during this year’s AMA Young Physicians Section (YPS) Annual Meeting.</p> <p> The AMA-YPS adopted one resolution, “Transgenerational Effects of Environmental Toxins on Reproductive Health” that requests the National Institutes of Health conduct a study on this important issue. This resolution will be submitted at a future AMA House of Delegates meeting.</p> <p> After reviewing the House of Delegates handbook, the AMA-YPS Assembly identified items of particular relevance to the section and developed testimony for reference committee hearings and on the House floor. Details of all YPS positions can be found on the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section.page" target="_blank">AMA-YPS Web page</a>.</p> <p> The AMA-YPS C. Clayton Griffin, MD, Memorial Luncheon featured an interactive session with several companies from <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-taking-lead-health-technology">MATTER</a>, Chicago's new health care technology incubator that has partnered with the AMA.</p> <p> The assembly also held elections for the AMA-YPS Governing Council. Henry C. Lin, MD, was elected as chair-elect, Stefanie M. Putnam MD, was elected as alternate delegate and L. Shane Hopkins, MD, was elected as speaker.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:96c8591e-c852-4892-bde4-39606630cf99 Burnout busters: How to boost satisfaction in personal life, practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_burnout-busters-boost-satisfaction-personal-life-practice Fri, 05 Jun 2015 23:04:00 GMT <div> Burnout is an all-too-common problem among physicians, but that doesn’t mean the problem isn’t reversible. Here are expert-recommended solutions and wellness strategies to help improve physician satisfaction and resiliency. </div> <div>  </div> <div> Studies have shown that individuals with burnout and depression remain independently associated with liability lawsuits, higher rates of suicidal ideation, depersonalization, medical errors and sub-par patient care, Lotte Dyrbye, MD (pictured below), said during a presentation at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>. </div> <div>  </div> <div> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/10/9e62cce0-67bf-4752-9a4d-4fa2e3d3712b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/10/9e62cce0-67bf-4752-9a4d-4fa2e3d3712b.Large.jpg?1" style="margin:15px;float:right;" /></a>Dr. Dyrbye has studied burnout in medical education since 2004 and is a member of the consortium of 11 medical schools that are part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative. </div> <div>  </div> <div> Dr. Dyrbye urged physicians to understand the <a href="http://www.ama-assn.org/ama/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">key drivers for burnout</a> and then consider a “two-bucket” approach for addressing the issue in practice. </div> <div>  </div> <div> This first bucket of burnout solutions revolves around individual coping strategies physicians can implement to improve self-care and build resiliency, she said.</div> <div>  </div> <div> But solutions in the first bucket have to be paired with ones from the second bucket in order to produce long-term results.</div> <div>  </div> <div> “If you only talk about individual strategies, when you get back to your practice, you’re going to breed cynicism, and that can backfire. So [we have to] combine these personal strategies with discussions about the detrimental aspects of our work environments and wellness programs that will facilitate positive behaviors.” </div> <div>  </div> <div> <strong>Bucket No. 1: Taking personal responsibility for self-care, happiness </strong></div> <div> “Individuals who pursue hobbies and engage in things outside of medicine are not only less likely to develop burnout, but they are more likely to report higher quality of life, so it’s important to schedule that time … for the things that really matter,” Dr. Dyrbye said. </div> <div>  </div> <div> While balancing personal interests with the demands of practice can be difficult, she said even taking just one day a week to pursue a hobby can lower rates of depersonalization and keep physicians from the clenches of cynicism.  </div> <div>  </div> <div> Ways to boost your personal well-being include: </div> <div>  </div> <div style="margin-left:40px;"> •<strong><span class="Apple-tab-span" style="white-space:pre;"> </span>Set time each week to pursue a duty at your practice that you enjoy.</strong> “We all have that one thing we like to do at work, whether it involves patient care or something administrative,” Dr. Dyrbye said. “Individuals who find meaning in their work develop a higher sense of satisfaction and are less likely to burn out.” </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Actually take vacations. </strong>In previous research, Dr. Dyrbye said she was surprised to find that physicians left multiple days of vacation on their calendars in favor of prioritizing work over personal satisfaction—a practice that can kick burnout into overdrive.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Maintain a healthy diet and exercise. </strong>Dr. Dyrbye noted that physicians who are compliant with the Centers for Disease Control and Prevention’s aerobic guidelines are less likely to have burnout. </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Talk to your spouse.</strong> While <a href="http://www.ama-assn.org/ama/ama-wire/post/doctors-marry-doctors-exploring-medical-marriages" target="_blank">medical marriages</a> have their benefits, managing the potential stress of two physician workloads can be challenging. However, communication can help minimize work-home conflicts, one of the key drivers of burnout, Dr. Dyrbye said.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Avoid delayed gratification.</strong> This can begin as early as medical school and occurs when physicians routinely deny personal interests—like playing the violin or volunteering at an organization they enjoy—to pursue medicine, Dr. Dyrbye said. Avoid this by finding time for your hobbies now, instead of saving them for retirement. </div> <div>  </div> <div> <strong>Bucket No. 2: Establishing an environment of wellness </strong></div> <div> “There’s something about the work environment for those on the front lines of care, where tasks just seem to be increasing every day,” Dr. Dyrbye said. “And it’s really hard to find meaning in those tasks.”  </div> <div>  </div> <div> She recommends that hospitals and practices build supportive communities and wellness programs that meet these parameters: </div> <div>  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Offer honest discussions.</strong> “I find that sometimes there may be people who are already attempting wellness solutions, but they’re doing it in isolation,” Dr. Dyrbye said. “The first place any practice can start is by addressing burnout through discussions.” Doing so can help the organization understand how to coordinate efforts and resources. </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Encourage physicians to talk about medical errors.</strong> “We know that when doctors talk about medical errors, it can help prevent future errors and reduce inappropriate self-blame and distress,” she said. “Incorporate these discussions into your grand rounds or individual talks in your practice.” </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Build a wellness index or tool to help physicians properly assess their risks for burnout. </strong>Despite having the ability to assess patients’ needs, physicians often struggle to assess their own well-being and stress, Dr. Dyrbye said. </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> For instance, in a 2013 <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333681/" rel="nofollow" target="_blank">study</a> of 1,150 surgeons, surgeons’ personal assessment of well-being relative to colleagues was poor. Among the participants, 89 percent of surgeons believed their well-being was at or above average, including 70.5 percent with scores in the bottom 30 percent relative to national norms. But after receiving objective, individualized feedback based on the Mayo Clinic Physician Well-Being Index score, 46.6 percent of these surgeons indicated that they intended to make specific life changes.  </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> Establish a similar survey, tool or wellness index at your practice to help physicians and care staff assess their wellness needs and learn how to seek help. </div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span><strong>Develop flexible schedules.</strong> In hospitals and practices that are able, flexible work schedules and systems that facilitate handoffs can alleviate the “exorbitant responsibility to work around all hours,” she said. </div> <div>  </div> <div> Preventing physician burnout is a priority for the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, which aims to help physicians and their practices thrive so they can continue to put patients first. Stay tuned for more from <em>AMA Wire</em> about tools and approaches to help reduce burnout in your practice. </div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:539534b3-213b-4479-949f-e06ff6511685 What physicians need for integrating with hospitals http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-need-integrating-hospitals Fri, 05 Jun 2015 21:34:00 GMT <p> Physicians discussed the challenges they're experiencing firsthand with integrating into employed settings—and the potential solutions—during a panel discussion Friday at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>.</p> <p> John Flores, MD, an internist at a Texas medical clinic, thought joining a hospital group could help his practice run more smoothly.</p> <p> “When your cash flow is connected to a payment that might come in the next 30-60 days, and your bills are due today, it becomes very challenging,” Dr. Flores said. “And that's why I decided to talk to hospital groups.”</p> <p> But his experiences over the 18 months he's been employed haven't been what he expected.</p> <p> “I was hoping to experience a corporation who knew how to run a practice—electronic health records (EHR) issues, accounts payable issues,” he said. “I found it was very new to them, too.”</p> <p> For Dr. Flores, an important part of his job is communication with hospital leadership.</p> <p> “I have to work to get my point across to the hospital administration because they're outside my world,” he said. “They don't deal with the same kinds of problems I do.”</p> <p> <strong>Making physicians’ concerns heard</strong></p> <p> That type of communication is a key part of successful integration, said Kelly Guglielmi, MD, medical staff president at Advocate Christ Hospital Medical Center in Oak Lawn, Ill. She stressed the importance of a culture that gives physicians opportunities to voice their concerns and suggest solutions.</p> <p> “My role is to keep the voice at the table for [physicians],” she said. “And that's not always easy. The needs and wants are different … but if you're not part of the solution, you're part of the problem. I ask you to be at the table.”</p> <p> But it isn't always easy to actually get to the table, a problem some physicians raised. For example, when meetings are held during the day, physicians are taken away from their practices and must forego seeing patients, which can deter participation.</p> <p> Successful physician-hospital integration can remedy that, Dr. Kelly said. For instance, the hospital system where she works offers stipends to physicians who take time to sit on committees and develop programs.</p> <p> <strong>Challenges to successful integration</strong></p> <p> The challenges physicians discussed are familiar ones. <a href="http://www.ama-assn.org/ama/ama-wire/post/6-characteristics-of-successful-physician-hospital-relationships">New guidelines</a> from the AMA and the American Hospital Association (AHA) seek to address many of these issues with principles for building successful integrated leadership. This includes:</p> <ul> <li> Differing mindsets. Physicians and hospital administrators have different perspectives, and it can be difficult to have an understanding of, and respect for, each other's point of view.</li> <li> Lack of clarity on values. If physicians and hospital leaders are misaligned in the organization's values, both groups may be uncertain of what to expect from one another.</li> <li> Inadequate leadership and management skills. Physicians don't have business training, which can prevent them from fully participating in the business side of providing care.</li> </ul> <p> See the <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/ama-aha-integrated-leadership-principles.pdf">full list</a> (log in) of proposed solutions.</p> <p> The AMA-AHA guidelines are a positive start to increased communication and better integration, said Hoyt Burdick, MD, vice president and chief medical officer at Cabell Huntington in West Virginia.</p> <p> “We talk a lot about integrated practice, but nobody's talking about integrated leadership, and this is a breakthrough,” Dr. Burdick said. “You need to be at the table when these decisions are being made.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b7d0ce5f-1d09-4632-b62c-1ecb09b820c7 Food, health care groups commit to antibiotic best practices http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_food-health-care-groups-commit-antibiotic-practices Thu, 04 Jun 2015 21:34:00 GMT <p> A national forum to discuss responsible antibiotic use took place at the White House Tuesday, underscoring the importance of combating bacteria that have become resistant to drugs as a result of antibiotic overuse.</p> <p> The White House Forum on Antibiotic Stewardship brought together more than 150 food companies, retailers, government agencies, and human and animal health experts to exchange ideas for future antibiotic stewardship. Officials at the event discussed their plans to implement changes over the next five years that will help slow antibiotic-resistant bacteria and prevent the spread of infections.</p> <p> These discussions echo previous debates surrounding antibiotic overuse, which has been spurred by agriculturalists feeding livestock high quantities of antibiotics to prevent disease outbreaks and enhance growth. With little regulation or oversight, this excessive use of antibiotics has resulted in the development of dangerous microbes that no longer respond to antibiotics.  </p> <p> Misinformation about best practices for prescribing and using antibiotics also has contributed to the growth of these combative bacteria, according to <a href="http://www.ama-assn.org/ama/ama-wire/post/cdc-gives-ways-improve-antibiotic-use-hospitalized-patients" target="_blank">previous data</a> from the Centers for Disease Control and Prevention (CDC).</p> <p> But solutions are in the works. Here are some of the collaborative plans for antibiotic stewardship that stakeholders from Tuesday’s forum have committed to developing:</p> <ul> <li style="margin-left:0.25in;"> A partnership between the CDC and the Department of Health and Human Services (HHS) will provide <strong>data about antibiotic use and prescribing trends</strong>. This information is intended to help physicians improve antibiotic use and cut inappropriate prescribing by 50 percent in practices and 20 percent in hospitals.<br />  </li> <li style="margin-left:0.25in;"> <strong>Health care systems</strong> representing thousands of hospitals, long-term acute care facilities and skilled nursing centers plan to develop or expand <a href="http://www.cdc.gov/getsmart/healthcare/pdfs/core-elements.pdf" target="_blank" rel="nofollow">stewardship programs</a> to help improve antibiotic prescribing at their locations.<br />  </li> <li style="margin-left:0.25in;"> <strong>Major food producers</strong> have committed to phase out giving unnecessary antibiotics to animals, and food retailers have committed to offer more antibiotic-free options.<br />  </li> <li style="margin-left:0.25in;"> <strong>Drug stores and pharmaceutical companies</strong> plan to integrate the CDC’s stewardship principles into their programs that provide free or reduced-price antibiotics to patients.</li> </ul> <p> Long <a href="http://www.ama-assn.org/ama/pub/news/news/antibiotic-resistance-public-health.page" target="_blank">a champion of efforts to curb antibiotic overuse</a>, the AMA will make actionable findings from the study available to as many practicing physicians as possible.  An education session at the 2015 AMA Interim Meeting in November will focus on the problem of antimicrobial resistance and offer insights for promote antimicrobial stewardship. The AMA Council on Science and Public Health also plans to release a report on the topic at that time.</p> <p> <strong>Resources for hospitals to implement antibiotic stewardship programs</strong></p> <p> The CDC offers a <a href="http://www.cdc.gov/vitalsigns/antibiotic-prescribing-practices/" target="_blank" rel="nofollow">self-assessment checklist</a>  and an in-depth implementation document for hospitals. The Joint Commission provides a <a href="http://www.jointcommission.org/hai.aspx" target="_blank" rel="nofollow">health care-associated infections portal</a>, which has a number of free resources, including an <a href="http://www.jointcommission.org/topics/hai_antimicrobial_stewardship.aspx" target="_blank" rel="nofollow">antimicrobial stewardship toolkit</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:816c39e9-5b4d-4493-9c83-2b471cf032eb 3 ways to be a part of the action, from near or far http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-ways-part-of-action-near-far Thu, 04 Jun 2015 19:27:00 GMT <p> About 2,000 doctors and physicians in training are gathering June 4-10 in Chicago to weigh new AMA policy that will help forge a healthier nation for all Americans. Even if you’re not attending the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>, here’s how you can stay on top of hot news and be a part of important discussions.</p> <p> All the nation’s physicians will be represented via delegations from the 50 states, along with the District of Columbia, Guam, Puerto Rico and the Virgin Islands. In addition, other groups with one or more seats in the House of Delegates include the federal services (e.g., U.S. Air Force and Public Health Service), national medical specialty societies, professional interest medical associations, AMA sections and other groups.</p> <p> Make sure you’re part of this important meeting, whether you attend or not:</p> <ol> <li style="margin-left:0.25in;"> <strong>Keep on top of the latest policy news.</strong><br /> You can find meeting news in a variety of places. Beginning Friday night, look for <a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Meeting/1" target="_blank">daily updates</a> at <em>AMA Wire</em>®, and check the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">Twitter</a> (#AMAmtg) news feeds.<br />  </li> <li style="margin-left:0.25in;"> <strong>Participate in discussions of proposed policy.</strong><br /> Reference committee hearings allow AMA members to speak their minds about potential AMA policy. Even if you aren’t at the meeting, your voice can still make a difference. Take a look at <a href="http://www.ama-assn.org/sub/meeting/reportsresolutions.html" target="_blank">reports and resolutions</a> to be discussed and submit your comments digitally in the <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2014/reference-committee.page" target="_blank">Online Member Forums</a> (log in). Comment by close of business Saturday to make sure your remarks are included.</li> </ol> <p style="margin-left:.75in;"> Some of the topics up for discussion include:</p> <ul> <li style="margin-left:0.75in;"> Development of a single national prescription drug monitoring program</li> <li style="margin-left:0.75in;"> Data transparency principles to promote quality and care delivery innovations</li> <li style="margin-left:0.75in;"> Medical licensing issues faced by international medical graduates</li> <li style="margin-left:0.75in;"> Model guidelines for expansion of residency programs</li> <li style="margin-left:0.75in;"> Targeted pharmaceutical packaging to reduce drug overdose</li> </ul> <ol start="3"> <li style="margin-left:0.25in;"> <strong>Tell us why you love your specialty.</strong><br /> More than 500 medical student attendees will be at the AMA Medical Specialty Showcase. You can help them narrow their future choices by tweeting the reason you chose your specialty with the hashtag <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank">#ShadowMySpecialty</a>.</li> </ol> <p> If you are attending the meeting, make sure you:</p> <ul> <li style="margin-left:0.25in;"> Read the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">Speakers’ Letter</a> (log in) for everything you need to know.</li> <li style="margin-left:0.25in;"> Determine which <a href="http://www.ama-assn.org/sub/meeting/cme.html" target="_blank">continuing medical education</a> sessions to attend.</li> <li style="margin-left:0.25in;"> Download the <a href="http://www.ama-assn.org/sub/meeting/mobile.html" target="_blank">mobile app</a> to get the most up-to-date schedule during the meeting.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dbc3c881-8e1d-4a45-8f5a-9667c7a942db 5 effective ways to teach ethics in med ed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-effective-ways-teach-ethics-med-ed Wed, 03 Jun 2015 20:21:00 GMT <p> A recent report outlined the <a href="http://www.ama-assn.org/ama/ama-wire/post/top-10-ethical-issues-students-should-taught" target="_blank">top ethics issues students should learn</a>, but what are the best practices for teaching students these issues? Educators may have more options than you think. Read on for an expert-approved list of teaching methods and ideas.</p> <p> “There is no single, best pedagogical approach for teaching medical ethics and professionalism. Learning styles and institutional resources vary, so teaching methods need to be flexible and varied to reflect this diversity,” said authors of the <a href="http://journals.lww.com/academicmedicine/Citation/2015/06000/The_Essential_Role_of_Medical_Ethics_Education_in.19.aspx" rel="nofollow" target="_blank">Romanell Report</a> on ethics education, recently published in <em>Academic Medicine.</em></p> <p> To mitigate this issue, the report urges educators to consider approaches to teaching ethics that transcend basic instruction. Here are some effective methods that are becoming more common in medical school:</p> <ol> <li> <strong>A “flipped classroom” approach. </strong>Educators can “flip” the traditional class structure by offering content online. This allows students to watch lectures on their own and saves time for discussion and application of materials in class, the report authors said.<br />  </li> <li> <strong>Teaching the patient perspective. </strong>Presenting patient perspectives can help “illuminate issues of diversity” and “address the evolution of different worldviews on health and healing,” the report said. Here are <a href="http://www.ama-assn.org/ama/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">some innovative ways</a> schools already have helped students learn about diverse patient perspectives.<br />  </li> <li> <strong>Traditional lecture. </strong>This approach still is helpful, especially when discussing issues that lend themselves to various perspectives. For instance, educators can lecture on such topics as “sensitivity and responsiveness to a diverse patient population,” one of the Accreditation Council for Graduate Medical Education’s professional sub-competencies. Adding clinical cases or “trigger tapes” to lectures also can spark lively debate, according to the report.<br />  </li> <li> <strong>Exploring non-medical disciplines. </strong>“Whenever possible, medical ethics and professionalism instruction should involve collaboration among faculty from different disciplines.” This reinforces a team approach in clinical practice. In recent years, schools have incorporated applied art methods, such as improvisational theater exercises, comic drawings and creative writing in ethics education, according to the report.<br />  </li> <li> <strong>Writing it out. </strong>Invite learners to write reflective narratives about potential ethical cases they may encounter. Using this kind of “learner-driven” approach can help educators “move learners from knowledge acquisition and skills development to behavior change in which excellent patient care is the goal,” the report authors said.</li> </ol> <p> <strong>Additional ethics resources for physicians in training:</strong></p> <ul> <li style="margin-left:13.5pt;"> Follow the <em>AMA Journal of Ethics</em>, starting with <a href="http://journalofethics.ama-assn.org/" target="_blank">this month’s</a> issue, which examines <a href="http://www.ama-assn.org/ama/ama-wire/post/helping-patient-violate-professional-boundaries" target="_blank">the delicate balance</a> between a physician’s personal interest in patients and professional boundaries.</li> <li style="margin-left:15pt;"> Consult the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?" target="_blank"><em>Code of Medical Ethics</em></a><em> for current ethical opinions. </em></li> <li style="margin-left:15pt;"> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/lax-student-views-of-self-prescribing-impairment-tied-burnout" target="_blank">how burnout</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/student-sos-7-ways-avoid-distress-medical-school" target="_blank">distress</a> can impact students’ professional judgment.</li> <li style="margin-left:15pt;"> Read about the hotly contested issue of <a href="http://www.ama-assn.org/ama/ama-wire/post/should-physicians-google-patients" target="_blank">Googling patients</a>. This is one of two topics the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs.page" target="_blank">Council on Ethical and Judicial Affairs</a> also will discuss at its Open Forum at the 2015 AMA Annual Meeting in June.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:57ea79aa-05a9-4c44-a3bd-17076a6e6fe2 What residents really want in a future practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-really-want-future-practice Wed, 03 Jun 2015 20:19:00 GMT <p> As you prepare for life after residency, it’s important to ask yourself: What do I really want in a future practice? More than 1,000 residents answered that same question as part of a national survey, and the results were very telling. Find out what your colleagues really value when choosing where to practice, and see how you compare.</p> <p> Meritt Hawkins, a national health care consulting firm, recently released its <a href="http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/2014_MerrittHawkins_FYMR_Survey.pdf" rel="nofollow" target="_blank">2015 Survey of Final-Year Medical Residents</a> report. The survey, which aims to identify practice trends and career preferences that impact physicians at the end of training, was sent to more than 24,000 residents via email. Merritt Hawkins received 1,208 responses for a response rate of 5 percent.</p> <p> The firm offers these responses as a tool to help hospitals, health networks, medical groups and health care organizations recruit residents for future employment, according to the report.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/14/cb251132-f98e-4a02-9ed9-95f07072eb63.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/14/cb251132-f98e-4a02-9ed9-95f07072eb63.Large.png?1" style="margin:15px;float:right;" /></a></p> <p> When asked what was most important to them as they consider practice opportunities, residents ranked nine elements in order of importance. Here’s the list of practice must-haves and the percentage of respondents who selected these factors:  </p> <ol> <li style="margin-left:0.25in;"> Geographic location (69 percent)</li> <li style="margin-left:0.25in;"> Lifestyle (61 percent)</li> <li style="margin-left:0.25in;"> Adequate call hours and personal time (60 percent) </li> <li style="margin-left:0.25in;"> A good financial package (58 percent)</li> <li style="margin-left:0.25in;"> Proximity to family (48 percent)</li> <li style="margin-left:0.25in;"> Good medical facilities/equipment (48 percent)</li> <li style="margin-left:0.25in;"> Specialty support (32 percent)</li> <li style="margin-left:0.25in;"> Educational loan forgiveness (19 percent)</li> <li style="margin-left:0.25in;"> Low malpractice area (18 percent)</li> </ol> <p> The report authors note that the findings support the “common perception” that residents “have a specific location in mind for their first practice option” and that “this preference may override more practical considerations.” They urge residents not to overlook other important factors, such as payment options and community patient needs. </p> <p> <strong>Tell us:</strong> Do you agree with these “perceptions” about residents, and are there other factors that also impact your preferred practice? Share your thoughts in the comments below or on the <a href="https://www.facebook.com/amaresidentsandfellows?fref=nf" rel="nofollow" target="_blank">AMA Resident and Fellow Section Facebook page</a>.</p> <p> <strong>Looking for practical insights?</strong> If you’re transitioning to practice, also review <a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-resident-should-their-job-search" target="_blank">4 things every resident should know for their job search</a>, and stay tuned for more from <em>AMA Wire</em> on practice options after residency, part of our <a href="http://www.ama-assn.org/ama/ama-wire/blog/Life_After_Residency/1" target="_blank">series on life after residency</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4dc5f3ed-29c9-4457-8a71-107d6caf1f62 6 characteristics of successful physician-hospital relationships http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-characteristics-of-successful-physician-hospital-relationships Wed, 03 Jun 2015 15:25:00 GMT <p> For physicians who want to work in hospitals or health systems, or for those who are seeking to integrate their practices, the move can be confusing. New guidelines from the AMA and the American Hospital Association outline the six principles that enable successful integrated leadership.</p> <p> The <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/ama-aha-integrated-leadership-principles.pdf" target="_blank">Principles of Integrated Leadership for Hospitals and Health Systems</a> (log in), released Wednesday, can guide physicians on how to bring clinical skills and business insights together at the leadership level to foster more collaborative and cohesive decision-making at hospitals and health systems.</p> <p> “To lead the changes needed to move the health care system forward, many physicians and health care organizations may contemplate options for greater alignment and strong relationships to cultivate an environment centered on teamwork,” AMA President Robert M. Wah, MD, said in a statement.</p> <p> “The new principles support having more physicians in the boardroom and in key roles at the executive level so hospitals can succeed in the reformed models for health care delivery and payment,” Dr. Wah said.</p> <p> The six principles of success for integrated leadership between hospitals and physicians are:</p> <ol> <li style="margin-left:0.25in;"> <strong>Physician and hospital leaders who are united. </strong>Leadership should share similar values and expectations, and their financial and non-financial incentives should be aligned. Goals should be the same across the board, and responsibility should be shared for financial, cost and quality targets. Leaders in both spheres should be jointly responsible for strategic planning, management and engagement of patients as partners in care.<br />  </li> <li style="margin-left:0.25in;"> <strong>An interdisciplinary structure that supports collaborative decision-making.</strong> Physicians’ clinical autonomy must be preserved to ensure quality patient care while they work with others to deliver effective, efficient and appropriate care.<br />  </li> <li style="margin-left:0.25in;"> <strong>Clinical physician and hospital leadership present at all levels of the health system.</strong> All key management decisions should be made with representation from all clinicians, including nurses. Teams of clinicians and hospital or practice management administrators should lead together at every level of the health system, and should be accountable to, and for, each other.<br />  </li> <li style="margin-left:0.25in;"> <strong>A partnership built on trust. </strong>This sense of interdependence and working toward mutual achievement of the Triple Aim—better care, better health and lower costs—is crucial to alignment between and engagement with both physicians and hospital leaders. Those in clinical and hospital leadership positions also need to be able to trust each other’s good faith and abilities.<br />  </li> <li style="margin-left:0.25in;"> <strong>Open and transparent sharing of clinical and business information.</strong> Sharing data with all parties across the health system can improve care.<br />  </li> <li style="margin-left:0.25in;"> <strong>A clinical information system infrastructure that is useful.</strong> The system should capture and report key clinical quality and efficiency performance data. Physicians and other clinicians should be involved in technology decisions that will affect their day-to-day practice.</li> </ol> <p> In March, the AMA released its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/ama-rand-study.page" target="_blank">most recent study</a> with the RAND Corporation. The study investigated <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">physician experiences</a> with adopting health care delivery and payment reforms. The study made it clear that physicians aren’t alone in struggling with new payment models—other stakeholders, including hospitals and health systems, are experiencing the same challenges. By collaborating at the leadership level, physicians and health systems may find it easier to adopt new payment models.</p> <p> The study came out of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, which is helping physicians successfully navigate the health care environment by promoting sustainable practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3f20403f-eb98-41ae-a618-6ed0493948a1 IPAB repeal bill moves forward in House http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ipab-repeal-bill-moves-forward-house Tue, 02 Jun 2015 20:26:00 GMT <p> A bipartisan measure introduced by Rep. Phil Roe, MD, R-Tenn., to repeal the Independent Payment Advisory Board (IPAB), a controversial federal panel charged with reducing health care spending, Tuesday was approved by the U.S. House of Representatives’ Ways and Means Committee.</p> <p> The Affordable Care Act called for creating the 15-member IPAB to extend Medicare solvency and reduce spending growth by using a spending target system and fast-track legislative approval process. The yet-to-be-appointed board would reduce Medicare spending only by cutting payments to physicians and other health care providers.  The panel could not make changes in benefits or in patient cost sharing.</p> <p> “IPAB is a flawed policy, and the AMA has been advocating for the repeal of it since the ACA was passed,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-02-vote-repeal-ipab.page" target="_blank">statement</a>. “It would put significant health care payment and policy decisions in the hands of an independent body of individuals with far too little accountability. Additionally, IPAB’s arbitrary, annual cost-cutting targets would lead to short-term strategies that would threaten access to care for millions of Medicare patients across the country.”</p> <p> In March, the AMA <a href="http://www.ama-assn.org/ama/ama-wire/post/law-could-repeal-arbitrary-federal-panel" target="_blank">sent letters of support</a> for the legislation, likening the IPAB to Medicare’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/sgr-gimmick-holding-health-care-back" target="_blank">sustainable growth rate</a> (SGR) formula, which finally was <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repealed</a> in April. The letters called the IPAB “another arbitrary and rigid system that relies solely upon payment cuts.” The AMA also pointed to the SGR as a cautionary tale about policy decisions based on projections that require subsequent adjustments to reflect more accurate data.</p> <p> “Getting rid of IPAB will allow physicians and policymakers to focus on long-term efforts to improve care quality, improve health outcomes and make Medicare more sustainable while preserving access to care for seniors now and in the future,” Dr. Wah said.</p> <p> A budget offset for the cost of eliminating the IPAB has not yet been identified. The legislation could be scheduled for consideration on the House floor later in June.</p> <p> Learn more about IPAB at the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/independent-payment-advisory-board.page" target="_blank">Web page on advocacy</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:eb577ec2-0e49-406f-9f2b-b51f914cd954 Why CMS should stop Stage 3 of meaningful use http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-should-stop-stage-3-of-meaningful-use Tue, 02 Jun 2015 20:16:00 GMT <p> The Centers for Medicare & Medicaid Services’ (CMS) proposed modifications for Stages 1 and 2 of the meaningful use electronic health record (EHR) program <a href="http://www.ama-assn.org/ama/ama-wire/post/good-news-meaningful-use-realistic-requirements" target="_blank">offered some good news</a> for physicians—but CMS should stop there before moving forward with Stage 3, the AMA told the agency this week in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/mu-stage3-comment-letter-29may2015.pdf" target="_blank">comment letter</a> (log in).</p> <p> The notoriously burdensome program could undergo changes that will make it easier for physicians to achieve success through 2017. However, it will take time for those changes to take effect, which is one of the reasons the AMA is urging CMS to assess the impact of the proposed changes before implementing Stage 3 in 2018.</p> <p> About 80 percent of physicians already have incorporated EHRs into their practices, <a href="http://www.hhs.gov/news/press/2014pres/08/20140807a.html" rel="nofollow" target="_blank">according to</a> the U.S. Department of Health and Human Services Office of the National Coordinator for Health IT (ONC). At the same time, participation remains very low, the AMA said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-05-29-critical-changes-needed-meaningful-use-stage3.page" target="_blank">statement</a>.</p> <p> <strong>Medicare reform will affect the program</strong></p> <p> More time also is needed to assess the structure, requirements and impact of the new merit-based incentive payment system. Referred to as “MIPS,” this program will be created as a result of the Medicare Access and CHIP Reauthorization Act of 2015, which repealed the Medicare sustainable growth rate (SGR) formula.</p> <p> The current web of financial penalties under the Physician Quality Reporting System (PQRS), meaningful use and the value-based payment modifier will expire at the end of 2018 and will be replaced by the MIPS.</p> <p> <strong>Interoperability still a challenge</strong></p> <p> Many health IT systems obstruct interoperability through excessive vendor fees or technical limitations that hinder physicians’ ability to meet Stage 2 of meaningful use, according to a <a href="http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf" rel="nofollow" target="_blank">recent ONC report</a>. Without focusing on the <a href="http://www.ama-assn.org/ama/ama-wire/post/ehrs-talking-one-another-understanding" target="_blank">cornerstone issues</a> necessary for interoperability, the meaningful use program can’t be truly meaningful, the letter said.</p> <p> <strong>What to address if Stage 3 is rolled out</strong></p> <p> If the administration decides to proceed with Stage 3, the AMA’s recommendations include:</p> <ul> <li style="margin-left:0.25in;"> Making 2017 a transitional year to ease many of the concerns both vendors and physicians have regarding program updates, system changes and reengineering work flows</li> <li style="margin-left:0.25in;"> Implementing a reporting period that is less than a full year</li> <li style="margin-left:0.25in;"> Consulting physicians and vendors before removing or adding  measures</li> <li style="margin-left:0.25in;"> Heavily modifying the proposed objectives to align with the needs of medical specialists</li> <li style="margin-left:0.25in;"> Allowing quality measures reported to clinical registries to count for meaningful use quality-reporting requirements</li> </ul> <p> The AMA continues its aggressive push for solutions to the one-size-fits-all meaningful use program, as outlined in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint submitted to CMS</a> in October.</p> <p> In addition, the AMA is building on a new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">framework for EHR usability</a> that it recently developed with an external advisory committee of practicing physicians and health IT experts, researchers and executives. More than 30 physician groups also joined the AMA in recommending <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-outline-improvements-ehr-certification-process" target="_blank">three changes to improve the EHR certification process</a> to make it easier for physicians to use EHRs and care for patients.</p> <p> As a founding member of <a href="http://healthewayinc.org/" rel="nofollow" target="_blank">Healtheway</a> and <a href="http://healthewayinc.org/carequality/" rel="nofollow" target="_blank">Carequality</a>, two organizations working on factors such as patient matching and information exchange rules, the AMA will continue its work to resolve interoperability issues.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1d6485f-daad-46d0-ac81-cb54ee2c82ce Everything you need to know about MOC http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_everything-need-moc Tue, 02 Jun 2015 18:53:00 GMT <p> No matter what your feelings are about the maintenance of certification (MOC) process, you still may have unanswered questions. Here’s where you can learn some of the answers.</p> <p> MOC includes assessment, educational and practice improvement activities that physicians need to complete to become board certified by one of <a href="http://www.abms.org/member-boards/contact-an-abms-member-board/" target="_blank" rel="nofollow">24 member boards</a> of the American Board of Medical Specialties (ABMS). It is intended to support continuous professional development and improved patient care.</p> <p> If you have questions about MOC, here are some answers:</p> <p style="margin-left:.5in;"> <strong>How are board certification and medical licensure different?</strong></p> <p style="margin-left:.5in;"> While every physician must be licensed to practice medicine, board certification is a voluntary process. According to the ABMS, medical licensure sets the minimum competency requirements to diagnose and treat patients and is not specialty specific. Meanwhile, board certification is supposed to demonstrate a physician’s “exceptional expertise in a particular specialty and/or subspecialty of medical practice.”</p> <p style="margin-left:.5in;"> <strong>So it isn’t mandatory that a physician become board certified?</strong></p> <p style="margin-left:.5in;"> No, not technically. But some health plans implement programs that recognize and reward physicians who participate in MOC activities. Some health plans and health systems require board certification for credentialing to maintain hospital privileges. This causes problems for some physicians who may not maintain their board certification through MOC.</p> <p style="margin-left:.5in;"> <strong>Why is MOC such a hot topic?</strong></p> <p style="margin-left:.5in;"> Some physicians support MOC because they feel it improves physician knowledge and demonstrates a commitment to lifelong learning. Others criticize it because they feel it is expensive, burdensome and not relevant to their daily practice.</p> <p style="margin-left:.5in;"> <strong>How is the AMA involved?</strong></p> <p style="margin-left:.5in;"> The AMA has been urging the ABMS to improve MOC for physicians. For example, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page" target="_blank">Council on Medical Education</a> has been successful in helping shape the 2015 standards, which provide a more flexible framework for ABMS member boards to develop their own MOC programs.</p> <p style="margin-left:.5in;"> The AMA also is working with the ABMS to explore alternatives to the secure, high-stakes exam for assessing knowledge and cognitive skills, a major pain point for MOC critics. The AMA convened an <a href="http://www.ama-assn.org/ama/ama-wire/post/ama-abms-convene-stakeholders-discuss-moc-exam" target="_blank">unprecedented meeting</a> last year with the ABMS and other experts to discuss this issue. A white paper about the meeting and its next steps is forthcoming.</p> <p style="margin-left:.5in;"> As part of the 2015 AMA Annual Meeting next week, the Council on Medical Education is releasing a draft report that would ask the ABMS to develop fiduciary standards for its member boards, urging full transparency related to the costs of preparing, administering, scoring, and reporting MOC and exams.</p> <p style="margin-left:.5in;"> <strong>What are the 2015 standards?</strong></p> <p style="margin-left:.5in;"> The ABMS 2015 Updated Standards include language requiring each member board to continue evaluating their MOC program for effectiveness, costs and outcomes. The AMA has strongly urged the ABMS to be fully transparent in MOC-related costs, and the updated standards reflect that advocacy. The standards also focus on developing additional efficiencies to control costs for physicians.</p> <p style="margin-left:.5in;"> <strong>How much does MOC cost?</strong></p> <p style="margin-left:.5in;"> It depends. The participation fee, which includes the cost of continuing medical education (CME) and time away from practice, varies depending on which activities a physician participates in. Some may choose to spend more than the baseline fees.</p> <p style="margin-left:.5in;"> In its 2015 Standards for Programs for MOC, the ABMS recognizes that physicians have multiple expenses associated with ongoing learning and assessment, and the group is working with member boards to identify redundancies among multiple programs.</p> <p style="margin-left:.5in;"> <strong>Is there data that supports MOC?</strong></p> <p style="margin-left:.5in;"> The AMA Council on Medical Education believes that physicians generally recognize the need for MOC and ongoing formative assessment and feedback, and AMA policy reflects the need for ongoing learning and practice improvement. Studies show MOC is based on sound rationale, but there are differences of opinion about the ability of MOC to improve care and outcomes with how it has been.</p> <p style="margin-left:.5in;"> Last year, the AMA contacted two separate research centers to study the impact that MOC and maintenance of licensure requirements may have on the physician workforce, practice costs, outcomes, patient safety and access to care. The AMA was advised that data currently aren’t available to study these effects. The AMA Council on Medical Education is committed to continuous study of its evidence, which will be important in identifying improvements to the program.</p> <p style="margin-left:.5in;"> <strong>How does MOC work for physicians with multiple board certifications?</strong></p> <p style="margin-left:.5in;"> The ABMS launched its member board program to review MOC processes in 2015, which will allow the group to collect information on boards’ policies pertaining to multiple certifications.</p> <p style="margin-left:.5in;"> Meanwhile, the ABMS <a href="http://mocportfolioprogram.org/" target="_blank" rel="nofollow">Multi-Specialty MOC Portfolio Approval Program</a> offers a streamlined approach for hospitals and health care organizations to support physician involvement in quality improvement initiatives. The program allows physicians from multiple specialties to receive credit for team-based, multi-specialty projects that they already are doing at their organizations and apply it to MOC. Currently 19 member boards are participating in the portfolio program.</p> <p> The MOC process is expected to be hotly debated at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>. If you aren’t attending but still want your voice to be heard, visit the AMA <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/reference-committee.page" target="_blank">Online Member Forums</a> (log in). Any AMA member can comment on any item of business. While the forums will be open until the start of the meeting, comments posted after June 1 will not be captured in the comment summaries that will be posted on the <a href="http://www.ama-assn.org/sub/meeting/reportsresolutions.html" target="_blank">2015 AMA Annual Meeting website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b27bbf1c-defe-4a27-933e-9b4577178f4f Physicians coming together to improve nation’s health http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-coming-together-improve-nations-health Tue, 02 Jun 2015 18:49:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/7/34892807-6d21-4cec-975d-ea627833ff9f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/7/34892807-6d21-4cec-975d-ea627833ff9f.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> Later this week, I’ll be joining my colleagues from across the country in Chicago for four days of discussion, learning and policymaking at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>.</p> <p> This meeting promises to be brimming with hot topics that will benefit from all physicians’ voices. We’ll be discussing the benefits and drawbacks of maintenance of certification, potential solutions to the nation’s opioid epidemic, regulatory issues that detract from patient care, and a host of other topics.</p> <p> It’s important that you <a href="http://www.ama-assn.org/ama/ama-wire/post/weigh-medicines-important-issues">make your voice heard</a>—even if you won’t be in Chicago. This policymaking process is where positive changes in health care begin. When the voice of medicine comes together and works toward solutions for our patients, our profession and our nation, we become a powerful force for the future.</p> <p> In addition to policy discussion, we’ll be participating in a number of important education sessions. Many of this year’s offerings focus on practical advice that physicians can take with them and implement immediately, such as turnkey tools for improving hypertension control and preventing type 2 diabetes. <a href="http://www.ama-assn.org/ama/ama-wire/post/cme-sessions-look-timely-topics-moc-value-based-payment" target="_blank">Read about</a> the continuing medical education activities at <em>AMA Wire</em>®.</p> <p> I’m also excited about this year’s <a href="http://www.ama-assn.org/ama/ama-wire/post/events-residents-2015-ama-annual-meeting" target="_blank">programming for residents</a>. The focus will be on physician wellness, a topic very important to me as an educator and chair of the World Medical Association committee on the issue. From a session specifically designed to listen to residents’ concerns about burnout to a health panel of residents discussing how they stay healthy, attendees will leave armed with ways to better care for themselves.</p> <p> Medical students will have a <a href="http://www.ama-assn.org/ama/ama-wire/post/events-medical-students-shouldnt-miss" target="_blank">packed schedule</a> as well. Sessions will cover topics such as choosing a medical specialty, the best ways to repay medical school loans and addressing health challenges through technological innovation.</p> <p> One of the highlights of the meeting for me will be when my colleague and friend Steven J. Stack, MD, is inaugurated as the 170th president of the AMA. Last year around this time, I was giving my inaugural, driving home this truth: Tradition is important, but convention can hold us back. We must use tradition as a foundation to drive change and innovation.</p> <p> Over the past year, we did just that. We won major victories and we reached some <a href="http://www.ama-assn.org/ama/ama-wire/post/mapping-years-landmarks-medicine-advancing" target="_blank">important landmarks</a> in medicine, and I’m confident we will continue to do so in the year ahead.</p> <p> It’s been a true privilege to serve as president of the AMA, and I am proud of the strides we have made in improving the health of the nation.</p> <p> Stay in touch: I want to hear your ideas, comments and questions. Connect with me on Twitter (<a href="https://twitter.com/RobertWahMD" target="_blank" rel="nofollow">@RobertWahMD</a>). </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3e321ecb-fe38-4bb2-9e09-967e152c09ba What it’s like to be in family medicine: Shadowing Dr. Wergin http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-family-medicine-shadowing-dr-wergin Mon, 01 Jun 2015 19:17:00 GMT <p> As a student, do you ever wonder what it’s like to specialize in family medicine? Here’s your chance to find out.</p> <p> The family physician is a key player in primary care as the nation struggles with <a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill" target="_blank">a predicted shortage</a> of 46,000-90,000 physicians by 2025. An estimated12,000-31,000 of these physicians will be in primary care, <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" rel="nofollow" target="_blank">according to the Association of American Medical Colleges.</a></p> <p> These numbers have spurred <a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill" target="_blank">recent legislation</a> that could benefit students pursuing graduate medical education programs in primary care in the coming years, so if family medicine interests you, it’s a timely specialty to explore. Start by hearing what it’s really like to practice family medicine from a physician in the field.</p> <p> Meet Robert Wergin, MD, a family physician and president of the American Academy of Family Physicians (AAFP). Dr. Wergin is the latest featured physician in <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read his insights to help determine whether a career in family medicine is a good fit for you.</p> <p style="margin-left:40px;"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/4/e8ad8c50-8199-4c94-9445-7a390646339d.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/4/e8ad8c50-8199-4c94-9445-7a390646339d.Large.jpg?1" style="float:right;margin:15px;" /></a><strong>“Shadowing” Dr. Wergin</strong></p> <p style="margin-left:40px;"> <strong>Specialty:</strong><br /> Family medicine</p> <p style="margin-left:40px;"> <strong>Practice type:</strong><br /> Small practice in a rural community of about 2,000 people</p> <p style="margin-left:40px;"> <strong>A typical week:</strong><br /> I practice the full spectrum of primary care, from obstetrics to geriatrics, at Milford Family Practice Center. But my day doesn’t end there. I also provide emergency room coverage, hospital coverage and serve as the medical director of Crest View Care Center. I generally work 60-70 hours per week.</p> <p style="margin-left:40px;"> <strong>The most challenging aspect of caring for patients in family medicine is:</strong><br /> The most challenging aspect is definitely paperwork—particularly any paperwork that is unrelated to patient care.</p> <p style="margin-left:40px;"> <strong>The most rewarding aspect of caring for patients in family medicine is:</strong><br /> The most rewarding part is the relationship I have with my patients, and that outweighs all the challenges. As a family physician in a small town, I care for generations of families over the entire life span. I get to know people so well that I sometimes feel like I’m part of the family. I can’t tell you how fulfilling those relationships are.</p> <p style="margin-left:40px;"> <strong>Three adjectives to describe the typical physician in family medicine:</strong><br /> Caring. Comprehensive. Patient-centered.</p> <p style="margin-left:40px;"> <strong>How my lifestyle matches or differs from what I envisioned in medical school:</strong><br /> In medical school, I envisioned becoming an integral part of my community and working with patients to improve their health. Years later, I’m proud to say that I’m doing exactly that.</p> <p style="margin-left:40px;"> <strong>The main skills every physician should have for family medicine but won’t be tested for on the board exam:</strong><br /> A caring attitude and sense of altruism.</p> <p style="margin-left:40px;"> <strong>One question every physician in training should ask themselves before pursuing family medicine:</strong><br /> “What is going to make me feel happy and self-actualized?”</p> <p style="margin-left:40px;"> <strong>The three books I think every medical student interested in family medicine should read are:</strong></p> <ul style="margin-left:40px;"> <li> <em>Executive Strategies for Tough Times</em> by Donald T. Phillips</li> <li> <em>The Song of the Bird by </em>Anthony De Mello</li> <li> <em>The Tipping Point</em> by Malcolm Gladwell</li> </ul> <p style="margin-left:40px;"> <strong>If you want to learn more about family medicine, I also recommend students follow:</strong><br /> The AAFP’s website is a great resource for health care professionals. I especially like our Family Medicine SmartBrief, which is a free daily email newsletter that gives you a quick overview of the latest news in family medicine. </p> <p style="margin-left:40px;"> <strong>One thing students considering family medicine should remember:</strong><br /> Family physicians often practice late into life due to our love for the profession. Family medicine isn’t a job. It’s a passion.</p> <p style="margin-left:40px;"> <strong>If my life in family medicine were a song, it’d be:</strong><br /> “Imagine” by The Beatles.</p> <p> <strong>Want to learn more about family medicine and other specialty options? Don’t miss the specialty showcase June 6.</strong><br /> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/medical-specialty-showcase.page?" target="_blank">AMA’s Medical Specialty Showcase</a> will take place from 11:30 a.m. to 1:30 p.m. June 6 at the Hyatt Regency Chicago. A variety of specialties will be represented, and students can speak directly with physicians about their practices. Physicians also will share information about mentorship programs and organizations that can help students learn more about their preferred specialties.</p> <p> The showcase is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a>. Don’t miss out—<a href="https://login.ama-assn.org/account/login" target="_blank">register for the meeting</a> today (login), and find additional resources on choosing a specialty such as the <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.page?">AMA’s specialty resource guide</a>, which features overviews of the major specialties and subspecialties.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:95e44615-46ef-4174-a6ac-b9ff121ac2e5 What it’s like to be in pediatrics: Shadowing Dr. Meade http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-pediatrics-shadowing-dr-meade Mon, 01 Jun 2015 19:10:00 GMT <p> As a student, do you ever wonder what it’s like to specialize in pediatrics? Here’s your chance to find out.</p> <p> Pediatricians are key players in primary care, which is in serious need of patient care as the nation struggles with <a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill" target="_blank">a predicted shortage</a> of 46,000-90,000 physicians by 2025. An estimated12,000-31,000 of these physicians will be in primary care, <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" rel="nofollow" target="_blank">according to the Association of American Medical Colleges.</a></p> <p> Meet Elizabeth Meade, MD, a pediatrician and featured physician in <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read her insights to help determine whether a career in pediatrics is a good fit for you.</p> <p style="margin-left:40px;"> <strong>“Shadowing” Dr. Meade</strong></p> <p style="margin-left:40px;"> <strong>Specialty: </strong><br /> Pediatric hospital medicine</p> <p style="margin-left:40px;"> <strong>Practice type:</strong><br /> In a large multispecialty medical group, employed by a hospital</p> <p style="margin-left:40px;"> <strong>A typical week:</strong><br /> There really is no typical day or week for me. As a hospitalist, I work various shifts—days, nights and weekends—which means that every week is totally different. It also means that my schedule has a lot of flexibility and allows for lots of travel and other pursuits.<br /> <br /> A shift might include being on service at our main hospital taking care of 10-20 pediatric inpatients, or at a satellite location doing well newborn care, inpatients and ER consults. I also spend 25 percent of my time as teaching faculty for one of our family medicine residencies, so mornings are often spent doing teaching rounds with family practice residents on our pediatric ward.</p> <p style="margin-left:40px;"> <strong>The most challenging aspect of caring for patients in pediatrics:</strong><br /> The most challenging thing is working with patients who are very sick, and their families who are stressed, worried and sad. But actually, this is the most rewarding thing as well. Most pediatric patients get better. When they do and they are discharged home with their family [feeling] happy and healthy, there is no bigger joy.</p> <p style="margin-left:40px;"> <strong>Three adjectives to describe the typical physician in pediatrics:</strong><br /> Curious. Empathetic. Flexible.</p> <p style="margin-left:40px;"> <strong>How my lifestyle matches or differs from what I envisioned in medical school:</strong><br /> It’s generally much better than I thought it would be. A hospitalist schedule allows me flexibility to travel and take time off for other activities. I work really hard when I’m at work but feel like I can really disconnect when I’m not.</p> <p style="margin-left:40px;"> <strong>The main skills every physician should have for pediatrics but won’t be tested for on the board exam are:</strong><br /> The ability to be a savvy diagnostician, which really comes with experience, especially in pediatrics; flexibility and ability to “roll with the punches”; good bedside manner and skills with everyone from newborns to adolescents and their families/parents.</p> <p style="margin-left:40px;"> <strong>One question every physician in training should ask themselves before pursuing pediatrics:</strong><br /> Do I like only seeing sick children rather than well, and would I miss the continuity of a typical pediatric practice?</p> <p style="margin-left:40px;"> <strong>The books I think every medical student interested in pediatrics should read are:</strong></p> <ul style="margin-left:40px;"> <li> <em>The Spirit Catches You and You Fall Down </em>by Anne Fadiman</li> <li> <em>Complications</em> by Atul Gawande</li> <li> Read anything not about medicine. This will keep you well-rounded.</li> </ul> <p style="margin-left:40px;"> <strong>If you want to learn more about pediatrics, I also recommend students follow:</strong><strong style="font-size:12px;">One thing students considering pediatrics should remember:</strong><br /> The American Academy of Pediatrics <a href="https://www.aap.org/en-us/Pages/Default.aspx" rel="nofollow" target="_blank">website</a> has an incredible wealth of information about care of pediatric patients, careers and mentoring.</p> <p style="margin-left:40px;"> The best way to see what specialty might fit is to spend time with someone actually doing it. Go shadow someone doing this work!</p> <p style="margin-left:40px;"> <strong>If my life in pediatrics were a song, it’d be:</strong><br /> “<a href="https://vimeo.com/93466355" rel="nofollow" target="_blank">Crazy Babies</a>” by Ozzy Osbourne.</p> <p> <strong>Learn more from another pediatrician</strong><br /> Check out an additional profile of a practicing pediatrician in the “Shadow Me” Specialty Series: Learn more from <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-pediatrician-shadowing-dr-berkowitz" target="_blank">Carol Berkowitz, MD</a>.</p> <p> <strong>Want to learn more about pediatrics and other specialty options? Don’t miss the specialty showcase June 6.</strong><br /> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/medical-specialty-showcase.page?" target="_blank">AMA’s Medical Specialty Showcase</a> will take place from 11:30 a.m. to 1:30 p.m. June 6 at the Hyatt Regency Chicago. A variety of specialties will be represented, and students can speak directly with physicians about their practices. Physicians also will share information about mentorship programs and organizations that can help students learn more about their preferred specialties.</p> <p> The showcase is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a>. Don’t miss out—<a href="https://login.ama-assn.org/account/login" target="_blank">register for the meeting</a> today (log in), and find additional resources on choosing a specialty such as the <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.page?">AMA’s specialty resource guide</a>, which features overviews of the major specialties and subspecialties.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9366c4cd-2554-4545-aedd-9fc39e061889 6 things to know about Medicare’s claim data release http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-things-medicares-claim-data-release Mon, 01 Jun 2015 19:00:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) Monday released data on the medical services physicians provide and how much they are paid under Medicare Part B fee for service, marking the second annual release of individual physicians’ Medicare claims data. These resources can prepare you to talk with your patients and others about your data.</p> <p> Information that is a part of the data includes billed charges, Medicare payments and the number of different Medicare services provided in 2013. This year’s release also includes some trend data and state and specialty comparisons. For doctors who are receiving inquiries from patients or reporters about their charges or payments, giving a response that provides context for the data may be in order.</p> <p> While circumstances will vary on a case-by-case basis, here are some of the most important points to clarify:</p> <ul> <li> <strong>Medicare payments aren’t the physician’s personal income.</strong> These payments are practice revenues that must cover business expenses, including pay and benefits for practice staff, billing and other professional services, office rent, utilities, professional liability insurance, medical equipment and supplies.<br />  </li> <li> <strong>The majority of physicians don’t receive noteworthy Medicare payments.</strong> Although some attention-seeking news headlines may focus on sizeable pay-outs to individual physicians, the average physician doesn’t generate that much revenue from Medicare payments. In fact, 75 percent of physicians and other health care professionals receive less than $85,000 per year in Medicare payments, as reported in <a href="http://www.ama-assn.org/ama/ama-wire/post/3-things-need-medicares-claims-data-release" target="_blank">last year’s CMS data file</a>. The median payment amount was scarcely more than $30,000.<br />  </li> <li> <strong>Attribution issues could distort the data.</strong> Because the data is tied to the National Provider Identifier (NPI) under which the services were billed, some physicians who provide Medicare services may not be included in the data at all because their claims were filed using a group NPI. Other physicians may be included in the data release, but the services attributed to them may not reflect the care they actually gave because some of those services were reported using their group NPI. </li> </ul> <div style="margin-left:40px;"> In addition, residents, physician assistants, nurse practitioners and others under a physician’s supervision can all file claims under that physician’s NPI, which can make it appear that some physicians personally performed far more services than was actually the case.<br />  </div> <ul> <li> <strong>Physicians can’t correct errors in the data. </strong>It isn’t uncommon for Medicare’s database to list physicians with incorrect information, such as wrong addresses or specialties. As of right now, there is no mechanism for physicians to review and correct their information.<br />  </li> <li> <strong>Patients shouldn’t use the data to determine where they seek care.</strong> The data doesn’t include facility fees, which could change the amount ultimately paid by Medicare. Physicians who provide services in a hospital or hospital outpatient department are paid less by Medicare, but the hospital is also paid, making it seem as though care provided in these facilities is less expensive when in reality it could be more expensive.<br />  </li> <li> <strong>Remember:</strong> <strong>This isn’t a whole picture. </strong>The data is an incomplete representation of the services physicians provide. It also only includes Medicare data—nothing for private insurance or Medicaid patients. This means some physicians’ true experiences are underrepresented.</li> </ul> <p> In addition to the raw data, CMS also published some analyses, including regional utilization and specialties with the highest Medicare allowed amounts. Physicians should recognize that these analyses do not include quality information. They also show that a large portion of the costs are due to the costs of drugs, not earned physician income.</p> <p> Read the AMA’s <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-01-ama-statement-medicare-part-d-data-release.page">statement</a> and its <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-01-ama-guide-media-reporting-cms-medicare-data.page">guide to media reporting</a> on the data release.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:90d7f8c5-e214-4e63-86c6-6d794c517ce2 States that could save the most by reducing sodium intake http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_states-could-save-reducing-sodium-intake Sun, 31 May 2015 21:00:00 GMT <p> If everyone in your state reduced their sodium consumption by one-half a teaspoon, how much money could be saved?</p> <p> The Center for Science in the Public Interest’s (CSPI) <a href="http://www.cspinet.org/new/201505211.html" rel="nofollow" target="_blank">new analysis</a> of potential health care costs savings to be achieved by reducing sodium in the American diet shows annual savings ranging from $36 million for Wyoming to $2.4 billion for California.</p> <p> Americans currently consume about 3,500 milligrams of sodium per day—that’s about a teaspoon and a half of salt. The 2015 Dietary Guidelines Advisory Committee calls for a reduction to 2,300 milligrams a day. Excess sodium consumption can boost blood pressure, potentially leading to hypertension.</p> <p> The national health care costs for treating hypertension are enormous: Direct medical spending to treat hypertension totaled $43 billion in 2010, with almost one-half of that total in the form of prescription medications, according to the Agency for Healthcare Research and Quality. Previous research has estimated national medical savings ranging from $10 billion to $24 billion with a reduction of 1,200 milligrams in sodium intake per day (about one-half of a teaspoon of salt), according to the analysis.</p> <p> CSPI’s analysis adjusted for inflation and population growth to determine the state-by-state savings in health care costs that could be achieved as a result of the recommended sodium reduction.</p> <p> <a href="http://cspinet.org/images/sodium-reduction-costs.png" rel="nofollow" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/12/2cb0f142-1576-4fd6-9c2a-5b1aef5bc21c.Large.png?1" style="float:right;margin:15px;height:275px;width:365px;" /></a></p> <p> Four states stand to save more than $1 billion a year:</p> <ul> <li> $2.4 billion for California</li> <li> $1.6 billion for Texas</li> <li> $1.2 billion for Florida</li> <li> $1.2 billion for New York</li> </ul> <p> Eight other states would potentially save between $500 million and $1 billion:</p> <ul> <li> $787 million for Illinois</li> <li> $782 million for Pennsylvania</li> <li> $709 million for Ohio</li> <li> $617 million for Georgia</li> <li> $608 million for North Carolina</li> <li> $606 million for Michigan</li> <li> $546 million for New Jersey</li> <li> $509 million for Virginia</li> </ul> <p> The findings echo a call from the Institute of Medicine’s 2010 report that asked the U.S. Food and Drug Administration to reduce sodium in the food supply in a gradual manner.</p> <p> The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative seeks to address heart disease by reducing the incidence of uncontrolled hypertension, in part by advocating for improved dietary guidelines for Americans. The AMA sent a letter last month in support of the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion’s 2015 dietary guidelines, which stress consumption of whole foods, reduced consumption of added sugars and sugar-sweetened beverages, and accessibility of healthy foods and beverages.</p> <p> Physicians can take action to improve health outcomes and lower costs associated with high blood pressure by taking practical steps with their patients. Start with these resources:</p> <ul> <li> Read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">three questions you should ask patients</a> when measuring their blood pressure.</li> <li> Hear <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-saying-doing-control-hypertension" target="_blank">what other physicians are doing</a> to control hypertension in their practices.</li> <li> See how you can <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring">help patients manage blood pressure outside of office visits</a>.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2f1c60ff-e77e-46fe-bbe2-0f6299548a42 Supreme Court rules against delayed lawsuits, damages http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_supreme-court-rules-against-delayed-lawsuits-damages Fri, 29 May 2015 19:56:00 GMT <p> Physicians who provide services under Medicare and other federal health care programs won’t face the possibility of civil lawsuits being brought against them for an unlimited period, thanks to a recent decision by the Supreme Court of the United States.</p> <p> In <em>KBR v. United States of America Ex Relator Benjamin Carter</em>, petitioners sought to overturn earlier court decisions that would eliminate the existing six-year limit on damage claims under the federal False Claims Act. The U.S. Supreme Court ruling last week maintains the six-year limitation on damage claims—including those brought by “qui tam” plaintiffs who file lawsuits on behalf of the government—under the False Claims Act.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/3/74bc48cb-951f-40ff-b31b-d456a18b5d2a.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/3/74bc48cb-951f-40ff-b31b-d456a18b5d2a.Large.jpg?1" style="float:right;margin:15px;" /></a>The ruling is significant because the False Claims Act, a Civil War-era statute, often is used to raise inappropriate claims against businesses, hospitals and other health care providers. The outcome of the court’s decision affects lawsuits brought by parties on behalf of the government for services provided under federally funded health care programs.</p> <p> In a friend-of-the-court brief filed last year, the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?" target="_blank">Litigation Center of the AMA and State Medical Societies</a> pointed out that if the statute of limitations were removed, physicians could be “forced to defend against stale, repetitive and frequently meritless claims.” This task would require significant costs in maintaining records for an indefinite period, planning for unknown contingencies and defending against inappropriate suits.</p> <p> The AMA long has expressed concern over ambiguities in the False Claims Act and previously has filed several court briefs reflecting concerns over this law.</p> <p> Last year, physicians reaffirmed AMA policy recognizing the False Claims Act is often disproportionately applied to physicians. The policy calls for the AMA to lobby for modification or repeal of the False Claims Act and similar statutes.</p> <p> Under the federal False Claims Act, the penalty for each claim is between $5,000 and $10,000, adjusted for inflation, plus three times the amount of damages “sustained by the federal government.” If information was misrepresented on multiple Medicare claims, for instance, penalties would apply to each claim—regardless of how small the billed amount was.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/false-claims-act.page?" target="_blank">Read more</a> about this case and other cases related to the False Claims Act at the Litigation Center Web page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:770935ff-e76b-4529-bc9c-db1af501db52 The top 10 ethical issues students should be taught http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_top-10-ethical-issues-students-should-taught Thu, 28 May 2015 21:56:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/5/f81fe553-fac0-4807-9516-66ab83d712a7.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/5/f81fe553-fac0-4807-9516-66ab83d712a7.Large.jpg?1" style="float:right;margin:15px;" /></a></p> <p> Ethics can impact <a href="http://www.ama-assn.org/ama/ama-wire/post/teach-medical-students-feel-like-physicians" target="_blank">the professional and personal development of students</a>, but what are the specific present-day issues educators should prepare them for as future physicians? If you’re searching for concrete insights, look no further. An infographic breaks down the top ethical issues researchers suggest physicians in training learn right now. <br /> <br /> Although there isn’t one single approach to teaching ethics and professionalism, students must understand ethical standards and how they meet them in practice while they’re still in school. That’s where modernizing ethics education becomes valuable. Enter the <a href="http://journals.lww.com/academicmedicine/Abstract/publishahead/The_Essential_Role_of_Medical_Ethics_Education_in.98809.aspx" rel="nofollow" target="_blank">Romanell Report</a> on medical ethics education, recently published in <em>Academic Medicine</em>.</p> <p> The report creates a more comprehensive list of 26 proposed objectives for present-day medical school and residency training programs. Some objectives expound on common principles in medicine—like protection of patient privacy and disclosure of information to patients—while others offer moral considerations beyond the typical “patient-physician dyad,” according to the report’s authors.</p> <p> Here are some of these more emerging ethical issues for students to explore. (Also check out the <em>AMA Code of Medical Ethics</em> for in-depth policies on each topic).</p> <ul> <li style="margin-left:0.25in;"> Self-awareness, including professional identity and self-care (see the <em>Code</em> on <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion90305.page" target="_blank">physician health and wellness</a>)</li> <li style="margin-left:0.25in;"> Social media (see the <em>Code on </em><a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page?" target="_blank">professionalism in the use of social media</a>)</li> <li style="margin-left:0.25in;"> Concerns about colleagues’ impairment, incompetence and mistakes (see the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/principles-medical-ethics.page" target="_blank"><em>Principles of Medical Ethics</em></a> and the <em>Code </em>on <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9031.page" target="_blank">reporting impaired, incompetent or unethical colleagues</a>)</li> <li style="margin-left:0.25in;"> Medical trainee issues, including disclosure of student status, the tension between education and best care for patients, the hidden curriculum, and moral distress (see the <em>Code </em>on <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8087.page" target="_blank">medical student involvement in patient care</a>)</li> <li style="margin-left:0.25in;"> Acceptance of gifts from patients and grateful patient philanthropy (see the <em>Code </em>on<a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion10017.page?" target="_blank"> gifts from patients).</a></li> <li style="margin-left:0.25in;"> Assessment of patient decision-making skills, especially related to surrogate decision making</li> <li style="margin-left:0.25in;"> Cross-cultural competencies and health disparities (see the <em>Code </em>on <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9121.page" target="_blank">racial and ethnic disparities in health care</a>)</li> <li style="margin-left:0.25in;"> How to manage conflicts of interest versus obligations in education, clinical practice and research (see <em>Code</em> on such relevant topics as  <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion803.page" target="_blank">guidelines for conflicts of interest</a>, <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8031.page" target="_blank">conflicts of interest in biomedical research</a>, managing <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion80315.page" target="_blank">conflicts of interest in the conduct of clinical trials</a> and <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion90115.page?" target="_blank">financial relationships</a> with industry in continuing medical education)</li> <li style="margin-left:0.25in;"> Maternal-fetal medicine, including reproductive technologies and termination of pregnancy</li> <li style="margin-left:0.25in;"> Role of health professional’s personal values in the clinical encounter</li> </ul> <p> The report also urges educators to consider new approaches to teaching ethics that transcend basic instruction. Schools “must strive to move learners from knowledge acquisition and skills development to behavior change in which excellent patient care is the goal,” the authors said.</p> <p> For instance, employing role-play scenarios for students to test their decision-making skills or creating online courses using a “flipped classroom” approach (in which students watch lectures online on their own, saving class time for discussion and application of the material) are helpful methods to try, according to the report. Stay tuned for more on strategies and teaching methods for medical education ethics at <em>AMA Wire</em>®.</p> <p> <strong>Additional information on ethics in training:</strong><br /> Follow the <em>AMA Journal of Ethics</em>, starting with <a href="http://journalofethics.ama-assn.org/" target="_blank">this month’s</a> issue, which examines <a href="http://www.ama-assn.org/ama/ama-wire/post/helping-patient-violate-professional-boundaries" target="_blank">the delicate balance</a> between a physician’s personal interest in patients and professional boundary guidelines.</p> <ul> <li style="margin-left:0.25in;"> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/lax-student-views-of-self-prescribing-impairment-tied-burnout" target="_blank">how burnout</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/student-sos-7-ways-avoid-distress-medical-school" target="_blank">distress</a> can impact students’ professional judgment.</li> <li style="margin-left:0.25in;"> Read about the hotly contested issue of <a href="http://www.ama-assn.org/ama/ama-wire/post/should-physicians-google-patients" target="_blank">Googling patients</a>. This is one of two topics the Council on Ethical and Judicial Affairs will also discuss at its Open Forum at the AMA Annual Meeting in June. </li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0e6b0ef4-5b02-493b-bac0-cc675f2ae06a ACGME seeks to transform residency to foster wellness http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_acgme-seeks-transform-residency-foster-wellness Thu, 28 May 2015 15:00:00 GMT <p> Research confirms that <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-real-reason-residents-burn-out-tell">burnout impacts nearly every aspect of residency</a>, but how can programs actually help residents improve quality of life in training? <em>AMA Wire<sup>®</sup></em> spoke to Timothy Brigham, PhD, senior vice president of the department of education and chief of staff at the Accreditation Council of Graduate Medical Education (ACGME), about the organization’s efforts to support resident wellness and why an answer to that question requires a collaborative plan. Here’s where he says the real solution begins.</p> <p> <strong>Q: In November 2015 the ACGME will convene a conference on physician well-being. What made the ACGME decide to pursue this issue?</strong><strong>Brigham</strong>: Last summer, the tragic suicides of three residents within a few weeks of each other prompted the ACGME Resident Council and Board of Directors to focus on the issue of physician well-being. Our focus includes building resiliency; recognizing stress, depression and burnout; creating interventions to promote well-being; and learning from the experience of the tragedy to help other grieving communities manage their grief.</p> <p> <strong>Q: Since launching this project, has the ACGME found any data that really surprised you?</strong><br /> <strong>Brigham: </strong>Yes. For one, it appears that when people enter medical school on the first day of orientation, they are psychologically healthier than their same-age cohorts. But after they enter training, their depression and burnout rates increase compared to their peers.</p> <p> So, it appears we’re taking a group of psychologically healthy people, and <a href="http://www.ama-assn.org/ama/ama-wire/post/student-sos-7-ways-avoid-distress-medical-school">something happens to them in training</a>. It also appears that physicians in training commit suicide at a lower rate than their same-age cohorts. Outside of medicine, however, practicing physicians commit suicide at a higher rate than people in any other profession.</p> <p> Statistics show that about 400 physicians a year are estimated to commit suicide. Let’s put that in perspective: That means one physician a day, or roughly three average-sized medical school classes.</p> <p> What we’ve been trying to figure out now is: While the rate of suicide may be lower for residents compared to their same-age cohorts, are we planting the seeds in training that come to negative fruition in practice?</p> <p> While the tragic suicides of the three residents were the initial impetus for our efforts, we plan to broaden our focus to all aspects of physician well-being.</p> <p> <strong>Q: Considering the complexity of the problem, are there any actionable solutions for physicians and program directors to consider? And if so, which are top-of-mind for the ACGME?</strong><br /> <strong>Brigham:</strong> Right now, the ACGME has decided to host a working conference that’s designed to understand the scope of the problem and begin discussing solutions. It’s not a conference for people to gather, hear some interesting and empowering speeches, and go home. Instead, we are inviting 100-120 people including residents, physicians and professional from other fields to propose solutions.</p> <p> What we want to do is understand the problem and give recommendations to the ACGME board about what the ACGME can do in the realm of its responsibility. For instance, we may recommend modifications to GME requirements, milestones, and other career and educational factors that the ACGME oversees.  <br /> <br /> We’d also like to build collaborative opportunities—let’s say between the AMA, ACGME, AAMC and others, for instance—to make sure we’re taking the most comprehensive approach to improving wellness.<br /> <br /> This conference is really a launch for solutions and not a stand-alone event. We’re looking for transformative cultural change at an institutional and national level. We also plan to examine practices from other organizations outside of medicine to see what lessons we can learn for physicians to share with each other. Burnout and physician suicides are really sobering, sad topics, but we hope to learn from these tragedies to make life better for residents and faculty members.  </p> <p> <strong>Q: Do you think there is a stigma around mental health in medicine? If so, how can programs and schools work together to help reduce this for physicians in training?</strong><br /> <strong>Brigham:</strong> There are a number of variables at play. There’s a stigma attached to admitting vulnerability because no one wants to be considered a problem. For many residents and faculty members, there’s an assumption that if you’re a physician, you have to transcend what a normal human being can do. There are also licensure issues, and some residents have concerns that if they seek psychological treatment, they’ll put their entire careers in jeopardy.</p> <p> And in terms of how schools and programs can destigmatize this—that’s the golden question we’re looking to answer at the conference. This will take a constellation of efforts.</p> <p> This has to be collaborative change. We—as a collective community in medicine—have to come together to help move the needle forward.</p> <p> <strong>Residents: Voice your concerns and be a part of the solution, too.</strong><br /> The AMA is offering three ways residents can help improve the residency environment to better promote the wellness of physicians in training.</p> <p style="margin-left:.75in;"> 1. <strong>Tell the ACGME what you think. </strong>Attend the education session “Taking the pulse of trainees” from 1:30 to 2:30 p.m. June 5 as part of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/rfs-meetings.page?" target="_blank">Resident and Fellow Section (RFS) Annual Meeting</a> at the Hyatt Regency Chicago.<br /> <br /> A representative from the ACGME will present data on determinants of resident well-being from the organization’s 2013–2014 national survey data.<br /> <br /> By attending, you’ll have a chance to tell the ACGME face to face how to improve its survey methods, better train physicians in graduate medical education programs to support residents and identify solutions that matter to you.</p> <p style="margin-left:.75in;"> 2. <strong>Weigh in at a resident health panel at 8:45 a.m. June 6.</strong> Residents who are attending the annual meeting in Chicago can join a discussion with their peers and speakers about innovative solutions to physician wellness. Can yoga or dance help residents avoid burnout? Attend the panel to find out and share your own creative ideas.</p> <p> Also, review the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-things-institutions-can-prevent-resident-burnout" target="_top">5 things institutions can do to prevent resident burnout</a>, and educate yourself on the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">signs of burnout</a> to maintain better wellness. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:db754b4d-15dc-4303-91fe-2c8d18892fbf Get your practice in line with current coding needs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_practice-line-current-coding-needs Wed, 27 May 2015 21:57:00 GMT <p> Do you have what you need for accurate coding? Get your coding skills in gear with current resources.</p> <p> Save 40 percent at the AMA Store on <a href="https://commerce.ama-assn.org/store/content/2015-annual-codebooks?node_id=2015-annual-codebooks">2015 annual resources</a>.</p> <p> Prepping for ICD-10? Use the following:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480009&navAction=push">ICD-10-PCS 2015</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480010&navAction=push">ICD-10-CM 2015</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480013&navAction=push">ICD-10-CM Documentation 2015</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480012&navAction=push">Advanced Anatomy and Physiology for ICD-10-CM/PCS 2015</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480011&navAction=push">ICD-10-CM Mappings 2015</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500001&navAction=push">ICD-10-CM 2015 Express Reference Mapping Cards</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500002&navAction=push">Electronic ICD-10-CM 2015 Express Reference Mapping Cards</a></li> </ul> <p> There also are two CPT® resources on sale, including:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480008&navAction=push">CPT 2015 Professional Edition</a></li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480006&navAction=push">CPT Changes 2015</a></li> </ul> <p> AMA members receive an additional discount on these products. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p> This promotion is available for customers that purchase from the AMA directly (excludes wholesalers, resellers and bookstores), is valid only on the products listed directly above, and expires May 31. No promo code necessary. Prices as marked. The code cannot be combined with other promotions or packages.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f162e548-e37d-4aab-8aca-611e7fdfef76 Some good news for meaningful use: More realistic requirements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_good-news-meaningful-use-realistic-requirements Wed, 27 May 2015 19:36:00 GMT <p> The Centers for Medicare & Medicaid Services' (CMS) proposed modifications to the meaningful use electronic health record (EHR) system program will make it easier for physicians to achieve success, the AMA this week told the agency in a <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/meaningful-use-comment-letter-20may2015.pdf" target="_blank">comment letter.</a> Here’s how the modified version stacks up to the original—and what it means for you.</p> <p> CMS released its proposed changes to Stages 1 and 2 of the notoriously burdensome program April 15. The changes reflect <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/digital-health/medicare-medicaid-incentive-programs.page" target="_blank">recommendations</a> the AMA has been making for years, such as adding flexibility and lessening penalties.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/4/27d0c782-1ab1-4f08-b4e2-67b777c4b16f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/4/27d0c782-1ab1-4f08-b4e2-67b777c4b16f.Full.jpg?1" style="width:525px;height:500px;margin:15px;float:right;" /></a></p> <p> Look right for the key proposed changes you should know:</p> <p> About 80 percent of physicians already have incorporated EHRs into their practices, <a href="http://www.hhs.gov/news/press/2014pres/08/20140807a.html" rel="nofollow" target="_blank">according to</a> the U.S. Department of Health and Human Services Office of the National Coordinator for Health IT. This proves physicians are on board with new technologies that can strengthen the physician-patient relationship and make them more efficient, said AMA President-elect Steven J. Stack, MD, in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-05-20-cms-proposed-modifications-meaningful-use.page" target="_blank">statement</a>.</p> <p> “However, physicians have faced significant barriers in participating in the meaningful use program and many are receiving penalties despite their investments in those types of innovations,” Dr. Stack said. “We believe CMS’ proposal offers common sense solutions that, if finalized quickly, will help more physicians use EHRs in a truly meaningful way while supporting patient engagement.”</p> <p> According to CMS data released in mid-December, about one-half of eligible professionals will face payment penalties next year because they could not fulfill meaningful use requirements. Only about 9 percent of physicians and other eligible providers had attested to Stage 2 of meaningful use in 2014, highlighting the difficulty of the program.</p> <p> <strong>Changes good but should go farther</strong></p> <p> The AMA offered more recommendations for CMS to consider before it publishes its final rule on the matter late this summer, including:</p> <ul> <li style="margin-left:21pt;"> Establishing a reporting period of less than 365 days for 2016 and 2017.</li> <li style="margin-left:21pt;"> Allowing accommodations for new participants in 2016 and 2017.</li> <li style="margin-left:21pt;"> Making electronic reporting to public health agencies optional.</li> <li style="margin-left:21pt;"> Adding hardship exemptions for physicians who experience such difficulties as switching EHRs, system downtime, cyber attacks and other circumstances that could prevent them from achieving meaningful use.</li> </ul> <p> The AMA urged CMS to publish a final rule “as quickly as possible to instill confidence in the program.” The deadline for groups to submit comments on the rule is June 15.</p> <p> The AMA continues its aggressive push for solutions to the one-size-fits-all program, as outlined in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint submitted to CMS</a> in October.</p> <p> In addition, the AMA is building on a new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">framework for EHR usability</a> that it recently developed with an external advisory committee of practicing physicians and health IT experts, researchers and executives. More than 30 physician groups also joined the AMA in recommending <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-outline-improvements-ehr-certification-process" target="_blank">three changes to improve the EHR certification process</a> to make it easier for physicians to use EHRs and care for patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed4ab988-6d13-422e-8412-7995cdb79c1a The best tips and resources for every stage of med school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tips-resources-stage-of-med-school Wed, 27 May 2015 19:13:00 GMT <p> It’s that time of year: Classes have ended, the sun is out and students are poised for change. But new transitions also require new adjustments. No matter what year of training you’re in, as you move through medical school, here are some of the top resources you’ll want to take with you.</p> <p> <strong>Prepping for the USMLE</strong><br /> You may feel stressed as you prepare to take the United States Medical Licensing Exam (USMLE) Step 1, but not to worry—use this advice to make the most of your preparation:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/studying-usmle-step-1-watch-out-4-mistakes" target="_blank">4 mistakes to avoid while studying</a></li> <li> The <a href="http://www.ama-assn.org/ama/ama-wire/post/definitive-usmle-step-1-study-guide-here" target="_blank">definitive USMLE Step 1 guide</a></li> </ul> <p> <strong>Managing finances in school</strong><br /> The cost of medical education is high, but that doesn’t mean you have to be crushed by debt. Save money with these resources and tips:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/five-ways-manage-student-debt" target="_blank">5 ways to manage student debt</a></li> <li> The AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/ama-financial-aid.page" target="_blank">financial aid Web page</a> lists helpful information about rewards, scholarships and debt management.    </li> </ul> <p> <strong>Staying happy and healthy</strong><br /> We know classes and rotations are very demanding. But try not to let the pressures of training make you neglect your personal relationships or well-being. Here are some must-reads to help you avoid burnout and maintain good health in training:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/student-sos-7-ways-avoid-distress-medical-school" target="_blank">Student SOS: 7 ways to avoid “distress” in medical school</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/fit-wellness-busy-schedule" target="_blank">How to fit wellness into your busy schedule</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/4-tips-communicating-medical-student" target="_blank">4 tips for communicating with a medical student</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/volunteering-made-doctors-students-happier-healthier" target="_blank">How volunteering has made doctors, students happier and healthier</a></li> </ul> <p> <strong>Choosing what to practice</strong><br /> Whether you're a first- or fourth-year medical student, choosing your specialty is one of the most crucial decisions you will make in your career as a physician, so make sure you explore a variety of specialties before deciding what to practice. Start with these insights:  </p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/5-things-students-overlook-choosing-specialty" target="_blank">5 things students overlook when choosing a specialty</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/medical-specialties-vary-gender" target="_blank">How medical specialties vary by gender</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which features advice from physicians about the pros and cons of practicing in their specialties, insight about their lifestyles and student-friendly tips you don’t want to miss. Find out what physicians say about <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-orthopedic-surgeon-shadowing-dr-dangles" target="_blank">practicing orthopedic surgery</a>.</li> </ul> <p> <strong>Transitioning to residency</strong><br /> As a fourth-year student, transitioning to residency will mark a period of excitement and major change. Follow these tips to prepare for your future as a resident:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/families-of-new-residents-need-navigate-change" target="_blank">What families of new residents need to navigate change</a></li> </ul> <p> Also, try these links to properly plan your next steps after matching to a program: </p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/matched-residency-program-now" target="_blank">So you matched to a residency program—now what?</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/thinking-fellowship-5-things-consider" rel="nofollow" target="_blank">Thinking about a fellowship? 5 things to consider</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/after-match-ready-pay-loans" target="_blank">After you Match, are you ready to pay your loans?</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:20d062c0-f9c9-4536-b110-73062da96969 Mapping the year’s landmarks: How medicine is advancing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_mapping-years-landmarks-medicine-advancing Tue, 26 May 2015 19:31:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/15/0741fbc5-2e0d-459b-8f03-121068cc6d2b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/15/0741fbc5-2e0d-459b-8f03-121068cc6d2b.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD</em></p> <p> Over the year I have been AMA president, we’ve worked to maintain a strong foundation of tradition while also maximizing the opportunity for positive changes in our evolving health care system.</p> <p> I’m proud to say that the AMA has hit a number of important landmarks this past year.</p> <p> The biggest landmark was overcoming the hurdle of Medicare’s sustainable growth rate (SGR) formula. We physicians and our patients endured the SGR formula’s perennial threats of steep payment cuts and the instability those threats created. By speaking out together, we managed the strenuous, uphill marathon and at last ended this problem that has plagued us for over a decade, <a href="http://www.ama-assn.org/ama/ama-wire/post/overcame-sgr-hurdle" target="_blank">clearing the hurdle</a>.</p> <p> Now, we’re in a <a href="http://www.ama-assn.org/ama/ama-wire/post/5-ways-health-care-will-look-different-post-sgr-era" target="_blank">new era of health care</a>—one of promise, stability and sustainability. A huge landmark, to be sure.</p> <p> <strong>Advancing practice sustainability</strong></p> <p> We also have seen landmarks in other important areas.</p> <p> In March, the AMA released its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/ama-rand-study.page" target="_blank">most recent study</a> with the RAND Corporation. The study investigated physician experiences with the adoption of health care delivery and payment reforms. It was a clear look into <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">what physicians are saying about the evolution of payment models</a>—and a window into how the AMA needs to help physicians adopting these new models.</p> <p> Part of new practice model adoption is having the right technology to get things done. The problem is that many electronic health records (EHR) systems don’t make it easy. In September, a panel of experts convened by the AMA developed a <a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">framework for EHR usability</a> that will drive improvements to both the technology and the delivery of care.</p> <p> And we’re working with entrepreneurs and innovators at the ground level with our involvement in health technology incubator <a href="http://www.ama-assn.org/ama/ama-wire/post/innovators-tap-physicians-technology-insights" target="_blank">MATTER</a>. All of this work reflects our commitment to securing long-term paths to <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">professional satisfaction and practice sustainability</a> through research, data and analytics.</p> <p> <strong>Relieving the burden of chronic disease</strong></p> <p> Beside helping physicians put the joy back into the practice of medicine, we also are working to relieve the burden of disease facing our country.</p> <p> This burden is heavy. The PBS documentary, <a href="http://www.ama-assn.org/ama/ama-wire/post/welcome-future-doctors-changing-patient-care" target="_blank"><em>Rx: The Quiet Revolution</em></a>, which aired in April, did a great job of giving a glimpse into the challenges and opportunities in America’s health care system. Emmy-winning director David Grubin also found doctors transforming the way we provide medical care to patients with chronic diseases through a team approach that lowers costs, enhances quality and improves outcomes.</p> <p> Nationally, we’re working to relieve this burden through our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page?" target="_blank">Improving Health Outcomes</a> initiative. Through this effort, we’re developing ways physician practices can partner with their patients and the community to prevent two of the most common chronic conditions—heart disease and type 2 diabetes—before they start.</p> <p> For example, we just launched a new multi-year partnership with the Centers for Disease Control and Prevention: <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act—Today<em>™</em></a>. The partnership will help physicians connect patients with <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevention-program" target="_blank">diabetes prevention programs</a> in their communities or online. We also have released a guide to help physicians set up <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring" target="_blank">self-measured blood pressure monitoring programs</a> in their practices, which can empower patients to get high blood pressure under control.</p> <p> <strong>Creating the physician of tomorrow</strong></p> <p> Through our work, we’re imagining a better, healthier future. Physicians need to be better equipped to handle the health needs of that future.</p> <p> To that end, our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative has advanced with our consortium of  medical schools where we invested 11 million dollars in grants, which are a year into implementing innovative projects. These projects will spur change in med ed across the country—a system that can use new ideas and innovation, since the Flexner Report was published more than a 100 years ago.</p> <p> Our team is listening to <a href="http://www.ama-assn.org/ama/ama-wire/post/students-wish-were-learning-med-school" target="_blank">what students wish they were learning in med school</a> and adapting to students’ needs. We’re investigating a <a href="http://www.ama-assn.org/ama/ama-wire/post/new-core-science-could-prep-med-students-health-care-changes" target="_blank">new core science</a> that will give students the skills they need to navigate the complicated health care system. And we’re <a href="http://www.ama-assn.org/ama/ama-wire/blog/MedEd_IT/1" target="_blank">harnessing new technology</a> to improve patient care.</p> <p> <strong>Staying connected</strong></p> <p> One of the best parts of being AMA president has been hearing from my peers. Over the past year, I had the opportunity to speak with physicians across the country about the challenges they were facing—both in person and online. I hope you continue to tweet at me (<a href="https://twitter.com/robertwahmd" target="_blank" rel="nofollow">@RobertWahMD</a>) so we can keep discussing and celebrating important landmarks.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:33adfe22-0810-454a-ac8d-45a4af561771 The beginner and expert’s guide to ICD-10 prep: Steps for June http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_beginner-experts-guide-icd-10-prep-steps-june Tue, 26 May 2015 19:26:00 GMT <p> As the clock ticks down to the Oct. 1 deadline to implement the ICD-10 code set, physicians should be prepping their practices. In Month Two of our ICD-10 primer, learn the next steps you should take.</p> <p> <strong>What to tackle in June</strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/2/3092fb3e-463b-4204-829a-c0ba9c0d59a8.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/2/3092fb3e-463b-4204-829a-c0ba9c0d59a8.Large.png?1" style="margin:15px;float:right;" /></a><br /> Use these <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank">tips from the AMA</a> and the Centers for Medicare & Medicaid Services’ <a href="http://cdn.roadto10.org/wp-uploads/2014/02/Road_To_10_Implementation_Guide.pdf" target="_blank" rel="nofollow">Road to 10 Implementation Guide</a> to bring your practice in line with the new code set.</p> <p style="margin-left:.5in;"> <strong>Just getting started?</strong><br /> If you’re still in the early stages of preparation, spend your time next month contacting vendors about upcoming changes.</p> <p style="margin-left:.5in;"> Most practices will need vendors to complete system updates to support the new code set. The two largest systems impacted will be your practice management system and your electronic health record system. You also may need to update your ePrescribing module, disease management registry or other systems.</p> <p style="margin-left:.5in;"> Find a list of questions to ask your vendors on this <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-talk-to-your-vendor-about-updates.pdf" target="_blank">tip sheet</a> (log in).</p> <p style="margin-left:.5in;"> This also is the time to communicate with your payers and related vendors, such as billing offices, and other physician practices and agencies from which your practice may seek advice, assistance or materials. Be sure to <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-talk-to-your-payers-about-reimbursement-changes.pdf" target="_blank">ask the insurers</a> (log in) you contract with about payment changes, processes for “unspecified” codes and other information.</p> <p style="margin-left:.5in;"> <strong>Already on your way?</strong><br /> If preparations already are well underway in your practice, now is the time to test your practice’s ICD-10 readiness and identify potential problems. There are different <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-testing-your-readiness.pdf" target="_blank">types of testing</a> (log in), and each type serves a different purpose.</p> <ul> <li style="margin-left:0.75in;"> <strong>Content-based testing</strong> assesses your practice’s documentation and ability to code in ICD-10. It involves being given documentation and coding a clinical scenario in the new code set. The Healthcare Information and Management Systems Society offers <a href="http://www.himss.org/library/icd-10/national-pilot-program" target="_blank" rel="nofollow">resources</a> for your practice.<br />  </li> <li style="margin-left:0.75in;"> <strong>Internal testing </strong>evaluates your practice’s ability to create and use ICD-10 codes throughout the patient work flow where you currently use ICD-9 codes. This type of testing requires system upgrades to be installed already and helps you follow the flow of a patient through a visit to see where codes are used. Use this testing to identify any gaps in your ICD-10 updates.<br />  </li> <li style="margin-left:0.75in;"> <strong>External testing</strong> tests your practice’s ability to send and receive transactions that use ICD-10 codes with your external trading partners, including your billing service, clearinghouse or payers. Check with these groups about their testing plans.<br /> <br /> One type of external test is acknowledgement testing with Medicare, which simply acknowledges that a claim has been received. Physicians can do acknowledgement testing with their Medicare Administrative Contractors and the Common Electronic Data Interchange contractor any time up to the Oct. 1 implementation date. Medicare, however, has placed special focus on specific weeks. The last such week will be June 1-5. Learn more in an <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8858.pdf" target="_blank" rel="nofollow"><em>MLN Matters®</em> article</a>.</li> </ul> <p> <strong>Easing the transition</strong></p> <p> AMA efforts to ease the burden of ICD-10 implementation on physicians continue. Still, experts caution that physician practices should make sure they are prepared for the Oct. 1 deadline.</p> <p> Visit the AMA ICD-10 Web page to access additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help you prepare. An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> also is an essential resource.</p> <p> <strong>Editor’s note:</strong> This post is the second part of a new monthly series that will provide timely transition tips and resources as the Oct. 1 ICD-10 implementation deadline approaches. <a href="http://www.ama-assn.org/ama/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">See the first post</a>, and learn what your practice should do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially</a> for ICD-10.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/2/fab4dfb6-c180-402e-a218-6285be3ad3ff.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/2/fab4dfb6-c180-402e-a218-6285be3ad3ff.Full.png?1" style="width:850px;height:136px;margin:15px;float:left;" /></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f85917a3-e9b9-43fe-ae4e-dc388231333e What’s happening at the AMA-IMG Section Annual Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_whats-happening-ama-img-section-annual-meeting Mon, 25 May 2015 14:05:00 GMT <p> Don’t miss out on events at the AMA International Medical Graduates (IMG) Section Annual Meeting, taking place June 5-8 at the Hyatt Regency Chicago.</p> <p> Highlights include:</p> <ul> <li> <strong>Trustee candidates’ forum at 3 p.m. June 5</strong><br /> Co-sponsored by the AMA Minority Affairs Section, this forum provides the opportunity to meet the candidates who are running for an AMA Board of Trustees position.</li> </ul> <ul> <li> <strong>Council candidate interviews at 10:30 a.m. June 6</strong><br /> Meet the candidates running for a position with the AMA Council on Medical Education.</li> </ul> <ul> <li> <strong>Reception and congress at 5:30-8 p.m. June 6</strong><br /> Get an update from the Educational Commission on Foreign Medical Graduates, learn the latest on the graduate medical education crisis and weigh in on important topics—including resolutions being considered at the AMA Annual Meeting, resolutions that will be considered for the AMA Interim Meeting and organizational reports.</li> </ul> <ul> <li> <strong>Ninth annual “Desserts from Around the World” reception at 9:30-11 p.m. June 6</strong><br /> Each year this event gets bigger and tastier! Join us in trying new and exciting ethnic desserts while enjoying live entertainment.</li> </ul> <ul> <li> <strong>AMA-IMG Section delegate caucus at 8:30-9:30 a.m. June 8</strong><br /> Meet your AMA-IMG Section delegate and discuss the strategies for deliberations on reference committee reports and resolutions.</li> </ul> <ul> <li> <strong>Busharat Ahmad, MD, Leadership Development Program at 10:30-11:30 a.m. June 8</strong><br /> Hear two featured speakers: Christine Sinsky, MD, of the AMA, and Lisa Shah, MD, of Evolent Health, who will discuss the loss of physician leadership and how to increase physician satisfaction in medical practice.</li> </ul> <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20152370E&TID=KSqJVcQWzARm7b6pY6w8aQ%3d%3d&OID=130" target="_blank"><u>Register online today</u></a> to attend the meeting. For information on hotel and flight reservations, visit the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank"><u>meeting website</u></a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f2614f75-20be-484a-adf9-13081eb33df2 Congresswoman to discuss health disparities June 5 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_congresswoman-discuss-health-disparities-june-6 Mon, 25 May 2015 14:00:00 GMT <p> Don’t miss the AMA Minority Affairs Section Annual Meeting June 5 in Chicago. Rep. Robin Kelly, D-Ill. and chair of the Congressional Black Caucus (CBC) Health Braintrust, will provide updates on national initiatives that address health disparities.</p> <p> The CBC Health Braintrust has been tasked with creating legislative and policy solutions to reduce health disparities and promote good health outcomes in multicultural communities. It is the authority on African American and minority health disparities on Capitol Hill.</p> <p> The CBC Health Braintrust’s theme for the 114th Congress is “<a href="http://www.robinkelly.house.gov/sites/robinkelly.house.gov/files/CBC%20Health%20Braintrust%202015%20%28The%20March%20Toward%20Health%20Equity%29.pdf" rel="nofollow" target="_blank">The March Toward Health Equity</a>,” in honor of the 50th anniversary of the voting rights march from Selma to Montgomery. The group’s agenda is three-fold:</p> <ul> <li style="margin-left:0.5in;"> Strengthening communities</li> <li style="margin-left:0.5in;"> Improving health care access</li> <li style="margin-left:0.5in;"> Achieving health equity in a generation</li> </ul> <p> Rep. Kelly was appointed chair of the CBC Health Braintrust earlier this year.  She serves as the CBC’s principal health care adviser and is responsible for advancing the caucus’ health priorities.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6ebcf4b4-e697-4b36-88a4-45262decc136 How physicians are slowing health care costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-slowing-health-care-costs Fri, 22 May 2015 18:29:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/3/3e2ea3ad-5f1d-4108-83b1-ac2538999294.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/3/3e2ea3ad-5f1d-4108-83b1-ac2538999294.Large.jpg?1" style="float:left;margin:15px;" /></a><em>An AMA </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>Viewpoints</em></a><em> post by </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page?" target="_blank"><em>Barbara L. McAneny, MD</em></a><em>, chair of the AMA Board of Trustees.</em></p> <p> As physicians, we hear firsthand from the media and other places how health care costs are out of control, and we’re often asked what can be done to control those costs. A <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/spending-health-care.page" target="_blank">new analysis</a> from the AMA helps shed some light on how the health care dollar is spent, and reveals that costs aren’t as out of control as we may think.</p> <p> This analysis shows how health care is financed and where the money goes. In 2013, the last year for which data are available, national health expenditures were more than $2.9 trillion—that breaks down to $9,255 per person. This reflects growth of only 3.6 percent over the previous year—the lowest annual growth rate since 1961, the first year the current framework for spending was used.</p> <p> And that data doesn’t stand alone. The past five years have been characterized by slow growth in spending.</p> <p> What’s interesting is that out of that $2.9 trillion, only 16.1 percent went to physician services. Moreover, physicians are part of the reason that spending is at historically low growth levels. Physician spending grew more slowly over the 2003-2013 period than hospital spending, clinical spending and total personal health spending.</p> <p> The largest piece of this spending pie goes to hospital care—about 32 percent. But acute care often is preventable. That’s why my clinic seeks to keep our patients out of the hospital. Through an aggressive approach to managing cancer treatments and its side effects, we keep our patients as healthy as possible, minimizing emergency room visits and hospitalizations. By offering same day appointments many practices in multiple specialties can intervene in a patient’s problem and avoid admissions.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/5/9fb4576a-8552-4f8a-8545-df48eb1e7e3f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/5/9fb4576a-8552-4f8a-8545-df48eb1e7e3f.Large.jpg?1" style="float:right;margin:15px;" /></a><strong>Lowering costs through innovation</strong><br /> At my clinic, we manage the overall care for our patients, handle insurance issues, take care of scheduling and more. All the patient has to do is show up.</p> <p> We found that offering same-day appointments and encouraging patients to call us before racing to the emergency room—along with some other changes—reduced overall health care costs. This new delivery model kept patients out of the hospital and became a way to deliver cost-effective care.</p> <p> I was awarded a grant from the Center for Medicare and Medicaid Innovation (CMMI) three years ago to take what we’d done at this first clinic, the New Mexico Cancer Center, and replicate it in <a href="http://www.comehomeprogram.com/index.php/come-home-practices/" target="_blank" rel="nofollow">six other practices</a> across the country.</p> <p> We’ve started what we call <a href="http://www.comehomeprogram.com/" target="_blank" rel="nofollow">Community Oncology Medical Homes</a> (COME HOME) to test how oncology private practices can provide better care for patients with cancer at lower costs. Now we have worked with the American College of Surgeons to obtain Commission on Cancer accreditation. By keeping patients out of the hospital and handling what we can in physician offices, we expect to realize significant cost savings. You can read more about my work in this area in <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-improving-patient-care-reducing-costs" target="_blank">another Viewpoints post</a>.</p> <p> Here’s another way we can minimize health care costs: Addressing the burdens of chronic diseases.</p> <p> The AMA is doing this now by working to prevent cardiovascular disease and type 2 diabetes—and <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">improving outcomes</a> for people with these conditions.</p> <p> For example, we recently launched a new multi-year partnership with the Centers for Disease Control and Prevention: <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act—Today<em>™</em></a>. The partnership will help physicians connect patients to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevention-program" target="_blank">diabetes prevention programs</a> in their communities or online. We also have released a guide to help physicians set up <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring">self-measured blood pressure monitoring programs</a> in their practices, which can empower patients to get high blood pressure under control.</p> <p> And we also can lower our own costs by reducing what we spend on administrative burdens and increasing our efficiency in our practices. Last week, I wrote a post about <a href="http://www.ama-assn.org/ama/ama-wire/post/were-fighting-administrative-burdens-regaining-time" target="_blank">the ways</a> the AMA is making that possible.</p> <p> <strong>Tell us: </strong>How are you reducing costs in your practice? Let me know in the comments below.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5589c530-800b-4bf4-8345-5faa86f17817 How to start a home blood pressure monitoring program http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_start-home-blood-pressure-monitoring-program Fri, 22 May 2015 18:16:00 GMT <p> Studies show that self-measured blood pressure readings can offer a better picture of a patient’s true blood pressure than measurements taken in a clinical setting, especially if a patient suffers from “white coat hypertension.” Now that you have <a href="http://www.ama-assn.org/ama/ama-wire/post/need-self-measured-blood-pressure-monitoring" target="_blank">everything you need to know</a> about self-measured blood pressure monitoring, learn how to start a home monitoring program for your patients.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/5/13510f3e-2662-4262-a5da-f508b86a71b1.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/5/13510f3e-2662-4262-a5da-f508b86a71b1.Large.jpg?1" style="margin:15px;float:right;" /></a>Here are four things you need to do to implement such a program:</p> <p> <strong>1. Ensure clinical competency.</strong><br /> Blood pressure measurement is a routine task in most practices, but it’s easy to get skewed results if clinicians and patients aren’t on the same page about how to take accurate blood pressure measurements. Clinical staff should be trained and tested on measuring blood pressure accurately to make sure they can effectively teach patients how to measure their own blood pressure.</p> <p> First, make sure your health care team is getting the most accurate readings by using the “<a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf" target="_blank">M.A.P.” (Measure accurately, Act rapidly, Partner with patients) checklists</a> (log in) for measurement. A new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-graphic-patients-need-accurate-blood-pressure-reading" target="_blank">infographic</a> is a quick reference for health professionals and patients to make sure they are avoiding common measurement errors that can result in a misleading reading.</p> <p> Next, use a <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/smbp.pdf" target="_blank">new AMA guide</a> (log in) to help your team expertly work with patients to explain what self-measured blood pressure monitoring is and demonstrate how they should take accurate readings at home.</p> <p> <strong>2. Determine whether you want to provide blood pressure monitors for your patients.</strong><br /> Patients can buy blood pressure monitors at drug stores. Prices for a typical high-quality device can range from $50 to $150. The AMA guide explains how to check a patient’s home blood pressure monitor for accuracy and ensure it has been approved under a formal validation protocol.</p> <p> Unfortunately, many public and private health insurance plans don’t cover the cost of self-monitoring devices. Some physicians choose to purchase monitors and loan them out to patients. The AMA guide includes a checklist to ensure continuity and consistency among staff members when distributing a loaner blood pressure device to patients and a sample device loaner agreement. It also includes a recommended infection prevention process for loaner devices.</p> <p> <strong>3. Follow criteria for selecting patients to participate.</strong><br /> Patients whose blood pressure is measured as greater than 140/90 mm Hg on the first and subsequent readings during an office visit should be screened for the following criteria before becoming part of a home monitoring program:</p> <ul> <li> Elevated readings persist for two or more subsequent office visits.</li> <li> The patient has a diagnosis of hypertension, is being ruled out for a diagnosis of hypertension or has white coat hypertension.</li> <li> Your practice’s device has a cuff size appropriate for the patient. (If it doesn’t, the measurement could be skewed.)</li> <li> The patient has the aptitude to take an accurate measurement and willingness to take measurements consistently.</li> <li> The patient is capable of documenting the readings if the device doesn’t have memory storage capability.</li> </ul> <p> <strong>4. Set up procedures to document and manage the process.</strong><br /> To be most effective, self-measured home blood pressures readings should be communicated back to the physician’s office for interpretation. This can happen via phone, fax, patient portal or other ways, as outlined in the guide.</p> <p> As part of the program, your practice should inform patients how and when you will respond to patient communications and what the patient should do if a measurement is concerning. The average home measurement should be documented in the patient’s health record.</p> <p> <strong>Additional resources</strong><br /> Use the AMA guide to begin engaging your patients in their self-measurement. This resource has fact sheets, patient handouts and adaptable practice tools to help your practice establish and maintain a program for your patients. You also can use additional resources, including:</p> <ul> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf" target="_blank">Evidence-based checklists to improve blood pressure control</a> (log in)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-office-poster.pdf" target="_blank">Poster to demonstrate proper patient positioning when taking blood pressure</a> (log in)</li> </ul> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices.</p> <p> <strong>National High Blood Pressure Education Month</strong>: <em>AMA Wire</em> <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2015051601amaweekend&r=6231389-68fb&l=01b-5ba&t=c" rel="nofollow">offers additional information and resources</a> that can help your practice engage with and educate your patients on this important issue.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e756ab0c-bdcf-44cb-b63e-18412e5eb8fe What it’s like to be an orthopedic surgeon: Shadowing Dr. Dangles http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-orthopedic-surgeon-shadowing-dr-dangles Fri, 22 May 2015 18:05:00 GMT <p> As a medical student, do you ever wonder what it’s like to specialize in orthopedic surgery? Here’s your chance to find out.</p> <p> Meet Chris Dangles, MD, an orthopedic surgeon and featured physician in <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/f20a8cf3-e2c4-477c-800b-cf7bbdf9b7ec.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/f20a8cf3-e2c4-477c-800b-cf7bbdf9b7ec.Large.jpg?1" style="float:right;margin:15px;" /></a>Read Dr. Dangles’ insights to help determine whether a career in orthopedic surgery is a good fit for you.</p> <p style="margin-left:40px;"> <strong>“Shadowing” Dr. Dangles </strong></p> <p style="margin-left:40px;"> <strong>Specialty: </strong><br /> Orthopedics with an emphasis on joint reconstruction</p> <p style="margin-left:40px;"> <strong>Practice setting:</strong><br /> Rural health hospital with additional offices in college communities. I became a hospital-employed physician nine months ago after 33 years of being in physician-owned group practices.</p> <p style="margin-left:40px;"> <strong>A typical week:</strong><br /> At age 65, I have reduced my schedule to about 40 hours/week with no E.R. call and about 300 cases per year.</p> <p style="margin-left:40px;"> <strong>The most challenging aspect of caring for patients in orthopedic surgery is:</strong><br /> Providing care for patients with multiple comorbidities who also require joint replacement, but accomplishing this with a good result is very rewarding.</p> <p style="margin-left:40px;"> <strong>Three adjectives to describe the typical orthopedic surgeon:</strong><br /> Male (but changing). Meticulous. Demanding.</p> <p style="margin-left:40px;"> <strong>How my lifestyle matches or differs from what I envisioned in medical school:</strong><br /> I have surprised myself by finding a practice environment not as demanding as what I experienced for 25 years and expected as a student. General orthopedic practice with Level I trauma responsibilities became a chore, but elective joint reconstruction is fun.</p> <p style="margin-left:40px;"> <strong>The main skills every physician should have for orthopedic surgery but won’t be tested for on the board exam:</strong><br /> Physical endurance, empathy and the ability to cope with sub-optimal outcomes when they occur. Management skills also will be necessary for success.</p> <p style="margin-left:40px;"> <strong>One question every physician in training should ask themselves before pursuing orthopedic surgery:</strong><br /> Can I accept the challenges of decreasing reimbursement and increasing demand for joint replacement and still provide excellent quality?</p> <p style="margin-left:40px;"> <strong>The two books I think every medical student interested in orthopedic surgery should read are: </strong></p> <p style="margin-left:80px;"> • <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292940/" rel="nofollow">John Charnley: The Man and the Hip</a></em> by William Waugh</p> <p style="margin-left:80px;"> • <em>It's Your Ship: Management Techniques from the Best D*** Ship in the Navy</em><em> b</em>y Michael Abrashoff</p> <p style="margin-left:80px;"> • Other management guides since you will need to know how to manage a team in the office and O.R.</p> <p style="margin-left:40px;"> <strong>If you want to learn more about orthopedic surgery, I also recommend students follow: </strong></p> <p style="margin-left:80px;"> • <a href="http://www.aahks.org/" rel="nofollow">aahks.org</a></p> <p style="margin-left:80px;"> • <a href="http://www.aaos.org" rel="nofollow">aaos.org</a></p> <p style="margin-left:40px;"> <strong>One thing students considering orthopedic surgery and its sub-specialties should remember:</strong><br /> Joint reconstruction has become a sub-specialty training after general orthopedic residency, but there are residency programs that can prepare you properly for a career in joint arthroplasty.</p> <p> <strong>Want to learn more about palliative care and other specialty options? Don’t miss the specialty showcase June 6.</strong><br /> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/medical-specialty-showcase.page?" target="_blank">AMA’s Medical Specialty Showcase</a> will take place from 11:30 a.m. to 1:30 p.m. June 6 at the Hyatt Regency Chicago. A variety of specialties will be represented, and students can speak directly with physicians about their practices. Physicians also will share information about mentorship programs and organizations that can help students learn more about their preferred specialties.</p> <p> The showcase is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a>. Don’t miss out—<a href="https://login.ama-assn.org/account/login" target="_blank">register for the meeting</a> today (login), and find additional resources on choosing a specialty such as the <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.page?">AMA’s specialty resource guide</a>, which features overviews of the major specialties and subspecialties. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:863ef630-7487-4be6-9a06-0d5c70a0b950 4 things students should know about the new GME bill http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-things-students-should-new-gme-bill Wed, 20 May 2015 19:44:00 GMT <p> Medicare-funded residency positions could increase by 15,000 over the next five years if a newly introduced bill is adopted. The legislation underscores the importance of increasing graduate medical education (GME) funding amid a <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" target="_blank" rel="nofollow">predicted shortage</a> of 46,000 to 90,000 physicians by 2025.</p> <p> The <a href="https://www.congress.gov/bill/114th-congress/house-bill/2124/text" target="_blank" rel="nofollow">Resident Physician Shortage Reduction Act of 2015</a> is part of a multi-pronged approach to increase the number of residency spots available to students as medical schools have increased enrollment by 30 percent over the last several years. But a proportional increase of GME positions has yet to happen, chiefly because the Balanced Budget Act of 1997 has left the number of GME positions funded by Medicare capped at 1996 levels.</p> <p> The act, which was introduced to the U.S. House of Representatives by Rep. Joseph Crowley, D-N.Y., and to the U.S. Senate by Sen. Jon Tester, D-Mont., outlines important provisions about the new residency slots and funding.</p> <p> <strong>1. The number of new residency spots would gradually increase each year—not all at once. </strong><br /> Residency positions will increase nationally by 3,000 each year from 2015 to 2019, resulting in a cumulative 15,000 additional slots by the end of the five-year period.</p> <p> <strong>2. Students pursuing a “shortage specialty” like primary care would have an advantage. </strong><br /> Of the 3,000 new spots created each year, at least 1,500 of these positions must be used for a <a href="https://www.aamc.org/newsroom/reporter/february2014/370350/physician-shortage.html" target="_blank" rel="nofollow">shortage specialty residency program</a> as defined by the Health Resources and Services Administration. This distribution would apply until the National Health Care Workforce Commission issues a report on specialty shortages.</p> <p> <strong>3. Factors like neighboring medical schools and the number of residency applicants for a particular program will impact how new residency slots are distributed. </strong><br /> Programs will be prioritized for receiving funding for new positions in the following order:</p> <ul> <li style="margin-left:57.15pt;"> Hospitals in states with new medical schools</li> <li style="margin-left:57.15pt;"> Hospitals that have exceeded their resident cap at the time of enactment</li> <li style="margin-left:57.15pt;"> Hospitals that are affiliated with Veteran’s Health Administration medical centers</li> <li style="margin-left:57.15pt;"> Hospitals that emphasize training in community health center or community-based settings or in hospital outpatient departments</li> <li style="margin-left:57.15pt;"> Hospitals that are determined to be meaningful users of electronic health records for the fiscal year</li> <li style="margin-left:57.15pt;"> All other hospitals</li> </ul> <p> <strong>4. The act calls for additional research on specialty shortages and diversity in GME. </strong><br /> The bill would require the National Health Care Workforce Commission to conduct a study of the physician workforce. The study will identify the main specialties that disproportionally lack physicians; the results would be used to determine which specialties receive priority for residency spots under new GME funding.</p> <p> The act also calls on the comptroller general of the United States to conduct a study on diversity in health care, which would look at new ways to increase the number of physicians in practice from rural, lower income and underrepresented minority communities.</p> <p> This legislation is timely considering the recent <a href="http://www.ama-assn.org/ama/ama-wire/post/record-breaking-match-sees-higher-percentage-of-unmatched-seniors" target="_blank">record-breaking number of unmatched students</a> who have graduated from medical school without securing a place to complete their training. Still, <a href="http://www.ama-assn.org/ama/ama-wire/post/students-residents-saving-gme" target="_blank">students and residents continue to advocate</a> for expanded GME programs, using social media and other tools that call on Congress to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/students-residents-saving-gme" target="_blank">#SaveGME</a>.</p> <p> The AMA also is addressing this issue by continuing its advocacy for federal support of GME. In addition, the AMA is working across stakeholder groups to reduce restrictions to rural and other underserved community experiences for GME programs and encouraging innovative ways to train physicians, with emphasis on physician-led, team-based care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f013232a-ead7-4d18-8fde-3781ac117d9b How we’re fighting administrative burdens and regaining time http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_were-fighting-administrative-burdens-regaining-time Wed, 20 May 2015 19:41:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/15/8216f6f0-a5ab-414f-bfbc-e5807bc3ecc0.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/15/8216f6f0-a5ab-414f-bfbc-e5807bc3ecc0.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An AMA </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>Viewpoints</em></a><em> post by </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page?" target="_blank"><em>Barbara L. McAneny, MD</em></a><em>, chair of the AMA Board of Trustees.</em></p> <p> My fellow physicians know: The administrative burdens we shoulder every day in our practices take quite a toll in physician time and money.</p> <p> Billing and insurance-related paperwork drain time and resources from physician practices. <a href="http://content.healthaffairs.org/content/30/8/1443.full" target="_blank" rel="nofollow">One study</a> that appeared in <em>Health Affairs</em> estimated that in the United States, physician practices spend $82,975 per physician, interacting with insurers each year. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19443477" target="_blank" rel="nofollow">Another study</a> estimates physicians spend an hour each week on prior authorization alone, with nurses spending more than 13 hours a week on the task. This means less time with patients, lower job satisfaction for us and more uncompensated work.</p> <p> Fortunately, change could be on the horizon.</p> <p> <strong>Solutions for physicians</strong></p> <p> The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative is honing in on ways to put the joy back into practice. We’ve just launched an administrative burden study to get reliable data on exactly where physicians’ time is going. This data will be gathered through direct observation of physicians and practice staff by trained observers and will inform efforts to put that time back into caring for patients.</p> <p> We also are engaged in national advocacy to reduce the burdens associated with payer interactions. For example, we’ll be speaking before the National Committee on Vital and Health Statistics next month. This testimony will evaluate how standard electronic transactions, mandated by the Health Insurance Portability and Accountability Act, are meeting physicians’ needs and request transaction changes and enhancements to support further administrative simplification.</p> <p> We’re gathering intelligence and preparing to make recommendations on the various regulations that will be required to implement the newly passed H.R. 2 bill. Besides <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repealing the sustainable growth rate formula</a> and removing the annual threat to Medicare patients’ access to care, the bill also created a new program that aims to align and, hopefully, simplify all the existing quality reporting programs.</p> <p> The new “merit-based incentive payment system” envelopes the Physician Quality Reporting System, value-based modifier measures and the electronic health record meaningful use program. By 2019, this new program will be the only Medicare quality reporting program—which, if properly implemented, could mean physicians get some time back.</p> <p> We’re also working on automating prior authorization through federal and state advocacy. State medical societies and their partners are building coalitions to drive prior authorization reform, and the AMA offers support and assistance to states pursuing legislation to streamline the prior authorization system and improve transparency.</p> <p> <strong>How to make immediate changes</strong></p> <p> The AMA has resources you can use right now to reduce your administrative burdens.</p> <p> The AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/appeal-your-claim/appealing-claims-payment-issues.page" target="_blank">appeals resource</a> can help you navigate the process of identifying improper claims payments and appealing claims. Our online <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/appeal-your-claim/overpayment-recovery-toolkit.page?" target="_blank">overpayment recovery toolkit</a> helps you regain precious time with patients while still managing the process. And the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/remittance-advice.page" target="_blank">electronic remittance advice</a> toolkit helps you transition to using electronic versions of explanations of payment.</p> <p> Get more assistance navigating the claims process with the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives.page?" target="_blank">administrative simplification initiatives</a> resources, including:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-things-must-overpayment-recovery" target="_blank">How to handle overpayment recovery requests</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-tips-providing-point-of-care-pricing" target="_blank">Tips for providing point-of-care pricing</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/refine-patient-payment-management-process-tips" target="_blank">Ways to refine your patient payment management process</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/learn-electronic-payments-work-practice" target="_blank">How to make electronic payments work for your practice</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-things-physicians-can-avoid-high-virtual-credit-card-fees" target="_blank">Ways to avoid high virtual credit card fees</a></li> </ul> <p> These resources can help you take action now. In the meantime, the AMA will continue to work for fewer administrative burdens so you can spend more time with patients. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2544653a-c4d3-4794-9987-e8b676f17d08 What to know about the other kind of CME credit http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_other-kind-of-cme-credit Wed, 20 May 2015 13:00:00 GMT <p> You’ve heard of <em>AMA PRA Category 1 Credit</em>™, but did you know there is also <em>AMA PRA Category 2 Credit</em>™? Learn about how to get continuing medical education (CME) credit for other educational experiences.</p> <p> These experiences may provide valuable learning for physicians, despite not being certified by an accredited CME provider or qualifying for direct credit from the AMA.</p> <p> <em>AMA PRA Category 2 Credit</em>™ is self-designated and self-claimed by individual physicians for participation in educational activities not certified for <em>AMA PRA Category 1 Credit</em>™ that meet the following criteria:</p> <ol> <li> Comply with the AMA definition of CME</li> <li> Comply with relevant AMA ethical opinions</li> <li> Are non-promotional</li> <li> Are a worthwhile learning experience related to a physician’s practice, as determined by the physician</li> </ol> <p> Examples of learning activities that might meet the requirements for <em>AMA PRA Category 2 Credit</em>™ include:</p> <ul> <li> Unstructured online searching and learning (i.e., not Internet point-of-care)</li> <li> Reading authoritative medical literature</li> <li> Consultation with peers and medical experts</li> <li> Self-assessment activities</li> <li> Medical writing</li> <li> Preceptorship participation</li> <li> Peer review and quality assurance participation</li> </ul> <p> Accredited CME providers must not certify activities for <em>AMA PRA Category 2 Credit</em>™ and may not advertise that an activity qualifies or is eligible for <em>AMA PRA Category 2 Credit</em>™.  Each physician is responsible for claiming and maintaining a record of their <em>AMA PRA Category 2 Credit</em>™.</p> <p> Recording <em>AMA PRA Category 2 Credit</em>™ activities is important, as these credits may count toward meeting the requirements for the AMA Physician’s Recognition Award, as well as for licensing and other credentialing requirements. Physicians should contact licensing and other credentialing entities directly to determine the number and type of credits required. </p> <p> Learn more about CME at <em>AMA Wire</em>®, including:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/going-abroad-earn-cme-international-activities">How to obtain CME credit for international activities</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/unconventional-ways-earn-cme">Unconventional ways to earn CME</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/decipher-cme-requirements">How to decipher CME requirements</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:eda913cd-4445-4d34-a8ca-fefff8456bca How physicians are changing med ed by going back to school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-changing-med-ed-going-back-school Wed, 20 May 2015 13:00:00 GMT <p> <em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Toni L. Johnson, MD, clinical associate professor and residency program director in the department of psychiatry and behavioral medicine at Brody School of Medicine at East Carolina University. Appeared in the May 2015 </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/0/6baa1809-9d5e-4812-a0fd-fe2d68589693.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/0/6baa1809-9d5e-4812-a0fd-fe2d68589693.Large.jpg?1" style="float:right;margin:15px;" /></a>Why would a busy physician voluntarily go back to school?</p> <p> This is the question I asked myself as I considered applying to the <a href="http://www.ama-assn.org/ama/ama-wire/post/faculty-development-crucial-med-ed-innovation">Teachers of Quality Academy</a> (TQA), a faculty development program that is part of the Redesigning Education to Accelerate Change in Healthcare (REACH) Initiative at the Brody School of Medicine at East Carolina University. After all, wasn’t I already a quality teacher?</p> <p> But I couldn’t deny the frustration I had developed over the years when witnessing the mismatch between what we teach medical students and what they really need to know to practice medicine most effectively today. So when I learned one of the primary goals of REACH, in addition to faculty development, is to develop a new curriculum that will better prepare physicians to work and lead within our evolving health care system, I was sold. I went back to school!</p> <p> I joined the Teachers of Quality with 26 other health sciences and clinical faculty from the Brody School of Medicine and the College of Allied Health, who like me, were interested in learning how to teach patient safety and quality improvement concepts and model them in our clinical work. We spent 15 months developing the knowledge and skills to practice and teach patient safety, quality improvement and population health through completion of the Institute for Healthcare Improvement’s Open School online certificate—six two-day learning sessions and development and implementation of an applied quality improvement project in the clinical area of our choosing.</p> <p> We also enrolled in three graduate courses in medical education, which included learning how to teach the adult learner, instructional strategies and program evaluation. As members of interprofessional teams we broadened our ability to develop curricula and began to explore better ways to prepare future health care providers.</p> <p> For many of us, this experience filled in gaps of knowledge missing from our own education. I was excited by the immediate impact of the learning activities. It seemed as soon as I learned a new concept in quality improvement, I was able to apply it to patient care and incorporate it into teaching. Rather than “see one, do one, teach one,” this was more like the “see one, teach one” approach. There is an urgency to transform what and how we teach.</p> <p> One of the highlights for me was participating in the first Brody Medical Education Day, a half-day event sponsored by the REACH Initiative in April. This event brought together faculty and students to share innovations in curriculum and teaching, educational research and medical education leadership. Faculty across the health science campus joined together to showcase their scholarly work related to medical education.</p> <p> As part of our graduate coursework, the TQA fellows developed educational projects that could be used to enhance the Brody curriculum. Medical Education Day was the perfect venue to present my educational project, “<a href="http://www.ecu.edu/cs-dhs/medicaleducation/reach/upload/Poverty-Privilege-and-Professionalism-REACH-Johnson.pdf" rel="nofollow">Poverty, privilege and professionalism: A consideration of resources with problem-based learning</a>." The major goal in this learning activity is to promote the development of professionalism by engaging learners in small group, problem-based learning using case vignettes with a patient or family living in poverty. This type of experiential learning can be used with interprofessional groups and engages learners with the real-world challenges of patient care.</p> <p> My experience of “going back to school” taught me that we truly are never too old to learn, we learn best by solving problems, and that leading change can be an invigorating and exciting endeavor.</p> <p> <em>Get</em> <em>AMA MedEd Update</em> <a href="http://www.ama-assn.org/ama/pub/news/subscribe-newsletters.page" target="_blank"><em>sent to your inbox</em></a><em> monthly to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0694c26d-e0c7-4a91-a1c5-baaf4fa5e5ce This year’s 3 top med ed priorities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_this-years-3-top-med-ed-priorities Wed, 20 May 2015 13:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/10/bda3e613-98b8-4a2e-aaab-8e4e98ddd9d9.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/10/bda3e613-98b8-4a2e-aaab-8e4e98ddd9d9.Large.png?1" style="float:right;margin:15px;" /></a>What are the top medical education issues for physicians this year? Hear from a med ed expert about the topics you should keep an eye on.</p> <p> <em>AMA Wire</em>® talked with Darlyne Menscer, MD, who will start her one-year term as the chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page">Council on Medical Education</a> at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>. A clinical associate professor in family medicine at the Carolinas Medical Center in Charlotte, N.C., Dr. Menscer has been a member of the Council on Medical Education since 2009.</p> <p> Dr. Menscer outlined the council’s top three priorities for the upcoming year:</p> <p style="margin-left:40px;"> <strong>1. Transforming medical education</strong><br /> The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?">Accelerating Change in Medical Education</a> initiative, which got underway in 2013, is moving full speed ahead. The council has been monitoring the initiative’s progress and joining the consortium of 11 schools at its meetings to better understand the many changes schools are implementing now. For example, the consortium is discussing the possibility of a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-core-science-could-prep-med-students-health-care-changes">new core science</a> and asking medical students <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/students-wish-were-learning-med-school">what they wish they were learning</a>.</p> <p style="margin-left:40px;"> “We’re fortunate that one of the AMA’s key areas of interest is med ed,” Dr. Menscer said. “I think it’s going quite well. I see that the national media is concerned about medical education, and we have the useful information about our initiative that we can put forward.”</p> <p style="margin-left:40px;"> <strong>2. Graduate medical education (GME)</strong><br /> “Medical students who are U.S. graduates and don’t have a place to complete their training after medical school—that’s a national crisis,” Dr. Menscer said. “It’s poor planning in the absolute worse sense of the word, but the solutions are clearly not simple.”</p> <p style="margin-left:40px;"> “Not simple” is right—from the Institute of Medicine’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gme-financing-system-needs-overhaul-iom-report">system overhaul recommendations</a> to the Association of American Medical College’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-road-map-calls-better-stronger-gme-system">GME roadmap</a> to the AMA council’s own <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/alternative-gme-solutions-needed-meet-workforce-demands">call for innovative solutions</a>, there are many moving pieces in the effort to transform GME.</p> <p style="margin-left:40px;"> But the AMA Council on Medical Education expects to hear more proposals about GME in the near future and plans to sift through all proposed solutions to whittle down to the best policy.</p> <p style="margin-left:40px;"> <strong>3. Maintenance of certification (MOC)</strong><br /> Traditionally a hot-button topic, Dr. Menscer and the council expect a lot of debate over MOC in the near term. In February, the American Board of Internal Medicine <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/moc-requirements-modified-internal-medicine-physicians">apologized</a> for getting its MOC programs wrong and releasing them before they were ready.</p> <p style="margin-left:40px;"> “My personal hope is that people will recognize that, although some parts of the board certification system may be rightly criticized, to say the entire system of physician accountability for continued competence should be thrown out with the bathwater is a huge mistake,” Dr. Menscer said. “Complaining is very easy to do—finding appropriate solutions is much harder.”</p> <p style="margin-left:40px;"> Physicians at the 2014 AMA Interim Meeting voted to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-adopts-principles-maintenance-of-certification">update the AMA’s MOC policy</a>, emphasizing the need for an evidence-based process that is evaluated regularly to ensure physicians’ needs are being met and activities are relevant to clinical practice.</p> <p style="margin-left:40px;"> In June, the AMA and American Board of Medical Specialties <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-abms-convene-stakeholders-discuss-moc-exam" target="_blank">convened stakeholders in Chicago</a> to discuss Part III of the MOC exam, focusing on the value of MOC Part III and innovative concepts that could potentially enhance or replace the secure exam requirement.</p> <p> Regardless of what issues come before the council, its No. 1 job is to stick to the facts and support the best policy possible.</p> <p> “We have to hear all voices and weigh them against the facts,” Dr. Menscer said. “We have to strategize what can be done, what venues we can speak in to have an effect and where we can advocate.”</p> <p> Weigh in on medicine’s most important issues, including topics in medical education, via the <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/reference-committee.page">Online Member Forums</a> (log in). </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:11ab6e2f-15c6-4b52-be33-611d5bcb8be3 Graduating residents reflect, share advice and challenges http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_graduating-residents-reflect-share-advice-challenges Tue, 19 May 2015 20:53:00 GMT <p> For many residents and fellows reaching the end of their training, they’re riding a wave of emotions from excitement and fear to relief, anxiety and plain old exhaustion. While this can be a stressful time, it’s also a perfect opportunity for reflection. <em>AMA Wire</em><sup>®</sup> asked several graduating residents about their experiences. Here are their honest perspectives—and advice every new physician in training needs.</p> <p> <strong>Reflections on the early months of residency</strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/b20fa3a2-d821-4ca8-b0fb-753186cd1ff2.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/0/b20fa3a2-d821-4ca8-b0fb-753186cd1ff2.Full.jpg?1" style="margin:15px;float:right;" /></a></p> <p> The first few months as a resident often present memorable first-time experiences. Graduating residents recount some of those moments:</p> <ul> <li style="margin-left:0.75in;"> “One instance that particularly comes to mind is a patient I responded to with acute respiratory distress. I was a fresh intern and the first provider on the scene of a rapid response.<br /> <br /> “Although I was fully equipped and trained on managing the patient, I remember frantically calling my senior in the middle of the night to double check. He agreed with my medical management, and we were able to successfully stabilize the patient.”<br /> —<em>Rezwan Ahmed, MD, a fourth-year resident at Marshall University in Huntington, W.V</em>.</li> </ul> <ul> <li style="margin-left:0.75in;"> “In OB-GYN, we have a lot of big emergencies that you can’t truly prepare for. One of them is bleeding or hemorrhages after delivery.<br /> <br /> “I remember I was out early rounding one morning on the floor, and as the only resident in sight, I was called into the room on a post-prime hemorrhage. This was three weeks into residency, so I hadn’t seen one yet. And this woman was bleeding everywhere. I had read what to do in books before and knew all the theories. But the actual exam and someone being in that much danger was just terrifying.<br /> <br /> “I was fortunate that my upper-level resident came into the room and saw that I was on the right track. She talked me through it, and I was able to stabilize the patient.”<br /> —<em>Brandi Ring, MD, a fourth-year resident at York Hospital in York, PA</em></li> </ul> <p> <strong>Coping with patient death for the first time</strong></p> <p> Losing a patient is a tough experience for any resident, and learning from those first encounters is important.</p> <ul> <li style="margin-left:0.75in;"> “I had a patient who had end-stage heart failure, but [he began to feel] better. His vitals were stable; he was eating and sitting up in his own chair. It looked like he was going to be discharged at any moment.<br /> <br /> “Yet the patient one morning kept telling me, ‘I’m going to die. I’m going to die.’ But I assured him that he was doing better. The labs showed it.<br /> <br /> “Well, that afternoon he coded and died, and we never knew why. I kept blaming myself, wondering if maybe I should have listened to him more. The way I coped with it was talking to my attending. He told me, ‘No matter what you do, for some patients, it really is their time. You have to stop blaming yourself, but you have to learn from this.’”<br /> —<em>Jonathan Ang, MD, a fourth-year resident at Montefiore New Rochelle Hospital in New Rochelle, N.Y.</em></li> </ul> <ul> <li style="margin-left:0.75in;"> “I remember taking care of a patient who had end-stage liver disease. The patient’s belly was distended, and he became progressively confused. After discussion with several specialists, it was decided that the patient needed an urgent liver transplant. I remember working arduously to facilitate this. I discussed various options and the plan of care with a renowned transplant surgeon.<br /> <br /> “[But the patient didn’t live to receive the transplant.] The entire situation was very challenging for me to comprehend, and I felt a deep remorse for the patient’s family.<br /> <br /> “A few weeks later, I received a letter from the patient’s wife, stating how appreciative she and her family were of our efforts and she was comforted knowing that we tried everything we could to help the patient. Although this provided me some solace, it was nevertheless difficult to cope with.”<br /> —<em>Dr. </em><em>Ahmed</em></li> </ul> <p> <strong>The rewards of treating patients</strong></p> <p> No matter the long work hours, residents loved treating patients in their programs:</p> <ul> <li style="margin-left:0.75in;"> “It’s wonderful in OB-GYN when you can truly establish relationships with patients because you see them every month and every week. You really get to know them. They’re really motivated to change, and … you can get folks who may not otherwise have stopped smoking to quit for good. I find that really motivating. And being able to openly deliver the baby is just fabulous.”<br /> —<em>Dr. Ring</em></li> </ul> <ul> <li style="margin-left:0.75in;"> “The incredible privilege of a physician-patient relationship is often forgotten. As providers, we have such a unique privilege to help another human being. I’ve noticed that I find the most satisfaction in this profession when I put aside personal matters and simply listen to the patient.”<br /> —<em>Dr. Ahmed</em></li> </ul> <p> <strong>How residency was different from expectations</strong></p> <p> Residents shared how their experiences compared to what they anticipated coming out of medical school:</p> <ul> <li style="margin-left:0.75in;"> “It’s way harder than you expect. Just the constant stress every single day of trying to do your absolute best for every patient who walks through the door. You’re wrong sometimes. As smart, high-functioning people, we residents hate to be wrong—particularly when it affects someone else, instead of ourselves, then we really hate being wrong.”<br /> —<em>Dr. Ring</em></li> </ul> <ul> <li style="margin-left:0.75in;"> “It’s one thing to know medicine, but the art of practicing it is completely different. That’s where the training comes in. For instance, one thing I have learned specifically in training is how to talk to families. I’ve learned how to get to know them and establish trust through a relationship with my patients. That’s one thing that’s never taught in medical school. That’s only taught by experiencing it.”<br /> —<em>Dr. Ang</em></li> </ul> <p> <strong>Advice for those in early stages of residency</strong></p> <p> The first few months of residency mark a major life transition. Here are tips these residents found for successfully surviving it.</p> <ul> <li style="margin-left:0.75in;"> “I would tell myself to take it easy at times and not to stress over circumstances that were beyond my control. The time spent toiling over little things could have been repurposed to a better use of my time, yielding more quality time spent with my friends and family.<br /> <br /> “And don't lose your sense of self. After all, that's what makes us who we are. I've found that patients appreciate authenticity, and it is the only effective way to make an indelible impression in the lives of others.”<br /> <em>—Dr. Ahmed</em></li> </ul> <ul> <li style="margin-left:0.75in;"> “A smile goes a long way when it comes to people you’re working with. Nurses or assistants can be your best friends in the world and help you with everything. Or you could end up doing things on your own, so being nice and friendly to people can actually make your life much easier.<br /> <br /> “Also, communicate with your team. Don’t be one of those residents who just writes something down in a chart and expects everyone to know it. Let your nurse know your plan for your patient and be aware of how you’re expressing yourself with others.”<br /> <em>—Dr. Ang</em></li> </ul> <ul> <li style="margin-left:0.75in;"> “Be good to your co-residents. Being good to each other creates an environment where you’re happier, and your satisfaction is higher. When residents do things together—go out to dinner, hang out and become actual friends—the quality of life in residency is totally different.”<br /> <em>—Dr. Ring</em></li> </ul> <p> <strong>Practical insights for graduating residents</strong></p> <p> If you’re a graduating resident, make sure to check out <em>AMA Wire’s</em> practical advice for advancing into the next stage of your career. Tips include:</p> <ul> <li style="margin-left:0.75in;"> How to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/life-after-residency-finances-order" target="_blank">get your finances in order</a> after residency</li> <li style="margin-left:0.75in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-things-resident-should-their-job-search" target="_blank">4 things every resident should know</a> before a job search</li> <li style="margin-left:0.75in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/things-consider-before-choose-practice-setting" target="_blank">Things to consider</a> before you choose a practice setting</li> <li style="margin-left:0.75in;"> How to <a href="http://www.ama-assn.org/ama/ama-wire/post/life-after-residency-discover-perfect-practice-location" target="_blank">discover the perfect practice location</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1515fc92-b472-4f4b-b845-05fd748b410b New commission to help streamline medical licensure http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-commission-streamline-medical-licensure Tue, 19 May 2015 20:44:00 GMT <p> Alabama this week became the seventh state to pass legislation to join the Interstate Medical Licensure Compact that will ease medical licensure burdens in some states. Passage of this seventh state launches the compact, and work will begin to create an interstate commission that will oversee the compact.</p> <p> The compact is designed to facilitate a speedier process with fewer administrative burdens for physicians seeking licensure in multiple states.</p> <p> Here’s how:</p> <ul> <li style="margin-left:0.25in;"> The eligible physician designates a member state as his or her state of principal licensure and selects other member states in which he or she desires a medical license.</li> <li style="margin-left:0.25in;"> The state of principal licensure verifies the physician’s eligibility and provides credential information to the interstate commission.</li> <li style="margin-left:0.25in;"> The commission collects applicable fees and transmits the physician’s information and licensure fees to the additional state medical boards.</li> <li style="margin-left:0.25in;"> Upon receipt by the additional state medical boards, the boards will grant the physician a license.</li> </ul> <p> The commission also will create and enforce rules governing this process, but will not have authority over a state’s medical practice act. Each state participating in the compact will have two representatives on the commission.</p> <p> The AMA <a href="http://www.ama-assn.org/ama/ama-wire/post/ama-backs-interstate-compact-streamline-medical-licensure" target="_blank">endorsed the compact</a>—an initiative of the Federation of State Medical Boards (FSMB)—in November. The AMA also created new policy to work with interested medical associations, the FSMB and other stakeholders to ensure expeditious adoption of the compact and the creation of the interstate commission.</p> <p> Among states that adopt it, the compact would act as an independent law and as a contract among the states to help ensure ongoing cooperation and adaptation. It’s based on several key principles:</p> <ul> <li style="margin-left:0.25in;"> The practice of medicine is defined as taking place where the patient receives care, requiring the physician to be licensed in that state and under the jurisdiction of that state’s medical board. This tenant aligns with AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">principles for telemedicine</a>.</li> <li style="margin-left:0.25in;"> Regulatory authority will remain with the participating state medical boards.</li> <li style="margin-left:0.25in;"> Participation in the compact is voluntary for both physicians and state boards of medicine.</li> </ul> <p> FSMB has created a <a href="http://www.fsmb.org/policy/interstate-model-compact/" rel="nofollow" target="_blank">map</a> that highlights the growing support in state legislatures for the compact. The interactive map allows physicians to see whether their state has introduced and passed legislation to join the compact.</p> <p> For more information, visit the <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/telemedicine.page?" target="_blank">AMA Web page on telemedicine</a>. </p> <p> <strong>Update: </strong>Minnesota became the eighth state to pass legislation to join the compact, with the governor signing the bill into law Tuesday.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b0be7267-e812-428d-8209-75f09b4f556b Prep your practice for 2016 changes: Coding resource sale http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prep-practice-2016-changes-coding-resource-sale-1 Tue, 19 May 2015 20:39:00 GMT <p> The Oct. 1 deadline to implement the ICD-10 code set is approaching—make sure your practice has the latest resources to code correctly.</p> <p> Save 20 percent at the AMA Store on <a href="https://commerce.ama-assn.org/store/content/2016-annual-titles?node_id=2016-annual-titles" target="_blank">2016 annual resources</a> . The most recent ICD-10 resources include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610008&navAction=push" target="_blank">ICD-10-PCS 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610007&navAction=push" target="_blank">ICD-10-CM 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610024&navAction=push" target="_blank">ICD-10-CM Documentation 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610009&navAction=push" target="_blank">ICD-10-CM Mappings 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank">Pocket Guide to Understanding ICD-10-CM Documentation</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430005&navAction=push" target="_blank">Principles of ICD-10-CM Coding</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430006&navAction=push" target="_blank">Principles of ICD-10-CM Coding Workbook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610022&navAction=push" target="_blank">Advanced Anatomy and Physiology for ICD-10-CM/PCS 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620029&navAction=push" target="_blank">ICD-10-CM 2016 Snapshot Coding Cards</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620026&navAction=push">ICD-10-CM 2016 Mapping Cards</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620030&navAction=push">ICD-10-PCS 2016 Snapshot Coding Card Collection</a></li> </ul> <p> CPT® resources include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610015&navAction=push" target="_blank">CPT 2016 Professional Edition</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610006&navAction=push" target="_blank">CPT Changes 2016: An Insider’s View</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2570002&navAction=push" target="_blank">Netter’s Atlas of Surgical Anatomy for CPT Coding</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510015&navAction=push" target="_blank">CPT Reference Guide for Cardiovascular Coding 2015</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510016&navAction=push" target="_blank">Principles of CPT Coding</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480001&navAction=push" target="_blank">CPT Case Studies: Examples of Procedures & Services</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2620027&navAction=push" target="_blank">CPT 2016 Express Reference Cards</a></li> </ul> <p> Other coding resources that are part of the sale include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610026&navAction=push" target="_blank">Medicare RBRVS 2016: The Physicians’ Guide</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610017&navAction=push" target="_blank">HCPCS 2016 Level II Professional Edition</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2530024&navAction=push" target="_blank">Medical Record Auditor</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1250077&navAction=push" target="_blank">Coding with Modifiers</a></li> </ul> <p> AMA members receive an additional discount on these products. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p> This promotion is available for customers that purchase from the AMA directly (excludes wholesalers, resellers and bookstores). The code is valid only on the products listed directly above, and expires June 30. The code cannot be combined with other promotions or packages.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c0a5789e-ac28-42a3-b8c9-19f3939590c7 3 events that are transforming learning in med ed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-events-transforming-learning-med-ed Tue, 19 May 2015 13:00:00 GMT <div> <p> The local AMA medical student sections at Georgetown University School of Medicine, SUNY Upstate College of Medicine and William Carey College of Osteopathic Medicine recently earned their schools recognition for the AMA’s Event of the Month, which showcases creative recruitment, community service and education events coordinated by individual AMA medical student sections. Looking to host an upcoming event at your school? Check out <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-month.page">the winners</a> for ideas and <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-year.page">vote for your favorite event</a> of the year.</p> <p> Here are the events the AMA’s recent winners hosted:</p> <p> <strong>Charting new approaches to patient care</strong><br /> Is “upstream medicine” the future of patient care? That’s the question the local AMA medical student section at Georgetown University School of Medicine aimed to discuss at its recent lecture and clinical visit on upstream medicine. The event started with a 15-minute video on the issue of upstream medicine and how physicians can care for patients using this newly conceived approach. After the video, Erica McClaskey, MD, a family medicine physician at Georgetown Medical Center that has experience in upstream medicine, shared clinical scenarios and advice with students on the benefits of using an upstream approach to treat patients.  </p> <p> <strong>Debating the future of health policy</strong><br /> The local AMA medical student section at SUNY Upstate College of Medicine won for its third annual Dialogues in Health Policy debate, which aims to give students and faculty a forum to discuss hot topics in health care policy. This year’s discussion focused on the pros and cons of accountable care organizations (ACOs) and featured presentations from eight students selected from SUNY Upstate’s College of Medicine and School of Public Health through an essay-based application.</p> <p> "By presenting the pros and cons of ACOs in a debate format, the audience became more engaged about health policy issues and concerns than if the topic were presented as a lecture," said Yuxin Liu and Olivia Yost, co-debate coordinators from the local AMA medical student section at SUNY Upstate. "Many attendees commented that they learned a lot and really enjoyed the event format."</p> <p> <strong>Mastering emergencies outside</strong><br /> Talk about survival skills: The William Carey College of Osteopathic Medicine took that concept to a whole new level in its “Step Outside” event where students ventured into the great outdoors for a collaborative session on emergency care in the wilderness. The two-day session featured presentations from Will Smith, MD, a medical director for several emergency wilderness first responder agencies and a military physician from the U.S. Army Reserve who shared some of the challenges he faced rescuing patients and walked students through a typical triage process.<br /> <br /> Students also learned how to make their own splints using outdoor equipment such as sleeping bags, pads, clothing and backpacks. The hands-on clinic focused on teaching students utility and efficacy in real-life emergency scenarios.</p> <p> “The skills clinic was very educational and exciting because it consisted of skills that we don't learn in every day curriculums. When would you normally make a forearm splint out of a sleeping pad?” said Cameron Petro-Sakuma, president of the local AMA medical student section.<br /> <br /> Is your AMA medical student section holding similar events? Submit a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/sig-follow-up.page">Section Involvement Grant (SIG) Recap Form</a> and photos within 30 days of your event to be eligible for the Event of the Month nomination, which the AMA selects each month. At the end of the school year, all monthly awards will be showcased in June at the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page">National Medical Student Meeting</a> and be voted on by students for one Event of the Year winner.</p> <p> Through the SIG program, the AMA-MSS provides an opportunity for local AMA medical student sections to:</p> <p> •  Educate students about the AMA and provide an opportunity for students to get more involved</p> <p> •  Help put AMA policy into action by providing a service to medical school campuses or communities</p> <p> •  Engage in activities that focus on AMA's top priorities</p> <p> Don’t forget to also <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-year.page">cast your vote</a> for the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-year.page">Event of the Year Award</a>. Winners will be announced at the National Medical Student Meeting June 5-6 in Chicago. </p> </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d72597be-939f-4b70-a7c3-d37b961524ed How self-monitoring blood pressure changed this patient’s life http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_self-monitoring-blood-pressure-changed-this-patients-life Mon, 18 May 2015 18:48:00 GMT <p> Bob Brown* smoked a pack of cigarettes and drank a six-pack of beer every day. The 61-year-old didn’t have a physician and didn’t think he needed one—until he got a slew of diagnoses that changed his life. With the help of his new physician, he took his health into his own hands.</p> <p> In 2014, Brown began experiencing shortness of breath, chest pain and swollen legs, so he sought care at MedStar Family Health Center (FHC) at MedStar Franklin Square Medical Center in Baltimore. His physician found that Mr. Brown had severe chronic obstructive pulmonary disease, symptoms of congestive heart failure, chronic kidney disease and uncontrolled hypertension. He also was morbidly obese.</p> <p> “But worst of all, Mr. Brown’s spirit was at an all-time low,” Seung “Jay” Chung, DO said. “He wanted to sign out against medical advice several times during his nearly two-week hospital stay.”</p> <p> <strong>Taking control of his health</strong><br /> Fortunately for Mr. Brown, MedStar is part of an AMA-Johns Hopkins initiative that helped Dr. Chung get his symptoms under control.</p> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices and health centers.</p> <p> Once Mr. Brown’s acute medical conditions were managed, the staff at MedStar FHC closely followed his health.</p> <p> “From the beginning, I thought Mr. Brown would be a good candidate for self-measured blood pressure monitoring,” Dr. Chung said, who used a protocol similar to that now available in an <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/smbp.pdf">AMA-JHM guide</a> (log in) for physicians and care teams. He loaned Mr. Brown a home blood pressure monitor for two weeks, taught him how to measure his blood pressure and involved him in his own self-care.</p> <p> It wasn’t easy for Mr. Brown. His kidney disease, obesity and other ailments added to the challenge of getting his blood pressure under control. But he stuck with it—and it worked.</p> <p> “Even the cardiologist stated that it is quite uncommon to see such a great improvement,” Dr. Chung said. “But the most important thing was the improvement in the patient’s spirit. He realized he has the most important role in improving his own health.”</p> <p> As a result of his success in getting his blood pressure under control, Mr. Brown’s overall health has improved, and he is making lifestyle changes to lose weight and eat better.</p> <p> <strong>Feeling empowered</strong><br /> “Monitoring my blood pressure has made me feel more helpful and involved with my doctors, who are helping me get better and be more proactive in taking care of myself,” Mr. Brown said. “I believe that if I had participated in a program like this one sooner, I might not be in the same predicament, health-wise, that I am in now.”</p> <p> Mr. Brown said he’ll continue to monitor his blood pressure, even though he completed the program with MedStar FHC, to prevent any further health issues.</p> <p> “When I first met this patient in the hospital, I thought he would not be long for life,” Dr. Chung said. “But by modifying his lifestyle and participating in the self-measured blood pressure monitoring program, he turned his situation around nearly 180 degrees.”</p> <p> <strong>More ways to improve</strong><br /> Learn what you need to know about self-measured blood pressure monitoring programs. You also can observe National High Blood Pressure Education Month by sharing a new infographic on <a href="https://www.facebook.com/AmericanMedicalAssociation/posts/10155456370275109" rel="nofollow" target="_blank">Facebook</a> or <a href="https://twitter.com/AmerMedicalAssn/status/595318481832280064" rel="nofollow" target="_blank">Twitter</a> with your practice team and patients so they understand how seemingly minor factors can affect their blood pressure measurements.</p> <p> You also can use additional resources, including:</p> <ul> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-patient-flyer.pdf">Patient handout on how to measure blood pressure at home</a> (log in)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf">Evidence-based checklists to improve blood pressure control</a> (log in)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-office-poster.pdf">Poster to demonstrate proper patient positioning when taking blood pressure</a> (log in)</li> </ul> <p> <em>*Patient’s name has been changed.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4bf1ac0e-fe76-4f96-9c66-114893c7a55f Health leaders discuss blood pressure control disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-leaders-discuss-blood-pressure-control-disparities Mon, 18 May 2015 17:35:00 GMT <p> Join leading health care groups at 4 p.m. Eastern time May 27 for a tweet chat about disparities in blood pressure control. Use hashtag <strong>#HBPLeaderChat </strong>to participate.</p> <p> As part of National High Blood Pressure Education Month, the American Heart Association and Kaiser Permanente are hosting a tweet chat looking at new research, best practices and potential solutions for tackling ethnicity-based disparity gaps in blood pressure control and stroke incidence. Special attention will be placed on disparities among African Americans.</p> <p> A physician representative from the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">Improving Health Outcomes</a> initiative will be among the chat panelists, and American Heart Association CEO Nancy Brown (@NancyatHeart) will moderate.</p> <p> Access <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Blood_Pressure_Education/1">additional resources</a> for National High Blood Pressure Education Month at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:43ea0cb4-604c-47f9-97be-ad67f609fe08 What motivates physicians--and how health care needs to change http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_motivates-physicians-health-care-needs-change Mon, 18 May 2015 17:33:00 GMT <p> What would inspire you to provide the best care—a financial reward, or knowing you would get rapid feedback that could help you improve?</p> <p> Studies show physicians are more motivated by intrinsic values that uniquely define the profession, such as actionable data and information-sharing capabilities, rather than external values, such as financial rewards.</p> <p> In a recent <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290650" rel="nofollow"><em>JAMA</em> Viewpoint on professionalism</a>, AMA Executive Vice President and CEO James L. Madara, MD, discusses how the health care environment should be changed from one that is governed by burdensome financial regulations to one that gives physicians what they need to provide the highest quality care.</p> <p> <strong>Current environment is misaligned</strong><br /> A disconnect between what really motivates physicians and the current incentive system that largely relies on such external motivators as financial penalties is creating misalignment.</p> <p> The Viewpoints points out that physicians often find themselves embedded in systems that:</p> <ul> <li> “Diminish time with patients (due to administrative demands on their time—often of trivial nature)”</li> <li> “Provide tools that are far from optimized for clinical care (such as the current state of most electronic health records)”</li> <li> “Rely on extensive sets of measures, many of which fail to relate to either practice type on one hand or on actual outcome on the other”</li> </ul> <p> The solution to realigning the health care system lies in obtaining “active and ongoing quantitative and qualitative studies of environmental influences that promote the professionalism naturally embedded in physicians,” Dr. Madara wrote.</p> <p> It also requires “applying what is learned toward structuring new delivery system environments that naturally leverage the motivators intrinsic in physicians.” And this is not easy.</p> <p> <strong>Taking on the challenge</strong><br /> Changing the health care environment to better match physicians’ needs to provide high-quality care is one challenge the AMA has taken on through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?">Professional Satisfaction and Practice Sustainability</a> initiative.</p> <p> Results from a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-views-new-payment-models-5-things">recent AMA study</a> conducted by the RAND Corporation revealed how physicians are actually implementing new payment models.</p> <p> The study found that doctors are trying to make these moves but need help successfully managing the transition, including how to respond to the many quality programs and metrics from payers and need for more timely and accurate clinical data to ensure long-term success. These findings will guide the AMA’s work in improving alternative payment models and find ways to help physician practices make successful transitions to new models.</p> <p> A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/quality-of-patient-care-primary-driver-of-physician-satisfaction-rand-study">2013 study</a> released by the AMA and RAND found that being able to provide high-quality care to their patients is the primary reason for job satisfaction among physicians, while obstacles to doing so are a key source of stress in the profession.</p> <p> The AMA is taking the insights its gleaned from its research and discussions to create tools for physicians that will help put the joy back in practice.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicine-considers-defines-professionalism">Read more</a> about professionalism and challenges for medicine at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9c4e971b-353e-41b2-92ad-26f9a2418e35 Student SOS: 6 ways to avoid “distress” in medical school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_student-sos-7-ways-avoid-distress-medical-school Fri, 15 May 2015 21:26:00 GMT <div>  </div> <div> <div>  </div> <div> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/6/f52533f2-e354-427b-b604-43dd4060a7b5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/6/f52533f2-e354-427b-b604-43dd4060a7b5.Large.jpg?1" style="margin:15px;float:right;" /></a>Burnout can be pervasive through all phases of physicians’ medical careers, beginning with students. But that doesn’t mean you have to live in a constant state of distress. Take time to learn the key signs of “student distress,” so you can boost well-being during medical school. </div> </div> <div>  </div> <div> <strong>Defining distress and its impact on future physicians</strong></div> <div> Dr. Lotte Dyrbye, MD, professor of medicine at Mayo Medical School, has studied burnout in medical education since 2004 and is a member of the AMA’s Accelerating Change in Medical Education initiative consortium, which consists of 11 U.S. medical schools that received $1 million grants to reshape the way physicians are trained.</div> <div>  </div> <div> During a recent consortium meeting at Oregon Health and Science University (OHSU), Dr. Dyrbye shared this surprising finding about student distress and burnout: Nearly 50 percent of medical students across all U.S. medical schools experience burnout according to several studies over the last decade. And the problem persists throughout physician training.</div> <div> <br /> Yet “when students matriculate into medical school, they have mental health profiles that are similar or better than similarly aged individuals in the population,” Dr. Dyrbye said, noting that incoming medical students enjoy a better quality of life, lower rates of depression and a more composed state of well-being than their peers in other professions.</div> <p> So what drains medical students of this healthy optimism? Simply put: They’re under distress, Dr. Dyrbye said. “When they enter medical school, they start to experience a high level of psychological distress, which can manifest in many different ways. For some [students], that means burnout. Others experience depression or have very high levels of fatigue.”</p> <p> No matter how it manifests, student distress often involves a trifecta of mental and emotional stressors, coupled with poor learning environments. If unattended, these factors can produce serious personal and professional ramifications for physicians in training.</p> <p> Studies already have shown that students who experience burnout are more likely to engage in “dishonest and unprofessional behaviors,” Dr. Dyrbye said. She gave examples of students who have reported a lab exam as pending when they weren’t sure whether it was ordered. Others have reported a finding on a physical exam as normal when they knew it was actually omitted from the exam. Burned out students also are more likely to believe it is acceptable to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/lax-student-views-of-self-prescribing-impairment-tied-burnout" target="_blank">self-prescribe antidepressants to themselves or a spouse</a>. They also are less likely to believe physicians should report impaired colleagues.</p> <p> <strong>How educators and students can curb distress</strong><br /> While there’s no simple solution for student distress, understanding what contributes to this state for physicians in training can help educators and students create an actionable plan to support well-being in medical schools, Dr. Dyrbye said. Here are some of the key drivers of student distress.</p> <p> <strong>1. An unsupportive learning environment and disorganized clinical rotations </strong></p> <p> “In our studies with students, the number of hours they’re working in the clinic and the patients they’re seeing isn’t necessarily related to burnout. Students expect and want to work hard but need to do so in a supportive and well-organized environment,” Dr. Dyrbye said.</p> <p> She noted that certain environmental factors—such as unsupportive faculty members, disorganized clinical rotations, inadequate supervision or a lack of variety in medical problems to solve—are commonly associated with student burnout.</p> <p> <strong>Solutions:</strong> Monitor students’ learning environment and respond with solutions specific to your medical education program. For instance, schools can evaluate resident-student teaching interactions and determine whether residents are effective teachers for students on clinical rotations. If they aren’t, programs can create new strategies to improve student teaching during clinical rotations, Dr. Dyrbye said.</p> <p> Also, schools can include students in discussions about curriculum and create courses that embody <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/students-wish-were-learning-med-school" target="_blank">what they really want to learn</a>. Check out how Mayo Clinic also has created <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/pivoting-new-way-of-training-future-physicians-mayo-clinic" target="_blank">innovative ways to teach students about team-based care</a>.</p> <p> <strong>2. An overemphasis on grades, especially in the first and second years of medical school</strong></p> <p> Dr. Dyrbye reports that a longitudinal study <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gender-grading-systems-shape-medical-students-views" target="_blank">evaluated a number of factors</a> that might contribute to student burnout, including hours of lecture, small group experiences, clinical rotations and exams. Grading structure was the one factor that consistently predicted student burnout.</p> <p> <strong>Solution:</strong> Implement a pass/fail grading structure during the first two years of medical school, so students can balance learning with well-being instead of over-occupying themselves with competition for the highest letter grade, Dr. Dyrbye advised.</p> <p> <strong>3. Mistreatment:</strong> Students who report suboptimal experiences, such as being harassed or belittled, have an increased risk of burnout. “For example, if minority medical students perceive that their race adversely impacted their medical school experience, they’re much more likely to have burnout and depression and poor quality of life,” Dr. Dyrbye said.</p> <p> <strong>Solution:</strong> Programs should support students in recognizing mistreatment and offer solutions for reporting and resolving these issues.</p> <p> Programs also can look at ways to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/debunking-5-myths-diversity-medical-education" target="_blank">foster diversity</a> in medical schools and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-tips-communicating-medical-student" target="_blank">improve communication</a> with students.  </p> <p> <strong>4. Debt:</strong> “My colleagues [researched] the issue of debt in residents—which contributes to burnout—but this also applies to students,” Dr. Dyrbye said. “If you’re $200,000 in debt, that can be an obvious source of stress.”</p> <p> <strong>Solution:</strong> Students can access resources to learn <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/budgeting-101-money-management-tips-medical-students" target="_blank">how to properly manage loans and budget now</a>, rather than expecting they will figure out financial planning in residency or practice.</p> <p> Schools and programs also can continue to develop scholarship opportunities. For example, the AMA Foundation’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-of-tomorrow-lighten-student-loan-debt-applying-this-scholarship" target="_blank">Physicians of Tomorrow Award</a> offers $10,000 scholarships to students approaching their final year of medical school. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/opportunities/grants-awards-scholarships.page?" target="_blank">Follow the AMA Foundation</a> to receive updates about scholarship opportunities and deadlines.</p> <p> <strong>5. Personal life events</strong></p> <p> Medical school coincides with a time in a young person’s life when they are experiencing many personal events. Some of them are positive, such as falling in love and getting married. Some students even choose to have children. But this also is a time when negative life events, such as a family death or a relative who becomes ill, can increase their risk of burnout.</p> <p> <strong>Solutions:</strong> “That’s not something that we can fix as educators,” Dr. Dyrbye said. “But it’s important to be aware of them and provide accommodations around [these issues].”</p> <p> <strong>6. An unwillingness to ask for help, which spurs poor self-assessment </strong></p> <p> “We know that the willingness to seek help for personal medical problems is a huge issue,” Dr. Dyrbye said. “And it’s not just [among] medical students. It’s also prevalent among residents and physicians in practice.”</p> <p> “We tend to think, ‘Well, everyone is stressed out, so I’m just like everyone else.’ And then by the time our level of mental distress comes to the attention of the people we’re working with, we’ve really been suffering for a long time and face negative consequences.”</p> <p> <strong>Solutions:</strong> Educate students about resiliency and individual choices, so they know how to respond to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">the common signs of burnout</a>. For instance, Mayo Clinic has created a course on resiliency that teaches students positive coping strategies that support well-being. </p> <p> Dr. Dyrbye’s school also created a self-assessment tool that students can complete online and get immediate feedback about their stress and their risk of professional consequences. The tool immediately links them to resources.</p> <p> Dr. Dyrbye also noted that if educators and physicians discuss moments they felt vulnerable in their careers with students, it creates an opportunity for students to openly share their experiences and seek advice. “We have to be role models for students to talk about stressors and how [we’ve managed] them in times when life has been really out of balance,” she said.</p> <p> <strong>Tell us:</strong> If you’re an educator, what are other ways you’re supporting students with distress? And if you’re a student, what are other solutions you think would help? </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f4650f19-b64a-4678-8f2a-2aa57c32624d Crunching the costs of diabetes: Graphic breaks it down http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_crunching-costs-of-diabetes-graphic-breaks-down Fri, 15 May 2015 20:10:00 GMT <p> Take a guess: How much more money is spent on medical care for people with diabetes than those without diabetes?</p> <p> A May <a href="http://www.healthcostinstitute.org/issue-brief-capita-health-care-spending-diabetes-2009-2013" target="_blank" rel="nofollow">study</a> from the Health Care Cost Institute found that among adults with employer-sponsored insurance, average per capita spending for those with diabetes is nearly $15,000—about $10,300 more than for those without diabetes.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/6/d7a4175c-82df-4f86-96ee-4703bac5a374.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/6/d7a4175c-82df-4f86-96ee-4703bac5a374.Large.jpg?1" style="float:right;margin:15px;" /></a>The study also found that the out-of-pocket health care spending by people with diabetes was more than 2.5 times higher than for people without diabetes.</p> <p> The findings underscore the importance of a newly introduced bill that could help reduce the incidence of diabetes and help to control costs. The <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-legislation-could-cover-diabetes-prevention-program" target="_blank">Medicare Diabetes Prevention Act</a> would require Medicare to cover services provided under the evidence-based National Diabetes Prevention Program.</p> <p> Although the study examined individuals with employer-sponsored insurance, the high cost of diabetes affects the Medicare population, too. A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-diabetes-bill-could-save-13-billion-over-10-years" target="_blank">study</a> released last year estimated the bill could reduce federal spending by $1.3 billion over 10 years.</p> <p> The study also estimated that the legislation would help reduce the cumulative rate of type 2 diabetes in the Medicare population by an estimated 37 percent after a decade. That means there would be nearly 1 million fewer cases of diabetes among seniors by 2024.</p> <p> <strong>Stopping type 2 diabetes before it starts</strong><br /> Part of controlling the spiraling costs of treating patients with type 2 diabetes is preventing the disease before it starts. That’s why the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative is focused on prediabetes, the precursor to type 2 diabetes.</p> <p> In 2012, the Centers for Disease Control and Prevention (CDC) launched the <a href="http://www.cdc.gov/diabetes/prevention/" target="_blank" rel="nofollow">National Diabetes Prevention Program</a> based on <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa012512" target="_blank" rel="nofollow">research</a> led by the National Institutes of Health, which showed that individuals at high risk of developing type 2 diabetes who participated in structured lifestyle change programs saw a significant reduction in the incidence of the disease.  </p> <p> The AMA spent the past year <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-physician-helping-stop-diabetes-among-her-patients" target="_blank">working with the YMCA of the USA</a> and 11 physician practice pilot sites in four states to increase physician screening and testing for prediabetes. Physicians in the pilot then referred patients with prediabetes to diabetes prevention programs offered by local YMCAs that use the CDC’s program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.</p> <p> <strong>What physicians can do now</strong><br /> To help physicians and care teams address the growing prevalence of prediabetes, the AMA and the CDC recently <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-03-12-ama-cdc-initiative-aims-to-prevent-diabetes-stat.page" target="_blank">announced</a> a call to take urgent action with <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank"><em>Prevent Diabetes STAT: Screen, Test, Act – Today™</em></a>. The multi-year initiative will help physicians refer patients to diabetes prevention programs in their communities or online. Get the <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/toolkit.html">toolkit</a> now.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevention-program" target="_blank">Learn more</a> about diabetes prevention programs and the AMA’s Improving Health Outcomes initiative at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:42e5b078-4a32-47b7-a43f-3bd693ed17f7 Medicine considers what defines professionalism http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medicine-considers-defines-professionalism Thu, 14 May 2015 20:07:00 GMT <p> Physicians take an oath to uphold ethical standards, but rapid changes in the health care system may have begun to blur lines across the practice of medicine. What measures should physicians be held accountable to, and who should regulate the profession?</p> <p> The <a href="http://jama.jamanetwork.com/issue.aspx" target="_blank" rel="nofollow">May 12 issue of <em>JAMA</em></a> takes a deep dive into professionalism, including Viewpoints from scholars and academic leaders about the responsibility and accountability of medicine to self-govern, self-regulate and ensure the highest degree of professionalism.</p> <p> Prominent physicians among the authors include AMA Executive Vice President and CEO James L. Madara, MD; Ezekiel J. Emanuel, MD, vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania; Thomas J. Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education; and Lois Margaret Nora, MD, president and CEO of the American Board of Medical Specialties.</p> <p> The issue examines the key roles and responsibilities of modern governing and accrediting bodies and of professional organizations and societies. Find out what these entities are doing—and what they should do differently—to enhance self-governance, safeguard self-regulation and foster professionalism.</p> <p> <strong>Instilling professionalism</strong></p> <p> Where does the foundation for professionalism begin? According to one <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290648" target="_blank" rel="nofollow"><em>JAMA </em>Viewpoint</a>, it’s laid before medical school, and undergraduate medical education reinforces the commitment to professionalism. This piece holds that developing competence in professionalism is a core expectation for a physician learner, the same as developing competence in medical knowledge.</p> <p> On a related note, <a href="http://journalofethics.ama-assn.org/" target="_blank">this month’s issue</a> of the <em>AMA Journal of Ethics</em> tackles this topic. The issue examines where professional boundaries start and stop, and how far physicians may go to assist patients with nonclinical matters.</p> <p> Earn continuing medical education credit and investigate professional boundaries further by using a <a href="https://cme.ama-assn.org/Activity/1981026/Detail.aspx" target="_blank">module</a> from the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs.page" target="_blank">Council on Ethical and Judicial Affairs</a>. Learn about key areas where establishing boundaries with patients may be challenging and issues outside the patient-physician relationship where boundaries are essential.</p> <p> <strong>Continuous learning and self-regulation</strong></p> <p> Professionalism and lifelong learning go hand-in-hand, which gives way to professional self-regulation, according to another <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290652" target="_blank" rel="nofollow"><em>JAMA </em>Viewpoint</a>. Topics up for discussion include maintenance of certification and reforming the continuing medical education system.</p> <p> With the increasing proportion of physicians employed by health care systems, what is the role of employers in governing and overseeing professionalism among physician-employees? Another <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290645" target="_blank" rel="nofollow"><em>JAMA </em>Viewpoint</a> explores how employment can advance or detract from professionalism goals.</p> <p> Finally, the <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290650" target="_blank" rel="nofollow"><em>JAMA </em>Viewpoint</a> by Dr. Madara asks how physician and professional organizations can assist in professionalism. One way is to understand physicians’ intrinsic motivators and help craft environments that leverage these motivators. </p> <p> Read an <a href="http://jama.jamanetwork.com/article.aspx?articleid=2290620" target="_blank" rel="nofollow">editorial</a> outlining all of these topic areas and <a href="http://jama.jamanetwork.com/issue.aspx#10227ArticleTypeName" target="_blank" rel="nofollow">view the list</a> of 19 Viewpoints.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7d15f21b-c897-43eb-a13b-f5ef2a609e7b Volunteer for final ICD-10 end-to-end testing week http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_volunteer-final-icd-10-end-end-testing-week Wed, 13 May 2015 22:00:00 GMT <p> Physicians have one last chance to find out whether their claims will be processed by Medicare following the Oct. 1 implementation of the ICD-10 code set. Volunteer by May 22 for a special end-to-end testing week being conducted by the Centers for Medicare & Medicaid Services (CMS) in July.</p> <p> CMS extended the volunteer deadline and will select about 850 submitters to participate in the July 20-24 testing week. If you participated in the January or April end-to-end testing weeks, you may test again in July without re-applying. </p> <p> The testing is designed to determine three things:</p> <ul> <li style="margin-left:0.25in;"> Whether people who submit claims are able to do so successfully using ICD-10 codes in the Medicare fee-for-service claims systems</li> <li style="margin-left:0.25in;"> Whether the software changes CMS made to support ICD-10 result in appropriately processed claims</li> <li style="margin-left:0.25in;"> Whether accurate remittance advice is produced</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-moves-forward-end-end-testing-results-released" target="_blank">Read the results</a> of the agency’s first end-to-end testing week at <em>AMA Wire</em>®.</p> <p> <strong>What volunteers need to do</strong></p> <p> Physicians who are interested in volunteering should visit their Medicare Administrative Contractor’s (<a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/provider-compliance-interactive-map/index.html" target="_blank" rel="nofollow">MAC) website</a> to download an application form, which must be completed and submitted by May 22. </p> <p> CMS has said that any issues identified during testing will be addressed prior to ICD-10 implementation. Educational materials will be developed based on the testing results.</p> <p> Additional information about CMS’ ICD-10 testing is available in a recent <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1409.pdf" target="_blank" rel="nofollow"><em>MLN Matters</em>® article</a>.</p> <p> <strong>Participate in webinar</strong></p> <p> CMS will host a webinar from 1:30 to 3 p.m. Eastern time June 18. Experts will present strategies and resources to help physicians prepare for the new code set. The webinar will also cover the ICD-10-PCS Section X for new technologies, and participants will be able to ask questions.</p> <p> <a href="http://www.eventsvc.com/blhtechnologies/register/d0b2ec78-772e-4630-9022-bba5d29ea659" target="_blank" rel="nofollow">Register</a> by noon Eastern time June 18 to participate.</p> <p> <strong>Learn more before Oct. 1</strong></p> <p> The AMA secured end-to-end testing through extensive advocacy with regulators and will continue to urge regulators to ease the burden of ICD-10 implementation on physicians. In the meantime, practice management experts advise physicians to begin preparing their practices now for the transition to ICD-10.</p> <p> To help with the testing process, the AMA has developed an ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a>. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> <p> Experts anticipate that physicians will experience cash flow interruptions, especially for those who aren’t fully prepared. Learn more about what your practice should do to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially</a> for ICD-10, and read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">first in a series</a> about how to prep for ICD-10, whether you’re a beginner or an expert.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6adefa8c-6511-4ba6-b64f-b3e50c2590c3 4 things every resident should know for their job search http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-things-resident-should-their-job-search Wed, 13 May 2015 16:01:00 GMT <p> Completing your residency is a major accomplishment, but as one chapter of your medical career ends and another begins, searching for employment can pose its own unique challenges. Not to worry—we’ve got you covered. Here are four things every resident should know to make the most of their job search and employment after residency.</p> <p> <strong>1. The JAMA Network can help you find a job, too. </strong></p> <p> In addition to providing cutting-edge medical research, the <a href="http://jama.jamanetwork.com/journal.aspx" rel="nofollow" target="_blank">JAMA Network</a> offers professional resources for physicians. Visit the <a href="http://www.jamacareercenter.com/" rel="nofollow" target="_blank">JAMA Career Center</a> to search for employment opportunities. The site features more than 6,000 job postings and reference guides to help physicians prepare for key transitions in their careers.</p> <p> <strong>2. Learn how to negotiate a contract before you walk into the interview.  </strong></p> <p> Whether you plan to work for a hospital or group practice, negotiating a contract is an important part of the hiring process for all employed physicians. How can you know whether your contract is fair and reasonable?</p> <p> Use these resources to learn how to negotiate with future employers and identify the key areas of a contract before starting a new job:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/7-things-must-before-signing-employment-contract" target="_blank">7 things you must know before signing an employment contract</a></li> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2752919/Detail.aspx" target="_blank">“Negotiating your employment contract” webcast</a></li> <li style="margin-left:0.25in;"> <a href="http://media01.commpartners.com/AMA/contracting101/index.html" rel="nofollow" target="_blank">“Contracting 101: You get what you negotiate” webcast</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/contract-presentation-registration.page" target="_blank">“Negotiate with confidence: Know what's in your contract</a>” webcast</li> </ul> <p> <strong>3. Getting paid what you deserve is possible—it just requires a little know-how.  </strong></p> <p> Discussing compensation is its own part of negotiations, but it doesn’t have to be intimidating. Review the AMA’s annotated model employment agreements—one for physicians seeking <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240028&navAction=push" target="_blank">employment with a hospital</a> and one for physicians looking for a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2530052" target="_blank">group practice position</a>—to gain a better understanding of various compensation methodologies and learn how to negotiate a fair compensation package.</p> <p> These resources also discuss such important contractual considerations as working conditions, liability insurance, restrictive covenants and termination of the contract.</p> <p> <strong>4. Prepare for success by mastering principles of physician employment.</strong></p> <p> What happens if you and your employer disagree on how to treat a patient? When should you be loyal to your employer or advocate for your patients’ health? And how can you ensure these disagreements won’t negatively impact your peer reviews and evaluations?</p> <p> Find answers to these employment questions and more in the <a href="https://ssl3.ama-assn.org/apps/ecomm/PolicyFinderForm.pl?site=www.ama-assn.org&uri=%2fresources%2fhtml%2fPolicyFinder%2fpolicyfiles%2fHnE%2fH-225.950.HTM" target="_blank">AMA’s Principles for Physician Employment</a>. This principles deal with addressing conflict of interests, advocating for patients and the profession, contracting, hospital medical staff relations, peer review and performance evaluations, and payment agreements.</p> <p> <strong>Tell us:</strong> What other tips and resources are you using to find a job after residency? Share your favorites in the comments below or on the AMA’s <a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow" target="_blank">Residents and Fellows Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:85055acd-ca22-4d0c-8074-564ff5a4bece Register now for June 6 education program on aging physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_luncheon-explore-successful-aging-june-6 Wed, 13 May 2015 14:19:00 GMT <p> Join the AMA Senior Physicians Section (SPS) for an education program on the possibilities and perils of the aging physician, to take place from noon to 1:30 p.m. on June 6 as part of the AMA-SPS Annual Meeting in Chicago.</p> <p> Recent surveys of physicians indicate that late-career physicians, compared to those in early- or mid-career, are generally the most satisfied and have the lowest rates of distress. Practicing medicine often is the core of the senior physician’s identity. Limiting one’s practice or retiring can challenge the physician’s sense of purpose and self-image, and physicians frequently struggle with retiring gracefully.</p> <p> This education session will look at the difficulties and gratifications of the golden years, research on successful aging and recommendations for senior physicians.</p> <p> The featured speaker will be Glen O. Gabbard, MD, of the Clinical College of Psychiatry at Baylor College of Medicine. The moderator will be Barbara S. Schneidman, MD, of the AMA-SPS Governing Council. Reaction panelists will be Louis J. Kraus, MD, of the AMA Council on Science and Public Health; David J. Welsh, MD, of the AMA Organized Medical Staff Section; and Lt. Colonel Ronit B. Katz, MD, of the AMA International Medical Graduates (IMG). The facilitator will be Nancy W. Dickey, MD, a former AMA president.</p> <p> A luncheon will be served at 11:30 a.m. on a first-come, first-served basis. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/meetings.page?" target="_blank">Advanced registration</a> is appreciated. If you have questions about the meeting or registering, contact Alice Reed of the AMA <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">via email</a> or phone at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:34a64703-c8e8-4e46-8c85-4e1bf2fa0893 AMA-SPS Governing Council election results http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-sps-governing-council-election-results Wed, 13 May 2015 14:14:00 GMT <p> Congratulations to the new 2015–2016 AMA-Senior Physicians Section (SPS) Governing Council officers at-large listed below. Their terms begin at the conclusion of the AMA Annual Meeting on June 7.</p> <p> <u><a href="https://download.ama-assn.org/resources/doc/sps/x-pub/biosketch-mcbryde.pdf">Angus M. McBryde, Jr., MD</a></u> (<em>Columbia, S.C.</em>)</p> <p> <u><a href="https://download.ama-assn.org/resources/doc/sps/x-pub/biosketch-schneidman.pdf">Barbara A. Schneidman, MD</a></u> (<em>Seattle, Wash.</em>)</p> <p> They will join the current <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/about-us/governing-council-election.page">AMA-SPS Governing Council officers</a> listed below.</p> <ul> <li> Paul H. Wick, MD, chair (Tyler, TX)</li> <li> Barbara A. Hummel, MD, chair-elect (<em>Muskego, Wis.</em>)</li> <li> Claire V. Wolfe, MD, delegate (<em>Dublin, </em>Ohio)</li> <li> John A. Knote, MD, alternate delegate (<em>West Lafayette, Ind.</em>)</li> <li> Louis Weinstein, MD (<em>Charleston, S.C.</em>)</li> </ul> <p> Thank you to all who participated in the recent AMA-SPS Governing Council elections and to those who applied to serve on the governing council. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:81e66c1a-d403-47fd-82eb-e5bceb901431 Plan to attend 2015 AMA-SPS Annual Meeting June 6 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-2015-ama-sps-annual-meeting-june-6 Wed, 13 May 2015 14:05:00 GMT <p> Members of the AMA Senior Physicians Section (SPS) are invited to attend the 2015 AMA-SPS Annual Meeting on June 6 at the Hyatt Regency Chicago.</p> <p> Participants can introduce new items of business related to the section's mission and review items in the AMA House of Delegates Handbook that are related to senior physician issues. The meeting is scheduled from 11:30 a.m. to noon June 6 in Columbus K/L (East Tower, Gold Level). </p> <p> A luncheon will be served at 11:30 a.m. on a first-come, first-served basis. We hope you can join us and enjoy the fellowship of your senior physician colleagues. If you have questions about the meeting or registering, please <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">email Alice Reed</a> of the AMA, or call her at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6a7d9d7e-74e4-4d92-b265-1f7e4e06c8f8 Weigh in on medicine’s most important issues http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_weigh-medicines-important-issues Tue, 12 May 2015 20:54:00 GMT <p> How do you think the practice of medicine should be improved in the United States? Weigh in on important health care topics—and have a chance to shape AMA policy—via the AMA <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/reference-committee.page" target="_blank">Online Member Forums</a> (log in). They’re now open in advance of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>, June 6-10 in Chicago.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/14/eb70e150-ab79-4f1e-be6c-8db9328baa4f.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/14/eb70e150-ab79-4f1e-be6c-8db9328baa4f.Full.png?1" style="width:365px;height:250px;margin:15px;float:right;" /></a></p> <p> Online forums allow AMA members to weigh in on key policy issues facing medicine from the comfort of their homes or offices. By participating in the forums, you can add your voice to the AMA policy discussion at your convenience.</p> <p> Resolutions and reports up for discussion at the 2015 AMA Annual Meeting address such topics as:</p> <ul> <li style="margin-left:0.25in;"> Development of a single national prescription drug monitoring program</li> <li style="margin-left:0.25in;"> Data transparency principles to promote quality and care delivery innovations</li> <li style="margin-left:0.25in;"> Medical licensing issues faced by international medical graduates</li> <li style="margin-left:0.25in;"> Model guidelines for expansion of residency programs</li> <li style="margin-left:0.25in;"> Targeted pharmaceutical packaging to reduce drug overdose</li> </ul> <p> All items of business from initial reports and resolutions for this policymaking meeting are posted in the forums, which are sorted by reference committee. Any AMA member can comment on any item of business. While the forums will be open until the start of the meeting, comments posted after June 1 may not be captured in the comment summaries that will be posted on the <a href="http://www.ama-assn.org/sub/meeting/reportsresolutions.html" target="_blank">2015 AMA Annual Meeting website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9cdeb1d5-2cc3-43b1-bc2d-69cc369e8a1e Banding together, physicians take on world health issues http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_banding-together-physicians-world-heath-issues Tue, 12 May 2015 20:20:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/2/7fe7fe90-e972-4136-a286-59e07f96da4a.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/2/7fe7fe90-e972-4136-a286-59e07f96da4a.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An AMA Viewpoints post by AMA President Robert M. Wah, MD.</em></p> <p> When I talk to physicians from other countries, I am always struck by how similar our struggles are, despite our different cultures, and how steadfast our commitments to our patients are.</p> <p> At a recent council meeting of the World Medical Association (WMA) in Oslo, Norway, I spent time with physicians from Brazil, Korea, Uganda, Japan and Germany. We’re spread across the globe, but many of the health care issues we’re tackling here in the United States are similar to the ones our counterparts are addressing in their homelands as well.</p> <p> As the international organization representing physicians, the WMA’s membership is comprised of 111 national medical associations. I have represented the AMA alongside AMA President-elect Steven J. Stack, MD, and Immediate-past President Ardis Dee Hoven, MD. (In fact, Dr. Hoven just <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/world-medical-association-elects-first-woman-chair" target="_blank">became the first female chair</a> of the WMA.)</p> <p> Talking with colleagues from around the world was a good reminder that we aren’t alone in the struggles we face and that banding together can make us stronger in conquering these challenges.</p> <p> For example, physicians in many countries are grappling with public health challenges, the burdens of chronic diseases and health IT issues. While our individual challenges may differ, the global community shares many of the same concerns. That’s why it’s so important that our voices come together on the international level.</p> <p> Among other things, the WMA is revving up its work on the social determinants of health (the social and economic circumstances in which people are born and live that can give rise to poor health conditions). As physicians, we’re used to picking up the pieces and repairing the damage that comes from these social determinants. Our global work seeks to better address these social determinants and apply what we know to prevent poor health, rather than just treating the symptoms of socially rooted diseases.</p> <p> Amidst the business of our practices, it can be difficult for us to see beyond the patients we care for every day. But it’s good to take a step back from time to time and remember we’re all facing similar challenges. Our collective efforts can help us surmount these struggles more comprehensively to produce healthier patients and a healthier world.</p> <p> I also am inspired and heartened by physicians’ commitment to high quality care and dedication to patients—the same dedication across the globe, no matter where we are.</p> <p> Later this month, I’ll be heading to Geneva, Switzerland, for the World Health Assembly of the World Health Organization. Our global community again will discuss issues that affect us all: Childhood obesity, chronic disease, women’s health and vaccinations, among others. I’m looking forward to what the worldwide power of physicians can accomplish. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8652a36b-89e9-48c7-bfd1-e6953dcc3226 What it’s like to be a pediatrician: Shadowing Dr. Berkowitz http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-pediatrician-shadowing-dr-berkowitz Mon, 11 May 2015 21:33:00 GMT <p> As a medical student, do you ever wonder what it’s like to specialize in pediatrics? Here’s your chance to find out.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/13/a810c70f-4ffb-44a9-ad4c-d882cec62348.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/13/a810c70f-4ffb-44a9-ad4c-d882cec62348.Large.jpg?1" style="margin:15px;float:right;" /></a>Meet Carol Berkowitz, MD, a pediatrician and featured physician in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank"><em>AMA Wire’s</em> “Shadow Me” Specialty Series</a>, which offers advice directly from physicians about life in their specialties.</p> <p> Read Dr. Berkowitz’s insights to help determine whether a career in pediatrics is a good fit for you.</p> <p style="margin-left:40px;"> <strong>“Shadowing” Dr. Berkowitz</strong></p> <p style="margin-left:40px;"> <strong>Specialty:</strong> Pediatrics</p> <p style="margin-left:40px;"> <strong>A typical week:</strong><br /> I work in academic pediatrics in a university affiliated county hospital [for] five days with weekend call. I attend in three clinics a week and do six weeks on the pediatric in-patient service. I also cover for our child abuse team.</p> <p style="margin-left:40px;"> <strong>The most challenging aspect of caring for patients in pediatrics:</strong><br /> Child abuse is difficult because it is hard to see children injured by their parents, [but ] intervening is very rewarding.</p> <p style="margin-left:40px;"> <strong>Three adjectives to describe the typical pediatrician:</strong><br /> Caring. Likes children. Optimistic.</p> <p style="margin-left:40px;"> <strong>My lifestyle in pediatrics has allowed me to:</strong><br /> Have regular hours and raise a family.</p> <p style="margin-left:40px;"> <strong>The main skill every physician should have for pediatrics but won’t be tested for on the board exam is:</strong><br /> Good communication skills.</p> <p style="margin-left:40px;"> <strong>One question every physician in training should ask themselves before pursuing pediatrics:</strong><br /> What makes you happy and professionally satisfied?</p> <p style="margin-left:40px;"> <strong>One thing students considering pediatrics should remember:</strong><br /> If you don’t like kids and don’t find them uplifting, don’t choose pediatrics.</p> <p style="margin-left:40px;"> <strong>My two mantras as a pediatrician are:</strong><br /> “Even on your worst day, a hug from a child can light up the sky,” and “becoming a pediatrician is an iterative process.”</p> <p style="margin-left:40px;"> <strong>If my life in pediatrics were a song, it’d be: </strong><a href="https://www.youtube.com/watch?v=WO4wcNVbYOQ" rel="nofollow" target="_blank">“I Never Promised You a Rose Garden”</a> by Lynn Anderson.</p> <p> <strong>Want to learn more about pediatrics and other specialty options? Don’t miss the </strong><strong>specialty showcase June 6.</strong><br /> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/medical-specialty-showcase.page?" target="_blank">AMA’s Medical Specialty Showcase</a> will take place from 11:30 a.m. to 1:30 p.m. June 6 at the Hyatt Regency Chicago. A variety of specialties will be represented, and students can speak directly with physicians about their practices. Physicians will also share information about mentorship programs and organizations that can help students learn more about their preferred specialties.</p> <p> The showcase is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a>. Don’t miss out—<a href="https://login.ama-assn.org/account/login" target="_blank">register for the meeting</a> today (login), and find additional resources on choosing a specialty such as <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.page?" target="_blank">the AMA’s resource guide</a>, which features overviews of the major specialties and subspecialties. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:40828cbe-0d86-493a-a957-13f122f86647 What it’s like to be in palliative care: Shadowing Dr. Edmonds http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-like-palliative-care-shadowing-dr-edmonds Mon, 11 May 2015 21:33:00 GMT <div> As a medical student, do you ever wonder what it’s like to specialize in palliative care? Here’s your chance to find out. </div> <div>  </div> <div> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/a32cf562-379f-4a41-99df-33f9a605317b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/a32cf562-379f-4a41-99df-33f9a605317b.Large.jpg?1" style="margin:15px;float:left;" /></a>Meet Kyle P. Edmonds, MD, a palliative care specialist and featured physician in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-choosing-specialty-dont-miss-this-series" target="_blank">AMA Wire’s “Shadow Me” Specialty Series </a>, which offers advice directly from physicians about life in their specialties.</div> <div>  </div> <div> Read Dr. Edmond’s insights to help determine whether a career in palliative care is a good fit for you. </div> <div style="margin-left:40px;"> <div>  </div> <div> <strong>"Shadowing"  Dr. Edmonds </strong></div> <div>  </div> <div> <strong>Specialty:</strong> Palliative care</div> <div>  </div> <div> <strong>Years in practice: </strong>3 </div> <div>  </div> <div> <strong>A typical week:</strong></div> <div> [I work at ] the Howell Palliative Care Service at University of California at San Diego, [which] provides inter-professional consultation five days a week during business hours. There is no weekend or call responsibility at this time.</div> <div>  </div> <div> Our team consists of fellowship-trained physicians, nurse practitioners, clinical social workers and pharmacists, as well as learners of all stages in each of those disciplines. I typically arrive at work at 8 a.m. and prepare for our daily interdisciplinary sit-down rounds. We will see follow-up patients in the morning and new consults later in the day for an average of two new consults and six follow-up visits each day. We see most patients as a full team so that each discipline on the team can bring their own skill set to the bedside for each patient. We end our clinical day around 5 p.m.</div> <div>  </div> <div> As a full-time clinical physician, I have a four week on and two weeks off service schedule. We have two inpatient teams that I rotate across—one in a more inner-city trauma center, where I see lots of medical-surgical, ICU, trauma and liver transplant patients. The other service serves our tertiary oncology center inpatients as well as our advanced interventional cardiovascular patients.</div> <div>  </div> <div> In my two weeks off service, I am expected to be academically and administratively productive. I also spend time directing or co-directing courses at the schools of medicine and pharmacy as well as serving on multiple committees within the organization.</div> <div>  </div> </div> <div> <p style="margin-left:40px;"> <strong>The most challenging aspect of caring for patients in palliative care:</strong><br /> The most challenging part of my job is competing with the myths surrounding palliative care. When we are doing our job as it’s meant to be done, we [see] any patient with serious illness to help with symptom management, the stress of illness, advance care planning and shared decision making to help her tolerate the curative or potentially curative therapy she is undergoing.</p> <p style="margin-left:40px;"> <strong>The most rewarding aspect of caring for patients in palliative care:</strong><br /> I get to learn enough about patients to see them in the context of their lives, beyond the acute medical issues.</p> <p style="margin-left:40px;"> <strong>Three adjectives to describe the typical palliative care specialist:</strong><br /> Compassionate. Thorough.  Heretical.</p> <p style="margin-left:40px;"> <strong>How my lifestyle matches or differs from what I envisioned in medical school:</strong><br /> To be honest, in medical school I envisioned working much longer hours than I do. My job differs from my expectations in that I don’t have call or weekend responsibilities.</p> <p style="margin-left:40px;"> <strong>The main skills every physician should have for palliative care but won’t be tested for on the board exam:</strong><br /> Experts in palliative care see [very] challenging patients—whether that challenge is difficult symptoms, maladaptive coping, serious mental illness or complex family dynamics. This requires professionals who are not only compassionate and thorough but also comfortable with ambiguity and careful advocates for their patients. It also requires people with good boundaries and a healthy sense of their own counter-transference. Fellowship in palliative medicine is, in a way, a reprogramming for physicians away from the traditional medical approach to these challenging situations.</p> <p style="margin-left:40px;"> <strong>One question every physician in training should ask themselves before pursuing palliative care:</strong><br /> Palliative care is a team sport in which the physician is often not the authority in any given situation.  Are you comfortable working with highly trained experts in other disciplines and deferring to their expertise when the patient’s needs are out of your scope?</p> <p style="margin-left:40px;"> <strong>The three key books I think every medical student should read regardless of planned field of practice are:</strong></p> <ul> <li style="margin-left:40px;"> <em>Being Mortal</em> by Atul Gawande</li> <li style="margin-left:40px;"> <em>How Doctors Think</em> by Jerome Groopman</li> <li style="margin-left:40px;"> <em>Cutting for Stone</em> by Abraham Verghese</li> </ul> <p style="margin-left:40px;"> <strong>If you want to learn more about palliative care, I also recommend students follow:</strong></p> <ul> <li style="margin-left:40px;"> <a href="http://pallimed.org/" rel="nofollow" target="_blank">pallimed.org</a></li> <li style="margin-left:40px;"> <a href="http://geripal.org/" rel="nofollow" target="_blank">geripal.org</a></li> <li style="margin-left:40px;"> And on Twitter: #HPM and the #HPM Tweetchat, every Wednesday at 9 p.m. Eastern time</li> </ul> <p style="margin-left:40px;"> <strong>One thing students considering palliative care should remember:</strong><br /> There are certain people who can find the joy in this work and others for whom the joy remains obscured. Start reaching out and talking to many different types of people who work in the field to get a good understanding of what we do and whether you are one of those who sees the joy. A good way to do this is to get yourself to Twitter and follow the #hpm hashtag, where we have a diverse group of interesting people from whom to learn.</p> <p style="margin-left:40px;"> <strong>My mantra with each new patient is:</strong><br /> “No agenda.” This helps me leave my agenda or the primary team’s agenda outside of the room and focus my assessment in a patient-centered and family-oriented way.</p> <p> <strong>Want to learn more about palliative care and other specialty options? Don’t miss the specialty showcase June 6.</strong><br /> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/medical-specialty-showcase.page?" target="_blank">AMA’s Medical Specialty Showcase</a> will take place from 11:30 a.m. to 1:30 p.m. June 6 at the Hyatt Regency Chicago. A variety of specialties will be represented, and students can speak directly with physicians about their practices. Physicians will also share information about mentorship programs and organizations that can help students learn more about their preferred specialties.</p> <p> The showcase is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a>. Don’t miss out—<a href="https://login.ama-assn.org/account/login" target="_blank">register for the meeting</a> today (login), and find additional resources on choosing a specialty such as <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.page?" target="_blank">the AMA’s resource guide</a>, which features overviews of the major specialties and subspecialties.</p> </div> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:41b5a852-7c06-429b-948e-02e52a0791e6 What you need to know about self-measured blood pressure monitoring http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-self-measured-blood-pressure-monitoring Mon, 11 May 2015 21:07:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/3/ad70750d-5f05-4a98-b35e-8d35dfa411d2.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/3/ad70750d-5f05-4a98-b35e-8d35dfa411d2.Large.jpg?1" style="float:right;margin:10px;" /></a>Having patients measure their own blood pressure at home can improve diagnosis of hypertension, and for those patients who have it, can help get their hypertension under control. Learn the facts about self-measured blood pressure monitoring, including how you can get a self-measured blood pressure monitoring program started in your practice.</p> <ul> <li> <strong>What is self-measured blood pressure monitoring?</strong><br /> Sometimes called “home blood pressure monitoring,” this patient self-measurement occurs outside of a clinical setting. Research shows this process can improve adherence and health outcomes for patients with hypertension.</li> </ul> <ul> <li> <strong>Why would I want patients to self-measure their blood pressure at home?</strong><br /> Randomized controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office blood pressure measurements, so using it to guide you in diagnosing and treating hypertension likely will produce better outcomes than using office blood pressure readings alone.<br /> <br /> Self-measurements provide more blood pressure readings over a longer period of time, which better represents what a patient’s true blood pressure is.<br /> <br /> By having more reliable blood pressure readings to work with, you are less likely to misdiagnose a patient as having sustained hypertension when they really have isolated office blood pressure elevations (known as “white coat hypertension”).<br /> <br /> This concept also applies to assessing the blood pressure control of a patient with hypertension. Having more accurate and reliable readings allows clinicians to assess whether a patient’s anti-hypertensive treatment is sufficiently controlling their blood pressure. If it is not controlled, a clinician can act more rapidly, being confident that the multiple readings taken over the course of several days are more reliable than a few blood pressure measurements taken during a single office visit.</li> </ul> <ul> <li> <strong>How do my patients get a home blood pressure monitor?</strong><br /> Your patients can buy a monitor at their local drug store. Many public and private health insurance plans don’t cover the cost of self-monitoring devices, unfortunately. Prices for a typical high-quality device can range from $50 to $150. Another option is to purchase monitors for your practice and loan them out to patients.</li> </ul> <ul> <li> <strong>How can I help my patients determine which monitor to buy?</strong><br /> Most of the methods of monitoring patients’ blood pressure that are shown to improve patient outcomes use automated (oscillometric) devices. With this type, the patient wraps a cuff around his or her arm and presses a button to get a digital blood pressure reading.<br /> <br /> When recommending an automated device, tell the patient to make sure the device meets these four criteria:</li> </ul> <p style="margin-left:1.5in;"> • <strong>Valid.</strong> Automatic devices should be certified by the Association for the Advancement of Medical Instrumentation, the British Hypertension Society or the European Society of Hypertension.</p> <p style="margin-left:1.5in;"> • <strong>Meant for the upper arm.</strong> Only upper arm monitors produce reliable measures. Monitors for the wrist do not produce accurate results.</p> <p style="margin-left:1.5in;"> • <strong>Easy to use.</strong> Devices come in a range of models with varying features, so the patient should choose a device that is easiest for him or her to use.</p> <p style="margin-left:1.5in;"> • <strong>Able to share data.</strong> Some devices can store readings and report back at a later time, calculate an average measure and transmit to other devices, such as your electronic health record system.</p> <ul> <li> <strong>How should my patient use a home blood pressure monitor?</strong><br /> Have your patient use this <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-graphic-patients-need-accurate-blood-pressure-reading">infographic</a> to get in an appropriate position before they take the reading. (See below for additional free resources your practice can download and use.) Your patient should take two readings at one- to two-minute intervals, both in the morning and evening for seven consecutive days. This will provide four measurements a day, 28 for a week, which is ideal. Make sure the patient knows to record each measurement.<br /> <br /> Offer additional support when using this process, such as a one-time training session when you or someone on your staff can watch the patient obtain his or her blood pressure measurement. This way you make sure the patients understands how to do so correctly.</li> </ul> <ul> <li> <strong>How do I use the data from my patient’s measurements?</strong><br /> When you receive the patient’s measurements, calculate the average value of all the systolic and diastolic blood pressures. Use this single average to determine whether your patient has hypertension or your patient’s blood pressure is controlled.<br /> <br /> Research shows this process improves blood pressure control when physicians provide personalized support and advice based on the patient’s data.</li> </ul> <ul> <li> <strong>Do I need to give the patient any warnings?</strong><br /> Make sure your patient knows what to do if he or she has a measurement that is outside your pre-determined acceptable range, or if he or she experiences any symptoms with a high or low blood pressure measurement. This could mean seeking emergency treatment, if appropriate.</li> </ul> <p> <strong>How you can take action</strong><br /> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices.</p> <p> Use the AMA’s guide to <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/smbp.pdf">starting a self-measured blood pressure monitoring program</a> (log in) to begin engaging your patients in their self-measurement. This resource has fact sheets, patient handouts and adaptable practice tools to help your practice establish and maintain a program for your patients. You also can use additional resources, including:</p> <ul> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-patient-flyer.pdf">Patient handout on how to measure blood pressure at home</a> (log in)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf">Evidence-based checklists to improve blood pressure control</a> (log in)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-office-poster.pdf">Poster to demonstrate proper patient positioning when taking blood pressure</a> (log in)</li> </ul> <p> <strong>More ways to improve</strong><br /> Observe National High Blood Pressure Education Month by sharing this infographic on <a href="https://www.facebook.com/AmericanMedicalAssociation/posts/10155456370275109" rel="nofollow" target="_blank">Facebook</a> or <a href="https://twitter.com/AmerMedicalAssn/status/595318481832280064" rel="nofollow" target="_blank">Twitter</a> with your practice team and patients so they understand how seemingly minor factors can affect their blood pressure measurements.</p> <p> Here are some additional resources to help you improve your practice’s hypertension management:</p> <ul> <li> Read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">three questions you should ask patients</a> when measuring their blood pressure.</li> <li> Hear <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-saying-doing-control-hypertension" target="_blank">what other physicians are doing</a> to control hypertension in their practices.</li> <li> See how you can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">manage blood pressure outside of office visits</a>.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9fb758c1-8a31-4bc8-9fdc-ce805448f3ea Need help choosing your specialty? Don’t miss this series http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-choosing-specialty-dont-miss-this-series Mon, 11 May 2015 18:00:00 GMT <p> Whether you’re a first- or fourth-year medical student, choosing your specialty is one of the most crucial decisions you will make in your career as a physician. Yet we’ve heard from many students that <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-things-students-overlook-choosing-specialty">navigating your options can become tricky</a>, especially if you lack exposure to various specialties and practice settings. That’s where a new series can help.<br /> <br /> Over the next several weeks, <em>AMA Wire</em> will feature physician profiles as part of its new “Shadow Me” Specialty Series. Each profile will offer honest advice, observations and resources from physicians in different specialties.<br /> <br /> In their own words, physicians will share the pros and cons of practicing in their specialties, personal observations about their lifestyles and student-friendly tips you don’t want to miss.<br /> <br /> Review profiles from physicians in these very different fields:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-like-pediatrician-shadowing-dr-berkowitz" target="_blank">Carol Berkowitz, MD, in pediatrics</a></li> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-like-palliative-care-shadowing-dr-edmonds" target="_blank">Kyle P. Edmonds, MD, in palliative care</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-orthopedic-surgeon-shadowing-dr-dangles" target="_blank">Chris Dangles, MD, in orthopedic surgery</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-pediatrics-shadowing-dr-meade" target="_blank">Elizabeth Meade, MD, in pediatrics</a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-sports-medicine-shadowing-dr-vasudevan" style="font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;line-height:16.5454540252686px;" target="_blank">John Vasudevan, MD, in physical medicine and rehabilitation</a><span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;line-height:16.5454540252686px;"> (emphasis in sports medicine)</span></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-family-medicine-shadowing-dr-wergin" target="_blank">Robert Wergin, MD, in family medicine </a></li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe" target="_blank">Claire Wolfe, MD, in physical medicine and rehabilitation</a></li> </ul> <p> <strong>Are you a physician who’d like to contribute a profile?</strong><br /> If you’d like to help students learn more about your specialty, <a href="mailto:mr.feedback@ama-assn.org?subject=Shadow%20Me%20Specialty%20Series" rel="nofollow">send us an email</a> to be considered for a potential feature in this series.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:64bd0292-d7e8-4540-9cb5-9d9d5879ec5e When does helping a patient violate professional boundaries? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_helping-patient-violate-professional-boundaries Fri, 08 May 2015 19:47:00 GMT <p> Nonclinical factors such as unemployment, lack of transportation or a fear of doctors’ offices can impede patients’ medical treatment. But how far should doctors go to assist in these matters?</p> <p> <a href="http://journalofethics.ama-assn.org/">This month’s issue</a> of the <em>AMA Journal of Ethics</em> examines the delicate balance between a physician’s personal interest in patients and professional boundary guidelines. Contributors help distinguish boundary <em>crossings</em>—benevolent acts outside the scope of clinical interventions—from boundary <em>violations</em>—breaches of practice that may place patients’ bodily or psychological well-being at risk.</p> <p> The May issue features:</p> <ul> <li> “<a href="http://journalofethics.ama-assn.org/2015/05/medu1-1505.html">Where the rubber meets the road: The challenge of reporting ethical breaches</a>.” Obstacles to reporting include confusion over boundary lines, fear of hurting a colleague and the potential for colleague retaliation, according to the author of this piece.<br />  </li> <li> “<a href="http://journalofethics.ama-assn.org/2015/05/msoc1-1505.html">Necessary boundary crossing in pediatrics</a>.” To help a seriously ill young patient whose normal childhood has been disrupted, pediatricians must be more than sympathetic professionals in white coats—they must know how to motivate each patient and then go the extra mile to do so.<br />  </li> <li> “<a href="http://journalofethics.ama-assn.org/2015/05/pfor1-1505.html">Professional codes, public regulations and the rebuilding of judgment following physicians’ boundary violations</a>.” The author of this piece believes remedial intervention following boundary violations must emphasize the importance of physician judgment and self-regulation rather than mere knowledge of the “rules.”</li> </ul> <p> Listen to the journal’s May <a href="http://journalofethics.ama-assn.org/podcast/ethics-talk-may-2015.mp3">podcast</a> to hear why Gordon D. Schiff, MD, believes that physicians’ human connection to patients sometimes calls on them to openly cross professional boundaries in efforts to help needy patients. Dr. Schiff is a primary care physician and a safety and quality improvement researcher at Harvard Medical School.</p> <p> Also, take the monthly <a href="http://journalofethics.ama-assn.org/site/poll.html">ethics poll</a>, which asks: Which examples of physician conduct do you think are within the bounds of appropriate professional behavior?</p> <p> <a href="https://twitter.com/JournalOfEthics" target="_blank" rel="nofollow">Follow</a> the journal on Twitter for more ethics news.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b3b22556-a3dc-4ae8-8e21-2a31cb12f040 CME sessions look at timely topics from MOC to value-based payment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cme-sessions-look-timely-topics-moc-value-based-payment Fri, 08 May 2015 19:46:00 GMT <p> Take advantage of <a href="http://www.ama-assn.org/sub/meeting/cme.html" target="_blank">continuing medical education (CME) events</a> at the 2015 AMA Annual Meeting, to be held June 6-10 in Chicago. Sessions will include practical advice and immediate takeaways on health care’s hottest topics.</p> <p> All sessions will be held at the Hyatt Regency Chicago.</p> <ul> <li> <strong>How the </strong><a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank"><strong>Accelerating Change in Medical Education</strong></a><strong> initiative is impacting the med ed continuum. </strong>Get an update on this AMA initiative and its implications across pre-med, undergraduate medical education, graduate medical education and the practicing physician’s continuing medical education. The session will take place from 8 to 9 a.m. June 8 in Regency Ballroom D.</li> </ul> <ul> <li> <strong>Turnkey tools for improving hypertension control and preventing type 2 diabetes. </strong>The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">Improving Health Outcomes</a> initiative has resulted in easy-to-use approaches and tools for improving blood pressure control in patients with hypertension as well as efficiently identifying patients with prediabetes and referring them to evidence-based diabetes prevention programs. Learn how you can use these tools from 9 to 10 a.m. June 8 in Regency Ballroom D.</li> </ul> <ul> <li> <strong>Advantages and disadvantages of moving toward value-based payment. </strong>Earlier this year, the U.S. Department of Health and Human Services announced ambitious goals and timelines for moving Medicare and the private sector toward value-based payments. Understand the impact of these changes at a session moderated by AMA Executive Vice President and CEO James L. Madara, MD, from 2 to 3:15 p.m. June 5 in Crystal Ballroom A.</li> </ul> <ul> <li> <strong>Ways the maintenance of certification (MOC) program could change. </strong>Experts will review the American Board of Medical Specialties’ current MOC program and discuss ways it could be made more workable and transparent. Hear about concerns and potential progress from 7:30 to 8:45 a.m. June 6 in Crystal Ballroom A.</li> </ul> <ul> <li> <strong>What to do about the growing number of unmatched medical students. </strong>Experts will review data from the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/record-breaking-match-sees-higher-percentage-of-unmatched-seniors">most recent Match</a> and discuss ways to mitigate the number of unmatched students in the future. Hear new ideas and innovative approaches from 9 to 10:15 a.m. June 6 in Crystal Ballroom A.</li> </ul> <p> Each of these educational activities has been approved for <em>AMA PRA Category 1 Credit</em><em>™</em>.</p> <p> Participants do not need to be AMA members to claim credit, but a free AMA username and password are required to complete the CME activity evaluation forms and save certificates in the AMA <a href="https://cme.ama-assn.org/Education.aspx">Online Learning Center</a>. Have your AMA login information ready if you are attending the 2015 AMA Annual Meeting. No paper evaluation forms will be available.</p> <p> If you have questions regarding your AMA username and password, or if you need to create a username and password before the meeting, contact the AMA Unified Service Center at (800) 621-8335.</p> <p> Check the <a href="http://www.ama-assn.org/resources/doc/hod/x-pub/a15-speakers-letter.pdf">Speaker’s Letter</a> (log in) to learn about additional educational sessions.</p> <p> Be sure to download the <a href="http://www.ama-assn.org/sub/meeting/mobile.html">2015 Annual Meeting app</a>, your guide to all events taking place during the meeting. Get the most up-to-date schedule before and during the meeting and receive text alerts about schedule changes, new sessions or location changes.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f0bea68b-3329-45ab-b052-be04a5b99fe4 Events medical students shouldn't miss http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_events-medical-students-shouldnt-miss Fri, 08 May 2015 16:36:00 GMT <p> If you’re attending the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">National Medical Student Annual Meeting</a> June 4-6 in Chicago, don’t miss these 10 top events that will help give you a firm foundation in the medical profession.</p> <p> <strong>June 4:</strong></p> <p style="margin-left:40px;"> <strong>1.     </strong><strong>Addressing health challenges through technological innovation. </strong>Participate in a mini-workshop from 6 to 7 p.m. June 4 as health care technology incubators discuss how collaboration among physicians and entrepreneurs will advance new technology to improve the way the health care system works.</p> <p> <strong>June 5:</strong></p> <p style="margin-left:40px;"> <strong>2.     </strong><strong>Inspiring school kids to become doctors. </strong>Join other medical students, residents and physicians in a special AMA Doctors Back to School™ Improving Health Outcomes Together event from 7:30 a.m. to noon June 5. By participating, you can share your passion for the profession with the next generation.</p> <p style="margin-left:40px;"> <strong>3.     </strong><strong>Defining your professional social media presence. </strong>Do you know your brand? Learn how to avoid ethical missteps and professional blunders while strengthening your online brand. A session from 1 to 2:30 p.m. June 5 will empower you to shape your future medical practice and promote public health through your use of social media.</p> <p style="margin-left:40px;"> <strong>4.     </strong><strong>Understanding how changes in Medicare will affect you. </strong>Come hear David O. Barbe, MD, immediate-past chair of the AMA Board of Trustees, explain how recent legislative changes to Medicare will affect how physicians will practice in the coming years. This session will take place from 3 to 4 p.m. June 5.</p> <p style="margin-left:40px;"> <strong>5.     </strong><strong>Learning about why cutting-edge drugs are so costly. </strong>A session from 5 to 6 p.m. June 5 will look at the complex process of pharmaceutical development that can result in burdensome costs for the people who need to use these drugs.</p> <p> <strong>June 6:</strong></p> <p style="margin-left:40px;"> <strong>6.     </strong><strong>Choosing a specialty. </strong>Get a leg up on choosing your specialty at the annual AMA Medical Specialty Showcase, set to take place from 11:30 a.m. to 1:30 p.m. June 6. Come talk to representatives from more than 50 specialties, who will give you an introduction to their field and provide materials to assist with this important career decision. The event also is an excellent opportunity to network with residents and physicians in your desired specialty.</p> <p style="margin-left:40px;"> <strong>7.     </strong><strong>Hearing from a panel of residency program directors. </strong>Residency program directors from Yale, Johns Hopkins and other distinguished programs will discuss what they’re looking for in residency candidates. Come get answers to your questions before you start interviewing. Don’t miss this one-of-a-kind event from 11:30 a.m. to 1 p.m. June 6.</p> <p style="margin-left:40px;"> <strong>8.     </strong><strong>Getting experience with clinical skills. </strong>Rising second-year medical students can get hands-on experience with placing advanced airways, improving suturing skills and using ultrasound technology for line placement, among other important tasks, during this session from 1 to 2:30 p.m. June 6. Experts in the field will provide guidance, offer tips and share tricks of the trade.</p> <p style="margin-left:40px;"> <strong>9.     </strong><strong>Demystifying student loan repayment. </strong>If you’re trying to figure out the best way to handle student loan repayment and deferment after graduation, a session from 1 to 2 p.m. June 6 is for you. Learn about repayment strategies, loan forgiveness and changes that may be coming in the future. This session also will offer tips for creating a monthly budget for residency.</p> <p style="margin-left:40px;"> <strong>10.     </strong><strong>Connecting with Apple and digital health.</strong> Don’t miss this session from 3:30 to 5 p.m. June 6 with Vin Capone, national development executive from Apple, as he discusses what Apple is doing in health care, what the Apple ReseachKit is and how everybody can do their part to advance medical research. Audience participation, commentary and interactions are encouraged.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dd0f4c58-beda-4f94-8c86-85baeb2b6b10 University tackles team-based care across health care schools http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_university-tackles-team-based-care-across-health-care-schools Thu, 07 May 2015 20:40:00 GMT <p> When real-life patients present, their ailments often require treatment from a variety of experts—physicians aren’t the only professionals patients will interact with. So medical schools are building new programs to educate students about health care teams, but implementing such a curriculum isn’t easy.</p> <p> Interprofessional education breaks the tradition of health professions students that are educated in siloes and instead places them together in a variety of education settings. The goal of these new programs is for students to learn the skills of collaboration and team care that lead to improved patient care outcomes.</p> <p> These learning strategies are gaining steam in schools across the country, such as at the Oregon Health and Science University (OHSU) in Portland. But the school has discovered that coordinating university-wide curricula can be challenging—things like room scheduling, school calendars and discipline-specific cultures can be impediments to implementation.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/3/90cfa1fe-792a-4c7f-83d0-997617f744bb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/3/90cfa1fe-792a-4c7f-83d0-997617f744bb.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>Beginning the change</strong><br /> As a consortium member of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page">Accelerating Change in Medical Education</a> initiative, OHSU is making sweeping changes to its curricula and has made <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/making-case-interprofessional-education">interprofessional education</a> a cornerstone.</p> <p> “Early on, we had an institutional commitment to interprofessional education and collaborative practice,” Jeanette Mladenovic, MD (pictured right), executive vice president and provost at OHSU, said at the consortium’s recent meeting. “We partner, we collaborate and we innovate. Under that strategic plan, every aspect has something about interprofessional education.”</p> <p> The school is designing sessions that put dental, medical, nursing, nutrition, physician assistant and radiation therapy students together to learn specific skills while they also examine issues such as professionalism and professional identity formation. Students will learn clinical foundation skills together and will practice clinical scenarios side by side as they progress through their education.</p> <p> <strong>Encountering challenges</strong><br /> The first step required to allow all health professions students to work together started by aligning all calendars to ensure students were on the same schedules. This included neighboring institutions Portland State University and Oregon State University.</p> <p> “This set the stage for moving forward,” Dr. Mladenovic said. “We could orient all 500 beginning students at the same time.”</p> <p> But it wasn’t a totally smooth transition, she said.</p> <p> “The culture of the schools was very different,” Dr. Mladenovic said. “There are faculty and language differences …. It was a change for us as an institution to say, ‘this is not just for medical students.’”</p> <p> Other consortium schools, including the University of Michigan Medical School and the Warren Alpert Medical School at Brown University, also are <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-team-based-care">tackling the challenges</a> of interprofessional education.</p> <p> Part of the consortium’s work is to reinforce the importance of change and to eliminate the tendency to say that “we’ve done things the way we’ve done them forever,” Dr. Mladenovic said.</p> <p> “We need flexibility because health care is changing,” she said. “We’ll have students of different levels, different backgrounds, different experiences. We need to make sure the profession views themselves as totally dependent on other professions to deliver the kind of care we need to keep the population healthy—and that requires a huge culture change.”</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Changing_MedEd/1">Read more</a> at <em>AMA Wire</em>® to learn how schools are making this culture change.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7f21e902-f1eb-40ba-8606-320d9999d8f4 Events for residents: 2015 AMA Annual Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_events-residents-2015-ama-annual-meeting Thu, 07 May 2015 15:00:00 GMT <p> If you’ll be in Chicago for the 2015 AMA Annual Meeting in June, be sure to participate in these events especially for residents and fellows:</p> <ul> <li> <strong>Welcome reception. </strong>Connect with resident and fellow physician colleagues from across the country during a networking reception from 9 to 11 p.m. June 4.</li> </ul> <ul> <li> <strong>ACGME listening session on resident burnout. </strong>Attend the education session “Taking the pulse of trainees” from 1:30 to 2:30 p.m. June 5.<br /> <br /> A representative from the Accreditation Council for Graduate Medical Education (ACGME) will present data on determinants of resident well-being from the organization’s 2013–2014 national survey data.<br /> <br /> By attending, you’ll have a chance to tell the ACGME face to face how to improve its survey methods, better train physicians in graduate medical education programs to support residents and identify solutions that matter to you.</li> </ul> <ul> <li> <strong>Resident health panel.</strong> Join a discussion with your peers and speakers about innovative solutions to physician wellness from 8:45 to 9:30 a.m. June 6. Can yoga or dance help residents avoid burnout? Attend the panel to find out and share your own creative ideas.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4f5da522-37b4-4bb9-966e-12b5a5949c06 Why physicians switch EHRs--and what happens afterward http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-switch-ehrs-happens-afterward Wed, 06 May 2015 20:01:00 GMT <p> Electronic health record (EHR) systems are part of the fabric of medical practice in the 21st century, but many of today’s systems are far from perfect. Find out why physicians are changing from one EHR to another, and the challenges they encounter in doing so.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/5/0c3118aa-5571-4851-a5af-c663d5f49772.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/5/0c3118aa-5571-4851-a5af-c663d5f49772.Full.jpg?1" style="margin:15px;float:right;width:365px;height:250px;" /></a></p> <p> A <a href="http://www.aafp.org/fpm/2015/0100/p13.html" rel="nofollow" target="_blank">survey</a> published in the January issue of <em>Family Practice Magazine </em>examined physicians’ experiences with changing EHRs in the past five years. The magazine’s medical editor, Kenneth Adler, MD, presented the findings last month at a <a href="http://files.himss.org/2015Conference/handouts/156.pdf" rel="nofollow" target="_blank">session</a> during the 2015 annual meeting of the Healthcare Information and Management Systems Society in Chicago.</p> <p> <strong>Why physicians change EHRs</strong></p> <p> The top reasons given for switching EHR systems were:</p> <ul> <li style="margin-left:0.25in;"> Gain added functionality</li> <li style="margin-left:0.25in;"> Achieve meaningful use</li> <li style="margin-left:0.25in;"> Get better usability</li> <li style="margin-left:0.25in;"> Find better support and training</li> <li style="margin-left:0.25in;"> Consolidate multiple EHRs</li> </ul> <p> <strong>Challenges to change</strong></p> <p> About 80 percent of respondents said the biggest challenge in changing EHRs was the time investment required, and 70 percent pointed to productivity loss as the biggest challenge. Many also said they found it challenging to learn how to use a new EHR and that the cost of the switch was burdensome.</p> <p> <strong>How the change is working now</strong></p> <p> About 60 percent of respondents said their new EHR has useful functionality, and around 55 percent said their new EHR has allowed them to achieve meaningful use.</p> <p> The responses not surprisingly also showed that changing EHRs is a major undertaking, expensive and time-consuming.</p> <p> But did making the switch improve their productivity? Almost one-half said no, and about one-quarter said yes. The remaining one-quarter were neutral.</p> <p> “Although changing an EHR does add useful functionality and helps achieve meaningful use,” Dr. Adler said. “[It] does not make physicians happier or lead consistently to better overall EHR performance.”</p> <p> Of the 305 family physician respondents to the survey, about one-half worked in hospital- or health system-owned practices. About 41 percent worked in physician-owned practices. Roughly one-quarter worked in practices with 100 or more physicians, while 21 percent were in solo practice.</p> <p> The AMA is working to improve EHRs through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Physician Satisfaction and Practice Sustainability</a> initiative, ensuring the voices of physicians are part of EHR development.</p> <p> Last year, the AMA released a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint</a> outlining ways to improve the Medicare and Medicaid meaningful use program and a framework that details <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight priorities</a> for moving toward more usable EHR systems. The AMA is using this framework to work with physicians, vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance the delivery of high-quality, affordable care.</p> <p> <strong>Tell us: </strong>Have you changed EHRs in the past five years? What was your experience like? Tell us in a comment below.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4cb4b2fb-89f0-457b-ba6e-d280abe84524 Residents seek solutions to wellness problems http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-seek-solutions-wellness-problems Wed, 06 May 2015 18:59:00 GMT <p> What would improve your residency environment and help you stay well? Residents at the 2015 AMA Resident and Fellow Section (RFS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/rfs-meetings.page?" target="_blank">Annual Meeting</a> will weigh solutions, and you can add your opinions to the discussion.</p> <p> The meeting will be held June 4-6 in Chicago, but residents can log into the <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/rfs-reference-committee.page" target="_blank">AMA-RFS forum</a> now to review proposals on topics that could eventually become AMA policy.</p> <p> Three issues on wellness include:</p> <ul> <li style="margin-left:0.25in;"> <strong>Improving resident well-being through new partnerships.</strong> This proposed policy asks the AMA to join with companies that promote residents’ physical well-being, potentially providing discounts.</li> <li style="margin-left:0.25in;"> <strong>Reducing barriers to health care.</strong> This policy proposal asks the AMA to study how to best track whether residency programs are providing access to necessary preventive and routine physical and mental health care for their trainees.</li> <li style="margin-left:0.25in;"> <strong>Mental health services for medical staff.</strong> This resolution encourages health systems, hospitals and medical schools to offer physicians, residents and medical students unrestricted access to confidential, comprehensive mental health services not affiliated with their places of employment.</li> </ul> <p> Residents also can weigh in on other timely topics, including:</p> <ul> <li style="margin-left:0.25in;"> Evaluation of resident and fellow compensation levels</li> <li style="margin-left:0.25in;"> Graduate medical education funding reform</li> <li style="margin-left:0.25in;"> The optimal use of telehealth technology</li> </ul> <p> The June meeting will be laser-focused on resident wellness. A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/whats-real-reason-residents-burn-out-tell" target="_blank">new study</a> in the <em>Journal of Graduate Medical Education</em> found factors that related to poor wellness include inadequate sleeping conditions and a lack of quality food.</p> <p> Residents who are attending the annual meeting in Chicago can join a discussion about innovative solutions to physician wellness at 8:45 a.m. June 6. Can yoga or dance help residents avoid burnout? Attend the panel to find out and share your own creative ideas.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:516a85dc-d823-479a-bffc-fcbf1abe10bf World Medical Association elects first woman chair http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_world-medical-association-elects-first-woman-chair Tue, 05 May 2015 17:38:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/7/dc9e05a7-d9c6-4fb9-b7d9-39e49c66553b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/7/dc9e05a7-d9c6-4fb9-b7d9-39e49c66553b.Large.jpg?1" style="margin:15px;float:left;height:280px;width:200px;" /></a>Ardis Dee Hoven, MD, immediate-past president of the AMA, last month became the first female chair of the World Medical Association (WMA) at the organization’s 200th council meeting in Oslo, Norway. <em>AMA Wire</em>® talked with Dr. Hoven about her new role and what she hopes to accomplish.</p> <p> The WMA is the international organization representing physicians from 111 national medical associations. The AMA is represented by its three presidents, which includes AMA President Robert M. Wah, MD, AMA President-Elect Steven Stack, MD. Dr. Hoven has been chair of the AMA delegation to the WMA for the past few years and now will serve a two-year term as chair of the WMA.</p> <p> <strong>Q: How does it feel to be part of WMA history as the first female chair?</strong></p> <p> <strong>A: </strong>I feel fortunate to have the opportunity to do this. I see myself not so much as a woman in this role but as a leader of a global organization of physicians who are working to support their peers around the world and improve the lives of their patients. I also am very proud to represent the United States and American medicine.<br /> <br /> There have been some amazing people from the AMA who’ve held leadership positions within the WMA before me, so we have a history of involvement with this organization. My work at the AMA has taught me how to be a responsive leader.</p> <p> <strong>Q: What’s your No. 1 goal for the WMA’s upcoming year?</strong></p> <p> <strong>A: </strong>I would like the WMA to raise its profile internationally and increase the impact of its policies and advocacy on behalf of physicians and patients. It has a remarkable message about the duties of physicians, their relationships with the private sector and their governments, and their role in protecting the health of patients. Many national medical associations use WMA policies as global positions to influence actions of their governments.</p> <p> Our work over the past years has given us extremely good credibility. For example, the work around the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/declaration-of-helsinki-reminder-medicine-boundaries" target="_blank">Declaration of Helsinki</a> (which establishes guidelines for physicians conducting research on humans) has been very important in the global arena. But we have a lot of other topics under development—for example, the ethics around the uses of health databases and biobanks.</p> <p> So I want to make our footprint bigger and our voice stronger. And I think how you do this is by engaging the various members of the WMA, reaching out to national medical associations from countries that are not yet involved and collaborating with other international groups, such as the World Health Organization.</p> <p> <strong>Q: What is it like to work with so many different people and cultures?</strong></p> <p> <strong>A: </strong>It can be a challenge to make sure everyone’s voice is heard, because people are diverse in their languages, their cultures and their medical communities. Yet it’s that diversity of knowledge, backgrounds and practice environments that makes the WMA strong.</p> <p> A classic example I can recall is when we were working on the Declaration of Helsinki. We were sitting around the table, and the way to address one particular ethical issue seemed so “obvious” to members from economically advanced countries. But that same issue was really difficult for a national medical association from a developing country because of how their countrymen were exploited in the past as a result of the poverty in their communities. It’s important to have these different perspectives when looking at global issues.</p> <p> <strong>Q: Can you describe an issue the WMA is working on that’s particularly important to you?</strong></p> <p> <strong>A: </strong>This fall, Sir Michael Marmot will become WMA president. His work on the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/improving-health-heart-of-matter" target="_blank">social determinants of health</a> has been extraordinary. The WMA has adopted policy that supports the role of physicians and medical associations in addressing the societal issues that can impact health. I’d like to see the WMA serve as a platform for his work and undertake some specific activities that will demonstrate how physicians can help on these issues.</p> <p> I also want the WMA to continue to speak out on violence against <a href="http://www.wma.net/en/20activities/20humanrights/45womenhealth/10vaw/" rel="nofollow" target="_blank">women and children</a>. This issue is partly embedded in the social determinants of health, and such factors as women being victims of conflict and long-held cultural practices also play a role. I am confident the WMA can make a big difference for people around the world.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c5875ef5-3898-496d-be69-78f498c9a4b6 4 tips for communicating with a medical student http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-tips-communicating-medical-student Tue, 05 May 2015 17:35:00 GMT <p> Medical students find themselves in unique situations that their significant others who aren’t in the profession often may not understand. If this sounds familiar, use these tips from the <a href="http://www.amaalliance.org/site/" rel="nofollow" target="_blank">AMA Alliance</a> magazine, <a href="http://www.physicianfamilymedia.org/" rel="nofollow" target="_blank"><em>Physician Family</em></a>, for how to connect with medical students.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/7/8f6b7774-c200-4dcb-b7a5-4279c1fe2c6d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/7/8f6b7774-c200-4dcb-b7a5-4279c1fe2c6d.Full.jpg?1" style="margin:15px;float:right;width:365px;height:250px;" /></a></p> <p> Here’s what medical students’ significant others can do to facilitate better communication:</p> <ol> <li style="margin-left:0.25in;"> <strong>Ask about what they’re studying. </strong>This is a great way to connect with one another, and it can help your student retain what they’re spending time learning.</li> <li style="margin-left:0.25in;"> <strong>Choose your moments wisely. </strong>Wait until your student takes a break from studying, or set aside a certain time every day to talk about family, friends and future plans. Forcing conversations when your med student counterpart is deep into studying can lead to frustration.</li> <li style="margin-left:0.25in;"> <strong>Keep a shared calendar. </strong>Whether the calendar is on your fridge or shared online, both of you should add events, important test dates and other specific dates so you can spot conflicts early and plan accordingly.</li> <li style="margin-left:0.25in;"> <strong>Talk about money. </strong>A medical student’s life can be expensive with textbooks, supplies, study materials and exam fees. It’s important that you both know how much money you have, how you’re going to budget and what you need to be saving for.</li> </ol> <p> See more <a href="http://bluetoad.com/publication/?i=252735&p=14" rel="nofollow" target="_blank">tips for communicating with a medical student</a> in the spring 2015 issue of <em>Physician Family</em>, published online four times a year and delivered in hard copy to members of the AMA Alliance.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a48fcb79-5923-4aab-83eb-2adbd93d34fd 6 things you can do to prevent opioid abuse http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-things-can-prevent-opioid-abuse Tue, 05 May 2015 17:23:00 GMT <p> The rate of fatal prescription drug overdoses involving opioids in the United States almost quadrupled over the past decade, according to the Centers for Disease Control and Prevention (CDC)—and physicians on the front lines of patient care see the human toll this epidemic takes every day.</p> <p> Deaths from heroin also have increased substantially. According to the CDC, more than 8,000 people died from heroin-related causes in 2013—a 39 percent increase from 2012. </p> <p> “Communities across the United States have seen a tragic rise in heroin-related deaths,” AMA Board of Trustees Secretary Patrice A. Harris, MD, told a congressional committee in April. “Some suggest this is due to restrictions on prescribing prescription opioids or the lower cost and easier accessibility of heroin. There may be other reasons as well, and we need the data to help guide our interventions, but it is clear that we need to act.”</p> <p> “We need a comprehensive public health approach to combatting the nation’s prescription opioid abuse and growing heroin epidemic,” said Dr. Harris, who directs county health services in the Atlanta area, including health partnerships that deliver a wide range of public safety, behavioral health and primary care treatment and prevention services. “It is up to physicians to be leaders in preventing and reducing abuse, misuse, overdose and death from prescription drugs through ensuring appropriate prescribing practices as one part of a multi-pronged public health strategy.”</p> <p> Dr. Harris emphasized six key actions physicians can take:</p> <ol> <li> <strong>Follow appropriate prescribing practices.</strong><br /> Enhanced education about pain management can help physicians and other prescribers identify the risks of prescription drug misuse and help prevent diversion and overdose. Physicians can take the lead in training and educating themselves and their colleagues to make informed prescribing decisions, consider all available treatment options and make appropriate referrals for patients with opioid use disorders. Ideally, education will begin in medical school.<br /> <br /> The AMA is developing new training materials on responsible opioid prescribing as part of a collaborative with the <a href="http://pcss-o.org/" target="_blank" rel="nofollow">Prescriber Clinical Support System for Opioid Therapies</a>. It’s also creating an educational module on opioid risk management for residents.<br />  </li> <li> <strong>Ensure patients in pain aren’t stigmatized.</strong><br /> Patients who require opioid therapy to manage their pain shouldn’t be stigmatized. This means avoiding using terms like “drug seeker” for these patients, Dr. Harris said.<br /> <br /> “Patients who need care are simply ‘patients,’ and we should seek to change the tone of the debate toward more attention on multidisciplinary, patient-centered approaches to pain management,” she said.<br /> <br /> This includes addressing the lack of access to non-pharmacologic approaches. Because objective tests for the presence of pain are still at a basic stage of development, the best clinical approach most often is to assume the patient is reporting a true experience.<br />  </li> <li> <strong>Support increased coverage for and access to treatment.</strong><br /> Opioid use disorder is a chronic disease that can be treated effectively, but it requires ongoing care. The health care community needs more resources to ensure access to evidence-based treatment, including broad-based treatment services as well as medication-assisted treatment, Dr. Harris said. Comprehensive insurance coverage for such treatment is necessary.<br /> <br /> “We are deeply concerned by the barriers faced by physicians in finding and placing patients in addiction treatment and recovery programs,” Dr. Harris said. “A profound need exists to address the workforce limitations and the lack of accessible and affordable treatment programs.”<br />  </li> <li> <strong>Support overdose prevention measures.</strong><br /> Many states are enacting laws that increase access to the opioid overdose-reversal drug naloxone, specifically to trained first responders and friends and family members who may be in positions to help save lives.<br /> <br /> “Good Samaritan” laws also protect and encourage friends, family members and bystanders who may witness an overdose and are in a position to help provide care and call for help.<br />  </li> <li> <strong>Use and support prescription drug monitoring programs (PDMP).</strong><br /> Physicians must examine their prescribing practices and be sure they are appropriate. If available, physicians should consult PDMPs when clinically indicated.<br /> <br /> Every state except Missouri has passed legislation establishing PDMPs. However, some PDMPs need to be modernized and fully funded to make them truly useful.<br />  </li> <li> <strong>Work with stakeholders in your state.</strong><br /> State and specialty medical societies and the AMA are working together to ensure new policies directly address this national epidemic. Different regions of the country have different problems, which is why a one-size-fits-all approach does not work.<br /> <br /> “The interventions needed in more rural parts of Kentucky and Tennessee, for example, might differ from what is needed in the Chicago, Philadelphia or Denver suburbs,” Dr. Harris said.<br /> <br /> Nearly every state legislature is considering one or more laws dealing with opioid misuse. The AMA and state medical societies have worked together to advocate for solutions that will positively change physicians’ prescribing practices and ensure patients’ access to care.</li> </ol> <p> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Learn more</a> about how physicians nationwide are combatting prescription drug abuse and diversion. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:063b6cef-5712-4d69-bd15-b9ad8052b58c The one graphic you need for accurate blood pressure reading http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-graphic-patients-need-accurate-blood-pressure-reading Mon, 04 May 2015 20:00:00 GMT <p> Blood pressure measurement is a routine task in most practices, but are you sure it’s done accurately in yours? It’s easy to get skewed results if clinicians and patients aren’t on the same page about how to take accurate blood pressure measurements. This infographic offers a simple way to help your patients and practice get the most accurate results.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/15/431fb47b-9591-4e74-8fb2-ba3252b019b7.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/15/431fb47b-9591-4e74-8fb2-ba3252b019b7.Full.png?1" /></a></p> <p> <strong>More ways to improve</strong></p> <p> Observe National High Blood Pressure Education Month by sharing this infographic on <a href="https://www.facebook.com/AmericanMedicalAssociation/posts/10155456370275109" rel="nofollow" target="_blank">Facebook</a> or <a href="https://twitter.com/AmerMedicalAssn/status/595318481832280064" rel="nofollow" target="_blank">Twitter</a> with your practice team and patients so they understand how seemingly minor factors can affect their blood pressure measurements.</p> <p> In particular, take note of May 7, the <a href="http://www.measureuppressuredown.com/" rel="nofollow" target="_blank">Measure Up/Pressure Down National Day of Action</a> when the health care community is making a concerted effort to raise awareness about hypertension control.</p> <p> Here are some additional resources to help you improve your practice’s hypertension management:</p> <ul> <li style="margin-left:0.25in;"> Read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">three questions you should ask patients</a> when measuring their blood pressure.</li> <li style="margin-left:0.25in;"> Hear <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-saying-doing-control-hypertension" target="_blank">what other physicians are doing</a> to control hypertension in their practices.</li> <li style="margin-left:0.25in;"> See how you can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">manage blood pressure outside of office visits</a>.</li> </ul> <p> Watch <em>AMA Wire</em>® in the coming weeks for information about how to implement self-measured blood pressure monitoring for patients, which can up your chances of getting patients under control.</p> <p> <strong>Why you should take action</strong></p> <p> The number of hypertension-related deaths in the United States <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/hypertension-related-deaths-climb-upward-heres-can" target="_blank">increased by 66 percent</a> over the past decade, according to new data from the Centers for Disease Control and Prevention. To put that in perspective, the number of deaths from all other causes combined increased only 3.5 percent during that period.</p> <p> The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative is taking steps to reverse this trend.</p> <p> Through this initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b8412890-ca3d-4da1-8ab8-a74af8323bc8 How we overcame the SGR hurdle http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_overcame-sgr-hurdle Mon, 04 May 2015 17:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/2/b388004f-2b89-44fb-92b7-abea7d974484.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/2/b388004f-2b89-44fb-92b7-abea7d974484.Large.jpg?1" style="margin:15px;float:left;" /></a><em>How did we get over the SGR hurdle? </em>The short answer is simple: We did it together.</p> <p> The long answer involves a strenuous, uphill marathon of more than a decade. We physicians all have stories about how the sustainable growth rate (SGR) formula’s perennial threats of steep payment cuts created instability for our practices and uncertainty about access to care for our patients who relied on Medicare and TRICARE.</p> <p> Through the years, we had countless interactions with our lawmakers about this issue and made it clear that Medicare had to be fixed.</p> <p> And we poured on the steam this year, calling on Congress to seize the opportunity to eliminate the SGR formula through bipartisan legislation <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/house-unveils-bipartisan-sgr-repeal-package" target="_blank">introduced in March</a>.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/5/80b03436-22f0-4406-a587-aef3aceb058a.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/5/80b03436-22f0-4406-a587-aef3aceb058a.Full.jpg?1" style="margin:15px;float:right;" /></a></p> <p> In a five-week sprint that got underway with a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/medicare-sgr-repeal-sign-on-letter-16march2015.pdf" target="_blank">formal letter</a> (log in) to Congress signed by more than 750 medical associations, we physicians and our patients used the AMA’s <a href="http://www.fixmedicarenow.org" rel="nofollow" target="_blank">Fix Medicare Now</a> campaign to flood our members of Congress with messages to pass this legislation. Here’s how they heard from us:</p> <ul> <li style="margin-left:0.25in;"> More than 26,700 social media actions</li> <li style="margin-left:0.25in;"> 60,229 phone calls</li> <li style="margin-left:0.25in;"> 243,907 emails</li> </ul> <p> This unified effort paid off. We <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">overcame the SGR hurdle</a> with overwhelmingly favorable votes in both chambers of Congress.</p> <p> While details of how the law will be implemented still need to be figured out (and rest assured that the AMA will diligently press for appropriate execution of the law), we have overcome our chief obstacle and are moving toward a brighter future.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-ways-health-care-will-look-different-post-sgr-era" target="_blank">new era of health care</a> now before us is one of promise. Our patients will have greater stability in their access to care, our practices will be more sustainable, and doors will open for new models of care, improved health outcomes and advanced medical education.</p> <p> There’s still a lot to do to reach our goals for a healthier nation, but we will achieve them by continuing to work together.</p> <p> Let’s continue this race and finish it strong.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cad07554-f2fc-4c4f-83d5-0a07fe4cd842 New legislation could cover diabetes prevention program http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-legislation-could-cover-diabetes-prevention-program Mon, 04 May 2015 16:55:00 GMT <p> A newly introduced Medicare bill could help reduce the incidence of type 2 diabetes by more than one-third.<br /> <br /> The Medicare Diabetes Prevention Act would require Medicare to cover services provided under the evidence-based National Diabetes Prevention Program. The bill was introduced Thursday to the U.S. Senate by Sens. Al Franken, D-Minn., and Susan Collins, R-Maine, and to the U.S. House of Representatives by Reps. Susan Davis, D-Calif.<br /> <br /> A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-diabetes-bill-could-save-13-billion-over-10-years" target="_blank">study</a> released last year on the bill estimated that the legislation would help reduce the cumulative rate of type 2 diabetes in the Medicare population by an estimated 37 percent after a decade, resulting in nearly 1 million fewer cases of diabetes among seniors by 2024. The study also found that the bill could reduce federal spending by $1.3 billion over 10 years.</p> <p> <strong>Solutions to the problem</strong></p> <p> Every year, the number of people who develop prediabetes, the precursor to type 2 diabetes, increases, rising by about 51 percent between 2007 and 2012, according to a December <a href="http://care.diabetesjournals.org/content/37/12/3172.abstract" target="_blank" rel="nofollow">study</a> published in <em>Diabetes Care</em>. In 2012, the Centers for Disease Control and Prevention launched the <a href="http://www.cdc.gov/diabetes/prevention/" target="_blank" rel="nofollow">National Diabetes Prevention Program</a> based on <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa012512" target="_blank" rel="nofollow">research</a> led by the National Institutes of Health, which showed that individuals at high risk of developing type 2 diabetes who participated in structured lifestyle change programs saw a significant reduction in the incidence of the disease.  </p> <p> To help physicians and care teams address the growing prevalence of prediabetes, the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative and the CDC recently <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-03-12-ama-cdc-initiative-aims-to-prevent-diabetes-stat.page" target="_blank">announced</a> a call to take urgent action with <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank"><em>Prevent Diabetes STAT: Screen, Test, Act – Today™</em></a>. The multi-year initiative will help physicians refer patients to diabetes prevention programs in their communities or online.</p> <p> Meanwhile, the AMA spent the past year <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-physician-helping-stop-diabetes-among-her-patients" target="_blank">working with the YMCA of the USA</a> and 11 physician practice pilot sites in four states to increase physician screening and testing for prediabetes, and referral of patients with prediabetes to diabetes prevention programs offered by local YMCAs, which use the CDC’s program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.</p> <p> “Prediabetes is a serious medical condition in our country that must be addressed. With more than 50 percent of America's seniors currently at risk for developing type 2 diabetes, we must act now to ensure our nation's seniors have access to these proven diabetes prevention programs,” AMA President Robert M. Wah, MD, said.</p> <p> “We urge Congress to join us in tackling this public health epidemic that continues to strain our health care system and act swiftly to cover these important programs under Medicare,” Dr. Wah said.<br /> <br /> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevention-program" target="_blank">Learn more</a> about diabetes prevention programs and the AMA’s Improving Health Outcomes initiative at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:893620ce-8fdc-4214-850b-d8533a1391c1 What your patients need to know about the Medicare Rx data release http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patients-need-medicare-rx-data-release Fri, 01 May 2015 16:01:00 GMT <p> With the Centers for Medicare & Medicaid Services (CMS) <a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html" target="_blank" rel="nofollow">release of Medicare Part D prescription drug data</a> Thursday, your patients may have questions about your prescribing practices. Here are several points you might need to clarify in conversations with them.</p> <p> The data shows which medications were prescribed to Medicare Part D beneficiaries, primarily broken down by individual practitioners or practices. The data release contains information for approximately $103 billion in drugs and supplies prescribed by more than one million health care professionals and paid under the Part D program in 2013. The data set shows physicians’ individual prescribing patterns, including the total number of prescriptions dispensed and the total drug cost paid by beneficiaries, Part D plans and other sources.</p> <p> “The AMA is committed to transparency and the availability of reliable information for patients to make informed decisions about their medical care,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-04-30-ama-statement-medicare-part-d-data-release.page" target="_blank">written statement</a>. But the data set is more complex than meets the eye.</p> <p> “The limitations of [the data set] should be more comprehensively listed and highlighted more prominently so that patients can clearly understand them,” Dr. Wah said. “We are also troubled by the lack of context provided with the data that could help explain physician prescribing practices and pharmacy filling practices before conclusions are drawn.”</p> <p> “In addition to improving transparency with the public, we are also calling on CMS to provide accurate, timely and actionable data to physicians that will support the implementation of new delivery and payment models that can improve patient care,” he said.</p> <p> <strong>8 facts patients should know about the data</strong><br /> Here are eight issues patients should understand when looking at the data:</p> <ul> <li> <strong>Dosage variations are unaccounted for.</strong><br /> The data set doesn’t account for varying medication strengths or dosage levels or the spectrum of patient needs, so it isn’t wise to draw conclusions about treatments from this data. For instance, depending on the conditions and patients they treat, one physician might typically prescribe one 50 mg tablet of a particular drug while another might more commonly prescribe two 20 mg tablets. This could lead to erroneous comparisons of the drug costs and utilization they generated.<br />  </li> <li> <strong>Differences in physicians’ typical patient mix are not adequately recognized.</strong><br /> The specialty descriptions and practice types in the data are not detailed enough to identify physicians who routinely treat patients whose conditions generate higher drug costs. In some cases, physicians who appear to have the same specialty can serve very different types of patients. For example, physicians who work in a hospice or palliative care setting could look like outliers in their prescribing of opioids.<br />  </li> <li> <strong>The data shouldn’t be used to evaluate quality of care.</strong><br /> The data solely focuses on payment and utilization, so it should not be used to evaluate care provided. The utilization part of the data may not be accurate if a patient had poor medication adherence or an adverse reaction to a pharmaceutical that required a prescription for alternative treatment.<br />  </li> <li> <strong>The data does not provide a full picture of a physician’s practice.</strong><br /> When there were fewer than 10 claims for a certain treatment by a particular prescriber, data isn’t included. In addition, some treatments could be listed under the physician’s organization instead of their individual National Provider Identifier, making their prescription levels seem lower than they actually are. The data set also is a limited view of the patients a physician cares for. It does not include treatments paid for by private insurance plans, for patients not covered under Medicare Part D or for Medicaid beneficiaries. It also fails to take into account patients’ health, socioeconomic status or medication adherence—all of which impact prescribing practices.<br />  </li> <li> <strong>Information about generic substitutions isn’t provided.</strong><br /> Some physicians may look like outliers in how frequently they prescribe brand-name medications because they treat patients for conditions that are best treated by medications still on patent with no generic equivalent. In addition, comparing branded prescriptions versus generic alternatives to other parts of the country is difficult because state laws governing generic substitutions vary.<br />  </li> <li> <strong>Charges and payments are different.</strong><br /> The cost information does not include manufacturers’ coupons or rebates that often help lessen patients’ out-of-pocket costs. Depending on where a patient gets his or her prescription, there also could be price differences.<br />  </li> <li> <strong>This data shouldn’t be compared with other data from CMS.</strong><br /> There are significant differences between this data set and other CMS data, including last year’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-medicare-claims-data-release-assistance" target="_blank">physician Medicare claims data</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-should-answer-sept-30" target="_blank">financial data</a> reported under the Physician Payments Sunshine Act. These releases have different timeframes and Medicare populations, and they also have identified physicians in multiple ways.<br />  </li> <li> <strong>Physicians don’t have a way to correct the information reported.</strong><br /> If data reported is inaccurate, physicians aren’t able to report it or update the data.</li> </ul> <p> For more information, get the AMA’s <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-04-30-ama-guide-media-reporting-cms-medicare-data.page" target="_blank">guide to media reporting</a> on the data set.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dcbd59ea-f831-43cd-9449-c578bb228005 Everything you need for self-measured blood pressure monitoring http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_everything-need-self-measured-blood-pressure-monitoring Fri, 01 May 2015 15:00:00 GMT <p> Having patients measure their own blood pressure at home can help get their hypertension under control. Learn the facts about self-measured blood pressure monitoring, including how you can get started in your practice.</p> <p> Log in to get these resources:</p> <ul> <li> <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/smbp.pdf" target="_blank">Self-measured blood pressure monitoring program: Engaging patients in self-measurement</a> (clinical guide)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-office-poster.pdf" target="_blank">Proper patient positioning when taking blood pressure</a> (poster)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-technique-patient-flyer.pdf" target="_blank">Measuring your blood pressure at home</a> (patient handout)</li> <li> <a href="https://www.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf" target="_blank">M.A.P. for improving blood pressure control</a> (clinical guide)</li> <li> <a href="https://www.ama-assn.org/resources/doc/iho/x-pub/self-measured-blood-pressure.pdf" style="color:rgb(34, 34, 34);cursor:pointer;" target="_blank"><span style="color:#0000ff;">Fast facts on self-measured blood pressure</span></a> (fact sheet)</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1656cfa7-1cf4-4945-8f5e-31f5dc81b80b Learn how MOC is changing at Chicago meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-moc-changing-chicago-meeting Fri, 01 May 2015 15:00:00 GMT <p> The maintenance of certification (MOC) program of the American Board of Medical Specialties (ABMS) is an important topic for practicing physicians and for students and residents as they approach the next stage in their careers. Academic physicians need to be able to synthesize the data on MOC and share this information as they mentor resident and fellow physicians and young physicians.</p> <p> Listen to an update and learn about changes in the MOC program at the 2015 AMA Section on Medical Schools (SMS) Annual Meeting, June 5-6 in Chicago.</p> <p> A special session from 7:30 to 8:45 a.m. June 6 will provide an update on recent MOC changes. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%253d%253d&OID=130" target="_blank">Register now</a> (log in). ABMS President and CEO Lois Margaret Nora, MD, will review the current status of MOC and explain how MOC is changing, based on physician input, to meet physicians’ needs and serve as a metric for quality of care, and then two physician leaders on a reactor panel will give their thoughts.</p> <p> First, Richard J. Baron, MD, president and chief executive officer of the American Board of Internal Medicine, will provide a case study of how that board is <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/moc-requirements-modified-internal-medicine-physicians" target="_blank">addressing concerns</a> about its MOC program and make it more workable and transparent for participants.</p> <p> Then, Joshua M. Cohen, MD, director of education at Mount Sinai Beth Israel, Roosevelt, and St. Luke's Hospitals, and chair of the AMA Young Physician Section Committee on Maintenance of Certification and Maintenance of Licensure, will provide the perspective of young physicians.</p> <p> Physicians can earn continuing medical education credit for this session. Read the AMA-SMS <a href="http://www.ama-assn.org/resources/doc/medical-schools/x-pub/a-15-sms-agenda.pdf" target="_blank">meeting agenda</a> (log in) for more information.</p> <p> Also at the 2015 AMA Annual Meeting, don’t miss Report 2, an update on MOC and Osteopathic Continuous Certification from the AMA Council on Medical Education. You can also review resolutions on MOC to come before the House of Delegates in the <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/reference-committee.page#plckcategoryid=cat%3Ad1022fc3-37b7-4a3b-b4e8-6a36bc4fb478&plckforumpage=ForumCategory&plckforumpostshowfirstunread=&plckfindpostkey=" target="_blank">Online Member Forums</a>. During its meeting, the AMA-SMS will also debate these and other medical education-related reports and resolutions, to inform its vote in the AMA House of Delegates.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:77a28b0d-adbd-4cc4-910a-35376fd9700e Is the growing number of unmatched medical students a crisis? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_growing-number-of-unmatched-medical-students-crisis Fri, 01 May 2015 15:00:00 GMT <p> The rising number of unmatched U.S. medical school graduates is an issue of growing concern for many in medicine. Learn more about this topic and what students and their mentors can do at a special session during the AMA Section on Medical Schools (SMS) 2015 Annual Meeting, June 5-6 in Chicago.</p> <p> “The growing number of unmatched medical students: Is it a crisis? What are the options?” will take place from 9 to 10:15 a.m. June 6 at the Hyatt Regency in Chicago. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%253d%253d&OID=130" target="_blank">Register now</a> (log in). This session will feature a review of current and recent data on Match rates from the National Resident Matching Program, presented by Geoffrey Young, PhD, program leader for the Group on Student Affairs at the Association of American Medical Colleges.</p> <p> Next, two reactors will contribute their perspectives on options for unmatched students and suggestions for mitigating the problem. These include better counseling on students’ options as well as a more holistic approach to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/schools-reconsidering-med-school-applicants-evaluated" target="_blank">medical school admissions</a>. Holistic reviews are associated with both increased diversity and high academic achievement and may have a corresponding beneficial impact on subsequent Match rates.</p> <p> Reactors are Kathleen Kashima, PhD, senior associate dean of students at the University of Illinois College of Medicine and Betty Drees, MD, AMA-SMS liaison to the AMA Council on Medical Education.</p> <p> Physicians can earn continuing medical education credit. Read the AMA-SMS <a href="http://www.ama-assn.org/resources/doc/medical-schools/x-pub/a-15-sms-agenda.pdf" target="_blank">meeting agenda</a> (log in) for more information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d7803cb2-567e-49bf-82c9-db63bf9fcf56 Quality reporting should be focused on 15 themes: IOM http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_quality-reporting-should-focused-15-themes-iom Thu, 30 Apr 2015 20:08:00 GMT <p> A wide variety of programs and organizations require physicians to report health measures, often non-standardized—so which metrics matter most? A new <a href="http://www.iom.edu/Reports/2015/Vital-Signs-Core-Metrics.aspx" rel="nofollow" target="_blank">report</a> from the Institute of Medicine (IOM) outlines 15 core metrics to assess health and health care measurement and provides a clearer picture of what’s necessary for physicians and other stakeholders to adopt these measures.</p> <p> Many of the quality measures in place today are similar, but the differences across programs and organizations often are enough to prevent direct comparisons of data or streamlined reporting and diffuse attention from what is important.</p> <p> “The establishment of a core set of measures could improve efficiency and ensure a focus on the most important health outcomes,” the report said.</p> <p> View an <a href="http://resources.iom.edu/Infographics/VitalSigns/index.html" rel="nofollow" target="_blank"><strong>infographic</strong></a> of the 15 measures and examples of each.</p> <p> The report’s findings are consistent with a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">recent joint study</a> from the AMA and RAND Corporation. The study found an uncoordinated approach has resulted in too much variability in the large array of measures being promoted across the health system.</p> <p> “Medical practices struggle to cope with hundreds of uncoordinated measures in order to create a coherent response that will advance the high goals of new delivery and payment models,” AMA CEO and Executive Vice President James L. Madara, MD, said in a written statement. “Chasing data for uncoordinated measures requires significant time and resources that could be better spent on patient care or technology that practices need to achieve the desired outcomes for patients.”</p> <p> In a panel during the report’s release Wednesday, Dr. Madara discussed potential barriers and benefits to physicians adopting the recommended metrics.</p> <p> “These goals will need to be assisted by electronic health records that actually function in a way that allows timely availability of actionable clinical data at the point of care for all providers,” he said. “The recent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-ways-health-care-will-look-different-post-sgr-era" target="_blank">repeal of the [Medicare] sustainable growth rate</a> has also been important …. A lot of that bill is about payment and delivery reform and is simpatico with this report.”</p> <p> “Leadership will be required at nearly every level of the health system” to implement these measures, according to the report.</p> <p> The report findings mesh with the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, which is ensuring that physicians can successfully navigate the evolving health care environment through sustainable practices that can result in improved outcomes for patients and greater professional satisfaction for physicians.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:18d66168-c36d-460a-9a9b-ffc5c3a15c0a Your questions about telemedicine answered http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_questions-telemedicine-answered Thu, 30 Apr 2015 19:34:00 GMT <p> There’s no doubt that telemedicine offers significant promise—but with this promise come significant gray areas that physicians are attempting to navigate now. How can you use telemedicine responsibly? Get the answers to your questions.</p> <p> <strong>Q: What types of technologies can be used for telemedicine?</strong></p> <p> <strong>A: </strong>Three main types of technologies are being used today:</p> <ol> <li style="margin-left:0.25in;"> <strong>Store-and-forward telemedicine</strong> transmits medical data, such as medical images, to a physician for assessment. This type of interaction doesn’t require the presence of the patient and the physician at the same time.<br />  </li> <li style="margin-left:0.25in;"> <strong>Remote monitoring</strong>, or self-monitoring, allows physicians to monitor a patient remotely. This method is typically used to manage chronic diseases or specific conditions with devices that patients can use at home to capture health indicators.<br />  </li> <li style="margin-left:0.25in;"> <strong>Interactive telemedicine services</strong> provide real-time, face-to-face interaction between the patient and physician. This can be used as an alternative to in-person care delivery and can be used to diagnose, consult and treat patients.</li> </ol> <p> <strong>Q: Do health plans cover telemedicine?</strong></p> <p> <strong>A:</strong> Some do, some don’t—it varies widely. Many public and private payers have developed formal mechanisms to pay for these services, but they are inconsistent from one payer to the next.</p> <p> Medicare pays physicians for a relatively narrow list of Part B services provided via telemedicine. The originating sites where telemedicine-using Medicare beneficiaries are located are limited to qualified centers in areas outside of major metropolitan areas and places designated as Health Professional Shortage Areas. Medicare requires telemedicine services to have both interactive audio and video with real-time communication.</p> <p> The Medicaid programs in 46 states and Washington, D.C., pay for some services administered via real-time audio and video. Programs in nine states pay for store-and-forward at some level, and 14 states pay for remote patient monitoring. In addition, nearly one-half of states require private insurers to cover telemedicine-provided services comparable to that of in-person services. Over the past few years, the number of states with these telemedicine parity laws has doubled.</p> <p> <strong>Q: How can we be sure telemedicine is used appropriately?</strong></p> <p> <strong>A:</strong> Physicians <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-telemedicine-policy-lays-out-principles-coverage-payment" target="_blank">voted last year</a> on policy to govern the appropriate use of telemedicine. Most importantly, a valid physician-patient relationship must exist before telemedicine services are provided. This relationship can be established in a few different ways:</p> <ul> <li style="margin-left:0.25in;"> A face-to-face examination—an exam utilizing two-way, real-time audio and visual capabilities, like a videoconference—if a face-to-face encounter would be required for the same service in person</li> <li style="margin-left:0.25in;"> A consultation with another physician who has an ongoing relationship with the patient</li> <li style="margin-left:0.25in;"> Meeting evidence-based telemedicine practice guidelines developed by major medical specialty societies for establishing a patient-physician relationship</li> </ul> <p> There are exceptions to these steps, such as emergency medical treatment, and on-call or cross coverage situations. Other exceptions may arise in the future.</p> <p> Once that relationship is established, physicians can use telemedicine technologies with their patients at their discretion.</p> <p> The AMA policy requires physicians who deliver telemedicine services to be licensed in the state where the patient receives services, and the delivery of care must be consistent with state’s scope-of-practice laws.</p> <p> Patients seeking telemedicine care must be able to choose their physician and be aware of their cost-sharing responsibilities. The physician must have the patient’s medical history as part of providing telemedicine care, and the care should be coordinated with physicians who already are treating the patient.</p> <p> <strong>Q: What can I do to improve coverage and payment for telemedicine?</strong></p> <p> <strong>A:</strong> At the state level, you can support state legislation that requires coverage of telemedicine.</p> <p> At the federal level, you can support use of telehealth services as part of the recently passed bill that eliminated the sustainable growth rate, as well as coverage of telehealth services for dual-eligible beneficiaries (those who qualify for both Medicare and Medicaid benefits) where state Medicaid beneficiaries receive telemedicine serves.  In addition, you can support removal of the geographic restriction on telemedicine services and research to develop a stronger evidence base for telemedicine and the expansion of pilot programs under Medicare to enable coverage.</p> <p> You also can encourage your national medical specialty society to take the lead in developing telemedicine clinical practice guidelines and comprehensive practice parameters to address the clinical and technological aspects of telemedicine.</p> <p> <strong>Q: Are there efforts underway to streamline the medical licensure process?</strong></p> <p> Yes. Many states require physicians who practice telemedicine to be licensed in your state and abide by your state’s licensure and medical practice laws. If you treat patients via telemedicine in multiple states, or plan to, you will need to get a medical license from each state.</p> <p> This year, state legislatures are considering an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/first-states-join-compact-streamline-medical-licensure" target="_blank">interstate compact</a> that would create a new pathway to expedite the licensing of physicians seeking to practice medicine in multiple states. The proposal, which <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-licensure-streamlined-under-new-interstate-compact" target="_blank">the AMA supports</a>, could increase access to health care for individuals in underserved or rural areas and allow patients to more easily consult medical experts through the use of telemedicine technologies. Half a dozen states already have joined the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/first-states-join-compact-streamline-medical-licensure" target="_blank">compact, and more are expected to join before the year’s end</a>.</p> <p> <strong>Q: Where can I find more information?</strong></p> <p> <strong>A:</strong> Visit the AMA’s Web pages on <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/telemedicine.page?" target="_blank">state telemedicine advocacy </a>or <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/digital-health.page" target="_blank">federal digital health advocacy</a> for additional information, and read more about telemedicine’s challenges for the medical profession in the <a href="http://journalofethics.ama-assn.org/2014/12/toc-1412.html" target="_blank"><em>AMA Journal of Ethics</em></a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a7de5c68-3742-4179-a531-839c98f0fb49 Do you have the 6 traits of a financially prepared physician? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-traits-of-financially-prepared-physician Wed, 29 Apr 2015 20:50:00 GMT <p> Physicians work in one of the busiest professions, and finding time to dedicate to personal finances can be challenging. Would you classify yourself as financially prepared or behind schedule?</p> <p> In a <a href="http://amainsure.com/2015-introduction-to-women-physicians-financial-preparedness-report.html?utm_source=AMA&utm_medium=AMA&utm_campaign=Women" rel="nofollow" target="_blank">new study</a> of the financial preparedness of U.S. women physicians, AMA Insurance revealed the top six traits of financially prepared women physicians—those who consider themselves “on track” or “ahead of schedule” when it comes to retirement readiness.</p> <p> Here are the six traits of a financially prepared woman physician:</p> <ol> <li style="margin-left:0.25in;"> <strong>Considers her retirement portfolio “on track” or “ahead of schedule” for her age and career stage.</strong><br /> On average, more than one-half of women physicians feel as though their retirement savings are “on track,” including 7 percent who consider themselves “ahead of schedule.” Financially prepared women physicians have significantly more retirement savings than peers who consider themselves “behind schedule.” More than one-third of financially prepared women physicians have more than $1 million in their retirement portfolio.<br /> <br /> If you need to get started, read about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/retirement-savings-strategies-physicians-start-late" target="_blank">retirement savings strategies</a> for physicians who start late and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/residents-should-begin-saving-retirement" target="_blank">tips to get started</a> during residency.<br />  </li> <li style="margin-left:0.25in;"> <strong>Keeps a liquid emergency fund adequate for her current lifestyle.</strong><br /> Nearly 80 percent of financially prepared women physicians have a separate, emergency-only fund, and more than one-half keep at least $50,000 available in this fund. In fact, nearly 60 percent say they could write a $25,000 check to cover an emergency expense “with no problem.”<br /> <br /> Two-thirds of women physicians would need to move funds or liquidate assets if faced with a large emergency expense, and about 7 percent said they simply couldn’t do it.<br />  </li> <li style="margin-left:0.25in;"> <strong>Feels adequately protected in the event of a disability.</strong><br /> Most financially prepared women physicians feel prepared to handle their finances if they became disabled and couldn’t practice medicine. Financially prepared women were more likely to have recently revisited their disability insurance policy and were confident that they carried enough disability insurance to cover their current lifestyle.<br /> <br /> About 70 percent of employed women physicians receive disability insurance through their employer. Financially prepared employed women physicians also were more likely to know whether their employer pays the premium on that insurance and whether their benefit would be taxable.<br /> <br /> Read <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/need-physician-disability-insurance" target="_blank">what you need to know</a> about disability insurance.<br />  </li> <li style="margin-left:0.25in;"> <strong>Uses a professional financial advisor.</strong><br /> Two out of three financially prepared women physicians use the services of a professional financial planner. Most said they found their planner through a referral, and the majority said they are “satisfied” or “very satisfied” with their choice. Those who don’t use an advisor said the main reason is because they haven’t found someone they trust.<br />  </li> <li style="margin-left:0.25in;"> <strong>Has updated will and medical and end-of-life directives in place.</strong><br /> Since most women physicians are the breadwinners in their families, end-of-life and medical directives and wills are important. More than one-half of women physicians who consider themselves “behind schedule” do not have any elements of an estate plan.<br />  </li> <li style="margin-left:0.25in;"> <strong>Feels more knowledgeable and confident about personal finances.</strong><br /> Most financially prepared women physicians are either “very confident” or “somewhat confident” in their ability to make financial planning decisions, while nearly one-half of those women physicians who are behind in planning said they aren’t very confident.<br /> <br /> Read <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-personal-finance-tips-experienced-physicians" target="_blank">the top personal finance tips</a> from experienced physicians.</li> </ol> <p> Find more physician-exclusive research in the <a href="https://www.amainsure.com/research-and-insights.html" rel="nofollow" target="_blank">AMA Insurance Research Center</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1496fbc5-42f4-43b8-8fbd-3c003bee3fdb What’s the real reason residents burn out? You tell us http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_whats-real-reason-residents-burn-out-tell Wed, 29 Apr 2015 15:00:00 GMT <p> Residents, we hear you: Burnout is all too common in life on call. A <a href="http://www.jgme.org/doi/abs/10.4300/JGME-D-14-00022.1" rel="nofollow" target="_blank">new study</a> in the <em>Journal of Graduate Medical Education</em> explores why burnout pervades residency, citing some surprising factors that contribute to poor resident well-being.</p> <p> The study data is based on an online survey from residents at the University of Calgary in Alberta, Canada. To develop the survey, researchers used the <a href="https://www.psykiatri-regionh.dk/who-5/Pages/default.aspx" rel="nofollow" target="_blank">WHO-Five Well-Being Index</a>, personal and work-related subscales of the <a href="http://www.arbejdsmiljoforskning.dk/upload/cbi-scales.pdf" rel="nofollow" target="_blank">Copenhagen Burnout Inventory</a> and questions on residents’ work dissatisfaction, sleep and nutritional needs on-call. 317 of the 706 eligible residents responded.</p> <p> The survey revealed that 39 percent of respondents reported that their sleeping needs on call were “never, seldom or only sometimes adequately met.” Meanwhile, 81 percent reported that they “never, seldom or only sometimes” fulfill their nutritional needs on call.</p> <p> Residents also reported factors that disrupt their sleep arrangements and eating habits. Those barriers to well-being in residency programs include:</p> <ul> <li style="margin-left:0.25in;"> Sleeping rooms that are uncomfortable, dirty and noisy</li> <li style="margin-left:0.25in;"> Insufficient time to eat</li> <li style="margin-left:0.25in;"> A lack of quality food</li> </ul> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/12/5443bf8d-1176-4d25-bc4b-f82b05483c22.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/12/5443bf8d-1176-4d25-bc4b-f82b05483c22.Full.jpg?1" style="width:600px;" /></a></p> <p> These wellness barriers echo similar research on the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/challenging-hidden-curricula-residency-programs" target="_blank">hidden pressures of residency programs</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ways-residents-found-conquer-burnout" target="_blank">burnout woes</a> many residents have shared with the AMA. But how can we help residents avoid skipping meals and running rotations on sleepless fumes, so they’re able to care for themselves as well as their patients?</p> <p> <strong>Voice your concerns and be a part of the solution </strong></p> <p> The AMA is offering three ways residents can help improve the residency environment to better promote the wellness of physicians in training:</p> <ol> <li style="margin-left:0.25in;"> <strong>Tell the ACGME what you think. </strong>Attend an education session “Taking the pulse of trainees,” from 1:30 to 2:30 p.m. June 5 as part of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/rfs-meetings.page?" target="_blank">Resident and Fellow Section (RFS) Annual Meeting</a> at the Hyatt Regency Chicago.<br /> <br /> A representative from the Accreditation Council for Graduate Medical Education (ACGME) will present data on determinants of resident well-being from the organization’s 2013–2014 national survey data.<br /> <br /> By attending, you’ll have a chance to tell the ACGME face to face how to improve its survey methods, better train physicians in graduate medical education programs to support residents and identify solutions that matter to you.<br />  </li> <li style="margin-left:0.25in;"> <strong>Share your perspective in a survey.</strong> Take the AMA-RFS survey to share your views about what most impacts your well-being and career as a physician in training. If you’d like to participate, <a href="mailto:rfs@ama-assn.org?subject=residency%20wellness%20survey" rel="nofollow">email the section</a> to receive a personalized link.<br />  </li> <li style="margin-left:0.25in;"> <strong>Weigh in at a resident health panel at 8:45 a.m. June 6.</strong> Residents who are attending the annual meeting in Chicago can join a discussion with their peers and speakers about innovative solutions to physician wellness. Can yoga or dance help residents avoid burnout? Attend the panel to find out and share your own creative ideas.</li> </ol> <p> Also, review the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-things-institutions-can-prevent-resident-burnout" target="_top">5 things institutions can do to prevent resident burnout</a>, and educate yourself on the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/beat-burnout-7-signs-physicians-should" rel="nofollow" target="_blank">signs of burnout</a> to maintain better wellness. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:baa24730-5c61-4ee9-8418-6f4975b24abd 3 important events that can help us adopt new payment models http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-important-events-can-adopt-new-payment-models Tue, 28 Apr 2015 19:52:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/15/9d418bfe-aec8-4057-8f01-d371472e2061.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/15/9d418bfe-aec8-4057-8f01-d371472e2061.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An AMA Viewpoints post by AMA President Robert M. Wah, MD.</em></p> <p> We’ve reached some important milestones on the road to better payment models in the last few months. As a physician, I always want to talk about delivery reform first, or at least simultaneously, with payment reform. We have seen what happens when we tweak the payment system and hope to force change in delivery—it leads to unexpected consequences.</p> <p> While we physicians always are looking for better ways to care for our patients, actually doing so isn’t easy. We’ve come to expect obstacles to be thrown in our way. But right now, many factors are helping us on the journey to new care and payment models.</p> <p> <strong>1. Data that backs us up</strong></p> <p> Last month, we released the results from a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">new AMA study</a> conducted by the RAND Corporation that gave a look into how physicians are actually implementing new payment models. The study found that doctors are trying to make these moves but need help successfully managing the transition, including how to  respond to the many quality programs and metrics from payers to ensure long-term sustainability.</p> <p> These findings will help the AMA change the environment for you and provide practical resources. We’ll use the results to guide the AMA’s work in improving alternative payment models and find ways to help physician practices make successful transitions to new models.</p> <p> <strong>2. Regulatory support</strong></p> <p> A few days after our AMA-RAND study release, we saw the launch of the U.S. Department of Health and Human Services’ Health Care Payment Learning and Action Network.</p> <p> The network is a collaborative of payers, employers, physicians, patients, consumer groups and other partners within the health care community. Network participants will work together to capture best practices, disseminate information and apply lessons learned for supporting the increased adoption of value-based payment models. The idea is that all of these groups will transform our nation’s health system by working together.</p> <p> I attended the network’s launch, where President Barack Obama outlined the importance of this network.</p> <p> “We don’t need to reinvent the wheel—you’re already figuring what we need to do to reduce infections in hospitals or help patients with complicated needs,” he said. “What we have to do is share these best practices, these new ideas, including new ways to pay for care so that we’re rewarding quality. And that’s what this network is all about.”</p> <p> We want to contribute to the success of this network. More than 2,800 groups from across the health care environment already registered to participate.</p> <p> <strong>3. The end of SGR</strong></p> <p> The most exciting recent development is the elimination of Medicare’s sustainable growth rate (SGR) formula. This failed budgetary gimmick created in 1997 has made Medicare unstable and unpredictable and prevented physicians from implementing innovative approaches to care—but we’re now in a new era.</p> <p> Under the new law that eliminated the SGR, many of the competing quality-reporting programs in Medicare will be consolidated and better aligned. The risk of penalties also has been substantially reduced, and physicians now have potential for earning significant bonuses.</p> <p> The law also provides monetary and technical support for those who choose to adopt new models of care suited to the 21st-century needs of physicians and their patients.</p> <p> One of our main goals is to further lift physicians’ regulatory burdens and provide practical resources to advance <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">professional satisfaction and practice sustainability</a>. Now we can ramp up these efforts. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-ways-health-care-will-look-different-post-sgr-era" target="_blank">Read more</a> about how physicians’ worlds will be different in a post-SGR era.</p> <p> <strong>Looking ahead</strong></p> <p> So what’s next in the journey to innovative payment models? I wish I had a crystal ball, but I can’t say exactly how things will play out.</p> <p> But I am confident that we physicians will continue to move ahead and adopt new models of payment and <em>care</em> delivery that make our patients healthier. I know we’ll be exploring innovative ideas and new ways to adapt and transform our practices.</p> <p> I also know that the AMA will continue to work toward ensuring that physicians in all specialties, practice sizes and locations across the country can participate successfully in new payment and delivery models that allow them to better provide the best care to patients.</p> <p> <strong>Tell me: </strong>What would make it easier for you to adopt new payment models? Tweet me <a href="https://twitter.com/robertwahmd" target="_blank" rel="nofollow">@RobertWahMD</a> and let me know.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:95c2a262-46e8-455c-ac38-2e18137e9b52 How a tablet can help treat diabetes: Watch this film to find out http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tablet-can-treat-diabetes-watch-this-film-out Mon, 27 Apr 2015 20:01:00 GMT <p> What if you could read the exact blood sugar levels of your patients with diabetes right now, send this information to your care staff and alert your patients about their high glucose levels even if they’re 100 miles away—all with the help of a touch screen? Sound like futuristic fanfiction?</p> <p> Think again. This is telemedicine and a key component of patient care at the University of Mississippi Medical Center (UMMC) in Jackson, Miss., one of four team-based practices featured in a new PBS documentary, <a href="http://rxfilm.org/the-film/full-film/" rel="nofollow"><em>Rx: The Quiet Revolution</em></a>.</p> <p> Created by 10-time Emmy Award winner David Grubin, the AMA-sponsored film showcases physicians and care teams across the nation who are changing how people receive medical care by lowering costs and making patients the central focus of their practices.</p> <p> For Kristi Henderson, chief telehealth and innovation officer at UMMC, this entailed creating strategic technology to help physicians overcome barriers and better partner with patients to improve health outcomes.</p> <table align="left" border="0" cellpadding="5" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/13/c23cf4c2-a5bf-4545-bd95-76289cd8ad0f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/13/c23cf4c2-a5bf-4545-bd95-76289cd8ad0f.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;">A patient in rural Mississippi checks her blood sugar, then uses a tablet to transmit her blood sugar level.</span></em></td> <td>  </td> </tr> </tbody> </table> <p> In August of 2014, UMMC launched the <a href="http://www.umc.edu/News_and_Publications/Press_Release/2014-12-03-00_Diabetes_Telehealth_Network_sees_early_success_in_Mississippi.aspx" rel="nofollow" target="_blank">Diabetes Health Network</a>, which employs wireless electronic tablets loaded with a care management application called “Care Innovations.” This application allows patients with diabetes to capture their blood pressure and glucose levels, and instantly transmit this information to their physicians. When patients’ blood sugar is too high, their physicians know immediately to intervene on their behalf or call them to discuss how to lower their glucose levels in real-time.</p> <p> “Diabetes is kind of a quiet disease, and there [are] many times you aren’t even aware that you have it,” said Cindy Broome, an RN coordinator at UMMC who uses Care Innovations to checks her patients’ blood sugar levels each morning. “The purpose of this is daily interventions, so we can catch things before they become problems.” </p> <p> As prediabetes, the precursor to type 2 diabetes, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/prediabetes-here-signs">silently grips the lives of as many as one in three U.S. adults</a>, the UMMC’s tablets offer a timely solution for patients who have diabetes and may need consistent communication with a physician to make healthier choices each day.  </p> <p> This is particularly true for patients in largely rural states such as Mississippi, where obesity is rampant yet the average resident lives more than 40 minutes away from specialists who treat patients with diabetes, Dr. Henderson said.  </p> <p> Physicians at the <a href="http://northsunflower.com/" rel="nofollow">North Sunflower Medical Center</a> in Ruleville are participating in a state-wide study using the UMMC’s technology and already have seen positive results among tablet-toting patients, including decreased glucose levels and fewer emergency room visits.  </p> <p> <strong>How can your practice improve diabetes outcomes?</strong><br /> Learn more about UMMC’s tablet technology and diabetes outcomes by viewing <em>Rx: The Quiet Revolution</em>: Watch the full film <a href="http://rxfilm.org/the-film/full-film/" rel="nofollow">online</a> or <a href="http://rxfilm.org/schedule/" rel="nofollow">check to see</a> when it airs where you live. </p> <p> Even if you don’t have tablet technology to monitor your patients, you still can help patients at risk for diabetes make important changes to improve their health outcomes.</p> <p> Check out a <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/toolkit.html">new toolkit</a> recently released by the AMA and the Centers for Disease Control and Prevention as part of the <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html">Prevent Diabetes STAT: Screen, Test, Act – Today™</a> initiative. The toolkit helps physicians and their care teams integrate into their practice work flows screening and testing patients for prediabetes as well as referring them to evidence-based diabetes prevention programs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:247ce5c1-33db-462f-8e92-b3c53b999ad0 What students wish they were learning in med school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-wish-were-learning-med-school Mon, 27 Apr 2015 19:57:00 GMT <p> It’s no secret that today’s medical students will be part of a health care system that is vastly different from just a decade ago, and more rapid changes are expected. So what are current students hoping to learn to prepare them for their future careers?</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/1/b06e9d7c-6c3d-4f78-b168-bc43819e6f6b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/1/b06e9d7c-6c3d-4f78-b168-bc43819e6f6b.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;">From right to left: Kevin Harris, second-year student at the Brody School of Medicine at East Carolina University; Ian Kim, first-year student at the University of California Davis School of Medicine; Nate Friedman, a second-year student Vanderbilt University School of Medicine; Grayson Armstrong, a fourth-year student at the Warren Alpert Medical School of Brown University and chair of the AMA Medical Student Section.</span></em></td> </tr> </tbody> </table> <p> At a recent meeting of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative held at Oregon Health and Science University, a panel of 10 medical students from across the country shared their views. The group told academic physicians the topics they wish were a more integral part of their schools’ curricula.</p> <p> An informal survey among the panel of students identified the following topics as high priorities for tomorrow’s physicians.</p> <p> <strong>Leadership training</strong><br /> First-year University of California Davis School of Medicine student Ian Kim didn’t take a traditional path to med school, and his unique perspective flagged the need for formal leadership training for medical students. Kim has an MBA and worked for the past decade in the advocacy sector.</p> <p> “I got to learn from amazing leaders,” he said. “Through my life experience, I understand the importance of leadership and why we can’t just sit on our hands. We need to manage the changes.”</p> <p> Some of the schools in the AMA’s consortium are developing purposeful leadership programs. The University of Michigan Medical School, for instance, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-schools-new-approach-producing-physician-leaders">hosted a retreat</a> for first-year students to help them understand how to be leaders in team-based care.</p> <p> <strong>Health policy</strong><br /> The student panel indicated they needed to know more about the political and regulatory forces shaping health care.</p> <p> “If we’re going to be agents of change, you have to have an understanding not only of the basic laws and rules of how health care works but the external forces that shape it,” said Nate Friedman, a second-year medical student at Vanderbilt University School of Medicine. “What we get [in school now] tends to be a little drier or a little bit more down in the weeds. We know labs are expensive—but why are they expensive? How did we get there?”</p> <p> Friedman also said more information on health policy could instill a sense of urgency in students that the current system needs to be fixed.</p> <p> “We’re going to be entering a system that is critically ill and needs true fixing, not in 20-25 years, but in five to 10 years,” he said. “I’d love to [learn] more about that. The students I talk to about this have a vague conception that we’re in trouble, but not a sense of urgency.”</p> <p> Pennsylvania State University College of Medicine is moving in this direction with its new systems navigation curriculum. The first part of the two-pronged curriculum will incorporate systems-based practice topics, including health policy, over a 17-month period.</p> <p> <strong>Health economics</strong><br /> For Varun Shahi, a third-year student at Mayo Medical School, a big need for tomorrow’s physicians is information about how much their work will actually cost patients.</p> <p> “It’s interesting that we don’t fully understand the costs related to what we’re providing,” Shahi said. “Having a solid economic foundation pushes the student to take on more economic roles.”</p> <p> Mayo is incorporating aspects of health systems education and economics in its Science of Health Care Delivery program, which covers specific content with a combination of face-to-face education and online modules. The school is developing tools to document student achievement in this new topic area, including surveys, quality improvement reviews, patient safety knowledge assessments and checklists.</p> <p> Health economics and policy are part of a new, larger area of learning called health care delivery science. The consortium is investigating <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-core-science-could-prep-med-students-health-care-changes?utm_source=Lyris&utm_medium=email&utm_term=042215B&utm_content=%20accelerating_change_in_med_ed">innovative ways to teach this new “third science.”</a></p> <p> <strong>Experiential learning</strong><br /> Students want fewer hours in lecture halls and more time learning by doing, the panel said.</p> <p> “If you give students ownership of something related to a topic and delve into experiential learning versus just lectures, I think you would have more uptake,” said Grayson Armstrong, a fourth-year medical student at the Warren Alpert Medical School of Brown University and chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a>. “I believe experiential learning is what we should move toward in general. Learn because it’s necessary, not because it’s going to be tested.”</p> <p> The Brody School of Medicine at East Carolina University is moving toward a more practical-based curricula, with a special program that will enroll 10 students per year. These students will complete advanced coursework and experiential activities, allowing them to obtain a special “distinction in health care transformation and leadership” designation in addition to their MD degrees.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:78ad5734-25be-4fd3-9a08-a491d9fc481c Delve deep into the Guides® Sixth at Chicago seminar http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_delve-deep-guides-sixth-chicago-seminar-1 Sun, 26 Apr 2015 14:00:00 GMT <p> Learn how to accurately apply permanent impairment methodology and get continuing medical education credit at the AMA Guides® Sixth Training <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2490005&navAction=push" target="_blank">seminar</a> May 15 in Chicago.</p> <p> Physicians and others who handle aspects of impairment ratings will increase their knowledge of the <em>Guides to the Evaluation of Permanent Impairment, Sixth Edition</em>, and its role in workers’ compensation. The seminar will cover a step-by-step progression of the impairment calculation for conditions and injuries related to individual body systems.</p> <p> See a detailed <a href="https://commerce.ama-assn.org/catalog/media/Guides%202015%20Training%20Agenda-041015.pdf" target="_blank">workshop agenda</a> online.</p> <p> The AMA designates this educational activity for a maximum of 8.0 <em>AMA PRA Category 1 Credits</em>™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2490005&navAction=push" target="_blank">Register for the seminar today</a>. AMA members receive a $100 discount on the registration fee for this seminar. Attendees receive a 30 percent discount on products from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:81346850-7e57-4a7e-8bfb-12a132f9940f Health data vital to patient safety under Supreme Court review http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-data-vital-patient-safety-under-supreme-court-review Fri, 24 Apr 2015 18:48:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/0/d7df9f18-a179-4a18-9032-8f31bac787eb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/0/d7df9f18-a179-4a18-9032-8f31bac787eb.Large.jpg?1" style="float:right;margin:10px;" /></a>Patient care information shared by physicians for the purpose of improving health care quality and safety could lose its protected status in a case that could be heard before the Supreme Court of the United States.</p> <p> <strong>What’s at stake</strong><br /> Where physicians now freely share patient safety information without fear of liability in support of higher quality health care, the Kentucky-based case <em>Tibbs v. Bunnell</em> could allow this data to be released for use in lawsuits.</p> <p> Health care professionals now are asking the highest court in the land to overturn a Kentucky Supreme Court ruling that would lift confidentiality protections in place under the federal Patient Safety and Quality Improvement Act of 2005 (PSQIA) for data that is collected in patient safety systems.</p> <p> PSQIA gives physicians and other health care providers a confidential way to share information related to patient safety events through a patient safety organization (PSO). Information submitted to a PSO is meant to be used for improving care quality and safety without threat that the information will be used against the physicians involved.</p> <p> If upheld, the Kentucky court’s decision “will stifle the collection and use of ‘patient safety work product,’ and frustrate one of the fundamental purposes of the act—to provide a nationwide repository where adverse health care outcomes can be studied and corrected,” physicians said in a friend-of-the-court brief filed by the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page" target="_blank">Litigation Center of the AMA and State Medical Societies</a>.</p> <p> <strong>The case’s origins</strong><br /> The issue began when a patient died while being treated for a medical condition at a University of Kentucky hospital, and the patient’s estate brought a medical liability suit against the hospital. The hospital submitted an incident report to a PSO so the incident could be analyzed and added to the database, but the patient’s estate asked for production of the incident report as part of litigation discovery.</p> <p> The hospital argued that the incident report was privileged under the PSQIA, but a trial court ruled that it wasn’t. The case wound its way up to the Kentucky Supreme Court, which reasoned that the PSQIA didn’t protect this information because records of this sort are required to be created under state law, even if they aren’t actually submitted to a state regulatory agency. The hospital now is asking the U.S. Supreme Court to take up the case.</p> <p> <strong>Not the only threat</strong><br /> <em>Tibbs v. Bunnell</em> isn’t the only case that seeks to release data at the heart of patient safety efforts. A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/protected-patient-information-stake-florida-case">similar case</a> now is making its way through the Florida court system.</p> <p> In <em>Southern Baptist Hospital of Florida, Inc. v. Charles</em>, a Florida court ordered a hospital to produce patient safety work product documents as part of litigation discovery. The hospital has appealed this ruling.</p> <p> This past week, the Michigan Supreme Court upheld hospitals’ privilege in another similar case, <em>Krusac v. Covenant Medical Center</em>. The case dealt with protecting confidential incident reports from discovery, in this case prepared in conjunction with peer review processes.</p> <p> Visit the AMA Litigation Center <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/patient-safety.page" target="_blank">Web page</a> to learn more about these cases and others related to patient safety.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3d54e93c-2ff4-4224-ba4e-9b04566f1505 What your practice should do to prepare financially for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_practice-should-prepare-financially-icd-10 Fri, 24 Apr 2015 18:46:00 GMT <p> How ready is your practice for the financial impact of implementing the ICD-10 code set? With the Oct. 1 implementation date a little more than five months away, practices are <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">preparing to make the switch</a>—but they also should be ready for what will happen following the deadline, experts say.</p> <p> Betty Gomez, an independent consultant on regulatory strategy, said practices should know exactly what it will take to “keep the lights on.” Gomez spoke at a <a href="http://files.himss.org/2015Conference/handouts/HS26.pdf" target="_blank" rel="nofollow">session </a>last week at the 2015 annual meeting of the Healthcare Information and Management Systems Society in Chicago.</p> <p> “The smaller [your practice is], the more important this is,” she said.</p> <p> Gomez said practices should have three to six months’ worth of cash on hand before the first day of October rolls around in case of payment bottlenecks. The money should be kept in a way that can be accessed any time, or quickly liquidated, if there are payment delays.</p> <p> “You need to have enough of a cushion so that other organizational problems—outside of yours—don’t impact you,” she said.</p> <p> Here are four things Gomez said practices should do to prepare financially for ICD-10 and decrease their chances of having claims issues later:</p> <ul> <li> Take note of key financial metrics, such as payer analyses and cash flow data.</li> <li> Place high priority on the quality and completeness of documentation.</li> <li> Track data on coders’ productivity for a period before ICD-10 implementation so you can compare post-implementation productivity.</li> <li> Make sure your practice is as prepared as possible to make the switch.</li> </ul> <p> <strong>Industry expects payment disruptions</strong><br /> Even the Centers for Medicare & Medicaid Services (CMS) recognizes that the ICD‐10 transition will have an impact on physician payment processes. The agency estimates that “in the early stages of implementation, denial rates will rise by 100-200 percent,” according to a 2013 <a href="http://www.hfma.org/denialsmanagementicd-10/" rel="nofollow">report</a> from the Healthcare Financial Management Association.</p> <p> A 2014 <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/icd-10-costs-for-physician-practices-study.pdf" target="_blank">AMA study</a> (log in) conducted by Nachisom Advisors on the cost of implementing ICD-10 estimated that a small practice could see payment disruptions ranging from $22,579 to $100,349 during the first year of ICD-10 implementation. The study also estimates that a small practice could incur a 5 percent drop in revenue because of productivity loss during and after the change.</p> <p> The AMA is urging regulators to ease the burden of ICD-10 implementation on physicians, but you should make sure your practice is prepared.</p> <p> An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> is an essential resource. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> <p> Check out the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/prep-icd-10-whether-beginner-expert">first post</a> in a series that offers timely transition tips and resources as the implementation deadline approaches.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b5f3f4e6-c66b-4ecc-9339-9d94d65fdbb9 Lend your voice to AMA-YPS proposals online http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lend-voice-ama-yps-proposals-online-2 Fri, 24 Apr 2015 14:30:00 GMT <p> Weigh in on issues that matter to you and your peers through the AMA Young Physicians Section (AMA-YPS) <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/yps-reference-committee.page" target="_blank">Online Member Forum</a>. Enter your comments by 4 p.m. (CST), May 11, to have your opinions considered at the section’s annual meeting.</p> <p> Resolutions and reports to be addressed include:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-resolution-1.pdf" target="_blank">Transgenerational Effects of Environmental Toxins on Reproductive Health</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-resolution-2.pdf" target="_blank">Formalizing the MSS–RFS–YPS Coalition</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-report-e.pdf" target="_blank">Update on Efforts to Increase Specialty Society Representation in the AMA-YPS</a></li> </ul> <p> Commenting on these important issues online gives all physicians a voice in the AMA’s policymaking process, even if they can’t attend the AMA-YPS Annual Meeting.</p> <p> Learn more about registering for the meeting on the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page" target="_blank">section Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:aea5a16d-b6d6-4639-aa3d-dd95399ef2af Prepare for National Women’s Health Week http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prepare-national-womens-health-week Fri, 24 Apr 2015 14:25:00 GMT <p> May 10 through May 16 is <a href="http://womenshealth.gov/nwhw/about/" rel="nofollow" target="_blank">National Women’s Health Week</a>, a weeklong health observance coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health.</p> <p> The week brings together communities, businesses, government, health organizations, and other groups in an effort to promote the importance of women’s health. It also empowers women to make their health a priority and encourages them to take steps to improve their physical and mental health and lower their risks of certain diseases.</p> <p> Visit the <a href="http://womenshealth.gov/nwhw/" rel="nofollow" target="_blank">Office on Women’s Health</a> to learn more about ways to support National Women’s Health Week.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:971d92e4-3f6b-4195-a790-6bdb01b260fe Participate in the 2015 AMA-WPS Annual Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_participate-2015-ama-wps-annual-meeting-1 Fri, 24 Apr 2015 14:20:00 GMT <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%3d%3d&OID=130" target="_blank">Register now</a> for this year's AMA Women Physicians Section (WPS) Annual Meeting before 11:59 p.m. (EST) on Tuesday, May 26.</p> <p> Also, please consider volunteering for the section’s handbook review committee. You can sign up by registering or sending an email to the <a href="mailto:WPS@ama-assn.org" target="_blank" rel="nofollow">AMA-WPS</a> by May 8.</p> <p> Please visit our <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/wps-meetings.page?" target="_blank">meetings and events</a> page for more updates.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7d1e975d-4939-40fe-914b-ddc23c2e01a7 Celebrate Older Americans Month this May http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_celebrate-older-americans-month-this-may Fri, 24 Apr 2015 14:15:00 GMT <p> President John F. Kennedy established Older Americans Month in order to recognize the important contributions of our nation’s seniors, who now make up 13.7 percent of the total U.S. population.</p> <p> This year’s theme is “Get into the Act,” which is focused on how older adults are taking charge of their health, getting engaged in their communities and making a positive impact in the lives of others. </p> <p> Find a <a href="http://www.usa.gov/Topics/Seniors.shtml" target="_blank" rel="nofollow">wide range of information</a> on topics for seniors from usa.gov, which includes health, money, housing and more. Also, learn more <a href="http://www.aoa.acl.gov/Aging_Statistics/Profile/2013/3.aspx" target="_blank" rel="nofollow">interesting facts</a> about America’s 65 and above crowd!  </p> <p> Many senior physicians are interested in sharing their time and expertise with others in volunteer roles. The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/physician-volunteers.page?" target="_blank">Senior Physicians Section Web page</a> offers ideas for staying active and involved.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:37dced05-471c-4b21-8886-c6a392ba60fe Vote in governing council run-off elections by May 6 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_vote-governing-council-run-off-elections-may-6 Fri, 24 Apr 2015 14:10:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">Senior Physicians Section</a> (SPS) is holding a run-off election to determine its officer at-large position. Ballots were sent to AMA-SPS members beginning April 29, and members can vote through May 6.</p> <p> Final election results for all positions will be announced via email May 13.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c38ce1a0-90b0-43a6-b33b-c730dc3135ea Develop AMA policy, network with colleagues June 5-6 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_develop-ama-policy-network-colleagues-june-5-6 Fri, 24 Apr 2015 14:00:00 GMT <p> Have you <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%253d%253d&OID=130" target="_blank">registered</a> yet for the next AMA Section on Medical Schools (SMS) meeting? Scheduled for June 5-6 in Chicago, the meeting is held in conjunction with the AMA Annual Meeting.</p> <p> Join your academic physician colleagues for this important event. AMA-SMS members can play a role in helping shape AMA policy by expressing their viewpoints on reports and resolutions to come before the AMA House of Delegates. The meeting also offers great networking opportunities to enjoy dialogue with your colleagues at medical schools nationwide.</p> <p> View the draft <a href="http://www.ama-assn.org/resources/doc/medical-schools/x-pub/a-15-sms-agenda.pdf" target="_blank">meeting agenda</a>.</p> <p> <strong>June 5: Updates on key medical education activities</strong></p> <p> The meeting begins Friday afternoon at 1 p.m. (with an optional review of medical education-related reports/resolutions that morning, from 10 to 11:45 a.m.).</p> <p> Meeting participants will learn about a variety of topics, including:</p> <ul> <li> The progress of the AMA's $11 million <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative</li> <li> Updates from the Liaison Committee on Medical Education</li> <li> How the AMA-SMS plays a role in AMA policy setting</li> <li> The latest legislative news from the AMA’s Washington, D.C., office</li> </ul> <p> The meeting will kick off with a presentation from Thomas A. Deutsch, MD, dean of the host medical school Rush Medical College of Rush University.</p> <p> Attendees are invited to join the AMA Council on Medical Education at 3 p.m. for its forum “Moving from time-based to competency-based medical education: Mission impossible?”</p> <p> <strong>June 6: Sessions on maintenance of certification and unmatched med school graduates</strong></p> <p> Be sure to join us at 7:30 a.m. Saturday for an educational session on maintenance of certification featuring Lois Margaret Nora, MD, president and chief executive officer of the American Board of Medical Specialties. A reactor panel will follow, along with a Q/A and discussion period.</p> <p> The topic of unmatched medical school graduates will be covered in a second educational session at 9 a.m. Presenting will be Geoffrey Young, PhD, program leader of the Group on Student Affairs at the Association of American Medical Colleges. Two reactors will present options to address this issue.</p> <p> At 10:30 a.m., the AMA-SMS business meeting will commence. This will include AMA-SMS review of medical education-related reports/resolutions and the election of the 2015-2016 SMS Governing Council.</p> <p> <strong>Travel, registration and meeting logistics; hotel reservation cut-off date coming soon</strong></p> <p> If you haven’t registered for the meeting yet, be sure to <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%253d%253d&OID=130" target="_blank">register now.</a></p> <p> Make hotel reservations and obtain discounts on United Airline flights now via the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/2015-annual-meeting.page?" target="_blank">2015 Annual Meeting Web page</a>. </p> <p> In addition, check the <a href="http://www.ama-assn.org/go/sms" target="_blank">AMA-SMS website</a> to stay apprised of any news/updates, and read a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-school-deans-faculty-debate-policy-ama-sms-meeting-highlights" target="_blank">summary</a> of the Nov. 6 section meeting.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6d2b315d-5318-47d5-957c-51434f4c8cf3 School takes coaching into medical field http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_school-takes-coaching-medical-field Thu, 23 Apr 2015 20:00:00 GMT <p> Coach K., John Wooden, Pat Summitt: Some of sports’ great coaches may influence the education of future physicians. As medical education undergoes a transformation, more schools are taking plays out of coaches’ books as they train medical students.</p> <p> In med ed, a coach is different from an advocate or an advisor.</p> <p> “A coach is a 2x4,” said Nicole Deiorio, MD, director of the undergraduate coaching program at Oregon Health and Science University. “They can be there to support the student and hold them up … or they’re there to ... present reality to them.”</p> <p> The school started a coaching program to ensure its graduating students were people who “acknowledge that they have a lifetime of self-improvement ahead of them,” said Dr. Deiorio at a recent consortium meeting of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative. “Humans in general are not great at self-assessment …. We want to create students who are better self-assesors, and there’s always room for an external assessor—a coach—to give them feedback.”</p> <p> <strong>How med ed coaching is playing out</strong></p> <p> OHSU rolled out its coaching program at the beginning of this academic year with 28 coaches, each paired with five entering medical students. Each successive year, coaches will take on five additional students to have a cohort of 20 students. Coaches sign up for a four-hour weekly commitment.</p> <p> They aren’t evaluating students, but they are privy to every piece of academic information about their students. One-on-one meetings between a student and a coach occur about every three weeks, and a structured form allows the coach to focus on identified areas the student wants to improve.</p> <p> The coach also hosts cohort meetings with all of their students, using the time to discuss themes such as problem solving, ethical issues and grief.</p> <p> “It’s not just academic,” Dr. Deiorio said, pointing to wellness issues as another example. In that case, the coach would help the student get the assistance they required. To be prepared, coaches met with representatives from the school’s range of student services, from student health to financial management.</p> <p> <strong>Sharing the win</strong></p> <p> Coaching programs in medical school are still in the nascent stages, so there isn’t a lot of literature on the topic as it applies to medical education. However, it isn’t difficult to see how it relates to athletic coaching, which relies on ongoing skills assessment and specific feedback. And coaching has been used in the business world to “provide a results-oriented and stigma-free method to address burnout,” according to a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371007/pdf/11606_2014_Article_3144.pdf" rel="nofollow" target="_blank">2014 article</a> in the <em>Journal of General Internal Medicine.</em></p> <p> So far, Dr. Deiorio said, students are playing ball with the idea of coaches. Initial evaluations show student satisfaction is high.</p> <p> Other schools in the consortium are learning from OHSU’s experience.  If it proves to be a winning idea, they will be able to apply that knowledge to begin their own coaching programs in the future. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:40dd5277-a038-4d93-90e0-45655c8dfa23 5 health care topics medical students are discussing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-health-care-topics-medical-students-discussing Wed, 22 Apr 2015 20:18:00 GMT <p> Vaccinations, Medicaid expansion, medical education loans and the current opioid epidemic—what do these things have in common? They’re some of the hottest topics in health care right now, and they also are issues that will be at the forefront during the National Medical Student Meeting.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page?" target="_blank">meeting</a> will be held June 4-6 in Chicago, but medical students can log in to the <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/mss-reference-committee.page" target="_blank">AMA Medical Student Section forum</a> now to review proposals on these topics that could eventually become AMA policy.</p> <p> Here are five of the top issues in front of medical students:</p> <ul> <li style="margin-left:0.25in;"> <strong>Vaccination rates</strong><br /> Over the past year, the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/answer-patients-questions-vaccinations" target="_blank">outbreak of measles cases</a> in the United States continually made national news. This medical student proposal asks the AMA to develop physician resources aimed at improving patient education about the safety of vaccines, their effectiveness at preventing communicable diseases.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Business and economics of health care</strong><br /> Medical students <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-core-science-could-prep-med-students-health-care-changes" target="_blank">want to learn more</a> about the external forces shaping today’s health care system. This proposal asks for the development of model business and economics curriculum for medical schools and residency programs. It also encourages medical schools and residency programs to make it easy for trainees to get information on personal finances and health care economics.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Medicaid expansion</strong><br /> Physicians support Medicaid expansion, and even <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-urge-expanded-access-medicaid" target="_blank">passed policy</a> in November that urges lawmakers to identify realistic coverage options for adults currently in the “coverage gap,”— historical gaps in Medicaid eligibility for adults—even if states choose not to adopt the Medicaid expansion outlined in the Affordable Care Act.<br /> <br /> This proposal asks the AMA to monitor the impact of reduced payments to safety-net hospitals, which could cause them to close and further limit access for those in the coverage gap. It also encourages AMA advocacy to encourage states to expand their Medicaid programs.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Medical education loan forgiveness</strong><br /> Debt for medical education can be overwhelming. <a href="https://www.aamc.org/download/152968/data/debtfactcard.pdf" target="_blank" rel="nofollow">Data</a> from the Association of American Medical Colleges shows that 40 percent of medical school graduates in 2014 expected to make use of a loan forgiveness or repayment program.<br /> <br /> The U.S. Department of Education (DOE) has <a href="http://www2.ed.gov/about/overview/budget/budget15/justifications/s-loansoverview.pdf" target="_blank" rel="nofollow">proposed</a> capping Public Service Loan Forgiveness at the aggregate limit of undergraduate borrowing ($57,500) and moving all borrowers onto this repayment plan. This resolution asks the AMA to work with the DOE to ensure that any cap on loan forgiveness under the Public Service Loan Forgiveness program is equal to the principal amount borrowed. Any accrued interest would remain the responsibility of the borrower.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Nationwide opioid overdose epidemic</strong><br /> Nearly four dozen people in the United States die each day from prescription drug overdoses, according to the Centers for Disease Control and Prevention, and the number of people dying from heroin overdose is rapidly increasing. Two proposals seek to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/safety-leaders-physicians-seek-stronger-state-rx-efforts" target="_blank">address this epidemic</a>.<br /> <br /> The first proposal asks the AMA to advocate for over-the-counter availability of the opioid overdose-reversal drug naloxone. The second asks the AMA to study the use and effectiveness of opioid return programs and how to improve implementation of such programs.</li> </ul> <p> Visit the online AMA <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/mss-reference-committee.page" target="_blank">Medical Student Section forum</a> to review these proposals and others, comment with your opinions and discuss resolutions with other students. Comments will be accepted through May 7.</p> <p> <strong>Tell us: </strong>What current topics in health care matter most to you?</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f48e270d-2ac2-46ed-9ec6-0148d25c6f5a Tobacco to be banned from San Francisco ballparks http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tobacco-banned-san-francisco-ballparks Wed, 22 Apr 2015 20:10:00 GMT <p> The nation’s favorite pastime just became a healthier sport in the home of Major League Baseball’s Giants, thanks to a historic ordinance passed Tuesday. The rule would ban tobacco products from San Francisco’s baseball venues and athletic fields.</p> <p> The draft ordinance will prohibit all tobacco products—including chewing tobacco, which is popular among professional baseball players—from athletic fields in San Francisco city and county, beginning Jan. 1. It was passed by the San Francisco Board of Supervisors in a unanimous vote. A final vote will be taken April 28 before the ordinance goes to the mayor for his signature.</p> <p> The ordinance comes just nine months after several of the nation’s largest health care and public health groups, including the AMA, <a href="http://www.tobaccofreekids.org/pressoffice/2014/mlbletter.pdf" target="_blank" rel="nofollow">formally called on</a> Major League Baseball and the Major League Baseball Players Association to completely prohibit tobacco use at ballparks and on camera.</p> <p> “Kids see athletes as role models, and when baseball stars use smokeless tobacco, the kids who look up to them are much more likely to as well,” said Matthew Myers, president of the <a href="http://www.tobaccofreekids.org/" target="_blank" rel="nofollow">Campaign for Tobacco-Free Kids</a>. “Our national pastime should have nothing to do with promoting a deadly and addictive product.”</p> <p> “San Francisco will become the first city to take tobacco out of baseball, setting a powerful example that all of Major League Baseball and the rest of the country should quickly follow,” Myers said.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/50-years-of-anti-smoking-efforts-save-8-million-lives" target="_blank">Learn more</a> about the past 50 years of anti-tobacco activity.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:61653286-b7e5-4916-98c2-9710c22e4f9d 5 ways health care will look different in the post-SGR era http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-ways-health-care-will-look-different-post-sgr-era Tue, 21 Apr 2015 16:58:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/1/3cc1ca70-05ec-4b65-a183-8f178ef57e6f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/1/3cc1ca70-05ec-4b65-a183-8f178ef57e6f.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD</em></p> <p> Our nation stepped into a new era for health care last week when it <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">adopted legislation</a> to eliminate Medicare’s sustainable growth rate (SGR) formula.</p> <p> Medicare had been locked in persistent instability thanks to this failed budgetary gimmick created in 1997. Yes, you read it correctly: 1997. That’s back when we were using dial-up connections, the general public was just becoming aware of the possible Y2K catastrophe and Google had yet to appear on the market.</p> <p> For more than a decade, the unified voice of medicine tirelessly called on lawmakers to release Medicare into the 21st century. And now it has happened.</p> <p> With SGR behind us, we now can build a forward-looking health care system that puts patients first—a system in which we can provide cost-effective care with top-notch health outcomes in a sustainable practice environment.</p> <p> Here are five ways our health care system will begin to look different:</p> <p style="margin-left:40px;"> <strong>1.     Medicare and TRICARE patients will no longer face constant uncertainty over whether they might lose their access to care.</strong><br /> The perennial threat of devastating payment cuts under SGR made it difficult for many physicians to know whether they would be able to keep their doors open for treating these patients.</p> <p style="margin-left:40px;"> <strong>2.     Physicians’ practices will be more sustainable.</strong><br /> Under the new law, many of the competing quality-reporting programs in Medicare will be consolidated and better aligned. The risk of penalties also has been substantially reduced, and physicians now have potential for earning significant bonuses.</p> <p style="margin-left:40px;"> <strong>3.     </strong><strong>The path will be cleared for new models of care.</strong><br /> The new law not only removes the financial instability caused by the SGR formula but also provides monetary and technical support for those who choose to adopt new models of care suited to the 21st-century needs of physicians and their patients.</p> <p style="margin-left:40px;"> One of our primary goals at the AMA is to further lift physicians’ regulatory burdens and provide practical resources to advance <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">professional satisfaction and practice sustainability</a>. Now that the SGR is out of the way, we can ramp up these efforts.</p> <p style="margin-left:40px;"> <strong>4.     </strong><strong>Health outcomes will be improved in the clinic setting and the community.</strong><br /> Chronic diseases have become the primary sources of poor health and death today. Treating these conditions requires new approaches, and the new law permanently requires Medicare to pay for care management of these patients.<br /> <br /> We have an <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page?" target="_blank">initiative underway</a> that is developing ways physician practices can partner with their patients and the community to prevent two of the most common chronic conditions—heart disease and type 2 diabetes—before they start. We’re also advocating for Medicare and other insurance plans to cover evidence-based prevention programs.</p> <p style="margin-left:40px;"> <strong>5.     </strong><strong>Physicians in training will be taught how to practice in the new health care environment.</strong><br /> Even as the health care system undergoes dramatic change, an <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">AMA consortium of medical schools</a> is exploring how to prepare the next generation of physicians for practicing in the new environment. Students will learn how to succeed in new models of care, provide high-quality but cost-effective care, and team up with other health care professionals and the community so their patients can lead the healthiest lives possible.</p> <p> Just as we partnered in the past to end an unsuccessful system that hindered our practices and threatened our patients, let’s step into the future together. Let’s shape this new era of health care into one in which our profession and our patients thrive.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:91ea522b-9b5c-4434-9f74-8a2dd5699721 The hidden dangers of EHR pop-up fatigue http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hidden-dangers-of-ehr-pop-up-fatigue Mon, 20 Apr 2015 21:09:00 GMT <p> Here’s a situation most physicians are probably familiar with: You’re entering patient information into your electronic health record (EHR), and a pop-up window appears on your screen—the same window you’ve seen 10 times already that day. What’s your reaction?</p> <p> <strong>Bombarded by alerts</strong></p> <p> <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/ClinicalDecisionSupport_Tipsheet-.pdf" rel="nofollow">Clinical decision support</a> technology, whether integrated into EHRs or as add-on software, is intended to increase quality of care, enhance health outcomes, help avoid errors and adverse events, and improve efficiency, according to the Centers for Medicare & Medicaid Services. Although clinical decision support is not limited to pop-up windows, many physicians associate it with the alerts that appear on their screens as they attempt to move through a patient’s record, offering prescription reminders, patient care information and more.</p> <p> But the hidden dangers in these pop-ups can bring the threat of medical liability, two experts explained during a <a href="http://files.himss.org/2015Conference/handouts/191.pdf" rel="nofollow">session</a> last week at the 2015 annual meeting of the Healthcare Information and Management Systems Society in Chicago.</p> <p> “Are we bombarding our providers with so much information in disparate areas of the medical record that they don’t have time to get through their day, so they bypass that information?” said Sheryl Bushman, DO, chief medical information officer at Optimum Healthcare IT. “Are we teaching them to pay attention to these alerts or teaching them [that] it’s okay to bypass this alert because you’ve seen it 50 times?”</p> <p> <strong>Clicks and bypasses tracked</strong><br /> Data suggest that systems likely are cultivating this bypass behavior. A <a href="http://aci.schattauer.de/en/contents/archive/issue/1884/manuscript/22414.html" rel="nofollow">2014 study</a> in <em>Applied Clinical Informatics</em> found 95.1 percent of drug-drug alerts were overridden by physicians in a large teaching hospital system. A <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052586/" rel="nofollow">2013 review</a> of clinical decision support alert effectiveness in <em>The Ochsner Journal</em> showed alert overrides occur for 49-96 percent of alerts.</p> <p> An EHR tracks everything, Dr. Bushman said—not only what you click but also what you don’t click. It can even record how long you spend on a particular page. Combine this ability to log a physician’s every action with potential alert fatigue, and there may be an open door for medical liability cases, she said.</p> <p> For example, as a physician, are you liable if you bypass an order set? If you print out a patient education sheet, as prompted by the EHR, are you sure that the information on the sheet is in alignment with what you or your nurses would tell the patient? If you get a reminder for an overdue result, how liable are you if you don’t follow up immediately?</p> <p> The overarching question, Dr. Bushman said, is: If you are interfacing with clinical decision support in your EHR, “have you just opened up everything within that software to making you liable for it?”</p> <p> <strong>How to avoid liability</strong><br /> Potentially, said Paul A. Testa, MD, chief medical information officer at New York University Langone Medical Center and a trained attorney. There haven’t yet been enough high-level medical liability court cases on topics involving clinical decision support to know what physicians could be held liable for.</p> <p> However, physicians can practice general risk management when working with an EHR in two ways, Dr. Testa said: Document and communicate.</p> <p> “These two actions are the best defensive practices in medicine,” he said. “Well-documented cases are not attractive.”</p> <p> But this can be difficult for physicians bombarded with data and information each day, Dr. Testa acknowledged. A <a href="http://www.ncbi.nlm.nih.gov/pubmed/22269625/" rel="nofollow">2012 review</a> in the <em>American Journal of Medicine </em>found that primary care physicians receive an average of 56 alerts per day, spending an estimated average of 49 minutes each day processing these alerts.</p> <p> “It’s easy to blow past it—but now there’s a record,” Dr. Testa said of alerts.</p> <p> The AMA is working to improve EHRs through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?">Physician Satisfaction and Practice Sustainability</a> initiative, ensuring the voices of physicians are part of EHR development. Last year, the AMA released a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint</a> outlining ways to improve the Medicare and Medicaid meaningful use program and a framework that details <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight priorities</a> for moving toward more usable EHR systems. The AMA is using this framework to work with physicians, vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance the delivery of high-quality, affordable care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fa50cdaa-4ce7-4cd9-a3e7-2675e37e1eee 5 things institutions can do to prevent resident burnout http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-things-institutions-can-prevent-resident-burnout Mon, 20 Apr 2015 21:00:00 GMT <p> Physician burnout is a pressing issue, but we’ve heard from readers that avoiding burnout goes beyond taking charge of one’s own wellness. The institutions in which medical students, residents and physicians learn and work need to help them build resilience as well.</p> <p> A <a href="http://www.jgme.org/doi/abs/10.4300/JGME-07-01-42" rel="nofollow">perspective piece</a> in the March issue of the <em>Journal of Graduate Medical Education</em> examined the trainee perspective on current resources that support resident wellness. It’s no secret that physicians in training are at increased risk for depression as compared to their peers, but many physician wellness tips are focused on what trainees can personally do in their lives to help avoid depression and burnout rather than focusing on their environment.</p> <p> The piece admits that some of the negative aspects of physician training cannot be changed, such as the physical and emotional challenges, the enormous workload and trainees’ failures, despite their best efforts. But institutions can do more to help residents achieve wellness in optimal learning environments, and the piece identifies changes programs can make to do this.</p> <p> According to the article authors, several of whom are residents and fellows, here are the five things institutions can do to promote wellness in their programs:</p> <ol style="margin-left:40px;"> <li> <strong>Destigmatize and raise awareness about depression during training. </strong><br /> Discussing depression at orientation and during regular meetings and retreats can bring the topic to the forefront. For example, when New York University discovered surgical residents didn’t recognize the early warning signs of depression in their peers, the school held a seminar on the topic. The program employed video clips, a standardized patient-actor and time for self-reflection.</li> <li> <strong>Build systems to confidentially identify and treat depression. </strong><br /> Trainees should have access to confidential mental health service and wellness programs that offer extended hours to accommodate their work schedules, such as the program at Oregon Health and Science University. With such programs, a resident who may be reluctant to seek intervention still has access to nonjudgmental dialogue and support.</li> <li> <strong>Establish a more formal system of peer and faculty mentoring. </strong><br /> Encouraging mentorship by pairing junior and senior residents at the start of residency could help decrease stressors and build camaraderie. Having a peer to talk to about overcoming day-to-day hardships can be a vital source of support.</li> <li> <strong>Promote a supportive culture during training. </strong><br /> Trainees spend most of their time in the clinical setting, so residency naturally creates a family and community. An environment that acts as a safety net of support can be a major contributor to wellness.</li> <li> <strong>Foster efforts to learn more about resident wellness. </strong><br /> Institutions need to uphold resident wellness efforts, and more study should be done to better understand problem areas and highlight best practices, the perspective piece said.</li> </ol> <p> For more on <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Physician_Health/1">physician wellness</a>, visit <em>AMA Wire</em>®, and watch for details about an upcoming Tweet chat that addresses physician trainee wellness at the institutional level.</p> <p> <strong>Tell us: </strong>What does your institution do to help trainees avoid burnout? In an ideal world, what support services would you like to see?</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a875b8de-52b9-4d64-8a68-4f21df55bf25 What “HIPAA-compliant” really means http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hipaa-compliant-really-means Fri, 17 Apr 2015 20:58:00 GMT <p> If your practice were to come under a random audit for monitoring compliance with the Health Insurance Portability and Accountability Act (HIPAA), would you pass? Learn what it really means to be in compliance with HIPAA and learn tips from experts.</p> <p> Dana DeMasters, a privacy and security officer at Liberty Hospital in Liberty, Missouri, and Tom Walsh, president and CEO of tw-Security, discussed what HIPAA compliance looks like during a session last week at the 2015 annual meeting for the Healthcare Information and Management Systems Society in Chicago.</p> <p> <strong>Compliance should be an ongoing effort</strong></p> <p> According to DeMasters and Walsh, the most important thing doctors should know is that there’s no such thing as “HIPAA-compliant certification.”</p> <p> In other words, practices can’t earn a “seal of approval” that makes them compliant once and always. While credentialed staff at independent firms can give their professional opinion on your practice’s HIPAA compliance status,  any HIPAA assessment is just a “snapshot in time.” Changes in your organization can impact your overall compliance status.</p> <p> That means that HIPAA compliance is a continual effort of your practice.</p> <p> <strong>4 steps to take</strong><br /> To protect your practice against a security breach and ensure you’re in compliance with HIPAA, taking these three steps on an ongoing basis:</p> <ul> <li> Educate your staff about the importance complying with HIPAA requirements.</li> <li> Ensure all electronic patient information is encrypted when in transit and at rest.</li> <li> Perform a privacy and security risk assessment for all health care information technology, not just your electronic health records.</li> <li> Document, document, document. Maintaining a paper trail is not only important in managing your own compliance, but vital in the event of an audit.</li> </ul> <p> <strong>Resources to use</strong><br /> Free resources can help your practice stay compliant.</p> <p> Start by taking advantage of the AMA’s <a href="http://ama-assn.org/resources/doc/washington/x-pub/hipaa-toolkit.pdf" target="_blank">HIPAA privacy and security toolkit</a> (log in) or an <a href="https://cme.ama-assn.org/Activity/2217925/Detail.aspx" target="_blank">online activity</a> offering continuing medical education in the form of <em>AMA PRA Category 1 Credit™</em> to bring your practice up to speed. You also can use a <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/hipaa-phi-encryption.pdf">FAQ sheet about encryption</a> (log in), including what it means and why it matters.</p> <p> Additional information and materials are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act.page" target="_blank">HIPAA Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9dff00e4-1709-4c17-bf48-d261e2e56b8a Can house calls transform patient care? New film explores how http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_can-house-calls-transform-patient-care-new-film-explores Fri, 17 Apr 2015 06:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/2/675ae9c5-e784-4db3-a24f-551da7ea4a37.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/2/675ae9c5-e784-4db3-a24f-551da7ea4a37.Large.jpg?1" style="float:right;margin:10px;" /></a>Physicians making house calls may sound like fabled history—long before the era of electronic health records and complex payment models—but what if this is exactly how some physicians are transforming health care today?</p> <p> David Loxterkamp, MD, a family physician in Belfast, Maine, has made house calls a key component of his practice, <a href="http://seaportcommunityhealthcenter.com/" rel="nofollow">Seaport Community Health Center</a>, one of four team-based practices featured in a new PBS documentary, <a href="http://rxfilm.org/the-film/full-film/" rel="nofollow"><em>Rx: The Quiet Revolution</em></a>.</p> <p> Created by 10-time Emmy Award winner David Grubin, the AMA-sponsored film showcases physicians and care teams across the nation who are changing how people receive medical care by lowering costs and making patients the central focus of their practices.</p> <p> Dr. Loxterkamp, whose father was also a physician who made house calls to patients during lunch and evening hours, said this personal touch to medicine can empower patients to find real health solutions that fit their complicated lives.</p> <p> “We’ve been trained exquisitely well in medical school to fix what can be fixed. When we know what the problem is and there’s a technical solution, boy, are we good—and we’re fast and a little expensive,” Dr. Loxterkamp said of physicians. Yet he notes that most chronic illnesses develop from patient habits and lifestyles that extend beyond charting diagnostics or prescribing medicine.  </p> <p> And that’s where the house calls, team-based care and partnering with patients to improve health outcomes can bolster solutions.</p> <p> While some physicians may lack ample time for house calls or “negotiating” lifestyle changes with patients, Dr. Loxterkamp credits his practice’s team of physicians, nurses, medical assistants, a psychiatrist and a physical therapist for helping him manage beleaguering tasks, so he can forge more meaningful relationships with patients. </p> <p> The results speak for themselves:</p> <ul> <li> One-third of patients in his smoking cessation program have quit smoking. The last reported national cessation rate was 6.2 percent, according to the CDC.  </li> <li> Emergency room visits have dropped 40 percent in the last four years.</li> <li> Last year, the blood sugar level of patients with uncontrollable diabetes dropped 100 points.</li> </ul> <p> <strong>Help your patients chart similar progress</strong><br /> Learn more about Dr. Loxterkamp’s practice and the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/welcome-future-doctors-changing-patient-care">future of medicine</a> in <em>Rx: The Quiet Revolution</em>: Watch the full film <a href="http://rxfilm.org/the-film/full-film/" rel="nofollow">online</a> or <a href="http://rxfilm.org/schedule/" rel="nofollow">check to see</a> when it airs near you. </p> <p> Even if you’re not able to make house calls for your patients, you still can help them make important changes to improve their health outcomes within their communities. The AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">Improving Health Outcomes</a> initiative offers resources to aid physicians and their patients in getting high blood pressure under control and preventing the development of type 2 diabetes.</p> <p> Learn about resources that can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits">manage their blood pressure outside office visits</a>.</p> <p> Check out a <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/toolkit.html">new toolkit</a> recently released by the AMA and the Centers for Disease Control and Prevention as part of the <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html">Prevent Diabetes STAT: Screen, Test, Act – Today™</a> initiative. The toolkit helps physicians and their care teams integrate into their practice work flows screening and testing patients for prediabetes as well as referring them to evidence-based diabetes prevention programs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:64373532-9db7-4baa-bc9c-6a96396a7e1d Participate in the 2015 AMA-WPS Annual Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_participate-wps-2015-ama-wps-annual-meeting-1 Thu, 16 Apr 2015 18:00:00 GMT <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20152014E&TID=C8lTfMODbd19mAzbQuFPDw%3d%3d&OID=130" target="_blank">Register now</a> for this year's AMA Women Physicians Section (WPS) Annual Meeting by May 26.</p> <p> Also, please consider volunteering for the section’s handbook review committee. You can sign up by registering or sending an email to the <a href="mailto:WPS@ama-assn.org" rel="nofollow" target="_blank">AMA-WPS</a> by April 30.</p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/wps-meetings.page?" target="_blank">meetings and events</a> page for more updates.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bc03724-d167-40e7-9a26-ed7edc7c7118 Lend your voice to AMA-YPS proposals online http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lend-voice-ama-yps-proposals-online-1 Thu, 16 Apr 2015 14:00:00 GMT <p> Comment on issues that matter to you and your peers through the AMA Young Physicians Section (AMA-YPS) <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2015/yps-reference-committee.page" target="_blank">Online Member Forum</a>. Enter your comments by 5 p.m. Eastern time May 11 to have your opinions considered at the AMA-YPS Annual Meeting.</p> <p> Resolutions and reports to be addressed include:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-resolution-1.pdf" target="_blank">Transgenerational Effects of Environmental Toxins on Reproductive Health</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-resolution-2.pdf" target="_blank">Formalizing the MSS–RFS–YPS Coalition</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/resources/doc/yps/x-pub/no-index/a15-yps-report-e.pdf" target="_blank">Update on Efforts to Increase Specialty Society Representation in the AMA-YPS</a></li> </ul> <p> Commenting on these important issues online brings your voice to the AMA’s policymaking process, even if you can’t attend the AMA-YPS Annual Meeting. Register for the AMA-YPS Annual Meeting on the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page" target="_blank">section Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:83cb56e7-7b51-4fdd-a392-9fe36d755916 New “core science” could prep med students for health care changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-core-science-could-prep-med-students-health-care-changes Thu, 16 Apr 2015 06:00:00 GMT <p> For medical students of the future, one day there could be a new science on their Step 1 exams.</p> <p> Traditionally, students are schooled in two core science areas—basic science and clinical science. But the work of the AMA's <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative has helped push to the surface the need for a third: health care delivery science.</p> <p> <strong>Defining the third core science</strong></p> <p> There have been rumblings of the need for such education for years, educators at the AMA's recent consortium meeting at Oregon Health and Science University said.</p> <p> For this area of study, which often includes “systems-based practice,” quality improvement and practice-based learning, students must demonstrate awareness of the “larger context and systems of health care and the ability to call on system resources to provide care that is of optimal value,” according to the Accreditation Council for Graduate Medical Education.</p> <p> But what does that mean?</p> <p> “New skills are required for the changing health care marketplace, from interprofessional teams to payment reform to health IT,” said Jeffrey Borkan, MD, chair of family medicine at the Warren Alpert Medical School at Brown University. “Now, there's greater recognition that there is a gap, and we must equip students.”</p> <p> This new third science ideally would include curricula on health care policy and economics, clinical informatics and health IT, population and public health, socioecological determinants of health, value-based care, and health system improvement. It also would incorporate teachings in leadership, teamwork, critical thinking and professionalism.</p> <p> <strong>Med students looking for additional education</strong></p> <p> The need for such education isn't only recognized by academic physicians.</p> <p> “While health care delivery science is resonating with the educators in this room, it's also resonating with the students as a perceived need,” said Grayson Armstong, a fourth-year medical student at Brown and chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a>.</p> <p> Armstrong said in an informal poll of a panel of medical students, most indicated the interest in—and need for—curricula on economics, policy and health systems.</p> <p> “If we're going to be agents of change, you have to have an understanding not only of the basic laws and rules of how health care works but the external forces that shape it,” said Nate Friedman, a second-year medical student at Vanderbilt University School of Medicine. “What we get [in school now] tends to be a little drier, or a little bit more down in the weeds. We know labs are expensive—but why are they expensive? How did we get there?”</p> <p> <strong>Schools adopting the new science</strong></p> <p> Mayo Medical School is moving forward with such curricula in its Science of Health Care Delivery program, which covers specific content with a combination of face-to-face education and online modules. The school is developing tools to document student achievement in these new topic areas, including surveys, quality improvement reviews, patient safety knowledge assessments and checklists.</p> <p> Pennsylvania State University College of Medicine launched its new systems navigation curriculum last year with its first-year students. The first part of the two-pronged curriculum will incorporate systems-based practice topics over a 17-month period.</p> <p> The second part will make the students “patient navigators,” linking them with local clinics to give the students experience in actually dealing with systems-based practice. As navigators, students will help patients handle insurance, find community resources and coordinate complex care issues.</p> <p> The consortium's goal is to have curricula, competencies and assessments in the new third science mapped out so other medical schools can begin incorporating these principles into their programs. The group is using existing research and conducting its own research to push the idea of health care delivery science to the forefront.</p> <p> The physician of the future really needs to be a person who understands what the issues are for a patient, their family, and their community, and brings the best resources to bear on problem solving,” said Susan Skochelak, MD, group vice president for medical education at the AMA. “They have to manage information. They have to provide leadership. They have to provide coaching, and they really have to focus on health for the patient, the family, and their community.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4ab26a93-ccd0-4b7c-a0f2-847c6cec3166 How to prep for ICD-10--whether you’re a beginner or expert http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prep-icd-10-whether-beginner-expert Wed, 15 Apr 2015 22:00:00 GMT <p> Physicians have less than six months to transition to the ICD-10 code set, meaning it’s officially crunch time. Whether you’re already on the road to implementation in your practice or you need a little more guidance, use this month-by-month primer to get you ready for the Oct. 1 deadline.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/0/d4271234-439d-4983-903d-1da74b63c5ba.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/0/d4271234-439d-4983-903d-1da74b63c5ba.Large.png?1" style="float:right;margin:15px;" /></a><strong>What to tackle in May</strong></p> <p> Use these <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank">tips from the AMA</a> and the Centers for Medicare & Medicaid Services’ <a href="http://cdn.roadto10.org/wp-uploads/2014/02/Road_To_10_Implementation_Guide.pdf" rel="nofollow" target="_blank">Road to 10 Implementation Guide</a> to bring your practice in line with the new code set.</p> <p style="margin-left:.5in;"> <strong>Just getting started?</strong></p> <p style="margin-left:.5in;"> Spend your time in the month ahead identifying the changes you need to make in your practice for ICD-10.</p> <p style="margin-left:.5in;"> For example, you’ll need to update your systems, forms and work flow processes. Pull together a group of all staff members involved in coding, billing, claims processing, revenue management and clinical documentation, then figure out each task necessary to bring your practice in line with the new code set. Ask the group members how and where they use ICD-9, and go from there.</p> <p style="margin-left:.5in;"> Once you have a plan, you can more easily estimate and secure funds to update your practice management system, purchase new coding guides and send your staff to training. Use a <a href="http://www.cms.gov/eHealth/downloads/eHealthU_SmallMedPracChecklist.pdf" rel="nofollow" target="_blank">transition checklist</a> to get started.</p> <p style="margin-left:.5in;"> <strong>Already on your way?</strong></p> <p style="margin-left:.5in;"> ICD-10 requires new levels of documentation requirements, so now’s the time to assess your current documentation practices and how they will support the new code set.</p> <p style="margin-left:.5in;"> The documentation for ICD-10 coding may not be that different from your current documentation—it’s likely that the more detailed information required under ICD-10 is already in your clinical notes. For example, the ICD-10 pregnancy codes are broken down into trimesters, which will be in your documentation.</p> <p style="margin-left:.5in;"> Also, keep in mind the changes in codes and increased level of detail are specific to specialties. Orthopedics has the highest increase in codes because many are simply separate codes for “right” versus “left.” This information would already be in your documentation.</p> <p style="margin-left:.5in;"> Decide whether you want to perform the documentation assessment yourself or you would like to get outside expertise. There are organizations that will provide feedback on your current situation and whether it will be sufficient for ICD-10. You also can conduct your own assessment with resources, such as this <a href="http://www.ama-assn.org/resources/doc/washington/icd10-assess-your-documentation.pdf" target="_blank">tip sheet</a> (log in) or a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/guide-icd-10-documentation" target="_blank">how-to guide</a> from the AMA.</p> <p> The AMA is urging regulators to ease the burden of ICD-10 implementation on physicians, but you should make sure your practice is prepared.</p> <p> An ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a> is an essential resource. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> <p> Editor’s note: This post is the first part of a new monthly series that will provide timely transition tips and resources as the Oct. 1 ICD-10 implementation deadline approaches. </p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/13/7bbe411f-a64d-4e3d-bd44-136b6de52baf.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/13/7bbe411f-a64d-4e3d-bd44-136b6de52baf.Full.png?1" /></a></p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:065b13c0-7a5e-49e6-bb69-6a9c5108d9f5 Challenging the “hidden curricula” in residency programs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_challenging-hidden-curricula-residency-programs Wed, 15 Apr 2015 19:00:00 GMT <p> Put yourself in this situation: You’re an anesthesia resident, and a staff anesthesiologist in the operating room asks you to give blood to a patient who is a Jehovah’s Witness. The patient has explicitly stated that receiving blood is against his or her beliefs. What do you do?</p> <p> A <a href="http://www.ncbi.nlm.nih.gov/pubmed/25792523" rel="nofollow" target="_blank">new study</a> published in the March issue of the <em>Canadian Journal of Anesthesia</em> put real anesthesia residents in this simulated scenario and found that the majority of trainees in the two groups that underwent the simulation gave blood to the “patient.” Despite knowing the patient’s religious beliefs did not allow the patient to receive a blood transfusion, the trainees felt the need to listen to their attending physician.</p> <p> After the simulation, participants shared their thoughts about why they went through with the transfusion. Many residents discussed the hierarchical influences in the operating room, often characterized by fear or intimidation. Few residents in the simulation managed to effectively challenge the inappropriate care, perceiving this as a devaluation of their role within the care team.</p> <p> “The hierarchy is well established with the surgical staff,” one resident said in the study, which took place at two Ontario universities. “I think they pride themselves on sort of abusing the junior residents.”</p> <p> The study also highlighted the culture of the operating room—a space with obstacles or boundaries that must be respected, though these boundaries may not be made explicit. For example, a single anesthesiology consultant might have a different way of handling the management of each case, and residents are expected to anticipate these differentiations.</p> <p> <strong>Revealing the hidden curricula</strong></p> <p> These findings bolster discussions about the “hidden curricula”—subtle structural issues within an institution that shape how and what trainees are taught. These are the lessons residents learn that were never explicitly intended and may be contrary to the formal curriculum, according to Frederic W. Hafferty, PhD, associate dean of professionalism at the Mayo Medical School and associate director of the program on professionalism and ethics at the Mayo Clinic.</p> <p> “We live in a world organized around, and driven by, other-than-formal rules,” Dr. Hafferty said. “Medical trainees come to us already conditioned to pay close attention to the other-than-formal rules and to have their lives organized and dictated by these structures.”</p> <p> Residents in the Canadian simulations spoke about their experiences with the hidden curricula.</p> <p> “You learn through shock and trauma, so when you’re yelled at, you never forget,” one resident said in the study. “For the most part, you don’t tend to remember the people who are lax, but the people are strict … [and] you make sure that you do it their way.”</p> <p> <strong>Taking action</strong></p> <p> The Canadian study suggests residency programs should focus on formal curricula to provide residents with the competencies necessary to challenge staff management decisions in a clear and effective manner, especially when patient safety is at risk.</p> <p> However, the study acknowledges that “institutional and professional cultures are much harder to change than individual competencies.”</p> <p> “Delivering an effective curriculum [is] not just about deciding what to teach and what they should learn,” Dr. Hafferty said. “It’s about deciding what to do in the context of everything going on in learning environment.”</p> <p> <strong>Tell us: </strong>What are your experiences with the “hidden curricula”? Share your thoughts in a comment below or on the <a href="https://www.facebook.com/amaresidentsandfellows?fref=ts" rel="nofollow" target="_blank">AMA Resident and Fellow Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:605a52e6-ed63-4275-9445-c8620e984d47 Medicare payment formula bites the dust http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medicare-payment-formula-bites-dust Wed, 15 Apr 2015 03:05:00 GMT <p> The sustainable growth rate (SGR) formula is no more. Thanks to new legislation adopted Tuesday, Medicare patients and the physicians who care for them no longer will be threatened by the flawed payment formula that left the Medicare program unstable and threatened access to care.</p> <p> <strong>New legislation</strong></p> <p> Following years of advocacy by the nation’s physicians standing up for their patients and their practices, the U.S. Senate Tuesday evening followed the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/house-passes-sgr-repeal-bill" target="_blank">U.S. House of Representatives’ lead</a> and passed a bill to immediately repeal the SGR formula.</p> <p> The Medicare Access and CHIP Reauthorization Act was adopted by a vote of 92 to 8 on the eve a 21 percent cut to physicians’ Medicare payments was set to take place. Instead, the bill provides positive annual payment updates of 0.5 percent, starting July 1 and lasting through 2019. Claims that were held for the first half of April will be processed and paid at the rates that were in place before the 21 percent cut was scheduled to take effect.</p> <p> “Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians—facilitating the implementation of innovative care models that will improve care quality and lower costs," AMA Executive Vice President and CEO James L. Madara, MD, said in a statement. “Patients will be able to get the care they need and deserve.”</p> <p> In addition to addressing Medicare payment, the legislation outlines several provisions that should be beneficial for physicians, including:</p> <ul> <li> Medicare’s current quality reporting programs will be streamlined and simplified into one merit-based incentive payment system, referred to as “MIPS.” This consolidation will reduce the aggregate level of financial penalties physicians otherwise could have faced.</li> <li> Protections are included so that medical liability cases cannot use Medicare quality program standards and measures as a standard or duty of care.</li> <li> Incentive payments will be available for physicians who participate in alternative payment models and meet certain thresholds.</li> <li> Technical support will be provided to help smaller practices participate in alternative payment models or the new fee-for-service incentive program.</li> </ul> <p> While the bill supports physicians who choose to adopt new payment and delivery models, it also retains Medicare’s fee-for-service model. Participation in new models is entirely voluntary.</p> <p> Additional information about provisions of the new legislation is available in a <a href="http://www.ama-assn.org/resources/doc/washington/hr2-myth-fact.pdf" target="_blank">new frequently asked questions document</a> (log in).</p> <p> <strong>Going forward</strong></p> <p> The legislation takes an important first step by eliminating the SGR formula, and the AMA will remain vigilant in working to ensure that implementation bolsters the sustainability of physician practices and empowers physicians to provide the best possible care for patients.</p> <p> Additional challenges physicians continue to face in the Medicare program include impractical requirements of the electronic health record meaningful use program, eliminating the Independent Payment Advisory Board and the costly transition to the ICD-10 code set.</p> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA will continue its work to clear these roadblocks to improving the nation’s health.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:37eda8a4-c406-4e9f-b911-fdc7b4e91d20 Welcome to the future: How doctors are changing patient care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_welcome-future-doctors-changing-patient-care Tue, 14 Apr 2015 16:58:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/7/cf8dba49-059b-4876-973c-3a296d1517fc.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/7/cf8dba49-059b-4876-973c-3a296d1517fc.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An AMA Viewpoints by AMA President Robert M. Wah, MD</em></p> <p> Here’s the future of health care: A patient with diabetes in a rural Mississippi town—population: 4,000—tests her blood sugar, then inputs the number into a tablet programmed with special software. The software instantly sends her measurement to a nurse in the state’s capital, and the nurse sees that her patient’s blood sugar has been high for a few days. So the nurse calls the patient and asks her, “What can I do to help you control your blood sugar?”</p> <p> This scenario is real, it’s happening now, and it’s highlighted in a new PBS documentary, <em>Rx: The Quiet Revolution</em>. Emmy-winning director David Grubin fixed his lens on the challenges and opportunities in America’s health care system and found doctors, nurses and health care professionals transforming the way we provide medical care. He found a team approach that lowers costs, enhances quality and improves outcomes—an approach that benefits quality of life and saves lives.</p> <p> <strong>Medicine’s mission</strong></p> <p> This is no surprise to us physicians. We know that each day, doctors are on the front lines of medicine working against mounting challenges to provide the absolute best care possible to our patients. That’s why we are proud to be the lead national sponsor of this documentary—it aligns with what physicians work toward.</p> <p> The film explores medicine's fundamental mission: to promote health, prevent sickness and help people live longer, more productive lives. As you’ll see in <em>Rx</em>, disease in this country has evolved to chronic conditions that affect tens of millions of people, cause debilitating illness and cost hundreds of billions of dollars every year to treat.</p> <p> We can’t just stand by and watch these diseases permeate society—so we’re stepping forward to do something about it.</p> <p> <strong>It’s all about the patients</strong></p> <p> We’re committed to preventing cardiovascular disease and type 2 diabetes—and <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">improving outcomes</a> for people with these conditions. You’ve probably <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Health_Outcomes/1" target="_blank">read about the work</a> that’s already seeing results across the nation, most recently with our new multi-year partnership with the Centers for Disease Control and Prevention: <a href="http://www.ama-assn.org/sub/prevent-diabetes-stat/for-health-care-professionals.html" target="_blank">Prevent Diabetes STAT: Screen, Test, Act—Today<em>™</em></a>. The partnership will help physicians tap <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevention-program" target="_blank">diabetes prevention programs</a> in their communities or online.</p> <p> The work we’re doing with partners across the country, especially with <em>Rx</em>, is important because it shows Americans what we already know: Our priority as physicians is high-quality, affordable care for patients. When we share stories like this, patients win, and <em>Rx</em> brings these stories vividly to life.</p> <p> <a href="http://rxfilm.org/the-film/full-film/" target="_blank" rel="nofollow">Stream the film online</a>, or find out <a href="http://rxfilm.org/schedule/" target="_blank" rel="nofollow">when it’s airing</a> in your area.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c87324c2-147b-4cc5-a966-3ddf99ed82a1 Lax student views of self-prescribing, impairment tied to burnout http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lax-student-views-of-self-prescribing-impairment-tied-burnout Tue, 14 Apr 2015 16:00:00 GMT <p> Medical students’ attitudes toward inappropriate prescribing behaviors and impairments from alcohol and substance abuse are surprisingly relaxed, reflected in an unwillingness to report their colleagues. A new <a href="http://journals.lww.com/academicmedicine/Fulltext/2015/04000/A_National_Study_of_Medical_Students__Attitudes.27.aspx" rel="nofollow" target="_blank">national study</a> shows that those views are closely connected to students’ own wellness.</p> <p> <strong>Opinions vary according to type of drug</strong></p> <p> More than one-half of students believe it is acceptable for a physician to write a prescription for an antibiotic to treat a bladder infection in a spouse, and more than one-third think it’s acceptable for a physician to self-prescribe an antibiotic, according to a recent study in <em>Academic Medicine</em>.</p> <p> Meanwhile, only 8.6 percent of students agree that it’s okay for a physician to prescribe an antidepressant to a spouse, and just 4.9 percent agree that a physician should self-prescribe an antidepressant.</p> <p> The study examines survey results from 4,402 medical students about their attitudes toward inappropriate prescribing behaviors. Students also were screened for symptoms of burnout and depression based on the Maslach Burnout Inventory.</p> <p> Study authors compared each data set—students’ survey responses about prescriptions, burnout scores and depression screening levels—to determine how personal distress and mental wellness impact professionalism when it comes to students self-prescribing or reporting substance abuse among their colleagues.</p> <p> <strong>The role of burnout and wellness in professional judgment </strong></p> <p> Students who demonstrated <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">symptoms of burnout or depression</a> “were significantly more likely to indicate that each of the inappropriate prescribing behaviors was acceptable,” the study authors wrote. “For example, students with burnout had a more than 50 percent increased chance of indicating that self-prescribing antidepressants was acceptable than students without burnout.”</p> <p> Burnout was associated with participants endorsing three of the four inappropriate prescribing behaviors on the survey, while participants with depression endorsed two of the four inappropriate prescribing behaviors. Similarly, students with burnout were less likely to feel that they needed to support the health and wellness of colleagues or report colleagues’ impairments resulting from alcohol or substance abuse.</p> <p> “These relationships between burnout and students’ beliefs about appropriate prescribing behaviors and duties regarding impaired colleagues are important because burnout is prevalent not only among medical students but also physicians,” the study authors wrote. “If burnout has a similar effect on these professional attitudes among practicing physicians, burnout may at least partially explain suboptimal physician participation in the process of reporting impaired colleagues and self-prescribing tendencies.”</p> <p> <strong>Reporting impairment: 5 ways medical schools can respond </strong></p> <p> Survey results also found that a substantial percentage of students don’t feel personally obligated to report impaired judgment or performance among their colleagues.</p> <p> Although nearly all students—81.7 percent—understand the importance of helping a fellow peer if his or her health is compromised, survey results indicate that they’re less likely to actually report their colleagues’ impairments to authorities. Just 47.5 percent think they should actually report instances of impairment among colleagues tied to mental health, and only a slightly higher proportion of students—58.7 percent—would report a colleague’s impairment from substance or alcohol abuse, according to survey results.</p> <p> The study authors recommend a few next steps to help medical educators better prepare students for prescribing and monitoring colleagues in practice:</p> <p> <strong>1. Start teaching students about prescribing practices early in their medical careers. </strong>“Our findings suggests that medical students may benefit from explicit curricula on appropriate prescribing practices,” the study authors note. They add that each course should include lessons on how professional impairment threatens quality care and how to appropriately intervene and support colleagues.</p> <p> <strong>2. Medical schools needs to partner with “physician groups, accrediting organizations, academic medical centers and hospitals” to better educate students about appropriate prescribing and the importance of self-regulation</strong>. This is especially important for third and fourth-year students who are more likely to support inappropriate prescription practices as they further explore clinical training, according to survey responses.</p> <p> <strong>3. Medical educators need to address the hidden curriculum, </strong>which “fosters greater reluctance to report colleagues impaired from mental health problems than alcohol or substance abuse.”</p> <p> <strong>4. Medical schools should incorporate self-care and wellness into curricula. </strong>The low percentage of students willing to report a colleague for self-impairment or seek their own help should they become impaired supports the need for “screening medical students for distress, student wellness programming and innovative curricula focused on self-care,” study authors recommend.</p> <p> <strong>5. Conduct more research on self-prescribing among male medical students. </strong>Throughout the study, researchers spotted an interesting gender divide: Female medical students were less likely—by about 30-47 percent—to demonstrate “suboptimal attitudes about prescribing and professional responsibility to report” compared to male students. </p> <p> <strong>Tell us:</strong> Do you agree with these recommendations? What other solutions should be explored? Share your thoughts in the comments below or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociationFoundation?fref=nf" rel="nofollow" target="_blank">Medical Student Facebook page.</a></p> <p> The AMA discourages self-prescribing or prescribing for family members as “professional objectivity may be compromised when an immediate family member or the physician is the patient.” The physician’s personal feelings also may “unduly influence his or her professional medical judgment.” Treating a family member also raises concerns about patient autonomy and informed consent. Review <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.page" target="_blank">Opinion E-8.19</a> in the <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.page?" target="_blank">AMA’s <em>Code of Medical Ethics</em> </a>to learn more about ethical policy on self-treatment and treating family.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6375321c-6d0d-49c0-a7e8-e7f06198c854 Hypertension-related deaths climb upward--here’s what you can do http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hypertension-related-deaths-climb-upward-heres-can Tue, 14 Apr 2015 00:14:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/404d97f0-519b-4a78-8062-4db70221ccdb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/404d97f0-519b-4a78-8062-4db70221ccdb.Large.jpg?1" style="margin:10px;float:right;" /></a>The number of hypertension-related deaths in the United States increased by 66 percent over the past decade, according to new data from the Centers for Disease Control and Prevention (CDC). To put that in perspective, the number of deaths from all other causes combined increased only 3.5 percent during that period, pointing to an urgent need to better control high blood pressure and improve patient outcomes.</p> <p> <strong>A look at the problem</strong></p> <p> The <a href="http://www.cdc.gov/nchs/data/databriefs/db193.htm" rel="nofollow" target="_blank">March CDC report</a> also revealed that from 2000 to 2013, the rate of deaths related to hypertension increased by 23.1 percent, while the rate of deaths from all other causes combined actually decreased by roughly the same percent.</p> <p> The CDC data also highlights disparities in hypertension-related deaths. In 2013, the death rate was highest among the non-Hispanic black population, compared with non-Hispanic white and Hispanic populations.</p> <p> <strong>Tools for physicians and care teams </strong></p> <p> This data raises an alarm about the urgency of better addressing high blood pressure in the United States. That’s where the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative comes in.</p> <p> Through this initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations.</p> <p> To address hypertension disparities, the AMA is collaborating with the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to leverage the work of Lisa Cooper, MD, who is leading one of the first <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/novel-approach-hypertension-care-also-can-address-disparities" target="_blank">studies to address hypertension</a> using multiple quality improvement approaches and combining community-based participatory and implementation science principles.</p> <p> <strong>What you can do now</strong></p> <p> National High Blood Pressure Education Month is coming this May—watch <em>AMA Wire</em>® next month for ways to improve your patients’ hypertension outcomes.</p> <p> In the meantime, here are some additional resources to help you improve your practice’s hypertension management:</p> <ul> <li style="margin-left:33pt;"> Learn <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/accurate-blood-pressure-measurement" target="_blank">how to get the most accurate</a> blood pressure measurement.</li> <li style="margin-left:33pt;"> Read the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-ask-patients-measuring-blood-pressure" target="_blank">three questions you should ask patients</a> when measuring their blood pressure.</li> <li style="margin-left:33pt;"> Hear <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-saying-doing-control-hypertension" target="_blank">what other physicians are doing</a> to control hypertension in their practices.</li> <li style="margin-left:33pt;"> See how physicians can help patients <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">manage blood pressure outside of office visits</a>.</li> <li style="margin-left:33pt;"> Discover how a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/novel-approach-hypertension-care-also-can-address-disparities" target="_blank">novel approach to hypertension care</a> also can address disparities.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6edaf355-138f-40ce-aba1-115b1165a6ed KevinMD answers doctors’ top social media questions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_kevinmd-answers-doctors-top-social-media-questions Mon, 13 Apr 2015 20:47:00 GMT <p> Are you a social media user? Get answers to your questions from one of medicine’s top social media experts.</p> <p> Kevin Pho, MD, founder and editor of <a href="http://www.kevinmd.com/blog/" target="_blank" rel="nofollow">KevinMD.com</a>, answers <a href="http://bluetoad.com/publication/?i=252735&p=10" target="_blank" rel="nofollow">physicians’ questions about social media</a> in the latest issue of <a href="http://www.physicianfamilymedia.org/" target="_blank" rel="nofollow"><em>Physician Family</em></a>, the AMA Alliance magazine. Here are some of the highlights from Dr. Pho that can assist you in smartly using social media:</p> <p style="margin-left:.5in;"> <strong>Why should I bother with social media?</strong></p> <p style="margin-left:.5in;"> Physicians should engage with social media for three reasons: Educate patients, define their online reputations, and make their perspectives and voices heard.</p> <p style="margin-left:.5in;"> More patients than ever are going online to research their health condition, but the accuracy of the information they may find is questionable. Social media is a powerful way for physicians to guide patients to better health information or create their own health content. It’s also a way to proactively define their online presence so they can control how patients perceive them on the Web. Finally, in this era of health reform, the voice of the practicing physician is often missing. Social media provides a visible platform for these doctors to be heard.</p> <p style="margin-left:.5in;"> <strong>How should I get started?</strong></p> <p style="margin-left:.5in;"> Start with an incremental approach. First, spend a few hours creating profiles on professional social networks such as LinkedIn—then stop. At this point, ask yourself, “What are my goals for social media?” Is it educating patients, advocating for a cause or debating health reform?</p> <p style="margin-left:.5in;"> As you become more comfortable with being online, you can incrementally adopt social media platforms that fit your goals, from curating links on Twitter to creating content on a blog or YouTube.</p> <p style="margin-left:.5in;"> If you find that you just don’t have the time, you can stop after creating your initial profile on LinkedIn. Just that act alone is powerful—these sites get ranked high on Google searches and will be patients’ first impressions of you online.</p> <p style="margin-left:.5in;"> <strong>What should I avoid doing online?</strong></p> <p style="margin-left:.5in;"> Protecting patient privacy is key to protecting an online reputation. Discussing specific patients or cases would be a violation of patient privacy laws and could seriously damage your reputation.</p> <p style="margin-left:.5in;"> Further, avoid “airing dirty laundry” from your practice. Anything posted on social media should be considered permanent and has the potential to spread to the public.</p> <p style="margin-left:.5in;"> <strong>How should I respond to online reviews?</strong></p> <p style="margin-left:.5in;"> My first tip is to listen to criticism. When patients leave reviews online, it’s the only way they have a voice.</p> <p style="margin-left:.5in;"> Whenever you read criticism online, there’s a strong temptation to respond to it immediately. You want to set the record straight—but hold off on that temptation because it’s rare that an online argument is going to result in anything productive. Instead, here’s my second tip: Take the conversation offline. Respond with a standard reply, thanking the patient for the comment and asking him or her to call your office. If you can resolve the dispute over the phone or in person, the patient may take down the negative review, or even add an addendum saying, “Hey, this office is listening to what I’m saying.” That can turn a negative situation into a more constructive one.</p> <p style="margin-left:.5in;"> Ask more patients to rate you online. There are dozens of studies that have found the majority of online ratings are, in fact, positive and better than the majority of doctors would think. Asking more patients to rate you online will make rating sites more useful by populating them with more reviews, and they will dilute any negative ratings and make them look more like outliers.</p> <p> Find <a href="http://bluetoad.com/publication/?i=252735&p=8" target="_blank" rel="nofollow">more social media advice</a> in <em>Physician Family </em>and get <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/manage-online-reputation-top-4-tips" target="_blank">tips to manage your online reputation</a> at <em>AMA Wire®</em>.</p> <p> <strong>Need more help?</strong> Watch <em>AMA Wire</em> for more information on the Social Media Guru Bar to be featured at the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/house-delegates/2015-annual-meeting.page?" target="_blank">2015 AMA Annual Meeting</a> June 6-10 in Chicago, where social media experts will be available to answer all of your questions, from basic to advanced.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f0fd8162-6508-4bba-832a-beb1ffb2c81c Students get a taste of what it’s like to be a patient http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-taste-of-its-like-patient Mon, 13 Apr 2015 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/1/e5564b9e-fcd6-4727-a115-a1ec9abab4bd.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/1/e5564b9e-fcd6-4727-a115-a1ec9abab4bd.Large.jpg?1" style="float:right;margin:10px;" /></a><em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Barbara Blatt and Jed Gonzalo, MD, of Penn State College of Medicine</em><em>.</em></p> <p> The scent of cocoa may linger through the town, and the pockets of our white coats might contain a few Hershey’s candy wrappers, but Hershey, Penn. is not all about the chocolate.</p> <p> At Penn State College of Medicine, located in the heart of Hershey, or “Chocolate Town,” medical students are getting a taste of a new curriculum that will span their full medical school experience.  </p> <p> In August 2014, the school implemented a new Systems Navigation Curriculum (SyNC), which includes a conceptual-based course related to the Healthcare Delivery Science topics including health care delivery, policy, population and public health, quality improvement and teamwork.</p> <p> It also includes an experiential component where first-year students serve as patient navigators within the healthcare system. Through this role, students work directly with patients and interprofessional care teams to identify barriers in patient care, and help them overcome and “navigate” through an often complex healthcare environment.</p> <p> In the inaugural year, 85 students chose to be embedded as patient navigators at clinical sites not only within the Penn State Hershey Health System but in healthcare systems throughout south-central Pennsylvania. By the fall of 2015, all medical students will be serving in patient navigator roles.</p> <p> <object align="left" data="http://www.youtube.com/v/YnqeYcXH9Hs" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/YnqeYcXH9Hs" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/YnqeYcXH9Hs" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/YnqeYcXH9Hs" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>When asked why they volunteered to participate in the patient navigation experience, students responded:</p> <p style="margin-left:40px;"> “<em>My past patient-care experiences have centered around one founding principle—continuity. As a future physician, the idea of loyalty and being a part of a culture of longitudinal care is very important to me, and an important reason why I was so drawn to Penn State College of Medicine. I would like to continue building upon this culture as a patient navigator. Through this experience, I am excited to develop the skills to become the type of physician I strive to be.” <strong>Steven Zhou, Class of 2018</strong></em></p> <p style="margin-left:40px;"> <em>“I chose patient navigation because I’d like to have a longitudinal experience with a patient and learn more about the health care system firsthand by helping that patient through the system.” <strong>Connor Carmichael, Class of 2018</strong></em></p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/two-schools-embracing-new-science-medical-education">Read more</a> about Penn State’s patient navigators at <em>AMA Wire</em>®, and watch the video at right about the program.</p> <p> <em>Get</em> <em>AMA MedEd Update</em> <a href="http://www.ama-assn.org/ama/pub/news/subscribe-newsletters.page" target="_blank"><em>sent to your inbox</em></a><em> monthly to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ab41a4e1-b2fb-452a-b9b6-e17c793f9279 Going abroad? Earn CME for international activities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_going-abroad-earn-cme-international-activities Mon, 13 Apr 2015 15:00:00 GMT <p> You may be familiar with the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/unconventional-ways-earn-cme">many ways to earn continuing medical education</a> (CME) credit in the States, but did you know you can earn CME for participation in <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs.page">certain international activities</a>?</p> <p> Physicians may earn <em>AMA PRA Category 1 Credit</em>™ for participation in select international educational activities through agreements between the AMA and two organizations:</p> <ul> <li> <strong>European Union of Medical Specialists (UEMS) </strong><br /> The AMA will convert CME credit issued to physicians for participation in <a href="http://www.eaccme.eu/" rel="nofollow">live</a> and <a href="http://www.uems.eu/" rel="nofollow">e-learning activities</a> certified by the European Accreditation Council for Continuing Medical Education, the accrediting arm of the <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs/uemseaccme-credit-conversion.page">UEMS</a>, to <em>AMA PRA Category 1 Credit</em>™ (processing fee applies).</li> <li> <strong>Royal College of Physicians and Surgeons of Canada</strong><br /> The AMA will convert <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs/credit-through-rcpsc.page">Royal College</a> maintenance of certification credits issued to physicians for participation in CME activities, approved by Royal College-accredited providers, that fall within the eligibility requirements of the AMA agreement with the Royal College (processing fee applies). </li> </ul> <p> Certain international conferences also are approved for <em>AMA PRA Category 1 Credit</em>™ through the AMA International Conference Recognition (ICR) Program. Check the <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs/international-conference-recognition-program/international-cme-conferences.page?">list</a> of approved international conferences, or <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs/international-conference-recognition-program.page">learn more</a> about how large international congresses can apply to be involved in the program (eligibility requirements and fees apply).</p> <p> <a href="http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/physicians-recognition-award-credit-system/other-ways-earn-ama-pra-category/international-programs.page">Learn more</a> about how you can earn credit for participation in international activities. You can also read about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/decipher-cme-requirements">how to decipher CME requirements</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ad8f702c-0864-408a-961f-edde7f5ffcae Med ed experts weigh in on health tech http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-ed-experts-weigh-health-tech Mon, 13 Apr 2015 15:00:00 GMT <p> The bustling, buzzing health technology incubator MATTER in Chicago’s Merchandise Mart has a vibe quite different from a typical physician’s exam room—and that’s the point.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/10/563a3a35-ffcc-491f-8a68-dd8642c747ba.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/10/563a3a35-ffcc-491f-8a68-dd8642c747ba.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;">Members of the AMA Council on Medical Education meet with entrepreneurs at MATTER. From left to right: Darlene Menscer, MD, chair-elect; Jacqueline A. Bello, MD; Carol D. Berkowitz, MD, William A. McDade, MD, PhD, chair; AMA and MATTER employees.</span></em></td> </tr> </tbody> </table> <p> <a href="http://www.matterchicago.com/" rel="nofollow" target="_blank">MATTER</a> gives entrepreneurs interested in health tech a supportive space and community to nurture their ideas. MATTER members benefit from mentorship, networking and shared resources as they develop the next generation of health tech—advancements like evidence-based digital health interventions, software that automates physician practices’ daily tasks and mobile solutions for integrated care planning.</p> <p> Recognizing the importance of harnessing new health solutions, the AMA partnered with MATTER to give physicians and entrepreneurs a two-way pipeline. With the AMA Interaction Studio at MATTER, physicians can connect directly with the innovators behind tomorrow’s health tech, and entrepreneurs can tap the minds of people who care for patients every day.</p> <p> <strong>Physician input sparks inspiring conversation</strong><br /> Most recently, the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">Council on Medical Education</a> went to MATTER to meet with a few entrepreneurs and hear about the future of health tech.</p> <p> Carol Berkowitz, MD, council member and executive vice chair of the department of pediatrics at Harbor/UCLA Medical Center, said the visit was “eye-opening” for her.</p> <p> “It was an opportunity to get a view into the entrepreneurial approach to improving the quality of health care delivery,” Dr. Berkowitz said. “Interacting with MATTER provides an excellent opportunity for the AMA to remain on the forefront of new and creative approaches to improve the quality of care.”</p> <p> Council members offered their expertise to Carrie Mendoza, MD, an emergency physician who developed a platform that allows emergency room patients and physicians to communicate by text message. Her tool allows emergency physicians to quickly text patients waiting in emergency rooms with updates on lab results or X-rays or just to let them know that a physician is on the way.</p> <p>  “Who doesn’t wonder why things are taking so long?” Dr. Berkowitz said of the platform.</p> <p>  “It’s a patient satisfier,” Dr. Mendoza said. “And the residents I work with, it’s second nature for them. They’re digital natives.”</p> <p> She’s currently using the tech at Advocate Illinois Masonic Medical Center in Chicago and said she hopes to one day make it easy for physicians to achieve continuing medical education credit by using her tool. Council members weighed in on the tool and asked questions that Dr. Mendoza can consider for future iterations—for example, can patients text physicians, or is it one-way? Currently, patients can respond, but Dr. Mendoza said they rarely do.</p> <p> The conversations were “informative and inspiring, and should be continued,” said Jacqueline Bello, MD, council member and director of neuroradiology at Montefiore Medical Center and Albert Einstein College of Medicine. “Keeping physicians central to these discussions is satisfying from two very different perspectives—preserving our autonomy in influencing the technology that will define how we deliver the best care, and enjoying the excitement of discovering and developing the unknown. This is a great opportunity to map the course and enjoy the ride.”</p> <p> <strong>Mapping the course together</strong><br /> “Physician and medical student input in new health technologies is key to maintaining physician, and ultimately patient, satisfaction” said Beth Griffiths, a council member and fourth-year medical student at the University of California San Diego School of Medicine. Griffiths points to physicians’ <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/improving-ehrs-reports-comments-changes-2014" target="_blank">current frustrations with electronic medical records</a> as an example of what happens when physicians aren’t part of the health tech development process.</p> <p> “I hope we can now start to see better use of health technologies with the consultation of physicians,” she said. “I hope that the AMA’s involvement with MATTER allows for this two-way communication between health tech companies and physicians.”</p> <p> “At the end of the day, health care gets delivered from a physician to a patient,” said Jonathan Weiss, MD, a health care entrepreneur and operator. Dr. Weiss’ company, <a href="https://www.healthengine.com/" rel="nofollow">HealthEngine</a>, is a MATTER partner. “Everything else should be a support structure. Leaving the prime decision-maker, the trusted choice partner of the patient, out of anything dealing with medical care… it’s like leaving a chef out of the design of the menu.”</p> <p> This thinking reflects the AMA’s pushes in other areas, such as its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative. By sponsoring 11 innovative projects with partner medical schools, the AMA is helping develop new educational models that can eventually be adapted by other schools, triggering wide-scale change in how tomorrow’s physicians are taught.</p> <p> This means schools will adopt creative solutions focused on teamwork, policy, cost and patient safety to reflect how physicians will care for patients in the future. It means they will train students to adapt to rapid changes in technology, in dissemination of information and data and in personalized care delivery. And it means that partnerships like the one with MATTER can help propel these changes.</p> <p> “In the sphere of medical education, AMA’s transformative initiative is fueled by original thinking and palpable energy, similar to what ‘matters’ at MATTER,” said Dr. Bello.</p> <p> It’s also the basis of the AMA’s work in <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a>, an AMA initiative that is helping physicians successfully navigate the current—and future—health care environment by promoting sustainable practices that can result in improved health outcomes for patients and greater professional satisfaction for physicians.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-taking-lead-health-technology">Read more</a> about how physicians are taking the lead in health tech at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fca8d590-4eb7-4438-9721-867f656c85a8 AMA-IMG Section resolution approval due April 22 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-img-section-resolution-approval-due-april-22 Sat, 11 Apr 2015 11:00:00 GMT <p> International medical graduates (IMG): Don’t miss the opportunity to approve resolutions being considered for the 2015 AMA-IMG Section Annual Meeting. </p> <p> Members of the section will receive a SurveyMonkey invitation to approve these resolutions April 15. The last day to submit approval is April 22.</p> <p> Resolutions can be viewed on the section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates/meetings/virtual-congress.page" target="_blank">virtual congress Web page</a>, and questions can be <a href="mailto:img@ama-assn.org" rel="nofollow">emailed to the section</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6cc4eebc-61f0-4137-b2ec-a93046df6338 How volunteering has made doctors, students happier and healthier http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_volunteering-made-doctors-students-happier-healthier Fri, 10 Apr 2015 17:18:00 GMT <p> Whether you’re an experienced physician or new to the profession, caring for patients at volunteer clinics can revive your passion for practice and offer a mental break from <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">some of the daily stressors that lead to physician burnout</a>, according to members of the medical profession who regularly volunteer.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/1/f61b293e-62f0-4ae2-b1a2-934e547ec054.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/1/f61b293e-62f0-4ae2-b1a2-934e547ec054.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:left;vertical-align:middle;height:35px;"> <p> <em><span style="font-size:12px;">Grant Turner, a fourth-year student, and his patient, Maria Neri, who he treated for more than a year at the University of Nebraska Medical Center’s Sharing Clinics. </span></em></p> </td> </tr> </tbody> </table> <p> Louis Weinstein, MD, a retired OB-GYN physician who worked in academic medicine and volunteer physician at Barrier Islands Free Medical Clinic in Charleston, South Carolina, and Grant Turner, a fourth-year student at University of Nebraska Medical Center (UNMC) who volunteers at the University of Nebraska’s Sharing Clinic program (pictured right), spoke with <em>AMA Wire</em> about their experiences volunteering at free clinics. Here’s why they encourage their peers in the profession to give back by doing what they do best—improving patients’ lives.</p> <p> <strong>Q: What do you enjoy most about volunteering?</strong></p> <p style="margin-left:40px;"> <strong>Dr. Weinstein: </strong>Since the clinic operates on grants and government financing, I don’t have to work under the same time constraints as most physicians in private practice. I don’t have to see a patient every 15 minutes. There are no economics involved, and that’s what makes this so much fun. </p> <p style="margin-left:40px;"> I can spend time with my patients. Anything I do for them is because I genuinely want to do it. If a patient needs a biopsy, I schedule it for 40 minutes, or I take an additional 10 minutes talking to them about smoking cessation rates. The return I get on volunteering is [tremendous] because when I go home, I know I’ve done everything possible to potentially make a difference in someone’s life.</p> <p style="margin-left:40px;"> If spending extra time talking to my patients can prevent one stroke, one heart attack or break the cycle of poverty for one person, than I’ve done more than enough. It was more than worth it to me.</p> <p style="margin-left:40px;"> <strong>Turner: </strong>At our school clinics, medical students have the option to work as “continuity providers,” which means we work with one patient on a long-term basis. I’ve worked with one of my patients, Maria, for roughly two years, and I’m very proud of the progress we’ve made with getting her diabetes under control.</p> <p style="margin-left:40px;"> Working here has also exposed me to two really important sides of medicine: As a volunteer, I’ve learned how to walk in the shoes of my patients and really understand the cultural and lifestyle factors that may contribute to health disparities for many people. Yet on the clinical side, I’ve learned all about the busy operations of how to run a clinic, paperwork, team building with your care staff—all that. I know this will help me in my career and future residency program, which I also chose based on the fact that they have a free clinic, where I plan to continue volunteering.</p> <p> <strong>Q: What are the biggest challenges of volunteering?</strong></p> <p style="margin-left:40px;"> <strong>Dr. Weinstein: </strong>The hardest part is knowing how to help a patient but being unable to because of limited resources.</p> <p style="margin-left:40px;"> There was one woman I saw who definitely showed early signs of malignancies on her cervix, and she needed surgery, which isn’t a service we offer at the clinic. I called around asking other hospitals if they could help, but I couldn’t find anyone to take her because she is undocumented. It breaks my heart that I can’t do the surgery because I know that in about 10-20 years, this woman will develop cervical cancer, and there’s nothing I can do about it.</p> <p style="margin-left:40px;"> <strong>Turner:</strong> Just seeing all the life challenges and barriers patients struggle with can be overwhelming.</p> <p style="margin-left:40px;"> There are so many social and cultural factors—like a lack of fresh produce in your neighborhood, language barriers, low income or family issues—that impact a patient’s health. This can be very challenging to see when you want to help.</p> <p style="margin-left:40px;"> Even Maria had legal issues regarding custody of her child that caused her to stress, and her diabetes worsened. Fortunately, I was able to refer her to a free legal clinic at a nearby college, and the help she received minimized her stress, which got her nutrition back on track. But I know most physicians don’t have a chance to help like this.</p> <p> <strong>Q: What’s something that surprised you about your experience?</strong></p> <p style="margin-left:40px;"> <strong>Dr. Weinstein:</strong> Most of my patients live below the poverty [line], which means they can make less than $15,000 to $20,000 a year, yet don’t qualify for Medicaid because of state-specific guidelines. [Our free clinic] is their only way to receive health care, and their gratitude always stuns me.</p> <p style="margin-left:40px;"> It may sound surprising, but physicians in private practice can help a patient and never hear, “thank you.” That’s not the case here, though. I’ve even had a patient write me a letter thanking me for my help and the fact that someone would go to those lengths, just to show appreciation for me doing my job. [That] means a lot to me.</p> <p style="margin-left:40px;"> <strong>Turner:</strong> Having the chance to really see more of the whole picture of how underserved patients need so much more than medical care was eye-opening. I’ve done my best to help with some of these issues, like language barriers between patients and physicians.</p> <p style="margin-left:40px;"> Since I began volunteering four years ago, I’ve created two modules at the UNMC clinics to help students use translators while treating patients. Still, the work involved with doing this was extensive and taught me that so much about patient care extends beyond the exam room.</p> <p> <strong>Q: How has volunteering helped advance your career? Do you have any tips for your peers who are interested in doing the same?</strong></p> <p style="margin-left:40px;"> <strong>Dr. Weinstein: </strong>I tell people all the time that once you receive your medical degree, you can be a doctor for the rest of your life, but that doesn’t mean you’ll always be a physician. Since I’ve retired, volunteering allows me to maintain my role as a practicing physician.</p> <p style="margin-left:40px;"> When I’m in the clinic, my colleagues and I still talk about the latest developments in <em>JAMA</em> and our specialties. This is my way of being a physician for life. To anyone interested in volunteering, especially senior physicians, please maintain an active medical license. Don’t let your license go. Keep it active because if you ever want to care for patients, you always can.</p> <p style="margin-left:40px;"> <strong>Turner:</strong> My volunteer work with Maria was really the main focus of my personal statement for residency program applications, and I received an amazing letter of recommendation from the volunteer clinic director for my personal interview. I know this really helped me in the residency match since I received my No. 1 program choice.</p> <p style="margin-left:40px;"> The experience also … expanded my perspective and developed my patient management skills. If you’re a student and you’d like to volunteer, research clinical options at your medical school or attend club fairs early in your first year to learn more about ways you can volunteer on campus.</p> <p> <strong>Where to look for volunteering opportunities:</strong> If you are interested in volunteering, but aren’t sure where to start, visit the <a href="http://www.jamacareercenter.com/volunteer_opportunities.cfm" rel="nofollow" target="_blank">JAMA Network Career Center</a>, which lists dozens of opportunities for physicians in the United States and abroad.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:390f1854-91d2-4354-931a-7301bde16905 EHRs talking to one another without understanding http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ehrs-talking-one-another-understanding Fri, 10 Apr 2015 17:14:00 GMT <p> What can your electronic health record (EHR) system do? It may be able to send and receive information to other EHRs. However, the ability for information to be exchanged, incorporated and presented in a contextual manner still is lacking, physicians told the Office of the National Coordinator for Health Information Technology (ONC) last week.</p> <p> In a letter to National Coordinator Health Information Technology Karen B. DeSalvo, MD, the AMA outlined key facets of achieving true interoperability between EHRs based on the ONC’s <a href="http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf" target="_blank" rel="nofollow">Interoperability Roadmap</a>:</p> <p style="margin-left:.5in;"> <strong>Prioritize cornerstone issues to lay a strong foundation</strong><br /> Issues that are fundamental to information exchange should be among the top priorities. For instance, unified standards and data vocabulary for EHRs and clinical data registries is a necessary building block to achieve better results later on. Physicians also need uniform clinical data definitions so data elements mean the same thing across registries and EHRs. The letter also outlined the necessity for functional standards.</p> <p style="margin-left:.5in;"> “For example, when a patient complains of shortness of breath, this is simply typed into the EHR, but for performance improvement you need to know exactly what the patient means by shortness of breath,” the letter said. “Is it shortness of breath because the patient just walked a mile or due to a particular condition? These functional status types of definitions, while important for quality improvement activities, are not widely defined because it is neither needed nor relevant for payment.”</p> <p style="margin-left:.5in;"> <strong>Don’t use a punitive approach</strong><br /> Penalizing physicians and other health care providers for not using certified systems will not help achieve a more robust health IT system.</p> <p style="margin-left:.5in;"> “This is simply a flawed and misguided means of removing the current barriers to interoperability,” the letter said. “The reality is that the penalty program created by the government has created an artificial marketplace that requires physicians to use poor-performing systems that do not facilitate data exchange.”</p> <p style="margin-left:.5in;"> Physicians and care providers can’t control whether systems are interoperable, so punishing them for lackluster EHRs isn’t fair, the letter said.</p> <p style="margin-left:.5in;"> <strong>Address cost and usability barriers</strong><br /> The cost to exchange, extract and analyze data from an EHR can be prohibitively pricey for many physicians, especially since doctors might not realize these costs are on top of the initial EHR purchase price.</p> <p style="margin-left:.5in;"> The ONC proposed in the Version 2015 EHR certification rule that all vendors seeking certification must publish their fees online and in marketing material. Because this requirement would be a major step towards addressing this barrier, the letter urged the agency to implement this proposal.</p> <p style="margin-left:.5in;"> The AMA also is urging the ONC to work with the Centers for Medicare & Medicaid Services to publish the costs of transmitting data through a health information service provider in a central online location. Such a report should be easily accessible and understandable.</p> <p style="margin-left:.5in;"> Usability barriers also exist, which the AMA continues to work on as outlined in its <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">framework for improved EHRs</a>.</p> <p style="margin-left:.5in;"> <strong>Acknowledge the meaningful use program’s impact</strong><br /> The notoriously burdensome EHR meaningful use program stymies innovation, limits resources and prioritizes the wrong efforts to improve usability, safety and interoperability, the letter said. The AMA continues to advocate for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/sure-meaningful-use-meeting-original-goals-2" target="_blank">meaningful use changes</a> that make it easier for physicians to meet the program requirements.</p> <p> “I always say this: Physician’s aren’t afraid of technology,” AMA President Robert M. Wah, MD, said in a recent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/making-physician-voices-heard-future-health-success" target="_blank">AMA Viewpoints blog post</a>. “We will always embrace innovative tech that actually improves patient care. We are also the first to push back when technology hinders our work.”</p> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA is helping physicians successfully navigate the health care environment by promoting sustainable practices. The AMA also is using the collective physician voice to work with vendors, policymakers, health care systems and researchers to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/improving-ehrs-reports-comments-changes-2014" target="_blank">drive EHR improvements</a> that doctors can use to take better care of their patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:448eb7e4-9d49-4772-b6e1-5975b3adc669 Register for AMA-IMG Section Annual Meeting, June 5-8 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_img-section-national-annual-meeting-june-5-8-2015 Fri, 10 Apr 2015 14:00:00 GMT <p> Registration is open for AMA International Medical Graduates (IMG) Section members and guests planning to attend the18th AMA-IMG Section Annual Meeting, scheduled to take place June 5-8 in conjunction with the 2015 AMA Annual Meeting taking place in Chicago.</p> <p> The deadline to register is May 26. <a href="http://www.ama-assn.org/go/a15registration">Log in</a> to the AMA website to register for the meeting. Questions may be directed to the section <a href="mailto:img@ama-assn.org" rel="nofollow">via email</a>. </p> <p> The meeting and reception will be held from 5:30 to 7:30 p.m. June 6 and will feature two speakers:</p> <ul> <li> Lisa Cover, vice president of operations and business development at the Educational Commission for Foreign Medical Graduates, will provide an update on her organization’s work</li> <li> Dr. Gamini Soori, vice chair of the AMA Council on Long Range Planning and Council on Graduate Medical Education, will talk about graduate medical education in crisis</li> </ul> <p> The 9th annual Desserts from Around the World reception will be held from 9:30 to 11 p.m. June 6. This is a tasty affair with international flair, which will feature entertainment and a fortune cookie surprise.</p> <p> The AMA IMG Section Delegates Caucus will review all reference committee reports from 8:30 to 9:30 a.m. June 8.</p> <p> <strong>Hotel booking:</strong></p> <p> <a href="https://aws.passkey.com/g/33918239" rel="nofollow" target="_blank">Book your hotel online</a> or by phone at (888) 421-1442. Plan to make your reservation by the cutoff date of May 10 to ensure that your requirements are met. Hotel room availability cannot be guaranteed after the published cutoff date.</p> <p> <strong>Special airline discount:</strong></p> <p> United Airlines offers a discount for <a href="http://www.united.com/" rel="nofollow" target="_blank">reservations made online</a>. Enter “ZTXM362176” in the offer code box. Available flights will be displayed. When an available flight is selected, the discounted fare will automatically be calculated. The discount is valid for travel three days prior to and three days after the official meeting dates.</p> <p> A discount also may be obtained by calling United Airlines at (800) 426-1122 (a service fee will apply). Mention Z code “ZTXM” and agreement code “362176.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0c5bde4a-27c3-4eda-9b9c-a08241b88abc Debunking 5 myths about diversity in medical education http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_debunking-5-myths-diversity-medical-education Thu, 09 Apr 2015 22:00:00 GMT <p> As medical education changes to reflect <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/newest-medical-class-looks-like" target="_blank">a more diverse student body</a>, it’s important that the mindsets of those involved reflect these changes, too. While conversations about race and inclusion can seem elusive, they don’t have to be. April is National Minority Health Month—take this time to learn five quick facts that can help you promote diversity among students and future physicians.</p> <p> William McDade, MD, PhD, chair of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a> and deputy provost for research and minority issues at the University of Chicago, has worked extensively to reduce cultural disparities in medicine and help patients who have limited access to health services. Through his work and research, he’s found that there are real ways for educators and physicians to support minority students in medicine. But enacting these solutions may require a shift in perspective.</p> <p> Here are a few mental notes Dr. McDade recommends to help clarify misconceptions about diversity and promote cultural awareness in medical school and residency programs:</p> <p> <strong>1. Diversity in medical education isn’t all about affirmative action; research shows it impacts health disparities.</strong></p> <p> “When you try to increase diversity in medical education and residency programs, I think people get confused [because] they assume this is just another affirmative action thing,” Dr. McDade said. “But it’s much more than that. There’s actually a practical reason for increasing diversity of the student population: Evidence suggests that minority physicians disproportionately care for minority populations. So when we talk about diversity in medical schools, we’re actually talking about communities and lives that are at risk.”</p> <p> In fact, <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1792913" target="_blank" rel="nofollow">a recent study in <em>JAMA</em></a> found that non-white physicians cared for 53.5 percent of minority and 70.4 percent of non-English-speaking patients. The study notes that “the preferences of physicians in choosing practice settings and of patients in choosing physicians combine to create an outsized role for minority physicians caring for the disadvantaged.” </p> <p> “And that’s the beauty of trying to enhance diversity in medicine,” Dr. McDade said. “It’s not just about providing equal opportunity …. When minority students finish medical school and residency, they will go on to serve society in a way that hasn’t been done before.”</p> <p> <strong>2. Saying “I don’t see color” isn’t necessarily a good thing.</strong></p> <p> This one is tricky to navigate, especially in conversations about race and diversity, but it’s important.</p> <p> When people talk to a minority student or resident, “there’s a tendency to say ‘I don’t see color’ as a way of expressing an idea that ‘I won’t be biased,’” Dr. McDade said. “But I think we have to move beyond this. I say it’s okay to see color.”</p> <p> “Let’s see and evaluate color and respect the resiliency a person had to show to overcome societal barriers,” Dr. McDade said. He noted that if people shed the assumption that colorblindness equates to fairness, minority students can feel more comfortable discussing cultural differences with colleagues in medical school and clinical practice.</p> <p> <strong>3. Diversity in medical school entails more than increasing the number of minority students—it means supporting them once they’re in that environment.</strong></p> <p> Studies show that there’s a direct link between resident satisfaction and the experiences students have in medical school, Dr. McDade said. </p> <p> “If a student is doing great and feels welcomed in medical school, then they’re going to perform well. But if they’re a victim of bias or discrimination, then it’s going to be an absolutely horrible experience for that student. And that’s something we have to be cognizant of as educators.”</p> <p> “So many students who have to fight discrimination lose the passion for medicine,” Dr. McDade said. “But if they feel welcomed, they’re more likely to continue their medical careers and advance as physicians.”</p> <p> <strong>4. Mentors for minority medical students and residents don’t have to look like their mentees.</strong></p> <p> Mentorship is one way medical educators and residency program directors can help minority students feel “welcomed in spaces where they have not historically been present,” Dr. McDade said. “We also have to let minority students know that mentors don’t have to always look like them.”</p> <p> At the same time, Dr. McDade said, “if more students had mentors who looked like them, they’d feel more welcomed.”</p> <p> To mitigate this issue, he recommends physicians and educators actively mentor minority students in medical school, residency and fellowship programs with the intent of training “our future replacements.”</p> <p> Dr. McDade also offered a word to the wise: Avoid seeing minority mentorship as some “great act of social service or cultural engineering” but rather as a chance to train a new young physician who can “work with patients and impact medicine in a way that [you] couldn’t.”</p> <p> “For instance, when I bring a medical student into my lab, I’m thinking that I’m training the next great anesthesiologist to take my place when I’m gone, and I want this person to be able to give care to my community just as much as I do. I want them to be greater than me in my career. Think of their potential as being your success,” he added.</p> <p> <strong>5. Medical schools aren’t just talking about the problem; they’re exploring real solutions.</strong></p> <p> Medical schools have been incorporating new approaches to educating minority and non-minority students about diversity, inclusion and health disparities that will impact underserved patients. For instance, the University of Chicago Pritzer School of Medicine’s <a href="http://pritzker.uchicago.edu/about/diversity/bowman.shtml" target="_blank" rel="nofollow">Bowman Society</a> (named in honor of James E. Bowman, MD, the first tenured African-American professor in the university’s Biological Sciences Division) hosts bimonthly meetings and quarterly lectures to discuss health disparities and issues that impact minority patient care. The meetings are open to external and internal faculty, and they often feature presentations from minority physicians who have created new practices for minority patient care.</p> <p> Dr. McDade said that med school also previously has offered courses on health disparities in which students work directly with patients in underserved communities.</p> <p> He encourages more medical educators to incorporate health inequities within pedagogy: “These kinds of courses give students a much more tangible sense of what it’s like to be a patient within a certain culture. Because of so many barriers in our society, one walk of life really doesn’t see how the other lives, and as a physician, you have to know that.”</p> <p> <strong>Learn more:</strong> See <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">how medical schools are tackling challenges</a> in health disparities and diversity.  </p> <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page?" target="_blank">Minority Affairs Section</a> is addressing similar issues. The section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/doctors-back-school.page?" target="_blank">Doctors Back to School program</a> connects minority physicians and medical students with local schools to introduce kids to professional role models and strengthen the pipeline of future doctors. The AMA also is a founding member of the <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities.page?" target="_blank">Commission to End Health Care Disparities</a>, which is seeking to better understand and address these disparities in ambulatory clinical practices.</p> <p> <strong>Tell us:</strong> What are other ways students, educators and physicians can work together to promote diversity and better support minority physicians? Share your thoughts by commenting below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5a4d72ce-1966-46d6-9464-fedd1d033a07 Will social media impact your residency, fellowship application? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_will-social-media-impact-residency-fellowship-application Wed, 08 Apr 2015 20:58:00 GMT <p> In an era of incessant tweets and Facebook posts, your online presence can be as private or ubiquitous as profile settings allow, but whether program directors will use this information to evaluate future residents or fellows remains unclear. Review recommendations from a peer and share your thoughts on the issue.</p> <p> <strong>Trends in using social media to review applicants</strong></p> <p> It is estimated that 19-31 percent of collegiate admissions officers vet applicants through online searches, while nearly one-half of employers do so, according to <ins cite="mailto:AMA" datetime="2015-04-08T15:47"><a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00363.1" target="_blank" rel="nofollow">an article</a></ins> from the <em>Journal of Graduate Medical Education</em>. But data is much sparser regarding fellowship and residency program admission. However, recent studies suggest that program directors are already using social media searches to evaluate candidates, according to the same article.</p> <p> A <a href="http://www.ncbi.nlm.nih.gov/pubmed/23351574" target="_blank" rel="nofollow">survey of surgical program directors</a> in the <em>Journal of Emergency Medicine</em> found that 17 percent screened applicants by using social media networking sites, and 33 percent of that group gave lower rankings to applicants based on the online content they found. At the same time, the survey also found that more general Google searches among program directors in emergency medicine didn’t negatively or positively impact residency applicants.</p> <p> Considering this conflicting data, applicants may not have to police every post online, but they “should certainly maintain discretion, secure their accounts from public view, and recognize that their online behavior may have important implications for clinical care, should their patients search for them on social media networks,” said Deva M. Wells, a fourth-year student at University of Washington School of Medicine.</p> <p> <strong>Recommendations for program directors</strong></p> <p> In an <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00363.1" target="_blank" rel="nofollow">article</a> for the <em>Journal of Graduate Medical Education</em>, Wells outlines three potential policies for program directors to consider using social media for evaluation clues:</p> <p> <strong>1. If you search social media, please let applicants know.</strong> Program practices of searching social media networks “should be explicitly publicized on programs’ websites in the interest of transparency and honesty,” Well said, noting that this information can help applicants be more cognizant of what they post.</p> <p> <strong>2. Supporting program staff should conduct social media searches. </strong>To prevent potential bias, program “searches should be performed by someone other than the program director—either randomly or on all applications at certain phases of the selection process, and queries should generate reports only on a standardized set of unequivocal offenses.”</p> <p> <strong>3. If you spot “red flags” on a program applicants’ social media, allow him or her to explain. </strong>Medical educators and program directors should be mindful that social media may reflect a snapshot of an applicant’s lifestyle but not their entire identity, especially considering people mature as they grow older and continue to share posts online. With this in mind, “when more dubious findings surface, programs might consider allowing applicants to explain the content during an interview,” Wells said.</p> <p> <strong>Tell us:</strong> Do you agree with these recommendations? Should program directors evaluate residency applicants’ social media? If so, what should they look for? Share your thoughts in the comments below or on the AMA’s <a href="https://www.facebook.com/amaresidentsandfellows" target="_blank" rel="nofollow">Residents and Fellows Facebook page</a>.</p> <p> Also review the AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/manage-online-reputation-top-4-tips" target="_blank">top tips for managing your online reputation</a> and visit Reputation.com—the preferred provider of online reputation management services offered through the <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program.page" target="_blank">AMA MVP Program</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dcd0f301-772e-42c7-a65a-097af7d3a487 Help the AMA advocate for fairness in physician payment methods http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-advocate-fairness-physician-payment-methods Wed, 08 Apr 2015 20:44:00 GMT <p> An increasingly common payment method among health insurers could be racking up fees for your practice. Find out how to avoid paying these unnecessary fees in your practice—and what you can do to help secure more fairness in electronic health insurer payments.</p> <p> If your practice accepts virtual credit card (VCC) payments from health plans, you may be losing a significant amount of your contractual payments to high interchange fees charged by your credit card company. These payments often offer health insurers significant financial rewards while sticking physicians with all the associated fees and extra work.</p> <p> Many insurers are choosing to use VCCs for claims payments to physicians instead of sending paper checks or paying via the electronic funds transfer (EFT) standard transaction. When paying via virtual credit card, insurers send single-use credit card payment information and instructions to physicians via mail, fax or email. The physician’s office staff then processes the payment as they would a patient’s credit card.</p> <p> For each of these payments, physicians are charged fees that typically amount to 3-5 percent of the total payment—and that adds up.  If a physician contractually is owed $5,000, for instance, he or she could have to shell out up to $250 in fees.</p> <p> So what should physicians do? Here are three actions you can take to prevent health plans from imposing VCC payments on your practice:</p> <p> 1.  <strong>Register for electronic funds transfer (EFT) payments. </strong>The Health Insurance Portability and Accountability Act (HIPAA) requires all health plans to offer standardized EFT using the Automated Clearing House (ACH) Network to physicians that request it. Similar to direct deposit, ACH EFT allows health plan payments to be directly deposited into a physician’s designated bank account. Each ACH EFT transaction carries a banking fee of about 34 cents, far less than the potential 5 percent fee charged for VCC transactions. In order to receive ACH EFT, physicians should request and enroll in this payment method.</p> <p> 2.  <strong>Be aware of restrictions in payment methods when contracting with health plans. </strong>Even though HIPAA requires health plans to make ACH EFT payments available upon request, health plans may try to require other payment methods, such as VCC, within their contracts with physicians. Be cognizant of any restrictions and avoid signing contracts with inflexible payment terms.</p> <p> 3.  <strong>Educate your practice staff. </strong> Make sure your staff is able to differentiate between patient and health plan credit card payments to avoid authorization of VCC payments. If your practice staff processes both patient and health plan payments, their education on the matter is crucial.</p> <p> The AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page" target="_blank">EFT toolkit</a> has more information on EFT payment, including a <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/virtual-cards.pdf" target="_blank">VCC resource</a> (log in) with more information on avoiding high fees.</p> <p> <strong>Do you have experience with virtual credit cards in your practice?</strong></p> <p> If so, take a <a href="https://www.surveymonkey.com/s/H2Q9NTN" target="_blank" rel="nofollow">brief survey </a>by May 8 to share your experiences and help the AMA, the Medical Group Management Association and the American Dental Association bolster their advocacy on health plan payment issues. The survey will collect data on the scope and impact of VCC usage, which will support the AMA’s push to ensure physician choice in health plan payment methods.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c1789fb0-90ac-41b7-bd1d-1bd18ed43ed6 IMGs: Participate in State of the Section teleconference April 30 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_save-date-next-img-state-of-section-teleconference Wed, 08 Apr 2015 11:00:00 GMT <p> If you’re a member of the AMA International Medical Graduate (IMG) Section, participate in the next State of the Section teleconference, scheduled for April 30 at 8 p.m. Eastern time</p> <p> Plan to join this teleconference to hear a guest speaker and learn about section activities, receive an update on Missouri’s assistant physician legislation and more.</p> <p> <a href="mailto:img@ama-assn.org" rel="nofollow">Email the section</a> to request an agenda and teleconference dial-in information.</p> <p> Visit the AMA-IMG Section <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page?" target="_blank">web page</a> for more information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:785b8445-4cf7-4d72-a4bf-15f50e9efc61 Doctors have unearthed the root of new payment model challenges http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-unearthed-root-of-new-payment-model-challenges Tue, 07 Apr 2015 20:22:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/5/968d1c35-9126-4e9c-a589-eaf1549d40e1.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/6/5/968d1c35-9126-4e9c-a589-eaf1549d40e1.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An AMA Viewpoints post by AMA President-elect Steven J. Stack, MD</em></p> <p> One of my favorite things about being involved in organized medicine is the frequent opportunities I get to talk to physicians across the country. I remain amazed at how different we physicians may be in location, specialty and background, but how similar we are in our challenges, successes and experiences.</p> <p> <strong>The root of our challenges</strong></p> <p> Here’s something I hear frequently: Physicians are being flooded with data but are not provided the right tools to decipher and apply it for improved patient health outcomes. Most doctors want to make new payment and delivery methods work. We’re not obstructionist dinosaurs. We want to succeed for our patients. But we need the appropriate resources to help redesign the health care system.</p> <p> That’s really the driving focus of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/ama-rand-study.page" target="_blank">recent study</a> with the RAND Corporation, released last month. The study investigated physician experiences with the adoption of health care delivery and payment reforms. This <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">investigation</a> is especially important at a time when the government, private insurers and others are upping the ante for changing the ways physicians are paid, in theory, to create stronger incentives for efficient, high-quality care.</p> <p> At a panel the AMA convened last month in Washington, D.C., folks from across the health care system—a private insurance company, a large hospital system and a small private practice—shared their diverse experiences and came to the same conclusion: When physicians have data in a meaningful context and tools to act on it, they respond positively, and patient care improves.</p> <p> <strong>How we’re securing better data and tools</strong></p> <p> This is part of the reason the AMA will have <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/making-physician-voices-heard-future-health-success" target="_blank">such a presence</a> at this year’s Healthcare Information and Management Systems Society (HIMSS) 2015 <a href="http://www.himssconference.org/" target="_blank" rel="nofollow">Annual Conference</a>, taking place next week. We’ll be able to connect with some of the top minds in health IT to ensure physicians are in on the ground floor of innovation. (In fact, there’s still time to share your thoughts on the good and the bad in using technology in health care by <a href="https://twitter.com/robertwahmd" target="_blank" rel="nofollow">tweeting at our president Robert M. Wah, MD</a>, who is a keynote speaker at the conference.)</p> <p> It also is part of the reason we have worked so hard to eliminate the Medicare <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-left-uncertainty-until-senate-back-recess" target="_blank">sustainable growth rate</a> formula that hinders physician practices from adopting new practice models. I’m cautiously optimistic that, after much effort, we are very close to success in this area.</p> <p> Finally, and perhaps most importantly, it is part of the reason we are dedicating so many resources to the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative. Through this effort, we’re helping physicians successfully navigate the health care environment in sustainable practices.</p> <p> Physicians’ professionalism shouldn’t be taken for granted. At the AMA, we are advocating to reduce the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">tsunami of regulatory penalties</a> and working to make it easier for physicians to adopt new payment models. And, we’re doing all we can to ensure physicians in all specialties, practice sizes and locations across the country can participate successfully in new payment and delivery models that allow them to efficiently provide the best care to patients.</p> <p> <strong>Tell me: </strong>What’s the biggest challenge for you in adopting new practice models? Weigh in with a comment below.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:98266597-fd34-407a-9af4-a0e71ddca506 Prep your practice for 2016 changes: Coding resource sale http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prep-practice-2016-changes-coding-resource-sale Tue, 07 Apr 2015 20:00:00 GMT <p> The Oct. 1 deadline to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-moves-forward-end-end-testing-results-released" target="_blank">implement the ICD-10 code set</a> is less than six months away—make sure your practice has the latest resources to code correctly.</p> <p> Save 20 percent at the AMA Store on <a href="https://commerce.ama-assn.org/store/content/2016-annual-titles?node_id=2016-annual-titles" target="_blank">2016 annual resources</a> by using promo code FSYE7. The most recent ICD-10 resources include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610008&navAction=push" target="_blank">ICD-10-PCS 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610007&navAction=push" target="_blank">ICD-10-CM 2016 Codebook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610024&navAction=push" target="_blank">ICD-10-CM Documentation 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610009&navAction=push" target="_blank">ICD-10-CM Mappings 2016</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank">Pocket Guide to Understanding ICD-10-CM Documentation</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430005&navAction=push" target="_blank">Principles of ICD-10-CM Coding</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2430006&navAction=push" target="_blank">Principles of ICD-10-CM Coding Workbook</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610022&navAction=push" target="_blank">Advanced Anatomy and Physiology for ICD-10-CM/PCS 2016</a></li> </ul> <p> Other coding resources that are part of the sale include:</p> <ul> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610026&navAction=push" target="_blank">Medicare RBRVS 2016: The Physicians’ Guide</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610017&navAction=push" target="_blank">HCPCS 2016 Level II Professional Edition</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610015&navAction=push" target="_blank">CPT 2016 Professional Edition</a></li> <li style="margin-left:0.25in;"> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2610006&navAction=push" target="_blank">CPT Changes 2016: An Insider’s View</a></li> </ul> <p> The promo code expires April 30. AMA members receive an additional discount on these products. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p> This promotion is available for customers that purchase from the AMA directly (excludes wholesale/resellers and bookstores). The code is valid only on the products listed directly above, and expires April 30. The code cannot be combined with other promotions or packages.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5fcdfb1a-972b-496b-b7e3-39e1d7bf79df