AMA Wire&#174; http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page Tue, 16 Sep 2014 18:40:00 GMT 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 a 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-physicians 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="https://www.ama-assn.org/resources/doc/washington/x-pub/rescheduling-hydrocodone-products.pdf" target="_blank">Download a printable version</a> (log in) of 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 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 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 for 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, 08 Sep 2014 06:00:00 GMT <p> Plan to attend the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">Senior Physicians Section</a> (SPS) meeting Nov. 8, taking place in conjunction with the 2014 AMA Interim Meeting in Dallas. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144452E&TID=vCIaLRgK%252bYeYYFMXecjotQ%253d%253d&OID=130" target="_blank">Register today</a> (log in).</p> <p> The keynote presentation 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.</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.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ef3d48cc-6b57-49f0-b36e-bce21b38d863 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 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 18:05:00 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" target="_blank" rel="nofollow">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" target="_blank" rel="nofollow">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> Participate in live streaming the week of the event. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" target="_blank" rel="nofollow">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:1fbb6654-0f5e-4ced-a2cb-bc9fa89e8794 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 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 Wed, 03 Sep 2014 06:00:00 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 Physician 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">log in</a> to register today.</p> <p> The AMA-YPS also is calling for <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events/ama-yps-assembly/submitting-resolutions.page" target="_blank">policy resolutions</a> for the upcoming meeting. Email the <a href="mailto:YPS@ama-assn.org" rel="nofollow">AMA-YPS</a> by Sept. 26 to submit a resolution.</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 to the <a href="mailto:YPS@ama-assn.org" rel="nofollow">AMA-YPS</a> by Sept. 30.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6752637-e6d4-4e97-b9b2-a96f13030cdb 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 Wed, 03 Sep 2014 06:00:00 GMT <p> Participate in the AMA Women Physician 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” on November 8.</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">log in</a> and register today.</p> <p> Volunteer to serve on the AMA-WPS Handbook Review Committee by Sept. 30. This committee convenes prior to each WPS business meeting to review items of business that are referred to the House of Delegates reference committees. In advance of the WPS business meeting, committee members work with the AMA-WPS delegate and alternate delegate to review a portion of the AMA-HOD handbook for items of business that are relevant to the AMA-WPS and propose an initial course of action for relevant items (active support, support, oppose, active oppose, monitor).</p> <p> If you have questions or would like to volunteer for the handbook review committee, please contact the <a href="mailto:wps@ama-assn.org" rel="nofollow">AMA-WPS</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b08f1bd-2f7d-4094-90e2-59b76abf33a7 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 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 20:34:00 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" target="_blank" rel="nofollow">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" target="_blank" rel="nofollow">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> Participate in live streaming the week of the event. Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" target="_blank" rel="nofollow">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:52f0f48f-0f9b-4b5b-a0c6-fea62781f696 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 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. 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 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 20:05:00 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> <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> 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:b7b5aeab-68c9-4988-8466-aee59e34122f 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 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 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 18:00:00 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 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 20:42:00 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" target="_blank" rel="nofollow">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" target="_blank" rel="nofollow">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. 10-13 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" target="_blank" rel="nofollow">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" target="_blank" rel="nofollow">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:4775a09d-c6e1-4895-ab28-e5a773b89fa7 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 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 ICD-10 codebooks can help practices gear up for 2015 compliance http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_icd-10-codebooks-can-practices-gear-up-2015-compliance Tue, 19 Aug 2014 19:30:00 GMT <p> The Centers for Medicare & Medicaid Services recently confirmed that Oct. 1, 2015, is the new deadline to comply with implementation of the ICD-10 code set. As the deadline approaches, new products can help your practice get ready for this major transition.</p> <p> Two new codebooks, available next month, are essential references: ICD-10-CM 2015 and ICD-10-PCS 2015.</p> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480010&navAction=push#usage-tab" target="_blank">ICD-10-CM 2015</a> codebook offers valuable features on diagnostic coding, including:</p> <ul> <li style="margin-left:0.25in;"> ICD-10-CM conventions and official guidelines</li> <li style="margin-left:0.25in;"> Color coding to identify additional character requirements, instructional notes and Medicare code edits</li> <li style="margin-left:0.25in;"> Indexes to diseases and injuries and to external causes</li> </ul> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480009&navAction=push#description-tab" target="_blank">ICD-10-PCS 2015</a> codebook, meanwhile, contains a complete draft code set for hospital procedural coding. That includes classifications for procedures, devices and technologies. In addition to illustrating a summary of changes for 2015, this codebook includes detailed information on the structure and conventions of ICD-10-PCS and coding exercises.</p> <p> A 30 percent discount applies to both codebooks through Sept. 30. Use promo code “FOJ” during check-out.</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. 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:3307eda2-8703-4531-9635-ac21a18d5558 How new students can jump headfirst into medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-students-can-jump-headfirst-medicine Tue, 19 Aug 2014 19:25:00 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/2/10/b21ada43-f750-4ac9-aad6-6f5577f2c424.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/10/b21ada43-f750-4ac9-aad6-6f5577f2c424.Large.jpg?1" style="float:left;margin:10px;" /></a>It’s funny that no matter how old you are, the autumn season always signals a fresh start. As we move into August and September, my thoughts turn to the students heading back to school, and to the new medical students just joining our ranks.</p> <p> I had the privilege of meeting with the new first-year students at the University of Mississippi School of Medicine last Thursday. Having taught hundreds of students for many years at military medical centers such as Walter Reed National Military Medical Center in Bethesda, Maryland, and civilian places like Harvard Medical School, I know that being a medical student today is very different from what I remember.</p> <p> With schools moving to new curriculum models and incorporating technology into teaching and learning, it’s definitely a different world. But some things stay the same: the excitement of fall and starting a new year, and the exhilaration of immersing oneself into the world of medicine.</p> <p> Those new to medical school can take advantage of all the AMA has to offer. Stay on top of important news, connect with your peers and take on leadership roles. Here are a few easy ways to get started:</p> <ul> <li style="margin-left:20.5pt;"> Check out <em>AMA Wire</em>®, the AMA’s news site, for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Student_News/1" target="_blank">comprehensive coverage</a> of issues that matter to medical students. Recent favorite topics include: <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-ways-prepare-usmle" target="_blank">five ways to prepare for the United States Medical Licensing Exam</a>, the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-5-apps-modern-medical-student" target="_blank">top apps for the modern med student</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-tips-manage-medical-school-loans-after-graduation" target="_blank">how to manage student loans</a> after graduation.</li> <li style="margin-left:20.5pt;"> <a href="http://www.ama-assn.org/ama/pub/news/subscribe-newsletters.page" target="_blank">Sign up</a> for <em>AMA Morning Rounds</em> to get this news delivered straight to your inbox every weekday. It contains the most important health care and medicine news every day, helping med students stay in the know.</li> <li style="margin-left:20.5pt;"> Join 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) to have a voice in the future of medicine. The AMA-MSS offers resources, <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/opportunities.page" target="_blank">leadership opportunities</a>, <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy.page?" target="_blank">advocacy and policy information</a> and more.</li> <li style="margin-left:20.5pt;"> Follow the AMA-MSS 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> for even more news, involvement opportunities and interesting discussion.</li> </ul> <p> Good luck to both new and returning medical students as they get one step closer to becoming physicians.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b39ca3df-01c6-4722-9c0a-f9a97f98111e What physicians are saying: Hassles with EHRs, CMS website http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-saying-hassles-ehrs-cms-website Tue, 19 Aug 2014 06:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/10/af42fed9-ba1e-40b6-bac0-a5faa8d4165b.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/10/af42fed9-ba1e-40b6-bac0-a5faa8d4165b.Large.png?1" style="margin:15px;float:right;" /></a></p> <p> <em>AMA Wire<sup>®</sup></em> readers are sharing their pain in dealing with electronic health records (EHR) and the Centers for Medicare and Medicaid Services computer systems and voicing their thoughts on measuring blood pressure accurately.</p> <p> Those were some of the topics recently addressed in physician comments on <em>AMA Wire</em> posts. It’s easy to express your opinion on <em>AMA Wire</em> topics. Just click the button at the bottom of every post to either sign in with your AMA credentials or create an account today.</p> <p> Here’s what your colleagues are saying on the topic “<a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-identify-primary-concern-health" target="_blank">Physicians identify primary concern with health IT</a>”:</p> <p style="margin-left:40px;"> ahbrader: “I currently use EPIC and find it cumbersome to wade through the program. It is not intuitive. Why would a programmer not tab the screen like a chart so practitioners can flip through the program like we have done with paper charts for years?”</p> <p style="margin-left:40px;"> jastev: “Electronic records can be a valuable tool for data retrieval on a national scale. However data is misleading if the input is sloppy and unreliable [when] picking any answer for any question not directly queried. Always a problem with long shopping lists of information.”</p> <p style="margin-left:40px;"> dorkinh: “If I could make only one change [in EHRs], it would be that every EHR in the country had the same look and feel, the same commands, regardless of the vendor. Every medical student and every nursing student would start with this same core medical record EHR from the day they entered training.”</p> <p style="margin-left:40px;"> ADOBZYNIAK: “I am not sure the current and recent past iterations of EHRs were ready for prime time. They were poorly planned, oversold and driven by huge government windfalls for vendors.”</p> <p> Additional comments posted on the story “<a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-saying-measuring-blood-pressure-accurately" target="_blank">What doctors are saying about measuring blood pressure</a>” include:</p> <p style="margin-left:40px;"> lvidaver: “My own systolic BP drops 9% with 3 minutes of simply calming my thoughts.”</p> <p style="margin-left:40px;"> wcljbl: “On a recent visit to my cardiologist, I started rolling up my sleeve for the nurse to check my BP—he said roll it back down, I'll check it through your shirt sleeve. My med school mentors 50+ years ago said that a stethoscope always needs to go on bare skin, whether chest, heart, or elsewhere. Maybe we need to digress a bit.”</p> <p> Finally, we think a number of physicians might have experienced this same frustration when trying to check their Sunshine Act financial data on the CMS website because the system was down Aug. 3-14 as a result of technical difficulties (from “<a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dispute-incorrect-financial-data-before-goes-public" target="_blank">How to dispute incorrect financial data before it goes public</a>”):</p> <p style="margin-left:40px;"> “This is what I get today Aug. 9, 2014:</p> <p style="margin-left:40px;"> My Portal</p> <p style="margin-left:40px;"> Open Payments ▼</p> <p style="margin-left:40px;"> CMS Portal > Open Payments > Open Payments - Home</p> <p style="margin-left:40px;"> This portlet is unavailable.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c05fd620-e48e-4ae1-87c1-b81c4932732c Med students make health fundraising, awareness social http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-students-health-fundraising-awareness-social Mon, 18 Aug 2014 21:34:00 GMT <p> <a href="https://www.facebook.com/pages/Georgetown-University-School-of-Medicine/165723350120340" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/b28afdd8-0f55-4935-86d9-3701e7cc5568.Large.jpg?1" style="float:right;margin:10px;" /></a>Medical students are working every day to learn the best ways to treat tomorrow’s patients—but many are having an impact on important health issues today, too. Social media is the perfect place for students and medical schools to share their good work.</p> <p> Some schools are taking the #ALSIceBucketChallenge to raise awareness for amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease. The challenge swept social media over the past few weeks, and the University of Massachusetts Medical School students, the school’s chancellor and one of its top ALS researchers took the challenge, dumping buckets of ice cold water over their heads.</p> <p> Albany Medical College’s class of 2018 joined the #ALSIceBucketChallenge, too, as did medical students from the University of North Carolina School of Medicine.</p> <p> Other schools are taking to social media to benefit other causes and share their work. The Commonwealth Medical College’s bike club, the Spin Doctors, recently raced in the 2014 Tour de Shore, a 65-mile bike ride to benefit the Irish Pub Children’s Foundation, which supports children of law enforcement killed in the line of duty.</p> <p> Students at the Eastern Virginia Medical School participated in the school’s Community Impact Day, sprucing up a local elementary school. The Georgetown University School of Medicine AMA Medical Student Section hosted a clothing drive to benefit the local community.</p> <p> <strong>Share your school’s success: </strong>How is your school benefiting a good cause or local organization? Share your projects with the AMA on <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook</a> and <a href="https://twitter.com/ama_mss" rel="nofollow" target="_blank">Twitter</a>.</p> <p> <object data="http://www.youtube.com/v/sq2l5OYzC4Y" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/sq2l5OYzC4Y" type="application/x-shockwave-flash" width="450"><param name="movie" value="http://www.youtube.com/v/sq2l5OYzC4Y" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowFullScreen" value="true" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /></object></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0c913ebc-202c-4273-9328-d3cebb7cdabe 40 percent of Americans will develop diabetes: New study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_40-percent-of-americans-will-develop-diabetes-new-study Mon, 18 Aug 2014 21:23:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/4/43a868d3-1cc7-48b8-a469-85a77bfbeb99.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/4/43a868d3-1cc7-48b8-a469-85a77bfbeb99.Large.jpg?1" style="float:right;margin:10px;" /></a>About two in five Americans will develop type 2 diabetes at some point in their lives, according to the findings of a new study, which underscore the increasing need for evidence-based programs that help prevent or delay the onset of diabetes.</p> <p> According to the <a href="http://www.thelancet.com/journals/landia/article/PIIS2213-8587(14)70161-5/fulltext" target="_blank" rel="nofollow">study</a>, published last week in <em>The Lancet Diabetes and Endocrinology</em>, the lifetime risk of diagnosed diabetes is 40.2 percent for the average 20-year old man, a 20 percentage point increase since the late 1980s. Among women, the lifetime risk is 39.6 percent, a 13 percentage point increase. Hispanic men and women and non-Hispanic black women have the highest lifetime risks at more than 50 percent.</p> <p> The findings highlight the importance of screening patients for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/determine-whether-patients-prediabetes" target="_blank">prediabetes</a> to help them avoid becoming one of these statistics. People with prediabetes are at a heightened risk for developing type 2 diabetes, but it is a reversible condition. That means prevention measures are crucial.</p> <p> The AMA has teamed up with the YMCA of the USA to increase physician screening for prediabetes and create a model for referring patients to YMCA Diabetes Prevention Programs in their local communities. Based on the Center for Disease Control and Prevention’s (CDC) evidence-based National Diabetes Prevention Program, the YMCA 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> reverse their prediabetes.</p> <p> The partnership 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, which is working to prevent the development of diabetes and its associated health complications among adults who have prediabetes. The AMA pilot, currently in three states, will establish a process for physicians to routinely screen for prediabetes, refer patients to the YMCA’s Diabetes Prevention Program and receive updates to incorporate into their patients’ care plans.</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:03fb66bc-d77d-4d2a-8438-b6ac76558ec3 Insurers not paying correctly? Free tool helps address denials http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_insurers-not-paying-correctly-tool-helps-address-denials Fri, 15 Aug 2014 19:21:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/9/bc8c7dc4-743d-466b-a970-682474ca52e4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/9/bc8c7dc4-743d-466b-a970-682474ca52e4.Large.jpg?1" style="float:right;margin:10px;" /></a>A newly updated online tool can help your practice ensure accurate payment of claims and appeal inappropriate denials. The <a href="http://97.65.39.51/AMADenialManagement/Default.aspx" target="_blank" rel="nofollow">Claims Workflow Assistant</a>, developed by the AMA, can help your practice understand digital explanations of payment known as electronic remittance advice (ERA) transactions and address any issues with how the insurer handled your claims.</p> <p> While the electronic claims process can improve health care billing efficiency and reduce administrative burdens and costs, physicians can’t gain these full benefits without understanding and being able to act upon the coding used in these transactions.</p> <p> The Claims Workflow Assistant makes it easier for your practice to:</p> <ul> <li style="margin-left:20.5pt;"> Look up codes used in ERA transactions</li> <li style="margin-left:20.5pt;"> Fully understand the code meanings</li> <li style="margin-left:20.5pt;"> Review recommended step-by-step work flows for addressing claim denials and non-payments</li> </ul> <p> This tool recently was updated to reflect the latest code combinations that could be used in insurers’ responses to your claims. AMA members also have access to appeal letter templates for contesting claim payments.</p> <p> If your practice hasn’t yet adopted ERA transactions, the AMA offers an <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/remittance-advice.page?" target="_blank">ERA toolkit</a> with detailed information about transitioning to using these transactions. Additional tools to streamline practice work flows are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives.page" target="_blank">“administrative simplification initiatives” Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4ac679a6-321c-4ffa-ade9-0e163ca49c52 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-41 Thu, 14 Aug 2014 19:07:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/1q-iVNGBmtg?list=UUlpzWSNUo4kEgZbD2V-dRaA" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/1q-iVNGBmtg?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/1q-iVNGBmtg?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/1q-iVNGBmtg?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object></strong><strong>Flexible sigmoidoscopy screening reduces colorectal cancer incidence, rate of death</strong><br /> Among about 100,000 study participants, screening with flexible sigmoidoscopy resulted in a reduced incidence and rate of death of colorectal cancer, compared to no screening, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1895247" rel="nofollow" target="_blank">study</a> in the Aug. 13 issue of the<em> </em><em>Journal of the American Medical Association</em> (<em>JAMA</em>).</p> <p> <strong>Experiencing atrial fibrillation while hospitalized for surgery associated with increased long-term risk of stroke</strong><br /> In a study that included 1.7 million patients undergoing inpatient surgery, experiencing atrial fibrillation while hospitalized was associated with an increased long-term risk of ischemic stroke, especially following noncardiac surgery, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1895248" rel="nofollow" target="_blank">study</a> in <em>JAMA.</em> View a <a href="http://youtu.be/1q-iVNGBmtg?list=UUlpzWSNUo4kEgZbD2V-dRaA" rel="nofollow" target="_blank">video</a> about the study.</p> <p> <strong>Bisphosphonates for osteoporosis not associated with reduced breast cancer risk</strong><br /> An analysis of data from two randomized clinical trials finds that three to four years of treatment with bisphosphonates to improve bone density is not linked to reduced risk of invasive postmenopausal breast cancer, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1893923" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Normal cognition in patient without apolipoprotein E, risk factor for Alzheimer</strong><br /> A 40-year-old California man exhibits normal cognitive function although he has no apolipoprotein E, which is believed to be important for brain function but a mutation of which also is a known risk factor for Alzheimer disease. Researchers suggest this could mean that therapies to reduce apoE in the central nervous system may one day help treat neurodegenerative disorders, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1893443" rel="nofollow" target="_blank">study</a> in <em>JAMA Neurology</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:71633b07-633f-4d3f-8ff6-77ec36d4bd63 AMA Senior Physicians Section offers online member forum http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-seniors-physician-section-offers-online-member-forum Thu, 14 Aug 2014 06:00:00 GMT <p> A new online discussion board from 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) allows you to share your opinions, experiences and updates on topics affecting seniors across the country.</p> <p> All AMA senior physicians are invited to participate in this newly launched <a href="http://www.ama-assn.org/ama/pub/community/forums/annual-2014/senior-physicians-reference-committee.page" target="_blank">online member forum</a> (AMA login required). Log into this forum at any time to submit policy ideas and interact with your senior physician peers.</p> <p> Current conversations look at how groups are assessing impairment in senior physicians and the first AMA-SPS resolution adopted by the AMA House of Delegates, which addresses the issue of competency and the aging physician. New posts may be added over time, and the forum will remain open for comments until the opening of the AMA Interim Meeting, Nov. 8.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4a6f3748-2118-429f-ad9e-7b1003d79daf Troubles with Sunshine Act website? We’re taking them to CMS http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_troubles-sunshine-act-website-were-taking-cms Wed, 13 Aug 2014 15:39:00 GMT <p> As the federal website through which physicians can review their Sunshine Act financial data continues to experience technical problems, you can share your experience using the site in a brief <a href="https://www.surveymonkey.com/s/P38BRZR" rel="nofollow" target="_blank">survey</a>, open through Monday. The survey findings will be presented to the Centers for Medicare & Medicaid Services (CMS) as the AMA seeks improvements and a six-month extension for physicians.</p> <p> In addition to the survey, you can send an email to <a href="mailto:OpenPayments@ama-assn.org" rel="nofollow">OpenPayments@ama-assn.org</a> to outline your experience registering and the problems you may have encountered.</p> <p> <strong>Update:</strong> As of Thursday morning, CMS reported that the site was back online. Physicians can now complete steps 1 and 2 of the registration process. Detailed information about how to complete each part of the process is available on the AMA <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> The portal for the Sunshine Act, also known as the “Open Payments program,” was taken offline last week so CMS could “investigate a reported issue.” The agency said it would adjust the dispute deadline for each day the Open Payments system is offline but hasn’t issued an update on the new deadline. The site reportedly has been down since Aug. 3.</p> <p> At the same time, physicians who previously were able to complete the process of registering and reviewing their data reported numerous difficulties with navigating the portal. The process has proven to be confusing and time-consuming.</p> <p> Citing these issues, 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">urged CMS earlier this month</a> to postpone the release of physician financial data from the current Sept. 30 date until March 31. The groups also pointed to the agency’s lack of communication surrounding the review and dispute process, ongoing website problems and the short timeline for physicians.</p> <p> Watch <em>AMA Wire</em>® for additional updates.</p> <p> <strong>Get insights into the Sunshine Act process: </strong>Don’t forget to <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">follow the AMA on Twitter</a> and check out our <a href="https://twitter.com/hashtag/SunshineTips?src=hash" rel="nofollow" target="_blank">#SunshineTips</a> and share your own insights into the registration and review process.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6e5a56c9-fe79-4838-a57d-766d0376d802 Ethics journal explores the humanities in medical education http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ethics-journal-explores-humanities-medical-education Wed, 13 Aug 2014 14:55:00 GMT <p> This <a href="http://virtualmentor.ama-assn.org/" target="_blank">month’s issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal, explores what “medical humanities” comprises. Contributing authors argue that medical education is incomplete without it.</p> <p> The famous Flexner Report of 1911 called for a lab- and clinic-heavy curriculum for physician training. More than 60 years later, George Engel, MD, a psychiatrist, recommended that the psychological and social contributors to illness be addressed in medical school in his “biopsychosocial” model. Soon, ethics and professionalism were introduced to the formal curriculum. Educators are now recommending that the humanities be part of every physician’s education.</p> <p> Highlights from the August issue include:</p> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/08/ecas3-1408.html" target="_blank">Do future bench researchers need humanities courses in medical school?</a>” Medical student Rimma Osipov points out that, through the humanities, students more oriented to the hard sciences become aware that this perspective is not the only way to see health, illness and healing.</li> </ul> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/08/imhl1-1408.html" target="_blank"><em>Tangles</em>: An illness narrative in graphic form</a>.” Author Sarah Leavitt wrote her graphic memoir about her experience with her mother’s Alzheimer’s disease to convey the multiple layers of a single experience. With both text and image at her disposal, she uses one to enhance the other or create contradictions and juxtapositions that were jarring or darkly humorous.</li> </ul> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/08/msoc1-1408.html" target="_blank">A complete medical education includes the arts and humanities</a>.” David S. Jones, MD, PhD, asks “Why must we prove that the arts and humanities make better doctors?”</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9b14e1e3-9a2d-483d-8e1c-7f81a773231f Resource offers strategies to prevent hospital infections http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_resource-offers-strategies-prevent-hospital-infections Wed, 13 Aug 2014 14:25:00 GMT <p> An updated version of the popular <a href="http://www.shea-online.org/PriorityTopics/CompendiumofStrategiestoPreventHAIs.aspx" target="_blank" rel="nofollow">compendium of recommendations</a> for preventing common health care-associated infections (HAI) in acute care hospitals has been published in the <em>Infection Control and Healthcare Epidemiology</em>.</p> <p> “What makes the compendium unique is its commitment to the usability of its content at the ground level,” Margaret VanAmringe, executive vice president for Public Policy and Government Relations at the Joint Commission, said in an accompanying <a href="http://www.jstor.org/stable/10.1086/677147" target="_blank" rel="nofollow">commentary</a>. “By presenting information in a format that can make operational sense out of complicated knowledge, the compendium jump starts the ability of health care professionals to translate essential information into practice.”</p> <p> Compiled by the Joint Commission in partnership with the Society for Healthcare Epidemiology of America and other health care organizations, the updated compendium:</p> <ul> <li> Synthesizes best evidence for the prevention of surgical site infections, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, clostridium difficile, methicillin-resistant staphylococcus aureus (MRSA) and hand hygiene</li> <li> Highlights basic HAI prevention strategies and advanced approaches for outbreak management and other special circumstances</li> <li> Recommends performance and accountability measures to apply to individuals and groups working to implement infection prevention practices</li> </ul> <p> The <a href="http://www.shea-online.org/PriorityTopics/CompendiumofStrategiestoPreventHAIs.aspx" target="_blank" rel="nofollow">entire compendium</a> is available online. A bound supplement will be available for sale in the fall. Additional information about this topic is available via the Joint Commission’s <a href="http://www.jointcommission.org/hai.aspx" target="_blank" rel="nofollow">HAI portal</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8bb5bba9-bea8-4a00-8550-9f851a852656 Neighborhood socioeconomic status associated with readmissions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_neighborhood-socioeconomic-status-associated-readmissions Wed, 13 Aug 2014 14:00:00 GMT <p> According to a <a href="http://circoutcomes.ahajournals.org/content/early/2014/07/29/CIRCOUTCOMES.113.000911.abstract" rel="nofollow" target="_blank">study</a> published online last week by the journal <em>Circulation: Cardiovascular Quality and Outcomes </em>by the American Heart Association, patients hospitalized for heart failure are more likely to be readmitted within six months if they live in neighborhoods with low socioeconomic status.</p> <p> Neighborhood socioeconomic status was significantly associated with six-month, all-cause readmission even after adjusting for patient-level factors, including individual socioeconomic status.</p> <p> “To prevent readmission, we may need to focus on neighborhood factors, as well as individual patient factors,” the article states.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:23ed0b6c-3e83-401b-abae-737056bb6140 Why faculty development is crucial to med ed innovation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_faculty-development-crucial-med-ed-innovation Wed, 13 Aug 2014 13:00:00 GMT <p>  </p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:295px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/5/51e5cfde-3a85-4895-85ee-8231738ad9fb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/5/51e5cfde-3a85-4895-85ee-8231738ad9fb.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">Thomas Viggiano, MD, associate dean for faculty affairs at Mayo Medical School, addresses attendees at a consortium meeting of the AMA’s Accelerating Change in Medical Education initiative at the University of Michigan in April.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> Academic physicians and faculty across the country are innovating new ways to teach the physicians of tomorrow, but first, the trainers must become the trainees.</p> <p> “Medical education is largely an apprenticeship system—students rotate with us and work with us in clinical settings,” said Thomas Viggiano, MD, associate dean for faculty affairs at Mayo Medical School. “If we don’t have the competencies that we want our students to have, then we are not effective role models.”</p> <p> Dr. Viggiano is part of a curriculum transformation at Mayo that is overhauling the traditional model of medical school. The program will place greater emphasis on preserving wellness and health over treating disease and will embed students in communities for longitudinal clinical experiences. But the school can’t just focus on how they’ll teach students.</p> <p> “We have an enormous task,” he said. “Our task is to help faculty learn about a variety of science of health care delivery topics that many faculty members did not learn when they attended medical school. The goal is for all faculty to be knowledgeable so they can discuss topics like population health and be good role models for how to practice high-value, person-centered care.”</p> <p> Mayo is part of 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 seeks to advance the education of future physicians by developing innovative training models. The 11 schools in the initiative are devising and testing things like competency-based curriculum, integrating technology into learning, and giving hands-on training in team-based care.</p> <p> The school is using a blended learning model, a combination of online resources and face-to-face learning time, to get its faculty to a high level of proficiency on medical education innovations that eventually will be a core part of the school’s curriculum. A second layer of faculty development will train “champions,” or faculty with a deeper interest in these topics that can act as leaders of the new curriculum.</p> <p> Taking a similar approach is the Brody School of Medicine at East Carolina University through its <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-faculty-training-program-aims-transform-medical-education" target="_blank">Teachers of Quality Academy</a> (TQA). But there’s one major difference: The faculty participating in the TQA will be trained on medical education innovations while simultaneously creating the school’s new curriculum. Brody also is participating in the AMA initiative.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:295px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/13/6bea1bd7-cb4c-4dee-8d8f-8eb1989d308b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/13/6bea1bd7-cb4c-4dee-8d8f-8eb1989d308b.Large.jpg?1" /></a></td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> <td> <em><span style="font-size:12px;">Elizabeth Baxley, MD, senior associate dean for academic affairs at the Brody School of Medicine at East Carolina University, speaks at a consortium meeting of the AMA’s Accelerating Change in Medical Education initiative at the University of Michigan in April.</span></em></td> </tr> </tbody> </table> <p> “We knew the faculty didn’t have the core content they would need, and we created the TQA to design the curriculum while training them on the content,” said Elizabeth Baxley, MD, senior associate dean for academic affairs at Brody School of Medicine. “We’re letting [faculty] serve as the larger curriculum development group. We’re starting with faculty and engaging them in helping us be the change leaders.”</p> <p> Brody’s program was open to faculty from across the health sciences, including nursing and public health.</p> <p> “Training this broader group gave us more hands on deck,” Dr. Baxley said. “We needed the perspective of people who weren’t in our education planning circles, and we needed to broaden the chances that these principles would get reinforced in the daily practice of teaching.”</p> <p> While the approaches are different, both Brody and Mayo are experiencing the same challenges—time and money. Both schools are working to incentivize faculty development.</p> <p> “How do you get busy people who are working very hard to engage in this?” said Dr. Viggiano. “The resources have to be designed very well—as concise as they can be with no wasted time and excellent quality.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:627ec138-fb83-4dc5-978a-58d5aee81edc Top reasons residents leave their programs--and why they stay http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_top-reasons-residents-leave-their-programs-stay Tue, 12 Aug 2014 21:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/8/fcdcecb8-ea39-45f5-983a-f1f6e6eb2d63.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/8/fcdcecb8-ea39-45f5-983a-f1f6e6eb2d63.Large.jpg?1" style="float:right;margin:10px;" /></a>Why do some residents leave their residency? A new <a href="http://archsurg.jamanetwork.com/article.aspx?articleid=1891300" rel="nofollow" target="_blank">study</a> published in <em>JAMA Surgery</em> found that more than half of general surgery residents have seriously considered leaving their training programs. The findings offer insight for graduate medical education programs and residents as they progress through their training.</p> <p> The study surveyed more than 300 residents and found the most frequent reasons for wanting to leave were sleep deprivation on a specific rotation, an undesirable future lifestyle and excessive work hours on a specific rotation. The top reasons residents ultimately decided to stay in training were support from family and significant others, support from other residents and the perception of being better rested.</p> <p> The study did not find that work hours overall contributed to a desire to leave residency, which “may suggest that it is the workload of an individual rotation that residents find most stressful rather than the rigor of the entirety of general surgery,” the study said. It suggested that programs should identify high work-hour rotations and modify them.</p> <p> Women were more likely than men to report wanting to leave their residency program, underscoring the importance of supporting female residents through the balance between motherhood and professional life, the study said. Women also were more likely to list the absence of a faculty mentor as a contributing factor for wanting to leave.</p> <p> General surgery attrition rates are between 3 and 5 percent annually. “The training of surgical residents is a long and arduous process that necessitates an immense investment of time for the trainee and the faculty,” the study said. “As such, resident attrition is a tremendous loss for all involved parties.”</p> <p> The findings, especially those that said an undesirable future lifestyle caused them to consider leaving residency, point to the difficult issue of work-home balance, the study said. Practicing surgeons continue to experience high levels of work-home conflicts and burnout. With support from family and significant others as a top reason residents decide to remain in their programs, it is clear that home life has a significant effect on work life.</p> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models.page?" target="_blank">Physician Satisfaction and Practice Sustainability</a> initiative, the AMA is developing practice-level solutions to enhance the practice of medicine for physicians. While the AMA’s research into professional satisfaction is focused on workplace issues, the AMA Alliance works to support medical families and devise helpful resources for physicians’ family lives. </p> <p> The AMA Alliance magazine, <em>Physician Family</em>, offers <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-tips-survive-residency-advice-partners-of-residents" target="_blank">10 tips for partners of medical residents</a>. The Alliance also has supported programming on the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/achieving-resilient-medical-family-special-session-june-9" target="_blank">resilient medical family</a> and how to maintain a healthy life balance.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:747c451e-55a6-4b4f-98f6-c42e13f5da69 4 common misconceptions patients have about their insurance http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-common-misconceptions-patients-their-insurance Tue, 12 Aug 2014 19:16:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/15e907a9-7e8e-4037-9460-0f71edfc919c.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/15e907a9-7e8e-4037-9460-0f71edfc919c.Large.jpg?1" style="float:left;margin:10px;" /></a></p> <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> There’s been a lot about health insurance exchanges in the news lately, and I think it underscores the general confusion many of our patients have around their insurance coverage. Now that the Affordable Care Act (ACA) is fully in place, many of us are seeing patients for whom navigating the complexities of health care insurance is a brand new challenge.</p> <p> Here are four questions your patients are likely to ask you or your practice staff—and how to answer them.</p> <ol> <li style="margin-left:0.25in;"> <strong>What does my plan cover?</strong> Patients need to look to their summary of benefits and coverage. If they purchased their coverage through a health insurance exchange, they can find this information by contacting their health plan. <a href="https://www.healthcare.gov/how-does-the-health-care-law-protect-me/summary-of-benefits-and-coverage" rel="nofollow">Simple instructions</a> for how to do that are available from the U.S. Department of Health and Human Services.</li> <li style="margin-left:0.25in;"> <strong>Why do I have to pay a copay or deductible?</strong> Patients might not understand that a deductible or copay (or co-insurance) will be required for much of the care they receive. Healthcare.gov provides a helpful <a href="https://www.healthcare.gov/glossary/" rel="nofollow" target="_blank">glossary of common insurance terms</a> that gives basic explanations and simple examples to help patients understand what they can expect under their plan.</li> <li style="margin-left:0.25in;"> <strong>What is a tax credit?</strong> Some patients may qualify for cost assistance on their state’s exchange. If they do, they could get a lower monthly premium and lower cost-sharing. They can check whether they are eligible for a subsidy using a <a href="http://kff.org/interactive/subsidy-calculator/" rel="nofollow" target="_blank">subsidy calculator</a> offered by the Kaiser Family Foundation, and then can contact their state exchange.</li> <li style="margin-left:0.25in;"> <strong>How do I renew my coverage?</strong> Open enrollment starts for many health plans in October. For plans sold through the exchanges, that period starts Nov. 15. Insurance companies will send information about updated benefits to policyholders. If a patient’s income and household size haven’t changed, they don’t need to do anything: they will be re-enrolled automatically. If one of these two factors has changed, they’ll need to report it so they get the right tax credit. You can direct your patients for <a href="https://www.healthcare.gov/blog/we-are-making-it-easy-for-you-to-keep-your-marketplace-coverage-next-year/" rel="nofollow" target="_blank">more information</a> at healthcare.gov.</li> </ol> <p> For basic information about how patients can secure insurance coverage through the health insurance exchanges, visit the AMA <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/affordable-care-act.page" target="_blank">Web page about ACA insurance coverage</a>. Help your patients understand how they can use their coverage to make sure they and their families get the care they need and stay healthy.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ee7a697c-1396-401d-9a4e-2d4df644d358 Easily import codes using new CPT® 2015 Data File http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_easily-import-codes-using-new-cpt-2015-data-file Tue, 12 Aug 2014 19:12:00 GMT <p> Simplify CPT<strong><sup>®</sup></strong> coding by importing the 2015 CPT code set into your claims and billing software using the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500013&navAction=push#usage-tab" target="_blank">CPT<strong><sup>®</sup></strong> 2015 Data File</a> on CD-ROM.</p> <p> This product consists of easy-to-understand features to support your daily coding needs, including:</p> <ul> <li style="margin-left:0.25in;"> CPT clinician descriptors clearly and specifically explain the procedure or service performed by a physician or qualified health care provider at the point of care.</li> <li style="margin-left:0.25in;"> Consumer-friendly descriptors explain each CPT code in language easily understood by the average patient or caregiver. These descriptors support objectives in Stage 2 of the electronic health record meaningful use program.</li> <li style="margin-left:0.25in;"> Code descriptions are provided in fixed-field and tab-delimited file formats.</li> <li style="margin-left:0.25in;"> Three descriptor lengths can be used as needed.</li> <li style="margin-left:0.25in;"> A summary of re-sequenced CPT codes as well as additions, deletions and revisions is included.</li> </ul> <p> Also available for immediate download is the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">ICD-10 2015 Date File</a>, which includes essential code information and descriptions. Use the data file to begin testing your electronic coding and billing systems in preparation for the <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">new Oct. 1, 2015, compliance deadline</a>.</p> <p> AMA members receive a discount on these products and others from the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500013&navAction=push#usage-tab" target="_blank">AMA Store</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dab9a4f8-6cf8-4093-bcaf-837a1669066d Grants help at-risk youth learn about dangers of Rx drug misuse http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_grants-risk-youth-learn-dangers-of-rx-drug-misuse Tue, 12 Aug 2014 19:07:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/3/3f31ab1a-7666-457f-8301-29ce01ef97b7.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/3/3f31ab1a-7666-457f-8301-29ce01ef97b7.Large.jpg?1" style="float:right;margin:10px;" /></a>Do you have an idea for a grassroots public health program that addresses prescription medication safety for underserved or at-risk youth? Apply by Sept. 12 for a <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?" target="_blank">Healthy Living Grant</a> from the AMA Foundation to see your project come to life.</p> <p> Proposed projects involve partnerships between medical organizations and community nonprofit or government organizations with annual operating budgets of $2 million or less, and must target an underserved or at-risk population of youth and young adults between the ages of 2 and 21.</p> <p> Last year, the grant program awarded 30 grants totaling more than $240,000 to community organizations in 19 states, supporting prescription medication safety projects that met the needs of local communities.</p> <p> One grant project last year is helping coaches educate high school athletes about the risky path from pain relief to addiction. The Robert Crown Center for Health Education in Hinsdale, Illinois, developed the 3-Point Advantage program to train Illinois high school coaches how to explain the science behind addiction to their student athletes.</p> <p> Following one 3-Point Advantage presentation, a wrestler approached Barb Barrett, a registered nurse and health educator at the center, and told her that he had overused pain pills because he thought he was following the instructions.</p> <p> “He had no idea that prescription medication could be addictive,” said Barrett. “He took the painkillers every four hours, despite the fact that his pain did not necessitate it.”</p> <p> Other grant-winning projects from last year include:</p> <ul> <li style="margin-left:0.25in;"> Formation of a task force in a local area to deliver educational programming on reducing prescription drug abuse among teenagers</li> <li style="margin-left:0.25in;"> A social media campaign, created by teens for other teens, about the dangers of prescription drug abuse</li> <li style="margin-left:0.25in;"> School-based education in health classes and outreach to parents</li> <li style="margin-left:0.25in;"> Educational programs for elementary school students that encourage healthy habits related to prescription drug use</li> </ul> <p> View the <a href="http://www.ama-assn.org/resources/doc/ama-foundation/x-pub/healthy-living-grant-recipients-2013.pdf" target="_blank">complete list</a> (AMA login required) of last year’s grant recipients.</p> <p> <a href="http://www.ama-assn.org/resources/doc/ama-foundation/x-pub/healthy-living-grant-application-2014.doc" target="_blank">Applications</a> (AMA login required) are due by 6 p.m. Eastern time on Sept. 12. Read the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants/faq.page?" target="_blank">frequently asked questions</a> on the Healthy Living Grants Web page for more information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ac4e8d4f-6c88-479e-89c8-c06d68fcd654 3 steps for acting rapidly to control high blood pressure http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-steps-acting-rapidly-control-high-blood-pressure Mon, 11 Aug 2014 19:42:00 GMT <p> Recently, <em>AMA Wire</em>® has focused coverage on 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>, the first action to appropriately managing high blood pressure. Once a patient’s hypertension is confirmed, physicians and their practice staff should act rapidly to help bring that blood pressure under control. Here are three recommended steps to take:</p> <ol> <li style="margin-left:0.25in;"> Make an explicit change in the patient’s care plan before your interaction ends.</li> <li style="margin-left:0.25in;"> Ensure there will be a follow-up interaction every two to four weeks until blood pressure is less than 140/90 mmHg.</li> <li style="margin-left:0.25in;"> Use an evidence-based protocol, such as the U.S. Department of Health and Human Service’s Million Hearts<sup>®</sup> initiative <a href="http://millionhearts.hhs.gov/resources/protocols.html" rel="nofollow" target="_blank">framework</a>, to guide selection of antihypertensive medications.</li> </ol> <p> These actions are from the second part of a checklist called the <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/ihobp-map-for-optimal-hypertension-control.pdf" target="_blank">“M.A.P. framework”</a> (AMA login required) to improve outcomes around hypertension, being developed and tested by physicians in a pilot program taking place in Maryland and Illinois. The M.A.P. calls for physicians and care teams to take action around these three concepts:</p> <ul> <li style="margin-left:0.25in;"> Measure accurately</li> <li style="margin-left:0.25in;"> Act rapidly</li> <li style="margin-left:0.25in;"> Partner with patients to promote patient self-management</li> </ul> <p> The pilot 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 which the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based recommendations.</p> <p> Along with clinical changes, the pilot practices are establishing clinical-community linkages, where physicians refer patients to community resources that can help them improve their blood pressure. For example, one Baltimore physician set up a fitness clinic in her office, in which patients can meet with her for 40 minutes to discuss weight loss goals, diet and nutrition and identify nearby locations where they can safely exercise. The practices are also testing different ways to maintain contact with patients outside of office visits and empowering patients to take control of their blood pressure. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a374d8cb-fe6a-44e6-9420-48f8395e619e Expand your career: Unique journal editor opportunity http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_expand-career-unique-journal-editor-opportunity Mon, 11 Aug 2014 19:29:00 GMT <p> Take ownership of a peer-reviewed ethics journal for a month and get the chance to explore complex topics in medicine as an editor of <a href="http://virtualmentor.ama-assn.org/" target="_blank"><em>Virtual Mentor</em></a>, the AMA’s online ethics journal. Apply by Oct. 15 to be considered for this career-enriching opportunity.</p> <p> Issue editors will be selected from medical student and resident applicants in November. Editors receive a $2,000 stipend and attend an all-expenses-paid meeting in Chicago to discuss themes, generate article ideas and  determine which publication month fits best with each editor’s schedule.</p> <p> Ajay Major, a third-year medical student at Albany Medical College and a former <em>Virtual Mentor </em>editor, said the experience offers a collaborative way to generate ideas and then allows the editor to be autonomous in managing his or her own journal issue.</p> <p> “I loved getting to know students from across the country and hear them present on  a variety of topics with which I was unfamiliar,” said former editor Samyukta Mullangi, an MD/MBA joint degree student at Harvard Business School and Harvard Medical School. “I was heartened by how many of my peers spent time passionately considering these diverse subjects, and through them, expanded my own understanding of how broad medicine's reach can be.”</p> <p> Major said the opportunity is perfect for anyone with an interest in “medicine-plus”—for example, medicine plus ethics, medicine plus journalism or medicine plus law.</p> <p> “It’s the perfect place to start to explore areas outside of medicine that you really want to bring into medicine and create a collaborative career for yourself,” he said.</p> <p> Editors begin planning their individual issues eight months before publication. They manage the entire process, including choosing the issue’s theme, generating case narratives, identifying and  corresponding with issue contributors and editing the manuscript. While it’s not a small amount of work, for Major it was well worth it. He had the opportunity to interact with well-known physicians while he put together his issue.</p> <p> “When you’re meeting these people who are heavy players in the field, it doesn’t feel like work,” he said.</p> <p> “The beauty of <em>Virtual Mentor</em> is that it offers such privilege and scope for a young medical student to gather some of the country's most pre-eminent educators and researchers to write essays on topics that the student gets to choose,” Mullangi said. “How often does such an opportunity come around?”</p> <p> Visit the <a href="http://virtualmentor.ama-assn.org/site/issue-edscall.html" target="_blank"><em>Virtual Mentor</em> website</a> to view instructions for applying to be an issue editor in 2015. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:67de5a1d-bb9c-42cc-8b4a-6158a738c0cc Tell lawmakers on summer break to repeal SGR http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tell-lawmakers-summer-break-repeal-sgr Fri, 08 Aug 2014 20:43:00 GMT <p> After failing to pass bipartisan legislation that would have fixed the sustainable growth rate (SGR) crisis, Congress has another chance to solve the problem once and for all. Your elected officials are in their home states for the summer recess through Sept. 5, listening to their constituents. Take this opportunity to tell them to repeal the SGR formula this year and move toward a high-performing Medicare physician payment system.</p> <p> Without congressional action, the SGR formula calls for a 20.8 percent cut to physician payments when the current short-term patch expires March 31. <a href="http://fixmedicarenow.org/physician-action/" rel="nofollow" target="_blank">Email</a> your members of Congress or call their district offices via the AMA’s Physician Grassroots Network at (800) 833-6354. Urge them to find a permanent solution to SGR this year.</p> <p> Physicians also can <a href="mailto:grassroots@ama-assn.org" rel="nofollow">email the AMA</a> for information about local events their lawmakers may host during the recess, providing an opportunity to ask them face-to-face to repeal the SGR formula.</p> <p> The AMA continues to urge Congress to enact the bipartisan Medicare <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3Aaf492466-72dd-449d-a053-8720eacadb3f" target="_blank">payment reform legislation</a> that was supported unanimously by three congressional committees of jurisdiction earlier this year.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e9952491-934d-484d-a50d-fe4eea1881f9 How states are taking on the national Rx abuse crisis http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_states-taking-national-rx-abuse-crisis Fri, 08 Aug 2014 20:27:00 GMT <p> <span style="font-size:12px;">As the nation’s prescription drug abuse crisis continues its devastating course—with 46 people dying every day from overdose and many more requiring hospitalization—physicians and policymakers are trying to tackle the issue head on, at both the national and state levels.</span></p> <p> Here are some key ways prescription drug abuse is being addressed in the states:</p> <p> <strong>Overdose reversal legislation: </strong>Many state lawmakers have embraced the opportunity to help prevent opioid overdose deaths by supporting legislation for the overdose reversal drug naloxone. As of mid-May, 24 states and the District of Columbia passed laws to increase access to this life-saving antidote, according to a <a href="https://www.networkforphl.org/_asset/qz5pvn/network-naloxone-10-4.pdf" target="_blank" rel="nofollow">report</a> of the Network for Public Health Law. “Good Samaritan” laws that encourage people to call for medical aid in the event of a drug overdose also have been adopted in 16 states and the District of Columbia.</p> <p> The AMA and numerous state and specialty medical associations have been instrumental in supporting and securing enactment of these laws over the past few years.</p> <p> While these laws provide access to a key medication for saving lives, they are only a part of the bigger picture. A comprehensive public health approach with a focus on prevention and treatment is essential to help get this ever-growing crisis under control.</p> <p> <strong>Access to addiction treatment and recovery programs: </strong>As the National Governors Association continues its work to develop recommendations for addressing drug abuse, the AMA has <a href="http://www.ama-assn.org/resources/doc/arc/x-pub/nga-recommendations-lessons-learned.pdf" target="_blank">helped convince this influential group</a> (AMA login required) to place a greater emphasis on treatment programs to help break the cycle of addiction. That includes removing barriers to access and making treatment programs more affordable.</p> <p> <strong>Prescription drug monitoring programs (PDMP): </strong>Many states have turned to these data registries to track patients’ use of prescription drugs. Unfortunately, many programs are underfunded and inadequately maintained. The AMA is calling for state governors and lawmakers to focus on making real-time data available and enabling interstate interoperability to make sure data is shared properly.</p> <p> Additionally, the AMA has <a href="https://www.ama-assn.org/resources/doc/arc/x-pub/ama-comments-ncoil-letter.pdf" target="_blank">urged the National Conference of Insurance Legislators</a> (AMA login required) to consider how PDMPs can be used as beneficial clinical support tools.</p> <p> <strong>Clinical standards:</strong> Some states have considered mandating standards of care for prescribing painkillers, but the AMA is advocating for a more targeted approach that allows physicians to exercise the appropriate balance between preventing overuse of drugs and under-treatment of pain. A patient-specific focus, not a “one-size-fits-all” approach, is required to achieve this goal.</p> <p> <strong>Task forces, public education and drug take-back: </strong>Other community leaders also are increasing efforts around this issue. Active prescription drug task forces are in 34 states, up from 29 in 2012, according to a recent survey of the National Association of State Alcohol and Drug Abuse Directors.</p> <p> A number of states also have established ongoing drug take-back programs to help residents dispose of unused medications. Kentucky, for instance, offers disposal locations in 110 of its 120 counties. Oklahoma also has a statewide plan, and Pennsylvania offers an online map of safe disposal locations. Several other states have passed legislation around making these programs available.</p> <p> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Read more online</a> about the AMA’s efforts to combat prescription drug abuse and diversion in the states and at the national level.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:764cde4f-b062-490f-8430-28daa0454234 Get an inside look at future of health and medicine: TEDMED 2014 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_inside-look-future-of-health-medicine-tedmed-2014 Fri, 08 Aug 2014 20:11:00 GMT <p> Physicians and doctors in training are invited to have an exclusive first-hand look at what’s driving health and medical progress today. <strong><a href="http://www.tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a>, </strong>the annual health and medicine edition of the world-renowned TED Talks, is convening its first dual-coast event for the physician community.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/13/25b776ff-8303-4b61-adcb-d272b20823f9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/13/25b776ff-8303-4b61-adcb-d272b20823f9.Large.jpg?1" style="margin:15px;float:right;" /></a>As part of its relentless pursuit to improve the health of the nation, the AMA this year joins TEDMED in seeding the innovations of today to make possible the breakthroughs of tomorrow. With its theme of “Unlocking imagination,” this year’s TEDMED features a <strong>world-class roster</strong> of thought-provoking speakers who will offer illuminating insights on topics that will challenge your thinking, including:</p> <ul> <li> Ending the global physician shortage</li> <li> Revolutionizing medical education</li> <li> Understanding the obesity epidemic and addiction</li> <li> Identifying childhood factors that impact serious adult-onset diseases, such as heart disease and cancer</li> <li> Advancing high-tech diagnostics</li> </ul> <p> <strong>Experience TEDMED in person—special opportunity for AMA members only</strong><br /> The event will be held Sept. 10–12 simultaneously in Washington, D.C., and San Francisco. 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> Benefits of this special offer include:</p> <ul> <li> <strong>Thought-provoking speakers. </strong>TEDMED’s curation team of physicians, scientists, public health experts, technologists and business leaders have vetted thousands of nominations to select 80 speakers and performers.</li> <li> <strong>Dual venue choice</strong>. With the same program on either coast, you can select the location that works best for you and your guest.</li> <li> <strong>Networking in the TEDMED “Hive.”</strong> Connect with the AMA and an exclusive community of startups and entrepreneurs who are powering transformation and innovation toward a healthier future.</li> <li> <strong>Meals and onsite transportation. </strong>Breakfast, lunch and snacks are included for you and your guest each day, along with a special invitation to attend TEDMED’s Evening Celebration Wednesday night. Transportation is provided from preferred event hotels to the Kennedy Center in Washington, D.C., and the Palace of Fine Arts in San Francisco.</li> <li> <strong>Special hotel rates.</strong> Preferred event hotels are offering special rates to you and your guest.</li> </ul> <p> <strong>Act now! TEDMED 2014 is Sept. 10–12</strong><br /> TEDMED always is a sold-out event, and this special opportunity is available only until <strong>Aug. 25</strong>. <a href="https://www.tedmed.com/register?gc=CRAMA14" rel="nofollow" target="_blank">Visit the TEDMED website</a> to take advantage of your pre-approved registration status using group code <strong>“CRAMA14” </strong>to bypass the formal application process.  Upon payment of your registration fee and verification of AMA membership, AMA members will receive a one-time code to register their guests—who will have the same rights and privileges—at no additional charge.</p> <p> <strong>Visit AMA at the TEDMED Hive</strong><br /> As part of the TEDMED Hive, the AMA will meet and greet you as we discuss our three highly ambitious initiatives to improve health outcomes, create the medical school of the future, and enhance practice sustainability and professional satisfaction. Be sure to stop by and connect with your fellow AMA members.</p> <p> <strong>Participate in TEDMED 2014 via live streaming</strong><br /> AMA members receive<strong> complimentary access </strong>to participate via live streaming: Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" target="_blank" rel="nofollow">TEDMED 2014 website</a> and use invitation code <strong>“</strong><strong>TMLicAMA14.”</strong> You can view talks on demand as your schedule permits, or participate in portions of the event in real-time. You also can gather a group of your colleagues and staff to view presenters of interest.</p> <p> <strong>TEDMED 2014</strong>—be part of this unique opportunity to glimpse the future and to learn from and be inspired by leading voices in health and medicine. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fde2cf5c-78ba-41fa-82a1-be92dafe848d How is health IT used? School investigates competencies http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-used-school-investigates-competencies Fri, 08 Aug 2014 18:00:00 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 two faculty from Oregon Health and Science University School of Medicine. William Hersh, MD, is a professor and chair of the school’s department of medical informatics and clinical epidemiology. George Mejicano, MD, is the school of medicine’s senior associate dean for education. Appeared in the August 2014 </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></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/6/0/6660ee05-cb44-4912-801c-69e5dd53c991.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/0/6660ee05-cb44-4912-801c-69e5dd53c991.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">George Mejicano, MD, and William Hersh, MD, both from Oregon Health and Science University School of Medicine, talk with Therese Wolpaw, MD, from Pennsylvania State University College of Medicine during the AMA Accelerating Change in Medical Education Conference in October 2013.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> At Oregon Health and Science University, we recognize the importance that competence in clinical informatics will play in the success of the 21st century physician. With the ever-expanding knowledgebase of medicine, the growing need for more accountable care and patients’ desires to interact electronically with the health care system the way they interact with other industries, the use of health IT will continue to grow. An additional reason for competence in clinical informatics is the career opportunities provided its designation as a new medical subspecialty, with the first 456 physicians certified in 2013.</p> <p> With both our medical student curriculum revision process as well as our work with the AMA’s <a href="http://changemeded.org/" target="_blank" rel="nofollow">Accelerating Change in Medical Education</a> initiative, we aim to integrate more clinical informatics into our curriculum. As a first step, we established a working group of informatics faculty leaders to develop a set of competencies in clinical informatics. We aimed to go beyond the usual searching and basic EHR skills that increasing numbers of medical schools provide. We also wanted to focus less on the technology and more on the tasks for which health IT will be used.</p> <p> From the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-need-better-use-of-technology" target="_blank">broad competencies</a>, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. After producing this material, we believe there would be value in publishing our work in a peer-reviewed journal. By doing so, we hope that this work, and the resulting curricula, will be evaluated by ourselves and our colleagues. To this end, our <a href="http://www.dovepress.com/beyond-information-retrieval-and-electronic-health-record-use-competen-peer-reviewed-article-AMEP" target="_blank" rel="nofollow">published paper</a> recently appeared in <em>Advances in Medical Education and Practice</em>.</p> <p> We have moved to next steps of implementing this new portion of our medical school curriculum. We are also working to define the optimal relationship between 21st century physicians and the data they and others generate about their patients and their practice.</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> to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:254b94fa-50ea-4134-baad-273ef5c1fda8 What physicians need to make better use of technology http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-need-better-use-of-technology Thu, 07 Aug 2014 18:00:00 GMT <p> How can tomorrow’s physicians integrate technology into their practice beyond simply using electronic health records (EHR)? One medical school outlined exactly how physicians of the future can be adept at making technology work for them.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/13/826fb299-e641-4bd8-bd3c-6fa86df5ec0a.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/13/826fb299-e641-4bd8-bd3c-6fa86df5ec0a.Large.jpg?1" style="margin:15px;float:right;" /></a>As part of its undergraduate medical education transformation, Oregon Health and Science University (OHSU) School of Medicine identified competencies medical students should have surrounding informatics, or using technology to provide better care to patients. This extends beyond using an EHR system, according to a recent <a href="http://www.dovepress.com/beyond-information-retrieval-and-electronic-health-record-use-competen-peer-reviewed-article-AMEP" rel="nofollow" target="_blank">article</a> from the institution in <em>Advances in Medical Education and Practice</em>.</p> <p> “The health record is no longer a passive collection of information used mainly to justify billing,” the article said. “Rather, it is a source of data, organized into coherent information that allows the health care team to deliver the best, safest and most cost-effective care.”</p> <p> The school assembled a team to identify 13 competencies in clinical informatics. The team mapped each competency to the six competency domains for residents defined by the Accreditation Council for Graduate Medical Education, then developed learning objectives and milestones to achieve each competency in the continuum of medical education. The skills defined by the new curriculum include:</p> <ul> <li> <strong>Finding and applying information</strong> to patient care and other clinical tasks, including how to choose the best online source for a specific task, evaluating information sources to determine whether they are high-quality and formulating answerable clinical questions</li> <li> <strong>Effectively using an EHR</strong>, including recognizing medical safety issues related to poor chart maintenance, creating usable notes and comparing results over time</li> <li> <strong>Using information to improve patient safety</strong>, including performing a root-cause analysis to uncover patient safety problems and then using resources to solve the issue</li> <li> <strong>Engaging patients to improve their health and care delivery</strong> through a patient portal, including electronic communication with patients and integrating technology into patient education</li> </ul> <p> “The 21st-century clinician must have a basic understanding of informatics issues, such as capturing data that is correct and complete as well as consistent in its expression,” the article said. “He or she must be able to work in partnership with informatics professionals to achieve what we know is so critical in the application of informatics: adhering to standards, achieving system interoperability, appropriately and optimally implementing clinical decision support, and maintaining security to assure privacy and confidentiality.”</p> <p> The <a href="http://www.ohsu.edu/xd/education/schools/school-of-medicine/about/curriculum-transformation/" rel="nofollow" target="_blank">curriculum transformation</a> at OHSU is part of a grant project under the AMA’s <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Medical Education</a> initiative. OHSU and 10 other schools are working to reinvent traditional medical education by incorporating elements such as competency-based assessment, team-based care and informatics into daily training. The 13 informatics competencies are already being integrated into OHSU’s new curriculum, which begins next week.</p> <p> <strong>Competencies in clinical informatics</strong></p> <ol> <li> Find, search, and apply knowledge-based information to patient care and other clinical tasks</li> <li> Effectively read and write from the electronic health record for patient care and other clinical activities</li> <li> Use and guide implementation of clinical decision support</li> <li> Provide care using population health management approaches</li> <li> Protect patient privacy and security</li> <li> Use information technology to improve patient safety</li> <li> Engage in quality measurement selection and improvement</li> <li> Use health information exchange to identify and access patient information across clinical settings</li> <li> Engage patients to improve their health and care delivery though personal health records and patient portals</li> <li> Maintain professionalism through use of information technology tools</li> <li> Provide clinical care via telemedicine and refer those for whom it is necessary</li> <li> Apply personalized/precision medicine</li> <li> Participate in practice-based clinical and translational research</li> </ol> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:95c3bf02-20dc-4c0c-b372-181046523cc5 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-40 Thu, 07 Aug 2014 14:41:00 GMT <p> <strong>Study finds brief interventions ineffective for reducing unhealthy drug use</strong><br /> Richard Saitz, MD, of the Boston University School of Public Health and colleagues tested the effectiveness of two brief counseling interventions for unhealthy drug use (any illicit drug use or prescription drug misuse) among primary care patients identified by screening, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1892250" rel="nofollow">study</a> in the <em>Journal of the American Medical Association</em> (<em>JAMA</em>). Watch a <a href="http://youtu.be/mknQj14ACzI?list=UUlpzWSNUo4kEgZbD2V-dRaA" rel="nofollow">video</a> on the study. <object align="right" data="http://www.youtube.com/v/mknQj14ACzI?list=UUlpzWSNUo4kEgZbD2V-dRaA" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/mknQj14ACzI?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/mknQj14ACzI?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/mknQj14ACzI?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object></p> <p> <strong>Using long-detection interval for ICDs associated with reduction in hospitalizations, costs</strong><br /> Use of implantable cardioverter-defibrillators (ICD) programmed with long-detection intervals for ventricular arrhythmias was associated with an increase in the time to first hospitalization and reductions in hospitalization rate, length of stay and costs, compared with standard interval programming, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1892235" rel="nofollow">study</a> in the Aug. 6 issue of <em>JAMA</em>.</p> <p> <strong>Aggressive outreach increases organ donation among Hispanic Americans</strong><br /> An outreach campaign that included local media and culturally sensitive educational programs in targeted neighborhoods was associated with an increase in consent rates for organ donation among Hispanic Americans in the Los Angeles area, according to a <a href="http://archsurg.jamanetwork.com/article.aspx?articleid=1891732" rel="nofollow">study</a> in <em>JAMA Surgery</em>.</p> <p> <strong>Medical consultations for surgical patients examined amid payment changes</strong><br /> The use of medical consultations for surgical patients varied widely across hospitals, especially among patients without complications, in a study of Medicare beneficiaries undergoing colectomy (to remove all or part of their colon) or total hip replacement, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1892182" rel="nofollow">study</a> in <em>JAMA Internal Medicine</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:eee99bf6-2602-4995-84f1-9195a9a5e0fc Nominations open for Joint Commission Professional and Technical Advisory Committee http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nominations-open-joint-commission-professional-technical-advisory-committee Thu, 07 Aug 2014 14:28:00 GMT <p> The AMA is seeking nominations for its alternate representative to the Joint Commission Professional and Technical Advisory Committee (PTAC) for the Home Care Accreditation Program.</p> <p> Joint Commission PTACs, which represent the views of a diverse group of professional associations and other interests, are an integral part of the Joint Commission’s advisory structure. These groups assist the Joint Commission in the development and refinement of accreditation standards and elements of performance.</p> <p> PTACs also provide observations to the Joint Commission regarding environmental trends, educational needs and other important issues facing the fields in which the Joint Commission offers accreditation services.</p> <p> <a href="http://www.ama-assn.org/resources/doc/omss/temp/ptac-nomination.docx" target="_blank">Nomination forms</a> (AMA login required) must be submitted by <strong>Aug. 15</strong>. <a href="mailto:keith.voogd@ama-assn.org" rel="nofollow">Email Keith Voogd</a> of the AMA or call him at (312) 464-4539 for additional information.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8a1a223d-38e3-44b1-afd5-7abaa852fdb3 Apply by Sept. 12 for a community health grant http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_apply-sept-12-community-health-grant Thu, 07 Aug 2014 14:25:00 GMT <p> Smaller senior physician groups can apply for grants to fund projects designed to meet the needs of young people in their local communities. This year’s AMA Foundation <strong><a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?" target="_blank" title="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?">Healthy Living Grant program</a></strong> provides funding to support educating youth about prescription medication safety.</p> <p> Promoting and establishing healthy behaviors among younger people is more effective, and often easier, than efforts to change unhealthy behaviors already established in adults.</p> <p style="margin-left:.75pt;"> Since 2002, the AMA Foundation has award has awarded funding to more than 350 organizations. This year, AMA Foundation will award grants of $8,000-$10,000 to support youth-focused programs addressing prescription medication safety projects. The grant application and eligibility criteria are <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?" target="_blank" title="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-living-grants.page?"><strong> available</strong></a> online. This year’s application deadline is Sept. 12.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5d2aaf9c-5802-419c-a6c1-66e1266cbb81 Tackling quality improvement competencies? Webcast gives guidance http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tackling-quality-improvement-competencies-webcast-gives-guidance Wed, 06 Aug 2014 16:14:00 GMT <p> As part of their training, medical residents now must participate in quality improvement (QI) projects, under the latest Accreditation Council for Graduate Medical Education (ACGME) requirements. Get an in-depth look at quality improvement—including how to structure QI projects—with guidance in a new <a href="http://www.ama-assn.org/ama/priv/about-ama/our-people/member-groups-sections/resident-fellow-section/rfs-quality-improvement.page" target="_blank">webcast module</a> (AMA login required).</p> <p> Beside the ACGME requirement for residents to be involved in QI at all levels of their institutions, training in clinical quality has other implications.</p> <p> “The fact is that you have to care about QI if you’re going to want to maintain your board certification status,” said Claudia Reardon, MD, an assistant professor of psychiatry at the University of Wisconsin School of Medicine and Public Health. “Moving forward, as well, states are increasingly requiring QI projects to maintain licensure.”</p> <p> Dr. Reardon is one of the webcast’s presenters. She is joined by Krystal Tomei, MD, a neurosurgery resident at the University of Medicine and Dentistry of New Jersey, and Jesse Ehrenfeld, MD, member of the AMA Board of Trustees and an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine.</p> <p> The webcast is free for AMA members and includes:</p> <ul> <li> Questions residents can ask themselves to identify QI opportunities</li> <li> How to satisfy ACGME requirements specific to QI</li> <li> Ways to structure QI projects, using examples from multiple specialties</li> <li> Resources available to help complete QI projects</li> </ul> <p> The webcast is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/introduction-to-practice-medicine.page?" target="_blank">Introduction to the Practice of Medicine</a>, an interactive, Web-based and tablet-compatible educational series that helps residents and their institutions develop the ACGME-required competencies. Residents who attend institutions that sponsor the program have 24-hour access to a library of modules on a variety of topics, including patient safety and resident sleep deprivation.</p> <p> Residents interested in QI also can check out the AMA Resident and Fellow Section <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/rfs-resources/rfs-qi-landing.page?" target="_blank">QI forum and project database</a> (AMA login required), a members-only resource to help residents start their own QI initiatives, learn about projects by peers and share their own ideas.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cff48a12-6b94-437a-9c9c-664b8ac40134 Register for the ACG’s Women in Gastroenterology Forum http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-acgs-women-gastroenterology-forum Wed, 06 Aug 2014 14:33:00 GMT <p> <a href="http://meetings.gi.org/" target="_blank" rel="nofollow">Registration</a> now is open for the American College of Gastroenterology’s first annual Women in Gastroenterology Forum. This program combines career and life balance strategies to help participants ensure their success.</p> <p> During this day-and-a-half program, participants will hear from a leading panel of experts providing the latest clinical updates on women’s gastrointestinal health issues and other topics. In addition, the program will highlight practice-related issues and career-life balance strategies, such as stress reduction and avoiding burnout, maximizing productivity, and the power of negotiation.</p> <p> Experts will also discuss coding, shared medical appointments and implementing shared decision-making. A successful practice owner also will share her experience in managing a clinic focused on women’s digestive health. This course addresses the challenges female gastroenterologists face in practice, identifies the stresses in everyday life and offers strategies for success.</p> <p> Come network with fellow colleagues, share your experiences and benefit from rewarding peer-to-peer mentoring in a collegial environment. <a href="http://meetings.gi.org/" target="_blank" rel="nofollow">Register today</a>.</p> <p> Are you connected to the AMA Women Physicians Section? <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section.page" target="_blank">Learn more</a> about their activities around women’s health and women in the medical profession, and find out how you can get involved.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:41339279-ec01-45d1-a94e-61f67c4d0985 Volunteer your expertise as an AMA Research Symposium judge http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_volunteer-expertise-ama-research-symposium-judge Wed, 06 Aug 2014 06:00:00 GMT <p> Advance the work of the next generation of physicians by serving as a judge for the 12th annual AMA Research Symposium. Lend your expertise either in person or virtually by evaluating the original research of medical students, residents and international medical graduates (IMG).</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/10/d5b0fa3d-9544-4634-9a89-2bb1bc6e5c83.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/10/d5b0fa3d-9544-4634-9a89-2bb1bc6e5c83.Large.jpg?1" style="margin:15px;float:right;" /></a>While the event will take place Nov. 7 at the Hilton Anatole in Dallas, you don’t need to be a local resident to participate. Physicians and medical faculty who won’t be in the Dallas area but want to participate can judge virtually prior to the event, from Sept. 23 to Oct. 19. Physicians and faculty at Dallas-area medical schools are invited to judge in person Nov. 7 so they can interact with the symposium participants. Sign up to judge on the <a href="http://www.ama-assn.org/ama/no-index/about-ama/research-symposium-judges.page" target="_blank">AMA Research Symposium Web page</a>.</p> <p> The competition has two components, and judges may be asked to judge both events, depending on their availability. Podium presentations are from 4 to 5 p.m., followed by poster presentations from 5 to 6 p.m. A reception at 6 p.m. will follow, and onsite judges are invited to attend.</p> <p> Research will be in these groups:</p> <ul> <li> Eight categories are available for medical student participants: Biochemistry/cell biology, cancer biology, clinical outcomes and health care improvement, immunology/infectious disease/inflammation, neurobiology/neuroscience, public health and epidemiology, radiology/imaging, and surgery/biomedical engineering.</li> <li> Two categories are available 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 are available to IMG members of the AMA who are certified by the Educational Commission for Foreign Medical Graduates: clinical medicine/clinical vignette, health policy or medical education, and basic science.</li> </ul> <p> “The posters were excellent and very scientific,” said Tirso Rojas, MD, an anesthesiologist in Yuma, Ariz., who served as a judge for the event in 2012. Then a first-time symposium judge, Dr. Rojas said the symposium was a learning opportunity for him and his fellow judges as well.</p> <p> Judges will receive a small token of appreciation for their time.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:89b86a1e-3f00-4ee4-b75b-d9e85a987f3a Pushing for better EHRs: How physicians are taking the lead http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_pushing-better-ehrs-physicians-taking-lead Tue, 05 Aug 2014 20:10:00 GMT <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> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/7/bffb6b41-c46b-41db-87f0-728de6a4c833.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/7/bffb6b41-c46b-41db-87f0-728de6a4c833.Large.jpg?1" style="height:135px;width:100px;margin:10px;float:left;" /></a>I will be participating later this month in a “user group” discussion with my electronic health record (EHR) vendor, during which we will be able to share our thoughts on the technology so the vendor can determine next steps. I suspect that what my vendor wants to do and what I’m going to ask them to do will be slightly different—I’m going to tell them how difficult and frustrating using the EHR really is for physicians.</p> <p> I know I’m not alone in my frustrations. A <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdf" target="_blank" rel="nofollow">2013 AMA study</a> we conducted with the RAND Corporation looks at factors that influence physicians’ professional satisfaction, demonstrating that most of us find the current state of EHR technology to be lacking and cite the serious shortcomings of EHR systems as a major cause of professional dissatisfaction.</p> <p> I’m an early adopter of this technology because I believe it can work. My office went paperless in 2002, so now I’m on my second EHR product. At this point, I know what I need to make using EHRs worth my time, and I plan to share these needs with my vendor.</p> <ul> <li> <strong>Searchable data.</strong> I don’t want to have to submit a ticket to my vendor to get actionable data that I want to use today. Six-month-old data is no good to me. I need a way to pull that information immediately.</li> <li> <strong>Interoperability:</strong> I need my EHR to allow me to import data without having to pay for expensive interfaces for every system with which I communicate or having to manually enter data.</li> <li> <strong>Quality guidelines.</strong> If we’re going to be asked to prove our adherence to quality measures, we need those guidelines built directly into our EHRs. That way, when we suggest a course of action, we know whether or not it adheres to quality guidelines, and can electronically prove our compliance.</li> <li> <strong>Better notes.</strong> In my system, the electronic notes aren’t really useful. There’s no easy way for me to input what the patient is saying at the time of their visit, my thoughts on the patient’s issues or what we plan to do. The information is mostly for billing purposes, not patient care.</li> </ul> <p> We can share our feedback with our EHR vendors and let them know their systems need our input so they can work in a way that enhances the physician practice and the care we give our patients.</p> <p> As part of our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA is developing a set of characteristics and recommendations to improve EHR usability, identifying opportunities to achieve these improvements, and determining a research agenda to advance the evidence base for increasing usability. We will be addressing the factors that lead to reduced productivity and increased frustration directly with the EHR vendor community.</p> <p> But that’s not all. The AMA also is continuing our intensive advocacy to address the overly burdensome EHR regulations that require us to spend so much time in front of the computer. The AMA has achieved improvements to the meaningful use program, including extending Stage 2 of the program through 2016 and securing additional hardship exemptions to help physicians avoid penalties. We are pushing for a greater federal focus on making sure products can exchange data with one another and simplifying EHR certification so vendors can spend time developing innovative products and addressing physician user concerns.</p> <p> The AMA is also developing educational modules that will give us the tools and information we need to be better EHR purchasers, implementers and users, regardless of our practice size.</p> <p> Between physicians taking a lead role in shaping this technology and the AMA’s work in this arena, we’ll soon have systems that help—not hinder—the patient-physician relationship.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0fea14a9-2a19-400e-bbdb-5224f7d666db Insurers shell out $1.9 billion in refunds to patients http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_insurers-shell-out-19-billion-refunds-patients Tue, 05 Aug 2014 20:06:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/6/a9497eda-5efc-40e7-b6be-2def1def80b3.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/6/a9497eda-5efc-40e7-b6be-2def1def80b3.Large.jpg?1" style="float:right;margin:10px;" /></a>Health insurance companies that spent too little on medical care last year had to refund more than $330 million to consumers by Aug. 1 in order to be compliant with a little-known provision in the Affordable Care Act (ACA). The total payout since 2011 comes to more than $1.9 billion, according a <a href="http://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Final-MLR-Report_07-22-2014.pdf" rel="nofollow" target="_blank">new report</a> from the U.S. Department of Health and Human Services (HHS).</p> <p> The refunds stem from what is known as the medical loss ratio, or 80/20 rule, which calls for a minimum of 80 percent of insurance premiums to be spent on medical care or activities to improve health care quality. No more than 20 percent can be devoted to administrative costs and profit. In large group markets, the ratio is more stringent, at 85/15.</p> <p> Based on 2013 spending, health insurers were required to give refunds to 6.8 million consumers. The average refund was $80 per family. Patients should see refunds as a check in the mail, a reimbursement to the account that was used to pay the premium or a direct reduction in their future premiums. If the patient has insurance through their employer, a fourth option is that the employer can apply the refund in a manner that benefits its employees.</p> <p> The 80/20 rule also has helped to keep premiums more affordable because insurers are required to operate more efficiently than they had prior to this requirement. HHS estimates that if insurers had maintained their 2011 ratios of premiums to spending on medical care, consumers likely would have paid an estimated $3.8 billion in additional premiums last year.</p> <p> The AMA played a key role in supporting this rule to prevent health insurers from diverting patients’ premium dollars away from medical care.</p> <p> Through its advocacy efforts to the National Association of Insurance Commissioners, the AMA prevented the health insurance industry from undermining this important patient benefit from the health care law. When this rule was under development, insurers were advocating for provisions that would have allowed them to claim administrative expenses as medical losses, artificially inflate the medical loss ratio and calculate ratios generally at the national level.</p> <p> More recently, the AMA was instrumental in <a href="http://www.ama-assn.org/resources/doc/arc/x-pub/naic-letter-3-22-2013.pdf" target="_blank">blocking revisions</a> (AMA login required) to the rule that would have provided considerable wiggle room for insurers to reduce their required refund payments and get away with not being fully compliant with the law each year.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ae699b2d-e054-44b7-8217-ca5cdc714973 Ready for CPT® 2015? New codebook has the latest changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ready-cpt-2015-new-codebook-latest-changes Tue, 05 Aug 2014 19:57:00 GMT <p> More than 500 changes to CPT<sup>®</sup> codes and guidelines are set to take effect next year to capture important updates in medical services and procedures. <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480008&navAction=push" target="_blank"><em>CPT® 2015 Professional Edition</em></a>, now available to order, is the essential coding reference your practice needs.</p> <p> Noteworthy changes to the 2015 CPT code are included in the cardiovascular, digestive, and pathology and laboratory sections. Among the enhanced features included in this codebook are:</p> <ul> <li> Coding tips throughout each section</li> <li> A comprehensive index that simplifies locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation</li> <li> A summary of additions, deletions and revisions provides a quick reference to next year’s changes</li> <li> A copy of the <em>CPT 2015 E/M Express Reference Tables Pocket Guide</em></li> </ul> <p> AMA members receive a discount on this product and others from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>. An additional 30 percent discount is being offered on <em>CPT 2015 Professional Edition</em> through Sept. 30. Just use promo code “FOJ” during check-out. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:51eff4dc-fb10-4bae-b994-09efd24cd8bb Physicians ask CMS to postpone Sunshine Act data release http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-ask-cms-postpone-sunshine-act-data-release Tue, 05 Aug 2014 16:00:00 GMT <p> The Physician Payments Sunshine Act roll-out is suffering from a major lack of communication, a shortened timeline and a confusing registration process, the AMA and 112 specialty and state medical societies told the Centers for Medicare & Medicaid Services (CMS) in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/sunshine-act-sign-on-letter-5august2014.pdf" target="_blank">letter</a> (AMA login required) sent Wednesday. The groups asked the agency to postpone the release of physician financial data to March 31, six months after the current publication date of Sept. 30.</p> <p> Physicians had until Aug. 27 under the Sunshine Act, also known as the Open Payments program, to dispute data about their financial interactions with manufacturers of drugs and medical devices in order for inaccuracies to be flagged in the public data release scheduled for Sept. 30. <strong>UPDATE: </strong>CMS announced Thursday that it will delay the public release of physician financial data to give doctors more time to review and dispute the data. The website used to review data had been taken offline due to technical difficulties. The length of the delay was not specified.</p> <p> CMS repeatedly missed its own deadlines, resulting in delays to the date when physicians could begin registering to access the reported data and a truncated period in which they could review and dispute their data. Under the current timeline, physicians were given a total of 45 days to review and dispute data.</p> <p> “There are widespread concerns that the implementation of this new system for data collection … will not be ready and will likely lead to the release of inaccurate, misleading and false information,” the letter said. “The agency has not provided effective notification to the vast majority of physicians nor provided a reasonable amount of time … to engage and educate physicians on the registration and dispute process.”</p> <p> The letter outlines additional concerns, including:</p> <ul> <li> An overly complex registration process that is made up of more than 20 individual steps that requires physicians to register over a period of several days to see their data. The AMA urged CMS to streamline the process.</li> <li> The importance of maintaining the exclusion of continuing medical education data from reporting when the industry donor is unaware of the speakers and other participants before committing to fund the activity.</li> <li> The need to exclude journal article reprints, medical textbooks and other services used to educate physicians from Sunshine Act reporting because they have a direct benefit to patients. A specific exclusion in the Sunshine Act, as set forth by Congress, excludes materials that directly benefit patients; including them in the Sunshine Act is inconsistent with congressional intent, the letter said.</li> <li> The potential for industry organizations to unilaterally dismiss disputes initiated by physicians. CMS has not clarified previous guidance that said drug manufacturers could dismiss a dispute if they were to determine no change was necessary, without resolving the dispute with the initiating physician.</li> </ul> <p> Less than a month remains for physicians to register with CMS to evaluate whether the data reported about them is accurate. The AMA offers <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page" target="_blank">detailed guidance and resources</a> to help simplify the process for physicians.</p> <p> <strong>Share your experience with Sunshine Act registration:</strong> Take a short <a href="https://www.surveymonkey.com/s/P38BRZR" rel="nofollow" target="_blank">survey</a> by Aug. 18 to share your experiences with registering in the Open Payments system and reviewing data. The AMA will use the survey data and physician anecdotes in its advocacy efforts on this issue. You also can send an email to <a href="mailto:OpenPayments@ama-assn.org" rel="nofollow">OpenPayments@ama-assn.org</a> to outline your experience registering and the problems you may have encountered.</p> <p> Don’t forget to check out <a href="https://twitter.com/hashtag/SunshineTips?src=hash" rel="nofollow" target="_blank">#SunshineTips</a> on Twitter to view and share tips on the Sunshine Act registration and review process.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ba687ab-cbb2-4793-a22f-05ab8ed23dd8 What doctors are saying about measuring blood pressure accurately http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-saying-measuring-blood-pressure-accurately Mon, 04 Aug 2014 16:00:00 GMT <p> When Wisconsin family medicine physician Kim Hardy, MD, saw <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page#plckblogpostonpage=3&plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A8a41250b-fd2f-453c-9fa1-243f852b4863" target="_blank">this blood pressure chart</a> the AMA posted on <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">Twitter</a>, she knew it was something that could help her practice obtain more accurate blood pressure measurements. She shared her success story, which inspired other physicians to weigh in on how they ensure accurate blood pressure measurement in their practices.</p> <p> Using the chart helped Dr. Hardy immediately improve a patient’s blood pressure measurement, preventing her from having to readjust the patient’s medication. Here's what other physicians had to say:</p> <blockquote> <p style="margin-left:.5in;"> <u>CHAIMTN</u>: A diary of multiple recordings, AM & PM, for month prior to visit may be best measure for adjusting Rx.</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> <u>lissr</u>: Surprised size of cuff not mentioned...very big deal in some circles—different widths can make very disparate readings!</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> <u>lonestar32</u>: Another common contributor to elevated readings: The patient is running late, rushes from parking lot, checks in and BP is read immediately before returning to baseline. This happened to me, with a hillside parking compounding the problem. With very well-controlled mild essential hypertension, I was getting systolic readings of 135-140. When I made a point of coming 10 minutes early and sitting in the waiting room before checking in, I got the below -110 readings I was getting at home, avoided the risk of "dealing with" the elevated reading inappropriately.</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> <u>james blaine</u>: I have practiced medicine for 40 years, half of that in emergency trauma and the last half in family practice. Diagnosing and treating hypertension has always seemed mystical to me. As an emergency physician, almost all of my patients had elevated blood pressures. As a family physician, the regulation seemed unscientific at best.</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> A few years ago, I read an article in the <em>Hypertension Journal </em>that made a great deal of sense: home blood pressure monitoring (HBPM). The patient is instructed in the proper method of taking his/her BP and asked to take the measurement twice in the morning (a few minutes apart) and twice in the evening for a week. The patient then returns the list, and we average it.</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> A significant percentage of the patients are normotensive at home and turn out to have office hypertension; the others are treated with diet, salt restriction and aerobic exercise, and then, if needed, medication. Their treatment efficacy is also monitored by HBPM. We have preprinted HBPM monitor sheets for the patients, and loan them an automatic BP machine if they do not have one. If they are diagnosed as hypertensive, they are requested to purchase their own.</p> <p style="margin-left:.5in;">  </p> <p style="margin-left:.5in;"> Since initiating this protocol, hypertension diagnosis and treatment is no longer mystical to me, and my patients seem to assume better ownership of their BP management.</p> <p style="margin-left:.5in;">  </p> </blockquote> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page#plckblogpostonpage=3&plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A8a41250b-fd2f-453c-9fa1-243f852b4863&plckblogpostgotocomments=true" target="_blank">Read more comments</a> at <em>AMA Wire®.</em></p> <p> Several physicians touched on what is known as “white coat” hypertension, pointing to home blood pressure monitoring as a way to ensure more accurate readings. Physician practices in Illinois and Maryland are addressing this issue and others 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, which seeks to apply principles of safe design in the ambulatory setting to improve outcomes around high blood pressure.</p> <p> Practices participating in the program are investigating resources in their communities that could help patients get home blood pressure devices or direct patients to local programs that could take blood pressure measurements and provide feedback to physicians.</p> <p> Other participating practices are employing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3Ab4ef7884-51c0-4ae2-9525-ab45b66e1845" target="_blank">automated blood pressure devices</a>, which help gain accurate measurements outside of the medical office setting.</p> <p> <strong>Join the discussion: </strong> Share what methods you’ve found successful in improving outcomes around hypertension in your practice in a comment below on <em>AMA Wire</em>,and on <a href="https://www.facebook.com/AmericanMedicalAssociation/photos/a.10152110163780109.904296.246323280108/10154343003720109/?type=1&theater" rel="nofollow" target="_blank">Facebook</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:32bb2a7a-75c6-4a3a-b4dd-9438f2da20b7 6 top tips for using social media smartly http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_6-top-tips-using-social-media-smartly Mon, 04 Aug 2014 14:42:00 GMT <p> There’s more to social media than selfies and study breaks—smart use can enhance your learning and position you as an expert to patients. Follow these tips from physicians and medical students in the field to make sure you’re making the most of your social media use as a medical student.</p> <ol> <li> Stay on top of your field. Social media is great for being aware of the latest news, literature and ideas.</li> <li> Establish a positive reputation online. Members of the medical profession who don’t invest in social media risk being defined by rating sites.</li> <li> Be a responsible disseminator of information. Your patients will find you and follow you, so it’s crucial that you share accurate health information. Be a curator of medical and drug information.</li> <li> Don’t give medical advice via social media. The 140 characters available for a tweet are not enough to give accurate or in-depth advice to patients. Something you write could cause significant harm—just avoid it.</li> <li> Use social media as a study tool and support community. Tweet challenging questions to fellow students, help clarify concepts for others and get encouragement from your peers. You can even search for exam-specific hashtags—such as #USMLE—to zero in on what you need.</li> <li> Trust your instincts when grappling with whether or not to post something. Before you post, put yourself in the position of a non-medical professional reading the post first thing in the morning. If it doesn’t feel right, you probably shouldn’t post it.</li> </ol> <p> You can find more guidance on adhering to patient privacy and confidentiality guidelines, safeguarding your information and other key issues in the AMA <a href="https://ssl3.ama-assn.org/apps/ecomm/PolicyFinderForm.pl?site=www.ama-assn.org&uri=%2fresources%2fhtml%2fPolicyFinder%2fpolicyfiles%2fHnE%2fE-9.124.HTM" target="_blank">policy on social media</a>. A session at the 2014 AMA Annual Meeting honed in on <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3Af0dd0bb7-9848-44d7-8bf6-1763b8a9fb2a" target="_blank">how to use Twitter</a>, with even more tips on using hashtags, sparking debate and being an influencer.</p> <p> <strong>Join the discussion: </strong>See <a href="https://storify.com/AmerMedicalAssn/using-social-media-as-a-medical-professional" target="_blank" rel="nofollow">how other medical students use social media</a> and learn more tips via the AMA Medical Student Section’s (MSS) <a href="https://www.facebook.com/amamss" target="_blank" rel="nofollow">Facebook page</a>. Follow both the <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">AMA</a> and the <a href="http://www.twitter.com/amamss" target="_blank" rel="nofollow">AMA-MSS</a> on Twitter.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:93d4080b-854d-40e3-a542-b20a3c016e51 Physicians explain method for meeting meaningful use Stage 2 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-explain-method-meeting-meaningful-use-stage-2 Mon, 04 Aug 2014 14:40:00 GMT <p> Learn how to meet requirements for Stage 2 of the electronic health record (EHR) meaningful use program using a health information exchange (HIE). A <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/health-information-exchanges.page?" target="_blank">free podcast series</a> produced by the Healthcare Information and Management Systems Society (HIMSS) and the AMA explains how.</p> <p> “Even though only one or two [meaningful use Stage 2 measures] require an HIE, if you look carefully at them, probably 95 percent of them will be facilitated by having an HIE,” explains Joe Heyman, MD, a past chair of the AMA Board of Trustees.</p> <p> Dr. Heyman is the founder, former president and current chief medical information officer of Whittier Independent Practice Association (IPA) in Northeastern Massachusetts, which owns and operates the Wellport Health Information Exchange. He shares his expertise in this series alongside Dan Paoletti, vice president and CEO of the Ohio Health Information Partnership.</p> <p> The podcast series covers three important topics:</p> <ul> <li> Episode No. 5 explores the benefits of engaging with HIEs for physicians and their practices, as well as challenges and recommendations for physicians who don’t have access to an HIE organization.</li> <li> Episode No. 7 explains the basics of HIE participation, meaningful use requirements, the role of public health departments and clinical decision support.</li> <li> Episode No. 8 looks at medication reconciliation, registries, health information service providers and the business case to engage with HIE.</li> </ul> <p> HIEs govern the electronic sharing of health information within a defined geographic area to improve health and care within the community. Governance, structure and geographic scope of an HIE organization varies across the country, with some organizations serving small regions while others serve entire states or multi-state regions. Different HIE organizations may use different models, and the types of clinical data exchanged and services offered can vary, too.</p> <p> <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/health-information-exchanges.page?" target="_blank">Listen to the podcasts today</a> to learn more about how participating in an HIE can help your practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed127be5-e933-4497-b33b-a6177769fe39 Physician voice helps shape veterans’ health care reform law http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-voice-helps-shape-veterans-health-care-reform-law Fri, 01 Aug 2014 18:19:00 GMT <p> The unified voice of medicine calling for swift action to address veterans’ urgent health care needs resonated this week on Capitol Hill as Congress passed reform legislation.</p> <p> The bipartisan framework agreed upon last week passed the U.S. House of Representatives Monday in a vote of 420-5, paving the way for veterans to seek medical care outside the U.S. Department of Veterans Affairs (VA) health care system if they aren’t receiving timely treatment. The U.S. Senate followed suit and passed the bill Thursday night. The AMA House of Delegates in June had <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A79bdc548-b2f8-4aa0-b19c-284481ba67ed" target="_blank">adopted policy</a> urging Congress to act quickly on improving access to care for veterans.</p> <p> “The AMA believes that all Americans should have timely access to health care, especially those who bravely serve our country,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-08-01-ama-applauds-action-addressing-veterans-access-to-care.page" target="_blank">statement</a>. “Our nation’s physicians can and should be a part of the solution to ensure America’s veterans can access the care they need and deserve.”</p> <p> A resolution also was adopted separately to ensure that veterans will be able to seek care from both non-VA hospitals and physicians. The AMA secured this language based on physician consensus around the June policy.</p> <p> The legislation aims to address the access-to-care crisis that has left thousands of veterans unable to receive care when they need it. Physicians already have been gearing up for the legislative reform by <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3Acb134dd4-d645-4459-a923-3f55e75b693e" target="_blank">preparing registries</a> of those who are willing to care for veterans, which will be ready to share with local communities and VA sites across the country.</p> <p> Reforms outlined in the bill include:</p> <ul> <li> Veterans who cannot secure an appointment at a VA facility within established wait times or who live more than 40 miles from a VA facility will be able to seek care from physicians and hospitals outside the VA system using the new “Veterans Choice Card.”</li> <li> Additional VA facilities will be opened in 18 states and Puerto Rico, increasing access to facilities and specialists.</li> <li> Additional funds will be devoted to hiring more primary care physicians and specialists as well as other clinical professionals who are insufficiently staffed.</li> <li> The VA health system will be tasked with improving administrative functions throughout the system.</li> </ul> <p> President Obama is expected to sign this bill into law immediately.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c63734a7-a026-40b2-a6de-0f58d150f89a It’s official: ICD-10 compliance date now Oct. 1, 2015 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_its-official-icd-10-compliance-date-now-oct-1-2015 Fri, 01 Aug 2014 14:00:00 GMT <p> Physicians officially have until Oct. 1, 2015, to transition to the ICD-10 code set, according to a <a href="http://www.gpo.gov/fdsys/pkg/FR-2014-08-04/pdf/2014-18347.pdf" target="_blank" rel="nofollow">final rule</a> issued Thursday by the U.S. Department of Health and Human Services (HHS).</p> <p> The delay offers an extra year to prepare for implementation of the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A016f380c-5eef-41fd-9146-ed83abca0537" target="_blank">costly code set</a>, 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> A federal law signed in April prevented HHS from implementing ICD-10 before Oct. 1, 2015, and the final rule made it official. Prior to passage of the federal law, physicians only had six remaining months to prepare for the implementation deadline of Oct. 1, 2014. Those who had not begun preparing their practices would likely face considerable cash-flow problems and other serious administrative issues.</p> <p> CMS has implemented a “comprehensive testing approach,” according to a <a href="http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-07-31.html" rel="nofollow" target="_blank">news release</a> issued Thursday, including end-to-end testing in 2015. End-to-end testing will be available in January, April and July next year, giving about 2,550 volunteers the chance to help determine the preparedness of the industry and their practices for this transition. CMS said more information about end-to-end testing will be available soon.</p> <p> Physicians now have slightly more than a year to work with software vendors, and CMS has more time to iron out issues that arise prior to implementation, minimizing expected cash-flow disruptions that could hinder the provision of patient care. CMS has estimated that claims denial rates could increase 100-200 percent in the early stages of coding with ICD-10.</p> <p> Physicians can take advantage of 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">free ICD-10 resources</a>, including tip sheets that offer guidance on completing an impact assessment, determining training needs, conducting testing and improving documentation </p> <p> Additional resources and training from the <a href="https://commerce.ama-assn.org/store/catalog/subCategoryDetail.jsp?category_id=cat1150010&navAction=push" target="_blank">AMA Store</a> can help physicians prepare as well, including a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2460015&navAction=push" target="_blank">downloadable data file</a> of the complete ICD-10 2015 code set to use in testing practice management systems and a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1250085&navAction=push" target="_blank">documentation guide</a> that provides essential training. Also available are online documentation training and live training events set for September, November and December.</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.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A69395571-cc32-4518-9c4f-09031dc2a367&plckblogid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0" target="_blank">dramatically high implementation costs</a> of ICD-10, 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> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ecc564fd-7ca3-49a0-a6a4-ff05159f65ee 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-38 Thu, 31 Jul 2014 20:43:00 GMT <p> <strong>Research letter examines pacemaker use in patients with cognitive impairment</strong><br /> Patients with dementia were more likely to receive a pacemaker then patients without cognitive impairment. Older adults with mild cognitive impairment and dementia can have co-existing cardiac illnesses, and that makes them eligible for therapy with devices to correct rhythm abnormalities. But the risks and benefits need to be weighed carefully with patients, families and clinicians, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1890284" target="_blank" rel="nofollow">study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Electronic screening tool to triage teenagers and risk of substance misuse</strong><br /> An electronic screening tool that starts with a single question to assess the frequency of substance misuse appears to be an easy way to screen teenagers who visited a physician for routine medical care, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1889047" target="_blank" rel="nofollow">study</a> in <em>JAMA Pediatrics</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c4703569-5aac-4d00-a713-71beae1c7647 Move to align GME accreditation paves way for “ideal” continuum http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_move-align-gme-accreditation-paves-way-ideal-continuum Thu, 31 Jul 2014 18:00:00 GMT <p> With a “strong affirming vote” from the American Osteopathic Association (AOA) House of Delegates, the plan to implement a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpostonpage=8&plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A7c8a6c91-29c7-4b78-93b3-6f45b8c68157" target="_blank">single accreditation system</a> for all U.S. graduate medical education (GME) programs moves forward, a significant step in efforts to create an ideal medical education continuum.</p> <p> The shift to a single GME accreditation system will provide “the greatest opportunity for optimization of use of the GME resources provided by the public to the profession and maximizes opportunities for the residents of today and tomorrow,” Thomas J. Nasca, MD, CEO of the Accreditation Council of Graduate Medical Education (ACGME) said in a July 19 <a href="http://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/AOA_letter_to_the_Community.pdf" rel="nofollow" target="_blank">letter</a>.</p> <p> The accreditation of allopathic and osteopathic medical education has largely followed separate paths, according to a <a href="http://ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt4-a-14.pdf" target="_blank">new report</a> (AMA login required) from the AMA Council on Medical Education that explores some principles for an ideal medical education continuum.</p> <p> Although standards for undergraduate medical education and GME have evolved independently over time, it isn’t that unusual for learners to move from osteopathic colleges to ACGME-accredited residency programs. In 2012, for example, 8 percent of residents enrolled in ACGME-accredited and specialty GME programs were osteopathic medical college graduates.</p> <p> With the recently confirmed agreement between the AOA, ACGME and the American Association of Colleges of Osteopathic Medicine to move osteopathic GME accreditation in line with ACGME accreditation, all U.S. medical school graduates will be eligible for all residency positions, whether they hold an MD or DO degree.</p> <p> The Council on Medical Education report discussed how to support a medical education continuum, which would follow a learner from premedical education through medical school and residency training and into practice. “In the ideal continuum, there is coordination of the processes for both the accreditation of educational programs and the assessment of learners,” the AMA council report states.</p> <p> An aligned learning continuum is challenging to achieve because it requires cooperation across all the phases of physicians’ training to create and implement:</p> <ul> <li> <strong>Agreed-upon, outcomes-based competencies: </strong>The ACGME’s six competency domains are widely accepted as a way to ensure residency training assesses learners on key areas of competence. Many medical schools also have adopted these competencies, and the language of the competencies offers a framework for other educational programs.</li> </ul> <ul> <li> <strong>Benchmarks for progression: </strong>The ACGME is implementing its Next Accreditation System, which will shift program accreditation to a more continuous, quality improvement model. As part of this system, the ACGME has created specialty-specific milestones that reflect the trajectory of professional development.<br /> <br /> Medical schools can use these milestones to create competencies for medical students, such as the Association of American Medical Colleges’ core entrustable professional activities, which provide a framework  to assess whether a learner can be trusted to competently perform an activity. For example, a student would have to demonstrate that he or she could develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter, and would be evaluated on whether that student could be trusted to appropriately perform that activity without supervision.</li> </ul> <ul> <li> <strong>Processes and tools for education and assessment: </strong>Some of the schools in the AMA’s Accelerating Change in Medical Education initiative are working on digital portfolios that will follow learners from medical school through residency into private practice. With such tools, learners and mentors can track competency growth over time.</li> </ul> <p> The AMA will work with other relevant associations and accreditation bodies to develop strategies that will help reach the ideal medical education continuum. This includes identifying areas in which accreditation standards overlap between medical school and residency, and creating a standardized method of feedback from medical school to premedical institutions and from residency programs to medical schools about their graduates’ preparedness for entry.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:53f24d65-8a27-4459-a53c-38851237559d Negotiating an employment contract? Here’s what you need http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_negotiating-employment-contract-heres-need Thu, 31 Jul 2014 16:06:00 GMT <p> Nearly 42 percent of physicians are employed, according to a 2013 AMA study. If you’re interested in employment, or you’re a practice owner and want to hire physicians, get the new primer on preparing to negotiate an employment agreement.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/2/ab8eabff-12ae-4f69-a230-8d2385663786.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/2/ab8eabff-12ae-4f69-a230-8d2385663786.Large.jpg?1" style="float:right;margin:15px;" /></a>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><em>”</em> gives descriptions of common contract terms, in-depth explanations of business and legal consequences, negotiation tips, and sample contract provisions.</p> <p> Experts predict that interest in employed positions is expected to continue as more physicians entering into employment and other contractual relationships with group practices, hospitals, and health systems. 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 is developing tools physicians can use to enhance the practice of medicine and help them make informed decisions about their practice environments.</p> <p> “Physicians often need to navigate complex issues when negotiating agreements with their current or prospective employers,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-07-31-resource-group-practice-negotiations.page" target="_blank">news release</a>. “This new AMA resource will ensure physician interests can be fully taken into account in these discussions.”</p> <p> “By helping physicians successfully navigate this choice, the AMA hopes to establish sustainable medical practices that result in optimal health outcomes for patients and greater professional satisfaction for physicians,” Dr. Wah said.</p> <p> Other AMA resources that can help you with employment and contractual relationships include:</p> <ul> <li> The “<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>” addresses the specific needs of physicians who are preparing to negotiate employment contracts with hospitals.</li> <li> The <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) provides a framework to help guide physicians and their employers as they collaborate on providing safe, high-quality and cost-effective patient care.</li> <li> The <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>, which includes a variety of resources to help meet the unique needs of a growing population of employed physicians.</li> </ul> <p> If you’re an AMA member, you can obtain the new handbook on group practice employment contracts free of charge from the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2530052" target="_blank">AMA Store</a>. Non-members can purchase the handbook through the AMA Store or <a href="https://commerce.ama-assn.org/membership/" target="_blank">join the AMA</a> to take advantage of this resource and other practical tools.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:527b319e-34df-47e2-8d40-e188984c282b This is a poll test http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_this-poll-test Thu, 31 Jul 2014 06:00:00 GMT <p> The CTA today released <a data-mce-="" href="http://www.transitchicago.com/news/default.aspx?Month=&Year=&Category=2&ArticleId=3322" rel="nofollow" target="_blank">crime stats</a> that showed big drops in most categories of transit crime in the first half of this compared to the same period in 2013.</p> <p> Robberies were down 35 percent, and thefts dropped 18 percent.</p> <p> But do you feel safe on the CTA? Take the quick poll below and let us know. Your perception is reality for you.</p> <p> <div class="TWIIGSPOLL"> <div class="TWIIGSPOLLpolllink" style="background-color:transparent;background-image:none;border-style:none;clear:none;display:block;float:none;position:static;visibility:visible;height:auto;line-height:normal;width:auto;margin-top:10px;margin-right:0;margin-bottom:0;margin-left:0;outline-style:none;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;clip:auto;overflow:hidden;vertical-align:baseline;z-index:auto;letter-spacing:normal;text-align:right;text-decoration:none;text-indent:0;text-shadow:none;text-transform:none;white-space:normal;word-spacing:normal;"> <a class="TWIIGSPOLLmorelink" href="http://www.twiigs.com/" style="background-color:transparent;background-image:none;border-style:none;clear:none;display:inline;float:none;position:static;visibility:visible;height:auto;line-height:normal;width:auto;margin-top:0;margin-right:0;margin-bottom:0;margin-left:0;outline-style:none;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;clip:auto;overflow:hidden;vertical-align:baseline;z-index:auto;letter-spacing:normal;text-align:left;text-indent:0;text-shadow:none;text-transform:none;white-space:normal;word-spacing:normal;font-weight:bold;" rel="nofollow">poll by twiigs.com</a> </div> </div> <p> The CTA has made many safety improvements in the last three years, including "expanding police patrols and rail saturation missions on the CTA system; increased undercover operations targeting pick-pocket theft rings, vandalism and other crimes; and the huge expansion of CTA’s bus and rail surveillance camera network to more than 23,000 cameras, which have significantly aided in making arrests and securing convictions."</p> <p> I'm actually impressed and do feel safer personally.</p> <p> But it doesn't matter what I think. What do you think?</p></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:178d035d-8750-402d-9396-9f3c3c18701a Physicians identify primary concern with health IT http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-identify-primary-concern-health Wed, 30 Jul 2014 21:25:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/7/f2fe490f-2d7e-4edb-a7d9-836ad85db2bb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/7/f2fe490f-2d7e-4edb-a7d9-836ad85db2bb.Large.jpg?1" style="float:right;margin:10px;" /></a>When it comes to issues with health IT, physicians overwhelmingly point to one problem. Here’s what physicians think about electronic health record (EHR) systems.</p> <p> A recent <a href="http://www.physicianspractice.com/technology-survey/2014-technology-survey-results" rel="nofollow" target="_blank">survey</a> (login required) by Physicians Practice found that physicians say EHR adoption, implementation and interoperability are their most pressing technology problem.</p> <p> While about 53 percent of the more than 1,400 physicians who responded to the survey said they did have a fully implemented EHR system in their practices, about 20 percent said they didn’t yet have one. The main reasons for not having an EHR system were related to cost or the lack of products available to meet their needs, according to the survey. Another 17 percent said they used an EHR system selected by their parent hospital or corporation.</p> <p> Roughly one-third of respondents said their EHR system has made practice work flow less efficient, while nearly one-half said the technology has made it more efficient.</p> <p> The survey results echo findings from the <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdf" rel="nofollow" target="_blank">AMA’s 2013 study</a>, conducted in partnership with the RAND Corporation, which found EHR systems to be a major contributor to physicians’ professional dissatisfaction. The physicians surveyed for the AMA study expressed concern that current technology requires physicians to spend too much time on clerical work, putting up barriers to providing high-quality care.</p> <p> The AMA study also revealed that EHRs were more costly than anticipated and didn’t provide the technology needed to interact with other systems, causing difficulties in transmitting patient information.</p> <p> About 16 percent of physicians surveyed by Physicians Practice indicated the lack of EHR interoperability was their most pressing issue, and another 13 percent cited costs to implement the systems as a problem. About one-quarter of physicians that did not have an EHR said they didn’t have the technology because it was too expensive. Nearly two-thirds said they have not seen a return on investment.</p> <p> According to Physicians Practice, EHR use is seeing a slow but steady trend upward. In 2010, 48 percent of responding practices had implemented an EHR. By 2014, that number climbed to 70 percent.</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 is developing a set of priorities and recommendations to improve the usability of EHR systems, identifying opportunities to achieve these improvements, and determining a research agenda to advance the evidence base for increasing usability.</p> <p> The AMA is taking physician issues and recommendations directly to EHR vendors to encourage them to make the necessary changes in their future product designs and is working with the Electronic Health Records Association on these efforts.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A89d66c31-26c4-4d91-bedd-cff7f86ed37f" target="_blank">Read more</a> about how the AMA is working to make EHR systems less burdensome and more beneficial for physicians and their patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a61ff44b-794f-4b7a-a465-7c360c220535 Residents discuss determining the “one best test” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-discuss-determining-one-test Wed, 30 Jul 2014 21:23:00 GMT <p> An estimated one-third of health care costs—about $750 billion—don’t actually improve health, according to the <a href="http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13444" rel="nofollow" target="_blank">Institute of Medicine</a> (IOM). Residents’ exams often ask them to choose the “one best test” for diagnosis to avoid health care waste, but what if the real-world choice is “all of the above”?</p> <p> “Trainees watch role models take a ‘do-everything-at-once’ approach, often just because they can,” said Sharon Rikin, MD, a member 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) Committee on Science and Public Health. “Often we are too far removed from the actual money exchanging hands to see the necessity of practicing cost-effective medicine.”</p> <p> According to Choosing Wisely, reasons residents and other physicians may over-order tests include:</p> <ul> <li style="margin-left:0.25in;"> Concerns about medical liability</li> <li style="margin-left:0.25in;"> Just to be safe</li> <li style="margin-left:0.25in;"> Securing additional information as reassurance</li> <li style="margin-left:0.25in;"> Patients insist on specific testing</li> <li style="margin-left:0.25in;"> Keeping patients happy</li> <li style="margin-left:0.25in;"> Not enough time with patients</li> <li style="margin-left:0.25in;"> Fee-for-service system</li> <li style="margin-left:0.25in;"> New technology in practice</li> </ul> <p> Residents also have pointed to such reasons as duplicating behavior they have seen role modeled, a lack of knowledge of the costs and harms, or limited training in weighing the benefits relative to the costs and potential patient harms.</p> <p> To address health care waste, institutions are incorporating cost-effective medicine curricula into training for medical students and residents. Programs like “<a href="http://www.acponline.org/education_recertification/education/curriculum/" rel="nofollow" target="_blank">High value cost-conscious care</a>,” from the American College of Physicians and the Alliance for Academic Internal Medicine, provide a way to train physicians in cost-effective care.</p> <p> The <a href="http://www.choosingwisely.org/" rel="nofollow" target="_blank">Choosing Wisely</a> campaign, created by the American Board of Internal Medicine Foundation, aims to promote conversations between physicians and patients by helping patients choose care that is evidence-based, non-duplicative of other tests or procedures, and above all, truly necessary. Specialty medical societies have provided <a href="http://www.choosingwisely.org/doctor-patient-lists/" rel="nofollow" target="_blank">lists</a> of the top five things physicians and patients should question, offering a guide for physicians in training.</p> <p> “Initially, the cost of a basic metabolic panel is shocking, but eventually it fades and the ordering of ‘daily labs’ reoccurs,” Dr. Rikin said. “As a senior resident myself, I hope to role model appropriate stewardship of finite health care resources. As I discuss my expectations with my team, I ask my interns to question what labs we order on a daily basis, and I task my medical students to identify potentially wasteful tests.”</p> <p> Residents are taking health care waste to heart, as exemplified in a <a href="http://www.tennessean.com/story/opinion/contributors/2014/07/17/choose-wisely-testing-patients/12757097/" rel="nofollow" target="_blank">recent op-ed</a> in <em>The Tennessean </em>by two residents at Vanderbilt University Medical Center. In the first three months of Choosing Wisely implementation, Vanderbilt eliminated more than 1,000 unnecessary tests and saved nearly $150,000.</p> <p> “What residents may lack in experience is more than made up for through their eagerness to do the right thing, their pursuit of knowledge and strong sense of compassion for patients,” the op-ed said. “Residents have recently graduated medical school equipped with the most up-to-date knowledge and are eager to read the latest research and constantly challenge the system to remain on the cutting edge of medical treatment.”</p> <p> The AMA Section on Medical Schools recently examined health care resource stewardship, including how medical schools could ensure physicians-in-training learn to practice high-value, cost-conscious care. Find more information on the <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">AMA Section on Medical Schools Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c5f429c9-8461-436a-b86d-0da7653aea29 Take advantage of CDC's vaccine program for children http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_advantage-of-cdcs-vaccine-program-children Wed, 30 Jul 2014 15:03:00 GMT <p> With August observed as <a href="http://www.cdc.gov/vaccines/events/niam.html" rel="nofollow" target="_blank">National Immunization Awareness Month</a>, a federal program that provides free vaccines to eligible children can help physicians ensure that children are protected from getting dangerous childhood diseases.</p> <p> The Centers for Disease Control and Prevention's (CDC) <a href="http://www.cdc.gov/vaccines/programs/vfc/index.html" rel="nofollow" target="_blank">Vaccines for Children</a> program provides free vaccines to children who don’t have health insurance coverage. Children who can participate in the program include Medicaid enrollees, American Indians and Alaskan natives, and kids who have health insurance that doesn’t cover vaccines and go to federally qualified health clinics or rural health centers.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page" target="_blank">AMA Minority Affairs Section</a> strongly encourages physicians, parents and teachers to promote proper immunization to protect children from contracting dangerous childhood diseases.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9f731392-32c6-48b4-a288-7572fef0c8e1 Download the JAMA Network Reader app http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_download-jama-network-reader-app Wed, 30 Jul 2014 15:02:00 GMT <p> The JAMA Network Reader provides free instant access to research, reviews and viewpoints for all 10 JAMA Network journals. In addition, it works on virtually any device—phone, tablet or desktop—so it’s easy to stay up to date when you’re on the go.</p> <p> Learn how to <a href="http://mobile.jamanetwork.com/installation.html" target="_blank" rel="nofollow">install the reader</a> on your mobile device.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0b3cb630-58b5-4ebf-af5e-a98db4550e49 Help create an inclusive list of LGBT groups in organized medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_create-inclusive-list-of-lgbt-groups-organized-medicine Wed, 30 Jul 2014 14:50:00 GMT <p> The AMA Advisory Committee on Lesbian, Gay, Bisexual and Transgender (LGBT) Issues is working on a comprehensive listing of LGBT groups in organized medicine to share on its <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page" target="_blank">Web page</a>.</p> <p> If you are aware of an LGBT group or committee in a medical association, <a href="mailto:lgbt@ama-assn.org" rel="nofollow">send an email</a> with the information to the committee or call Stephanie Groeninger of the AMA at (312) 464-5041.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1ac4ded3-f819-49f1-ab2a-eba0d0d723fd State to cover gender reassignment surgery for employees http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_state-cover-gender-reassignment-surgery-employees Wed, 30 Jul 2014 14:39:00 GMT <p> Maryland’s recent policy change to <a href="http://www.msnbc.com/msnbc/maryland-cover-gender-reassignment-surgery-state-employees" target="_blank" rel="nofollow">cover gender reassignment surgery</a> for state employees reflects a wave of growing understanding and acceptance around what used to be considered a disorder.</p> <p> In the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), counseling, cross-sex hormones, gender reassignment surgery and legal transition to the desired gender are all listed as treatment options for gender dysphoria—a condition in which there is a marked difference between a person’s expressed or experienced gender and the gender others would assign him or her.</p> <p> Earlier this year, the AMA wrote that “the only effective treatment of [gender dysphoria] is medical care to support the person’s ability to live fully consistent with one’s gender identity.”</p> <p> Learn more about the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page" target="_blank">Advisory Committee on Lesbian, Gay, Bisexual and Transgender Issues</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ad7726f3-a4c2-42e2-8cec-dd90e79f2efe GME financing system needs overhaul: IOM report http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gme-financing-system-needs-overhaul-iom-report Tue, 29 Jul 2014 21:11:00 GMT <p> A long-awaited <a href="http://www.iom.edu/Reports/2014/Graduate-Medical-Education-That-Meets-the-Nations-Health-Needs.aspx" rel="nofollow" target="_blank">report</a> from the Institute of Medicine (IOM) calls for transitioning the current graduate medical education (GME) system to a transparent, performance-based system.  Adding additional funds to the system, however, isn’t one of the recommendations—a fact that concerns the AMA.</p> <p> “Despite the fact that workforce experts predict a shortage of more than 45,000 primary care and 46,000 specialty physicians in the U.S. by 2020, the report provides no clear solution to increasing the overall number of graduate medical education positions to ensure there are enough physicians to meet actual workforce needs,” AMA Immediate-Past President Ardis Dee Hoven, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-07-29-support-graduate-medical-education-funding.page">statement</a>.</p> <p> While the IOM report does not address increasing the number of residency slots, it makes <a href="http://www.iom.edu/Reports/2014/Graduate-Medical-Education-That-Meets-the-Nations-Health-Needs/Recommendations.aspx" rel="nofollow" target="_blank">five significant recommendations</a> that would be part of the decade-long overhaul:</p> <p style="margin-left:40px;"> 1.     Maintain current Medicare GME funding while modernizing payment methods to reward performance, ensure accountability and create incentive for innovation, eventually phasing out the current system. Roughly $15 billion in public funding supports GME, and two-thirds of that—about $9.7 billion—comes from Medicare, with an additional $4 billion coming from Medicaid.</p> <p style="margin-left:40px;"> 2.     Rebuild the GME policy and financing infrastructure with a two-pronged approach:</p> <p style="margin-left:80px;"> • Create a GME policy council in the U.S. Department of Health and Human Services to develop a strategic plan for Medicare GME financing, research sufficiency of workforce and geographic or specialty issues, develop future federal policies, coordinate among stakeholders, and provide annual progress reports to Congress and the president on the state of GME.</p> <p style="margin-left:80px;"> • Create a GME center within the Centers for Medicare & Medicaid Services to manage the operational aspects of GME funding, manage the new GME transformation fund, and collect and report on data to ensure transparency in the use of those funds.</p> <p style="margin-left:40px;"> 3.     Create one Medicare GME fund with two subsidiary funds:</p> <p style="margin-left:80px;"> • An operational fund to distribute funds for residency training positions that are currently approved and funded.</p> <p style="margin-left:80px;"> •  A transformation fund to finance initiatives to develop and evaluate innovative GME programs, pilot alternative payment methods, and award new positions in priority areas, among other opportunities.</p> <p style="margin-left:40px;"> 4.     Modernize the GME payment methodology. This proposal would shift from the current two independent funding streams, made up of direct GME payments and indirect medical education adjustments. Instead, organizations sponsoring GME programs would receive one payment based on a national per-resident amount. Payments would eventually be performance-based, using information from the transformation fund pilot studies.</p> <p style="margin-left:40px;"> 5.     Ensure the same level of transparency and accountability in Medicaid GME funding.</p> <p> Although the committee that developed the report noted that it didn’t find “credible evidence” to support claims of a looming physician shortage, it did say that evidence suggests a worsening imbalance of the proportions between primary care, specialty and subspecialty physicians.</p> <p> The AMA points to the predicted physician shortage in continuing to advocate for increased residency slots. “The AMA believes the number of residency slots must be increased to produce an appropriately sized and geographically distributed physician workforce to accommodate our country’s future health care needs,” Dr. Hoven said.</p> <p> In July, the AMA <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/bill-would-fund-residency-slots-underserved-areas" target="_blank">sent a letter urging support</a> for the Creating Access to Residency Education Act of 2014, which would expand the physician workforce by authorizing grants for GME positions in states that have a low rate of residents relative to the general population.</p> <p> Recently, the AMA House of Delegates <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/alternative-gme-solutions-needed-meet-workforce-demands" target="_blank">passed policy</a> to investigate new solutions for GME funding and workforce expansion and to continue advocating for additional federal GME funding.</p> <p> “The AMA will continue to encourage the federal and state government, along with private payers, to fund graduate medical education to protect access to care and address physician shortages in undersupplied specialties and underserved areas,” Dr. Hoven said. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5a1ecf31-4eea-4209-8b3a-c70b0a227ddc Need some help with meaningful use? Turn to physician guide http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_need-meaningful-use-turn-physician-guide Tue, 29 Jul 2014 19:58:00 GMT <p> Leverage your electronic health record (EHR) system to redesign work flow and improve outcomes using <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240066&navAction=push#usage-tab" target="_blank"><em>A Guide to Achieving Meaningful Use</em></a>. Authored by EHR implementation experts, this resource equips primary care physicians trying to overcome barriers found in Stage 1 and plan for reporting in Stage 2 and 3.</p> <p> This resource can help your practice manage EHR projects and data builds, create policies and procedures, and advise medical colleagues. Features include:</p> <ul> <li style="margin-left:0.25in;"> Meaningful use gap analysis guidance</li> <li style="margin-left:0.25in;"> Tested work flow analysis and redesign measures</li> <li style="margin-left:0.25in;"> Documentation requirements</li> <li style="margin-left:0.25in;"> Benchmarks for EHR vendor applications and training components</li> <li style="margin-left:0.25in;"> Information about EHR incentive programs</li> <li style="margin-left:0.25in;"> Downloadable sample forms, checklists and charts</li> </ul> <p> AMA members receive a discount on this product and others from the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240066&navAction=push#description-tab" target="_blank">AMA Store</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e6d48875-e5a1-4db0-9a1c-f564ff9d0435 Medicare trustees assume no future SGR payment cuts: Report http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medicare-trustees-assume-future-sgr-payment-cuts-report Tue, 29 Jul 2014 19:53:00 GMT <p> In their <a href="http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2014.pdf" target="_blank" rel="nofollow">annual report</a> about the financial future of the program released Monday, the Medicare trustees announced that they will no longer base their budget assumptions on current law calling for physician payment cuts resulting from the sustainable growth rate (SGR) formula, demonstrating a general agreement that it’s time to get rid of the broken formula once and for all.</p> <p> “The assumption supports the fact that the failed SGR policy paints a false picture of Medicare finances and underlines the need for Congress to pass a permanent solution to this flawed policy this year,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-07-29-annual-medicare-board-of-trustees-report.page" target="_blank">statement</a>.</p> <p> Without congressional action, the SGR formula calls for a 20.8 percent cut to physician payments when the current short-term patch expires March 31.</p> <p> “The temporary SGR patches that Congress has passed over the last 12 years are fiscally irresponsible, and have impeded the implementation of new health care delivery and payment reforms that would benefit patients and taxpayers by improving the quality of care and increasing efficiencies in the Medicare program,” Dr. Wah said.</p> <p> The AMA continues to urge Congress to enact the bipartisan Medicare <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3Aaf492466-72dd-449d-a053-8720eacadb3f" target="_blank">payment reform legislation</a> that was supported unanimously by three congressional committees of jurisdiction earlier this year.</p> <p> In addition to its assumptions about physician payment, the Medicare trustees report projected that the trust fund financing Medicare’s coverage for hospital services will remain solvent until 2030, four years beyond last year’s projections. Per capita spending also is expected to continue to grow more slowly than the overall economy for the next several years.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:496acb02-6962-422f-8ba0-cdd5598c8f8c Why you should act now on your Sunshine Act data http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_should-act-now-sunshine-act-data Tue, 29 Jul 2014 06:00:00 GMT <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 AMA president Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/5/421af4ac-d673-4cf1-b518-b311dd116455.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/5/421af4ac-d673-4cf1-b518-b311dd116455.Large.jpg?1" style="float:left;margin:10px;" /></a>This fall, patients will be able to see what kinds of financial interactions you may have had with manufacturers of drugs and medical devices. Physicians have less than 30 days to review this information, reported by industry organizations, and make sure it’s accurate. Act now to ensure the public won’t see inaccurate financial information about you.</p> <p> Now through Aug. 27, you can complete the Centers for Medicare & Medicaid Services (CMS) three-step process to review data reported by the industry under the Physician Payments Sunshine Act (also known as the Open Payments program). The process is complex and cumbersome, but it’s crucial to make sure your data is correct.</p> <p> In an effort to make the confusing three-step data review process a bit clearer, the AMA has guidance on how to navigate the process. If you haven’t already, follow our instructions for step 1, step 2 and step 3 to complete the registration process and review data that has been reported about you.</p> <p> CMS is giving physicians the chance to dispute any data that might be wrong, so use this opportunity.</p> <p> We’re also working on a social media campaign that will offer tips for getting through the process. Check out <a href="https://twitter.com/hashtag/SunshineTips?src=hash" rel="nofollow" target="_blank">#SunshineTips</a> on Twitter for tidbits we’ve gathered from CMS and physicians who offer insights into the quirks they learned while going through the registration and review process.</p> <p> If, after the Aug. 27 deadline, you find that the reports about you are incorrect, you can still dispute the data—but it won’t be corrected or flagged in the initial data release. CMS only refreshes the data on a yearly basis.</p> <p> With less than a month to go before the deadline, now is the time to get registered and start reviewing your data so you aren’t surprised later on—and so misinformation about you isn’t available to patients.</p> <p> Learn more about the kinds of financial interactions that will be reported about you—and find additional resources to help you prepare for the data review and dispute process—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> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:28d3b34b-bc03-4585-9953-17f508edae87 Bill would fund residency slots for underserved areas http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_bill-would-fund-residency-slots-underserved-areas Mon, 28 Jul 2014 19:38:00 GMT <p> A recent federal bill is seeking to authorize grants for graduate medical education (GME) positions in states that have a low rate of medical residents relative to the general population, increasing residency slots in needed areas.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/11/6b1e79b9-10d1-4264-bb17-851e661d3c11.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/11/6b1e79b9-10d1-4264-bb17-851e661d3c11.Large.jpg?1" style="float:right;margin:15px;" /></a>The <a href="https://www.govtrack.us/congress/bills/113/hr4282" rel="nofollow" target="_blank">Creating Access to Residency Education Act of 2014</a>, also known as the CARE Act, “offers a creative solution” to ensuring access to care and expanding the physician workforce, AMA Executive Vice President and CEO James L. Madara, MD, said in a <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/care-act-support-letter-17july2014.pdf" target="_blank">letter</a> (AMA login required) to the bill’s sponsors, U.S. Reps. Kathy Castor, D-Florida, and Joe Heck, R-Nevada.</p> <p> If passed, the bill would create a $25 million grant program through the Centers for Medicare & Medicaid Services that would allow certain hospitals to apply for matching funds to support new medical residency training positions. Only public or nonprofit teaching hospitals or accredited GME training programs in a state with fewer than 25 medical residents per 100,000 people would be eligible for funding.</p> <p> The grant recipient must cover one-third of the cost for new primary care residency positions and one-half of the costs for any other field. However, the bill encourages such organizations to enter into partnerships with states, local governments, community health centers, local health departments and other appropriate organizations to cover the remainder of the expense.</p> <p> Expanded insurance coverage under the Affordable Care Act is expected to increase demand for primary care physicians by 14 percent by 2025, according to a recent <a href="https://download.ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt7-a-14.pdf" target="_blank">report</a> (AMA login required) from the AMA Council on Medical Education. More insured patients, combined with an aging population and retiring physicians, will contribute to the need for more physicians to enter the workforce.</p> <p> Medical schools have increased their class sizes to help meet this need, but a proportional increase of GME positions has yet to happen, the report noted. Medicare’s current cap on financial support for GME prevents teaching hospitals from increasing the number of residency training positions and often prevents new hospitals from establishing teaching programs. The AMA has been calling for increased federal funding for GME positions via its <a href="http://savegme.org/" rel="nofollow" target="_blank">SaveGME</a> campaign and has been advocating for new or expanded residency programs in rural and other underserved locations.</p> <p> The CARE Act’s focus on areas with significant need would mean 16 states—including Mississippi, Wyoming, Idaho and Florida—would be eligible for funding, all of which have fewer than 25 medical residents per 100,000 people, according to a 2013 <a href="http://www.aamc.org/data/workforce/359282/2013physician.html" rel="nofollow" target="_blank">report</a> from the Association of American Medical Colleges.</p> <p> As part of its <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Medical Education</a> initiative, the AMA is working with 11 medical schools from across the country to establish innovative new medical education models. Emphasis on primary care and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckTag=MedEd_News#plckblogpostonpage=8&plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A5dc89d0b-994b-46d3-b823-4cfaeac75ae5" target="_blank">programs that address the unique needs of underserved populations</a> is a core factor of several programs. Students graduating from Brown University Warren Alpert Medical School’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckTag=MedEd_News#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A6d5756ca-6068-4817-ac53-48430f844115" target="_blank">new program</a>, for instance, will hold a dual degree, MD-ScM, in population medicine with training in health disparities and social determinants of health.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0a517c2c-5ea6-477b-8eac-1d1abb7878c3 How your EHR can help get hypertension under control: Study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ehr-can-hypertension-under-control-study Mon, 28 Jul 2014 19:03:00 GMT <p> Applying certain computer-based algorithms to an electronic health record (EHR) system could help identify patients with undiagnosed hypertension, according to a <a href="http://annfammed.org/content/12/4/352.full" rel="nofollow" target="_blank">new study</a> in the July/August issue of the <em>Annals of Family Medicine</em>.</p> <p> The technology-based strategy filtered patients with potential hypertension based on three algorithms that included parameters around patients’ most recent blood pressure measurements or average blood pressure measurements. More than 100 physicians in 23 primary care practices ran the algorithms through their EHRs, eventually targeting 1,432 patients for the study.</p> <p> Staff from each office mailed letters to at-risk patients notifying them that they may have hypertension and requesting that they schedule an office visit for evaluation. One week after the letters were mailed, office staff called the patients to answer questions and schedule an office visit, during which staff would take the patient’s blood pressure measurement with an automated blood pressure device. These devices automatically take six measurements with no health care provider present, each a minute apart, discard the first measurement and average the remaining five measurements.</p> <p> In an effort to capture patients who chose not to come in for the automated office blood pressure evaluation, as well as all future patients who might become at risk for hypertension, the participating practices established a continuous quality improvement initiative to evaluate these patients. Staff routinely followed up with patients by phone and provided physicians with special lists of patients who were identified as potentially having undiagnosed hypertension.</p> <p> In addition, when an at-risk patient arrived for an office visit, a notification appeared on the EHR screen to alert the medical assistant or physician that the patient needed an automatic blood pressure measurement.</p> <p> More than 70 percent of patients received a diagnosis of hypertension, and the quality improvement initiative improved the accuracy of hypertension diagnoses by 72 percent over a 30-month period by screening for those patients with undiagnosed hypertension.</p> <p> “Our experience suggests that such strategies have the potential to eliminate undiagnosed hypertension and may well be applicable to other common undiagnosed chronic diseases,” the study said. “Furthermore, similar methods can be adapted to assess and inform clinicians and patients on blood pressure control after the diagnosis of hypertension.”</p> <p> The study’s lead author, Michael K. Rakotz, MD, is a Chicago family medicine physician participating in 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. As part of this, the AMA is working with physician practices in Illinois and Maryland to apply principles of safe design in the ambulatory setting to improve outcomes around hypertension.</p> <p> The clinical sites piloting the initiative have been using checklists to ensure more accurate blood pressure readings and applying safe design principles to blood pressure management. The AMA and pilot sites are collaborating with researchers at Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test a set of evidence-based recommendations.</p> <p> The AMA plans to take what is learned about improving control of high blood pressure to spread effective models and methods to more practice settings and communities.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b4ef7884-51c0-4ae2-9525-ab45b66e1845 Addiction treatment to get a boost under new federal bill http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_addiction-treatment-boost-under-new-federal-bill Fri, 25 Jul 2014 18:12:00 GMT <p> In an effort to help get one of the nation’s most pressing epidemics under control, a <a href="http://www.markey.senate.gov/imo/media/doc/2014-07-23_TREATAct_text.pdf" target="_blank" rel="nofollow">new bill</a> was introduced to the U.S. Senate Wednesday with the goal of changing federal restrictions that can get in the way of providing life-saving medication assisted therapies for patients who suffer from opioid addiction.</p> <p> Despite the prevalence of this condition—more lives now are lost to overdoses than automobile collisions in the United States—fewer than 40 percent of the approximately 2.5 million people who abused or were dependent on opioids in 2012 received medication assisted therapy for their disease.</p> <p> The Recovery Enhancement for Addiction Treatment Act, also known as the TREAT Act, would increase the number of patients for whom physicians are allowed to prescribe treatment.</p> <p> “The AMA supports a public health approach to addressing the prescription drug abuse epidemic that includes policies and strategies to provide treatment that promotes recovery for patients,” AMA President Robert M. Wah, MD, said in a <a href="http://www.markey.senate.gov/news/press-releases/markey-introduces-legislation-to-expand-treatment-for-heroin-and-prescription-drug-addiction" target="_blank" rel="nofollow">news release</a>. “Restricting access to certain prescription drugs for the patients who need them does not stop prescription drug abuse, diversion, overdose or death. In fact, it may lead patients to seek illegal drugs that are more dangerous and have no legitimate medical use.”</p> <p> The TREAT Act, introduced by Sen. Edward Markey, D-Massachusetts, comes several months after the senator introduced the Opioid Overdose Reduction Act, which would protect trained individuals who administer opioid overdose prevention drugs, such as naloxone, from civil liability. Similar protections would apply to physicians who prescribe an opioid overdose reversal drug to a patient at risk of overdose or a third party, such as a family member.</p> <p> Physicians can access online educational activities about medication assisted treatment, including patient education and overdose reversal drugs, free of charge through the <a href="http://www.pcss-o.org/archived-webinars" target="_blank" rel="nofollow">Prescriber Clinical Support System for Opioid Therapy</a> and the <a href="http://pcssmat.org/" target="_blank" rel="nofollow">Providers’ Clinical Support System for Medication Assisted Treatment</a>, groups of health care organizations led by the American Academy of Addiction Psychiatry that received grant funding from the Substance Abuse and Mental Health Services Administration.</p> <p> In addition to its offerings through these clinical support collaborations, the AMA also offers a comprehensive <a href="http://www.ama-assn.org/ama/pub/physician-resources/pain-management.page" target="_blank">continuing medical education series</a> on pain management. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3bf7cc42-c233-4257-9b63-105550889ef7 Proposed EHR meaningful use changes still miss the mark http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_proposed-ehr-meaningful-use-changes-still-miss-mark Fri, 25 Jul 2014 18:10:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/14/6be0fa86-bbf8-4fd9-8ea5-3e5d1861ac70.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/14/6be0fa86-bbf8-4fd9-8ea5-3e5d1861ac70.Large.jpg?1" style="float:right;margin:10px;" /></a>Recent changes proposed for the electronic health record (EHR) meaningful use program are important ones, physicians are telling the Centers for Medicare & Medicaid Services (CMS), but they don’t get at the heart of the problem.</p> <p> CMS and the Office of the National Coordinator for Health IT (ONC) have released a <a href="http://www.gpo.gov/fdsys/pkg/FR-2014-05-23/pdf/2014-11944.pdf" rel="nofollow" target="_blank">proposed rule</a> that would allow physicians to use their currently installed Version 2011 certified EHR software to meet this year’s requirements if their vendors are unable to get their practice upgraded to Version 2014 software in time. </p> <p> In addition, physicians who were scheduled to move to Stage 2 would be allowed to stay at Stage 1 for another year using either Version 2011 or Version 2014 EHR software. Physicians who are in the process of upgrading but have not fully implemented their EHR software to Version 2014 also may participate in another year of Stage 1 measures.</p> <p> While the proposal is a step in the right direction, it doesn’t go far enough to provide the relief physicians need in this burdensome program.</p> <p> “[T]he rule fails to acknowledge the chief problem with the program’s design—the ‘all-or-nothing’ approach used to evaluate participants,” the AMA said last week in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/meaningful-use-comment-letter-21july2014.pdf" target="_blank">comment letter</a> (AMA login required).</p> <p> The association repeated its call for CMS to replace the existing pass-fail approach with a 75 percent pass rate for physicians to qualify as having met the program requirements. The AMA also pressed CMS to allow physicians who meet at least 50 percent of the meaningful use requirements to avoid a financial penalty.</p> <p> “[W]e have serious concerns that, unless the meaningful use program is modified, the majority of physicians will not move to Stage 2 of the program and will never reach Stage 3,” the letter said. To date, one-half of physicians have yet to meet Stage 1 requirements, and only 1 percent of physicians have attested to Stage 2 so far this year.</p> <p> The AMA also pointed to three other significant shortcomings of the proposed rule:</p> <ul> <li> The revisions are aimed generally at early adopters of EHRs and larger groups and hospitals, leaving other physicians with little relief.</li> <li> The proposal does not address much-needed quality alignment between the meaningful use program and the Physician Quality Reporting System, so physicians still have to report twice to avoid monetary penalties.</li> <li> The timing of the proposed rule, which would not take effect until September, likely will be too late to offer significant help for most physicians.</li> </ul> <p> In particular, the AMA pointed to the fact that the deadline to file for a hardship exemption was July 1, and the proposed rule caused some confusion about how it might apply to different physicians. The letter urges CMS to extend the hardship deadline until 30 days after the final rule is published so physicians have time to understand the revised program requirements and apply for a hardship exemption if needed.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f2907ad1-4cc1-40d2-92a4-8eb14029ad73 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-39 Thu, 24 Jul 2014 21:21:00 GMT <p> <strong>Overall HIV diagnosis rate decreases significantly in U.S., although increase seen for certain groups</strong><br /> The annual HIV diagnosis rate in the United States decreased more than 30 percent from 2002 to 2011, with declines observed in several key populations. At the same time, increases were found among certain age groups of men who have sex with men, especially young men, according to a <a href="http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.8534" rel="nofollow" target="_blank">study</a> in the July 23/30 issue of the <em>Journal of the American Medical Association</em> (<em>JAMA</em>), a theme issue on HIV/AIDS.</p> <p> <strong><object align="right" data="http://www.youtube.com/v/svIZqOKy2vI?list=UUlpzWSNUo4kEgZbD2V-dRaA" height="350" hspace="5" id="ltVideoYouTube" src="http://www.youtube.com/v/svIZqOKy2vI?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="5" width="365"><param name="movie" value="http://www.youtube.com/v/svIZqOKy2vI?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="5" quality="best" src="http://www.youtube.com/v/svIZqOKy2vI?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="5" width="365" wmode="transparent"></embed></object>Combination treatment for hepatitis C associated with favorable response among patients with HIV</strong><br /> HIV-infected patients also infected with hepatitis C virus (HCV) who received a combination of the medications sofosbuvir plus ribavirin had high rates of sustained HCV virologic response 12 weeks after cessation of therapy, according to a <a href="http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.7734" rel="nofollow" target="_blank">study</a> in the July 23/30 issue of <em>JAMA.</em> Watch a <a href="http://youtu.be/svIZqOKy2vI?list=UUlpzWSNUo4kEgZbD2V-dRaA" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Greater odds of adverse childhood experiences in those with military service</strong><br /> Men and women who have served in the military have a higher prevalence of adverse childhood events, suggesting that enlistment may be a way to escape adversity for some, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1890091" rel="nofollow" target="_blank">study</a> in <em>JAMA Psychiatry</em>.</p> <p> <strong>Study examines blood markers, survival in patients with ALS</strong><br /> The blood biomarkers serum albumin and creatinine appear to be associated with survival in patients with amyotrophic lateral sclerosis (ALS) and may help define prognosis in patients after they are diagnosed with the fatal neurodegenerative disorder commonly known as Lou Gehrig’s disease, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1889563" rel="nofollow" target="_blank">study</a> in <em>JAMA Neurology</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:785a560d-1766-4ee6-bcd5-0e04384f362d Fund enables research in areas crucial to women in medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_fund-enables-research-areas-crucial-women-medicine Wed, 23 Jul 2014 19:47:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/2/6eaae109-5f08-4629-82e1-a0c79a509aba.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/2/6eaae109-5f08-4629-82e1-a0c79a509aba.Large.jpg?1" style="float:right;margin:15px;" /></a>Without funding, Rashmi Kudesia, MD, would not have been able to lead research into the reproductive knowledge, barriers and outcomes among female U.S. medical students and trainees. As a past recipient of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/about-wps/joan-f-giambalvo-memorial-scholarship.page?" target="_blank">Joan F. Giambalvo Fund for the Advancement of Women</a>, she was able to “think big” to help make a difference in this critical issue for women in medicine. This year’s fund application deadline is July 31.</p> <p> “The support was instrumental in affording us the resources to incentivize medical students, residents and fellows to take the time out of their busy schedules to participate in the work,” said Dr. Kudesia, a 2013 recipient of the fund.</p> <p> The program is unique in that it offers funding specifically for health care researchers to identify and address the issues that affect women physicians and medical students. Established 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 Physicians Section</a> (WPS) in conjunction with the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a>, the goal of the program is to promote women in the medical profession and strengthen the ability of the AMA to identify and address the needs of women physicians and medical students.</p> <p> “There aren’t many resources focused toward research on female physicians,” said Dr. Kudesia. “As such, though issues affecting us are often discussed between colleagues, mentors/mentees and at events … there isn’t much focus on doing the research to investigate the problems or solutions.” </p> <p> View a <a href="http://www.ama-assn.org/resources/doc/wps/x-pub/a-14-kudesia.pdf" target="_blank">presentation</a> (AMA login required) about Dr. Kudesia’s research. Other topics explored by recent winners include flexible work options, gender differences in the practice patterns of OB-GYNs, and promotion and retention of diversity in medical education.</p> <p> “Given the historic nature of being a male-dominated field and the all-encompassing nature of medical training even now—but particularly prior to work-hour reform—some female students or physicians deal with supervisors that have somewhat anachronistic views or expectations,” Dr. Kudesia said. “Though the fund is tailored to address the needs of women physicians and students, I think it is critical to remember that all of us—men and women—do share in these concerns and benefit from the work it supports.”</p> <p> Download an <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/giambalvo-grant-application.doc" target="_blank">application</a> (AMA login required) today. The deadline to apply is 6 p.m. Eastern time July 31.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:84158a47-15ad-4752-bf7d-f65b32844fde 5 top tips for your financial life after residency http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-top-tips-financial-life-after-residency Wed, 23 Jul 2014 19:33:00 GMT <p> As a medical resident, you’re probably used to sticking to a budget and spending wisely. Your income as a practicing physician will seem substantial after being a resident, but don’t start spending it all just yet.</p> <p> These five top tips from the AMA Resident and Fellow Section’s (RFS) “<a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/succeeding-medical-school-practice.page?" target="_blank">Succeeding from Medical School to Practice</a>” resource can help you prepare for financial life after residency.</p> <ol> <li> <strong>Consolidate your medical education loans.</strong></li> </ol> <p style="margin-left:40px;"> Under the Federal Direct Consolidation Loan Program, you can consolidate your loans into the longest repayment period and at the lowest interest rate possible. Doing so will allow you to pay the lowest current monthly payment.</p> <ol> <li value="2"> <strong>Fund retirement plans to the maximum possible.</strong></li> </ol> <p style="margin-left:40px;"> Given the tax incentives to fund retirement plans, contributing to your retirement plan may be as important as paying off your medical school loans. Have your contribution deducted from your paycheck directly into your retirement plan so it doesn’t feel like giving up expected income.</p> <ol> <li value="3"> <strong>Avoid or eliminate credit card debt.</strong></li> </ol> <p style="margin-left:40px;"> Credit cards have benefits, but the unpaid balance is revolving debt and can be bad debt if you use the card to purchase disposable items, such as clothes. Paying off the entire balance each month is a great goal but may not be realistic for you. Research a credit card that meets your needs, and use it smartly.</p> <ol> <li value="4"> <strong>Buy disability insurance first, then term life insurance. </strong></li> </ol> <p style="margin-left:40px;"> Disability insurance is crucial to physicians. Focus on obtaining that first, then buy life insurance if you have dependents. If you are single without dependents, don’t have co-signers on your loans and don’t have debts that would burden other people, you may not even need life insurance.</p> <ol> <li value="5"> <strong>Make tax-deductible investments in your practice or investments in your training.</strong></li> </ol> <p style="margin-left:40px;"> If you become a practice owner, spending money on marketing or revenue-producing skills will have benefits. You can take coding training or other courses for high returns on investment, too.</p> <p> Find more information about transitioning from medical school to residency to practice with <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/rfs-resources.page?" target="_blank">resources</a> from the AMA-RFS.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e7bc08f7-b7f5-4401-ac8c-28ecb9fbb697 Find out whether your collections practices are compliant http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_out-whether-collections-practices-compliant Wed, 23 Jul 2014 19:27:00 GMT <p> Learn how to protect your practice from the constantly changing regulations surrounding collections by participating in a free webinar from 1 to 2 p.m. Eastern time July 31. <a href="https://www1.gotomeeting.com/register/842512817" rel="nofollow" target="_blank">Register now</a>.</p> <p> Industry expert Jim Kirby, vice president of collections at TransworldSystems, will answer questions and provide insights about:</p> <ul> <li> The litigious collections environment</li> <li> Current federal and state regulations and their most recent changes</li> <li> Risks to physician practices and hospitals</li> </ul> <p> Attendees also will receive a compliance checklist to use as a guide when working with a collections agency.</p> <p> The webinar is presented as part of the <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program.page" target="_blank">AMA MVP Program</a>, which provides resources and savings for AMA members and their practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6594cf09-e3dd-4946-a4a5-d8b07ae6dc56 Volunteers needed to conduct mock residency interviews http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_volunteers-needed-conduct-mock-residency-interviews Wed, 23 Jul 2014 14:00:00 GMT <p> The AMA International Medical Graduates (IMG) Section is seeking volunteer interviewers for its <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates/img-mock-interview.page" target="_blank">Mock Residency Interview Program</a> for medical graduates going through the 2015 Match process. Physicians, residents and fellows with recent residency program interview experience are encouraged to participate.</p> <p> Mock interviews may be conducted in person, via telephone or over Skype. Guidelines, sample questions, CVs and personal statements will be provided to volunteer interviewers. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20143333E&TID=ZZWxJfnzkfrWuPOliNnmmg%253d%253d&OID=130" target="_blank">Register online</a> to volunteer.</p> <p> Medical graduates will be able to request interviews online in early September.</p> <p> Questions can be directed to Stephanie Groeninger of the AMA <a href="mailto:stephanie.groeninger@ama-assn.org" rel="nofollow">via email</a> or phone at (312) 464-5041.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c259faaa-ca9d-4b19-94a3-cf26ce0ebbd0 Free symposium will equip IMGs to enter residency programs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_symposium-will-equip-imgs-enter-residency-programs Wed, 23 Jul 2014 13:53:00 GMT <p> If you’re an international medical graduate (IMG) trying to secure a residency slot for U.S. training, a special symposium the evening of Aug. 14 in New York City can give you the insights you need to successfully navigate the 2015 Match.</p> <p> Physician presenters will give advice about such crucial topics as:</p> <ul> <li> Preparing for the USMLE</li> <li> Applying for residency</li> <li> Interviewing for residency</li> </ul> <p> The event will be held from 5:30 p.m. to 7:30 p.m. at the Icahn School of Medicine at Mount Sinai. <a href="http://www.ama-assn.org/resources/doc/img/x-pub/img-symposium-flyer.pdf" target="_blank">Download a flier</a> (AMA login required) to learn more, and <a href="mailto:%20internship@essenmd.com" rel="nofollow">send an email to sign up</a> by Aug. 10.</p> <p> This event is co-sponsored by the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page" target="_blank">AMA-IMG Section</a>, the Medical Society of the State of New York, the New York Chapter of the American College of Physicians, Essen Medical Associates and Mount Sinai.</p> <p> Refreshments will be provided, and attendees will be entered in a raffle to win a $1,000 scholarship for Kaplan Medical courses.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d5ffe937-cab6-4e3e-8ecf-6c6234d66fa3 5 ways to combat Rx drug abuse http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-ways-combat-rx-drug-abuse Tue, 22 Jul 2014 20:23:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/8/b5452a21-f405-4473-a81c-a41c29cb602c.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/8/b5452a21-f405-4473-a81c-a41c29cb602c.Large.jpg?1" style="float:left;margin:10px;" /></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 AMA President Robert M. Wah, MD.</em></p> <p> Nearly four dozen people die each day from prescription drug overdoses, according to a recent report from the Centers for Disease Control and Prevention. As physicians, we have the job of monitoring and treating our patients’ pain while also playing a strong role in prevention—and these are no easy tasks.</p> <p> The AMA has taken on the issue of addressing the prescription drug overdose crisis, working with groups such as the National Governors Association to advance the association’s five-pronged approach to curbing this epidemic. Here’s what the AMA is doing to ensure physicians play a leading role:</p> <ol> <li style="margin-left:0.25in;"> <strong>Advocating for continued balance and state flexibility to guide policy. </strong>We know that pain is the most common medical complaint and can be difficult to effectively diagnose, treat and manage. We work hard to balance our ethical obligation to treat pain against the need to recognize signs of abuse and diversion. Policymakers should endorse this balance, not a one-size-fits-all approach.</li> <li style="margin-left:0.25in;"> <strong>Urging state licensing boards, public health agencies, state medical and pharmacy associations, and other stakeholders to work together. </strong>This includes community-based prevention and increased access to substance abuse treatment, both of which still are lacking even as overdose and death rates continue to climb.</li> <li style="margin-left:0.25in;"> <strong>Making prescription drug monitoring programs useful for physicians. </strong>We want states to support programs that can provide reliable, real-time data at the point of care. These programs should be interoperable with other states and agencies. Most states have struggled to fully fund or modernize prescription drug monitoring programs to make them as useful as possible to physicians.</li> <li style="margin-left:0.25in;"> <strong>Urging states to support a full range of clinical treatment services and enact policies that support treatment and prevention. </strong>Substance abuse and addiction demands medical treatment. Balancing treatment and prevention with law enforcement efforts is crucial. We support the use of the overdose antidote <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3aa9b47eb0-57ea-47d0-b151-2d975fe1778a&plckScript=blogScript&plckElementId=blogDest" target="_blank">naloxone</a> by first responders and family and friends of patients or addicts to prevent overdose deaths.</li> <li style="margin-left:0.25in;"> <strong>Cautioning policymakers to carefully proceed with mandates. </strong>When states seek to enact overly restrictive mandates, it has reduced the supply of opioids. But that has led to two troubling consequences: Patients who suffer needlessly because they lose access to medication they need, and surges in heroin use.</li> </ol> <p> <span style="font-size:14px;">We need more discussion about how enhanced education, increased use of drug courts and removing unwanted medications from communities, all of which are part of the AMA’s comprehensive public health focus. The AMA is ready to work with policymakers across the country to address this public health crisis.</span></p> <p> Physicians also must continue to enhance their own knowledge about treatment, prevention, responsible prescribing and other areas specific to their practice. The AMA has educational activities for physicians, including a 12-module online <a href="http://www.ama-assn.org/ama/pub/physician-resources/pain-management.page" target="_blank">pain management series</a> and free <a href="http://www.pcss-o.org/archived-webinars" rel="nofollow" target="_blank">archived webinars</a>. 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> to learn about the AMA’s work with state medical associations, federal agencies and lawmakers to stop prescription drug abuse and preserve access to treatment for the patients who need it.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e8298ee5-8bbe-4856-9ce4-f1e0189b65e8 Boost your coding accuracy, save time using online CPT® reference http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_boost-coding-accuracy-save-time-using-online-cpt-reference Tue, 22 Jul 2014 20:20:00 GMT <p> Get access to coding insights directly from the source through <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod270004&navAction=push" target="_blank"><em>CPT® Assistant Online</em></a>. This searchable newsletter offers tools to appeal insurance claim denials, validate coding to auditors, train staff and answer day-to-day coding questions.</p> <p> <em>CPT Assistant Online</em> includes code and guideline changes since 2000 as well as the complete historical CPT code list from 1990. Integrate <em>CPT Assistant Online</em> with any of the <em>CodeManager® Online</em> products for the optimal coding experience or use it as a stand-alone resource.</p> <p> Product features include:</p> <ul> <li> Alerts when the latest issue is available</li> <li> More than 20 years of historical reference material</li> <li> Official interpretations of guideline changes from the CPT Editorial Panel</li> <li> Unlimited access to every article written in <em>CPT Assistant</em> since 1990</li> <li> Simple search options by keyword, phrase, code number, article index and more</li> <li> Anatomical illustrations, charts and graphs</li> <li> Answers to frequently asked questions </li> </ul> <p> AMA members receive a 25 percent discount on <em>CPT Assistant Online</em>. If you’re not an AMA member, join today to receive this discount and many others from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fcc8670a-6851-403c-8c4f-70436049cfed How to dispute incorrect financial data before it goes public http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dispute-incorrect-financial-data-before-goes-public Tue, 22 Jul 2014 14:00:00 GMT <p> Physicians can review reports about their financial interactions with manufacturers of drugs and medical devices now through Aug. 27 under the Physician Payments Sunshine Act (also known as the Open Payments program). Here’s how to make sure the information reported about you is accurate before the data is released to the public Sept. 30.</p> <p> <strong>Update: </strong>After numerous technical difficulties with the CMS Open Payments portal, CMS has extended the deadline for physicians to review and dispute their data until Sept. 8.</p> <p> To review and affirm or dispute your financial data, you must complete a three-step process. Step 1 is to register with the Centers for Medicare & Medicaid Services’ (CMS) <a href="https://portal.cms.gov/wps/portal/unauthportal/home/!ut/p/b1/04_Sj9Q1tTQzNTUwMjfWj9CPykssy0xPLMnMz0vMAfGjzOLdDSDAyN_QzMjA08vF3MMryNHYwN8MqCASqMAAB3A0IKTfzyM_N1U_NyrHAgAXYk_e/dl4/d5/L2dBISEvZ0FBIS9nQSEh/" rel="nofollow" target="_blank">Enterprise Portal</a>—if you haven’t completed this step, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ready-release-of-financial-data-this-week">read more about how you can do so</a> now. Step 2 is to register with CMS’ Open Payments system, for which <em>AMA Wire</em>™ provides information about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/must-this-week-before-financial-data-goes-public" target="_blank">how to do that</a>.</p> <p> Follow this process to complete step 3 after logging in to the Open Payments system:</p> <ol> <li style="margin-left:0.25in;"> Select the “Review and dispute” tab.</li> <li style="margin-left:0.25in;"> Select the physician name and program year you wish to review data for, then click the “Show records” button. If records have been reported about you, then you will be taken to the “Review and dispute” page. If no records have been reported about you, you will receive an error message stating there are no records to review. If you do not see your name in the list, that could mean that no financial data has been reported about you.</li> <li style="margin-left:0.25in;"> On the “Review and dispute” page, you will see a list of all submitted records. You can filter using the tools in the search box. View all information available for each record, including links to view the payment record, using the scroll bar at the bottom of the table.</li> <li style="margin-left:0.25in;"> Review your records by scrolling to the right and selecting the “View” link under the “View record” column.</li> <li style="margin-left:0.25in;"> Choose whether you want to affirm or dispute the record. You may also withdraw a dispute you previously initiated. Select the desired record and click on the corresponding button. Follow the on-screen text to complete the action.</li> </ol> <p> If you experience any difficulties while attempting to use the Open Payments system, you can contact the CMS help desk <a href="mailto:openpayments@cms.hhs.gov" rel="nofollow">via email</a> or phone at (855) 326-8366.</p> <p> <strong>Disputing a record</strong></p> <p> If you choose to dispute a record, you must enter a reason for the dispute within the text box before continuing. The text box allows you to input up to 4,000 characters (including spaces). Any text you enter into this box will be made available to the organization that reported the payment, and the organization will receive an email notifying them that you have initiated a dispute.</p> <p> Records that have been disputed will be listed with one of the following statuses:</p> <ul> <li style="margin-left:0.25in;"> “Initiated” indicates that you have initiated a dispute against a record.</li> <li style="margin-left:0.25in;"> “Acknowledged” indicates that the industry organization has received and acknowledged the dispute initiated against them. Acknowledging a dispute will trigger a notification to you, letting you know your dispute has been received.</li> <li style="margin-left:0.25in;"> “Resolved, no change” indicates that either the manufacturer does not agree with the dispute or the manufacturer has discussed the dispute with you and it was determined that no change in the data was necessary. You can initiate a new dispute if you disagree with the “resolved, no change” status.</li> <li style="margin-left:0.25in;"> “Withdrawn” indicates that you have withdrawn a dispute you initiated against a record.</li> <li style="margin-left:0.25in;"> “Resolved” indicates that disputed data was updated and then resubmitted and re-attested to by the manufacturer.</li> </ul> <p> Industry organizations either will correct <a href="https://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Dispute-and-Resolution.html" rel="nofollow" target="_blank">disputed data</a>, or, if not corrected right away, that data will be marked as disputed when it is released to the public. The industry will have a 15-day period, from Aug. 28 to Sept. 11, to submit dispute corrections. CMS plans to release physicians’ financial data to the public by Sept. 30.</p> <p> CMS recommends using only Internet Explorer version 8 or later to access the Open Payments system, and cautions against using your browser’s navigation buttons, which can delete data. However, physicians who use Macs have reported that they have been able to use Safari. CMS makes the financial data only available on the Open Payments system, and it cannot be downloaded.</p> <p> The agency has updated its <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Open-Payments-User-Guide-%5bJuly-2014%5d.pdf" rel="nofollow" target="_blank">Open Payments user guide</a> and <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Physician-and-Teaching-Hospital-Record-Review-Dispute-Instructions-%5bJuly-2014%5d.pdf" rel="nofollow" target="_blank">Quick Reference Guide </a>with new information about how to dispute information.</p> <p> Visit 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> to learn more about the kinds of financial interactions that will be reported and access resources to help you prepare for reviewing data and challenging any false, inaccurate or misleading reports.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1188bdf4-e19f-4b95-af6f-c9ee7452fea1 Congressman to share insights into SGR state of affairs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_congressman-share-insights-sgr-state-of-affairs Mon, 21 Jul 2014 17:45:00 GMT <p> Hear first-hand from Rep. Ami Bera, MD, D-California, about what the current state of play is in Congress and how that might affect the chances of repealing Medicare’s physician payment formula. <a href="https://www.votervoice.net/link/clickthrough/ext/377561.aspx" target="_blank" rel="nofollow">Sign up today</a> to participate in a grassroots webinar July 28 at 7:30 p.m. Eastern time.</p> <p> Hosted by the AMA, this webinar will explain how physicians can turn up the heat to repeal Medicare’s sustainable growth rate (SGR) formula during this session of Congress.</p> <p> In addition to hearing from Rep. Bera, participants will receive an update on efforts to raise the profile of this issue on Capitol Hill and generate momentum toward repeal.</p> <p> Participants also will learn about essential grassroots tools and next steps for advocates in medicine to conduct effective in-person meetings and influence legislators while they are in their home districts during Congress’ recess for the month of August.</p> <p> <a href="https://www.votervoice.net/link/clickthrough/ext/377561.aspx" target="_blank" rel="nofollow">Register today</a> to take this chance to make a lasting impact on one of medicine’s most pressing issues.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b7636e57-1103-4b84-9fa3-848b24101cc7 How a doctor quickly improved patients’ blood pressure readings http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctor-quickly-improved-patients-blood-pressure-readings Mon, 21 Jul 2014 06:00:00 GMT <p> Although measuring blood pressure may seem like a normal routine in most physicians’ office workflows, seven seemingly minor factors can artificially inflate patients’ blood pressure measurements.</p> <p> For Kim Hardy, MD, a family medicine physician with Prohealth Care <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/12/021c77fe-6faa-4ee3-bc36-4f21b51d4f3f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/12/021c77fe-6faa-4ee3-bc36-4f21b51d4f3f.Large.jpg?1" style="float:right;margin:15px;" /></a>Medical Associates in Sussex, Wisconsin, a simple reminder helped her avoid needlessly adjusting medications for a patient. Dr. Hardy and her staff use a blood pressure management chart she learned about via the <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">AMA’s Twitter feed</a> as a daily cue to ensure patients’ blood pressure measurements are as accurate as possible.</p> <p> “I recently had a patient in the office whose blood pressure remained significantly elevated after repeated measurement,” Dr. Hardy said. “I asked her if she needed to use the restroom, and she said she did.  After emptying her bladder, her blood pressure reading was to the goal of less than 140/90.  My medical assistants were amazed.”</p> <p> “It prevented me from having to readjust [the patient’s] medications,” she said.</p> <p> Falsely high blood pressure measurements can lead to unnecessary prescriptions and potentially harmful medication doses. Monitor these seven factors to prevent an inaccurate blood pressure reading:</p> <ol> <li> The patient has a full bladder.</li> <li> The patient’s back is unsupported.</li> <li> The patient’s feet are unsupported.</li> <li> The patient’s legs are crossed.</li> <li> The sphygmomanometer cuff is over clothing.</li> <li> The patient’s arm is unsupported.</li> <li> The patient is talking or hasn’t had at least three minutes of quiet time prior to the measurement.</li> </ol> <p> Incorporating evidence-based principles like these into practice workflows is a key element 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 pilot program involving multiple clinical sites in two states is implementing principles of safe design into the ambulatory setting to improve outcomes around hypertension. Similar approaches, such as hospitals using checklists to reduce central-line infections, have seen successful results. </p> <p> To apply safe design principles to blood pressure management, the AMA is collaborating with pilot sites and researchers at Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test a set of evidence-based recommendations, based on a simple framework called the “M.A.P. for achieving optimal hypertension control”:</p> <ul> <li> Measuring blood pressure accurately every time it’s measured</li> <li> Acting rapidly to address high blood pressure readings</li> <li> Partnering with patients to promote self-management of high blood pressure</li> </ul> <p> The pilot sites are integrating best evidence into each step of the M.A.P. framework. For example, the AMA is incorporating successful elements of a program at Johns Hopkins Center to Eliminate Cardiovascular Health Disparities in designing resources to help practices engage patients in better self-management. </p> <p> <strong>Stay connected for additional insights:</strong> <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">Follow the AMA on Twitter</a> to get timely tips as Dr. Hardy did about this issue and other topics of importance to your practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8a41250b-fd2f-453c-9fa1-243f852b4863 Who’s leading ACOs--physicians or hospitals? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_whos-leading-acos-physicians-hospitals Fri, 18 Jul 2014 19:15:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/13/56949013-9249-4eed-9ded-3aac1a51de20.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/13/56949013-9249-4eed-9ded-3aac1a51de20.Large.jpg?1" style="float:right;margin:10px;" /></a>The first national survey of accountable care organizations (ACO) examines who is playing the strongest leadership and ownership roles in the development of these new models of care.</p> <p> The <a href="http://content.healthaffairs.org/content/33/6/964.full" target="_blank" rel="nofollow">survey results</a>, published last month in <em>Health Affairs</em>, found that more than one-half of surveyed ACOs are physician-led, and one-third are jointly led by physicians and hospitals. In more than three-quarters of ACOs, physicians constituted a majority of the governing board. Physicians also owned 40 percent of ACOs.</p> <p> The study noted that the health care climate is shifting to population-based care models like ACOs, requiring major changes that will impact physicians’ incomes, degrees of autonomy, work environments and clinical routines.</p> <p> “Physicians’ buy-in to these changes is likely to be critical,” the survey results said. “Previous research has shown that involving physicians in the governance of provider organizations improves communication and builds trust by assuring practicing physicians and clinical staff that their professional values are represented when key organizational decisions are made.”</p> <p> According to the survey, physician-led organizations had more individual medical groups than other types of ACOs, indicating that at least some of these organizations consist of independent practice associations or physician-owned practices. More than one-third of physician-led organizations consisted solely of physician practices, compared to 6 percent of other types of ACOs.</p> <p> Fifteen percent of physician-led ACOs were participating in the <a href="http://innovation.cms.gov/initiatives/Advance-Payment-ACO-Model/" target="_blank" rel="nofollow">Advanced Payment Program</a>, which the AMA was instrumental in securing from the Centers for Medicare & Medicaid Services. This model provides start-up capital to physician-led organizations and rural groups. Allowing physicians in all practice settings and sizes to participate increases the number of Medicare ACOs and maximizes the benefits for patients, physicians, taxpayers and the Medicare system as a whole.</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 is identifying effective care delivery and payment models and developing solutions for physicians in practices of all sizes.</p> <p> The AMA Innovators Committee, an advisory group of physicians with real-life experience implementing innovative delivery and payment models in their own practices, has created <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/payment-model-resources.page" target="_blank">resources and webinars</a> to share their learnings. Physicians can use the resources to guide them in setting up a physician-led, integrated health care delivery group, such as an ACO.</p> <p> In addition, physicians who are part of or working toward multi-specialty physician-led integrated health care delivery groups can join the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/integrated-physician-practice-section.page?" target="_blank">Integrated Physician Practice Section</a> (IPPS). The section seeks to influence medical policy and regulations around the integrated practice model and provides a way for physicians to share their experiences with integration.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ebe279ed-551e-43ca-95f6-df7e1a8d2326 8 things you should know about Medicare’s proposed payment rule http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-things-should-medicares-proposed-payment-rule Fri, 18 Jul 2014 19:10:00 GMT <p> If the policies set forth in the 2015 Medicare Physician Fee Schedule <a href="http://www.gpo.gov/fdsys/pkg/FR-2014-07-11/pdf/2014-15948.pdf" rel="nofollow" target="_blank">proposed rule</a> take effect, physicians will be in for a lot of changes—many of them unfavorable—next year. Here are the top eight things that you should know:</p> <p style="margin-left:40px;"> <strong>1. A 21 percent payment cut is scheduled for April 1. </strong>The Centers for Medicare & Medicaid Services (CMS) observed in a <a href="http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-1.html" rel="nofollow" target="_blank">fact sheet</a> that current payment rates will apply through March as a result of a temporary payment patch enacted earlier this year and projected that payment rates will be cut by 20.9 percent April 1 unless Congress intervenes. The agency stated its support for repeal of the flawed sustainable growth rate formula that has triggered such large cuts.</p> <p style="margin-left:40px;"> <strong>2. Global surgical packages will be eliminated.</strong> The rule proposes to discontinue all 10-day global surgical packages by 2017 and 90-day packages the following year. Packages instead would include only preoperative care and care given the day of surgery.</p> <p style="margin-left:40px;"> <strong>3. Payments will be adjusted by the Value-Based Payment Modifier beginning next year.</strong> Despite continued AMA opposition, CMS plans to levy steeper payment adjustments and to continue basing the adjustments on costs and quality data two years before the adjustment is applied.  </p> <p style="margin-left:40px;"> Physicians in groups of 100 or more will see payment penalties or bonuses next year, determined by their group’s cost and quality performance in 2013. Bonuses and penalties based on 2014 performance will be applied to groups of 25-100 starting in 2016.</p> <p style="margin-left:40px;"> All physicians will be subject to the modifier beginning in 2017, at which point the potential penalty will double to 4 percent. The pool of money available for bonuses depends on how much is collected in penalties so potential bonuses are not yet known.</p> <p style="margin-left:40px;"> <strong>4. Quality reporting requirements will be increased in the face of penalties.</strong> CMS has reiterated a 2 percent payment penalty for physicians who don’t meet the 2015 Physician Quality Reporting System (PQRS) requirements and is proposing additional requirements physicians will need to fulfill.</p> <p style="margin-left:40px;"> At the same time, the agency is proposing to cut the period physicians have to request an informal review of a PQRS penalty from 90 days to just 30 days.</p> <p style="margin-left:40px;"> <strong>5. PQRS data will be publicly reported.</strong> The rule proposes making all 2015 measure data from group practices available in 2016. The agency also is hoping it will be able to publish later that year individual measures for all physicians on <a href="http://www.medicare.gov/physiciancompare/search.html?AspxAutoDetectCookieSupport=1" rel="nofollow" target="_blank">Physician Compare</a>, a website plagued by accuracy and usability problems since it launched in 2010.</p> <p style="margin-left:40px;"> <strong>6. Chronic care management services will be covered.</strong> Beginning next year, Medicare will pay $43.67 per patient per month for chronic care management provided by a physician’s office and $32.58 for care provided by a facility. Such services involve non-face-to-face care coordination for patients with multiple serious chronic conditions that are expected to last at least 12 months or until death.</p> <p style="margin-left:40px;"> <strong>7. More telehealth services will be covered beginning in 2016.</strong> The proposed changes include greater access for patients in rural locations by expanding the number of rural sites.</p> <p style="margin-left:40px;"> <strong>8. A new timeline for changing physician codes and service values would take effect in 2016. </strong>This revised timeline will mean physicians can submit recommendations no later than Jan. 15 for the following year.</p> <p style="margin-left:40px;"> The change not only will severely limit recommendations from 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">Relative Value Scale Update Committee</a> (RUC) and CPT<sup>®</sup> Editorial Panel but also will increase the time for a new or revised code to be included in the Medicare fee schedule from 10-20 months to 20-27 months. The AMA already has suggested timeline revisions to CMS that would provide greater transparency and better alignment between relative value unit recommendations and the regulatory process.</p> <p> The AMA will be submitting comments detailing physician concerns with these proposals later this summer.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:44d6a1dd-2594-4caf-8d02-b4a483ceaa7b Attend annual AAIP meeting July 23-26 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_attend-annual-aaip-meeting-july-23-26 Thu, 17 Jul 2014 20:57:00 GMT <p> Join your colleagues at the 43rd Association of American Indian Physicians (AAIP) <a href="http://www.aaip.org/annual-meeting/about-annual-meeting/" rel="nofollow" target="_blank">Annual Meeting and National Health Conference</a>, scheduled to take place July 23-26 in Denver, Colorado.</p> <p> A distinguished faculty and renowned clinical experts will celebrate this year’s theme, "Now is our time for optimizing sustainable change and excellence in health for Indian country." Attendees will collaborate with American Indian and Alaskan Native physicians, residents, medical students and other health care practitioners to share the most effective practices from multidisciplinary experiences.</p> <p> Presentations will address disease prevention strategies for diabetes, cardiovascular disease, cancer, depression, substance abuse, trauma, childhood obesity, suicide, domestic violence and many other health-related topics.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page" target="_blank">AMA Minority Affairs Section</a> encourages all physicians and medical students to attend.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2d68e3a3-aadd-4666-a520-ca0f8275c944 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 Thu, 17 Jul 2014 17:38:00 GMT <p> <object align="right" data="http://www.youtube.com/v/Dkcth6-1d38?list=UUlpzWSNUo4kEgZbD2V-dRaA" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/Dkcth6-1d38?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/Dkcth6-1d38?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/Dkcth6-1d38?list=UUlpzWSNUo4kEgZbD2V-dRaA" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object></p> <p> <strong>Study finds decrease in incidence of stroke, subsequent </strong><strong>death</strong><br /> In a study that included a large sample of black and white U.S. adults from several communities, rates of stroke incidence and subsequent death decreased from 1987 to 2011, with decreases varying across age groups, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1887762" rel="nofollow">study</a> in the July 16 issue of the <em>Journal of American Medical Association</em> (<em>JAMA</em>).</p> <p> <strong>Telecare intervention improves chronic pain</strong><br /> A telephone-delivered intervention, which included automated symptom monitoring, produced clinically meaningful improvements in chronic musculoskeletal pain compared to usual care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1887761" rel="nofollow">study</a> in the July 16 issue of <em>JAMA</em>. Also, see video at right.</p> <p> <strong>Persistent symptoms following concussion may be posttraumatic stress disorder</strong><br /> Long-lasting symptoms that many patients contend with following mild traumatic brain injury may be posttraumatic stress disorder and not post-concussion syndrome, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1888683" rel="nofollow">study</a> in <em>JAMA Psychiatry</em>.</p> <p> <strong>Study examines dietary fatty acid intake, risk for Lou Gehrig’s disease </strong><br /> Eating foods high in ω-3 polyunsaturated fatty acids from vegetable and marine sources may help reduce the risk for amyotrophic lateral sclerosis, the fatal neurodegenerative disease commonly referred to as Lou Gehrig’s disease, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1886776" rel="nofollow">study</a> in <em>JAMA Neurology</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7f65f4e5-3a31-416a-a287-18163824467d California allots $7 million for primary care residency slots http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_california-allots-7-million-primary-care-residency-slots Wed, 16 Jul 2014 18:09:00 GMT <p> Unprecedented grassroots advocacy by the physician and medical student community, including 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> and the California Medical Association, has led the California legislature to approve and the governor to sign a <a href="http://www.ebudget.ca.gov/2014-15/Enacted/BudgetSummary/BSS/BSS.html" rel="nofollow" target="_blank">state budget</a> that includes $7 million for new primary care residency slots.</p> <p> This critical funding will help California meet an increased demand for medical services. An AMA letter to the state legislature strongly encouraged this funding, stressing that support for graduate medical education (GME) is necessary to preserve a health care system that provides high-quality preventive, acute and chronic care that meets the needs of an aging and increasingly diverse population.</p> <p> Of this new funding, $3 million will be applied to expand a state residency funding program to include family medicine, internal medicine, obstetrics-gynecology and pediatric primary care specialties. The additional $4 million will provide one-time funding for residency programs that wish to expand and train more residents.</p> <p> The budget act requires that priority be given to programs with graduates of California-based medical schools, reflecting the <a href="https://members.aamc.org/eweb/upload/State%20Physician%20Workforce%20Data%20Book%202013%20(PDF).pdf" rel="nofollow" target="_blank">overwhelming data</a> that physicians are very likely to practice in the state in which they obtain their medical degree and complete training.</p> <p> The AMA will continue to advocate for increased GME funding to enhance the ability of medical schools and teaching hospitals to train physicians, while ensuring access to care for patients.</p> <p> Check out the AMA’s grassroots campaign <a href="http://savegme.org/" rel="nofollow" target="_blank">SaveGME.org</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:451def04-123c-4961-ad3a-4a5fc1c7b0a8 Prevent opioid overdose: CME module explains how http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prevent-opioid-overdose-cme-module-explains Wed, 16 Jul 2014 18:05:00 GMT <p> Learn how to prevent opioid overdose through patient education and the overdose reversal drug naloxone by participating in a free continuing medical education (CME) <a href="http://pcssmat.org/education-training/modules/amersa-online-module-preventing-opioid-overdose-with-education-and-naloxone-rescue-kits/" rel="nofollow" target="_blank">online activity</a>.</p> <p> Offered by the Providers’ Clinical Support System for Medication Assisted Treatment (PCSS-MAT), a group of health care organizations led by the American Academy of Addiction Psychiatry that received grant funding from the Substance Abuse and Mental Health Services Administration, the online module features a case vignette and focuses on overdose prevention education and prescribing naloxone, an antidote for opioid overdoses.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/15/eca0f0dd-3201-4b12-8f64-d8bb4c0ed5fd.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/15/eca0f0dd-3201-4b12-8f64-d8bb4c0ed5fd.Large.jpg?1" style="margin:15px;float:left;" /></a>The module reviews the epidemiology of overdose, provides the rationale and scope of existing overdose prevention education, and takes a look at naloxone rescue kit programs. It also explains how to educate patients about overdose risk reduction and how to prescribe naloxone rescue kits, including barriers to naloxone prescription and resources available.</p> <p> Nearly four dozen people die in the United States every day as a result of prescription drug overdoses, according to a <a href="http://www.cdc.gov/vitalsigns/opioid-prescribing/index.html" rel="nofollow" target="_blank">new report</a> from the Centers for Disease Control and Prevention. The AMA, part of a related effort called the Prescriber Clinical Support System for Opioid Therapy (PCSS-O), is advocating for an evidence-based, public health approach to address the prescription drug abuse crisis. Last month, the association participated in a White House summit on responses to the prescription drug abuse crisis.</p> <p> The AMA is making headway in its work with state medical associations, federal agencies and lawmakers to stop prescription drug abuse and preserve access to treatment for the patients who need it. Physicians can access a number of educational activities from the AMA, including a 12-module online <a href="http://www.ama-assn.org/ama/pub/physician-resources/pain-management.page" target="_blank">pain management series</a>.</p> <p> Other <a href="http://www.pcss-o.org/archived-webinars" rel="nofollow" target="_blank">free archived webinars</a> on clinical issues at the intersection of pain management, opioid prescribing and substance use disorders including addiction can be found on the PCSS-O website, including:</p> <ul> <li> <a href="http://pcss-o.org/archived-webinar-89" rel="nofollow" target="_blank">Partnering with pharmacists: Naloxone prescribing and dispensing to prevent overdose deaths</a></li> <li> <a href="http://www.pcss-o.org/archived-webinar-88" rel="nofollow" target="_blank">Difficult conversations in opioid management: Limiting, reducing or stopping opioids</a></li> <li> <a href="http://www.pcss-o.org/archived-webinar-82" rel="nofollow" target="_blank">Non-opioid pharmacologic management of chronic pain: A primer</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:307b896b-6d56-48d0-88a6-63e6fecab531 Join the AMA-WPS liaison network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_join-ama-wps-liaison-network Wed, 16 Jul 2014 18:00:00 GMT <p> An important component in the success of the AMA Women Physicians Section (WPS) is its partnership with other medical associations to expand involvement and advocacy at all levels. The AMA-WPS liaisons serve as the foundation of this partnership and play a key role in the success of the section.</p> <p> Liaisons work with the section to identify emerging issues, contribute to policy development, build consensus on issues for women in medicine and participate in efforts to advance women into leadership positions.</p> <p> Each AMA member organization is allowed a liaison and an alternate liaison. The AMA-WPS liaison network is a great way to engage members of your medical association, stay connected to issues impacting women physicians and patients, and have a positive influence.</p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section.page" target="_blank">AMA-WPS Web page</a> to learn more or join the network. <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/about-wps/wps-liaisons/appointment-form.page" target="_blank">Apply online</a> today.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bc83c250-b585-4823-9843-8571e5da39de Make a lasting difference: AMA Foundation legacy program http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lasting-difference-ama-foundation-legacy-program Wed, 16 Jul 2014 18:00:00 GMT <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation’s</a> legacy giving program now offers a variety of opportunities for physicians, families and other members of the medical community to complete a lifetime of giving or make a significant gift that might not be possible during their lifetime.</p> <p> The legacy program helps fund such AMA Foundation initiatives as awarding scholarships to medical students, increasing grants to free clinics and nonprofit organizations that aid underserved populations, and supporting community-based health education programs for youth.</p> <p> Robert McAfee, MD, a past president of the AMA and member of 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><strong>,</strong> invites senior physicians to support the AMA Foundation by becoming a member of the AMA Foundation Legacy Society and making a planned gift. </p> <p> “I hope you will give most careful consideration to honoring the past and securing opportunities for future generations of physicians and patients through a legacy gift to the AMA Foundation,” Dr. McAfee said. “Having made my own legacy gift, I can tell you how great it feels to honor those who helped me along the way and to share the aspirations of medical students and young physicians throughout our country.”</p> <p> If you’d like more information about the AMA Foundation Legacy Society or other ways to get involved, call Jane Erb of the AMA Foundation at (312) 464-5852, <a href="mailto:jane.erb@ama-assn.org" rel="nofollow">send her an email</a> or visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/endowment-gifts.page?" target="_blank">program’s Web page</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:58bf45b9-6612-456d-81b5-c28271f4295a What you must do this week before your financial data goes public http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_must-this-week-before-financial-data-goes-public Wed, 16 Jul 2014 14:00:00 GMT <p> Now through Aug. 27 is the time for physicians to review reports about their financial interactions with manufacturers of drugs and medical devices and dispute potentially inaccurate reporting under the Physician Payments Sunshine Act (also known as the Open Payments program). Here’s what you should do this week to make sure you’re protected.</p> <p> <strong>Update: </strong>After numerous technical difficulties with the CMS Open Payments portal, CMS has extended the deadline for physicians to review and dispute their data until Sept. 8.</p> <p> Physicians already should have registered with the Centers for Medicare & Medicaid Services’ (CMS) <a href="https://portal.cms.gov/wps/portal/unauthportal/home/!ut/p/b1/04_Sj9Q1tTQzNTUwMjfWj9CPykssy0xPLMnMz0vMAfGjzOLdDSDAyN_QzMjA08vF3MMryNHYwN8MqCASqMAAB3A0IKTfzyM_N1U_NyrHAgAXYk_e/dl4/d5/L2dBISEvZ0FBIS9nQSEh/" rel="nofollow" target="_blank">Enterprise Portal</a>, the first phase in a three-step process for data review. If you haven’t completed this step, read more about how you can do so now.</p> <p> Follow this process to complete step 2. Registration is rather cumbersome, so make sure to follow the directions closely and allow enough time to complete it in one session:</p> <p style="margin-left:40px;"> 1.     Log in to the CMS Enterprise Portal.</p> <p style="margin-left:40px;"> 2.     Click the button on the far right that says “Request access now,” then click “Request new system access.</p> <p style="margin-left:40px;"> 3.     Select “Open Payments” from the drop-down menu and input your personal information.</p> <p style="margin-left:40px;"> 4.     Log out of the system and wait two minutes, then log back in.</p> <p style="margin-left:40px;"> 5.     Select “Create my profile.”</p> <p style="margin-left:40px;"> 6.     Select “Start profile” at the bottom of the next screen.</p> <p style="margin-left:40px;"> 7.     Select the profile type “Physician” and then select “Continue.”</p> <p style="margin-left:40px;"> 8.     Enter your personal information, making sure to fill in the required fields that are marked with an asterisk. When you are done, select “Continue.” Do not choose “Cancel” unless you want to start over; canceling will erase all data.</p> <p style="margin-left:40px;"> 9.     Enter your details, making sure to fill in the required fields that are marked with an asterisk.</p> <p style="margin-left:80px;"> – When the system asks for your specialty identification code, what it really requires is your provider taxonomy code. The list of these codes is provided in a <a href="http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/TaxonomyCrosswalk.pdf" rel="nofollow" target="_blank">CMS document</a>, which lists the codes by specialty. Enter the taxonomy code in the Open Payments system.</p> <p style="margin-left:80px;"> – Physicians are required to enter at least one license number by selecting “Add license” and entering the state in which the license is held and the license number. When you are finished, select “Continue.”</p> <p style="margin-left:40px;"> 10.  If desired, choose an individual to represent you within the Open Payments system by entering the required information and the access level. You do not need to designate an authorized representative during this initial registration and may choose to do so later.</p> <p style="margin-left:40px;"> 11.  Review the information you’ve entered. Select “Back” to edit any information. If the information is correct, select “Submit.”</p> <p> The entire registration process will take about 30 minutes to complete and must be finished in a single session, according to CMS. Users cannot save entries or complete their profiles at later times. In addition, the system times out after 15 minutes of inactivity, and it does not have an auto-save feature.</p> <p> CMS recommends using only Internet Explorer version 8 or later to register for the Open Payments system. CMS also cautions users against using their browser’s navigation buttons, which can delete registration data.</p> <p> If you experience any difficulties while attempting to use the Open Payments system, you can contact the CMS help desk <a href="mailto:openpayments@cms.hhs.gov" rel="nofollow">via email</a> or phone at (855) 326-8366.</p> <p> After registration, physicians will be able to review data reported about them and affirm or dispute the data. Industry organizations either will correct <a href="https://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Dispute-and-Resolution.html" rel="nofollow" target="_blank">disputed data</a>, or, if not corrected right away, that data will be marked as disputed when it is released to the public. If you choose to begin the review process directly after registration, you will need to logout of the Open Payments system and then login again. CMS has said that you may need to wait up to 24 hours before you are able to access your data.</p> <p> The industry will have a 15-day period, from Aug. 28 to Sept. 11, to submit dispute corrections. CMS plans to release physicians’ financial data to the public by Sept. 30. Learn how to <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 reports</a>.</p> <p> <strong>Want to learn more?</strong> CMS will host a call from 2:30 to 4 p.m. Eastern time July 22 to provide step-by-step instructions on registering in the Open Payments system and participating in the review and dispute process. <a href="http://www.eventsvc.com/blhtechnologies/register/1cc63346-1ff3-42a8-ac11-469987100b99" rel="nofollow" target="_blank">Register</a> for the call by noon Eastern time July 22.</p> <p> The agency has updated its <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Open-Payments-User-Guide-%5bJuly-2014%5d.pdf" rel="nofollow" target="_blank">Open Payments user guide</a> and <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Physician-Registration-Instructions-%5bJuly-2014%5d.pdf" rel="nofollow" target="_blank">Quick Reference Guide</a> with new information about how to register in the system.</p> <p> Visit 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> to learn more about the kinds of financial interactions that will be reported and access resources to help you prepare for reviewing data and challenging any false, inaccurate or misleading reports.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1f38f06b-5f19-4c73-a290-1f1ab9f5ab85 Volunteer your expertise as a Research Symposium judge http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_volunteer-expertise-research-symposium-judge Tue, 15 Jul 2014 18:00:00 GMT <p> Physicians and faculty at Dallas-area medical schools and residency programs are invited to judge the AMA Research Symposium, Nov. 7 at the Hilton Anatole in Dallas.</p> <p> The competition has two components, and judges may be asked to judge both events, depending on their availability. Podium presentations are from 4 to 5 p.m., followed by poster presentations from 5 to 6 p.m. A reception from 6 to 7:30 p.m. will follow. Judges may stay for the entire event.</p> <ul> <li> Students submit abstracts in one of eight categories: Biochemistry/cell biology, cancer biology, clinical outcomes and health care improvement, immunology/infectious disease/inflammation, neurobiology/neuroscience, public health and epidemiology, radiology/imaging, and surgery/biomedical engineering</li> <li> Residents and fellows submit abstracts in one of two categories: clinical vignette and clinical medicine (includes quality improvement, health policy, clinical research and medical education.)</li> <li> IMG members of the AMA who are certified by the Educational Commission for Foreign Medical Graduates and awaiting residency submit abstracts in one of three categories: clinical medicine/clinical vignette, health policy or medical education and basic science</li> </ul> <p> Send an email to <a href="mailto:researchsymposium@ama-assn.org" rel="nofollow">researchsymposium@ama-assn.org</a> to volunteer.</p> <p> Volunteers will receive a small token of appreciation for their time.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e4f58152-91de-400b-943e-d5b86c1a3df9 Medical educators examine century-old problem at Harvard event http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-educators-examine-century-old-problem-harvard-event Tue, 15 Jul 2014 18:00:00 GMT <p> Today’s medical students—and tomorrow’s physicians—have a vast amount of information available to them, and teaching them to sort through the good information and use it appropriately is a challenge medical educators are working to solve.</p> <p> Despite the relatively recent advent of the information age ushered in by the Internet, this problem isn’t a new one. Mark Quirk, EdD, AMA vice president for medical education outcomes, explained the problem at a workshop during the Harvard Macy Institute (HMI) 20th Anniversary Symposium in June.</p> <p> “Back in the late 1800s when <em>Index Medicus</em> was created, John Billings complained about the plethora of medical information” Dr. Quirk said. “In fact, Billings noted that much of it was bad information. Around the same time, William Osler talked about the problems of overburdening students with knowledge and information. … There was consensus that not only were physicians and medical students overburdened with information, but that medical education, was too focused on knowledge at the expense of patient experience.”</p> <p> To address this century-old problem, 11 schools 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 seeking to reinvent traditional medical education by incorporating such elements as competency-based assessment, new technology and team-based care into daily training. Investigators from some of the participating schools hosted a workshop at the HMI event.</p> <p> Participants discussed medical education as it falls under three key areas:</p> <ul> <li> <strong>Individual learning with flexible progression and seamless transition across phases of training. </strong>Participants discussed the challenges of assessing students in an individualized learning pathway. For example, medical students early in their training often don’t participate in clinical activity. Trusting students to care for patients earlier in medical school is ideal, but it’s a difficult cultural barrier to overcome, said Maryellen Gusic, MD, executive associate dean for educational affairs at the Indiana University School of Medicine.</li> </ul> <ul> <li> <strong>Effective use of technology to promote learning and assess competence.</strong> Participants agreed schools must understand which modes of technology are best for their curricula.  Teaching students and faculty how to effectively use new technology to manage information inside and outside of the traditional classroom must be an important goal of medical education.</li> </ul> <p> There’s another issue: “Are we teaching our students how to manage all these ‘pipelines’ of information?” said George Mejicano, MD, senior associate dean for education at Oregon Health and Science University School of Medicine. He added that not only managing information pipelines, but implementing feedback loops so faculty know how students are using technology, is important.</p> <ul> <li> <strong>Partnering with clinical systems to enhance care. </strong>Participants discussed how an integrated learning organization between clinical and health professions educational systems would be ideal but can present challenges. Managing relationships and roles are crucial.</li> </ul> <p> “Busy faculty members don’t want any additional work,” said Thomas Viggiano, MD, associate dean for faculty affairs at Mayo Medical School. “We have to be respectful at integrating whatever we’re going to do in a way that’s easy to navigate with significant payoff.”</p> <p> Participants agreed that reimagining medical school curricula to fall under these areas will help future physicians sort through the information overload and make more informed care choices. The consortium of schools within the AMA initiative already is delving into solutions for these issues, including:</p> <ul> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3a5b0f9145-4668-49d1-9403-aee4f16b4eab&plckScript=blogScript&plckElementId=blogDest" target="_blank">Systems-based learning</a></li> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3a5dc89d0b-994b-46d3-b823-4cfaeac75ae5&plckScript=blogScript&plckElementId=blogDest" target="_blank">Diversity, health care disparities and workforce issues</a></li> </ul> <ul> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3a60e91f20-9d05-4508-b0f3-e1ba02aca255&plckScript=blogScript&plckElementId=blogDest" target="_blank">Competency-based assessment</a></li> </ul> <ul> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3a40976490-9185-4d58-85dc-8da9d3e77827&plckScript=blogScript&plckElementId=blogDest" target="_blank">Adaptive, lifelong learning</a></li> </ul> <ul> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=e38cf47a-fc5f-473b-9234-c9e714c1c8f0&plckPostId=Blog%3ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3ab2f1b845-b278-499d-b27e-fe675719fdf1&plckScript=blogScript&plckElementId=blogDest" target="_blank">New technologies</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3ab12683-eac9-4534-a3d6-bf7e24b46759 Project gets underway to ensure sustainable med school innovations http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_project-gets-underway-ensure-sustainable-med-school-innovations Tue, 15 Jul 2014 18:00:00 GMT <p> How can a medical school completely change its curriculum in a smooth, efficient and sustainable way? By applying principles of business organizational change to medical schools, faculty at some of the schools participating in the AMA’s <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Education</a> consortium are seeking to measure schools’ readiness for change and ways to ensure changes can be maintained over time.</p> <p> The 11 schools that make up the consortium are planning and testing innovative education models, from competency-based assessment to team-based, interprofessional classes to electronic health records fully integrated into learning. But implementing such major transformations can’t happen overnight.</p> <p> “You have to have some vision that you want to move toward,” said Kevin Souza, associate dean for medical education at the University of California San Francisco, one of the consortium schools. “You have to be able to articulate it very clearly and in a way that is compelling to others. Finally, you need to be able to communicate why it’s urgent.”</p> <p> Souza heads the consortium’s organizational change group and is piloting a survey at his institution that will assess medical schools’ organizational readiness for change. Gathering data on a school’s willingness to change and areas that may present challenges will allow him to develop strategies around how to implement new curriculum.</p> <p> After UC San Francisco tests the survey, all of the consortium schools will be able to use it to gauge their institutions’ readiness for change and where they may need to focus to ensure smooth and sustainable implementation.</p> <p> “It lets us customize strategies and plans based off those results,” said Daniel Reimer, a curriculum specialist at UC San Francisco who is working with Souza on the project. “The strategies allow for schools to direct time and resources to address areas of concern so the school can address these areas and maximize their effectiveness.”</p> <p> The group uses a business change model with a “top-down” approach as the basis of its own model, meaning the impetus for change comes from the higher levels of the organization.</p> <p> “Medical education does not have a strong tradition of deliberate change management,” Souza said. “Changing curricula is always difficult, and the more comprehensive the change, the more difficult it is.”</p> <p> For the consortium schools, the challenge likely will be getting faculty buy-in.</p> <p> “Curricula in academic institutions are owned by the faculty and therefore must be changed by the faculty,” Souza said. “However, motivation to innovate in the curriculum often is the vision of academic leadership who are constantly monitoring the entire curriculum, its outcomes, trends and pressures external to the school and workforce needs. Therefore, the first big challenge is communicating the need for change and aligning faculty to the new vision.”</p> <p>  </p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7679c5e2-bd4a-45b6-9fb9-ad6fa7ff279b Health IT monitoring crucial to patient safety http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-monitoring-crucial-patient-safety Tue, 15 Jul 2014 16:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/771a6fc4-e9a0-495e-a09f-4ecd66111b06.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/771a6fc4-e9a0-495e-a09f-4ecd66111b06.Large.jpg?1" style="float:left;margin:15px;" /></a><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 AMA President Robert M. Wah, MD.</em></p> <p> As we physicians know, health IT is a field that is rapidly expanding and promises to continue its speedy evolution. Health professionals are starting to realize that increased oversight of these technologies, specifically with regard to patient safety, is crucial.</p> <p> As part of the Food and Drug Administration (FDA) Safety and Innovation Act, the FDA, the Federal Communications Commission and the U.S. Department of Health & Human Services’ Office of the National Coordinator for Health Information Technology (ONC) collaborated to produce a proposed risk-based regulatory framework for health IT. The proposed plan would create oversight of health IT and establish a safety center to monitor any patient safety problems with electronic health records (EHR) and other health IT.</p> <p> I’m a proponent for using technology smartly and safely, so I’m proud that the AMA supports this collaborative effort. While health IT has the potential to help improve patient safety, it also can cause unintended harm. Developing and implementing a patient safety infrastructure is urgently needed.</p> <p> The AMA weighed in on the FDA’s proposed framework last week, encouraging a comprehensive and integrated approach to patient safety and health IT.</p> <p> For example, we support the creation of a multi-stakeholder safety center that includes practicing physicians who use and understand EHRs and other health IT. A center that focuses on promoting health IT innovation by building on evidence would provide more formal industry oversight and contribute to improved patient safety.</p> <p> The FDA strategy proposes using successful safety models, such as those used by the Aviation Safety Information Analysis and Sharing and patient safety organizations, as a basis for identifying and diminishing adverse events. The AMA agrees, and we’re pushing for a framework that is cooperative between the government and the health IT industry.</p> <p> Our comments also highlighted that more attention should be paid to health IT in the ambulatory setting. Research is currently lacking in this area, but we need to consider how processes and systems can differ across care settings. This will help us to make smart decisions about how health IT is employed and how patient safety can be protected.</p> <p> Additionally, we’re asking for increased focus on mobile health apps. Growing evidence suggests that many consumer- and physician-targeted apps are misleading at best and dangerous at their worst. The agencies involved in this proposal should continue exploring collaborations with technology vendors to learn more about these apps and their uses.</p> <p> The AMA has <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?#plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A89d66c31-26c4-4d91-bedd-cff7f86ed37f" target="_blank">made it a priority</a> to ensure health IT is implemented in a way that is most beneficial for physicians and their patients. We’re working to improve the usability of EHR systems, reduce burdens placed on physicians by programs like meaningful use and develop tools that will equip physicians to be better EHR users.</p> <p> Overall, we’re on the right track in moving toward more efficient, safety-driven regulation of health IT. The collaborative efforts between these government agencies are a huge step forward. Taking a unified approach will ensure widespread deployment of well-developed and safe technology that better serves our practices and our patients.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6b5d10e6-1f01-4708-9d93-6ba293712ddd Court considers: Can doctors sue insurers for underpaid claims? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_court-considers-can-doctors-sue-insurers-underpaid-claims Tue, 15 Jul 2014 15:16:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/7/28f9c8e6-7b6d-4fa1-a7aa-950fba3844a9.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/7/28f9c8e6-7b6d-4fa1-a7aa-950fba3844a9.Large.jpg?1" style="float:right;margin:10px;" /></a>At stake in a case before an appeals court is physicians’ right to bring a lawsuit against an insurer that fails to pay correctly for medically necessary services provided to a covered patient. Physicians are weighing in as the court considers whether a previous ruling that bars such action should stand.</p> <p> In <em>North Jersey Brain and Spine Center v. Aetna</em>, a physician practice that received assignments of benefits from patients with employer-sponsored health plans sued the insurer for denying and underpaying medically necessary surgeries for three different patients. The claims were brought to court only after the practice exhausted internal appeals processes with the insurer.</p> <p> The district court in which the case originally was heard ruled that physicians must have more than the standard assignment of benefits to give them grounds for a lawsuit. The decision goes against decades of previous court rulings, accepted practice and the intention of the Employee Retirement Income Security Act (ERISA). The case now is being heard by a U.S. court of appeals in Philadelphia.</p> <p> “Physicians are willing to provide medical care without demanding … up-front payments because they are confident that, if necessary, they can pursue remedies under ERISA for improperly denied insurance benefits,” 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 Medical Society of New Jersey said in a friend-of-the-court brief filed last week.</p> <p> “The district court’s holding … that patient assignments only transfer ERISA rights if they explicitly include some unspecified magic language is completely inconsistent with settled federal common law, the purpose of ERISA and the reasonable expectations of physicians and patients,” the brief said. “If the district court’s decision is affirmed, it will harm physicians and patients alike.”</p> <p> Supporting physicians’ ability to deal directly with insurance companies when there is an issue with how a claim has been paid not only saves the patient who may be ill from dealing with overwhelming administrative processes but also prevents financial constraints from interfering in the patient-physician relationship.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/physician-payment-issues.page" target="_blank">Read more</a> about this case and similar ones in which the AMA Litigation Center is involved.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:50eb3981-87fe-4fc9-9bfd-97d0b51956ab Reduce audit risk using CodeManager® Online http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_reduce-audit-risk-using-codemanager-online Tue, 15 Jul 2014 15:13:00 GMT <p> Help minimize the risk of audits and achieve optimal reimbursement using <a href="https://commerce.ama-assn.org/store/catalog/subCategoryDetail.jsp?category_id=cat1150076&navAction=jump" target="_blank">CodeManager<sup>®</sup> Online</a>.</p> <p> <span style="font-size:12px;">Updated monthly, this tool bundles 30 digital coding resources into one comprehensive product, intersecting and cross-referencing one another to give coders the confidence they need to code correctly and efficiently.</span></p> <p> CodeManager<sup>®</sup> Online is available in three versions: Standard, Professional and Elite. Determine which version is right for your practice with this product <a href="https://commerce.ama-assn.org/catalog/media/codemanager-comparison-chart.pdf" target="_blank">comparison chart</a>.</p> <p> AMA members receive discounts on this product and others 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:a69c9fda-c697-4e74-b37c-273216b2789a Growing numbers call for change to blood donation policy for MSM http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_growing-numbers-call-change-blood-donation-policy-msm Tue, 15 Jul 2014 13:00:00 GMT <p> Activists across the country participated in a <a href="http://www.thedailybeast.com/articles/2014/07/11/activists-fight-antiquated-policy-with-national-gay-blood-drive.html" rel="nofollow" target="_blank">National Gay Blood Drive last week</a>, calling attention to a decades-old policy that requires a lifetime deferral of blood donation by men who have sex with men (MSM). AMA policy strongly supports eliminating such public policies, calling instead for scientifically based deferral periods that are consistently applied to donors based on their risk levels.</p> <p> Following are two of these AMA policies, affirmed at the 2013 AMA Annual Meeting.</p> <p> <strong>H-50.973 Blood donor deferral criteria</strong></p> <p> Our AMA: (1) supports the use of rational, scientifically based blood and tissue donation deferral periods that are fairly and consistently applied to donors according to their level of risk; and (2) opposes the current lifetime deferral on blood and tissue donations from MSM.</p> <p> <strong>H-50.975 Safety of blood donations and transfusions</strong></p> <p> Our AMA: (1) Supports working with blood banking organizations to educate prospective donors about the safety of blood donation and blood transfusion; (2) supports the use of its publications to help physicians inform patients that donating blood does not expose the donor to the risk of HIV/AIDS; (3) encourages physicians to inform high-risk patients of the value of self-deferral from blood and blood product donations; and (4) supports providing educational information to physicians on alternatives to transfusion.</p> <p> Learn how the AMA is engaged in similar issues through the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page" target="_blank">Advisory Committee on Lesbian, Gay, Bisexual and Transgender Issues</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e22466ee-4dd9-44a3-b188-ada31513f850 Dual degree program targets a new type of physician http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_dual-degree-program-targets-new-type-of-physician Tue, 15 Jul 2014 06:00:00 GMT <p> <em><a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/9/057182a8-bad3-4cee-b96d-cdb46f9d0f35.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/9/057182a8-bad3-4cee-b96d-cdb46f9d0f35.Large.jpg?1" style="float:left;margin:15px;" /></a>A </em><em>Spotlight on Innovation</em><em> post by Paul George, MD, associate director of preclinical curriculum at the Warren Alpert Medical School of Brown University.</em></p> <p> As a primary care physician, I manage many of the diseases I learned about in medical school—hypertension, diabetes, and depression, to name a few. The pathophysiology and pharmacology of these illnesses are still relevant and fresh in my mind.</p> <p> But every day, I also interpret medical literature to make evidence-based decisions about my patients, serve as a community leader, assist my underserved and underinsured patients to obtain social services, and analyze statistics about my patient panel to determine whether I am providing highly effective care. These are essential research, leadership and analytical skills I learned “on the job.” I wish they were a more formal part of my training in medical school and residency. </p> <p> This is why I am excited about the new Primary Care-Population Medicine program at the Warren Alpert Medical School of Brown University. This innovative program, in which students will graduate with a  dual degree, MD-ScM, in population medicine, will provide students with substantive training in areas such as health disparities, social determinants of health, health systems, health policy, biostatistics, epidemiology, leadership skills and training to work in interprofessional  teams.</p> <p> Students still will learn the very important basic science underpinnings of medicine while at the same time honing skills often neglected in medical school and residency, but crucial to clinical practice as a  primary care physician.  </p> <p> Students will gain knowledge of these critical topics during a newly designed nine-course sequence leading to the awarding of the master’s degree. They will then apply these skills in a longitudinal integrated clerkship (LIC), an innovative model of clinical learning in which students do all of their clerkships simultaneously, promoting continuity with patients, mentors and communities.</p> <p> We expect students in the LIC to, among other things, advocate for underserved patients, demonstrate leadership skills and interpret the medical literature to make the best possible clinical decisions for their patients. In introducing the Primary Care-Population Medicine program, we hope to foster the development of a new type of physician—one who can seamlessly integrate basic science, clinical medicine and population health in the care of individuals for the betterment of health in society.</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> to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6d5756ca-6068-4817-ac53-48430f844115 Exposure to pharma reps affects trainees’ Rx knowledge: Study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_exposure-pharma-reps-affects-trainees-rx-knowledge-study Mon, 14 Jul 2014 21:18:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/0/72193d42-ef40-4396-80fc-f5e295fac92d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/0/72193d42-ef40-4396-80fc-f5e295fac92d.Large.jpg?1" style="float:left;margin:15px;" /></a> Medical students and residents who report higher levels of pharmaceutical marketing interactions were more likely to prescribe brand name drugs and less likely to rely on evidence-based treatment options, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1878469" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine.</em></p> <p> The study surveyed first- and fourth-year medical students and third-year residents, a random selection of at least 14 at each level per school.</p> <p> “There is little active marketing or commercial outreach for generic drugs or behavioral interventions,” the study said. “This imbalance in information appears to crowd out more evidence-based choices.”</p> <p> The study also revealed where trainees get their prescription drug information. Nearly one in five residents reported getting basic information about drugs from pharmaceutical sales representatives and other industry sources, while fewer medical students said the same. Over the course of medical training, the study found an increased use of peer-reviewed journal articles and clinical practice guidelines.</p> <p> A large fraction of residents still reported common use of unfiltered sources, such as Google or Wikipedia, for prescription drug information. The study said this “is concerning because these sources are conduits for inaccurate or biased information. Even PDA and iPhone applications, generally considered to be more reliable resources, can present industry bias through paid advertisements.”</p> <p> Growing concerns that financial relationships with pharmaceutical companies negatively affect quality and cost of patient care have led medical schools to implement policies limiting these interactions with students and faculty. In an <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1878465" rel="nofollow" target="_blank">Editor’s Note</a> that accompanied the study, Joseph S. Ross, MD, said medical schools and teaching hospitals should continue to adopt policies that restrict industry interactions.</p> <p> “Medical school and postgraduate training are times of rapid, intensive clinical learning, when professional identities are formed, and the ‘habits’ of clinical practice are begun,” Dr. Ross writes. “It is becoming increasingly clear that restricting these interactions during medical school and postgraduate training leads to higher-quality, more evidence-based prescribing among physicians, which is good for the profession, for patient care and for the public’s trust in medicine.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f1560172-3a78-45b9-ba15-1fe16c23fe05 Patient-doctor relationship crucial to preventing drug abuse http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patient-doctor-relationship-crucial-preventing-drug-abuse Mon, 14 Jul 2014 19:21:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/1/f8548486-7c8b-4bbb-a1dd-6ca2cb110741.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/1/f8548486-7c8b-4bbb-a1dd-6ca2cb110741.Large.jpg?1" style="float:left;margin:15px;" /></a>Treatment, not stigmatization, should be the priority for addressing substance abuse, AMA Board of Trustees Member Mary Anne McCaffree, MD, told state legislators Thursday, emphasizing the need for evidence-based, public health practices to treat women who may be abusing drugs and increasing the risk for their babies to be born with neonatal abstinence syndrome.</p> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/mary-anne-mccaffree.page" target="_blank">Dr. McCaffree</a> (pictured left), a neonatal-perinatal specialist in Oklahoma City, testified on behalf of the AMA before the National Conference of Insurance Legislators (NCOIL). She expressed the AMA’s support for additions to the NCOIL’s recommended best practices to combat prescription drug abuse and diversion, which generally advocate for a comprehensive approach on many areas rather than a one-size-fits-all solution.</p> <p> In particular, she highlighted the AMA’s support for Tennessee’s Safe Harbor Act, signed in 2013. The act prioritizes treatment for women who suffer from substance abuse issues and are pregnant, which would help ensure the safety of both the patient and the fetus, as well as increase the likelihood of a healthy baby at birth.</p> <p> On the flip side, Dr. McCaffree pointed to another Tennessee law enacted this year that undermines the patient-physician relationship—new legislation that potentially subjects a pregnant woman to criminal charges if her baby is born with withdrawal symptoms associated with neonatal abstinence syndrome.</p> <p> “As a physician, I can tell you right now that if my patients knew that law enforcement was looking over my shoulder, they would be scared,” she said. “That fear is dangerous for the patient and her fetus. That fear could make the obstetric patient delay her prenatal care, or forgo it altogether, resulting in sicker mothers and preterm, ill newborns.”</p> <p> Rather than forcing through legislation that may have adverse, unintended consequences, Dr. McCaffree said, the better approach is to work with the nation’s medical societies, such as the AMA, American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, and American Society of Addiction Medicine, and others who have developed educational materials and clinical guidelines.</p> <p> Dr. McCaffree’s remarks echoed a <a href="https://download.ama-assn.org/resources/doc/arc/x-pub/ama-comments-ncoil-letter.pdf" target="_blank">recent letter</a> (AMA login required) the AMA sent to NCOIL regarding the update of its best practices document. In the letter, the AMA addresses neonatal abstinence syndrome, privacy issues with respect to prescription drug monitoring programs and the AMA’s support for drug take-back programs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b808a5d5-dfe6-4e74-8511-8d090c4e00c9 Physicians should know about their personal data, AMA tells CMS http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-should-their-personal-data-ama-tells-cms Fri, 11 Jul 2014 15:56:00 GMT <p> Personally identified data about physicians not publicly available soon could be shared with government agencies, law enforcement and Medicare contractors without physicians’ knowledge, under a new “system of records” announced by the Centers for Medicare & Medicaid Services (CMS).</p> <p> The agency has said it will disclose information collected about doctors through the Physician Payments Sunshine Act (also known as the “Open Payments” program) that won’t be made available through the public data release scheduled for Sept. 30.</p> <p> This data can include a physician’s Social Security number, date of birth, primary phone number, email address and some personal financial information.</p> <p> The purposes CMS has outlined for sharing such data would include:</p> <ul> <li> Supporting regulatory, payment and policy functions by CMS contractors and consultants</li> <li> Supporting litigation involving the agency</li> <li> Assisting with fraud, waste and abuse detection and prevention activities</li> </ul> <p> The AMA has told CMS it is overstepping its bounds in this expansion of data sharing.</p> <p> The Sunshine Act “was intended to create accurate reporting of data and transparency, not as a means to override physicians’ due process and privacy rights,” the AMA stated in a letter sent to the agency last week.</p> <p> “Physicians are entitled to be notified whenever CMS, a contractor or other federal agency, state entity, party, company or organization is provided personally identified information from CMS other than through the public Open Payment portal,” the letter said.</p> <p> The letter points to concerns about the accuracy of this data, not the least of which is that CMS has not given physicians sufficient time to dispute inaccurate information before it is shared.</p> <p> In the meantime, physicians can protect themselves against inaccurate data being reported to the public in the Sept. 30 data release by registering now to review and dispute their data. Learn about the steps you need to take and important dates in 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 toolkit</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:72d1095f-b216-42e8-93d2-59187f9acb1b Who can provide input into values of Medicare services? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_can-provide-input-values-of-medicare-services Thu, 10 Jul 2014 19:54:00 GMT <p> While actual payment rates for Medicare services are limited by congressional budget games, the relative values assigned to those services are carefully weighed based on the resources required to provide each service. You might be surprised about who can provide input to shape those values.</p> <p> The Centers for Medicare & Medicaid Services (CMS) announced earlier this month in its 2015 Medicare Physician Fee Schedule proposed rule that the agency plans to solicit public comment on changes under consideration for rates of specific services beginning in 2016. But this isn’t the first opportunity the health care community has had to help guide decisions about service values.</p> <p> Medicare’s regulatory process allows physicians, hospitals, home health agencies, nursing homes and others to provide input into the policies that determine their Medicare payment rates. In fact, all regulated professions and industries are able to submit comments on government regulations that affect their work and their livelihoods.</p> <p> To make sure physicians have a say in this process, for over 20 years the AMA convened 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">Relative Value Scale Update Committee</a> (RUC), a volunteer group of 31 physicians and health care professionals with input from 300 advisers and other experts who represent each sector of medicine. These physicians contribute their highly technical expertise about complex medical procedures and make recommendations that take into account such factors as the cost of supplies and equipment and the time required of physicians and nurses to provide those services.</p> <p> This process allows physicians and other health care professionals to provide direct consultation to the government, helping to meet the changing needs of medicine and facilitating speedier inclusion of updated medical techniques in the Medicare fee schedule.</p> <p> CMS itself has recognized the value of receiving insight directly from members of the medical profession.</p> <p> “For many codes, the surveys conducted by specialty societies as part of the RUC process are the best data that we have regarding the time and intensity of work,” the agency stated in the 2015 Medicare Physician Fee Schedule proposed rule. “The RUC determines the criteria and the methodology for those surveys. It also reviews the survey results. This process allows for development of survey data that are more reliable and comparable across specialties and services than would be possible without having the RUC at the center of the survey vetting process.”</p> <p> “In addition, the debate and discussion of the services at the RUC meetings … provides a good understanding of what the service entails and how it compares to other services in the family and to services furnished by other specialties,” CMS said.</p> <p> In recent years, the committee has evaluated more than 1,700 medical services accounting for $38 billion in Medicare spending. The committee has recommended reductions or deletions for 934 services, resulting in a redistribution of more than $3 billion within the Medicare program.</p> <p> “Medicine is a profession with a heart. The RUC has allowed me to be my patients’ advocate,” said Doug Leahy, MD, a primary care physician and a RUC participant. “There is no group who does a better job to get it right and I am very honored to be part of the process.”</p> <p> Learn more about how the RUC works by viewing an <a href="https://download.ama-assn.org/resources/doc/cpt/x-pub/cpt-simplified.pdf" target="_blank">AMA infographic</a> (AMA login required).</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7070e454-3327-43ff-a72e-69a85ca2f6b6 Risk and athletics: Ethics journal explores physician role http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_risk-athletics-ethics-journal-explores-physician-role Thu, 10 Jul 2014 19:31:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/14/e73f97b0-68c7-458a-9edf-9bc3b1d41aea.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/14/e73f97b0-68c7-458a-9edf-9bc3b1d41aea.Large.jpg?1" style="float:right;margin:10px;height:208px;width:325px;" /></a>This <a href="http://www.virtualmentor.org/" target="_blank" rel="nofollow">month’s issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal, examines the physician’s role in supporting athletes in their endeavors while discouraging risky behavior.</p> <p> Whether the goal is winning, adventure, exercise or just fun, engaging in athletic activity exposes patients to various degrees of harm. Physicians frequently confront ethical challenges in their relationships with athletes and parents of aspiring competitors—whether in weighing the risks and benefits of high school football, clearing an amateur adventurer for a strenuous climb or managing requests for performance-enhancing substances.</p> <p> Authors of articles in the July issue of <em>Virtual Mentor</em> share their vast knowledge and experience about how those challenges can best be met.</p> <p> Highlights from this issue include:</p> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/07/pfor1-1407.html" target="_blank">Addressing concussion in youth sports</a>.” Author Kevin D. Walter, MD, examines one of the greatest concerns in sports medicine today. Dr. Walter explains that one major difficulty in collecting data on which to base injury prevention strategies is the lack of large epidemiologic studies or comprehensive injury surveillance.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/07/stas1-1407.html" target="_blank">Drug testing in sport: hGH (human growth hormone)</a>.” In this piece, Gary A. Green, MD, surveys state-of-the-art sports drug testing, including its limitations. The only studies in which hGH was shown to have a positive effect on athletic performance were in anabolic steroid users, so testing for hGH alone may not accomplish the intended goal.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/07/ecas2-1407.html" target="_blank">A patient’s request for steroids to enhance participation in wilderness sport and adventure</a>.” This case commentary by Christopher Madden, MD, Aaron D. Campbell, MD, and Jessica Pierce, PhD, concludes that the use of medication for the prevention and treatment of life-threatening altitude-related illness is very different, medically and morally, from the use of medication to enhance performance. </li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f45b9488-5674-47d2-acfa-29c2f4277e65 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-1 Thu, 10 Jul 2014 19:27:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/mYamSgqx4u4" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/mYamSgqx4u4" type="application/x-shockwave-flash" vspace="10" width="365"><param name="loop" value="false" /><param name="movie" value="http://www.youtube.com/v/mYamSgqx4u4" /><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" loop="false" quality="best" src="http://www.youtube.com/v/mYamSgqx4u4" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Study estimates rate of survival after minimally invasive repair of failed bioprosthetic aortic valves</strong><br /> In an analysis of about 460 patients with failed bioprosthetic aortic valves who underwent transcatheter valve-in-valve implantation, overall survival at one year was 83 percent, with survival associated with surgical valve size and mechanism of failure, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1886189" rel="nofollow">study</a> in the <em>Journal of the American Medical Association </em>(<em>JAMA</em>).</p> <p> <strong>Varenicline combined with nicotine patch improves smoking cessation rates</strong><br /> Combining the smoking cessation medication varenicline with nicotine replacement therapy was more effective than varenicline alone at achieving tobacco abstinence at six months, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1886188" rel="nofollow">study</a> in <em>JAMA</em>.</p> <p> <strong>Antibiotics after gall bladder surgery do not appear to reduce risk of infection</strong><br /> Among patients who underwent gall bladder removal for acute calculous cholecystitis, lack of postoperative antibiotic treatment did not result in a greater incidence of infections, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1886190" rel="nofollow">study</a> in <em>JAMA.</em></p> <p> <strong>Removing gall bladder for suspected common duct stone shows benefit</strong><br /> Among patients with possible common duct stones, removal of the gall bladder, compared with endoscopic assessment of the common duct followed by gall bladder removal, resulted in a shorter length of hospital stay without increased illness and fewer common duct examinations, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1886191" rel="nofollow">study</a> in <em>JAMA</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0eaed24f-cba4-4bcb-85c9-35f95c28fa67 Medical education explores competency-based assessment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-education-explores-competency-based-assessment Thu, 10 Jul 2014 06:00:00 GMT <p> More medical schools are moving their learning models toward competency-based assessment, requiring greater collaboration information-sharing in this relatively new area.</p> <p> Competency-based medical education “focuses on the skills and progression of learning of an individual, promoting greater learner-centeredness and potentially allowing greater flexibility in the time required for training,” according to a <a href="http://ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt3-a-14.pdf" target="_blank">report</a> (AMA login required) by the AMA Council on Medical Education. Taking a learner-centered approach could allow physicians to acquire competencies in new specialty areas.</p> <p> Competency education redesign allows students to progress at their own rates of knowledge and skills achievements.  For example, some of the newer three-year “fast track” programs are using competency-based education to assess students’ progress and readiness for residency. A few schools participating in the AMA <a href="http://www.ama-assn.org/sub/accelerating-change/index.shtml" target="_blank">Accelerating Change in Medical Education</a> initiative are investigating such models, including New York University School of Medicine, which uses an electronic patient portfolio and a virtual patient panel, in addition to core clinical work with patients,  to teach and track skills within competency domains for students in the three-year program.</p> <p> Vanderbilt University School of Medicine’s Curriculum 2.0 also is based on competency assessment, built on the idea that an inflexible, classroom- and clerkship-based curriculum should be replaced by one that focuses on lifelong learning. Assessing competency throughout a physician’s learning continuum—from medical school to practice—is a major component of the work by the AMA-led consortium of 11 schools.</p> <p> Shifting from time- to competency-based curricula isn’t without challenges. Assessing student competencies requires valid and reliable assessment tools, and faculty must consistently interpret their observations and evaluations of learners, requiring increased investment in faculty development. Plus, competencies are necessarily complex, requiring assessment of learners throughout the physician continuum.</p> <p> Schools participating in the AMA’s consortium and moving to competency-based assessment also are figuring out how to resolve issues related to data management and administrative flexibility.</p> <p> In an effort to build bridges across the phases of physician training, the AMA House of Delegates in June passed policy based on the AMA Council on Medical Education report to create consistency through pre-medical education and into a physician’s lifelong learning stage. The new policy calls on the AMA to continue studying the challenges and opportunities for achieving a competency-based curriculum across the medical education continuum.</p> <p> The AMA also will contribute to work that establishes a framework of consistent vocabulary and definitions across health sciences education that will facilitate competency-based curriculum, adult learning and assessment implementation. The Association of American Medical Colleges already is compiling and comparing <a href="https://www.aamc.org/initiatives/cir/about/348808/aboutpcrs.html" rel="nofollow" target="_blank">various competency frameworks</a>, taking the first step in establishing a common taxonomy of competencies.</p> <p> As consortium schools continue to implement solutions, schools will share materials, tools and ideas with one another. Once refined as best practices, the consortium will disseminate these solutions to medical schools across the country. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d6efd444-6a3e-499c-8b56-b49bdc0db7a7 Top tips to survive residency--advice for partners of residents http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_top-tips-survive-residency-advice-partners-of-residents Wed, 09 Jul 2014 15:00:00 GMT <p> The years in residency can be difficult and stressful, both for residents and their significant others. The <a href="http://www.amaalliance.org/site/" rel="nofollow">AMA Alliance</a> magazine, <em>Physician Family</em>, offers 10 top tips for partners of medical residents to survive residency, including:</p> <ol> <li> <strong>Find support. </strong>Residents work long hours and are stressed and tired. These pressures can affect everyone in the family, so it’s important to have a support network, such as the AMA Alliance.</li> <li> <strong>Share calendars.</strong> A resident’s schedule is unpredictable, so keep a calendar handy that includes the schedules of every member of the household. This practice can help make planning easier and  encourage communication.</li> <li> <strong>Schedule alone time.</strong> Spouses and significant others of residents get stressed, too. Setting aside time to reflect and rejuvenate can be very beneficial.</li> <li> <strong>Be flexible.</strong> Taking care of sick and injured patients is inherently unpredictable. Always have a back-up plan.</li> </ol> <p> See more <a href="http://www.physicianfamilymedia.org/pdfs/Spring2014PhysicianFamilyMagazine2.pdf#page=14" rel="nofollow" target="_blank">tips for surviving residency</a> from the spouse of a pain management fellow in the summer 2014 issue of <a href="http://www.physicianfamilymedia.org/" rel="nofollow" target="_blank"><em>Physician Family</em></a><em>, </em>published online four times a year especially for the loved ones of physicians, residents and medical students. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:26039b6a-ae10-4813-a1f8-01da94a204a3 Ready for release of your financial data? What to do this week http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ready-release-of-financial-data-this-week Wed, 09 Jul 2014 14:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/73704d7c-5e56-4841-a687-2b9360963ccd.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/73704d7c-5e56-4841-a687-2b9360963ccd.Large.jpg?1" style="float:right;margin:10px;" /></a>Financial interactions between physicians and manufacturers of drugs and medical devices—including everything from research and ownership interests to reprinted journal articles and meals—soon will be made public. Act quickly to make sure you’re protected from potentially inaccurate reporting under the Physician Payments Sunshine Act. Here’s the first step you should take this week.</p> <p> While the AMA convinced the Centers for Medicare & Medicaid Services (CMS) that physicians should be able to review and dispute the financial data drug companies have reported about them prior to publication, the agency has left very little time for physicians to do so.</p> <p> The first step is to complete CMS’ e-verification process. If you haven’t done so already, here’s how to do that:</p> <ol> <li> Visit the <a href="https://portal.cms.gov/" rel="nofollow" target="_blank">CMS Enterprise Portal</a> and select “New user registration”</li> <li> Accept the terms and conditions, being sure to read the “Consent to monitoring” and “Collection of personal identifiable information” sections. Identity verification is required for all users requesting access to any CMS application.</li> <li> Enter your personal information. You’ll speed up the verification process by completing all fields, including those that aren’t required.</li> <li> Select your user ID, password and security questions.</li> <li> Complete registration and wait for your confirmation email.</li> </ol> <p> CMS has contracted with Experian, a respected credit-reporting company that also specializes in identity theft protection, to verify your identity. Experian cross-references your registration information to the financial information it already has on file but that only you would know, such as your mortgage amount. CMS does not access or retain this information. This process involves a soft credit check that does not affect your credit score.</p> <p> This verification process takes some time, so be sure to complete this step as soon as possible.</p> <p> Starting July 14, you should be able to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/must-this-week-before-financial-data-goes-public" target="_blank">complete step 2</a>: registering with CMS’ Open Payments system. After that, you should have 45 days to review and dispute data reported about you.</p> <p> CMS plans to release physicians’ data to the public by Sept. 30. The agency has said physicians will need to dispute data by Aug. 27 in order for it to be flagged as such for the Sept. 30 publication. <span style="color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size:13px;line-height:18.200000762939453px;">Learn how to <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 reports</a>.</span></p> <p> <strong>Update: </strong>After numerous technical difficulties with the CMS Open Payments portal, CMS has extended the deadline for physicians to review and dispute their data until Sept. 8.</p> <p> Visit 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> to learn more about the kinds of financial interactions that will be reported and access resources to help you prepare for reviewing data and challenging any false, inaccurate or misleading reports. CMS also provides <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Phys-Teaching-Hosp-Phase-1-EIDM-Registration-Steps-[June-2014].pdf" rel="nofollow" target="_blank">detailed instructions</a> for completing step 1.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8add3370-d385-4ffc-a305-0b42456570a8 Court squelches challenge to customary practice of medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_court-squelches-challenge-customary-practice-of-medicine Tue, 08 Jul 2014 17:56:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/15/6cfdf6c1-d728-46d4-9fd8-08c6677aad65.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/15/6cfdf6c1-d728-46d4-9fd8-08c6677aad65.Large.jpg?1" style="float:right;margin:10px;" /></a>An appeals court decision delivered June 27 defeated a move that would have brought government intrusion into the regular scope of medical practice.</p> <p> In <em>Kentucky Board of Chiropractic Examiners v. Barlow</em>, an appeals court upheld the ability of physicians to provide expert review and testimony in keeping with their full scope of practice and training.</p> <p> “Providing expert opinions and testimony is a facet of the practice of medicine for many physicians, and it is an important service to their patients and the community at large,” the AMA stated in a <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/kentucky-v-barlow.pdf" target="_blank">friend-of-the-court brief</a> (AMA login required) filed by the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?" target="_blank">Litigation Center of the AMA and State Medical Societies</a> in support of the physicians involved in the case.</p> <p> In its suit, the Kentucky Board of Chiropractic Examiners claimed that physicians could not provide expert review of medical records involving chiropractic services, citing a state statute that limits peer review to other chiropractors. The argument sought to conflate peer review, which assesses the actions or competence of a licensed practitioner, with the broader concept of expert opinions.</p> <p> “Blurring the lines between expert review and peer review would be a disservice both to litigants and to health care professionals,” the brief stated. “Each type of review serves different purposes and involves different processes, procedures and results.”</p> <p> The appeals court upheld an earlier circuit court decision that preserved the distinction between the two kinds of review and affirmed that providing expert opinions is perfectly within the scope of medical practice.</p> <p> In this case, the two physicians in question were evaluating medical records for an auto insurance company to determine whether health care services provided to claimants likely were caused by injuries sustained in automobile accidents. The physicians were not evaluating the quality of that care, whether provided by chiropractors or other clinicians.</p> <p> The appeals court ruled unanimously in favor of the physicians. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed46b6e7-f754-45c3-a4ab-81a6c3384068 Get your practice’s documentation practices up to speed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_practices-documentation-practices-up-speed Tue, 08 Jul 2014 06:00:00 GMT <p> As implementation of the ICD-10 code set is little more than a year away, now is a perfect time to make sure your documentation practices are in tip-top shape—both for your current coding needs and to prepare for a smooth transition to the new code set. A new guide from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a> can help you do just that.</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</em></a>, which will be available Aug. 31, gives you and your practice staff the information you need to succeed. The book includes a collection of best practices for medical documentation and provides tools for performing an effective documentation analysis and developing an action plan.</p> <p> This practical guide includes:</p> <ul> <li> <span style="font-size:14px;">A general overview of documentation requirements</span></li> <li> <span style="font-size:14px;">Basic comparisons of the ICD-9-CM and ICD-10-CM code sets</span></li> <li> <span style="font-size:14px;">Official ICD-10-CM guidelines and documentation requirements for specific conditions, diseases and disorders</span></li> <li> <span style="font-size:14px;">Identification of diagnoses and conditions that require additional documentation under ICD-10-CM</span></li> <li> <span style="font-size:14px;">Checklists to identify opportunities for documentation improvement</span></li> <li> <span style="font-size:14px;">End-of-chapter quizzes to test retention and understanding of content</span></li> </ul> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, the Centers for Medicare & Medicaid Services is expected soon to publish a rule officially naming Oct. 1, 2015, as the new compliance deadline. Read more about how the AMA is working 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:447c384d-5f89-42a3-98dc-9c71438914fc How my practice is improving patient care and reducing costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_practice-improving-patient-care-reducing-costs Tue, 08 Jul 2014 06:00:00 GMT <p> <em>An </em><em>AMA Viewpoints</em><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/15/14/1f1c5502-86ff-4afd-aec1-d017874742bf.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/14/1f1c5502-86ff-4afd-aec1-d017874742bf.Large.jpg?1" style="height:210px;width:150px;margin:15px;float:left;" /></a>As physicians, our No. 1 priority is always our patients. In my work as an oncologist/hematologist at New Mexico Cancer Center, we have been working on how to serve our patients even better.</p> <p> We take care of very sick people who simply aren’t able to manage their care in a complicated health care environment, so we set out to be the solution for helping them be as healthy as possible.</p> <p> We figured out that using an aggressive approach to managing cancer side effects can help minimize emergency room visits and hospitalizations. We manage the overall care for our patients, handle insurance issues, take care of scheduling and more. All we ask the patient to do is show up. And we found that offering same-day appointments and encouraging patients to call us before racing to the emergency room—along with some other changes—reduced overall health care costs.</p> <p> This new delivery model kept patients out of the hospital and became a way to deliver cost-effective care.</p> <p> In 2012, I was given an award from the Center for Medicare and Medicaid Innovation (CMMI) to take what we’d done in New Mexico Cancer Center and replicate it in <a href="http://www.comehomeprogram.com/index.php/come-home-practices/" rel="nofollow" target="_blank">six other practices</a> across the country. We’ve started what we call <a href="http://www.comehomeprogram.com/" rel="nofollow" target="_blank">Community Oncology Medical Homes</a> (COME HOME) to test how oncology private practices can provide better care for patients with cancer at a lower cost. By keeping patients out of the hospital and handling what we can in physician offices, we expect to realize significant cost savings.</p> <p> Our innovative model includes seven important components:</p> <p style="margin-left:40px;"> 1.  An ongoing relationship with a personal oncologist to provide first contact and continuous, comprehensive care</p> <p style="margin-left:40px;"> 2.  Physician-led team-based care, where every member of the team works at the top of their license</p> <p style="margin-left:40px;"> 3.  Whole-person orientation</p> <p style="margin-left:40px;"> 4.  Integrated and coordinated care</p> <p style="margin-left:40px;"> 5.  Evidence-based medicine and performance measures to assure quality and safety</p> <p style="margin-left:40px;"> 6.  Enhanced access, such as late hours and same-day appointments</p> <p style="margin-left:40px;"> 7.  Payment to recognize the value-add of a medical home</p> <p> With this work, we estimate an overall Medicare cost savings of more than $4,000 per patient each year, and we’ll enroll about 8,022 Medicare and 1,530 non-Medicare patients during the three-year project. That’s a total Medicare cost savings of $33.5 million and a net savings of $13.77 million, after budget costs.</p> <p> I’m proud of the work we’re doing. With this new care delivery model, we’re able to improve health outcomes, enhance patient care and increase cost savings. It’s an example of how physicians need to devise new ways of caring for patients in a rapidly evolving health care system.</p> <p> We physicians should take the lead on creating and testing these new models. At New Mexico Cancer Center, we didn’t figure out a solution overnight. It took time. But once we realized how our aggressive approach was improving patient care and saving money, we knew it was time to expand the model and see how it might transform the way we care for cancer patients.</p> <p> The AMA is working to identify care delivery and payment models that best serve physicians and patients through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative. We’re also developing practice resources that will help physicians minimize administrative burdens in their current practice models. By embracing effective care delivery and payment models, we can improve patient care, reduce costs and increase professional satisfaction.</p> <p> <span style="font-size:10px;">This post was made possible by Grant Number <u>ICICMS330969</u> from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a8da6c67-de2a-4318-bb55-95a11912d0ca HIPAA audits to resume shortly; make sure you’re compliant http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hipaa-audits-resume-shortly-sure-compliant Mon, 07 Jul 2014 20:37:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/67f06b8e-39a5-4ba1-adc2-291957f0289c.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/67f06b8e-39a5-4ba1-adc2-291957f0289c.Large.jpg?1" style="margin:15px;height:243px;width:365px;float:right;" /></a>If you haven’t conducted a privacy and security risk assessment recently, now’s the time to do so. The U.S. Department of Health and Human Services Office for Civil Rights (OCR) plans to implement random Health Insurance Portability and Accountability Act (HIPAA) audits to monitor compliance, beginning as soon as later this summer.</p> <p> Building on a HIPAA auditing program piloted in 2012, the agency expects to launch random HIPAA audits focused on ferretting out major threats to patient health information confidentiality and network security.</p> <p> Failure to comply with HIPAA’s privacy, security and breach notification requirements likely will result in financial penalties that could be significant. Recent OCR data shows that 60 percent of security breaches come from theft and loss of technology containing protected health information. However, issues related to hospital and practice staff using their own mobile devices and unsecure Wi-Fi networks are on the rise.</p> <p> Your practice should take these three steps to protect against a breach in security and the loss of patient information:</p> <ul> <li> Educate your staff about the importance complying with HIPAA requirements</li> <li> Ensure all electronic patient information is encrypted when in transit and at rest</li> <li> Perform a privacy and security risk assessment for all health care information technology, not just your electronic health records</li> </ul> <p> The AMA offers a number of free resources to help your practice comply with the HIPAA requirements, including a <a href="http://ama-assn.org/resources/doc/washington/x-pub/hipaa-toolkit.pdf" target="_blank">HIPAA privacy and security toolkit</a> (AMA login required) and an <a href="https://cme.ama-assn.org/Activity/2217925/Detail.aspx" target="_blank">online activity</a> offering continuing medical education in the form of <em>AMA PRA Category 1 Credit™</em>.</p> <p> These resources and additional information are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act.page" target="_blank">HIPAA Web page</a>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fb5c9b26-0b94-4376-91c3-0177024d9e72 Resolutions due Sept. 5 for the AMA-SPS Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_resolutions-due-sept-5-ama-sps-interim-meeting Mon, 07 Jul 2014 18:03:00 GMT <p> Submit a resolution for consideration at the 2014 AMA Senior Physicians Section (SPS) Interim Meeting. The deadline to do so is Sept. 5.</p> <p> Any member of the section may submit a resolution for the governing council’s review and approval. By authoring a resolution, you can raise awareness of relevant senior issues. <a href="mailto:sps@ama-assn.org" rel="nofollow">Email the section</a> with your submission.</p> <p> Resolution guidelines are available on the section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section/meetings/meeting-timeline.page" target="_blank">meeting Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:67459002-694a-46db-b28f-f09df8303009 Physical activity helps older adults stay mobile longer: JAMA study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physical-activity-helps-older-adults-stay-mobile-longer-jama-study Mon, 07 Jul 2014 18:02:00 GMT <p> A structured, moderate-intensity physical activity program compared with a health education program reduced major mobility disability over 2.6 years among older adults at risk for disability, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1875328&resultClick=3" rel="nofollow" target="_blank">recent study</a> in the <em>Journal of the American Medical Association</em> (<em>JAMA</em><em>)</em><em>.</em></p> <p> The study included participants who were recruited from urban, suburban and rural communities at eight centers throughout the United States. A structured, moderate-intensity physical activity program was compared with a health education program for reducing major mobility disability.</p> <p> The findings suggest mobility benefit from such a program in vulnerable older adults.</p> <p> <object data="http://www.youtube.com/v/WS8ke_7FPBk" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/WS8ke_7FPBk" type="application/x-shockwave-flash" width="450"><param name="movie" value="http://www.youtube.com/v/WS8ke_7FPBk" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowFullScreen" value="true" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /></object></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2d66dcb9-c87d-4029-b08b-286927224c5f Register by July 31 for ethnic physicians summit http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-july-31-ethnic-physicians-summit Mon, 07 Jul 2014 18:01:00 GMT <p> The Network of Ethnic Physician Organizations (NEPO) <a href="http://www.thecmafoundation.org/Programs/NEPO/2014-NEPO-Leadership-Summit" rel="nofollow" target="_blank">Leadership Summit</a> provides information that empowers physicians, public health professionals and community leaders to be advocates for positive change in their communities.</p> <p> This summit is an opportunity those who work with underserved communities to learn about emerging health care policy issues, share best practices for reducing health disparities and increase access to health care services for the populations they serve.</p> <p> This year’s summit will be held at the Riverside Conference Center in Riverside, California, with rooms available at the historic Mission Inn and Spa. Continuing medical education credit will be offered, and the agenda will include a thought-provoking array of plenary sessions and workshops.  </p> <p> The summit will take place Sept. 19-21.  <a href="https://www.eventbrite.com/e/2014-nepo-leadership-summit-tickets-11573812585" rel="nofollow" target="_blank">Register</a> by July 31 to get an early-bird rate of $150.00.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e815c100-183c-4c0b-a0e2-9c35e48c44be New webcasts explore key issues in medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-webcasts-explore-key-issues-medicine Mon, 07 Jul 2014 18:00:00 GMT <p> <span style="font-size:14px;">View <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section/education/webcasts.page">new webcasts</a> from the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section.page">Organized Medical Staff Section</a> to learn about such timely topics as implementation of the ICD-10 code set, physician leadership in patient safety and quality, employment principles, and conflict management.</span></p> <p> <span style="font-size:14px;">These activities are approved for continuing medical education credit in the form of <em>AMA PRA</em> <em>Category 1 Credit</em>™.</span></p> <p> <span style="font-size:14px;">The webcast titles include:</span></p> <ul> <li> <a href="https://cme.ama-assn.org/Activity/2547425/Detail.aspx">ICD-10: Actions physicians need to take now</a></li> <li> <a href="https://cme.ama-assn.org/Activity/2545503/Detail.aspx">Physicians leading change for better outcomes</a></li> <li> <a href="https://cme.ama-assn.org/Activity/2547104/Detail.aspx">Care delivery: Professional satisfaction and practice sustainability</a></li> <li> <a href="https://cme.ama-assn.org/Activity/2546989/Detail.aspx">The role of the physician as a leader in patient safety and quality</a></li> <li> <a href="http://cmsdocs.inreachce.com/Details?resultsPage=1&sortBy=&q=Physician+Wellness&searchType=1&groupId=6c2693de-ffac-4003-bd1e-ea9ede13b268" target="_blank" rel="nofollow">Physician wellness: The medical and legal shift toward a culture of safety</a> ($29 for members; $79 for non-members)</li> <li> <a href="http://cmsdocs.inreachce.com/Details?resultsPage=1&sortBy=&category=00fcbe27-ab99-4e93-abaf-77faa2835210&groupId=cd3200d2-c4e0-4ea4-998b-cd65a038af7b" target="_blank" rel="nofollow">AMA Principles for Physician Employment</a> ($29 for members; $79 for non-members)</li> <li> <a href="http://cmsdocs.inreachce.com/Details?resultsPage=1&sortBy=&q=principle&searchType=1&groupId=794c4cc2-9275-4be2-9736-80d0e2be73cc" target="_blank" rel="nofollow">The Joint Commission’s leadership standard on conflict management</a> ($29 for members; $79 for non-members)</li> </ul> <p> AMA members can view most of these webcasts for free; nonmembers can watch them for $30 per credit hour. If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" title="http://www.ama-assn.org/go/join">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:991d0343-9c1e-4a0b-b2c1-f3c089f81c24 CDC report: 46 people die from Rx painkiller overdose each day http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-report-46-people-die-rx-painkiller-overdose-day Mon, 07 Jul 2014 15:02:00 GMT <p> The prescription drug overdose epidemic claims nearly four dozen lives in the United States every day, according to a <a href="http://www.cdc.gov/vitalsigns/opioid-prescribing/index.html" rel="nofollow" target="_blank">new report</a> from the Centers for Disease Control and Prevention (CDC). Meanwhile, states are considering a number of different policy options to combat this public health crisis.</p> <p> For the AMA, the approach to addressing this issue “must include a strong emphasis on increasing access to substance abuse treatment and prevention efforts across the nation,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-07-02-cdc-prescription-drug-abuse-prevention.page" target="_blank">statement</a>. “This new data will help provide states and public health authorities with important information that can be used to reduce the crisis of prescription drug abuse, diversion, overdose and death."</p> <p> According to the report, some state success has occurred as a result of policies that have led to closing illegal “pill mills” as well as opportunities to increase access to the overdose reversal drug naloxone, which can save lives.</p> <p> “We recognize that this is a multipronged problem and have long-advocated for an evidence-based, public health approach to address this crisis,” Dr. Wah said. “We continue to work with national organizations such as the National Governors Association to advance such an approach.”</p> <p> Just last month, the AMA <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page#plckblogpostonpage=4&plckblogpage=BlogPost&plckpostid=Blog%3Ae38cf47a-fc5f-473b-9234-c9e714c1c8f0Post%3A5cf1008c-1814-440f-9285-7b4ac4be3f5c" target="_blank">participated in a White House summit</a> on responses to the prescription drug abuse crisis, and the organization is making headway in its work with state medical associations, federal agencies and lawmakers to stop prescription drug abuse and preserve access to treatment for the patients who need it.</p> <p> “Several elements of our policy are echoed in the CDC recommendations,” Dr. Wah said. He pointed to several components of the AMA’s comprehensive approach to the problem, including:</p> <ul> <li> Enhanced educational opportunities for physicians.</li> <li> Robust prevention efforts. Specifically, clinicians need improved clinical decision support tools as part of modernized, fully funded prescription drug monitoring programs so they can access their patients’ information at the point of care.</li> <li> Broader implementation of drug take-back programs.</li> <li> Increased overdose prevention measures, including access to naloxone.</li> </ul> <p> The AMA also offers a number of educational activities for physicians, including a 12-module online <a href="http://www.ama-assn.org/ama/pub/physician-resources/pain-management.page" target="_blank">pain management series</a> and free <a href="http://www.pcss-o.org/archived-webinars" rel="nofollow" target="_blank">archived webinars</a> offered through the Providers’ Clinical Support System for Opioid Therapies, a group of health care organizations led by the American Academy of Addiction Psychiatry that received grant funding from the Substance Abuse and Mental Health Services Administration.</p> <p> Recent AMA-hosted webinars include:</p> <ul> <li> <a href="http://eo2.commpartners.com/users/ama/session.php?id=13708" rel="nofollow" target="_blank">Difficult conversations in opioid management: Limiting, reducing or stopping opioids</a></li> <li> <a href="http://eo2.commpartners.com/users/ama/session.php?id=13724" rel="nofollow" target="_blank">Trends in state prescription drug laws</a></li> <li> <a href="http://eo2.commpartners.com/users/ama/session.php?id=13337" rel="nofollow" target="_blank">Opioid safety with naloxone</a></li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6d75ae7-486c-47e9-9843-f968e952ea82 5 ways to prepare for the USMLE http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-ways-prepare-usmle Mon, 07 Jul 2014 15:01:00 GMT <p> Are you getting ready to take the United States Medical Licensing Exam (USMLE)? These five steps outline practical tips for preparing, including useful resources.</p> <p> <strong>1. Take a USMLE prep course:</strong> USMLE test prep courses can offer insight into what will be on the exam. You may wish to take the course two to three months before your exam date for adequate preparation. Experts recommend purchasing a USMLE exam book, such as <em>First Aid for the USMLE</em>, to supplement the course and taking the Step 1 exam in June.</p> <p> Kaplan Medical offers <a href="http://www.kaptest.com/partnerships/ama.jhtml" rel="nofollow" target="_blank">in-person and online events</a> featuring information on USMLE Steps 1-3 and other USMLE-related topics. AMA members receive 30 percent off Kaplan Medical’s Step 2 CK High Yield and Qbank courses.</p> <p> <strong>2. Set a goal:</strong> Determine what your current score is and decide what score you want to aim for when you take the exam. <a href="http://www.usmle.org/bulletin/scores/" rel="nofollow" target="_blank">According to the USMLE</a>, the mean score for first-time examinees from accredited medical school programs in the United States is in the 220-240 range.</p> <p> <strong>3. Take practice tests:</strong> Working through test exams in advance can help you hone your test-taking skills and identify areas for additional study.</p> <p> The Kaplan Medical’s <a href="https://www.usmleworld.com/Step1/step1_qbank.aspx" rel="nofollow" target="_blank">QBank</a> products offer practice tests and give a breakdown by topic of how you did so you can work on target areas.</p> <p> <strong>4. Time yourself:</strong> Only so much time is allowed to take the USMLE. Time your practice tests to make sure you’ve set a good pace for a better overall score outcome.</p> <p> <strong>5. Prep on the go: </strong>Turn down time into a higher score using Kaplan Medical’s <a href="http://www.kaptest.com/Medical-Licensing/Med-Promos/usmle-mobile.html" rel="nofollow" target="_blank">Qbank integrated mobile app</a> for iPhone<sup>®</sup> and Android™ and lectures optimized for iPad<sup>®</sup> and iPad mini. The app is free for Qbank subscribers.</p> <p> Visit the <a href="http://www.kaptest.com/partnerships/ama.jhtml" rel="nofollow" target="_blank">Kaplan Medical website</a> to learn more about the AMA member discount. Use promotional code “AMASAVINGS30.” If you’re not an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:89daaae2-fcf1-483b-a29a-bbf75b26c7da Avoid 2016 Medicare penalty: Use a registry for quality reporting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_avoid-2016-medicare-penalty-use-registry-quality-reporting Mon, 07 Jul 2014 15:00:00 GMT <p> Physicians who don’t successfully report for Medicare’s Physician Quality Reporting System (PQRS) this year will face a 2 percent payment penalty in 2016. One of the ways to report is <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Registry-Reporting.html" rel="nofollow" target="_blank">through clinical registries</a>, for which the Centers for Medicare & Medicaid Services (CMS) just released the approved lists.</p> <p> Individual physicians and group practice who wish to report using the clinical registry method can identify this year’s qualified registries in an <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014QualifiedRegistries.pdf" rel="nofollow" target="_blank">online list</a> from CMS.</p> <p> The new qualified clinical data registries <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Qualified-Clinical-Data-Registry-Reporting.html" rel="nofollow" target="_blank">reporting option</a>, however, is available only to individual physicians, not group practices. <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014QCDRPosting.pdf" rel="nofollow" target="_blank">This year’s list</a> is available online.</p> <p> Additional information about these clinical data registry reporting options is outlined in the CMS documents “<a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014_QualifiedClinicalDataRegistry_MadeSimple.pdf" rel="nofollow" target="_blank">2014 PQRS: Qualified clinical data registries participation made simple</a>” and “<a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014_PQRS_Registry_Made_Simple_F01-08-2014.pdf" rel="nofollow" target="_blank">2014 registry reporting made simple</a>.”</p> <p> Individual physicians who are not using one of the two registry reporting options instead can report on individual PQRS quality measures using the following methods: </p> <ul> <li> Medicare Part B claims </li> <li> Direct electronic health record (EHR) using certified EHR technology</li> <li> Certified EHR technology via data submission vendor</li> </ul> <p> Visit the CMS website to learn more about how to <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/How_To_Get_Started.html" rel="nofollow" target="_blank">get started reporting</a> for this year’s PQRS requirements.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a71d8efa-8b6e-4112-8440-704fb63c7599 Physicians take on telemedicine to bolster care delivery http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-telemedicine-bolster-care-delivery Thu, 03 Jul 2014 15:18:00 GMT <p> Recognizing the ability of telemedicine to improve access to care, increase care coordination and quality, and reduce growth in health care spending, the nation’s physicians have set out to shape essential elements of telemedicine to ensure patients receive the best possible care.</p> <p> At the 2014 AMA Annual Meeting last month, physicians approved a set of principles for telemedicine set forth in a <a href="https://download.ama-assn.org/resources/doc/cms/x-pub/a14-cms-report7.pdf" target="_blank">new report</a> (AMA login required) by the AMA Council on Medical Service. Here are some of the top issues the AMA is addressing so the potential benefits of telemedicine can be harnessed for physicians and their patients:</p> <p> <strong>Developing a solid evidence base. </strong>The new telemedicine principles call for additional research and the development of evidence-based clinical practice guidelines that should be followed when delivering telemedicine services. The AMA is working with medical specialty societies and is urging the Center for Medicare and Medicaid Innovation and the Patient Centered Outcomes Research Institute to significantly increase funding in this area.</p> <p> <strong>Promoting the patient-physician relationship and care coordination.</strong> To ensure proper diagnoses and follow-up care, the principles specify that a valid patient-physician relationship should exist before using telemedicine or the physician should meet the standard of care and other safeguards outlined in the AMA policy for establishing this relationship using appropriate telecommunication technologies. (Even when physicians have an existing valid relationship, use of telemedicine should comply with the patient safeguards outlined in the policy.) Chief among the safeguards outlined in AMA policy is the need to ensure that these technologies are covered to enhance care coordination and information-sharing between those who provide virtual care and in-person care.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/82009a03-1802-4f16-a62a-da04672e745d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/82009a03-1802-4f16-a62a-da04672e745d.Large.jpg?1" style="margin:15px;float:right;" /></a></p> <p> <strong>Ensuring physicians are able to practice in the patient’s state. </strong>The AMA is working with the Federation of State Medical Boards and other stakeholders to advance an interstate compact that would streamline the licensing process, removing administrative and financial barriers to licensure in more than one state and facilitating the responsible practice of telemedicine across state lines. The principles call for physicians to be licensed where the patient receives the services and to follow that state’s medical practice laws.</p> <p> <strong>Identifying technical solutions and requirements.</strong> Telemedicine technology also must facilitate easy information sharing and comply with Health Insurance Portability and Accountability Act (HIPAA) privacy and security requirements. The AMA is working with telemedicine stakeholders to identify solutions and establish technical standards.</p> <p> <strong>Enabling appropriate reporting, payment and coverage. </strong>Medicaid programs in 46 states and the District of Columbia offer some form of payment for telemedicine services, but the definition and regulation of telemedicine varies considerably. Similarly, coverage by private insurers is quite different from one payer to another. The new telemedicine principles call for additional pilots that can demonstrate which kinds of payment and delivery models work best with this care. The AMA also is providing clear recommendations to policymakers and others about the conditions that should be met for telemedicine services to be covered and paid.</p> <p> <strong>Providing education and tools for physicians. </strong>Educational resources can help physicians safely navigate this emerging field of care delivery, including such weighty concerns as HIPAA compliance and medical liability coverage. The AMA principles advise physicians to make sure their liability insurance covers telemedicine services—especially for patients in other states—before engaging in such activity.</p> <p> The AMA also is advocating for adoption of these principles with state and federal lawmakers through testimony to congressional committees and other vital activities.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2c2f8d82-236d-472c-a0eb-629ae27cbe93 What you should consider when planning a team-based care model http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_should-consider-planning-team-based-care-model-1 Thu, 03 Jul 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/15/ba726fb9-9f70-4e3f-af85-d7032641e002.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/15/ba726fb9-9f70-4e3f-af85-d7032641e002.Large.jpg?1" style="margin:15px;float:left;" /></a>As team-based models of delivering care become an increasingly common way to improve care coordination and efficiency, a new report offers guidance for the crucial elements physicians should consider when planning such a team.</p> <p> The <a href="https://download.ama-assn.org/resources/doc/cms/x-pub/a14-cms-report6.pdf" target="_blank">report</a> (AMA login required) from the AMA Council on Medical Service stresses that there isn’t a single one-size-fits-all model for team-based care, and each physician practice should design its model according to its needs, the population it serves and state laws.</p> <p> The report established policy defining  physician-led team-based health care as “the consistent use by a physician of the leadership knowledge, skills and expertise necessary to identify, engage and elicit from each team member the unique set of training, experience and qualifications needed to help patients achieve their care goals, and to supervise the application of these skills.”</p> <p> “The AMA believes that the ultimate responsibility for the individual patient’s medical care rests with the physician,” the report said. “Physicians must be responsible and have authority for initiating and implementing quality-control programs for non-physicians delivering medical care in integrated practices.”</p> <p> The council outlined elements physicians should consider when planning a team-based care model for their practices, including:</p> <ul> <li> <strong>A patient-centered focus.</strong> A relationship is established between the patient and the team at the onset of care, including explanation of each team member’s role in care. Patients have access to the team or designated coverage at any time of day or night and are treated as integral members of the team providing their care.</li> <li> <strong>Teamwork.</strong> Physicians lead the medical team and have the ultimate responsibility and authority to carry out final decisions. The number and variety of practitioners in the team reflects the needs of the practice. Interdependence among team members is expected, and communication is routine. Team members complete tasks according to set protocols as directed by the physician leader.</li> <li> <strong>Clinical roles and responsibilities.</strong> Physician leaders are focused on individualized patient care and treatment plan development. Non-physician practitioners are focused on providing treatment within their scope of practice, and as delegated and supervised by the physician leader. Care coordination and case management are integral to the team’s practice.</li> <li> <strong>Practice management.</strong> Electronic health records are used to the fullest capacity. Quality improvement processes are in place and constantly evolving. The practice uses data analytics, including statistical and qualitative analysis on costs and use.</li> </ul> <p> “Leadership on teams of highly-skilled health professionals doing complex or innovative work does not require physician leaders to have all the right answers for every task the team needs to accomplish,” the report said. “Rather, it requires physicians to ask the right questions, invite participation, communicate clearly, promote a culture of respect, reward excellence and ensure accountability, among other important leadership skills.”</p> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA is identifying effective care delivery and payment models to improve the quality of patient care, reduce health care costs for the nation and increase professional satisfaction. </p> <p> Physicians also can use <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/shaping-delivery-and-payment-models/payment-model-resources.page" target="_blank">educational webinars and practical guides</a> from the AMA Innovators Committee to learn more about how to implement new care delivery and payment models into their own practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:83a4e754-4269-4fc8-8115-342d8ccdc11c 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-2 Wed, 02 Jul 2014 14:16:00 GMT <p> <strong><object align="left" data="http://www.youtube.com/v/dpWEp_Wc7RE" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/dpWEp_Wc7RE" type="application/x-shockwave-flash" vspace="15" width="365"><param name="movie" value="http://www.youtube.com/v/dpWEp_Wc7RE" /><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/dpWEp_Wc7RE" type="application/x-shockwave-flash" vspace="15" width="365" wmode="transparent"></embed></object>Bone marrow transplantation shows potential for treating adults with severe sickle cell disease</strong><br /> Use of a lower intensity bone marrow transplantation method showed promising results among 30 patients (16-65 years of age) with severe sickle cell disease, according to a <a href="http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.7192" rel="nofollow" target="_blank">study</a> in the July 2 issue of the <em>Journal of the American Medical Association </em>(<em>JAMA</em>). </p> <p> <strong>Drug everolimus does not improve overall survival in patients with advanced liver cancer</strong><br /> Despite strong preclinical data, the drug everolimus failed to improve overall survival in patients with advanced liver cancer, compared to placebo, according to a <a href="http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.7189" rel="nofollow" target="_blank">study</a> published in <em>JAMA</em>.</p> <p> <strong>Research letter examines reports of chronic pain, opioid use by U.S. soldiers</strong><br /> In a survey of U.S. soldiers returned from deployment, 44 percent reported chronic pain and 15.1 percent reported recent use of opioid pain relievers, according to <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1885986" rel="nofollow" target="_blank">research</a> published in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Blood lead levels associated with increased behavioral problems in kids in China</strong><br /> Elevated blood lead levels appear to be associated with teacher-reported behavioral problems in a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1884486" rel="nofollow" target="_blank">study</a> of preschool children in China published in <em>JAMA Pediatrics</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e70e2c6e-dfd7-42a8-9f40-7c2d7d700cfb Tips for successful research abstracts: Free webinar Wednesday http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tips-successful-research-abstracts-webinar-wednesday Wed, 02 Jul 2014 13:51:00 GMT <p> How do you set yourself apart when submitting a research abstract? Previous winners of the AMA Research Symposium will offer pointers for success July 9 at 7 p.m. Eastern time during a special webinar for medical students, residents and fellows, and international medical graduates (IMG) who are awaiting residency. <a href="https://ecfmgevents.webex.com/ecfmgevents/onstage/g.php?d=660139979&t=a" rel="nofollow" target="_blank">Sign up today</a>.</p> <p> Rashi Aggarwal, MD, assistant professor in the Department of Psychiatry at Rutgers New Jersey Medical School, will discuss the do’s and don’ts of writing and submitting a case or research abstract, as well as creating a poster for presentation.</p> <p> Participants will learn tips for submitting noteworthy abstracts and giving winning poster and podium presentations from previous symposium winners. The webinar panelists also will answer questions from participants. Questions can be submitted in advance or during the event.</p> <p> Space is limited, so <a href="https://ecfmgevents.webex.com/ecfmgevents/onstage/g.php?d=660139979&t=a" rel="nofollow" target="_blank">register today</a> to participate. This webinar is jointly hosted by the AMA and the Educational Commission for Foreign Medical Graduates (ECFMG).</p> <p> <strong>Is this webinar for you?</strong></p> <p> If you’re a physician in training and interested in successfully participating in the 12th annual <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">AMA Research Symposium</a>—an opportunity for accepted applicants to set themselves apart from the crowd—then this event is for you.</p> <p> Submissions are being accepted from AMA members in three categories:</p> <ul> <li style="margin-left:0.5in;"> Medical students</li> <li style="margin-left:0.5in;"> Residents and fellows</li> <li style="margin-left:0.5in;"> IMGs certified by the ECFMG and awaiting residency</li> </ul> <p> <strong>Applying for the AMA Research Symposium</strong></p> <p> This year’s symposium will take place Nov. 7-8 at the Hilton Anatole in Dallas, in conjunction with the 2014 AMA Interim Meeting. Abstracts are being accepted until midnight Eastern time Aug. 19.</p> <p> Additional details about applying—including topic categories, submission guidelines and frequently asked questions—are available on the <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">symposium Web page</a>.</p> <p> Don’t miss this opportunity to gain recognition for your work, network with your peers and learn from the experienced physicians judging the event. For IMGs awaiting residency, the symposium also can help increase your attractiveness to residency programs by showcasing your research or case on a national level.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5c362eb7-40b8-459a-9c16-4ad71df97feb Duty-hours innovation needed: Report http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_duty-hours-innovation-needed-report Wed, 02 Jul 2014 06:00:00 GMT <p> While the medical profession needs continued investigation of resident duty-hours, it also needs to encourage new models for duty-hours requirements, physicians, residents and medical students agreed last month.</p> <p> Based on a <a href="http://ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt5-a-14.pdf" target="_blank">report</a> (AMA login required) from the AMA Council on Medical Education, physicians at the 2014 AMA Annual Meeting adopted new policy that supports duty-hours research to explore a variety of issues, including:</p> <ul> <li> Patient safety</li> <li> Trainees’ preparedness for practice</li> <li> Workload and patient volume</li> <li> Patient handoffs and continuity</li> <li> Professionalism and personal responsibility</li> </ul> <p> The new policy also encourages the study of innovative models of duty-hour requirements, including potentially creating specialty- or rotation-specific duty-hours requirements that would optimize competency-based learning opportunities.</p> <p> The report highlights the AMA’s support for the Accreditation Council for Graduate Medical Education’s (ACGME) duty-hours standards, established in 2003, and encourages the ACGME to continue its duty-hours work. Specifically, the AMA will urge the ACGME to continue offering residency program incentives to ensure compliance with the standards, meeting with peer-selected or randomly selected residents during site visits, and collecting and sharing data on at-home call.</p> <p> The AMA also will encourage the ACGME to:</p> <ul> <li> Decrease barriers to reporting duty-hours violations and resident intimidation</li> <li> Ensure that accessible, timely and accurate information about duty hours is not constrained by the cycle of ACGME site visits</li> <li> Use recommendations from respective specialty societies and evidence-based approaches to any future revision of duty hours</li> <li> Disseminate aggregate data from the annual ACGME survey on the educational environment of resident physicians</li> </ul> <p> The ACGME in March announced it would waive certain duty-hour standards for two large national, multi-institutional resident trials. The core standards of 80-hour work weeks (averaged over four weeks), one day off for every seven worked (averaged over four weeks) and call no more frequently than every third night will remain in place for both trials. AMA policy supports these studies.</p> <p> “Due to the wide range of issues that are related to duty hours and duty-hour limits, systemic change in residency education (and medical practice) may be needed to fully address this issue—beyond the simple metric of hours worked each week,” the report’s executive summary states. “This need is reflected in the work of the ACGME as it seeks to improve the quality and safety of residency training and move from a focus on process toward outcomes.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5c954195-9d5b-4282-8d95-17f4e494cf54 Doctors tell CMS to put the brakes on new medical staff rules http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-tell-cms-put-brakes-new-medical-staff-rules Tue, 01 Jul 2014 18:10:00 GMT <p> A <a href="http://www.gpo.gov/fdsys/pkg/FR-2014-05-12/pdf/2014-10687.pdf" target="_blank" rel="nofollow">final rule</a> revising Medicare’s conditions of participation for hospitals could impact physicians’ role in hospital governance and patient care activities. The Centers for Medicare & Medicaid Services (CMS) needs to give the rule more thought and institute an immediate delay before implementation, the AMA and more than 80 other medical associations told the agency in a letter Tuesday.</p> <p> Under the latest final rule, published in May and scheduled to take effect July 11, a multi-hospital health system would be permitted to have a single, integrated medical staff. CMS took a middle ground approach by requiring that when a hospital elects to have a single medical staff, each individual hospital medical staff must opt in or opt out.</p> <p> The final rule also replaces a requirement for the hospital governing body to include a member of the medical staff with a requirement that the governing body must directly consult at least two times per year with the medical staff.</p> <p> The AMA and other medical societies are calling on CMS to delay the rule’s effective date until May 12, 2015, a year after the rule was published.</p> <p> “We think this is an ill-conceived policy that will disenfranchise physicians and hinder their input into hospital programs, especially for those physicians in rural or geographically distant hospitals,” the <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/conditions-of-participation-letter-01july2014.pdf" target="_blank">letter said</a> (AMA login required). “We have also expressed serious concerns about the negative effects that this structure may have on patient care as well as the negative repercussions for system-wide care coordination activities.”</p> <p> The organizations argued that medical staffs need more time to prepare and that CMS must provide guidance on a number of issues before the rule can be implemented. The letter reiterated the importance of delaying the rule after CMS responded to <a href="http://www.ama-assn.org/resources/doc/omss/x-pub/cops-060314.pdf" target="_blank">earlier correspondence</a> and conveyed it didn’t plan to delay the effective date.</p> <p> The letter also asks the agency to further consider several issues that are unclear in the latest version of the final rule, including licensure requirements and peer review protections.</p> <p> “This rule makes unprecedented changes to the Medicare hospital conditions of participation that will dramatically alter the make-up and efficacy of hospital medical staffs nationwide,” the letter said.</p> <p> Learn more about key provisions of the final rule in an AMA-prepared <a href="http://www.ama-assn.org/resources/doc/omss/x-pub/cops-final-rule.pdf" target="_blank">summary</a> (AMA login required).</p> <p> In addition to the AMA’s advocacy work with CMS, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section.page" target="_blank">Organized Medical Staff Section</a> is working on resources to help medical staffs inform their membership about how to best influence the path forward, such as whether to join a system-wide medical staff, and structure consultations with the governing body.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b2d74f2f-bd4b-47cb-8358-68ead0eb7bc1 New practice training program comes right to your office http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-practice-training-program-comes-right-office Tue, 01 Jul 2014 18:04:00 GMT <p> If you’re interested in getting your practice up to speed on the latest coding guidelines and information, turn to a new on-site consultation program: “<a href="http://info.commerce.ama-assn.org/train-with-ama" target="_blank">Train With AMA</a>.” By following five easy steps, you can bring expert AMA training directly to your practice:</p> <p> 1.     Choose one of the following three training programs. Sample agendas and instructor profiles are available online.</p> <ul> <li style="margin-left:1.25in;"> AMA Guides® Sixth Training</li> <li style="margin-left:1.25in;"> CPT® Changes Workshop</li> <li style="margin-left:1.25in;"> ICD-10-CM Workshop</li> </ul> <p> 2.     Complete a request form about your practice and training needs. Customization of a training event can be requested by providing an explanation of the training you envision when completing the request form. (Note that a customized event requires at least two months of development time.)</p> <p> 3.     An AMA executive sales manager will follow up with a proposal and estimated cost within 10 business days after your request form has been submitted.</p> <p> 4.     Finalize training details and complete a final work contract with the executive sales manager.</p> <p> 5.     Enjoy your onsite AMA training with an expert educator!</p> <p> <a href="http://info.commerce.ama-assn.org/train-with-ama" target="_blank">Learn more</a> about this opportunity for your practice today.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f543fda4-8736-4315-8f8e-caa45e746e4c Early retirees struggle with gap in health coverage http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_early-retirees-struggle-gap-health-coverage Tue, 01 Jul 2014 13:12:00 GMT <p> Physicians planning to retire early often face a gap in their health insurance coverage. Until they become eligible for Medicare, early retirees frequently choose between expensive individual plans and COBRA continuation plans to eliminate the gaps in their health insurance coverage.</p> <p> <a href="https://www.amainsure.com/index.html" rel="nofollow" target="_blank">AMA Insurance</a> now offers access to the American Health Insurance Exchange (AHIX) to help address potential gaps in a physician’s health insurance coverage. Physicians either can call the exchange to speak with a licensed professional for guidance, or they can navigate through the “do-it-yourself” option online.</p> <p> AHIX offers guidance to calculate tax credit subsidies, deductions and penalties, and gives access to both the subsidized public “on-exchange” plans and the non-subsidized private “off-exchange” plans. The platform also allows physicians to manage their plan from a computer, mobile device or tablet and offers real-time billing alerts via email or text messaging.</p> <p> Physicians who wish to address gaps in their health coverage can learn more by visiting the AMA Insurance <a href="http://www.amainsure.com/products/health/majormedical.html" rel="nofollow" target="_blank">website</a> or contacting a licensed representative at (800) 647-4505.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2aba7114-5ccb-4039-8219-336413dd90c2 Apply by Aug. 1 for student spot on AMPAC board http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_apply-aug-1-student-spot-ampac-board Tue, 01 Jul 2014 13:06:00 GMT <p> Make a difference in the nation’s capital by serving on the AMA Political Action Committee (<a href="http://www.ampaconline.org/" rel="nofollow" target="_blank">AMPAC</a>) Board of Directors. The deadline to apply for the medical student member position is Aug. 1.</p> <p> AMPAC supports the AMA’s advocacy agenda by making campaign contributions to medicine-friendly candidates for Congress. AMPAC also focuses on educating and expanding the political participation of physicians and medical students. The board of directors evaluates, updates and guides these efforts to maximize the AMA’s effectiveness in the nation’s capital.</p> <p> One seat of the board is reserved for a medical student, who serves a two-year term. Only students graduating in the spring of 2014 or later are eligible to apply.</p> <p> Visit the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/opportunities/national-leadership-positions.page?" target="_blank">Web page on student leadership opportunities</a> to download an application and learn more about this position and other openings.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f04be6cf-70c4-4895-a814-b803c0bd266c Apply by July 31 for advancement of women research opportunity http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_apply-july-31-advancement-of-women-research-opportunity Tue, 01 Jul 2014 13:00:00 GMT <p> Take advantage of a unique program for health care researchers to identify and address the issues that affect women physicians and medical students: Apply for the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/about-wps/joan-f-giambalvo-memorial-scholarship.page?" target="_blank">Joan F. Giambalvo Fund for the Advancement of Women</a> by July 31.</p> <p> The AMA Women Physicians Section (WPS) has established this fund in conjunction with the AMA Foundation with the goal of promoting women in the medical profession and strengthening the ability of the AMA to identify and address the needs of women physicians and medical students. </p> <p> Topics explored by recent winners have included:</p> <ul> <li> Flexible work options</li> <li> Gender differences in the practice patterns of OB-GYNs</li> <li> Promotion and retention of diversity in medical education</li> </ul> <p> View a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section.page?" target="_blank">presentation</a> about reproductive knowledge, barriers and outcomes among female U.S. medical students and trainees by 2013 Giambalvo winner Rashmi Kudesia, MD.</p> <p> Download an <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/giambalvo-grant-application.doc" target="_blank">application</a> (AMA login required) today. The deadline to apply is July 31 at 6 p.m. Eastern time.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b68a005b-2061-4bcc-8526-41d03cb3363a This is a test poll http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_this-test-poll Tue, 01 Jul 2014 06:00:00 GMT <div> The CTA today released <a href="http://www.transitchicago.com/news/default.aspx?Month=&amp;Year=&amp;Category=2&amp;ArticleId=3322" target="_blank" rel="nofollow">crime stats</a> that showed big drops in most categories of transit crime in the first half of this compared to the same period in 2013.</div> <div>  </div> <div> Robberies were down 35 percent, and thefts dropped 18 percent.</div> <div>  </div> <div> But do you feel safe on the CTA? Take the quick poll below and let us know. Your perception is reality for you.</div> <div>  </div> <div> <div class="TWIIGSPOLL"> <div class="TWIIGSPOLLpolllink" style="background-color: transparent; background-image: none; border-style: none; clear: none; display: block; float: none; position: static; visibility: visible; height: auto; line-height: normal; width: auto; margin-top: 10px; margin-right: 0; margin-bottom: 0; margin-left: 0; outline-style: none; padding-top: 0; padding-right: 0; padding-bottom: 0; padding-left: 0; clip: auto; overflow: hidden; vertical-align: baseline; z-index: auto; letter-spacing: normal; text-align: right; text-decoration: none; text-indent: 0; text-shadow: none; text-transform: none; white-space: normal; word-spacing: normal;"> <a class="TWIIGSPOLLmorelink" href="http://www.twiigs.com/" style="background-color: transparent; background-image: none; border-style: none; clear: none; display: inline; float: none; position: static; visibility: visible; height: auto; line-height: normal; width: auto; margin-top: 0; margin-right: 0; margin-bottom: 0; margin-left: 0; outline-style: none; padding-top: 0; padding-right: 0; padding-bottom: 0; padding-left: 0; clip: auto; overflow: hidden; vertical-align: baseline; z-index: auto; letter-spacing: normal; text-align: left; text-indent: 0; text-shadow: none; text-transform: none; white-space: normal; word-spacing: normal; font-weight: bold;">poll by twiigs.com</a> </div> </div> </div> <div>  </div> <div> The CTA has made many safety improvements in the last three years, including "expanding police patrols and rail saturation missions on the CTA system; increased undercover operations targeting pick-pocket theft rings, vandalism and other crimes; and the huge expansion of CTA’s bus and rail surveillance camera network to more than 23,000 cameras, which have significantly aided in making arrests and securing convictions."</div> <div>  </div> <div> I'm actually impressed and do feel safer personally.</div> <div>  </div> <div> But it doesn't matter what I think. What do you think?</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a9577ac1-d204-4689-a24e-b12f8d6ee64e Diverse physician voices can improve nation’s health http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_diverse-physician-voices-can-improve-nations-health Tue, 01 Jul 2014 06:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/9/104e8538-35da-41b8-b937-97659a8b9e32.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/9/104e8538-35da-41b8-b937-97659a8b9e32.Large.jpg?1" style="height:135px;width:100px;margin:15px;float:left;" /></a><em>An </em><em>AMA Viewpoints</em><em> post by AMA President Robert M. Wah, MD.</em></p> <p> One of my recent stops in my busy traveling schedule as AMA president was Charlotte, North Carolina, where I had been invited to participate in the 12th annual Diversity Symposium hosted by Carolinas HealthCare System. I joined physician leaders from the National Medical Association, Chinese American Medical Society and National Hispanic Medical Association for a panel discussion of how to enhance culturally competent care.</p> <p> I was able to share some of the good work the AMA is doing to promote diversity in the health care workforce. The AMA Minority Affairs Section’s Doctors Back to School program, for instance, connects practicing physicians with schools in underserved areas of their communities. A recent event paired more than 50 medical students with nearly 600 inner-city kids in Chicago’s South Side during the 2014 AMA Annual Meeting.</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/14/9/8ed5dc40-c930-4a25-8994-5a671f99e83c.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/9/8ed5dc40-c930-4a25-8994-5a671f99e83c.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:left;vertical-align:middle;height:35px;"> <p> <span style="font-size:12px;"><em>I snapped a selfie with the audience during the 12th annual Diversity Symposium hosted by Carolinas HealthCare System—it got more than 4,000 views on Twitter! Follow me at <a href="https://twitter.com/RobertWahMD" rel="nofollow" target="_blank">@RobertWahMD</a>.</em></span></p> </td> </tr> </tbody> </table> <p> I also highlighted our work with the Commission to End Health Care Disparities, which recently realigned its strategic goals to improve accuracy and reliability of data collection and reporting for such vital elements as patient race, ethnicity and preferred language. The hope is that better data from ambulatory settings will help physicians zero in on health care disparities, including diseases such as heart disease and type 2 diabetes that disproportionally affect certain minorities.</p> <p> As an OB-GYN, I made a point to discuss gender diversity, too. Some data suggest gender bias may play a role in medical decision-making, and social attitudes toward women may unintentionally play out in care. It’s crucial that women be represented in studies and clinical trials as well.</p> <p> Shining the spotlight on diversity helps us as physicians ensure we are an accurate reflection of the population we serve. It also gives us a broader spectrum of backgrounds and experiences, uniting us in a common purpose—improving health care. As the AMA’s first Asian-American president, I’m proud to serve on one of the association’s most culturally diverse Board of Trustees.</p> <p> As physicians, we’re leaders in our communities, and we serve as role models. Several young physicians approached me at the 2014 AMA Annual Meeting to let me know that my success has inspired them and helped them know they also can achieve their goals.</p> <p> That’s one of the reasons diversity in health care is so important: Younger generations need to know they can enter this profession and make a difference, regardless of where they are from or what their backgrounds may be. I’m looking forward to continuing our work with the varied voices of AMA leaders and physicians across the nation to improve the health of our culturally diverse nation.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7a7a204e-8e23-411e-b088-98a67bce2d0e Register today: Minority faculty career development seminar http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-today-minority-faculty-career-development-seminar Mon, 30 Jun 2014 21:44:00 GMT <p> If you aspire to achieve a leadership position in academic medicine, a three-day seminar will provide the real-world guidance and tools you need to succeed. Registration now is open for the Association of American Medical Colleges (AAMC) <a href="http://www.cvent.com/events/2014-minority-faculty-career-development-seminar/event-summary-9e314b744ceb4cf587241b9fff9601f7.aspx?RefID=MinFac0616STAT" target="_blank" rel="nofollow">Minority Faculty Career Development Seminar</a>, to be held Sept. 5–8 in Vancouver, Canada.</p> <p> This program is intended for junior faculty (senior clinical and research fellows, instructors, and assistant professors) and post-doctoral individuals. Participants will be equipped to pursue career advancement in academic medicine, develop key professional competencies, build grant-writing and communications skills, and expand their networks of colleagues and role models.</p> <p> Additionally, faculty who are preparing a National Institutes of Health Career Development K or R grant proposal can apply to attend the <a href="http://www.cvent.com/events/2014-aamc-grant-writers-coaching-group-for-nih-awards/event-summary-8a1a107c34094a75b21932c2768f3a9f.aspx?RefID=GrantWrit" target="_blank" rel="nofollow">Grant Writers Coaching Group for NIH Awards</a>, which is offered on the first day of this seminar and includes an individual meeting with the coach, followed by biweekly virtual group meetings to facilitate ongoing review and discussion. The deadline to apply for the coaching group is July 10.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4152747a-4b14-4976-a55f-78e9f95c90c0 Learn how to make electronic payments work for your practice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-electronic-payments-work-practice Mon, 30 Jun 2014 06:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/5/1a42ba08-d5a1-4d6d-9592-32aa18e02398.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/5/1a42ba08-d5a1-4d6d-9592-32aa18e02398.Large.jpg?1" style="float:right;margin:10px;" /></a>Have you asked the health insurers you work with to pay claims via electronic funds transfer (EFT)? Insurers are required to offer this regulatory standard payment method using the Automated Clearing House (ACH) network if you request it. Know how to make ACH EFT work for your practice with updated, free resources from the AMA.</p> <p> The ACH EFT payment method, similar to direct deposit of paychecks, is a model in which payer-to-physician payment is processed through the ACH network and directly credited to a physician’s bank account. In comparison to paper checks and virtual credit cards, the ACH EFT standard can save you money and reduce your administrative burden.</p> <p> A <a href="http://www.ama-assn.org/resources/doc/psa/x-ama/know-your-ach-eft-rights.pdf" target="_blank">new AMA resource</a> (AMA login required) can help you understand what to expect under the new mandatory ACH EFT payment option; it details your rights as a physician and the health insurer’s responsibilities established in the new EFT standard. The resource also offers advice for avoiding the percentage-based fees and auto-debit programs some payment solution vendors may attempt to impose.</p> <p> More comprehensive information about the EFT payment method is available in the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page?" target="_blank">EFT toolkit</a>, including tips for getting started with EFT and information about virtual credit cards.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:59675294-7d85-40b9-b17a-c85999019a83