AMA Wire® http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page Fri, 28 Aug 2015 18:28:00 GMT What you should know about student loan refinancing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_should-student-loan-refinancing Fri, 28 Aug 2015 18:28:00 GMT <p> More than 80 percent of physicians under the age of 40 still are paying off their medical school loans, according to AMA Insurance’s <a href="http://www.amainsure.com/resourcecenter/introduction-to-work-life-profiles-of-todays-us-physician.html" target="_blank" rel="nofollow">National Work/Life Profiles 2013 survey</a>. Nearly one-half of these young physicians carry a debt of $150,000-$200,000. If you’ve been considering refinancing your medical school loans, find out what you need to know—and learn about a simple solution that can help you.</p> <p> <strong>What is student loan refinancing?</strong></p> <p> Student loan lenders will buy out your loans—public and private—from you existing servicers, allowing you to have one new loan at a potentially lower interest rate. This process also will consolidate all of the loans you refinance into one payment. The average physician can save around $40,000 by refinancing.</p> <p> <strong>Why does student loan refinancing exist?</strong></p> <p> Refinancing exists because lenders are willing to offer loans at terms that are different from the original student loans. Market interest rates have dropped over the last few years, which is one reason lenders would take on loan refinancing.<br /> <br /> Also, when students graduate and gain employment and a work history, they become better candidates for loan repayment because their chance of default is lower. Finally, refinancing rates are based on the individual credit and financial situation of borrowers, whereas federal loans are largely one-size-fits-all, with everyone getting the same rate for most loans.</p> <p> <strong>How do I get the best offer?</strong></p> <p> To get the best refinancing offer, you should:</p> <ul> <li> Be in good credit standing</li> <li> Have a low debt-to-income ratio</li> <li> Have work experience</li> <li> Be aware of current market rates</li> <li> Apply with a cosigner</li> <li> Compare multiple offers</li> </ul> <p> <strong>Why would I need a cosigner?</strong></p> <p> If you have a credit score of 680 or lower, you should add a cosigner because it will give you a greater chance of being approved. Regardless of credit score, anyone can add a cosigner—it could potentially give you a lower interest rate. Pick someone to cosign that has a strong credit history and high income, and someone you have a strong relationship with.</p> <p> <strong>Who should <em>not</em> refinance?</strong></p> <p> Refinancing your student loans can impact your eligibility for certain benefits. For example, if you’re a family practice physician in a small town, you could be eligible for federal grants, and refinancing would affect that. Four situations in which you would reconsider loan refinancing are:</p> <ul> <li> If you’re using an income-based repayment plan, which allows you to peg your repayment to a percentage of your income rather than a set monthly amount</li> <li> If you’re eligible for public service or health shortage area loan forgiveness</li> <li> If your loans are in forbearance</li> <li> If you’ve deferred your student loan payments on the basis of economic hardship</li> </ul> <p> <strong>What’s the process like to refinance?</strong></p> <p> Traditionally, you would need to find multiple lenders, submit an application to each lender and sift through offers to determine which you think is best. AMA members now have access to Credible Labs, a student loan refinancing group endorsed by the AMA MVP Program.</p> <p> With Credible, you can check to see whether you’re paying too much for your existing loans as compared to your peers. If you are, complete a single form on Credible’s website, and you’ll receive personalized offers from multiple lenders. Credible allows you to compare all offers side-by-side to see which works best for you.</p> <p> AMA members who use Credible can receive refinancing offers as low as 1.93 percent APR and get a $420 bonus. Read stories from real people who refinanced with Credible and learn more at the <a href="https://www.credible.com/ama" target="_blank" rel="nofollow">Credible website</a>.</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:5e023e23-b56f-450a-8db7-9e0429d2d816 Court rules physicians can stand up for their patients http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_court-rules-physicians-can-stand-up-their-patients Fri, 28 Aug 2015 18:25:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/1/989fbab9-9224-46d8-b123-593fea2bc33b.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/1/989fbab9-9224-46d8-b123-593fea2bc33b.Large.jpg?1" style="float:right;margin:15px;" /></a>Mental health parity gained important momentum this month when a U.S. appeals court ruling gave legal power to patients who face unfair scrutiny or rejection of their mental health claims and enabled their physicians to stand up for this vulnerable population in court.</p> <p> The New York State Psychiatric Association (NYSPA) in March 2013 brought a class action lawsuit, representing its members, alleging violation of various state and federal laws, including the Mental Health Parity and Addiction Equity Act, the New York Parity Act, the New York Prompt Pay Statute and Employee Retirement Income Security Act (ERISA).</p> <p> The lawsuit claims that United’s practices were “designed to create the illusion of impartiality, fairness and due process while simultaneously undermining access to treatment for the most vulnerable segment of our society.” Read <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-court-their-mental-health-patients" target="_blank">the details of the complaints</a> at <em>AMA Wire</em>®.</p> <p> In respect to the lawsuit, United challenged NYSPA’s legal standing to represent the interests of its members and its members’ patients. A trial court dismissed the suit in October, partly on the grounds that NYSPA lacked this standing.</p> <p> But the 2nd U.S. Circuit Court of Appeals determined NYSPA does in fact have standing to represent its members.</p> <p> “At this stage in the litigation, it remains plausible that the participation of a limited number of NYSPA members will allow NYSPA to prove that United’s practices violate the relevant statutes,” the court wrote in its decision.</p> <p> <strong>Implications for other cases</strong></p> <p> The results of <em>NYSPA v. United</em> will have important implications for a similar mental health parity case, <em>American Psychiatric Association v. Anthem Health Plans</em>. In that case, Connecticut psychiatrists are challenging Anthem, alleging that the insurer systematically failed to pay proper mental health and substance abuse benefits.</p> <p> The allegation is that the insurer failed to abide by beneficiaries’ plans and various laws in the state, including the Mental Health Parity and Addiction Equity Act, ERISA and Connecticut common law. A trial court had dismissed the case, finding that physicians and their medical societies lacked the legal standing to sue under ERISA. <a href="http://www.ama-assn.org/ama/ama-wire/post/ruling-could-restrict-access-psychiatric-care" target="_blank">Read the details</a> at <em>AMA Wire</em>.</p> <p> In both cases, 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 respective state medical societies filed friend-of-the-court briefs to support physicians. To learn more about this and other <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/patient-rights.page">patient rights cases</a>, visit the Litigation Center Web page.</p> <p> An <a href="http://www.ama-assn.org/ama/ama-wire/post/ruling-could-give-insurers-leeway-terminate-physicians" target="_blank">additional case</a> originating in New York also is dealing with physicians’ standings under ERISA. The stakes in <em>Rojas v. Cigna Health and Life Insurance Company</em> include termination of physicians from the insurer’s network and medical necessity of services.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:20.2222232818604px;text-align:right;">By AMA staff writer</em><span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:20.2222232818604px;text-align:right;"> </span><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:20.2222232818604px;text-align:right;" target="_blank"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0491dc41-f1c5-41c3-b0dc-825a3fcc4375 5 ways to boost diversity in the medical community http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-ways-boost-diversity-medical-community Thu, 27 Aug 2015 20:33:00 GMT <p> Despite a recognized need for an increasingly diverse physician workforce, <a href="http://www.ama-assn.org/ama/ama-wire/post/decline-of-black-men-medical-education" target="_blank">research confirms</a> that fewer black men attend medical school today than in 1978. How can physicians and educators ban together to help reverse this problem? A recent report from <em>Academic Medicine </em>outlines key diversity solutions.  </p> <p> Of all the common misconceptions about diversity in medicine, perhaps the most prevailing are that it only impacts students of color or fills perfunctory affirmation action quotas. But considering the outcomes for black patients—who have some of the <a href="http://www.ama-assn.org/ama/ama-wire/post/african-americans-diabetes-hypertension-need" target="_blank">highest rates</a> of diabetes, heart disease and hypertension in the nation—such thinking couldn’t be farther from the truth.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/6/adba659f-00f7-47d2-b603-2eb28b5c0295.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/6/adba659f-00f7-47d2-b603-2eb28b5c0295.Full.jpg?1" style="margin:15px;float:right;width:450px;height:810px;" /></a></p> <p> In fact, <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1792913" rel="nofollow" target="_blank">a recent study in <em>JAMA</em></a> found that non-white physicians cared for 53.5 percent of minority patients and 70.4 percent of non-English-speaking patients, underscoring the crucial link between diversifying the physician workforce and reducing health disparities.</p> <p> This is why <a href="https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=PubDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_prc_prd_key=78B38423-34D5-433C-B4FB-76F0F5CAE008" rel="nofollow" target="_blank">“Altering the Course: Black Males in Medicine,”</a> a new report from the Association of American Medical Colleges (AAMC), gathered the perspectives of 11 black premedical students, physicians, researchers and leaders through interviews to explore possible factors for the decline of black men in medical school and broad-based solutions to alter them.</p> <p> While one solution won’t instantly curb the dearth of black men in medicine, institutions can take certain steps to connect with black men in their communities and attract more diverse applicants, according to the report. Some of these steps include:   </p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Making diversity an actionable value and priority. </strong>For diversity initiatives to thrive, medical school leaders must believe in the importance of diversity and advocate for more institutional initiatives that support inclusion.<br /> <br /> School leaders should view diversity as an institutional asset that enriches the education and experience of all physicians in training—not only those of color. And they should implement inclusion programs that reflect this priority, according to the report.<br /> <br /> For instance, the University of California—Davis School of Medicine already is prioritizing diversity in its work within the AMA’s Accelerating Change in Medical Education Consortium, which received a $1 million grant to transform the way future physicians are trained.<br /> <br /> Administrators at UC Davis have adapted a <a href="http://www.ucdmc.ucdavis.edu/diversity/" rel="nofollow" target="_blank">diversity statement</a> as part of the school’s official mission and offer a <a href="http://occr.ucdavis.edu/diversity/" rel="nofollow" target="_blank">diversity education program</a>, which provides staff, faculty and students with educational opportunities to learn more about inclusion through workshops and seminars.</p> <p style="margin-left:40px;"> <strong>2.  Enhancing school policies and administrative processes to promote diversity. </strong>Beyond rhetoric that openly supports diversity, interviewees in the report said it’s crucial for administrators to “examine existing policies and how they influence administrative practices” for students of color.<br /> <br /> For instance, <a href="http://urbanuniversitiesforhealth.org/media/documents/Holistic_Admissions_in_the_Health_Professions.pdf" rel="nofollow" target="_blank">a national study</a> of admissions in university health programs in 2014 found that students admitted to medical school through a “<a href="https://www.aamc.org/initiatives/holisticreview/about/" rel="nofollow" target="_blank">holistic review process</a>” performed just as well as those who were not. Schools that used a holistic review process “experienced increased diversity, no change to student success metrics and an improved teaching and learning environment,” according to the study.<br /> <br /> Physicians in the report encouraged admissions officers to consider a similar review process and shed the false perception that increasing diversity means lowering admission standards.</p> <p style="margin-left:40px;"> <strong>3.</strong>  <strong>Developing mentorship programs that teach black males about the pipeline to medical school early in their education.</strong> A lack of information about the medical school application process, financial concerns and scarce access to role models are common barriers to black men entering medicine, according to the report.<br /> <br /> To address these issues, the report suggested that medical schools should think creatively about pipeline and recruitment efforts, whether formal or informal, to engage black men and their communities.<br /> <br /> For instance, the AMA’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</a> program allows physicians to visit K-12 schools in underserved communities and speak directly with students about their work as physicians. Students can learn more about how they can pursue a career in medicine.<br /> <br /> The report also recommends that schools investigate opportunities to connect with black men through premedical school programs, faith-based organizations, high school mentoring programs and the Student National Medical Association as well as the National Medical Association, the oldest and largest organization that specifically represents black health professionals.  </p> <p style="margin-left:40px;"> <strong>4. </strong> <strong>Partnering with historically black college universities (HBCU) and minority organizations that have demonstrated success with black males. </strong>HBCUs—such as Morehouse College and Howard University—are a major source of black male applicants to U.S. medical schools. In fact, four out of the top 10 institutions that provided the largest number of black male applicants to med schools were HBCUs in 2010-2014, according to recent matriculant data from the AAMC.<br /> <br /> In light of this, the report notes the importance of building stronger relationships with HBCUs as part of medical schools’ diversity strategies.</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Hiring more physicians of color as medical school faculty and staff. </strong>Although medical school classes <a href="http://www.ama-assn.org/ama/ama-wire/post/newest-medical-class-looks-likehttp:/www.ama-assn.org/ama/ama-wire/post/newest-medical-class-looks-like" target="_blank">are increasingly diversifying</a>, only 2 percent of medical school faculty at MD-granting institutions are black men, according to data from the AAMC.<br /> <br /> “The presence of other black men will likely influence decisions to attend a particular school or apply for a residency or faculty position,” according to the report. </p> <p> <strong>Want to explore more diversity solutions? Check out these med ed resources:</strong></p> <ul> <li> Learn about <a href="http://www.ama-assn.org/ama/ama-wire/post/21-med-students-selected-future-minority-physician-leaders" target="_blank">the 21 medical students</a> the AMA Foundation recently selected as future minority physician leaders. Read their unique perspectives on being a student of color in medical school and <a href="http://www.ama-assn.org/ama/ama-wire/post/21-med-students-selected-future-minority-physician-leaders" target="_blank"><u>how they plan to succeed while promoting diversity in medicine</u></a>.   </li> <li> See <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">how these medical schools are tackling challenges</a> in health disparities and cultural competencies.</li> <li> Educate yourself and your peers on the <a href="http://www.ama-assn.org/ama/ama-wire/post/debunking-5-myths-diversity-medical-education" target="_blank">5 myths of diversity in med ed</a>.</li> <li> Watch <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">this Google hangout</a> to learn more ways schools and students are promoting diversity in medical education.</li> <li> Visit the AMA Minority Affairs Section <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/about-us.page?" target="_blank">Web page</a><u>,</u> which features the latest on AMA policies, news and events to promote diversity in medicine and public health. You can also <a href="http://www.ama-assn.org/go/joinmas" target="_blank">join the section</a> to get further involved.</li> </ul> <p style="text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6923f1fe-b832-4223-a4fd-c5b35671d9b9 Improving verbal sign-outs: One simple method you need http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_improving-verbal-sign-outs-one-simple-method-need Wed, 26 Aug 2015 22:11:00 GMT <p> As a resident, your ability to safely care for patients often depends on how well you capture and communicate information about them to colleagues. How do you make sure you’ve discussed the most pertinent patient details with the next resident on your shift? An easy-to-remember acronym can help you conduct highly effective verbal sign-outs.</p> <p> During sign-outs, it’s not uncommon for residents to “start reading from the very first patient on their sign-out,” Vineet Arora, MD, said in a presentation about the art and science of handoffs. Dr. Arora is an academic hospitalist and associate professor at the University of Chicago Medicine, who specializes in improving the learning environment for medical trainees and the quality, safety and experience of care delivered to hospitalized adults.</p> <p> But running through a litany of patient details in conversation won’t help your fellow residents learn the information they need to successfully care for your patients after your shift.</p> <p> In fact, “by the time you get to the 10th patient, the receiver is not paying attention,” Dr. Arora said.</p> <p> To avoid this, she said researchers have developed a simple acronym—SIGNOUT—to help residents identify the key patient information they should communicate with care members during sign-outs. Follow this quick checklist for the top details to cover the next time you discuss your patients with a colleague:</p> <ul> <li> <strong>S</strong>—<strong>Sick or DNR? </strong>Be sure to explain if your patient falls into either of these categories and offer and explain how.  <br /> <br /> <strong>Example:</strong>  “Okay, this is Mr. Jones. He’s our sickest patient, and he’s full code.”</li> </ul> <ul> <li> <strong>I</strong>—<strong>Identifying data. </strong>This information specifically pertains to describing the patient’s identity and the main reason for their hospitalization, which you should be able to summarize for another resident in one clear, succinct sentence.<br /> <br /> <strong>Example:</strong> “Mr. Jones is a 77-year-old gentleman with a right middle lobe pneumonia."</li> </ul> <ul> <li> <strong>G</strong>—<strong>General hospital</strong>. Offer a concise explanation of the patient’s overall hospital stay, particularly noting how long he or she has stayed in the hospital  and key developments on their treatment.<br /> <br /> <strong>Example:</strong> “Mr. Jones came in a week ago hypoxic and hypotensive but improved rapidly with IV levofloxacin.”</li> </ul> <ul> <li> <strong>N</strong>—<strong>News events of the day. </strong>Before handing your patient over to a colleague, ask yourself what the biggest events of the day were that impacted your patients and/or their treatment. Taking mental inventory of these events will help you identify the most timely background information to share during sign-out.<br /> <br /> <strong>Example:</strong> “Today, Mr. Jones’ temperature spiked to 39.5 degree Celsius, and his white count bumped from eight to 14. His portable chest x-ray was improved from admission. We sent blood and urine cultures. Urinalysis was negative, but his IV site looked red, so we started Vanco.”</li> </ul> <ul> <li> <strong>O</strong>—<strong>Overall health status. </strong>This should give a clear snapshot description of your patient’s current health condition.<br /> <br /> <strong>Example: </strong>“Right now, Mr. Jones is sitting at 98 percent on two liters NC and is afebrile.”</li> </ul> <ul> <li> <strong>U</strong>—<strong>Upcoming possibilities. </strong>Explain any potential situations that may impact your patient’s current health status and your plans to address them. When offering treatments or solutions, be sure to explain the rationale behind your plan, especially during emergencies.<br /> <br /> <strong>Example: </strong>“If he becomes persistently febrile or starts to drops his pressures, start normal saline at 125 cc per hour and have a low threshold for calling the ICU to take a look at him because of possible sepsis.”</li> </ul> <ul> <li> <strong>T</strong>—<strong>Tasks to complete overnight. </strong>Discuss a clear action-item list of the patient tasks you’d like your colleague to complete and your rationale for these tasks.<br /> <br /> <strong>Example: </strong>“I’d like you to look in on him around midnight and make sure his vitals and exam are unchanged. I don’t expect any blood culture results back tonight, so there is no need to follow those up.”</li> </ul> <p> After you’ve discussed these items, also be sure to leave room for questions. This gives the listener a chance to actively engage, filling crucial knowledge gaps that may impact the patient’s treatment and help avoid medical errors.</p> <p> <strong>Want more resident-friendly tips for your next rotation? Explore these resources:</strong></p> <ul> <li> Review <a href="http://www.ama-assn.org/ama/ama-wire/post/5-tips-night-shift-success" target="_blank">these 5 tips</a> for night shift success.</li> <li> Learn how to master patient hand-offs with <a href="http://www.ama-assn.org/ama/ama-wire/post/7-tips-master-patient-handoffs" target="_blank">these 7 expert pointers</a>.</li> <li> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/graduating-residents-reflect-share-advice-challenges" target="_blank">advice from former residents</a> on how they managed clinical challenges.</li> <li> Review the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/succeeding-medical-school-practice.page?" target="_blank"><em>Succeeding from Medical School to Practice</em></a> guide, which features expert advice on clinical and non-clinical issues for residents. The guide also comes with a video library, packed with practical presentations such as this one on handoffs by physicians and other health care experts. </li> </ul> <p style="text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:10ee104f-7956-4377-9764-e5f7c1d105f5 The beginner and expert’s guide to ICD-10 prep: Steps for September http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_beginner-experts-guide-icd-10-prep-steps-september Wed, 26 Aug 2015 22:06:00 GMT <p> If you’ve followed our ICD-10 series, you’re probably well-prepared for the Oct. 1 deadline. Use this last month before the transition to finalize your plans.</p> <p> <strong>What to tackle in September</strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/9/87319f15-6267-4caa-99b7-84c684e765f7.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/7/9/87319f15-6267-4caa-99b7-84c684e765f7.Large.png?1" style="margin:15px;float:right;" /></a></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’ (CMS) <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> <strong>Still getting started?</strong></p> <p> Even though you may have gotten a late start in prepping for ICD-10, by now you have tackled a lot and should be in good shape if you’ve been taking the steps in our monthly guide. Spend your final month before the transition preparing for claims processing disruptions.</p> <p> While the AMA has secured provisions from CMS to <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-icd-10-transition-less-disruptive-physicians" target="_blank">ease the transition</a> to the new code set, physicians still should be ready, especially because private payers may not ease up their claims payment processes.</p> <p> Make sure you have taken the most important steps to prevent cash flow interruptions. They are to ensure:</p> <ul> <li style="margin-left:0.25in;"> Your systems can accommodate the ICD-10 codes</li> <li style="margin-left:0.25in;"> Your staff is trained</li> <li style="margin-left:0.25in;"> You have tested thoroughly with your trading partners</li> </ul> <p> If you’ve been following a solid transition plan, you should be well-prepared to handle any potential claims disruptions. Learn what else your practice can do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially for ICD-10</a>.</p> <p> <strong>Already on your way?</strong></p> <p> Spend September refreshing your staff on training and repeating an assessment of your documentation needs. Visit the <a href="http://www.ama-assn.org/ama/ama-wire/post/prep-icd-10-whether-beginner-expert" target="_blank">first month</a> of this primer series for more on documentation assessment and the <a href="http://www.ama-assn.org/ama/ama-wire/post/beginner-experts-guide-icd-10-prep-steps-july" target="_blank">third month</a> of the series for staff training tips.</p> <p> <strong>More ways to prepare</strong></p> <p> Additional important resources that can help you get ready over the next few weeks include:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/6-things-need-icd-10-transition" target="_blank">Six things you should know</a> about the ICD-10 transition and the flexibilities the AMA secured for physicians</li> <li style="margin-left:0.25in;"> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire®</em> provides important insights for what you need to know about the new code set.</li> <li style="margin-left:0.25in;"> The AMA’s ICD-10 Web page offers important <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> on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.</li> <li style="margin-left:0.25in;"> CMS also is offering free assistance, including its “<a href="http://www.roadto10.org/" rel="nofollow" target="_blank">Road to 10</a>” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. <a href="http://www.ama-assn.org/ama/ama-wire/post/icd-10-countdown-continues-sure-ready" target="_blank">Read more</a> about the agency’s resource offerings.</li> </ul> <p style="margin-left:0.25in;text-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> <p style="margin-left:0.25in;"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/2/2c63a7a9-002b-4240-b2f2-c293f06b7dcf.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/2/2c63a7a9-002b-4240-b2f2-c293f06b7dcf.Full.png?1" style="margin:15px;float:left;width:835px;height:165px;" /></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:eb9c18fb-9438-4e45-86c5-93b6a7e6c8f5 Stopping overdose: Your one-hour primer to Rx monitoring http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_stopping-overdose-one-hour-primer-rx-monitoring Wed, 26 Aug 2015 21:59:00 GMT <p> Do you use a prescription drug monitoring program (PDMP)? Now in 49 states, these programs can help you identify patients at risk for opioid misuse. Participate in a free continuing medical education webinar from noon to 1 p.m. Eastern time Sept. 2 that will serve as a PDMP primer for physicians.</p> <p> 44 people die each day in the United States from an overdose of opioids. In response, states have set up PDMPs, which are designed to help physicians assess their patient’s prescription history, help identify “doctor shopping” or when patients may need additional counseling or referral for treatment of persistent pain or a substance use disorder and support clinical decision-making.</p> <p> The <a href="http://pcss-o.org/" target="_blank" rel="nofollow">Providers’ Clinical Support System for Opioid Therapies</a>, a collaborative of national health care organizations that includes the AMA, is offering a free webinar for physicians to provide an overview of PDMPs, their strengths and limitations, and practical guidelines on how to best use the information provided by PDMPs in clinical practice. <a href="https://attendee.gotowebinar.com/register/762204917255239681" target="_blank" rel="nofollow">Register now</a>.</p> <p> Physicians who participate will learn:</p> <ul> <li style="margin-left:0.25in;"> The essential features and functions of PDMPs</li> <li style="margin-left:0.25in;"> Limitations and interstate variability of PDMPs</li> <li style="margin-left:0.25in;"> How to use your state’s PDMP to enhance patient safety in a variety of clinical settings</li> <li style="margin-left:0.25in;"> The regulatory mandates that may govern PDMP use in different states</li> <li style="margin-left:0.25in;"> Regional challenges to using PDMPs</li> </ul> <p> The American Academy of Addiction Psychiatry designates this educational activity for a maximum of 1 <em>AMA PRA Category 1 Credit</em>™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.</p> <p> If you can’t participate live, this webinar is scheduled to be <a href="http://pcss-o.org/calendar-of-events/list/?tribe_event_display=past&tribe_eventcategory=5" target="_blank" rel="nofollow">archived online</a> by the end of September.</p> <p> <strong>Why physicians are crucial to stopping the epidemic</strong></p> <p> The AMA has convened a <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/preventing-opioid-abuse/opioid-abuse-task-force.page?" target="_blank">task force</a> with the American Osteopathic Association, the American Dental Association, and more than 20 state and specialty medical associations to work collaboratively to address the opioid public health epidemic by identifying best practices and implementing them across the country.</p> <p> The group identified <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-can-stop-opioid-overdose-epidemic" target="_blank">three initial steps physicians can take</a> now to help their patient populations. Registering for and using state-based PDMPs is one of those steps. Physicians also can discuss with patients available treatment options and take advantage of educational opportunities such as this webinar. Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/preventing-opioid-abuse.page" target="_blank">opioid abuse prevention Web pages</a> for more information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fb84bfd3-9d5a-433a-acb0-c0d2836371aa How physicians are paid http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-paid Tue, 25 Aug 2015 21:25:00 GMT <p> In the shift toward value-based care, physicians are getting paid by their practices in a variety of ways. Learn six key things about payment trends that physicians should know and see how you stack up.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/15/ba17ecaa-b0b2-4cea-bf44-7ec5cc4fbcf8.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/10/15/ba17ecaa-b0b2-4cea-bf44-7ec5cc4fbcf8.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> A new <a href="https://download.ama-assn.org/resources/doc/health-policy/x-pub/prp-payment2014.pdf" target="_blank">AMA report</a> (log in) sheds light on physician payment methods as it examines data on non-solo physicians from 2014. Based on a nationally representative survey of post-residency physicians who provided at least 20 hours of patient care per week, the report highlighted six trends:</p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Slightly more than one-half of physicians (51 percent) reported being paid by multiple methods.</strong> Thirty percent received compensation through two methods, and 14.4 percent received payment through a combination of three methods.</p> <p style="margin-left:40px;"> <strong>2.  </strong><strong>Salary and productivity-based payment were the most common payment methods.</strong> Sixty-one percent said they received a salary, and 53.5 percent reported receiving productivity-based payment.</p> <p style="margin-left:40px;"> <strong>3.  </strong><strong>On average, one-half of physicians’ total compensation was earned from salary.</strong> Also on average, about one-third of payment was based on productivity, 11.8 percent was based on practice financial performance, and about 5.5 percent was from a bonus or other methods. However, these shares varied greatly depending on the physician’s practice ownership status.</p> <p style="margin-left:40px;"> <strong>4.  </strong><strong>Being employed didn’t necessarily mean a salary.</strong> Twenty-three percent of employed physicians didn’t receive salaried payments at all. Productivity was a common payment method, with almost one-half receiving at least some pay based on productivity and 13.8 percent receiving payment exclusively based on their productivity.</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Outside of group practice, salary was more often a key factor than inside group practice. </strong>In group practices, 42.4 percent of physicians in a single-specialty practice and 52.9 percent in a multi-specialty practice received more than one-half of their compensation from salary. For physicians not in a group practice (for example, physicians who worked in a faculty practice plan, medical school, or who were employed by a hospital), more than three-quarters relied on salary for more than one-half of their compensation.</p> <p style="margin-left:40px;"> <strong>6.  </strong><strong>Physician payment methods vary widely across specialties.</strong> The percentage of physicians who were exclusively salaried ranged from 9.4 percent of surgical specialists to 47.9 percent of psychiatrists.</p> <p> The report shows that the structure of physician payment appears to have changed little between 2012—the last AMA study of this kind—and 2014. The largest changes in these years came in the use of productivity-based pay (from 50.5 percent of physicians who received that method in 2012 to 53.5 percent in 2014) and bonuses (from 27.1 percent in 2012 to 30.5 percent in 2014).</p> <p> <strong>New payment models</strong></p> <p> According to the AMA’s <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-views-new-payment-models-5-things" target="_blank">recent joint study</a> with the RAND Corporation, physicians are attempting to transition to new payment models but need help successfully managing and responding to the many quality programs and payer metrics so they can ensure their long-term sustainability. In addition, despite the continued focus on alternative payment models, this report indicates that productivity-based pay is still an important factor in physician compensation.</p> <p> The findings from the AMA-RAND study dovetail 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 paving the way for physicians to successfully navigate the health care environment in sustainable practices that can result in improved outcomes for patients and greater professional satisfaction for physicians and their health care teams.</p> <p> Meanwhile, the AMA is focusing advocacy efforts on reducing 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. That includes urging Congress to pause Stage 3 of the meaningful use electronic health record incentive program and <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-hear-ehr-meaningful-use-isnt-meaningful" target="_blank">bringing physicians’ concerns with the program to the forefront</a>.</p> <p> In addition, the legislation that repealed the sustainable growth rate (SGR) formula includes financial support for physicians who want to participate in new care delivery and payment models. Beginning in 2019, physicians who choose to develop and participate in new models of care will receive bonus payments from Medicare. <a href="http://www.ama-assn.org/ama/ama-wire/post/sgr-repeal-law-supports-new-payment-models" target="_blank">Read more</a> about how the SGR repeal law supports new payment models. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8b9e4c59-6618-4364-8436-a57ee9de6831 Stories from the field: How physicians feel about meaningful use http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_stories-field-physicians-feel-meaningful-use Tue, 25 Aug 2015 19:28:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/14/2dc3d406-e927-476e-8e9e-3afe2144b4e0.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/14/2dc3d406-e927-476e-8e9e-3afe2144b4e0.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> Since the <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-hear-ehr-meaningful-use-isnt-meaningful" target="_blank">town hall event</a> hosted by the AMA and Medical Association of Georgia last month, physicians’ stories about burdensome meaningful use requirements and cumbersome electronic health record (EHR) systems have been pouring in. Here are a few stories that struck me. I suspect that several of these situations will sound all too familiar to you as well.</p> <p style="margin-left:.5in;"> <strong>Family medicine in Indiana</strong></p> <p style="margin-left:.5in;"> “I thought I’d love EHRs—I’m a stickler for detail, I hate reading handwriting and I love using data to improve my medical practice …. But as I struggle to work around my second EHR in as many years and look toward an impending switch to yet another EHR next year, I feel that I am typing my way into burnout. Instead of spending my days listening to patients and solving their problems, I feel that I spend most of my time struggling to make unique stories and needs fit into an arcane system of clicks and drop-down menus.”</p> <p style="margin-left:.5in;"> <strong>Hematology/oncology in Michigan</strong></p> <p style="margin-left:.5in;"> “I must make [a choice] between direct care for sick, needy, dying and suffering patients, and the need to satisfy the many EHR requirements to complete the visit …. The health of patients is taking a back seat to the need to chart ostensibly to satisfy administrative, regulatory and financial needs.<br /> <br /> “I am considering accepting a financial penalty by not participating in [meaningful use Stage 3]. I worry about my own care as I age (56 and counting), knowing my care will be delivered with focus on data entry and billing accuracy, a path towards which we are currently heading. This has become a 24/7/365 career just to keep up—not what I anticipated or previously experienced. I cannot let my patients suffer [from] this—they do not deserve it.”</p> <p style="margin-left:.5in;"> <strong>Cardiology in Kentucky</strong></p> <p style="margin-left:.5in;"> “I am struggling to keep my office doors open. Since implementation [of my EHR] …. We are much less efficient, much more stressed and certainly financially worse off …. The hope of integrated availability of medical information throughout the country (or even in the same town) was entirely false. The system is totally ruined, and I see no light at the end of the tunnel except to pay off my current lease in August 2018 and close the doors. I love practicing cardiology, but I simply cannot afford to.”</p> <p style="margin-left:.5in;"> <strong>Emergency medicine in North Dakota</strong></p> <p style="margin-left:.5in;"> “I started using [an EHR] in residency. I had to document for eight hours after my shift, so now an 8-10 hour shift is a 16-18 hour shift. I was so burnt out by the end of my residency [that] I no longer really wanted to be an emergency physician. I still have not fully recovered from that and still get stressed easily …. Many days I just want to quit and go into something else. I have many colleagues that feel the same way. Medicine is no longer worth it.”</p> <p style="margin-left:.5in;"> <strong>Internal medicine in South Carolina</strong></p> <p style="margin-left:.5in;"> “It has been very difficult for me as an older physician to do all of the necessary EHR tasks in a timely fashion …. My time for a routine office visit increased from 15 minutes to 30 minutes, cutting my productivity in half …. Even though I love my job and wanted to work more years, I am retiring … spurred on by this EHR disaster. Gone will be 35 years’ worth of experience in outpatient general internal medicine.”</p> <p> These stories are devastating, but they are sadly similar to others I’ve heard from physicians across the country. The physicians quoted above recognize that EHRs have potential, but government regulations have made them almost unusable. As a result, good doctors are leaving medicine, we’re wasting valuable time and patients ultimately will lose out.</p> <p> Physicians will always ensure that our patients’ clinical needs are given greater importance than meeting federal regulations. Based on our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/physician-practices/steps-forward.page#rand" target="_blank">study</a> with the RAND Corporation, we know EHRs are a major driver of physicians’ dissatisfaction with their practice environments. As a result, we worked with doctors and other experts to create <a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight priorities</a> for making EHRs usable. These priorities continue to serve as a guide for our activities with vendors, policymakers and health care systems.</p> <p> I need you to <a href="http://breaktheredtape.org/share-your-story" target="_blank" rel="nofollow">share your story</a> with us. Contribute your experiences and help us drive home this issue with D.C. policymakers through a groundswell of physician input. Do not sit on the sidelines. This is urgent, and we need your EHR experiences and stories—how EHRs and current meaningful use regulations have impacted your practice and the care you provide your patients. Then <a href="http://breaktheredtape.org/email-congress" target="_blank" rel="nofollow">email your members of Congress</a> and ask them to halt Stage 3 of meaningful use until the program is fixed.</p> <p> Several government reporting programs, including meaningful use, will soon be realigned. The problem is that the government seems poised to do so without addressing these fundamental issues first. We need regulators to hit pause, fix the problems and make the meaningful use program actually meaningful.</p> <p> Visit <a href="http://breaktheredtape.org/" target="_blank" rel="nofollow">breaktheredtape.org</a> to watch the town hall meeting, share your stories about EHRs and meaningful use, and contact your members of Congress. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:08c01232-3526-4bca-af47-a10a7c988788 GME by the numbers: Here’s what to know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gme-numbers-heres Mon, 24 Aug 2015 20:03:00 GMT <p> Amid concerns of a predicted <a href="https://www.aamc.org/newsroom/newsreleases/426166/20150303.html" rel="nofollow" target="_blank">physician shortage</a>, students and residents continue to call on Congress to increase support for graduate medical education (GME) funding—and their persistence has produced a national effort. See for yourself. Here’s a look at the numbers and facts on #SaveGME Week.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/b3f52c76-17a8-4924-89e1-0fabd194d912.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/b3f52c76-17a8-4924-89e1-0fabd194d912.Full.jpg?1" style="float:right;margin:15px;width:175px;height:125px;" /></a>More GME positions are necessary to ensure there are enough physicians to meet the nation’s health care needs, according to a <a href="https://download.ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt7-a-14.pdf" target="_blank">report</a> (log in) by the AMA Council on Medical Education. The United States’ current physician workforce won’t be enough to care for patients under expanded insurance coverage and with an aging population.</p> <p> Yet funding for residency programs in most states does not reflect this need, leaving students to progress through medical school with the stress of wondering whether they’ll find themselves <a href="http://www.ama-assn.org/ama/ama-wire/post/arent-medical-students-matching-happens-next" target="_blank">unmatched or without a clear path</a> to advance their training. </p> <p> As a result, students have taken control of their own futures by sending a powerful, unified message to Congress to <a href="http://savegme.org/" rel="nofollow" target="_blank">Save GME</a>. Make sure you’re up to speed on the latest numbers and figures around this national campaign:</p> <ul> <li> <strong>90,000:</strong> The physician shortage number <a href="https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/" rel="nofollow" target="_blank">experts predict</a> the country could reach by 2025 if more residency program positions aren’t created.</li> <li> <strong>33,000: </strong>The number of emails and phone calls Congress already has received from students and physicians, calling on them to protect the future of physician training.</li> <li> <strong>40</strong>: The percent of U.S. charity care that’s provided by residents at teaching hospitals. It adds up to roughly $8.4 billion in care annually.</li> <li> <strong>6: </strong>The number of states—California, Georgia, Indiana, Maryland, North Dakota and Oregon—that have passed legislation in 2015 to support more GME funding and proactive plans to curb physician shortages.</li> <li> <strong>1:</strong> Voice, email or tweet is all it takes to stand in solidarity and support your peers in saving GME.</li> </ul> <p> <strong>What you can do </strong></p> <ul> <li> <a href="http://savegme.org/take-action/" rel="nofollow" target="_blank"><strong>Contact your lawmakers</strong></a> by email or phone, and tell them to save GME.</li> <li> <a href="http://savegme.org/wp-content/uploads/2015/08/2015-save-gme-week-action-kit.pdf" rel="nofollow" target="_blank"><strong>Download the #SaveGME</strong></a> student action toolkit, which offers information on special events during Save GME Week and easy-to-use scripts on what to say when you contact lawmakers about the campaign.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/4-things-students-should-new-gme-bill" target="_blank"><strong>Read the 4 things</strong></a> students should know about the new federal GME bill.</li> <li> <strong>Share your support by tweeting using #SaveGME</strong> or posting to the AMA medical students’ <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook</a> page.</li> <li> <strong>Change your social media profile picture</strong> to the image pictured at right to show your solidarity in calling on Congress to Save GME.</li> </ul> <p>  </p> <p style="text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e99424b0-2aa5-4500-baa6-88b85ff06d4d 3 insights from physician entrepreneurs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-insights-physician-entrepreneurs Mon, 24 Aug 2015 18:40:00 GMT <p> As a physician, you know better than anyone what types of technology could help improve your daily practice. If you’ve ever had an innovative idea or wanted to be involved in testing new technology, these key insights from physician entrepreneurs are for you.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/8/c308e560-83d6-4492-98ad-d5971fdc95ac.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/8/c308e560-83d6-4492-98ad-d5971fdc95ac.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> A special panel at the health technology incubator MATTER in Chicago’s Merchandise Mart brought <a href="https://www.ama-assn.org/ama/pub/news/matter-forum.page" target="_blank">physician innovators</a> together to share the insights they’ve gleaned through developing new products, companies and investments. Here are their top three insights:</p> <p style="margin-left:40.5pt;"> <strong>1.   </strong><strong>Know your value as a physician.</strong><br /> While the business and clinical worlds may be different, your unique insights as a physician are valuable, said Tom Schwieterman, MD, founder of ChartScribe and medical director at Midmark Corporation. After seeing patients all day, “you get pretty good at reading subtle clues,” he said. “You’re a scientist, you’re dealing with complex, multidimensional data …. You have to be able to make decisions very quickly and be confident.”</p> <p style="margin-left:40.5pt;"> <strong>2.   </strong><strong>Trust your instincts.</strong><br /> If a tech innovation doesn’t fit into clinical work flow, it won’t succeed, said James Cantorna, MD, director of quality and integration at Medical Specialists of Indiana. Dr. Cantorna said he relies on “access, affability and excellence” as a litmus test for new ideas “If it impedes those three things, it’s not good,” he said.<br /> <br /> Dr. Schweiterman explained part of the design process for his software. “I invariably sent things back two or three times and said, ‘I know this works, but you have to move it around because that is not how most of us practice medicine,’” he said. “Make sure physicians who are helping you trust their instincts. It has to be simple, it has to be fluid and it has to be in the work flow of a doctor.”</p> <p style="margin-left:40.5pt;"> <strong>3.   </strong><strong>Accept that there will be failure.</strong><br /> “In the clinical area, failure is not something where you’ll have a long-lasting career,” said James Kelly, MD, founder of Cascade Partners. “But guess what happens when you try something that really hasn’t been done before? You find out things, and sometimes you fail.”<br /> <br /> One way physicians may be able to handle failure is to liken it to peer review, said Ajeet Singh, a medical student at the Loyola University Chicago Stritch School of Medicine and medical advisor at Varsa Health. “Get your proof of concept and drill it through a rigorous peer review stage,” he said.</p> <p> <strong>Why physician entrepreneurship and this workspace matter</strong></p> <p> MATTER co-founder David Schonthal, who moderated the panel, had a final message for physicians: “We built this place for you,” he said, stressing that innovations in health tech will require that entrepreneurs “understand how you practice, how you live, how you desire your flow of work to exist and what you want to change in your practice. Do not be a stranger. We’re counting on you.”</p> <p> The AMA built flexible space in MATTER for physicians to test new models for health care delivery. Called the AMA Interaction Studio, the space will give physicians the ability to connect directly with entrepreneurs. The collaboration gives clinicians—who may not have business training to navigate the startup space—a way to take their big ideas to market. The collaboration also provides a way to make sure physicians can positively influence health care innovation.</p> <p> The AMA Interaction Studio will be designed with the physical and virtual infrastructures that will simulate a health care environment. Advanced video and audio technologies will give users of the space a way to better understand work flows and how new products and services will fit into the health care delivery environment of the future.</p> <p> The partnership with MATTER reflects a commitment to investigate 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">practice sustainability and professional satisfaction</a> through research, data and analytics. The AMA is identifying effective care delivery and payment models that can improve the quality of patient care, reduce health care costs for the nation and increase professional satisfaction. Facilitating physician innovations is crucial in that process.</p> <p> <strong>Future events</strong></p> <p> Interested in attending an event like this one? Keep an eye on the AMA’s <a href="https://www.ama-assn.org/ama/pub/news/matter-forum.page?" target="_blank">upcoming events</a>. AMA members were able to attend this $500 event free of charge as a member benefit. If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p style="text-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:4a0aaad6-5271-453d-98ee-65ceee39eb33 Ruling could give insurers more leeway to terminate physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ruling-could-give-insurers-leeway-terminate-physicians Fri, 21 Aug 2015 22:13:00 GMT <p> The outcome of a recent case could have implications for other physicians and their patients as a federal court decided it was permissible for a large health insurer to terminate two physicians from its network following a dispute over the necessity of medical services they provided.</p> <p> In <em>Rojas v. Cigna Health and Life Insurance Company</em>, two New York physicians and their medical practice sued Cigna after the health plan decided it should not have paid the physicians for certain allergy tests, arguing that the tests the physicians had ordered weren’t in line with its coverage policies. Cigna asked the plaintiffs to return the alleged overpayment and said it would terminate the physicians from its network.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/15/891e17f0-0934-4d2d-9fce-95ea0e02fdfc.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/15/891e17f0-0934-4d2d-9fce-95ea0e02fdfc.Large.jpg?1" style="margin:15px;float:right;" /></a>The physicians said they could not be terminated because they should be considered plan beneficiaries under the Employee Retirement Income Security Act (ERISA) based on assignment of benefits by their patients. ERISA prohibits discrimination against beneficiaries who exercise rights made available under employee benefit plans.</p> <p> While the physicians contended that they were beneficiaries by virtue of signed assignment-of-benefit forms, the court said these forms only would transfer patients’ rights to be paid by Cigna. Under this interpretation, the “benefit” can only belong to patients.</p> <p> Because the plaintiffs were not seeking payment, ERISA did not apply, the court ruled.</p> <p> The court also criticized the outcome of another recent ERISA-related case, <a href="http://www.ama-assn.org/ama/ama-wire/post/court-weigh-physicians-right-payments-recourse" target="_blank"><em>Pennsylvania Chiropractic Association v. Independence Hospital Indemnity Plan, Inc</em></a><em>.</em>, which did hold that payments to health care professionals would make these professionals “beneficiaries” within the meaning of ERISA.</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 Medical Society of the State of New York, backed the physician plaintiffs and filed an amicus brief supporting a rehearing of this case. The brief points out numerous cases in which other courts have concluded that “benefit” under ERISA means monetary payment, not medical care.</p> <p> “[The decision] threatens the ability of providers ever to assert any ERISA claim, even if the provider is designated by the plan and an insured as entitled to benefit payments,” the brief said. “That conclusion is contrary to virtually every other circuit court decision addressing providers’ rights to bring claims under ERISA.”</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/erisa-preemption.page" target="_blank">Read more</a> about cases related to ERISA on the Litigation Center Web page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:38e92a42-de50-41c1-b578-b85c65ad6ee5 5 barriers to hypertension control: What they are and how to address them http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-barriers-hypertension-control-address Fri, 21 Aug 2015 21:53:00 GMT <p> Given that one in three U.S. adults has hypertension, nearly all physicians face the challenge of helping their patients control their blood pressure. But addressing hypertension effectively in practice can be difficult. Learn the barriers to hypertension control and what you can do to address them in your practice.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/13/43251feb-f045-484c-9d0c-33324e82768f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/13/43251feb-f045-484c-9d0c-33324e82768f.Large.jpg?1" style="margin:15px;float:right;" /></a>Five common barriers to hypertension control are:</p> <ol> <li> Poor or inconsistent blood pressure measurement techniques</li> <li> “White coat effect,” which causes a temporary elevation in a patient’s blood pressure during an office visit in a person with normal blood pressure outside of the office</li> <li> Clinical inertia, which occurs when the care team does not initiate or intensify treatment during an office visit if the patient’s blood pressure isn’t at a goal level, or fails to schedule frequent follow up when indicated</li> <li> Lack of use of evidence-based treatment protocols by the care team</li> <li> Poor patient participation in self-management behaviors </li> </ol> <p> Fortunately, physicians can use a free online module to address all five barriers and get their patients’ blood pressure under control. The <a href="https://www.stepsforward.org/modules/hypertension-blood-pressure-control" rel="nofollow" target="_blank">module</a>, part of the AMA’s <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a> website, includes practical strategies and tools that you can immediately implement.</p> <p> The module is built off of a checklist called the <a href="https://www.stepsforward.org/Static/images/modules/8/downloadable/M.A.P.%20checklists%20for%20improving%20blood%20pressure%20control.pdf" rel="nofollow" target="_blank">“M.A.P. for achieving optimal blood pressure control</a>,”  developed by the AMA, Johns Hopkins Medicine and physicians in pilot sites across the country to improve outcomes around hypertension. The pilot practice sites also tested and helped evolve the tools. The M.A.P. calls for physicians and care teams to <strong>m</strong>easure blood pressure accurately <strong>a</strong>ct rapidly to reduce clinical inertia and <strong>p</strong>artner with patients, families and communities to promote patient self-management.</p> <p> The M.A.P. framework includes a number of resources, which are products of 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. Under 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, test and spread an evidence-based  program to improve blood pressure control nationally. </p> <p> The following resources also provide simple practical tips you can use to help your patients get their hypertension under control:</p> <ul> <li> Get <a href="http://www.ama-assn.org/ama/ama-wire/post/one-graphic-patients-need-accurate-blood-pressure-reading" target="_blank">the one graphic you need</a> for accurate blood pressure readings.</li> <li> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/self-monitoring-blood-pressure-changed-this-patients-life" target="_blank">how a physician used the M.A.P.</a> to help a patient change his life.</li> <li> Learn 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" target="_blank">help patients manage blood pressure outside of office visits</a>.</li> </ul> <p> <strong>Submit your ideas by Sept. 1: Practice Innovation Challenge</strong></p> <p> This module on hypertension control and the 15 others 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 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> Visit the STEPS Forward website to see the <a href="https://www.stepsforward.org/modules" rel="nofollow" target="_blank">current modules</a>.</li> <li> Check out upcoming <a href="https://www.stepsforward.org/events" rel="nofollow" target="_blank">live STEPS Forward events</a>.</li> <li> <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> <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:c61c73ca-a051-499f-97d9-eaa0036fd99b Participate in AMA-SPS online member forum Sept. 14-25 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_participate-ama-sps-online-member-forum-sept-14-25 Fri, 21 Aug 2015 14:19:00 GMT <p> This forum enables senior physicians from across the United States to access, review and comment on resolutions of the AMA Senior Physicians Section (SPS) in advance of the 2015 Interim Meeting.</p> <p> Also plan to participate in the <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">virtual AMA-SPS assembly</a> conference call Oct. 1 at 8 p.m. Eastern time. Senior physicians on the call will develop consensus opinions on AMA-SPS resolutions that have been approved for consideration. </p> <p> Please <a href="mailto:sps@ama-assn.org" rel="nofollow">RSVP to the section</a> by Sept. 28 to receive information about how to participate on the call.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ab902dfb-2b9b-4678-85db-829bc3b23d0f Submit AMA-SPS resolutions by Sept. 8 for 2015 AMA Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_submit-ama-sps-resolutions-sept-8-2015-ama-interim-meeting Fri, 21 Aug 2015 14:00:00 GMT <p> Any member of the AMA Senior Physicians Section (SPS) may submit a resolution to the governing council for review and approval. By authoring a resolution, you can raise awareness of relevant senior issues. Resolutions should fall into one of these categories:</p> <ul> <li style="margin-left:0.25in;"> Resolutions that are directed to the interests of senior physicians (65 years of age and older, whether working full time, part time or fully retired)</li> <li style="margin-left:0.25in;"> Resolutions that relate to or otherwise would benefit patients who are 65 years of age and older. </li> </ul> <p> If you would like to receive support with your resolution, please <a href="mailto:cwolfe@columbus.rr.com" rel="nofollow"><u>email AMA-SPS delegate Claire Wolfe, MD</u></a>, or <a href="mailto:johnknote@frontier.com" rel="nofollow"><u>AMA-SPS alternate delegate John Knote, MD</u></a>.</p> <p> Resolution guidelines are available on the <a href="http://www.ama-assn.org/resources/doc/sps/timeline-annual-meeting.pdf" target="_blank"><u>section’s Web page</u></a>. Completed resolutions must be submitted to the section <u><a href="mailto:sps@ama-assn.org" rel="nofollow"><u>via email</u></a></u>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:aa90b825-6f9f-4254-88ae-dedc87a9c532 5 tips for night shift success http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-tips-night-shift-success Wed, 19 Aug 2015 20:44:00 GMT <p> If you’re taking on nights at the hospital, avoiding fatigue and providing quality care likely are primary concerns. Here are some tried-and-true tips that have helped residents adjust to practicing at night and safely caring for patients.</p> <p> When it comes to transitioning from daytime to working at night, establishing a good routine and health are key, according to a <a href="http://doc2doc.bmj.com/assets/secure/youwillsurvive.pdf" rel="nofollow" target="_blank">special guide</a> from the <em>British Medical Journal</em> composed by and for physicians in training. It offers tips, cautionary tales and lessons learned.</p> <p> Here are the top five to know for working late nights:</p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Get a good day’s sleep. </strong>Learning how to sleep when the sun is out may feel unnatural, but it’s necessary when you need to maintain a successful night routine.<br /> <br /> To ensure you get the rest you need during the day, “[buy] blackout blinds, use an eye mask, turn your phone on silent, make sure your room is cool, and earplugs are a must,” the guide recommends.<br /> <br /> Exercising or reading a good book before bed also can help your mind unwind and ready itself for rest. </p> <p style="margin-left:40px;"> <strong>2.  </strong><strong>Sustain your energy by eating before and during shifts. </strong>Eating a good meal before starting a shift is important. Doing so is relatively easy because it often coincides with your usual evening mealtime. The more challenging practice to follow is making time to eat and drink during your shift—no matter your workload.<br /> <br /> “Although you may not feel like eating at 3 a.m., it’s important to fuel yourself,” the guide advises. “Caffeine is tempting, but try not to rely on it; you’ll regret it afterwards.”</p> <p style="margin-left:40px;"> <strong>3.  </strong><strong>Don’t be afraid to ask for help. </strong>So you get a call at 4 a.m.: A previously stable patient has taken a sudden nose dive. Your care team has run all the tests they can, and you still don’t have answers. What do you do?<br /> <br /> When treating patients at odd hours of the night, emergencies are likely to occur. In these situations, stay composed, and act decisively by seeking the help you need for your patient, even if that means phoning an on-call specialist or attending.<br /> <br /> “Never be afraid to ask your seniors for help or advice, no matter how trivial the issue,” the guide advises. “The most dangerous [resident] is the one who doesn’t ask for senior help when it is clearly warranted. Nights can be scary—but they do make us better doctors.”</p> <p style="margin-left:40px;"> <strong>4.  </strong><strong>Bring your nighttime goods. </strong>Hospitals can be very cold at night, so be sure to bring a warm sweater and additional clothing you may need. This is especially helpful for quiet spells when you don’t have many patient calls and want to feel comfortable. Also bring a stash of healthy snacks to help you stave off early morning cravings.</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Develop strategies for partnering with care teams and completing paperwork. </strong>Residents in the BMJ’s guide cited instances when they were able to improve how well they worked during night shifts by using strategies that save time and maximize efficiency.<br /> <br /> For instance, one resident devised a system in which he’d touch base with care staff for “mini-job” rounds at three different times of the night. This check-in system allowed him to complete smaller patient tasks—such as writing up fluids or rewriting drug charts—in one sitting, rather than dispersing them throughout multiple interactions.<br /> <br /> When called to see a patient, another resident said she’d ask the nurse to do a fresh set of observations and other relevant tests while she walked from one ward of the hospital to the next. Doing so ensured she’d save time and have more information prepared upon interacting with the patient.<br /> <br /> The key to whatever approach you take is using a strategy that fits your style of care, increases team efficiency and minimizes your chance of missing vital patient details.</p> <p> <strong>Want more resident-friendly tips for your next rotation? Explore these resources:</strong></p> <ul> <li> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/graduating-residents-reflect-share-advice-challenges" target="_blank">advice from former residents</a> on how they managed clinical challenges.</li> <li> Learn how to master patient hand-offs with <a href="http://www.ama-assn.org/ama/ama-wire/post/7-tips-master-patient-handoffs" target="_blank">these 7 expert tips</a>.</li> <li> Review the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/succeeding-medical-school-practice.page?" target="_blank"><em>Succeeding from Medical School to Practice</em></a> guide, which features expert advice on clinical and non-clinical issues for residents. The guide also comes with <a href="http://www.ama-assn.org/resources/doc/rfs/x-ama/rfs-video-library.pdf" target="_blank">a video library</a>, packed with presentations from health care experts and physicians. </li> </ul> <p style="text-align:right;"> <em style="font-size:12px;">By AMA staff writer</em><span style="font-size:12px;"> </span><a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="font-size:12px;" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d007af44-f800-43e8-a87e-73de7d10b949 ICD-10 testing: What you need to know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_icd-10-testing-need Wed, 19 Aug 2015 20:21:00 GMT <p> Physicians have less than 50 days to transition to the ICD-10 code set and should be well into preparations now as the Oct. 1 deadline draws close. One major piece of your prep should be testing your systems and processes.</p> <p> Testing is vital to making sure you can create and submit claims using ICD-10 codes. Testing as early as possible allows you time to resolve any issues during the claims creation process, which lasts from documentation to claims submission. It’s also one of the best ways to avoid potential cash flow issues.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/c0dd4c37-ddda-4604-806f-dba2947393d1.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/c0dd4c37-ddda-4604-806f-dba2947393d1.Large.jpg?1" style="margin:15px;float:right;" /></a></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 (CMS) to bring your practice up to speed for the new code set.</p> <p> <strong>Types of testing</strong></p> <p> 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:0.25in;"> <strong>Perform content-based testing</strong> to assess your practice’s documentation and ability to code in ICD-10. In this type of testing, your practice uses documentation to code 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" rel="nofollow" target="_blank">resources</a> to help your practice with this kind of testing.</li> <li style="margin-left:0.25in;"> <strong>Conduct internal testing</strong> to evaluate your practice’s ability to create and use ICD-10 codes throughout the patient work flow in place of when you currently use ICD-9 codes. This type of testing requires your practice to have system upgrades installed already and helps you follow the flow of a patient through a visit to identify the points at which codes are used. Use this testing to identify any gaps in your ICD-10 upgrades.</li> <li style="margin-left:0.25in;"> <strong>Do external testing</strong> to test your practice’s ability to send and receive transactions that use ICD-10 codes with your external trading partners, including your billing service, clearinghouse and payers. Check with these groups about their testing plans.</li> </ul> <p> Two important parts of external testing are acknowledgement testing and end-to-end testing:</p> <ul> <li style="margin-left:0.25in;"> In <strong>acknowledgement testing</strong>, physicians and other submitters, such as clearinghouses, submit claims with ICD-10 codes and ICD-10 companion qualifiers. While claims are not adjudicated, submitters receive an acknowledgement that their claim was accepted or rejected. This is an important step to ensure you don’t experience problems getting your claims into the adjudication pipeline.<br /> <br /> Physicians can perform acknowledgement testing with their Medicare Administrative Contractors and the Common Electronic Data Interchange contractor any time until the Oct. 1 implementation date.</li> </ul> <ul> <li style="margin-left:0.25in;"> During <strong>end-to-end testing</strong>, physicians submit claims containing valid ICD-10 codes. Health insurers process the claims through system edits to return an electronic remittance advice.<br /> <br /> While registration has closed for Medicare end-to-end testing, some health insurers continue to offer opportunities. If you have not conducted end-to-end testing yet, check with your health insurers, clearinghouses and billing services about opportunities. Check for testing opportunities with the <a href="http://www.cooperativeexchange.org/" rel="nofollow" target="_blank">Cooperative Exchange</a>, an association of clearinghouses.</li> </ul> <p> <strong>Make a plan</strong></p> <p> To get the most out of testing for your practice, you should:</p> <ul> <li style="margin-left:0.25in;"> Review testing requirements to understand the scope and format of the testing available</li> <li style="margin-left:0.25in;"> Focus on your highest-risk scenarios, such as claims processing and the diagnoses you see most often</li> <li style="margin-left:0.25in;"> Prioritize testing with health insurers, concentrating on the ones that account for the majority of your claims</li> <li style="margin-left:0.25in;"> Avoid common billing errors, such as an invalid National Provider Identifier, invalid Health Care Procedure Coding System codes, or invalid postal ZIP codes</li> </ul> <p> When testing with vendors, clearinghouses, billing services and health insurers, make sure you:</p> <ul> <li style="margin-left:0.25in;"> Verify that you can submit, receive and process data with ICD-10 codes</li> <li style="margin-left:0.25in;"> Understand how ICD-10 updates affect the transactions you submit</li> <li style="margin-left:0.25in;"> Identify and address specific issues before Oct. 1</li> </ul> <p> Even if you don’t have an ICD-10-ready system installed yet, you still can conduct testing. CMS recommends looking at the ICD-10 codes for the top 10 conditions you see. Consider the volume of conditions and those that account for most of your revenue. Look at recent medical records for patients with these conditions and try coding them in ICD-10 for practice. Do the records include the documentation needed to select the correct ICD-10 code? It could be beneficial to use any cases of insufficient documentation as the basis of a checklist that you can consult in the future.</p> <p> <strong>Tools for testing</strong><br /> CMS offers the following tools to assist with testing:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTUwNzI0LjQ3NDk2NjkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE1MDcyNC40NzQ5NjY5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NTE1NjU0JmVtYWlsaWQ9bGF1cmVuLnJlZXNAYW1hLWFzc24ub3JnJnVzZXJpZD1sYXVyZW4ucmVlc0BhbWEtYXNzbi5vcmcmZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&100&&&http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html" rel="nofollow" target="_blank">National coverage determination and local coverage determination conversions</a> from ICD-9 to ICD-10</li> <li style="margin-left:0.25in;"> The <a href="http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTUwNzI0LjQ3NDk2NjkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE1MDcyNC40NzQ5NjY5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NTE1NjU0JmVtYWlsaWQ9bGF1cmVuLnJlZXNAYW1hLWFzc24ub3JnJnVzZXJpZD1sYXVyZW4ucmVlc0BhbWEtYXNzbi5vcmcmZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&101&&&http://cms.gov/Medicare/Coding/ICD10/ICD-10-MS-DRG-Conversion-Project.html" rel="nofollow" target="_blank">ICD-10 Medical Severity Diagnosis-Related Groups (MS-DRGs)</a> conversion project, which is available along with payment logic and software replicating the current MS-DRGs. Also on this Web page are the:</li> <li style="margin-left:0.75in;"> ICD-10-CM MS-DRG Grouper</li> <li style="margin-left:0.75in;"> Medicare Code Editor (available from the National Technical Information Service)</li> <li style="margin-left:0.75in;"> MS-DRG Definitions Manual, which allows you to analyze any payment impact from the conversion of the MS-DRGs from ICD-9 to ICD-10</li> <li style="margin-left:0.25in;"> The 2015 versions of the <a href="http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTUwNzI0LjQ3NDk2NjkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE1MDcyNC40NzQ5NjY5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NTE1NjU0JmVtYWlsaWQ9bGF1cmVuLnJlZXNAYW1hLWFzc24ub3JnJnVzZXJpZD1sYXVyZW4ucmVlc0BhbWEtYXNzbi5vcmcmZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&102&&&https://www.cms.gov/Medicare/Coding/OutpatientCodeEdit/OCEQtrReleaseSpecs.html" rel="nofollow" target="_blank">Integrated Outpatient Code Editor</a>, which include ICD-10</li> </ul> <p> <strong>More resources</strong></p> <p> The AMA secured flexibilities with CMS to address claims processing and denials, quality reporting penalties, payment disruptions and navigating transition problems. Mainly, physicians should be aware that for the first year ICD-10 is in place, Medicare Part B claims will generally not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.</p> <p> Still, physicians should be as prepared as possible. Get <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">everything you need to know about ICD-10</a> at <em>AMA Wire</em>®.</p> <p style="text-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:53f295d2-9dfb-4d14-8308-8d124696d5b2 How schools, students are transforming med ed--and now you can too http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_schools-students-transforming-med-ed-now-can Wed, 19 Aug 2015 20:00:00 GMT <p> If you could launch your dream project to better prepare medical students for practice, what would it be? A progressive initiative wants to hear your innovative ideas and give you the funding you need to make them reality. One physician leading this initiative explains how.</p> <p> The AMA has partnered since 2013 with 11 leading medical schools as part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">Accelerating Change in Medical Education</a> initiative, which provided $1 million grants to each school to help fund novel programs that bridge the gap between how physicians are currently trained and the future needs of our health care system.</p> <p> From overhauling curriculums to launching new training projects, these 11 schools, <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/schools.page" target="_blank">the founding members</a> of the Accelerating Change in Medical Education Consortium, are completely reshaping the way future physicians are trained—and now they’re ready to expand.</p> <p> The AMA invites additional schools to apply to join the consortium and collaborate on transformative projects that will prepare physicians in training to thrive in complex health care systems. Starting Jan. 1, up to 20 schools each will receive a grant award of $75,000 disbursed over the course of three years.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/236ec363-7abe-4dac-99c6-2f8e76ed0b1f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/9/236ec363-7abe-4dac-99c6-2f8e76ed0b1f.Large.jpg?1" style="margin:15px;float:left;" /></a><em>AMA Wire</em>® checked in with Susan Skochelak, MD, AMA group vice president of medical education, about this new application opportunity, the work the 11 consortium schools have already done and how the consortium plans to continue its success starting with this year’s exciting round of applicants.</p> <p> <strong><em>AMA Wire</em></strong><strong>:</strong> <strong>The consortium seeks medical schools that wish to join a “community of innovation.” What does that really mean? Often, when people hear the word “innovation,” they think of something larger than life. When it comes to joining the consortium, what truly constitutes “innovation” in this setting?</strong></p> <p> <strong>Dr. Skochelak:</strong> Innovation in the setting of medical education means a number of things.</p> <p> It means trying new content—material that students need to know but haven’t historically been taught. It means trying new methods. For instance, “Does this content have to be a lecture, or can students learn it more effectively or efficiently through simulation or electronic methods?”  It also means trying new assessment methods—knowing how they’ve learned and if they’ve achieved what you want them to achieve. </p> <p> Innovation is a combination of any one or all three of those ways in which young physicians learn how to become a doctor.</p> <p> <strong><em>AMA Wire</em></strong><strong>: The founding members of the AMA’s Accelerating Change in Medical Education Consortium already have made significant strides in transforming med ed. What are some of the additional opportunities in medical education that you hope future schools applying to the consortium will address?</strong></p> <p> <strong>Dr. Skochelak:</strong> We’re hoping that schools that apply to the consortium can do two things: One is to try out some of the things the 11 founding schools have already tried. They may be able to implement some of these new methods at their schools—like using flexible learning plans, faculty coaches or training students as patient navigators. Applicants would benefit from being part of a learning community when they’re ready to go and will have [the benefit of knowing] what’s already been tried for two years, so they don’t have to reinvent the wheel.</p> <p> Then there’s a second group of schools that we know are trying innovations in medical education that aren’t already in the portfolio of things the 11 founding schools are already doing. We’d like to hear from schools that have been trying some interesting and maybe radical new ideas they think other schools are ready to adapt and they’d like to share. These new schools would be able to enter the consortium and not only benefit from sharing with our 11 founding schools, but the existing consortium members also will benefit from them, finding new strategies or techniques they’ d like to borrow.</p> <p> <strong><em>AMA Wire</em></strong><strong>: The consortium thrives on collaboration and sharing big ideas to create collective change. Can you talk a little about how schools within the consortium are partnering together? Are there any exciting projects consortium members are already working on that new applicants will help expand?</strong></p> <p> <strong>Dr. Skochelak:</strong> Our 11 founding schools have told us that the consortium has been the biggest surprise and biggest benefit of the whole initiative. I don’t think they anticipated the amount of value or fun they’d have with sharing their ideas with other schools. We have probably more than a half dozen cross-school projects that you can find on the <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page#section2-inner" target="_blank">consortium website</a>, but let me give you a couple examples here:</p> <p style="margin-left:40px;"> One of the [larger projects includes] teaching students to be lifelong learners, so they don’t just memorize information and regurgitate it on tests, but they actually know where their knowledge depths are and what they need to [learn]. This style of [instruction] has been called master adaptive learning, so many of our schools are thinking through how to teach differently for this.<br /> <br /> You don’t have a lecturer who gives you a bunch of information, and every month you take a test and forget what was on the test. That’s kind of the old style. What’s been going on here now at is that faculty become coaches, and they work with each student to say, “Here’s what you’re good at. Here’s what you can do well, but you haven’t learned how to identify heart murmurs yet, so for the next few weeks, this is your job. How do you think you’re going to learn it?”</p> <p style="margin-left:40px;"> Then from there, the student proposes what [he or she] thinks the best resources would be. So the whole way students learn in this new master adaptive learning approach becomes the way they learn the rest of their lives.</p> <p style="margin-left:40px;"> We know how to do lectures and those old-fashioned tests, but now we’re learning together across our 11 schools about the best way to produce master adaptive learners.</p> <p style="margin-left:40px;"> A different [project schools are working on] has to do with the use of technology and how physicians in training use the electronic health record and patient data on health outcomes to actually improve the health of the patient populations they’re working with. Many schools have been sharing ideas across technology platforms. Any schools joining the consortium can use [this information for their work] instead of having to start over from the very beginning.</p> <p> <strong><em>AMA Wire:</em></strong><strong> What do you expect to be different about this new group of applicants?</strong></p> <p> <strong>Dr. Skochelak: </strong>I anticipate the new round of applicants will have a greater breadth of ideas.  At the beginning of the consortium in 2013, we had specific goals listed in the RFA, and we were very specific about wanting the consortium schools to address them. This time, we’re not putting boundaries around what schools can tell us about, so I’m anticipating that the variety of proposed ideas will be great.<br /> Another thing that will be different is that the consortium will now have 30 schools instead of 11 so the weight of the voice of that many medical schools together saying the same thing will make people really listen. If you have 30 schools all focusing on these specific innovations, it’s going to be kind of hard for other medical schools not to pay attention to that.</p> <p> <strong><em>AMA Wire:</em></strong><strong> Are there any openings for different types of schools this year as well? </strong></p> <p> <strong>Dr. Skochelak:</strong> Yes, we have expanded the eligible application schools from just MD-granting schools to now include MD- and DO-granting schools. We’re also really encouraging schools from locations we haven’t tapped into. For instance, we’ve expanded eligibility this year to include some of the new schools that are [just getting underway]. These are schools that may have received provisional accreditation from the Liaison Committee of Medical Education to start schools, but they haven’t admitted their first class yet.</p> <p> <strong><em>AMA Wire:</em></strong><strong> In an interview </strong><a href="http://www.npr.org/sections/health-shots/2015/04/09/390440465/medical-schools-reboot-for-21st-century" rel="nofollow" target="_blank"><strong>with NPR</strong></a><strong> this year, you made a great point about learning among consortium members. You said that as more schools adapt curricular changes, the learning process continues to flow between students and faculty. Can you talk a bit about how many of the consortium schools are collaborating with students and some of the surprising lessons faculty have learned from this as well?</strong></p> <p> <strong>Dr. Skochelak:</strong> The students are very important in this process, and they’re surprising their faculty. For example, at the University of Michigan Medical School (UMMS), students organized and gave [feedback] on what was redundant in the curriculum. As a faculty person, you don’t always know what’s in someone else’s course or rotation, but the students know because they go through it all. So the students at University of Michigan got together and presented their administration with the full list of redundancies where information in classes was being covered more than once. This allowed UMMS to find efficiencies so they could put new material [into their curriculum].</p> <p> The students themselves really want to be prepared for health care the way it’s delivered now with team-based care and working interprofessionally, so many students have asked for more experiences with other health professions. They’re asking for more experiences within the health care system early in training and have been real champions for the kind of education they know they want.</p> <p> <strong><em>AMA Wire:</em></strong><strong> Is there anything else you’d like to add for schools interested in applying to the consortium? </strong></p> <p> <strong>Dr. Skochelak:</strong> This application is really meant to be an easy process for schools. It’s straightforward with only five pages, and we’re really just looking for schools to tell their story. That’s why we’re not making it hard to apply. We know there are a lot of really good ideas out there, and we’d rather have schools get their ideas in front of us, so we can help put together the best portfolio of [projects] out there right now.</p> <p> <strong>How to apply</strong></p> <p> Proposals are due Sept. 16 at 6 p.m. Eastern time, and schools will be notified of their acceptance Oct. 30.</p> <p> To apply, <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">submit a proposal for consideration</a>. Also, be sure to learn more about the <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/schools.page" target="_blank">11 medical schools</a> in the Accelerating Change in Medical Education Consortium and <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">the current projects</a> they have underway and <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/ama-ace-promotion-new-models-in-meded-rfa.pdf" target="_blank">application FAQs</a> (log in).</p> <p align="right"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2e3b2261-3b5f-4715-a491-f8ddb82f0a8e How to kick your financial plan into high gear http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_kick-financial-plan-high-gear Tue, 18 Aug 2015 20:35:00 GMT <p> Developing <a href="http://www.ama-assn.org/ama/ama-wire/post/6-traits-of-financially-prepared-physician" target="_blank">the traits of a financially prepared physician</a> requires more than balancing a checkbook. You need to proactively plan. Here’s what to do—follow these expert tips to boost your financial IQ and plot a successful path to retirement.</p> <p> <strong>Age is only a number: Why financial preparedness starts with a plan</strong></p> <p> People tend to think that age, specialty and experience can predict whether physicians will be financially prepared. But physicians’ attitudes and dedication to developing a strong financial plan can have a greater impact on their success, according to a <a href="https://cc.readytalk.com/cc/playback/Playback.do?id=9p59ho" target="_blank" rel="nofollow">recent webinar</a> from AMA Insurance.  </p> <p> That’s why Robin Robertson, a senior wealth advisor for the Millennium Brokerage Group, urges physicians to plot their own paths to prosperity by developing a sound financial plan.</p> <p> Robertson said physicians often contact her, requesting one tell-all figure to let them know their portfolio is progressing as planned. But invariably, she tells them to look beyond basic digits and first consult their financial plan. Only a comprehensive analysis can let them know where they really stand on the path to retirement.</p> <p> “Your plan should be comprehensive [and include] savings, spending, future goals and a risk assessment for disability, life insurance and long term care …. What you don’t want is a pretty binder that sits on a shelf and does not create an action plan,” Robertson said. </p> <p> “You want to think of your [financial] plan as a living, breathing assessment that needs to be monitored regularly,” she said, adding that the earlier physicians review their earnings and financial plans, the better. </p> <p> <strong>How to proactively execute your plan </strong></p> <p> Once you create a plan, Robertson recommends you take certain precautions to ensure it succeeds. These include:</p> <ul> <li> Making personal financial planning a priority.</li> <li> Becoming empowered by partnering with a <a href="http://www.ama-assn.org/ama/ama-wire/post/5-ways-partner-physician-friendly-financial-advisor" target="_blank">professional advisor</a>.</li> <li> Building a comprehensive plan beyond debt repayment and money management.</li> <li> Planning for unexpected emergencies during your working years. Evaluate your risks in each emergency, so you can make decisions about how to financially protect yourself.</li> <li> Getting your family security items handled: Be prepared for life emergencies, disability, will and directives. Don’t delay this step, especially if you have a family.</li> <li> Consulting your advisor if you’re behind on your financial roadmap. They’ll willingly help you build a plan to get back on track.</li> <li> Revisiting your master plan annually and adjusting it as your life changes.</li> <li> Staying active in your decision making.</li> </ul> <p> <strong>Ready for financial success? Explore more on planning and retirement: </strong></p> <ul> <li> Check out Robin Robertson’s <a href="http://www.ama-assn.org/ama/ama-wire/post/5-ways-partner-physician-friendly-financial-advisor" target="_blank">5 tips for partnering</a> with a physician-friendly financial advisor.</li> <li> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/top-personal-finance-tips-experienced-physicians" target="_blank">these top personal finance insights</a> from experienced physicians.</li> <li> Find out whether you have <a href="http://www.ama-assn.org/ama/ama-wire/post/6-traits-of-financially-prepared-physician" target="_blank">the 6 traits</a> of a financially prepared physician.</li> <li> Review benefits available through AMA Insurance on <a href="https://www.amainsure.com/insurance-products/retirement/retirement-legacy-planning.html" target="_blank" rel="nofollow">retirement and legacy planning</a>.</li> </ul> <p style="text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" target="_blank" rel="nofollow"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:73f8e0c4-bd3e-4e24-843d-2b064299160c 3 clinical documentation tips you should know for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-clinical-documentation-tips-should-icd-10 Tue, 18 Aug 2015 20:31:00 GMT <p> Just six weeks remain until Oct. 1, when physician practices must switch from ICD-9 to ICD-10. Understand three common scenarios and how to code them using ICD-10.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/5/4ee3ca52-5e34-41dc-b5da-6fcfe276d477.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/14/5/4ee3ca52-5e34-41dc-b5da-6fcfe276d477.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> In ICD-10, the main categories of change are definition changes, terminology differences and increased specificity. Here is guidance for coding common clinical scenarios:</p> <p style="margin-left:.5in;"> <strong>1. Hypertension</strong></p> <p style="margin-left:.5in;"> In ICD-10, hypertension is defined as essential—the concept of “benign or malignant” as it relates to hypertension no longer exists. When documenting hypertension, include the following:</p> <p style="margin-left:1.0in;"> 1.  Type (such as essential or secondary)</p> <p style="margin-left:1.0in;"> 2.  Causal relationship (such as renal or pulmonary)</p> <p style="margin-left:.5in;"> Examples:</p> <p style="margin-left:.75in;"> I10: Essential (primary) hypertension</p> <p style="margin-left:.75in;"> I11.9: Hypertensive heart disease without heart failure</p> <p style="margin-left:.75in;"> I15.0: Renovascular hypertension</p> <p style="margin-left:.5in;"> <strong>2. Underdosing</strong></p> <p style="margin-left:.5in;"> Underdosing is an important new concept and term in ICD-10. It allows you to identify when a patient is taking less of a medication than is prescribed. When documenting underdosing, include the following:</p> <p style="margin-left:1.0in;"> 1.  Intentional, unintentional or noncompliance</p> <p style="margin-left:1.0in;"> 2.  Reason (such as financial hardship)</p> <p style="margin-left:.5in;"> Examples:</p> <p style="margin-left:.75in;"> Z91.120: Patient’s intentional underdosing of medication regimen due to financial hardship</p> <p style="margin-left:.75in;"> T36.4x6A: Underdosing of tetracyclines, intial encounter</p> <p style="margin-left:.75in;"> T45.526D: Underdosing of antithrombotic drugs, subsequent encounter</p> <p style="margin-left:.5in;"> <strong>3. Diabetes</strong></p> <p style="margin-left:.5in;"> The diabetes mellitus codes are combination codes that include the type of diabetes, the body system affected and the complications affecting that body system. When documenting diabetes, include the following:</p> <p style="margin-left:1.0in;"> 1.  Type (including type 1 or type 2 and caused by a drug or chemical)</p> <p style="margin-left:1.0in;"> 2.  Complications (such as other body systems that are affected)</p> <p style="margin-left:1.0in;"> 3.  Treatment (such as insulin)</p> <p style="margin-left:.5in;"> Examples:</p> <p style="margin-left:.75in;"> E08.65: Diabetes mellitus due to underlying condition with hyperglycemia</p> <p style="margin-left:.75in;"> E09.01: Drug or chemical induced diabetes mellitus with hyperosmolarity with coma</p> <p> These tips come from the Centers for Medicare & Medicaid’s (CMS) <a href="https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10ClinicalConceptsFamilyPractice1.pdf" target="_blank" rel="nofollow">Clinical Concepts for Family Practice</a> guidance. Find much more practical guidance, including coding scenarios, in this guide and others in the series, including internal medicine, OB-GYN, cardiology, orthopedics and pediatrics.</p> <p> <strong>More ways to prepare</strong></p> <p> CMS will host a call for physicians preparing for ICD-10 from 2:30 to 4 p.m. Eastern time Aug. 27. Experts will discuss coding guidance and tips, answers to coding questions, information about claims that span before and after the implementation date, and resources. <a href="http://www.eventsvc.com/blhtechnologies/register/c259b437-6014-4dcb-b4ea-cbb93b5c4b6c" target="_blank" rel="nofollow">Register online</a>.</p> <p> A <a href="https://www.stepsforward.org/modules/ICD-10-implementation-plan" target="_blank" rel="nofollow">free online resource</a> in the AMA’s STEPS Forward collection also has materials to help you prepare.</p> <p> Additional important resources that can help you get ready over the next six weeks include:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/6-things-need-icd-10-transition" target="_blank">Six things you should know</a> about the ICD-10 transition and the flexibilities the AMA secured for physicians</li> <li style="margin-left:0.25in;"> A <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank">special series</a> at <em>AMA Wire</em>® examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started.</li> <li style="margin-left:0.25in;"> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire</em> provides important insights for what you need to know about the new code set.</li> <li style="margin-left:0.25in;"> The AMA’s ICD-10 Web page offers important <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> on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.</li> <li style="margin-left:0.25in;"> CMS also is offering free assistance, including its “<a href="http://www.roadto10.org/" target="_blank" rel="nofollow">Road to 10</a>” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. <a href="http://www.ama-assn.org/ama/ama-wire/post/icd-10-countdown-continues-sure-ready" target="_blank">Read more</a> about the agency’s resource offerings.</li> </ul> <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:c6947f0c-65ee-4555-aa6b-040566634b0b What patient advisors do--and why your practice needs one http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patient-advisors-practice-needs-one Mon, 17 Aug 2015 21:29:00 GMT <p> Hospitals and health systems are using patient and family advisors to help them reach the Triple Aim—better quality of care, lower cost and greater satisfaction with care delivery—tapping insights directly from people who have to navigate the patient side of the world of health care. Physicians can take these learnings and apply them to their own practices in ambulatory settings to help them achieve better care, smarter spending and healthier, happier patients.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/13/3b867c31-09de-4ccf-bdf5-f20e1f3698b2.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/13/3b867c31-09de-4ccf-bdf5-f20e1f3698b2.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> Partnering with patients and families can help patients make more informed choices about their care, use medications more safely and better manage chronic disease, according to the <a href="http://patientfamilyengagement.org/" rel="nofollow" target="_blank">Roadmap for Patient and Family Engagement in Healthcare</a> that includes a <a href="http://patientfamilyengagement.org/vision" rel="nofollow" target="_blank">video</a> of their vision of a transformed system involving patients and families. Physicians can apply these ideas to their own practices by selecting patient and family advisors to share their experiences.</p> <p> A patient and family advisor is someone who:</p> <ul> <li style="margin-left:0.25in;"> Gives feedback based on his or her own experiences as a patient or family member of someone with a chronic disease</li> <li style="margin-left:0.25in;"> Helps improve the patient experience and quality of care for those with chronic conditions</li> <li style="margin-left:0.25in;"> Works with the practice team for either short- or long-term commitments</li> </ul> <p> These advisors can help you ensure your practice is focused on patient-centered care needs and aren’t just making assumptions about what patients and their families want. Advisors can identify things that can be improved in your practice from a patient perspective and share ideas about how to make sure other patients and families get the best health care possible and have a positive experience.</p> <p> Patients and family advisors can:</p> <ul> <li style="margin-left:0.25in;"> <strong>Share their stories.</strong> Advisors can provide insight by talking about their health care experiences with physicians, staff and other patients.</li> <li style="margin-left:0.25in;"> <strong>Review or help create patient materials.</strong> Advisors provide a patient perspective and can help make forms or educational handouts easier for patients and family members to understand and use.</li> <li style="margin-left:0.25in;"> <strong>Partner with the community.</strong> Advisors can discuss what programs or resources are available or could be offered in the community to help support patient self-management of chronic conditions.</li> </ul> <p> A <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-patient-and-family-advisor-recruitment-guide.pdf" target="_blank">new AMA resource</a> (log in required) gives you everything you need to know about recruiting and engaging patient and family advisors in your practice, developed as part of 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.</p> <p> The AMA, 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, test and spread evidence-based recommendations on improving blood pressure control that provide practical tools for physician practices and health centers, including the <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/iho-bp-patient-and-family-advisor-recruitment-guide.pdf" target="_blank">patient and family advisor recruitment guide and onboarding toolkit</a>.</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:836cd89d-61bd-4b7d-9f4b-cfaa02122c11 Here’s your must-have checklist for med school success http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_heres-must-checklist-med-school-success Mon, 17 Aug 2015 20:00:00 GMT <p> A new school year marks the perfect time to organize your goals and priorities, which is why we’ve done the preliminary work for you. Here’s an easy-to-navigate list of the top tasks students should prioritize during their first and second years of training, including resources on studying, building your CV and choosing a specialty. Keep this list handy as you move through your early years of training.</p> <p> <strong>Succeeding in medical school: First and second years  </strong></p> <p> Welcome to the great transition. These first two years of med school often entail major changes. You may suddenly feel just how big the difference between attending college and medical school is as you’re determining the best ways to study, deciding whether to sleep or nap at night, or cancelling plans for your third consecutive Saturday and drinking your third consecutive coffee. No matter the issue, life in medical school is completely unique and requires its own unique strategies to succeed.</p> <p> But not to worry—these first two years can be very rewarding. While specific courses vary by medical school, expect to spend your first year in lectures and labs, mastering your knowledge of basic sciences and human anatomy. By year two, you should be prepping for Step 1 of the United States Medical Licensing Exam (USMLE) and thinking about which specialty you’d like to choose.</p> <p> Dive into your medical passions and broaden your exposure to different practice fields, so by the time you begin clinical rotations, you’ll have a clearer sense of your professional interests. During your first two years, be sure to prioritize these activities:</p> <p> <strong><input name="x" type="checkbox" />Start building your CV </strong></p> <p> Getting published or gaining new clinical skills early in training can help you build a stronger application for residency programs. Expand your CV by taking advantage of these resources and opportunities:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/4-reasons-build-cv-ama-research-symposium" target="_blank">4 reasons to build your CV at the AMA Research Symposium</a>. The 2015 deadline for abstract submissions is Aug. 19. If you can’t participate this year, mark your calendar for next year.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/publish-top-journals-physicians-training" target="_blank">Where to publish: Top journals for physicians in training</a>. Knowing where to submit your research is half the battle of breaking into medical publishing. Check out this must-have list of journals that accept submissions from trainees.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/9-top-tips-getting-published-medical-journal" target="_blank">9 top tips for getting published in a medical journal</a>. These tips are from published residents and fellows and the deputy editor of clinical content at <em>JAMA</em>.</li> <li> The <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" target="_blank">AMA’s Section Involvement Grant</a>. This program helps students fund innovative events at their medical school campuses. Hosting an event is a great way to get involved in your medical community while developing CV-worthy leadership skills.</li> </ul> <p> <strong><input name="x" type="checkbox" />Learn to balance work and wellness</strong></p> <p> While it may be tempting to spend every free moment studying, try to avoid doing so. Replacing personal hobbies and self-care with endless work can <a href="http://www.ama-assn.org/ama/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">lead to burnout.</a> Instead, try to take mindful breaks for yourself, even if only for a half-hour each day.<br /> <br /> Follow this advice to develop healthy habits on a student budget and schedule:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/student-sos-7-ways-avoid-distress-medical-school" target="_blank">6 ways to avoid “distress” in medical school</a>. Learn the key signs of student distress, so you can boost well-being during medical school.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/want-eat-healthy-budget-5-student-friendly-tips" target="_blank">5 student-friendly tips for eating healthy on a budget</a>. See these tips from a registered nutritionist and recent medical student for planning meals that fit your lifestyle.</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>. As a busy medical student, you might find it hard to dedicate time to wellness, but by committing to your own health, you also are committing to the health of your community and patients.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/volunteering-made-doctors-students-happier-healthier" target="_blank">How volunteering can make you happier and healthier</a>. Caring for patients at volunteer clinics can give you experience and feed your passion for medicine and offer a mental break from some of the daily stressors that lead to burnout.</li> </ul> <p> <strong><input name="x" type="checkbox" />Join student clubs and specialty groups </strong></p> <p> Deepening your knowledge of specialties is crucial to your success in residency and practice. Exposing yourself to versatile fields of practice can help you choose a specialty based on genuine insights rather than limited knowledge. By the end of year two, plan to contact physicians in your specialty of interest to ask if you can shadow them. This will help you arrange clerkships and meet physicians who can offer guidance as you choose your specialty in your third year. </p> <p> Be sure to access these resources:</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>. Learn how to choose a specialty with tips from a physician advisor who understands your mindset.</li> <li> The AMA’s newly updated <em>Choosing a Medical Specialty</em> <a href="http://www.ama-assn.org/resources/doc/membership/x-ama/choosing-a-medical-specialty-resource-guide.pdf" target="_blank">resource guide</a> (log in). This essential resource for students highlights the major specialties and subspecialties, and offers Match data and career information statistics.</li> <li> <a href="http://www.ama-assn.org/ama/ama-wire/post/need-choosing-specialty-dont-miss-this-series?utm_source=BulletinHealthCare&utm_medium=email&utm_term=071115&utm_content=students&utm_campaign=article_alert-morning_rounds_weekend" target="_blank"><em>AMA Wire’s®</em> “Shadow Me” Specialty Series</a>. Get advice directly from physicians in the field. The latest profiles feature unique perspectives from <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-physical-medicine-rehabilitation-shadowing-dr-wolfe?utm_source=BulletinHealthCare&utm_medium=email&utm_term=071115&utm_content=students&utm_campaign=article_alert-morning_rounds_weekend" target="_blank">Dr. Wolfe</a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-sports-medicine-shadowing-dr-vasudevan?utm_source=BulletinHealthCare&utm_medium=email&utm_term=071115&utm_content=students&utm_campaign=article_alert-morning_rounds_weekend" target="_blank">Dr. Vasudevan</a> in physical medicine and rehabilitation, Dr. Ding in <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-interventional-radiology-shadowing-dr-ding?utm_source=BulletinHealthCare&utm_medium=email&utm_term=071115&utm_content=students&utm_campaign=article_alert-morning_rounds_weekend" target="_blank">interventional radiology</a> and Dr. Dangles in <a href="http://www.ama-assn.org/ama/ama-wire/post/its-like-orthopedic-surgeon-shadowing-dr-dangles" target="_blank">orthopedic surgery</a>.</li> <li> 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 Medical Specialty Showcase</a>. Held each June in Chicago as part of the AMA’s National Medical Student Meeting, this event features representatives from more than 50 specialties. Students can get an introduction to their field and network with residents and physicians from national medical specialty societies.</li> <li> Review <a href="http://www.ama-assn.org/cgi-bin/fed_dir/fedspecialties.pl" target="_blank">this list</a> of national medical specialty associations to find ones that interest you.</li> </ul> <p> <strong><input name="x" type="checkbox" />Prepare for the USMLE </strong></p> <p> You may feel stressed as you prepare to take the USMLE Step 1, but this advice can help you 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>. An expert highlights four common mistakes not to make when preparing for this test and gives advice for studying smartly.</li> <li> Your <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>. Consult this roundup for top tips and study advice.</li> </ul> <p> <strong>Want an expert guide for your third and fourth years of training?</strong> Stay tuned for part two of this story, which will offer a second checklist on the key steps students should take to succeed in clinical rotations and prepare their best residency program applications.</p> <p align="right" style="margin-left:4.0in;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:46ae02c6-5a76-4465-93c3-4bbb3a15bc43 Physicians discuss racial bias and health in JAMA Viewpoint http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-discuss-racial-bias-health-jama-viewpoint Mon, 17 Aug 2015 18:19:00 GMT <p> In a recent Viewpoint in <em>JAMA</em>, co-authors Ronald Wyatt, MD, of the Joint Commission and David R. Williams, PhD, of the Harvard T.H. Chan School of Public Health discuss the potential contribution of societal racial bias to disparities in health care and health status.</p> <p> Titled “<a href="http://jama.jamanetwork.com/article.aspx?articleid=2425753&utm_source=silverchair%20information%20systems&utm_medium=email&utm_campaign=master:jamalatestissuetocnotification08/12/2015" rel="nofollow" target="_blank">Racial bias in health care and health: Challenges and opportunities</a>,” the piece asks what can be done to approach these interconnected issues. The authors write, “Successfully addressing the possibility of clinician bias begins with awareness of the pervasiveness of disparities, the ways in which bias can influence clinical decision making and behavior, and a commitment to acquiring the skills to minimize these processes.”</p> <p> The authors also recommend that “Medical schools, health care organizations and credentialing bodies should pay greater attention to disparities in health and health care as a high national priority. These organizations should redouble their efforts to increase awareness of disparities, enhance diversity in the health professions, and work toward eliminating discrimination and its adverse effects on health and health care.”</p> <p> “These economic disparities affect where people live, learn, work, play and worship—and all of these factors can in turn impact health,” Williams said in a follow-up <a href="http://www.hsph.harvard.edu/news/features/racial-bias-and-its-effect-on-health-care/" rel="nofollow" target="_blank">interview at Harvard</a> about the <em>JAMA</em> piece.</p> <p> Williams is the Florence Sprague Norman and Laura Smart Norman Professor of Public Health at the Harvard T. H. Chan School of Public Health and professor of African and African American Studies and of Sociology at Harvard University. </p> <p> Dr. Wyatt is the medical director in the Division of Healthcare Improvement at the Joint Commission. Dr. Wyatt will be the featured keynote speaker during the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page" target="_blank">AMA Minority Affairs Section</a> Annual Meeting, scheduled for June 2016 in Chicago.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7d09d117-7454-47f7-95ef-39c7c78242ea 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 Mon, 17 Aug 2015 18:00:00 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> The book is on sale through Aug. 31. 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 6 ways to improve resiliency in a demanding practice environment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-ways-improve-resiliency-demanding-practice-environment Fri, 14 Aug 2015 18:44:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/12/ac29f2b3-7a15-4c92-bca9-3685807bfeb2.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/12/ac29f2b3-7a15-4c92-bca9-3685807bfeb2.Large.jpg?1" style="float:right;margin:15px;" /></a>It’s no wonder physicians are feeling crushed under stress. The daily demands of practice, from managing regulatory burdens to navigating medical liability issues, are stacked on top of actually caring for patients. And then there are the responsibilities of life outside of the office. Learn strategies for boosting your resiliency in the face of stress and reducing your risk for burnout.</p> <p> Resiliency for physicians is the ability to adapt and bounce back from the stress of the clinical environment. Physicians who are resilient are better equipped to handle the many challenges presented by patient care and less likely to experience burnout. <a href="https://www.stepsforward.org/modules/improving-physician-resilience" rel="nofollow">A free online module</a> in the AMA’s <a href="https://www.stepsforward.org/" target="_blank" rel="nofollow">STEPS Forward</a> collection shows you how to increase your resiliency one small step at a time:</p> <p style="margin-left:40px;"> <strong>1. Take stock of your desires, feelings and actions that may be contributing to stress or burnout.</strong><br /> Take a “moral inventory”—an assessment of your own role in any problematic areas of your life. This can help you examine how you may be contributing to your own stress and understand how these factors influence your happiness and well-being. Read some examples and strategies in the module.</p> <p style="margin-left:40px;"> <strong>2. Write your individual mission statement.</strong><br /> What do you stand for? Write it down. Each time you consider doing something, ask yourself whether it’s consistent with your mission statement to help you decide whether to do it or not.</p> <p style="margin-left:40px;"> <strong>3. Start a gratitude journal.</strong><br /> Write down three items you are grateful for each day. This easy practice has been shown to increase self-reported happiness and prevent burnout. Read some examples in the module.</p> <p style="margin-left:40px;"> <strong>4. Enlist your peers for support.</strong><br /> As a physician, you’re probably often involved in unsettling events and may be involved in adverse outcomes. To cope, consider joining a peer support group or talking over issues with your fellow physicians. The module includes a success story from Brigham and Women’s Hospital in Boston.</p> <p style="margin-left:40px;"> <strong>5. Learn something new.</strong><br /> In general, people who choose a career in medicine have a thirst for knowledge. But after many years in practice, the problems that were initially challenging may become routine. Consider quenching your thirst by signing up to learn something new, whether it’s medicine- or career-related or not.</p> <p style="margin-left:40px;"> <strong>6. Write down inspiring patient stories.</strong><br /> Capturing patient stories as narratives, rather than for medical records, is a powerful way to connect with your emotions and can help you remember why you chose medicine. The module includes information about a formal program in narrative medicine if you choose to share your stories.</p> <p> There are many other ways to boost your resiliency and put joy back into your practice of medicine—the module includes 12 more ideas and also offers continuing education credit.</p> <p> <strong>Submit your ideas: Practice Innovation Challenge</strong><br /> The physician resiliency module and the 15 others 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/" target="_blank" rel="nofollow">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 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> Visit the STEPS Forward website to see the <a href="https://www.stepsforward.org/modules" target="_blank" rel="nofollow">current modules</a>.</li> <li> Check out upcoming <a href="https://www.stepsforward.org/events" target="_blank" rel="nofollow">live STEPS Forward events</a>.</li> <li> <a href="https://www.stepsforward.org/get-updates" target="_blank" rel="nofollow">Sign up</a> to be notified when new modules and events are available.</li> </ul> <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:44db2955-7189-4de0-84ac-f5a6088579f4 When “Shark Tank” and health tech meet, innovation thrives http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_shark-tank-health-tech-meet-innovation-thrives Fri, 14 Aug 2015 18:00:00 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 AMA President Steven J. Stack, MD</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/12/2bd644ba-64bd-45e4-9caa-c1e5bbf69536.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/12/2bd644ba-64bd-45e4-9caa-c1e5bbf69536.Large.jpg?1" style="margin:15px;float:left;" /></a></p> <p> Have you seen the show “Shark Tank”? I had the chance to act as a “shark” this week for an innovative challenge where entrepreneurs took to the stage to pitch their best health tech ideas.</p> <p> I have the privilege of representing the AMA as the secretary of the <a href="http://www.ehidc.org/" rel="nofollow">eHealth Initiative</a> (eHi), a non-profit multi-stakeholder organization committed to improving health and healthcare through information technology. The group just held its iTHRIVE Challenge, receiving 60 “pitches” from entrepreneurs. The pitches were viewed online 15,000 times and 1,000 people voted on the pitches to select 12 finalists who presented them in Washington, D.C. </p> <p> Along with senior leaders from organizations such as Mayo Clinic, PriceWaterhouseCooper, United Healthcare, Accenture, Marshfield Clinic and Cerner Corporation, I had the novel experience to judge these proposals. As I journey now to my next destination, I’m still admiring the creativity of these entrepreneurs and thought I’d share some.</p> <p style="margin-left:.5in;"> <a href="http://www.easeapplications.com/" rel="nofollow"><strong>EASE</strong></a><strong> – Electronic Access to Surgical Events</strong></p> <p style="margin-left:.5in;"> If you have ever used Snapchat, you’ll be familiar with how EASE works. The mobile app enables operating room teams to send photos and text updates to family members of patients undergoing operative procedures. The information auto-deletes after 45 seconds. This communication relieves family anxiety and simplifies after-surgery discussions with family.</p> <p style="margin-left:.5in;"> EASE is already used in a number of prominent hospitals and ready for more. One of their founders is an AMA member and this is how they describe themselves: “EASE was created by doctors inside of an operating room.  We are not a tech company trying to make our way into an OR.  Our team consists of a business executive, two anesthesiologists and a cardiac surgeon.”  </p> <p style="margin-left:.5in;"> <a href="http://careangel.com/" rel="nofollow"><strong>Care Angel</strong></a></p> <p style="margin-left:.5in;"> The creator describes this as a “high-touch, low-tech” way to care for our aging loved ones. Using a mobile platform, families will schedule automated phone calls to isolated elderly family members. The calls can include a recorded message from family members and will ask questions to ascertain the wellness of the loved one. The loved one answers verbally (that’s the low-tech part). Care Angel collects the answers and makes them available to family members via the mobile platform.</p> <p style="margin-left:.5in;"> If the answers raise concern or there is no answer to repeated calls, the platform (the high-tech part) immediately notifies family members. There’s a lot more detail than I can cover here, but this looks to be a neat idea with much potential.</p> <p style="margin-left:.5in;"> <a href="http://www.meetmeerkat.com/" rel="nofollow"><strong>Meerkat Health</strong></a></p> <p style="margin-left:.5in;"> Here is an example of the needle worth finding in an overwhelming haystack of useless data. Reliably tracking daily weight is an elegantly simple way to monitor fluid status for congestive heart failure and renal failure patients to identify patients at risk for distress and preventable hospitalization. Meerkat uses an ultra-thin wi-fi scale under a bathmat, measures and transmits daily weights, uses algorithms to identify patients with worrisome weight gain and alerts clinicians to intervene before decompensation occurs. The innovation here is creating a reliable end-to-end process that is effortless for the patient, inexpensive and easily actionable by clinicians.      </p> <p style="margin-left:.5in;"> <a href="http://www.stepsforward.org/" rel="nofollow"><strong>STEPS Forward</strong></a></p> <p style="margin-left:.5in;"> Okay, this wasn’t presented at the iTHRIVE challenge and is an add-on, but I want to call attention to STEPS Forward. It’s just one of the AMA’s many new innovation initiatives directly tailored to improving the satisfaction of physicians and the sustainability of their practices.</p> <p style="margin-left:.5in;"> This is a web-based platform of clinical practice solutions designed by physicians, for physicians. I strongly encourage physicians in small and mid-size practices to explore the modules to see if they can help you work smarter, not harder.  And I invite anyone with their own innovative solutions to clinical challenges to <a href="http://www.innovatewithama.com/" rel="nofollow">submit your own ideas</a> to win a $10,000 prize and help us create the next round of solutions for STEPS Forward.</p> <p> As a practicing emergency physician married to an allergist who works in a two-physician office, I know our profession faces many challenges. Amidst these challenges, though, there is an exciting world of innovation in which we have more tools than ever to help our patients lead healthier, happier lives.</p> <p> I want to be a part of that bright future. I want to make it even brighter. And I look forward to joining many of you in the creation of it.</p> <p> Thank you for all you do, every day, for our patients and our profession.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a4a72bdc-2182-4dbc-ba52-fe157f6ceda3 Attend special IMG symposium Sept. 24 in Detroit http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_attend-special-img-symposium-sept-24-detroit Fri, 14 Aug 2015 14:14:00 GMT <p> You are invited to bring a friend or colleague to the AMA’s 7th annual networking and educational event for international medical graduates (IMG) Sept. 24 in Detroit. This event is complimentary for medical students, ECFMG-certified individuals, residents and physicians interested in IMG issues and AMA resources.</p> <p> The event will take place from 6 to 8 p.m. at Fishbones in Detroit. During the symposium, program panelists will discuss topics including:</p> <ul> <li style="margin-left:0.25in;"> Resources from the AMA-IMG Section</li> <li style="margin-left:0.25in;"> Improving Health Outcomes</li> <li style="margin-left:0.25in;"> Successfully navigating the Match</li> </ul> <p> Space is limited. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=AMA710E&TID=L6IcRbwsD3e0%252b0oSjB2QIA%253d%253d&OID=130" target="_blank">Register</a> (log in) by Sept. 17. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:27907296-e394-4e1f-8318-a0ccad571754 The decline of black men in medical education http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_decline-of-black-men-medical-education Thu, 13 Aug 2015 18:44:00 GMT <p> Despite an overall increase in the number of black men graduating from college, they aren’t attending medical school in similar rates. In fact, the number of black males applying to medical school is lower now than it was in the 1970s. A new<a href="https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=PubDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_prc_prd_key=78B38423-34D5-433C-B4FB-76F0F5CAE008" rel="nofollow" target="_blank"> report</a> explains why and offers key diversity solutions.</p> <p> <strong>Stuck in ’78: Black male med school applicants by the numbers </strong></p> <p> <a href="https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=PubDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_prc_prd_key=78B38423-34D5-433C-B4FB-76F0F5CAE008" rel="nofollow" target="_blank">“Altering the Course: Black Males in Medicine,”</a> a new report from the Association of American Medical Colleges (AAMC) gathers the perspectives of 11 black premedical students, physicians, researchers and leaders through interviews that explore possible factors for the decline of black men in medical school. The report also uses research and data to understand these trends and find broad-based solutions to alter them for black men.</p> <p> In an analysis of black male applicants in medical school admissions, the report noted that:</p> <ul> <li> In 1978, there were 1,410 black male applicants to medical school. But in 2014, there were just 1,337.</li> <li> The number of black male matriculants to medical school over more than 35 years has not surpassed the 1978 numbers.</li> <li> In 1978, medical schools saw 542 black male matriculants, and in 2014, they had 515.</li> <li> No other minority group has experienced such a decline in medical school applications. Disparity also exists between genders, with black women making up 62.2 percent of black medical school applicants in 2014, while black males only accounted for 37.8 percent.</li> </ul> <p> Interviewees cited several factors for this applicant decline, including pitfalls in the public education system, limited knowledge about the pathway to becoming a physician and poor access to positive black role models. These factors combined with common concerns about medical school debt often stunt black males’ interest in medicine before it even starts.</p> <p> <strong>How medical schools can help</strong></p> <p> But these factors don’t mean medical schools can’t change the current trajectory, starting by making cultural inclusion an institutional priority and changing the kind of conversations students and educators have about diversity, according to the report.</p> <p> One of the <a href="http://www.ama-assn.org/ama/ama-wire/post/debunking-5-myths-diversity-medical-education" target="_blank">common myths about diversity in medical education</a> is that it only benefits people of color, but if more black males are to attend medical school, that perception must change, according to Cedric Bright, MD, assistant dean of admissions at the University of North Carolina School of Medicine.</p> <p> “Most universities, I feel, when we talk about diversity, immediately think of losing positions for other deserving students,” Dr. Bright said. “In actuality, you increase the educational satisfaction by having a more diverse student body. Research has shown that.”</p> <p> To combat this issue, the report recommends that medical schools create strategic student outreach programs with versatile influencers—like faith-based and grassroots organizations—in underserved communities. It also suggests partnering with minority-based institutions on diversity programming, hiring more black physicians to serve as medical school faculty and improving academic advising among black male students in high school and college.</p> <p> <strong>Want more diversity solutions?</strong> Stay tuned for part two of this story, which will take a look at key recommendations from the AAMC and practical examples of diversity efforts for medical schools to consider in their own universities and training programs.</p> <p> <strong>Explore additional efforts to improve diversity and reduce health disparities:</strong></p> <ul> <li> Learn about <a href="http://www.ama-assn.org/ama/ama-wire/post/21-med-students-selected-future-minority-physician-leaders" target="_blank">the 21 medical students</a> the AMA Foundation recently selected as future minority physician leaders. Read their unique perspectives on being a student of color in medical school and <a href="http://www.ama-assn.org/ama/ama-wire/post/21-med-students-selected-future-minority-physician-leaders" target="_blank">how they plan to succeed while promoting diversity in medicine</a>.   </li> <li> See <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">how these medical schools are tackling challenges</a> in health disparities and cultural competencies.</li> <li> Educate yourself and your peers on the <a href="http://www.ama-assn.org/ama/ama-wire/post/debunking-5-myths-diversity-medical-education" target="_blank">5 myths of diversity in med ed</a>.</li> <li> Watch <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">this Google hangout</a> to learn more ways schools and students are promoting diversity in medical education</li> <li> Visit the AMA Minority Affairs Section <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. You can also <a href="http://www.ama-assn.org/go/joinmas">join the section</a> to get further involved.</li> </ul> <p style="text-align:right;"> <em style="text-align:-webkit-right;">By AMA staff writer</em><span style="text-align:-webkit-right;"> </span><a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="text-align:-webkit-right;" target="_blank"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2852e392-047e-401a-ab93-fab9a68b11da Vets still waiting for care--How you can help http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_vets-still-waiting-care-can Wed, 12 Aug 2015 22:00:00 GMT <p> Despite the launch of a program intended to give veterans better access to care, the U.S. Department of Veterans Affairs (VA) is still experiencing a physician shortage. Learn how you can help deliver care to veterans with an AMA-hosted webinar from 7 to 8 p.m. Eastern time Aug. 26. <a href="http://eo2.commpartners.com/users/ama/series.php?id=4009" rel="nofollow">Register now</a>.</p> <p> A <a href="http://www.usatoday.com/story/news/nation/2015/07/23/va-has-41500-unfilled-medical-jobs-forcing-vets-into-costly-private-care/30504525/" rel="nofollow" target="_blank">recent analysis</a> estimates the VA has about 41,500 job vacancies for doctors, nurses and other medical professionals, which translated into long appointment wait times and access-to-care issues for veterans.</p> <p> In an effort to serve the more than 30,000 vets who live 40 miles or more from a VA medical facility and mitigate access issues, the agency last year started the Veterans Choice Program. The program enables the VA to enter into agreements with non-VA physicians to deliver care to veterans who are either unable to receive care within a 30-day wait period or who live too far from a VA facility.</p> <p> According to the <a href="http://www.va.gov/HEALTH/docs/PublicData_PendingAccess_20150715RptDate_Final.pdf" rel="nofollow" target="_blank">most recent VA data</a>, nearly 8 percent of appointments were not able to be scheduled within the 30-day time frame. That’s about 469,000 appointments. Meanwhile, the same data shows that the number of appointments scheduled more than 120 days from veterans’ preferred appointment date has grown from under 15,000 in October to more than 27,000 in July. Another <a href="http://www.va.gov/oig/pubs/VAOIG-15-00430-103.pdf" rel="nofollow" target="_blank">report</a> shows that physicians, referred to as medical officers in the report, are the most in-demand staffing need for the VA.</p> <p> In November, VA Secretary Robert A. McDonald <a href="http://www.ama-assn.org/ama/ama-wire/post/va-secretary-need-physicians" target="_blank">asked physicians</a> at the 2014 AMA Interim Meeting to help the VA provide better, faster care. He discussed the Veterans Access, Choice and Accountability Act—a law the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physician-voice-helps-shape-veterans-health-care-reform-law" target="_blank">AMA helped shape</a>—that gave rise to the Veterans Choice Program.</p> <p> “We need to configure the Choice program in a way that enables all doctors caring for veterans to work as teams, no matter who is paying the bill,” McDonald said. “We need you to participate in the program, and we know you won’t if it’s too much trouble.”</p> <p> <strong>What you can do</strong></p> <p> <a href="http://eo2.commpartners.com/users/ama/series.php?id=4009" rel="nofollow" target="_blank">Register now</a> to hear leading VA officials discuss new community-based care options for veterans in an AMA-hosted webinar from 7 to 8 p.m. Eastern time Aug. 28.</p> <p> The webinar will look at how the VA is relying on private practitioners as a short-term solution to delivery problems and workforce shortages. Participants will hear how non-VA physicians can sign up to deliver care through the Veterans Choice Program and learn how to troubleshoot claims processing issues and payment delays. </p> <p> In the meantime, make sure you understand the criteria for participation. Physicians who want to participate must:</p> <ul> <li style="margin-left:0.25in;"> Accept Medicare rates</li> <li style="margin-left:0.25in;"> Meet all Medicare Conditions of Participation and <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/index.html" rel="nofollow" target="_blank">Conditions for Coverage</a></li> <li style="margin-left:0.25in;"> Be in compliance with all applicable federal and state regulatory requirements</li> <li style="margin-left:0.25in;"> Have a full, current and unrestricted license in the state where services are delivered</li> <li style="margin-left:0.25in;"> Have the same or similar credentials as VA staff</li> <li style="margin-left:0.25in;"> Submit a copy of veterans’ medical records to the contractor for medical care and services provided to veterans for inclusion in the VA electronic record</li> </ul> <p> Read <a href="http://www.va.gov/opa/choiceact/for_providers.asp" rel="nofollow" target="_blank">more information for physicians</a> on the Veterans Choice Program website. You also can learn <a href="http://www.ama-assn.org/ama/ama-wire/post/va-program-needs-physicians-provide-veterans-care" target="_blank">how to sign up</a> for the program at <em>AMA </em>Wire® 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">veteran health Web page</a>.</p> <p style="text-align:right;"> <em>By AMA staff writer <a href="https://twitter.com/Lauren_AMAWire" rel="nofollow">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f16b4da6-e698-4791-a80e-822baf5ef0e5 Only weeks until ICD-10--CMS call can help you prep http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_only-weeks-until-icd-10-cms-call-can-prep Wed, 12 Aug 2015 21:31:00 GMT <p> Fewer than 50 days remain before the Oct. 1 deadline to adopt ICD-10. Is your practice ready? Do you know how to handle claims that span the implementation date? If you are not sure of the answers to these questions, make sure to participate in a provider call with the Centers for Medicare & Medicaid Services (CMS) from 2:30 to 4 p.m. Eastern time Aug. 27.</p> <p> Experts from the American Health Information Management Association and the American Hospital Association will offer coding guidance and tips, along with updates from CMS.</p> <p> The call also will cover:</p> <ul> <li style="margin-left:0.25in;"> How to get answers to coding questions</li> <li style="margin-left:0.25in;"> What to do with claims that span the implementation date</li> <li style="margin-left:0.25in;"> Results from acknowledgement and end-to-end testing weeks</li> <li style="margin-left:0.25in;"> Resources for physician practices</li> </ul> <p> CMS has already expanded registration for this call once, so <a href="http://www.eventsvc.com/blhtechnologies/register/c259b437-6014-4dcb-b4ea-cbb93b5c4b6c" rel="nofollow" target="_blank">register now</a> to secure a spot.</p> <p> <strong>More ways to prepare</strong></p> <p> Additional important resources that can help you get ready over the next seven weeks include:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/ama-wire/post/6-things-need-icd-10-transition" target="_blank">Six things you should know</a> about the ICD-10 transition and the flexibilities the AMA secured for physicians</li> <li style="margin-left:0.25in;"> A <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank">special series</a> at <em>AMA Wire</em>® examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started.</li> <li style="margin-left:0.25in;"> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire</em> provides important insights for what you need to know about the new code set.</li> <li style="margin-left:0.25in;"> The AMA’s ICD-10 Web page offers important <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> on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.</li> <li style="margin-left:0.25in;"> CMS also is offering free assistance, including its “<a href="http://www.roadto10.org/" rel="nofollow" target="_blank">Road to 10</a>” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. <a href="http://www.ama-assn.org/ama/ama-wire/post/icd-10-countdown-continues-sure-ready" target="_blank">Read more</a> about the agency’s resource offerings.</li> </ul> <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:505e0051-b22c-421d-8a09-6aea795b971e Tired of miserable schedules? One residency program’s solution http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tired-of-miserable-schedules-one-residency-programs-solution Wed, 12 Aug 2015 20:23:00 GMT <p> Residents’ clinical schedules don’t have to be as stressful as they tend to be. At least, that’s what one residency program decided and found a solution to address many of the common problems surrounding residency scheduling. Learn more about this innovative scheduling solution that may be coming to a program near you.</p> <p> <strong>Exploring operations research </strong></p> <p> A number of factors play into poor satisfaction among residents when manually scheduling is in place. Those can include favoritism in the creation of the schedule and inequity across residents in the number of night shifts and the frequency of day-to-night shift transitions.</p> <p> Automated scheduling based on operations research, on the other hand, can create a more equal playing field, ensure compliance with duty-hour requirements, accommodate personal requests and help ensure that residents in procedure-based specialty programs get the required number of cases.</p> <p>  “Manual scheduling issues have become an everyday part of graduate medical education but could be alleviated to some degree by adopting solutions other industries have used for years,” authors of a recent <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00581.1" target="_blank" rel="nofollow">perspective piece</a> in the <em>Journal of Graduate Medical Education </em>said.</p> <p> Operations research has been used to address complex issues in health care since the 1980s when hospitals began <a href="http://www.ijmijournal.com/article/0020-7101(81)90054-4/abstract" target="_blank" rel="nofollow">applying research-based strategies to improve nurse scheduling</a> and operating room utilization.</p> <p> <strong>How one program is putting it into practice </strong></p> <p> Now residency programs are using operations research to maximize rotation schedules while balancing educational goals and service requirements in training. For instance, the University of Michigan Health System (UMHS) has partnered with several students and faculty from its Department of Industrial and Operations Engineering and the Center for Healthcare Engineering and Patient Safety to create operations research techniques that optimize scheduling.</p> <p> Their collaboration has resulted in improved scheduling for staff in the UMHS pediatrics department, which now creates schedules for residents by simply pressing a button. Once the automated system creates a new resident schedule, it’s sent to the program’s chief residents and administrators for review.</p> <p> “This has led to a number of benefits, including improved efficiency in schedule creations, elimination of favoritism in the creation of the schedule, and the ability to quickly recover from last-minute changes in the schedule. Perhaps even more importantly, these schedules can prioritize equity across residents in terms of the number of night shifts, the frequency of day-to-night shift transitions, [and] personal requests,” the perspective authors said.</p> <p> Each of the perspective authors work as professors and residents at University of Michigan where they helped implement the school’s new scheduling system.  </p> <p> For more of their insights on operations research in residency scheduling, view <a href="http://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00581.1" target="_blank" rel="nofollow">the perspective piece</a> in the <em>Journal of Graduate Medical Education</em>.</p> <p style="text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" target="_blank" rel="nofollow"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bceb6fe1-fe8e-49fc-9ef9-e5e0509ffecc Here’s how many residency programs med students really apply to http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_heres-many-residency-programs-students-really-apply Tue, 11 Aug 2015 21:47:00 GMT <p> Take a guess: How many residency programs does the average medical student apply to each year? A recent survey of more than 1,000 fourth-year students explored this question, and the results were very telling. Whether you’re a first-year student beginning to plan for residency or a seasoned vet already looking ahead to your next phase of training, check out this graphic to see the number of residency programs your peers applied to in each specialty. Future applicants, here’s what to expect.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/6/45c8a439-840f-4ffa-96b6-f944f532fe13.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/6/45c8a439-840f-4ffa-96b6-f944f532fe13.Full.jpg?1" style="width:600px;height:1530px;margin:15px;float:right;" /></a></p> <p> <strong>Capturing the student perspective</strong></p> <p> Newly published research in <em>Academic Medicine</em> captures the sheer volume of activities graduating students undertake as they seek to secure a residency slot. This study is unique in that it is “the first national, representative sample of fourth-year medical students from U.S. MD-granting medical schools.”</p> <p> With a sample size of 1,376 students from 20 schools, the study was able to look at the influence of career specialty choice and other factors on the activities of graduating medical students.</p> <p> <strong>Applying for residency: Student applications by the numbers</strong></p> <p> Of those factors, applying to residency programs ranked high on the fourth-year to-do list, with students submitting a whirlwind of applications that sometimes climbed to high double digits.</p> <p> Students applied to the most programs when they were interested in internal medicine (20.7 percent), surgery (18.8 percent) and pediatrics (14.6 percent). Students applying to psychiatry and radiology submitted the lowest number of applications (with 5.1 percent and 3.8 percent, respectively).</p> <p> Behind these percentages lies another story: Arduous nights of applying to programs no matter the hour, the rotations they may have the next day or the mounting application fees. Students in the survey proved that applying to residency is such a priority, it even eclipses the moments of personal reflection and nostalgia that tend to capture the average graduating student, according to the study.</p> <p> Amid concerns of <a href="http://www.ama-assn.org/ama/ama-wire/post/match-numbers-up-but-slots-needed-meet-doctor-shortage" target="_blank">a predicted physician shortage,</a> the stakes of a med student’s final year are high—both personally and for the patient population. In a time when a growing percentage of students have found themselves <a href="http://www.ama-assn.org/ama/ama-wire/post/record-breaking-match-sees-higher-percentage-of-unmatched-seniors" target="_blank">unmatched in training limbo</a>, securing a residency spot and preparing for training is understandably the top priority for fourth-year students, evident in the number of programs to which they apply for residency. </p> <p> Broken down by specialty, here’s the average number of programs students applied to:</p> <ul> <li> Surgery: 58.2</li> <li> Radiology: 41.8</li> <li> Emergency medicine: 41.3</li> <li> OB-GYN: 36.4</li> <li> Internal medicine: 34.6</li> <li> Anesthesiology: 31.7</li> <li> Pediatrics: 25.6</li> <li> Family medicine: 23.5</li> <li> Psychiatry: 21.7</li> <li> Other/subspecialties: 21.7</li> </ul> <p> <strong>Why students are so concerned with residency applications</strong></p> <p> While the exact reason for this application volume isn’t entirely known, authors of the study agree that applying to residency is more competitive for today’s physician in training.</p> <p> Compared to previous research, students surveyed for this study may seem more driven by residency selection and preparation because matching to a residency program was much more challenging when this study was conducted, the authors said.</p> <p> “By 2014, there were as many as nine applicants for each residency position, and failure to match in the [National Resident Matching Program] was associated with dire consequences, including failure to obtain any residency at all,” the study said.</p> <p> But if you’re applying to programs next year, stay positive. Despite the high number of applications students submitted, 94.8 percent of students surveyed in the study still matched to a program in their chosen specialty.</p> <p> <strong>Tell us:</strong> How many programs did you apply to during your final year of training? If you haven’t applied yet, do you know how many programs you plan to pursue in your specialty? Share your thoughts on the <a href="https://www.facebook.com/AMAmedstudents" rel="nofollow" target="_blank">AMA Medical Student Facebook</a> or in the comments below.</p> <p> Also, stay tuned for a special series from <em>AMA Wire®</em> on preparing for residency, which will feature expert advice on compiling your best application and how to make the most of your fourth year as you transition to residency.</p> <p align="right"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" target="_blank"><em>Lyndra Vassar</em></a></p> <p> <span style="font-size:10px;"><em>Note: An earlier version of this infographic incorrectly reported the standard deviation rather than the mean for the number of programs applied to and the number of interviews. The above infographic has been corrected.</em></span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:66d5128b-bbaf-456c-bae9-2d278957db33 7 steps to prevent burnout in your practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_7-steps-prevent-burnout-practice Tue, 11 Aug 2015 20:47:00 GMT <p> Physicians have been hearing a lot about burnout and how it can lead to cynicism, negative attitudes toward patients, exhaustion and the desire to quit practicing medicine. The good news is that you can make changes in your practice to reduce your risk of burnout—learn how.</p> <p> A <a href="https://www.stepsforward.org/modules/physician-burnout" target="_blank" rel="nofollow">free online module</a>, part of the AMA’s <a href="https://www.stepsforward.org/" target="_blank" rel="nofollow">STEPS Forward</a> website, shows you how to measure and respond to burnout in your practice. Follow these seven steps:<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/10/433f9774-9676-4d5f-ba24-99ba5c22d931.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/10/433f9774-9676-4d5f-ba24-99ba5c22d931.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p style="margin-left:.5in;"> <strong>1.  </strong><strong>Establish wellness as a quality indicator.</strong><br /> Burnout has a broad-reaching impact—on physicians, patients, the quality of care delivered and practice finances. Encourage your practice to establish physician wellness as a quality indicator that is regularly measured. The module has information about why preventing burnout should be a priority for your practice.</p> <p style="margin-left:.5in;"> <strong>2.  </strong><strong>Start a wellness committee or choose a wellness champion.</strong><br /> A wellness committee made up of clinicians (doctors, nurses and physician assistants) as well as administrators (finance and management staff) should work with organizational leaders on the issue.<br /> <br /> If you have a solo or small practice, a wellness champion may be a better option. The champion should be an individual in the organization who promotes the use of wellness resources and models positive behaviors. The module includes talking points for discussing this idea with practice leaders.</p> <p style="margin-left:.5in;"> <strong>3.  </strong><strong>Distribute an annual wellness survey.</strong><br /> The 10-item Zero Burnout Program survey, often called the “mini Z,” is short and easy to use. Distribute the survey annually to all clinicians in your practice. The mini Z can be completed individually online (use the module to access the link) or printed out.</p> <p style="margin-left:.5in;"> <strong>4.  </strong><strong>Meet regularly with leaders to discuss data and interventions.</strong><br /> The wellness committee or wellness champion can use the data from the mini Z to inform practice improvements and identify areas of greatest concern. The module offers ways to share the data and explains how to address naysayers who may not believe burnout matters.</p> <p style="margin-left:.5in;"> <strong>5.  </strong><strong>Initiate selected interventions.</strong><br /> Your practice can prioritize and select interventions to address burnout where it exists, from work flow redesign to better communication to quality improvement projects. The module includes extensive information about each of these three areas, examples of interventions and tactics to reduce burnout.</p> <p style="margin-left:.5in;"> <strong>6.  </strong><strong>Repeat the survey to re-evaluate the situation.</strong><br /> Compare stress and burnout scores from before and after any interventions. Develop an understanding of what worked and celebrate the successes, but don’t forget to examine aspects that remain unchanged or increased their contribution to burnout after the interventions.</p> <p style="margin-left:.5in;"> <strong>7.  </strong><strong>Seek answers within data, refine the interventions and continue improvements.</strong><br /> Once you determine what’s working, refocus on those interventions and reinvigorate staff to carry them out. The commitment of the wellness committee or champion can help convince clinicians that your practice is dedicated to staying on the path to improvement.</p> <p> Remember—change is slow and steady. Small improvements can make a big difference in the day-to-day work lives of physicians, so don’t be discouraged if you can’t make big changes right away.</p> <p> Read real-world stories in the module from physicians who implemented small improvements in their practices and saw big results. You also can find information about how to get support for intervention implementation. The module offers continuing medical education credit.</p> <p> <strong>Submit your ideas: Practice Innovation Challenge</strong><br /> The burnout prevention module and the 15 others 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/" target="_blank" rel="nofollow">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 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" target="_blank" rel="nofollow">current modules</a>.</li> <li style="margin-left:0.25in;"> Check out upcoming <a href="https://www.stepsforward.org/events" target="_blank" rel="nofollow">live STEPS Forward events</a>.</li> <li style="margin-left:0.25in;"> <a href="https://www.stepsforward.org/get-updates" target="_blank" rel="nofollow">Sign up</a> to be notified when new modules and events are available.</li> </ul> <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:55503421-0cca-431d-81d2-d32d18e2d78c How the “profit motive” affects American medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_profit-motive-affects-american-medicine Mon, 10 Aug 2015 20:09:00 GMT <p> The United States has a market-based, capitalist system, which means market forces—including the profit motives of corporate interests—can shape the delivery of and payment for medical services. Read about this quintessentially American topic and its implications for medical ethics.</p> <p> The <a href="http://journalofethics.ama-assn.org/site/current.html" target="_blank">August issue</a> of the <em>AMA Journal of Ethics </em>examines how the market orientation of the U.S. system influences medical education and physicians’ relationships with drug and device manufacturers. It also examines the market-based system’s influence on the availability of drugs, patients’ access to care, the types of treatment prescribed and what happens when patients can’t pay for care.</p> <p> This issue also includes an opportunity to receive continuing medical education credit. Read “<a href="http://journalofethics.ama-assn.org/2015/08/peer1-1508.html" target="_blank">Medicine’s valuing of ‘normal’ cognitive ability</a>” and complete a quiz to receive one <em>AMA PRA Category 1 Credit™</em>.</p> <p> The issue features:</p> <ul> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/08/fred1-1508.html" target="_blank">Medicine and the market</a>.” In taking for granted that the U.S. health care system is market-based, we sometimes overlook the ethics problems created by the profit motive in medicine. The issue editor discusses how these ethics issues can appear as soon as medical students start their education.</li> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/08/msoc1-1508.html" target="_blank">Money and medicine: Indivisible and irreconcilable</a>.” Physicians deserve payment for their services, but to some, the thought of medicine as a road to personal wealth is an example of the free market gone awry. This author examines the ethical issues arising from the inextricability of money and medicine.</li> <li style="margin-left:0.25in;"> “<a href="http://journalofethics.ama-assn.org/2015/08/pfor1-1508.html" target="_blank">The all-payer rate-setting model</a>.” The all-payer rate-setting model improves price transparency for patients and can eliminate variation in payments, thereby improving access to care. This author examines the pros and cons of this and other payer models.</li> </ul> <p> In the journal’s <a href="http://journalofethics.ama-assn.org/podcast/ethics-talk-august-2015.mp3" target="_blank">August podcast</a>, Peter A. Ubel, MD, explains how cost containment can be compatible with profit-making in medicine. Dr. Ubel is the Dennis T. McLawhorn University Professor at the Duke University Fuqua School of Business.</p> <p> <strong>Ethics poll: Your chance to weigh in</strong></p> <p> Would you like to see a single-payer health care system in the United States? <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>More ethics news</strong></p> <p> Current U.S. medical students have until Oct. 12 to submit their responses for the <em>Journal of Ethics</em> <a href="http://journalofethics.ama-assn.org/site/conley-ethics-essay.html" target="_blank">John Conley Ethics Essay Contest</a>. 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 style="text-align:right;"> <a href="https://twitter.com/Lauren_AMAWire" rel="nofollow"><em>By AMA staff writer Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:500ef566-d398-449d-ae6e-eda7ee244032 8 things physicians are saying about their EHRs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-things-physicians-saying-their-ehrs Mon, 10 Aug 2015 08:09:00 GMT <p> Most physicians today have major issues with their electronic health record (EHR) systems, but regulatory requirements mean they must use the technology or face penalties. Read physicians’ thoughts about their EHRs—and what can be done to improve them.</p> <p> A new survey from AmericanEHR Partners found that from the perspective of physicians, the significant investment in EHRs over the past few years is failing to offer significant returns.</p> <p> The survey results echo findings from the <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdf" rel="nofollow" target="_blank">AMA’s 2013 study</a>, conducted in partnership with the RAND Corporation, which found EHR systems to be a major contributor to physicians’ professional dissatisfaction.</p> <p> The physicians surveyed for the AMA study expressed concern that current technology requires physicians to spend too much time on clerical work, putting up barriers to providing high-quality care. The AMA study also revealed that EHRs were more costly than anticipated and didn’t provide the technology needed to interact with other systems, causing difficulties in transmitting patient information.</p> <p> Here are eight key insights physicians shared through the AmericanEHR survey:</p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Many physicians feel their EHRs have had a negative impact on costs, efficiency and productivity.</strong><br /> Close to one-half of respondents reported negative effects on total operating costs and said they had yet to overcome productivity challenges. Nearly three-quarters reported negative impacts on the ability of the EHR to decrease their workload.</p> <p style="margin-left:40px;"> <strong>2.  </strong><strong>Even though more physicians are using EHRs, the overall satisfaction with these systems has declined.</strong><br /> In a similar survey administered five years ago, the majority of respondents reported that they were satisfied with their EHR. Now, more than one-half say they are dissatisfied. According to the survey, only about one-third said they were satisfied or very satisfied with their system.</p> <p style="margin-left:40px;"> <strong>3.  </strong><strong>Physicians’ assessment of EHR ease of use is declining.</strong><br /> In almost all cases where comparative data was available, fewer respondents reported that specific functionality was easy or very easy to use or that it had a positive effect on their practice.</p> <p style="margin-left:40px;"> <strong>4.  </strong><strong>Physicians have to address the additional workload that EHRs impose.</strong><br /> Some practices are employing scribes to address the increased data entry requirements—nearly one-quarter of respondents said they already employed scribes or were planning to do so.</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Documenting a progress note for encounters is becoming more difficult.</strong><br /> The number of physicians reporting that it was easy or very easy to document a progress note decreased from 64 percent of respondents last year to 46 percent of respondents this year. Meanwhile, just over one-third of respondents said they found it difficult or very difficult to document a progress note, up from about one-quarter last year.</p> <p style="margin-left:40px;"> <strong>6.  </strong><strong>The most significant positive impact of EHRs is on the time spent processing prescriptions and refills.</strong><br /> Most respondents were positive or neutral on the amount of time it takes for their staff to process prescriptions and refills with the EHR. Less than one-third were negative about this aspect.</p> <p style="margin-left:40px;"> <strong>7.  </strong><strong>Total practice operating costs stay the same or increase after EHR deployment.</strong><br /> Slightly more than one-half of respondents said total practice operating costs increased, and 20 percent reported that total practice operating costs remained the same.</p> <p style="margin-left:40px;"> <strong>8.  </strong><strong>The longer a respondent used their EHR system, the more likely they were to report it had a positive impact.</strong><br /> In most cases, it appears to take at least three years for respondents to overcome initial challenges and experience any benefits their EHR system may offer. Still, more than one-half reported that they still had issues.</p> <p> Access the full report <a href="http://www.americanehr.com/research/reports/Physicians-Use-of-EHR-Systems-2014.aspx" rel="nofollow" target="_blank">online</a>. AMA members get 50 percent off the purchase of the report.</p> <p> <strong>How the landscape is changing</strong></p> <p> Improved health IT is a piece 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. Through this initiative, physicians are calling for overhauled EHRs.</p> <p> One of the products of the initiative is <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">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" rel="nofollow" target="_blank">selecting an EHR vendor</a> and <a href="https://www.stepsforward.org/modules/ehr-implementation" rel="nofollow" target="_blank">implementing an EHR system</a>.</p> <p> The AMA also is embedding the voice of physicians in efforts to make EHRs work better for physicians and patients through the <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-helping-rethink-ehrs" target="_blank">SMART project</a>. Through this work, a special group of health IT leaders is building an infrastructure that allows for free, open development of plug-and-play apps. Such apps are intended to increase cost-effective interoperability across health technology, including EHRs.</p> <p> Finally, the AMA is addressing regulatory issues that have important implications for EHR use. Last month, the AMA hosted a <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-hear-ehr-meaningful-use-isnt-meaningful" target="_blank">town hall</a> in Atlanta to get first-hand reports from physicians about their EHRs. The message was loud and clear: EHRs have potential, but frustrating government regulations have made them almost unusable.</p> <p> At the event, Dr. Stack asked physicians to <a href="http://breaktheredtape.org/email-congress" rel="nofollow" target="_blank">contact their members of Congress</a> and ask them to halt Stage 3 of EHR meaningful use until the program is fixed. The AMA has been <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-should-stop-stage-3-of-meaningful-use" target="_blank">calling for the Centers for Medicare & Medicaid Services to stop Stage 3</a> to assess how changes to earlier stages of the program will affect physician participation and success.</p> <p> Meanwhile, both chambers of the <a href="http://www.ama-assn.org/ama/ama-wire/post/congress-moves-delay-stage-3-of-meaningful-use" target="_blank">U.S. Congress recently took action</a> on meaningful use. Rep. Renee Ellmers, R-N.C., introduced her Further Flexibility in HIT Reporting and Advancing Interoperability Act (Flex IT 2 Act), which would provide more flexibility in the meaningful use program and ensure EHR systems address interoperability challenges. The bill also would pause Stage 3 rulemaking to align it with technology advancements and the new <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr" target="_blank">merit-based incentive payment system</a>, which will combine current quality programs.</p> <p> Sen. Lamar Alexander, R-Tenn., chair of the U.S. Senate Health, Education, Labor and Pension Committee (HELP), also asked U.S. Secretary of Health and Human Services Sylvia Burwell to consider a delay in the release of the final rule on Stage 3.</p> <p style="text-align:right;"> <a href="https://twitter.com/Lauren_AMAWire" rel="nofollow"><em>By AMA staff writer Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d25b7cc6-f1e3-4f6d-91a3-65ee99c75b79 8 things that can put you at risk of burnout http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-things-can-put-risk-of-burnout Fri, 07 Aug 2015 20:20:00 GMT <p> As a physician, you have a higher risk of burnout than your peers in other professions—in fact, nearly one-half of physicians say they feel burned out. Depending on your lifestyle, practice type and other factors, you may be at an even higher risk of developing burnout. Learn the risk factors, and what you can do to prevent burnout.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/4/f3663e5a-2754-4cf0-8444-691663e0f104.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/4/f3663e5a-2754-4cf0-8444-691663e0f104.Large.jpg?1" style="float:right;margin:15px;" /></a>According to a <a href="https://www.stepsforward.org/modules/improving-physician-resilience" rel="nofollow" target="_blank">free online module</a>, part of the AMA’s <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a> website, evidence shows stressed, burned-out physicians have:</p> <ul> <li> Lower patient satisfaction scores</li> <li> Higher rates of medical liability suits</li> <li> Increased likelihood of leaving the profession</li> <li> Tendency to make more medical errors</li> <li> Greater likelihood of exhibiting disruptive behaviors</li> </ul> <p> <strong>Who is more likely to be burned out?</strong><br /> Physicians who feel high degrees of stress at work, often brought on by time pressure, lack of control, chaotic work environment or lack of values alignment with leadership, are at risk of burnout. Conversely even in high demand jobs, strong support in doing the work and significant control over the work can protect against burnout.</p> <p> Physicians who experience the following factors are more likely to be burned out:</p> <ol> <li> Demanding workload</li> <li> Number of nights on call</li> <li> A partner who also is a physician</li> <li> Children to raise</li> <li> A medical error made recently</li> <li> Midway through their medical career</li> <li> Conflicts between work and home</li> <li> Less than 20 percent of their time is spent on the most meaningful aspects of work</li> </ol> <p> Delve deeper into burnout risk factors with the <a href="http://www.ama-assn.org/ama/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank">seven signs of added stress</a> that physicians should know.</p> <p> For male physicians, the risk of suicide is up to three times the risk of suicide for non-physicians, according to a <a href="http://www.ncbi.nlm.nih.gov/pubmed/12813122" rel="nofollow" target="_blank">consensus statement</a> on physician depression developed by experts on the subject. For female physicians, it’s even worse—this risk increases up to five times.</p> <p> <strong>What can physicians do?</strong><br /> There are two main strategies for combatting burnout: You can do so internally by improving your own resiliency. And you can do so externally by making changes at the practice level to improve efficiency and make time for the most important part of being a physician—caring for your patients.</p> <p> Two modules in the AMA’s STEPS Forward series take on both sides of the problem:</p> <ul> <li> The <a href="https://www.stepsforward.org/modules/improving-physician-resilience" rel="nofollow" target="_blank">first module</a> shows you how to improve your own resiliency. You’ll learn how to start small and gradually increase your hardiness against stress, ultimately improving yourself and your practice.</li> <li> The <a href="https://www.stepsforward.org/modules/physician-burnout" rel="nofollow" target="_blank">second module</a> explains how to prevent burnout in your practice. You’ll read real-life ways physicians across the country improved patient satisfaction, quality outcomes, and clinician recruitment and retention.</li> </ul> <p> The modules also offer continuing medical education credit.</p> <p> 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 to <em>AMA Wire®</em> for more ways to improve your resiliency and prevent burnout in your practice.</p> <p> <strong>Submit your ideas: Practice Innovation Challenge</strong><br /> These two modules on boosting resiliency and preventing burnout and the 14 others 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 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> Visit the STEPS Forward website to see the <a href="https://www.stepsforward.org/modules" rel="nofollow" target="_blank">current modules</a>.</li> <li> Check out upcoming <a href="https://www.stepsforward.org/events" rel="nofollow" target="_blank">live STEPS Forward events</a>.</li> <li> <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> <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:61b8287c-b751-439e-b07c-595ed760a7e3 6 things you need to know about the ICD-10 transition http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-things-need-icd-10-transition Fri, 07 Aug 2015 18:14:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) is making the transition to the ICD-10 code set more flexible, but there are several clarifying points physicians should know. </p> <p> The flexibilities the AMA secured with CMS address claims processing and denials, quality reporting penalties, payment disruptions and navigating transition problems. Mainly, physicians should be aware that for the first year ICD-10 is in place, Medicare Part B claims will generally not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.</p> <p> To answer questions about the code change, CMS issued a <a href="https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-to-the-July-6-2015-CMS-AMA-Joint-Announcement.pdf" rel="nofollow" target="_blank">question-and-answer document</a>. <em>AMA Wire</em>® has pulled together some of the highlights. The agency plans to issue further guidance specifically for physicians in the coming weeks.</p> <p style="margin-left:40px;"> <strong>1. ICD-10 will not be delayed. </strong><br /> The deadline to switch to ICD-10 remains Oct.1, although CMS has agreed to flexibilities for Medicare Part B claims that should help make that transition smoother.</p> <p style="margin-left:40px;"> <strong>2. Medicare claims with a date of service on or after Oct. 1 will be rejected if they do not contain a valid ICD-10 code.</strong><br /> <span style="font-size:12px;">ICD-10-CM is composed of codes with between three and seven characters. Codes with three characters act as the heading of a category of codes and can either be further subdivided to provide greater specificity (which would add characters) or stand alone.</span></p> <p style="margin-left:40px;"> For example, C81—Hodgkin’s lymphoma—cannot stand alone and is not a valid code. But it can be further subdivided into C81.00 (nodular lymphocyte predominant Hodgkin lymphoma, unspecified site), C81.03 (nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes) or a few other options.</p> <p style="margin-left:40px;"> In this example, using any one of the valid codes for Hodgkin’s lymphoma would <strong>not</strong> be cause for a rejected claim or an audit under the recently announced flexibilities for Medicare Part B claims.</p> <p style="margin-left:40px;"> A complete list of valid codes and code titles is <a href="https://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-CM-and-GEMs.html" rel="nofollow">on the CMS website</a> and listed in tabular order, the same order in the ICD-10-CM codebook.</p> <p style="margin-left:40px;"> <strong>3. A “family of codes” is the ICD-10 three-character category.</strong> Codes within a category are clinically related and provide differences in capturing specific information on the type of condition. For example, category H25—age-related cataract—contains a number of specific codes that captures information about the type of cataract and information on the eye involved.</p> <p style="margin-left:40px;"> With few exceptions (described in more detail below), Medicare Part B claims will not be denied or subject to an audit solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.</p> <p style="margin-left:40px;"> <strong>4. Certain claims fall outside of the coding flexibility.</strong><br /> <span style="font-size:12px;">In certain circumstances, a claim may be denied because the ICD-10 code is not consistent with an applicable policy, such as Local Coverage Determinations or National Coverage Determinations. Check </span><a href="https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-to-the-July-6-2015-CMS-AMA-Joint-Announcement.pdf" rel="nofollow" style="font-size:12px;" target="_blank">CMS’ document</a><span style="font-size:12px;"> for more information.</span></p> <p style="margin-left:40px;"> <strong>5. These flexibilities do not extend to prior authorization requests. </strong><br /> The flexibilities only pertain to claims processing and post-payment reviews. ICD-10 codes with the correct level of specificity will be required for prepayment reviews and prior authorization.</p> <p style="margin-left:40px;"> <strong>6. CMS’ changes do not affect Medicaid or commercial payers. </strong>The official guidance only applies to Medicare fee-for-service claims from claims by physicians and other practitioners that are billed under the Medicare Fee-For-Service Part B physician fee schedule. It does not apply to claims submitted for beneficiaries with Medicaid coverage. Check <a href="https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-to-the-July-6-2015-CMS-AMA-Joint-Announcement.pdf" rel="nofollow" target="_blank">CMS’ document</a> for more information.</p> <p style="margin-left:40px;"> The AMA continues to seek similar commitments from major commercial firms.</p> <p> <strong>More ways to prepare</strong></p> <p> Although physicians now have the yearlong transition period, you should still make sure your practice is as prepared as possible ahead of Oct. 1.</p> <p> CMS will host a call for physicians preparing for ICD-10 from 2:30 to 4 p.m. Eastern time Aug. 27. Experts will discuss coding guidance and tips, answers to coding questions, information about claims that span before and after the implementation date, and resources. <a href="http://www.eventsvc.com/blhtechnologies/register/c259b437-6014-4dcb-b4ea-cbb93b5c4b6c" rel="nofollow" target="_blank">Register online</a>.</p> <p> Additional important resources that can help you get ready over the next three months include:</p> <ul> <li> A <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank">special series</a> at <em>AMA Wire</em>® examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started.</li> <li> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire</em> provides important insights for what you need to know about the new code set.</li> <li> The AMA’s ICD-10 Web page offers important <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> on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.</li> <li> CMS also is offering free assistance, including its “<a href="http://www.roadto10.org/" rel="nofollow" target="_blank">Road to 10</a>” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. <a href="http://www.ama-assn.org/ama/ama-wire/post/icd-10-countdown-continues-sure-ready" target="_blank">Read more</a> about the agency’s resource offerings.</li> </ul> <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:224bd394-3819-45fa-af32-21cbf05271d6 Submit resolutions for AMA-YPS by Aug. 28 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_submit-resolutions-ama-yps-aug-28 Fri, 07 Aug 2015 14:00:00 GMT <p> The AMA Young Physicians Section (YPS) is calling for <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events/ama-yps-assembly/submitting-resolutions.page" target="_blank">resolutions</a> for the upcoming Interim Meeting. <a href="mailto:YPS@ama-assn.org" rel="nofollow">Email the AMA-YPS</a> to submit a resolution by Aug. 28. More information about writing resolutions is available on the section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page" target="_blank">Web page</a>.</p> <p> Details regarding the AMA-YPS Online Discussion Forum will be coming soon.</p> <p> Also, please consider <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events/ama-yps-assembly-meeting-service-opportunities.page" target="_blank">volunteering</a> for the section’s reference, handbook review or credentials committees. You can send an email to the <a href="mailto:YPS@ama-assn.org" rel="nofollow">AMA-YPS</a> by Sept. 30 to sign up.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:55f6ed44-1637-4b88-8749-f3dfbbe6cd89 8 ways med schools can take nutrition from classroom to kitchen http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-ways-med-schools-can-nutrition-classroom-kitchen Thu, 06 Aug 2015 13:00:00 GMT <p> The state of nutrition education in U.S. medical education requires readjustment, and some medical schools and educators are exploring solutions. Review this expert-approved list of recommendations for how to start a nutrition education program at your school.</p> <p> Authors of a recent <a href="http://journals.lww.com/academicmedicine/Fulltext/2015/07000/Nutrition_Education_in_an_Era_of_Global_Obesity.11.aspx" rel="nofollow">perspective</a> in <em>Academic Medicine </em>on the <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-stake-nutrition-education-during-med-school">state of nutrition education</a> in medical schools have offered some suggestions for versatile ways to teach students about nutrition in and out of the classroom. And some of them already have been gaining momentum in medical education.</p> <p> “We offer these suggestions with the intention of elevating the prominence of nutrition science, self-care, lifestyle medicine, and behavioral optimization and placing them on par with existing educational requirements,” the authors said.</p> <p> Some of these curricular suggestions include:</p> <p> <strong>1. </strong><strong>Teach holistically. </strong>Students should be required to take courses in nutrition exercise, stress management and sleep hygiene.</p> <p> <strong>2. </strong><strong>Test for nutritional knowledge. </strong>Med schools should consider competency examinations that cover factual knowledge and students’ ability to give sound advice on nutrition and wellness. These classes can operate as prerequisites for professional certification.</p> <p> <strong>3. </strong><strong>Use teaching kitchens as laboratories for nutritional instruction.</strong> Can combining anatomy with culinary lessons actually teach students about the dietary impact of foods? This question has been the impetus for medical schools across the country that are taking students from the classroom to the kitchen for a taste of experiential learning.</p> <p> For instance, the Geisel School of Medicine at Dartmouth “[is] creating curricula for medical students and internal medicine residents” that will teach “nutrition didactics … in lecture format, and cooking classes will be offered through partnerships with area culinary class venues near the college,” the authors wrote. </p> <p> Tulane University School of Medicine has followed a similar approach, offering medical students an optional elective “‘clinical rotation at a professional cooking school.”</p> <p> The University of Chicago Pritzker School of Medicine has enlivened its curriculum with culinary lessons. The school’s “Healthy Kitchen, Healthy Lives—Caring for Our Patients and Ourselves” medical education conference, which “blends didactic and experiential learning through academic lectures, cooking demonstrations and hands-on cooking … across a variety of instructional kitchens,” continues to gain popularity, according to the perspective.</p> <p> <strong>4. </strong><strong>Find ways to assess this form of learning.</strong> For instance, using objective structured clinical examination may be helpful for training and evaluating students on lifestyle counseling, the authors of the perspective said.</p> <p> <strong>5. </strong><strong>Practice what you teach.</strong> Create “hospitals and ambulatory care venues with exceptional cafeterias, restaurants, teaching kitchens, and inpatient menus showcasing foods that are healthy, delicious, affordable and easy to make,” the authors said, noting that nutritious foods should replace their processed predecessors in hospital eateries.</p> <p> <strong>6. </strong><strong>Get your information from a new source.</strong> Incorporate data from wearable or implantable devices as routine elements of the everyday electronic health record.</p> <p> <strong>7. </strong><strong>Support sound mental health.</strong> Train students in “self-regulatory methods, including mind-body and mindfulness techniques,” the authors said.</p> <p> <strong>8. </strong><strong>Lead by example.</strong> Align physicians and care teams in a collaborative effort to maintain a healthy diet and lifestyle, just as physicians did in anti-smoking campaigns of the 1970s. When they quit smoking and urged their patients to do the same, they helped to “catalyz[e] the successful ‘movement’ to lower smoking rates in the United States.” The authors suggest uniting with the same dedication to quit eating unhealthy foods.</p> <p> For more information about nutrition in medical education, review <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-stake-nutrition-education-during-med-school">part one</a> of this two-part series, which discusses the pitfalls and considerations educators should know about nutrition education.</p> <p style="margin-left:4in;text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:73e4194f-7a57-4d78-aedc-de2852ec3968 How one health system is boosting care using race, language data http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-health-system-boosting-care-using-race-language-ethnicity-data Wed, 05 Aug 2015 21:08:00 GMT <p> Collecting accurate information about patients can help improve the quality of care and identify ways to reduce health disparities, which is exactly what’s happening at Henry Ford Health System (HFHS). The organization has collected race, ethnicity and language data from more than 90 percent of patients to improve care quality—and their efforts are thriving. Here’s how they did it.</p> <p> <strong>Getting REaL: How HFHS collects patient data </strong><br /> HFHS, which consists of five hospitals and 27 medical centers, launched its <a href="http://www.henryford.com/body.cfm?id=56744&fr=true" rel="nofollow">Race Ethnicity and Primary Language (REaL) Data Collection</a> effort in 2011 to ensure it provided high-quality and culturally appropriate care across a diverse range of patient needs.</p> <p> “We really wanted to make sure every patient counts, literally and figuratively,” said Christine Joseph, PhD, director of health disparities research at HFHS.</p> <p> In the case of patient data, it turns out that nearly every patient at HFHS was counted, but not in the most accurate way. In fact, “some clinical service representatives—CSRs—would collect racial information just by looking at the patient through ‘observation,’” Joseph said. “There was no standardized process.”</p> <p> That’s why HFHS created an inter-professional task force using the <a href="http://www.ahrq.gov/research/findings/final-reports/iomracereport/iomracereport.pdf" rel="nofollow">Institute of Medicine’s (IOM) recommendations</a> for collecting the data and tailored those recommendations for patients based on input from diverse community focus groups.</p> <p> To implement the IOM’s recommendations, the task force trained front-line care staff at HFHS on how to properly ask questions about race and grapple with challenging scenarios when patients may not want to openly identify their race in a health care setting.</p> <p> “The training piece is the biggest and most crucial part of this whole process because the front-line staff need [to know] how to ask these questions,” Joseph said, noting that patients most often worried about the misuse of their information. </p> <p> “Transparency is important,” she said. “People often want to know how you’re using the data, so it’s best to explain. There was a lot of concern about visa or citizenship issues.”</p> <p> <strong>The benefits of collecting race, ethnicity and primary language data</strong><br /> Providing training to staff proved effective as HFHS now asks nearly all patients for race, ethnicity and language information when they call to schedule an appointment through the organization’s call center. Each of the IOM’s recommendations for racial and ethnic data collection also have been implemented across the entire health system, said Megan Brady, a project manager for the system’s Institute on Multicultural Health.</p> <p> Brady works with a team to compile this newly collected patient data to create an Equity Dashboard, featuring “10 clinical quality and service measures that we’re looking at by ethnicity, race, English proficiency [and] preferred language,” she said. The intent in collecting this data is to provide high-quality care to all patient groups and achieve equity in health outcomes.</p> <p> Using this data, quality improvement plans are underway at HFHS to investigate the percentage of patients who list “unknown” or decline to provide their race or ethnicity in hopes of making patient data even more accurate. They’re also using the insights they glean from the REaL patient data to pursue additional research opportunities in health disparities.</p> <p> “There are many institutions and agencies that provide services to patients but do not collect this information,” Joseph said. “But if you’re talking about doing research to eliminate health disparities, you’ll [need to know this data], so it’s really important that we collect this information accurately.”</p> <p> HFHS was <a href="http://www.ama-assn.org/ama/ama-wire/post/race-ethnicity-language-data-crucial-quality-care">recognized earlier this year</a> by the Commission to End Health Care Disparities for its work to collect patient data to improve care.</p> <p> <strong>Want to explore more health equity solutions? Share your project ideas</strong><br /> The <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 Care Disparities</a> is accepting proposals from organizations that excel in providing services with measurable outcomes to vulnerable populations, including racial and ethnic minorities.</p> <p> These services should improve blood pressure control among patients with hypertension, improve medication adherence among patients with hypertension or increase participation in community-based programs that are part of the <a href="https://nccd.cdc.gov/DDT_DPRP/Registry.aspx" rel="nofollow">National Diabetes Prevention Program</a>.</p> <p> Selected proposals will receive an all-expense paid trip to Chicago to highlight their program in front of an audience of national leaders in medicine and allied health during the <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities/meetings.page?">fall meeting</a> of the Commission to End Health Care Disparities Sept. 26. Attendees will receive an award for excellence in controlling blood pressure and preventing diabetes.</p> <p> Submit your proposals to the commission <a href="mailto:tanya.lopez@ama-assn.org" rel="nofollow">via email</a>. The deadline is Aug. 14.</p> <p style="margin-left:4in;text-align:right;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:163ab100-59a7-486f-8c74-cf244952ea5e How one residency program improved documentation, reduced stress http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-residency-program-improved-documentation-reduced-stress Wed, 05 Aug 2015 20:58:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/1/bbf24fc5-a848-4f11-b1c7-b2984cdb90f6.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/11/1/bbf24fc5-a848-4f11-b1c7-b2984cdb90f6.Large.jpg?1" style="float:right;" /></a></p> <p> Creating greater customization for collecting patient information in electronic health records (EHR) may improve documentation timeliness and reduce stress for residents and attending physicians, according to a <a href="http://journals.lww.com/academicmedicine/Abstract/publishahead/Improving_Documentation_Timeliness___A__Brighter.98764.aspx" rel="nofollow" target="_blank">new study</a>. Find out how one resident clinic improved its documentation process and dramatically increased physician satisfaction.</p> <p> <strong>Hosting an intervention: Switching from free-text to structured data forms</strong><br /> While EHRs can offer observed patient benefits, “there is evidence that the use of EMRs cause work disruption, which may delay documentation of patient encounters,” the study, which was published in <em>Academic Medicine</em>, said. This compelled researchers and professors at Vanderbilt School of Medicine to host an EHR-based intervention that would “improve compliance with institutional standards of documentation of well child checks for residents and attending physicians without increasing stress,” according to the study. </p> <p> The intervention was hosted at the Children’s Hospital Primary Care Clinic at Vanderbilt, which is staffed by 74 residents and supervised by 17 attending physicians. The institutional standards at Vanderbilt University require residents to complete their documentation within three days and attendings to complete their attestations within 14 days. The process for doing so used free-text notes in StarPanel, a Web-based EHR specifically built for Vanderbilt.</p> <p> For the study, researchers created an alternate approach that streamlined the process using a collection process more specific to the patient. They created 18 age-specific, structured data entry forms for residents and attendings to use for point-of-care documentation instead of free-text notes.</p> <p> The new forms included age-appropriate risk screening questions and anticipatory guidance recommendations from the American Academy of Pediatrics Bright Futures Guidelines. They also featured “specific areas for parental concerns and interval history, nutrition and sleep elimination information, developmental screening questions … and embedded links to growth curves, including body mass index,” according to study authors.</p> <p> <strong>The results: More timely documentation, less resident stress</strong><br /> All residents and attendings at the clinic participated in the intervention. Researchers monitored their documentation completion rates and derived patient data for an average of 231 patient visits per month. Using pre- and post-intervention surveys, they also assessed participants’ stress and satisfaction levels related to documentation.</p> <p> The alternate documentation approach increased the median percentage of resident documentation and physician attestations completed within Vanderbilt’s required timeframe from:</p> <ul> <li> 54.7 percent to 78.9 percent for residents</li> <li> 38.2 percent to 83.5 percent for attendings</li> </ul> <p> After the intervention, the number of people who reported high satisfaction with documentation increased dramatically, from:</p> <ul> <li> 20.5 percent to 85.7 percent for residents</li> <li> 11.1 percent to 76.9 percent for attendings</li> </ul> <p> As a result, residents reporting stress with documentation was cut in half, from 59.1 percent to 28.6 percent.</p> <p> Although authors acknowledge the limitations of this study, the intervention’s marked success suggests that it may be a beneficial approach to explore further. The authors now are teaching computer-based documentation in exam rooms.</p> <p> <strong>Improving EHRs to support physicians, patient care</strong><br /> The shortcomings of EHRs that present roadblocks to high-quality patient care are a source of constant concern for many physicians. As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/physician-practices/digital-health.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA is working with physicians, vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance care delivery.</p> <p> Learn more about the <a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">8 top challenges and solutions</a> identified by practicing physicians and health IT experts.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:16.5454540252686px;text-align:-webkit-right;">By AMA staff writer</em><span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:16.5454540252686px;text-align:-webkit-right;"> </span><a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:16.5454540252686px;text-align:-webkit-right;"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f6324282-b2e1-4625-bf50-b8cec88ccb37 CPT® codes, then and now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cpt-codes-then-now Tue, 04 Aug 2015 21:47:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/11/122dcee1-ce2c-439f-bb5b-867d55d3e316.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/11/122dcee1-ce2c-439f-bb5b-867d55d3e316.Large.jpg?1" style="float:right;margin:15px;" /></a>There isn’t a single physician who isn’t familiar with the Current Procedural Terminology (CPT®) code set today. With more than 10,000 codes, CPT is the most widely accepted medical nomenclature used to report medical procedures and services to health insurers. The 2016 codebook, available now, marks the code set’s 50th anniversary.</p> <p> The original 175-page code book had about 3,500 codes and cost a whopping $2—or $1.50 if you were a medical student or resident.</p> <p> According to a 1966 <em>AM News</em> article, the first version of the code set was published “because of a need intensified by the increasing use of computers in claims administration and statistical analysis.”</p> <p> And as computers came into play, so did a major issue that affected the codebook’s second edition.</p> <p> “One digit separates AMA [and] insurers in computerizing data,” a 1970 <em>AM News </em>article said.</p> <p> At the time, physicians’ CPT codes had just been increased to five digits, and similar codes maintained by the National Association of Blue Shield Plans (today, the Blue Cross and Blue Shield Association) had four digits.</p> <p> Eventually, physicians and insurers aligned—by 1983, the Health Claim Financial Administration, now known as the Centers for Medicare & Medicaid Services, adopted CPT for reporting physician services for Medicare Part B, and in 1987, adopted CPT for reporting outpatient surgical procedures.</p> <p> Today, CPT is a HIPAA designated code set, maintained by the CPT Editorial Panel, which meets three times a year to discuss issues associated with new and emerging technologies. Learn everything you need to know about <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page?">CPT</a>.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/4/a97ec2d4-a5da-4698-b4cf-02d396ed58af.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/4/a97ec2d4-a5da-4698-b4cf-02d396ed58af.Large.jpg?1" /></a></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> <p align="right">  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cfea9e92-3212-428e-95a9-eda25643f774 3 ways electronic transactions can help manage payment errors http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-ways-electronic-transactions-can-manage-payment-errors Tue, 04 Aug 2015 21:44:00 GMT <p> Practices that have made the transition from paper to an electronic claims revenue cycle spend less time on administrative processes and have more time to ensure correct payment and appeal inappropriate denials. Learn how to make this transition in your practice.</p> <p> More practices are improving their revenue cycle by accepting electronic remittance advice (ERA), an electronic version of a paper explanation of payment. The <a href="http://www.ama-assn.org/ama/ama-wire/post/6-ways-practice-can-save-using-electronic-transactions">benefits of using ERAs</a> are many, and a major one is having an easier time identifying payment errors. A free <a href="https://cc.readytalk.com/cc/playback/Playback.do?id=95035m" rel="nofollow">webinar</a> gives you what you need to know about effective use of the ERA transaction, processing tips and other resources.</p> <p> View the webinar to understand how ERAs can help you manage payment errors in your practice in these three ways:</p> <ol> <li> The ERA’s class of contract code can identify the specific contract or fee schedule that applies to a claim. Then, compare the allowed amount to the fee schedule to validate discrepancies and appeal to the payer.<br />  </li> <li> The ERA allows multiple processes for reporting overpayments and includes information to ensure your practice management system can automatically track reported overpayments and payers’ recovery of overpaid amounts.<br />  </li> <li> Using ERA with <a href="http://www.ama-assn.org/ama/ama-wire/post/learn-electronic-payments-work-practice">electronic funds transfer</a> (EFT) can let you further automate your revenue cycle. When your practice management system tracks both ERAs and EFTs, practice staff won’t need to manually match and post them. Instead, they can focus on missing ERAs or EFTs, which represent exceptions or errors.</li> </ol> <p> <strong>Get more assistance</strong></p> <ul> <li> 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.<br />  </li> <li> 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 claims have been processed properly 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.<br />  </li> <li> 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> <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> <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> <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> </ul> <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:0fbddfbe-c497-4fd0-957c-be5376432fda New report looks at drop in black males in physician pipeline http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-report-looks-drop-black-males-physician-pipeline Tue, 04 Aug 2015 15:00:00 GMT <p> The Association of American Medical Colleges (AAMC) released a report this week during the National Medical Association’s annual conference on the drop in black males applying to and matriculating in medical schools over the past three decades, despite efforts across the country to expand diversity in the physician pipeline.  </p> <p> “<a href="https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=PubDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_prc_prd_key=78B38423-34D5-433C-B4FB-76F0F5CAE008" target="_blank" rel="nofollow">Altering the Course: Black Males in Medicine</a>” gathers the perspectives of 11 black premedical students, physicians, researchers and leaders through interviews that explore possible factors for the decline. The report also highlights research and data from various sources to build the narrative to understand these trends and find broad-based solutions to alter them for black men.</p> <p> Mark Nivet, EdD, AAMC’s chief diversity officer states, “This report aims to be a clarion call to leaders across the education continuum, from kindergarten through professional school, to rise to the challenge of increasing the number of black males in medicine and to recognize the opportunity we have to alter the course for black males by collectively redoubling our efforts and partnering in new ways.”  </p> <p> With the predicted physician shortage of between 46,000 and 90,000 physicians by the year 2025, and the changing demographics of the patient population, it’s even more critical to provide greater access to care for a more diverse patient population. </p> <p> The AMA Minority Affairs Section’s (MAS) <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</a> program is one way that physicians and medical students can encourage youth to consider careers in medicine. You can contact the AMA-MAS <a href="mailto:mas@ama-assn.org?subject=Doctors%20Back%20to%20School" rel="nofollow">via email</a> for additional information and to request supplies and suggestions for your school visits. Last year AMA-MAS members reached more than 10,000 students across 17 states through this program.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7d76882d-c932-4886-86d6-c96faaaeb282 21 med students selected as future minority physician leaders http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_21-med-students-selected-future-minority-physician-leaders Mon, 03 Aug 2015 21:11:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;" width="365"> <tbody> <tr> <td> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/1/30e50dae-203c-45b9-9116-d55104af71c9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/1/30e50dae-203c-45b9-9116-d55104af71c9.Large.jpg?1" /></a></p> </td> <td>  </td> </tr> <tr> <td> <p align="right"> <span style="font-size:11px;"><em>Denise Kimbrough, a 2015 Minority Awards Scholar and second-year student at Medical University of South Carolina, College of Medicine. </em></span><em style="font-size:11px;">  </em></p> </td> </tr> </tbody> </table> <p> Diversity in the medical profession and health equity for minority populations have stepped into the spotlight with the recognition of 21 medical students as future minority physician leaders. Find out who they are and how they plan to succeed while promoting diversity in medical education.</p> <p> Research shows that <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1792913" rel="nofollow" target="_blank">diversifying the physician workforce</a> can reduce health disparities and improve patient outcomes among minority patient populations. Yet less than 9 percent of U.S. physicians actually have African-American, Hispanic, Native American, Native Hawaiian or Alaska Native heritages, according to AMA data.</p> <p> That’s where the AMA Foundation’s Minority Scholars Award comes in. The annual award gives $10,000 scholarships to first- and second-year students who demonstrate high academic achievement and a commitment to improving minority health.</p> <p> This <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/2015-minority-scholars-award-recipients.page" target="_blank">year’s awardees</a> hail from medical schools across the country—spanning more than a dozen states—and represent culturally diverse experiences in training, including international medical school graduates. Here’s what they have to say about the support students need to thrive in training, facing cultural adversity and improving health disparities.</p> <p> <strong>What fuels their passion for health equity </strong><br /> Improving health disparities is a necessary but complex task for physicians. Here’s why these medical students say they’re committed to </p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;" width="365"> <tbody> <tr> <td> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/12/a2fc4ee6-98db-45ac-acc5-da6cccf7f9b3.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/2/12/a2fc4ee6-98db-45ac-acc5-da6cccf7f9b3.Large.jpg?1" /></a></p> </td> <td>  </td> </tr> <tr> <td> <p align="right"> <span style="font-size:11px;"><em> Franklyn Rocha-Cabrero, a 2015 Minority Awards Scholar and  third-year student at University of Illinois College of Medicine-Rockford.</em></span></p> </td> </tr> </tbody> </table> <p> the cause. </p> <p> “I enjoy giving back, having an impact in the community, and being a leader within organizations such as the AMA and the Latino Medical Student Association (LMSA),” said Franklyn Rocha-Cabrero, a third-year student at University of Illinois College of Medicine-Rockford.</p> <p> For other awardees, the passion has roots in early personal experiences.</p> <p> “My grandfather had multiple heart attacks when I was child, which sparked my interest in the cardiovascular system,” said Denise M. Kimbrough, PhD, a second-year student at the Medical University of South Carolina, College of Medicine. “What stuck out the most was after each visit, his surgeon would sit with the family and insist that my grandfather needed a good primary care physician and cardiologist to follow up with.”</p> <p> “He could have chosen to just continue to see my grandfather and perform surgery after surgery, but instead he saw a man who lacked good preventative care,” Kimbrough said. “He saw a person whom he felt he didn’t need to keep seeing [in the hospital], and he made a suggestion that was not beneficial to him [as a surgeon] but that was instead the right choice for his patient. ... In that act, I could see myself helping another family, so that they too got to spend more time with their loved ones, and I knew medicine was for me.”</p> <p> Kimbrough is a recipient of the Dr. Richard Allen Williams and Genita Evangelista Johnson/Association of Black Cardiologists Award, a special scholarship given as part of the Minority Scholars Award to promote diversity in medicine and support future African-American cardiologists.</p> <p> <strong>Advice for students coping with cultural adversity </strong></p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;" width="365"> <tbody> <tr> <td> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/3/5cf16781-da25-4d90-8359-ef8ebc379276.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/3/5cf16781-da25-4d90-8359-ef8ebc379276.Large.jpg?1" /></a></p> </td> <td>  </td> </tr> <tr> <td> <p align="right"> <span style="font-size:11px;"><em>Kendrick Kennedy, a 2015 Minority Awards Scholar and second-year student at Medical University of South Carolina, College of Medicine.</em></span></p> </td> </tr> </tbody> </table> <p> No two students’ experiences are the same, but taking certain measures can help build resiliency for those who grapple with cultural challenges in training.</p> <p> “It is challenging to be a student of color in any profession, but [it] can be more profound in schools where you might be one of the few in your class,” Rocha-Cabrero said. “Surround yourself with mentors and administration that are legitimately interested in helping you succeed. Don’t be afraid to reach out to advisors you trust and be honest about the issues you have encountered or need help with.”</p> <p> Kimbrough also noted that minority students should share their opinions and perspectives. “The one thing I have learned is that if you don’t speak up, you can’t be heard,” she said. “So voice your opinion, respectfully of course, [and] make sure people pay attention.”</p> <p> <strong>How they plan to address health disparities</strong><br /> Minority Scholars have plans in mind for how they will make a difference as future physician leaders, and much of that will start in the exam room.</p> <p> “As a physician, [I’d like to] continue to promote appropriate patient education in a manner that is well received by the population in which I serve,” said Kendrick Kennedy, a second-year student at the Medical University of South Carolina, College of Medicine. </p> <p> Kennedy noted that heart disease and stroke are the <a href="http://www.ama-assn.org/ama/ama-wire/post/cdc-1-3-heart-disease-deaths-preventable" target="_blank">No. 1 and No. 4 killers of Americans</a>, respectively. But the risk of acquiring these diseases is <a href="http://millionhearts.hhs.gov/abouthds/risk-factors.html#hdRace" rel="nofollow" target="_blank">significantly higher</a> for African Americans.</p> <p> “[My] ultimate goal is to facilitate open communication between the provider and the patient while also assisting with the promotion of progressive health behaviors,” Kennedy said. “With proper health education and continuous exposure to diverse teaching methods, [I believe] we will begin to reduce the number of [patients] with diseases that are associated with the progression of cardiovascular illnesses.”</p> <p> Kimbrough also pointed to the importance of educating patients about representation in clinical studies and participating in research.</p> <p> “Current cardiovascular therapies are often not tested on representative populations; therefore, breakthrough drugs are truly only a breakthrough for certain individuals,” she said. “I hope to use my position as a physician to encourage minorities to participate in these studies by conveying the importance to them.”</p> <p> The <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> are given in partnership with the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page?" target="_blank">AMA Minority Affairs Section</a> and the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a>. To learn more about this year’s winners, <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/2015-minority-scholars-award-recipients.page" target="_blank">see the list of all 21 Minority Scholars</a>. Applications for the award will open in the winter, so be sure to tune into <em>AMA Wire</em><sup>® </sup>for details on how to apply.</p> <p> <strong>For more on diversity and health disparities:</strong></p> <ul> <li>  See <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">how these medical schools are tackling challenges</a> in health disparities and cultural competencies.</li> <li> Educate yourself and your peers on the <a href="http://www.ama-assn.org/ama/ama-wire/post/debunking-5-myths-diversity-medical-education" target="_blank">5 myths of diversity in med ed</a>.</li> <li> Watch <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">this Google hangout</a> to learn more ways schools and students are promoting diversity in medical education.</li> </ul> <p align="right" style="margin-left:4in;"> <em>By AMA staff writer</em> <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow"><em>Lyndra Vassar</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3095df4a-aae8-46d4-b851-107c5157998b How community health workers can improve your patients’ health http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_community-health-workers-can-improve-patients-health Mon, 03 Aug 2015 20:49:00 GMT <p> A new recommendation for preventing cardiovascular disease based on an in-depth evidence review calls for engaging community health workers to help patients manage risk factors.</p> <p> The Community Preventive Services Task Force, a group that identifies population health interventions and makes recommendations to health departments and communities, last week <a href="http://www.thecommunityguide.org/cvd/CHW.html" rel="nofollow">released its findings</a> on how engaging community health workers in a team-based care model can improve patients’ blood pressure and cholesterol.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/1/3337634c-f1e1-408c-91ed-b445bcc4ece4.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/1/3337634c-f1e1-408c-91ed-b445bcc4ece4.Large.jpg?1" style="float:right;margin:15px;" /></a>The findings support interventions that engage these workers for health education, outreach and enrollment in programs. Community health workers also can serve as information agents who help increase important healthy behaviors such as physical activity, beneficial eating habits and smoking cessation in patients at increased risk for cardiovascular disease.</p> <p> Most of the studies included in the review focused on community health workers and minority and medically underserved groups, suggesting these interventions can be effective in improving minority health and reducing health disparities.</p> <p> Community health workers serve as the bridge between communities and health care systems, <a href="http://www.cdc.gov/dhdsp/docs/chw_brief.pdf" rel="nofollow">according to</a> the Centers for Disease Control and Prevention. They have a close understanding of the community they serve and are trained to provide culturally appropriate health education and information, offer social support and informal counseling, and connect people with needed services. In some cases, they also deliver health services such as blood pressure screening.</p> <p> <strong>Identifying local ways to control blood pressure</strong></p> <p> To help control blood pressure, community health workers can help patients learn how to reduce their daily intake of sodium, <a href="http://www.cdc.gov/bloodpressure/docs/mh_commhealthworker_factsheet_english.pdf" rel="nofollow">according to</a> the Centers for Disease Control and Prevention. They may also work with patients to find easy, less expensive ways to increase the intake of fruits and vegetables and ways to stay active in patients’ neighborhoods.</p> <p> Community health workers are crucial because one in three adults has high blood pressure, and cardiovascular disease is the No. 1 cause of death in the United States. Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">Improving Health Outcomes</a> initiative, the AMA is helping physicians improve blood pressure control.</p> <p> 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> Physicians are encouraged to use community linkages, such as community health care workers, to help their 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>. Watch <em>AMA Wire</em>® in the coming weeks for more on how to engage others in your patients’ care.</p> <p> Here are more resources to help improve your practice’s hypertension control rates:</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> </ul> <p align="right" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:right;"> <i><span style="font-family:"color:#1A1414;">By AMA staff writer</span></i><span style="font-family:"color:#1A1414;"> <i><a href="https://twitter.com/Lauren_AMAWire" target="_blank" rel="nofollow">Lauren Rees</a></i><p></p></span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e415607d-533c-4dd7-9fee-22eefa31aff0 5 resources that help physicians address opioid Rx issues http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-resources-physicians-address-opioid-rx-issues Fri, 31 Jul 2015 20:20:00 GMT <p> The data doesn’t lie—with 44 people dying each day in the United States from an overdose of opioids, it’s clear something needs to be done to stop this epidemic. One way physicians can help is to take advantage of educational opportunities to better understand optimal care for each patient.</p> <p> The <a href="http://pcss-o.org/" rel="nofollow" target="_blank">Providers’ Clinical Support System for Opioid Therapies</a> (PCSS-O), a collaborative of national health care organizations that includes the AMA, develops free, evidence-based educational opioid use resources for physicians. Physicians can use the PCSS-O’s <a href="http://pcss-o.org/modules" rel="nofollow" target="_blank">online modules</a> and <a href="http://pcss-o.org/calendar-of-events/list/?action=tribe_list&tribe_event_display=past&tribe_eventcategory%5B%5D=5" rel="nofollow" target="_blank">webinars</a> for information they can put to use in their daily practice.</p> <p> Here are five resources from the PCSS-O, some of which offer continuing medical education credit in the form of <em>AMA PRA Category 1 Credit(s)</em>™:</p> <ol> <li> Pediatricians can use a special six-part series to learn more about pediatric pain management. The next <a href="http://pcss-o.org/event/putting-the-pieces-together-strategies-for-pain-management/" rel="nofollow" target="_blank">webinar</a> in this series, from noon to 1 p.m. Eastern time Aug. 6, will focus on treatment options for pain and how to minimize drug diversion.<br />  </li> <li> Physicians in primary care can be the first line of assistance for patients who misuse opioids. A <a href="http://pcss-o.org/event/an-sbirt-approach-to-pain-and-addiction/" rel="nofollow" target="_blank">webinar</a> from noon to 1 p.m. Eastern time Sept. 1 will explain how physicians can use the “SBIRT” method—screening, brief intervention and referral to treatment—to reduce misuse.<br />  </li> <li> Increased use of prescription drug monitoring programs (PDMP) can help physicians identify patients at risk for opioid misuse. A <a href="http://pcss-o.org/event/how-to-optimize-use-of-state-prescription-drug-monitoring-programs/" rel="nofollow" target="_blank">webinar</a> from noon to 1 p.m. Eastern time Sept. 2 will give physicians the basics on PDMPs and how to maximize their benefit.<br />  </li> <li> Physicians who treat patients with low back pain may benefit from a <a href="http://pcss-o.org/2014/10/28/approach-to-use-of-opioids-in-patients-with-low-back-pain/" rel="nofollow" target="_blank">module</a> on whether to use opioids to treat these patients. The module addresses psychosocial contributors to pain and recognizes that opioids are not first-line treatment for low back pain and may not be appropriate for many patients.<br />  </li> <li> Older adults <a href="http://www.oas.samhsa.gov/2k10/229/229OlderAdms2k10Web.pdf" rel="nofollow" target="_blank">represent</a> an increasing proportion of individuals who misuse drugs. One <a href="http://pcss-o.org/2014/10/28/prescription-opioid-addiction-and-chronic-pain-in-older-adults/" rel="nofollow" target="_blank">module</a> can help physicians make an overall plan for pain assessment and management in older adults.</li> </ol> <p> Physicians interested in medication-assisted treatment also can register for an upcoming webinar from the <a href="http://pcssmat.org/" rel="nofollow" target="_blank">Providers’ Clinical Support System for Medication Assisted Treatment</a>. The <a href="http://pcssmat.org/involving-the-family-in-treatment-for-substance-use/" rel="nofollow" target="_blank">webinar</a>, to be held from 3 to 4 p.m. Eastern time Sept. 3, will address the impact that substance use has on families and how physicians can engage families to improve the patient’s health.</p> <p> <strong>Why physicians are crucial to stopping the epidemic</strong></p> <p> The AMA has convened a <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/preventing-opioid-abuse/opioid-abuse-task-force.page?" target="_blank">task force</a> with the American Osteopathic Association, the American Dental Association, and more than 20 state and specialty medical associations to work collaboratively to address the opioid public health epidemic by identifying best practices and implementing them across the country.</p> <p> The group identified <a href="http://www.ama-assn.org/ama/ama-wire/post/physicians-can-stop-opioid-overdose-epidemic" target="_blank">three initial steps physicians can take</a> now to help their patient populations:</p> <ul> <li> <strong>Register and use state-based prescription drug monitoring programs.</strong> Register for and consult these databases to identify patients at risk for opioid misuse and help patients with substance use disorders get appropriate treatment.<br />  </li> <li> <strong>Discuss with patients available treatment options.</strong> When caring for patients with pain, understand the best possible course for managing that pain with the tools available.<br />  </li> <li> <strong>Take advantage of educational opportunities.</strong>  Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/preventing-opioid-abuse.page" target="_blank">Opioid Abuse Prevention Web pages</a> to access resources to enhance your education, and promote comprehensive, appropriate pain treatment while safeguarding against opioid overdose.</li> </ul> <p>  </p> <p align="right"> <em>By AMA staff writer</em> <em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" target="_blank">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:db8c3efb-dd38-4a64-bfa9-4946454c81c6 How physicians will steer implementation of the SGR repeal law http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-will-steer-implementation-of-sgr-repeal-law Fri, 31 Jul 2015 20:06:00 GMT <p> The Medicare Access and CHIP Reauthorization Act (MACRA), the law that <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">eliminated the sustainable growth rate</a> (SGR) formula, has a variety of provisions physicians need to know—and many implications for the future of Medicare. Learn how physicians will work to influence how the law is put into practice.</p> <p> <strong>What’s in the SGR repeal law</strong></p> <p> MACRA will do a lot of things, including:</p> <ul> <li> Change <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr" target="_blank">payments and penalties</a> for physicians in fee-for-service practice by aligning quality reporting programs into one merit-based incentive payment system (MIPS)</li> <li> Provide important <a href="http://www.ama-assn.org/ama/ama-wire/post/sgr-repeal-law-affects-medical-liability" target="_blank">medical liability protections</a> by incorporating the Standard of Care Protection Act</li> <li> Ensure access to care for kids by <a href="http://www.ama-assn.org/ama/ama-wire/post/sgr-repeal-law-ensures-access-care-kids" target="_blank">extending funding</a> for the Children’s Health Insurance Program, which provides low-cost health care coverage to kids in low-income families who don’t qualify for Medicaid</li> <li> Support physician transitions to <a href="http://www.ama-assn.org/ama/ama-wire/post/sgr-repeal-law-supports-new-payment-models" target="_blank">new payment models</a> by providing 5 percent bonus payments, technical assistance grants and establishing a payment models advisory committee</li> </ul> <p> <strong>What physicians are focusing on</strong></p> <p> Last month, the AMA convened a meeting with leaders from 19 specialty and state medical societies to discuss key elements of MACRA and how physicians can successfully navigate the new law.</p> <p> To start, the AMA will educate physicians about the coming changes and develop resources to help them understand their options and choices under MACRA, particularly those in small and independent practices. The AMA also will develop mechanisms to ensure frequent communication and good cooperation with all the state societies and national specialty societies as the regulatory and implementation process gets underway.</p> <p> Here are more ways the AMA is working to make MACRA implementation beneficial for patients and their physicians:</p> <ul> <li> Although maximum penalties under the MIPS will be lower than potential penalties under previous law, the MIPS program will only be as good as the programs rolled into it. To make the MIPS useful, improvements must be made to the electronic health record meaningful use program, Physician Quality Reporting System and value-based modifier.<br />  </li> <li> The support for alternative payment models is encouraging, but the medical community needs to be engaged in designing the new models to make sure they break down the barriers and allow needed flexibility to improve patient care.<br />  </li> <li> The AMA will develop two workgroups—one to focus on the MIPS, one to focus on the alternative payment models pathway—to build on physician experiences and best practices as implementation proceeds.</li> </ul> <p> MACRA also authorizes a Physician-Focused Payment Model Technical Advisory Committee, which will review proposed models and provide recommendations to the U.S. Department of Health and Human Services. The Comptroller General of the United States will appoint the 11 committee members this October.</p> <p> Participants at the AMA-convened meeting stressed the need to develop consensus on a set of principles, such as fairness and transparency, to guide future steps on MACRA implementation.</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 the MACRA, 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 and read a <a href="http://www.ama-assn.org/ama/ama-wire/blog/SGR_Repeal_Series/1" target="_blank">series of articles</a> about the legislation at <em>AMA Wire</em>.</p> <p align="right"> <em>By AMA staff writer</em> <em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" target="_blank">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b9336a59-75ef-4586-ba33-0e538fc0107e Congress moves to delay Stage 3 of meaningful use http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_congress-moves-delay-stage-3-of-meaningful-use Thu, 30 Jul 2015 15:59:00 GMT <p> The U.S. Congress may step in to the Centers for Medicare & Medicaid Services (CMS) electronic health record (EHR) meaningful use program, with both chambers taking action on the third and final stage of the program.</p> <p> Rep. Renee Ellmers, R-N.C., yesterday introduced her Further Flexibility in HIT Reporting and Advancing Interoperability Act (Flex IT 2 Act), which would provide more flexibility in the meaningful use program and ensure EHR systems address interoperability challenges. The bill also would pause Stage 3 rulemaking to align it with technology advancements and the new <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr">merit-based incentive payment system</a>, which will combine current quality programs.</p> <p> “This important bill addresses many of the fundamental shortcomings in government regulations that have made many EHR systems very difficult to use,” AMA President Steven J. Stack, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-07-30-legislative-effort-revise-meaningful-use-program.page">statement</a>. “We heard loud and clear from physicians at the AMA’s first-ever town hall meeting on EHRs and the Meaningful Use program that the systems they use are cumbersome, poorly designed and unable to ‘talk’ to each other thereby preventing necessary transmission of patient medical information.”</p> <p> Meanwhile, Sen. Lamar Alexander, R-Tenn., chair of the U.S. Senate Health, Education, Labor and Pension Committee (HELP), last week asked U.S. Secretary of Health and Human Services Sylvia Burwell to consider a delay in the release of the final rule on Stage 3.</p> <p> <strong>Physicians ramp up calls for changes to program</strong></p> <p> The action in Congress comes just days after the AMA’s town hall meeting on EHRs and the meaningful use program, held with the Medical Association of Georgia. About 50 Atlanta-area physicians attended the event last week, which was live-streamed to about 500 registrants. Physicians discussed their everyday challenges with EHRs and burdensome government regulations that detract from patient care.</p> <p> One physician at the event, Albert Johary, MD, who practices internal medicine in an Atlanta suburb, is in his fourth year of meaningful use. He said the program has slowed down productivity in his practice by about 25-30 percent.</p> <p> “There are so many more things that you have to report on that I don’t think really add to patient care,” Dr. Johary said. “I’m trying to work with it. I think meaningful use is not necessarily a bad thing. But I don’t think [patients] have an idea what we’re going through. To give them a copy of their note, it’s not just printing it … there are four or five steps just to give somebody a copy of their note.”</p> <p> At the event, Dr. Stack asked physicians to <a href="http://breaktheredtape.org/email-congress" rel="nofollow">contact their members of Congress</a> and ask them to halt Stage 3 of meaningful use until the program is fixed. The AMA has been <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-should-stop-stage-3-of-meaningful-use">calling for CMS to stop Stage 3</a> to assess how changes to earlier stages of the program will affect physician participation and success.</p> <p> Visit <a href="http://breaktheredtape.org/" rel="nofollow" target="_blank">breaktheredtape.org</a> to watch the town hall meeting, share your stories about EHRs and meaningful use, and contact your members of Congress.</p> <p align="right"> <em>By AMA staff writer</em> <em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" target="_blank">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8f11bd52-6199-4cc4-bffb-c97b2898a439 New grant to aid transformation of physician training http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-grant-aid-transformation-of-physician-training Thu, 30 Jul 2015 13:00:00 GMT <p> A transformation is underway for medical education as a progressive initiative advances its work to create the medical school of the future. As many as 20 additional MD- and DO-granting med schools will join in this effort, implementing bold projects with a new funding opportunity from the AMA.  </p> <p> <strong>Expanding the success of the AMA consortium</strong><br /> The AMA has partnered since 2013 with 11 leading medical schools as part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">Accelerating Change in Medical Education</a> initiative, which provided $1 million grants to each school to help fund novel programs that bridge the gap between how physicians are currently trained and the future needs of our health care system.</p> <p> These 11 schools, the <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/schools.page" target="_blank">founding members</a> of the Accelerating Change in Medical Education Consortium, are making significant strides in reshaping medical education.</p> <p> The AMA now is inviting additional schools to apply to join the consortium and work together with the founding 11 schools to share innovative ideas and best practices on new programs and curricula.</p> <p> Schools interested in applying should have the capacity to adopt, implement and build on <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page#section2-inner" target="_blank">the innovations</a> that have emerged from the founding members of the Accelerating Change in Medical Education Consortium or have their own unique projects for promoting systemic change in undergraduate medical education that they are interested in sharing with both new and founding consortium members.</p> <p> Proposals may fit one of six consortium themes: </p> <ul> <li> <strong>Developing flexible, competency-based pathways</strong><br /> Learn how several consortium schools are <a href="http://www.ama-assn.org/ama/ama-wire/post/medical-education-explores-competency-based-assessment" target="_blank">reshaping</a> competency-based assessments.</li> </ul> <ul> <li> <strong>Teaching and/or assessing new content in health care delivery sciences</strong><br /> Review the creative innovations consortium schools are adopting around <a href="http://www.ama-assn.org/ama/ama-wire/post/new-third-science-bedrock-transforming-med-ed" target="_blank">this new core science</a>.</li> </ul> <ul> <li> <strong>Working with health care delivery systems in novel ways</strong><br /> Find out <a href="http://www.ama-assn.org/ama/ama-wire/post/pivoting-new-way-of-training-future-physicians-mayo-clinic" target="_blank">how one consortium school prepares</a> future physicians to practice complex patient care.</li> </ul> <ul> <li> <strong>Making technology work to support learning and assessment</strong><br /> Get expert <a href="http://www.ama-assn.org/ama/ama-wire/post/equip-new-doctors-digital-health-frontier" target="_blank">insights into health IT</a> from a recent consortium meeting on informatics.</li> </ul> <ul> <li> <strong>Envisioning the master adaptive learner</strong><br /> Here’s <a href="http://www.ama-assn.org/ama/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">how consortium schools plan</a> to incorporate lifelong learning into the undergraduate medical education curriculum.</li> </ul> <ul> <li> <strong>Shaping tomorrow’s leaders</strong><br /> Read about one consortium school’s <a href="http://www.ama-assn.org/ama/ama-wire/post/one-schools-new-approach-producing-physician-leaders" target="_blank">creative approach</a> to shaping future physician leaders.</li> </ul> <p> Projects that do not fit one of these themes but add value to the consortium will be considered.</p> <p> “In such a short amount of time, our consortium schools have made impressive strides toward creating the medical school of the future,” AMA President Steven J. Stack, MD, said in a news release. “Many of the schools have already implemented new curriculum models that are supporting innovative training for 7,000 medical students who will one day care for more than 12.2 million patients each year.”</p> <p> “It is because of this tremendous progress that we’ve decided to collaborate with more medical schools and continue on the path to spreading innovation across the entire medical education system to close the gaps that exist between the way physicians are educated and how health care will be delivered in the future,” Dr. Stack said.</p> <p> <strong>What these grants mean for innovations in medical education</strong><br /> Up to 20 schools will be selected to receive three-year grants based on innovation education projects underway at their local institutions. Starting Jan. 1, each school will receive a grant award of  $75,000 disbursed over the course of three years.</p> <p> Participating schools will select principal investigators to attend two consortium meetings for each year of the grant, participate in several thematic meetings and participate in national evaluation activities.</p> <p> Such events aim to give schools the chance to design real solutions in collaborative settings.</p> <p> “Bringing systemic change to our medical education system as we know it will require many more partners and many more schools,” said Susan E. Skochelak, MD, AMA Group Vice President for Medical Education. “We are excited about the high level of interest that we’re seeing from medical schools for changing and enhancing medical education in our country, and look forward to growing the community of innovation that we’ve created with new ideas and fresh perspectives from additional medical schools.” </p> <p> <strong>How to apply</strong><br /> Proposals are due Sept. 16 at 6 p.m. Eastern time, and schools will be notified of their acceptance Oct. 30.</p> <ul> <li style="margin-left:0.5in;"> Find out <a href="http://www.ama-assn.org/ama/ama-wire/post/schools-students-transforming-med-ed-now-can">what the consortium is looking for</a> in this year’s applicants, then <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">submit a proposal for consideration</a>.</li> <li style="margin-left:0.5in;"> Learn more about the <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/schools.page" target="_blank">11 medical schools</a> in the Accelerating Change in Medical Education Consortium and <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education/innovations.page" target="_blank">the current projects</a> they have underway.</li> <li style="margin-left:0.5in;"> Review the <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/ama-ace-promotion-new-models-in-meded-rfa.pdf">consortium application FAQs</a> (login). </li> </ul> <p style="text-align:right;"> <em style="text-align:right;color:rgb(26, 20, 20);line-height:18.2px;font-family:Gotham, "font-size:13px;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);overflow:hidden;cursor:pointer;word-wrap:break-word;">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b8f22b29-1de5-4092-9a9d-5f439212793e 7 tips for how to master patient handoffs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_7-tips-master-patient-handoffs Wed, 29 Jul 2015 21:20:00 GMT <p> High-quality patient handoffs <a href="http://www.ama-assn.org/ama/ama-wire/post/medical-errors-curtailed-through-patient-handoff-program-study-finds" target="_blank">can reduce medical errors</a> and prevent adverse events in patient care, but learning how to effectively manage handoffs requires a special skill of its own. Follow these expert tips to improve handoffs and enhance team-based care in training.</p> <p> Vineet Arora, MD, an academic hospitalist and associate professor at the University of Chicago Medicine, specializes in improving the learning environment for medical trainees and the quality, safety and experience of care delivered to hospitalized adults. She also is an internationally recognized expert on patient handoffs.</p> <p> While there is no magic “cure all” for bad handoffs in complex health systems, Dr. Arora said there are certain guidelines and best practices physicians in training can implement to improve communication in clinical settings and improve patient safety. She discusses some of these in a video that is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/succeeding-medical-school-practice.page?" target="_blank"><em>Succeeding from Medical School to Practice</em></a> resource:<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/8/2426dac7-e304-423a-9803-40e7cb9c3241.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/8/2426dac7-e304-423a-9803-40e7cb9c3241.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Avoiding “back channeling.”</strong> This often occurs in “data dump” situations when one physician quickly runs through his or her notes about a patient while the person receiving the handoff nods or utters filler phrases like “uh-huh” during the conversation to passively express that they understand the information that’s being communicated, Dr. Arora said.<br /> <br /> “[T]hat is not an active display of understanding,” she said. “Handoffs are meant to be a conversation, so the next time you are in a handoff [ask yourself], ‘How can I, as the receiver, take a more active role and assure the sender that I really understand everything?’”</p> <p style="margin-left:40px;"> <strong>2.  </strong><strong>Conducting intern interviews.</strong> “Understanding what went wrong and why things fail is the first step to improving patient safety,” Dr. Arora said, which is why she conducted “critical incident interviews” with interns at the University of Chicago. These interviews were designed to ask honest questions about communication errors that could lead to patient harm and solicit suggestions for improvement.<br /> <br /> In these interviews, she learned that “the worse event interns reported from a bad handoff was resuscitating somebody who is a DNR … and the most minor or annoying distraction people reported was their printer being out of paper.”<br /> <br /> Residency programs seeking to improve handoffs can pilot a similar feedback process to determine the key barriers to effective patient communication among trainees, she said.   </p> <p style="margin-left:40px;"> <strong>3.  </strong><strong>Ensuring that all written sign-outs are clear.</strong> While sign-out processes vary by specialty and program, “the overall features of an effective written sign-out [are] that they should be …accurate and update to date,” Dr. Arora said. She noted that keeping the patients’ information updated is an intrinsic but pertinent challenge for trainees who often act as the “masters of information” for patients.</p> <p style="margin-left:40px;"> <strong>4.  </strong><strong>Offering face-to-face interaction.</strong> A <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837504/" rel="nofollow" target="_blank">study</a> of handoff processes among internal medicine residents confirmed that “[physicians in training] desired a verbal sign-out that was face to face [and] only reviewed the anticipated issues [about a patient].”<br /> <br /> While physicians have multiple channels for communication, “the highest level of communication still occurs when we are face to face with someone,” she said. “That is the highest, most effective level of communication.”</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Providing the most pertinent patient information.</strong> When conducting or receiving a handoff, ask yourself, “What information do I really need to effectively care for this patient right now?” Instead of offering unnecessary biographic details about your patient or running through every review system in their physical exam, Dr. Arora urges physicians in training to focus on the major “if-then” and “to-do” items about the patient.<br /> <br /> “Don’t worry about [explaining] that Mrs. Smith is from Michigan, and this is what her CT showed,” she said. “If it doesn’t relate to the anticipatory guidance, it’s probably okay to leave it on the written information and move on.”</p> <p style="margin-left:40px;"> <strong>6.  </strong><strong>Knowing which clinical tasks are susceptible to fatigue.</strong> “There are familiar tasks that are more susceptible to handoffs,” she said. “A lot of them deal with complex decision making.”<br /> <br /> For instance, “studies show that when you’re tired, it takes you four times longer to put in an arterial line.” Shortness of breath, patient discharge and end-of-life care also have been linked to studies on fatigue.</p> <p style="margin-left:40px;"> <strong>7.  </strong><strong>Paying special attention to high-risk handoffs.</strong> “You have to think about the type of handoffs you’re working with,” Dr. Arora said. “There are many different types of handoffs, and some of the highest-risk handoffs are when the patient’s physically moving, they’re critical or unstable.”<br /> <br /> High-risk handoffs also increase in situations where the handoff may be permanent or it marks the first time the physician is hearing about a patient, Dr. Arora said.</p> <p> Physicians in training can access a variety of resources to help hone their handoff skills, including model procedures, educational videos and specialty-specific recommendations. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/rfs-resources/patient-handoffs.page" target="_blank">Learn more</a> about these resources for safer, more streamlined handoffs. </p> <p style="text-align:right;"> <em>By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ddad0c68-653f-4aa6-ae85-f6b2d6caa9e5 What physicians can do to stop the opioid overdose epidemic http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-can-stop-opioid-overdose-epidemic Wed, 29 Jul 2015 13:00:00 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 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/ddf19058-8a99-4413-be74-a1d739c83b51.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/13/14/ddf19058-8a99-4413-be74-a1d739c83b51.Large.jpg?1" style="margin:15px;float:left;" /></a>With 44 people dying each day in the United States from an overdose of opioids, we physicians see people affected by this epidemic on a regular basis—whether it’s in our local newspapers or in our own offices.</p> <p> From the inner city to the suburbs and rural regions, no community is untouched. But there are things we can do to amplify our current efforts.</p> <p> That’s why the AMA has convened a <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/preventing-opioid-abuse/opioid-abuse-task-force.page?" target="_blank">task force</a> with more than 20 state and specialty medical associations, the American Osteopathic Association and the American Dental Association to work collaboratively to address the opioid public health epidemic by identifying best practices and implementing them across the country. This epidemic is complex, and the remedy won’t be simple. It will require a sustained, comprehensive approach.</p> <p> As a group, we have developed a strong roadmap that we hope will bring America’s physicians, other health care professionals and patients together as partners on the path to eliminating this public health epidemic.</p> <p> Our initial focus is on steps we physicians can take now to help our patient populations:</p> <ul> <li> <strong>Use state-based prescription drug monitoring programs (PDMP).</strong> We should register for and consult these databases to identify patients at risk for opioid misuse and help patients with use disorders get appropriate treatment.<br />  </li> <li> <strong>Discuss with patients available treatment options.</strong> When caring for patients with pain, we need to understand the best possible course for managing that pain with the tools available to us.<br />  </li> <li> <strong>Take advantage of educational opportunities.</strong> Engaging in robust education activities that meet the needs of our specialties, practices and patient populations is key to delivering appropriate care for each patient. Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Opioid Abuse Prevention Web pages</a> to access resources to enhance your education, and promote comprehensive, appropriate pain treatment while safeguarding against opioid overdose. Resources also support treating patients with substance use disorders and expanding access to naloxone.</li> </ul> <p> The AMA also is calling on states to make sure their PDMPs are truly valuable tools. These databases need to protect patient privacy, contain relevant and reliable data, allow care teams to seamlessly integrate that data into their work flows, and enable data sharing across state lines.</p> <p> In the coming months, we’ll share additional recommendations and educational resources from the task force that can help you in your daily practice of medicine.</p> <p> America’s patients who live with acute and chronic pain deserve compassionate, high-quality and personalized care. We are committed to equipping the physician community to achieve that goal so patients can live longer, fuller and more productive lives.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dd011c20-7df6-4175-8441-a3ee4f959c8c 6 steps to start Lean health care in your practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-steps-start-lean-health-care-practice Tue, 28 Jul 2015 21:01:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/7/416701c1-7a3a-4c27-97b3-27af4cdf6a8e.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/7/416701c1-7a3a-4c27-97b3-27af4cdf6a8e.Large.jpg?1" style="margin:15px;float:right;" /></a>More physician practices are starting to “go Lean,” using management principles from manufacturing companies to eliminate waste, improve efficiency and add value for patients. Learn how to implement Lean methods in your practice.</p> <p> Lean manufacturing is a philosophy from the Toyota Production System, focused on systematically eliminating waste created through inefficiencies or unevenness in workloads. Although health care and auto manufacturing are totally different, there are important similarities, according to the Institute for Healthcare Improvement (IHI).</p> <p> “Whether building a car or providing health care for a patient, workers must rely on multiple, complex processes to accomplish their tasks,” an IHI <a href="http://www.ihi.org/resources/Pages/IHIWhitePapers/GoingLeaninHealthCare.aspx" rel="nofollow" target="_blank">white paper</a> on Lean said. “Waste—of money, time, supplies or good will—decreases value.”</p> <p> A <a href="https://www.stepsforward.org/modules/lean-health-care" rel="nofollow">free online module</a>, part of the AMA’s <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a> website, shows you how to implement Lean principles in your practice. By engaging your fellow physicians and staff in Lean, your practice can run more smoothly. Here are the six steps to starting Lean.</p> <p style="margin-left:40px;"> <strong>1.  </strong><strong>Identify a high-level champion.</strong><br /> <br /> Lean requires culture change and therefore requires the buy-in of a high-level person, such as the lead physician for the practice. This person should have sufficient authority and access to organizational resources and should be dedicated to leading the effort.</p> <p style="margin-left:40px;"> <strong>2.  </strong><strong>Create an interdisciplinary improvement team.</strong><br /> <br /> Members of this team should be from all areas of your practice—reception staff, nurses, administration and other areas. It is important that everyone understands from the beginning that the group’s purpose is to work together toward a common organizational goal.</p> <p style="margin-left:40px;"> <strong>3.  </strong><strong>Empower front-line workers.</strong><br /> <br /> Successful Lean projects are usually chosen and designed by the people doing the work. Use the AMA’s <a href="https://www.stepsforward.org/Static/images/modules/11/downloadable/Starting_Lean_Health_Care.pdf" rel="nofollow">team improvement idea worksheet</a> to identify everyday problems in the practice and easy-to-implement solutions. The idea is to change the culture to be one in which all team members are empowered to identify sources of inefficiency and innovative solutions.</p> <p style="margin-left:40px;"> <strong>4.  </strong><strong>Choose a starter project.</strong><br /> <br /> The best way to learn Lean is to dive in. Pick a project that is small but meaningful—for example, decreasing the number of steps in the patient registration process, reducing faxes between different offices or improving inbox management.</p> <p style="margin-left:40px;"> <strong>5.  </strong><strong>Celebrate and spread.</strong><br /> <br /> Share how you’ve improved processes with others in the practice to help build a team culture. And if the solution doesn’t work, it’s not a failure. Your team can celebrate the problem-solving and learning process and try again.</p> <p style="margin-left:40px;"> <strong>6.  </strong><strong>Make the improvement stick.</strong><br /> <br /> Encourage lasting change by naming the new process and making it part of standard work for everyone involved. Remind staff of the improvement using visual systems that reinforce the new process, such as a checklist or flow diagram that they see at the point of work.</p> <p> <a href="https://www.stepsforward.org/modules/lean-health-care" rel="nofollow">Complete the module</a> on STEPS Forward to learn more details, get answers to common questions and concerns, and access case vignettes about how practices are successfully using Lean techniques to provide better patient care. The module also offers continuing medical education credit.</p> <p> <strong>Submit your ideas: Practice Innovation Challenge</strong><br /> The Lean module and the 15 others 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 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> <p style="margin-left:0.25in;text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;">By AMA staff writer</em><span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;"> </span><em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;"><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:267f1939-1657-4143-ae4b-726220107c06 Medicare, Medicaid turn 50: Taking a look at their past and future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medicare-medicaid-turn-50-taking-look-their-past-future Tue, 28 Jul 2015 21:01:00 GMT <p> About one in every three Americans has health coverage under Medicare or Medicaid, and the number of people with coverage under the programs is expected to increase in the next decade. On the 50th anniversary of these two programs, learn about their pasts and what’s in store for the future.</p> <p> President Lyndon B. Johnson signed both programs into law in 1965. Prior to the launch of Medicare, roughly one-half of older adults in the United States lacked health insurance, but after its launch, coverage became nearly universal. Today, Medicaid covers nearly one-half of all births. A <a href="http://jama.jamanetwork.com/article.aspx?articleid=2411288" rel="nofollow" target="_blank">special communication</a> in <a href="http://jama.jamanetwork.com/issue.aspx" rel="nofollow" target="_blank"><em>JAMA’s </em>theme issue</a> on Medicare and Medicaid takes a close look at the history of these programs and what to expect in the coming years.</p> <p> Almost overnight, Medicare and Medicaid became the core of the nation’s public health insurance system. Together these programs serve more than 100 million of the nation’s most vulnerable patients—low-income children and families, people with disabilities and the elderly.</p> <p> In part due to the success of these programs in improving patients’ access to care, between 2010 and 2050, the number of Americans older than 80 years will nearly triple, and the number older than 90 years will quadruple, according to the <em>JAMA </em>report. Meanwhile, gains in longevity are likely to lead to more people living longer with multiple chronic conditions, the report said.</p> <p> <strong>New models for Medicare</strong></p> <p> Initially, Medicare’s payment system followed practices used by private insurers. Over time, the program has become a leader—for example, it developed the diagnosis related group classification for hospitals and the resource-based relative value scale for physicians, which became models for many private insurers, according to the report.</p> <p> The program also has sought to usher in payment and delivery system reforms such as accountable care organizations and stronger incentives for quality improvements. The movement to new models of care is likely to accelerate as implementation of the most recent Medicare legislation, the Medicare Access and CHIP Reauthorization Act (MACRA), gets underway.</p> <p> “Although it is too soon to tell, these changes could have far-reaching effects for clinicians and health care entities in the years ahead,” the <em>JAMA </em>report said.</p> <p> Another significant change comes 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. The MACRA legislation that repealed the SGR includes two paths for Medicare payments beginning in 2019: A modified fee-for-service model with a <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr" target="_blank">merit-based incentive payment system</a> or <a href="http://www.ama-assn.org/ama/ama-wire/post/sgr-repeal-law-supports-new-payment-models" target="_blank">alternative payment models</a>.</p> <p> <strong>Difficulties with Medicaid</strong></p> <p> As the nation’s main source of health coverage for people with low incomes, Medicaid serves nearly 70 million people per year. Over the last five decades, the U.S. Congress and the states have expanded Medicaid to cover more low-income people, especially children and pregnant women. Today, Medicaid provides coverage to more than one-third of all children and more than three-fourths of children in households below 100 percent of the federal poverty level.</p> <p> According to the <em>JAMA</em> report, people with Medicaid coverage fare better than those who are uninsured on key measures of access to care, use, unmet needs and financial security. For example, 87 percent of adults with Medicaid report that they have access to a usual source of care other than an emergency department, compared to 47 percent of uninsured adults. Most Medicaid beneficiaries are also more likely to see a physician regularly compared with the uninsured population.</p> <p> Still, access to physicians continues to be an issue for Medicaid. According to the <em>JAMA </em>report, about one-third of primary care physicians do not accept new Medicaid patients, and physician participation is more limited in Medicaid than in Medicare or private insurance. “This is related to the relatively low reimbursement rates in many states,” the report said.</p> <p> <strong>Future state of health care</strong></p> <p> With so many Americans using Medicare and Medicaid for their insurance coverage and both programs accounting for nearly 40 percent of national health spending, it’s clear that these programs will continue to shape the future of health care.</p> <p> Payment and delivery reforms will continue, especially for Medicare. According to a recent <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability/ama-rand-study.page" target="_blank">AMA study</a> conducted with the RAND Corporation, physicians reported that they want to move to new payment models but need help managing and responding to the many quality programs and metrics from payers to ensure their long-term sustainability. The provisions for alternative payment models in the SGR repeal legislation were created to offer that assistance.</p> <p> The AMA has been working to support <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-alternative-payment-models.page" target="_blank">physician-designed alternative payment models</a>, focusing on identifying and developing models so that physicians in each specialty—whether they are independent or employed—have at least one model in which they could feasibly participate. </p> <p> It’s also clear that addressing chronic diseases will take an increasingly prominent place in medical care. The AMA is working to <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">improve health outcomes</a> for two of the nation’s most troubling chronic diseases. By tackling high blood pressure and prediabetes,  and collaborating with other stakeholders, the AMA is developing new approaches to prevent progression of heart disease and type 2 diabetes. <a href="http://www.ama-assn.org/ama/ama-wire/blog/Health_Outcomes/1" target="_blank">Learn more</a> about the AMA’s efforts in improving health outcomes around chronic disease at <em>AMA Wire</em>®.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;">By AMA staff writer</em><span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;"> </span><em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;"><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:80e741f2-bfca-400a-b50a-e9011054f1bf Nutrition Facts change would put added sugars into context http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nutrition-change-would-put-added-sugars-context Mon, 27 Jul 2015 19:52:00 GMT <p> Nutrition Facts labels could include more information on added sugars if a newly proposed rule from the U.S. Food and Drug Administration (FDA) moves forward.</p> <p> The FDA Friday <a href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM455837.htm" rel="nofollow">proposed</a> including the percent daily value of added sugars to the labels, indicating how the amount of sugar in a specific food fits in the context of people’s daily diets. The percent daily value would be based on the recommendation that the daily intake of calories from added sugars not exceed 10 percent of total calories.</p> <p> “Without information like this about a nutrient, it’s hard to know if you’re eating too much or too little in a given day,” Susan Mayne, FDA director of the Center for Food Safety and Applied Nutrition, said in a <a href="http://blogs.fda.gov/fdavoice/index.php/2015/07/putting-added-sugars-into-context-for-consumers/" rel="nofollow">blog post</a>. “For example, a consumer who drinks a 20-ounce sugared beverage may be surprised to know it contains about 66 grams of added sugar, which would be listed on the label as 132 percent of the daily value.”</p> <p> The proposed label change comes after the 2015 Dietary Guidelines Advisory Committee’s recent summary of scientific data on added sugars, which showed that it is difficult for people to meet nutrient needs while staying within calorie requirements if they exceed 10 percent of total calories from added sugar.</p> <p> The committee’s summary also showed that healthy dietary patterns, including lower amounts of sugar-sweetened foods and beverages, are strongly associated with reduced risk of cardiovascular disease and other chronic diseases.</p> <p> The AMA is working to <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page">improve health outcomes</a> for chronic diseases. By tackling high blood pressure and prediabetes, the precursor to type 2 diabetes, and collaborating with other stakeholders, the AMA is developing new approaches to prevent progression of chronic disease. <a href="http://www.ama-assn.org/ama/ama-wire/blog/Health_Outcomes/1">Learn more</a> about the AMA’s efforts in this area at <em>AMA Wire</em>®.</p> <p align="right"> <em>By AMA staff writer</em> <em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a75766c1-19e7-4f23-9979-7d8b499b2b96 4 tricks to a successful residency program search http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-tricks-successful-residency-program-search Mon, 27 Jul 2015 17:53:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/4/f5151bb5-686c-41a0-b41b-7c5406166b0f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/4/f5151bb5-686c-41a0-b41b-7c5406166b0f.Large.jpg?1" style="float:right;margin-left:10px;margin-right:10px;" /></a>Finding a residency program is a priority for medical students no matter your level of training. But how do you search for a program that best fits your needs and specialty interests? That’s where FREIDA Online®—the Fellowship and Residency Electronic Interactive Database--can help. Follow these hacks to keep track of your program options and conduct an effective search for residency.</p> <p> FREIDA is an online database of over 9,800 medical residency and fellowship programs accredited by the Accreditation Council for Graduate Medical Education. It also includes over 100 combined specialty programs.</p> <p> Students using FREIDA can find information about training programs, key application deadlines, and specialty training statistics, which provide a helpful overview of residency programs based on trends across all programs in a specialty.</p> <p> The online database, which has helped students find future training opportunities since the late 1990’s, recently received upgrades aimed at helping you make the most of your search for residency. Try these tips as you navigate FREIDA for program listings:</p> <p> <strong>1. </strong><strong>Find programs that specifically fit your preferences using FREIDA’s keyword search functionality. </strong>FREIDA now offers recommended keywords to simplify searches of its thousands of listings<strong>. </strong>Once you’ve logged in, you can find these keywords by clicking on the small purple “keywords help” link beneath the keyword search bar on the main navigation screen, which will generate <a href="https://freida.ama-assn.org/Freida/user/search/keywordsSearchTips.do" target="_blank">a list of 30 keywords</a> for you to search in the database.</p> <p> The list also provides keyword definitions you can review before beginning your search so you know the best terms to use. Students can narrow their search to residency programs that use J-1 visas, Electronic Residency Application Service, National Residency Matching Program or even find programs that accommodate certain lifestyle preferences under terms such as “on-site child care” and “parking.”</p> <p> However, while keywords can focus your search, be sure not to overuse them. Loading your search bar with many connectors and terms can significantly limit your results. Starting out, try limiting your searches using one or two terms.  </p> <p> <strong>2. </strong><strong>Use Boolean search. </strong>Use Boolean operators—such as “AND,” “OR” and “NOT”—with keyword terms to make sure you receive the search results you really want.</p> <p> But be careful. As with all Boolean searches, know which connectors you’d like to use based on the search results you wish to achieve because each connector-keyword combination will generate different search listings. For a quick brush-up on Boolean searches, review <a href="https://freida.ama-assn.org/Freida/user/search/keywordsSearchTips.do" target="_blank">these keyword tips</a> from FREIDA (log in).  </p> <p> <strong>3. Check “expanded listings” for additional clues to help you determine which of your program options truly fits you. </strong>Carefully read the details under a program’s expanded listing to gain insights you really need as you plan for residency. Expanded listings feature the programs’ application deadlines, interview dates, NRMP codes, program sizes, numbers of faculty and even breakdowns of the characteristics of trainees in those particular programs.  </p> <p> Programs with an expanded listing are identified in the search results with an asterisk. You can view an expanded listing by clicking on the program name in your general search results.</p> <p> <strong>4. Save and compare your results. </strong>When you find a program you like, be sure to select the option in the top right corner to “save” the program listing or “compare” it to another program.</p> <p> If you’re an AMA member, you can save your comparisons for future use and add programs of special interest to your dashboard, a personalized section of the database that allows you to add custom notes, and your own ratings and opinions about programs. Saving residency searches on your dashboard also allows you to easily print program listings at a later time or return to your searches with one easy click.</p> <p> If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a> for access to this feature and other resources.</p> <p> For more FREIDA-friendly tips, <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page?" target="_blank">register</a> for FREIDA Online and <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online/about-freida-online/frequently-asked-questions.page" rel="nofollow" target="_blank">review the database’s FAQs</a>.</p> <p style="text-align:right;"> <em style="text-align:right;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dcc92bb7-5a66-4499-b7a1-f67babe153e9 Small programs are taking on big problems with drugs, cancer http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_small-programs-taking-big-problems-drugs-cancer Fri, 24 Jul 2015 22:12:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/15/b5d53e9e-c572-42db-aff7-20673bd6dc3d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/15/b5d53e9e-c572-42db-aff7-20673bd6dc3d.Large.jpg?1" style="height:279px;width:365px;" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><em>Medical students teach school children in Oklahoma City about the consequences of smoking.</em></span></span></td> <td>  </td> </tr> </tbody> </table> <p> Community and medical organizations are teaming up to prevent the tragic consequences of drug misuse and preventable cancers by educating their communities about safe practices and healthy behaviors.</p> <p> Through the AMA Foundation’s <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?">Healthy Living Grants program</a>—which now is accepting applications—community programs with limited budgets are able to be an important part of the solution for prescription drug misuse and preventable cancers.</p> <p> This year’s grant program has allocated funds for community projects by programs with annual operating budgets of less than $2 million that are partnering with medical organizations to educate their communities on these two pressing public health issues.</p> <p> Among the dozens of projects executed by past awardees were programs such as:</p> <ul> <li> At-risk youth in Portland, Maine, took a hands-on approach to prescription drug safety by educating their peers via a television special and public service announcement as part of the Yes! Program in 2014.</li> <li> Youth Think of Wasco County Oregon organized a prescription drug take-back event in 2013 to help keep medications out of the hands of people for whom they were not prescribed.</li> <li> Underserved families in Salt Lake City received assistance with smoking cessation by the group Pediatricians Against Secondhand Smoke, thanks to a grant in 2009.</li> <li> School children in Oklahoma City were taught about the health consequences of smoking via a Schools for Healthy Lifestyles program in 2008.</li> </ul> <p> As a past awardee, the <em>Virginia College of Osteopathic Medicine in Blacksburg, Va.,</em> noted that the program for which they used their grant “has had a great impact in an impoverished region of Appalachia where the students are at great risk for substance abuse and an area where there is the greatest increase in deaths from prescription drug abuse.”</p> <p> The deadline to apply for a Healthy Living Grant is Sept. 11.</p> <p> <strong>Want to contribute?</strong> If you’re interested in giving toward programs like these, consider <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/donate-now.page">donating to the AMA Foundation</a>. In addition to Healthy Living Grants, the foundation offers funding for physician-led clinics that care for underserved patients, grants for medical research and scholarships for medical education.</p> <p align="right"> <em>By AMA Wire editor </em><a href="https://twitter.com/Amy_AMAWire" rel="nofollow"><em>Amy Farouk</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:590dddd7-0ebf-4d82-b3c8-1c8b9cd8aa65 How the SGR repeal law supports new payment models http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_sgr-repeal-law-supports-new-payment-models Fri, 24 Jul 2015 20:39:00 GMT <p> The legislation that <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repealed the sustainable growth rate</a> (SGR) formula includes financial support for physicians who want to participate in new care delivery and payment models. Learn about this opportunity.</p> <p> The Medicare Access and CHIP Reauthorization Act (MACRA), the law that eliminated the SGR, has a variety of provisions, including support for physicians who choose to transition to alternative payment models. This is the fourth post in a <a href="http://www.ama-assn.org/ama/ama-wire/blog/SGR_Repeal_Series/1">series that examines what physicians need to know about MACRA</a>.</p> <p> Beginning in 2019, physicians have two paths for Medicare payments:</p> <ul> <li> <strong>Fee-for-service model.</strong> Physicians can continue to offer care within this model, just as they are now. This payment model will be governed by the new <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr">merit-based incentive payment system</a> (MIPS).</li> <li> <strong>Alternative payment models.</strong> Physicians who develop and participate in new models of care will receive bonus payments of 5 percent from 2019 to 2024.</li> </ul> <p> Under the alternative model option, physicians will be subject only to quality reporting requirements for their specific payment model—they will not be subject to the MIPS. The 5 percent annual bonus is intended to help cushion physicians’ finances since the new models will require them to assume a certain amount of downside financial risk. The one payment model that will not require downside financial risk is the patient-centered medical home.</p> <p> Physicians’ proposals for new models will be considered by a new advisory panel. The secretary of the U.S. Department of Health and Human Services (HHS) will establish criteria for this panel by Nov. 1, 2016.</p> <p> MACRA also requires the secretary of HHS to submit a study to Congress on the feasibility of integrating alternative payment models into Medicare Advantage by July 1, 2016.</p> <p> Additionally, the MACRA authorizes coverage for telehealth services that are provided in alternative payment models, even if those services aren’t otherwise covered by the traditional Medicare program.</p> <p> <strong>What physicians can do now</strong></p> <p> Physicians reported that they want to move to new payment models but need help managing and responding to the many quality programs and metrics from payers to ensure their long-term sustainability, according to a recent <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability/ama-rand-study.page" target="_blank">AMA study</a> conducted with the RAND Corporation. The provisions for alternative payment models in the MACRA were created to offer that assistance.</p> <p> The AMA has been working to support physician-designed alternative payment models, focusing on identifying and developing models so that physicians in each specialty—whether they are independent or employed—have at least one model in which they could feasibly participate. </p> <p> Find resources for and additional information about <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-alternative-payment-models.page">alternative payment models</a> on the AMA website.</p> <p style="text-align:right;"> <em>By AMA staff writer <a href="https://twitter.com/Lauren_AMAWire" rel="nofollow">Lauren Rees</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:016ae2ec-48d6-4eb8-bdb0-e18d4b11670e Plan to attend IMG Symposium Sept. 24 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-img-symposium-sept-24 Fri, 24 Jul 2015 14:00:00 GMT <p> Mark your calendar for the 7th annual AMA IMG Symposium on resources for international medical graduates (IMG) Sept. 24 from 6 to 8 p.m. in Detroit.</p> <p> This networking and educational event is complimentary for medical students, individuals certified by the Educational Commission for Foreign Medical Graduates, residents and physicians interested in solutions to IMG issues and AMA resources.</p> <p> Watch <em>AMA Wire®</em> for additional details closer to the event.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:13f227c2-ed73-4d5b-a42b-fc54a389afa6 Nominate a colleague for Joint Commission Board of Commissioners http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nominate-colleague-joint-commission-board-of-commissioners Fri, 24 Jul 2015 13:55:00 GMT <p> The AMA is seeking nominations for two AMA-appointed members of The Joint Commission Board of Commissioners for terms beginning Jan. 1. </p> <p> The Board of Commissioners is The Joint Commission’s governing body, which provides policy leadership and oversight. Board members govern The Joint Commission with a dedication to its mission to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.</p> <p> Nominees should have a record of significant accomplishment in the health care field as well as demonstrated service on other boards or other significant contributions to the medical community. Nominees from all specialties and areas of practice experience will be considered.</p> <p> Submit <a href="http://www.ama-assn.org/resources/doc/joint-commission/x-pub/boc-nomination.docx" target="_blank">nominations</a> (log in) by Aug. 14.  Contact Keith Voogd of the AMA <a href="mailto:keith.voogd@ama-assn.org" rel="nofollow">via email</a> or at (312) 464-4539 for more information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2f806f92-9889-41a9-8859-501a1c6a96d7 NMA holds convention, installs new president http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nma-holds-convention-installs-new-president Fri, 24 Jul 2015 13:50:00 GMT <p> The <a href="http://nmanet.org/" target="_blank" rel="nofollow">National Medical Association</a> (NMA) is holding its 113th <a href="http://convention.nmanet.org/" target="_blank" rel="nofollow">Annual Convention and Scientific Assembly</a> Aug.1–5 in Detroit, Mich. During the conference, the NMA will pay tribute to its 115th president <a href="http://nmanet.org/index.php/about-us/who-we-are/board-of-trustees?id=198" target="_blank" rel="nofollow">Lawrence "Dusty" L. Sanders Jr., MD</a>.</p> <p> Dr. Sanders is an associate professor of internal medicine at the Morehouse School of Medicine in Atlanta. He will continue in his role as co-chair 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 he co-chairs alongside AMA President-elect Andrew Gurman, MD. The Commission was established 11 years ago by the AMA, the NMA and the <a href="http://www.nhmamd.org/" target="_blank" rel="nofollow">National Hispanic Medical Association</a>. </p> <p> NMA’s 116th president, <a href="http://www.nmanet.org/index.php/component/content/article?id=278" target="_blank" rel="nofollow">Edith P. Mitchell, MD</a>, will be installed for her one-year term during a formal installation that includes a ceremonial passage of the past president’s cane. Dr. Mitchell is a clinical professor of medicine and oncology at the Kimmel Medical College of Thomas Jefferson University in Philadelphia. She was named the 2012 recipient of the American Society of Clinical Oncology Humanitarian Award.</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> (MAS) will exhibit during the conference. The AMA-MAS Governing Council has a designated seat for an NMA representative. The current NMA representative is Leonard Weather, Jr., MD, an OB-GYN in Shreveport, La., and a past NMA president. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0c67f64e-a880-4d65-b578-e3c1ebb84755 What's at stake in nutrition education during med school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_whats-stake-nutrition-education-during-med-school Thu, 23 Jul 2015 18:11:00 GMT <p> While physicians encourage patients to make healthy food choices, only 27 percent of U.S. medical schools actually offer students the recommended 25 hours of nutritional training, according to a recent <a href="http://journals.lww.com/academicmedicine/Fulltext/2015/07000/Nutrition_Education_in_an_Era_of_Global_Obesity.11.aspx" rel="nofollow" target="_blank">perspective piece</a> in <em>Academic Medicine</em>. Hear why experts say improving health outcomes may require physicians in training to move from the classroom to the kitchen.</p> <p> <strong>Seeing the big picture: Nutrition and the health of the nation</strong></p> <p> “In an era when rates of obesity, diabetes and other lifestyle-related disease challenge medical educators and governments worldwide, it is necessary to consider novel educational strategies, both didactic and experiential, whereby current and future health professionals can be prepared to proactively advise and teach patients enhanced self-care skills,” the authors of the perspective wrote.</p> <p> A <a href="http://www.ama-assn.org/ama/ama-wire/post/prediabetes-burdens-nation-new-solution-available-physicians" target="_blank">recent study</a> from <em>Diabetes Care</em> revealed that more than 86 million American adults have prediabetes, the precursor to type 2 diabetes—and these increased burdens on the health care system break down to a national cost of roughly $322 billion.</p> <p> Still, many chronic illnesses, such as type 2 diabetes, are preventable, the authors wrote. They cited instances when simple lifestyle changes—such as not smoking, limiting alcohol use, being physically active and maintaining a healthy diet—reduced patients’ chances for coronary heart disease by 82 percent.</p> <p> So while the country’s rate of chronic illness may be daunting, medical educators are looking at how they can change these trends on what they are calling a “societal scale.”</p> <p> That’s where creating courses in medical schools on self-care, nutrition, cooking and life skills can make a difference. If medical schools teach students how to adapt healthy lifestyle and self-care skills in training, the authors argue, they’ll know how to impart this information to their patients.</p> <p> <strong>The current state of nutrition in medical education </strong></p> <p> Modern medicine maintains the importance of proper nutrition, yet on average, U.S. medical schools only offer 19.6 hours of nutrition education across four years of medical education, according to the perspective authors. “This corresponds to less than 1 percent of estimated total lecture hours,” they wrote. “Moreover, the majority of this educational content relates to biochemistry, not diets or practical, food-related decision making.”</p> <p> A lack of external incentives that support schools teaching nutrition also deepens this educational void, the authors note. Current United States Medical Licensing Examination tests evaluate “biochemical knowledge and information relating to nutritional deficiencies, but no standardized patient examination tests the knowledge or skills of medical trainees to advise a patient seeking guidance with regard to evidence-based diet and lifestyle modification,” they wrote.  </p> <p> Training at the postgraduate level has followed suit, they said. They pointed to how the word “nutrition” isn’t included in board examination requirements for internal medicine certification, and cardiology fellows don’t need to complete a single requirement in nutrition counseling.</p> <p> <strong>What this means for educators: How to innovate nutrition education </strong></p> <p> Despite the low rate of nutrition education in medical schools, the authors of the perspective offer a hopeful consideration for educators: Most students in the beginning of training actually value nutritional knowledge.</p> <p> In fact, among entering medical students, “71 percent think nutrition is clinically important. Upon graduation, however, fewer than half believe that nutrition is clinically relevant. Once in practice, fewer than 14 percent of physicians believe they were adequately trained in nutritional counselling,” the authors wrote.</p> <p> Improving this outcome and maintaining students’ interest in nutrition will require schools to think “outside of the box” about creative integrations between core curriculums and nutritional content.</p> <p> Some schools already are addressing this need through interactive courses that explore the impact of social determinants on access to whole and nutritious foods. For instance, the New York University School of Medicine, a member of the consortium of schools in the <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">AMA’s Accelerating Change in Medical Education</a> initiative, recently conducted a neighborhood food project in which students canvassed 30 neighborhoods across Manhattan to investigate the availability and cost of basic foods in local grocery stores and restaurants.</p> <p> Armed with neighborhood maps that they created as part of their research, students recorded characteristics and costs of local food sources in each neighborhood, noting advertising for foods and beverages. This information has been compiled in a database that faculty will use to further analyze the impact of food environments on childhood disability.  </p> <p> Other schools, such as the Pritzker School of Medicine at the University of Chicago, have taken a more direct skills-building approach to national education. This school is simulating “teaching kitchens,” where medical students study the value of food <a href="http://www.npr.org/sections/thesalt/2015/07/01/419167750/a-dose-of-culinary-medicine-sends-med-students-to-the-kitchen" rel="nofollow" target="_blank">in a culinary setting</a>.</p> <p> <strong>Interested in exploring similar solutions at your school?</strong> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/8-ways-med-schools-can-nutrition-classroom-kitchen" target="_blank">the second post</a> of this two-part series<em>, </em>which features an expert-approved list of recommendations to help educators develop their own nutrition education curriculums.  </p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:right;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:94669c19-6c01-4b53-a2d3-5cb24b72ed18 4 reasons to build your CV at AMA Research Symposium http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-reasons-build-cv-ama-research-symposium Wed, 22 Jul 2015 22:30:00 GMT <p> If you’d like to advance your research and expand your CV, plan to attend the 13<sup>th</sup> annual AMA Research Symposium, which is <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">now accepting abstracts</a> from physicians in training. Learn more about the event and its surprising benefits for trainees.</p> <p> The AMA Research Symposium offers a collaborative way for physicians in training to share their research across a diverse range of specialties. Participants who submit their research can compete for cash prizes and the chance to present their findings before experts in their field. The event will take place Nov. 13 in Atlanta.</p> <p> Expect to enjoy the following benefits if you participate:</p> <ol> <li> <strong>A rare chance to submit your research to a national audience. </strong>Each year, the symposium allows physicians in training to present and discuss their research among hundreds of attendees. More than 400 of the country’s brightest medical students, residents, fellows and international medical graduates (IMG) awaiting residency flocked to the symposium last year, which offered the added benefit of attendees learning from each other’s respective research.  <br /> <br /> “I really like the fact that we can learn from the posters and oral presentations,” said Sravanthi Nandavaram, MD, who was a third-year medical resident in Syracuse, N.Y., when she attended the symposium in 2013. “It keeps me up to date in the field of medicine.”<br />  </li> <li> <strong>Building your credibility</strong>. Research and credibility go hand-in-hand, so don’t miss this chance to establish your expertise. Judges will come from among attendees of the AMA Interim meeting, medical schools, residency programs and hospitals.<br /> <br /> Discussing your research before a reputable panel of judges from around the country can set you on the fast-track to credibility and teach you new insights to advance your career as you progress through training.<br />  </li> <li> <strong>Networking.</strong> The symposium offers a nexus of potential contacts for physicians in training.<br /> <br /> “It’s a great opportunity to make my lab work more known to others,” said Ki-Yoom Kim, who attended the symposium in 2014 as a second-year medical student at Rutgers New Jersey Medical School. “It’s a good way to branch out, make connections and meet other students.”<br />  </li> <li> <strong>Exposure to multiple disciplines and specialties. </strong>Unlike conferences that expound on a few select topics, the AMA Research Symposium accepts submissions under several categories spanning more than a dozen specialties.<br /> <br /> Darlyne Menscer, MD, clinical associate professor of family medicine at Carolinas Medical Center in Charlotte, N.C., has been a judge for the symposium for about five years. She said the breadth and quality of the research she reviewed last year was rewarding to see.<br /> <br /> “The quality [of projects] is amazing,” said Dr. Menscer, who <a href="http://www.ama-assn.org/ama/ama-wire/post/this-years-3-top-med-ed-priorities" target="_blank">recently started her term</a> as the chair of the AMA Council on Medical Education. “I like talking to the people who did the work. I think the thought behind these projects is really better than what you might estimate.”</li> </ol> <p> <strong>Submit your research for the symposium</strong></p> <p> Research submissions this year are being accepted in these groups:</p> <ul> <li> <strong>For students: </strong>Submit your abstract for one of eight categories—biochemistry/cell biology, cardiovascular disease/diabetes, clinical outcomes and health care improvement, immunology/infectious disease/inflammation, neurobiology/neuroscience, public health and epidemiology, radiology/imaging, or surgery/biomedical engineering.<br />  </li> <li> <strong>For residents and fellows: </strong>Submit your abstract for one of three categories—clinical vignette, clinical medicine (this includes quality improvement, health policy, clinical research and medical education), or improving health outcomes (cardiovascular disease/diabetes).<br />  </li> <li> <strong>For IMGs: </strong>If you are certified by the Educational Commission for Foreign Medical Graduates and awaiting residency, you can submit your abstract for one of three categories—clinical medicine, clinical vignette or improving health outcomes (specifically among patients with cardiovascular disease and diabetes).</li> </ul> <p> Each eligible participant may only submit one abstract and must send his or her research using the symposium’s online submission form.</p> <p> Read the <a href="http://www.ama-assn.org/resources/doc/mss/x-pub/symposium-guidelines.pdf" target="_blank">symposium’s guidelines</a> (log in) and <a href="http://www.ama-assn.org/resources/doc/mss/x-pub/symposium-faqs.pdf" target="_blank">FAQs</a> (log in) before applying to make sure your research qualifies. The deadline to submit is Aug. 19, and authors of submissions will be notified of their status by Sept. 16.</p> <p> The AMA Annual Research Symposium is organized by 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>, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section.page?" target="_blank">Resident and Fellow Section</a> and the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page?" target="_blank">AMA-IMG Section</a>.</p> <p> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/future-physicians-present-research-largest-ama-symposium" target="_blank">more about last year’s event</a> and winners. Also follow the AMA Research Symposium <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">Web page</a> for key registration and submission details.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:right;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:72069fbb-41dd-47ad-a60f-ef9826ac6c24 The beginner and expert's guide to ICD-10 prep: Steps for August http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_beginner-experts-guide-icd-10-prep-steps-august Wed, 22 Jul 2015 20:39:00 GMT <p> Less than 75 days remain before the Oct. 1 deadline to implement the ICD-10 code set, so make sure you’re prepping your practice. In Month Four of our ICD-10 primer, learn the next steps you should take.</p> <p> <strong>What to tackle in August</strong><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/11/c5fe6a6c-5777-463b-abd0-e30098f4a762.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/11/c5fe6a6c-5777-463b-abd0-e30098f4a762.Large.png?1" style="float:right;margin:15px;" /></a></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’ (CMS) <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>Still getting started?</strong></p> <p style="margin-left:.5in;"> If you’re still in the early stages of prepping your practice, spend the month testing 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:51pt;"> <strong>Perform content-based testing</strong> to assess your practice’s documentation and ability to code in ICD-10. In this type of testing, your practice uses documentation to code 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" rel="nofollow" target="_blank">resources</a> to help your practice with this kind of testing.<br />  </li> <li style="margin-left:51pt;"> <strong>Conduct internal testing</strong> to evaluate your practice’s ability to create and use ICD-10 codes throughout the patient work flow in place of when you currently use ICD-9 codes. This type of testing requires your practice to have system upgrades installed already and helps you follow the flow of a patient through a visit to identify the points at which codes are used. Use this testing to identify any gaps in your ICD-10 updates.<br />  </li> <li style="margin-left:49.5pt;"> <strong>Do </strong><strong>external testing</strong> to test your practice’s ability to send and receive transactions that use ICD-10 codes with your external trading partners, including your billing service, clearinghouse and 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 perform acknowledgement testing with their Medicare Administrative Contractors and the Common Electronic Data Interchange contractor any time until the Oct. 1 implementation date.</li> </ul> <p style="margin-left:.5in;"> <strong>Already on your way?</strong></p> <p style="margin-left:.5in;"> Now is the time to prepare for possible disruptions in claims processing. While the AMA has secured provisions from CMS to ease the transition to the new code set, physicians should still be ready, especially because private payers may not ease up their claims payment processes.</p> <p style="margin-left:.5in;"> Make sure you have taken the most important steps to prevent cash flow interruptions. They are to ensure:</p> <ul> <li style="margin-left:0.75in;"> Your systems can accommodate the ICD-10 codes</li> <li style="margin-left:0.75in;"> Your staff is trained</li> <li style="margin-left:0.75in;"> You have tested thoroughly with your trading partners</li> </ul> <p style="margin-left:.5in;"> If you’ve been following a solid transition plan, you should be well-prepared to handle any potential claims disruptions. Learn what else your practice can do to <a href="http://www.ama-assn.org/ama/ama-wire/post/practice-should-prepare-financially-icd-10" target="_blank">prepare financially for ICD-10</a>.</p> <p> The provisions the AMA secured from CMS address claims denials, quality reporting penalties, payment disruptions and navigating transition problems. <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-icd-10-transition-less-disruptive-physicians" target="_blank">Read more</a> about the changes at <em>AMA Wire</em>®.</p> <p> For even more help, get the AMA’s <a href="http://www.ama-assn.org/ama/ama-wire/post/8-must-icd-10-resources" target="_blank">must-have ICD-10 resources</a> and read the rest of the posts in this <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank">monthly series</a>.</p> <p> <strong>Plan to participate in CMS call Aug</strong><strong>. 27</strong></p> <p> CMS will host a call from 2:30 to 4 p.m. Eastern time Aug. 27, during which experts will discuss coding guidance and tips, answers to coding questions, information about claims that span before and after the implementation date, and resources. <a href="http://www.eventsvc.com/blhtechnologies/register/c259b437-6014-4dcb-b4ea-cbb93b5c4b6c" rel="nofollow">Register online</a> to participate.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/7/b1af09b8-1bc0-4a5b-976c-65cf21dc6d29.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/7/b1af09b8-1bc0-4a5b-976c-65cf21dc6d29.Full.png?1" style="width:850px;height:136px;margin:15px;float:left;" /></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:206e53cb-9b42-44bf-b1ba-04762333f96f Awareness of risk status key to prevention of diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_awareness-of-risk-status-key-prevention-of-diabetes Wed, 22 Jul 2015 03:48:00 GMT <div> A new study found that patients who have the precursor to type 2 diabetes are more likely to play an active role in preventing the onset of the disease if they are aware of their risk status, highlighting the importance of physician engagement on this issue. </div> <div>  </div> <div> The <a href="http://www.ncbi.nlm.nih.gov/pubmed/26091928" rel="nofollow" target="_blank">study</a>, recently published in the <em>American Journal of Preventive Medicine</em>, found that out of nearly 2,700 participants who <a href="http://www.ama-assn.org/ama/ama-wire/post/determine-whether-patients-prediabetes" target="_blank">met the criteria for having prediabetes</a>, only about 11 percent were aware of their diagnosis. Those who were aware of their diagnosis were more likely to engage in physical activity and weight management than the patients who did not know they had prediabetes. </div> <div>  </div> <div> The study also looked at the success rates in diabetes prevention programs, such as the Centers for Disease Control and Prevention’s evidence-based <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a>. Patients who were aware of having prediabetes were more likely to achieve goals in these lifestyle intervention programs versus those who didn’t know they had prediabetes.</div> <div>  </div> <div> “The impact of prediabetes awareness on the odds of engagement in physical activity and weight management highlights the special influence physician advice and input can have on patient behaviors,” the study said. </div> <div>  </div> <div> The low awareness of prediabetes in the study is alarming, and unfortunately, it’s in line with national data. Of the 86 million American adults who have prediabetes, only one in 10 knows they have it. </div> <div>  </div> <div> “To maximize the impact of physician discussions about prediabetes on reducing the incidence of diabetes, physicians must not only communicate this diagnosis to patients but must do so in a meaningful way,” the study said. “Physicians should counsel patients that having prediabetes greatly increases the chances of developing diabetes and has been linked to increased risk of cardiovascular disease.”</div> <div>  </div> <div> <strong>What you can do in your practice</strong></div> <div> 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. </div> <div>  </div> <div> 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™</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 identify patients with prediabetes, patient-facing resources, and sample telephone scripts and referral forms for connecting patients with prevention programs.</div> <div>  </div> <div> In addition, the AMA’s newly launched STEPS Forward website offers an <a href="https://www.stepsforward.org/modules/prevent-type-2-diabetes" rel="nofollow" target="_blank">interactive educational module</a> to address prediabetes in your practice: Earn continuing medical education credit and see how to make the Prevent Diabetes STAT tools work for you. </div> <div>  </div> <div> <a href="http://www.ama-assn.org/ama/ama-wire/post/effective-diabetes-prevention-programs-near-practice" target="_blank">Find effective diabetes prevention programs</a> near your practice, and start screening, testing and referring patients today.</div> <div>  </div> <div style="text-align:right;"> <em>By AMA staff writer <a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" target="_blank">Lauren Rees</a></em></div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d6b30889-001f-40f0-a60a-45a9a30e18bd Physicians, we hear you: EHR meaningful use isn't meaningful http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-hear-ehr-meaningful-use-isnt-meaningful Tue, 21 Jul 2015 21:18:00 GMT <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/11/180cbde6-e6d1-48be-9bb3-d4abd8e4ff31.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/11/180cbde6-e6d1-48be-9bb3-d4abd8e4ff31.Large.jpg?1" style="margin:15px;float:left;" /></a><i><span style="font-size:10pt;">An </span></i><a href="http://www.ama-assn.org/ama/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><i><span style="font-size:10pt;">AMA Viewpoints</span></i></a><i><span style="font-size:10pt;"> post by AMA President Steven J. Stack, MD</span></i></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">The message from physicians is loud and clear: Electronic health record (EHR) systems have so much potential, but frustrating government regulations have made them almost unusable.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">Atlanta-area physicians told me this firsthand Monday in the AMA’s first-ever town hall meeting on EHRs and the meaningful use program. Rep. Tom Price, MD, from Georgia’s sixth district, joined me to listen to physicians’ everyday challenges with EHRs and burdensome government regulations that detract from patient care. About 500 other people registered to watch the event via live-streaming.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">As an emergency physician, I experience my own struggles with my hospital’s EHR system. But I wanted to hear from physicians in all specialties in a live venue that would enable policymakers to hear their concerns firsthand and unfiltered. Not surprisingly, it turns out that we’re all struggling.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">For example, Melissa Rhodes, MD, a Georgia physician in pulmonary critical care and sleep medicine, is fed up. She was an early adopter of the technology, implementing her first EHR in 2006, more than three years before the meaningful use program was created in legislation. She wanted the system to live up to its promise—but that didn’t happen.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">“I don’t think we’re going to do meaningful use Stage 2,” she said at the town hall. “And we’ll take the penalty.”</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">Dr. Rhodes tallied up how much her three-physician practice has spent on her EHR and related IT costs—over the past year, that number hit $84,000.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">But more important than the costs, Dr. Rhodes’ EHR has limitations that affect her patients. The system won’t allow her to titrate orders for patients in the intensive care unit. And she has to personally enter orders, no matter what time of day or night, without being permitted to benefit from the help of nursing colleagues at the hospital.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">“There are so many orders you can’t put in,” she said. “It only leads to harm for patient care, and more medical errors—not less.”</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">Dr. Rhodes’ story sounds like so many others we heard at the town hall: Physicians are trying to use EHRs to improve patient care, investing a lot of time and money into making them work, but they are being thwarted.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">The goal of the meaningful use program was to encourage physician adoption of EHRs. This has been accomplished. Today, more than 80 percent of physicians have implemented some form of EHR system. But we’re not getting what we expected from this technology.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">As physicians, we had hoped that these tools would help facilitate patient engagement, reduce administrative burdens and promote the exchange of data. Those three things have definitely not happened. Instead, we’re dealing with systems that won’t talk to one another, cost too much to maintain and require us to spend an inordinate amount of time entering data instead of helping patients.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">The consensus Monday night was that EHRs do not give accurate information in usable forms. Without this, they cannot and will not improve the quality of care.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">A top priority for the AMA, just as it is for Dr. Rhodes, is ensuring that our patients’ clinical needs and those of the clinicians providing their care are given greater importance than meeting federal regulations. Based on our </span><a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/physician-practices/steps-forward.page#rand" target="_blank"><span style="font-size:10pt;">study</span></a><span style="font-size:10pt;"> with the RAND Corporation, we know EHRs are a major driver of physicians’ dissatisfaction with their practice environments. As a result, we worked with doctors and other experts to create </span><a href="http://www.ama-assn.org/ama/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank"><span style="font-size:10pt;">eight priorities</span></a><span style="font-size:10pt;"> for making EHRs usable. These priorities continue to serve as a guide for our activities with vendors, policymakers and health care systems.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">That’s why I need you to </span><a href="http://breaktheredtape.org/share-your-story" rel="nofollow" target="_blank"><span style="font-size:10pt;">share your story</span></a><span style="font-size:10pt;"> with us. Please help us take this viral with a groundswell of physician input to inform D.C. policymakers. Please tell us your EHR experiences and stories—how EHRs and current meaningful use regulations have impacted your practice and the care you provide your patients. Then, </span><a href="http://breaktheredtape.org/email-congress" rel="nofollow" target="_blank"><span style="font-size:10pt;">email your members of Congress</span></a><span style="font-size:10pt;"> and ask them to halt Stage 3 of meaningful use until the program is fixed.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">We need policymakers to hear our stories and take action, which is why I’m so pleased Rep. Price was able to listen firsthand. Despite plans to realign several government reporting programs, including meaningful use, the government seems poised to do so without addressing these issues first. We need regulators to hit pause, fix the problems and make the meaningful use program actually meaningful.</span></span></p> <p class="Default"> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:10pt;">Please visit </span><a href="http://breaktheredtape.org/" rel="nofollow" target="_blank"><span style="font-size:10pt;">breaktheredtape.org</span></a><span style="font-size:10pt;"> to watch the town hall meeting, share your stories about EHRs and meaningful use, and contact your members of Congress. Help us get the government to listen.</span></span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:82a5a895-a405-4359-9351-d5c4501e0013 Immerse yourself in the Guides® Sixth at Chicago seminar http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_immerse-yourself-guides-sixth-chicago-seminar Tue, 21 Jul 2015 20:52:00 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> Sept. 25 in Chicago.</p> <p> Physicians and others who handle 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, hosted with the American Academy of Disability Evaluating Physicians, 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> <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> <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> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b76c1400-3aab-4670-86cd-4445ce6789e4 Where to publish: Top journals for physicians in training http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_publish-top-journals-physicians-training Mon, 20 Jul 2015 21:04:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/10/7583a615-bd65-4d1e-8acd-53817af8af0c.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/5/10/7583a615-bd65-4d1e-8acd-53817af8af0c.Large.jpg?1" style="float:right;" /></a></p> <p> Getting published as a physician in training can build your CV and reputation in the profession, but knowing where to submit your research is half the battle of breaking into medical publishing. Whether you’ve recently started your research or already have plans to publish it, here’s a must-have list of journals that accept submissions from trainees. Flag this to keep handy as you plot your publishing plans.</p> <p> Competitive publications such as the <em>New England Journal of Medicine</em> <a href="http://www.nejm.org/page/author-center/manuscript-submission" rel="nofollow" target="_blank">publish</a> “only the top 5 percent of the 5,000 research submissions [they] receive each year,” and<em> JAMA Internal Medicine</em>—although devoted to a single specialty—receives approximately 3,000 submissions per year and has a 13 percent acceptance rate.</p> <p> But don’t be discouraged. These are the heavyweights of medical publishing, but many other opportunities exist. For instance, <em><a href="http://jama.jamanetwork.com/public/instructionsForAuthors.aspx#JAMAClinicalChallenge" rel="nofollow" target="_blank">JAMA’s </a></em><a href="http://jama.jamanetwork.com/public/instructionsForAuthors.aspx#JAMAClinicalChallenge" rel="nofollow">Clinical Challenge</a> is particularly well-suited for writing teams of attending physicians and residents or medical students. So when you’re considering where to send your work, take time to research publication guidelines and special opportunities that fit your level of training.</p> <p> Here’s a list of peer-reviewed publications to help you get started on the road to successful publication.</p> <p> <strong>Especially for students</strong><br /> These journals specifically seek submissions from physicians in training and are accessible for newcomers in publishing.  </p> <ul> <li> <strong> <em>T</em></strong><strong><em>he American Medical Student Research Journal</em></strong><br /> Created by medical students, this journal gives future physician-scientists the opportunity to develop the critical thinking skills needed to succeed in academia and clinical practice. The journal is authored, reviewed and edited by medical students working under the guidance of faculty mentors. It accepts submissions ranging from basic science research and case reports to personal experience essays. See <a href="http://www.amsrj.org/index.php?journal=amsrj&page=about&op=submissions#authorGuidelines" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong> </strong><strong><em>The Harvard Medical Student Review</em></strong><br /> The <em>Harvard Medical Student Review</em> is student-founded, student-managed and student-administered, under the guidance of faculty and staff. Its mission is to provide a platform for students to contribute to important issues facing health and medicine through a variety of formats, including scholarly articles, editorials and original artwork. See <a href="http://www.hmsreview.org/?page_id=19" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>Harvard Public Health Review</em></strong><br /> This publication seeks diverse research interests that addresses issues of health equity and invites submissions from students and faculty across academic disciplines. The staff announces publication themes each quarter with special calls for contributions released in response to pressing public health issues. See <a href="http://harvardpublichealthreview.org/about/" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>International Journal of Medical Students</em></strong><br /> <strong><em>​</em></strong>The <em>International Journal of Medical Students</em> is a peer-reviewed, open-access scientific journal created to share the research and experiences of medical students worldwide. See <a href="http://www.ijms.info/ojs/index.php/IJMS#.Vaj_l_lViko" rel="nofollow" target="_blank">submission guidelines</a></li> </ul> <ul> <li> <strong><em>Student BMJ</em></strong><br /> Launched in 1992, this international journal publishes articles that have been commissioned with medical students in mind. See <a href="http://student.bmj.com/student/static-pages.html?pageId=2" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <p> <strong>Publications residents should consider</strong><br /> If you’re a resident or fellow, these publications may be a good fit for you. Many of these journals are ideal for publishing <a href="http://www.ama-assn.org/ama/ama-wire/post/tackling-quality-improvement-competencies-webcast-gives-guidance" target="_blank">quality improvement project</a> research and results.</p> <ul> <li> <em style="font-weight:bold;">Journal of Graduate Medical Education</em><br /> The <em>Journal of Graduate Medical Education</em> publishes original research articles, educational innovations, narrative and systematic reviews, brief reports, personal essays about teaching and learning, commentaries, editorials and letters to the editor. The journal focuses on the education of medical residents and fellows, and the environment in which they learn. See <a href="http://www.jgme.org/page/author_instructions" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>Journal for Healthcare Quality</em></strong><br /> The <em>Journal for Healthcare Quality</em>, a publication of the National Association for Health Quality, features creative and scientific solutions in the pursuit of health care quality. See <a href="http://www.editorialmanager.com/JHQ/default.aspx" rel="nofollow" target="_blank">submission guidelines</a>. </li> </ul> <ul> <li>  <strong><em>The Journal of Healthcare Risk Management</em></strong><br /> This journal publishes research, trends and new developments in the field of health care risk management with the ultimate goal of advancing safe and patient-centered health care delivery. See <a href="http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2040-0861/" rel="nofollow" target="_blank">submission guidelines</a></li> </ul> <ul> <li> <strong><em>Implementation Science</em></strong><br /> <em>Implementation Science</em> is an open-access, peer-reviewed online journal that publishes research relevant to the scientific study of methods to promote the uptake of research findings into routine health care in clinical, organizational or policy contexts. See <a href="http://www.implementationscience.com/authors/instructions" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>PLOS ONE</em></strong><br /> <em>PLOS ONE</em> is an international peer-reviewed, open-access online publication that welcomes reports on primary research from any scientific discipline. See <a href="http://journals.plos.org/plosone/s/criteria-for-publication" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <p> <strong>Top recognized publications</strong><br /> As some of the most prestigious publications in health care, these journals are highly competitive. At this point in your career, publishing in them now may be a long shot, but they are great references as you develop your research skills. Follow studies from these publications, paying close attention to abstracts and figures as examples of exceptional research for your own work.</p> <ul> <li> <strong><em>The BMJ (formerly the British Medical Journal)</em></strong><br /> This international peer-reviewed medical journal is a fully online-first publication that seeks to lead the debate on health and engage, inform and stimulate physicians, researchers and other health professionals in ways that will improve outcomes for patients. See <a href="http://www.bmj.com/about-bmj/resources-authors/article-submission" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>BMJ Quality & Safety</em></strong><br /> <em>BMJ Quality & Safety</em> (previously <em>Quality & Safety in Health Care</em>) is an international peer-reviewed publication providing research, opinions, debates and reviews for academics, clinicians and health care managers. It focuses on the quality and safety of health care and the science of improvement. See <a href="http://qualitysafety.bmj.com/" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong>The JAMA Network</strong><br /> Published continuously since 1883, <em>JAMA</em> is an international peer-reviewed general medical journal published 48 times per year in print/online issues, and new articles are published several times a week online. <em>JAMA</em> is the most widely circulated medical journal in the world. See <a href="http://jama.jamanetwork.com/public/instructionsForAuthors.aspx" rel="nofollow" target="_blank">submission guidelines</a>. See information about the 10 <a href="http://jamanetwork.com/public/about.aspx" rel="nofollow" target="_blank">specialty journals</a> that also make up the JAMA Network.</li> </ul> <ul> <li> <strong><em>The Joint Commission Journal on Quality and Patient Safety</em></strong><br /> Published monthly, <em>The Joint Commission Journal on Quality and Patient Safety</em> is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. See <a href="http://www.jcrinc.com/the-joint-commission-journal-on-quality-and-patient-safety/" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <ul> <li> <strong><em>New England Journal of Medicine</em></strong><br /> The <em>New England Journal of Medicine</em> is dedicated to bringing physicians the best research and key information at the intersection of biomedical science and clinical practice. See <a href="https://cdf.nejm.org/misc/authors/" rel="nofollow" target="_blank">submission guidelines</a>.</li> </ul> <p> For additional publications you might consider, <a href="http://www.ihi.org/education/IHIOpenSchool/resources/Pages/WhereToSubmitYourWritingQIFriendlyPeerReviewedJournals.aspx" rel="nofollow" target="_blank">view a list</a> from the Institute for Healthcare Improvement.</p> <p> <strong>Ready to send your work to one of these publications? Reference these resources: </strong></p> <ul> <li> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/research-published" target="_blank">how to get your research published</a>.</li> <li> Follow <a href="http://www.ama-assn.org/ama/ama-wire/post/9-top-tips-getting-published-medical-journal" target="_blank">these 9 expert tips</a> for getting published in a medical journal.</li> <li> Remember that publishing (like research) is a learning process, so if your paper gets rejected—don’t worry. Here’s <a href="http://www.ama-assn.org/ama/ama-wire/post/research-paper-got-rejected-heres-handle" target="_blank">how to handle it</a>.</li> </ul> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;text-align:right;line-height:18.2000007629395px;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c79a24ce-9037-4f5a-9fc6-6a71d7282e99 How the SGR repeal law ensures access to care for kids http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_sgr-repeal-law-ensures-access-care-kids Fri, 17 Jul 2015 20:50:00 GMT <p> The law that <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repealed the sustainable growth rate</a> (SGR) formula also included important provisions to help maintain the health and well-being of American children.</p> <p> The Medicare Access and CHIP Reauthorization Act (MACRA) addresses a variety of issues, including extending funding to the Children’s Health Insurance Program (CHIP), which provides low-cost health care coverage to children in low-income families who don’t qualify for Medicaid. This post, the third in a series examining what physicians need to know about the MACRA, looks at the CHIP provisions, which include increased funding provided to states for the program.</p> <p> As of last year, 8.1 million children were enrolled in the program, which is implemented in all 50 states. CHIP was authorized through 2019, but no new funding was available after 2015, until passage of the MACRA.</p> <p> The law extends funds for CHIP for two additional years (through 2017) with no major structural program changes. It maintains the general financing structure and the provisions to the program put forth by its last reauthorization in 2009. That includes extending coverage to pregnant women and coverage protections included in the Affordable Care Act, such as streamlined enrollment processes and increased outreach.</p> <p> The law also extends for two years “express lane eligibility” for certain enrollment programs. This provision allows states to use data from other agencies to facilitate enrollment in CHIP coverage, such as information from the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants and Children. Finally, the MACRA extends funding for the CHIP outreach and enrollment program for two years, which helps states find uninsured children who are eligible for CHIP.</p> <p> “Physicians see the benefits of CHIP on a daily basis: Parents who work hard but are unable to afford health insurance are able to obtain the care their children need to stay healthy and strong,” the AMA said about the program in a 2009 letter to a U.S. Senate committee. “CHIP provides a critical health insurance safety net for children from low-income families and has been successful in significantly reducing the number of children without coverage.”</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 the MACRA, 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 and read other posts in this <a href="http://www.ama-assn.org/ama/ama-wire/blog/SGR_Repeal_Series/1">MACRA series</a> at <em>AMA Wire</em>. Watch for future posts on the many facets of the MACRA and how they’ll affect how physicians practice in years to come.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8a382384-c243-469f-8979-56b2205febcc 5 ways to partner with a physician-friendly financial advisor http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-ways-partner-physician-friendly-financial-advisor Thu, 16 Jul 2015 22:02:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/2/e0c35edd-058e-4be6-b2ea-7a8bd9418b45.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/2/e0c35edd-058e-4be6-b2ea-7a8bd9418b45.Large.jpg?1" style="margin:15px;float:right;" /></a><span style="font-size:11px;">If you want to get your finances in order, working with a financial planner is a great way to start. Follow these expert-approved tips to find a trusted advisor who understands physicians’ unique needs and get the insights you need to build financial success.</span></p> <p> <span style="font-size:11px;">Robin Robertson, a senior wealth advisor for the Millennium Brokerage Group, specializes in partnering with physicians and has three decades of experience. She said partnering with a credible financial advisor is the best way for physicians to strategically develop a strong portfolio and roadmap for achieving secure retirement.</span></p> <p> <span style="font-size:11px;">But before you start talking dollars and figures, here’s what you’ll need to know to find a physician-friendly planner who meets your financial needs:</span></p> <ol> <li> <span style="font-size:11px;"><strong>Find your planner through referrals in the medical community.</strong> Begin your search by asking people or organizations you trust for potential contacts. <a href="https://www.amainsure.com/" rel="nofollow" target="_blank">AMA Insurance</a> offers their Physicians Financial Partners program that can pair physicians with vetted financial advisors, which Robertson recommends as an ideal starting point for <a href="https://www.amainsure.com/physicians-financial-partners.html" rel="nofollow" target="_blank">physicians</a>.<br /> <br /> “Referral is the best route—either through AMA Insurance, a friend or a colleague. Also, some hospitals have programs where they refer physicians to advisors, but that really depends on what’s available in your area,” she said.<br />  </span></li> <li> <span style="font-size:11px;"><strong style="font-size:12px;">Ensure your advisor understands diverse aspects of financial planning for physicians.</strong> Money management is only the beginning. Your advisor also should be able to assist you with such things as:<br /> <br /> <strong style="font-size:12px;">Risk analysis.</strong> “Physicians want a comprehensive financial advisor,” Robertson said. “For instance, they’d want someone who understands disability, medical student loan debt and how to assess risks,” she said, noting that helpful advisors should be able to evaluate physicians’ finances holistically and address common questions around timing and payments. <br /> <br /> Questions a physician-friendly financial advisor should anticipate include: “Do I pay my loans off first? How much life insurance do I need? Should I save for my children’s education or for our retirement first? What debt refinancing program should I look at?”<br /> <br /> <strong style="font-size:12px;">Personalized macro- and micro-analysis of finances.</strong> “Physicians need someone to help them think through their options,” Robertson said. This is especially true when discussing <a href="http://www.ama-assn.org/ama/ama-wire/post/top-tips-developing-med-school-loan-repayment-strategy" style="font-size:12px;" target="_blank">loan repayment strategies</a> and public loan forgiveness.<br /> <br /> Make sure you find a planner who can help you critically devise a plan that aligns with all aspects of your long-term personal and career goals—not simply your debt, she said. “Physicians are constantly hammered with deals, which is why they need someone who can step back, enter the ‘financial helicopter’ and help them see the whole picture [of their plan].”<br /> <br /> <strong style="font-size:12px;">How to advise on specific topics that impact physicians, especially disability.</strong> While individual finances vary, Robertson said there are certain wheelhouse topics that financial advisors working with physicians have experience discussing. These include “debt reduction, life insurance programs, efficient savings programs and the best disability policy they can find.”<br /> <br /> “A physician needs the Cadillac of disability policies,” she said. “They need a policy that is portable, guaranteed renewable and protects them in their own medical specialty because their livelihood completely depends on their ability to work.”</span><br />  </li> <li> <span style="font-size:11px;"><strong style="font-size:12px;">If you’re a resident or new physician, pair yourself with an advisor in the early stages of his or her career.</strong> When it comes to financial planning, the earlier you start, the better. But if you’re a resident or young physician, finding a planner with enough experience in your budget range can be tricky—but not impossible, Robertson said.<br /> <br /> The key is to find “a CFP—certified financial planner—but a younger one,” she said. “If they’re a CFP, they would have had at least four years of experience and passed the CFP exam. So in terms of their education and experience, they’re in a similar life stage as young physicians, and they’re more willing to take on newer clients.”<br /> <br /> Comparatively, fees for veteran financial planners can start at more than $2,000, she said, so it’s important to take the time to find a planner with the proper experience level. Plus, finding a CFP in your career stage offers the added opportunity to develop a strong professional relationship with your planner throughout your careers as your finances grow.<br /> <br /> “I have 30 years of experience, so [I may not be the best fit for] that young resident or physician just starting out,” Roberston said. “But for my partner who is 29? He’d be the perfect fit [for them] because he’s still building his practice. In 30 years from now, they’d be 60 together and would have built [financial success together],” Robertson said.</span><br />  </li> <li> <span style="font-size:11px;"><strong style="font-size:12px;">Be careful about fees and expenses.</strong> Full disclosure about costs is essential. “We try to keep our fees and expenses down as low as possible and still provide great service to the client,” Robertson said. “If you’re just starting to invest, normally you’re investing in mutual funds because you don’t have enough to diversify a stock portfolio. [Advisors for] these mutual funds [charge] a range of fees from 50 basis points, which is half of a percent, all the way up to 2 percent, so you want to watch those fees.”<br /> <br /> “These mutual funds can pay the advisor a commission, or the advisor can charge a fee. You obviously don’t want someone who [charges] both,” Robertson said.<br /> <br /> Avoid hidden expenses by carefully reading the fine print on all documented agreements—not simply for what’s written but for information that may not be there as well. For instance, “Let’s say you’re at the point where you have $50,000-100,000 saved and now you’re going to a fee-based financial advisor. When you begin working with this advisor, there will be a fee agreement that you sign, which fully discloses what fees your planner will charge and what they will do in exchange for those fees.” Read this agreement with a keen eye, and “make sure your advisor really shows you their value for every expense,” Robertson said.</span><br />  </li> <li> <span style="font-size:11px;"><strong style="font-size:12px;">When establishing trust, let the numbers be your guide. </strong>In a <a href="http://amainsure.com/2015-introduction-to-women-physicians-financial-preparedness-report.html" rel="nofollow" style="font-size:12px;" target="_blank">new study</a> of the financial preparedness of U.S. women physicians, AMA Insurance found that 58 percent of women physicians work with a professional financial planner as a trusted advisor. However, of those physicians who reported not working with a financial planner, 45 percent of them said they haven’t partnered with an advisor because they haven’t found one they trust.  <br /> <br /> But there’s a way avoid such distrust. To maintain open relationships with clients, Robertson said her company offers data analysis of clients’ portfolios so they know how their financial progress compares to that of people with unmanaged accounts on the general market.<br /> <br /> “We do an analysis of the portfolio a client [initially] has and compare it to the portfolio we would [offer] to illustrate how our investment choices, our structure and model portfolios outperform the portfolio the client currently has. We also do a risk analysis of our own portfolios on an ongoing basis,” Robertson said, noting that she uses this information to offer measured insights and research to clients, so they have full disclosure about their financial performance at all times.<br /> <br /> Offering this data builds transparency and trust, she said. “The more straight-forward details and data your planner gives, the better. [Avoid] the guy who says, ‘Oh honey, don’t worry about it. I’ll take care of you.’ That’s when you worry. You want facts and an analysis.”</span></li> </ol> <p> <span style="font-size:11px;"><strong>Explore more on financial planning and retirement:</strong></span></p> <ul> <li> <span style="font-size:11px;">Read <a href="http://www.ama-assn.org/ama/ama-wire/post/top-personal-finance-tips-experienced-physicians" target="_blank">these top personal finance tips</a> from experienced physicians</span></li> <li> <span style="font-size:11px;">Find out if you have <a href="http://www.ama-assn.org/ama/ama-wire/post/6-traits-of-financially-prepared-physician" target="_blank">the 6 traits</a> of a financially prepared physician</span></li> <li> <span style="font-size:11px;">Review benefits available through AMA Insurance on <a href="https://www.amainsure.com/insurance-products/retirement/retirement-legacy-planning.html" rel="nofollow" target="_blank">retirement and legacy planning</a></span></li> </ul> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:right;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Lyndra Vassar</a></em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c791b0b9-0e0b-460a-9f3f-d9a661e44152 Task force issues new clinical guideline for preventing diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_task-force-issues-new-clinical-guideline-preventing-diabetes Thu, 16 Jul 2015 20:57:00 GMT <p> A new recommendation for preventing type 2 diabetes based on an in-depth evidence review calls for increased use of evidence-based diabetes prevention programs.</p> <p> The Community Preventive Services Task Force, a group that identifies population health interventions and makes recommendations to health departments and communities, this week released its <a href="http://www.thecommunityguide.org/diabetes/combineddietandpa.html" rel="nofollow" target="_blank">findings on how to prevent type 2 diabetes</a>. The task force found that combined diet and physical activity promotion programs, such as diabetes prevention programs that are part of the Center for Disease Control and Prevention’s National Diabetes Prevention Program, are among the best ways to help people with prediabetes reduce their risk of developing type 2 diabetes.</p> <p> <strong>Strong evidence of success</strong></p> <p> Findings from the task force's extensive <a href="http://www.thecommunityguide.org/diabetes/dm-annals-evrev-combineddietpa.pdf" rel="nofollow" target="_blank">evidence review</a> point toward the success of these accessible community-based interventions in helping to halt the onset of one of the nation’s most troubling chronic diseases. This is particularly encouraging at a time when one in three U.S. adults has prediabetes, the precursor to type 2 diabetes.</p> <p> For the evidence review, researchers screened articles for single-group or comparative studies of combined diet and physical activity promotion programs. Participants at increased risk for type 2 diabetes had to have at least two sessions over at least three months. The researchers extracted data on study design, description (participant, intervention and outcome) and results in order to assess the quality of the studies.</p> <p> Ultimately, 53 studies were reviewed. They evaluated 66 programs. Compared with usual care, diet and physical activity promotion programs reduced the incidence of type 2 diabetes, decreased body weight, lowered fasting blood glucose level and improved other cardiometabolic risk factors.</p> <p> The task force also published a <a href="http://www.thecommunityguide.org/diabetes/dm-annals-econ-combineddietpa.pdf" rel="nofollow" target="_blank">related literature review</a> that looked at the cost of these interventions, finding that diet and physical activity promotion programs are cost-effective among persons at increased risk for type 2 diabetes. In addition, costs are lower when programs are delivered to groups in community or primary care settings.</p> <p> <strong>Reaching a tipping point</strong></p> <p> In a related <a href="http://www.thecommunityguide.org/diabetes/dm-annals-commentary-combineddietpa.pdf" rel="nofollow" target="_blank">editorial</a>, also published in the <em>Annals of Internal Medicine</em>, Ronald Ackermann, MD, director of the Center for Community Health at Northwestern University Feinberg School of Medicine, explains how diabetes prevention efforts are at the "tipping point."</p> <p> "As a society, we should no longer hold for ransom the potential to reduce the burden of diabetes by continuing to await further evidence that interventions will be cost-saving or prevent myocardial infarctions or deaths," Dr. Ackermann said in the editorial. "It is imperative that we promote a known cost-effective intervention that improves health, reduces the need for medication, and has the potential to enable millions of Americans to evade a remaining lifetime burdened by the daily management of diabetes."</p> <p> Successes such as those confirmed in this evidence review have led to a <a href="http://www.ama-assn.org/ama/ama-wire/post/new-legislation-could-cover-diabetes-prevention-program" target="_blank">bill</a> that was introduced to Congress. The legislation would require Medicare to cover services provided under the National Diabetes Prevention Program.</p> <p> A <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-diabetes-bill-could-save-13-billion-over-10-years" rel="nofollow" target="_blank">recent study</a> estimated that the legislation could to help reduce the cumulative rate of type 2 diabetes in the Medicare population by 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>How physicians are taking action</strong></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/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, testing and referral for prediabetes.</p> <p> The practices referred their patients with prediabetes to diabetes prevention programs offered by local YMCAs, which were part of the National Diabetes Prevention 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 Centers for Disease Control and Prevention have <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">teamed up</a> to issue 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">Prevent Diabetes STAT: Screen, Test, Act–Today™</a>. This multi-year initiative helps physicians refer adults who have prediabetes to prevention programs in their communities and online.</p> <p> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/identify-patients-undetected-prediabetes" target="_blank">how to identify</a> patients with undetected prediabetes, and <a href="http://www.ama-assn.org/ama/ama-wire/post/effective-diabetes-prevention-programs-near-practice" target="_blank">find effective diabetes prevention programs</a> near your practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:aa06d8f0-81b3-408d-a354-d5c0a1960041 Fed up with your EHR? Now’s your chance to explain http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_fed-up-ehr-nows-chance-explain Thu, 16 Jul 2015 20:45:00 GMT <p> Most physicians are unhappy with the way electronic health record (EHR) systems are working, largely due to government regulations that have encroached on time with patients and stifled technological innovations that would transform these systems into useful clinical tools. If you’re frustrated with your EHR and want to share your thoughts about problems and solutions, join a special <a href="http://breaktheredtape.org/" target="_blank" rel="nofollow">town hall meeting</a> that will be live-streamed online from 7 to 8:30 p.m. Eastern time Monday.<a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/0/c9e0c8ae-9264-4fe5-800a-8fb76bb8a87b.Full.png?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/9/0/c9e0c8ae-9264-4fe5-800a-8fb76bb8a87b.Large.png?1" style="margin:15px;float:right;" /></a></p> <p> Among the national and local leaders who will be a part of the conversation will be Rep. Tom Price, MD, a Republican from Georgia’s 6th District, and AMA President Steven J. Stack, MD. Hosted by the AMA and the Medical Association of Georgia, this live event in Atlanta allows physicians to attend in person or via live streaming—<a href="https://www.eventbrite.com/e/town-hall-electronic-health-records-tickets-17680283203" target="_blank" rel="nofollow">sign up</a> online to participate. Those who live stream the town hall also can participate on Twitter with #FixEHR.</p> <p> Even if you can’t take part in this event, the AMA still wants to make sure your voice is heard on this critical issue. Visit <a href="http://www.elabs10.com/c.html?ufl=5&rtr=on&s=x8pbgr,2agpk,3vnl,2hem,40s3,71io,lizs" target="_blank" rel="nofollow">BreaktheRedTape.org</a> to learn more about the regulation of EHRs and share your own experiences in dealing with them.</p> <p> Government requirements have distorted EHR technology so it interferes with face-to-face discussions with patients, requires physicians to spend too much time performing clerical work and hampers the usefulness of the patient’s medical record. Meanwhile, many of the much-anticipated benefits of being able to share important patient health care information electronically among health care professionals in different settings have gone unfulfilled.</p> <p> Physician participation in Stage 2 of the meaningful use program is less than 10 percent, even though 80 percent of physicians have adopted EHRs. If the Centers for Medicare & Medicaid Services (CMS) moves forward with Stage 3 as planned, it could mean less time with patients, hinder improvements to current EHR products, and result in costly penalties. The town hall will include information about the AMA’s push to reframe federal regulations and encourage better EHR design to support high-quality patient care.</p> <p> Learn more <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-should-stop-stage-3-of-meaningful-use" target="_blank">why CMS should postpone Stage 3</a>, and read more <a href="http://www.ama-assn.org/ama/ama-wire/blog/Meaningful_Use/1" target="_blank">meaningful use news</a> at <em>AMA Wire®</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e556f7c1-a57b-4770-bcac-704a9511ed4a Become a part of the AMA-WPS policymaking process http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_become-part-of-ama-wps-policymaking-process-1 Thu, 16 Jul 2015 14:00:00 GMT <p> The AMA Women Physicians Section (WPS) Resolution Committee is responsible for generating resolution ideas and working with the AMA-WPS delegate and alternate delegate to vet potential resolutions. <a href="mailto:wps@ama-assn.org?subject=AMA-WPS%20Resolution%20Committee" target="_blank" rel="nofollow">Email the section</a> by July 30 to join this committee. The AMA-WPS Resolution Committee will convene electronically in August.</p> <p> The deadline to submit resolutions for consideration at the AMA-WPS Interim Meeting is Aug. 30. <a href="mailto:wps@ama-assn.org?subject=AMA-WPS%20Resolution%20Committee" target="_blank" rel="nofollow">Email the section</a> to submit a resolution. Learn about writing resolutions on 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">AMA-WPS Web page</a>.</p> <p> The AMA-WPS Handbook Review Committee will convene prior to each business meeting of the section to review items of business that will be referred to each House of Delegates reference committee. In advance of the AMA-WPS meeting, committee members will work with the AMA-WPS delegate and alternate delegate to: review a portion of the AMA-HOD handbook for items of business that are relevant to the section and propose an initial course of action for relevant items (active support, support, oppose, active oppose, monitor).</p> <p> Interested individuals should <a href="mailto:wps@ama-assn.org?subject=A-15%20HOD%20Handbook%20Review%20Committee" target="_blank" rel="nofollow">email the section</a> by Sept. 30 to review items for the 2015 Interim Meeting.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:89efc2d1-b586-43a5-9f6d-646b9bc4fa48 5 licensure tips every resident should know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-licensure-tips-resident-should Wed, 15 Jul 2015 21:25:00 GMT <p> Navigating the medical licensure process can be daunting, but proactive planning can help you save time and ease stress. Follow these top tips when you apply for your medical license.</p> <p> The licensure process requires physicians to complete individual applications for each state in which they seek to practice medicine (including <a href="http://www.ama-assn.org/ama/ama-wire/post/questions-telemedicine-answered" target="_blank">telemedicine</a>), according to the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/succeeding-medical-school-practice.page?" target="_blank"><em>Succeeding from Medical School to Practice</em></a> resource, a must-have guide for AMA members that features credible advice and resources to successfully prepare physicians in training for practice. It recommends these licensure tips:</p> <ol> <li style="margin-left:0.25in;"> <strong>When contacting a licensing board for the first time, ask for a copy of its current licensing requirements and the average time it takes to process applications. </strong>“This will provide you with a solid idea of when to consider closing an existing practice and/or plan a move, as well as information about the potential problem areas in completing an application,” the guide states.<br /> <br /> Also provide the licensing board your resume or curriculum vitae. This will allow the board “to evaluate potential problem areas early in the process,” the guide states. Initial contact with your board “should be used to develop a set of reasonable expectations about the direction and complexity of the licensing process in [the] state to avoid frustration about the time required to obtain licensure.”<br />  </li> <li style="margin-left:0.25in;"> <strong>Stay current on policies and legislative decisions in your state that impact licensure. </strong>Following state-specific policies will keep you informed on major legislative decisions that may impact your medical board or the time required to approve your license. For example, “the passage of a medical  [liability] cap in Texas led to significant delays in processing of licensure applications due to an increase in the number of physicians seeking to practice in the state,” according to the guide. Monitor state media sources, and look to other physicians and physician recruiters for valuable licensure updates.<br />  </li> <li style="margin-left:0.25in;"> <strong>Prepare your documents early, and track your progress in training. </strong>Licensure requirements for U.S medical graduates differ by state, but all states will require proof of certain documents to demonstrate your credibility as a physician.  <br /> <br /> “Direct primary-source verification of education, graduate training, exam scores, references, current and past licenses, additional queries, profiles, and reviews will be expected,” the guide notes. As you continue through residency, track and prepare these materials to avoid last-minute scrambles for information when it’s time to apply for your license:<br /> <p style="margin-left:.25in;"> Proof of prior medical education and graduate training </p> <p style="margin-left:.25in;"> Proof of successful completion of all three steps of the United States Medical Licensing Examination.</p> <p style="margin-left:.25in;"> Any additional materials your state medical board requires for licensure </p> </li> <li style="margin-left:0.25in;"> <strong>Be honest with your medical board about information that may negatively impact your application. </strong>“A physician should never try to hide derogatory information from a licensing board,” the guide states. “It is much better to come forward with the information, assist the board in obtaining records and other necessary data, and provide information about mitigating circumstances that would prevent license denial. Full and frank disclosure of all information requested is by far the best approach to successful licensure.<br />  </li> <li style="margin-left:0.25in;"> <strong>Practice patience. </strong>“Exercise patience and courtesy in the licensing process. State licensing boards and their staff, in most cases, do the best job possible to protect the public with the resources provided [to] them,” the guide states. “This requires taking the necessary time to fairly evaluate each application for licensure.”<br /> <br /> The guide also explains that physicians should plan for a 60-day period from the time they submit a complete application for license and the actual date licensure is granted. In addition, April through September is generally the peak period for volume of licensure applications, so if you’re applying for a license at that time, temper any hurried expectations and properly prepare.</li> </ol> <p> For more tips on licensure and board requirements, review the AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure.page" target="_blank">Web page</a> on medical licensure.<br /> <br /> The AMA’s <em>Succeeding from Medical School to Practice</em> resource offers practical insights into many essential topics for residents, including board certification, financial management, and ethical and legal considerations in the patient-physician relationship. If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a> to access this helpful guide.</p> <p style="text-align:right;"> <em style="text-align:right;">  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:452a0668-6fd4-47a8-9569-1178d3af7782 How to learn about health policy and advocate for change http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-health-policy-advocate-change Wed, 15 Jul 2015 20:47:00 GMT <p> Historic changes are happening now in health care policy. A new program lets you learn how these changes will affect medical students’ future practice environment and enables you to help your peers do the same.</p> <p> The AMA Medical Student Section’s (MSS) Advocacy Champions Program connects medical students across the nation to strengthen health policy grassroots efforts. For students who are interested in health policy, the program is an opportunity to get more involved in advocacy efforts and inspire others to be active in organized medicine.</p> <p> Students who are Advocacy Champions act as legislative liaisons between their medical schools and the AMA-MSS. The section hosts a special Advocacy School session at its annual meeting.</p> <p> Being an Advocacy Champion “has given me the opportunity to be a part of the key conversations that will shape the future of health care and the way I care for my patients as a future physician,” said Elizabeth Fracica, a third-year medical student at Mayo Medical School. “To me, advocacy on behalf of my patients and my profession is not only my right but my responsibility.”</p> <p> No prior experience is necessary. Fill out an <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20153216E&TID=dAuaeTcBhgnn3p12jym%252f3g%253d%253d&OID=130" target="_blank">application</a> to be considered for a position.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3731e6c0-e070-49e3-9072-82b5fb67349a 3 ways to battle unconscious bias http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-ways-battle-unconscious-bias Wed, 15 Jul 2015 20:43:00 GMT <p> There’s no question that physicians want to provide the highest quality care for each of their patients. But sometimes, with packed schedules and fast-moving days, physicians may be unconsciously influenced in how they interact with patients and deliver their care. Learn how this happens and what you can do to prevent it.</p> <p> Experts explain that people are implicitly and unintentionally biased. The problem lies in how much information human brains must process: When there’s too much to take in, humans rely on mental shortcuts, falling back on unconscious categorizations and preferences. This is even more likely to occur when someone is stressed, under time constraints, multi-tasking and needing to move quickly from one thing to the next—all factors physicians routinely experience.</p> <p> Research supports the existence of unconscious bias and its effect on patient care. A 2012 <a href="http://www.ncbi.nlm.nih.gov/pubmed/22420787" rel="nofollow" target="_blank">study</a> found that primary care physicians with an unconscious bias toward white patients tended to dominate conversations with black patients during routine visits and pay less attention to these patients’ social and emotional needs. In another <a href="http://www.ncbi.nlm.nih.gov/pubmed/21249483" rel="nofollow" target="_blank">study</a>, black and Hispanic patients were less likely than white patients to receive pain medication, and more likely to receive lower doses of pain medication, despite higher pain scores.</p> <p> “Patients of color have a radically different experience from the moment they enter the hospital to their discharge,” said David B. Hunt during a recent education session hosted by 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>. Hunt is a leading expert on cultural competence in health care and diversity-related issues in law and business. “Unconscious bias is like a chronic illness. It needs constant caring, and we all have the disease.”</p> <p> According to Hunt, physicians can help counter unconscious bias in three ways:</p> <ol> <li style="margin-left:0.25in;"> <strong>Explore your own potential for implicit bias.</strong> The <a href="https://implicit.harvard.edu/implicit/index.jsp" rel="nofollow" target="_blank">Implicit Association Test</a>, a free online tool from Harvard, measures how quickly you associate good or bad words with people from each race.</li> <li style="margin-left:0.25in;"> <strong>Slow down when providing patient care.</strong> This won’t be easy, but shifting from “think fast” to “think slow” can help you take deeper consideration of the patient in front of you.</li> <li style="margin-left:0.25in;"> <strong>Ask for feedback from a diverse mix of employees and colleagues.</strong> Hearing different perspectives can help shed light on factors you may take for granted.</li> </ol> <p> Within medical practices and institutions, there are even more strategies to combat unconscious bias. For example, the Commission to End Health Care Disparities is helping practices test better ways to collect <a href="http://www.ama-assn.org/ama/ama-wire/post/race-ethnicity-language-data-crucial-quality-care" target="_blank">race, ethnicity and language data</a> and how to use this data to change practice policies. Practices and hospitals also can collect other metrics, such as patient satisfaction reports, and stratify that data with patient demographic data to see patterns, Hunt said.</p> <p> Medical schools are helping to address unconscious bias by educating students that it exists in the first place. <a href="http://www.ama-assn.org/ama/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">Some solutions</a> schools have put in place include cultural competency training, a student-run course in medical Spanish, and special mentoring and counseling.</p> <p> Interested in learning more? Hunt recommends two books: <em>Thinking, Fast and Slow</em> by Daniel Kahneman and <em>Blink: The Power of Thinking Without Thinking</em> by Malcolm Gladwell.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/ama-wire/blog/Health_Disparities/1" target="_blank">health disparities</a> and <a href="http://www.ama-assn.org/ama/ama-wire/blog/Diversity/1" target="_blank">diversity in health care</a> at <em>AMA Wire</em>®.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;">By AMA staff writer </em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.2000007629395px;text-align:-webkit-right;" target="_blank"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e7899c99-ee1a-4809-a0f7-aeb0ffc9eef8 Opioid overdose epidemic worsens: How physicians can help http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_opioid-overdose-epidemic-worsens-physicians-can Tue, 14 Jul 2015 19:16:00 GMT <p> The nation’s heroin epidemic is worsening, and a large part of it is fueled by people who also meet diagnostic criteria for “abuse of” or “dependence on” prescription opioids, according to <a href="http://www.cdc.gov/vitalsigns/heroin/index.html" target="_blank" rel="nofollow">new data</a> from the Centers for Disease Control and Prevention (CDC). New guidance can help physicians identify these patients and help them get treatment.</p> <p> Heroin use has increased across the United States, and heroin-related overdose deaths nearly quadrupled from 2002 to 2013, according to the CDC’s latest Vital Signs.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/a0e94e87-0d7c-429b-8068-06f1d23d6403.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/0/0/a0e94e87-0d7c-429b-8068-06f1d23d6403.Large.jpg?1" style="margin:15px;float:left;" /></a>And while heroin is an illicit drug, the strongest risk factor for abuse or dependence on it may be surprising. Nearly one-half of the people studied previously abused or were dependent on prescription opioids. According to the CDC, people who met these criteria for prescription opioids are 40 times more likely to abuse or be dependent onto heroin.</p> <p> Physicians collectively took steps at the 2015 AMA Annual Meeting to address this public health issue, <a href="http://www.ama-assn.org/ama/ama-wire/post/rx-monitoring-treatment-solutions-overdose-epidemic" target="_blank">adopting policies</a> that call for increased registration and physician use of prescription drug monitoring programs (PDMP), more robust education, and adequate coverage for comprehensive pain management approaches and addiction treatment. Meanwhile, physicians individually can <a href="http://www.ama-assn.org/ama/ama-wire/post/6-things-can-prevent-opioid-abuse" target="_blank">take action to prevent opioid abuse</a> in their patient populations, including following appropriate prescribing practices using PDMPs and supporting overdose prevention efforts.</p> <p> The CDC also encourages physicians to support medication-assisted treatment, using methadone, buprenorphine and naltrexone, in patients who may be addicted to prescription opioids or heroin.</p> <p> A <a href="http://store.samhsa.gov/product/Clinical-Use-of-Extended-Release-Injectable-Naltrexone-in-the-Treatment-of-Opioid-Use-Disorder-A-Brief-Guide/SMA14-4892R" target="_blank" rel="nofollow">new free guide</a> from the United States Substance Abuse and Mental Health Services Administration emphasizes the fact that “many studies show that the treatment of an opioid use disorder can be successfully integrated into general office practice by physicians and health providers who are not addiction specialists.” The guide focuses on a new option, extended-release injectable naltrexone, for treating patients with opioid use disorders. It also gives clinical guidance, such as assessing patients’ need for treatment, making treatment plans and deciding when to end treatment.</p> <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:5dcbd0e5-ed38-4006-bb17-c656bf24ea27 Advance care planning could become a more routine part of care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_advance-care-planning-could-become-routine-part-of-care Tue, 14 Jul 2015 19:13:00 GMT <p> Making decisions ahead of time about how they are cared for at the end of life soon could become a more routine part of medical care for Medicare patients under a proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would adopt physicians’ calls to pay for end-of-life counseling.</p> <p> The proposed 2016 Medicare Physician Fee Schedule would establish two new codes to be used to cover early conversations about care options between patients and their physicians, as recommended by the <a href="http://www.ama-assn.org/ama/no-index/physician-resources/ruc-recommendations-agreement.page" target="_blank">AMA/ Specialty Society Relative Value Scale Update Committee</a>. This advance care planning would include discussions before an illness progresses and during the course of treatment so the patient can decide on the type of care that is right for him or her. One code would cover the first 30 minutes, and the other would cover additional 30-minute blocks.</p> <p> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/" target="_blank">2015 AMA Annual Meeting</a> collectively passed policy urging insurers to pay for such counseling, which would include goals of care, living wills and durable powers of attorney for health care. CMS cited the AMA’s recommendations in its <a href="http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-08.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending" target="_blank" rel="nofollow">fact sheet</a> about the proposed rule.</p> <p> “The proposed Medicare payment rule affirms the need to support conversations between patients and physicians to establish and communicate the patient’s wishes in responding to various medical situations,” AMA President-Elect Andrew W. Gurman, MD, said in a statement. “The AMA has long supported coverage of advance care planning and provided recommendations and input to help Medicare create a payment policy based on a full understanding of this medical service.”</p> <p> The proposed rule also is the first to address provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), which repealed the sustainable growth rate formula.</p> <p> The agency is seeking comment from the public on how it proposes to implement certain provisions of MACRA, including the new <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr" target="_blank">merit-based incentive payment system</a>. The proposed rule also includes updates to payment policies, the Physician Quality Reporting System and the value-based payment modifier. CMS will accept comments on the <a href="https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-16875.pdf" target="_blank" rel="nofollow">815-page document</a> until Sept. 6 and will publish its final rule this fall. The AMA is reviewing the proposed rule in detail and will submit comments.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c7987bcd-d16f-4043-9553-8bc109b7fd90 Learn everything you need to know about CPT® code changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-everything-need-cpt-code-changes Tue, 14 Jul 2015 19:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/8/c4ebc8e7-8cb4-4883-985f-00d7a3da85c7.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/8/c4ebc8e7-8cb4-4883-985f-00d7a3da85c7.Large.jpg?1" style="float:right;margin:15px;" /></a>Keep pace with changes to the 2016 CPT® code set and Medicare’s Resource-Based Relative Value Scale (RBRVS) by attending the CPT and RBRVS Annual Symposium, Nov. 18-20 in Chicago.</p> <p> Experts on CPT, RBRVS and Medicare payment policy will guide you through changes to the 2016 CPT codes and descriptors, payment policy and RBRVS changes to the Medicare physician payment schedule.</p> <p> See the <a href="https://commerce.ama-assn.org/catalog/media/symposium-general-attendees-info-20150218.pdf" target="_blank">agenda</a>, and <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20152214E&TID=Cc6wKfoSMmhZptmP7NP9mg%3d%3d&OID=130" target="_blank">register online now</a>.</p> <p> Discounted registration rates are available for AMA members, CPT and Relative Value Scale Update Committee advisers and staff, previous attendees, CPT licensees, members of the American Association of Professional Coders, members of the American Health Information Management Association, and members of the Professional Association of Health Care Office Management. </p> <p> If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a250271e-a9f8-4242-98f8-7d89f301cb29 Shape med ed: Become a leader in key organizations http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_shape-med-ed-become-leader-key-organizations Tue, 14 Jul 2015 16:00:00 GMT <p> Want to be a leader in the medical education community? Seek nomination by the AMA for leadership positions in  organizations such as AC GME and the ABMS member Boards</p> <p> The AMA is currently accepting nomination applications for positions with the following organizations:</p> <ul> <li> <strong>Accreditation Council of Graduate Medical Education Review Committees</strong>: Review committee nomination opportunities include anesthesiology, pathology, pediatrics, psychiatry, general surgery and thoracic surgery, as well as the Institutional Review Committee and the Transitional Year Review Committee. The deadline for nominations is <strong>July 20.</strong></li> <li>  <strong>The American Board of Surgery: </strong>The deadline for nominations<strong> is July 20. </strong></li> </ul> <p> To learn more about these opportunities and to apply, visit the AMA Council on Medical Education’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education/leadership.page?">Leadership Opportunities</a> page. Should you have questions, please contact <a href="mailto:mary.oleary@ama-assn.org" rel="nofollow">Mary O’Leary</a> of the AMA at 312-464-4515.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b8db925c-e0c3-42a2-8464-ae6e5ff48930 Navigating the system through patients' eyes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_navigating-system-through-patients-eyes Tue, 14 Jul 2015 15:56:00 GMT <p>  </p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/0/f397429b-7f66-4854-804e-253595d54f07.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/0/f397429b-7f66-4854-804e-253595d54f07.Large.jpg?1" style="float:right;" /></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 </em><em>Paige Driver, a second-year medical student at the Brody School of Medicine at East Carolina University.</em></p> <p> At 6 a.m. on a Friday, most medical students are donning their white coats and heading to the hospital or a medical office practice to learn how to navigate the health care system through the eyes of physicians. However, the Brody School of Medicine at East Carolina University had a different idea for their first group of student leaders in a new program—to try navigating the system through the eyes of patients.</p> <p> Five students from the Brody School of Medicine’s inaugural cohort of <a href="http://www.ecu.edu/cs-dhs/medicaleducation/reach/lincCurriculum.cfm" rel="nofollow">Leaders in INovative Care (LINC) Scholars</a> program (including me) spent a day this summer shadowing patients’ entire experiences in a variety of health care settings to observe them navigating the very complex system of Vidant Medical Center and the school’s outpatient clinics.</p> <p> I shadowed a patient in pediatric outpatient surgery, from parking the car to driving away, and I believe the exercise was integral to learning about patient-centered care and patient safety.</p> <p> Most medical students have had the good fortune of never having been the patient, so we can’t expect to understand that experience. We will never truly achieve patient-centered care without putting ourselves in the shoes of a patient and family and getting lost in the system with them a time or two.</p> <p> We used a <a href="http://www.ihi.org/education/ihiopenschool/courses/Pages/default.aspx" rel="nofollow">module</a> from the Institute for Healthcare Improvement, “A Guide to Shadowing: Seeing Care Through the Eyes of Patients and Families,” to guide our experience. We presented our findings from these experiences, including recommendations for improving the care experience, at a session that included patient advisors from Vidant Medical Center who provided additional patient perspectives on navigating health care settings.</p> <p> <em>“</em>The future success of health care improvement for all is tied to every participant's understanding of just how much trust and mutual engagement plays a role in patient healing,” said Henry Skinner, a retired businessman and active patient advisor with the school. “Thanks for allowing us to participate and observe the awakening of five bright new minds to the world of participative care.”</p> <p> The first LINC Scholars cohort is taking a summer immersion course that provides a deep dive into the principles of patient safety, quality improvement, population health and team-based care. At the end of our fourth year of medical school, we’ll take the National Association for Healthcare quality’s Certified Professional in Healthcare Quality exam and will graduate with a distinction in health care transformation and leadership.</p> <p> <a href="http://www.ama-assn.org/ama/ama-wire/post/students-taste-of-its-like-patient">Learn more</a> about a similar program at the Penn State College of Medicine.</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:0386a82c-fe6a-4dbd-b3c8-059db3ff8ad9 3 ways to take personalized medicine to the next level http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-ways-personalized-medicine-next-level Mon, 13 Jul 2015 21:24:00 GMT <p> The term “personalized medicine” has come to mean targeting treatments based on patients’ genetic profiles—but for some physicians, it has a different meaning.</p> <p> “A person’s ZIP code matters more than their genetic code,” Garth Graham, MD, president of the Aetna Foundation, said during a recent presentation. “Where people live really defines their health outcomes.”</p> <p> Dr. Graham, a former deputy assistant secretary in the U.S. Department of Health and Human Services, led the Office of Minority Health. He joined other health disparities experts at Spotlight Health last month as part of the 2015 Aspen Ideas Festival.</p> <p> Thinking about personalized medicine in this way—where a patient grew up, where they live and how they view themselves—is crucial to tackling health disparities, Dr. Graham said.</p> <p> “The best part of clinical care is knowing the patient,” he said. “Technology has taken us away from that a little bit, but now I think we’re coming full circle—being at the bedside, being engaged, is as much a part of clinical care as understanding the best use of any procedure. … A cry or tear means something, just as much as a lab result does.”</p> <p> Here are three ways physicians are minimizing health disparities and taking personalized medicine to the next level:</p> <p style="margin-left:40px;"> <strong>1. Improving race, ethnicity and language data collection in ambulatory settings.</strong> Data collection has come a long way, but there are still challenges, Dr. Graham said. For example, how granular should the data be? “Our populations are diversifying as we speak,” he said. “The moving part of data makes it challenging.”<br /> <br /> Through the Commission to End Health Care Disparities, practices are <a href="http://www.ama-assn.org/ama/ama-wire/post/race-ethnicity-language-data-crucial-quality-care">testing better ways to collect this data</a> and then using it to change their policies and processes or determine future clinical projects.</p> <p style="margin-left:40px;"> <strong>2. Educating future physicians about health disparities and ways to counteract those disparities. </strong>“Cultural competency is evolving now,” Dr. Graham said. “It’s not just in terms of racial background but also ethnic background, geographic background. … If you look at some of the ways that [Sir William] Osler would train clinicians, he would talk about understanding and knowing the patient. The heart comes along with the patient; the heart doesn’t come by itself.”<br /> <br /> Cultural competency is becoming more crucial in undergraduate medical education, and some of the 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 are tackling health care disparities. </p> <p style="margin-left:40px;"> <strong>3. Becoming more engaged on a local level.</strong> Forming links between clinical practices and communities can help physicians better target disparities. For example, a <a href="http://www.ama-assn.org/ama/ama-wire/post/diabetes-risks-solutions-may-lie-patients-communities">recent study</a> in <em>JAMA Internal Medicine</em> pointed to a lack of community resources as a potential risk factor for type 2 diabetes. The more activity spaces and healthy food stores there are, the healthier community residents usually are—“but we don’t disperse our resources with that in mind,” Dr. Graham said. “As we try to understand the statistics and prevent some of these diseases, the solution becomes more and more local.”<br /> <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 <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 are part of the CDC’s <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow">National Diabetes Prevention Program</a>. Physicians can find resources at <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 CDC, to identify patients with prediabetes and work with them to prevent the onset of type 2 diabetes by referring them to local, evidence-based programs. </p> <p> <a href="http://www.ama-assn.org/ama/ama-wire/blog/Health_Disparities/1">Read more</a> about solutions to health disparities at <em>AMA Wire</em>®. Watch the panel from Spotlight Health to hear the discussion firsthand.</p> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:20.2222232818604px;text-align:-webkit-right;">By AMA staff writer </em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:20.2222232818604px;text-align:-webkit-right;" target="_blank"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:55867cdb-38a8-4c0e-b910-decb97dc95cb What you need to know about loan consolidation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-loan-consolidation Mon, 13 Jul 2015 21:22:00 GMT <p align="left"> As a physician in training, you’re probably already thinking about how to manage your medical school debt. Is consolidating your loans a good option? An expert in student loan consulting offers insights.</p> <p align="left"> Paul Garrard, founder and president of student loan consulting group PGPresents, has more than 30 years of experience in student financial aid and higher education. <em>AMA Wire</em>® spoke to Garrard, who recently presented at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2015 AMA Annual Meeting</a>, about considerations for loan consolidation.</p> <p align="left"> This is the second in a two-part series on loan repayment. The <a href="http://www.ama-assn.org/ama/ama-wire/post/top-tips-developing-med-school-loan-repayment-strategy" target="_blank">first post</a> examines the best ways to develop a repayment strategy.</p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: Should medical school grads consolidate their loans?</strong></p> <p align="left"> <strong>Garrard:</strong> Many recent graduates are not candidates for federal consolidation because they don’t gain anything by consolidating their loans. In general, the only medical residents we work with who are consolidating are those with multiple loan servicers or borrowers with non-Direct Loans who are interested in maximizing their potential forgiveness amount under <a href="https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service#what-is-pslf" rel="nofollow">Public Service Loan Forgiveness</a> (PSLF) by converting these non-Direct Loans into a Direct Loan balance.</p> <p align="left"> There are very few of the former, because as mentioned earlier, many graduates find their loans are all with one loan servicer. </p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: How does consolidation impact interest rates?</strong></p> <p align="left"> <strong>Garrard: </strong>There is still a misconception that consolidation lowers the interest rate.  In fact, borrowers get a slightly higher rate when they consolidate, though not prohibitively so. </p> <p align="left"> The rate is a weighted or “blended” rate of all the loans being consolidated, rounded up an eighth of a point [and] then fixed. </p> <p align="left"> Once again, it is not a prohibitively higher rate [and] certainly not a reason to not consolidate if a borrower really needs to.</p> <p align="left"> <strong><em>AMA Wire: </em></strong><strong>Is refinancing student loans through one of the companies now offering to do so a good idea?</strong></p> <p align="left"> <strong>Garrard: </strong>Borrowers have always wanted a way to lower the rates on their loans, and the past few years have seen a rapid increase in the number of companies offering to do just that. While this can no doubt be a sound decision for some, we always encourage due diligence before doing so, especially for medical residents who are considering refinancing their federal loans into a private loan.</p> <p align="left"> As you know, residency is at least three years, but often much longer when you consider subspecialties and fellowships. And a lot can happen during that time. Borrowers may want to carefully consider whether they are willing to give up the repayment and postponement flexibility inherent with federal loans for a private loan with more restrictive repayment and postponement options, at least while they are still in residency—even [if the trade-off is] a promised lower rate. </p> <p align="left"> These borrowers may want to revisit refinancing once they are out and have a steady income. They are likely a stronger candidate at that point anyway. We tend to think borrowers with a steady source of income who are not interested in forgiveness programs tend to be the strongest candidates for refinancing.  </p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: What’s your advice for current medical students?</strong></p> <p align="left"> <strong>Garrard:</strong> To current medical students, I would always encourage responsible borrowing, with a reminder to never borrow more than you really need. Take note each year of your total debt and estimated payments amounts to date. There is absolutely no reason to be surprised when you graduate at how much debt you have, especially considering all the available resources to help. </p> <p align="left"> I would also encourage current students to talk with residents about how they are handing their student loans, as you can often learn a lot from your colleagues about things that worked for them and things they wish they had done differently in terms of their repayment strategies.</p> <p> <strong>Additional resources and information on repaying student loans:</strong></p> <ul> <li align="left"> <a href="http://www.aamc.org/FIRST" rel="nofollow">FIRST</a> from the Association of American Medical Colleges</li> <li align="left"> <a href="http://www.studentloans.gov/" rel="nofollow">StudentLoans.gov</a></li> <li align="left"> <a href="http://www.nslds.ed.gov/" rel="nofollow">National Student Loan Data System</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dbb99fe5-3e6d-4682-a98e-e966e450db51 How the SGR repeal law affects medical liability http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_sgr-repeal-law-affects-medical-liability Fri, 10 Jul 2015 20:00:00 GMT <p> The new law that <a href="http://www.ama-assn.org/ama/ama-wire/post/medicare-payment-formula-bites-dust" target="_blank">repealed Medicare’s sustainable growth rate</a> (SGR) formula does more than you might realize. One provision provides important medical liability protections.</p> <p> The Medicare Access and CHIP Reauthorization Act (MACRA) has a variety of provisions, including payment and penalty changes and incentives for physicians who participate in alternative payment models. This second post in a series that examines what physicians need to know about the MACRA looks at a provision that prevents federal health care reform laws and regulations from being used as grounds for medical liability.</p> <p> The MACRA incorporates the Standard of Care Protection Act, which prevents quality program standards and measures (such as the Physician Quality Reporting System (PQRS) or the electronic health record meaningful use program) from being used as a standard of care in medical liability actions.</p> <p> For example, a plaintiff won't be able to use the fact that a physician didn't earn an incentive under PQRS as the basis for a medical liability lawsuit.</p> <p> “Physicians should not have to worry about potential new causes of action or liability exposure in an age of developing and implementing new ways to improve the quality and efficiencies of care,” the AMA said in a 2013 <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/hr1473-standard-of-care-protection-act-support-letter-11april2013.pdf" rel="nofollow" target="_blank">letter</a> (log in) to Congress supporting the act.</p> <p> Find <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/medical-liability-reform.page?" target="_blank">more information</a> about the AMA’s medical liability reform efforts.</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 the MACRA, 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 and read the <a href="http://www.ama-assn.org/ama/ama-wire/post/payments-penalties-will-change-post-sgr" target="_blank">first post</a> in this series at <em>AMA Wire</em>. Watch for future posts on the many facets of the MACRA and how they’ll affect how physicians practice in years to come.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:55dbb1fb-8a59-4e28-9c20-fb2c70e812ef Association of American Indian Physicians announces new leadership http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_association-of-american-indian-physicians-announces-new-leadership Fri, 10 Jul 2015 14:10:00 GMT <p> The <a href="http://www.aaip.org/" target="_blank" rel="nofollow">Association of American Indian Physicians</a> (AAIP) has announced the selection of Polly Olsen as its new executive director. Olsen will start in September, filling the position currently held by Margaret Knight, who is retiring after 27 years with the organization. The AAIP Board of Directors selected Olsen after a national search.</p> <p> Olsen has more than 14 years of experience in academia and health care. She is currently the director of community relations at the University of Washington, where she liaisons between tribal communities, organizations and the academic institution. Previously, Olsen was the director of the Native American Center of Excellence in Seattle. She also serves at the president of the board of directors for the Seattle Indian Health Board. Olsen is an enrolled member of the Yakama tribe.</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> (MAS) is pleased that since its inception, the AAIP has had a seat on the AMA-MAS Governing Council. The current AAIP representative is <a href="https://www.ndsu.edu/centers/american_indian_health/staff/donald_warne_md_mph/" target="_blank" rel="nofollow">Donald K. Warne, MD</a>. </p> <p> Dr. Warne is the director of the Masters of Public Health Program at North Dakota State University, and he serves as the senior policy advisor to the Great Plains Tribal Chairmen’s Health Board. In addition, he is an adjunct clinical professor at the Arizona State University Sandra Day O’Connor College of Law, where he teaches American Indian health policy. Dr. Warne is a member of the Oglala Lakota tribe from Pine Ridge, S.D., and comes from a long line of traditional healers and medicine men.</p> <p> The AMA-MAS will exhibit at the <a href="https://www.aaip.org/events/calendar/m.calendar/453/view/53" target="_blank" rel="nofollow">AAIP’s upcoming annual meeting and national health conference</a>, July 27–Aug. 2 in Tulalip<strong>,</strong> Wash.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dbe3938c-ca45-43df-b4dd-dfaa8fb25a2e AMA Foundation Healthy Living Grant applications now accepted http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-foundation-healthy-living-grant-applications-now-accepted Fri, 10 Jul 2015 14:05:00 GMT <p> The AMA Foundation Healthy Living Grants support health education programs to develop school and community-based solutions to behavioral health challenges. In 2015, grants will be awarded in two categories:</p> <ul> <li style="margin-left:0.25in;"> The youth-focused prescription medication safety category supports projects that provide awareness programs about the dangers of prescription drug abuse for at-risk children and youth who are 2-21 years old. </li> <li style="margin-left:0.25in;"> The cancer prevention education category supports projects that focus on awareness and education of underserved populations about preventing a specific type of cancer.</li> </ul> <p> Funded projects in both categories must involve a partnership with a medical organization. The application deadline is Sept. 11. Application guidelines and forms are available on the foundation’s <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page" target="_blank">website</a> under “grantseekers.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4c3ae581-f881-4a5c-aa7b-0357b8fba15c Financial services and insurance for senior physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_financial-services-insurance-senior-physicians Fri, 10 Jul 2015 14:00:00 GMT <p> Get advice you can count on from the AMA’s Physicians Financial Partners (PFP) program. This program provides access to a nationwide network of independent, local and experienced financial professionals who have undergone a comprehensive due-diligence process by AMA Insurance, which has been serving physicians since 1988. </p> <p> This program provides access to a wide variety of financial services and products, including: </p> <ul> <li> Cash value life</li> <li> Disability</li> <li> Long-term care</li> <li> Annuities</li> <li> Wealth management</li> <li> Retirement planning</li> <li> Traditional and Roth IRAs</li> <li> Charitable giving</li> </ul> <p> In connection with the Physicians Financial Partners program, the products and services are offered through Millennium Brokerage Group, LLC, a strategic marketing partner of AMA Insurance.</p> <p> Contact the Physicians Financial Partners program at (855) 210-4015 Monday through Friday from 9:30 a.m. to 5 p.m. Eastern time, or <a href="http://www.amainsure.com/pfp" rel="nofollow" target="_blank">visit the website</a> to learn more about the program.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:05ead7c3-b29b-466f-bc18-1f5ec362f2c4 How patient care has changed in the ACA era: Ethical perspectives http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patient-care-changed-aca-era-ethical-perspectives Fri, 10 Jul 2015 01:14:00 GMT <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">More than 16 million people have been covered by insurance under the Affordable Care Act (ACA), the most significant health care reform since Medicare and Medicaid. Read about the ethical implications the ACA has on a variety of issues.</span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> </span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">The </span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2fsite%2fcurrent.html" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">July issue</span></font></a><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> of the </span></font><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"><i>AMA Journal of Ethics</i></span></font><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> seeks to help physicians understand what the ACA means for patients, clinical research, physician specialty choice and payment.</span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> </span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">The issue features:</span></font></span></font></div> <ul> <li style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> </span></font></span></font><font face="Arial,sans-serif" size="2" style="text-indent:-18pt;"><span style="font-size:10pt;">“</span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2f2015%2f07%2ffred1-1507.html" style="text-indent:-18pt;font-family:"font-size:12pt;" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Learning how health care works</span></font></a><font face="Arial,sans-serif" size="2" style="text-indent:-18pt;"><span style="font-size:10pt;">.” Physicians enter medicine to become healers, not economists—but knowing how health care works is crucial to delivering high value care. This issue’s editor discusses how medical students, residents and physicians can keep up with the impact of health policy on patient care.</span></font></li> <li style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3" style="text-indent:-18pt;"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">“</span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2f2015%2f07%2fpfor1-1507.html" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Comparative effectiveness research, cost effectiveness and ethical policy-making</span></font></a><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">.” This author believes that using data from comparative effectiveness studies to inform cost effectiveness analyses or other economic evaluations would strengthen ethical policy-making. </span></font></span></font><font face="Symbol" style="text-indent:-18pt;font-size:12pt;"> </font></li> <li style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Arial,sans-serif" size="2" style="text-indent:-18pt;"><span style="font-size:10pt;">“</span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2f2015%2f07%2fstas1-1507.html" style="text-indent:-18pt;font-family:"font-size:12pt;" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Incentives for physicians to pursue primary care in the ACA era</span></font></a><font color="blue" face="Arial,sans-serif" size="2" style="text-indent:-18pt;"><span style="font-size:10pt;"><u>.”</u></span></font><font face="Arial,sans-serif" size="2" style="text-indent:-18pt;"><span style="font-size:10pt;"> High-functioning primary care services have decreased mortality and improved health outcomes, justifying legislative incentives for pursuit of that sector of medicine. This author discusses how expanding the primary care workforce will promote access to care and better health for Americans. </span></font></li> </ul> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> </span></font></span></font><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">The journal’s </span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2fpodcast%2fethics-talk-july-2015.mp3" style="font-family:"font-size:12pt;" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">July podcast</span></font></a><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">, featuring Donald M. Berwick, MD, outlines post-ACA steps toward improving patient care. </span></font><font color="#333333" face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Dr. Berwick is a senior fellow and president emeritus at the Institute for Healthcare Improvement and former head of the Centers for Medicare & Medicaid Services.</span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"> </span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Times New Roman,serif" size="3"><span style="font-size:12pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;"><b>Ethics poll: Your chance to weigh in</b></span></font></span></font></div> <div style="margin:0px;color:rgb(0, 0, 0);font-family:"font-size:medium;"> <font face="Consolas" size="2"><span style="font-size:10.5pt;"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Would you rely on patient satisfaction surveys as sources of information in choosing a hospital, clinic or physician? </span></font><a href="https://mail10.ama-assn.org/OWA/redir.aspx?C=LLVMVynM9EudGlF8NChqmIzOZphEjtIIuXGSp9O9fQgk5gkYExyVOHjcFjy-sYrcowIxW3QapOM.&URL=http%3a%2f%2fjournalofethics.ama-assn.org%2fsite%2fpoll.html" target="_blank"><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">Share your response</span></font></a><font face="Arial,sans-serif" size="2"><span style="font-size:10pt;">in this month’s ethics poll.</span></font></span></font></div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8d4b4cae-e324-4b41-96ad-b099a3bc3596 Frustrated with EHRs? Voice your concerns http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_concerned-meaningful-use-voice-heard Thu, 09 Jul 2015 23:00:00 GMT <p> The electronic health record (EHR) meaningful use program isn’t working, as many physicians have implemented EHRs but still can't comply with program requirements. Yet that hasn’t stopped regulators from moving forward with increasingly burdensome stages for physicians. Come voice your concerns at a special town hall meeting from 7 to 8:30 p.m. Eastern time July 20 in Atlanta.</p> <p> Hosted by the AMA and the Medical Association of Georgia, the town hall will give physicians a chance to discuss EHRs, the meaningful use program and looming regulations. Among the national and local leaders who will be a part of the conversation will be Rep. Tom Price, MD, a Republican from Georgia’s 6th District, and AMA President Steven J. Stack, MD.</p> <p> <a href="http://breaktheredtape.org/" rel="nofollow" target="_blank">Register online</a> to make your voice heard. The event will take place at the <a href="http://www.westinatlantanorth.com/" rel="nofollow" target="_blank">Westin Atlanta Perimeter North</a>. While we prefer to have you attend in person, the town hall will stream live online. Watch <em>AMA Wire</em>® for details.</p> <p> Physician participation in Stage 2 of meaningful use is less than 10 percent, even though 80 percent of physicians have adopted EHRs. Moving forward with Stage 3 could mean less time with patients, hindrances to practice innovation and costly penalties.</p> <p> Learn more about <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-should-stop-stage-3-of-meaningful-use" target="_blank">why CMS should postpone Stage 3</a>, and read more <a href="http://www.ama-assn.org/ama/ama-wire/blog/Meaningful_Use/1" target="_blank">meaningful use news</a> at <em>AMA Wire</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c79cc496-3b81-43eb-8e06-8420120cbeeb 8 free must-have ICD-10 resources http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-must-icd-10-resources Thu, 09 Jul 2015 19:00:00 GMT <p> Although Centers for Medicare & Medicaid Services (CMS) has announced policies that could help make the transition to the ICD-10 code set less disruptive for physicians, it’s still crucial to prepare as much as possible before the Oct. 1 implementation deadline. Get the top free resources you can use in your practice.</p> <p> In response to the AMA’s extensive communication of physicians’ concerns, the CMS announced Monday that it is making some critical changes to the transition period between ICD-9 and ICD-10. The changes are intended to allow physicians to continue providing high-quality patient care without worrying about the potential for claims disruptions.</p> <p> For example, for the first year ICD-10 is in place, Medicare claims will not be denied solely based on the specificity of diagnosis codes, as long as they are from the appropriate family of ICD-10 codes. <a href="http://www.ama-assn.org/ama/ama-wire/post/cms-icd-10-transition-less-disruptive-physicians" target="_blank">Read more</a> about the changes at <em>AMA Wire</em>®.</p> <p> To help make the transition as smooth as possible for your practice, make sure you’re prepared ahead of the year-long transition period. These eight resources can help get your practice up to speed for the code switch:</p> <ol> <li style="margin-left:0.25in;"> <strong>The AMA’s ICD-10 </strong><a href="http://www.ama-assn.org/resources/doc/washington/x-pub/icd-10-project-plan-template.xlsx" target="_blank"><strong>project plan template</strong></a><strong> (log in).</strong> This downloadable template is customizable in Microsoft Excel and can be your guide to getting ready.</li> <li style="margin-left:0.25in;"> <strong>A </strong><a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank"><strong>special series</strong></a><strong> at <em>AMA Wire.</em></strong> This series examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started.</li> <li style="margin-left:0.25in;"> <a href="http://www.roadto10.org/ics/" rel="nofollow" target="_blank"><strong>Sample medical cases</strong></a><strong> from CMS. </strong>Use these 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;"> <a href="http://www.roadto10.org/events/" rel="nofollow" target="_blank"><strong>Free trainings</strong></a><strong> with CMS for small and rural practices. </strong>The trainings 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>An AMA </strong><a href="http://www.ama-assn.org/ama/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank"><strong>tip sheet series</strong></a><strong> for each step of the transition process.</strong> The series will walk you through what you need to know, from  <a href="http://www.ama-assn.org/resources/doc/washington/icd10-assess-your-documentation.pdf" target="_blank">assessing your documentation needs</a> (log in) to <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-testing-your-readiness.pdf" target="_blank">completing thorough testing</a> (log in) and understanding <a href="http://www.ama-assn.org/resources/doc/washington/icd-10-prevent-cash-flow-interruptions.pdf" target="_blank">cash-flow interruptions</a> (log in).</li> <li style="margin-left:0.25in;"> <strong>The </strong><a href="https://www.aapc.com/icd-10/icd-10-news.aspx" rel="nofollow" target="_blank"><strong>ICD-10 Tips and Resources newsletter</strong></a><strong> from the American Academy of Professional Coders (AAPC). </strong>This newsletter delivers monthly tips to your inbox, and the entire archive is available online.</li> <li style="margin-left:0.25in;"> <strong>CMS’ </strong><a href="http://www.roadto10.org/specialty-references/" rel="nofollow" target="_blank"><strong>specialty-specific references</strong></a><strong>.</strong> Get common codes for your specialty, primers for clinical documentation and clinical scenarios. The agency also has <a href="http://www.roadto10.org/webcasts/" rel="nofollow" target="_blank">webcasts</a> on unique clinical documentation needs and hot topics for each medical specialty.</li> <li style="margin-left:0.25in;"> <strong>The AMA’s </strong><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"><strong>ICD-10 Web page</strong></a><strong>.</strong> Find background information, reports and other resources, including additional tip sheets and checklists.</li> </ol> <p> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire</em> provides important insights for what you need to know as the deadline approaches. Keep an eye out for more news and tips in the weeks and months ahead.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4019b208-bf64-4d1f-9a6c-ad2ffd923fd7 Applying medical ethics to the modern practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_applying-medical-ethics-modern-practice Wed, 08 Jul 2015 20:37:00 GMT <p> How should the availability of personal information online, patient use of smartphones in the exam room and rapidly diversifying cultures in the patient population affect medical care and physicians’ professional ethics? Physicians are considering answers to these questions for inclusion in 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>.</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/1/11/818d8543-ddfe-4d86-9b5f-65d93e477c12.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/1/11/818d8543-ddfe-4d86-9b5f-65d93e477c12.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td> <span style="font-size:11px;"><em>AMA members comment on cultural competency in medical practice during the CEJA Open Forum.</em></span></td> </tr> </tbody> </table> <p> Physicians, residents and students provided insight into modern medical trends and their associated ethical issues in an Open Forum of the AMA <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> (CEJA) during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a> in June.</p> <p> <strong>Investigating patients online</strong></p> <p> In the age of social media and online publication, vast amounts of information about patients—including many minute details—are available within a matter of seconds. How much online research about a patient is appropriate for a physician, and how does it affect the patient-physician relationship?</p> <p> Physicians asked the council to consider guidance on a wide array of nuanced issues tied to digital information and noted the dangers of what physicians might find.</p> <p> Several physicians commented that looking for information beyond the clinical details available from the patient or health databases could deliver inaccurate information or details that could introduce bias into the patient’s care. At the same time, a little research on a patient could be a useful tool for improving care.</p> <p> Medical situations could require a carefully balanced approach. For instance, one emergency physician posed a dilemma in which the physician suspects a patient of being a professional drug seeker. Is it the physician’s ethical obligation to do as much research as possible to determine how best to handle the situation to ensure the patient does not receive medications or other treatment that could harm the patient or others?</p> <p> Physicians have been <a href="http://www.ama-assn.org/ama/ama-wire/post/should-physicians-google-patients" target="_blank">discussing this issue</a> in medical journals and elsewhere and now are looking for clear ethical guidance.</p> <p> <strong>Defining cultural competency</strong></p> <p> Another pressing topic physicians identified for further examination and ethical guidance was cultural competency in patient care.</p> <p> CEJA member Kathryn Moseley, MD, noted that the U.S. population is becoming much more diverse, but diversity of the physician population isn’t keeping pace. “A lot of us will be taking care of patients who are much different from us,” Dr. Moseley said.</p> <p> She noted that while physicians should always provide the same standard of care, they also need to understand what helps and hinders them in taking care of patients from diverse populations.</p> <p> Several physicians observed that cultural competency training often doesn’t go deep enough to really help physicians as they care for patients. Ethnic, racial, cultural, language and educational backgrounds all can play a role in what patients prioritize, how they make decisions and how they interact with their physicians.</p> <p> “It’s about understanding how cultural factors affect how physicians and patients are able to arrive at the appropriate treatment,” one physician commented.</p> <p> Questions raised included the role of family members in the exam room, how to overcome language barriers with patients who don’t speak English and the physician’s responsibility when patients come to them seeking to get rid of physical traits that are tied to their race or ethnicity.</p> <p> <strong>Modernizing the <em>Code of Medical Ethics</em></strong></p> <p> As the oldest code of professional ethics, the 168-year-old AMA <em>Code of Medical Ethics</em> is a living document. Ethical opinions are frequently added to keep up with emerging medical issues, and CEJA hosts semi-annual Open Forums to hear more from physicians about topics under consideration.</p> <p> Over the past six years, the <em>Code</em> has been undergoing a more comprehensive update to help make it more accessible for physicians in their daily practice of medicine.</p> <p> As part of this historic project<em>, </em>CEJA has reviewed ethical opinions for relevance, timeliness, clarity and consistency across topics and incorporated feedback from the medical community to produce an updated <em>Code</em> with a more intuitive chapter structure.</p> <p> The proposed updates are under review, and AMA members will be able to view and comment on the latest draft. Watch <em>AMA Wire</em>® for details when it becomes available</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:98a8b478-5e48-42e7-90d6-8aa7bb9d9bad Is private practice really giving way to hospital ownership? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_private-practice-really-giving-way-hospital-ownership Wed, 08 Jul 2015 17:59:00 GMT <p> Although a common perception is that hospital ownership of practices is skyrocketing even as the number of physicians in small practices is shrinking, newly released data tell a far less dramatic story.</p> <p> A new AMA <a href="http://www.ama-assn.org/resources/doc/health-policy/x-pub/prp-practice-arrangement-2015.pdf" target="_blank">report</a> (log in) looked at both short- and long-term changes in physician practice arrangements using data from the most recent AMA Physician Practice Benchmark Survey, finding that growth in hospital ownership has been slow while most physicians still provide care for patients in small practices.</p> <p> The number of physicians in small practices with 10 or fewer physicians remained the majority at 60.7 percent. And 56.8 percent of physicians worked in practices wholly owned by physicians, only a slight decrease from 2012, when 60.1 percent of physicians worked in physician-owned practices.</p> <p> The share of physicians who worked directly for a hospital or in practices that had at least some hospital ownership, meanwhile, increased modestly from 29 percent in 2012 to 32.8 percent in 2014.</p> <p> The report delves into four aspects of physician practice arrangements:</p> <ul> <li style="margin-left:0.25in;"> Whether physicians are owners, employees or independent contractors with their main practice</li> <li style="margin-left:0.25in;"> What type of practice best describes their main practice (including solo, single specialty, multi-specialty, direct hospital employee and faculty practice)</li> <li style="margin-left:0.25in;"> What the ownership structure of their main practice is</li> <li style="margin-left:0.25in;"> How many physicians are in their main practice</li> </ul> <p> Additional insights from the report include:</p> <ul> <li style="margin-left:0.25in;"> Younger physicians were more likely than older physicians to be employed. About 59 percent of physicians under the age of 40 were employed, versus 46.0 percent of physicians aged 40-54 and 33.3 percent of physicians 55 and above.</li> <li style="margin-left:0.25in;"> Nearly one-third of physicians are in practices with more than 10 physicians, including 13.5 percent in practices with 50 or more physicians.</li> <li style="margin-left:0.25in;"> Multi-specialty practice physicians were more likely than single-specialty practice physicians to report that their practices were hospital owned—44.6 percent compared to 23.0 percent.</li> </ul> <p> “The AMA is committed to ensuring physicians in all practice sizes and types can thrive and offers innovative strategies and resources that address common practice challenges in the new health environment,” AMA President-elect Andrew W. Gurman, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2015/2015-07-08-majority-americas-physicians-work-small-practices.page" target="_blank">statement</a> about the report.</p> <p> No matter what your practice type or size, the AMA has resources to make your practice thrive:</p> <ul> <li style="margin-left:0.25in;"> Use the AMA’s <a href="https://www.stepsforward.org/" rel="nofollow" target="_blank">STEPS Forward</a>, a free online series of proven solutions developed for physicians by physicians. The interactive educational modules help physicians address common practice challenges while earning continuing medical education credit. <a href="http://www.ama-assn.org/ama/ama-wire/post/real-physicians-making-their-practices-thrive" target="_blank">Read more</a> at <em>AMA Wire</em>®.</li> <li style="margin-left:0.25in;"> Get help with the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives.page" target="_blank">necessities of running a practice</a>, such as selecting a practice management system, adopting electronic transactions and appealing payment denials.</li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-alternative-payment-models.page" target="_blank">Learn about</a> payment and delivery reform, including how to determine whether <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/private-payer-reform/state-based-payment-reform/competing-in-the-marketplace.page?" target="_blank">medical practice integration</a> makes sense for you.</li> <li style="margin-left:0.25in;"> Follow <a href="http://www.ama-assn.org/ama/ama-wire/blog/Practice_News/1" target="_blank">practice news</a> at <em>AMA Wire</em> for practical tips you can implement in your practice immediately on topics from ICD-10 to meaningful use.</li> </ul> <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:c57195ba-2daa-4f3e-8db7-b3542b255d76 How one program achieved resident wellness, work-life balance http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-program-achieved-resident-wellness-work-life-balance Tue, 07 Jul 2015 21:07:00 GMT <p> Feeling your way through a maze while blindfolded, untangling your colleagues in a web of rope or searching the hidden contents of a container using papers clips probably aren’t the first things that come to mind when you think of resident wellness. Yet these are the exact activities that have improved the health and happiness of surgical residents in one innovative residency program. Learn more about how making time for certain activities is boosting productivity in training.</p> <p> Authors of a <a href="http://archsurg.jamanetwork.com/article.aspx?articleid=2293073" rel="nofollow">recent <u>editorial in <em>JAMA</em></u></a> discussed the compelling history and progress of Stanford University School of Medicine’s Balance in Life program, which started in 2010 after the tragic suicide of a recent graduate from the school’s general surgery training program.</p> <p> “After mourning his loss only five months after having left Stanford, our residency program took decisive action to create a multifaceted program aimed at enhancing resident wellness,” the authors wrote.</p> <p> “We first formed a committee consisting of residents and faculty. Through several meetings over the course of four months, we arrived at the structure of a Balance in Life program, now in its fourth year of implementation."</p> <p> The program features a comprehensive curriculum based on four domains of wellbeing: professional, physical, psychological and social. Through activities and structured emotional and mental resources, residents learn how to strike work-life balance despite <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-real-reason-residents-burn-out-tell">the</a> <a href="http://www.ama-assn.org/ama/ama-wire/post/whats-real-reason-residents-burn-out-tell"><u>inherent stressors</u></a> of physician training.</p> <p> Here are creative ways the program fosters wellness among residents:</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;" width="365"> <tbody> <tr> <td> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/3/a319514f-9b8b-4e4c-b3a9-f10f3c94bf83.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/3/3/a319514f-9b8b-4e4c-b3a9-f10f3c94bf83.Large.jpg?1" /></a></p> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/2/489cec02-8960-407f-92a5-3d35041ce4d8.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/8/2/489cec02-8960-407f-92a5-3d35041ce4d8.Large.jpg?1" /></a></p> <p align="right"> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/0/8411a0cd-928c-4883-a05a-0d27265276b2.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/4/0/8411a0cd-928c-4883-a05a-0d27265276b2.Large.jpg?1" /></a></p> </td> <td>  </td> </tr> <tr> <td> <p align="right"> <span style="font-size:11px;"><em>Photos by Norbert von der Groeben / Stanford University School of Medicine   </em></span></p> </td> </tr> </tbody> </table> <p style="margin-left:1in;"> <strong>1. </strong><strong>Providing resident mentorship and leadership training. </strong></p> <p style="margin-left:1in;"> To develop residents’ professional well-being, the program pairs junior residents with senior resident mentors. “Quarterly lunch meetings between the junior and senior pairs are funded by the program to facilitate an ongoing relationship. This provides junior residents a private, informal setting in which to discuss concerns about work, research or their personal lives,” the editorial said.  </p> <p style="margin-left:1in;"> Participants in the Balance in Life program also receive leadership training through sessions that encourage residents to explore various leadership styles. For instance, one session used a rope course to focus on leadership, mutual support and team bonding. Another activity saw residents setting sail together in San Francisco Bay (pictured right) as part of a special sailing lesson designed to counter stress and boost team morale.</p> <p style="margin-left:1in;"> <strong>2. </strong><strong>Stocking resident environments with healthy food and snacks. </strong></p> <p style="margin-left:1in;"> “A significant challenge our residents faced was the lack of healthy food options in the hospital, particularly in the evenings and on weekends. To solve this problem, we purchased a refrigerator that was placed in a secure location in our surgical education center, to which residents have badge access. The residents appreciate having a refrigerator that is stocked weekly with healthy drinks and snacks,” the authors wrote.</p> <p style="margin-left:1in;"> <strong>3. </strong><strong>Offering residents resources that support their mental, emotional and physical health. </strong></p> <p style="margin-left:1in;"> While maintaining wellness is important, there often is a silent stigma around mental health in medicine that discourages seeking help. This is why the Balance in Life program offers residents confidential counseling as an integral part of training.</p> <p style="margin-left:1in;"> “One of the primary goals of the Balance in Life program is to provide residents with tools to manage stress in their lives. We enlisted an expert clinical psychologist with experience working with high-performance teams to meet with our residents weekly. These 90-minute confidential meetings are scheduled by postgraduate year on a rotating schedule, with each postgraduate-year group meeting with the psychologist every six weeks,” the editorial said. “This time is protected in the same way as weekly educational time, and topics are selected by the residents.”         </p> <p style="margin-left:1in;"> Through these meetings, residents have collaborative discussions with peers and share positive coping strategies. They also are “encouraged and expected to see a physician annually and a dentist semiannually,” the editorial said. The program provides residents with a guide that lists physicians, dentists and physical-fitness venues recommended by their peers.  </p> <p style="margin-left:1in;"> <strong>4. </strong><strong>Hosting social gatherings and events. </strong></p> <p style="margin-left:1in;"> “We recognize the value of social well-being and its relationship with physical and psychological well-being. To this end, the Balance in Life program sponsors informal social gatherings such as happy hour, sports events and outdoor activities for promoting balance and mutual support among our residents,” the authors wrote.</p> <p style="margin-left:1in;"> Each year, the program appoints one or two residents to plan monthly social events, which “provide opportunities for residents and their families to spend time together away from the hospital. Faculty are also invited to a subset of these events, allowing for the development of meaningful relationships among residents and faculty,” the editorial said.</p> <p style="margin-left:33pt;">  <strong>More well-being solutions and tips for residents:</strong></p> <ul> <li style="margin-left:33pt;"> Read <a href="http://www.ama-assn.org/ama/ama-wire/post/acgme-seeks-transform-residency-foster-wellness" target="_blank"><u>how the Accreditation Council for Graduate Medical Education (ACGME) plans</u></a> to foster resident wellness.</li> <li style="margin-left:33pt;"> See how you compare to your peers in a <a href="http://www.ama-assn.org/ama/ama-wire/post/acgme-survey-reveals-concerning-data-resident-wellness-1"><u>national wellness study</u></a> from the ACGME.</li> <li style="margin-left:33pt;"> Educate yourself on <a href="http://www.ama-assn.org/ama/ama-wire/post/beat-burnout-7-signs-physicians-should" target="_blank"><u>the signs of burnout</u></a> and <a href="http://www.ama-assn.org/ama/ama-wire/post/burnout-busters-boost-satisfaction-personal-life-practice" target="_blank"><u>how to avoid them</u></a></li> <li style="margin-left:33pt;">  Review <a href="http://www.ama-assn.org/ama/ama-wire/post/5-things-institutions-can-prevent-resident-burnout" target="_blank"><u>5 things institutions can do</u></a> to prevent resident burnout.</li> <li style="margin-left:33pt;"> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/ways-residents-found-conquer-burnout" target="_blank"><u>how other residents have conquered</u></a> burnout in training.</li> <li style="margin-left:33pt;"> Get inspired with these <a href="http://www.ama-assn.org/ama/ama-wire/post/residents-programs-tackle-wellness-4-solutions" target="_blank">4 wellness solutions</a> and ideas.</li> </ul> <p style="text-align:right;margin-left:33pt;"> <em style="text-align:right;">  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:bf80a41c-5d77-460c-a1ab-2d4b4cb9dd70 What physicians need to know about patient portals http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-need-patient-portals Tue, 07 Jul 2015 20:56:00 GMT <p> Patients are used to accessing information online immediately, from checking their bank balance to booking travel. Physicians can tap into this expectation using patient portals, which allow patients to access their health information online and also satisfy a requirement for the electronic health record (EHR) meaningful use incentive program. Learn what you need to know to get patients to use this tech feature.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/13/cc1cab4a-d323-4c4a-adfb-f2b45a6e04b1.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/12/13/cc1cab4a-d323-4c4a-adfb-f2b45a6e04b1.Large.jpg?1" style="float:right;margin:15px;" /></a><strong>Meaningful use measures</strong></p> <p> Under the current Stage 2 requirements, physicians must provide online access to at least one-half of their patients so they can view, download and electronically transmit the data to a third party. This health information must be made available to the patient within four business days after becoming available to the physician.</p> <p> In addition, at least 5 percent of patients must actually use this service. In its <a href="http://www.ama-assn.org/ama/ama-wire/post/good-news-meaningful-use-realistic-requirements">proposed modifications to Stage 2</a>, the Centers for Medicare & Medicaid Services may be loosening this standard, instead requiring that only one patient has used the portal. However, the change is not final, and 5 percent remains the current standard. Meanwhile, CMS is not changing the requirement that physicians provide access to patient information online. The AMA will continue to help physicians engage their patients in their care via patient portals.</p> <p> <strong>Technology requirements</strong></p> <p> In order to demonstrate meaningful use and comply with federal privacy requirements, your EHR vendor must ensure patients can access clinical data through a secure and encrypted connection. Data also must be available for download in a standardized format.</p> <p> In some cases, patient portals are built into the EHR system, while other systems use separate applications. In either case, set up, configuration and management of patient passwords is required. Talk to your vendor to determine whether you need any special configuration to make your patient portal usable.</p> <p> <strong>How to get patients to use the portal</strong></p> <p> You may have met the first measure—enabling patients to see their data—but now your patients must actually use the portal to access their data. Here’s how you can encourage use:</p> <ol> <li> Train your staff on how the portal works, what data is available and how to get patients connected.</li> <li> Post signs in your office or provide fliers promoting the patient portal and its benefits.</li> <li> Encourage patients to view or download their health information. While the measure includes “transmitting” health data, this is still a challenge with current technology. It is often more effective for patients to download and print their data rather than using the transmit function.</li> <li> Consider adding a computer workstation or tablet in a public area of your office. Following a patient visit, have a staff member walk the patient through setup of the portal account and demonstrate how to access data.</li> <li> Use your current patient contact methods to encourage portal use, including the recorded hold messages on your phone, voicemail and appointment reminder communications.</li> <li> Explain to patients during their visit what information will be available, such as lab results, current medications lists or instructions.</li> <li> Include family members in discussions. Highlight that online access helps family members (who have appropriate permission) stay informed about what is happening with a parent, spouse or child.</li> </ol> <p> <strong>Resources to help</strong></p> <p> The AMA continues to seek less restrictive meaningful use requirements and continues to advocate for changes to the program. Meanwhile, physicians can get help with meeting current requirements by using tip sheets and other resources on the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/digital-health/medicare-medicaid-incentive-programs.page">AMA meaningful use Web page</a> and patient <a href="http://www.healthit.gov/sites/default/files/measure-tools/nlc-faqs-about-patient-portal.docx" rel="nofollow">FAQs</a> from the Office of the National Coordinator for Health IT.</p> <p align="right"> <em>By AMA staff writer </em><a href="https://twitter.com/Lauren_AMAWire" rel="nofollow"><em>Lauren Rees</em></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:795c37be-4b72-458b-ba79-74eb1930e911 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, 07 Jul 2015 14:31:00 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> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c0a5789e-ac28-42a3-b8c9-19f3939590c7 Top tips for developing a med school loan repayment strategy http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_top-tips-developing-med-school-loan-repayment-strategy Mon, 06 Jul 2015 21:06:00 GMT <p align="left"> With how high med school debt can be, developing a strategy for paying back your loans can help make handling that debt more manageable. Here’s what physicians in training need to know to develop a sensible repayment strategy.</p> <p align="left"> Paul Garrard, founder and president of student loan consulting group PGPresents, has more than 30 years of experience in student financial aid and higher education. <em>AMA Wire</em>® spoke to Garrard, who recently presented at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2015 AMA Annual Meeting</a>, about the best ways to develop a repayment plan and which repayment plans  to consider if you’d like to qualify for public loan forgiveness.</p> <p align="left"> This is the first in a two-part series on loan repayment. The <a href="http://www.ama-assn.org/ama/ama-wire/post/need-loan-consolidation" target="_blank">second post</a> examines considerations for loan consolidation.</p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: You work with thousands of medical residents and fellows who have questions about student loan repayment. What is one of the main questions or concerns you hear from them?</strong></p> <p align="left"> <strong>Garrard:</strong> The most frequent question or concern we get is whether or not they should try to take control of their own debt during residency or rely on the federal government for help through one of the forgiveness programs, most notably <a href="https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service#what-is-pslf" rel="nofollow" target="_blank">Public Service Loan Forgiveness</a> (PSLF).</p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: What do physicians in training need to know about PSLF?</strong></p> <p align="left"> <strong>Garrard: </strong>The eligibility requirements for PSLF match up well for many medical school graduates, at least during residency, regardless of their ultimate career plans. PSLF is available to borrowers who have Direct Loans (federal loans directly from the government) and make 120 payments with an Income-Driven Repayment Plan like Income Based Repayment (IBR) or the newer version called Pay As You Earn (PAYE) while they work at least 30 hours per week (certainly not a problem for residents) for an eligible non-profit employer. </p> <p align="left"> [Here’s] how this plays out for many medical residents: First, they already have Direct Loans since the government now makes all federal loans and has for years. Second, many residents cannot afford repayment under any plan other than IBR or PAYE. And third, many teaching hospitals are non-profits. </p> <p align="left"> So this pretty much guarantees several years towards PSLF eligibility while they are residents, whether they are ultimately interested in public sector work or not, as long as they start making payments [toward the 120 payment requirement]. This is why we tell all medical school borrowers we work with that the decision about pursing PSLF likely comes toward the end of residency or fellowship when hopefully they have multiple job offers. </p> <p align="left"> They simply “start the clock” towards [PSLF] eligibility [by making payments] during residency.</p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: What are the drawbacks of starting these repayment plans during residency?</strong></p> <p align="left"> <strong>Garrard: </strong>The challenge comes in that for many residents, their required minimum payment under these income plans is often so low that it doesn’t come close to covering the interest due on the loans because of how much they borrowed. [This] results in the balances growing even more during residency and fellowship. </p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: How can residents approach loan repayment?</strong></p> <p align="left"> <strong>Garrard: </strong>Many residents we work with can afford to be at least a little aggressive and pay more each month, but they don’t want to as long as PSLF is part of their repayment strategy because they would be paying down their potential forgiveness amount. So they make their minimum payments and watch their balances grow, all the while hoping PSLF will be there for them later. </p> <p align="left"> Others take the approach of still using IBR or PAYE for a manageable payment, but they overpay on their worst loan any time they can and thus try to take control of their debt. </p> <p align="left"> We think the latter is a very common repayment strategy, and [it is] certainly a sound one.</p> <p align="left"> <strong><em>AMA Wire</em></strong><strong>: Any tips for how medical school graduates should go about figuring all this out?</strong></p> <p align="left"> <strong>Garrard: </strong>At a minimum we suggest at least three things for figuring out an effective repayment strategy:</p> <p align="left" style="margin-left:40px;"> <strong>First</strong>: Borrowers need to know what they borrowed, who services their loans (companies like FedLoan Servicing, Great Lakes, Navient and Nelnet) and when their loans come due. </p> <p align="left" style="margin-left:40px;"> The <a href="http://www.nslds.ed.gov/" rel="nofollow" target="_blank">National Student Loan Data System</a> lists all a borrower’s federal loans and also provides information on loan servicers. Most loans come due about six months after medical school. Step No. 1 is really quite simple, and many recent graduates are finding that all their loans are already with one loan servicer, which negates one of the reasons to consolidate. Borrowers who have other loans not listed on NSLDS (such as private loans) can check their credit report for similar information.</p> <p align="left" style="margin-left:40px;"> <strong>Second:</strong> We suggest they take a good look at their own repayment objectives. Do they want to aggressively pay down their debt whenever they can, or do they want to make minimal payments, at least in residency and fellowship, perhaps with an end game of maximizing their potential forgiveness under PSLF?</p> <p align="left" style="margin-left:40px;"> We always encourage medical residents to review their repayment objectives on a regular basis. We have worked with many borrowers who started out making minimum payments in residency, perhaps with an eye towards PSLF, only to land a job in the for-profit sector after residency that they really wanted, which effectively took PSLF “off the table.” [This] resulted in a new repayment objective geared towards aggressive repayment.</p> <p align="left" style="margin-left:40px;"> <strong>Third:</strong> The final step is to pick a repayment plan that will help them meet their repayment objectives with a required monthly payment they can comfortably afford, again remembering they can aggressively pay later if needed with no penalty.</p> <p align="left" style="margin-left:40px;"> IBR and PAYE are popular with medical residents and fellows because they allow affordable payments when the debt level greatly exceeds income. However, we always encourage borrowers to look at other options as well and to “back into” IBR and PAYE. In other words, they should not assume they cannot afford another more aggressive plan from the start, especially if their debt is relatively low and they have access to other resources, perhaps courtesy of a spouse or partner. There are calculators that can help with this third step, and loan servicers should be able to help as well.</p> <p> <strong>           Explore more loan repayment tips:  </strong></p> <ul> <li style="margin-left:0.75in;"> Watch <a href="https://www.facebook.com/AMAmedstudents/videos" rel="nofollow">this Facebook video series</a>  from the AMA’s Medical Student Section featuring advice from students on how to tackle loan debt and financial planning.</li> <li style="margin-left:0.75in;"> Learn <a href="http://www.ama-assn.org/ama/ama-wire/post/five-ways-manage-student-debt">5 ways to manage your student debt</a>.</li> <li style="margin-left:0.75in;"> Research loan repayment options on the AMA Medical Student Section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/opportunities/other-financial-aid-resources.page" target="_blank">financial aid resources Web page</a>.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9cbf478c-d73c-43c9-b0a7-7bdf1c4b6f50 Dropping weight and spending: A proven way to curb diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dropping-weight-spending-proven-way-curb-diabetes Mon, 06 Jul 2015 20:48:00 GMT <p> People with prediabetes who participate in lifestyle intervention programs cost less to care for over time, according to a <a href="http://www.clinicalendocrinologynews.com/specialty-focus/diabetes/single-article-page/ymca-prediabetes-program-results-in-weight-loss-lower-costs/6cba7c43b884fa97bb156d82d2bb64a1.html" rel="nofollow" target="_blank">new study</a>. These findings are encouraging in a time when one in three U.S. adults has this precursor to type 2 diabetes.</p> <p> Released at the annual scientific sessions of the American Diabetes Association in June, the study found that lifestyle interventions result in clinical benefits and potential health care savings. Adults with prediabetes who took part in a program adapted from the evidence-based <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a> and delivered at local YMCAs lost weight and spent less on health care over three years than those who did not participate in such a program.</p> <p> Participants in the large, nationwide study had health insurance coverage through UnitedHealth Group and were given the option to participate in the program at no cost. Those who participated lost an average 3.6 percent of body weight and spent about $364 less on health care over three years than individuals with prediabetes who did not participate in the intervention program. About 35 percent of people who were encouraged by UnitedHealth to attend the program actually did it, according to the study.</p> <p> <strong>Calculating the cost savings</strong></p> <p> Successes such as those confirmed in this study have led to a <a href="http://www.ama-assn.org/ama/ama-wire/post/new-legislation-could-cover-diabetes-prevention-program" target="_blank">bill</a> that was introduced to Congress. The legislation would require Medicare to cover services provided under the National Diabetes Prevention Program.</p> <p> 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 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>How physicians are taking action</strong></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,testing and referral for prediabetes. The practices referred their patients with prediabetes to diabetes prevention programs offered by local YMCAs, which were part of the National Diabetes Prevention 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 helps physicians refer adults who have prediabetes to prevention programs in their communities and online.</p> <p> Learn <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/identify-patients-undetected-prediabetes" target="_blank">how to identify patients</a> with undetected prediabetes, and <a href="http://www.ama-assn.org/ama/ama-wire/post/effective-diabetes-prevention-programs-near-practice" target="_blank">find effective diabetes prevention programs</a> near your practice.</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:28c4a1cf-c7c5-4158-a795-a7e0c7120fb9 CMS to make ICD-10 transition less disruptive for physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-icd-10-transition-less-disruptive-physicians Mon, 06 Jul 2015 14:35:00 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 AMA President Steven J. Stack, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/3/bf4eb84c-c3f1-4fcb-b3ca-0e9a30cbeff5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/../static/images/store/15/3/bf4eb84c-c3f1-4fcb-b3ca-0e9a30cbeff5.Large.jpg?1" style="margin:15px;float:left;" /></a>Implementation of the ICD-10 code set is just around the corner, with a hard deadline of Oct. 1. Many physicians have been concerned about adopting this code set because of the heavy investment of time and resources and the potential for claims disruptions that could interfere with patient care.</p> <p> Fortunately, the AMA has secured provisions that will ease this transition, particularly for physicians in practices with limited resources.</p> <p> In response to our extensive communication of physicians’ concerns, the Centers for Medicare & Medicaid Services (CMS) announced today that it is making several critical changes to the transition period so that physicians can continue to provide high-quality patient care without risking their livelihood.</p> <p> These changes address:</p> <ul> <li> <strong>Claim denials.</strong> For the first year ICD-10 is in place, Medicare claims will not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.<br /> <br /> This means that Medicare will not deny payment for these unintentional errors as practices become accustomed to ICD-10 coding. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes. This transition period will give physicians and their practice teams time to get up to speed on the more complicated code set.<br /> <br /> Both Medicare Administrative Contractors and Recovery Audit Contractors will be required to follow this policy.</li> </ul> <ul> <li> <strong>Quality-reporting penalties. </strong>Similar to claim denials, CMS will not subject physicians to penalties for the Physician Quality Reporting System, the value-based payment modifier or meaningful use based on the specificity of diagnosis codes as long as they use a code from the correct ICD-10 family of codes.<br /> <br /> In addition, penalties will not be applied if CMS experiences difficulties calculating quality scores for these programs as a result of ICD-10 implementation.</li> </ul> <ul> <li> <strong>Payment disruptions. </strong>If Medicare contractors are unable to process claims as a result of problems with ICD-10, CMS will authorize advance payments to physicians.<br />  </li> <li> <strong>Navigating transition problems. </strong>CMS has said it will establish a communication center to monitor issues and resolve them as quickly as possible. This will include an “ICD-10 ombudsman” devoted to triaging physician issues.</li> </ul> <p> These provisions are a culmination of vigorous efforts to convince the agency of the need for a <a href="http://www.ama-assn.org/ama/ama-wire/post/doctors-call-two-year-grace-period-icd-10-penalties" target="_blank">transition period</a> to avoid financial disruptions during this time of tremendous change. These provisions are a testament to the power of organized medicine and what we can achieve when we band together for the good of our patients and our profession.</p> <p> <strong>What you need to prepare</strong></p> <p> Although physicians now have a yearlong transition period, now is still the time to buckle down and make sure your practice is as prepared as possible ahead of Oct. 1. Here are several important resources that can help you get ready over the next three months:</p> <ul> <li> A <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1" target="_blank">special series</a> at <em>AMA Wire</em>® examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started.</li> <li> Additional <a href="http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1" target="_blank">ICD-10 content</a> at <em>AMA Wire</em> provides important insights for what you need to know about the new code set.</li> <li> The AMA’s ICD-10 Web page offers important <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> on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.</li> <li> CMS also is offering free assistance, including its “<a href="http://www.roadto10.org/" rel="nofollow" target="_blank">Road to 10</a>” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. <a href="http://www.ama-assn.org/ama/ama-wire/post/icd-10-countdown-continues-sure-ready" target="_blank">Read more</a> about the agency’s resource offerings.</li> </ul> <p> These significant improvements for the impending ICD-10 roll-out are just one way our collective voice is helping improve our practice environment for greater practice stability and ongoing quality care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1cf81918-1e2c-491b-9a0e-55cd52083503 Say "thank you" to someone who's made a difference: July 31 deadline http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_say-thank-someone-whos-made-difference-july-31-deadline Thu, 02 Jul 2015 18:00:00 GMT <p> Acknowledge the people who have made a difference in your professional life by nominating them to be a part of the AMA Women Physicians Section (WPS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/mentor-recognition.page" target="_blank">Inspirational Physicians</a>. </p> <p> AMA-WPS members are invited to tell us about a professional colleague or teacher who has served a special role in your life and career. The individual may have inspired you to greater heights, steered you into a specialty you love, helped you find balance in life and work, guided you through your professional society, challenged you to surprise yourself, or unknowingly been a role model for you and others.</p> <p> All nominees will be issued a special certificate and recognized during Women in Medicine Month this September. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/physician-mentor-recognition-form.page?" target="_blank">Nominations forms</a> are due July 31.</p> <p> Visit the AMA-WPS Web page to learn more about our <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/mentor-recognition.page?" target="_blank">2014 physician honorees</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c33db6cb-753b-45a8-a992-ca052f1dc9f4 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 17:27:00 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 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:8ec499f1-2b20-4f24-a848-204cebbf02da Program funds research on women in medicine: Apply by July 31 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_program-funds-research-women-medicine-apply-july-31 Thu, 02 Jul 2015 14:00:00 GMT <p> The AMA Women Physicians Section in conjunction with the AMA Foundation has established the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/joan-f-giambalvo-memorial-scholarship.page" target="_blank">Joan F. Giambalvo Fund for the Advancement of Women</a> with the goal of promoting women in the medical profession and strengthening the ability of the AMA to identify and address the needs of women physicians and medical students. </p> <p> Recent topics have included:</p> <ul> <li style="margin-left:0.25in;"> Gender differences in promotion and retention</li> <li style="margin-left:0.25in;"> Empathy and burnout among emergency medicine residents</li> <li style="margin-left:0.25in;"> Reproductive barriers and outcomes among female medical students and trainees</li> <li style="margin-left:0.25in;"> Flexible work options</li> <li style="margin-left:0.25in;"> Promotion and retention of diversity in medical education</li> </ul> <p> Learn more about <a href="http://www.ama-assn.org/ama/ama-wire/post/new-research-outlines-women-academic-physicians-challenges" target="_blank">research</a> by 2013 Giambalvo winner, Janet Lee, MD, on challenges facing women chief residents.</p> <p> <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/giambalvo-grant-application.doc" target="_blank">Applications</a> (log in) for the 2015 program are due July 31 at 6 p.m. Eastern time. Email the <a href="mailto:WPS@ama-assn.org?subject=Joan%20F.%20Giambalvo%20Fund%20for%20the%20Advancement%20of%20Women" rel="nofollow">Email the section</a> with any questions. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f438669d-ccdb-4c9a-b353-adc61314f798 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/" rel="nofollow" target="_blank">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> <li> <span style="color:windowtext;">Attend an exclusive TEDMED  event featuring inspiring speeches from pioneers in health care, including </span><a href="http://www.elabs10.com/c.html?ufl=e&rtr=on&s=x8pbgr,2b3z9,698o,5mfa,eglq,krg3,eu3" rel="nofollow">Robert Wachter, MD</a>, <span style="color:windowtext;">author of the New York Times best-seller <em>The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age</em>, maverick engineer </span><a href="http://www.elabs10.com/c.html?ufl=e&rtr=on&s=x8pbgr,2b3z9,698o,hqmn,fqsk,krg3,eu3" rel="nofollow">Peter Janicki</a>, <span style="color:windowtext;">and scientific catalyst </span><a href="http://www.elabs10.com/c.html?ufl=e&rtr=on&s=x8pbgr,2b3z9,698o,l5yf,cede,krg3,eu3" rel="nofollow">Roberta Ness, MD</a>. <span style="color:windowtext;">The event will take place Oct. 1 from 6-8:30 p.m. </span></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" rel="nofollow" target="_blank">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 Governing Council gets new officers 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 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="margin-right:15px;margin-left:15px;float:right;" /></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="width:365px;height:281px;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:14.62px;">© 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> <p style="text-align:right;"> <em style="text-align:right;color:rgb(26, 20, 20);line-height:18.2px;font-family:Gotham, "font-size:13px;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);overflow:hidden;cursor:pointer;word-wrap:break-word;" target="_blank">Lyndra Vassar</a></em></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;"> <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 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</a></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/" rel="nofollow" target="_blank">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" rel="nofollow" target="_blank">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="http://www.matterchicago.com" rel="nofollow" target="_blank">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/" rel="nofollow" target="_blank">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" rel="nofollow" target="_blank">selecting an EHR vendor</a> and <a href="https://www.stepsforward.org/modules/ehr-implementation" rel="nofollow" target="_blank">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> <p style="text-align:right;"> <em style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;text-align:right;line-height:18.2000007629395px;">By AMA staff writer <a href="https://twitter.com/Lyndra_AMAWire" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;">Lyndra Vassar</a></em></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" rel="nofollow" target="_blank">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" rel="nofollow" target="_blank">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> <ul> <li> Encourage physicians to use state-based prescription drug monitoring programs (PDMP).</li> <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 23:09:00 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> <div style="text-align:right;"> <em>By AMA staff writer <a href="http://twitter.com/Lyndra_AMAWire" target="_blank" rel="nofollow">Lyndra Vassar </a></em></div> <div style="text-align:right;">  </div> <div style="text-align:right;">  </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 b