AMA Wire&#174; http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page Thu, 30 Oct 2014 21:25:00 GMT CDC expert to share latest Ebola guidance on Nov. 9 - View via live streaming http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-expert-share-latest-ebola-guidance-live-nov-9 Thu, 30 Oct 2014 21:25:00 GMT <p> Learn how to prepare for and manage Ebola patients in hospital and ambulatory care settings by participating in a continuing medical education session led by an expert from the Centers for Disease Control and Prevention (CDC). Taking place Nov. 9 during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, this session can be attended in person or viewed remotely via live streaming.</p> <p> The session will be held from 4:30 p.m. to 6 p.m. Central time Nov. 9 in the Trinity Ballroom of the Hilton Anatole in Dallas. Live streaming also will be available for those unable to attend in person. Watch <em>AMA Wire</em>® for details on how to watch the session online.</p> <p> Arjun Srinivasan, MD, associate director for health care- associated infection prevention programs at the CDC, will discuss:</p> <ul> <li> The epidemiology of Ebola disease</li> <li> Best practices in Ebola disease prevention and management in hospital and ambulatory care settings</li> <li> Current risk assessment and risk communication guidance</li> <li> Available resources for patients and health professionals</li> </ul> <p> Ample time will be allocated for questions and interactive discussion with Dr. Srinivasan.</p> <p> The AMA designates this live activity for a maximum of 1.5 <em>AMA PRA Category 1 Credits</em>™.</p> <p> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> to easily access up-to-date Ebola materials developed for physicians and the public by the CDC and other national experts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e4fea4f2-9f31-42e2-b8a1-935318a35f02 Real-time tracker puts education decisions into students’ hands http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_real-time-tracker-puts-education-decisions-students-hands Thu, 30 Oct 2014 19:44:00 GMT <p> A new real-time data tracker from Oregon Health and Science University School of Medicine will help medical students know exactly how well they are meeting educational objectives, and a mobile app component will allow busy students to input information on the go.</p> <p> The school’s REDEI system (Research and Evaluation Data for Educational Improvement) will let medical students, their coaches and school leaders immediately input and track evaluation information, displaying a snapshot of each student’s performance in real time.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/65fde8a0-662d-4edb-946c-17fb181166d7.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/65fde8a0-662d-4edb-946c-17fb181166d7.Large.jpg?1" style="float:left;margin:10px;" /></a>Patricia Carney, PhD, professor of family medicine and professor of public health and preventive medicine at the OHSU (pictured left), presented the system at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as 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. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> “We really wanted to be able to help students navigate their educational experiences and provide information to the coaches and learners that would help develop faculty and develop the students as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">master adaptive learners</a>,” Dr. Carney said.</p> <p> Having data on tests, quizzes and instructional quality will allow students to immediately reflect on areas they need to improve upon—a necessary skill for lifelong learners.</p> <p> The mobile app component of the system will allow students to enter data about their clinical experiences, which will upload into an educational portfolio.</p> <p> “The learners have no time to do anything—that’s why we created the phone app, so they can just do a tap and enter,” Dr. Carney said. “We wanted them to enter the data when they were working with their preceptors and not have to keep it in their heads until they got home.”</p> <p> Giving students access to this information will help them navigate their educational experiences.</p> <p> Students “can choose settings and other experiences that they have not yet explored to be sure their training is very comprehensive and tailored to meet their educational goals,” Dr. Carney said. “Our primary goal at OHSU is customized education. Thus, the REDEI system is key to allowing this to happen while ensuring that our physician graduates are the best they can be.”</p> <p> Dr. Carney and George Mejicano, MD, senior associate dean for education at OHSU, are working with the AMA and the Accelerating Change in Medical Education consortium schools to keep the system open-source and exportable, potentially allowing other schools to build similar systems.</p> <p> This post is the final installment in a brief series on new medical education technology published at <em>AMA Wire</em>® over the last few weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a>, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank">second post</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-giving-med-students-real-world-experience" target="_blank">third post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:38b92aa6-5ae4-41b2-b20f-f0f1321953f0 JAMA Highlights: Traumatic brain injury may increase dementia risk in older adults http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-traumatic-brain-injury-may-increase-dementia-risk-older-adults Thu, 30 Oct 2014 19:42:00 GMT <p> <strong>Genetic predisposition to elevated LDL-C associated with narrowing of aortic valve</strong><br /> In an analysis that included approximately 35,000 participants, genetic predisposition to elevated low-density lipoprotein cholesterol (LDL-C) was associated with aortic valve calcium and narrowing of the aortic valve. These findings support a causal association between LDL-C and aortic valve disease, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1919440" target="_blank" rel="nofollow">study</a> appearing in <em>JAMA</em>. The study is being released to coincide with its presentation at the Canadian Cardiovascular Congress. </p> <p> <strong>Initial choice of oral medication to lower glucose in diabetes patients examined</strong><br /> Patients diagnosed with diabetes and initially prescribed metformin to lower their glucose levels were less likely to require treatment intensification with a second oral medicine or insulin than patients treated first with sulfonylureas, thiazolidinediones or dipeptidyl peptidase 4 inhibitors, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1918925" target="_blank" rel="nofollow">study</a> published online by <em>JAMA Internal Medicine</em>.</p> <p> <strong>Traumatic brain injury may increase dementia risk in older adults</strong><br /> Traumatic brain injury appears to be associated with an increased risk of dementia in adults 55 years and older, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1919070" target="_blank" rel="nofollow">study</a> published online by <em>JAMA Neurology</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:53c86ded-0cb8-40e1-b73e-78acbe02dea1 Improve quality, avoid penalties using clinical data registries http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_improve-quality-avoid-penalties-using-clinical-data-registries Wed, 29 Oct 2014 19:24:00 GMT <p> Physicians providing care to Medicare patients this year will face a 2 percent <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">payment penalty</a> in 2016. As the AMA works to lessen this burden, you can take advantage of a new reporting option to improve patient outcomes while simultaneously lessening your chances of incurring penalties.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-things-clinical-data-registries" target="_blank">Clinical data registries</a> have the potential to provide meaningful clinical information to improve quality and value of health care, according to a <a href="http://www.ama-assn.org/resources/doc/cms/x-pub/a14-cms-report8.pdf" target="_blank">recent report</a> (log in) from the AMA Council on Medical Service. The <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/nqrn.page" target="_blank">National Quality Registry Network</a> (NQRN), a voluntary network of organizations that operate registries and others interested in using registry information, is coordinating the nation’s 100-plus registries to ensure they are used appropriately and the collected data is readily available to physicians in a useful format.</p> <p> Registries differ depending on the intended use of the data they collect, but generally they are used to:</p> <ul> <li> Monitor the quality of care that individual patients receive</li> <li> Track clinical and cost effectiveness of treatments</li> <li> Measure processes and outcomes of care</li> <li> Report performance to clinicians and payers</li> <li> Support clinical research</li> </ul> <p> In an NQRN registry landscape survey of 32 registries, more than three-quarters of the registries collected national-level data related to a specific disease or condition. Most registry stewards use the data for performance improvement and comparative effectiveness research.</p> <p> “Well designed and managed clinical data registries can provide physicians with critical information to help them provide quality care to their individual patients,” the report said.</p> <p> The AMA has been actively engaged in efforts to advance the use of clinical data registries. Through its work, the AMA helped shape language in the American Taxpayer Relief Act of 2012 that allows for the Centers for Medicare & Medicaid Services (CMS) to add the reporting option of a Qualified Clinical Data Registry to fulfill the Physician Quality Reporting System (PQRS) reporting requirement.</p> <p> Under this option, those eligible to participate in PQRS are able to report measures selected by the Qualified Clinical Data Registry as a substitute to the traditional PQRS list of measures with the intent of providing physicians credit for their quality improvement activities and reduce the PQRS reporting burden. Get a <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014QualifiedRegistries.pdf" rel="nofollow" target="_blank">list of CMS’ Qualified Clinical Data Registries</a>.</p> <p> Through the NQRN, the AMA will continue to encourage the development of clinical registries to facilitate quality improvement and research that result in better health care, improved population health and lower costs.</p> <p> It’s good news that CMS is willing to accept participation in Qualified Clinical Data Registries as an alternative pathway for PQRS. The relationship with CMS “creates a unique opportunity to promote and expand the use of registries as a physician-led alternative to data collection and quality reporting mechanisms developed by government regulators,” the report said.</p> <p> Physician leadership is crucial to ensuring these registries continue to grow. With input from practicing physicians, registries will be designed and used in the best ways to enhance patient care and the physician-patient relationship. By adopting the report as policy, the AMA encourages national medical specialty societies, state medical associations and other physician groups to join the NQRN to advance the development and use of clinical data registries. The policy also supports multi-stakeholder funding of registries, and calls for flexibility in registry development and implementation.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f76f6607-c19c-475d-9f6c-b961774063a9 Get published: Ethics journal now accepting articles for peer review http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_published-ethics-journal-now-accepting-articles-peer-review Wed, 29 Oct 2014 19:21:00 GMT <p> The AMA’s online ethics journal, <a href="http://virtualmentor.ama-assn.org/" target="_blank"><em>Virtual Mentor</em></a>, now offers an outstanding opportunity for physicians and physicians in training to be part of an important discussion and get their peer-reviewed articles published. Expand your professional horizons: <a href="https://www.rapidreview.com/AMA/CALogon.jsp" target="_blank" rel="nofollow">Submit your article</a> for publication in this MEDLINE-indexed journal today.</p> <p> <em>Virtual Mentor</em> is a student- and resident-driven journal published online monthly; it is advertisement-free and open-access. For the first time in its 15-year history, the journal is accepting unsolicited manuscripts for peer review and consideration through its online manuscript submission and review system.</p> <p> The journal accepts article submissions on all medical ethics topics, from those of ongoing interest to those on a current event or recent debate in the medical ethics world. The editorial focus is on commentaries and articles that offer practical advice and insight for medical students, residents and physicians.</p> <p> Review <a href="http://virtualmentor.ama-assn.org/site/archives.html" target="_blank">archived issues</a> of <em>Virtual Mentor</em> to see past topics.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f11e3ea3-ccf6-48bc-8a90-023e368e993a Halloween ICD-10 codes help prep for scary season http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_halloween-icd-10-codes-prep-scary-season Wed, 29 Oct 2014 18:00:00 GMT <p> Be prepared for the spookiest season of the year. With ICD-10 implementation coming Oct. 1 of next year, here are the ICD-10 diagnosis codes you may need for Halloween.</p> <ul> <li> If one of your patients is unlucky enough to cross paths with a surly black cat, ICD-10 allows you to code for a bite from a cat (W55.01). The equivalent ICD-9 code didn’t allow for distinction by animal, so potential complications from a bite could be easier to monitor under the new code set.<br />  </li> <li> Watch that neck: An encounter with a vampire could result in ICD-10 code S11.83, which denotes puncture wounds to a specified part of the neck.<br />  </li> <li> Did your patient’s hand slip while carving a pumpkin? If you’re dealing with a finger cut, ICD-10 has codes for the left hand versus right hand and the exact finger that is injured.</li> </ul> <p> <br /> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/10/a887ad14-3fb3-438d-aaa4-2c813b78fbaa.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/10/a887ad14-3fb3-438d-aaa4-2c813b78fbaa.Large.jpg?1" style="float:right;margin:15px;" /></a>While the minute detail of these codes could be silly, the ICD-10 code set is no trick. ICD-10-CM has 68,000 codes—a five-fold increase from the approximately 13,000 diagnosis codes in ICD-9. Physicians have less than a year to transition to the code set.</p> <p> The AMA continues to urge regulators to ease this physician burden, citing the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> of ICD-10, coupled with an already onerous regulatory environment.</p> <p> However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Physicians should begin preparing for implementation by working with software vendors and testing their systems, if they haven’t already. The AMA offers <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now">resources</a> to make the transition easier.</p> <p> The Centers for Medicare & Medicaid Services recently announced three weeks that will be dedicated to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/will-icd-10-claims-accepted-cms-designates-testing-weeks" target="_blank">helping physicians test</a> whether their claims will be accepted in the Medicare claims processing system. The first testing week will be from Nov. 17-21.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d7645457-7492-43fd-bf6a-3a159de97482 Where you should practice: New tool reveals lay of the land http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_should-practice-new-tool-reveals-lay-of-land Tue, 28 Oct 2014 18:00:00 GMT <p> The United States has more than 6,000 designated health professional <a href="http://www.hrsa.gov/shortage/find.html" rel="nofollow" target="_blank">shortage areas</a> in primary care alone. A new mapping tool from the AMA lets you find out which regions are most in need of physicians in your specialty and would be served best if you establish or expand your practice there.</p> <p> With the <a href="http://www.ama-assn.org/ama/priv/advocacy/state-advocacy-arc/health-workforce-mapper-a.page" target="_blank">AMA Health Workforce Mapper</a> (log in), an interactive tool released Tuesday, you and your staff can determine locations to establish or expand your practice based on regional needs for access to care, geographic features and the existing health care workforce.</p> <p> The tool helps AMA members make wise practice decisions and meet pressing patient access needs by giving a map view of layered geographic information, health data, and practice locations of physicians and other health care providers—down to medical specialty and practice type.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/3/5d33d482-90a1-4c94-b373-6e434512014d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/3/5d33d482-90a1-4c94-b373-6e434512014d.Large.jpg?1" style="margin:15px;float:right;" /></a>For instance, an OB-GYN group practice located in St. Louis that is interested in expanding to another practice site in the state could select Missouri as the location, choose OB-GYN as the class of physicians they want to see on the map, and overlay that with nurse midwives and other health care professionals in the field.</p> <p> The resulting map would demonstrate where physicians and other providers involved in women’s health care are located and show the areas of greatest need with the ratio of patients to health care professionals. The practice then could choose to see where other group practices, hospitals and medical schools are in relation to the areas they’re considering for a new practice site. Physicians who are not AMA members have access to a <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/health-workforce-mapper-b.page" target="_blank">reduced view of the tool</a> that does not include physician data.</p> <p> Physicians in training and those already in practice can use this tool to:</p> <ul> <li> Identify and prioritize underserved areas for practice expansion or establishment</li> <li> Create and display ratios of physicians to population in any given region</li> <li> Map the practice locations of physicians and other clinicians in specific states or regions</li> <li> Select and compare across multiple categories of physician specialty types</li> <li> Identify shortage areas, hospital locations, population indicators and relevant health policy data</li> <li> View geographic features, including highways, mountain ranges and waterways</li> </ul> <p> <strong>Exclusive access:</strong> While a <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/health-workforce-mapper-b.page" target="_blank">reduced view</a> of this tool is open to anyone who wishes to view basic regional information and detailed non-physician provider data, AMA members get exclusive access to layered physician data that drills down to medical specialty and practice type and overlays the other mapping data for a complete picture of the selected location.</p> <p> If you’re not an AMA member, <a href="http://www.ama-assn.org/ama/pub/membership.page" target="_blank">join today</a>.</p> <p> <strong>Want to learn more? </strong><a href="https://www2.gotomeeting.com/register/783349514" rel="nofollow" target="_blank">Register today</a> to participate in a live demonstration at 1 p.m. Eastern time Nov. 14.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cee2ec45-c555-461b-a380-2c7532d5740b Why health insurance competition matters http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-insurance-competition-matters Tue, 28 Oct 2014 16:33:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/11/3338a171-6adf-4758-ab0f-11120ab1f472.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/11/3338a171-6adf-4758-ab0f-11120ab1f472.Large.jpg?1" style="float:left;margin:10px;" /></a>In my travels I often hear the concerns and successes physicians and patients across the country face every day. Perhaps one of the most concerning challenges in today’s health care environment is health insurance competition.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/10-top-states-health-insurers-dominate-new-study" target="_blank">newest edition</a> of the AMA’s <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets</em>, which provides a picture of competition in 388 metropolitan areas, all 50 states and Washington, D.C., gives us a measure of just how concerned we should be.</p> <p> In 17 states, and in 41 percent of metropolitan areas, a single health insurer had more than one-half of the commercial market. In 45 states, only two health insurers had a combined commercial market share of one-half or more. In nearly three-quarters of the metropolitan areas studied, there is a significant absence of health insurer competition.</p> <p> WellPoint Inc. had the largest market share in 82 of the metropolitan areas studied, Health Care Services Corp. dominated 37 areas and UnitedHealth Group led 35 metropolitan areas.</p> <p> Market power of big health insurers increases the risk of anti-competitive behavior. That means higher prices for patients and more pressure on physicians, and it presents a significant barrier to the market success and innovation of of smaller insurance rivals.</p> <p> The point of the study isn’t merely to raise alarm. It’s a way to inform researchers, policymakers and regulators about where mergers and acquisitions among health insurers could harm patients and physicians. The AMA regularly keeps these groups in the loop about the state of health insurance competition to help them make wise decisions to make sure America’s patients have the access to care they need.</p> <p> AMA members can access the study for free through the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560005&navAction=push" target="_blank">AMA Store</a>. It’s also available for purchase to nonmembers. 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:93f29870-b871-42f2-9ffe-73c8dca113e5 Seminar gives guidance on changes to CPT® 2015 codebook http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_seminar-gives-guidance-changes-cpt-2015-codebook Tue, 28 Oct 2014 16:31:00 GMT <p> Looking for a comprehensive way to review changes to the 2015 CPT® codebook? Attend a one-day seminar, offered in five locations, to keep up to date with new procedural terminology.</p> <p> The CPT® Changes 2015 Workshop gives attendees access to leading CPT experts and information on changes to the code set, including guidelines, modifiers and E/M codes. Participants in this workshop will receive:</p> <ul> <li> An introduction to and overview of CPT changes that include added, revised and deleted codes</li> <li> A detailed explanation of rationale behind added, revised and deleted codes and guidelines</li> <li> Expert-led, interactive training</li> <li> A copy of the <em>CPT® 2015 Professional Edition </em>codebook and a copy of <em>CPT® Changes 2015: An Insider’s View</em></li> </ul> <p> The one-day workshop will take place in five states:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510005&navAction=push" target="_blank">Newark, New Jersey</a>: Dec. 8</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510006&navAction=push" target="_blank">Atlanta, Georgia</a>: Dec. 8</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510008&navAction=push" target="_blank">Baltimore, Maryland</a>: Dec. 11</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510007&navAction=push" target="_blank">Las Vegas, Nevada</a>: Dec. 11</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510009&navAction=push" target="_blank">San Antonio, Texas</a>: Dec. 15</li> </ul> <p> Review the <a href="https://commerce.ama-assn.org/catalog/media/cpt-changes-2015-workshop-agenda-december.pdf" target="_blank">workshop agenda</a> (log in) for more information. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:af5a4c42-fba2-468e-865e-9745fd91a591 Physicians’ ethical considerations in emergencies http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-ethical-considerations-emergencies Mon, 27 Oct 2014 19:25:00 GMT <p> As flu season approaches and public health outbreaks are making headlines, physicians and health systems across the country are reviewing disaster preparedness procedures. The <em>AMA Code of Ethics</em> and physician-authored articles provide guidance on ethical deliberations the medical community should consider regarding public health and disaster preparedness.</p> <p> The <em>Code</em> gives <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9067.page" target="_blank">guidance on physician obligation in epidemics</a> and other public health emergencies, stating that “individual physicians have an obligation to provide urgent medical care during disasters.” It also states that physicians “should take appropriate advance measures to ensure their ability to provide medical service at the time of disasters, including keeping current on relevant knowledge and skills.</p> <p> Outside of the <em>Code</em>, there are further discussions when it comes to ethics in public health emergencies, including:</p> <ul> <li> “<a href="http://www.tandfonline.com/doi/abs/10.1080/15265160701307613?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&#.VEgmkvnF_ng" rel="nofollow">Ethics and public health emergencies: Encouraging responsibility</a>.” It’s extremely difficult to predict whether people and institutions will live up to their responsibilities in a crisis and plan accordingly. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors’ responsibilities.</li> <li> “<a href="http://www.tandfonline.com/doi/abs/10.1162/152651604773067497?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#.VEgmsPnF_ng" rel="nofollow">When pestilence prevails … Physician responsibilities in epidemics</a>.” Physicians’ responses to epidemics throughout history suggest an evolving acceptance of the professional duty to treat contagious patients. This article suggests that a renewed embrace of physicians’ duty to treat patients during epidemics—despite conditions of personal risk—might improve capacity to prepare for threats such as bioterrorism and new epidemics.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2006/04/ccas3-0604.html">Should I stay or should I go? The physician in time of crisis</a>.” In the face of an epidemic, where do physicians’ obligations lie? The ethical definition of obligation often provides little guidance for how one should behave in the face of conflicting duties.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2004/05/ccas1-0405.html">Duty to treat versus personal safety</a>.” In becoming a professional, a physician takes an oath to be a healer and serve the sick. There is an implied contract between patients and clinicians, which must be considered in determining whether to treat a patient or care for one’s own personal safety.</li> <li> “<a href="http://www.tandfonline.com/doi/full/10.1080/15265160601021256#.VEgnSvnF_ng" rel="nofollow">Ethics and public health emergencies: Rationing vaccines</a>.” A recent U.S. shortage of annual influenza vaccine, combined with the threat of pandemic flu, has given policymakers an opportunity to think about rationing in very concrete terms. </li> </ul> <p> In addition, the AMA’s online ethics journal <em>Virtual Mentor</em> has an <a href="http://virtualmentor.ama-assn.org/2006/04/toc-0604.html" target="_blank">issue</a> dedicated to ethics questions raised by emerging epidemics.</p> <p> <strong>Looking for more ethics discussions? </strong>Visit the <a href="http://virtualmentor.ama-assn.org/" target="_blank"><em>Virtual Mentor</em></a> website.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cbaa5711-3935-47a0-9d50-a257a735a0d1 How med students handle uncertainty could predict career future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-students-handle-uncertainty-could-predict-career-future Mon, 27 Oct 2014 19:20:00 GMT <p> Medical students’ level of tolerance for ambiguity may be closely tied to how they deal with stress and where they will practice, according to a recent <a href="http://www.ncbi.nlm.nih.gov/pubmed/25250742" target="_blank" rel="nofollow">study</a> in <em>Academic Medicine</em>.</p> <p> Researchers surveyed nearly 14,000 entering medical students as part of the Association of American Medical Colleges (AAMC) matriculating student questionnaire. The survey asked incoming students to rate how they agreed with statements such as, “I don’t like to work on a problem unless there is a possibility of getting a clear-cut and unambiguous answer.”</p> <p> The survey found that high tolerance for ambiguity was associated with students’ intention to work in underserved areas and with lower levels of perceived stress.</p> <p> Tolerance for ambiguity—or the tendency to perceive uncertain situations as more desirable than threatening—is an important competency for physicians. For instance, the AAMC includes tolerance of and adaptation to stressful or changing environments as part of its core competencies for entering medical students.</p> <p> The organization also deems “comfort with ambiguity” as a professional activity believed essential for graduated medical students entering residency. Similarly, the Accreditation Council of Graduate Medical Education considers tolerance for ambiguity an essential milestone for residents in certain specialties.</p> <p> “Medical schools committed to addressing [underserved populations] may consider prioritizing personal characteristics, such as tolerance for ambiguity, in the admission process to enhance the likelihood that the future health care workforce will better address disparities in health care access,” the study said.</p> <p> The survey also found that tolerance for ambiguity was higher in men and older students.</p> <p> “If tolerance for ambiguity can be taught or strengthened through the learning environment, medical schools will need to develop evidence-based curricular and pedagogical approaches to nurture this quality in their students,” the study said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0b18a9b5-dbfd-4625-a8d9-c3c55aa25b0f Underserved communities to get help preventing diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_underserved-communities-preventing-diabetes Mon, 27 Oct 2014 18:00:00 GMT <p> Fifteen free and charitable clinics across the country will receive funding to help reduce the incidence of type 2 diabetes as part of two grant programs from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page?" target="_blank">AMA Foundation</a> and <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-28-americares-ama-preventing-diabetes-underserved-areas.page" target="_blank">AmeriCares</a>.</p> <p> An estimated 86 million American adults have prediabetes, but only one in 10 of these people knows they are at risk of developing type 2 diabetes. The patients served by these clinics are generally low-income populations that suffer disproportionately from poor health outcomes associated with prediabetes and are at the highest risk of developing clinical diabetes.</p> <p> Each clinic awarded a grant will receive $10,000 over the next two years to implement the lifestyle change program that is part of the Centers for Disease Control and Prevention’s (CDC) <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a>. A recent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/benefits-of-diabetes-prevention-program-long-lasting-study" target="_blank">study</a> showed that such lifestyle change programs have long-lasting benefits for participants through preventing or delaying progression to type 2 diabetes.</p> <p> The AMA Foundation <a href="https://download.ama-assn.org/resources/doc/ama-foundation/x-pub/healthy-community-healthy-america-press-release.pdf">awarded grants</a> (log in) to eight free clinics through its <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-communities-healthy.page" target="_blank">Healthy Communities/Healthy America program</a>, and AmeriCares awarded grants to seven free clinics through its Transforming Prediabetes Care Initiative. Staff members at each clinic will receive training on how to deliver the CDC’s program to clinic patients.</p> <p> Both grant programs will build upon work the AMA has been accomplishing 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 joined with the YMCA of the USA over the past year to increase referrals to the YMCA’s Diabetes Prevention Program, which is part of the CDC’s National Diabetes Prevention Program.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at their local YMCAs. Participating physicians receive updates on their patients’ progress to incorporate into their care plans. The free clinics will use prediabetes screening and enrollment tools based on those that the AMA created for its work with these physician practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c42efbee-7a4a-4bd0-b21f-7f43a71822ef Comment on draft guidelines for assessing late-career practitioners http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-draft-guidelines-assessing-late-career-practitioners Mon, 27 Oct 2014 15:00:00 GMT <p> <a href="http://cppph.org/" target="_blank" rel="nofollow">California Public Protection and Physician Health</a> (CPPPH) is seeking comment on a draft guideline related to policies and procedures for age-based screening. The guideline was developed by a workgroup of members from the California Medical Association, the California Hospital Association Center for Hospital Medical Executives and the CPPPH.</p> <p> The workgroup members believe that hospitals and health care organizations themselves are best equipped to design and implement such a policy about late-career practitioners, and they are making this guideline available to assist in that process.</p> <p> For organizations that choose to develop and implement a policy for privileging late-career practitioners, this document can provide important background information and discussion of the core concepts involved. It also can serve as an example of policies and procedures as each organization prepares its own versions, taking into account the organization’s own particular needs.</p> <p> Before this guideline is made final, it is being circulated to all interested parties for review and comment:</p> <ul> <li> Access the <a href="https://cppphdotorg.files.wordpress.com/2011/02/assessing-late-career-practitioners-policies-and-procedures-for-age-based-screening-draft-21-8-22-14.pdf" target="_blank" rel="nofollow">draft guideline</a>.</li> <li> Submit comments via email to <a href="mailto:CPPPHInc@gmail.com" rel="nofollow">CPPPHInc@gmail.com</a>. </li> </ul> <p> Comments received by Nov. 14 will be considered as the workgroup prepares the next draft of this guideline. Workgroup members are grateful for your interest in this project and look forward to receiving your responses.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8bb33bc0-1926-4e2f-bb99-9f0a4ba1f6ef Attend AMA-SPS meeting taking place Nov. 8 in Dallas http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-ama-sps-meeting-taking-place-nov-8-dallas Mon, 27 Oct 2014 15:00:00 GMT <p> Attend the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">Senior Physicians Section</a> (SPS) meeting, 11:30 a.m. to 1:30 p.m. Nov. 8, taking place in conjunction with the 2014 AMA Interim Meeting in Dallas.</p> <p> The keynote presentation, "Grow healthier as you grow older," will be delivered by Kenneth H. Cooper, MD, known as the “father of aerobics.” Dr. Cooper was an U.S. Air Force physician who became interested in the role of exercise in preserving health and has since founded the Cooper Institute. He will discuss some of his lifelong experience focused on wellness and longevity.</p> <p> Participants in the AMA-SPS Assembly business meeting also can introduce new items of business related to the section’s mission and review items in the AMA House of Delegates handbook. AMA members 65 years of age or older, as well as anyone interested in senior physician issues, is encouraged to attend.</p> <p> If you have questions, please contact Alice Reed of the AMA via <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">email</a> or at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ef3d48cc-6b57-49f0-b36e-bce21b38d863 Attend the 2014 OMSS Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_attend-2014-omss-interim-meeting Mon, 27 Oct 2014 15:00:00 GMT <p> The 2014 OMSS Interim Meeting will be held Nov. 6-8 at the Hilton Anatole in Dallas. Onsite registration opens Nov. 6 at 10:30 a.m. in the Chantilly Foyer. On this year’s <a href="http://www.ama-assn.org/resources/doc/omss/x-pub/i14-agenda.pdf" target="_blank">meeting agenda</a> (log in) are a number of valuable opportunities.</p> <p> In addition to policymaking sessions and networking opportunities, the meeting will include education programs on the following topics:</p> <ul> <li> CMS hospital conditions of participation: What medical staff members need to know about the new regulations</li> <li> A hospital’s success through physician-led quality improvement initiatives</li> <li> Medical staff engagement of community physicians</li> <li> How patient satisfaction scores and physician ratings are affecting physician compensation</li> <li> The AMA’s advocacy efforts: Physicians’ voice in Washington</li> <li> Update on AMA’s strategic focus area: Professional Satisfaction and Practice Sustainability</li> </ul> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section/meetings.page?" target="_blank">OMSS Interim Meeting webpage</a> for complete meeting details.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c04967db-72a7-446c-be40-e438a5c50148 State high court to rule on expert witnesses in medical liability http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_state-high-court-rule-expert-witnesses-medical-liability Fri, 24 Oct 2014 19:43:00 GMT <p> Should testimony about standards of care be permitted in medical liability cases if the expert witness does not practice in a similar specialty as the defendant physician? A state supreme court is considering the question.</p> <p> The Florida Supreme Court is taking up <em>Edwards v. Sunrise Ophthalmology ASC</em>, in which a lower court had excluded the testimony of an infectious disease specialist, which was offered regarding the standard of care the plaintiff received from her ophthalmologist related to surgery on her lower eyelid.</p> <p> Under current law in the Sunshine State, expert medical opinion must come from a medical expert who practices in the “same specialty” or “similar specialty” to the physician defendant.</p> <p> “Physicians facing medical [liability] claims must be held to the standards of care in the specialty for which they are qualified and trained,” 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 Florida Medical Association stated in a friend-of-the-court brief filed Sept. 30. “They should be judged by others who are trained in the same standards of care.”</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/412ed6d7-7bc8-4a31-ac29-c9f5483426de.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/412ed6d7-7bc8-4a31-ac29-c9f5483426de.Large.jpg?1" style="float:left;margin:10px;" /></a>This policy “reduces the likelihood of unreliable testimony from experts with differing standards of care, and it assures consistency in standards in the courtroom and operating room,” the brief states.</p> <p> The brief also argues that allowing expert testimony from health care professionals who do not practice the same specialty as the defendant also would lead to “expert shopping.” One of the purposes of the Florida law on expert testimony is to prevent plaintiffs from looking “for a ‘hired gun’ to issue that testimony” if they cannot find a person in a similar specialty who will attest to a breach in standard of care.</p> <p> “Assuring that specialists are judged in litigation based on their standards of care and by individuals trained and experienced in those standards of care will help protect the integrity of medical [liability] claims,” the brief states.</p> <p> According to a <a href="http://www.ama-assn.org/resources/doc/health-policy/x-ama/prp-piaa-2013-final.pdf" target="_blank">recent AMA study</a> (log in), nearly two-thirds of medical negligence claims ultimately are dropped, withdrawn or dismissed without any payment. At the same time, the average expense of defending against a medical liability claims—regardless of its merits or success—is $50,000.</p> <p> “This cost comes at the expense of affordable and available care,” the brief states.</p> <p> Read more about the AMA’s recent work around <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Medical_Liability/1" target="_blank">medical liability reform</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:921d222b-75d4-45c2-95ec-9f723411aceb Video: Facing tough choices, how one physician brought peace http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_video-facing-tough-choices-one-physician-brought-peace Fri, 24 Oct 2014 19:40:00 GMT <p> Physicians face difficult decisions every day, and some of the results of these decisions leave their marks long after the patient has been treated. One physician recently shared his feelings around some tough choices—and how those choices made him a better doctor.</p> <p> William Lynn Weaver, MD, senior associate dean at Ross University School of Medicine Dominica campus, told a story about a very sick patient he helped during the AMA’s recent Inspirations in Medicine event.</p> <p> <object align="right" data="http://www.youtube.com/v/jXoPXY5QciU" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/jXoPXY5QciU" type="application/x-shockwave-flash" vspace="10" width="375"><param name="movie" value="http://www.youtube.com/v/jXoPXY5QciU" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/jXoPXY5QciU" type="application/x-shockwave-flash" vspace="10" width="375" wmode="transparent"></embed></object>The patient’s small intestines were dead, and he later lost the pulse in both his legs. Dr. Weaver did his best but still felt he had failed the man after having to amputate the patient’s legs and remove a large portion of his intestines.</p> <p> “I have a patient who walked into the hospital, and who now has no intestines and no legs,” Dr. Weaver said. “What had I done? I had not done what I had trained to be, which was compassionate and caring.”</p> <p> Seeking to ease his conscious, Dr. Weaver went to the patient’s room late one night. He wondered if he had really helped the patient at all.</p> <p> “The patient said, ‘Dr. Weaver, I am so glad you did not let me die,’” Dr. Weaver said. “’What you have done for me is that you have given me what everybody wants—just a little more time to say what I did not say or do before.’”</p> <p> “I realized I had failed to do what I thought was the most important thing—to save his life or make him better,” Dr. Weaver said. “But what I had done was to give some peace to him and his family.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" target="_blank" rel="nofollow">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b00d194f-8ff7-4a6d-a97a-d5e714bbe130 $840 million will fund improved care via new clinical networks http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_840-million-will-fund-improved-care-via-new-clinical-networks Thu, 23 Oct 2014 21:48:00 GMT <p> A new initiative announced Thursday is expected to deliver stronger health outcomes by giving medical practices the technical assistance and peer-level support they need to deliver efficient patient-centered care.</p> <p> As a new model of the Centers for Medicare & Medicaid Services (CMS), the <a href="http://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/" rel="nofollow" target="_blank">Transforming Clinical Practice Initiative</a> will award $840 million for the creation of evidence-based, peer-led collaboratives and practice transformation networks to support physicians in providing high-quality care.</p> <p> “The Transforming Clinical Practice Initiative will achieve a number of important goals,” said AMA Board Chair Barbara L. McAneny, MD, who participated in a CMS call announcing the initiative. “It will foster collaboration among a broad community of practices of various sizes, including collaboration between primary care physicians and specialists. It will also develop a network for sharing information among medical societies as well as multi-stakeholder regional collaboratives to support practice transformation.”</p> <p> The networks, which will be announced in the late spring, are expected to support 150,000 clinicians beginning May 1. Anticipated strategies include giving physicians better access to patient information, expanding how patients can communicate with their health care team and improving coordination of care.</p> <p> CMS is encouraging large group practices, medical associations, quality improvement organizations, regional health collaboratives and other organizations that have existing relationships with physician networks to apply. Optional letters of intent are due Nov. 20, and the application deadline is Jan. 6.</p> <p> The AMA has been urging CMS to assist physician practices in their efforts to adopt new payment and delivery models under physician leadership, a primary goal of this new model.</p> <p> “We strongly believe that practice transformation can lead to improvements in the quality of care for patients, control health care costs and enhance practice sustainability as physicians embrace innovative new models,” Dr. McAneny said.</p> <p> This federal effort aligns 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 promotes sustainable practices that can result in improved health outcomes for patients and greater professional satisfaction for physicians.</p> <p> The AMA is committed to identifying and supporting current and emerging payment and care delivery models that work best for physicians across a variety of practice settings to help them provide high-quality care and achieve professional satisfaction.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:43d82ec7-fe3a-4e9f-8631-6ccf7cd92a01 How health IT is giving med students real-world experience http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-giving-med-students-real-world-experience Thu, 23 Oct 2014 20:40:00 GMT <p> A new “teaching electronic health record” (tEHR) from Indiana University School of Medicine will give medical students a chance to learn clinical decision-making and system-based care using real data.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/15/4f651980-dcd3-47cd-8f4d-41d75edc6190.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/15/4f651980-dcd3-47cd-8f4d-41d75edc6190.Large.jpg?1" style="float:right;margin:10px;" /></a>IU cloned its health system’s existing EHR system and scrambled patient data to create the tEHR, then enhanced the design so the technology will send students reminders and information that can affect their clinical decisions.</p> <p> Blaine Takesue, MD, assistant professor of clinical medicine at the IU School of Medicine (pictured right), presented the tEHR at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as 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. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> For example, a student may be undergoing a training activity in which they are using patient data and the tEHR. If a patient in the training activity has renal problems and a student orders a test that could harm the patient’s kidneys, a traditional EHR with clinical decision support would send a warning about the test. But with the tEHR, the student would receive educational content—a video, some text or a link to an outside resource—to help him or her understand why the warning would be sent in the first place.</p> <p> The tEHR reflects the regulations and constraints that current EHRs offer. That means students will get exposure to things like the meaningful use program and the ICD-10 code set.</p> <p> “If you’re going to be evaluated based on quality measures, and you don’t understand the qualities of data, you’re going to have to play a lot of catch up,” Dr. Takesue said. “There’s no reason why during medical school we can’t teach our students some of these concepts. We need to impart to our students what EHRs can do, what they can’t do, and what their strengths and weaknesses are.”</p> <p> The school’s faculty will be able to look at user logs to see how individual students use the tEHR in different patient care scenarios. Because the tEHR uses real data, students also will be able to compare how their clinical decisions matched up with what real physicians actually did in caring for the same patients.</p> <p> “By using real medical data, one of the lessons we’ll impart to our students is that [health care] decisions can be complicated, and things are sometimes done for different reasons,” Dr. Takesue said.</p> <p> Dr. Takesue is working with the AMA and the Accelerating Change in Medical Education consortium schools to potentially adapt the tEHR for use at additional medical schools.</p> <p> This post is the third in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank">second post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2efba236-7a32-4e91-9601-692554dadf14 JAMA Highlights: Health services pricing availability linked to lower total claims payments http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-health-services-pricing-availability-linked-lower-total-claims-payments Thu, 23 Oct 2014 16:00:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/c0Of05gXAKU" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/c0Of05gXAKU" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/c0Of05gXAKU" /><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" quality="best" src="http://www.youtube.com/v/c0Of05gXAKU" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA: <em>Hospitals switching from non-profit to for-profit improve serving poor and minority patients</em>.</span></td> </tr> </tbody> </table> <p> <strong>Making health services pricing available linked to lower total claims payments</strong><br /> Searching a health service pricing website before using a medical service was associated with lower payments for clinical services, such as advanced imaging and laboratory tests, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1917438" rel="nofollow" target="_blank">study</a> in the Oct. 22/29 issue of <em>JAMA.</em></p> <p> <strong style="font-size:12px;">Hospitals switching from non-profit to for-profit improve serving poor and minority patients</strong></p> <p> A study of hospitals converting from non-profit to for-profit status found the conversion was associated with improvements in financial margins but not associated with differences in quality or mortality rates, or with the proportion of poor or minority patients receiving care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1917437" rel="nofollow" target="_blank">study</a> in the Oct. 22/29 issue of <em>JAMA</em>. Watch a <a href="http://youtu.be/c0Of05gXAKU" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Reports of impulse control disorders associated with dopamine agonist drugs</strong><br /> During a 10-year period, there were 1,580 adverse drug events reported in the United States and 21 other countries that indicated impulse control disorders in patients, including 628 cases of pathological gambling, 465 cases of hypersexuality and 202 cases of compulsive shopping. The total included 710 events associated with dopamine receptor agonist drugs (used to treat Parkinson disease, restless leg syndrome and hyperprolactinemia) and 870 events for other drugs, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916909" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Cigarette purchases accompany prescription refills at pharmacies</strong><br /> Patients using medication to treat certain respiratory conditions or high blood pressure, or using oral contraceptives often purchased cigarettes while filling prescriptions at pharmacies, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916908" rel="nofollow" target="_blank">research letter</a> in <em>JAMA Internal Medicine</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b0b379e1-bed1-40d2-8061-5e61e3e4ee30 4 top tips for presenting research http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-top-tips-presenting-research Wed, 22 Oct 2014 19:52:00 GMT <p> Get advice on how to present your research, both in poster and podium presentations, from those in the know: past winners and judges of the AMA Research Symposium.</p> <ol> <li> <strong>Be clear and concise. </strong>“Judges only have a short time to review each poster or presentation, so be clear with any important takeaway points and how [your work] may influence or impact future research or clinical management,” said Tracey Henry, MD, a health policy fellow at Georgetown University Medical Center who presented winning research at the AMA Research Symposium in 2013.<br /> <br /> Former judge Carol Berkowitz, MD, executive vice chair in the department of pediatrics at Harbor-UCLA Medical Center and professor of clinical pediatrics at the David Geffen School of Medicine at the University of California Los Angeles, said she looks for the “succinct presentation of the case, what was unique about it, what the take-home message is and how this message can be applied to other patients.”<br /> <br /> Former judge Jacqueline Bello, MD, director of neuroradiology at Albert Einstein College of Medicine, said she looks for presentations that are sharply focused, structured well and “as simple and straightforward as possible.”<br /> <br /> She added that the results should be “clearly communicated, in terms of their importance, potential implementation and further exploration.”<br />  </li> <li> <strong><a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/114d21f9-6490-4a96-acea-e40d2432efb5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/114d21f9-6490-4a96-acea-e40d2432efb5.Large.jpg?1" style="float:right;margin:10px;" /></a>Show enthusiasm for your work. </strong>“Be natural and animated,” said Gbolahan Ogunbayo, MD, an internal medicine resident at Rochester General Hospital, who presented winning research at the AMA Research Symposium in 2013. “It’s difficult to combine both, but you want to be animated without making [the judges] feel like you’re being fake. You have to show some enthusiasm and excitement about your work.”<br />  </li> <li> <strong>Practice, practice, practice.</strong> “You should practice presenting to your colleagues or someone with expertise in your topic of research to prepare for the kind of questions you may be asked by the judges,” Dr. Henry said.<br /> <br /> You also should practice how you’ll show the judges that you’re engaged and knowledgeable, said Dr. Ogunbayo. He added, “make a determined effort to try and connect with your audience. Make them feel like they’re in the scenario you’re describing in your case.”<br />  </li> <li> <strong>Follow the rules and be prepared. </strong>“Arrive early to set up your poster or to load your presentation on the computer and make sure it plays,” said Dr. Henry. “Follow the guidelines and stay within the allotted timeframe for your presentation. Don’t lose points because you didn’t adhere to the guidelines.”</li> </ol> <p> More than 300 students, residents, fellows and international medical graduates (IMG) will present their original research at the 12th annual AMA <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">Research Symposium</a> Nov. 7 in Dallas. The research competition submissions will be on display during the 2014 AMA <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">Interim Meeting</a>.</p> <p> The competition consists of two components: Podium presentations will take place from 4 p.m. to 5 p.m., followed by poster presentations from 5 p.m. to 6 p.m. All meeting participants and physicians in the local area are invited to attend.</p> <p> <strong>You tell us: </strong>What are your best research presentation tips? Comment below at <em>AMA Wire</em>® or on the AMA-RFS <a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c94abb09-cd4b-4a77-b70b-8531b26071e7 How med schools are tackling challenges in health disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-schools-tackling-challenges-health-disparities Wed, 22 Oct 2014 19:23:00 GMT <p> A <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">Google Hangout</a> featuring academic physicians and students Monday took a close look at how medical schools are taking on two huge challenges: addressing health disparities and focusing on diversity in how they train physicians.</p> <p> Panelists from the University of California Davis School of Medicine, Howard University College of Medicine, and Chicago Medical School at Rosalind Franklin University of Medicine and Science shared their insights into developing a diverse student body that is prepared for tomorrow’s patient population. William McDade, MD, PhD, chair of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a> and deputy provost for research and minority issues at the University of Chicago, moderated the hangout.</p> <p> Here are some real-world solutions these schools have implemented to tackle health disparities:</p> <ul> <li> Howard offers a preliminary academic reinforcement program, which gives conditional acceptance to certain disadvantaged medical school applicants. These students take a six-week pre-matriculation program and benefit from retention counseling and mentoring to enhance their academic success.</li> </ul> <ul> <li> UC Davis’ new three-year primary care program, called ACE-PC, includes an innovative admissions and recruitment strategy to select students from diverse backgrounds. The goal is to help these students go on to practice in underserved communities as primary care physicians. One-half of the students admitted into the first class of the program are from groups historically underrepresented in medicine. The program is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page">Accelerating Change in Medical Education</a> initiative</li> </ul> <p style="margin-left:40px;"> “It’s important that these sorts of curricula last for four years, or three years in our case, and are not one-off or what you do only at orientation or only in this one rotation,” said Tonya Fancher, MD, associate professor of internal medicine at UC Davis. “That’s an important commitment that the school makes to this type of work.”</p> <ul> <li> Chicago Medical School at Rosalind Franklin University of Medicine and Science is located in an area with a dense Mexican American population, so students have the option to do their second-year preceptorships at predominantly Spanish-speaking clinics. Some students also developed a student-run course in medical Spanish.</li> </ul> <p style="margin-left:40px;"> The focus on Spanish exemplifies the “school’s willingness to take student feedback and actually input it into the med school curriculum,” said Jalia Tucker, a second-year student at Chicago Medical School and a 2014 AMA Foundation Minority Scholar. “We’ll be able to better serve the patients we see at our student-run clinic.”</p> <ul> <li> To give students experience in culturally sensitive health care delivery, Howard has developed special case vignettes that put students face-to-face with culturally diverse patients.</li> </ul> <p style="margin-left:40px;"> “Keep in consideration that culturally responsive health care takes into account ethnicity as well as race,” said Walter Bland, MD, associate dean of student affairs and admissions at Howard. “A person may identify as black or Hispanic, but culturally their experiences will differ depending on their ethnicity. … It’s important that we ask questions about health practices and beliefs that might be important to specific populations we’re working with.”</p> <ul> <li> Mentoring and counseling can help students as well as faculty, said Dr. McDade. The University of Chicago’s Bowman Society brings medical students, residents and faculty together to focus on minority community health care and provide career development to these groups. The program has helped keep minority physicians in academic medicine, Dr. McDade said.</li> </ul> <p> Watch the <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">hangout</a> broadcast to hear even more about how these schools are approaching issues in health care disparities and diversity. The AMA shared more information and solutions in health disparities in a recent Tweet Chat hosted by Finding Answers: Disparities Research for Change. Read the highlights at the AMA’s <a href="https://storify.com/AmerMedicalAssn/equitychat" rel="nofollow" target="_blank">Storify</a>.</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> also is addressing similar issues. The section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/doctors-back-school.page?" target="_blank">Doctors Back to School program</a> connects minority physicians and medical students with local schools to introduce kids to professional role models and strengthen the pipeline of future doctors. The AMA also is a founding member of the <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities.page?" target="_blank">Commission to End Health Care Disparities</a>, which is seeking to better understand and address these disparities in ambulatory clinical practices.</p> <p> <strong>How do you think medical education should address health care disparities? </strong>Share your thoughts by commenting below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:aed87054-7eba-4b40-94cd-af167d905620 Learn how to make ICD-10 transition smoother: CMS call http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-icd-10-transition-smoother-cms-call Wed, 22 Oct 2014 19:23:00 GMT <p> With less than a year remaining to transition to the ICD-10 code set, the Centers for Medicare & Medicaid Services (CMS) is hosting a call at 1:30 p.m. Eastern time Nov. 5 to give insights into implementation issues, opportunities for testing and available resources. <a href="http://www.eventsvc.com/blhtechnologies/register/47c7acca-9e8a-46d0-a13f-247c9cf6acb8" target="_blank" rel="nofollow">Register now</a>.</p> <p> CMS experts will discuss:</p> <ul> <li> National implementation of ICD-10</li> <li> Medicare fee-for-service testing</li> <li> Partial code freeze and annual code updates</li> <li> Home health conversions</li> <li> Claims that span the implementation date</li> </ul> <p> The call also will include a question-and-answer session. <a href="http://www.eventsvc.com/blhtechnologies/register/47c7acca-9e8a-46d0-a13f-247c9cf6acb8" target="_blank" rel="nofollow">Register</a> by noon Eastern time Nov. 5 to participate.</p> <p> The AMA continues to urge regulators to ease the physician burden of ICD-10 implementation, which has <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> and is coupled with an already onerous regulatory environment.</p> <p> However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Learn about what <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now">physicians can do to prepare</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:784f5b64-c80a-43aa-9717-8dd7d4d291e4 Get the how-to guide for ICD-10 documentation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_guide-icd-10-documentation Tue, 21 Oct 2014 20:15:00 GMT <p> Learn how to navigate the new documentation complexities for diagnosis codes in the ICD-10-CM code set. An updated publication from the AMA Store provides guidance just in time to prepare for the Oct. 1, 2015, ICD-10 implementation deadline.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480013&navAction=push" target="_blank"><em>ICD-10-CM Documentation 2015: A How-To Guide for Coders, Physicians and Healthcare Facilities</em></a> has updated approaches and tools to provide ICD-10-CM documentation improvement, including:</p> <ul> <li> A basic comparison of the ICD-9-CM and ICD-10-CM code sets</li> <li> A general overview of the documentation requirements</li> <li> The official ICD-10-CM guidelines</li> <li> The requirements for specific conditions, diseases and disorders</li> <li> End-of-chapter quizzes</li> </ul> <p> Save 30 percent with promo code “FQB” through Oct. 31. AMA members receive a 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> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:07b76408-7484-46d5-a257-257685eaba12 Contribute to our unified voice across medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_contribute-unified-voice-across-medicine Tue, 21 Oct 2014 20:09:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD</em><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/1902c474-4545-47e4-b5d2-deda45920c4f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/1902c474-4545-47e4-b5d2-deda45920c4f.Large.jpg?1" style="float:left;margin:10px;" /></a>Now that fall is here, we’re all busy with a variety of medical association meetings. I’ve just returned from the World Medical Association meeting in South Africa, and I’ve spent much of the last two months attending meetings of a dozen different international, national, state and local medical associations.</p> <p> I enjoy these meetings because of the lively discussions that take place surrounding medicine’s most important topics. The upcoming <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 8-11 in Dallas, will be no exception.</p> <p> More than 500 representatives in the AMA House of Delegates will join me in Dallas to debate and make policy that will affect the future of medicine. These students, residents and physicians will come from every state and territorial medical society, 118 medical specialty societies, and the AMA sections, along with the American Medical Women’s Association, the National Medical Association and the five federal services.</p> <p> It’s exciting to hear physicians from so many locations and backgrounds discuss such varied issues, and it’s a true testament to the power of physician collaboration around common goals to support patients and the profession. Through the AMA, we speak with a unified voice.</p> <p> If you’re an AMA member, you can add your voice to ours by weighing in on reports and resolutions to come before the House during the meeting. Just <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">log in to the Online Member Forums</a> to review items, sorted by reference committee, and submit comments on any item.</p> <p> Although the forums will be open until just before the start of the meeting, make your comments by 7 p.m. Eastern time Nov. 2 to ensure your opinions are included in the comment summaries that will go to each reference committee and will be posted on the Interim Meeting website.</p> <p> The Online Member Forums make it easy to contribute from wherever you are, even if you aren’t able to attend the meeting or aren’t a delegate. The forums give anyone a chance to participate in the democratic process and contribute to the AMA’s powerful voice.</p> <p> I look forward to hearing and reading all of the thoughtful, informed debate at the Interim Meeting. Be sure to follow <em>AMA Wire® </em>for daily <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">meeting coverage</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1eac8d6-883a-47a7-962a-5e60584d9ad6 Regulatory penalties tsunami could cut doctors’ pay by 13 percent http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent Tue, 21 Oct 2014 15:00:00 GMT <p> Physicians providing care to Medicare patients could face a “tsunami” of regulatory penalties over the next 10 years, potentially seeing payments cut by more than 13 percent by the end of the decade. The AMA urged the Centers for Medicare & Medicaid Services (CMS) to streamline the competing laws and regulations that threaten access to care in a <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/medicare-incentive-program-letter-21oct2014.pdf" target="_blank">letter</a> (log in) sent Tuesday.</p> <p> Next year, some physicians could face cuts of more than 6 percent under the Medicare sequester cut and penalties from overlapping regulatory programs, including the meaningful use electronic health record (EHR) program, the Physician Quality Reporting System (PQRS) and the Value-Based Modifier program (VBM).</p> <p> <a href="http://www.ama-assn.org/resources/images/washington/medicare-sgr-penalties-850x1100.jpg" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/14/0705d606-ea16-417f-8e4c-c189f3233851.Large.jpg?1" style="float:right;margin:15px;" /></a>“Physicians want to provide our patients with the best care possible, but today there are confusing, misaligned and burdensome regulatory programs that take away critical time physicians could be spending to provide high quality care for their patients,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-21-regulatory-nightmare-threatens-seniors.page" target="_blank">news release</a>. “Government leaders should take the necessary steps to eliminate this regulatory nightmare and ensure America’s seniors can continue to receive the high-quality care they deserve.”</p> <p> The AMA told CMS these programs make it difficult for physicians to invest in health IT and payment and delivery reforms necessary to improve patient care. The AMA urged CMS to simplify and align incentive programs to ensure there is one streamlined process in place for physicians to meet a single set of quality reporting requirements, rather than the three separate sets of requirements that currently exist.</p> <p> “No other segment of the health care industry faces penalties as steep as these, and no other segment faces such challenging implementation logistics,” the letter said. “The tsunami of rules and policies surrounding the penalties are in a constant state of flux due to scheduled phase-ins and annual changes in regulatory requirements. In fact, the rules have become so convoluted that no one, including the staff in charge of implementing them, can fully understand and interpret them.”</p> <p> The letter discusses three Medicare programs with penalties that impact physicians:</p> <p> <strong>EHR meaningful use: </strong>CMS should adopt a more flexible approach for meeting meaningful use, instead of the program’s current all-or-nothing requirements, the letter said. The agency also should make optional measures that are out of physicians’ control, such as those based on interoperability. The letter also asks CMS to reduce burdensome technology requirements that stifle EHR usability and innovation.</p> <p> <strong>Physician Quality Reporting System: </strong>Without public, aggregate information on the number of physicians who successfully and unsuccessfully participated in PQRS, there’s no way to assess the program in a timely manner, the letter said.</p> <p> CMS should release aggregate PQRS data for 2013 so physicians can evaluate the program. The agency should create a more formal appeals process to give physicians more than 30 days to seek correction of any inaccurate information. Finally, CMS should maintain a more robust set of claims-based measures and reporting options to reduce reporting costs.</p> <p> <strong>Value-Based Modifier: </strong>The VBM program should be repealed, or at least limited in its implementation, the letter said. If it isn’t repealed, more time is needed to gauge its results on large physician groups before penalties are ratcheted up and extended to small and solo practices.</p> <p> “The current strategy of plowing ahead with policies that place an ever-increasing burden on both CMS and physicians—combined with the flawed roll-out of the Medicare claims data release and Open Payments program and the problems with these programs—is causing serious damage to the agency’s image and to physician confidence in the government’s stated goal of achieving a health care system that delivers more value for the dollar,” the letter said.</p> <p> The AMA will continue to advocate for needed changes to these and other regulatory programs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3cf3b826-7ce7-4ce6-ad4e-d18ef92ea084 CDC issues new Ebola guidelines to protect health professionals http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-issues-new-ebola-guidelines-protect-health-professionals Tue, 21 Oct 2014 14:04:00 GMT <p> The Centers for Disease Control and Prevention (CDC) Monday released <a href="http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html" target="_blank" rel="nofollow">tightened guidance</a> on use of personal protective equipment (PPE) for U.S. health care workers to ensure they are better prepared to treat Ebola patients.</p> <p> The guidance focuses on specific PPE health care workers should use and offers detailed, step-by-step instructions for how to put the equipment on and take it off safely. The CDC also released a <a href="http://www.cdc.gov/media/releases/2014/fs1020-ebola-personal-protective-equipment.html" target="_blank" rel="nofollow">fact sheet</a> on the changes in the PPE guidance.</p> <p> The original guidelines “were developed by experts at CDC with consultation and approval from infectious disease control experts around the United States and consistent with World Health Organization guidelines,” said CDC Director Tom Frieden, MD. They “have been used successfully before. “Even a single health care worker infection is one too many.”</p> <p> The enhanced guidelines center on three principles:</p> <ul> <li> All health care workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner.</li> <li> No skin is exposed when PPE is worn.</li> <li> All workers are supervised by a trained monitor who watches each worker taking PPE on and off.</li> </ul> <p> The guidance reflects recent experience from safely treating patients with Ebola at Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center.</p> <p> “The greatest risk in Ebola care is in the taking off of whatever equipment the health care worker has on—whether there’s skin exposed or not,” Dr. Frieden said. “One of the critical aspects of these guidelines is a very structured way of doing that step by step” under supervision, making it ritualized and done with standardized equipment.</p> <p> The CDC urged health care workers to ask any patient with a fever if that patient has traveled in the past 21 days.</p> <p> “Every health care worker needs to know how to screen a patient who may have Ebola,” Dr. Frieden said. “CDC is increasing training offerings for health care staff across the country and we'll be developing materials and videos, but really there's no alternative to hands-on training.”</p> <p> <strong>Looking for additional expert information about Ebola?</strong> Get the facts from credible sources via the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a>. Watch <em>AMA Wire</em><sup>®</sup> for ongoing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">Ebola coverage</a> provided by the AMA.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f76a8a53-a580-42b1-88d9-de14938754b7 Ways students can control residency application costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ways-students-can-control-residency-application-costs Mon, 20 Oct 2014 21:27:00 GMT <p> If you’re a medical student in the process of applying for residency positions, you’re probably discovering that the costs associated with applications, interviews and fees are adding up. Here are some ways you can manage those costs.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/d082dfd0-7884-452a-9de4-3918474051db.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/d082dfd0-7884-452a-9de4-3918474051db.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>Budget for the application costs. </strong>The <a href="https://www.aamc.org/services/eras/" rel="nofollow" target="_blank">Electronic Residency Application Service</a> (ERAS) sends applications, letters of recommendation, transcripts and other credentials to the programs you are interested in. ERAS fees vary by how many applications you submit, but they quickly can reach into the hundreds of dollars.</p> <p> <strong>Don’t forget the additional fees.</strong> It costs $75 to send your USMLE transcript to residency programs. You’ll also need to pay the National Resident Matching Program fee to participate in the Match at a cost of $60 for the first 20 programs to which you apply.</p> <p> <strong>Mitigate interview costs as best as possible. </strong>Travel, lodging and incidental costs related to interviews will be a huge chunk of your residency application costs. Think about how to take frugal shortcuts.</p> <p> For example, Jason Hall, a fourth-year medical student at the University of Alabama at Birmingham School of Medicine, said he started accumulating frequent flier miles well in advance and scheduled his residency interviews back-to-back in specific locations. Hall is interviewing for anesthesia residencies.</p> <p> “I knew because of the field I’m going into that no [program] would be paying for my flights or hotel rooms, and I knew it was going to be expensive,” Hall said. “The only thing I can attempt to control is to schedule as few trips as possible. I have three interviews back-to-back in New York, and I’m on the waitlist for a fourth interview to avoid a second trip.”</p> <p> You might also consider working through your medical school or undergraduate school’s alumni office or social networking groups to see whether any alumni who live in the area would be able to host you, instead of paying for a hotel.</p> <p> Get more ideas on how to keep interview costs down at the <a href="https://www.aamc.org/services/first/first_factsheets/94396/cost_of_applying_for_medical_residency.html" rel="nofollow" target="_blank">Association of American Medical Colleges website</a>.</p> <p> <strong>Try not to rely on credit cards. </strong>Robert Yermish, financial advisor in Philadelphia who works with AMA Insurance as a member of their Physicians Financial Partners program, frequently works with residents and young physicians. He said it’s difficult to budget for the fourth year of medical school and the uncertainty it can bring, but students shouldn’t rush to charge everything to credit cards. If you are going to incur more debt, it should be smart debt—and credit cards often have much higher interest than medical school loans.</p> <p> “The right answer is that you stop the credit cards, because a lot of people end up trying to use credit cards as a tool to get through medical school or residency,” Yermish said. “Which form of debt would I prefer? I’d rather see it from a med loan than a Visa.”</p> <p> AMA members can take advantage of the <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program/education-financing.page" target="_blank">Wells Fargo <em>MedCAP-XTRA</em></a> loan, which offers low interest, to help cover expenses related to residency interviews. You also can ask your school’s financial aid office for resources.</p> <p> <strong>How are you managing your money? </strong>Tell us in a comment below at <em>AMA Wire</em>®, or post your thoughts on the AMA Medical Student Section <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cede35fc-ddf3-47c6-811c-d13e4f314f40 How to grow healthier as you grow older: Register by Oct. 31 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_grow-healthier-grow-older-register-oct-31 Mon, 20 Oct 2014 21:00:00 GMT <p> Join the AMA Senior Physicians Section (SPS) Nov. 8 in Dallas to hear keynote speaker Kenneth Cooper, MD, a former U.S. Air Force physician and director of the Aerospace Medical Laboratory. As a leading pioneer of preventive medicine, Dr. Cooper will discuss some of his lifelong experiences focusing on health and wellness and how they link to longevity and quality of life<strong>. </strong>Join your senior physician colleagues for this time of learning and fellowship.</p> <p> The AMA-SPS business meeting will be held from 11:30 a.m. to 12:30 p.m., followed by the keynote presentation from 12:30 p.m. to 1:30 p.m. in the Peacock Terrace Room. A luncheon will be served at 11:30 a.m. on a first-come, first-served basis.</p> <p> Advanced registration is appreciated. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144180E&TID=cQGPLA3hGE6boUwT4nFrLQ%253d%253d&OID=130" target="_blank">Register online</a> (log in) by Oct. 31. If you have questions about the meeting or registering, please contact Alice Reed of the AMA via <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">email</a> or at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5249d5ba-5924-4bd2-809b-6c150e59d528 Apply for senior physician excellence in volunteerism award http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_apply-senior-physician-excellence-volunteerism-award Mon, 20 Oct 2014 21:00:00 GMT <p> The Jack B. McConnell, MD, Award for Excellence in Volunteerism recognizes the work of senior physicians who provide treatment to U.S. patients who lack access to health care. After a full career of practice, these physicians remain dedicated to the future of medicine through the spirit of volunteerism.</p> <p> Nominees must have volunteered a significant portion of their medical services while over the age of 55 and have demonstrated their commitment to health care access by assisting underserved U.S. patients. The application deadline is Jan. 20 at 6 p.m. Eastern time. <a href="http://www.ama-assn.org/resources/doc/ama-foundation/x-pub/excellence-named-award-application.doc" target="_blank">Download an application</a> (log in) today.</p> <p> Last year’s recipient, Samuel A. Cassell, MD, has spent much of his post-retirement career as founding chair of the Bergen Volunteer Medical Initiative. Inspired by participating in medical trips to the Far East and Haiti, Dr. Cassell and a team of dedicated individuals in 2009 created a five-day-a-week health center that offers free health care to working low-income, uninsured residents of Bergen County, New Jersey.</p> <p> Five years into its existence, the Bergen Volunteer Medical Initiative has 65 medical volunteers and staff who care for some 1,000 patients during 6,000 medical visits annually.</p> <p> Learn more about the volunteerism award and others that are a part of the AMA Foundation’s <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards.page?" target="_blank">Excellence in Medicine Awards</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0e6bbefd-72b1-4fc8-9e47-329bebb54da9 New hospital accreditation chapter puts heightened focus on safety http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-hospital-accreditation-chapter-puts-heightened-focus-safety Mon, 20 Oct 2014 21:00:00 GMT <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:"">The Joint Commission has released a </span><a href="http://www.jointcommission.org/patient_safety_systems_chapter_for_the_hospital_program/" target="_blank" rel="nofollow"><span style="font-size:10.0pt;font-family:"">new chapter</span></a><span style="font-size:10.0pt;font-family:""> on patient safety systems in the <em>2015 Comprehensive Accreditation Manual for Hospitals</em>. The purpose of the chapter is to inform and educate hospital leaders about the importance and structure of an integrated patient-centered system that aims to improve quality of care and patient safety.<p></p></span></p> <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:""> </span></p> <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:"">“A solid foundation for patient safety is a safety culture,” Ana Pujols McKee, MD, executive vice president and chief medical officer of the Joint Commission said in a </span><a href="http://www.jointcommission.org/new_hospital_accreditation_chapter_puts_heightened_focus_on_safety/" target="_blank" rel="nofollow"><span style="font-size:10.0pt;font-family:"">news release</span></a><span style="font-size:10.0pt;font-family:"">. “For leaders, our hope is they will study this chapter and use it as a tool to build or improve their safety culture program.” <p></p></span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1f4336e0-050b-4f17-a5cf-a20ab8ee09cc Comment on Code of Medical Ethics revisions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-code-of-medical-ethics-revisions Mon, 20 Oct 2014 20:12:00 GMT <p> As the process to update the <em>Code of Medical Ethics</em> moves forward, AMA members can <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/ceja-discussion-forum.page" target="_blank">comment</a> (log in) on the updated draft language that will serve as the ethical guide for physicians in the future.</p> <p> The AMA Council on Ethical and Judicial Affairs (CEJA) is in the final stages of modernizing the 167-year-old <em>Code</em>, last comprehensively updated more than 50 years ago. CEJA hosted an open forum at the 2014 AMA Annual Meeting to receive feedback on the draft <em>Code</em>, and also considered feedback from AMA members submitted to its online forum between January and the end of June.</p> <p> The modernized <em>Code</em> will appear as CEJA Report 3-I-14 in the Delegates Handbook for the 2014 AMA Interim Meeting. Comments posted online will be available to the Reference Committee on Amendments to Constitution and Bylaws.</p> <p> In its six-year project to modernize the <em>Code, </em>the council 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. CEJA then revised the <em>Code</em>, working conservatively to ensure the only changes were those that were absolutely necessary for the guidance to remain relevant in the face of changes in biomedical science and conditions of medical practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e7269b6d-280e-48c5-9690-ec6031db72a7 Better blood pressure, no added burden: One practice’s story http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_better-blood-pressure-added-burden-one-practices-story Mon, 20 Oct 2014 18:53:00 GMT <p> A Chicago-area physician has achieved a 90 percent control rate for his hypertension patients in the past year by working with his medical assistant, nurse and other staff members to execute standardized blood pressure protocols in the practice.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/90aee340-a790-4331-8848-f213ac50be25.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/90aee340-a790-4331-8848-f213ac50be25.Large.jpg?1" style="float:right;margin:10px;" /></a>Family medicine physician Michael K. Rakotz, MD (pictured right), is using a team-based care approach to improve hypertension control in his office. Dr. Rakotz is part of a pilot program 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, which involves physicians and their teams at multiple clinic sites in two states. Participating practices are incorporating evidence-based principles into their workflows to control hypertension.</p> <p> Since the start of the pilot, Dr. Rakotz’s practice has seen a double-digit leap in the number of hypertensive patients who have their blood pressure controlled, moving from 78 percent to 90 percent in 12 months. He attributes the practice’s success to the work of his practice staff, who have been trained in a standardized <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctor-quickly-improved-patients-blood-pressure-readings" target="_blank">checklist approach</a> to measuring blood pressure.</p> <p> Dr. Rakotz’s medical assistant (MA) follows a procedure to measure accurately. If an initial automated reading shows that blood pressure is elevated, she follows a specified protocol using an automated machine that takes multiple readings over six minutes, with no staff in the room to reduce the “white coat” effect on the patient’s blood pressure. If these readings indicate the patient has high blood pressure, the MA flags this information for Dr. Rakotz.</p> <p> “All of this occurs before the physician enters the room, so the system is very efficient,” Dr. Rakotz said. “It does not add any burden to the physician.”</p> <p> The practice also has a strong home-monitoring program for patients whose blood pressure management requires more clinical data. Practice staff give these patients a special checklist that explains how to properly position themselves for measurement as well as when and how often they should be measuring their blood pressure. Staff can validate and check the accuracy of patients’ personal blood pressure machines or lend patients machines that record a week’s worth of blood pressure readings.</p> <p> Practice staff enters all data from patients’ home monitoring into the practice’s electronic health record system.</p> <p> “This brings actionable information to the physician before the physician even walks into the exam room,” Dr. Rakotz said. “Those kinds of little innovations, little empowerments of the staff, make the system function really well.”</p> <p> He also employs a nurse to take charge of patient outreach.</p> <p> The challenge up front is training staff to understand and appropriately implement checklists and protocols. After that, “it’s autopilot,” Dr. Rakotz said.</p> <p> “Physicians are so overwhelmed with meaningful use criteria, insurance authorizations, paperwork and forms—all this nonclinical care,” he said. “Anything our staff can do to help us is huge. The more time I have to care for patients, the better. I want [my staff] to be smart and follow protocols using common sense. If someone has high blood pressure, I want my staff to know what to do. I want them to follow a set of guidelines.”</p> <p> The AMA pilot is working with researchers at Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop test protocols, including the one Dr. Rakotz uses. The tools are being refined before being made available to physicians across the country.</p> <p> “Even if you’re in a more rural, smaller practice, the more time you invest in training your staff up front, the more dividends you’re going to get on the back end in quality of care,” Dr. Rakotz said. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1a5e919a-05e5-4c69-b24e-abacd64fce17 Video: How physicians can see patients’ “unvisible” problems http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-can-see-patients-unvisible-problems Fri, 17 Oct 2014 23:05:00 GMT <p> Medicine gives physicians ways to see the invisible through X-rays, CAT scans and microscopes. But how can physicians see the “unvisible”—the uncomfortable topics that patients might need to discuss? One physician recently shared how physicians can uncover the details.</p> <p> <object align="right" data="http://www.youtube.com/v/uKlAV-RH-po" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/uKlAV-RH-po" type="application/x-shockwave-flash" vspace="15" width="365"><param name="movie" value="http://www.youtube.com/v/uKlAV-RH-po" /><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/uKlAV-RH-po" type="application/x-shockwave-flash" vspace="15" width="365" wmode="transparent"></embed></object>Stacy Tessler Lindau, MD, director of the University of Chicago Medicine’s program in integrative sexual medicine, <a href="http://youtu.be/uKlAV-RH-po" rel="nofollow" target="_blank">discussed her work</a> to help identify, treat and prevent sexual health problems in female cancer patients at the AMA’s recent Inspirations in Medicine event.</p> <p> One of Dr. Lindau’s female patients, Mrs. Jones, who had been a widow for years, had endometrial cancer. After Mrs. Jones’ family left for the day, she shared a secret with Dr. Lindau: She had a male companion that her children didn’t know about, and the patient feared her condition would worsen and her companion wouldn’t get the news.</p> <p> “Here she is at a critical moment in her life, and she couldn’t even share with her family …. She couldn’t share the relationship, nor could she gain the full benefit of that relationship,” Dr. Lindau said.</p> <p> Dr. Lindau explained how oncologists need to treat cancer, and other specialists need to focus on the patient’s illness that relates to that specialty, but it’s also important to understand other issues plaguing patients, including their sexual health. That should not be limited to the clinical aspect of sexual health but include how sexuality relates to health, such as how important Mrs. Jones’ partner was at this critical moment in her life, or how cancer treatment might affect a patient’s sex life.</p> <p> Physicians can “address the issue of sexuality, and give women information so they can know if they experience a problem, and it’s not just in their heads,” Dr. Lindau said. “Patients [need to] know they’re not alone if they experience these symptoms.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" rel="nofollow" target="_blank">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b46be3d-3757-4b0f-8cfb-d4deccdeb41f Is the U.S. ready for Ebola? JAMA Network authors comment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ready-ebola-jama-network-authors-comment Fri, 17 Oct 2014 22:55:00 GMT <p> A <a href="http://jama.jamanetwork.com/article.aspx?articleid=1918850" rel="nofollow" target="_blank">new Viewpoint</a> in <em>JAMA</em> looks at how the United States has handled Ebola screening, prevention and treatment thus far and touches on how best to control the international spread of the virus.</p> <p> The <em>JAMA</em> Viewpoint covers management of the Dallas Ebola cases, health system preparedness, isolation and quarantine, public health emergencies, international travel screening, and risk reduction.</p> <p> A <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1918461" rel="nofollow" target="_blank">second Viewpoint piece</a>, published in <em>JAMA Pediatrics</em>, examines what health care professionals need to know about Ebola when working with children. The article looks at transmission of Ebola to children, manifestations of the virus in children and specific considerations for pediatric professionals.</p> <p> <strong>Looking for additional expert information about Ebola?</strong> Get the facts from credible sources via the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bc8827e-7356-466d-ac54-613e867d0845 Make an impact on an upcoming election: AMPAC shows you how http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_impact-upcoming-election-ampac-shows Fri, 17 Oct 2014 22:44:00 GMT <p> Physicians, residents and students who want to actively influence health care policy can do so in a big way with help from AMPAC, the AMA’s bipartisan political action committee. Whether it’s running for public office or campaigning for a candidate who supports issues that are important to medicine, AMPAC offers programs to help physicians and doctors in training meet their political goals.</p> <p> <strong>Training for a successful candidacy</strong></p> <p> For AMA members or their spouses considering a run for public office, the <a href="http://www.ampaconline.org/political-education/ampac-candidate-workshop/" target="_blank" rel="nofollow">AMPAC Candidate Workshop</a> taking place Feb. 20-22 in Arlington, Virginia, helps physicians make the leap from the exam room to the campaign trail. The workshop provides training in campaign strategizing, media advertising, public speaking and fundraising.</p> <p> At the workshop, political veterans will share their advice about politics and explain the sacrifices required to run a competitive campaign. Attendees also will learn the secrets of effective fundraising, how to become a better public speaker and how to handle campaign crises, among other skills.</p> <p> In the 2012 elections, 13 graduates of the workshop were elected to state and federal offices. Thus far in 2014, 14 graduates have won primary elections.</p> <p> “The AMPAC program helped immeasurably,” anesthesiologist Steve Dickerson, MD, said. He won a seat in the Tennessee Senate in November 2012 after attending the AMPAC Candidate Workshop in 2007.</p> <p> “While I had always had an interest in politics, I had never been exposed to the nuts and bolts in any manner,” Dr. Dickerson said. “The program gave me an overview and provided the foundation for what I learned subsequently.”</p> <p> <strong>Learning the ropes of campaigning</strong></p> <p> For AMA members, spouses and state medical association staff who want to become more involved in campaigning for their candidates, the <a href="http://www.ampaconline.org/political-education/ampac-campaign-school/" target="_blank" rel="nofollow">AMPAC Campaign School</a> offers hands-on training.</p> <p> This five-day “boot camp” for politics centers around a simulated congressional campaign, during which attendees are trained in advertising, public speaking and fundraising and participate in such practical exercises as recording radio ads and writing fundraising letters. The campaign school takes place April 15-19 in Arlington, Virginia.</p> <p> Excluding travel, AMPAC covers all expenses for applicants who are accepted to one of these programs—an excellent value for AMA membership.</p> <p> <a href="http://www.ampaconline.org/political-education/apply/" target="_blank" rel="nofollow">Apply today</a> to participate in one of these education programs so you can influence an upcoming election for the better. If you’re not an AMA member, now is the time to <a href="https://commerce.ama-assn.org/membership/" target="_blank">join</a>.</p> <p> <strong>Special application deadlines for medical students: </strong>Student admission to these educational programs is limited, so applicants are selected based on a 500-word essay about why they would like to attend and what they hope to gain from participating. The deadline for medical student applications for the Candidate Workshop is Dec. 12, and the application deadline for the Campaign School is Jan. 23.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e0159a37-940e-4a9a-a459-aa0578ca14c0 Preparing for Ebola: How physicians are taking action http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_preparing-ebola-physicians-taking-action Fri, 17 Oct 2014 22:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/9/5fff8609-1f70-4ffe-995a-66463dabae6b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/9/5fff8609-1f70-4ffe-995a-66463dabae6b.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> As a physician and frequent international traveler, the recent Ebola developments have been on my mind. Despite the increasing attention from the media, we as physicians know that this is not a time to panic but a time to prepare.</p> <p> The AMA has created an online <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> to provide physicians with the expert information they need to understand Ebola, prepare their hospitals or practices, screen and diagnosis for the virus, and treat patients. Key resources and information for the public also are included.</p> <p> Having the most up-to-date information from the leading voice—the Centers for Disease Control and Prevention—and other expert sources can help us answer questions and assess patients who could present with symptoms. The resource center, available at <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">ama-assn.org/go/ebola</a>, will be regularly updated as new resources are released, so bookmark the page for your quick reference and share it with your colleagues and staff.</p> <p> Physicians globally are making sure their communities are prepared. I just returned from the general assembly of the World Medical Association in Durban, South Africa, where delegates from nearly 50 national medical associations passed an <a href="http://www.wma.net/en/30publications/10policies/30council/cr_19/index.html" rel="nofollow" target="_blank">emergency resolution</a> calling for comprehensive tactics to prevent and treat the Ebola virus, including adequate equipment, training and aid. Clearly, this is a hot topic that is getting the attention it deserves from physicians around the world.</p> <p> Follow <em>AMA Wire</em>® for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">ongoing coverage</a> of what you need to know about the virus.</p> <p> <em>Editor's note:</em> <a href="http://www.cbsnews.com/videos/was-the-u-s-health-care-system-prepared-to-handle-ebola-cases/" target="_blank" rel="nofollow">Watch Dr. Wah's appearance</a> on CBS' Face the Nation Sunday discussing efforts to prevent the spread of Ebola in the United States.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:36d25c89-1ae8-4946-8a24-c4a69f754a77 JAMA Highlights: Study estimates 14 million major smoking-related U.S. medical conditions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-estimates-14-million-major-smoking-related-medical-conditions Thu, 16 Oct 2014 18:03:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/qNcpltuYwKY" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/qNcpltuYwKY" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/qNcpltuYwKY" /><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" quality="best" src="http://www.youtube.com/v/qNcpltuYwKY" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA <em>video: Two widely used quality metrics for obstetric care are not associated with severe complications for mothers and babies.</em></span></td> </tr> </tbody> </table> <p> <strong>Study indicates need for more obstetric quality-of-care measures at hospitals</strong><br /> In an analysis of data on more than 100,000 deliveries and term newborns from New York City hospitals, rates for certain quality indicators and complications for mothers and newborns varied substantially between hospitals and were not correlated with performance measures designed to assess hospital-level obstetric quality of care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1915608" target="_blank" rel="nofollow">study</a> in the Oct. 15 issue of the <em>Journal of the American Medical Association</em> (<em>JAMA</em>)<em>.</em> Watch a <a href="http://youtu.be/qNcpltuYwKY" target="_blank" rel="nofollow">video</a> on the study.</p> <p> <strong>Better performance for skilled nursing facilities may not result in better patient outcomes</strong><br /> Among fee-for-service Medicare beneficiaries who received care at a skilled nursing facility following hospital discharge, better performance on various measures of quality of care was not consistently associated with a lower risk of hospital readmission or death at 30 days, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1915609" target="_blank" rel="nofollow">study</a> in the Oct. 15 issue of <em>JAMA.</em></p> <p> <strong>Study estimates 14 million major smoking-attributable medical conditions in U.S.</strong><br /> Adults in the United States suffered from approximately 14 million major medical conditions attributable to smoking. Smoking is the leading cause of preventable disease in the United States. Cigarette smoking harms nearly every organ and organ system in the body. The authors of the <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1915870" target="_blank" rel="nofollow">study</a> in <em>JAMA Internal Medicine</em> estimated major medical conditions (morbidity) attributed to smoking in 2009.</p> <p> <strong>No association seen between physical activity, depressive symptoms in adolescents</strong><br /> A <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1911003" target="_blank" rel="nofollow">study</a> of teenagers in <em>JAMA Pediatrics </em>suggests there is no association between physical activity and the development of depressive symptoms later in adolescence.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d80623ad-373f-4eb4-a578-089fcb6ace48 AMA assembles Ebola resources for physicians and public http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-assembles-ebola-resources-physicians-public Wed, 15 Oct 2014 23:50:00 GMT <p> The Centers for Disease Control and Prevention (CDC) on Sept. 30 confirmed the first U.S. case of Ebola, and developments associated with the virus continue to unfold. Prepare your practice and your patients with resources developed by Ebola experts and assembled by the AMA in one convenient location.</p> <p> Visit the AMA’s online <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> for information from the CDC and other public health groups. Resources cover:</p> <ul> <li> Understanding the virus</li> <li> Preparing your hospital or practice</li> <li> Screening and diagnosing Ebola</li> <li> Treating patients with the virus</li> </ul> <p> The resource center will be updated regularly to give you, your practice staff and your patients the most up-to-date information you need. Save <a href="http://www.ama-assn.org/go/ebola" target="_blank">ama-assn.org/go/ebola</a> to your favorites for an easy reference.</p> <p> Watch <em>AMA Wire</em><sup>®</sup> for ongoing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">Ebola coverage</a> provided by the AMA.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:db0a244b-8967-4f36-8d26-a4011d6434b2 Ways residents have found to conquer burnout http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ways-residents-found-conquer-burnout Wed, 15 Oct 2014 20:28:00 GMT <p> Emotional exhaustion, feelings of cynicism, detachment from patients—do these symptoms sound familiar? They can signal professional burnout, which studies show is more prevalent among physicians than other professionals. Experienced residents and fellows offer advice on what you can do to avoid burnout during training and become a more satisfied, resilient physician.</p> <p> Medical students and residents are more likely to be burned out, depressed or fatigued compared to similarly aged college graduates pursuing other careers, according to a recent <a href="http://journals.lww.com/academicmedicine/Citation/2014/03000/Burnout_Among_U_S__Medical_Students,_Residents,.25.aspx" rel="nofollow" target="_blank">study</a> in <em>Academic Medicine</em>.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/6cefac80-74ac-4dfa-81a4-779993757afb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/6cefac80-74ac-4dfa-81a4-779993757afb.Large.jpg?1" style="float:right;margin:10px;" /></a>“I think that intern year can be quite intimidating and overwhelming, and everyone feels like they are starting to burn out,” said Anna Piotrowski, MD, chief resident of the adult psychiatry residency program at the University of Chicago. “At that point, medicine becomes a job and a routine that you have to get through every day, instead of something engaging and enjoyable.”</p> <p> When that feeling crept in, Dr. Piotrowski said her solution was to maintain perspective and make time to relax and unwind.</p> <p> Tina Shah, MD, a pulmonary and critical care fellow at the University of Chicago and chair of 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> (RFS), echoed Dr. Piotrowski’s advice.</p> <p> “I tried not to isolate myself when I was feeling burned out and let off steam with my co-residents, who understood what I was going through,” Dr. Shah said. “When I was really motivated, exercising helped me feel less burned out.”</p> <p> Dr. Shah also recommends having a specific hobby.</p> <p> “Whether it’s running, playing video games or routine dinners with friends, this one activity will help you let go of the stress at work,” she said.</p> <p> “It’s important to remember you are a human being with wants, needs and desires, rather than just someone in medical training,” Dr. Piotrowski said.</p> <p> To prevent burnout before it sets in, many medical schools and residency programs are investigating and implementing resiliency training, teaching trainees to prioritize self-care and how to effectively manage their emotions.</p> <p> Most graduate medical education programs have wellness resources, both for physical and mental issues. These resources range from stress management programs to help centers and exercise programs.</p> <p> Although stress is inevitable, burnout is preventable. Make sure to identify coping strategies that work for you, and seek help if you need it.</p> <p> “Burnout is dangerous, both for ourselves and for our patients,” Dr. Piotrowski said. “When you are an exhausted and unhappy medical student or resident, you may not be very good at taking care of your patients. You can get ahead of the situation and prevent it.”</p> <p> <strong>You tell us: </strong>What methods do you use to beat burnout? Comment below at <em>AMA Wire</em><span style="font-size:12px;">®</span><em style="font-size:12px;"> </em><span style="font-size:12px;">or on the AMA-RFS </span><a href="https://www.facebook.com/amaresidentsandfellows" style="font-size:12px;" target="_blank" rel="nofollow">Facebook page</a><span style="font-size:12px;">.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1094dea0-b71f-46af-af26-c87f64280d0b 5 things to know about clinical data registries http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-things-clinical-data-registries Wed, 15 Oct 2014 20:00:00 GMT <p> As more federal regulations require reporting via clinical data registries, it’s important to understand what these registries are and how they work. Here are five things you need to know about clinical data registries and why they matter.</p> <ol> <li> <strong>Clinical data registries record information about patients’ health status and the care they receive over time. </strong>These registries typically focus on patients who share a common reason for needing care, allowing physicians to see what treatments are available and how patients with different characteristics respond to certain treatments.</li> <li> <strong>Different types of registries track specific aspects of care.</strong> A registry may focus on a disease or condition, a procedure, or a medical device. The registry defines a patient population, then recruits physicians and other health care professionals to submit data on a representative sample of those patients.</li> <li> <strong>Data are used in treatment analyses.</strong> Studying attributes of the population in the registry—and finding patterns—can help identify particular outcomes. Because all of the factors that might have an impact on outcomes are not necessarily known at the time of data collection, the data are stored and can be revisited to evaluate previously unrecognized associations.</li> <li> <strong>Data are collected via secure online portals or electronic health record (EHR) systems. </strong>As data enter the clinical data registry, quality checks are performed to ensure that the data are correct and complete. If something is missing or outside of the expected range, registry staff ask the submitting physician to review and verify the data.</li> <li> <strong>Registries help improve health care quality and safety.</strong> Registries are used for comparing the effectiveness of different treatments, evaluating different approaches to a procedure, and monitoring the safety of implanted devices. Information from registries is also increasingly employed to ensure that payment is adjusted based on the quality of care provided, or to give patients the information they need to make better choices.</li> </ol> <p> The <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/nqrn.page" rel="nofollow" target="_blank">National Quality Registry Network</a>, a voluntary network of organizations that operate registries, offers more detailed information about clinical data registries.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:080747b2-7e4f-4d10-8485-a2c3d600290a Record release law for medical liability suits upheld in court http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_record-release-law-medical-liability-suits-upheld-court Wed, 15 Oct 2014 19:18:00 GMT <p> A federal appeals court has upheld a state law that requires plaintiffs to release their relevant protected health information before proceeding with allegations of medical liability.</p> <p> In <em>Murphy v. Dulay</em>, the appeals court overturned a lower court ruling that said a Florida law requiring the release of relevant health information was impermissible under the federal Health Insurance Portability and Accountability Act (HIPAA).</p> <p> The state law requires authorization from a person seeking to bring a medical liability lawsuit so that the prospective defendant may obtain documents and conduct interviews with the plaintiff’s other medical professionals on matters pertinent to the liability claim.</p> <p> The appeals court found that the written authorization form required by the Florida law “is fully compliant with the HIPAA statute and its regulations.”</p> <p> This state law is patterned after a Texas law passed in 2003 that has enabled information sharing during early stages of medical liability claims. The purpose of the law is to screen out frivolous lawsuits and promote early settlement of claims that do have merit.</p> <p> As a result of that law, “the frequency of meritless claims has dropped substantially,” the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?">Litigation Center</a><a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?" target="_blank"> of the AMA and State Medical Societies</a> said in a <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/murphy-v-dulay.pdf" target="_blank">friend-of-the-court brief</a> (log in) submitted in this case. Other parties in the brief include the Florida Medical Association and the Texas Medical Association.</p> <p> Other benefits the brief highlights are improved access to care, an increase in physicians generally, and a greater number of specialists serving at-risk patients and rural communities.</p> <p> Visit the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/professional-liability.page" target="_blank">Litigation Center Web page</a> to learn more about this case and other key medical liability cases in which it has been involved.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8024f28d-e3a0-4ae9-9bf9-01a6901f585d 4 key changes needed for EHR meaningful use program http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-key-changes-needed-ehr-meaningful-use-program Tue, 14 Oct 2014 20:10:00 GMT <p> Challenges with electronic health record (EHR) systems are widespread, and the meaningful use program has only compounded those problems. Physicians this week called on the government to make four essential changes to meaningful use so EHR technology can become a tool for practice efficiency and enhanced patient care.</p> <p> In a 31-page <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/2014-10-14-meaningful-use.pdf" target="_blank">comment letter</a> (log in) submitted Tuesday to the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT, the AMA provided a blueprint for the future of the meaningful use program ahead of the announcement of Stage 3 requirements expected later this year.</p> <p> The four chief changes the letter outlines are:</p> <p style="margin-left:.25in;"> <strong>1. </strong><strong>Adopting a more flexible approach for meeting meaningful use. </strong>Among the components the letter identifies for achieving this flexibility are eliminating the concept of menu versus core requirements, revising the measures list to meet the needs of specialists and requiring physicians to meet no more than 10 measures under Stage 3.<br /> <br /> The letter also reiterates the AMA’s recommendation that CMS abandon the program’s all-or-nothing approach by adopting a 50 percent threshold for incurring a penalty and a 75 percent threshold for earning an incentive in Stages 1 and 2.<br /> <br /> Making the program more flexible “will also help mitigate challenges physicians are facing from factors outside of their control, such as EHR interoperability, usability issues and meeting measures that are contingent upon patient action,” the letter states.</p> <p style="margin-left:.25in;"> <strong>2. </strong><strong>Expanding hardship exemptions for all stages. </strong>Eligibility for an exemption for quality measures should include successful participation in the Physician Quality Reporting System (PQRS) and a broader list of “unforeseen circumstances” that prevent physicians from meeting meaningful use requirements. The letter also calls for exemptions for physicians close to retirement and hospitalists, who have little control over the technology available to them.<br /> <br /> <em>Note: If your practice needs a hardship exemption for 2014, CMS </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cms-reopens-period-apply-meaningful-use-hardship-exemption" target="_blank"><em>recently announced</em></a><em> that physicians have until Nov. 30 to apply.</em></p> <p style="margin-left:.25in;"> <strong>3. </strong><strong>Improving quality reporting. </strong>In particular, the letter urges CMS to build a sufficient quality infrastructure and continue to allow physicians to report on a menu of quality measures.<br /> <br /> The letter also stresses that EHRs must be made interoperable so physicians can focus more on outcomes and longitudinal tracking of patient care. That includes developing standards for sharing data between EHRs and clinical data registries.</p> <p style="margin-left:.25in;"> <strong>4. </strong><strong>Addressing physician EHR usability challenges. </strong>Citing the increasing dissatisfaction with this technology as evidenced in the <a href="http://www.rand.org/pubs/research_reports/RR439.html" target="_blank" rel="nofollow">AMA-RAND study</a> released last year, the letter points to how today’s EHRs are characterized by poor usability, time-consuming data entry, interference with face-to-face patient care, insufficient health information exchange and degradation of clinical documentation.<br /> <br /> “There is growing awareness across stakeholders that the meaningful use vendor certification process should be streamlined to enable higher performing products that focus on interoperability, quality measurement reporting and privacy/security,” the letter states.<br /> <br /> In addition, “EHRs should facilitate interoperability among various facilities that comprise our health care system, including hospital inpatient, ambulatory settings, lab and pharmacies.”</p> <p> “The whole point of the EHR incentive program was to build an interoperable health information technology infrastructure that would allow for the routine exchange of important medical information across settings and providers and put medical decision-making tools in the hands of physicians and patients, yet that vision is not being realized,” AMA President Robert M Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-14-ama-blueprint-improve-meaningful-use.page" target="_blank">statement</a>. “Physicians should not be required to meet measures that are not improving patient care or use systems that are decreasing practice efficiencies.”</p> <p> The AMA’s advocacy on this topic is supported by a <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) for EHR usability released last month. Developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives, the framework offers <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight top challenges and solutions</a> that can leverage the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bfa4ca9a-ba2d-4dfa-bf4d-138b6596c2db Interactive, on-demand training helps prepare for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_interactive-demand-training-helps-prepare-icd-10 Tue, 14 Oct 2014 20:06:00 GMT <p> Get help transitioning from the ICD-9 to ICD-10 code sets with interactive training that fits with your schedule.</p> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2440007&navAction=push" target="_blank"><em>3M™ ICD-10 Education Program: Physician Practice Package</em></a> provides Web-based training delivered in the specific context needed for different job functions and matches trainees to the appropriate education track. The training covers 19 specialties and includes:</p> <ul> <li> Physician documentation videos, with samples of documentation improvement and tips</li> <li> <span style="font-size:12px;">ICD-10 modules split between diagnostic and procedural coding that include printable references, case studies, practice questions and self-assessment tests by job function</span></li> <li> <span style="font-size:12px;">Two awareness courses—one for administrative staff, and a more advanced course for ancillary staff</span></li> </ul> <p> Access the training from any location, at any time, as often as you need.</p> <p> The deadline to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now" target="_blank">comply with ICD-10</a> is less than a year away. While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8bb65b6c-f48d-42bc-a181-995606a3c0a7 Culturally competent physicians can reduce disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_culturally-competent-physicians-can-reduce-disparities Tue, 14 Oct 2014 20:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/9/6a5cf07b-7997-4575-a9e1-eac5b8df2fc4.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/9/6a5cf07b-7997-4575-a9e1-eac5b8df2fc4.Large.jpg?1" style="float:left;margin:10px;" /></a>Last week, I wrote about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-tackling-health-care-disparities" target="_blank">what physicians are doing</a> to tackle health care disparities. One of the ways we can reduce health care disparities is to ensure we’re promoting diversity in the health care workforce. As an educator, this is important to me.</p> <p> Diversity and cultural competency are aspects of physician training that some of the schools awarded grants from 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 working on. Schools are moving to competency-based curriculum, which can potentially reduce the time needed for medical school, meaning it’s less expensive. They’re also focusing on population health in their local communities.</p> <p> For example, the University of California Davis School of Medicine’s new three-year primary care program, ACE-PC, has developed an innovative admissions and recruitment program to select students from diverse backgrounds, with the goal of these students going on to work in underserved communities as primary care physicians. Half of the students admitted into the first class of the program are from groups historically underrepresented in medicine.</p> <p> We, as physicians, should ensure we’re an accurate reflection of the population we serve. A broad spectrum of backgrounds and experiences can unite us in improving health care overall and in our local communities. This starts with attracting and retaining a diverse medical school body.</p> <p> To dive further into this topic, the AMA is hosting an online Google Hangout to discuss the most important factors in attracting a medical student body that reflects a diverse patient population.</p> <p> Experts, educators and physicians in training will hang out online from 8 p.m. to 9 p.m. Eastern time Oct. 20 Anyone can watch the event live or stream it later. To participate in the live-streaming event, simply visit the <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Hangout page</a>. If you would like to post questions for the panelists to answer, you will need to be a Google user. Participate in the discussion on Twitter and Facebook using #AMAHangout.</p> <p> Tonya Fancher, MD, UC Davis’ associate director for curriculum, will be answering questions as a panelist. Dr. Fancher will join Walter Bland, MD, associate dean for student affairs and admissions at the Howard University College of Medicine, and Jalia Tucker, a second-year medical student at the Chicago Medical School at Rosalind Franklin University of Medicine and Science. William McDade, MD, chair of the AMA Council on Medical Education and deputy provost for research and minority issues at the University of Chicago, will moderate the hangout.</p> <p> I hope you’ll join the hangout, or just listen to the discussion, about what medical schools can do to ensure students have the appropriate cultural competencies. The hangout is being jointly organized by the Accelerating Change in Medical Education initiative and the AMA Minority Affairs Section.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:acbee702-378d-41bc-be5c-353bbdd7c70f CDC bolstering efforts to equip health care workers for Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-bolstering-efforts-equip-health-care-workers-ebola Tue, 14 Oct 2014 20:00:00 GMT <p> <em>Updated at 8:39 a.m. Oct. 15 to include more information.</em></p> <p> Physicians and hospitals should be prepared to care for Ebola patients, Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, said Tuesday. His comments came after a Dallas nurse who had cared for the first Ebola patient in the United States was diagnosed with the virus.</p> <p> The nurse contracted Ebola despite wearing personal protective equipment. On Wednesday, the CDC <a href="http://www.cdc.gov/media/releases/2014/s1015-texas-second-health-care-worker.html" target="_blank" rel="nofollow">announced</a> a second health care worker at the Dallas hospital that treated the initial patient had also tested positive for Ebola.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/462d32ce-60eb-4a3a-955a-d9b5c2395c89.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/462d32ce-60eb-4a3a-955a-d9b5c2395c89.Large.jpg?1" style="float:right;margin:10px;" /></a>“I’ve been hearing loud and clear from health care workers from around the country that they’re worried, that they don’t feel prepared to take care of a patient with Ebola,” Dr. Frieden said. “Every hospital in the country needs to be ready to diagnose Ebola. … Anyone who cares for someone with a fever or signs of infection needs to ask, ‘Where have you been in the past month?’”</p> <p> Dr. Frieden said the CDC will ramp up webinars, conference calls and other outreach to U.S. health care workers to ensure physicians and hospital staff are prepared.</p> <p> The CDC is establishing an Ebola response team that will be dispatched to any hospital in the country that has a confirmed case of Ebola. The team will include experts in infection control, laboratory science, personal protective equipment and management of Ebola units.</p> <p> “We will put a team on the ground within hours,” Dr. Frieden said.</p> <p> He also said that health care workers should seek care immediately if they feel even a slight sore throat or headache. “We would much rather see a false alarm than someone who lets their illness go on for a day and potentially get sicker and expose it to others,” he said.</p> <p> The CDC offers a <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">special Web page</a> with resources for physicians to prepare for patients who might have the disease. The CDC and U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response have asked physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations. Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/screen-ebola-cdc-offers-resources" target="_blank">how to screen for Ebola</a> at <em>AMA Wire</em>®.</p> <p> “What we are dealing with is a disease that’s unfamiliar in the United States,” Dr. Frieden said. “Caring for Ebola can be done safely—but it’s hard. We want to make sure the protocol we have and the support we have for health care workers is there on the ground so we can assist.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:40eb3e73-70c7-4a82-97ce-1623e407bc55 What medical schools can expect in the future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-can-expect-future Tue, 14 Oct 2014 15:00:00 GMT <p> A special consortium of medical schools has spent the last year developing and implementing innovative ideas to transform the way future physicians are trained, and soon the medical education environment will experience the benefits of their efforts. In year two of its work, the consortium is testing and tweaking curriculum changes that other medical schools will be able to implement.</p> <p> “We’re shaping the physician of the future,” said Susan Skochelak, MD, group vice president for medical education at the AMA. “We’re creating the components of the medical school of the future, and our beacon that we’re working toward relates to readiness for practice. We want our physicians to hit the ground running.”</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/14/46e2075f-6d35-4cfc-9e6f-0a506b3e677a.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/14/46e2075f-6d35-4cfc-9e6f-0a506b3e677a.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>Looking back</strong><br /> In January 2013, the AMA announced its intent to fund five to 10 medical schools to implement bold innovations in medical education. More than 80 percent of the country’s 141 eligible medical schools submitted proposals, a sign that schools were eager for widespread change. The AMA chose to fund 11 schools, each receiving a $1 million grant over five years in its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page">Accelerating Change in Medical Education</a> initiative.</p> <p> After initial planning, the 11 schools began to implement new tools and ideas in September 2013. Since then, each school has worked both autonomously and with the input from the other consortium schools and the AMA, sharing new ideas and methods with one another in special meetings. The schools first convened in October 2013 at the AMA’s Accelerating Change in Medical Education conference in Chicago, and have also come together at the University of Michigan Medical School and Vanderbilt University Medical School.</p> <p> <strong>Current work</strong><br /> So far, schools have taken deep dives into specific education areas and are working on new ways to test and evaluate future physicians. Overall, the initiative seeks to ensure learner readiness to succeed in the health care system of today and tomorrow, and to implement sustainable medical education transformation. As their work continues, the schools will make their discoveries available to other medical schools, making it easier to enact widespread change.</p> <p> The consortium’s work is focused in a few areas:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-education-explores-competency-based-assessment" target="_blank"><strong>Competency-based assessment</strong></a><strong>.</strong> New assessment frameworks will allow students who show competence earlier in certain areas to move ahead more quickly or focus more time on other areas that need more instruction. Oregon Health and Science University School of Medicine is moving toward a learner-centered, competency-based curriculum, with progress based on predetermined milestones. The University of Michigan’s trunk-and-branches model is giving students a foundational “trunk” of knowledge, with different “branches” for students to pursue different courses of study that appeal most to them. Students’ pace through their program is based on achievement of specific milestones.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/two-schools-embracing-new-science-medical-education" target="_blank"><strong>Systems-based practice.</strong></a> Students will learn to navigate systems of care, quality improvement and population health—all which fall under the umbrella of the science of health care delivery—to optimize outcomes and cost. Pennsylvania State University College of Medicine will give students a 19-month program in systems-based practice topics, beginning in the first months of medical school and ending just before students enter clinical rotations. Students at Penn State also will become patient navigators linked with local clinics to gain experience in actually dealing with the health care system.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank"><strong>Adaptive, lifelong learners.</strong></a> The health care system is constantly changing, and new information is available every day. In the future, physicians will need to be adaptable and flexible, and to think critically about where and how to find information. Vanderbilt is instilling these qualities in its medical students with a special learning platform that lets students set their own learning goals, complete self-assessments and track their performance data.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-team-based-care" target="_blank"><strong>Team-based care.</strong></a> Future care delivery systems will require physicians to work on interprofessional teams. The Warren Alpert Medical School of Brown University incorporated interprofessional care into its curriculum, pairing medical students with students from other health profession schools to create patient care plans in special workshops. The workshops give medical students the chance to negotiate the role they play on teams and learn when to take the lead.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-school-curriculum-changes-aim-eliminate-health-care-disparities" target="_blank"><strong>Diversity and health care disparities.</strong></a> Diverse physicians will be necessary to meet the needs of underserved communities and address workforce gaps. The University of California Davis School of Medicine is choosing students from economically challenged backgrounds in the hopes that these students will work in underserved communities.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank"><strong>Technology.</strong></a> Schools will use mobile apps, learning platforms, databases and more to give students instant access to information. New York University School of Medicine used large, open clinical data sets to create virtual patient panels, giving students access to information about the health care system and de-identified patient data. Indiana University School of Medicine created a teaching electronic health record, populated with de-identified patient data that updates in real-time.</li> </ul> <p> Curriculum changes alone aren’t enough for transformative change. Medical school faculty must be prepared to teach and develop these new ideas, and that’s why <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/faculty-development-crucial-med-ed-innovation" target="_blank">faculty development</a> also is a core part of the consortium’s work. The Brody School of Medicine at East Carolina University and Mayo Medical School are educating faculty on new competencies and working on how to incentivize faculty development.</p> <p> Finally, large-scale change is enormously difficult, so some schools are looking at how to smoothly transition to new curriculum at their institution and across the medical education environment. The University of California San Francisco is taking the lead in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/project-gets-underway-ensure-sustainable-med-school-innovations" target="_blank">change management</a>, applying principles of business organizational change to medical schools. </p> <p> <strong>Moving forward</strong><br /> There’s been much progress in a year of implementation—but there’s a lot more to do. Heading into 2015, the schools will increase activation and adoption of their new curriculum models so other schools can begin enacting change, too.</p> <p> The consortium will also be moving on to new challenges, including how to involve graduate medical education.</p> <p> “Students are asking, ‘Is this going to get me the residency I want?’” said Bonnie Miller, MD, senior associate dean for health sciences education and associate vice-chancellor for health affairs at Vanderbilt. “I think we need to make sure that along the continuum, our efforts are focused on improving care delivery. … To sustain our successes, we need to think about other phases of education.”</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Changing_MedEd/1" target="_blank">Read more</a> about the Accelerating Change in Medical Education initiative at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a10f56c6-3bce-474d-b782-618c45547a92 AMA members serve as leaders in organized medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-members-serve-leaders-organized-medicine Tue, 14 Oct 2014 15:00:00 GMT <p> These AMA members were recently appointed by external organizations to leadership positions. These individuals were nominated by the AMA to the respective organizations. Each organization made the final appointment decision from among the candidates it received.</p> <p style="margin-left:.5in;"> <strong>Carol D. Berkowitz, MD</strong>, Rancho Palos Verde, California, has been appointed to the <strong>Accreditation Review Committee on Education for the Physician Assistant</strong> for a second term, effective January 2015. Dr. Berkowitz has also been appointed to the <strong>National Resident Matching Program</strong> Board of Directors, effective July 2014. Dr. Berkowitz has been an AMA member for 17 years.</p> <p style="margin-left:.5in;"> <strong>Anita K. Blanchard, MD</strong>, Chicago, has been appointed to the <strong>Obstetrics and Gynecology Review Committee of the Accreditation Council for Graduate Medical Education (ACGME)</strong>, effective July 2014. Dr. Blanchard has been an AMA member for two years.</p> <p style="margin-left:.5in;"> <strong>Donald W. Brady, MD</strong>, Nashville, has been appointed to the <strong>ACGME </strong>Board of Directors, effective September 2014. Dr. Brady has been an AMA member for three years.</p> <p style="margin-left:.5in;"> <strong>Dona S. Buchter, MD</strong>, Atlanta, has been appointed to the <strong>Pediatrics Review Committee of the ACGME</strong>, effective July 2015. Dr. Buchter has been an AMA member for one year.</p> <p style="margin-left:.5in;"> <strong>Tarah L. Castleberry, DO</strong>, Galveston, Texas, has been appointed to the <strong>Preventive Medicine Review Committee of the ACGME</strong>, effective July 2015. Dr. Castleberry has been an AMA member for seven years.</p> <p style="margin-left:.5in;"> <strong>Sharon P. Douglas, MD</strong>, Madison, Mississippi, has been appointed to the <strong>Liaison Committee on Medical Education Council</strong> for a second term, effective July 2015. Dr. Douglas has been an AMA member for 17 years.</p> <p style="margin-left:.5in;"> <strong>George W. Elgart, MD</strong>, Miami, has been appointed to the <strong>Dermatology Review Committee of the ACGME</strong>, effective July 2015. Dr. Elgart has been an AMA member for 14 years.</p> <p style="margin-left:.5in;"> <strong>Linda M. Famiglio, MD</strong>, Danville, Pennsylvania, has been appointed to the <strong>Accreditation Council for Continuing Medical Education (ACCME) Accreditation Review Committee </strong>for a third term, effective January 2015. Dr. Famiglio has been an AMA member for 15 years.</p> <p style="margin-left:.5in;"> <strong>James I. Fann, MD</strong>, Stanford, California, has been appointed to the <strong>American Board of Thoracic Surgery</strong>, effective October 2014. Dr. Fann has been an AMA member for 19 years.</p> <p style="margin-left:.5in;"> <strong>Gerald A. Isenberg, MD</strong>, Philadelphia, has been appointed to the <strong>Colon and Rectal Surgery Review Committee of the ACGME</strong>, effective July 2015. Dr. Isenberg has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Rohit K. Katial, MD</strong>, Denver, has been appointed to the <strong>Allergy and Immunology Review Committee of the ACGME</strong>, effective July 2015. Dr. Katial has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Natalie C. Kerr, MD</strong>, Memphis, Tennessee, has been appointed to the <strong>Ophthalmology Review Committee of the ACGME</strong>, effective July 2015. Dr. Kerr has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Jeffrey B. Matthews, MD</strong>, Chicago, has been appointed to the <strong>Surgery Review Committee of the ACGME</strong>, effective July 2014. Dr. Matthews has been an AMA member for 21 years.</p> <p style="margin-left:.5in;"> <strong>William A. McDade, MD</strong>, Chicago, has been appointed a member of the <strong>National Board of Medical Examiners</strong>, effective June 2014. Dr. McDade has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Darlyne Menscer, MD</strong>, Charlotte, North Carolina, has been appointed by the AMA Board of Trustees to serve as AMA representative to the <strong>Coalition for Physician Accountability</strong>. Dr. Menscer has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Lynn Parry, MD</strong>, Denver, has been appointed to the <strong>ACCME Accreditation Review Committee</strong>, effective January 2015. Dr. Parry has been an AMA member for 33 years.</p> <p style="margin-left:.5in;"> <strong>Carla M. Pugh, MD</strong>, Madison, Wisconsin, has been appointed to the <strong>American Board of Medical Specialties (ABMS) Research and Education Foundation</strong>. Dr. Pugh has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Liana Puscas, MD</strong>, Durham, North Carolina, has been appointed to the <strong>ABMS Research and Education Foundation</strong>. Dr. Puscas has been an AMA member for 22 years.</p> <p> AMA members can apply for AMA nomination for leadership positions with other organizations. To be considered for nomination by the AMA, visit the 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?%5d." target="_blank">leadership opportunities Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:15787353-6e4c-4133-aaaf-f42e5d85cb07 Medical school’s From Tots to Docs event earns recognition http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-tots-docs-event-earns-recognition Tue, 14 Oct 2014 15:00:00 GMT <p> The University of Florida College of Medicine’s weeklong From Tots to Docs event, in which the local AMA Medical Student Section (MSS) hosted educational sessions for kids, earned the school an AMA Section Involvement Grant (SIG) Event of the Month award.  </p> <p> The section partnered with the local Salvation Amy and their annual Vacation Bible School elementary camp to host five, 45-minute educational sessions focused on child safety topics, including gun safety, road safety, water safety and poison control, and the importance of preventive health measures such as immunizations and healthy eating habits. The Vacation Bible School campers enjoyed learning about safety and preventive health from the medical students and participating in the activities.</p> <p> The AMA provided funding for the equipment and supplies that the local section will reuse for future programs. Visit 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">Event of the Month Web page</a> for a detailed description. The AMA SIG Event of the Month showcases recruitment, community service, education and AMA-MSS National Service Project events coordinated by individual AMA medical student sections.</p> <p> Is your AMA medical student section holding similar events? Submit a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/sig-follow-up.page" target="_blank">SIG Recap Form</a> and photos within 30 days of your event to be eligible for the Event of the Month nomination, which the AMA selects each month. At the end of the school year, all monthly awards will be showcased in June at the AMA-MSS Annual Assembly Meeting and be voted on by students for one Event of the Year winner.</p> <p> Through the SIG program, the AMA-MSS provides an opportunity for local AMA medical student sections to:</p> <ul> <li> Educate students about the AMA and provide an opportunity for students to get more involved</li> <li> Help put AMA policy into action by providing a service to medical school campuses or communities</li> <li> Engage in activities that focus on AMA's top priorities</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6f09322-dec3-4db2-8f40-124f5d67bdbc AMA to consider policy on key med ed topics at upcoming meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-consider-policy-key-med-ed-topics-upcoming-meeting Tue, 14 Oct 2014 15:00:00 GMT <p> Greater emphasis on social determinants of health in medical school curriculum, and equal paternal and maternal leave for medical residents are two of the hot topics the AMA House of Delegates will discuss at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas, Nov. 8-11</p> <p> More medical education topics to be considered for adoption as possible AMA policy include:</p> <ul> <li> Combatting sex-linked discrimination of denying special request for lactation during medical board examination</li> <li> Promoting education of electronic health records in undergraduate medical education</li> <li> USMLE Step 1 timing</li> </ul> <p> All AMA-member physicians are invited to weigh in on these items prior to the meeting. <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">Log in now</a>  to express your views on these and other items of business to come before the House.</p> <p> These items of business will be reviewed during the Reference Committee K hearing at the meeting. The Reference Committee will consider the testimony presented during the hearing and then forward to the House its recommended actions on these resolutions. If approved by the House, the resolved clauses in these resolutions would become AMA policy, and serve to direct the work of the Association now and in the future.</p> <p> In addition, a number of educational sessions will be presented during the meeting, many of which will offer physician attendees the opportunity to earn CME credit. View the list of CME opportunities and educational sessions at the 2014 Interim Meeting <a href="http://www.ama-assn.org/sub/meeting/cme.html" target="_blank">website</a>.</p> <p> Finally, all physicians with an academic appointment are invited to attend the Academic Medicine Caucus during the meeting. The caucus will be held at 9:30 a.m. Nov. 10 in the Senators Lecture Hall.</p> <p> Attendees will discuss issues of mutual concern and interest pertaining to academic medicine and review the report of Reference Committee K. Come network with your colleagues and share your ideas on how the AMA can continue to provide leadership in medical education.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:34ee142b-6e5b-4a3e-b246-b0af5a92f465 How does the AMA develop policy? Find out Nov. 6 in Chicago http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-develop-policy-out-nov-6-chicago Tue, 14 Oct 2014 15:00:00 GMT <p> All academic physicians are invited to learn how the AMA develops policy and understand the role of the AMA Section on Medical Schools (SMS) during a special session at the AMA-SMS meeting Nov. 6 in Chicago. <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=SMSI12E&TID=INaoed0Ms5%2fD15CGT%2bWIjg%3d%3d&OID=130" target="_blank">Register now</a> (log in) to attend the AMA-SMS meeting, from 4:30 to 7:30 p.m., which is being held this year in conjunction with the annual meeting of the Association of American Medical Colleges.</p> <p> During the session, “The AMA and the AMA-SMS: What we do and how we do it,” participants will hear how the relationships between the various AMA sections, councils, caucuses and reference committees support the AMA House of Delegates.</p> <p> Other topics for the session include:</p> <ul> <li style="margin-left:18.75pt;"> How the section makes an impact on AMA policy</li> <li style="margin-left:18.75pt;"> How to be nominated to professional leadership opportunities in many key national organizations in medical education (via the AMA Council on Medical Education)</li> <li style="margin-left:18.75pt;"> How the House of Delegates accomplishes its work</li> </ul> <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=SMSI12E&TID=INaoed0Ms5%2fD15CGT%2bWIjg%3d%3d&OID=130" target="_blank">Register now</a> so that you can also:</p> <ul> <li style="margin-left:18.75pt;"> Voice your opinions on proposed AMA policy related to medical education, to be reviewed at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</li> <li style="margin-left:18.75pt;"> Get a guided tour of the AMA's new headquarters, housed in a building <a href="http://www.chicagoarchitecture.info/Building/1043/AMA-Plaza.php" target="_blank" rel="nofollow">designed</a> by internationally renowned architect Ludwig Mies van der Rohe.</li> <li style="margin-left:18.75pt;"> Enjoy a networking reception with your academic physician colleagues, with 360-degree views of Chicago from the AMA’s 47<sup>th</sup> floor.</li> </ul> <p> Review the <a href="https://www.signup4.net/Upload/AMER44A/SMSI12E/i14-sms-agenda.pdf" target="_blank" rel="nofollow">draft agenda</a> and be sure to check out <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/meetings/sms-past-meetings.page?" target="_blank">highlights from past section meetings</a>.</p> <p> If you’re not already a member of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page" target="_blank">AMA-SMS</a>, learn how to <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/members.page?" target="_blank">become a member</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1e37d9a9-8563-4a69-a090-3154e1a2102d Recognizing educational myopia, accepting feedback http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_recognizing-educational-myopia-accepting-feedback Tue, 14 Oct 2014 15:00:00 GMT <p> <em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckTag=MedEd_Innovation" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Bonnie Miller, MD (pictured left), associate vice-chancellor for health affairs and senior associate dean for health sciences education at Vanderbilt University School of Medicine. This appeared in the October 2014 </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/0/75300966-438f-4ac2-b0cc-e4fa1a9d2dd4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/0/75300966-438f-4ac2-b0cc-e4fa1a9d2dd4.Large.jpg?1" style="float:left;margin:10px;" /></a>Medical educators across the continuum are currently debating the importance and potential impact of learning portfolios. At Vanderbilt, we <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">developed a platform called VSTAR</a> that provides a robust electronic home for each medical student’s portfolio, comprised of competency-based assessments, experience logs, written reflections, coach-guided summaries and student-generated learning goals.</p> <p> The effort and resources required for a project of this magnitude put us at risk for a form of educational myopia. Those of us intimately involved with design, development and implementation have celebrated the fact that the system is online and the gears are moving. While we are tempted to proclaim success, feasibility alone does not prove that the system is meaningful for learners and valuable for the learning process.</p> <p> We were reminded of this recently when we held student and faculty focus groups on the first year of experience with the VSTAR portfolio. Aside from a few operational issues that could be expected with such a complex launch, the respondents indicated that the system had functioned in the ways for which it was designed. Beyond that, many students became highly engaged in the process of integrating multi-source competency-based assessments into meaningful learning objectives.</p> <p> However, a subset of students was not as fully engaged as we had hoped. These students gave voice to a more traditional understanding of the roles of students and teachers. Portfolios force learners to move from being passive recipients of performance information (e.g., grades) to true professionals-in-training who use feedback as a starting point for reflection, goal-setting and improvement. Not all of our students are ready for this transition.</p> <p> A second group also emerged. These students wondered whether the system was primarily about their learning, or whether it was really about faculty research, or a tool for measuring organizational effectiveness.</p> <p> Both groups challenge us to remember the importance of student development, of proactively preparing our students with an understanding of the theoretical and practical rationales for these educational innovations so that they can become wise, effective and activated users. While student representatives sit on all of the committees that oversee these projects, we must find creative ways to communicate the purpose to the broader student body of the school.</p> <p> Finally, the feedback from the focus groups reminded us that students must always remain an integral part of the ongoing evolution of our educational systems. Students must engage with the system not only as users, but also as members of the improvement team. We cannot reach our ultimate goals any other way. And, if we are really lucky, we will nurture the next generation of creative educators in the process.</p> <p> <em>Get 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:e9bd1398-8b5f-4bc8-974f-d1bb3e5cf457 New diabetes guidelines: Screen patients aged 45 and older http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-diabetes-guidelines-screen-patients-aged-45-older Mon, 13 Oct 2014 20:44:00 GMT <p> New <a href="http://www.uspreventiveservicestaskforce.org/Page/Name/us-preventive-services-task-force-opportunities-for-public-comment" rel="nofollow" target="_blank">draft guidelines</a> from the U.S. Preventive Services Task Force (USPSTF) recommend screening adults aged 45 and older for prediabetes and type 2 diabetes. The recommendation could mean identifying and treating undiagnosed diabetes in millions more people, preventing complications and improving quality of life.</p> <p> An independent expert panel under the U.S. Agency for Healthcare Research and Quality, the USPSTF makes evidence-based recommendations about clinical preventive services. It issued its updated recommended guidelines for prediabetes and type 2 diabetes screening last week. The guidelines are open for <a href="http://www.uspreventiveservicestaskforce.org/Comment/Collect/Index/RecommendationStatementDraft/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus" rel="nofollow" target="_blank">public comment</a> through Nov. 3.</p> <p> The recommendation calls for screening everyone beginning at 45 years of age and patients who meet one or more of these criteria:</p> <ul> <li> Younger adults with risk factors, including obesity</li> <li> Younger adults with a first-degree relative with diabetes</li> <li> Women with a history of gestational diabetes or polycystic ovarian syndrome</li> <li> Certain racial or ethnic minority groups, including African Americans, American Indians/Alaskan Natives, Asian Americans, Hispanics/Latinos and Native Hawaiians/Pacific Islanders</li> </ul> <p> The guidelines recommend the use of hemoglobin A1c testing as a primary method for screening at-risk individuals, which provides a rapid and accurate method of testing for both prediabetes and diabetes.</p> <p> An estimated 86 million Americans have prediabetes, but only one in nine of these people knows they are at risk of developing type 2 diabetes. Studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives.</p> <p> The AMA is working to prevent diabetes 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, partnering with the YMCA of the USA to increase referrals to the YMCA’s Diabetes Prevention Program. The program is an evidence-based lifestyle intervention that is part of the Centers for Disease Control and Prevention’s (CDC) <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a>.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at their local YMCAs. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.</p> <p> If the USPSTF adopts the draft guidelines, adults who meet the specified criteria would be eligible for screening, and most insurers would eventually be required to cover the screening. The guidelines would be more closely aligned with those of the American Diabetes Association, and the primary care professional societies that follow USPSTF guidelines would align their screening criteria as well.</p> <p> “For the first time, the USPSTF is recognizing value in screening for prediabetes,” said AMA President Robert M. Wah, MD. “Consequently, millions more patients at risk could ultimately be identified and helped by diabetes prevention programs recognized by the CDC through its National Diabetes Prevention Program.”</p> <p> Physicians can <a href="http://www.uspreventiveservicestaskforce.org/Comment/Collect/Index/RecommendationStatementDraft/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus" rel="nofollow" target="_blank">comment</a> on the draft guidelines through Nov. 3.</p> <p> <strong>You tell us: </strong>How do you think the new guidelines recommended by the USPSTF will help your patients? Leave a comment below at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cab84fd0-5804-43f8-a26f-7e7fad69a3e1 How these med students transformed their summer http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-students-transformed-their-summer Mon, 13 Oct 2014 20:36:00 GMT <p> Medical students at the University of Toledo College of Medicine and Life Sciences spent their summer vacation in a unique situation: delivering care to more than 600 patients in León, Nicaragua, one of the poorest countries in Latin America. In the process, they also gained valuable perspective and experience.</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/Content/images/store/14/0/0eaefb39-c565-4231-80a7-5494463c213b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/0/0eaefb39-c565-4231-80a7-5494463c213b.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;">Erik Rotterman, a fourth-year medical student at the University of Toledo College of Medicine and Life Sciences, treats a mother and child in León, Nicaragua during the school's trip in August 2014.</span></em></td> </tr> </tbody> </table> <p> U.S. medical students increasingly are seeking international experiences such as this. According to data from the Association of American Medical Colleges (AAMC), more than 65 percent of incoming medical students want to pursue global learning opportunities.</p> <p> “Cultural sensitivity, identifying community needs, fairness in the distribution of resources, robust public health systems and improving health care for everyone—these are goals medical students identify with because of our extensive humanistic training,” said Divya Sharma, a second-year medical student at Rutgers New Jersey Medical School and chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a> (MSS) Committee on Global and Public Health. “Global health issues impact all of us.”</p> <p> Students from the University of Toledo team—an interdisciplinary group of 28 people, including medical, physician assistant, pharmacy, dental and physical therapy students—saw firsthand the impact their care had on the León community.</p> <p> <strong>Acquiring a unique perspective</strong><br /> For these students, the eight-day experience in August spurred a new look at what it means to be a physician.</p> <p> “This trip provided a perspective on health care that is unlike anything we experience in the states,” said Kelsey Smith, a third-year medical student at the University of Toledo. “Not only do patients have a unique perspective on the concepts of sickness and medicine, but their culture and language differences challenged the members of our team to be creative and inventive during patient interviews.”</p> <p> At some of the more rural clinics, patients lack access to health care, and it’s difficult for patients to even get transportation to a medical facility. The team heard a story about one of the major causes of poor dental hygiene in local young children.</p> <p> “Mothers cannot afford fresh water for baby formula,” Smith said. “Instead, these parents mix their children’s formula with Coca-Cola because it is prepared with filtered water and is less expensive than fresh, bottled water.”</p> <p> At the same time, patients in urban community centers brought prescriptions for blood pressure or diabetes control medication that they couldn’t afford. Smith said the students return to the United States with an “extreme sense of humility.”</p> <p> <strong>Gaining new experiences</strong><br /> The team had to provide care in a variety of settings, from windowless sheds to outdoor pavilions. Students were required to rely on their history-taking and physical exam skills.</p> <p> “There is no way to get a CT scan on a patient with abdominal pain or a CBC in a patient with unexplained fatigue,” Smith said. “In this way, our trip exposed students to the most fundamental parts of medical practice.”</p> <p> The team leaders, including Smith, were responsible for obtaining and organizing all medications and supplies before the trip, and directed flow at the clinics. Students rotated through pediatric, adult and women’s health services, and assisted at dental clinics.</p> <p> <strong>Getting involved</strong><br /> Students interested in learning more about global health and participating in international experiences can check with their medical schools for resources. The AMA-MSS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/our-leaders/standing-committees.page" target="_blank">Committee on Global and Public Health</a> also can help students find more information about international health opportunities.</p> <p> The AAMC’s <a href="https://www.aamc.org/services/ghlo/" rel="nofollow" target="_blank">Global Health Learning Opportunities</a> collaborative, a network of medical schools in the United States and abroad, can help students in their final year of medical school find clinical, research or public health-related international opportunities.</p> <p> <strong>You tell us: </strong>Have you participated in an international medical trip? If not, would you? Share your thoughts and experiences by commenting below or on the <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">AMA-MSS Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:73595969-092b-4f43-877b-7a87946ec040 Plan to attend the AMA Women Physicians Section Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-ama-women-physicians-section-interim-meeting Mon, 13 Oct 2014 18:30:00 GMT <p> Participate in the AMA Women Physicians Section (WPS) Interim Meeting, November 8 in Dallas, for a unique opportunity to network with other women physicians from across the United States and meet with leaders from state and specialty societies, as well as from the AMA.</p> <p> This year’s meeting offers a variety of events, including policy discussions and education sessions. The AMA-WPS will host a session, “Communication as a Conflict Management Tool” from 12:15 p.m. to 1:45 p.m. Nov. 8 in the Governors Lecture Hall, presented by Andrea Jones, executive managing director of eWomen Network Dallas/Fort Worth. This session is approved for 1.5 <em>AMA PRA Category 1 Credits™</em>.</p> <p> The AMA-WPS Business Meeting and Reception will be from 5:30 p.m. to 7 p.m. Nov. 8 in the Wedgewood Room and will include a presentation by 2013 Giambalvo Fund for the Advancement of Women winner Juliet Lee, MD, and a review of the AMA House of Delegates Handbook and AMA-WPS items of business.</p> <p> Attend the AMA-WPS liaisons lunch from 12:30 p.m. to 2 p.m. in the Madrid Room to meet the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/about-wps/wps-liaisons.page" target="_blank">liaisons</a> from other medical societies.</p> <p> More details about the meeting and surrounding events are available on the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/wps-meetings.page" target="_blank">Meetings and events</a> Web page. Registration closes Saturday, November 1; <a href="http://www.ama-assn.org/go/i14registration" target="_blank">log in</a> and register today.</p> <p> The AMA is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b08f1bd-2f7d-4094-90e2-59b76abf33a7 Oral arguments begin in patient safety case before U.S. Supreme Court http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_oral-arguments-begin-patient-safety-case-before-supreme-court Mon, 13 Oct 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/13/dfbd1614-6850-499f-bdec-cc6ce951ee1b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/13/dfbd1614-6850-499f-bdec-cc6ce951ee1b.Large.jpg?1" style="margin:15px;float:right;" /></a>The nation’s highest court Tuesday will hear arguments in a case that will decide whether the Federal Trade Commission (FTC) can second-guess the work of state medical licensure boards.</p> <p> The Supreme Court of the United States is hearing oral arguments in <em>North Carolina State Board of Dental Examiners v. FTC</em>, a case previously decided by a federal appeals court that ruled in favor of the FTC’s claim that state licensure boards should be subject to federal antitrust laws. The decision of the appeals court could effectively limit the ability of these boards to regulate their health care professions and shield patients from unlawful practices.</p> <p> The AMA and other health care organizations filed an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patient-safety-stake-case-before-supreme-court" target="_blank">amicus brief</a> expressing support for the plaintiffs in this case, stating fear that if the court ruled for the FTC, it would have a chilling effect on state medical and dental boards to the detriment of public health.</p> <p> In June, physicians at the open forum of 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> heard both sides of the case argued in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/attorneys-argue-patient-safety-case-mock-hearing" target="_blank">mock court session</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8b543812-35ab-46ca-8b08-6faa9e9b1870 Ethics journal discusses tensions in reproductive medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ethics-journal-discusses-tensions-reproductive-medicine Fri, 10 Oct 2014 20:39:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9fc65af-0f53-4dc0-8a94-1bbd327de6ec.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9fc65af-0f53-4dc0-8a94-1bbd327de6ec.Large.jpg?1" style="margin:15px;float:right;" /></a>In reproductive medicine, advances in medical science and technology often outpace society’s opportunity for due deliberation about their ethical use. Physicians and other experts in the field explore these ethical considerations in the <a href="http://virtualmentor.ama-assn.org/" target="_blank">October issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal.</p> <p> Employing pre-implantation genetic diagnosis followed by embryo selection to choose the sex (and potentially other traits) of a child is just one topic of debate. <em>Virtual Mentor</em> contributors discuss the many questions and tensions that surround evolving technologies and practices—from those that prevent or enable conception to those used in hospital labor wards.</p> <p> Highlights include:</p> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/msoc1-1410.html" target="_blank">Judicial, legislative and professional attempts to restrict pregnant women’s autonomy</a>.” Ruth Macklin, PhD, writes that she believes physicians may—and should—make recommendations to women for maintaining a healthy pregnancy, but until the time a baby is born, the pregnant woman alone should have the last word in deciding what happens to her fetus.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/oped1-1410.html" target="_blank">Natural childbirth—A global perspective</a>.” Lauri J. Romanzi, MD, argues that industrialized nations could benefit from strategies emerging in developing nations, such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/ecas1-1410.html" target="_blank">Informing patients about declining fertility</a>.” In this commentary, Marc M. Beuttler, Kara N. Goldman, MD, and Jamie A. Grifo, MD, write about how respect for informed, autonomous decision-making demands women be made aware of useful, if anxiety-provoking, information about age-related decline in fertility.</li> </ul> <p> Be sure to take this month’s <a href="http://virtualmentor.ama-assn.org/site/poll.html" target="_blank">ethics poll</a> (“What do you think about using in vitro fertilization to select the sex of a child for the purpose of ‘balancing’ the family?”), and check out the October <a href="http://virtualmentor.ama-assn.org/podcast/ethics-talk-october-2014.mp3" target="_blank">podcast</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:46f9b6a8-d9af-428d-86a8-894e6e97ad23 Shape policy on key issues in medicine: Comment now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-proposed-ama-policy Fri, 10 Oct 2014 20:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/40f86c46-aaa2-4a4c-adfa-101d2d6c5a94.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/40f86c46-aaa2-4a4c-adfa-101d2d6c5a94.Large.png?1" style="margin:15px;float:right;" /></a>Weigh in on future AMA policy via the <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">Online Member Forums</a> (log in), now open in advance of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 8 to 11 in Dallas.</p> <p> All items of business from the initial reports and resolutions are posted in the forums, sorted by reference committee. Any AMA member can comment on any item of business. The forums will be open until just before the start of the meeting, but any comments posted after 7 p.m. Eastern time on Nov. 2 may not be captured in the comment summaries that will be posted on the Interim Meeting website.</p> <p> Online forums have allowed AMA members to weigh in on key policy issues facing medicine from the comfort of their homes or offices. They have permitted physicians and medical students, delegates and non-delegates alike to add their voices to the AMA policy discussion at their convenience.</p> <p> Resolutions and reports up for discussion at the 2014 AMA Interim Meeting address such topics as:</p> <ul> <li> U.S. Food and Drug Administration regulation of off-label drug promotion</li> <li> Physician unionization and collective bargaining</li> <li> Equity in telemedicine payments</li> <li> The role of pharmacists in improving immunization rates</li> <li> Timing of the United States Medical Licensing Examination Step 1</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f9d4024c-d86c-48ad-b7f3-d73f02ca1b08 How one physician helped a young patient realize her dream http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-physician-helped-young-patient-realize-her-dream Fri, 10 Oct 2014 18:58:00 GMT <p> Physicians are in the unique and privileged position to understand the dreams of their patients—and to help patients achieve those dreams. It’s this ability to impact that makes being a physician so inspirational, one physician recently explained.</p> <p> Robert Alan Probe, MD, chair of the board of Scott and White’s integrated medical group and chair of the department of orthopedic surgery, <a href="http://youtu.be/_tifHRYGfmg" rel="nofollow" target="_blank">shared his story</a> at the AMA’s recent Inspirations in Medicine event.</p> <p> <object align="left" data="http://www.youtube.com/v/_tifHRYGfmg" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/_tifHRYGfmg" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/_tifHRYGfmg" /><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/_tifHRYGfmg" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object>A young, bubbly girl named Maddy came to him with an unusually shortened humerus, and the growth plate at the top end of the bone had shut down asymmetrically. Because of this, Maddy couldn’t fulfill her dream of playing basketball.</p> <p> “In 25 years of practice, I can’t remember a patient where the art and science of medicine came together [like this], where we were understanding this girl’s dreams and doing something about it,” Dr. Probe said.</p> <p> Through an intense and long treatment plan, Dr. Probe was able to lengthen the bone and help the girl get back to the sport she loved.</p> <p> “What started it? This little girl, with a dream to be with her friends on the basketball team,” Dr. Probe said. “Because of her willpower, because of 21st-century medicine, because of the human spirit and the partnership between the patient and physician, she realized her dreams.”</p> <p> “Medicine is in chaos now,” Dr. Probe said. “The one thing that cannot change, that should not change, is that relationship of understanding your patients’ dreams, having a part in their life and doing what you can to help them.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" rel="nofollow" target="_blank">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2913aac8-545a-415b-b828-bf307e6840ac 10 top states where health insurers dominate: New study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_10-top-states-health-insurers-dominate-new-study Thu, 09 Oct 2014 19:30:00 GMT <p> An annual analysis of commercial health insurance markets revealed the 10 most competitive and 10 least competitive states among health insurers. Find out where your state ranks.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/1/92894b2e-7b32-4576-812d-cf964d1f8e87.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/1/92894b2e-7b32-4576-812d-cf964d1f8e87.Large.jpg?1" style="float:right;margin:10px;" /></a>In order of most competitive, the 10 top states are:</p> <ol> <li> Oregon</li> <li> Wisconsin</li> <li> Pennsylvania</li> <li> New York</li> <li> Colorado</li> <li> Missouri</li> <li> Washington</li> <li> Ohio</li> <li> California</li> <li> Florida</li> </ol> <p> The 10 states with the least competitive commercial health insurance markets are:</p> <ol> <li> Alabama</li> <li> Hawaii</li> <li> Michigan</li> <li> Delaware</li> <li> Louisiana</li> <li> South Carolina</li> <li> Alaska</li> <li> Illinois</li> <li> Nebraska</li> <li> North Dakota</li> </ol> <p> At No. 8, Illinois makes its first appearance in the top 10 least competitive markets this year, displacing Rhode Island from last year’s list. Louisiana entered the top five, moving from ninth on last year’s list.</p> <p> The 2014 edition of the AMA’s <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets</em> reports commercial health insurance market shares and federal concentration measures for 388 metropolitan markets as well as all 50 states and the District of Columbia. The study is based on 2012 data captured from commercial enrollment in fully insured and self-insured health plans, and includes participation in consumer-driven health plans.</p> <p> More findings include:</p> <ul> <li> In 72 percent of the metropolitan areas studied, there is a significant absence of health insurer competition. These markets are rated “highly concentrated,” based on the guidelines used by the U.S. Department of Justice and Federal Trade Commission to assess the degree of competition in a given market.</li> <li> In 17 states, a single health insurer had a commercial market share of 50 percent or more.</li> <li> In 45 states, two health insurers had a combined commercial market share of 50 percent or more.</li> <li>  In 90 percent of metropolitan areas, a single health insurer has at least a 30 percent share of the commercial health insurance market.</li> </ul> <p> This AMA report is intended to help researchers, lawmakers, policymakers and regulators identify markets where mergers and acquisitions among health insurers may cause competitive harm to patients, physicians and employers.</p> <p> “The AMA is greatly concerned that in 41 percent of metropolitan areas, a single health insurer had at least a 50 percent share of the commercial health insurance market,” said AMA President Robert M. Wah, MD in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-09-wellpoint-competition-health-insurance-market.page">news release</a>. “The dominant market power of big health insurers increases the risk of anti-competitive behavior that harms patients and physicians, and presents a significant barrier to the market success of smaller insurance rivals.”</p> <p> <strong>What insurers have the largest market shares?</strong><br /> WellPoint Inc. is the largest private health insurer by market share in more than one in five metropolitan areas.</p> <p> Soon to be renamed Anthem Inc., WellPoint has a bigger geographic footprint than any other private health insurer in the country, and it holds a market share advantage in more than double the number of metropolitan areas as the next two insurers. Health Care Service Corp. was second, with a market share lead in 37 metropolitan areas, followed by UnitedHealth Group, with a market share lead in 35 metropolitan areas.</p> <p> A <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets </em>is available for purchase through the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560005&navAction=push" target="_blank">AMA Store</a>; AMA members can access it for free. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:67cf65c5-b007-404b-a2ac-85190096882f Real clinical data gives medical students new perspectives http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_real-clinical-data-gives-medical-students-new-perspectives Thu, 09 Oct 2014 18:22:00 GMT <p> Medical students now can use real clinical data to examine patient populations and the value of health care with new, free tools from New York University School of Medicine.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/6/d6bb82f4-1107-4373-a6bb-6c8c325f873d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/6/d6bb82f4-1107-4373-a6bb-6c8c325f873d.Large.jpg?1" style="float:right;margin:10px;" /></a>NYU used publicly available, open clinical data sets and local data from NYU Langone Medical Center’s electronic health records (EHR) to develop <a href="http://education.med.nyu.edu/ace" rel="nofollow" target="_blank">two new educational clinical data tools</a>. Marc Triola, MD (pictured left), director of the Institute for Innovations in Med Education at NYU and associate dean of educational informatics presented the tools at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as 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. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> NYU used <a href="http://education.med.nyu.edu/ace/clinicaldata/" rel="nofollow" target="_blank">real clinical data</a> from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS)—more than 2.5 million patient-level records that include every inpatient discharge from 226 hospitals in New York—to create an interactive website.</p> <p> Students can sift through diagnosis-related group codes, providers or hospitals to answer a variety of questions. For example, a student could investigate whether severity of illness correlated with length-of-stay for patients with drug and alcohol dependence, or how much charges vary across hospitals for the same payer and a given diagnosis-related code.</p> <p> “We didn’t want to tell our students what they had to ask—if students were passionate about adolescent medicine or substance abuse or different types of surgeries, they could follow whatever path they wanted,” said Dr. Triola. “This instantly inspires students to want to delve deeper, and it means something to them because they know these hospitals.”</p> <p> The school also created a <a href="http://education.med.nyu.edu/ace/practice/" rel="nofollow" target="_blank">simulated health care group</a> that consists of three different types of practices. Combining de-identified data from NYU Langone Medical Center’s EHR, payer and demographic information from SPARCS, patient level lab data and more.</p> <p> Once students become familiar with the practice group, they complete an exercise: If they worked in this practice group, what quality improvement project would they propose for a $1 million grant?</p> <p> “It’s incredibly powerful stuff,” Dr. Triola said. “The students are thrilled because it’s real data—it’s not an exercise, it’s not their biostats textbook. It is authentic clinical data and it allows them to really follow their own personal interests.”</p> <p> Dr. Triola is working with the AMA and the Accelerating Change in Medical Education consortium schools to potentially adapt the tools for use at additional schools. The school is looking for more public data sources to expand the tools in the future.</p> <p> This post is the second in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3d89e654-728c-4b9e-9579-68e2e391ba9a JAMA Highlights: Antimicrobial use in hospitals appears to be common http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-antimicrobial-use-hospitals-appears-common Thu, 09 Oct 2014 18:20:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/nLz21BXr4qs" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/nLz21BXr4qs" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/nLz21BXr4qs" /><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" quality="best" src="http://www.youtube.com/v/nLz21BXr4qs" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA <em>video: Nearly one-half of patients receive at least one antibiotic while hospitalized.</em></span></td> </tr> </tbody> </table> <p> <strong>Antimicrobial use in hospitals appears to be common</strong><br /> A one-day prevalence survey of 183 hospitals found that approximately 50 percent of hospitalized patients included in the survey were receiving antimicrobial drugs, and that about one-half of these patients were receiving two or more antimicrobial drugs, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911328" rel="nofollow" target="_blank">study</a> in the Oct. 8 issue of the <em>Journal of the American Medical Association </em>(<em>JAMA</em>), a theme issue on infectious disease. Most antimicrobial use was for infection treatment. Watch a <a href="http://youtu.be/nLz21BXr4qs" rel="nofollow" target="_blank">video</a> about the study.</p> <p> <strong>Studies examine vaccination strategies for prevention, control of avian flu</strong><br /> Two randomized trials in the Oct. 8 issue of <em>JAMA</em> examine new vaccination strategies for the prevention and control of avian influenza, often referred to as “bird flu.” One <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911327" rel="nofollow" target="_blank">study</a> looks at safety and immunogenicity of different doses of a specific vaccine, and the other <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911325" rel="nofollow" target="_blank">study</a> looks at how previously receiving an older vaccine could affect a newer vaccine.</p> <p> <strong>Public health in the age of Ebola</strong><br /> A <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916610" target="_blank" rel="nofollow">new Viewpoints piece</a> in <em>JAMA Internal Medicine</em> examines the Ebola outbreak in West Africa as a “Black Swan” event.</p> <p> <strong>Study looks at cardiometabolic risk, schizophrenia and antipsychotic treatment</strong><br /> The duration of psychiatric illness and treatment for patients after first-episode schizophrenia spectrum disorders appears to be associated with being fatter and having other cardiometabolic abnormalities, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1911294" rel="nofollow" target="_blank">study</a> in<em> JAMA Psychiatry</em>.</p> <p> <strong>Prenatal BPA exposure associated with diminished lung function in children</strong><br /> Prenatal exposure to bisphenol A (BPA, a common chemical used in some plastics) appears to be inconsistently associated with diminished lung function and the development of persistent wheeze in children, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1913573" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5c649a8b-03c3-4aa9-a5cf-c9d51fb6cbd2 How to screen for Ebola: CDC offers resources http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_screen-ebola-cdc-offers-resources Wed, 08 Oct 2014 21:04:00 GMT <p> As the first patient diagnosed with Ebola in the United States died Wednesday morning in Dallas, a <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">special Web page</a> from the Centers for Disease Control and Prevention (CDC) offers the resources you need to be prepared for patients who might have this disease.</p> <p> The CDC and U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) have asked physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations.</p> <p> The CDC suggests that emergency departments screen for:</p> <ul> <li> Fever, headache, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite. In some cases, bleeding also is a symptom.</li> <li> Travel to West Africa within 21 days (3 weeks) of symptom onset. Countries include Guinea, Liberia, Nigeria, Senegal, Sierra Leone and other places where Ebola virus disease transmission has been reported by the World Health Organization.</li> </ul> <p> If both criteria are met, the patient should be moved to a private room with a bathroom. Standard, contact and droplet precautions should be followed during further assessment.</p> <p> The agencies have issued a <a href="http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf" rel="nofollow" target="_blank">hospital checklist for Ebola preparedness</a>. In addition, physicians can watch a <a href="http://www.phe.gov/Preparedness/responders/Pages/ebola-healthcare-webinar.aspx" rel="nofollow" target="_blank">webinar</a> from the CDC and ASPR on Ebola preparedness for the U.S. health care system. The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care workers</a> offers more information about testing, diagnosis and protection, as well as guidance on how to safely manage patients with the virus. Additional resources can be found on the <a href="http://www.phe.gov/preparedness/Pages/default.aspx" rel="nofollow" target="_blank">ASPR website</a>.</p> <p> “Our calls from doctors have increased tenfold since the first case was diagnosed,” said CDC Director Tom Frieden, MD, in a <a href="http://www.cdc.gov/media/releases/2014/t1007-ebola-confirmed-case.html" rel="nofollow" target="_blank">press briefing</a> Tuesday. “There’s a lot of awareness, and we’re working to increase that even further …. We want to make sure any lessons we learn from Dallas are rapidly incorporated into the practice of health departments around the country.”</p> <p> The virus is spread through contact with bodily fluids of a person who is sick with or has died from Ebola, and the chances of a widespread outbreak in the United States are unlikely, Dr. Frieden said last week. </p> <p> In addition, the <em>Journal of the American Medical Association </em>and Kaiser Family Foundation created a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911333" rel="nofollow" target="_blank">visual snapshot</a> of the 2014 Ebola outbreak, including key facts about Ebola, the number of cases in the current outbreak and a summary of the key U.S. agencies responding to the crisis.</p> <p> A new <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916610" target="_blank" rel="nofollow">Viewpoint piece</a> in <em>JAMA Internal Medicine</em> also looks at public health in the age of Ebola.</p> <p> On Tuesday, the National Institutes of Health (NIH) said it <a href="http://www.nih.gov/news/health/oct2014/od-07.htm" rel="nofollow">discharged a physician</a> who had been exposed to the virus and had been kept in isolation at the NIH’s Clinical Center. The physician was admitted to an isolation unit in Bethesda, Maryland, Sept. 28 after returning from Sierra Leone, where he was a volunteer in an Ebola unit and had been exposed to the virus by a needle stick injury.</p> <p> Patients can get more information about Ebola on the <a href="http://www.cdc.gov/vhf/ebola/index.html" rel="nofollow" target="_blank">CDC website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:98da53be-9044-4734-a172-689f657aca97 PQRS incentive payments now available http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_pqrs-incentive-payments-now-available Wed, 08 Oct 2014 20:24:00 GMT <p> Incentive payments for the Physician Quality Reporting System (PQRS) now are available for eligible professionals and group practices who successfully met the program’s reporting criteria for Medicare Physician Fee Schedule Part B services furnished in 2013.</p> <p> Physicians can access their 2013 feedback reports in two ways:</p> <ul> <li> <strong>National Provider Identifier (NPI)-level reports.</strong> These reports can be requested through the CMS <a href="https://www.qualitynet.org/portal/server.pt/community/communications_support_system/246" target="_blank" rel="nofollow">communication support page</a> by creating an NPI-level feedback report request. The report will be sent electronically in two to four weeks to the email address provided in the request.</li> <li> <strong>Taxpayer Identification Number (TIN)-level reports.</strong> These reports contain NPI-level detail and are available for download via CMS’ <a href="https://www.qualitynet.org/portal/server.pt/community/pqri_home/212" target="_blank" rel="nofollow">quality reporting portal</a>. An “Individuals Authorized to Access CMS Computer Services” (IACS) account is required to access a TIN-level report through the portal. To request an IACS account, consult the <a href="https://www.qualitynet.org/portal/server.pt/gateway/PTARGS_0_207_374_212_229_43/http%3B/pdpqap42-app.sdps.org%3B7087/publishedcontent/publish/pqri_content/pqri_guest_community/userrefguide.html" target="_blank" rel="nofollow">IACS quick references guides</a>. </li> </ul> <p> For more information about the PQRS incentive payments, review CMS’ <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html" rel="nofollow">analysis and payment</a> Web page. For more information about interpreting the data in the report, view the <a href="http://cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2013_PQRSFeedbackReportUserGuide_F04-02-2014.pdf" target="_blank" rel="nofollow">2013 PQRS feedback report user guide</a> or the <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ERxIncentive/Downloads/2013_eRxFeedbackReportUserGuide_F04042014.pdf" target="_blank" rel="nofollow">2013 eRx incentive program feedback report user guide</a>.</p> <p> Physicians can contact the QualityNet Help Desk for assistance 8 a.m.-8 p.m. Eastern time Monday through Friday at (866) 288-8912 or <a href="mailto:qnetsupport@hcqis.org" rel="nofollow">qnetsupport@hcqis.org</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b8363ac3-2326-43e8-9404-708eab3fb730 Plan to attend PCPI meeting Oct. 22-23 in Chicago http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-pcpi-meeting-oct-22-23-chicago Wed, 08 Oct 2014 20:14:00 GMT <p> Learn how organizations are engaging patients to develop meaningful, patient-reported outcomes at the AMA-Convened Physician Consortium for Performance Improvement® (PCPI) <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/pcpi-members/meetings.page" target="_blank">Membership and Committee Meeting</a>, Oct. 22 to 23 in Chicago.</p> <p> This meeting convenes the membership of the PCPI, as well as other experts in quality improvement and performance measurement.  A panel of PCPI member organizations will discuss ways specialty societies are responding to changes in reporting systems and the need for measures. Attendees also will learn about strategies to engage their members in important national and organizational outcomes like the Physician Quality Reporting System. </p> <p> <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144646E&TID=jJ3zaAmIfGM1jPdU904ESA%253d%253d&OID=130" target="_blank">Register</a> (log in) for the meeting and reserve a hotel room online by 1 p.m. Eastern time Oct. 20. Learn more about the PCPI on its <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement.page?" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:316662b3-2744-4fc4-a234-ead9d292e0be Learn what med schools are doing to increase diversity http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-med-schools-doing-increase-diversity Wed, 08 Oct 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/5/b3659f2b-c1a0-45e1-a519-2875c20e7fa9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/5/b3659f2b-c1a0-45e1-a519-2875c20e7fa9.Large.jpg?1" style="float:right;margin:10px;" /></a>What are the most important factors in attracting a medical student body that reflects a diverse patient population? Hang out with experts, educators and physicians in training from 8 p.m. to 9 p.m. Eastern time Oct. 20 to share your ideas and learn what others think.</p> <p> Join the online <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Google Hangout</a> to listen, watch and share ideas on:</p> <ul> <li> Innovative ideas to attract medical students from underrepresented groups</li> <li> New ways medical schools are preparing current students for an increasingly diverse patient population</li> <li> How institutions teach and collect feedback on racial and ethnic health care disparities</li> </ul> <p> Panelists from the University of California Davis School of Medicine, Howard University College of Medicine and Chicago Medical School at Rosalind Franklin University of Medicine and Science will share their insights into developing a diverse student body that is prepared for tomorrow’s patient population. William McDade, MD, chair of the AMA Council on Medical Education and deputy provost for research and minority issues at the University of Chicago, will moderate the hangout.</p> <p> To participate in the live-streaming event, simply visit the <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Hangout page</a>. If you would like to post questions for the panelists to answer, you will need to be a Google user. Participate in the discussion on Twitter and Facebook using #AMAHangout.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:372b939b-ed28-4e06-b596-c1eeefe97cb1 CMS reopens period to apply for meaningful use hardship exemption http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-reopens-period-apply-meaningful-use-hardship-exemption Tue, 07 Oct 2014 22:18:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) announced Tuesday it would reopen the submission period for hardship exception applications in the electronic health record (EHR) meaningful use program, allowing more physicians to avoid next year’s payment adjustments for not demonstrating meaningful use. The new deadline is Nov. 30.</p> <p> Previously, the hardship application deadline was April 1 for hospitals and July 1 for physicians. This new opportunity is particularly helpful for physicians who have never participated in the meaningful use program, as they will face penalties in 2015 if they did not attest by Oct. 1. The agency reopened the submission period as a result of AMA advocacy.</p> <p> “Giving physicians more time to file for a hardship exemption provides necessary relief as many physicians are struggling to meet a number of reporting mandates to avoid multiple penalties,” said AMA President Robert M. Wah, MD, in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-07-statement-meaningful-use.page" target="_blank">statement</a>. “The AMA remains committed, however, to ensuring that the meaningful use program requirements are in fact meaningful and deliver the intended improvements in patient care and practice efficiencies. We look forward to continuing to work with the Administration to make the program requirements <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/proposed-rule-improves-meaningful-use-but-doesnt-far-enough" target="_blank">more flexible</a> and ensure physicians have certified products that better support their practices and patients’ needs.”</p> <p> The reopened hardship exemption application submission period is for physicians and hospitals that both:</p> <ul> <li> Have been unable to fully implement 2014 Edition certified EHR technology due to delays in availability of such technology</li> </ul> <p> And</p> <ul> <li> Who were unable to attest by Oct. 1 (for physicians) or July 1 (for hospitals) using the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">flexibility options CMS implemented in September</a> that allow physicians to use older certified EHR technology for attestation</li> </ul> <p> CMS will only consider these circumstances for the reopened application submission period.</p> <p> Physicians who seek to avoid the 2015 penalty can read more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/last-chance-apply-july-1-avoid-meaningful-use-pay-penalty" target="_blank">hardship exemption categories</a> at <em>AMA Wire</em>®.</p> <p> CMS’ decision to reopen the hardship reporting period for physicians in this situation represents an important chance for Medicare physicians who have not yet participated in the meaningful use program to avoid a financial penalty in 2015. Any physician who wants to attest for a 90-day reporting period to obtain an incentive for 2014 can still do so—the deadline is Feb. 28—and can apply for a hardship exemption as a back-up plan.</p> <p> Find more information on CMS’ <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html" target="_blank" rel="nofollow">payment adjustments and hardship exceptions Web page</a>.</p> <p> View a <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/PaymentAdj_HardshipExcepTipSheetforEP.pdf" target="_blank" rel="nofollow">CMS tip sheet</a> about the meaningful use payment adjustments and hardship exceptions and the 2014 certified EHR technology hardship exception <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CEHRT2014_HEGuidance_EPs.pdf" target="_blank" rel="nofollow">guidance document</a> to learn more.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b6b4f903-a610-46d7-a829-3a919c899865 Coding cards can help prepare for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_coding-cards-can-prepare-icd-10 Tue, 07 Oct 2014 21:05:00 GMT <p> Physicians have one year to comply with implementation of the ICD-10 code set. Get ready with new coding cards from the AMA Store.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500016&navAction=push" target="_blank">ICD-10-CM 2015 Snapshot Coding Cards: Multiple Specialties</a> provide the most commonly reported diagnostic codes and associated guidelines for a specialty, including the specificity required to improve documentation. These reference cards include:</p> <ul> <li> Guidelines and tips to make coding more accurate and complete</li> <li> An alphabetical layout to quickly locate the code that accurately reflects a patient’s condition</li> <li> Tailor-made content for a particular specialty</li> <li> Portability—the cards fit into the codebook</li> </ul> <p> For hospital inpatient settings, the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500027&navAction=push" target="_blank">ICD-10-PCS 2015 Snapshot Coding Card Collection</a> includes a collection of cards to help build understanding around how to build an inpatient procedural code.</p> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:47ba20fc-ba46-455e-b118-a0d09c83337b How playing games can change medicine’s future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_playing-games-can-change-medicines-future Tue, 07 Oct 2014 21:02:00 GMT <p> In the health care system of tomorrow, physicians and patients will be playing many more games, according to some speakers with innovative ideas at TEDMED 2014, which took place last month in San Francisco and Washington, D.C.</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/07557238-e837-4d66-a04f-87e1f8974dbe.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/07557238-e837-4d66-a04f-87e1f8974dbe.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;"> <em><span style="font-size:11px;">“The act of play, overcoming these challenges through trial and error, recalibrates our perceptions,” said Howard Rose.</span></em></td> <td>  </td> </tr> </tbody> </table> <p> Giving medical students the opportunity for some hands-on gaming, particularly simulations, is part of the future, said Carla Pugh, MD, vice chair of education and patient safety at the University of Wisconsin School of Medicine and Public Health and clinical director of the University of Wisconsin Health Clinical Simulation Program.</p> <p> Dr. Pugh found the lack of haptic experience offered in medical school and residency to be challenging, so she researched the use of sensor and data acquisition technology to measure and characterize the sense of touch. Her E-Pelvis is an electronic pelvic mannequin attached to a computer monitor. Students practice pelvic exams on the device, and instructors can see the location and intensity of the students’ touch.</p> <p> “Reading about how to do a pelvic exam and then actually trying to do it, there’s so much that’s lost in translation,” Dr. Pugh said. “I think that everybody’s ready to kind of change the direction and the way in which we train and learn, and there’s so many things that are available right now. We just need to embrace them.”</p> <p> Physicians in training aren’t the only ones to benefit from games—simulations can help patients in ways other therapies sometimes can’t, said Howard Rose, president of Firsthand Technology, a 3D game and simulation developer.</p> <p> Mental health patients are using games to confront phobias, such as a fear of spiders, by placing patients into virtual situations with their fears. Patients with severe burns can play a therapeutic game that immerses them in a snowy, cold environment. Immersive simulations, such as a game set in Iraq, lets veterans return to virtual battle to reduce post-traumatic stress disorder.</p> <p> “The act of play, overcoming these challenges through trial and error, recalibrates our perceptions,” Rose said. “It’s time for us to embrace this technology and use this opportunity for health. … What if instead of prescribing drugs to mask pain or poor health habits, you prescribe virtual reality games for building resilience, bringing relief and changing health habits?”</p> <p> Video gaming may be useful to improve health outcomes, said Brian Primack, MD, associate professor of medicine, pediatrics, and clinical and translational science at the University of Pittsburgh School of Medicine. In his talk, Dr. Primack said the current state of technology is only scratching the surface of gaming’s potential to improve health.</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/Content/images/store/6/9/b684c274-3b62-468d-89f7-78bb93413adb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/9/b684c274-3b62-468d-89f7-78bb93413adb.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;"> <em><span style="font-size:11px;">"There is huge potential here,” said Brian Primack, MD. "We’re going to need to get much more serious about games."</span></em></td> </tr> </tbody> </table> <p> “The video game industry is really good at getting people to perform certain tasks and stick with them for the long haul,” Dr. Primack said. But it won’t be easy, he added.</p> <p> “There is huge potential here,” he said. “We’re going to have to carefully apply principles. We’re going to need to get much more serious about games.”</p> <p> <strong>Watch these speakers give their talks at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the appropriate video:</p> <ul> <li> For the beginning of Dr. Pugh’s talk, find the “Play is not a waste of time” video and go to 32:59.</li> <li> For the beginning of Rose’s talk, find the “Play is not a waste of time” video and go to 1:28:47.</li> <li> For the beginning of Dr. Primack’s talk, find the “Stealing smart – San Francisco stage” video and go to 02:24.</li> </ul> <p> View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1176c528-209b-4562-a807-d8667b63167a How physicians are tackling health care disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-tackling-health-care-disparities Tue, 07 Oct 2014 21:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/12/4b2df375-6642-49be-bcd2-e8036d887a34.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/12/4b2df375-6642-49be-bcd2-e8036d887a34.Large.jpg?1" style="float:left;margin:10px;" /></a>Recently I attended the National Indian Health Board’s annual meeting, where about 1,000 people from 500 tribes across the country met to discuss Native American health care issues, advocacy and policy. I was able to learn about the unique challenges Native American physicians and their patients face.</p> <p> One physician stood up and said that he spent 30 years practicing on a reservation, and that he believed Native Americans’ health issues stem primarily from poverty. Native communities continue to lag far behind other communities in basic resources and services. This means that though Native Americans face the same prevalent health issues as the rest of the country—diabetes and cardiovascular disease—their problems are magnified. And this can’t simply be addressed in our mainstream health care. We need different, customized strategies that acknowledge the particular challenges our patient populations face.</p> <p> I also recently attended the Korean American Medical Association meeting, and heard about one of their prime issues— gastric cancer in Asian American populations. There is no guideline for early gastric cancer screening in our country for this population, but in Korea, early detection and survival are much better because of screening at early age. Making a similar change here will require education, policy and payment changes.</p> <p> As physicians, we all see disparities like this in our own work. We know there are racial and ethnic disparities in chronic diseases and health care, and we’re working to better understand and address these disparities in ambulatory clinical practices through 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 met last month in Chicago.</p> <p> The commission is determining better ways to collect and use patient-level data, including patient race, ethnicity, preferred language and LGBT status, which will be helpful in improving the quality of care we provide for all patients. It’s also working to educate organized medicine on why a diversified health care workforce is crucial to eliminating disparities, as studies show that minority health professionals are more likely to serve minority and medically underserved populations.</p> <p> Health care disparities can feel like an overwhelming problem for the average physician, but there are things we are doing to make progress towards more equitable care. As an educator, I firmly believe that teaching our medical students about the disparities that exist, and ways to counteract these disparities, is the best first step.</p> <p> Our country also made forward strides in expanding health care coverage to more Americans, giving many more patients access to the care they need. In caring for our patients, physicians should be aware that racial and ethnic disparities exist, and that we can support policy and advocacy efforts aimed at eliminating these disparities.</p> <p> The commission has <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities/reports-resources-cehcd.page?" target="_blank">resources for physicians</a> to learn more about health care disparities.</p> <p> <strong>You tell me: </strong>How are you addressing health care disparities in your practice? Post a comment below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c0ec48fe-5fb1-4af7-b8e3-d72f6a9133f3 What MS4 students wish they had known about medical school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ms4-students-wish-known-medical-school Mon, 06 Oct 2014 20:00:00 GMT <p> First-year medical students, and even those farther along in their education, may be feeling a bit overwhelmed. Hear tips from seasoned fourth-year students on what they wish they had known about medical school that would have helped them.</p> <p style="margin-left:40px;"> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/9535c117-e07e-4024-8460-8a3c2a0f2ea5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/9535c117-e07e-4024-8460-8a3c2a0f2ea5.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>1. Your study style may need to change. </strong>“I remember treating my first anatomy test as I had done several of my tests in my undergraduate program: type up my notes, study those notes and then take the test,” said Laura Stone McGuire, a fourth-year medical student at the University of Miami Miller School of Medicine. “But I soon discovered that this study strategy did not work for anatomy. Be aware that you may have to try new study methods in order to succeed in your classes.”</p> <p style="margin-left:40px;"> McGuire said she found she had a kinesthetic learning style and that typing and reading her notes wasn’t enough for her to understand the material. “I needed to work hands-on in the lab to best learn anatomy,” she said. “I discovered something similar when I studied for Step 1, and I used multiple channels of leaning: I watched videos, listened to audio recordings, worked with models and studied from the book. To be adaptive and to readily assess what works best for you is important.”</p> <p style="margin-left:40px;"> <strong>2. Remember that your personal wellness is important. </strong>“Take advantage of study breaks when you can,” said John Lesko, a fourth-year medical student at Eastern Virginia Medical School. “It’s very easy to burn out early if you don’t find a balance. Find something—be it exercise, friends, involvement in a group—that gives you exposure to life beyond medical school.”</p> <p style="margin-left:40px;"> Ravi Shah, a fourth-year medical student at Rutgers New Jersey Medical School, shared similar advice about not neglecting your own health. “Always have exercise built into your schedule,” he said. “Tomorrow is another day.”</p> <p style="margin-left:40px;"> <strong>3. Look for research opportunities early. </strong>“Even if you’ve never done [research] and haven’t decided on a specialty, simply ask a department or individual, and most are very happy to help,” said Tessa Stamile, a fourth-year medical student at the University of Oklahoma College of Medicine. “The earlier you start, the better your chances will be to complete the project and get published.”</p> <p style="margin-left:40px;"> <strong>4. Participate in opportunities outside the classroom. </strong>“Take opportunities to explore your career and embrace your education by getting involved in extracurricular activities in the local and global community,” said Shannon Brockman, a fourth-year medical student at the University of Florida College of Medicine. “From student-run, free clinics to medical mission trips, it’s amazing how much you can learn when you experience medicine outside of the classroom.”</p> <p style="margin-left:40px;"> <strong>5. Take advantage of your “last summer.” </strong>“You may hear people talk about your ‘last summer’ between MS1 and MS2 years,” said Stone McGuire. “Well, it’s true that this is your last substantial amount of free time during your medical career, so do something fun, worthwhile and meaningful. Consider all the great possibilities out there: research, community service, travel and more.”</p> <p> <strong>What do you wish you had known about medical school? </strong>Share your tips for medical students on the AMA Medical Student Section <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b0700d80-7bef-4ba7-8b5d-c2f9897ddfd2 Make your voice heard on important topics to residents http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_voice-heard-important-topics-residents Mon, 06 Oct 2014 17:55:00 GMT <p> AMA members will debate some of the hottest issues in medicine at the AMA Resident and Fellow Section (RFS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/rfs-meetings.page?" target="_blank">Interim Meeting</a>, Nov. 6 to 8 in Dallas. Make sure your voice is heard: Even if you can’t attend the meeting, you can contribute your opinions on these key topics in the AMA-RFS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/rfs-reference-committee.page" target="_blank">Virtual Reference Committee</a> (log in), which is open through Oct. 17.</p> <p> Residents who participate in the meeting will discuss 13 different policy resolutions. Here are a few key issues up for debate:</p> <ul> <li> <strong>Opposition to proposed caps on Public Service Loan Forgiveness Amounts.</strong> One resolution discusses the importance of keeping medical student debt at a minimum and encouraging work in underserved areas or lower paying specialties, asking the AMA to oppose any budgetary proposals or legislation seeking to stop or reduce the <a href="https://studentaid.ed.gov/repay-loans/forgiveness-cancellation/charts/public-service#what-is-the-public" target="_blank" rel="nofollow">Public Service Loan Forgiveness Program</a>.</li> <li> <strong>Establishment of a quality improvement forum. </strong>Both individual residents and residency programs implement unique and innovative quality improvement interventions without a mechanism in place to discuss or share ideas. This resolution asks the AMA to establish a forum where resident members can discuss local quality improvement projects and outcomes in order to facilitate more rapid improvement across training programs.</li> <li> <strong>Response to epidemics and pandemics. </strong>With the current Ebola epidemic continuing to make front page news, global epidemics and pandemics are a very real and relevant topic. This resolution asks the AMA to work with the Centers for Disease Control and Prevention and international health organizations to provide organizational assistance to curb epidemics, including calling on American physicians to provide needed resources such as human capital and patient care-related supplies, as well as providing timely and regular updates to its constituents.</li> <li> <strong>Two-way communications between AMA members. </strong>This resolution asks the AMA to provide a communications platform for members that allows for the unrestricted exchange of ideas among individuals without time delay that is easy to access and allows for direct member-to-member discussion.</li> </ul> <p> AMA-RFS members can comment on resolutions through Oct.17 through the <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/rfs-reference-committee.page" target="_blank">Virtual Reference Committee</a> or in-person before the Reference Committee at the Interim Meeting. Learn more about resolutions and the policymaking process on the AMA-RFS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/advocacy-policy.page?" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b694a2aa-8f8b-4460-8194-398af43c400a Ruling could impede efforts to improve patient safety http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ruling-could-impede-efforts-improve-patient-safety Mon, 06 Oct 2014 17:54:00 GMT <p> Physicians and patient safety groups are petitioning a state supreme court to overturn a recent ruling that would force disclosure of peer review documentation and potentially bring ongoing efforts to improve the quality and safety of patient care to a halt.</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>, the Kentucky Medical Association and more than two dozen patient safety and health care quality groups from around the country have filed a brief with the Kentucky Supreme Court, arguing that the appeals court ruling in <em>Tibbs v. Bunnell</em> would hamper open discussions that are essential to maintaining and improving patient safety.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/8/2be6198f-2971-4188-a8ef-f88b5458cdcb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/8/2be6198f-2971-4188-a8ef-f88b5458cdcb.Large.jpg?1" style="float:left;margin:10px;" /></a>The brief calls out the errors of the ruling, which said that any medical records and reports required to be collected and maintained under state law should be subject to disclosure, even if they are confidential documents. The ruling identified peer-review, credentialing and pharmacy records as examples of information that cannot be protected from discovery.</p> <p> “It is therefore no surprise that numerous hospitals, patient safety organizations and other stakeholders are already expressing fear that the decision will effectively put an end to the confidential sharing of adverse events, peer review documents and other information relating to patient safety activities,” the brief states. “[This] sharing has proven so valuable in improving patient outcomes in Kentucky.”</p> <p> In particular, the ruling would undermine federal Patient Safety Act, which is intended to promote a protected space in which to conduct frank conversations about patient safety and exchange reports and analyses that have broad implications.</p> <p> “Unless the decision is modified or clarified, it will significantly impair and undermine efforts by hospitals, physicians and other providers to improve the quality of health care to patients in the Commonwealth of Kentucky,” the brief states.</p> <p> Visit the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/peer-review.page" target="_blank">Litigation Center’s Web page</a> to learn more about this case and others related to peer review.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:87e251d4-eea2-4ff2-b133-5964c099bfbe Nobel Prize awarded for “inner GPS” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nobel-prize-awarded-inner-gps Mon, 06 Oct 2014 15:04:00 GMT <p> The 2014 Nobel Prize in Physiology or Medicine was awarded to three scientists for their discoveries of cells that constitute a positioning system in the brain.</p> <p> The Nobel laureates have discovered an “inner GPS” in the brain that makes it possible to orient ourselves in space, demonstrating a cellular basis for higher cognitive function. The discovery can help answer how humans know where they are, how they find the way from one place to another and how they store this information in such a way that it can be immediately found.</p> <p> The Nobel Assembly at Karolinska Institutet announced the award Monday. One half will be awarded to John O’Keefe, PhD, an American-British professor of cognitive neuroscience and the director of the Sainsbury Wellcomme Centre in Neural Circuits and Behavior at the University of London. The other half will be awarded to two Norwegian scientists—May-Britt Moser, PhD, a professor of neuroscience and the director of the Centre for Neural Computation at the Norwegian University of Science and Technology, and her husband Edvard Moser, PhD, also a professor at the university and the director of the Kavli Institute for Systems Neuroscience.</p> <p> Read more about the winners and their discoveries at the <a href="http://www.nobelprize.org/nobel_prizes/medicine/laureates/2014/press.html" target="_blank" rel="nofollow">Nobel Prize website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8419a26b-7d1b-4350-944d-c060f5d78c8e Plan to attend AMA Young Physicians Section Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-ama-young-physicians-section-interim-meeting Mon, 06 Oct 2014 14:00:00 GMT <p> Take advantage of a unique opportunity to network with other young physicians from across the United States and meet with leaders from the AMA and your state and medical specialty societies: Participate in the AMA Young Physicians Section (YPS) Interim Meeting, to take place Nov. 6-8 in Dallas.</p> <p> This year’s meeting, which will take place at the Hilton Anatole in Dallas, offers a variety of events, including leadership training, policy discussion and education sessions.</p> <p> Details about the meeting and surrounding events are available on the AMA-YPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page?" target="_blank">meetings and events Web page</a>. Registration closes Nov. 1; <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144452E&TID=vCIaLRgK%252bYeYYFMXecjotQ%253d%253d&OID=130" target="_blank">log in</a> to register today.</p> <p> The AMA-YPS Online Discussion Forum will open Oct. 13. Testimony from AMA-YPS members will be accepted until 1 p.m Eastern time Oct. 27. To participate in the AMA-YPS online discussion forum, you will need your physician login credentials (username and password).  Click on the link above and log in on the left side of the screen. Visit the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/yps-reference-committee.page" target="_blank">Web page</a> for a link to the forum.</p> <p> If you don’t have an AMA username and password, you can obtain them using the right side of the screen to create an account. If you’ve forgotten your password or username, click on the “Forgot your password?” link for recovery assistance.</p> <p> 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. To do so, send an email with your committee preference to the <a href="mailto:YPS@ama-assn.org" rel="nofollow">AMA-YPS</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6752637-e6d4-4e97-b9b2-a96f13030cdb Joint Commission releases updated sentinel events data http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_joint-commission-releases-updated-sentinel-events-data Mon, 06 Oct 2014 14:00:00 GMT <p> Nearly 59 percent of sentinel events since 2004 have resulted in patient deaths, according to recently updated <a href="http://www.jointcommission.org/Sentinel_Event_Statistics/" target="_blank" rel="nofollow">sentinel event statistics</a> from the Joint Commission. The updated statistics include 2014 summary data for Jan. 1 through June 30.</p> <p> A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof, including any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Data from the 8,275 incidents reviewed from 2004 through the first half of 2014 show a total of 8,495 patients have been affected by these events, with 58.7 percent resulting in the patient’s death, 9.4 percent resulting in loss of function and 31.9 percent resulting in unexpected additional care and/or psychological impact. The Joint Commission reviewed a total of 394 sentinel events during the first half of 2014.</p> <p> The Joint Commission learns of sentinel events either voluntarily from accredited organizations, or through other mechanisms such as the complaint process or media coverage. It is estimated that fewer than 2 percent of all sentinel events are reported to the Joint Commission and that only about two-thirds of these are voluntarily reported by the organization. As these data are not an epidemiologic data set, no conclusions should be drawn about the actual relative frequency of events or trends in events over time.</p> <p> The Joint Commission Sentinel Event database is designed to increase the general knowledge about sentinel events, their contributing factors, and strategies for prevention. For more information, visit the Joint Commission sentinel event <a href="http://www.jointcommission.org/sentinel_event.aspx" target="_blank" rel="nofollow">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2278c565-2af3-4dfe-ac6e-442e6230e83f Doctors advocate for SGR repeal during lame duck session http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-advocate-sgr-repeal-during-lame-duck-session Fri, 03 Oct 2014 20:23:00 GMT <p> Members of Congress received house calls from physician leaders last month urging their U.S. senators and representatives to make repealing Medicare’s sustainable growth rate (SGR) formula a priority for the lame duck session.</p> <p> Members of the AMA Board of Trustees, leaders of four national specialty organizations, the AMA Council on Legislation and attendees of the annual AMPAC Federation meeting conducted more than 100 meetings on Capitol Hill. Physicians asked Congress to pass H.R. 4015/S. 2000, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which garnered bipartisan, bicameral support earlier this year.</p> <p> At the same time, the New Democrat Coalition held a briefing for its members and staff regarding the need for SGR repeal, during which the flaws of the formula and the negative impacts of perennial SGR patches were explained.</p> <p> All physicians should contact their U.S. senators and representatives while Congress is on recess over the next several weeks to encourage them to repeal the SGR formula during the lame duck session. Visit the <a href="http://fixmedicarenow.org/physician-toolkit/" rel="nofollow" target="_blank">Fix Medicare Now</a> website to access materials that can help these advocacy efforts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:355906da-c337-4c3c-be36-846e3e7b9157 My journey to Bemidji: Doctors’ views of EHRs, regulatory burdens http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_journey-bemidji-doctors-views-of-ehrs-regulatory-burdens Fri, 03 Oct 2014 18:51:00 GMT <p> <em>An </em><em> </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physician-wellness-global-issue" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President-Elect </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/steven-stack.page" target="_blank"><em>Steven J. Stack, MD</em></a><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/2/94b14771-008b-4c6a-82d2-c092c37da246.Full.jpg?1" target="_blank"><img alt="Steven J. Stack, MD" src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/2/94b14771-008b-4c6a-82d2-c092c37da246.Large.jpg?1" style="float:left;margin:10px;" /></a>Among the many privileges of serving as a president-elect of the AMA is traveling the country to meet fellow physicians in their own backyards. A couple weeks ago, those travels brought me to Bemidji, a small town of roughly 13,500 residents in rural upstate Minnesota. Bemidji is Paul Bunyan country (you know, the big lumberjack with the big blue ox), lying along the headwaters of the Mississippi River.</p> <p> Richard Stennes, MD, a fellow emergency physician and longtime AMA delegate, graciously hosted me and introduced me to the joys of small-town America: great people, great hospitality and great community. People there know each other and look after one another. It was a genuine pleasure to have this small glimpse into the special glue that holds folks together.</p> <p> While in Bemidji, I spoke with physicians from a variety of specialties and backgrounds and was struck by both the similarities to and differences from what I see and hear from other doctors across the country. Among the most common topics we discussed were the challenges of our rapidly changing health care system, the crushing burden of excessive government mandates and regulations, and the unique aspects of health care in rural America.</p> <p> Even in this delightful corner of America, they are not sheltered from the challenges all physicians face in this country.</p> <p> One family physician revered by his colleagues told me that after 40 years of loving the practice of medicine, he recently pulled up to his office and didn’t want to get out of his car. For the first time, he felt dread at the prospect of starting his day. He hadn’t lost any of the joy in his relationships with his patients, but the excessive paperwork and the painful burden of his cumbersome electronic health record (EHR) system had robbed him of being able to focus on his patients.</p> <p> Within the next few months, this doctor will hang up his stethoscope for good. His retirement clearly was a sad occasion not only for him but also for his colleagues and the other hospital staff with whom he works.</p> <p> Similarly, an anesthesiologist specializing in pain management told me how a recent change in Medicare payment policy dropped payment for key procedures by 40 percent, putting him out of business. He explained that more than 140 new patients were waiting to be seen, but he had to shutter his practice and tell them they would have to seek care elsewhere—many miles away from Bemidji. It simply was no longer possible to sustain his practice.</p> <p> If these were isolated occurrences, they would be bad enough. But they are not. I hear these kinds of stories from physicians of all ages and in a variety of specialties.</p> <p> Excessive regulations and mandates are crushing physicians and their ability to care for their patients. We know this from personal stories like these as well as from broader research, such as the <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdf" rel="nofollow" target="_blank">AMA study</a> conducted last year by the Rand Corporation. It is in large part because of this crisis that the AMA is devoting so much attention to our <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, one of our three strategic focus areas.</p> <p> As part of this initiative, we are using research, data and analytics to identify 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 for physicians.</p> <p> We’re also committed to improving the dire state of EHRs and redoubling our efforts to persuade the government that its EHR meaningful use program is undermining—not improving—the practice of medicine in our nation. In fact, just last month we released a framework of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight key EHR usability priorities</a> to guide our work.</p> <p> As you can see in the comments dozens of physicians shared in response to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tell-ehr-improvements-would" target="_blank">my last AMA Viewpoints post</a>, doctors want to embrace EHR systems and other health IT that can help them in their practices, but the meaningful use program with its excessive mandates and merciless rigidity is turning physicians into data entry clerks rather than the healers they are trained to be.</p> <p> As a physician just entering the middle stage of my career, I know this path is unsustainable. We are committed to supporting physicians in patient care, preserving the special bond of the patient-physician relationship and restoring joy to the practice of medicine.</p> <p> We’ll keep up our efforts here at the AMA. In the meantime, please know you’re not alone. And thank you for all you do for our patients.</p> <p> Please share your own comments and stories with us in the comment section below to help advance our efforts on your behalf. Simply select the button at the bottom of this page to either sign in with your AMA credentials or create an account to post a comment.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:864b4e70-8ad3-41a5-b6c3-76d5e6b43b58 YMCA, physicians join to prevent diabetes in Florida community http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ymca-physicians-join-prevent-diabetes-florida-community Fri, 03 Oct 2014 18:48:00 GMT <p> Physicians in a Florida community are getting help with screening patients for type 2 diabetes and improving outcomes around the disease.</p> <p> St. Petersburg, a southwest Florida coastal town, is the fifth location to be announced in a collaborative pilot program taking place among physician practices, the YMCA of the USA and the AMA. 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, this pilot is exploring a process for physicians to screen patients for prediabetes, refer eligible patients to participate in the local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.</p> <p> An estimated one-third of adults in Pinellas County, where St. Petersburg is located, have prediabetes. Fortunately, local residents who receive Medicare benefits can attend the YMCA Diabetes Prevention Program at no cost.</p> <p> “Diabetes prevention is vital to the future of medicine, and to the wellbeing of our patients,” said Miguel Faña Jr., MD, president of the Pinellas County Medical Association and a pilot participant. “Education is particularly important when combating this disease and the YMCA has been an invaluable resource for our community.”</p> <p> Based on the Centers for Disease Control and Prevention’s (CDC) evidence-based National Diabetes Prevention Program, the YMCA lifestyle intervention program <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-builds-proven-practical-approaches-improve-health-nationwide" target="_blank">has been proven to help patients</a> prevent or delay the onset of diabetes. To date, more than 650 participants have enrolled in the program in Pinellas County. Nationally, participants in the program achieve weight loss of about 6 percent, which significantly reduced their risk for developing type 2 diabetes.</p> <p> The AMA pilot will establish a process for physicians to routinely screen for prediabetes, refer patients to the YMCA and receive updates to incorporate into their patients’ care plans. The AMA last month announced another southwest Florida pilot site, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/southwest-florida-takes-diabetes-prevention" target="_blank">Venice</a>. Other locations include the state of Delaware, Indianapolis and Minnesota’s Twin Cities.</p> <p> Visit the CDC’s <a href="http://www.cdc.gov/diabetes/prevention/recognition/registry.htm#program" target="_blank" rel="nofollow">National Diabetes Prevention Program</a> website to find out whether an evidence-based diabetes prevention program is available in your community. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a0d90e30-3296-4385-be0b-b77a69482b1b JAMA Highlights: Study finds information lacking on implanted medical devices http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-finds-information-lacking-implanted-medical-devices Thu, 02 Oct 2014 21:00:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/ugCU0_46LZo" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/ugCU0_46LZo" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/ugCU0_46LZo" /><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" quality="best" src="http://www.youtube.com/v/ugCU0_46LZo" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;"> <p> <span style="font-size:11px;">JAMA</span><em><span style="font-size:11px;"> video: Providing team-based care after hospital discharge did not reduce readmission rates or deaths</span></em></p> </td> </tr> </tbody> </table> <p> <strong>Following hospital discharge, use of a "virtual ward" model of care does not reduce readmissions, risk of death</strong></p> <p> In a trial involving patients at high risk of hospital readmission or death, use of a virtual ward model of care (using some elements of hospital care in the community) after hospital discharge did not significantly reduce the rate of readmission or death up to a year following discharge, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1910109" rel="nofollow" target="_blank">study</a> in the October 1 issue of the <em>Journal of the American Medical Association (JAMA)</em>. Watch the <a href="http://youtu.be/ugCU0_46LZo" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Study examines medical professional liability claims related to esophageal cancer screening</strong></p> <p> An analysis of liability claims related to esophageal cancer screening finds that the risks of claims arising from acts of commission (complications from screening procedure) as well as acts of omission (failure to screen) are similarly low, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1910097" rel="nofollow" target="_blank">study</a> in the October 1 issue of JAMA.</p> <p> <strong>Study finds information lacking from FDA on implanted medical devices</strong></p> <p> Information is lacking on most implanted medical devices cleared by the U.S. Food and Drug Administration (FDA) despite a legal requirement that companies submit scientific evidence about the devices’ substantial equivalence to other devices already on the market, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1910556" rel="nofollow" target="_blank">study</a> in JAMA Internal Medicine.</p> <p> <strong>Post-approval studies to assess safety, efficacy of devices after FDA OK</strong></p> <p> Small sample sizes and delays on agreement of protocol may hinder the clinical usefulness of post-approval studies (PASs) on medical devices ordered by the U.S. Food and Drug Administration (FDA), according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1910557" rel="nofollow" target="_blank">study</a> in JAMA Internal Medicine.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a14e4c7c-4439-41fc-a62c-5762f446e7a9 How one medical school created a “student GPS” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-medical-school-created-student-gps Thu, 02 Oct 2014 19:35:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/2/e81b171c-ee9d-4989-82e8-a7aee271a83f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/2/e81b171c-ee9d-4989-82e8-a7aee271a83f.Large.jpg?1" style="float:right;margin:10px;" /></a>Medical schools across the country are developing new tools and technology to improve the way they educate tomorrow’s physicians. At Vanderbilt University School of Medicine, a new program is tracking where and how students learn, gathering data on a variety of metrics to provide students with a real-time snapshot of their progress through medical school.</p> <p> Collecting this data will help Vanderbilt chart students’ personalized learning routes and help students figure out where they’d like to head in their future careers.</p> <p> “All of a sudden, we’ve got some serious power to do some incredible analysis—to GPS our students and to GPS our programs,” said Anderson Spickard III, MD (pictured right), assistant dean of educational informatics and technology at Vanderbilt.</p> <p> Dr. Spickard presented Vanderbilt’s new system at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as 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. The consortium schools met at Vanderbilt in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes to come.</p> <p> Each student is assigned a portfolio coach for the entirety of their education. Teachers who elect to become portfolio coaches each work with 10 students. Students meet with their coaches three times a year to review their educational data and determine what areas they need to work on.</p> <p> Together, the learner and coach determine whether the student has developed the competencies necessary to move up to the next level of training. In this way, Vanderbilt is implementing competency-based education in its medical school. Promotion to the next phase isn’t based on grades but on individual students’ understanding and developing skill sets.</p> <p> The system behind this intense tracking is called “<a href="https://vstar.mc.vanderbilt.edu/" target="_blank" rel="nofollow">VSTAR</a>,” the school’s integrated learning platform. The software follows all the moving parts behind the medical school’s curriculum to provide broader snapshots of classes, groups and individual students over time.</p> <p> Because the software is open-source, it’s ready for other medical schools to tweak and apply to their own settings. Vanderbilt is continuing to refine VSTAR and investigate ways students can take their data with them after they graduate and move on to their residency programs.</p> <p> Vanderbilt and the other 10 medical schools participating in the AMA’s Accelerating Change in Medical Education initiative are working through new ways to train students. This consortium will identify best practices and rapidly disseminate them to other medical schools throughout the country.</p> <p> This post is the first in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9c0e3275-dd33-4a0c-915e-f3cd3a2b6fb8 CDC gives physicians guidance on Ebola screening http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-gives-physicians-guidance-ebola-screening Wed, 01 Oct 2014 21:35:00 GMT <p> Following detection of the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-need-first-case-of-ebola" target="_blank">first case of the Ebola virus</a> in the United States, the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) are asking physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations.</p> <p>  “Every healthcare organization should ensure it can detect a patient with Ebola, protect healthcare workers so they can safely care for the patient, and respond in a coordinated fashion,” the agencies said in an email. </p> <p> The CDC suggests that emergency department screen for:</p> <ul> <li> Fever, headache, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite, and in some cases bleeding.</li> </ul> <p> And:</p> <ul> <li> Travel to West Africa (Guinea, Liberia, Nigeria, Senegal, Sierra Leone or other countries where Ebola virus disease transmission has been reported by WHO) within 21 days (3 weeks) of symptom onset.</li> </ul> <p> If both criteria are met, then the patient should be moved to a private room with a bathroom, and standard, contact and droplet precautions followed during further assessment.</p> <p> The agencies also have issued a <a href="http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf" rel="nofollow" target="_blank">hospital checklist for Ebola preparedness</a>. In addition, physicians can watch a <a href="http://www.phe.gov/Preparedness/responders/Pages/ebola-healthcare-webinar.aspx" rel="nofollow" target="_blank">webinar</a> from the CDC and ASPR on Ebola preparedness for the U.S. health care system.</p> <p> The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care providers</a> offers more information on diagnosis and testing, protection and how to safely manage patients with the virus. Additional resources can be found on the <a href="http://www.phe.gov/preparedness/Pages/default.aspx" rel="nofollow" target="_blank">ASPR website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ca73ca2d-7182-4098-a3da-230587ddb1fb What physicians need to know about the first U.S. case of Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-need-first-case-of-ebola Wed, 01 Oct 2014 21:00:00 GMT <p> The Centers for Disease Control and Prevention (CDC) <a href="http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/united-states-imported-case.html" rel="nofollow" target="_blank">confirmed Tuesday</a> that the first case of Ebola has appeared in the United States. Here’s what physicians need to know.</p> <p> The virus is spread through contact with bodily fluids of a person who is sick with or has died from Ebola, and the chances of a widespread outbreak in the United States are unlikely, said CDC Director Tom Frieden, MD. And the CDC issued <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screen guidelines</a>.</p> <p> “I have no doubt that we will control this case of Ebola so that it does not spread widely in this country,” Dr. Frieden said. “It is certainly possible that someone who had contact with this individual could develop Ebola in the coming weeks … but there is no doubt in my mind that we will stop it here.”</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:318px;"> <tbody> <tr> <td> <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank"><img alt="Download CDC's Ebola screening guide" src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/2/557ed50e-92f8-4398-82de-52182f78d965.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;"><strong>See related story:</strong> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cdc-gives-physicians-guidance-ebola-screening" target="_blank">CDC gives physicians guidance on Ebola screening</a></span></em><br />  </td> <td>  </td> </tr> </tbody> </table> <p> The individual, who is not a health care worker, traveled from Liberia on Sept. 19 and arrived in the United States on Sept. 20, according to the CDC. The patient began developing symptoms of the virus on Sept. 24 and initially sought care on Sept. 26, but was not admitted to the hospital until Sept. 28, when he was placed into isolation at Texas Health Presbyterian Hospital in Dallas.</p> <p> Initial Ebola symptoms are often non-specific. The CDC is encouraging physicians to take patient travel histories. The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care providers</a> offers more information on diagnosis and testing, protection and how to safely manage patients with the virus.</p> <p> The patient will remain at Texas Health Presbyterian. Edward Goodman, MD, an epidemiologist at the hospital, said the hospital has had an Ebola preparedness plan in place for some time.</p> <p> “In the week before this patient presented, we had a meeting of stakeholders who might be involved,” Dr. Goodman said. “Because of that, we are well prepared to deal with this crisis.”</p> <p> “Virtually any hospital in this country that can do isolation, can do isolation for Ebola,” Dr. Frieden said. “We don’t see a need from either a medical or an infection control standpoint to try to move the patient.”</p> <p> Health workers have begun tracing people who may have had direct or indirect contact with the patient. Meanwhile, patients can get more information about Ebola on the <a href="http://www.cdc.gov/vhf/ebola/index.html" rel="nofollow" target="_blank">CDC website</a>.</p> <p> “Ebola is a virus, it’s a virus that’s easy to kill by washing your hands, it’s easy to stop by using gloves and barrier precautions,” Dr. Frieden said. “The issue is not with Ebola that it’s infectious. The issue with Ebola is that the stakes are so high.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1a246023-17c7-4795-a949-c1b41fe539f3 One-year countdown to ICD-10 begins: Start transition now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-year-countdown-icd-10-begins-start-transition-now Wed, 01 Oct 2014 19:33:00 GMT <p> With just a year left to transition to the ICD-10 code set, practice management experts advise physicians to begin preparing for implementation by working with software vendors and testing their systems, if they haven’t already. See what physicians can use to make the switch to this costly code set a bit easier.</p> <p> Originally scheduled for implementation in 2014, a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-official-icd-10-compliance-date-now-oct-1-2015" target="_blank">final rule issued in August</a> gave physicians an extra year to prepare for implementation of the costly code set, developed by the World Health Organization and adapted for use in the United States by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services (CMS). </p> <p> The AMA continues to urge regulators to ease this physician burden, citing the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> of ICD-10, coupled with an already onerous regulatory environment. However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Here are some resources that can help make this transition a bit easier:</p> <ul> <li> <strong>Free </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>planning tools and resources</strong></a><strong>. </strong>Increase your practice’s readiness for ICD-10 with help from an action plan, checklists and templates. Use the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank">free tip sheet series</a> to complete an impact assessment, talk to your vendors and complete thorough testing.</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/subCategoryDetail.jsp?category_id=cat1150010&navAction=push" target="_blank"><strong>Guides and training</strong></a>. Get a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">downloadable data file</a> of the complete ICD-10 2015 code set to use in testing your practice management system. A <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1250085&navAction=push" target="_blank">documentation guide</a>  provides essential training. In addition, a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank">pocket-sized reference</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-codebooks-can-practices-gear-up-2015-compliance" target="_blank">new codebooks</a> can help your practice make this major transition.</li> <li> <strong>System testing</strong>. CMS <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/will-icd-10-claims-accepted-cms-designates-testing-weeks" target="_blank">announced three weeks</a> that it will dedicate to helping physicians test whether their claims will be accepted in the Medicare claims processing system: Nov. 17-21, 2014; March 2-6, 2015; and June 1-5, 2015. But physicians don’t need to wait for these specific testing weeks; physicians should begin testing with their Medicare Administrative Contractors as soon as their practices are ready. Experts urge physicians to test internal and external systems as often as possible to ensure a smoother transition.</li> </ul> <p> CMS will host a call from 1:30 p.m. to 3 p.m. Eastern time Nov. 5 to discuss transitioning to ICD-10. Experts will cover implementation issues, opportunities for testing, code updates, how claims that span the implementation date will be handled and other important topics. <a href="http://www.eventsvc.com/blhtechnologies/register/ab900ea8-4d82-4d4e-99fa-4fd69a977483" target="_blank" rel="nofollow">Register</a> by noon Eastern time Nov. 5.</p> <p> For more information about ICD-10, visit <a href="http://www.cms.gov/Medicare/Coding/ICD10/index.html" target="_blank" rel="nofollow">CMS’ website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b2069282-8b67-47f4-bd88-5200ac340cdd Symposium to showcase research of students, residents, IMGs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_symposium-showcase-research-of-students-residents-imgs Wed, 01 Oct 2014 19:31:00 GMT <p> View the exciting original research of medical students, residents and international medical graduates (IMG) at the 12th annual AMA <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">Research Symposium</a> Nov. 7 in Dallas.<br /> <br /> The research competition submissions will be on display during the 2014 AMA <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">Interim Meeting</a>. The competition consists of two components: Podium presentations are from 4 p.m. to 5 p.m., followed by poster presentations from 5 p.m. to 6 p.m. All meeting participants and physicians in the local area are invited to attend.<br /> <br /> Research will be presented in the following categories:</p> <ul> <li> Eight categories for medical student participants: biochemistry and cell biology; cancer biology; clinical outcomes and health care improvement; immunology, infectious disease and inflammation; neurobiology and neuroscience; public health and epidemiology; radiology and imaging; and surgery and biomedical engineering.</li> <li> Two categories for resident and fellow participants: clinical vignette and clinical medicine (this includes quality improvement, health policy, clinical research and medical education).</li> <li> Three categories for IMG members of the AMA who are certified by the Educational Commission for Foreign Medical Graduates: clinical medicine/clinical vignette, health policy and medical education, and basic science.</li> </ul> <p> Consider serving as a judge during the presentations. <a href="http://www.ama-assn.org/ama/no-index/about-ama/research-symposium-judges.page" target="_blank">Sign up</a> now to judge.</p> <p> Following the display and judging, enjoy a sneak preview of a PBS documentary supported by the AMA at 6:30 p.m. Nov. 7 at the Hilton Anatole in Dallas.</p> <p> The film, <em>Rx: Hope for Health Care in the U.S.: How frontline innovators are creating dramatically higher-value health care solutions, </em>looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</p> <p> After the preview, AMA Research Symposium winners will be announced, followed by a reception with light hors d’oeuvres and beverages.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fbe01c08-2e44-4ada-b0fa-6005a967523f Interested in research? Apply for grant money by Dec. 5 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_interested-research-apply-grant-money-dec-5 Wed, 01 Oct 2014 19:28:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/11/68848b2e-3513-400b-8b32-123f0fa0d319.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/11/68848b2e-3513-400b-8b32-123f0fa0d319.Large.jpg?1" style="float:right;margin:10px;" /></a>Residents, fellows and medical students interested in entering the research field can apply for grants of up to $5,000 from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a> to conduct small research projects. Apply by 6 p.m. Eastern time Dec. 5.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/seed-grant-research.page" target="_blank">Seed Grant Research Program</a>, now in its 14th year, will provide trainees with funds to conduct research in these areas:</p> <ul> <li style="margin-left:0.25in;"> Cardiovascular and pulmonary diseases: up to $2,500</li> <li style="margin-left:0.25in;"> Pancreatic cancer: up to $2,500</li> <li style="margin-left:0.25in;"> Neoplastic diseases: up to $5,000</li> </ul> <p> John Evankovich, MD, received a seed grant during the first year of his pulmonary and critical care medicine research residency at the University of Pittsburgh Medical Center to investigate how a protein commonly found in most cells contributes to inflammation and cellular damage.</p> <p> “Receiving the seed grant has certainly been a positive experience for me as a medical resident,” Dr. Evankovich said. “While physicians in training cannot participate in full-time research, it is important to stay involved with research projects, and this is exactly the type of program that allows this to happen. Undoubtedly, having this award as part of my career development will show my dedication to a career in academic medicine.”</p> <p> Past research topics have included:</p> <ul> <li style="margin-left:0.25in;"> Evaluation of innate immune signaling in HIV immunological non-responder monocytes</li> <li style="margin-left:0.25in;"> Changing knowledge, attitudes and behaviors regarding cervical cancer screening</li> <li style="margin-left:0.25in;"> Mechanisms underlying remote ischemic pre-conditioning in children undergoing cardiac surgery</li> </ul> <p> “Being a successful physician scientist means one needs to be able to justify study rationale to others to obtain funding to support his or her research,” said Sherry Yan, a fourth-year medical student at Columbia University College of Physicians and Surgeons, and a 2014 seed grant recipient. “Applying to the AMA Seed Grant provided just that experience for me. And receiving the grant is even more rewarding.”</p> <p> Learn about eligibility, funding restrictions and how to apply on the AMA Foundation <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/seed-grant-research.page?" target="_blank">Web page</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:721f3303-9787-4b4f-b2db-1302bba92883 Hot topics covered at CME sessions during AMA Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hot-topics-covered-cme-sessions-during-ama-interim-meeting Wed, 01 Oct 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/bc6d539a-de0c-4665-91be-ef694e8663ab.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/bc6d539a-de0c-4665-91be-ef694e8663ab.Large.jpg?1" style="float:right;margin:10px;height:75px;width:200px;" /></a>Don’t miss educational events in trending health care topics at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 7-10 in Dallas. Learn from experts about your role as a physician during in-flight medical emergencies, a recently reversed medical liability case, issues in population health and more.</p> <p> All sessions will be held at the Hilton Anatole, and several are continuing medical education (CME) activities, including:</p> <ul> <li style="margin-left:0.25in;"> <strong>Improving Health Outcomes: National and local approaches to population health</strong>. Learn about 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, the implications of population health on the practice of medicine and how one practice is improving health outcomes. This session will be offered from 11:30 a.m. to 12:45 p.m. Nov. 8 in Senators Lecture Hall.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>How new hospital regulations will affect you and your staff</strong>. Participants will learn about a new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctors-tell-cms-put-brakes-new-medical-staff-rules" target="_blank">Medicare rule revising conditions of participation</a> for hospitals that could impact physicians’ role in hospital governance and patient care activities. This session will be offered twice: from 9:15 a.m. to 10:15 a.m. Nov. 8 in Grand Ballroom D-E, and from 3:30 p.m. to 4:30 p.m. Nov. 9. in Grand Ballroom A-B.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>A hospital’s success through physician-led quality improvement initiatives</strong>. This session will be held from 8 a.m. to 9 a.m. Nov. 8 in Grand Ballroom D-E.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Communication as a conflict management tool</strong>. Andrea Jones, executive managing director of eWomen Network Dallas/Ft. Worth, will present. This session will be held from 12:15 p.m. to 1:45 p.m. Nov. 8 in the Governors Lecture Hall.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Litigation Center Open Meeting</strong>. Hear a physician discuss a recent medical liability lawsuit brought against him and how his state medical society and the Litigation Center of the AMA and State Medical Societies helped reverse an adverse ruling. The event also will feature a panel discussion of <em>Wollschlaeger v. Governor of Florida</em>, which considers whether a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/law-limiting-physician-speech-upheld-doctors-call-rehearing" target="_blank">Florida statute</a> restricting the ability of physicians from discussing gun ownership with their patients is valid under the first amendment. This session will be offered from 3 p.m. to 5 p.m. Nov. 9 in the Wedgewood Ballroom.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Trends worth watching</strong>. Learn how current and emerging trends in health care could affect your patients and practice, with a focus on eight sectors of the health care system: health economics, public health infrastructure, health care resources and physician payment, science and technology in medicine, global health care, health status of the U.S. population, medical practice and quality, and medical education. Presented by the Council on Long Range Planning and Development, this session will be held from 9 a.m. to 10 a.m. Nov. 10 in Grand Ballroom C.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Council on Ethical and Judicial Affairs open forum</strong>. Physicians who attend can introduce issues to be considered for possible inclusion in the AMA <em>Code of Medical Ethics</em>, including topics specifically dealing with continuity of care in complex health care systems and the ethical obligation to provide competent care. This session will be offered from 9:30 a.m. to 11 a.m. Nov. 10 in Grand Ballroom D-E.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Stop paying to get paid: </strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/footing-bill-insurers-pay-methods-shouldnt-fall-doctors" target="_blank"><strong>Effective electronic payments</strong></a>. A national expert will help physicians understand how to avoid unnecessary fees and hassles in receiving payment from health insurers. This session will be held from 10 a.m. to 11 a.m. Nov. 10 in Grand Ballroom A-B.</li> </ul> <p> Participants do not need to be AMA members to claim credit, but an AMA username and password are required to complete the CME activity evaluation forms and save certificates in the AMA <a href="https://cme.ama-assn.org/Education.aspx" target="_blank">Online Learning Center</a>. Have your AMA login information ready if you are attending the 2014 AMA Interim Meeting. No paper evaluation forms will be available.</p> <p> If you have questions regarding your AMA username and password, or if you need to create a username and password before the meeting, contact the AMA Unified Service Center at (800) 621-8335.</p> <p> Other educational sessions of interest include:</p> <ul> <li style="margin-left:0.25in;"> <strong>In-flight medical emergencies</strong>. Learn about the pathophysiologic considerations of in-flight medical emergencies, the role of the flight crew and the legal implications for physicians who provide medical care during such situations. This session will be offered from 3 p.m. to 5 p.m. Nov. 9 in Senators Lecture Hall.</li> <li style="margin-left:0.25in;"> <strong>An update on the AMA Accelerating Change in Medical Education initiative</strong>. This session will take place from 8:45 a.m. to 9:30 a.m. Nov. 8 in Grand Ballroom A-B.</li> <li style="margin-left:0.25in;"> <strong>An update on the AMA </strong><a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank"><strong>Professional Satisfaction and Practice Sustainability</strong></a><strong> initiative.</strong> This session will take place from 10:30 a.m. to 11:30 a.m. Nov. 8 in Grand Ballroom D-E.</li> </ul> <p> For more information, consult the <a href="http://www.ama-assn.org/resources/doc/hod/x-pub/i14-speakers-letter.pdf" target="_blank">2014 Interim Meeting Speakers’ Letter</a> (log in).</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:08f6779a-b281-4983-a43f-4a4c0fc5a0f7 Health IT questions? These resources have the answers http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-questions-resources-answers Tue, 30 Sep 2014 23:00:00 GMT <p> Get help with your health IT needs using resources from the AMA Store to tackle the meaningful use electronic health record (EHR) program and the Health Insurance Portability and Accountability Act (HIPAA).</p> <p> Primary care physicians seeking to navigate the complexities of the meaningful use program can use <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240066&navAction=push" target="_blank"><em>A Guide to Achieving Meaningful Use: Leverage Your EHR to Redesign Workflows and Improve Outcomes</em></a>, with details on Stages 1 and 2 of the program, and some early guidance on Stage 3.</p> <p> The resource offers a roadmap for clinical quality improvement as well as patient and caregiver engagement in the care decision process, helping you approach your work flow redesign with the goal of providing the most effective patient care—not just meeting an EHR vendor’s application design.</p> <p> If you need more guidance around HIPAA, look to <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240031&navAction=push" target="_blank"><em>HIPAA Plain and Simple: After the Final Rule</em></a>. This resource includes the latest information and tools to implement systems and ensure compliance, helping you understand the complex regulation of HIPAA and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.</p> <p> For an even deeper understanding of HIPAA, use the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1230027&navAction=push" target="_blank"><em>Handbook for HIPAA-HITECH Security</em></a>. This quick-reference tool also provides step-by-step guidance to implement and maintain compliance with the latest regulations and federal laws. The handbook and accompanying CD-ROM offer the support you’ll need, including case studies, question-and-answer sections and customizable checklists to document your compliance activities.</p> <p> In addition, you can reference information on key topics in health IT on the AMA’s health IT <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology.page" target="_blank">Web page</a>.</p> <p> AMA members receive a discount on a wide range of products from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:af7ccfd0-9890-4f13-a40b-d41735740af6 How we’re making it easier to get paid http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_were-making-easier-paid Tue, 30 Sep 2014 22:59:00 GMT <p> <em>An </em><em> </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page" target="_blank"><em>Barbara L. McAneny, MD,</em></a><em> chair of the AMA Board of Trustees.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/10/90584091-8714-403a-9adb-0c37eb68a86b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/10/90584091-8714-403a-9adb-0c37eb68a86b.Large.jpg?1" style="float:left;height:140px;width:100px;margin:10px;" /></a>As managing partner of my practice, I know firsthand the many challenges physicians face in the day-to-day business of keeping a medical practice afloat.</p> <p> One of the biggest consumers of time and resources is securing claims payments from health insurers. And it’s a process that has become even more taxing thanks to a relatively new form of payment that puts money back into health insurers’ pockets at our expense.</p> <p> The entire claims payment process is a challenging one. At my practice, we have 22 billing staff to support the clinical work of 17 physicians. They’re busy not only submitting claims but trying to figure out what’s happening to them once they’re out the door—we don’t always know whether the claims were received, where they are in the process or why they are denied. Then there’s the challenge of addressing claims that were paid incorrectly—an all-too-common problem with many insurers.</p> <p> The AMA continues its aggressive efforts to improve these issues by advocating for key changes before the federal government and with standard-setting bodies.</p> <p> At the moment, one of the most pressing issues is virtual credit cards, a payment form that is gaining popularity among insurers over the standard electronic funds transfer (EFT) transaction and paper checks.</p> <p> The problem is that while insurers get cash-back rewards from paying this way, we physicians are charged fees per transaction—typically 3-5 percent of the total payment. So an insurer may owe $5,000. But if it’s paid with a virtual credit card, the physician could lose up to $250 in fees. Whether you’re a practice owner or an employed physician for whom payments impact productivity calculations, these fees can add up quickly.</p> <p> At the same time, these payments take practices more time to process. They require manually entering information, correcting entry errors and reconciling the payment with a separate claims remittance advice.</p> <p> We recently explained this situation in <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/ncvhs-virtual-cards.pdf" target="_blank">testimony</a> (log in) to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS). And we’re pressing HHS to issue additional guidance. Just a few weeks ago, we sent a <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/joint-virtual-card-letter-hhs.pdf" target="_blank">letter</a> (log in) alongside three other leading organizations, calling on the agency to prohibit insurers from forcing physicians to accept this form of payment.</p> <p> We also urged the agency to require insurers to give full upfront disclosures of associated fees, obtain physician authorization before implementing virtual card payments and ensure an easy opt-out process if a physician later chooses not to accept this form of payment.</p> <p> While we’re working on this issue, you can take action now to protect your practice. It’s your right to request insurers to pay via the EFT standard transaction, which works like direct deposit and can cut down the time your staff spends on processing paper checks. There are two easy ways to learn more:</p> <ul> <li> Our <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page?" target="_blank">EFT toolkit</a> gives guidance about physicians’ rights regarding electronic payments, the effects of virtual credit card payments, and the ins and outs of EFT payments.</li> <li> A continuing medical education session, “Stop paying to get paid: Effective electronic payments,” will take place at 10 a.m. Nov. 10 as part of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. Among the speakers will be a national electronic payments expert.</li> </ul> <p> If you aren’t familiar with these issues, now’s the time to learn more. It will save your practice time and money that can be better invested in patient care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3879df28-5580-4093-a2b2-894e8b1df70c What physicians are saying about EHR improvements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-saying-ehr-improvements Tue, 30 Sep 2014 21:09:00 GMT <p> Last month, an AMA-convened panel of experts outlined the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable">eight top challenges and solutions for improving electronic health records</a> (EHR). Physicians weighed in on which EHR improvements would help them the most.</p> <p> Here’s a sampling of what physicians had to say:</p> <p style="margin-left:.5in;"> <u>claudia koppelman</u>: Refocus “ALL” to the real purpose of a medical record—patient care ... NOT data collection for statisticians and insurance/payers, and the quality of care as well as outcomes will improve with resultant decrease in costs.</p> <p style="margin-left:.5in;"> <u>jmilammd</u>: Congrats, Steve, et. al., on an excellent document! After 2500+ deliveries, and 25 yrs. in private practice, you will be able to add my name to the list of those retiring early because the EHR and MU costs are not worth the cost of the lost time and sleep that I have experienced the last 5 months in my new job as a data entry clerk. Item #1 resonates the most w/ me since I feel no more enhanced today than I did last spring. The other posters have identified a variety of important issues; they’re not just whining. I hope CMS is listening!</p> <p style="margin-left:.5in;"> <u>dlmyers</u>: Unfortunately, the EHR companies figured out first that they could sell a product, but there were and mostly still are no national standards to use in their design. That is how we got the mess we have now, by getting the cart before the horse.</p> <p style="margin-left:.5in;"> <u>buttery</u>: All records should conform to a standard database lexicon so that records can be exchanged between physicians and hospitals, and allow research on health outcomes from use of medications and procedures.</p> <p style="margin-left:.5in;"> <u>cbschug</u>: I am an emergency physician, have been the lead for a hospital roll out of Cerner Millennium and currently work with Epic. … Care will be better because of the EMR; I am living that daily. But it seems that many hospital admins / EMR companies are happy to stop with the basic function and meaningful use dollar, not the functional improvements that we docs need to be better doctors.</p> <p style="margin-left:.5in;"> <u>lorenzl</u>: It would be nice for an EMR to actually help us practice cost-effective medicine .... I would love an EMR that is linked to the patient’s health insurance that could show me exactly what a particular medication and/or test would cost that patient in out-of-pocket expense. Seems a very simple thing for a computer system to do. That way, I could pick the most cost effective treatment for a patient’s problem, and let the patient know the likely out-of-pocket cost.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tell-ehr-improvements-would">Read more comments</a> at <em>AMA Wire</em>®.</p> <p> <strong>Join the discussion:</strong> Which of the priorities resonates the most with you? Share your opinion in a comment below or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow">Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:52d2d0b6-ed6c-499c-bbca-678825a524d6 Discuss breast cancer with patients this October http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_discuss-breast-cancer-patients-this-october Tue, 30 Sep 2014 18:00:00 GMT <p> October is Breast Cancer Awareness Month, a perfect time for physicians to talk to patients about screening and prevention of breast cancer.</p> <p> Every year, more than 200,000 women get breast cancer, and more than 40,000 women die from the disease, according to the <a href="http://www.cdc.gov/cancer/dcpc/resources/features/BreastCancerAwareness/" target="_blank" rel="nofollow">Centers for Disease Control and Prevention</a>. Although uncommon, about 2,000 men also get breast cancer, and about 400 men die from the disease. While most breast cancers are found in women who are 50 years old or older, young women are also affected. About 11 percent of all new cases of breast cancer in the United States are found in women younger than 45 years of age. </p> <p> It is important that patients are aware of the symptoms of breast cancer, understand measures that can be taken to lower their risk and undergo necessary screenings, such as self-breast exams and mammograms. </p> <p> <a href="http://my.chicagotribune.com/#section/504/article/p2p-81477947/" target="_blank" rel="nofollow">New technologies</a> have made it possible for large numbers of women to find out whether they carry genetic mutations that increase their risk of breast cancer — a development welcomed by many experts in the field.  Some of the mutations detected in those panels are relatively rare and scientists do not yet know how much additional risk they carry. A patient who has learned that they have one of those mutations can cause the unintended consequence of concern and anxiety with little information on making an informed decision on the next course of action.</p> <p> However, knowing the likelihood that someone who carries a certain mutation will actually develop breast cancer can help the physician and patient decide whether it is appropriate to take certain <a href="http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA" target="_blank" rel="nofollow">risk-reduction steps</a>. These steps may include:</p> <ul> <li> More intensive screening, such as an annual MRI in addition to mammography</li> <li> Chemoprevention, including taking a drug that blocks the effect of estrogen on the breasts</li> <li> Prophylactic surgery, such as removal of the fallopian tubes and ovaries</li> <li> Mastectomy</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:05445071-c678-4641-8c66-07cf9075362e Hydrocodone reclassification takes effect Oct. 6: Are you ready? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hydrocodone-reclassification-takes-effect-oct-6-ready Mon, 29 Sep 2014 19:23:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/b779f44f-cc1a-407d-9d78-ee72fd51cac9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/b779f44f-cc1a-407d-9d78-ee72fd51cac9.Large.jpg?1" style="float:right;margin:10px;" /></a>A <a href="https://www.federalregister.gov/articles/2014/08/22/2014-19922/schedules-of-controlled-substances-rescheduling-of-hydrocodone-combination-products-from-schedule" rel="nofollow" target="_blank">new rule</a> from the Drug Enforcement Administration (DEA) taking effect Oct. 6 reclassifies hydrocodone combination products as Schedule II controlled substances, establishing restrictions that will require considerable changes to prescribing practices.</p> <p> Here are the steps you need to take to ensure your patients who need these medications to alleviate pain don’t have to go without them:</p> <ul> <li style="margin-left:0.25in;"> <strong>Be prepared to issue new prescriptions.</strong> The new rule does not permit refills for prescriptions written after Oct. 6. While the rule does allow prescriptions issued before Oct. 6 to be refilled through April 8, 2015, many pharmacies may not be able to process refills because of computer system limitations.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Issue only hard-copy prescriptions or eScripts. </strong>Pharmacies will be prohibited from filling prescriptions delivered over the phone or via fax, with the exception of a limited quantity for emergency treatment only.<br /> <br /> Note that eScripts can be used only if state law permits and the prescriber is certified to ePrescribe Schedule II substances. Pharmacies also must be certified to accept eScripts for controlled substances.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Determine whether your allied health professionals will be able to write prescriptions. </strong>Depending on your state’s restrictions around Schedule II substances, non-physician members of your team who have prescriptive authority may not be able to continue issuing prescriptions for hydrocodone combination products. If that is the case, you also may need to modify your collaborative practice agreements accordingly.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Notify your patients of the new requirements and processes. </strong>Make sure your patients understand that their new prescriptions will not be refilled and are aware of the procedures they will need to follow going forward.</li> </ul> <p> For a convenient handout or office reference, download the AMA’s <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/rescheduling-hydrocodone-products.pdf" target="_blank">printable fact sheet</a> (log in) containing this information and additional details for physicians, patients and pharmacists.</p> <p> The AMA and other groups have <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/dea-hydrocodone-comment-letter-28april2014.pdf" target="_blank">warned the DEA</a> (log in) about the potential unintended consequences of reclassifying hydrocodone combination products since the agency made the proposal early last year. Eliminating phoned-in prescriptions and refills could make it difficult for some patients to get the pain relief they need, especially patients in nursing homes and those with persistent pain and disabilities.</p> <p> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Web page on combating prescription drug abuse and diversion</a> under “federal agency and administration activities” to learn more about this advocacy work.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c5b0f406-1cee-4b50-b8fa-96b06222a591 Students weigh in on improving patient handoffs, GME and more http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-weigh-improving-patient-handoffs-gme Mon, 29 Sep 2014 19:20:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/f298d3e7-44f2-43f4-96aa-0a06abd420ea.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/f298d3e7-44f2-43f4-96aa-0a06abd420ea.Large.png?1" style="float:right;margin:10px;" /></a>AMA members will debate some of the most talked about issues in medicine at the AMA Medical Student Section (MSS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page" target="_blank">Interim Meeting</a>, Nov. 6 to 8 in Dallas. Make sure your voice is heard: Even if you can’t attend the meeting, you can contribute your opinions on these key topics in the AMA-MSS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/mss-reference-committee.page" target="_blank">Virtual Reference Committee</a> (log in), which is open through Oct. 17.</p> <p> Students who participate in the meeting will discuss 40 different policy resolutions. Here are a few key issues up for debate:</p> <ul> <li style="margin-left:0.25in;"> <strong>Medical student involvement in handoffs.</strong> One resolution seeks to elevate the importance of medical student involvement in patient handoffs, asking the AMA to support and advocate for student training in using electronic health record (EHR) systems to improve involvement in handoffs.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Mobile medical apps. </strong>An estimated 97,000 <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/mobile-health-app-harmful-helpful" target="_blank">mobile health apps</a> are available for download across major app stores, but only a small portion have been approved by the Food and Drug Administration (FDA) or otherwise proven through scientific studies, according to a <a href="http://www.ama-assn.org/resources/doc/csaph/x-pub/a14csaph5-fulltext.pdf" target="_blank">new report</a> (log in) by the AMA Council on Science and Public Health. This resolution asks the AMA to support establishing proper protocols of such apps, including disclosure of conflicts of interests and patient privacy protections.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Factors that contribute to medical students not matching into residency programs. </strong>With graduate medical education (GME) <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gme-reform-essential-but-proceed-experts-debate" target="_blank">reform on the horizon</a> and an impending physician shortage, the number of medical students to residency positions is a hot topic. This resolution asks the AMA to collaborate with the Association of American Medical Colleges on a study to investigate common reasons for failures to match to residency slots, and suggests studying potential pathways for those who fail to match to reengage in the medical field.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Removing barriers to cross-state telemedicine. </strong>This resolution asks to support the development and enactment of an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-licensure-streamlined-under-new-interstate-compact" target="_blank">interstate licensure compact</a> or uniform act that will give physicians who wish to practice in multiple states a speedier licensure process with fewer administrative and financial burdens. Such a compact would make it easier to practice <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">telemedicine</a>.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Special category in Federal Direct Student Loan Program.</strong> Another resolution discusses the possibility of creating a “medical student” category in federal loans to ease medical student debt. This proposed category would include interest rates that are properly risk-adjusted and reduced, which would account for medical students’ earning potential and, in turn, the lowered risk of lending to medical students.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Encouraging diversity in medical school. </strong>This resolution is intended to help refine efforts to recruit medical students from underrepresented backgrounds. It asks the AMA to study the economic and non-economic factors that discourage the entry of graduates from underrepresented groups into medicine.</li> </ul> <p> AMA-MSS members can comment on resolutions through Oct. 17. Learn more about resolutions on the AMA-MSS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/policies-procedures/resolutions.page" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:add5123e-c9d3-470d-b5ef-4a2bd7e6adea Rate of diagnosed diabetes may be slowing but still too high http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_rate-of-diagnosed-diabetes-may-slowing-but-still-high Mon, 29 Sep 2014 19:15:00 GMT <p> The rate of diagnosed diabetes cases could be plateauing, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906616" target="_blank" rel="nofollow">new report</a> by the Centers for Disease Control and Prevention—but the numbers of diagnosed cases still are alarmingly high.</p> <p> The nationally representative data, published in the <em>Journal of the American Medical Association</em>, suggest a potential slowing in the diabetes epidemic. However, incidence rates continue to rise among some groups, including Hispanic and non-Hispanic black adults and people with less than a high school education.</p> <p> Despite a slowing of diagnosed cases, studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives. An estimated 86 million Americans have prediabetes, but only one in nine of these people knows they are at risk of developing type 2 diabetes.</p> <p> “While this news is encouraging, our work is more important now than ever,” said Ann Albright, PhD, director of the CDC’s Division of Diabetes Translation. “These evolving trends show we’re moving in the right direction, but millions of people are still diagnosed with diabetes yearly. We need to fortify our efforts to see a real, sustained decrease in new cases of diagnosed diabetes.”</p> <p> The report includes this recommendation: “In light of the well-known excess risk of amputation, blindness, end-stage renal disease, disability, mortality and health care costs associated with diabetes, the doubling of diabetes incidence and prevalence ensures that diabetes will remain a major public health problem that demands effective prevention and management programs.”</p> <p> The AMA is working to prevent diabetes 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, partnering with the YMCA of the USA to increase referrals to the YMCA’s Diabetes Prevention Program, an evidence-based lifestyle intervention that is part of the <a href="http://www.cdc.gov/diabetes/prevention/" target="_blank" rel="nofollow">CDC’s National Diabetes Prevention Program</a>.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at a local YMCA. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.</p> <p> Another <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/benefits-of-diabetes-prevention-program-long-lasting-study" target="_blank">recent study</a> found that diabetes prevention program participants continued to see the benefits of the program long after they participated. Overall, participants saw a 27 percent reduction in the rate of type 2 diabetes even 15 years after they started the program.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d44b7d7d-4a8b-408e-9eaa-0dc327f8c638 3 questions you should know how to answer by Sept. 30 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-questions-should-answer-sept-30 Mon, 29 Sep 2014 11:00:00 GMT <p> Physicians’ financial data under the Physician Payments Sunshine Act, also known as the “Open Payments” program, will be released to the public Tuesday. While your data might not make it into the local news, chances are your patients or others you know will ask you about it. Learn the three common questions you’ll hear—and how to answer them.</p> <p> Questions from confused patients are especially likely, given that the online database is not expected to offer much context for the financial interactions it reports between physicians and manufacturers of medical devices and drugs. While the Centers for Medicare & Medicaid Services (CMS) is required by law to provide such context—a key to true transparency—the agency has been unresponsive to AMA calls for greater public education.</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:40px;"> <strong>1. </strong><strong>Why do physicians get money or items of value from the industry?</strong><br /> <br /> Physicians interact with the industry in many ways, including as consultants, speakers, researchers or recipients of “items of value.” These interactions generally benefit patients. For instance, physicians often receive items of value, such as medical journal reprints or certain patient education materials.</p> <p style="margin-left:40px;"> <strong>2. </strong><strong>Don’t relationships with the industry influence physicians’ decisions and recommendations?</strong></p> <p style="margin-left:40px;"> 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:40px;"> <strong>3. </strong><strong>How could individual physicians be justified in accepting large sums of money from the industry?</strong></p> <p style="margin-left:40px;"> 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> You can download more 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) from the AMA website to help inform your conversations.</p> <p> <strong>Data accuracy concerns</strong><br /> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/0/6657c0eb-c7e8-4bc4-9031-88b03920ac83.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/0/6657c0eb-c7e8-4bc4-9031-88b03920ac83.Large.jpg?1" style="margin:15px;float:right;" /></a>If you weren’t able to review your data by the Sept. 11 deadline to flag any disputed information in the initial public data release, you should do so now. CMS is withholding one-third of the data from the initial public release as a result of concerns about accuracy. Much of the remaining two-thirds of data that will be released in the public database has yet to be verified by physicians and other covered recipients.</p> <p> Physicians still have until Dec. 31 to file disputes for any inaccurate information that should be corrected in the next data release. View instructions for doing so on the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page" target="_blank">Sunshine Act Web page</a>.</p> <p> <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.</p> <p> 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 Sept. 30 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:800d5153-1778-4caa-b3f9-8fcd1cb15ca3 How AMA has advocated for Sunshine Act implementation overhaul http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-advocated-sunshine-act-implementation-overhaul Mon, 29 Sep 2014 11:00:00 GMT <p> As the Centers for Medicare & Medicaid Services (CMS) rolls out the online database of physicians’ financial interactions with manufacturers of drugs and medical devices Tuesday, troubling questions remain about the accuracy of the data and the lack of context with which it is being presented.</p> <p> Although the AMA supports transparency as originally intended in the Physician Payments Sunshine Act (which CMS is calling the “Open Payments” program), safeguards are needed to ensure that information is depicted correctly and given context to be useful for patients and fair to physicians.</p> <p> Publishing inaccurate data can lead to misinterpretations, harm reputations and cause patients to question their trust in their physicians. Inaccurate data also can unfairly impact physicians’ ability to obtain or keep research grants and other employment opportunities that require disclosure.</p> <p> The AMA repeatedly has urged the federal government to adopt sensible measures to ensure that the information released is accurate. But CMS’ Open Payments program has been plagued by significant shortcomings.</p> <p> Recent AMA advocacy efforts on this front have included:</p> <ul> <li> <strong>Calling for a delay of the data release. </strong>In addition to accuracy issues CMS needed to address, the Open Payments portal had numerous technical problems that prevented physicians from reviewing and disputing their data. A delay in the data release would have allowed more physicians to review their information and CMS to correct errors that have characterized the program’s implementation. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-ask-cms-postpone-sunshine-act-data-release" target="_blank">Read more</a>.</li> <li> <strong>Reporting physicians’ troubles with the portal to CMS.</strong> An informal AMA survey of more than 200 physicians found that more than two-thirds of physicians had a poor registration experience overall. <a href="mailto:OpenPayments@ama-assn.org" rel="nofollow">Email the AMA</a> to share your experience with registering via the Open Payments portal. Your responses will be used in the AMA’s ongoing advocacy efforts. <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">Read more</a>. </li> <li> <strong>Urging CMS to exclude continuing medical education activities, medical textbooks and peer-reviewed medical journals from reporting. </strong>Requiring the industry to report funding for these educational activities could harm patient care by impeding ongoing efforts to improve quality through timely medical education. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-medical-groups-urge-hhs-overturn-cms-policy-sunshine-act" target="_blank">Read more</a>.</li> <li> <strong>Providing guidance for physicians to review and dispute their data.</strong> Although CMS failed to adequately communicate with physicians about roll-out of the Open Payments program, the AMA created an <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page">online toolkit</a> for physicians and provided timely updates about the latest developments, deadlines and tips for navigating the problematic Open Payments portal. View past <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Sunshine_Act/1" target="_blank">Sunshine Act coverage</a> in <em>AMA </em><em>Wire</em>®.</li> <li> <strong>Educating reporters about the data release. </strong>Ahead of the Sept. 30 data release, the AMA has been encouraging the media to make sure their reports about the data release are presented in an accurate and informative way. View the AMA’s <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>.</li> </ul> <p> <strong>Be prepared to answer questions about the data release: </strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-should-answer-sept-30" target="_blank">Read more</a> at <em>AMA Wire</em> about the three questions you’ll most likely hear from patients and others you know—and how to answer them. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dadf4651-64d7-401e-a463-80eb6962d761 5 superforces that are radically changing medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-superforces-radically-changing-medicine Fri, 26 Sep 2014 20:18:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/3/a897545d-318a-43c0-a318-cb39528c65ae.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/3/a897545d-318a-43c0-a318-cb39528c65ae.Large.jpg?1" style="float:right;margin:10px;" /></a>It’s no secret that the health care environment and the way physicians practice medicine today is vastly different from only a few years ago—but what’s to come in the future? Jay Walker, TEDMED curator, shared what he believes are the five superforces that will radically change the practice of medicine. Walker discussed these superforces during TEDMED 2014, which took place earlier this month in San Francisco and Washington, D.C.</p> <ol> <li> <strong>How we see things.</strong> The future of medicine goes beyond X-rays and MRIs. “We cannot see a cancer tumor until it’s been growing inside us for at least six years,” Walker said. “Soon, we’ll spot them in six days. We’re going to have to reimagine what it means to see disease and, even more challenging, how we respond to what we see.”</li> <li> <strong>All the new data in the world.</strong> “Every second, our bodies generate new cells,” Walker said. “Imagine printing a brand new encyclopedia every minute, 10,000 pages long, all about you. Big data: We’re going to have to reimagine how we learn about our medical choices and how we deal.”</li> <li> <strong>Connected data streams.</strong> Telemedicine, global patient communities, real-time feedback of health—all are powerful and will affect how physicians practice. “We’re going to reimagine the speed, scale and scope of medicine,” Walker said.”</li> <li> <strong>People.</strong> “We’ve reached a critical mass of human brain power,” Walker said. “We’re going to reimagine how power and responsibility get distributed in health and medicine.”</li> <li> <strong>Synthetic biology. </strong>For the past 3 billion years, biological evolution was the only way life on this planet evolved or changed—until now. “Scientists and amateurs called ‘biohackers’ have the software that controls every form of life on earth,” Walker said. “[They’re] creating artificial DNA in labs, doing things evolution could never have done and never prepared us to deal with.”</li> </ol> <p> In a later talk, Walker mentioned one more superforce that has the power to change the practice of medicine, and the one that is at the heart of every TEDMED talk: Imagination.</p> <p> “[Imagination is] the unique ability of the human mind to visualize what does not yet exist,” Walker said. “We are not a community of specialists. We are a community that imagines.”</p> <p> <strong>Watch Walker give his talks at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the “Vision Talk” video for Walker’s introductory talk. View his second talk by finding the “I was just thinking too small” video and advance to 1:22:10. View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cc8b25d3-63dd-4164-9178-fc3bd84e12b6 Corrected deadlines: Time running out to meet meaningful use requirements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_corrected-deadlines-time-running-out-meet-meaningful-use-requirements Thu, 25 Sep 2014 21:04:00 GMT <p> Physicians participating in the electronic health record (EHR) meaningful use program have limited time to meet requirements as attestation deadlines fast approach. Meanwhile, the majority of physicians are struggling to successfully participate in the program.</p> <p> <strong>Physicians participating in meaningful use for the first time</strong><br /> According to the latest numbers from the Centers for Medicare & Medicaid Services (CMS), nearly one-half of physicians haven’t yet started the meaningful use program.</p> <p> All physicians—including those who are new to the program this year—have until Feb. 28, 2015, to attest to any 90-day reporting period in 2014 to earn an incentive payment. However, Medicare physicians who are participating in meaningful use for the first time this year must attest by Oct. 1 if they want to avoid a penalty of up to 2 percent in 2015.</p> <p> A recent rule from CMS allows physicians to use older certified EHR technology, a combination of old and new technology, or just new technology. But the agency’s attestation system won’t be able to process reporting from physicians who aren’t using version 2014 certified EHR technology until mid-October. Unfortunately, this will not allow physicians who are new to the meaningful use program and using older software to avoid a penalty because it is after the Oct. 1 compliance date.</p> <p> The AMA is aggressively trying to get more time for these physicians by urging CMS to extend the Oct. 1 deadline. This discrepancy has prompted two members of Congress—Reps. Renee Ellmers, R-North Carolina, and Jim Matheson, D-Utah—to send a <a href="http://ellmers.house.gov/uploads/CMS%20EHR%20Portal%20Letter%20to%20CMS%20Final.pdf" target="_blank" rel="nofollow">letter</a> to CMS asking for more time for physicians using older technology to attest.</p> <p> CMS made several changes to Stage 1 in a rule published in 2012. A complete list of these changes is available in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/summary-table-stage-2-measures.pdf" target="_blank">chart</a> (log in) developed by the AMA that outlines Stage 1 and Stage 2 requirements.</p> <p> <strong>Physicians who have participated in meaningful use before</strong><br /> For physicians who have already been participating in the meaningful use program, the deadline to attest to meaningful use is Feb. 28. However, the last day to start reporting is Oct. 3 if they are to meet the 90-day requirement, which must be concluded by Dec. 31.</p> <p> <strong>Meaningful use changes</strong><br /> CMS’ new final rule published this month gives physicians more options to meet meaningful use requirements.</p> <p> Some physicians will be allowed to use older certified EHR technology, a combination of old and new technology, or just new technology to meet requirements, depending on roadblocks they encountered for implementing new technology. The rule also allows some physicians who were scheduled to meet Stage 2 requirements to continue meeting Stage 1 measures this year.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">Read more</a> about who qualifies for these additional options.</p> <p> However, the final rule didn’t adjust a major problem with the program: the 100 percent pass/fail policy, which places physicians at risk for financial penalties, even if all they fail to meet is a single measure.</p> <p> Learn more about demonstrating meaningful use on the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/medicare-medicaid-incentive-programs.page" target="_blank">AMA’s Web page</a>.</p> <p> In addition to its advocacy around the meaningful use program, the AMA also is calling for an EHR overhaul to make sure this technology has improved usability to meet the needs of physicians and their patients. Learn more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight primary challenges and solutions</a> identified by an expert panel, announced last week.</p> <p> <strong>Meaningful use deadlines for physicians to avoid penalties in 2015</strong></p> <ul> <li style="margin-left:0.25in;"> July 1–Sept. 30: The last 90-day reporting period in 2014 for Medicare physicians new to meaningful use program to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 1: The last day for Medicare physicians new to the program to attest to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 3–Dec. 31: The last 90-day reporting period for any Medicare physicians who have participated in meaningful use to obtain 2014 incentive</li> <li style="margin-left:0.25in;"> Feb. 28: The last day for Medicare physicians who have participated in meaningful use before to attest and obtain 2014 incentive</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:486f77f6-9a5e-4743-adc7-1b2ecb2a40f2 Get exclusive sneak preview of AMA-sponsored PBS documentary http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_exclusive-sneak-preview-of-ama-sponsored-pbs-documentary Thu, 25 Sep 2014 20:04:00 GMT <p> Attendees of the 2014 AMA Interim Meeting will enjoy a sneak preview of a PBS documentary supported by the AMA at 6:30 p.m. Nov. 7 at the Hilton Anatole in Dallas.</p> <p> The film, <em>Rx: Hope for Health Care in the U.S.: How frontline innovators are creating dramatically higher-value health care solutions, </em>looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</p> <p> The documentary is a moving series of patients and caregivers, placed within the context of innovative practices. It explores how physician practices foster affordable medicine while encouraging intimacy, inclusion, trust and healing.</p> <p> The documentary also looks at the hard facts about health care in America, placing these personal accounts within the context of the current American health care system. <em>Rx: Hope for Health Care in the U.S.</em> is scheduled to air on PBS in late spring/early summer 2015.</p> <p> The preview event will include a question-and-answer session with award-winning director, writer, producer and cinematographer <a href="http://www.grubin.com/" target="_blank" rel="nofollow">David Grubin</a>, who has produced more than 100 films. The session will be moderated by Edward H. Livingston, MD, deputy editor of clinical content for the <em>Journal of the American Medical Association</em>.</p> <p> After the Q&A session, this year’s AMA <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">Research Symposium</a> winners will be announced, followed by a reception with light hors d’oeuvres and beverages.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7f98809f-0060-4c1a-a00e-9124c20a0669 JAMA Highlights: Study examines adverse health effects of climate change http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-examines-adverse-health-effects-of-climate-change Thu, 25 Sep 2014 19:50:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/TChRQ9RGCsU" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/TChRQ9RGCsU" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/TChRQ9RGCsU" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/TChRQ9RGCsU" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Study examines adverse health effects of climate change</strong><br /> An examination of the evidence over the past 20 years indicates that climate change can be associated with adverse effects on various health conditions, including heat-related and respiratory disorders, and a projected increase in days with extreme heat could exacerbate various health issues, according to an <a href="http://jama.jamanetwork.com/article.aspx?articleid=1909928" target="_blank" rel="nofollow">article</a> the Sept. 24 issue of the <em>Journal of the American Medical Association</em> (<em>JAMA</em>). The study is being released early to coincide with the UN Climate Summit 2014. The authors note that substantial health and economic benefits could be associated with reductions in fossil fuel combustion.</p> <p> <strong>Women who receive detailed prenatal testing information less likely to undergo those tests</strong><br /> Full implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906614" target="_blank" rel="nofollow">study</a> in <em>JAMA</em>. Watch a <a href="http://youtu.be/TChRQ9RGCsU" target="_blank" rel="nofollow">video</a> on the study.</p> <p> <strong>Rate of diabetes in U.S. may be leveling off</strong><br /> Following a doubling of the incidence and prevalence of diabetes in the United States from 1990 to 2008, new data suggest a plateauing of the rate between 2008 and 2012 for adults. However, the incidence continued to increase in Hispanic and non-Hispanic black adults, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906616" target="_blank" rel="nofollow">study</a> in <em>JAMA.</em></p> <p> <strong>Statins associated with better outcomes in hospitalization for brain hemorrhage</strong><br /> Hospitalized patients who took statins after a stroke caused by an intracerebral hemorrhage appeared to have better 30-day survival and were more likely to be discharged to their home or an acute rehabilitation facility than patients who did not use statins or whose statin use was discontinued in the hospital, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1905923" target="_blank" rel="nofollow">study</a> in <em>JAMA Neurology</em>.</p> <p> <strong>Cytomegalovirus in infants with very low birth weights linked to maternal breast milk</strong><br /> The primary source of postnatal infection with cytomagelovirus (CMV) in infants with very low birth weights appeared to be maternal breast milk because no infections were linked to transfusions of CMV-seronegative and leukoreduced blood products, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1906021" target="_blank" rel="nofollow">study</a> in <em>JAMA Pediatrics.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7a702aa1-b140-485c-9039-b4346f539a29 Med schools preparing students for rapid changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-schools-preparing-students-rapid-changes Thu, 25 Sep 2014 19:47:00 GMT <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/Content/images/store/11/7/6b599255-8a0c-4279-8774-f51eee9b0883.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/7/6b599255-8a0c-4279-8774-f51eee9b0883.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;"><em>Martin Pusic, MD, PhD, New York University School of Medicine, discusses medical education at a special consortium meeting at Vanderbilt University Medical School in Nashville.</em></span></td> </tr> </tbody> </table> <p> How will physicians practice medicine in 2050—and how can medical schools train today’s students to be prepared? Physician educators tackled this question earlier this week during a special consortium meeting at Vanderbilt University Medical School in Nashville, where the 11 medical school recipients of AMA grants discussed how the changes they’re making are preparing tomorrow’s physicians for the rapid changes to come.</p> <p> “Whatever 2050 throws at you, you cannot just cope and survive,” said Martin Pusic, MD, PhD, director of the division of education quality and analytics at the Institute for Innovations in Medical Education and assistant professor in the department of emergency medicine at New York University School of Medicine. “You must in fact become the physician 2050 needs and get better and better—not just survive but thrive.”</p> <p> All 11 schools participating in 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 working through new ways to train students. Some of these approaches include:</p> <ul> <li> Switching from time-based to competency-based progression and assessments</li> <li> Implementing electronic portfolios that give students and educators real-time feedback and follow students through their careers</li> <li> Developing tools to analyze big data and better understand health populations</li> </ul> <p> At the heart of all these changes is teaching students how to be skilled learners. With so much data and rapidly changing information, it’s critical for students to learn how to identify and weed out the information they don’t need while also investigating and implementing the information they do need. And the consortium schools are discovering that achieving this aim of training “<a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">master adaptive learners</a>” isn’t easy.</p> <p> “We are trapped in a knowledge dilemma,” said Mark Quirk, EdD, professor in the department of family medicine and community health at the University of Massachusetts Medical School.</p> <p> “We have to introduce new competencies to address the needs of the new physician,” Quirk said. “[Today’s] clinical reasoning is taught by apprenticeship—pattern recognition with little reflection. The primary excuse is that we have insufficient time … but time is always going to be a factor.”</p> <p> The goal is to train students to move into the next phases of their careers with a set of self-regulated, self-directed learning skills. That way, tomorrow’s physicians will be equipped to adapt and thrive in the constantly changing health care environment.</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/3/aeb74085-4c17-4478-93a2-80f5f2776e15.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/3/aeb74085-4c17-4478-93a2-80f5f2776e15.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;"> <p> <span style="font-size:11px;"><em>Fourth-year Vanderbilt University School of Medicine students Brian Heiniger, Katie Guess and another student present their research poster during the school's Medical Education day, held concurrent with the AMA's special consortium meeting.</em></span><br />  </p> </td> <td>  </td> </tr> </tbody> </table> <p> Students also recognize that skills in “learning how to learn” are necessary.</p> <p> “We have to learn to navigate all the electronic resources at our fingertips … and we have to be knowledgeable about the false information out there,” said Katie Guess, a fourth-year medical student at Vanderbilt. “‘Dr. Google’ is going to be playing a role, and we have to manage that.”</p> <p> Brian Heiniger, also a fourth-year medical student at Vanderbilt, echoed Guess’ thoughts.</p> <p> “There are so many resources available, and so much information, that it is easy to get bogged down,” Heiniger said. “We need to know where and how to access information and to use it efficiently.”</p> <p> The consortium of schools, now a full year into implementing new programs and tools, spent time outlining its goals through 2015. In the coming year, the group, facilitated by the AMA, hopes to increase activation and adoption of some of the innovations it has spawned, potentially bringing other schools on board and disseminating ideas for wider use.</p> <p> “Curriculum change is not just schedule change. That would actually be very easy,” said Bonnie Miller, MD, senior associate dean for health sciences education and associate vice-chancellor for health affairs at Vanderbilt. “What we’re really talking about is culture change, and culture change of this magnitude is very difficult. We can’t do it alone.”</p> <p> Watch <em>AMA Wire</em>® for additional coverage of the consortium meeting and updates about the work of the 11 medical schools.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cf52d597-9597-420e-ab2f-ce8e0da411c7 New pilot to fight hepatitis C uses telemedicine, collaboration http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-pilot-uses-telemedicine-collaboration-fight-hepatitis-c Wed, 24 Sep 2014 20:34:00 GMT <p> Primary care physicians are getting assistance in making an early diagnosis and providing timely treatment for the hepatitis C virus (HCV) infection, which affects about 3 million patients in the United States.</p> <p> The <a href="http://www.healthit.gov/buzz-blog/health-innovation/pilot-helps-battle-hepatitis-c-health-telemedicine/" rel="nofollow" target="_blank">pilot program</a>, with funding from the Centers for Disease Control and Prevention (CDC), will implement Project ECHO, a telemedicine approach designed to increase primary care capacity for treatment of HCV and access to HCV care in rural and underserved areas.</p> <p> The CDC is working with the AMA-convened Physician Consortium for Performance Improvement® (PCPI) and the Office of the National Coordinator for Health Information Technology (ONC) to support the pilot program by facilitating integration of three measures from the <a href="http://www.qualitymeasures.ahrq.gov/browse/by-organization-indiv.aspx?objid=26194" rel="nofollow" target="_blank">PCPI hepatitis C measure set</a> into electronic health records. The program will develop eMeasures and corresponding clinical decision support tools.</p> <p> So far, 66 primary care physicians in Arizona and Utah, predominately from rural settings, have received training through the program. Almost none of the participants had prior experience in the care and treatment of HCV infection.</p> <p> The participating physicians interacted with specialists via videoconference each week, allowing them to collaborate on HCV infection treatments and exchange clinical information and advice on patient management practices. Through the project, nearly one-half of the involved patients received antiviral treatment, suggesting that the pilot is an effective model that can be used to expand primary care capacity to treat HCV populations.</p> <p> Annual health care costs for HCV-infected patients are five times higher than those for other patients, according to the ONC.</p> <p> “The hope is to facilitate not only measurement of provider performance but improvement in access to care for underserved and other populations facing barriers to HCV testing, care and treatment,” the ONC said.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement.page" target="_blank">Learn more</a> about the PCPI, a national physician-led program dedicated to enhancing quality and patient safety.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:31b33372-ca57-4ccc-b3de-dcac05d2fb14 Time running out to meet meaningful use requirements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_time-running-out-meet-meaningful-use-requirements Wed, 24 Sep 2014 20:00:00 GMT <h3> <strong>Editor’s note:</strong> Some of the deadlines noted in an earlier version of this story were inaccurate. This updated version contains all the correct information. We apologize for the error.</h3> <p> Physicians participating in the electronic health record (EHR) meaningful use program have limited time to meet requirements as attestation deadlines fast approach. Meanwhile, the majority of physicians are struggling to successfully participate in the program.</p> <p> <strong>Physicians participating in meaningful use for the first time</strong><br /> According to the latest numbers from the Centers for Medicare & Medicaid Services (CMS), nearly one-half of physicians haven’t yet started the meaningful use program.</p> <p> All physicians—including those who are new to the program this year—have until Feb. 28, 2015, to attest to any 90-day reporting period in 2014 to earn an incentive payment. However, Medicare physicians who are participating in meaningful use for the first time this year must attest by Oct. 1 if they want to avoid a penalty of up to 2 percent in 2015.</p> <p> A recent rule from CMS allows physicians to use older certified EHR technology, a combination of old and new technology, or just new technology. But the agency’s attestation system won’t be able to process reporting from physicians who aren’t using version 2014 certified EHR technology until mid-October. Unfortunately, this will not allow physicians who are new to the meaningful use program and using older software to avoid a penalty because it is after the Oct. 1 compliance date.</p> <p> The AMA is aggressively trying to get more time for these physicians by urging CMS to extend the Oct. 1 deadline. This discrepancy has prompted two members of Congress—Reps. Renee Ellmers, R-North Carolina, and Jim Matheson, D-Utah—to send a <a href="http://ellmers.house.gov/uploads/CMS%20EHR%20Portal%20Letter%20to%20CMS%20Final.pdf" rel="nofollow" target="_blank">letter</a> to CMS asking for more time for physicians using older technology to attest.</p> <p> CMS made several changes to Stage 1 in a rule published in 2012. A complete list of these changes is available in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/summary-table-stage-2-measures.pdf" target="_blank">chart</a> (log in) developed by the AMA that outlines Stage 1 and Stage 2 requirements.</p> <p> <strong>Physicians who have participated in meaningful use before</strong><br /> For physicians who have already been participating in the meaningful use program, the deadline to attest to meaningful use is Feb. 28. However, the last day to start reporting is Oct. 3 if they are to meet the 90-day requirement, which must be concluded by Dec. 31.</p> <p> <strong>Meaningful use changes</strong><br /> CMS’ new final rule published this month gives physicians more options to meet meaningful use requirements.</p> <p> Some physicians will be allowed to use older certified EHR technology, a combination of old and new technology, or just new technology to meet requirements, depending on roadblocks they encountered for implementing new technology. The rule also allows some physicians who were scheduled to meet Stage 2 requirements to continue meeting Stage 1 measures this year.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">Read more</a> about who qualifies for these additional options.</p> <p> However, the final rule didn’t adjust a major problem with the program: the 100 percent pass/fail policy, which places physicians at risk for financial penalties, even if all they fail to meet is a single measure.</p> <p> Learn more about demonstrating meaningful use on the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/medicare-medicaid-incentive-programs.page" target="_blank">AMA’s Web page</a>.</p> <p> In addition to its advocacy around the meaningful use program, the AMA also is calling for an EHR overhaul to make sure this technology has improved usability to meet the needs of physicians and their patients. Learn more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight primary challenges and solutions</a> identified by an expert panel, announced last week.</p> <p> <strong>Meaningful use deadlines for physicians to avoid penalties in 2015</strong></p> <ul> <li style="margin-left:0.25in;"> July 1–Sept. 30: The last 90-day reporting period in 2014 for Medicare physicians new to meaningful use program to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 1: The last day for Medicare physicians new to the program to attest to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 3–Dec. 31: The last 90-day reporting period for any Medicare physicians who have participated in meaningful use to obtain 2014 incentive</li> <li style="margin-left:0.25in;"> Feb. 28: The last day for Medicare physicians who have participated in meaningful use before to attest and obtain 2014 incentive</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ffa88ad-fa40-4d27-bfc0-a44c85e96668 How admitting mistakes may improve medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_admitting-mistakes-may-improve-medicine Wed, 24 Sep 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/0/aa991688-1bcd-4ce9-90f3-77202a973711.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/0/aa991688-1bcd-4ce9-90f3-77202a973711.Large.jpg?1" style="float:right;margin:10px;" /></a>As a resident or fellow, have you ever made a mistake—and kept quiet? One physician opened up about her experience as a medical trainee during TEDMED 2014, which took place earlier this month in San Francisco and Washington, D.C.</p> <p> “I nearly killed a patient—and I never told a soul,” said Danielle Ofri, MD, PhD (pictured right), at the <a href="http://www.tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a> event earlier this month.  In her talk, Dr. Ofri—now a physician at Bellevue Hospital, professor at New York University School of Medicine and editor-in-chief of the <em>Bellevue Literary Review</em>—shared how she overlooked a patient’s intracranial bleed.</p> <p> “It could have been a death,” Dr. Ofri said. “I was horrified at myself for not having done due diligence … in the end, this was a near-miss. But I had still made the error.”</p> <p> The culture in Dr. Ofri’s residency wasn’t an open one. “The message we got was that anything short of perfection was failure,” she said.</p> <p> And if the culture in an academic medical center is to remain tight-lipped about mistakes, that attitude will be instilled into residents. According to a <a href="http://journals.lww.com/academicmedicine/Fulltext/2014/03000/Role_Modeling_and_Medical_Error_Disclosure___A.30.aspx" rel="nofollow" target="_blank">2014 survey of medical trainees</a> published in <em>Academic Medicine</em>, most trainees had made or observed a harmful medical error, and role-modeling in the academic medical center has a strong effect on trainees’ attitudes and behaviors surrounding medical errors. For example, negative role models for responding to errors may impede trainees from disclosing them. </p> <p> But the sheer number of decisions a physician must make every day—diagnosis, prognosis, treatment guidelines, medications, side effects and interactions, to name a few—means it’s nearly impossible to be perfect all the time, Dr. Ofri said.</p> <p> “A certain percentage will always fall short—these are part of our native behavioral flora,” she said. “To think of them as foreign is to misunderstand the nature of error. If we can accept that errors are indigenous to the behavioral biome, then our goal is not some impossible expectation of sanitizing away all medical error, but rather to gather this collective ecology and shift it in our patients’ favor.”</p> <p> The good news is that the culture is changing. Identifying medical errors and advocating for system improvements are part of the Accreditation Council for Graduate Medical Education’s core competencies for residents.</p> <p> Beside oversight of academic medicine, individual physicians and residents can be more open and accepting that mistakes happen, and they can help determine processes to improve.</p> <p> “If we hear from the titans of medicine that errors are a reality in medicine … we might be able to redefine our definition of perfection,” Dr. Ofri said. “Patients are ill-served by an impossible ideal of perfection that gives patients unrealistic expectations and keeps doctors and nurses from coming forward with errors because of shame.”</p> <p> <strong>Watch Dr. Ofri give her talk at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the “Turn it upside down–D.C. Stage” video and go to 1:07:43 for the beginning of Dr. Ofri’s talk. View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a9018aff-150a-4cbd-b030-7cba295bd89a Is your mobile health app harmful or helpful? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_mobile-health-app-harmful-helpful Tue, 23 Sep 2014 20:16:00 GMT <p> A new report explores the largely unregulated mobile health app industry and provides some insight into whether the apps you and your patients use have been approved for use or otherwise proven to be helpful.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/8/34891d00-532e-424d-b805-62e36171fa39.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/8/34891d00-532e-424d-b805-62e36171fa39.Large.jpg?1" style="float:right;" /></a>Mobile health apps—from fitness support to disease management—deliver health-related services via mobile phones, smartphones or tablets. An estimated 97,000 mobile health apps are available for download across major app stores, but only a small portion have been approved by the Food and Drug Administration (FDA) or otherwise proven through scientific studies, according to a <a href="http://www.ama-assn.org/resources/doc/csaph/x-pub/a14csaph5-fulltext.pdf" target="_blank">new report</a> (log in) by the AMA Council on Science and Public Health.</p> <p> Most mobile health apps are targeted to patients to assist in their own health management, but there are some targeted to physicians and other health care professional as tools to improve patient care, including apps that:</p> <ul> <li> Provide access to medical textbooks and references, or offer training materials for physicians</li> <li> Give general patient education</li> <li> Allow patients to track symptoms</li> <li> Use GPS data to alert patients or track movement</li> <li> Offer preventive screening information</li> </ul> <p> Certain diabetes and weight loss apps have proven effective in clinical practice, such as the WellDoc Diabetes Management system, a software-based patient-coaching and clinical decision support system. With this app, a patient can upload blood glucose readings and other diabetes-related information and receive real-time feedback from a physician or member of WellDoc’s research team. After a year, a clinical trial group saw its A1c decrease by 1.9 percent and also experienced improvements in diet, medication adherence and exercise.</p> <p> The WellDoc app is approved by the FDA, one of only a small subset of health apps that the FDA will oversee. The agency is regulating mobile apps that act as medical devices and could pose a risk to patient safety if used incorrectly or if they malfunction. Included among these apps are ones that:</p> <ul> <li> Use a sensor or lead that connects to a mobile platform to measure and display heart rhythm</li> <li> Create a stethoscope</li> <li> Generate controlled tones for audiologic testing</li> <li> Use an attachment to a mobile platform to measure blood oxygen saturation, alter the function or setting of an infusion pump, or allow remote perinatal monitoring</li> </ul> <p> The FDA also is exercising “<a href="http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm368744.htm" rel="nofollow" target="_blank">enforcement discretion</a>” for some other mobile medical apps that function as medical devices but have little risk, including apps that provide periodic reminders or motivational guidance, or apps that use a checklist of common symptoms to provide a list of possible medical conditions. <a href="http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm368784.htm" rel="nofollow" target="_blank">Examples of mobile health apps</a> approved by the FDA are available on the agency’s website.</p> <p> Still, the mobile health market has no way of measuring the quality of mobile health apps, or whether these apps help patients or physicians achieve their intended purposes. A number of systematic app reviews found that most mobile health apps lacked overall quality, and only limited advice is available to help guide users’ choices of apps that may be more reliable and useful.</p> <p> A process, private certification or evaluation platform is needed to sort through the huge amount of mobile health apps that won’t be subject to FDA approval, the report said.</p> <p> The FDA and other regulatory bodies will work toward greater oversight in the future. The FDA, along with the Federal Communications Commission and the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology, are collaborating to produce a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-monitoring-crucial-patient-safety" target="_blank">risk-based, regulatory framework for health IT</a>. Part of this proposal includes creating a safety center to monitor patient safety problems with health IT. However, it is unclear whether this safety center would play a role in evaluating mobile health apps.</p> <p> The AMA will work with stakeholders to identify guiding principles for promoting a vibrant, useful and trustworthy mobile health app market, the report said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1b60f21-146a-472a-91c3-a01102f272a3 Physician wellness is a global issue http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-wellness-global-issue Tue, 23 Sep 2014 19:58:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Large.jpg?1" style="float:left;margin:10px;" /></a>As physicians, we went into this profession because we prioritize the health of others above all else. But what about our own health? I know that personally, my own wellness can get lost in the shuffle of my everyday life.</p> <p> There are so many facets to physician health: physical, mental, emotional, personal and professional. At the same time, physicians juggle many responsibilities and pressures—our patients, our practice, our family and friends, keeping up with important medicine news and regulations, maintaining personal interests and a social life, the constant buzz of our mobile devices. So taking time to focus on our personal health is quite a challenge.</p> <p> But if we’re in poor health, how can we counsel our patients on improving their health? Poor physician health affects us all—from our peers to our trainees, patients and the health care system as a whole, not to mention our own families.</p> <table align="right" border="1" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/80659c3f-6954-43ac-a8be-e1085b3ad5d0.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/80659c3f-6954-43ac-a8be-e1085b3ad5d0.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">The three presidents: AMA President Dr. Wah joined Professor the Baroness Ilora Finlay, president of the British Medical Association, and Dr. Chris Simpson, president of the Canadian Medical Association, at the International Conference on Physician Health.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> Attendees from 13 countries came to discuss the particular stressors surrounding our different career stages. From medical school through residency, practice and retirement, the things that ail us may change. Despite our different countries, backgrounds and health care systems, the thing that stood out to me was how much in common I have with physicians around the world when it comes to stress, burnout and the struggle for a work-life balance.</p> <p> In my welcome remarks, I reminded the audience that as physicians, we see one especially important patient every day: It’s the face in the mirror. We have to take care of this patient so that we can be at our best to take care of all our other patients.</p> <p> Over and over I’ve heard about the need for systematic and cultural changes in medicine in order to support the physical, mental and emotional health of physicians. Lucky for us, the AMA is working on systematic and cultural changes in its three strategic focus areas:</p> <ul> <li> Through our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative, we’re working with 11 medical schools to implement innovative curriculum. It’s important that medical education include such skills as coping mechanisms and business management so future physicians are equipped to have more satisfaction in their professional and personal lives.</li> <li> In our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, our goal is to reduce prediabetes and high blood pressure—which is difficult if we’re on the path to these diseases ourselves. For the sake of ourselves and our patients, we need to be good role models. We’re developing prototypes to embed screening and prevention into our daily processes. </li> <li> Professional satisfaction can be a huge determinant of overall wellness. The study of physician satisfaction we conducted last year with the RAND Corporation found that having an impact on the health of our patients is at the top of the list of satisfiers for physicians. <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Our Professional Satisfaction and Practice Sustainability</a> initiative is working to put the joy back into medicine and help you do what you do best: care for patients.</li> </ul> <p> The knowledge shared at the International Conference on Physician Health—such as how increasing numbers of young doctors are seeking help for mental health and how unfair treatment of medical students is potentially being underreported—will inform how I take care of myself, my trainees and my patients. You can view webcasts of the conference and get additional highlights and news on the <a href="http://bma.org.uk/icph2014" rel="nofollow" target="_blank">BMA’s website</a>.</p> <p> The next conference, to take place in 2016, will be hosted by the AMA in the United States. <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-health/international-conference-physician-health.page?" target="_blank">Stay tuned</a> for more information on the location and how you can participate.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e9ed5ff0-f8c2-46aa-bb13-ba10c016af3f Prepare for ICD-10 compliance with pocket-sized reference http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prepare-icd-10-compliance-pocket-sized-reference Tue, 23 Sep 2014 19:31:00 GMT <p> The deadline to comply with implementation of the ICD-10 code set is nearly one year away, making it the perfect time to get up to speed on proper documentation. A pocket-sized, tabular reference from the AMA Store can help you prepare for ICD-10 and better understand ICD-9.</p> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank"><em>Pocket Guide to Understanding ICD-10-CM Documentation</em></a> helps physicians understand new and established documentation concepts, and can improve documentation practices when coding with ICD-9. Helpful features of this reference include:</p> <ul> <li> A small profile—it fits in a pocket and is ideal for quick reference at the point of care</li> <li> Information on the importance of conducting a clinical documentation assessment</li> <li> At-a-glance convenience</li> </ul> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now. Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> <p>  </p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:150f401a-3c4a-40aa-87a3-41e0a8d83675 Report ranks top residency programs--see how yours stacks up http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_report-ranks-top-residency-programs-see-stacks-up Mon, 22 Sep 2014 21:53:00 GMT <p> Where are the top residency programs in the country? A new ranking based on a large physician survey lists the top 10 programs for 20 specialties.</p> <p> Physician network Doximity and <em>U.S. News & World Report</em> surveyed more than 17,000 U.S. physicians evaluating 3,691 residency training programs based on more than 50,000 peer nominations. The survey asked each physician to name up to five residency programs in their specific medical specialty that offer the best clinical training.</p> <p> After weighing each nomination to account for regional differences in response rates and the proportion of physicians who are Doximity users, the network ranked the top 10 programs in each specialty for its new <a href="https://www.doximity.com/residency_navigator/programs" rel="nofollow" target="_blank">Residency Navigator</a> tool.</p> <p> Some highlights include:</p> <ul> <li> <strong>Family practice. </strong>At the top of the list are Ventura County Medical Center, University of Washington and John Peter Smith Hospital.</li> <li> <strong>Emergency medicine.</strong> The best rankings were given to Indiana University School of Medicine, University of Cincinnati Medical Center and the University of Southern California.</li> <li> <strong>Pediatrics.</strong> Listed best of class are Children’s Hospital of Philadelphia, Children’s Hospital/Boston Medical Center and Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine.</li> </ul> <p> The University of California–San Francisco placed in the top 10 lists for 16 medical specialties and was ranked No. 1 in three of those specialties. Johns Hopkins University placed in the top 10 lists for 14 specialties and was ranked No. 1 in four specialties.</p> <p> The Residency Navigator tool is free to browse by specialty. </p> <p> <strong>Looking into residency program possibilities? </strong>The AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page" target="_blank">FREIDA Online</a> tool allows medical students to search graduate medical education (GME) programs and narrow down their choices. Additional information to help students find a residency position on the AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/finding-position.page?" target="_blank">GME Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e030e53e-3b8d-4aeb-9eb0-2c1ddc08286d CMS conducting end-to-end ICD-10 testing; apply by Oct. 3 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-conducting-end-end-icd-10-testing-apply-oct-3 Mon, 22 Sep 2014 21:49:00 GMT <p> <span style="font-size:12px;">In advance of ICD-10 implementation scheduled for Oct. 1 of next year, the Centers for Medicare & Medicaid Services (CMS) plans to conduct end-to-end testing in January to identify issues in the system that need to be addressed. Physicians who are interested in participating should apply by Oct. 3.</span></p> <p> CMS announced Friday that it will select approximately 850 volunteers to participate in a cross-sectional sample of those who submit claims for Medicare payment. The testing will be conducted with Medicare Administrative Contractors (MAC) and Medicare’s common electronic data interchange contractor.</p> <p> <span style="font-size:12px;">CMS had not originally planned to conduct testing of the new code set until the AMA pressed the agency, emphasizing the complexity behind adopting the new code set and the unpreparedness of many vendors and practices.</span></p> <p> <span style="font-size:12px;">This testing week, which will take place Jan. 26-30, is intended to determine whether physicians and others are able to successfully submit claims with ICD-10 codes to Medicare’s fee-for-service claims systems.</span></p> <p> <span style="font-size:12px;">The testing also should show whether CMS’ software changes to support ICD-10 can adjudicate claims appropriately and produce accurate remittance advice. CMS says it plans to address any issues identified during testing and develop educational materials for physicians and others who will be submitting claims with ICD-10 codes.</span></p> <p> <span style="font-size:12px;">If you’re interested in participating, visit your </span><a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Contractor-Directory-Interactive-Map/" rel="nofollow" style="font-size:12px;" target="_blank">MAC website</a><span style="font-size:12px;"> to access the volunteer form and submit it by Oct. 3. CMS will review applications and notify volunteers who have been selected to participate by Oct. 24.</span></p> <p> <span style="font-size:12px;">Additional information about CMS’ approach to ICD-10 testing is available in a recent </span><a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1409.pdf" rel="nofollow" style="font-size:12px;" target="_blank"><em>MLN Matters</em>® article</a><span style="font-size:12px;">.</span></p> <p> <span style="font-size:12px;">Visit the AMA’s </span><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" style="font-size:12px;" target="_blank">ICD-10 Web page</a><span style="font-size:12px;"> for a variety of free resources to help physicians prepare for testing and implementation of the new code set. In addition, the AMA Store offers the </span><em style="font-size:12px;">ICD-10 2015 Data File</em><span style="font-size:12px;">, available via </span><a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push#usage-tab" style="font-size:12px;" target="_blank">CD-ROM</a><span style="font-size:12px;"> or </span><a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" style="font-size:12px;" target="_blank">instant download</a><span style="font-size:12px;">, for physicians who still need to upload the latest codes into their electronic systems.</span></p> <p> <span style="font-size:12px;">While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now. Read more about </span><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" style="font-size:12px;" target="_blank">how the AMA is working</a><span style="font-size:12px;"> to help ease ICD-10 implementation for physicians.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:97350653-60ce-4c28-8f6a-0912a0a548d2 New journal JAMA Oncology to debut in 2015 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-journal-jama-oncology-debut-2015 Mon, 22 Sep 2014 21:43:00 GMT <p> The JAMA Network will launch the new journal <em>JAMA Oncology</em> early next year featuring cancer-related research.</p> <p> When <em>JAMA Oncology</em> premieres in early 2015, it will be the 11th journal in the JAMA Network, which includes the <em>Journal of the American Medical Association</em> (<em>JAMA</em>) and nine other specialty journals. All of the <em>JAMA Oncology</em> content–research, reviews and opinions–will be published <a href="http://oncology.jamanetwork.com/" target="_blank" rel="nofollow">online</a> every Thursday and then printed in a monthly paper issue. <em>JAMA Oncology</em> will be the first new journal to be launched by the JAMA Network since 1999.</p> <p> <em>JAMA Oncology</em> will address all aspects of medical, radiation and surgical oncology and its subspecialties. The journal will be a leader in the high-impact field of cancer research, where the volume of work and innovative discoveries have accelerated at a remarkable pace in an effort to keep up with the expected increase in patients diagnosed with cancer.</p> <p> “<em>JAMA Oncology</em> presents an important new initiative for the JAMA Network—our first new journal in many years,” said Howard Bauchner, MD, editor-in-chief of <em>JAMA</em> and the JAMA Network. “The worldwide research effort in oncology is substantial, including lab, translational, clinical and health services research, and there are many important evolving clinical and policy issues.”</p> <p> “<em>JAMA Oncology</em> will include original investigation, opinion (viewpoints, editorials, and invited commentaries) and clinical reviews,” Dr. Bauchner said. “And we could not be more fortunate than to have Nora Disis, MD, as our inaugural editor-in-chief. She is an internationally renowned investigator and a superb clinician.”</p> <p> As the journal’s founding editor, Dr. Disis brings extensive experience to her new role. In addition to serving as a professor of medicine, she is director of the Center for Translational Medicine in Women’s Health and director of the Institute of Translational Health Sciences at the University of Washington. Dr. Disis, who specializes in breast and ovarian cancer and immunotherapy, has been deputy editor of translational oncology for the <em>Journal of Clinical Oncology</em> and has served on the advisory board for Science Translational Medicine.</p> <p> Existing customers will have free access to <em>JAMA Oncology</em> in 2015. Individual physicians and other health care professionals also will be eligible to access content for free on the <a href="http://app.jamanetwork.com/" target="_blank" rel="nofollow">JAMA Network Reader</a>. AMA members enjoy unlimited access to the JAMA Network. Not a member? <a href="https://commerce.ama-assn.org/membership/" target="_blank">Join</a> today.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f34e71ff-973a-446a-961a-2d22c3247777 What people are saying about AMA’s EHR priorities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_people-saying-amas-ehr-priorities Mon, 22 Sep 2014 21:36:00 GMT <p> A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">new framework</a> for electronic health record (EHR) usability was issued last week. Developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives, the framework focuses on leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs.</p> <table align="left" border="1" cellpadding="1" cellspacing="15" style="width:315px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/6/57033708-a7d2-4b8a-9651-18627ab6c37a.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/6/57033708-a7d2-4b8a-9651-18627ab6c37a.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">Examples of some Twitter posts praising the AMA's leadership on putting forth the EHR priorities.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> The release of <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">eight solutions</a> (log in) to address the challenges physicians face in using EHRs was well received by both the media and physician community. Here’s a summary of what these influential people are saying about the AMA’s EHR priorities.</p> <p> “As Secretary of Health and Human Services, I saw firsthand the big picture challenges that this [poses]—and those issues the commenters are raising. Hopefully, the AMA’s efforts will help focus all of the relevant players in the health system to adopt seamless, effective EHRs that are as useful and as available as a patient’s bank accounts. This isn’t a cure-all, of course, but it is a welcome addition to the efforts to benefit patients.”</p> <p> —<strong>Tommy G. Thompson, former governor of Wisconsin secretary of the U.S. Department of Health and Human Services (HHS)</strong></p> <p> “We applaud the AMA for speaking out on this,” said<strong> Jacob Reider, MD, a family physician </strong>who formerly worked in EHR development. “It will take a few years before we will see an iPhone-like EMR. We’ll get there, but it’s primarily in the hands of the developers.”</p> <p> —“<a href="http://online.wsj.com/articles/ama-urges-overhaul-of-electronic-records-1410840063#livefyre-comment" rel="nofollow" target="_blank">AMA urges overhaul of electronic medical records</a>,” <em>The Wall Street Journal</em></p> <p> “We support the AMA’s efforts to improve EHRs for the end user—the health care providers who use these products to treat their patients,” said <strong>Peter Ashkenaz, spokesman for the Office of the National Coordinator for Health Information Technology at HHS</strong>.</p> <p> —“<a href="http://www.washingtonpost.com/national/health-science/frustrated-ama-calls-for-and8216action-plan-on-digital-records/2014/09/16/deccc96a-3dc5-11e4-a430-b82a3e67b762_story.html" rel="nofollow" target="_blank">Frustrated AMA pitches ‘action plan’ on digital records</a>,” <em>Washington Post</em></p> <p> “The American Medical Association …  has taken matters into its own hands, issuing an eight-point framework to impose EHR usability. AMA is willing to work with the agencies, but will no longer wait for the agencies to do the job and require improvements.”</p> <p> —“<a href="http://www.fierceemr.com/story/faux-mu-flexibility-rule-ghost-no-matter-what/2014-09-18" rel="nofollow" target="_blank">The ‘faux’ MU flexibility rule: A ghost no matter what</a>,” <strong>Marla Durben Hirsch</strong>, <strong>editor of <em>Fierce EMR</em></strong></p> <p> “Timely and important. I am glad that the AMA is going to bat for this. We need them to be louder, clearer and more forceful.”</p> <p> —<strong>Joe Flower, author and columnist for the American Hospital Association</strong></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9707b56f-b31f-43f7-8ffe-b7a32daaf12b Case could leave doctors vulnerable to repeat, delayed lawsuits http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_case-could-leave-doctors-vulnerable-repeat-delayed-lawsuits Fri, 19 Sep 2014 20:30:00 GMT <p> A case coming before the Supreme Court of the United States holds in the balance whether lawsuits and heavy fines can be brought indefinitely against physicians who provide services under Medicare and other federal health care programs.</p> <p> In <em>KBR v. United States of America Ex Relator Benjamin Carter</em>, petitioners are seeking to overturn earlier court decisions that would eliminate the existing six-year limit on pursuing “false claims” under the federal False Claims Act and would allow repeat lawsuits to be filed.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/8/3f0aaa24-0f33-467e-b8ea-0498309c7fe5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/8/3f0aaa24-0f33-467e-b8ea-0498309c7fe5.Large.jpg?1" style="margin:15px;float:right;" /></a>The AMA filed a friend-of-the-court brief alongside four other organizations, calling on the U.S. Supreme Court to consider the ramifications of earlier court rulings on the matter.</p> <p> “If affirmed, the combined effect of these rulings will invite private plaintiffs and the government to pursue indefinitely and repeatedly any claim involving alleged fraud against the government,” the brief states. “This elimination of all repose is not only contrary to law but would impose significant burdens on businesses, hospitals and other health care providers.”</p> <p> The brief points out that physicians could be “forced to defend against stale, repetitive and frequently meritless claims.” This task would require significant costs in maintaining records for an indefinite period, planning for unknown contingencies and defending against inappropriate suits.</p> <p> For physicians who don’t have sufficient documentation to mount a proper defense or who otherwise decide to settle, the financial damages are considerable.</p> <p> Under the federal False Claims Act, the penalty for each claim is between $5,000 and $10,000, adjusted for inflation, plus three times the amount of damages “sustained by the federal government.” If information was misrepresented on multiple Medicare claims, for instance, penalties would apply to each claim—regardless of how small the billed amount was.</p> <p> The case is expected to be argued this winter.</p> <p> The AMA long has expressed concern over ambiguities in the False Claims Act, a Civil War-era statute being used to raise inappropriate claims, and previously has filed several court briefs reflecting concerns over this law.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:56c35b41-4339-40c2-853a-13cf920df950 21 students selected as outstanding doctors of tomorrow http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_21-students-selected-outstanding-doctors-of-tomorrow Fri, 19 Sep 2014 20:23:00 GMT <p> A group of outstanding fourth-year medical students from across the country were announced earlier this month as recipients of the Physicians of Tomorrow Awards from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a>.</p> <p> The 21 honored students, chosen for their academic excellence and financial need, will each receive $10,000 to assist with their medical school tuition. The 2014 scholarship recipients are:</p> <ul> <li> Matthew Alvin, Case Western Reserve University School of Medicine</li> <li> Joshua Bakhsheshian, Chicago Medical School at Rosalind Franklin University of Medicine and Science</li> <li> Italo Brown, Meharry Medical College</li> <li> Elias Dayoub, University of Michigan Medical School</li> <li> Jennifer Girard, University of Illinois at Chicago College of Medicine</li> <li> Konstantin Grigoryan, University of Cincinnati College of Medicine</li> <li> Mickey Ising, University of Louisville School of Medicine</li> <li> Corbin Jacobs, University of Texas Southwestern Medical Center at Dallas</li> <li> Mariya Kalashnikova, Keck School of Medicine of the University of Southern California</li> <li> Jimin Kim, University of Chicago Pritzker School of Medicine</li> <li> Matthew Murphy, Loyola University Chicago Stritch School of Medicine</li> <li> Raja Narayan, University of California Irvine School of Medicine</li> <li> Alexander Nguyen, University of California Davis School of Medicine</li> <li> Derek Rogalsky, Georgetown University School of Medicine</li> <li> Taylor Stanton, University of Illinois College of Medicine at Rockford</li> <li> Tatiana Thema, Wake Forest School of Medicine</li> <li> Ryan Uselman, University of Minnesota Medical School</li> <li> Stephen Villa, University of California San Francisco</li> <li> LaBianca Wright, Loyola University Chicago Stritch School of Medicine</li> </ul> <p> In addition, two students each received $10,000 for their commitment to careers in medical journalism:</p> <ul> <li> Anna Garcia, Vanderbilt University School of Medicine</li> <li> Daniel Leifer, University of California Davis School of Medicine</li> </ul> <p> Read more about this year’s winners on the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/physicians-tomorrow-scholarships.page?" target="_blank">Physicians of Tomorrow Awards Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:96570cd4-3907-4d1f-a773-f4ab255f1380 Tell us: Which EHR improvements would help you most? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tell-ehr-improvements-would Thu, 18 Sep 2014 21:11:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post from AMA President-Elect </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/steven-stack.page" target="_blank"><em>Steven J. Stack, MD</em></a><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/14/99b40cb0-11be-4562-8ef9-10274b13df05.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/14/99b40cb0-11be-4562-8ef9-10274b13df05.Large.jpg?1" style="margin-right:15px;margin-left:15px;float:left;" /></a></p> <p> <br /> An AMA-convened panel of experts this week called for electronic health record (EHR) overhaul, outlining the eight top challenges and solutions for improving EHR usability. As chair of this committee, I ask you to share your thoughts with the AMA: Which of these eight priorities would make the biggest impact on your practice? Please share your thoughts in the comment section of this post.</p> <p> Click the button at the bottom of this page to either sign in with your AMA credentials or create an account to post a comment below. Tell us which of the following priorities resonates the most with you:<br />  </p> <ul> <li> Enhance physicians’ ability to provide high-quality patient care</li> <li> Support team-based care</li> <li> Promote care coordination</li> <li> Offer product modularity and configurability</li> <li> Reduce cognitive workload</li> <li> Promote data liquidity</li> <li> Facilitate digital and mobile patient engagement</li> <li> Expedite user input into product design and post-implementation feedback</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">Read more</a> about each of these priorities in an <em>AMA Wire</em><em>® </em>post from earlier this week.</p> <p> I look forward to hearing from you as we move forward with this important work and other efforts within 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.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4d1c0ffa-729b-4aec-a4a1-9564dce679ea JAMA Highlights: Waistlines of U.S. adults continue to increase http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-waistlines-of-adults-continue-increase Thu, 18 Sep 2014 20:47:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/UWw42-fon64" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/UWw42-fon64" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/UWw42-fon64" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/UWw42-fon64" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Waistlines of U.S. adults continue to increase</strong><br /> The prevalence of abdominal obesity and average waist circumference increased among U.S. adults from 1999 to 2012, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1904816" rel="nofollow" target="_blank">study</a> in the Sept. 17 issue of the <em>Journal of the American Medical Association </em>(<em>JAMA</em>)<em>.</em></p> <p> <strong>Combination therapy for COPD associated with better outcomes</strong><br /> Among older adults with chronic obstructive pulmonary disease (COPD)—particularly those with asthma—newly prescribed long-acting beta-agonists (LABAs) and inhaled corticosteroid combination therapy, compared with newly prescribed LABAs alone, was associated with a lower risk of death or COPD hospitalization, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1904829" rel="nofollow" target="_blank">study</a> in <em>JAMA</em>. Watch a <a href="http://youtu.be/UWw42-fon64" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Multiple-birth infants use more resources, spotlight on reproductive technology</strong><br /> Hospital costs are higher and the odds of complication and death are greater for multiple-birth infants than singleton births, and some of this clinical and economic burden can be alleviated through single-embryo transfer in assisted reproductive technology, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1903018" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics.</em></p> <p> <strong>PTSD symptoms associated with increased food addiction</strong><br /> Symptoms of posttraumatic stress disorder (PTSD) were associated with increased food addiction, especially when individuals had more symptoms or the symptoms occurred earlier in life, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1904804" rel="nofollow">study</a> in <em>JAMA Psychiatry</em>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b9aebf7b-f12b-401f-bf15-f7fdcd73fca6 Physicians share insights into how med schools are changing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-share-insights-med-schools-changing Thu, 18 Sep 2014 20:22:00 GMT <p> Take a closer look at unique programs medical schools across the country are testing with first-person perspectives from academic physicians on cutting-edge programs at their schools.</p> <p> Faculty at the 11 schools participating in the AMA’s <a href="http://changemeded.org/" target="_blank" rel="nofollow">Accelerating Change in Medical Education</a> initiative are sharing their thoughts on the changes their schools are making, the challenges they’re overcoming and the results they hope to achieve.</p> <p> At the Brody School of Medicine of East Carolina University, the incoming students of the class of 2018 heard a real-life story of a patient tragedy, inspiring them to put the patient first. Danielle Walsh, MD, a clinical associate professor at Brody, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-school-really-putting-patient-first" target="_blank">outlines other ways</a> the school is thinking differently, including its Teachers of Quality Academy.</p> <p> Two faculty at Oregon Health and Science University School of Medicine <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-used-school-investigates-competencies" target="_blank">shared how informatics</a>—the use of technology to better care for patients—is embedded into the school’s new curriculum. William Hersh, MD, chair of the school’s department of medical informatics and clinical epidemiology, and George Mejicano, MD, the senior associate dean for education at the school of medicine, explain how the school figured out the best ways to incorporate related topics, and how students will be evaluated.</p> <p> Finally, Paul George, MD, associate director of preclinical curriculum at the Warren Alpert Medical School of Brown University, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/dual-degree-program-targets-new-type-of-physician" target="_blank">explains Brown’s new dual degree program</a> aimed at cultivating a new type of physician. The program is designed to give students background in primary care and population medicine, including training in areas such as health disparities, health systems and leadership skills.</p> <p> The consortium of schools participating in the AMA’s initiative will meet this month at Vanderbilt University School of Medicine in Nashville to work through the each of the schools’ progress and determine future goals. Watch <em>AMA Wire</em>® for more coverage.</p> <p> Additional insights from faculty involved in the AMA’s Accelerating Change in Medical Education initiative will be posted to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1"><em>AMA Wire</em></a> over the coming months. You also can sign up for <a href="http://www.ama-assn.org/ama/pub/news/newsletters-journals/med-ed-archive.page"><em>AMA</em> <em>MedEd Update</em></a>, the AMA’s monthly e-newsletter with updates on the latest innovations in medical education.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed7f333e-833e-4e75-b9b9-19b98832cd70 Gender role in residency burnout, faculty promotion under scrutiny http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gender-role-residency-burnout-faculty-promotion-under-scrutiny Thu, 18 Sep 2014 15:00:00 GMT <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/Content/images/store/9/15/59da0c26-ca56-4452-af66-061e3516c5a5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/15/59da0c26-ca56-4452-af66-061e3516c5a5.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:12px;">Elizabeth H. Ellinas, MD (left), and Sneha Harshad Shah, MD (right), will examine  the role gender may play in key components of the medical profession as the winners of this year’s Joan F. Giambalvo Fund for the Advancement of Women.</span></em></td> </tr> </tbody> </table> <p> Two studies will be taking on questions about the role gender may play in key components of the medical profession, including empathy and burnout in residency and faculty promotion and retention at medical schools. The projects are the winners of this year’s Joan F. Giambalvo Fund for the Advancement of Women, announced Wednesday in conjunction with <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page" target="_blank">Women in Medicine Month</a>.</p> <p> The theme “Innovators and Leaders Changing Health Care” for this year’s Women in Medicine Month will be seen in action through these timely research projects. They’re being spearheaded by two women physicians:</p> <ul> <li style="margin-left:0.25in;"> Elizabeth H. Ellinas, MD, assistant dean for faculty affairs at the Medical College of Wisconsin, will be collaborating with colleagues to study how to enhance the position of female faculty in academic rank and leadership positions. The study will look at gender differences in seeking promotion and leadership and intent to leave.<br />  </li> <li style="margin-left:0.25in;"> Sneha Harshad Shah, MD, associate program director of the Emergency Medicine Residency Program at the University of Massachusetts Medical School, will be studying gender differences in empathy and burnout among emergency medicine residents. Her study also will test the effectiveness of an empathy training curriculum for residency.</li> </ul> <p> “The gap between women and men undeniably exists in the house of medicine,” said Dr. Shah. “I applied for this fund because it supports projects that raise awareness of gender inequalities so that women can persevere and rise through their professional careers.”</p> <p> “We are proud to recognize two outstanding members of the medical community, whose work is raising awareness about these issues,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-18-research-grants-study-women-in-medicine.page" target="_blank">news release</a>. “Their work will help propel the AMA’s advocacy efforts on the advancement and understanding of women in medicine.”</p> <p> The Joan F. Giambalvo Fund for the Advancement of Women was established by the AMA Women Physicians Section (WPS) and the AMA Foundation. This unique program offers funding specifically for health care researchers to identify and address issues that affect women physicians and medical students. Previous research topics have included flexible work options, gender differences in practice patterns, and promotion and retention of diversity in medical education.</p> <p> Celebrate Women in Medicine Month by learning more about women in the profession:</p> <ul> <li style="margin-left:15pt;"> Look for the #WIMmonth hashtag on 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> feeds, where the AMA is honoring innovative women all month.</li> <li style="margin-left:15pt;"> Listen to members of the AMA-WPS share their stories and reflections in a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page?" target="_blank">new video series</a>.</li> <li style="margin-left:15pt;"> Learn about the <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/profile-history-women-in-medicine.pdf" target="_blank">history of women physicians</a> (log in)—and what the future may bring.</li> <li style="margin-left:15pt;"> Get <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/governing-council-inspirations.page" target="_blank">insight into the mentors</a> who have driven women leaders.</li> <li style="margin-left:15pt;"> Check out the honorees of the AMA-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 Physician Awards</a>.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bc763a9-ff7e-4e68-92ea-44bbc0c914a2 How students and residents are saving GME http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-residents-saving-gme Wed, 17 Sep 2014 19:09:00 GMT <p> <a href="https://storify.com/AmerMedicalAssn/savegme-week-2014" target="_blank" rel="nofollow"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/b6e8c889-d2ea-4440-b20f-101f2bfa1892.Large.jpg?1" style="float:right;margin:10px;" /></a>Medical students and trainees took to social media last week, calling for Congress to support graduate medical education (GME) and bringing attention to the impending physician shortage during Save GME Week.</p> <p> Students and residents used #SaveGME on <a href="https://www.facebook.com/amamss" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AMA_MSS" target="_blank" rel="nofollow">Twitter</a>, posting facts about why more GME positions are crucial for the future of medicine and the health of the nation. Many also leveraged the <a href="http://savegme.org/take-action/" target="_blank" rel="nofollow">online advocacy tools</a> at SaveGME.org to contact their lawmakers directly, urging them to save GME.</p> <p> “A tremendous amount of medical care in the United States is delivered by residents and fellows, and that’s why it’s so important for trainees to participate in Save GME Week,” said Maya Babu, MD, the resident member of the AMA Board of Trustees. “Residents and fellows train in teaching hospitals, which provide a diverse range of critical health care services, including complex trauma care, burn units and neonatal intensive care units. These services are provided round-the-clock, seven days a week and heavily rely on the resident and fellow workforce.”</p> <p> The weeklong grassroots campaign needs student and resident involvement to be successful, said Sam Mackenzie, a third-year MD/PhD student at Upstate Medical University and a member of the AMA Board of Trustees, on a special Save GME episode of the medical student and trainee podcast <a href="http://radiorounds.org/savegme-the-ama-responds-to-the-iom/" target="_blank" rel="nofollow"><em>Radio Rounds</em></a>.</p> <p> “Medical school requires a lot of focus, and I think it can be difficult for students to get their heads out of their books sometimes and participate in some of these bigger picture processes of change going on around them,” said Mackenzie,. “Certainly health care reform comes to mind, but in the more immediate future, students really need to be active on the subject of GME.”</p> <p> Workforce experts predict a shortage of more than 45,000 primary care and 46,000 specialty physicians in the United States by 2020, and medical schools are producing more graduates to prepare for this expected shortage. At the same time, the number of residency positions has remained capped, meaning some students may not match to training positions, which could exacerbate the shortage.</p> <p> Meanwhile, physician maldistribution throughout the United States has led to a lack of doctors in underserved areas, both in primary care and in specialties. Mackenzie is planning to specialize in pediatric neurology, and said it can be difficult for patients to see pediatric neurologists.</p> <p> “At my institution, the waiting time just to see one of these few attending physicians that we have in child neurology is between four to six months,” he said. “There have been some pretty unfortunate barriers to expansion, thanks to a federal cap [on residency positions] … The cap very simply exacerbates the physician maldistribution in this country.”</p> <p> Check out what students and residents across the country <a href="https://storify.com/AmerMedicalAssn/savegme-week-2014" target="_blank" rel="nofollow">had to say about Save GME Week</a>, and learn more at <a href="http://savegme.org/" target="_blank" rel="nofollow">SaveGME.org</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8f70e327-5ad7-43df-9d6f-a768e373225f See how your cash flow compares to other practices http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_see-cash-flow-compares-other-practices Wed, 17 Sep 2014 19:06:00 GMT <p> What’s your practice’s cash flow score? Learn how your practice compares against industry benchmarks in setting payment expectations and supporting front and back office billing processes. A free interactive webinar from 1 p.m. to 2 p.m. Eastern time Sept. 25 shows you how. <a href="https://www1.gotomeeting.com/register/962271185" target="_blank" rel="nofollow">Register now</a>.</p> <p> Participants will receive on-the-spot results regarding how their practices compare to others  and will learn about:</p> <ul> <li style="margin-left:0.25in;"> Maintaining patient engagement</li> <li style="margin-left:0.25in;"> Following up with patient payments</li> <li style="margin-left:0.25in;"> Using a collection agency</li> </ul> <p> Participants will be prepared to incorporate tools into their practices’ processes and increase their cash flow.</p> <p> This webinar will be presented by Angie Slayton, director of marketing for <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program/mvp-transworld-systems.page" target="_blank">Transworld Systems</a>, a cash flow management service that is a part of the AMA <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program.page?" target="_blank">MVP Program</a>.</p> <p> <em>This webinar is provided for information and planning purposes. It is not intended to be, nor should it be substituted for, legal or compliance advice, which turn on specific facts.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7162022c-8b06-4344-9875-bdc6ea19ddb3 All I want for Health IT Week is an EHR overhaul http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_want-health-week-ehr-overhaul Tue, 16 Sep 2014 18:40:00 GMT <p> <em>An <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank">AMA Viewpoints</a> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Large.jpg?1" style="float:left;margin:10px;" /></a>If I had to capture the main shortcoming of electronic health record (EHR) technology in one word, this would be it: Usability.</p> <p> As we’re observing <a href="http://www.healthit.gov/healthitweek/" rel="nofollow">National Health IT Week</a> through Friday, I can’t think of a better time to call for EHR systems that better serve physicians and our patients. That’s why the AMA just released a new framework for improving EHR usability.</p> <p> As a chief medical officer for a health IT company and a former deputy national coordinator in the Office of the National Coordinator for Health Information Technology, I understand the complexities of what’s required to make EHRs first and foremost usable systems for the medical practice. When I say “all” I want for Health IT Week is an EHR overhaul, I realize that’s no simple request.</p> <p> But it is a basic request. Usability should be the driving quality of all health IT. Unless health IT functions in a way that makes our practices more efficient and facilitates improvements in our patient care, it isn’t doing what it was intended to do.</p> <p> As my colleague Steven J. Stack, MD, AMA president-elect, has said, most physicians are stuck with technology that <em>interferes</em> with their ability to provide first-rate medical care. And that’s reflected in physicians’ professional satisfaction.</p> <p> In the AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/quality-of-patient-care-primary-driver-of-physician-satisfaction-study" target="_blank">study</a> with the RAND Corporation released last fall, we identified that the primary driver of physician dissatisfaction was EHR technology that put up barriers to delivering high-quality patient care.</p> <p> As part of our <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, we convened an external advisory committee of noted health IT experts and practicing physicians to develop priorities that should illuminate the path for improving the usability of EHR technology to benefit physicians and their patients.</p> <p> Dr. Stack chaired this committee, which was responsible for developing the <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) we released this week. The framework outlines key challenges physicians face with EHRs and eight priorities that should be national priorities for improving the usability of this technology:</p> <ul> <li style="margin-left:0.25in;"> Enhance physicians’ ability to provide high-quality patient care</li> <li style="margin-left:0.25in;"> Support team-based care</li> <li style="margin-left:0.25in;"> Promote care coordination</li> <li style="margin-left:0.25in;"> Offer product modularity and configurability</li> <li style="margin-left:0.25in;"> Reduce cognitive workload</li> <li style="margin-left:0.25in;"> Promote data liquidity</li> <li style="margin-left:0.25in;"> Facilitate digital and mobile patient engagement</li> <li style="margin-left:0.25in;"> Expedite user input into product design and post-implementation feedback</li> </ul> <p> The framework is particularly important in that it was developed by a combination of practicing physicians and noted experts, researchers and executives in the health IT field. So we were looking at how to improve EHR technology from a variety of perspectives, and the concepts offered are ones that can be executed.</p> <p> To that end, we will be working with all stakeholders—physicians, vendors, federal and state policymakers, institutions, health care systems and researchers—to take these principles from ideas to realities. I look forward to witnessing the progress we’ll make by this time next year.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3a679c5d-9abd-4bb9-8723-c5b572fc2388 16 states let doctors get CME for state licensure at the JAMA Network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_16-states-let-doctors-cme-state-licensure-jama-network Tue, 16 Sep 2014 17:56:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/a6082777-3f8e-4766-922f-5fe2975dfb58.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/a6082777-3f8e-4766-922f-5fe2975dfb58.Large.jpg?1" style="float:right;margin:10px;height:75px;width:200px;" /></a>Physicians in 16 states can fulfill continuing medical education (CME) requirements for state medical licensure in one expert online resource: The JAMA Network. And for AMA members, this service is entirely free. Find out whether you’re in one of these states.</p> <p> The JAMA Network offers hundreds of CME activities related to studies published in its journals. For physicians in the following 16 states, their CME requirements for licensure can be met through these offerings:</p> <ul> <li style="margin-left:0.25in;"> California</li> <li style="margin-left:0.25in;"> Connecticut</li> <li style="margin-left:0.25in;"> Florida</li> <li style="margin-left:0.25in;"> Iowa</li> <li style="margin-left:0.25in;"> Massachusetts</li> <li style="margin-left:0.25in;"> Mississippi</li> <li style="margin-left:0.25in;"> Nevada</li> <li style="margin-left:0.25in;"> New Jersey</li> <li style="margin-left:0.25in;"> New Mexico</li> <li style="margin-left:0.25in;"> Oklahoma</li> <li style="margin-left:0.25in;"> Oregon</li> <li style="margin-left:0.25in;"> Pennsylvania</li> <li style="margin-left:0.25in;"> Rhode Island</li> <li style="margin-left:0.25in;"> Tennessee</li> <li style="margin-left:0.25in;"> Texas</li> <li style="margin-left:0.25in;"> Vermont</li> </ul> <p> Visit the JAMA Network CME site to <a href="http://jama.jamanetwork.com/cme.aspx?browsestate=true" rel="nofollow" target="_blank">view the CME activities</a> offered for your state (included under the “all CME courses” tab toward the bottom of the page).</p> <p> If your state isn’t one of these 16, it might not have any specific requirements, or it could require that CME activities are relevant to each physician’s specialty. Contact your state’s licensing board if you have questions about requirements.</p> <p> AMA members have free access to unlimited CME activities via the JAMA Network. Simply read an article and complete a brief quiz to obtain <em>AMA PRA Category 1 Credit</em><em>™</em>.</p> <p> The JAMA Network’s <a href="http://jama.jamanetwork.com/cme.aspx" rel="nofollow" target="_blank">online CME center</a> makes what otherwise can be an expensive and cumbersome process convenient. Here physicians easily can:</p> <ul> <li style="margin-left:0.25in;"> Search by journal, topic, year or state to find activities of interest.</li> <li style="margin-left:0.25in;"> Participate in activities related to a certain topic from several different journals.</li> <li style="margin-left:0.25in;"> View and print CME certificates.</li> <li style="margin-left:0.25in;"> Save partially completed quizzes and return to them later.</li> <li style="margin-left:0.25in;"> Keep track of CME credits in one place.</li> </ul> <p> While <a href="http://store.jamanetwork.com/productDetails.aspx?productCodeID=65" rel="nofollow" target="_blank">CME tokens</a> can be purchased for five or 10 quizzes, AMA members receive full access to the JAMA Network online and unlimited access to its CME offerings.</p> <p> If you aren’t an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ce28e005-b8a9-489f-910c-b87f1db283c7 8 top challenges and solutions for making EHRs usable http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-top-challenges-solutions-making-ehrs-usable Tue, 16 Sep 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/1/ce2195e5-a40c-478f-819a-608ca8ff18ad.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/1/ce2195e5-a40c-478f-819a-608ca8ff18ad.Large.jpg?1" style="margin:15px;float:right;" /></a>It’s no secret that many physicians are unhappy with their electronic health record (EHR) systems, thanks in large part to cumbersome processes and limited features that get in the way of patient care. Now a panel of experts has called for EHR overhaul, outlining the eight top challenges and solutions for improving EHR usability for physicians and their patients.</p> <p> This <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) for EHR usability—developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives—focuses on leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. Here are the eight solutions this group identified to address the biggest challenges:</p> <p> <strong>1. Enhance physicians’ ability to provide high-quality patient care. </strong>Poor EHR design gets in the way of face-to-face interaction with patients because physicians are forced to spend more time documenting required information of questionable value. Features such as pop-up reminders, cumbersome menus and poor user interfaces can make EHRs far more time consuming than paper charts.</p> <p> Instead, EHRs should be designed to enable physician-patient engagement. Technology should fit seamlessly into the practice and be based on work flow needs.</p> <p> <strong>2. Support team-based care.</strong> Current technology often requires physicians to enter data or perform tasks that other team members should be empowered to complete. EHR systems instead should be designed to maximize each person’s productivity in accordance with state licensure laws and allow physicians to delegate tasks as appropriate.</p> <p> <strong>3. Promote care coordination.</strong> Transitioning patient care can be a challenge without full EHR interoperability and robust tracking. EHR systems need to automatically track referrals, consultations, orders and labs so physicians easily can follow the patient’s progression throughout their care.</p> <p> <strong>4. Offer product modularity and configurability.</strong> Few EHR systems are built to accommodate physicians’ practice patterns and work flows, which vary depending on size, specialty and setting. Making EHR systems more modular would allow physicians to configure their health IT environment to best suit their work flows and patient populations. Allowing vendors to focus on specialized applications also would produce the tailored technology physicians need.</p> <p> <strong>5. Reduce cognitive work load. </strong>Although physicians spend significant time navigating their EHR systems, many physicians say that the quality of the clinical narrative in paper charts is more succinct and reflective of the pertinent clinical information. A lack of context and overly structured data capture requirements, meanwhile, can make interpretation difficult.</p> <p> EHRs need to support medical decision-making with concise, context-sensitive real-time data. To achieve this, IT developers may need to create sophisticated tools for reporting, analyzing data and supporting decisions. These tools should be customized for each practice environment.</p> <p> <strong>6. Promote interoperability and data exchange.</strong> Data “lock in” is a common problem. EHR systems should facilitate connected health care across care settings and enable both exporting data and properly incorporating data from other systems. The end result should be a coherent longitudinal patient record that is built from various sources and can be accessed in real time.</p> <p> <strong>7. Facilitate digital patient engagement.</strong> Most EHR systems are not designed to support digital patient engagement. But incorporating increased interoperability between EHR systems and patients’ mobile technologies and telehealth technologies would be an asset for promoting health and wellness and managing chronic illnesses.</p> <p> <strong>8. Expedite user input into product design and post-implementation feedback. </strong>The meaningful use program requires physicians to use certified EHR technology, but many of these products have performed poorly in real-world practice settings. EHR systems should give users an automated option to provide context-sensitive feedback that is used to improve system performance and safety.</p> <p> “Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus,” AMA President-Elect Steven J. Stack, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-16-solutions-to-ehr-systems.page" target="_blank">news release</a>.</p> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA will use this framework to work with physicians, vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance the delivery of high-quality, affordable care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1ed0e7a-406d-43e6-8a49-216785ec57db 6 things you need to know about hydrocodone reclassification http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-things-need-hydrocodone-reclassification Mon, 15 Sep 2014 20:33:00 GMT <p> If you prescribe hydrocodone combination products, prescribing these medications to the patients who need them to alleviate pain just became more complicated. A <a href="https://www.federalregister.gov/articles/2014/08/22/2014-19922/schedules-of-controlled-substances-rescheduling-of-hydrocodone-combination-products-from-schedule" rel="nofollow">new rule</a> from the Drug Enforcement Administration (DEA) taking effect Oct. 6 reclassifies these drugs as Schedule II controlled substances, prohibiting refills and establishing other restrictions that will require major changes to prescribing practices.</p> <p> These are the six key points you need to know so you can take appropriate action over the next few weeks:</p> <p> <strong>1. Refills aren’t allowed for prescriptions that are written beginning Oct. 6.</strong> Be prepared to issue new hard-copy or electronic prescriptions for patients. Note that eScripts can only be used if state law permits and the prescriber is certified to ePrescribe Schedule II substances. Pharmacies also must be certified to accept eScripts for controlled substances.</p> <p> <strong>2. Prescriptions issued before Oct. 6 won’t necessarily qualify for refills; plan to issue new ones. </strong>Although the DEA rule allows refills of prescriptions issued before Oct. 6 until April 8, 2015, other factors could prevent patients from getting those refills.</p> <p> Several states have published notices that they will treat hydrocodone combination product prescriptions issued before Oct. 6 in the same way they will handle prescriptions issued after the rule’s implementation date. In addition, any state laws that are more stringent than the DEA rule will govern refills. Meanwhile, some pharmacy quality and safety processes may not allow refills for prescriptions issued before Oct. 6, and some health insurers will not pay for those refills.</p> <p> <strong>3. Prescriptions can’t be called in or faxed. </strong>Make sure to plan ahead for any patients who may need refills. The new rule prohibits pharmacies from filling prescriptions delivered over the phone or via fax, so you’ll need to issue written scripts.<br /> <br /> The only exception to this rule is emergency treatment, which would allow physicians to call in a limited quantity of the medication to cover the emergency period only. Pharmacies are required to report prescribers to the DEA if they make such a request and do not give the pharmacy a written prescription within seven days.</p> <p> <strong>4. Allied health professionals might not be able to write prescriptions for these drugs going forward. </strong>Check your state’s restrictions around Schedule II substances to confirm whether any non-physician members of your team who have prescriptive authority will be able to continue issuing prescriptions for hydrocodone combination products. You may need to modify your collaborative practice agreements accordingly.</p> <p> <strong>5. Multiple prescriptions may be issued at one time under certain circumstances. </strong>The new rule does allow a patient to receive prescriptions that would total a 90-day supply, if the prescriber has determined it is appropriate to see the patient only once every 90 days. Each prescription must include written instructions that specify the earliest date it may be filled.<br /> <br /> In addition to sound medical judgment and established medical standards, make sure to base your practice’s policy on issuing multiple prescriptions on relevant federal and state laws.</p> <p> <strong>6. Patients should be notified of the new requirements and processes. </strong>Make sure your patients understand that their new prescriptions will not be refilled and are aware of the procedures they will need to follow going forward.</p> <p> <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/rescheduling-hydrocodone-products.pdf" target="_blank">Download a printable fact sheet</a> (log in) containing this information as well as details about how the new rule will impact patients and pharmacists for a convenient office reference or handout.</p> <p> “The AMA is strongly committed to combating prescription drug abuse and diversion while at the same time preserving patient access to medically necessary treatments for pain,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-18-new-dea-rule-fact-sheet.page" target="_blank">news release</a>. “This new fact sheet explains how new regulatory changes impact both physicians and pharmacists, which will help ensure patients continue having access to the care they need under the new federal rule.”</p> <p> The AMA and other groups have <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-warns-fda-weigh-unintended-consequences-of-reclassifying-hydrocodone" target="_blank">warned the DEA</a> about the potential unintended consequences of reclassifying hydrocodone combination products since the agency made the proposal early last year. Eliminating phoned-in prescriptions and refills  could make it difficult for some patients to get the pain relief they need, especially patients in nursing homes and those with persistent pain and disabilities.</p> <p> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Web page on combating prescription drug abuse and diversion</a> under “federal agency and administration activities” to learn more about this advocacy work.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:19167201-f9b8-4ddd-ba06-d46307745450 Top 5 things residents wish they had known about the Match http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_top-5-things-residents-wish-known-match Mon, 15 Sep 2014 20:33:00 GMT <p> Registration for the National Resident Matching Program opened this week, kicking off a busy season for fourth-year medical students. To help graduating students prepare, residents shared their top five tips on what they wish they had known when they participated in the Match.</p> <ol> <li style="margin-left:0.25in;"> <strong>Go with your gut. </strong>“Although pro/con lists or a systematic process might be helpful, you’ll know which programs are the best fits for you,” said Jessica Deslauriers, MD, an internal medicine resident at Yale-New Haven Hospital.<br />  </li> <li style="margin-left:0.25in;"> <strong>Don’t stress out over what you can’t control, but be prepared.</strong> “This is a stressful time, but you should take a moment to appreciate this exciting part of your journey to become a physician,” said Christopher Wee, MD, an internal medicine resident at the Cleveland Clinic.<br /> <br /> At the same time, “you should control the things you can control to avoid a careless mistake,” Dr. Wee said. “That means double-checking every piece of correspondence by making sure it’s going to the intended recipient and making sure you keep your calendar updated because you often have to respond to interview invitations on short notice.”<br />  </li> <li style="margin-left:0.25in;"> <strong>Apply to your dream programs.</strong> “You are likely more qualified and capable than you might imagine,” said Dr. Deslauriers. “If you are offered an interview, the program already thinks you would be a good match for them. Be yourself on interview day, and show them how great you really are!”<br />  </li> <li style="margin-left:0.25in;"> <strong>Anticipate a variety of interview styles.</strong> “You can’t predict every situation, but you should prepare for interviews in which you may need to answer a lot of questions, as well as interviews in which you might need to help direct the conversation by asking your own questions,” said. Dr. Wee.<br />  </li> <li style="margin-left:0.25in;"> <strong>Try to relax. </strong>“Even if you are convinced that you matched to the last program on your rank list, you will still be an employed doctor next year,” said Dr. Deslauriers. “That’s an honor and privilege that unfortunately not all medical students get.”</li> </ol> <p> Use the AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page">FREIDA Online</a> to search graduate medical education programs and narrow down your choices. Find more deadlines, tips and information on the <a href="http://www.nrmp.org/residency/main-match-events/" rel="nofollow">Match website</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2817898f-1b9d-4dff-b324-a60602c11256 How has your practice controlled hypertension? Be recognized http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_practice-controlled-hypertension-recognized Mon, 15 Sep 2014 20:29:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/6/5e021cf3-1c97-4cca-a6e2-7ffedb12d075.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/6/5e021cf3-1c97-4cca-a6e2-7ffedb12d075.Large.jpg?1" style="float:right;margin:10px;" /></a>How are you successfully controlling your patients’ hypertension? Share your methods with your fellow physicians as part of the 2014 Million Hearts® Hypertension Control Challenge.</p> <p> The latest data show that nearly one in three American adults—approximately 70 million—has high blood pressure, and more than one-half of these adults don't have it under control. The <a href="http://millionhearts.hhs.gov/index.html" target="_blank" rel="nofollow">Million Hearts</a> initiative is a program of the U.S. Department of Health and Human Services that aims to prevent 1 million heart attacks and strokes over five years.</p> <p> Because <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cdc-1-3-heart-disease-deaths-preventable" target="_blank">one in three </a>heart disease deaths is preventable, the AMA and other partners from across the private and public sectors are supporting the Million Hearts efforts to improve adherence to treatment plans for high blood pressure, expand access to effective care, and focus clinical attention on the prevention of heart attacks and strokes.</p> <p> If your practice has gotten blood pressure under control for more than 70 percent of your patients with hypertension, share how you’ve done it with the health care community. Your story could help get you recognized as a Hypertension Control Champion: <a href="http://millionhearts.hhs.gov/aboutmh/htn_champions.html" target="_blank" rel="nofollow">Apply on the Million Hearts website</a>. The challenge is open through Oct. 10.</p> <p> <strong>Achieving blood pressure control</strong></p> <p> Some physicians are using local resources to help their patients manage their high blood pressure, for instance. Willarda Edwards, MD, an internist in Baltimore, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patients-manage-blood-pressure-outside-office-visits" target="_blank">refers her patients</a> to community programs that offer accurate blood pressure measurements and safe exercise opportunities.</p> <p> Dr. Edwards is participating in a pilot program 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. In this program, physicians and care teams in Maryland and Illinois are developing and testing evidence-based recommendations to improve high blood pressure, working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities.</p> <p> The clinical sites in the pilot program are implementing principles of safe design to improve outcomes around hypertension, creating and testing a set of evidence-based recommendations called the “M.A.P. for achieving optimal hypertension control”:</p> <ul> <li> <strong>Measuring blood pressure accurately every time it’s measured</strong><br /> Many things can influence a patient’s blood pressure, so ensure your practice is doing all it can to get the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctor-quickly-improved-patients-blood-pressure-readings" target="_blank">most accurate measurement</a>.</li> </ul> <ul> <li> <strong>Acting rapidly to address high blood pressure readings</strong><br /> Use a Million Hearts resource to create a <a href="http://millionhearts.hhs.gov/resources/protocols.html" target="_blank" rel="nofollow">standardized hypertension treatment protocol</a> for your practice. </li> </ul> <ul> <li> <strong>Partnering with patients to promote self-management of high blood pressure</strong><br /> Help patients stick to their management plans, including eating right, exercising and adhering to medications using <a href="http://millionhearts.hhs.gov/resources.html" target="_blank" rel="nofollow">resources</a> from Million Hearts, including a <a href="http://millionhearts.hhs.gov/Docs/BP_Toolkit/BP_Wallet_Card.pdf" target="_blank" rel="nofollow">patient wallet card</a> and <a href="http://millionhearts.hhs.gov/Docs/TUPD/Medication_Tracker.pdf" target="_blank" rel="nofollow">medication tracker</a>.</li> </ul> <p> Million Hearts also has a physician <a href="http://millionhearts.hhs.gov/resources/action_guides.html#htnGuide" target="_blank" rel="nofollow">action guide</a> to hypertension control and a variety of <a href="http://millionhearts.hhs.gov/resources/tools.html" target="_blank" rel="nofollow">tools</a> to help patients manage their blood pressure and improve outcomes around hypertension.</p> <p> <strong>Share your success. </strong>What methods have you implemented to improve your patients’ hypertension? Describe it to your peers in a comment below or on our <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5f1abe71-cd4b-4ead-a5ce-e617ea063557 Find opportunities for senior physicians via the JAMA Career Center http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_opportunities-senior-physicians-via-jama-career-center Mon, 15 Sep 2014 18:00:00 GMT <p> The <a href="http://www.jamacareercenter.com/index.cfm" target="_blank" rel="nofollow"><em>JAMA</em> Career Center®</a> presents physician volunteer and career opportunities, news and information relevant to the full spectrum of medical practice. Job postings are updated daily for virtually every specialty, practice setting and region in the United States.</p> <p> This center offers a way to bring <a href="http://jamacareercenter.com/employer_account_benefits.cfm" target="_blank" title="physician employers: physician employer account benefits" rel="nofollow">employers</a> and <a href="http://jamacareercenter.com/jobseeker_account_benefits.cfm" target="_blank" title="physician job seeker: physician job seeker account benefits" rel="nofollow">job seekers</a> together, helping physicians realize their potential while addressing the needs of disparate communities. Opportunities can range from remote rural and underserved urban areas to thriving neighborhoods in towns and major metropolitan centers.</p> <p> If you’re searching for volunteer opportunities, the site offers a <a href="http://www.jamacareercenter.com/volunteer_opportunities.cfm" target="_blank" rel="nofollow">list of organizations looking for volunteers</a> as well as the areas each organization serves and the specialties needed.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6f6673d6-e12e-41d6-a560-08755b951c74 HHS awards $3.2 million to support minority health insurance coverage http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hhs-awards-32-million-support-minority-health-insurance-coverage Mon, 15 Sep 2014 18:00:00 GMT <p> The U.S. Department of Health and Human Services’ (HHS) Office of Minority Health last week <a href="http://minorityhealth.hhs.gov/omh/Content.aspx?ID=25&lvl=2&lvlid=8" rel="nofollow" target="_blank">announced</a> $3.2 million in grant awards to 13 organizations for supporting health coverage enrollment of racial and ethnic minorities.</p> <p> The new Partnerships to Increase Coverage in Communities (PICC) initiative will help identify, inform and enroll minority populations through the <a href="https://www.healthcare.gov/" rel="nofollow" target="_blank">health insurance marketplaces</a>, Medicaid and the Children’s Health Insurance Program. Information on financial assistance, education and translation services to support health insurance enrollment also is funded through the PICC grant awards.</p> <p> As a result of the Affordable Care Act, more minorities now have access to affordable, quality health care coverage. However, gaps in coverage continue to persist among minority populations.</p> <p> The PICC initiative awards will support organizations, partnerships and coalitions in developing culturally competent and linguistically appropriate services designed to reach racial and ethnic minorities and underserved communities.</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> encourages and supports the funding of minority enrollment in health insurance coverage. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a1a5ea4a-bd6f-4d75-a466-9735af8315ea Register for the LGBT and allies caucus and reception Nov. 7 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-lgbt-allies-caucus-reception-nov-7 Mon, 15 Sep 2014 18:00:00 GMT <p> Plan to attend 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 LGBT Issues</a> annual caucus and reception at 4:30 p.m. Nov. 7 at the Hilton Anatole in Dallas, taking place in conjunction with the 2014 AMA Interim Meeting.</p> <p> Following the networking reception, committee chair Gregory Blaschke, MD, will lead attendees through a discussion of current issues in lesbian, gay, bisexual and transgender (LGBT) health and items of business related to the LGBT community that are up for consideration by the AMA House of Delegates.</p> <p> Participants also will hear from a panel including Andy Miller, co-founder and president of the Handsome Father, Dorothy Sippo, MD, and Terrance Hines, MD. They’ll examine the topic, “The contemporary context of family building: What physicians need to know.”</p> <p> <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144452E&TID=vCIaLRgK%252bYeYYFMXecjotQ%253d%253d&OID=130" target="_blank">Register</a> to attend by 3 a.m. Eastern time Nov. 1. Everyone is welcome, so spread the word to your colleagues.</p> <p> If you’re interested in receiving occasional announcements from the AMA’s LGBT list serve, <a href="mailto:lgbt@ama-assn.org" rel="nofollow" target="_blank">send an email</a> to the committee. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5babb33a-fe22-4593-a752-e8d08396c263 Physicians’ role in driving social change: Ethics journal debates http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-role-driving-social-change-ethics-journal-debates Fri, 12 Sep 2014 19:45:00 GMT <p> The role of physicians in addressing the myriad of nonmedical factors that affect human health—from poverty to social injustice to infringement of human rights—is a complex one. Physicians and other experts in the field explore the role of physicians as agents of change in the <a href="http://virtualmentor.ama-assn.org/" target="_blank">September issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal.</p> <p> One concern is that well-intentioned physicians may not have the expertise on these non-clinical issues and yet be taken as authorities on the subject because of their professional status. On the other hand, these social, economic and environmental ills threaten the health and welfare of the public. Ignoring them is like treating the symptoms of the disease rather than the cause.</p> <p> <em>Virtual Mentor</em> contributors take a closer look at the topic. Highlights include:</p> <ul> <li>  “<a href="http://virtualmentor.ama-assn.org/2014/09/ecas1-1409.html" target="_blank">Advocate as a doctor or advocate as a citizen?</a>” This commentary by Matthew Wynia, MD, points out the hazards of physicians invoking their medical training when giving opinion on nonmedical matters. Doctors should be careful not to present their personal views as professional insights if they do not have special expertise in the area.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/09/ecas2-1409.html" target="_blank">A call to service: Social justice is a public health issue</a>.” Martin Donohoe, MD, and Gordon Schiff, MD, argue that unless physicians build bridges between their clinical work with patients and the public health mission prescribed by Rudolf Virchow, efforts to help patients could prove futile.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/09/mhst1-1409.html" target="_blank">The Medical Committee for Human Rights</a>.” In this piece, John Dittmer, PhD, looks at this special committee formed in the 1960s, which become a model for similar organizations, such as Physicians for Human Rights and Physicians for a National Health Program.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/09/spec1-1409.html" target="_blank">Structural competency meets structural racism: Race, politics and the structure of medical knowledge</a>.” Jonathan Metzl, PhD, and Dorothy E. Roberts write about how to better prepare physicians for medical practice in an ethnically diverse society. They also examine how to eliminate the misguided views of cultural competency that have proven ineffective in combatting racism and its health consequences.</li> </ul> <p> Be sure to take this month’s <a href="http://virtualmentor.ama-assn.org/site/poll.html" target="_blank">ethics poll</a> (“How should physicians manage their public advocacy and expressions of opinion?”), and check out the September <a href="http://virtualmentor.ama-assn.org/podcast/ethics-talk-september-2014.mp3" target="_blank">podcast</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9ab8a952-6cfa-4b04-b637-5bf4a0e2269b Footing bill for insurers’ pay methods shouldn’t fall on doctors http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_footing-bill-insurers-pay-methods-shouldnt-fall-doctors Fri, 12 Sep 2014 19:39:00 GMT <p> An increasingly common payment method among health insurers offers these companies significant financial rewards while sticking physicians with all the associated fees and extra work. But physicians are fighting back as the AMA and other health care associations take the issue to the federal government.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/6/6ff1d45f-2982-436c-8665-229e9dd3db5e.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/6/6ff1d45f-2982-436c-8665-229e9dd3db5e.Large.jpg?1" style="margin:15px;float:right;" /></a>Many insurers are choosing to use virtual credit cards for claims payments to physicians, instead of sending paper checks or paying via the electronic funds transfer (EFT) standard transaction. When paying via virtual credit card, insurers send single-use credit card payment information and instructions to physicians via mail, fax or email. The physician’s office staff then processes the payment as they would a patient’s credit card.</p> <p> For each of these payments, physicians are charged fees that typically amount to 3-5 percent of the total payment, the AMA explained in recent <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/ncvhs-virtual-cards.pdf" target="_blank">testimony</a> (log in) to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS).</p> <p> That adds up. If a physician contractually is owed $5,000, for instance, he or she could have to shell out up to $250 in fees.</p> <p> In addition, physicians’ practices are forced to devote more time to processing these payments, having to manually enter information, correct any entry errors and manually reconcile the payment with the separate claims remittance advice.</p> <p> Insurers, on the other hand, often receive cash-back incentives for making virtual card payments, including a portion of the fees the physician paid.</p> <p> The AMA is urging HHS to issue additional guidance on this issue. In a <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/joint-virtual-card-letter-hhs.pdf" target="_blank">letter</a> (log in) sent last week to HHS Secretary Sylvia Burwell, the AMA and three other leading organizations called on the agency to prohibit insurers from forcing physicians to accept this payment method. They also urged the agency to require insurers to give full upfront disclosures of associated fees, obtain physician authorization before implementing virtual card payments and ensure an easy opt-out process if a physician later chooses not to accept this form of payment.</p> <p> Physicians instead can request insurers to pay via the EFT standard transaction, which works like direct deposit and can cut down the time spent on processing paper checks. The AMA offers two educational opportunities for physicians who are interested in pursuing the EFT payment method:</p> <ul> <li> A free continuing medical education webinar, “Stop paying to get paid: Effective electronic payments,” will take place at noon Eastern time Sept. 16. <a href="http://eo2.commpartners.com/users/ama/session.php?id=14338" rel="nofollow" target="_blank">Registration</a> now is open.</li> <li> An <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page?" target="_blank">EFT toolkit</a> offers guidance about physicians’ rights regarding electronic payments, the effects of virtual credit card payments, and the ins and outs of EFT payments.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a6e449e5-33f3-4755-9928-f47b18590c84 Tomorrow’s doctors should question the status quo: TEDMED 2014 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tedmed-2014-tomorrows-doctors-should-question-status-quo Fri, 12 Sep 2014 19:00:00 GMT <p> If physicians are going to lead health care changes, they’ll need to take unconventional approaches, ask a lot of questions and support innovation, speakers emphasized at TEDMED 2014, which began Wednesday and ran through Friday in San Francisco and Washington, D.C.</p> <table align="left" cellpadding="1" cellspacing="1" style="width:400px;"> <tbody> <tr> <td>  <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/0/dc615a80-4ea0-45c6-8041-96b0a5644340.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/0/dc615a80-4ea0-45c6-8041-96b0a5644340.Large.jpg?1" /></a></td> <td>  </td> </tr> <tr> <td> <em style="font-size:11px;">"The way we frame our inquiries shapes the way we make our<br /> discoveries," said Eric Chen.</em></td> <td style="text-align:left;vertical-align:top;"> <p> <span style="font-size:11px;"><i>  </i></span></p> </td> </tr> </tbody> </table> <p> And challenging the status quo starts with changes in how the profession trains physicians of tomorrow. Specifically, it’s about injecting curiosity back into the learning process, according to Eric Chen, an 18-year-old “scientific wunderkind” who was recently awarded the grand prize at the Google Science Fair, the Siemens Competition and the Intel Science Talent Search for his work combining computer models and biological assays to speed up discovery of new anti-influenza drugs.</p> <p> In traditional education systems today, “the focus is on memorizing answers to questions, rather than proposing and asking your own [questions],” said Chen, a freshman at Harvard University. “The way we frame our inquiries shapes the way we make our discoveries.”</p> <p> Leading innovation might require physicians to learn new things that are not traditional components of the medical school curriculum. John La Puma, MD, the first physician to teach a cooking and nutrition course at a U.S. medical school, said food is the most important health care intervention the country has in its fight against chronic disease.</p> <p> “Food can save your life, if you know how to use it,” Dr. La Puma said. “Unlike prescription medication, food is sustainable. ... If doctors knew a little bit more about food, and were able to write culinary medicine prescriptions on prescription pads—recipes on prescription pads—they would find their patients totally more engaged about the importance of food in controlling their disease.”</p> <p> And learning by doing is crucial, said Carla Pugh, MD, PhD, vice chair of education and patient safety at the University of Wisconsin School of Medicine and Public Health and clinical director of the University of Wisconsin Health Clinical Simulation Program. </p> <table align="left" cellpadding="1" cellspacing="1" style="width:400px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/4/6b5846cf-76e5-40c9-94e4-6673cc87e495.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/4/6b5846cf-76e5-40c9-94e4-6673cc87e495.Large.jpg?1" /></a>  </td> <td>  </td> </tr> <tr> <td> <span style="font-size:11px;"><em>“Food can save your life, if you know how to use it,” said John<br /> La Puma, MD.</em></span> <div>  </div> </td> <td style="text-align:left;vertical-align:top;"> <p> <span style="font-size:11px;"><i>  </i></span></p> </td> </tr> </tbody> </table> <p> "Doctors go through years and years of training to become top notch, elite professionals,” Dr. Pugh said. “But we don’t have a test for hands-on skills, and we desperately need one. ... Let’s take medical training, and specifically assessment and testing, to the next level—above and beyond the paper tests."</p> <p> Watch TEDMED on-demand from your computer or personal device through Tuesday. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14”</strong> to participate. Video of the above speakers now can be found on demand at the TEDMED site.</p> <p> The AMA is a <a href="http://tedmed.com/partners/index" rel="nofollow" target="_blank">global institution partner</a> of TEDMED 2014.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d7982949-14e5-4223-ab3d-eca8b7b1f57c Physicians touch sensitive subjects at TEDMED 2014 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-touch-sensitive-subjects-tedmed-2014 Fri, 12 Sep 2014 00:21:00 GMT <div> Tackling the uncomfortable subjects—such as total transparency with patients regarding payment or medical errors—is a large part of TEDMED 2014, which began Wednesday and runs through Friday in San Francisco and Washington, D.C. </div> <div>  </div> <div> <table align="right" cellpadding="1" cellspacing="1" style="width:400px;"> <tbody> <tr> <td>   </td> <td>   <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/f6b0eb5f-6f13-450c-9529-cc719b56c7c9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/f6b0eb5f-6f13-450c-9529-cc719b56c7c9.Large.jpg?1" /></a></td> </tr> <tr> <td> <p>  </p> </td> <td style="text-align:left;vertical-align:top;"> <p> <em>"Health care is a team sport, and if collectively, together, we decide enough is enough and our system isn’t working, we can change it,” Patricia Horoho said.</em></p> </td> </tr> </tbody> </table> Physicians, health care leaders and innovators took on these tough topics at the annual health and medicine edition of TED, encouraging listeners to be open and honest with themselves in the practice of medicine in order to enhance the doctor-patient relationship.</div> <div>  </div> <div> Medical errors are often discussed in hushed tones, said Patricia Horoho, the surgeon general of the U.S. Army and the first nurse to hold that position. But what if clinicians were more open about making errors?</div> <div>  </div> <div> “The problem isn’t that we err—the problem is that we ignore the errors,” Horoho said. “As individuals, we need the confidence, the integrity and the courage to speak up …. Health care is a team sport, and if collectively, together, we decide enough is enough and our system isn’t working, we can change it.”</div> <div>  </div> <div> This shift in thinking requires turning upside down the current way medical students and residents are trained, the way physicians communicate with patients and how physicians practice. For example, Danielle Ofri, MD, PhD, a physician at Bellevue Hospital, professor at New York University School of Medicine and editor-in-chief of the Bellevue Literary Review, shared a memory from medical school of hearing an attending physician chew out a resident for allowing an error. It made her, as a student, feel like she shouldn’t discuss her mistakes.</div> <div>  </div> <div> The attending physician “was trying to get us to perfection—but the message we got was that anything short of perfection was failure,” Dr, Ofri said. “The current culture is zero tolerance of medical error … to think of [mistakes] as foreign is to misunderstand the nature of error.”</div> <div>  </div> <div> Dr. Ofri’s call for more transparency was echoed by Leana Wen, MD, an emergency physician at George Washington University, where she is director of patient-centered care in the department of emergency medicine. Dr. Wen called on physicians to break down the barrier that occurs when they put on their white coats.</div> <div>  </div> <div> “It’s not just patients that are scared. Doctors are scared, too,” Dr. Wen said. “We’re scared of patients finding out who we are and what medicine is all about.”</div> <div>  </div> <div> <table align="right" cellpadding="1" cellspacing="1" style="width:400px;"> <tbody> <tr> <td>   </td> <td> <em><span style="font-size:10px;"><a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/13/1aa28df7-f600-4027-8d95-4cff98c5703e.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/13/1aa28df7-f600-4027-8d95-4cff98c5703e.Large.jpg?1" /></a></span></em></td> </tr> <tr> <td>  </td> <td style="text-align:left;vertical-align:top;"> <p> <span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:12px;"><em>“Being totally transparent is scary,” Leana Wen, MD, said. “You feel naked, exposed and vulnerable. But that vulnerability, that humility, it can be an extraordinary benefit to the practice of medicine.”</em></span></span></p> <p>  </p> </td> </tr> </tbody> </table> Dr. Wen shared research on what patients want to know about their doctors. Most patients did want to know that their physicians were competent and making evidence-based decisions, but the vast majority had individualized preferences that were important to them. For example, one patient wanted a doctor with similar reproductive rights values. Another patient was seeking a doctor who believed in prevention first.</div> <div>  </div> <div> “Being totally transparent is scary,” Dr. Wen said. “You feel naked, exposed and vulnerable. But that vulnerability, that humility, it can be an extraordinary benefit to the practice of medicine.”</div> <div>  </div> <div> Watch TEDMED live from your computer or personal device through Friday, or watch the program on demand through Sept. 16. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14”</strong> to participate. Video of the above speakers now can be found on demand at the TEDMED site.</div> <div>  </div> <div> The AMA is a <a href="http://tedmed.com/partners/index" rel="nofollow" target="_blank">global institution partner</a> of TEDMED 2014.</div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:78d459df-652d-478c-a0ce-007f6a7259ab JAMA Highlights: New guideline to manage sickle cell http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-new-guideline-manage-sickle-cell-1 Thu, 11 Sep 2014 20:09:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/-EkZOBnkzr0?list=UUlpzWSNUo4kEgZbD2V-dRaA" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/-EkZOBnkzr0?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="400"><param name="movie" value="http://www.youtube.com/v/-EkZOBnkzr0?list=UUlpzWSNUo4kEgZbD2V-dRaA" /><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/-EkZOBnkzr0?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="400" wmode="transparent"></embed></object>New guideline created for managing sickle cell disease</strong></p> <p> An expert panel has created a new evidence-based guideline for managing sickle cell disease, including a strong recommendation for the use of the drug hydroxyurea and transfusion therapy for many individuals with this disease. However, high-quality evidence is limited, with few randomized clinical trials conducted for this disease, according to an <a href="http://jama.jamanetwork.com/article.aspx?articleid=1902235" rel="nofollow" target="_blank">article</a> in the Sept. 10 issue of <em>JAMA.</em></p> <p> <strong>Long-term follow-up shows benefit of statin therapy for children with inherited cholesterol disorder</strong></p> <p> Ten-year follow-up of children who have been taking statin therapy for an inherited cholesterol disorder showed benefit on a measure of atherosclerosis, although levels of low-density lipoprotein suggested that stronger or earlier initiation of statin therapy may be warranted, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1902218" rel="nofollow" target="_blank">study</a> in <em>JAMA.</em></p> <p> <strong>Patients with advanced dementia continue receiving medications of questionable benefit</strong></p> <p> More than one-half of nursing home residents with advanced dementia continue to receive medications of questionable benefit (including medications to treat dementia and lower cholesterol) at substantial financial cost, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1901117" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Access to care among young adults increases after health insurance expansion</strong></p> <p> Health insurance coverage increased, as expected, among 19 to 25 year-olds after the Affordable Care Act allowed them to remain on their parents’ insurance longer, but there were no significant changes in perceived health status or the affordability of health care, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1900952" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b2b7b3c-39a3-4a3d-bd5f-dc4fecea0b7a GME reform essential, but how to proceed? Experts debate http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gme-reform-essential-but-proceed-experts-debate Thu, 11 Sep 2014 15:04:00 GMT <p> On the heels of a long-awaited report on overhauling the graduate medical education (GME) system from the Institute of Medicine (IOM), national experts came together Wednesday in Washington, D.C., to discuss concerns, challenges and next steps for reforming the system to better meet the needs of future physicians and the patient population.</p> <p> A dozen experts—many of them physicians directly involved in medical education—presented an array of perspectives on the current state of GME and how to revise the system for the 21st century at a forum hosted by <em>Health Affairs</em>. Despite differing opinions on precisely how to move forward, everyone agreed that the nation needs to rethink its present approach so future physicians and patients can thrive in the new health care environment.</p> <p> Common problems highlighted by panelists included an imbalance in specialties, unmet geographic needs and ongoing threats of funding cuts.</p> <p> Some points generally accepted as positive <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gme-financing-system-needs-overhaul-iom-report" target="_blank">recommendations from the IOM report</a> included:</p> <ul> <li> Removing the cap on residency slots (although the report does not call for increased funding)</li> <li> Creating flexibility in the system to respond to changing needs for health care and training</li> <li> Facilitating innovation and evaluating with an eye toward improving outcomes</li> </ul> <p> “Those who are involved in GME really are doing an excellent job,” said Glenn Hackbarth, chair of the Medicare Payment Advisory Commission, which issued its own report on GME in 2010. “But now we need to focus on how we train physicians who are prepared to serve as leaders in a new kind of health care system.”</p> <p> Other panelists highlighted concerns that the IOM report could divert funding away from physician training. The IOM report also failed to provide an explicit future model for GME, leaving the possibility for innovation but providing no clear path forward.</p> <p> Among the next steps panelists recommended was more frequent workforce estimates.</p> <p> “Annual projections do change each year, but they would help us with modeling and planning,” said David Sklar, MD, associate dean of GME emeritus at the University of New Mexico and editor of <em>Academic Medicine</em>.</p> <p> Bringing stakeholders together to determine changes and implement them also will be key.</p> <p> “We need to have a common way of looking at these issues,” said Thomas J. Nasca, MD, CEO of the Accreditation Council of Graduate Medical Education. “They are not just GME issues but are issues that affect the entire health care system. Collaboration is imperative.”</p> <p> Experts agreed time is of the essence. “Clearly there are risks involved [in implementing change],” said Debra Weinstein, MD, vice president for GME at Partners Healthcare System. “But I don’t think we can get paralyzed by those worries because the risks of doing nothing are pretty heavy as well.”</p> <p> A <a href="http://ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt7-a-14.pdf" target="_blank">new report</a> (log in) from the AMA Council on Medical Education, released in June, gives physicians a snapshot of the current state of the physician workforce and alternative models for GME funding.</p> <p> Medical students, residents and fellows across the country, meanwhile, came together this week to call on Congress to preserve GME funding as part of <a href="http://savegme.org/2014-save-gme-action-week/" target="_blank" rel="nofollow">Save GME Week</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:70442933-e266-4c10-b089-eb092c5f8bbe Why physicians should admit what they don’t know: TEDMED 2014 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-should-admit-dont-tedmed-2014 Thu, 11 Sep 2014 00:32:00 GMT <div> Physicians, health care leaders and innovators examined and celebrated unbridled imagination at TEDMED 2014, which began Wednesday and runs through Friday in San Francisco and Washington, D.C.</div> <div>  </div> <div> <table align="left" border="1" cellpadding="1" cellspacing="20" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/12/e0b94fb9-24c4-4191-ace4-87d34f5decf1.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/12/e0b94fb9-24c4-4191-ace4-87d34f5decf1.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:top;height:35px;"> <p> <em><span style="font-size:12px;">“Health and medicine is about to change more in the next 20 years than in the last 20,000 years,” said TEDMED 2014 curator Jay Walker. “We’re rapidly heading for the biological version of the Big Bang.”</span></em></p> </td> <td>  </td> </tr> </tbody> </table> On the first day of TEDMED, the annual health and medicine edition of TED, transformative thinkers encouraged listeners to question current knowledge. Instead of putting imagination on trial, Jay Walker, curator and chairman of TEDMED, urged listeners to embrace new ideas.</div> <div>  </div> <div> “Health and medicine is about to change more in the next 20 years than in the last 20,000 years,” Walker said. “We’re rapidly heading for the biological version of the Big Bang.”</div> <div>  </div> <div> Tomorrow’s physicians will need to accept that they don’t—and won’t—know it all, and maintain humility in admitting that they need answers, said Elizabeth Nabel, MD, president of Brigham and Women’s Hospital in Boston. </div> <div>  </div> <div> “Have the intellectual courage to say, ‘I don’t know,’ because it’s empowering,” said Dr. Nabel. “And only then can you add, ‘I’m going to find out.’”</div> <div>  </div> <div> And what if you do have the power to know it all? For Amy McGuire, PhD, a geneticist and director of Baylor University’s Center for Medical Ethics and Health Policy, the ability to know the code to your existence still doesn’t guarantee having all the answers. McGuire gave listeners a close look at where genome sequencing is headed, but stressed that “there is no genome for the human spirit.” </div> <div>  </div> <div> <table align="left" border="1" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/6/e843f117-9073-46c3-9608-5e9869123c94.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/6/e843f117-9073-46c3-9608-5e9869123c94.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:top;height:35px;"> <p> <span style="font-size:12px;"><em>“Have the intellectual courage to say, ‘I don’t know,’ because it’s empowering,” said Elizabeth Nabel, MD. “And only then can you add, ‘I’m going to find out.’” </em></span></p> </td> <td>  </td> </tr> </tbody> </table> Dr. McGuire’s ideas echoed Dr. Nabel’s—that humility is a crucial quality in physicians of the future. “Students and trainees have access to the ability to find information,” she said. “Medical education reform is changing the curriculum and teaching people to research and get the answers they need... and recognizing that we might not know everything.”</div> <div>  </div> <div> Besides embracing innovation, listeners were able to hear about groundbreaking work that’s already a reality. For example, Gail Reed, international director of Medical Education Cooperation with Cuba, shared how more than 20,000 young people ended up in Cuba to transform health and improve access to care in the poorest places on the planet. </div> <div>  </div> <div> Reed talked about the Latin American Medical School, which recruits students from underserved areas with the specific goal of producing physicians who will return to their birthplaces to provide care. Students learn to treat the whole patient—mind and body—in the context of their communities and culture.</div> <div>  </div> <div> “Training has moved out of the ivory tower and into clinic classes and neighborhoods,” she said of the school, which has graduates from 83 countries. “Community-based learning starts on Day One.”</div> <div>  </div> <div> Watch TEDMED live from your computer or personal device through Friday, or watch the program on-demand through Sept. 16. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “<strong>TMLicAMA14</strong>” to participate. Video of the above speakers now can be found on demand at the TEDMED site.</div> <div>  </div> <div> The AMA is a <a href="http://tedmed.com/partners/index" rel="nofollow" target="_blank">global institution partner</a> of TEDMED 2014.</div> <div>  </div> <div>  </div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bf46bfec-40c5-45a8-9ae0-f8aca74dc6b8 CDC provides physicians with resources on Ebola outbreak http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-provides-physicians-resources-ebola-outbreak Wed, 10 Sep 2014 20:00:00 GMT <p> In response to the Ebola outbreak in West Africa, the Centers for Disease Control and Prevention (CDC) is educating physicians and health care workers in the United States on how to diagnose the disease and advise travelers on protecting their health.</p> <p> The <a href="http://www.cdc.gov/vhf/ebola/index.html" rel="nofollow" target="_blank">Ebola hemorrhagic fever</a> page on the CDC website contains <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">information for health care workers</a>, including diagnosis and testing, and specimen collecting, transport, testing and submission.</p> <p> The CDC also supplied a Medscape “expert commentary” <a href="http://www.medscape.com/viewarticle/830141" rel="nofollow" target="_blank">video</a> (free account required) about the risk of Ebola to international travelers.</p> <p> According to its website, the CDC is encouraging all U.S. health care professionals to:</p> <ul> <li> Ask patients about their travel histories to determine whether they have traveled to West Africa within the last three weeks.</li> <li> Know the signs and symptoms of Ebola: fever (greater than 38.6°C or 101.5°F) and additional symptoms, such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain or unexplained hemorrhage. </li> <li> Know what to do if they have a patient with Ebola symptoms: <ul> <li> First, properly isolate the patient.</li> <li> Then, follow infection control precautions to prevent the spread of Ebola. Avoid contact with blood and body fluids of infected people.</li> </ul> </li> </ul> <p> For more information, read the CDC <a href="http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html" rel="nofollow" target="_blank">questions and answers page</a> about Ebola.</p> <p> Also, read two Viewpoints on Ebola published this week in the <em>Journal of the American Medical Association.</em> “<a href="http://jama.jamanetwork.com/article.aspx?articleid=1905875" rel="nofollow">Evaluating novel therapies during the Ebola epidemic</a>” considers the ethical and scientific dilemmas that arise in evaluating the use of experimental therapies in an epidemic. And “<a href="http://jama.jamanetwork.com/article.aspx?articleid=1905876" rel="nofollow">Why should high-income countries help combat Ebola?</a>” outlines the reasons why those countries have a duty to fight Ebola disease.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:297c489d-2fb4-4520-98ad-b44416a54434 Keeping unused meds out of the wrong hands just got easier http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_keeping-unused-meds-out-of-wrong-hands-just-got-easier Wed, 10 Sep 2014 17:58:00 GMT <p> In the midst of a prescription drug epidemic, new <a href="https://www.federalregister.gov/articles/2014/09/09/2014-20926/disposal-of-controlled-substances" target="_blank" rel="nofollow">federal regulations</a> released Monday expand take-back options for patients to safely dispose their unused prescription drugs and prevent misuse of these controlled substances.</p> <p> The regulations, issued by the Drug Enforcement Administration, are intended to increase the availability of secure disposal programs. Entities now authorized to administer mail-back programs and maintain collection receptacles include retail pharmacies, hospitals and clinics with on-site pharmacies, and certain manufacturers and distributors.</p> <p> Authorized hospitals, clinics and retail pharmacies also will be permitted to maintain collection receptacles at long-term care facilities. And law enforcement will be able to continue conducting take-back events, coordinating mail-back programs and maintaining collection receptacles</p> <p> “Prescription drug abuse and diversion is a complex problem, and we have long advocated for a public health approach to combat the epidemic,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-08-final-rule-regarding-disposal-controlled-substances.page" target="_blank">statement</a>.</p> <p> In addition to take-back programs, Dr. Wah said, “important initiatives include educational opportunities about addiction prevention for physicians and patients, increased access to treatment programs, modernized and fully funded prescription drug monitoring programs, and increased access to overdose prevention measures such as the life-saving medicine naloxone.”</p> <p> The AMA has been helping to shape how the nation addresses the prescription drug abuse crisis on a variety of fronts—from <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/states-taking-national-rx-abuse-crisis" target="_blank">state-based legislation and programs</a> to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/grants-risk-youth-learn-dangers-of-rx-drug-misuse" target="_blank">youth education</a> to expansion of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/addiction-treatment-boost-under-new-federal-bill" target="_blank">addiction treatment</a> programs.</p> <p> “We look forward to continuing our work with the DEA, the White House Office of National Drug Control Policy and other stakeholders to stop prescription drug abuse, overdose and death while preserving access to medically necessary treatment for pain,” Dr. Wah said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4e65b62d-89c6-4d87-940c-f8b6a67e0417 4 ways to finish residency without falling further into debt http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-ways-finish-residency-falling-further-debt Wed, 10 Sep 2014 17:52:00 GMT <p> After graduating from medical school, you likely already have significant student loan debt—don’t add to your financial load by incurring even more debt throughout your residency. A certified financial planner offers some ways residents can finish their training with cash to spare.</p> <p> “What I see at the end of residency is just a need for cash—almost always,” said Chris Long, who specializes in financial planning for physicians. “Whether it’s preparing for boards, wanting to take a little time off before practice, relocation, all sorts of things …. If you don’t have a plan to accumulate some savings or have a savings target by the end of residency, you’ll probably go further into debt.”</p> <p> So how do you get to that goal? Follow the system Long developed for residents who don’t have time to micromanage a complicated budget.</p> <p style="margin-left:31.5pt;"> <strong>1. </strong><strong>Understand your cash flow using a monthly budget.</strong> You can use online budgeting tools and apps, but Long prefers a simple spreadsheet program like Excel (<a href="http://www.cplanningmd.com/links/" rel="nofollow" target="_blank">download Long’s template</a>.) List your monthly take-home pay, fixed expenses and savings. Make sure you budget for things like car or home maintenance and clothing. Aim for a slight surplus at the end of each month. </p> <p style="margin-left:31.5pt;"> <strong>2. </strong><strong>Establish separate accounts to keep track of your spending and saving.</strong> Set up two checking accounts and a savings account. From your budget worksheet, subtotal amounts for savings, discretionary, and fixed expenses<em>. </em>When you get paid, pay yourself first by putting an allocated amount of money into savings. Then transfer your allocated discretionary amount into your discretionary checking account. Leave the rest in the other checking account. Many residency programs will allow you to split your direct deposit into multiple accounts.</p> <p style="margin-left:31.5pt;"> The discretionary account should be your variable expense account, or what you use for groceries and the “fun” expenses, such as entertainment and dining out. Long said it’s helpful to use a debit card linked to an online bank account so you can quickly see how much you have in this account. Monitor your discretionary account balance and make spending decisions based on this balance until you get paid again. Don’t rob from the surplus in your primary account or savings, and avoid using credit cards.</p> <p style="margin-left:31.5pt;"> <strong>3. </strong><strong>Use your other checking account for your “fixed” expenses and bills.  </strong>Surplus should build-up in this account over time for things like house or car maintenance, clothing and seasonal variations in utility bills. The idea is to avoid using credit cards and invading savings for these expenses when they crop up. </p> <p style="margin-left:31.5pt;"> <strong>4. </strong><strong>Don’t rush to start investing.</strong> If you don’t have a surplus at the end of each month without investments, then it’s probably not wise to invest right now. Start with managing your cash flow, then move into learning about investments. </p> <p> “The first step always should be to create a budget that allows you to have some savings,” Long said. “People tend to underestimate how much they spend on eating out, groceries and those sorts of things. If they can actually save their target without dipping into their savings, then they can start discussing what they have access to in terms of IRAs and 401k's.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2621c4c6-a748-4f0b-9f4d-7f922b52060a Making the most of your payments? Find out at CME event Sept. 16 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_making-of-payments-out-cme-event-sept-16 Wed, 10 Sep 2014 17:50:00 GMT <p> If you haven’t recently evaluated the claims payment methods accepted by your practice, you could be paying fees and providing rebates to health insurers just to get paid. Learn how to make electronic payments work for your practice—and get continuing medical education credit—by participating in a webinar at noon Eastern time Sept. 16. <a href="http://eo2.commpartners.com/users/ama/session.php?id=14338" rel="nofollow" target="_blank">Sign up today</a>.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/11/d724fcc6-0aa0-427b-bbcf-1a824b6112a8.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/11/d724fcc6-0aa0-427b-bbcf-1a824b6112a8.Large.jpg?1" style="margin:15px;float:right;" /></a>The health care claims revenue cycle has increasingly moved from the use of paper checks to different forms of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/learn-electronic-payments-work-practice" target="_blank">electronic payment</a>. Physicians should know the risks and benefits associated with each form and understand their rights under federal regulations.</p> <p> The free webinar, “Stop paying to get paid: Effective electronic payments,” will cover the different types of electronic payments available, the implications of accepting virtual credit card payments and guidance on implementing the new standard electronic funds transfer (EFT) transaction in your practice.</p> <p> The AMA designates this webinar for a maximum of 1.0 <em>AMA PRA Category 1 Credits</em><em>™</em>. Physicians should only claim the credit commensurate with the extent of their participation in the activity.</p> <p> Learn more about electronic payment using the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page?" target="_blank">AMA’s EFT toolkit</a>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cf3615df-7bf1-4e88-a0cd-b5c8a94d2668 Law limiting physician speech upheld; doctors call for rehearing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_law-limiting-physician-speech-upheld-doctors-call-rehearing Tue, 09 Sep 2014 14:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/5/92ab80d3-9f02-4172-a59a-864dedd2e484.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/5/92ab80d3-9f02-4172-a59a-864dedd2e484.Large.jpg?1" style="float:right;margin:10px;" /></a>Physician groups last month filed a brief in support of a formal petition for the rehearing of a precedent-setting case. A federal appellate court earlier this summer issued a split-decision upholding a controversial Florida law that could restrict what physicians can talk about with their patients in the exam room.</p> <p> The state law bars physicians from freely discussing firearm safety with their patients, putting political agendas before public health and the patient-physician relationship. While one of the judges on the three-person panel sided strongly with physicians in opposing the law, the two other judges ruled in favor of the state.</p> <p> “[T]he panel decision … denigrates the practice of medicine,” the AMA and eight medical specialty societies wrote in the filing. “To be effective, [medicine] requires a special bond of trust between patient and physician, which depends for its existence on the ability to communicate freely.”</p> <p> “Patients must believe in their physicians’ absolute honesty and fidelity when relying on their physicians’ advice,” the filing said. Furthermore, “if physicians must tailor their communications to meet a legislative agenda, they cannot fully respect their patients’ needs.”</p> <p> The medical associations are pointing to the “exceptional importance of this case.” The ruling not only has direct negative consequences on the practice of medicine in Florida but also sets a precedent that could encourage other state lawmakers to proceed with legislation that similarly would restrict physicians’ conversations with their patients about health and safety.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page">Learn more</a> about how the Litigation Center of the AMA and State Medical Societies is standing up for physicians and patients in the nation’s courts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e824148a-c6aa-426a-8b4d-26371406bc03 Get inspired: See the future of medicine at TEDMED http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_inspired-see-future-of-medicine-tedmed Tue, 09 Sep 2014 13:29:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/11/54601703-9df7-4a5a-ab81-19189ccfa18c.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/11/54601703-9df7-4a5a-ab81-19189ccfa18c.Large.jpg?1" style="width:100px;height:140px;margin:10px;float:left;" /></a></p> <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckTag=AMA_Viewpoints" target="_blank"><em>AMA Viewpoints</em></a><em> post by </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page?" target="_blank"><em>Barbara L. McAneny, MD</em></a><em>, chair of the AMA Board of Trustees.</em></p> <p> As physicians, we’re in a profession that’s experiencing groundbreaking work almost every day. The catch-22 is that we’re so busy caring for patients, running our practices and keeping up with paperwork that we struggle to make time to read up on the latest innovations.</p> <p> That’s why <a href="http://tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a>—the annual health and medicine edition of the world-renowned TED Talks—is such a great opportunity. Starting today, physicians can watch transformative thinkers in science, health and medicine, from the comfort of their offices or homes, thanks to the AMA’s sponsorship of this year’s event. The talks are short, less than 15 minutes each, and offer inspirational perspectives on a tremendous variety of topics. All I have to do is choose a few I’m interested in, turn up my computer’s volume and take it in.</p> <p> Some of the topics to be covered include:</p> <ul> <li style="margin-left:0.25in;"> Ending the global physician shortage</li> <li style="margin-left:0.25in;"> Revolutionizing medical education</li> <li style="margin-left:0.25in;"> Identifying childhood factors that impact serious adult-onset diseases, such as heart disease and cancer</li> <li style="margin-left:0.25in;"> Understanding the obesity epidemic and addiction</li> <li style="margin-left:0.25in;"> Advancing high-tech diagnostics</li> </ul> <p> <object align="right" data="http://www.youtube.com/v/PcJ0HFX0Gfk" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/PcJ0HFX0Gfk" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/PcJ0HFX0Gfk" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/PcJ0HFX0Gfk" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object></p> <p> These talks are a quick way to share learnings and ideas that we can then discuss with our colleagues, implement in our own practices or build upon to develop even greater innovations.</p> <p> I know we’re all busy, and it’s hard to find spare time in the day. But we’re making it easy for you to participate as you’re able. You can watch the program live today through Sept. 12, or watch on demand through Sept. 16. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14” </strong>to participate. Watch alone, or gather co-workers or employees to view an enriching session together.</p> <p> I was fortunate to participate recently in a TED-style talk at the Brookings Institute, where I spoke on <a href="https://www.youtube.com/watch?v=PcJ0HFX0Gfk" rel="nofollow" target="_blank">how my practice is enhancing patient-centered care</a>. It was valuable experience, and I found much inspiration in my fellow speakers’ stories. I look forward to even more ingenuity and innovation to be shared at TEDMED 2014.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e6b96fdf-ad26-4f30-b77f-d31d1cde1d0c Longer-term weight loss predicts reduced diabetes risk: Study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_longer-term-weight-loss-predicts-reduced-diabetes-risk-study Mon, 08 Sep 2014 20:17:00 GMT <p> Weight loss over two years is a strong predictor of reduced diabetes risk, according to a recent <a href="http://care.diabetesjournals.org/content/early/2014/07/11/dc14-0018.abstract" target="_blank" rel="nofollow">study</a> that examined diabetes predictors among participants with prediabetes in a lifestyle intervention program.</p> <p> The study, published in <em>Diabetes Care</em>, examined measures of weight loss in relation to diabetes for 1,000 participants in the program. Every kilogram of weight loss (from the baseline measure) that was maintained for two years corresponded with a 10 percent decrease in that person’s risk of diabetes, according to the study.</p> <p> The study looked at participants in a Diabetes Prevention Program. The National Institutes of Health funded the creation of the one-year lifestyle program, designed to help participants lose weight and increase their activity levels to reduce their risk of developing type 2 diabetes. In the program, lifestyle coaches met with participants individually for 24 weeks, then offered individual sessions and group classes to discuss changes, such as healthy eating, physical activity, reducing stress and problem-solving.</p> <p> The results of the study in <em>Diabetes Care</em> point to the need for maintenance programs offered with prevention programs to maximize weight loss sustainability, which would increase the potential to prevent or delay diabetes, the study said.</p> <p> “Although lapses in eating behavior may lead to weight regain and some weight cycling, the ability to refocus on weight loss behaviors and achieve weight loss overall appears to be most important for diabetes prevention,” the study said.</p> <p> Another <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/benefits-of-diabetes-prevention-program-long-lasting-study" target="_blank">recent study</a> found that prevention program participants continued to see the benefits of the program long after they participated. Participants of a program saw a 27 percent reduction in the rate of type 2 diabetes even 15 years after they started the program.</p> <p> The YMCA of the USA offers a prevention program based on the National Diabetes Prevention Program’s model of lifestyle intervention and coaching, and the AMA is partnering with this organization 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. A big part of the initiative is a pilot with physicians that is testing ways to increase referrals to the YMCA Diabetes Prevention Program and to create a feedback mechanism from the program to physicians.</p> <p> Physician practice sites in three states are screening patients for prediabetes and referring them to the program at a local YMCA. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f06ca3ce-0dae-45ec-b817-fc730f3e7880 Medical licensure to be streamlined under new interstate compact http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-licensure-streamlined-under-new-interstate-compact Mon, 08 Sep 2014 20:12:00 GMT <p> Physicians who wish to practice in multiple states could soon see a speedier process with fewer administrative and financial burdens as they pursue state medical licensure, thanks to an interstate compact released Friday by the Federation of State Medical Boards (FSMB).</p> <p> The new <a href="http://www.fsmb.org/Media/Default/PDF/Advocacy/Interstate%20Medical%20Licensure%20Compact%20(FINAL)%20September%202014.pdf" target="_blank" rel="nofollow">model legislation</a>, which has been in the works since 2013, is designed to make the licensure process more efficient for physicians while ensuring high standards of patient safety. The compact also is anticipated to help increase access to care for patients in rural and other underserved populations via the responsible practice of telemedicine.</p> <p> “The interstate compact … aligns with our efforts to modernize state medical licensure, allowing for an expedited licensing pathway in participating states,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-05-ama-applauds-effort-to-modernize-licensure.page" target="_blank">statement</a>.</p> <p> The compact is based on several key principles, including:</p> <ul> <li> The practice of medicine is defined as taking place where the patient receives care, requiring the physician to be licensed in that state and under the jurisdiction of that state’s medical board. This tenant aligns with the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">principles for telemedicine</a> that were developed by the AMA Council on Medical Service and adopted at the 2014 AMA Annual Meeting.</li> <li> Regulatory authority will remain with the participating state medical boards, rather than being delegated to an entity that would administer the compact.</li> <li> Participation in the compact is voluntary for both physicians and state boards of medicine.</li> </ul> <p> Among states that adopt it, the compact would act as an independent law and as a contract among the states to help ensure ongoing corporation and adaptation.</p> <p> States can begin considering this legislation for adoption beginning in 2015, and there already is considerable interest in such a framework. Earlier this year, 16 U.S. senators—including lawmakers from several states with large rural populations—sent a <a href="http://www.thune.senate.gov/public/index.cfm?a=Files.Serve&File_id=9fa6c905-ec33-4191-bd79-ad6991942dac" target="_blank" rel="nofollow">letter of support</a> to the FSMB, pointing to the increased access to care the compact would enable for patients in their states.</p> <p> The AMA will continue to work with the FSMB and other stakeholders to advance this compact among interested states.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9e4d11e3-c3db-46c9-ad55-229d5b9622ec Why future physicians shouldn’t miss TEDMED http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_future-physicians-shouldnt-miss-tedmed Mon, 08 Sep 2014 20:08:00 GMT <p> Medical students across the country are planning to tune into <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" target="_blank" rel="nofollow">TEDMED 2014</a> this Wednesday through Friday. Make sure to join your peers in taking advantage of your complimentary access to TEDMED and hear inspirational perspectives from transformative thinkers in science, health and medicine.</p> <p> Students can watch TEDMED in real time as the conference takes place Sept. 10-12 or stream content on demand Sept. 10-16. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" target="_blank" rel="nofollow">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14</strong>” to participate.</p> <p> Here’s how you can make the most of this opportunity:</p> <ul> <li style="margin-left:0.25in;"> <strong>Personal access:</strong> Experience TEDMED from the comfort of your own desktop or personal device.</li> <li style="margin-left:0.25in;"> <strong>Group viewing: </strong>Get some fellow students together and view the program as a thought-provoking study break.</li> </ul> <p> Some schools have organized viewing parties to provide students with a way to watch innovative speakers together and discuss what they hear.</p> <p> The AMA Medical Student Section (MSS) at the University of Kentucky College of Medicine is planning a viewing party plus a multidisciplinary expert panel for each session to help spark discussion and relate the ideas presented in TEDMED sessions back to students’ own experiences. The idea is that students will be more comfortable with interdisciplinary collaboration, said Brad St. Martin, a second-year medical student at the University of Kentucky.</p> <p> “As busy medical students, we often get stuck in a routine of focusing solely on the information that will be on the next test, and we’re not always aware of the bigger picture of current changes in health and medicine,” St. Martin said, pointing to TEDMED as a way to shake up that routine.</p> <p> The University of Kentucky AMA-MSS and eight other school sections received <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.page" target="_blank">Section Involvement Grants</a> from the AMA to host viewing parties this week.</p> <p> “One of my favorite parts about TEDMED talks are their ability to convey excitement for the future and for big ideas in our field,” said Erica Smearman, a sixth-year MD/PhD student at Emory University and coordinator of that school’s viewing party. “I’m looking forward to having the medical students share in this together and reinvigorate a passion for this career.”</p> <p> “One perspective is never enough,” said Andrew Morrow, a second-year medical student at Indiana University School of Medicine–Terre Haute. “While we learn the best practices on the wards and in the clinic during medical school, it behooves us to keep an eye outwards and to the future. We think that the digestible ideas presented at TEDMED will challenge our thinking and add new equipment to our medical bag.”</p> <p> If your school isn’t offering a viewing party, you don’t have to miss out. Plan to view selections of the event on your own, with a roommate or with a group of your classmates.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7be581f6-9c50-4f38-8051-27fb80acf3ea Students, residents deliver message to Congress: Save GME http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-residents-deliver-message-congress-save-gme Mon, 08 Sep 2014 20:04:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/2/7a0d132d-ef97-4974-82f2-8f9042bf997a.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/2/7a0d132d-ef97-4974-82f2-8f9042bf997a.Large.png?1" style="float:right;margin:10px;" /></a>Students, residents and fellows across the country are coming together this week to call on Congress to preserve funding for graduate medical education (GME) during Save GME Week.</p> <p> 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> That’s why members of the AMA Medical Student Section (MSS) and AMA Resident and Fellow Section are calling on lawmakers via emails, phone calls and social media to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/part-of-movement-ask-congress-savegme" target="_blank">#SaveGME</a>.</p> <p> Participate in Save GME Week by including #SaveGME in your social media posts. Here are some GME facts to help you get started:</p> <ul> <li style="margin-left:0.25in;"> Experts predict a shortage of 91,500 physicians by the year 2020, which could be significantly reduced with increases in GME positions.</li> <li style="margin-left:0.25in;"> Teaching hospitals provide about 40 percent of all charity care in the United States—about $8.4 billion in care annually.</li> <li style="margin-left:0.25in;"> Residents serve the underserved: 89 percent of teaching hospitals offer AIDS services, compared to just 16 percent of nonteaching hospitals.</li> <li style="margin-left:0.25in;"> Residents care for veterans: More than 37,000 residents received some or all of their training at U.S. Department of Veterans Affairs hospitals while caring for active soldiers and veterans.</li> </ul> <p> Additional GME facts and resources are available at <a href="http://savegme.org/" target="_blank" rel="nofollow">SaveGME.org</a>.</p> <p> Follow the <a href="https://www.facebook.com/amamss" target="_blank" rel="nofollow">AMA-MSS Facebook</a> and <a href="https://twitter.com/AMA_MSS" target="_blank" rel="nofollow">Twitter</a> accounts for daily updates on how students and residents across the country are working to #SaveGME.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:275bfe84-b8bb-4700-a95d-d6ea4bb1ffbb Join AMA-YPS state of the section call Sept. 30 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_join-ama-yps-state-of-section-call-sept-30 Mon, 08 Sep 2014 15:03:00 GMT <p> Share your thoughts with the AMA Young Physicians Section (YPS) Governing Council during the next “state of the section” conference call to be held at 8 p.m. Eastern time Sept. 30.</p> <p> This conference call will provide an opportunity for members of the AMA-YPS Assembly to provide ideas and ask questions as the governing council plans section activities for next year. <a href="https://cc.readytalk.com/r/869m6xs0qu12&eom" target="_blank" rel="nofollow">Register</a> by Sept. 29 to participate in the call.</p> <p> Be sure to visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page" target="_blank">AMA-YPS meetings and events</a> Web page to learn more about the upcoming 2014 AMA-YPS Interim Meeting.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cd158781-cfc1-4fe7-9307-4f6fade9f06c Register today for AMA-IMG Section Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-today-ama-img-section-interim-meeting Mon, 08 Sep 2014 06:00:00 GMT <p> Registration now is open for the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page" target="_blank">International Medical Graduates (IMG) Section</a> Interim Meeting, to take place Nov. 7-10 at the Hilton Anatole in Dallas. Log in to <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144452E&TID=vCIaLRgK%252bYeYYFMXecjotQ%253d%253d&OID=130" target="_blank">sign up today</a>.</p> <p> Highlights of the meeting will include:</p> <p> <strong>AMA Research Symposium and reception: 4–6:30 p.m. Nov. 7</strong></p> <p> Hear oral research presentations and view abstracts by AMA-IMG Section members who are certified by the Educational Commission for Foreign Medical Graduates and awaiting residency. Medical students and residents also will be participating in this AMA Research Symposium.</p> <p> <strong>Education session on improving health outcomes: 11:30 a.m.–12:45 p.m. Nov. 7 </strong></p> <p> Learn about population health and its implications for the practice of medicine. Participants will get insights into the AMA’s population initiative and find out how a local practice is improving health outcomes.</p> <p> <strong>AMA-IMG Section reception and Congress: 5:30 p.m.–7:30 p.m. Nov. 8</strong></p> <p> Network with colleagues and discuss policy items for the AMA-IMG Section.</p> <p> <strong>Busharat Ahmad, MD, Leadership Development Program: 2:00 p.m.–3:30 p.m. Nov. 9</strong></p> <p> Learn how to take charge of team-based care as a physician leader during this special leadership program.</p> <p> <strong>AMA-IMG Section delegate caucus: 9:30 a.m.–10:30 a.m. Nov. 10</strong></p> <p> Review reference committee reports and discuss strategies for supporting AMA-IMG Section and AMA House of Delegates policy items.</p> <p> For more information, call the AMA-IMG Section staff at (312) 464-5678 or (312) 464-5397.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bcb4099-e497-4895-8702-6e24c4be8a64 Ratify policy resolution up for consideration by Sept. 19 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ratify-policy-resolution-up-consideration-sept-19 Mon, 08 Sep 2014 06:00:00 GMT <p> Members of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page" target="_blank">International Medical Graduates (IMG) Section</a> are invited to participate in ratification of the policy resolution being considered for the 2014 AMA-IMG Section Interim Meeting.</p> <p> A SurveyMonkey invitation will be sent to each member Sept. 15, and feedback should be submitted by Sept. 19.</p> <p> Your input is important to the section. Make sure to take part in this step of the policymaking process.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e786638f-e5f2-463b-b83e-b4da03ae5117 Rule offers meaningful use program changes, but not enough http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_rule-offers-meaningful-use-program-changes-but-not-enough Fri, 05 Sep 2014 19:49:00 GMT <p> A <a href="https://www.federalregister.gov/articles/2014/09/04/2014-21021/medicare-and-medicaid-programs-modifications-to-the-medicare-and-medicaid-electronic-health-record" target="_blank" rel="nofollow">final rule</a> published last week by the Centers for Medicare & Medicaid Services (CMS) implements a proposal giving more options to physicians trying to meet electronic health record (EHR) meaningful use requirements this year.</p> <p> The rule allows physicians to use older certified EHR technology (Version 2011), a combination of old and new technology (Versions 2011 and 2014) or just new technology (Version 2014) in order to meet meaningful use requirements this year. And physicians who were scheduled to move to Stage 2 this year instead will be allowed to meet Stage 1 requirements for an additional year.</p> <p> While the changes are helpful to some degree, they do not address the overarching problem with the meaningful use program: The 100 percent pass/fail policy places physicians at risk for financial penalties, even if all they fail to meet is a single measure.</p> <p> <strong>Key provisions of the final rule physicians need to know:</strong></p> <ul> <li> The changes only apply to physicians whose certified EHR technology (CEHRT) was not “fully functional” this year and who experienced “delays” in receiving their upgraded software. Physicians who encountered delays that impacted their ability to train staff, test upgrades or establish new work flows would qualify to take advantage of the changes.</li> <li> The changes do not apply to physicians who experienced the following challenges associated with implementing 2014 software: <ul> <li> Financial issues or costs to upgrade, install, test and so forth</li> <li> Challenges meeting the meaningful use objectives or measures (with some very limited exceptions)</li> <li> Staff changes or turnover</li> <li> Physician “inaction,” which led to delays in upgrading software</li> </ul> </li> <li> For physicians who practice at multiple locations, denominators should be limited to patient encounters at locations that are equipped with Version 2014 software that has been fully implemented for more than 50 percent of the patient encounters during the reporting period.</li> <li> Medicaid physicians in their first year of meaningful use are required to purchase Version 2014 software.</li> <li> The changes finalized in this rule are applicable to 2014 reporting periods only.</li> </ul> <p> The AMA is reviewing the impact of this rule on quality requirements and will provide more details shortly. <a href="http://www.ama-assn.org/resources/images/advocacy/meaningful-use-table.jpg" target="_blank">View a table</a> from the Aug. 28 final rule to see the options physicians have for meeting measures using different software versions.</p> <p> CMS also clarified that physicians who are just starting meaningful use this year and who are unable to meet the Oct. 1 attestation deadline still can attest for the last 90 days of the year and qualify for an incentive for 2014 data. That attestation deadline is Feb. 28. In addition, CMS made several other changes to Stage 1 in an earlier rule published in 2012. A complete list of these changes is available in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/summary-table-stage-2-measures.pdf" target="_blank">chart</a> (log in) developed by the AMA.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/14/b01d8fe1-fbc6-4d6a-be59-563fd748ac45.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/14/b01d8fe1-fbc6-4d6a-be59-563fd748ac45.Large.jpg?1" /></a></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4183891b-e715-4d1a-90a9-485ad51cad53 Will your ICD-10 claims be accepted? CMS designates testing weeks http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_will-icd-10-claims-accepted-cms-designates-testing-weeks Fri, 05 Sep 2014 19:45:00 GMT <p> A year ahead of the Oct. 1, 2015, compliance deadline for implementing the ICD-10 code set, the Centers for Medicare & Medicaid Services (CMS) has <a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8858.pdf" rel="nofollow" target="_blank">announced</a> three weeks that will be dedicated to helping physicians test whether their claims will be accepted in the Medicare claims processing system.</p> <p> While you should be able to begin testing with your Medicare Administrative Contractor as soon as your practice is ready, CMS has designated three testing weeks that will be focused on acknowledgment testing of ICD-10 claims:</p> <ul> <li> Nov. 17-21, 2014</li> <li> March 2-6, 2015</li> <li> June 1-5, 2015</li> </ul> <p> Participation in testing will help your practice determine its readiness for this portion of ICD-10 implementation and provide data for CMS’ own preparation for industry-wide use of the code set.</p> <p> Real-time help desk support will be available during these weeks, and more information will be posted on CMS’ website and the website of each Medicare Administrative Contractor as these testing periods approach.</p> <p> The acknowledgement testing weeks also are open to billing services and clearinghouses. If your practice uses one of these services, you should check with that group to learn whether it will be participating. </p> <p> Although acknowledgement testing is important for identifying any issues with claims being accepted by Medicare, you will not be able to test the complete processing of the claim or determine final payment at this time.</p> <p> The AMA continues to urge regulators to ease the burden of ICD-10 implementation on physicians, citing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatic implementation costs</a> coupled with an already onerous regulatory environment. However, practice management experts caution that physicians now should begin preparing their practices for the transition to ICD-10.</p> <p> To help with the testing process, the AMA has developed an ICD-10 data file available on <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push" target="_blank">CD-ROM</a> or via immediate <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">download</a>. Additional <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">information and resources</a> to help you get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:11b2fb75-187b-45f0-83ff-3d95812eeaa8 JAMA Highlights: This week’s top articles from the JAMA Network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-this-weeks-top-articles-jama-network-43 Thu, 04 Sep 2014 19:12:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/STNz_H62fO4" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/STNz_H62fO4" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/STNz_H62fO4" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/STNz_H62fO4" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Comparison of named diet programs finds little difference in weight loss outcomes</strong><br /> <span style="font-size:12px;">In an analysis of data from nearly 50 trials including about 7,300 individuals, significant weight loss was observed with any low-carbohydrate or low-fat diet, with weight loss differences between diet programs small. The findings support the practice of recommending any diet that a patient will adhere to in order to lose weight, according to a </span><a href="http://jama.jamanetwork.com/article.aspx?articleid=1900510" style="font-size:12px;" target="_blank" rel="nofollow">study</a><span style="font-size:12px;"> in the Sept. 3 issue of the </span><em style="font-size:12px;">Journal of the American Medical Association</em><span style="font-size:12px;"> </span><em style="font-size:12px;">(JAMA</em><span style="font-size:12px;">)</span><em style="font-size:12px;">.</em></p> <p> <strong>Use of double mastectomy increases, but procedure not associated with reducing risk of death</strong><br /> <span style="font-size:12px;">Among women diagnosed with early-stage breast cancer in California, the percentage undergoing a double mastectomy increased substantially between 1998 and 2011, although this procedure was not associated with a lower risk of death than breast-conserving surgery plus radiation, according to a </span><a href="http://jama.jamanetwork.com/article.aspx?articleid=1900512" style="font-size:12px;" target="_blank" rel="nofollow">study</a><span style="font-size:12px;"> in </span><em style="font-size:12px;">JAMA.</em><span style="font-size:12px;"> The authors did find that surgery for the removal of one breast was associated with a higher risk of death than the other options examined in the study. Watch a </span><a href="http://youtu.be/STNz_H62fO4" style="font-size:12px;" target="_blank" rel="nofollow">video</a><span style="font-size:12px;"> on the study.</span></p> <p> <strong style="font-size:12px;">Family dinners good for teens’ mental health, could protect from cyberbullying</strong><br /> <span style="font-size:12px;">Cyberbullying was associated with mental health and substance use problems in adolescents, but family dinners may help protect teens from the consequences of cyberbullying and also be beneficial for their mental health, according to a </span><a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1900477" style="font-size:12px;" target="_blank" rel="nofollow">study</a><span style="font-size:12px;"> in </span><em style="font-size:12px;">JAMA Pediatrics</em><span style="font-size:12px;">.</span></p> <p> <strong>Viewers ate more while watching Hollywood action flick on TV</strong><br /> <span style="font-size:12px;">Television shows filled with action and sound may be bad for your waistline. TV viewers ate more M&Ms, cookies, carrots and grapes while watching an excerpt from a Hollywood action film than those watching an interview program, according to a </span><a href="http://archinte.jamanetwork.com/article.aspx?articleid=1899554" style="font-size:12px;" target="_blank" rel="nofollow">research letter</a><span style="font-size:12px;"> in </span><em style="font-size:12px;">JAMA Internal Medicine</em><span style="font-size:12px;">.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d99d6f70-bb53-4dc6-b5ca-65ae9de7b9d0 Did you get your 2013 Medicare quality feedback report? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_did-2013-medicare-quality-feedback-report Wed, 03 Sep 2014 18:07:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) last month released the 2013 Physician Quality Reporting System (PQRS) feedback reports, as well as separate 2015 PQRS payment adjustment feedback reports. Physicians who did not successfully participate in PQRS in 2013 will receive a negative 1.5 percent payment adjustment on their Medicare Part B fee-for-service claims next year.</p> <p> Incentive payments are expected to be disbursed next month, and the AMA will provide more information as it becomes available.</p> <p> Physicians and their authorized representatives can download the reports using an up-to-date “Individuals Authorized Access to the CMS Computer Services” (IACS) account. Physicians who haven’t registered for such an account or have an outdated one can <a href="https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier2&cid=1187820137434" target="_blank" rel="nofollow">register online</a>. In addition, physicians can access <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2013_PQRSFeedbackReportUserGuide_F04-02-2014.pdf" target="_blank" rel="nofollow">CMS’ user manual</a> for the 2013 feedback reports.</p> <p> Physicians who will be affected by the 2015 PQRS payment adjustments should receive a letter of notification from CMS later this year.</p> <p> The AMA will continue to advocate for a better PQRS appeals process so that physicians who believe they will be inappropriately penalized with 2015 PQRS adjustments based on their 2013 reports may contest them with CMS.</p> <p> To make sure your practice is prepared to avoid financial penalties based on performance this year, participate in a CMS national provider call at 1:30 p.m. Eastern time Sept. 17. The call will offer guidance about how to avoid a negative payment adjustment, satisfy the clinical quality measure component of the electronic health records meaningful use program and prevent a payment penalty under the new value-based modifier.</p> <p> <a href="http://www.eventsvc.com/blhtechnologies/register/5893847b-57b7-4731-8a66-3a3c110ad9ec" target="_blank" rel="nofollow">Sign up now</a> to participate. Registration will close at noon Eastern time the day of the call or when space is full. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9720f9cf-8ba6-4c4f-a186-f1837f39c8d4 5 new topics you should explore for CME credit http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-new-topics-should-explore-cme-credit Wed, 03 Sep 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/5/3e024051-6aac-4bc6-850a-d5a75476de57.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/5/3e024051-6aac-4bc6-850a-d5a75476de57.Large.jpg?1" style="float:right;margin:10px;" /></a>Interested in diving deeper into topics like quality metrics, electronic health records or health care trends? New modules added to the <a href="https://cme.ama-assn.org/Education.aspx" target="_blank">AMA Online Learning Center</a> offer an efficient way to explore these issues and earn <em>AMA PRA Category 1 Credit</em>™ for continuing medical education (CME) requirements.</p> <ol> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2585703/Detail.aspx" target="_blank"><strong>Quality metrics: How to manage within a complex environment</strong></a><strong>. </strong>Learn how to manage quality metrics within integrated care, including strategies for shared accountability and dealing with the challenges of meeting quality metrics.</li> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2585992/Detail.aspx" target="_blank"><strong>EHR: Top 10 improvements needed to support integrated care</strong></a><strong>. </strong>Get strategies to manage some of the frustrations and unintended consequences of electronic health records (EHR).</li> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2586026/Detail.aspx" target="_blank"><strong>Patient experience: The physician’s role</strong></a><strong>. </strong>Take a look at the current environment of publicly reported metrics. In particular, this activity examines physician outcomes, behavior, compliance and the patient experience, as well as the regulatory triggers or risks around each one.</li> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2744363/Detail.aspx" target="_blank"><strong>Medical education: Health care trends</strong></a><strong>. </strong>Learn about the latest data on medical school applicants and enrollees, faculty, social media use, debt and funding. This activity also looks at the predicted impacts of these trends on patients, physicians, students and schools.</li> <li style="margin-left:0.25in;"> <a href="https://cme.ama-assn.org/Activity/2744448/Detail.aspx" target="_blank"><strong>Medical practice and quality: Health care trends</strong></a><strong>. </strong>Get the latest trends in clinical quality measurement, disparities in access to care for underserved patients, outcomes of new care delivery models. You’ll also learn about the predicted impacts of recent trends on patients, physicians, payers and policymakers.</li> </ol> <p> These activities have been approved for <em>AMA PRA Category 1 Credit</em>™.</p> <p> Don’t forget that you can <a href="http://jama.jamanetwork.com/cme.aspx" rel="nofollow" target="_blank">access CME through your subscription to the JAMA Network</a> at any time. To obtain credit, read an article and complete a brief online quiz.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:56c8be38-96d5-4282-a98d-f4822560f9c6 How one school is (really) putting the patient first http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-school-really-putting-patient-first Wed, 03 Sep 2014 15:30:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/14/009ad071-1c2c-4956-be0a-9f5477ab4f81.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/14/009ad071-1c2c-4956-be0a-9f5477ab4f81.Large.jpg?1" style="float:left;margin:10px;" /></a><em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Danielle Walsh, MD, a clinical associate professor at the Brody School of Medicine of East Carolina University. Appeared in the September 2014 </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></p> <p> The first day of medical school is usually filled with praise, platitudes and advice from a variety of medical school faculty, administrative staff and fellow students. But on Aug. 11, the Brody School of Medicine at East Carolina University did something quite unique – the first day of medical school started with the patient.</p> <p> The class of 2018 incoming students heard <a href="http://www.npsf.org/helen-haskell/" rel="nofollow" target="_blank">Helen Haskell</a> tell the story of her son, Lewis Blackman, who died tragically from preventable errors in a teaching hospital. Her compelling message brought home the importance of learning not only medical knowledge, but how to communicate with patients when things go wrong, how to change systems that cause harm unintentionally, and most importantly, why we must put the patient at the center of healthcare. The message struck an unforgettable chord with these impressionable and enthusiastic students as they began the journey of becoming physicians. </p> <p> As one of the 11 schools participating in the AMA’s <a href="http://changemeded.org/" rel="nofollow" target="_blank">Accelerating Change in Medical Education</a> initiative, the Brody School of Medicine is preparing its students to enter the profession of medicine with the knowledge, skills and attitudes to provide more reliable evidence-based care, to lead process improvement efforts, and to utilize quality measures to improve care systems and outcomes.</p> <p> The Brody REACH Initiative—Redesigning Education to Accelerate Change in Healthcare—began with the formation of a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/faculty-development-crucial-med-ed-innovation" target="_blank">Teachers of Quality Academy</a> to “train the trainers,” an interprofessional cohort of dedicated faculty with skills in process improvement, quality, patient safety, teamwork and population health. This innovative program is being followed with ambitious curricular revisions to bring these concepts into each aspect of medical student education.</p> <p> Haskell’s presentation, as part of the REACH Quality lecture series, served as the kick-off to a new academic year, and most importantly, a revolutionary change in how Brody will train the doctors, nurses, and healthcare professionals of the next generation.</p> <p> Her message—the importance of listening to the patient and family, communicating with all caregivers in an honest and open atmosphere, understanding where our system of healthcare fails, and committing to making it better—was the perfect message for student and faculty alike as we REACH for a safe, effective, equitable, efficient, timely and patient-centered experience that really puts the patient first.</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:4d005d89-c575-4f8a-a216-e265b5f75341 Why I serve: A profile of AMA leaders in medical education http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_serve-profile-of-ama-leaders-medical-education Wed, 03 Sep 2014 15:00:00 GMT <p> <em>This regular feature </em><em>appeared in the September 2014 </em>AMA MedEd Update<em>, a monthly medical education newsletter. It </em><em>profiles a leader in medical education and the AMA. If you know of an AMA member physician that we should profile, please </em><a href="mailto:fred.lenhoff@ama-assn.org" rel="nofollow"><em>email us</em></a><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/da3b6df1-cb5c-4430-9e29-9052d903be4b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/da3b6df1-cb5c-4430-9e29-9052d903be4b.Large.jpg?1" style="float:right;margin:10px;" /></a>Kenneth B. Simons, MD<br /> Specialty: Ophthalmology<br /> Current position and title: Senior associate dean for graduate medical education and accreditation, Medical College of Wisconsin<br /> Current AMA role: Alternate delegate for the AMA Section on Medical Schools<br /> AMA member since: 1997</p> <p> <strong>What compelled you to pursue a leadership role in the AMA?</strong></p> <p> I recognized that the AMA brought tremendous value to the work I was doing with medical student education. I also realized that if I wanted to do my job well, it required the help of lots of people, including those leaders in medical education who were involved in the AMA Section on Medical Schools (SMS). The AMA-SMS also provided the opportunity to be at the forefront of what was happening in undergraduate medical education, but the true beauty of the AMA-SMS is that all aspects of medical education are represented—undergraduate, graduate, and continuing medical education.</p> <p> I initially became active in the AMA-SMS by reviewing reports/resolutions. It allowed me to voice opinions and speak on the issues impacting medical education. I was encouraged by AMA-SMS leaders, including Emory Wilson, MD, a former chair of the section, to stay involved and pursue a leadership role.</p> <p> I was elected to a position on the AMA-SMS Governing Council in 2005 and subsequently became the AMA-SMS liaison to the Council on Medical Education in 2006. This role afforded me a great opportunity to have input into and insight about the important work of the Council. I also served as AMA-SMS chair in 2010-2011. In short, the AMA-SMS has been a terrific opportunity to get into AMA leadership and work with wonderful colleagues across the country, with the goal of making things better for our students, our residents, our faculty, and, ultimately, our patients.</p> <p> <strong>How has your role helped facilitate your professional development and your involvement in other medical organizations?</strong></p> <p> So much of what I’ve done in my career can be attributed to my work with the AMA-SMS. For example, I have served on the board of directors of the Accreditation Council for Graduate Medical Education, providing me an incredible opportunity to influence the direction of graduate medical education (GME) and residency training for thousands of tomorrow’s physicians. Currently, I am on the board of the National Resident Matching Program. Obviously, that organization saw value in the experience I’ve developed over the years—none of which would have been possible without my involvement in the AMA-SMS and the AMA.</p> <p> <strong>What are the most important issues today in medical education?</strong></p> <p> First of all, making sure there are enough GME positions for the graduates of our medical schools. You can’t graduate these students with significant debt and not have anywhere for them to go. Another issue is the time in medical school and residency training. Can we create efficiencies in the system, and are our future physicians being adequately trained in residency due to duty hour limits? In other words, how do we maximize the educational value during this period? How do we make sure our physician workforce is trained in an efficient and highly appropriate fashion to handle the issues they will be facing as they enter into practice?</p> <p> Finally, we must ensure that our students and residents have the right professional ethos for assuming the mantle of responsibility that the public expects of them. We in education have an obligation to society to ensure that these individuals have the correct knowledge, skills, and attributes to practice with compassion and professionalism.</p> <p> <strong>If you only had a minute, what advice would you give to a medical student or physician in training?</strong></p> <p> You need to be involved, and you are part of something that is larger than yourself. You entered freely into this wonderful profession to do good things for people, such that you have a responsibility to stay current in your field, to make our society healthier and safer for everyone, and to always remember that what you do is incredibly important and, while it may not be said to you, your efforts are appreciated. Even the smallest thing you do, that may not seem important to you—to your patients, it may be everything. You touch lives, you make a difference and you make the world a better place.</p> <p> <strong>What advice do you have for aspiring leaders in medicine, and what role can the AMA play in helping one reach that aspiration?</strong></p> <p> You need to be a role model. It comes back to the Hippocratic Oath: You need to practice your art, with uprightness and honor, so people see you as someone they aspire to be.</p> <p> If you’re going to talk the talk, you have to walk the walk. Don’t expect others to carry the load for you. You have to volunteer for the duties and challenges; you can’t shirk responsibilities. It’s a fine line between work and family, but “no” is a very difficult word to say if you want to be a leader. Once people recognize the value of the work you do, they want you to do more. It’s a win-win, and it enhances your leadership credibility. The AMA provides us with numerous opportunities at any number of levels to get involved in assisting the profession of medicine, colleagues, students and patients. All you need to do is volunteer that most precious gift, your time.</p> <p> <strong>How does volunteering as a leader in medicine help you in your daily work?</strong></p> <p> All the skills I have acquired over the years have helped me in my relationships with my colleagues, with organizations, and most importantly with my patients. And this has aided my students/residents as well. You learn how to carry yourself, and you learn that everyone’s opinion is important and worthy of respect. I’ve learned about values, and the art of compromise. It’s not just your way; let’s make it our way. In short, it has helped me be a better person. </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 feature and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e41fa64f-e126-4d8a-bd67-48180ccbb8b7 September is Women in Medicine Month http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_september-women-medicine-month Wed, 03 Sep 2014 15:00:00 GMT <p> In the 165 years since Elizabeth Blackwell became the first woman to graduate from medical school, there have been many pioneering women physicians to acknowledge and many accomplishments to celebrate. Join the AMA in honoring influential women physician leaders—like Sarah Hackett Stevenson, MD, who became the first woman physician to join the AMA in 1876—during September’s Women in Medicine Month.  </p> <p> The AMA Women Physicians Section (WPS) hosts the annual event. This year's theme, “<a href="http://www.elabs10.com/c.html?ufl=9&rtr=on&s=x8pbgr,201n5,5st9,mv7,cupo,d5m0,gi7z" target="_blank" rel="nofollow">Women in medicine: Innovators and leaders changing health care</a>” reaffirms the AMA’s commitment to increasing the influence of women physicians and advocating for women’s health issues.</p> <p> Here are some ways you can take part in Women in Medicine Month:</p> <ul> <li style="margin-left:0.25in;"> Look for the #WIMmonth hashtag on the <a href="https://www.facebook.com/AmericanMedicalAssociation?ref=stream" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">Twitter</a> feeds, where we will be honoring innovative women all month.</li> <li style="margin-left:0.25in;"> Listen to AMA-Women Physician Section (WPS) members share their stories and reflections in a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page?" target="_blank">new video series</a>.</li> <li style="margin-left:0.25in;"> Learn about the <a href="http://www.ama-assn.org/resources/doc/wps/x-pub/profile-history-women-in-medicine.pdf" target="_blank">history of women physicians</a>—and what the future may bring.</li> <li style="margin-left:0.25in;"> Get <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/governing-council-inspirations.page" target="_blank">insight into what has motivated</a> our WPS leaders.</li> <li style="margin-left:0.25in;"> Check out the honorees of the AMA-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 Physician Awards</a>.</li> <li style="margin-left:0.25in;"> Host an event or activity that honors women in medicine.</li> </ul> <p> <a href="mailto:wps@ama-assn.org" rel="nofollow">Email the AMA-WPS</a> to share the ways you are celebrating Women in Medicine Month.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7082e3a7-8f75-46ee-89d2-6d6fb7e0c41b Risks of tubing misconnections singled out in new alert http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_risks-of-tubing-misconnections-singled-out-new-alert Wed, 03 Sep 2014 15:00:00 GMT <p> The Joint Commission has issued a new Sentinel Event Alert, “<a href="http://www.jointcommission.org/sea_issue_53/" target="_blank" rel="nofollow">Managing risk during transition to new ISO tubing connector standards,</a>” which addresses the risks of accidental medical tubing misconnections that can cause severe patient injury or death.</p> <p> Two examples of potentially fatal misconnections are a feeding administration tube mistakenly connected to a tracheostomy tube and an intravenous tube connected to an epidural site.</p> <p> In an effort to prevent dangerous tubing misconnections, the International Organization for Standardization (ISO) has developed new international manufacturing standards for connectors.</p> <p> The standards are being introduced in phases and include engineering specifications for small-bore connectors with an inner diameter of less than 8.5 millimeters. The new connectors manufactured under the ISO standards will make it nearly impossible to connect tubing delivery systems that serve different functions.</p> <p> Although connectors manufactured to the new specifications are expected to enter the marketplace by October, the old connectors will remain in use until supplies are depleted. The Joint Commission is alerting health care organizations to begin preparing for the changes in connectors and to do everything possible during the transitional period to avoid tubing misconnections. These new engineered solutions should make systems safer for all patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c563f39e-45f3-43c2-8919-b2282a4f4c38 Obesity disparities addressed in health equity toolkit http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_obesity-disparities-addressed-health-equity-toolkit Wed, 03 Sep 2014 15:00:00 GMT <p> A <a href="http://www.cdc.gov/Obesity/Health_Equity/pdf/toolkit.pdf" target="_blank" rel="nofollow">toolkit</a> and <a href="http://www.cdc.gov/obesity/health_equity/index.html" target="_blank" rel="nofollow">website</a> developed by the Centers for Disease Control and Prevention can help physicians and other public health practitioners use a systematic approach to address obesity within the context of health care disparities.</p> <p> The toolkit is designed to increase the capacity of state health departments and their partners to work with and through communities to implement effective responses to obesity in populations that are facing health disparities.</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) promotes educating all patients about lifestyle changes that can be made to prevent obesity. <a href="mailto:mas@ama-assn.org" rel="nofollow">Email the AMA-MAS</a> if you have a project or idea that could help prevent this health disparity or raise awareness regarding obesity prevention.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7cfef940-90bf-4191-8b5b-7078d9456c3c LGBT patients more likely to be uninsured, lack personal doctor http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lgbt-patients-likely-uninsured-lack-personal-doctor Wed, 03 Sep 2014 15:00:00 GMT <p> Americans who identify as lesbian, gay, bisexual or transgender (LGBT) are more likely to report that they lack health insurance, according to a <a href="http://www.gallup.com/poll/175445/lgbt-likely-non-lgbt-uninsured.aspx" target="_blank" rel="nofollow">recent Gallup poll</a>.</p> <p> Although the percentage of LGBT adults without health insurance has decreased significantly since implementation of the Affordable Care Act’s health insurance requirement at the beginning of the year, these patients still are more likely to be uninsured than their non-LGBT counterparts.</p> <p> The poll found that 25 percent of LGBT respondents said they struggled to afford health care in the last 12 months, compared to 17 percent of non-LGBT respondents.</p> <p> Learn more about the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page" target="_blank">LGBT Advisory Committee</a> and resources it offers to help physicians care for LGBT patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3d142c6c-11d9-4028-b468-368d6e327876 Imagining a healthier world for tomorrow’s physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_imagining-healthier-world-tomorrows-physicians Wed, 03 Sep 2014 14:00:00 GMT <p> How are you imagining a healthier world? Explore the possibilities Sept. 10-12 as we hear inspirational perspectives from transformative thinkers in science, health and medicine at <a href="http://tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a>.</p> <p> Take advantage of your complimentary access to TEDMED 2014, the annual health and medicine edition of TED, made possible through an exciting partnership between TEDMED and the AMA. Receive a real-time feed of the program Sept. 10-12, or accommodate your busy schedule by watching on-demand Sept. 10-16. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14” to participate.</strong></p> <p> Here’s how you can make the most of this tremendous opportunity:</p> <ul> <li> <strong>Personal access:</strong> Experience TEDMED from the comfort of your own desktop or personal device.</li> <li> <strong>Group viewing: </strong>Book a conference room and view the program with your students, residents or colleagues.</li> </ul> <p> Here are just some of the innovators that will share their knowledge at TEDMED:</p> <ul> <li style="margin-left:0.25in;"> Erica Frank, MD, professor and Canada Research Chair at the University of British Columbia, who will turn many assumptions about medical education on their heads with a revolutionary prescription for ending the global doctor shortage.</li> <li style="margin-left:0.25in;"> Carla Pugh, MD, PhD, surgeon and director of the health clinical simulation program at the University of Wisconsin, who will share surprising information about a kind of skill and intelligence that can now be measured and taught for the first time.</li> <li style="margin-left:0.25in;"> Howard Rose, president of a design and development company specializing in real-time, interactive 3D games, who will explain how his health games tackle such areas as medical training, therapeutic pain management and exposure therapy.</li> </ul> <p> Don’t miss this opportunity to join your colleagues and peers in more than 100 countries around the world as we unlock our imagination for TEDMED 2014!</p> <p> Questions? <a href="mailto:tedmedlive@tedmed.com" rel="nofollow">Send an email</a> to TEDMED.</p> <p> <strong><object align="left" data="http://www.youtube.com/v/hpoqAJZtQ2A" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/hpoqAJZtQ2A" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/hpoqAJZtQ2A" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/hpoqAJZtQ2A" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Get a preview of TEDMED: </strong>In a past TEDMED talk, Marc Triola, MD, director of the Institute for Innovations in Medical Education at the New York University School of Medicine, discussed how medical school can be a “fantastic voyage.” Watch Dr. Triola share the details of a cutting-edge tool that can transform the learning ecosystem.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:48459e63-6cb1-4417-bc09-a75d5c8c8e25 Video: How payment codes help improve hospital readmission rates http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_payment-codes-improve-hospital-readmission-rates Wed, 03 Sep 2014 06:00:00 GMT <p> <object align="right" data="http://www.youtube.com/v/asHW4rUePeA" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/asHW4rUePeA" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/asHW4rUePeA" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/asHW4rUePeA" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Updating code sets so physicians can be paid for new models of care could be a “game-changer” in improving hospital readmission rates, according to one physician at the forefront of these changes.</p> <p> In an AMA “<a href="http://youtu.be/asHW4rUePeA" rel="nofollow" target="_blank">Innovations in Medicine” talk</a>—a brief, informal presentation in the style of TED Talks—David Ellington, MD, a family physician from Virginia and a member of the CPT® Editorial Panel, explains the process behind code development and how the panel is facilitating innovations in medicine.</p> <p> Dr. Ellington discussed how the panel works through new CPT codes for services that previously went unpaid. Many of these codes describe cutting-edge procedures, from surgical techniques to influenza vaccines. The panel has been looking at molecular pathology and creating codes around this pioneering area of medicine.</p> <p> But for family physicians like Dr. Ellington, who mostly see patients for health evaluation and management, groundbreaking surgical procedures might not be relevant to their daily practice. What is truly exciting are codes being developed for new areas of care, such as transitional care or complex care coordination.</p> <p> These new codes, and the services they support, could drastically reduce hospital readmission rates, Dr. Ellington said.</p> <p> Get inspired and hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1fbb6654-0f5e-4ced-a2cb-bc9fa89e8794 Participate in AMA-SPS online member forum and virtual assembly http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_participate-ama-sps-online-member-forum-virtual-assembly Wed, 03 Sep 2014 06:00:00 GMT <p> If you are 65 years of age or older and a member of the AMA, you are automatically part of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">AMA Senior Physicians Section</a> (SPS). Here are some ways you can get involved in the section and make your voice heard on issues of importance to the senior physician community:</p> <p style="margin-left:43.5pt;"> 1. <strong>Participate in the AMA-SPS </strong><a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2014/senior-physicians-reference-committee.page" target="_blank"><strong>online member forum</strong></a><strong> (log in) Sept. 10–24.</strong> This forum enables senior physicians from across the United States to access, review and comment on AMA-SPS resolutions and revisions to the section’s internal operating procedures.</p> <p style="margin-left:43.5pt;"> 2. <strong>Participate in the AMA-SPS </strong><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/meet" target="_blank"><strong>virtual assembly</strong></a><strong> via conference call at 8 p.m. Eastern time Sept. 25.</strong> During the call, senior physicians will develop consensus opinions on AMA-SPS resolutions that have been submitted and revisions to the internal operating procedures. RSVP to <a href="mailto:sps@ama-assn.org" rel="nofollow">sps@ama-assn.org</a> by Sept. 22 to receive the call-in information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0dbfc906-b500-4ae4-a747-8c62e26bef19 Physicians call for changes to Medicare payment policy proposals http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-call-changes-medicare-payment-policy-proposals Tue, 02 Sep 2014 21:48:00 GMT <p> New <a href="http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Federal-Regulation-Notices-Items/CMS-1612-P.html" rel="nofollow" target="_blank">proposed rules</a> from the Centers for Medicare & Medicaid Services (CMS) would <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-things-should-medicares-proposed-payment-rule" target="_blank">impact many aspects</a> of physician payment and federal regulatory programs, but many of these changes are not for the better. In a letter sent last week, the AMA urged the agency to make revisions to avoid negative effects on physicians and patients.</p> <p> Among the many topics addressed in the <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/medicare-physician-fee-schedule-comment-letter-29aug2014.pdf" target="_blank">64-page letter</a> (log in) were these issues of concern:</p> <p> <strong>Expanding the value-based modifier (VBM).</strong> CMS wants to expand the VBM to all physicians and increase the potential penalty from 2 percent to 4 percent. The AMA opposes any increase in the penalty and noted that under CMS’ proposal, some practices would be vulnerable to payment cuts from the various Medicare programs totaling 11 percent in 2017.</p> <p> The AMA, which has also called for repeal of the VBM, is pressing CMS to avoid a “rapid and risky expansion” where “some of Medicare’s sickest patients could lose access to their doctors, some physicians could be driven out of business and the government will have diverted scarce resources from other payment and delivery reforms that have a far better chance of achieving a more value-based health care system.”</p> <p> <strong>Including CME activities in Sunshine Act reporting.</strong> The AMA also weighed in on CMS’ proposal to include certain types of continuing medical education (CME) in the Physician Payments Sunshine Act, which requires public reporting of physicians’ financial interactions with medical device and drug manufacturers. Adding CME activities to this reporting would “chill physician participation in independent [continuing education] programs,” the letter said.</p> <p> The AMA and 112 specialty and state medical societies <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-ask-cms-postpone-sunshine-act-data-release" target="_blank">have been calling</a> for CMS to eliminate this proposal and ensure physicians have enough time to review their data.</p> <p> <strong>Reporting and paying for chronic care management.</strong> The agency said it will begin paying physicians for chronic care management next year, which is positive. However, CMS proposes using temporary “G” codes, which would require physicians to report these services every 30 days, rather than the new CPT® code that would simplify reporting to once per calendar month. The AMA is urging CMS to accept the CPT’s “monthly” structure, which is administratively simpler, and to adopt practice expense values, recommended by the AMA/Specialty Society Relative Value Scale Update Committee (RUC), that more adequately reflect the clinical resources required to deliver chronic care management.</p> <p> <strong>Eliminating global service packages.</strong> CMS wants to transition the more than 4,200 services that have 10- and 90-day global periods to zero-day global codes by 2017 and 2018, respectively. This change “would not accurately account for physician work, practice expense [or liability] risk for services performed within the current surgical global period,” the letter said. The change also would place substantial administrative burden on physicians.</p> <p> Instead, the AMA urges CMS to work with the RUC and the CPT® Editorial Panel to ensure physicians will be accurately paid for patient care services that currently don’t have separate coding or payment.</p> <p> <strong>Quality reporting.</strong> CMS proposes to increase the number of measures needed to avoid a 2 percent payment penalty under the Physician Quality Reporting System from three to nine and to simultaneously reduce the measures available for reporting.  The letter opposes the increase in measures “due to the unavailability of meaningful measures relevant to every specialty and the dramatic reduction of measures available to report.”</p> <p> The AMA also urged CMS to make the PQRS program more streamlined and stable, asking the agency not to change requirements on a yearly basis. In addition, physicians who successfully participate in PQRS or are successful demonstrators under the electronic health records meaningful use program should be counted as satisfying both programs, the letter said.</p> <p> Other issues discussed in the letter include:</p> <ul> <li style="margin-left:0.25in;"> A revised timeline for reviewing new, revised and potentially misvalued services. This proposal would significantly slow implementation of important CPT code updates and adjustments to the values of physician services. In addition to the comments in this letter, the AMA and 70 medical specialty associations submitted formal comments on the revised timeline in a separate letter dealing with this issue alone. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/dont-delay-needed-code-updates-physicians-tell-cms" target="_blank">Read more</a> in a recent <em>AMA Wire</em>® post.</li> <li style="margin-left:0.25in;"> Revisions to the clinical lab fee schedule.</li> <li style="margin-left:0.25in;"> The burdensome opt-out process for physicians who wish to participate in private contracting.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:98bbd761-2734-45d8-8097-e65dedd4b1f2 Delve deep into the Guides® Sixth at Chicago seminar http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_delve-deep-guides-sixth-chicago-seminar Tue, 02 Sep 2014 20:32:00 GMT <div class="wrapme"> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/9/1443ecf9-e46a-4de0-897d-4ca8f06a2a17.Full.jpg" target="_blank" title="Click here to view this image at full size in another window..."><img alt="blog post photo" id="1443ecf9-e46a-4de0-897d-4ca8f06a2a17" src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/9/1443ecf9-e46a-4de0-897d-4ca8f06a2a17.Large.jpg" /></a>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. 19 in Chicago. <div>  </div> <div> Physicians and others who handle aspects of impairment ratings will increase their knowledge of the <em>Guides to the Evaluation of Permanent Impairment, Sixth Edition</em>, and its role in workers’ compensation. The seminar will cover a step-by-step progression of the impairment calculation for conditions and injuries related to individual body systems.</div> <div>  </div> <div> 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.</div> <div>  </div> <div> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20142790E&TID=NoaqHJ51ezI66XacvDjATA%3d%3d&OID=130" 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>.</div> <div>  </div> </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f8559cb3-a0c9-40a9-9ab5-49dcec7c4246 Celebrate Women in Medicine month this September http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_celebrate-women-medicine-month-this-september Tue, 02 Sep 2014 20:32:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/7/3ba3ff3a-4f2f-4dc5-976b-7a196c396e76.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/7/3ba3ff3a-4f2f-4dc5-976b-7a196c396e76.Large.jpg?1" style="float:left;margin:10px;" /></a>As an OB-GYN, women’s health care issues are always at the forefront of my thoughts. And as an educator, seeing more female medical students and residents in my training programs is encouraging for keeping these issues a top priority. That’s why Women in Medicine Month, which we’re observing this month, is so close to my heart.</p> <p> This observance has been an annual event led by the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section.page?" target="_blank">Women Physician Section</a> (WPS) to increase the influence of women physicians and advocate for women’s health issues. The number of female physicians has been steadily increasing, and women increasingly are taking leadership positions in medical education, research, organized medicine and their communities.</p> <p> Women represent nearly 30 percent of all physicians, and that percentage is going up each year. This is great news for our profession and our patients. Increasing diversity in the physician workforce helps to bring a variety of perspectives and experiences to how we serve our patients.  Here are some ways you can participate in Women in Medicine Month:</p> <ul> <li style="margin-left:0.25in;"> Look for the #WIMmonth hashtag on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">Twitter</a> feeds, where we’ll be honoring innovative women all month.</li> <li style="margin-left:0.25in;"> Listen to AMA-WPS members share their stories and reflections in a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page?" target="_blank">new video series</a>.</li> <li style="margin-left:0.25in;"> Learn about the <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/profile-history-women-in-medicine.pdf" target="_blank">history of women physicians</a>—and what the future may bring.</li> <li style="margin-left:0.25in;"> Get <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/governing-council-inspirations.page" target="_blank">insight into the mentors</a> who have driven women leaders.</li> <li style="margin-left:0.25in;"> Check out the honorees of the AMA-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 Physician Awards</a>.</li> </ul> <p> This year’s theme “Innovators and Leaders Changing Health Care” is especially appropriate because increasing the involvement of women physicians and building awareness around women’s health care issues is an important part of supporting a healthy society.</p> <p> To all physicians and our patients, I invite you to join me in celebrating Women in Medicine Month throughout the weeks ahead. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7f062530-917c-421f-b0c7-10c42b65134c Don’t delay needed code updates, physicians tell CMS http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dont-delay-needed-code-updates-physicians-tell-cms Tue, 02 Sep 2014 19:25:00 GMT <p> A new timeline the Centers for Medicare & Medicaid Services (CMS) plans to implement for reviewing new, revised and potentially misvalued services could significantly slow the timeframe for implementing important CPT® code updates and changes to the values of physician services. The AMA and 70 medical associations sent a letter last month, calling on the agency to reconsider the proposal.</p> <p> While the proposed revisions would provide additional transparency to the code valuation process, the new timeline simultaneously would stand in the way of more timely code and valuation updates needed to reflect changes in clinical care. The proposed timeline would extend the time required to generate a code or relative value from 14-22 months from the time of application to 22-30 months, the <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/medicare-program-sign-on-letter-13aug2014.pdf" target="_blank">letter</a> (AMA login required) said.</p> <p> The new timeline calls for consideration of all code and relative value changes to shift from inclusion in the Medicare Physician Fee Schedule interim final rule to inclusion in the proposed rule, beginning with the 2016 rule. The letter calls for CMS instead to implement changes to the timeline and procedures in the 2017 CPT cycle and the 2017 Medicare Physician Fee Schedule.</p> <p> The letter also called out CMS’ proposal to require all recommendations from the Relative Value Scale Update Committee (RUC) to be submitted by Jan. 15 of each year. The change would only allow a single opportunity for the medical community to offer recommended valuation of new technology and code bundles for 2016.</p> <p> Meanwhile, for later years, the proposed changes would greatly delay the ongoing process of generating codes and relative values “at a time when CMS, the CPT Editorial Panel and the RUC are being asked to reduce the amount of time needed to accommodate changes,” the letter said.</p> <p> Accepting the proposed work flow modifications would eliminate the need for CMS to create “G” codes, which are temporary codes that essentially duplicate CPT codes. The organizations said that G codes would add to physician practices’ administrative burdens because they would need to learn and implement new codes within a short time period, also increasing the risk for coding errors.</p> <p> “We believe that the G code proposal is entirely unworkable and should not be considered in finalizing the new process,” the letter said.</p> <p> CMS also proposed to eliminate the “refinement panel” process, now used to consider comments on interim relative values.</p> <p> “For nearly two decades, the CMS refinement panel process was considered by stakeholders to be an appeals process,” the letter said. “The complete elimination of the refinement panel indicates that CMS will no longer seek the independent advice of contractor medical officers and practicing physicians and will solely rely on agency staff to determine if the comment is persuasive in modifying a proposed value.”</p> <p> CMS’ final rule will be released Nov. 1.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b3f1448a-786d-4a4e-97eb-8c40b497ecc9 Video: How to manage and embrace the future of medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_manage-embrace-future-of-medicine Tue, 02 Sep 2014 06:00:00 GMT <p> <object align="right" data="http://www.youtube.com/v/pb01J2QYcYs" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/pb01J2QYcYs" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/pb01J2QYcYs" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/pb01J2QYcYs" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Major advances in technology, diagnostics and treatment are likely parts of medicine’s near future, according the JAMA Network editor-in-chief Howard Bauchner, MD. From his unique position to learn about groundbreaking research, Dr. Bauchner walks physicians through what’s to come in the future—and how to manage changes in preparing for that care in an AMA “<a href="http://youtu.be/pb01J2QYcYs" rel="nofollow" target="_blank">Innovations in Medicine” talk</a>.</p> <p> In this brief, informal presentation in the style of TED Talks, Dr. Bauchner takes physicians through future innovations in medicine—such as injected devices that can predict myocardial infarction and individual patient prognostic and therapeutic fingerprints. He also offers up ways to ensure medical students today are the well-trained physicians of tomorrow.</p> <p> “How do you manage change in a complex situation?” he asks.</p> <p> He points to how the JAMA Network embraced change, managed risk and dared to experiment to bring cutting-edge advancement to the network’s journals. Similar forward thinking is necessary to make the bold changes in medical education that are necessary to equip future physicians with new tools, skills and competencies to care for future populations.</p> <p> For an example, he looks at the AMA’s <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Medical Education</a> initiative, which is exploring things like competency-based assessment, new technology and informatics within medical education.</p> <p> “Big data will enter your lives,” Dr. Bauchner says in the talk. “The march of technology has no limits.”</p> <p> Get inspired and hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:52f0f48f-0f9b-4b5b-a0c6-fea62781f696 AMA Section on Medical Schools to meet Nov. 6 in Chicago http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-section-medical-schools-meet-nov-6-chicago Tue, 02 Sep 2014 06:00:00 GMT <p> Academic physicians should plan to attend the AMA Section on Medical Schools (SMS) meeting from 4:30 to 7:30 p.m. Nov. 6 in Chicago.</p> <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=SMSI12E&TID=INaoed0Ms5%2fD15CGT%2bWIjg%3d%3d&OID=130" target="_blank">Register now</a> (log in) so that you will be able to:</p> <p> <ul> <li><span style="font-family:;font-size:10pt;">Get a guided tour of the AMA's new headquarters, housed in a building <a href="http://www.chicagoarchitecture.info/Building/1043/AMA-Plaza.php" rel="nofollow">designed</a> by internationally renowned architect Ludwig Mies van der Rohe.</span></li> <li> <span style="font-family:;font-size:10pt;">Enjoy a networking reception for academic physicians. </span></li> </ul> </p> <p><span style="font-family:;font-size:10pt;">In addition, learn how the AMA develops policy, and understand the AMA-SMS role in that work, in a special session, “The AMA and the AMA-SMS: What we do and how we do it.” Participants will hear how the relationships between the various AMA sections, councils, caucuses and reference committees support the AMA House of Delegates.</span></p> <p> <span style="font-family:;font-size:10pt;">Other topics for the session include:</span></p> <ul> <li> <span style="font-family:;font-size:10pt;">How the section makes an impact on AMA policy</span></li> <li> <span style="font-family:;font-size:10pt;">How to apply for current professional leadership opportunities for nomination to many key national organizations in medical education (via the AMA Council on Medical Education)</span></li> <li> <span style="font-family:;font-size:10pt;">How the House of Delegates accomplishes its work</span></li> </ul> <p> <span style="font-family:;font-size:10pt;">Review the <a href="https://www.signup4.net/Upload/AMER44A/SMSI12E/i14-sms-agenda.pdf" rel="nofollow" target="_blank">draft agenda</a> and be sure to check out <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/meetings/sms-past-meetings.page?" target="_blank">highlights from past section meetings</a>.</span></p> <p> <span style="font-family:;font-size:10pt;">If you’re not already a member of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page" target="_blank">AMA-SMS</a>, learn how to <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/members.page?" target="_blank">become a member</a>.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c1d711bf-b5fa-4c51-8624-892695c3083b Southwest Florida takes on diabetes prevention http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_southwest-florida-takes-diabetes-prevention Tue, 02 Sep 2014 04:55:00 GMT <p> At-risk seniors in a Florida community are getting some extra help with preventing the onset of type 2 diabetes. The new project comes not a moment too soon—about half of all U.S. adults aged 65 years or older have prediabetes, the precursor to diabetes, according to the Centers for Disease Control and Prevention (CDC).</p> <p> Venice, a southwest coastal town in Florida, is the fourth location to be announced in a collaborative pilot program taking place among physician practices, the YMCA of the USA and the AMA. 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, this pilot is exploring a process for physicians to screen patients for prediabetes, refer eligible patients to participate in the local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.</p> <p> Based on the CDC's evidence-based National Diabetes Prevention Program, the YMCA lifestyle intervention program <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-builds-proven-practical-approaches-improve-health-nationwide" target="_blank">has been proven to help patients</a> prevent or delay the onset of diabetes. Venice area residents over age 65 with prediabetes can attend the program at no cost.</p> <p> In Venice, that’s a big deal. An estimated 35 percent of local adults has prediabetes.</p> <p> Last year, participants of the SKY Family YMCA of Southern Florida’s Diabetes Prevention Program saw an average weight loss of 5 percent, which significantly reduced their risk for developing type 2 diabetes. More than 375 participants already have completed the program in the Venice area. The Diabetes Prevention Program is available to anyone with prediabetes over the age of 18.  </p> <p> The AMA pilot, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/prevention-program-helping-patients-avoid-diabetes" target="_blank">already in three other states</a>, will establish a process for physicians to routinely screen for prediabetes, refer patients to the YMCA and receive updates to incorporate into their patients’ care plans. Currently, the pilot exists in Delaware, Indiana and Minnesota, and a fifth location will be announced in the coming weeks.</p> <p> Visit the CDC’s <a href="http://www.cdc.gov/diabetes/prevention/recognition/registry.htm#program" rel="nofollow" target="_blank">National Diabetes Prevention Program</a> website to find out whether an evidence-based diabetes prevention program is available in your community. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7dc77b93-224e-4b3a-ba2b-9f787bb4303b Be a part of the movement: Ask Congress to #SaveGME http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_part-of-movement-ask-congress-savegme Mon, 01 Sep 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/14/efc29ebd-964b-434e-8e3a-8fe8cdba7862.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/14/efc29ebd-964b-434e-8e3a-8fe8cdba7862.Large.png?1" style="float:right;margin:10px;" /></a>Join your fellow students and residents next week in turning the nation’s attention to critical issues in graduate medical education (GME) by participating in the AMA Medical Student Section’s (MSS) annual Save GME Week, which kicks off Sept. 8.</p> <p> Workforce experts predict a shortage of more than 45,000 primary care and 46,000 specialty physicians in the United States by 2020, and medical schools are producing more graduates to prepare for this expected shortage. At the same time, the number of residency positions has remained capped, meaning some students may not match to training positions, which could exacerbate the shortage.</p> <p> Students and residents participating in Save GME Week are calling for Congress to inject more money into the GME system, allowing residency programs to accept more residents and ease the physician shortage.</p> <p> “I ask you all to join us in making our voices heard, to call for change in this system that so desperately needs reform,” said Taylor T. DesRosiers, the AMA-MSS government relations advocacy fellow and a fourth-year medical student at Johns Hopkins School of Medicine. “More and more medical students are entering the medical school pipeline—let’s do our part to ensure that those students can complete their training in order to provide the best quality health care to our growing and aging population.”</p> <p> Here’s how you can help save GME:</p> <ul> <li style="margin-left:0.25in;"> <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 style="margin-left:0.25in;"> <strong>Share your support by tweeting using #SaveGME</strong> or posting to the section’s <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook</a> page.</li> <li style="margin-left:0.25in;"> <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> <li style="margin-left:0.25in;"> <strong>Stream the </strong><a href="http://radiorounds.org/" rel="nofollow" target="_blank"><strong>Radio Rounds podcast</strong></a><strong> Sept. 11</strong> to hear Samuel Mackenzie, a member of the AMA Board of Trustees and medical student at SUNY Upstate Medical University, discuss the importance of creating more GME positions.</li> </ul> <p> “By participating in Save GME Week, you will actually be shaping our nation’s future,” DesRosiers said. “We are currently on a precipice of massive change in health care, and I challenge you all to become the architects of your own futures to improve our nation’s health.”</p> <p> Follow the <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">AMA-MSS Facebook</a> and <a href="https://twitter.com/AMA_MSS" rel="nofollow" target="_blank">Twitter</a> for daily updates on how students and residents across the country are working to #SaveGME.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c9eff7c8-d17d-4f65-96ef-77463df14cb0 VA seeks physician assistance in boosting referrals for veterans http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_va-seeks-physician-assistance-boosting-referrals-veterans Fri, 29 Aug 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/14/dc95808d-0fab-471a-ae22-661a7a978617.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/14/dc95808d-0fab-471a-ae22-661a7a978617.Large.jpg?1" style="float:right;margin:10px;" /></a>Following <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">recent adoption</a> of the veterans’ health care reform law, the U.S. Department of Veterans Affairs (VA) is reaching out to physicians in private practice to make sure veterans have access to timely medical care.</p> <p> The Veterans’ Access to Care Through Choice, Accountability and Transparency Act of 2014, signed into law earlier this month, authorizes the VA to enter into provider agreements with physicians in private practice so they can deliver care during the next two years to veterans who live too far from a VA facility or who cannot access care in one of those facilities in a timely manner.</p> <p> The legislation is intended to address the access-to-care crisis that has left thousands of veterans unable to receive care when they need it, a chief concern of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-ask-president-quicker-care-veterans" target="_blank">policy adopted</a> by the AMA House of Delegates in June.</p> <p> VA officials have said they will need input from the physician community to meet the 90-day implementation deadline issued by Congress, and they are looking to medical associations to help ensure the law is carried out in a way that ensures the access to care veterans need.</p> <p> The department is developing maps to identify gaps in access to VA facilities, and officials have said they would like to work with the AMA and state medical societies that have developed registries of physicians willing to see veterans in their practices. Registries have been created so far in Alabama, Florida, Georgia, Indiana, Nebraska (which has county-level registries), New York, Missouri, Oklahoma and Texas.</p> <p> If your state isn't included in this list, encourage your state medical association to develop a registry of physicians who are interested in treating veterans in their private practices.</p> <p> Key to ensuring adequate numbers of physicians are able to fill the current need will be developing a streamlined and simple process for individual physicians to enter into provider agreements to care for veterans, the AMA told VA officials in a meeting last week.</p> <p> In addition, part of the new law is authorization and funding for 1,500 new residency slots for veterans’ care. The VA will be issuing guidance on how this new graduate medical education funding will be implemented in the coming months. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bd44c310-9c73-4e90-9d56-8c9dc564634a How two schools are embracing a new science in medical education http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_two-schools-embracing-new-science-medical-education Thu, 28 Aug 2014 22:14:00 GMT <p> For future physicians preparing for the complexities of the 21st-century health care system, education beyond basic and clinical sciences can give them the tools they need to succeed in practice and in achieving positive outcomes for their patients.  Some medical schools are incorporating the science of health delivery into their education curriculum to meet this need.</p> <p> Most of the 11 schools that received grants in the AMA’s <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Medical Education</a> initiative are investigating how to teach systems-based practice, a blanket term that can cover systems of care, quality improvement, population health and other competencies that would fall under the science of health care delivery.</p> <p> “Systems” can be categorized as microsystems within a clinic or office, small macrosystems within a hospital or a state, or even large macrosystems, such as Medicare or the U.S. health care system. With so many elements of systems in play—including admitting and scheduling, ancillary services, referrals, insurers, community services, legal systems and more—it’s important that tomorrow’s physicians understand how to successfully navigate systems to optimize outcomes and cost, <a href="https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf#page=11" target="_blank" rel="nofollow">according to the Accreditation Council for Graduate Medical Education.</a></p> <p> Pennsylvania State University College of Medicine launched its new systems navigation curriculum earlier this month with its first-year students. The first part of the two-pronged curriculum will incorporate systems-based practice topics over a 19-month period, beginning in the students’ first month of their medical school experience and finishing just before they enter clinical rotations.</p> <p> The second part will make the students “patient navigators,” linking them with local clinics to give the students experience in actually dealing with systems-based practice. As navigators, students will help patients handle insurance, find community resources and coordinate complex care issues. They also will provide support and educate patients about their illnesses.</p> <p> The patient navigator network is a new concept, both for medical schools and for clinical sites, said Jed Gonzalo, MD, assistant dean for health systems education at Penn State.</p> <p> “Designing a model where students would be assigned to their clinic, learn about the workings of their goals and then perform a value-added component of their clinic’s work is a newer concept,” Dr. Gonzalo said. “This process has required building partnerships with these motivated and engaged professionals in these clinics to establish such a program.”</p> <p> Mayo Medical School is taking a similar approach, implementing the “Science of Health Care Delivery” curriculum to cover six content domains: person-centered care, population-centered care, high-value care, team-based care, health policy, economics and technology, and leadership. The school is using blended learning, or a combination of face-to-face education and online modules.</p> <p> The school is developing tools to document student achievement in these new topic areas, including surveys, quality improvement reviews, patient safety knowledge assessments and checklists. Mayo will work with the other schools in the AMA consortium—and medical schools nationwide—to create and share these tools, said Stephanie Starr, MD, assistant medical director  of the Mayo Clinic Quality Academy and director for science of health care delivery education at Mayo Medical School</p> <p> In contrast to Penn State, Mayo’s new curriculum will be slowly phased in over time. The school will simultaneously implement changes in other areas, such as technology use. For both schools, and the nine other schools that make up the consortium of schools in the AMA’s Accelerating Change in Medical Education initiative, there isn’t a “right” way to make these major changes—but there is agreement that change is necessary, particularly with systems-based education.</p> <p> “We’re talking about a denominator of content that hasn’t been explicit before,” Dr. Starr said. “It’s kind of a new frontier, and it’s changing so fast. But it’s clear that these are the things physicians need in 2014. We can only guess what they’ll need in 2020, but it will probably be more than this.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:058b8f4c-c8be-4093-b1b2-4d2f16a71016 How physicians are rethinking care delivery http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-rethinking-care-delivery Thu, 28 Aug 2014 22:13:00 GMT <p> <object align="right" data="http://www.youtube.com/v/K3e7JgCJa2Q" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/K3e7JgCJa2Q" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/K3e7JgCJa2Q" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/K3e7JgCJa2Q" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>The way care is delivered can have drastic effects on patients’ health, even in the treatment of the same illness. One physician shares her experience in the differences between fee-for-service and value-based care, and how these differences have directly affected her patients’ health outcomes.</p> <p> In an AMA “<a href="http://youtu.be/K3e7JgCJa2Q" rel="nofollow" target="_blank">Innovations in Medicine” talk</a>—a brief, informal presentation in the style of TED Talks—Grace Terrell, MD, explains how she and her colleagues at Cornerstone Health Care in High Point, North Carolina, decided to change everything about how they practice medicine.</p> <p> “As successful as we’ve been in the fee-for-service world … it was unsustainable,” Dr. Terrell, who is president and CEO of the group practice, said.</p> <p> She used two stories of two patients—both elderly women with the same illness—and how their health outcomes differed based on which system of care delivery they used. The health of the patient who underwent treatment in the traditional, fee-for-service model of care only grew worse. At the same time, her treatment costs totaled more than $200,000. The other patient, who was treated in a value-based payment model, saw immediate health improvement and a bill of less than $1,000.</p> <p> Dr. Terrell’s group of 180 physician owners and 360 health care professionals who banded together to transform care delivery had to make some important, upfront changes in order to see results, she said. That included investing in new ideas, such as patient care advocates, team-based care and a robust information infrastructure. They also had to change the way they were paid, and now all of the group’s contracts with payers are value-based.</p> <p> “It’s not a miracle,” Dr. Terrell said. “We are very average doctors in High Point, North Carolina. We just decided to go there.”</p> <p> Be inspired: Hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> <p> <strong>Want more inspiration? </strong>Get a first-hand look at what’s driving health and medical progress today with <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/announcing-tedmed-2014-live-streaming-imagining-health-medicines-future" target="_blank">TEDMED 2014</a>, the annual health and medicine edition of the world-renowned TED Talks, held Sept. 10-12 simultaneously in Washington, D.C., and San Francisco.</p> <p> Participate in live streaming the week of the event. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and use invitation code “TMLicAMA14” to watch talks on demand, or view portions of the event in real-time. You also can gather a group of your colleagues and staff to view presenters of interest.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:757a7e68-911a-4874-972b-7693a3d488db JAMA Highlights: This week’s top articles from the JAMA Network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-this-weeks-top-stories-jama-network Thu, 28 Aug 2014 20:28:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/v7LKCqukcAM" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/v7LKCqukcAM" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/v7LKCqukcAM" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/v7LKCqukcAM" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Hypertension self-management program helps reduce blood pressure for high-risk patients</strong><br /> Among patients with hypertension at high risk of cardiovascular disease, a program that consisted of patients measuring their blood pressure and adjusting their antihypertensive medication accordingly resulted in lower systolic blood pressure at 12 months compared to patients who received usual care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1899205" rel="nofollow" target="_blank">study</a> in the Aug. 27 issue of the <em>Journal of the American Medical Association</em> <em>(JAMA</em>)<em>.</em></p> <p> <strong>Collaborative care intervention improves depression among teens</strong><br /> Among adolescents with depression seen in primary care, a collaborative care intervention that included patient and parent engagement and education resulted in greater improvement in depressive symptoms at 12 months than usual care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1899203" target="_blank" rel="nofollow">study</a> in <em>JAMA.</em> Watch a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1899203" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Lower opioid overdose death rates associated with state medical marijuana laws</strong><br /> States that implemented medical marijuana laws appear to have lower annual opioid analgesic overdoses death rates (both from prescription pain killers and illicit drugs such as heroin) than states without such laws, although the reason is not clear, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1898878" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine.</em></p> <p> <strong>Weekend hospitalization linked to longer stay for pediatric leukemia patients</strong><br /> Weekend admission to the hospital for pediatric patients newly diagnosed with leukemia was associated with a longer length of stay, slightly longer wait to start chemotherapy and higher risk for respiratory failure, but weekend admissions were not linked to an increased risk for death, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1899235" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b43663f6-a6e9-46de-8ffe-126f9cb0cc10 Time running out to review Sunshine data--and it isn’t very accurate http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_time-running-out-review-sunshine-data-isnt-very-accurate Thu, 28 Aug 2014 06:00:00 GMT <p> Less than two weeks remain for physicians to review and dispute data about their financial interactions with medical device and drug manufacturers before the information goes public Sept. 30. Among physicians who have completed the complicated and time-consuming registration process, 62 percent found serious inaccuracies with the data in their reports, according to newly released survey findings.</p> <p> If you haven’t started the process to review and dispute your data, you should begin right away to allow enough time to complete all the steps. An informal online survey of more than 200 physicians found that more than two-thirds of physicians had a poor registration experience overall with the Sunshine Act portal (also known as the “Open Payments” system). Findings also show that 83 percent of respondents said the system wasn’t user friendly.</p> <p> Meanwhile, the Centers for Medicare & Medicaid Services (CMS) announced Thursday that the website again will be down for periods of time Aug. 30 and Sept. 6. As a result of the outages, the deadline for physicians to review and dispute their data has been extended by two days until Sept. 10.</p> <p> “Continuing to shut down the website and moving the deadline for physicians to seek corrections is causing confusion and frustration among physicians,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-08-28-new-shut-down-open-payments-system.page" target="_blank">news release</a>.</p> <p> “Patients need accurate information. If the government releases incorrect information to the public, it can lead to misinterpretations, harm reputations and cause patients to question their trust in their physicians,” Dr. Wah said. “Inaccurate data can also unfairly impact physicians’ ability to attain or keep research grants and other employment opportunities that require disclosure.”</p> <p> The AMA and 112 specialty and state medical societies earlier this month <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-ask-cms-postpone-sunshine-act-data-release" target="_blank">urged CMS to postpone the release</a> of physician financial data for six months, to March 31, pointing to the host of issues that have plagued the data review and dispute process and the agency’s lack of communication around the problems.</p> <p> In the meantime, physicians should get started with the Sunshine Act review process. Use the CMS <a href="https://portal.cms.gov/wps/portal/unauthportal/home/" rel="nofollow" target="_blank">Enterprise portal</a> and Open Payments system to register and review your data. Follow these three steps:</p> <ol> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ready-release-of-financial-data-this-week" target="_blank">Complete the CMS e-verification process</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/must-this-week-before-financial-data-goes-public" target="_blank">Register with the Open Payments system</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/dispute-incorrect-financial-data-before-goes-public" target="_blank">Review and dispute your data by Sept. 8</a></li> </ol> <p> The first two steps alone can take up to 48 hours to complete and receive verification, so allowing enough time is important.</p> <p> Any incorrect data that you haven’t disputed by Sept. 10 won’t be flagged as potentially inaccurate in the Sept. 30 public data release. Although you can dispute your data through Dec. 31, it will not be marked as disputed in the public database.</p> <p> If you previously had trouble accessing the online review portal, try again now. The site suffered from numerous technical problems and was shut down until last week after physicians were accessing incorrect data.</p> <p> According to CMS, the agency has identified about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/despite-errors-cms-gives-doctors-until-sept-8-review-data" target="_blank">one-third of the data as having errors</a> and plans to withhold this group of data from the initial public data release. It’s up to individual physicians to identify inaccuracies in their remaining data.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:57032370-de2a-4bcb-b512-fcba1153d775 Peanuts cartoon gives nod to AMA; Linus loses his blanket http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_peanuts-cartoon-give-nod-ama-linus-loses-his-blanket Wed, 27 Aug 2014 21:31:00 GMT <p> In a Peanuts cartoon republished this week, Lucy tells Linus that their grandmother has given up smoking, so he has to give up his treasured blanket, as previously agreed to.</p> <p> Linus’ reply?</p> <p> “I hope the AMA appreciates this.”</p> <p> This year we mark the 50th anniversary of the seminal 1964 U.S. Surgeon General’s Report on Smoking and Health. Read the <a href="http://jama.jamanetwork.com/article.aspx?articleid=1812962" rel="nofollow" target="_blank">study</a> from the <em>Journal of the American Medical Association</em> that notes public health efforts have cut smoking rates in half since then, saving 8 million lives.</p> <p> “For the last five decades, the AMA has been a proud supporter of anti-tobacco efforts ranging from urging the federal government to support anti-tobacco legislation prohibiting smoking on public transportation to calling on tobacco companies to stop targeting children in their advertising campaigns,” AMA Immediate Past President Ardis Dee Hoven, MD, said in a statement.</p> <p> This classic Peanuts cartoon originally was published three years after the 1964 surgeon general’s report.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/14/15e8f3e8-dd69-4e0f-ae08-7090467562a4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/14/15e8f3e8-dd69-4e0f-ae08-7090467562a4.Large.jpg?1" /></a></p> <p> © 2014 PEANUTS Worldwide LLC</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1979bde6-680a-4756-8633-6628a9a7bf90 What new physicians need to know about navigating regulations http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-physicians-need-navigating-regulations Wed, 27 Aug 2014 20:33:00 GMT <p> Transitioning from residency or fellowship into practice is a stressful time, and it’s not made any easier by the many regulatory issues physicians face on a daily basis. Fortunately, new physicians have help in navigating the complicated regulatory environment.</p> <p> Preparing to comply is important because many federal programs can bring financial penalties or other serious consequences if not carefully followed. Here are some of the main things new physicians need to know:</p> <ul> <li style="margin-left:0.25in;"> <strong>Physician Payments Sunshine Act:</strong> Manufacturers of drugs and medical devices must report certain payments and items of value given to physicians and teaching hospitals, and this data will be made available to the public on a yearly basis. Physicians will have the opportunity to review the data reported about them and dispute it with the reporting organization each year. While residents aren’t subject to the Sunshine Act, fellows are included, and should be sure to review their financial data following <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page" target="_blank">these three steps</a> by Sept. 8.</li> <li style="margin-left:0.25in;"> <strong>Health Insurance Portability and Accountability Act (HIPAA): </strong>The security aspect of HIPAA can be challenging. The U.S. Department of Health and Human Services Office for Civil Rights will be implementing random HIPAA audits, so compliance is crucial. Physicians must ensure all electronic patient information is encrypted and should perform security risk assessments for all health IT, not just their electronic health record (EHR) systems. Get more information on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act.page" target="_blank">HIPAA Web page</a>.</li> <li style="margin-left:0.25in;"> <strong>Meaningful use program: </strong>The Medicare/Medicaid meaningful use EHR incentive program isn’t mandatory, but physicians who want to accept Medicare or Medicaid will be subject to financial penalties if they don’t meet the requirements each year. <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/medicare-medicaid-incentive-programs.page" target="_blank">Learn how</a> to demonstrate meaningful use, avoid penalties and navigate the program.</li> <li style="margin-left:0.25in;"> <strong>Physician Quality Reporting System (PQRS): </strong>Physicians who accept Medicare patients must participate in the PQRS, which involves transmitting data on quality measures to the Centers for Medicare & Medicaid Services. Physicians who accept Medicare and do not participate in PQRS will be docked a percentage of their Medicare payments. Information about the program, how to participate and how the PQRS aligns with the meaningful use program is available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/clinical-practice-improvement/clinical-quality/physician-quality-reporting-system.page?" target="_blank">PQRS Web page</a>.</li> </ul> <p> <strong>Talk about the issues you face: </strong>Share the ways you’re preparing to transition from residency to practice with the AMA on <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">Twitter</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:93086afd-4e87-46be-bc3e-2c77de833e7c AMA-SPS Governing Council selects chair-elect http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-sps-governing-council-selects-chair-elect Wed, 27 Aug 2014 06:08:00 GMT <p> Barbara A. Hummel, MD, is the newly elected chair-elect of the AMA Senior Physicians Section (SPS) Governing Council.  Dr. Hummel is an independent solo family physician from Muskego, Wisconsin, and served on the Senior Physicians Section Governing Council since 2012.  </p> <p> Dr. Hummer also is currently a member of the Wisconsin delegation to the AMA House of Delegates, serving as alternate delegate.</p> <p> For more information about the Senior Physicians Section and its initiatives, please visit the AMA-SPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">website</a>.<br />  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b9b2dfd3-a57d-4cf8-bc75-cede79efc743 Submit AMA-SPS resolutions by Sept. 5 for Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_submit-ama-sps-resolutions-sept-5-interim-meeting Wed, 27 Aug 2014 06:00:00 GMT <p> Any AMA member is automatically a member of the AMA Senior Physicians Section (SPS) and may submit a resolution as an individual or on behalf of his or her state or specialty society.  Resolutions, which are due Sept. 5, propose policy positions that you believe the AMA-SPS should support. Criteria include:</p> <ul> <li> 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> Resolutions that relate to patients in this segment of the population (65 years of age and older), or are a proposed action that would benefit patients in this segment </li> </ul> <p> If you would like to receive support with your resolution, please <a href="mailto:cwolfe@columbus.rr.com" rel="nofollow">email</a> delegate, Claire Wolfe, MD, or <a href="mailto:johnknote@frontier.com" rel="nofollow">email</a> alternate delegate, John Knote, MD.</p> <p> Also, be sure to participate in the AMA-SPS <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">online member forum</a> Sept. 10–24. This forum enables senior physicians from across the United States to access, review and comment on AMA-SPS resolutions.</p> <p>  </p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2567922a-a07d-4881-ac96-429dda66301b Need help on creating research abstract? View webinar http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-creating-research-abstract-webinar Wed, 27 Aug 2014 06:00:00 GMT <p> If you are a physician certified by the Educational Commission on Foreign Medical Graduates (ECFMG)  working on a research or clinical case abstract, check out an archived webinar on the subject.</p> <p> The webinar, cosponsored by the ECFMG and the AMA, offers a step-by-step guide to help you get started in the scholarly activity process.</p> <p> <a href="http://www.ecfmg.org/echo/webinars-july-2014.html" target="_blank" rel="nofollow">View</a> the webinar.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:28dffb9d-b451-4a89-98a6-325d197ba077 What you need to make smart employment decisions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-smart-employment-decisions Tue, 26 Aug 2014 23:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/7/a618b009-0a9a-43e8-b7e5-e42ec628827f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/7/a618b009-0a9a-43e8-b7e5-e42ec628827f.Large.jpg?1" style="float:left;margin:10px;" /></a>There are a lot of considerations when it comes to entering into employment versus private practice, and it can be challenging for new physicians—or physicians seeking a change—to navigate.</p> <p> Contracts often are difficult to understand, making it hard to decipher whether key issues are fully covered or addressed in a way you’re willing to accept. If the process is convoluted, you might not be able to tell how much you’ll be compensated, or whether such major expenses as liability insurance will be included.</p> <p> If you’re a physician who is interested in employment, the AMA offers resources to help you make wise decisions about your professional future:</p> <ul> <li style="margin-left:0.25in;"> Get insight into negotiation tips, common contract terms, explanations of business and legal consequences, and sample contract provisions using the “<a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2530052" target="_blank">Annotated model physician-group practice employment agreement</a>” e-Book.</li> <li style="margin-left:0.25in;"> Preparing to negotiate an employment contract with a hospital? Our “<a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240028&navAction=push" target="_blank">Annotated model physician-hospital employment agreement</a>” e-Book helps you through the ins and outs.</li> <li style="margin-left:0.25in;"> You’ll find a framework to guide you in collaborating with your employer on providing safe, high-quality and cost-effective patient care in the AMA “<a href="http://www.ama-assn.org/resources/doc/hod/x-pub/ama-principles-for-physician-employment.pdf" target="_blank">Principles for Physician Employment</a>” (AMA login required).</li> <li style="margin-left:0.25in;"> Check out the information on our <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section/physician-employment.page" target="_blank">physician employment resources Web page</a>, designed to help meet the unique needs of a growing population of employed physicians.</li> </ul> <p> These resources can help you make sure your interests are fully considered before you enter an employment agreement and navigate the complexities of working as a physician employee.</p> <p> By helping physicians successfully navigate these difficult decisions, our goal is to establish sustainable medical practices that result in optimal health outcomes for patients and greater professional satisfaction for physicians.</p> <p> As part of our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA is developing tools to help you make informed decisions about your practice environment and enhance the practice of medicine wherever you work. I look forward to sharing more information about that in the coming months.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:19c9d55a-3dd6-48a3-b918-0ebe578493c0 Improved policies and procedures help your practice thrive http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_manual-can-improve-workflow-professionalism Tue, 26 Aug 2014 21:04:00 GMT <div> <p> Develop your practice’s policies and procedures manual, or improve your current manual, using the AMA’s <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1290008&navAction=push" target="_blank"><em>Policies and Procedures for a Successful Medical Practice</em></a>.</p> <p> The book comes with downloadable, customizable forms to help with your day-to-day practice administration. It mirrors an actual policy and procedure manual, separating administrative and general practice protocols, to help you better understand the rationale behind successful practice policies and procedures.</p> <p> Use the guide to:</p> <ul> <li style="margin-left:0.5in;"> Build infrastructure to improve workflow</li> <li style="margin-left:0.5in;"> Find the best documentation format</li> <li style="margin-left:0.5in;"> Incorporate marketing and social media into your practice’s operations</li> <li style="margin-left:0.5in;"> Comply with privacy measures, such as HIPAA</li> <li style="margin-left:0.5in;"> Add professionalism to your practice and ensure consistency in operating procedures</li> </ul> <p> The AMA Store is offering 30 percent off this product through Sept. 30. Use promo code “FPC” during check-out.  </p> <p> AMA members receive a discount on a wide range of 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/">join today</a>.</p> </div> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:64d134e2-e388-4c96-930d-6651d4c2bc52 Among 100 top influencers in health care, physician leaders shine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_among-100-top-influencers-health-care-physician-leaders-shine Tue, 26 Aug 2014 20:59:00 GMT <p> Politicians and federal agency heads weren’t the only ones voted into the newly released 2014 <a href="http://www.modernhealthcare.com/section/100-most-influential-2014" target="_blank" rel="nofollow">100 most influential people in American health care</a> by <em>Modern Healthcare</em>. AMA President Robert M. Wah, MD, and AMA CEO and Executive Vice President James L. Madara, MD, were named to the list, alongside 17 other AMA members.</p> <p> These physician leaders joined such notables as Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), Thomas Frieden, MD, director of the Centers for Disease Control and Prevention, and Karen DeSalvo, MD, national coordinator for health information technology. The honorees were nominated by their peers and voted on by both readers and senior editors of the publication.</p> <p> AMA members among the 100 most influential people in American health care include (in alphabetical order by last name):</p> <ul> <li style="margin-left:0.25in;"> Georges Benjamin, MD, executive director, American Public Health Association</li> <li style="margin-left:0.25in;"> Mark Chassin, MD, president and CEO, the Joint Commission</li> <li style="margin-left:0.25in;"> Carolyn Clancy, MD, assistant deputy under secretary for health, U.S. Department of Veterans Affairs</li> <li style="margin-left:0.25in;"> Francis Collins, MD, PhD, director, National Institutes of Health</li> <li style="margin-left:0.25in;"> Patrick Conway, MD, deputy administrator for innovation and quality, CMS</li> <li style="margin-left:0.25in;"> Toby Cosgrove, MD, president and CEO, Cleveland Clinic</li> <li style="margin-left:0.25in;"> Tejal Gandhi, MD, president, National Patient Safety Foundation</li> <li style="margin-left:0.25in;"> Darrell Kirch, MD, president and CEO, Association of American Medical Colleges</li> <li style="margin-left:0.25in;"> Gary Kaplan, MD, chairman and CEO, Virginia Mason Hospital and Medical Center</li> <li style="margin-left:0.25in;"> John Noseworthy, MD, president and CEO, Mayo Clinic</li> <li style="margin-left:0.25in;"> Jonathan Perlin, MD, PhD, president of clinical services and CMO, HCA Healthcare</li> <li style="margin-left:0.25in;"> Peter Pronovost, MD, PhD, senior vice president for patient safety, Johns Hopkins Medicine</li> <li style="margin-left:0.25in;"> Charles Sorenson, MD, president and CEO, Intermountain Healthcare</li> <li style="margin-left:0.25in;"> Glen Steele Jr., MD, PhD, president and CEO, Geisinger Health System</li> <li style="margin-left:0.25in;"> Andrew Sussman, MD, president, CVS MinuteClinic</li> <li style="margin-left:0.25in;"> Susan Turney, MD, CEO, Marshfield Clinic</li> <li style="margin-left:0.25in;"> Robert Wachter, MD, chief of hospital medicine, University of California San Francisco Medical Center</li> </ul> <p> Earlier this year, Dr. Wah and 20 other AMA members also were <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-president-president-elect-among-50-influential-physician-execs" target="_blank">recognized</a> by <em>Modern Healthcare</em> and <em>Modern Physician</em> magazines among the nation’s 50 most influential physician executives in health care for 2014.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b2b03b19-51ba-4aa5-898b-76ea8f1008c0 How to help patients manage blood pressure outside office visits http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patients-manage-blood-pressure-outside-office-visits Mon, 25 Aug 2014 20:04:00 GMT <p> In a perfect world, every physician would have ample time to dedicate to each patient—but in reality, sometimes patients’ regular office visits just aren’t long enough, or frequent enough. One physician has found how to get patients the extra help they need managing their high blood pressure, both while they’re in the office and through community resources.</p> <p> “An office visit is never just about blood pressure,” said Willarda Edwards, MD, an internist in Baltimore. “It’s more than just talking about their medication. It’s about lifestyle changes, the complications that come with living day to day, family, stress.”</p> <p> Dr. Edwards is participating in a pilot program to improve outcomes around hypertension, which is 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. In this program, physicians and care teams in Maryland and Illinois are developing and testing evidence-based recommendations to improve high blood pressure, working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities.</p> <p> The pilot practices are making clinical changes, such as how to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctor-quickly-improved-patients-blood-pressure-readings" target="_blank">measure blood pressure accurately</a> and then <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-steps-acting-rapidly-control-high-blood-pressure" target="_blank">act rapidly</a> when elevated blood pressure is discovered. They’re also exploring clinical-community linkages, in which physicians refer patients to community resources that can help them improve their blood pressure.</p> <p> Dr. Edwards recognized that regular office visits with patients were eaten up by clinical work and that her patients with high blood pressure needed extra attention. So her practice staff used her electronic health record system to identify patients with a body mass index of 27 or higher, then sent letters to those patients asking them to come in for a special appointment. The 100 patients that took her up on the offer had a 40-minute visit with Dr. Edwards, set up on a day she normally doesn’t see patients, to completely focus on weight loss, nutrition and exercise. Dr. Edwards used this time to give her patients information about where they can safely exercise in the community.</p> <p> Participating patients can come back to Dr. Edwards’ office every week to weigh in, and can see Dr. Edwards every two to four weeks for a 20-minute discussion on their progress and challenges to losing weight. Making time for these short appointments with at-risk patients now can help prevent longer appointments and worsening health problems later.</p> <p> “It’s been really productive because the patients recognize that we care, and when the doctor is focused on them individually, they’re encouraged to take action,” Dr. Edwards said. “When they’re in the office for their 20-minute visit for their blood pressure, or diabetes, I don’t have time to go over that. But when I set the time aside for 20 minutes to just focus on weight loss, we’ve been able to take people off medication, and we’ve seen improvement in their labs.”</p> <p> A key part of making these improvements was having places to direct patients who were interested in exercising but weren’t sure where to go. Dr. Edwards commonly recommends a local program through which patients can visit their local shopping mall to walk for exercise. The mall walker program also offers monthly blood pressure screenings and weekly exercise programs. She also helps patients figure out the best local places to get fruits and vegetables and high-quality foods to maintain a healthy diet.</p> <p> “You have to have some tie to the community for [patients] to feel confident in the care, so they trust you,” Dr. Edwards said. “Patients like to be able to see that they’re more than just numbers on a blood pressure reading, that you really care about their surroundings and the environment they’re in.”</p> <p> The AMA pilot also is exploring ways to get feedback from local programs and incorporate the feedback into patients’ care plans.</p> <p> <strong>Share your community linkages: </strong>Does your practice recommend local fitness or health programs to patients? Let us know in the comment section below or on <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:58b7e4ca-f1c5-4a4c-bfc4-fb0901bb192e The meaning behind your white coat http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_meaning-behind-white-coat Mon, 25 Aug 2014 15:00:00 GMT <p>  </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/Content/images/store/11/13/3bf11e28-3ced-42a9-8de6-6c51b70aa6a8.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/13/3bf11e28-3ced-42a9-8de6-6c51b70aa6a8.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:12px;">Photo by Cliff Hollis, ECU News Services. </span></em></td> </tr> </tbody> </table> <p> New medical students are slipping on their short white coats, a momentous and exciting occasion that marks the beginning of their careers.</p> <p> Often seen as a symbol of authority and professionalism, the white coat frequently is conferred on new students during a ceremony held at the very beginning of medical school. While every school hosts a white coat ceremony, not all schools host them at the same time. For example, new students at Johns Hopkins University School of Medicine don’t receive their white coats until April. Many schools incorporate their own traditions into the ceremonies as well.</p> <p> The ceremony signifies the beginning of students’ journeys to achieve the long white coat, when they are physicians. It also symbolizes professionalism, caring and trust, which they must earn from patients, according to a <em>Virtual Mentor</em> <a href="http://virtualmentor.ama-assn.org/2007/04/mhst1-0704.html" target="_blank">historical perspective</a> on the doctor’s white coat.</p> <p> The ceremony “welcomes those embarking on their medical careers to the community of physicians by giving them this powerful symbol of compassion and honor,” wrote the author, Vice Chair of Education and Faculty Affairs at New York University School of Medicine at March S. Hochberg, MD. “It also gives them a standard against which they must measure their every act of care to the patients who trust them.”</p> <p> Check out how some medical schools are sharing their ceremonies on social media.</p> <p> <strong>Share your white coat ceremony traditions: </strong>Does your medical school have a special ceremony? Tell us in a tweet to the AMA Medical Student Section (MSS) <a href="https://twitter.com/AMA_MSS" rel="nofollow" target="_blank">Twitter account</a>, which we may then post on the AMA-MSS <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook page</a>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a3b2745f-c4ff-4f93-b745-f313590e0a5d Video: How simple questions can save physicians time and money http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_simple-questions-can-save-physicians-time-money Mon, 25 Aug 2014 06:00:00 GMT <p> <object align="right" data="http://www.youtube.com/v/61ZnOj2dM8A" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/61ZnOj2dM8A" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/61ZnOj2dM8A" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/61ZnOj2dM8A" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Physicians can save millions of dollars—and eliminate unnecessary testing—by asking patients just a few quick questions, according to one physician.</p> <p> In an <a href="http://youtu.be/61ZnOj2dM8A" rel="nofollow" target="_blank">AMA “Innovations in Medicine” talk</a>—a brief, informal presentation in the style of TED Talks—Executive Director of the IU National Center of Excellence in Women’s Health Theresa Rohr-Kirchgraber, MD, said that asking her patients a couple questions about their diets can lead to simple solutions for health ailments.</p> <p> “It’s simple, it’s focused, and it doesn’t take a lot of time or effort,” Dr. Rohr-Kirchgraber said. “What did you eat in the last 24 hours?”</p> <p> In her experience, she’s been able to pinpoint ailments and prevent patients from taking potentially unnecessary medications by helping them fix trouble spots in their diets.</p> <p> For example, Dr. Rohr-Kirchgraber had a teen patient with horrible stomach pains. She guessed that he was eating lots of spicy snacks and drinking lots of soda.</p> <p> “Rather than starting him on Prilosec, rather than doing the EGD or testing for H. pylori, I just asked him, ‘What did you have to eat?’” she said. It was a simple choice: “Add on another medication or take away a food product?”</p> <p> Dr. Rohr-Kirchgraber encourages other physicians to ask their patients a few simple questions that potentially can eliminate the need for tests and medications, saving time and health care dollars.</p> <p> Get inspired and hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b7b5aeab-68c9-4988-8466-aee59e34122f Bill seeks to sustain higher Medicaid payments http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_bill-seeks-sustain-higher-medicaid-payments Fri, 22 Aug 2014 20:16:00 GMT <p> A new federal bill would extend the required Medicaid minimum payments for services provided by primary care physicians beyond 2014, when the enhanced payment rate is scheduled to expire under current law.</p> <p> The <a href="http://thomas.loc.gov/cgi-bin/query/z?c113:S.2694:" target="_blank" rel="nofollow">Ensuring Access to Primary Care for Women and Children Act</a> would continue the current requirement that Medicaid pay at rates no lower than Medicare for services provided by family physicians, general internists and pediatricians, as well for as ob-gyns who provide a significant volume of certain primary care services.</p> <p> Earlier this month, the AMA sent a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/medicaid-payment-parity-s2694-senate-letter-12aug2014.pdf" target="_blank">letter</a> (AMA login required) of support to the bill sponsors, Sen. Patty Murray, D-Washington, and Sen. Sherrod Brown, D-Ohio.</p> <p> “Research studies have demonstrated that low Medicaid reimbursement rates can significantly affect a physician’s ability to accept new Medicaid patients into his or her practice,” the letter said. “These payment increases recognize the value of access to primary care services for Medicaid beneficiaries and the importance of adequate payment to physicians participating in Medicaid.”</p> <p> Several states are unlikely to continue the increased payment if they have to finance it without federal support, according to state interviews conducted in 2012-2013. In addition, some states voiced concern that if the payment increase is discontinued in 2015, it may negatively impact efforts to recruit physicians to the Medicaid program.</p> <p> “The AMA believes that all physicians seeing Medicaid patients should be paid at least the Medicare rate to ensure adequate access,” the letter said. “We believe this bill is an important step in that direction.”</p> <p> Visit the AMA's <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/medicaid-payment-parity.page" target="_blank">Medicaid Payment Parity Web page</a> to learn more about the bill and view its cosponsors in Congress.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1e255145-a51a-4432-ad6f-bf757242d04a Patient privacy court ruling would interfere with care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patient-privacy-court-ruling-would-interfere-care Fri, 22 Aug 2014 20:12:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/2/cbdcc6e8-77cb-431a-82e3-68eb7f925f86.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/2/cbdcc6e8-77cb-431a-82e3-68eb7f925f86.Large.jpg?1" style="float:right;margin:10px;" /></a>Physicians are petitioning a state supreme court to hear a previously decided case that holds patient care in the balance by making patients’ personal prescription data too widely available.</p> <p> In <em>Lewis v. Superior Court (Medical Board of California)</em>, a lower court ruling grants law enforcement and other government employees broad access to the state’s prescription drug monitoring program’s database. Physicians are flagging the ruling as a violation of confidentiality in the physician-patient relationship.</p> <p> “The duty of physicians to protect patient privacy lies at the very core of the medical profession,” 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 California Medical Association stated in a petition submitted to the California Supreme Court last week.</p> <p> “Confidentiality is one of the most enduring ethical tenets in the practice of medicine, and is essential to the patient-physician relationship,” the petition continues. “It is the cornerstone of the patient’s trust [and is key to] successful medical information gathering for accurate diagnosis and treatment, an effective physician-patient relationship, good medicine and quality care.”</p> <p> The petition also points to the importance of this case because it deals both with fundamental elements of patient care and with the issue of personal privacy in the digital era. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8eeb651b-a42a-4152-bb93-485d758676cf Announcing TEDMED 2014 live streaming: Imagining health and medicine’s future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_announcing-tedmed-2014-live-streaming-imagining-health-medicines-future Fri, 22 Aug 2014 19:00:00 GMT <p> How are you imagining a healthier world? Explore the possibilities Sept. 10-12 as we hear inspirational perspectives from transformative thinkers in science, health and medicine at <a href="http://tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a>.</p> <p> Take advantage of your complimentary access to TEDMED 2014, the annual health and medicine edition of TED, made possible through an exciting partnership between TEDMED and the AMA. Receive a real-time feed of the program Sept. 10-12, or accommodate your busy schedule by watching on-demand Sept. 10-16.</p> <p> Here’s how you can make the most of this tremendous opportunity:</p> <ul> <li> <strong>Personal access:</strong> Experience TEDMED from the comfort of your own desktop or personal device.</li> <li> <strong>Group viewing: </strong>Book a conference room and view the program with your colleagues and practice staff.</li> </ul> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/86175875-d37c-4c3e-b22a-144de12ddb1a.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/86175875-d37c-4c3e-b22a-144de12ddb1a.Large.jpg?1" style="margin:15px;float:right;" /></a>Together we will explore multi-disciplinary topics through a stimulating <a href="http://www.tedmed.com/event/stage2014" rel="nofollow" target="_blank">stage program</a>, including:</p> <ul> <li> Ending the global physician shortage</li> <li> Revolutionizing medical education</li> <li> Identifying childhood factors that impact serious adult-onset diseases, such as heart disease and cancer</li> <li> Understanding the obesity epidemic and addiction</li> <li> Advancing high-tech diagnostics</li> </ul> <p> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code <strong>“TMLicAMA14” to participate.</strong></p> <p> Don’t miss this opportunity to join your colleagues and peers in more than 100 countries around the world as we unlock our imagination for TEDMED 2014!</p> <p> Questions? <a href="mailto:tedmedlive@tedmed.com" rel="nofollow">Send an email</a> to TEDMED.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fed85800-d875-4eaa-8480-aa614ac579a7 Fact check: The real truth about the RUC--and it’s no secret http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_fact-check-real-truth-ruc-its-secret Thu, 21 Aug 2014 18:58:00 GMT <p> The <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/medicare/the-resource-based-relative-value-scale/the-rvs-update-committee.page" target="_blank">AMA/Specialty Society Relative Value Scale Update Committee</a> (RUC) provides <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-announces-ruc-process-improvements-transparency-methodology" target="_blank">transparent</a> recommendations to the government on the resources required to provide a medical service. Yet its role is often mischaracterized and deeply misunderstood.</p> <p> The RUC consists of <a href="http://www.ama-assn.org/resources/doc/rbrvs/x-pub/ruc-members-current.pdf" target="_blank">doctors</a> (log in) who volunteer their highly technical expertise on complex medical procedures and make recommendations to the government based on their assessment of the time, supplies and equipment involved in patient care. The RUC’s recommendations are thoroughly reviewed by government officials who have the final say.</p> <p> The committee’s <a href="http://www.ama-assn.org/resources/doc/rbrvs/x-pub/ruc-update-booklet.pdf" target="_blank">work</a> (log in) relies on more than 300 participants, including physician advisers from every medical specialty and a dozen other health care professionals, to review the wide array of contemporary clinical services offered across all medical specialties. </p> <p> Too many times when reporters and policymakers bemoan the problems inherent in the Medicare payments system, it is fashionable to use the RUC as a universal kicking post.</p> <p> Take for example Thursday’s reporting by <a href="http://www.politico.com/magazine/story/2014/08/health-care-costs-110184.html?ml=m_t1_2h#.U_Y2mk0g85g" rel="nofollow" target="_blank"><em>Politico Magazine</em></a>. Normally a respected source of information, Politico’s reporter and editors disregarded sound and factual information provided to them about the RUC and instead chose to write a sensationalized story that only skirts any semblance of accuracy.</p> <p> The truth is that the RUC does not control the Medicare payment system, nor does it set rates for medical service. The regulatory process affords hospitals, home health agencies, nursing homes, private health insurers and others the same opportunity that the RUC has to provide input into the policies that determine Medicare payment rates. Yet only physicians are singled out for criticism when making recommendations in a manner so organized, thorough and accurate that those recommendations often are accepted.</p> <p> When providing input to Medicare, the RUC and others must follow principles established decades ago by economists at Harvard University that are required by federal law and regulations. This is one of many factors beyond the control of the RUC that are contributors to the current income differentials between primary care and specialty medicine. The real problem is that the Medicare payment system has become outdated, and the law must be redesigned to fit the new primary care delivery models that will improve value.</p> <p> The RUC attempts to bring balance to the inherent flaws in the Medicare payment system, and primary care physicians play a crucial role in the RUC’s highly technical work. The RUC values <em>all</em> physicians’ cognitive work and role tackling the growing number of Americans with long-term health problems that need continuous care. The committee’s work reflects the continued importance of services that all doctors—including primary care physicians—perform. The RUC’s strong <a href="http://www.ama-assn.org/resources/doc/rbrvs/x-pub/ruc-primary-care.pdf" target="_blank">support</a> (log in) for primary care has advanced innovative delivery models, including medical homes, and promoted recognition of services related to transitional care management, chronic care management and telephone consultations.</p> <p> In fact, during the last three years, the RUC has worked jointly with the CPT® Editorial Panel, which oversees the maintenance of the <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page" target="_blank">CPT code set</a> in an <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/medicare/care-coordination.page" target="_blank">open and transparent process</a> to review care management services, which ultimately led to the payment of transitional care management services.</p> <p> This landmark change in Medicare payment policy underscores that the work of primary care physicians is the glue of the U.S. health care system and should be compensated as such. These services include assessment and support for treatment regimen adherence and medication management, support of patient self-management, and communication with other professionals regarding aspects of patients’ care.</p> <p> The RUC process allows doctors and medical health professionals to provide direct consultation to the government, which helps meet the changing needs of medicine and speeds the inclusion of updated medical techniques. It also allows the committee’s valuable expertise to be balanced with the oversight of government officials, who bear sole responsibility for Medicare’s payment policies. However, the future success of Medicare depends in part on accurately assessing the constant evolution of science and technology and its impact on patient care. The explosion in health care advances continuously changes the work of physicians over time, and Medicare payments should mirror these changes.</p> <p> There is no substitute for relying on input from experienced physicians when gauging how much time and resources go into one medical service compared to another. No one knows more about what is involved in providing services to Medicare patients than the physicians who care for them. This unique insight makes the RUC the best option to review medical services to see whether they are appropriate, undervalued or overvalued.</p> <p> In recent years, the committee has <a href="http://www.ama-assn.org/resources/doc/rbrvs/x-pub/raw-progress-report.pdf" target="_blank">evaluated</a> (log in) more than 1,700 medical services accounting for $38 billion in Medicare spending. The committee has sent recommendations to the Centers for Medicare & Medicaid Services for reductions or deletions of 935 services, resulting in a redistribution of more than $3 billion in the Medicare program.</p> <p> In fact, the committee’s complicated work has long garnered the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/can-provide-input-values-of-medicare-services" target="_blank">praise of government officials</a>. After all, by tapping into the front-line knowledge of these physicians, Medicare gains the most credible insights into the complexities of patient care, which ultimately leads to better quality care, better health outcomes and a more sustainable Medicare system. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7742afa7-0c56-4c6d-9cec-41c2f4722997 JAMA Highlights: This week’s top articles from the JAMA Network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-this-weeks-top-articles-jama-network-42 Thu, 21 Aug 2014 18:03:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/s26rt2UtH2s" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/s26rt2UtH2s" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/s26rt2UtH2s" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/s26rt2UtH2s" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Intervention helps smokers quit following hospital stay</strong><br /> Among hospitalized adult smokers who wanted to quit, a post-discharge intervention that included automated telephone calls and free medication resulted in higher sustained smoking cessation rates at six months than standard post-discharge advice to use smoking cessation medication and counseling, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1896984" rel="nofollow" target="_blank">study</a> in the August 20 issue of <em>The</em> <em>Journal of American Medical Association </em>(<em>JAMA).</em> Watch <a href="http://youtu.be/s26rt2UtH2s" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Findings suggest over-reliance on pulse oximetry for determining whether children with respiratory infection should be hospitalized </strong><br /> Among infants presenting to a pediatric emergency department with mild to moderate bronchiolitis, those with an artificially elevated oxygen saturation reading were less likely to be hospitalized or receive hospital care for more than 6 hours than those with unaltered readings, suggesting that these readings should not be the only factor in the decision to admit or discharge, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1896981" rel="nofollow" target="_blank">study</a> in the August 20 issue of <em>JAMA.</em></p> <p> <strong>Patient perspectives on breast reconstruction following mastectomy </strong><br /> Less than 42 percent of women underwent breast reconstruction following a mastectomy for cancer, and the factors associated with foregoing reconstruction included being black, having a lower education level and being older, according to a <a href="http://archsurg.jamanetwork.com/article.aspx?articleid=1893807" rel="nofollow">study</a> in <em>JAMA Surgery</em>.</p> <p> <strong>Older patients with limited life expectancy still receiving cancer screenings</strong><br /> A substantial number of older patients with limited life expectancy continue to receive routine screenings for prostate, breast, cervical and colorectal cancer although the procedures are unlikely to benefit them, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1897549" rel="nofollow">study</a> in <em>JAMA Internal Medicine</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed44788e-ba5f-4de4-9aa3-1bedfa2ca88d Video: City is improving public health by sparking conversations http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_city-improving-public-health-sparking-conversations Thu, 21 Aug 2014 06:00:00 GMT <p> <object align="right" data="http://www.youtube.com/v/ta0PBlm2Cwc" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/ta0PBlm2Cwc" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/ta0PBlm2Cwc" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/ta0PBlm2Cwc" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>How do you improve the health of an entire city? Provide access to care, information and healthy choices, says one physician and city public health commissioner.</p> <p> In his role as commissioner of the Chicago Department of Public Health, Bechara Choucair, MD, leverages his experience as an internal medicine physician to empower patients to make the right choices.</p> <p> In an <a href="http://youtu.be/ta0PBlm2Cwc" rel="nofollow">AMA “Innovations in Medicine” talk</a>—a brief, informal presentation in the style of TED Talks—Dr. Choucair shares how his experience treating the “poorest of the poor” patients in his native Lebanon and in Houston, Texas, have informed his vision for Chicago.</p> <p> From replacing junk food in vending machines with healthy options to expanding bike lanes and access to a bike-sharing program, Dr. Choucair is helping transform what it means to be healthy in Chicago.</p> <p> A recent citywide campaign to reduce teen pregnancy sparked conversations throughout the city, nation and world, featuring a photo of a pregnant teenage boy with the caption, “Unexpected? Most teen pregnancies are.”<span style="font-size:12px;">                  </span></p> <p> Dr. Choucair encourages other physicians to spark conversations in their own communities by examining access to care, information and healthy choices. "You can make a difference," he said.</p> <p> Get inspired and hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> <p> <strong>Want more inspiration? </strong>Get a first-hand look at what’s driving health and medical progress today with <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/inside-look-future-of-health-medicine-tedmed-2014" target="_blank">TEDMED 2014</a>, the annual health and medicine edition of the world-renowned TED Talks, held Sept. 10-12 simultaneously in Washington, D.C., and San Francisco.</p> <p> A special courtesy rate is available for AMA members as a result of the AMA’s support of TEDMED. <strong>AMA members can attend this exclusive three-day event with a guest of their choice for the price of a single attendee</strong>.</p> <p> <a href="https://www.tedmed.com/register?gc=CRAMA14" rel="nofollow" target="_blank">Register to attend live</a>, using code “CRAMA14,” or participate in live streaming the week of the event. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and use invitation code “TMLicAMA14” to watch talks on demand, or view portions of the event in real-time. You also can gather a group of your colleagues and staff to view presenters of interest.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1857151c-df75-4f33-bdbd-0a32c907b1c9 Gender, grading systems shape medical students’ views http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gender-grading-systems-shape-medical-students-views Thu, 21 Aug 2014 06:00:00 GMT <p> Both gender and grading policies can have a big impact on the academic learning environment in medical school, according to a longitudinal cohort study of nearly 5,000 medical students from the matriculating classes of 2010 and 2011 at 28 medical schools in the United States and Canada.</p> <p> The AMA-sponsored <a href="http://www.ama-assn.org/ama/pub/education-careers/making-medical-education-better.page?" target="_blank">Learning Environment Study</a>, which collected data and insights on the medical student experience throughout the four years of medical school, found that both men and women showed an overall decline in attitudes toward empathy from their first to second year of school. However, gender plays a significant role in determining students’ perceptions.</p> <p> Relative to male students, females who participated in the study more strongly felt that there was no time for family, friends or outside interests. Women also tended to believe that their fellow students were less hesitant to assist each other and express opinions to faculty. Finally, males showed a stronger decline in the importance of empathy and females experienced a significantly stronger decline than males in the need to make a conscious effort to adopt the patient’s perspective.   Both are important ingredients in empathic behavior.</p> <p> “If female students feel that they cannot freely express their opinions as the findings suggest, then strategies should be implemented to overcome this barrier,” said AMA Vice President for Medical Education Outcomes Mark Quirk, EdD, who will be presenting the findings of this first phase of the study at an international medical education conference later this month. The study also recommended that medical schools consider gender when planning and making curricular and extracurricular changes.</p> <p> Beyond gender, schools with pass/fail grading systems were markedly different from schools that offered letter grades. Students at pass/fail schools perceived less competition and experienced a more integrated curriculum. However, pass/fail students saw faculty and upper-level students as more disconnected and distant, potentially because less experienced don’t perceive as much of a need to improve their performance and seek out help.</p> <p> “If the introduction of a pass/fail grading system detracts from these opportunities, then faculty and experienced students will need to be encouraged to reach out and create formal and informal policies to interact with these young learners,” the study said.</p> <p> The study now is moving into its next phase: Examining the impact on learners of the transition from classroom to clinical settings.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:01f5ca5d-8ec6-4b62-a067-e4419698de97 What every new resident should know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-resident-should Wed, 20 Aug 2014 20:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/4/72229d1b-d7c6-4520-8493-b631a5de510a.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/4/72229d1b-d7c6-4520-8493-b631a5de510a.Large.jpg?1" style="float:right;margin:10px;" /></a>Transitioning from medical school to residency isn’t easy, but it is exciting. Seasoned residents shared what they wish they knew about residency so new residents and medical students know how to prepare.</p> <p> <strong>Take your education into your own hands</strong></p> <p> Travis Meyer, MD, a radiology resident at the State University of New York Downstate Medical Center in Brooklyn, said new residents should take every opportunity to learn. That includes reading about their cases, even if they think they are too busy. </p> <p> “The more you read about the pathology each of your patients presents with, the less you will have to read in the later years when you have no patient corollary,” Dr. Meyer said. “Residency is much more independent learning than medical school and much less structured. It’s up to you—what you put into it is what you get out of it.”</p> <p> He also suggested asking often for feedback instead of waiting until the end of a rotation when the evaluation might not be great.</p> <p> “Approach your [senior] resident and attending and ask to have a formal, five-minute, constructive criticism feedback session at the two-week mark,” he said. “They will appreciate your willingness to learn, and your ability to work on the things you need to improve. Don’t accept ‘good’ as an answer—force them to give you specifics of cases where your management, differential diagnosis or documentation/communication could have been better.”</p> <p> <strong>Actively make social connections</strong></p> <p>  Everyone is nervous in the beginning, said Megan Gayeski, MD, an anesthesiology resident at Rush University Medical Center in Chicago.</p> <p> “You might be starting over in a place totally foreign from where you worked before. You have a bunch of new people to meet whom you will have to depend on for the next few years,” Dr. Gayeski said. “Yes, it’s scary, but you can get through it. Every physician has, and that will only help you relate to your patients, who themselves are nervous about being sick.”</p> <p> Dr. Gayeski also recommends unwinding at the end of the day.</p> <p> “Make friends with people who aren’t doctors,” she said. Work is stressful enough, and if you only talk about work even when you aren’t there, you never really have a chance to relax.”</p> <p> <strong>Seek out mentorship and be a team player</strong></p> <p> For Nicole Lee, MD, a maternal-fetal medicine fellow at the University of Mississippi Medical Center in Jackson, mentorship was crucial.</p> <p> “I went through my entire first year of residency as if I were a zombie,” she said. “I felt alone and over-worked. I became closer with one of the staff, who is now one of my best mentors. She helped me to understand the importance of family time and how to ‘learn on the go,’ instead of trying to read for hours at a time after work, which often meant I fell asleep while reading.”</p> <p> Perhaps most importantly, experienced residents recommend having a positive attitude and being a team player.</p> <p> “Learn as many names as possible, and say ‘hi’ whenever you can,” Dr. Gayeski said. “You never know whose help you might need during the day (or night). A friendly face might be just what you need after a rough day.”</p> <p> And don’t forget: Your co-residents and co-interns are there to help.</p> <p> “You are no longer competing for a grade or a residency slot,” Dr. Meyer said. “Helping them out when they need it, and accepting help back, is crucial. Always remember this is not about you—the patient comes first. You all work as a team and leave your pride at the door.”</p> <p> <strong>Share your best tips for new residents: </strong>Post what you wish you knew about residency on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7891e77e-08cf-400e-9123-34d6d5fa3e2f Medicare quality reports to compare doctors, impact payments http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medicare-quality-reports-compare-doctors-impact-payments Wed, 20 Aug 2014 19:11:00 GMT <p> Physicians should look for their confidential Medicare feedback reports next month. They will detail how the cost and quality of care physicians provided to their Medicare patients last year compares to that of other physicians. This is the first time the data will be used to adjust Medicare payments made to some physicians.</p> <p> The reports, based on care provided in 2013, are scheduled to be made available through the Centers for Medicare & Medicaid Services’ (CMS) <a href="https://portal.cms.gov/wps/portal/unauthportal/home/" target="_blank" rel="nofollow">Enterprise Portal</a> beginning in September.</p> <p> In addition to the comparison data, physicians in large groups of 100 or more practitioners will learn whether their Medicare payments next year will be affected by the new Value Based Modifier (VBM), which will bring bonuses to some physicians and financial penalties to others. Smaller practices will get a preview of how they may fare as the VBM is phased in over the next three years.</p> <p> CMS is required by law to apply the VBM to some physicians in 2015 and to all physicians in 2017. The agency has chosen to apply the modifier to groups of 100 or more practitioners in 2015, groups of 10 or more practitioners in 2016, and all medical groups and solo physicians in 2017. </p> <p> Adjustments will be based on cost and quality data from two years earlier. That means the forthcoming data, known as “Quality and Resource Use Reports” (QRUR), will determine payment adjustments next year for the groups of 100 or more physicians and other practitioners. The reports will identify which groups will receive positive adjustments, which will see no change and which will be subject to payment cuts of up to 1 percent.</p> <p> Because the underlying policies that determine the VBM are changing each year, the 2013 reports are not a perfect indicator of the likely impact of the VBM on physicians who will be subject to payment adjustments of up to 2 percent in 2016 and a proposed 4 percent maximum penalty in 2017. But they will offer some guidance about potential VBM adjustments in the future.</p> <p> For physicians in group practices, data is provided at the group level with drill-downs for individual physicians’ quality data. CMS first began providing QRURs to limited numbers of physicians in 2011 and has expanded report availability over time. <a href="http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/2012-QRUR.html" target="_blank" rel="nofollow">Reports using 2012 data</a> already are available for groups of 25 or more practitioners.</p> <p> The process for gaining access to the reports is complicated and requires a user ID and password for the “<a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/IACS/index.html?redirect=/IACS/04_provider_community.ASP" target="_blank" rel="nofollow">Individuals Authorized Access to the CMS Computer Services</a>” site, which must be renewed periodically. In preparation for the release of the 2013 reports, physicians should make sure their group has an up-to-date password.</p> <p> Additional information about the reports and the VBM is available on <a href="http://www.cms.gov/physicianfeedbackprogram" target="_blank" rel="nofollow">CMS’ website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f2362ecb-5543-4e9b-9933-c0e02fd8b15c Special resources for IMGs detailed at symposium Oct. 25 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_special-resources-imgs-detailed-symposium-oct-25 Wed, 20 Aug 2014 18:00:00 GMT <p> The sixth annual <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates/meetings/img-symposium.page" target="_blank">AMA symposium</a> for international medical graduates (IMG) will be held the morning of Oct. 25 at the Somerset Inn in Troy, Michigan. This networking and educational event will provide an update on issues of importance to IMGs and take a look at resources available to this segment of the medical community. <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=20144550E&TID=HZcMrG6ogbAaN4ZlKEQL0w%3d%3d&OID=130" target="_blank">Register</a> (log in) by Oct. 21.</p> <p> Hosted by the AMA in collaboration with the Michigan State Medical Society, the symposium is complimentary for medical students, IMGs who are certified by the Educational Commission for Foreign Medical Graduates, residents and physicians who are interested in IMG issues.</p> <p> Attendees will have the opportunity to network with colleagues and hear a panel of experts discuss workforce trends, advocacy initiatives and opportunities available for IMGs. Topics discussed will include successfully navigating the Match and the Michigan Conrad 30 residency waiver program for doctors on a J-1 visa. The symposium will take place from 9 a.m. to 11 a.m. Breakfast and beverages will be provided.</p> <p> In addition, attendees can participate in mock residency interviews to be held at 8 a.m.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:553761ba-51fb-4bdb-bb6c-0ffffc018197 Better ED efficiency a win-win in changing health care environment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_better-ed-efficiency-win-win-changing-health-care-environment Wed, 20 Aug 2014 16:49:00 GMT <p> Roughly one-half of all hospital admissions come from emergency department (ED) visits, according to a recent <a href="http://www.rand.org/pubs/research_reports/RR280.html" target="_blank" rel="nofollow">study by the RAND Corporation</a>.</p> <p> ED-related admissions increased 17 percent from 2003 to 2009, the study found, but the growth in all hospital admissions rose only 4 percent.</p> <p> A recent <a href="http://www.modernhealthcare.com/article/20140807/blog/308079997&utm_source=AltURL&utm_medium=email&utm_campaign=mpdaily?AllowView=VXQ0UnpwZTVBdlNaL1RIZ0s4WHRlRU9oajBzZEErOWE=" target="_blank" rel="nofollow">article</a> in <em>Modern Healthcare</em> takes a look at how two initiatives revamped the cultures of their EDs to improve satisfaction for physicians and other staff members and kept patient wait times to a minimum.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:434e08d9-f7d8-407a-a298-13d7cc4a5603 Kit supports physicians' efforts to end disparities in care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_kit-supports-physicians-efforts-end-disparities-care Wed, 20 Aug 2014 16:46:00 GMT <p> Physicians and their practice staff can rely on a resource from the AMA to help them take steps in eliminating health care disparities in their communities.</p> <p> The "Working Together to End Racial and Ethnic Disparities" kit features an enlightening video and supplemental training material that can be used to improve awareness and skills in addressing the inequities in care that racial and ethnic minority patients often receive. The kit is available through the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240029&navAction=push" target="_blank">AMA Store</a>.</p> <p> Physicians and other health care professionals are working together toward reducing health care disparities in the United States through the Commission to End Health Care Disparities. Read more about the commission’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-goals-doctors-working-toward-reduce-health-care-disparities" target="_blank">three goals</a>.</p> <p> Email the <a href="mailto:mas@ama-assn.org" rel="nofollow">AMA Minority Affairs Section</a> if you have a project or idea that could help prevent health disparities or raise awareness about this health care issue.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9f610bcc-f1d3-472f-ad32-fb59cbe124c7 Video: How one doctor is looking at obesity in a novel way http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-doctor-looking-obesity-novel-way Wed, 20 Aug 2014 06:00:00 GMT <p> <object align="right" data="http://www.youtube.com/v/jhbUc2kOjeI" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/jhbUc2kOjeI" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/jhbUc2kOjeI" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/jhbUc2kOjeI" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>For one physician, treating obesity is all about taking a new approach.</p> <p> “Obesity is the only entity, illness, process, disease … where we accuse the patient of doing something wrong,” said Fatima Cody Stanford, MD, a clinical and research fellow in obesity medicine and nutrition at Massachusetts General Hospital/Harvard Medical School. “When a patient comes in with hypertension, we don’t say, ‘You fix it. You go fix your hypertension and then come back.’”</p> <p> That approach isn’t working, Dr. Stanford said. If it were, we wouldn’t be spending more than 20 percent of U.S. health care dollars on obesity-related issues.</p> <p> In an <a href="http://youtu.be/jhbUc2kOjeI?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">AMA “Innovations in Medicine” talk</a>—a brief, informal presentation in the style of TED Talks—Dr. Stanford shares how her work at Massachusetts General Hospital’s weight center is changing the treatment approach for overweight patients. It’s more than just diet and exercise for many patients, she said. Her work includes investigating how patients’ environments, such as their sleep patterns, can affect their biology.</p> <p> Dr. Stanford shares stories of two obesity-related deaths that hit close to home—one, the loss of her young cousin, and the other, an 11-year-old patient. Both died from obstructive sleep apnea.</p> <p> “There’s something that we’re not doing,” she said. “People are going untreated for conditions that have an impact on their weight. I need to offer them solutions, or I am failing at my job.”</p> <p> Get inspired and hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qse8TAqAbCpdCgltO_folBs4" rel="nofollow" target="_blank">Innovations in Medicine</a> series.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4775a09d-c6e1-4895-ab28-e5a773b89fa7 Despite errors, CMS gives doctors until Sept. 8 to review data http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_despite-errors-cms-gives-doctors-until-sept-8-review-data Tue, 19 Aug 2014 19:38:00 GMT <p> After nearly two weeks of technical problems and a host of physician and industry complaints, the Centers for Medicare & Medicaid Services (CMS) has reopened its Sunshine Act portal (also known as the “Open Payments” system), where physicians can review data about their financial interactions with medical device and drug manufacturers. The agency has extended the deadline only until Sept. 8 for physicians to dispute their data and have it flagged as such before the information goes public.</p> <p> Meanwhile, about one-third of the data reportedly has errors that CMS already has identified, and the agency said it would withhold this data from the initial public data release. Because there are outstanding concerns about the data’s accuracy, it is critical that physicians review their reports and seek any necessary corrections. CMS has said the Sept. 30 public release date remains firm.</p> <p> The AMA and 112 specialty and state medical societies earlier this month <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-ask-cms-postpone-sunshine-act-data-release" target="_blank">urged CMS to postpone the release</a> of physician financial data for six months, to March 31. The groups also called attention to the agency’s lack of communication surrounding the review and dispute process, which is confusing and time-consuming even when it is working properly. The groups also pointed to the short timeline for physicians—a mere 45 days to complete CMS’ convoluted registration process, review their data and submit any disputes.</p> <p> CMS took the Open Payments system offline Aug. 3 “to resolve a technical issue,” according to a <a href="http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-08-15.html" target="_blank" rel="nofollow">press release</a> issued Aug. 15, which said the agency took “action after a physician reported a problem.” The agency reports that some manufacturers and group purchasing organizations erroneously submitted intermingled data, such as the wrong state license number or National Provider Identifier, for physicians with the same first and last names.</p> <p> The agency extended the time for physicians to review their records to Sept. 8 to account for the 13 days the site was unavailable but didn’t change the date that records would be made available to the public. This compressed timeframe has raised concerns that the public data will be inaccurate.</p> <p> “Reports that one-third of the data is not accurate and will be held back confirm our concerns about the data’s integrity and underscore the need for all parties involved to have more time to ensure accuracy and value,” said AMA President Robert M. Wah, MD, in a statement.</p> <p> “The publication of inaccurate data can potentially harm the physician-patient relationship, which is why the AMA maintains its call for a six month delay of the data release in order to give CMS, pharmaceutical and device manufacturers, and group purchasing organizations more time to ensure information housed in the database is accurate,” Dr. Wah said. “Physicians [need] enough time to review and correct any wrong information before it is published.”</p> <p> Although physicians can dispute their data until Dec. 31, it will not be marked as disputed in the public database.</p> <p> <strong>Review and dispute your data now: </strong>If you weren’t able to complete the entire registration and review process before the Open Payments system was taken offline, make sure you do so now to help ensure the accuracy of the data reported about you. Follow these three steps:</p> <ol> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ready-release-of-financial-data-this-week" target="_blank">Complete the CMS e-verification process</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/must-this-week-before-financial-data-goes-public" target="_blank">Register with the Open Payments system</a></li> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/dispute-incorrect-financial-data-before-goes-public" target="_blank">Review and dispute your data by Sept. 8</a></li> </ol> <p> <strong style="font-size:12px;">Share your thoughts about this process:</strong><span style="font-size:12px;"> Take a brief </span><a href="https://www.surveymonkey.com/s/P38BRZR" style="font-size:12px;" target="_blank" rel="nofollow">survey</a><span style="font-size:12px;"> to report your experience using the Open Payments system. The survey findings will be presented to CMS as the AMA continues to seek improvements and a six-month extension for physicians. The survey deadline has been extended to noon Eastern time Friday.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fec1fffb-5652-4a6d-834c-734163eca76c