AMA Wire&#174; http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page Fri, 21 Nov 2014 19:47:00 GMT Physicians and spouses perform well at the polls http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-spouses-perform-well-polls Fri, 21 Nov 2014 19:47:00 GMT <p> Two dozen physicians and spouses of physicians were elected to public office during the 2014 General Election in November, all graduates of educational programs provided by AMPAC, the AMA’s bipartisan political action committee.</p> <p> From local positions to state legislatures, U.S. Congress to governorships, these medicine-friendly political candidates were strong performers in the 2014 election season. The 17 physicians, six physician spouses and one state society executive who won elections join another seven physicians and three spouses who are former AMPAC program participants continuing their service in public offices.</p> <p> One other physician AMPAC grad is waiting for a run-off election: U.S Rep. Bill Cassidy, R-Louisiana, who is currently leading in polling for the Dec. 6 runoff for the U.S. Senate seat in the Pelican State. Meanwhile, U.S. Rep. Ami Bera, MD, D-California, was just declared the winner of his race after all ballots were counted.</p> <p> These successful campaigns all had one thing in common: The candidates participated in AMPAC training programs to prepare them for their run for office.</p> <p> Cardiothoracic surgeon Richard M. Briggs, MD, of Knoxville, Tennessee, participated in the AMPAC Candidate Workshop in 2013. Dr. Briggs just won a seat in the Tennessee State Senate.</p> <p> “I used the course as a model for my successful state senate campaign,” he said, citing the program’s detailed materials and professional consultants as the most beneficial components for him.</p> <p> If you’re an AMA member and you or your spouse are considering making the leap from the exam room to the campaign trail, the <a href="http://www.ampaconline.org/political-education/ampac-candidate-workshop/" rel="nofollow" target="_blank">AMPAC Candidate Workshop</a> taking place Feb. 20-22 in Arlington, Virginia, is for you.</p> <p> The workshop provides training in campaign strategizing, media advertising, public speaking and fundraising. At the workshop, political veterans will share their advice about politics and explain the sacrifices required to run a competitive campaign. Attendees also will learn the secrets of effective fundraising, how to become a better public speaker and how to handle campaign crises, among other skills.</p> <p> For those who want to become more involved in campaigning for their candidates, the <a href="http://www.ampaconline.org/political-education/ampac-campaign-school/" rel="nofollow" target="_blank">AMPAC Campaign School</a> offers hands-on training.</p> <p> This five-day “boot camp” for politics centers around a simulated congressional campaign, during which attendees are trained in advertising, public speaking and fundraising and participate in such practical exercises as recording radio ads and writing fundraising letters. The campaign school takes place April 15-19 in Arlington, Virginia.</p> <p> All expenses, minus travel to and from the Arlington area, are covered for accepted applicants. Participants must be AMA members, spouses of AMA members or state or county medical association staff members.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dee42ca3-fa5b-4ca8-910b-83b563caa5e2 Health care spending growth at record low, but why? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-care-spending-growth-record-low-but Fri, 21 Nov 2014 19:41:00 GMT <p> U.S. health care spending growth is at its slowest in the past 50 years, but the reasons behind this slowed growth are unclear. A new AMA <a href="http://www.ama-assn.org/resources/doc/health-policy/x-ama/prp-2014-03-spending-slowdown.pdf" target="_blank">review</a> (log in) examines trends behind U.S. health spending and looks at possibilities for future spending growth.</p> <p> Health care spending growth from 2009 to 2012 was below 4 percent each year, and data from the Centers for Medicare & Medicaid Services (CMS) show the deceleration began in 2003, five years before the “great recession.” Researchers attribute between 37 percent and 77 percent of the slowdown to the recession. While it’s clear that other factors have contributed, there’s a lack of consensus on what the most important ones were.</p> <p> Factors thought to have contributed to the historically slow growth rates, as outlined in the AMA review, include:</p> <ul> <li> Increased patient cost-sharing and decreased real income</li> <li> Changes in insurance mix from higher to lower paying payers</li> <li> Changes in Medicare payment policy</li> <li> A shift in the Medicare and Medicaid populations to younger and healthier beneficiaries</li> <li> Cost containment efforts as a reaction to lower revenue growth during the recession</li> </ul> <p> Recent data from the Altarum Institute suggest that an acceleration in spending growth began at the end of the first quarter of 2013, leading some researchers to wonder whether the slowed growth period may be over.</p> <p> CMS projects that health spending will grow at an average annual rate of 6.1 percent from 2016 to 2023—higher than recent growth rates, but still low from a historical perspective.</p> <p> Find this analysis and others on the <a href="http://www.ama-assn.org/ama/pub/advocacy/health-policy/policy-research.page" target="_blank">AMA policy research Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:db2ee709-14f3-41bc-9f98-9bd74c980f92 What future doctors need to know about health determinants http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_future-doctors-need-health-determinants Thu, 20 Nov 2014 17:21:00 GMT <p> Part of preparing future physicians to deliver the best care is teaching them about the nation’s vast variety of people, but understanding cultural differences requires more than just background in race, ethnicity and religion. Tomorrow’s doctors are learning more about socioeconomic status, gender, sexual orientation and other social determinants of health.</p> <p> Physicians nationwide support integrating more training on the social determinants of health into undergraduate medical education—they voted to make it AMA policy at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>. The new policy includes supporting faculty development to ensure medical educators have the appropriate knowledge as well.</p> <p> Under the new policy, the AMA will support medical schools in evaluating the effectiveness of their teachings on the social determinants of health and will work to gather data on medical students’ perspectives on the topic.</p> <p> Educators shared what their schools are doing to tackle challenges in teaching the social determinants of health at a recent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-tackling-challenges-health-disparities" target="_blank">Google Hangout</a> hosted by the AMA. Participants discussed how they’re training physicians, including addressing health disparities and focusing on diversity.</p> <p> For example, some of the schools that are part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative are tackling health care disparities. The University of California Davis School of Medicine is one such school, with a new three-year primary care program that includes an innovative admissions and recruitment strategy to select students from diverse backgrounds.</p> <p> The goal is to help these students go on to practice in underserved communities as primary care physicians. One-half of the students admitted into the first class of the program are from groups historically underrepresented in medicine.</p> <p> Other programs are working on addressing the needs of lesbian, gay, bisexual and transgender (LGBT) populations. At a recent education session hosted by the AMA Medical Student Section, students discussed health problems specific to these populations. For example, lesbian women have a higher risk of substance abuse.</p> <p> “If you’re in the LGBT community, you are likely to be at a lower economic status, with less of a support system,” said Jilyan Decker, a second-year medical student at Rutgers New Jersey Medical School. “Maybe you have had experiences in the past that have given you fears about going to see the doctor.”</p> <p> Understanding ethnogeriatrics—the way aging individuals are influenced by their culture, ethnicity, history, values and beliefs—is also crucial, said Phil Zegelbone, a third-year medical student at the University of South Florida College of Medicine.</p> <p> “Consider an 85-year-old African American female,” he said. “Think about what this person’s view of health care might be.” This particular patient would have lived through multiple wars, the advent of the television, numerous medical advances and more—and all of these experiences factor into how the patient will interact with the health care system.</p> <p> After the AMA works to help medical schools integrate teachings of social determinants of health into their curricula, study will begin on how such teachings can be folded into graduate medical education and continuing medical education.</p> <p> <strong>How can future physicians learn about the social determinants of health? </strong>Share your ideas in a comment below at <em>AMA Wire</em>® or on the AMA <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1a3abdb0-a35b-44d0-af2c-6d180c2a97e7 Open enrollment has started--know your plan options http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_open-enrollment-started-plan-options Thu, 20 Nov 2014 15:00:00 GMT <p> As a physician, you may be well aware of your patients’ options for health insurance—but what about your own coverage? With open enrollment now underway, get assistance choosing health insurance plans for you, your family and your practice staff through the <a href="https://www.ahix.com/home" rel="nofollow" target="_blank">American Health Insurance Exchange</a> (AHIX). Open enrollment runs through Dec. 15.</p> <p> AHIX, offered through <a href="http://www.amainsure.com/index.html" rel="nofollow" target="_blank">AMA Insurance</a>, provides important information about qualified health plans under the Affordable Care Act (ACA). Get tools and rate information, plus:</p> <ul> <li> Shop government health plans that are on the exchange and private health plans off the exchange</li> <li> Calculate premium subsidies in seconds</li> <li> Review high- and low-deductible and out-of-pocket plans</li> </ul> <p> Enrollment takes less than 15 minutes, and you can shop hundreds of ACA-compliant plans available for purchase on the exchange</p> <p> Get started <a href="https://www.ahix.com/health-insurance-exchange-marketscan" rel="nofollow">online</a>, or call (800) 647-4505. Learn more about health insurance with <a href="https://www.ahix.com/learn-about-health-insurance" rel="nofollow" target="_blank">AHIX resources</a>.</p> <p> <strong>Residents and students:</strong> Make sure you’re covered next year. This service can help you find a health plan that fits the needs of physicians in training.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3a1030e2-fce8-4ef1-91d2-9464f145173a The history of residency--and what lies ahead http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_history-of-residency-lies-ahead Wed, 19 Nov 2014 21:52:00 GMT <p> The medical residency system as we know it today was first introduced 125 years ago—and a lot has changed in that time. Examining the origins of residency programs, and the historical roots of its challenges, can help determine what residents of today—and tomorrow—can expect.</p> <p> At its beginning, residency was not the only option for all medical school graduates, Kenneth M. Ludmerer, MD, an internist, medical educator and historian of medicine, said during a recent presentation at the Accreditation Council of Graduate Medical Education (ACGME). Medical school graduates could take different pathways to become physicians, including apprenticeships or studying outside of the country.</p> <p> At this time, those who did participate in residency programs had certain attitudes about the work they did, which informed how well the programs worked. One principle was that “residents should have sufficient time to pursue problems in depth,” Dr. Ludmerer said. “They’d reflect on the total patient.” Thoroughness, attention to detail and high professional authority gave programs a scholarly feel. Residents lived in the hospital – hence residency training – and therefore easily followed the patient from admittance to discharge.</p> <p> “The values, education principles and moral principles were reinforced by the learning environment,” Dr. Ludmerer said. “There was sufficient time [to pursue problems]…. They weren’t any less busy, but they were busy because they were so careful and thorough.”</p> <p> By the early 1940s, specialty boards began to crop up, cutting off the alternative pathways to becoming a physician. By the 1950s and 1960s, things began to change—sicker patients and more technology increased the consequences of error. Faculty had shifting priorities, meaning fewer faculty on the wards.</p> <p> By the 1970s, when <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ways-residents-found-conquer-burnout">burnout</a> was officially recognized, residency had changed.</p> <p> “There was enormous unrest among residents,” Dr. Ludmerer said. “We need to know more about what causes burnout, but at the core was excessive workloads and a sense of being marginalized by the faculty institution.”</p> <p> New payment models, such as diagnosis-related groups, and duty-hour limits through the 1980s and into present day continued to change residency. What is really needed today, and for the future is a more holistic conception of residency, which may help lessen burnout and ensure professional satisfaction among trainees, said Dr. Ludmerer.</p> <p> “We need to concentrate on the quality of the entire learning environment, including relationships with faculty, intellectual stimulation and reasonable patient loads,” he said. “For the past generation, residents have been crying out, ‘Let me heal,’ but their sense of fulfillment in work has diminished greatly. … If we truly want to make the residency better, it’s the conditions of work that matter, and not work hours alone.”</p> <p> Dr. Ludmerer pointed to current efforts to improve residency, including the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gme-financing-system-needs-overhaul-iom-report" target="_blank">Institute of Medicine report</a> on graduate medical education (GME) financing and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-community-calls-closer-look-gme-solutions" target="_blank">other GME solutions</a>. The AMA is working on these issues as well, as outlined by the AMA Council on Medical Education, by collaborating with the ACGME and other stakeholders in creating an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/move-align-gme-accreditation-paves-way-ideal-continuum" target="_blank">ideal medical education continuum</a>. In addition, the AMA’s updated policy on <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/duty-hours-innovation-needed-report" target="_blank">resident duty-hours</a> supports research to explore a variety of issues in duty-hours, including innovative models for requirements.</p> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative, the AMA is working to transform undergraduate medical education and now is focusing on <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/residents-would-transform-gme" target="_blank">collaborating with GME stakeholders</a> to make innovative changes in these relationships as well.</p> <p> <strong>How would you improve residency? </strong>Share your thoughts in a comment below at <em>AMA Wire</em>® or on the AMA <a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow" target="_blank">Resident and Fellow Section Facebook page</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c262df21-801d-415e-80c3-a8992dc0cd4c Cardiovascular health under the microscope in special JAMA issue http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cardiovascular-health-under-microscope-special-jama-issue Wed, 19 Nov 2014 21:50:00 GMT <p> A <a href="http://jama.jamanetwork.com/issue.aspx" target="_blank" rel="nofollow">special theme issue</a> of <em>JAMA</em> released this week during the American Heart Association’s Scientific Sessions 2014 takes a close look at cardiovascular health, with studies related to the prevention, diagnosis and treatment of cardiovascular disease.</p> <p> The latest data show that nearly one in three American adults—approximately 70 million—have high blood pressure, and more than one-half of these adults don't have it under control. At the same time, <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 are preventable.</p> <p> <em>JAMA</em> studies look at such timely topics as:</p> <ul> <li> <strong>Prevalence and risk of death based on type of coronary artery disease in heart attack patients</strong>. This <a href="http://jama.jamanetwork.com/article.aspx?articleid=1935121" target="_blank" rel="nofollow">study</a> found that the presence of non-infarct-related artery (IRA) disease was significantly associated with increased 30-day mortality compared to patients without non-IRA disease.</li> <li> <strong>The decline of overall death rate from heart disease</strong>. While this <a href="http://jama.jamanetwork.com/article.aspx?articleid=1935111" target="_blank" rel="nofollow">study</a> demonstrated a continued decrease in overall heart disease mortality, it also found an increase in the risk of death from the subtypes of hypertensive heart disease and arrhythmia.</li> <li> <strong>Association between use of beta-blockers by patients with certain type of heart failure and improved rate of survival. </strong>Using data from the Swedish Heart Failure Registry, this <a href="http://jama.jamanetwork.com/article.aspx?articleid=1935124" target="_blank" rel="nofollow">study</a> found that among patients with heart failure and preserved ejection fraction, use of beta-blockers was associated with lower all-cause mortality. It was not associated with lower combined all-cause mortality or heart failure hospitalization.</li> </ul> <p> New <em>JAMA </em>Viewpoints and editorials in this issue examine such topics as population and personalized medicine in the modern era, patients with undiagnosed hypertension and administrative databases’ ability to provide complete information about potentially important confounders.</p> <p> The AMA is aiming to make a profound impact on cardiovascular disease in the United States through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, which focuses on hypertension and type 2 diabetes.</p> <p> As part of the initiative, physicians and care teams in Maryland and Illinois are developing and testing evidence-based recommendations to improve high blood pressure, working with the AMA and 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, using checklists and other tools to help them <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 <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> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:43825d84-a129-4e90-b93e-edecb85a2b29 Code of Medical Ethics undergoing update: Comment through Jan. 15 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_code-of-medical-ethics-undergoing-update-comment-through-jan-15 Wed, 19 Nov 2014 21:00:00 GMT <p> The 167-year-old AMA <em>Code of Medical Ethics</em> is in the final stages of a comprehensive update. If you’re an AMA member, <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/ceja-discussion-forum.page" target="_blank">provide your feedback</a> (log in) on the draft language through Jan. 15 to have a hand in shaping this ethical guide for current and future generations of physicians.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/6/4d7bec34-f8b7-4e5b-96bd-6d8bfb756329.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/6/4d7bec34-f8b7-4e5b-96bd-6d8bfb756329.Large.jpg?1" style="float:right;margin:10px;" /></a>The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs.page" target="_blank">Council on Ethical and Judicial Affairs</a> (CEJA) has been working for six years to modernize the <em>Code</em>, last comprehensively updated more than 50 years ago. CEJA hosted an open forum at the 2014 AMA Annual Meeting in June to receive feedback on the draft <em>Code</em> and considered feedback from AMA members submitted to its online forum during the first six months of the year.</p> <p> CEJA will continue to collect member feedback through Jan. 15. You can contribute via the online <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/ceja-discussion-forum.page" target="_blank">CEJA Forum</a> (log in) or by sending an <a href="mailto:bette.crigger@ama-assn.org?subject=Modernizing%20the%20Code%20of%20Medical%20Ethics" rel="nofollow">email to the AMA</a> with comments.</p> <p> CEJA will post a revised draft of the modernized <em>Code</em> before the 2015 AMA Annual Meeting, when the document will come before the AMA House of Delegates again. Comments posted online will be available to the Reference Committee on Amendments to Constitution and Bylaws.</p> <p> In this historic project to modernize the <em>Code, </em>CEJA reviewed ethical opinions for relevance, timeliness, clarity and consistency across topics and incorporated feedback from the medical community to produce an updated <em>Code</em> with a more intuitive chapter structure. The council then revised the <em>Code</em>, working conservatively to preserve the accumulated wisdom of the House of Delegates that the <em>Code</em> presents and to make only those changes those essential to ensuring that guidance remains relevant in the face of changes in biomedical science and conditions of medical practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:86eb0233-3a59-4be0-8ca5-ce5956a010aa AMA Store offers titles of interest to seniors online http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-store-offers-titles-of-interest-seniors-online Wed, 19 Nov 2014 16:00:00 GMT <p> Are you planning to ease into retirement or thinking about starting a new career? The AMA Store offers a number of best-selling titles, including:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1230033&navAction=push" target="_blank"><em>Valuing, Selling and Closing the Medical Practice</em></a>. This comprehensive resource helps physicians formulate medical practice disengagement strategies and procedures for selling or closing a medical practice, including appraising the practice’s value.</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1230022&navAction=push" target="_blank"><em>AMA Physician’s Guide to Financial Planning</em></a>. This fundamental reference provides all the information physicians need to create a successful financial plan for themselves and their families. It also offers such common-sense tools as worksheets, sample agreements and a complete glossary of terms.</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240087&navAction=push" target="_blank"><em>A Practical Guide to Global Health Service</em></a>. This book explains how to safely and effectively engage in medical volunteering and profiles about 300 organizations that place health service volunteers.</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1170006&navAction=push" target="_blank"><em>A Piece of My Mind</em></a>. This collection brings together revealing personal essays that first appeared in the <em>Journal of the American Medical Association</em> (<em>JAMA</em>).</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1170028&navAction=push" target="_blank"><em>The</em> <em>Art of JAMA</em></a><em>. </em>This longtime favorite is a compilation of the artistic works featured on more than 100 <em>JAMA</em> covers.</li> </ul> <p> AMA members receive a discount on these titles and others from the AMA Store. 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:6038b7a3-bf4e-42a8-ab83-414ac3669a7c One school’s new approach to producing physician leaders http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-schools-new-approach-producing-physician-leaders Tue, 18 Nov 2014 23:00:00 GMT <p> <em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Erin McKean, MD, director of both the Cranial Base Surgery Clinical Innovation Program and the Medical Student Leadership Initiative at the University of Michigan Medical School. This appeared in the November 2014 edition of </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></p> <p> On a beautiful sunny day in the first week of August, before the start of classes, first-year students at the University of Michigan Medical School (UMMS) could be found in an unusual place: on a small farm.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/x_--au59s6o" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/x_--au59s6o" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/x_--au59s6o" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" quality="best" src="http://www.youtube.com/v/x_--au59s6o" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:10px;">M1 medical students from the University of Michigan Medical School got training in leadership and team building at the school’s annual Leadership Day.</span></em></td> </tr> </tbody> </table> <p> The event was Leadership Day, and the students were spending time with <a href="http://www.zingtrain.com/" rel="nofollow" target="_blank">ZingTrain</a>, the training arm of Ann Arbor, Michigan-based Zingerman’s Deli, known for its successful sustainable business model that starts with the concepts of visioning and servant leadership.</p> <p> The annual Leadership Day event began in 2012 with the induction of UMMS’s Leadership Initiative, which is the centerpiece of Michigan’s new curriculum, made possible through the AMA’s Accelerating Change in Medical Education grant. This year’s Leadership Day placed emphasis on working in teams to build class camaraderie and develop skills to lead change in health care. Watch a <a href="http://youtu.be/x_--au59s6o" rel="nofollow" target="_blank">video</a> from this year’s Leadership Day.</p> <p> Leadership is a part of our professional identity and is embedded in our social contract. As health care changes, physicians are positioned to identify problems and opportunities, communicate and collaborate with all stakeholders (including other health professionals, administrators, patients and society as a whole), create a vision of the future of health care and manage the changes that will come. In this era of rapid change, UMMS aims to develop physicians with the capacity to work effectively in teams and lead positive change. </p> <p> Leadership training at UMMS will encompass four key competencies: leading teams, systems-based practice, influence and communication, and problem solving. The new curriculum will enhance existing leadership activities and expand the program to include:</p> <ul> <li> Intentional leadership coaching with a student-directed leadership portfolio and annual one-on-one formative assessments with faculty advisors</li> <li> Multifaceted and interprofessional evaluations</li> <li> Experiences with external experts (such as ZingTrain and the Alda Center for Communicating Sciences) and internal professionals (including faculty from schools across the University of Michigan and teams from the Michigan Quality System, which aims to continually improve quality, safety, efficiency and appropriateness of care within the UM Health System)</li> <li> Application of leadership skills in the activities and capstone experiences of our longitudinal Paths of Excellence (required scholarly concentrations)</li> </ul> <p> The curriculum emphasizes that leadership is not about holding a certain position of authority but rather having a vision for success and being able to plan, motivate others and work with a team to achieve that vision. </p> <p> As our curriculum leadership team joined the students on the farm on that August day, we also drafted a vision. We envisioned our graduates building systems of care that are innovative, patient-centered and value-driven, using their leadership training to create positive change.</p> <p> <em>Get AMA MedEd Update</em> <a href="http://www.ama-assn.org/ama/pub/news/subscribe-newsletters.page" target="_blank"><em>sent to your inbox</em></a><em> monthly to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:374f1ce2-23ae-49a0-9b6c-d1cca4d02475 See the latest grant opportunities for medical students, residents http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_see-latest-grant-opportunities-medical-students-residents Tue, 18 Nov 2014 23:00:00 GMT <p> Residents and medical students are making inroads into improving public health and promoting excellence in medical education through the AMA Foundation. Here’s how this group can help physicians in training create a healthier country.</p> <p> <strong>2015 AMA Foundation Seed Grant Research Award</strong></p> <p> Residents, fellows and medical students interested in entering the research field can <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/seed-grant-research.page" target="_blank">apply for grants</a> of up to $5,000 to conduct yearlong research projects. <strong>Apply by 6 p.m. Eastern time Dec. 5.</strong></p> <p> This year, grants will be awarded to support research in the areas of cardiopulmonary diseases, neoplastic diseases and pancreatic cancer. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/interested-research-apply-grant-money-dec-5" target="_blank">Read more</a> about past winners’ experiences with the program.</p> <p> <strong>2015 AMA Foundation Excellence in Medicine Leadership Award</strong></p> <p> Medical students, residents, fellows and early career physicians with strong, nonclinical leadership skills in advocacy, community service or education can be recognized with a leadership award. Recipients will attend the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards.page" target="_blank">Excellence in Medicine Awards</a> ceremony at the 2015 AMA Annual Meeting and will be invited to attend leadership training, with airfare and lodging accommodations provided. <strong>Apply by 6 p.m. Eastern time Jan. 20.</strong></p> <p> <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards/2014-excellence-in-medicine-winners.page">Read more</a> about last year’s winners.</p> <p> <strong>2015 AMA Foundation Minority Scholars Award </strong></p> <p> Current first- and second-year medical students from historically underrepresented groups in the medical profession can receive a <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/scholarship-forms.page?" target="_blank">Minority Scholars Award</a>. These $10,000 rewards recognize commitment to the elimination of health care disparities, outstanding academic achievements, leadership activities and community involvement. Recipients will attend the 2015 AMA Annual Meeting and will be invited to attend leadership training, with airfare and lodging accommodations provided. Each medical school may nominate two students for each of the general Minority Scholars Award categories. <strong>Apply by 6 p.m. Eastern time March 6.</strong></p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/scholarships-awarded-increase-physician-workforce-diversity" target="_blank">Read more</a> about last year’s winners.</p> <p> <strong>Dr. Richard Allen Williams and Genita Evangelista Johnson/Association of Black Cardiologists Scholarship</strong></p> <p> This $5,000 scholarship is awarded as a part of the Minority Scholars Awards program. This annual scholarship provides tuition support to a first- or second-year African American medical student with an expressed interest in cardiology. Each school may nominate one student for this scholarship category using the same application as the Minority Scholars Award. </p> <p> Read more about the work of the AMA Foundation at <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Foundation/1" target="_blank"><em>AMA Wire</em></a>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5173923c-21d7-44dd-a259-bbbe5b99eb0a Medical school’s Freshman Orientation Lunch event earns recognition http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-freshman-orientation-lunch-event-earns-recognition Tue, 18 Nov 2014 23:00:00 GMT <p> Louisiana State University School of Medicine in Shreveport’s Freshman Orientation Lunch, in which the local AMA Medical Student Section (MSS) hosted a meal for the incoming class of medical students to learn about the AMA, earned the school an AMA Section Involvement Grant (SIG) Event of the Month award. </p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:320px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/6/d57cc9ee-3069-4d1b-96eb-31a08032d796.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/6/d57cc9ee-3069-4d1b-96eb-31a08032d796.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:10px;">Louisiana State University School of Medicine in Shreveport coordinated a lunch event during the incoming class orientation week, earning the school an Event of the Month award.</span></em></td> </tr> </tbody> </table> <p> The local section coordinated a lunch event during the incoming class orientation week. Upperclassmen AMA members joined the freshman class, sharing personal experiences and discussing AMA benefits and opportunities for students. With the event being held during orientation week, the majority of the incoming class attended, and 90 new students became AMA members. The student leaders also shared upcoming section activities, such as community service projects, conferences and policymaking initiatives.</p> <p> The AMA provided funding for lunch. Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-month.page" target="_blank">Event of the Month Web page</a> for a detailed description. The AMA SIG Event of the Month showcases recruitment, community service, education and AMA-MSS National Service Project events coordinated by individual AMA medical student sections.</p> <p> Is your AMA medical student section holding similar events? Submit a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/sig-follow-up.page" target="_blank">SIG Recap Form</a> and photos within 30 days of your event to be eligible for the Event of the Month nomination, which the AMA selects each month. At the end of the school year, all monthly awards will be showcased in June at the AMA-MSS Annual Assembly Meeting and will be voted on by students for one Event of the Year winner.</p> <p> Through the SIG program, the AMA-MSS provides an opportunity for local AMA medical student sections to:</p> <p style="margin-left:40px;"> •  Educate students about the AMA and provide an opportunity for students to get more involved</p> <p style="margin-left:40px;"> •  Help put AMA policy into action by providing a service to medical school campuses or communities</p> <p style="margin-left:40px;"> •  Engage in activities that focus on AMA's top priorities</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c34a6b55-3adf-4820-bc54-7a71b19f4fad 3 questions patients should ask before choosing a health plan http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-questions-patients-should-ask-before-choosing-health-plan Tue, 18 Nov 2014 22:39:00 GMT <p> Now that open enrollment for health insurance exchanges is underway, patients may be overwhelmed with messages from health insurance companies vying for their attention. Whether patients are seeking new plans or renewing existing plans, they should thoroughly review all aspects of plans to prevent interruptions in care and higher out-of-pocket costs. These three questions are crucial for patients to ask before choosing a health plan.</p> <p> There are many factors patients should take into account when reviewing health plans, including deductibles, co-pays and formulary costs. Having answers to the following questions up-front can help patients ensure they’re making the most informed health care decisions for themselves and their families.</p> <p style="margin-left:40px;"> 1. <strong>Are your family’s doctors in the plan?</strong> If they’re not, check how much you’ll have to pay out-of-pocket for office visits or other services your family’s doctors prescribe. Ask the plan if their provider directory of participating physicians is up-to-date and accurate, and whether physicians on the list are accepting new patients.</p> <p style="margin-left:40px;"> 2. <strong>What does the plan cover?</strong> It’s important to know what percentage of your health care costs you’ll have to cover—how much can you afford? What will out-of-pocket costs be for the medicines your family needs?  Check to see whether you’ll be able to use hospitals, labs and other facilities that are convenient to where you live or work, and make sure the plan gives access to a sufficient number of specialists.</p> <p style="margin-left:40px;"> 3. <strong>Does your primary care physician have to receive permission from the insurance company to refer you to a specialist?</strong> If yes, check to see if the rule includes specialists you see regularly for chronic conditions. See if the insurer uses penalties or incentives to induce physicians in the plan to limit referrals in any way.</p> <p> “We want to make sure Americans choose a plan that is right for them and their families in terms of cost and coverage,” said AMA President Robert M. Wah, MD. “It is very important that patients look beyond the big print of color and price of insurance plans and check the small print details before making their selections. Patients deserve to know what coverage they’re buying when they choose a health insurance plan, including the physicians they will have access to.”</p> <p> The AMA is also working to make sure patients have access to the care and physicians they need. New <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-policy-calls-adequate-networks-patient-access-choice" target="_blank">policy</a> passed by physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> calls for health insurers to implement any provider network reductions before the open enrollment period begins each year, to help prevent patients from being stuck with plans that drop their physicians after they already have enrolled.  This new policy builds on advocacy efforts to ensure provider directories are accurate, complete and up-to-date.</p> <p> In addition, the AMA, the Children’s Hospital Association and more than 100 other stakeholder groups are urging the National Association of Insurance Commissioners to adopt <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-outline-6-key-provisions-network-adequacy-1" target="_blank">model legislation</a> that would give patients access to the care and physicians they need. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed355bc1-76a5-4aa3-a5b5-b3cbf43fefb7 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, 18 Nov 2014 21:13:00 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 Declaration of Helsinki a reminder that medicine has no boundaries http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_declaration-of-helsinki-reminder-medicine-boundaries Tue, 18 Nov 2014 21:12:00 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/8/12/787d7bdd-b733-4aa9-9c2d-cc59dc412ba3.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/12/787d7bdd-b733-4aa9-9c2d-cc59dc412ba3.Large.jpg?1" style="float:left;margin:10px;" /></a>If there’s one thing the Ebola outbreak in West Africa has shown us, it’s that diseases and pandemics do not respect boundaries. In a globalized world, what affects one country’s physicians and patients can affect all of us, no matter where we are.</p> <p> I just returned last month from the World Medical Association’s (WMA) <a href="http://www.wma.net/en/40news/20archives/2014/2014_27/index.html" target="_blank" rel="nofollow">General Assembly meeting</a> in South Africa, where delegates passed an <a href="http://www.wma.net/en/30publications/10policies/30council/cr_19/index.html" target="_blank" rel="nofollow">emergency resolution</a> calling for comprehensive tactics to prevent and treat the Ebola virus, including adequate equipment, training and aid. By passing this emergency resolution, we declared that the world must recognize Ebola as a global crisis, not just a problem for West Africa.</p> <p> It’s fitting that we take time right now to reflect on the WMA’s <a href="http://www.wma.net/en/30publications/10policies/b3/" target="_blank" rel="nofollow">Declaration of Helsinki</a>, a seminal document that celebrates its 50th anniversary this year. Delegates at the 1964 WMA meeting in Helsinki adopted the new declaration, setting out ethical regulations for biomedical research.</p> <p> Today, the Declaration of Helsinki is one of the world’s most important ethical documents and a foundation of contemporary research ethics. In light of the Ebola outbreak and use of unproven therapies to treat the disease, the declaration and our relationship with the WMA are perhaps more important than ever.</p> <p> The WMA held a special ceremony last week to mark the Declaration of Helsinki’s anniversary. Speakers from around the world discussed how millions of people have benefited from research carried out under its guidelines. WMA President Dr. Xavier Deau emphasized that the declaration is a living document and will continue to change as physicians address the latest challenges in medical research and practice.</p> <p> Similarly, the AMA’s own <em>Code of Medical Ethics</em> is a living document—one that’s in the process of being updated to keep pace with changing medical research and practice. The 167-year-old <em>Code</em>, like the Declaration of Helsinki, continues to guide us in our practice so many years after it first was drafted.</p> <p> Make your voice heard on changes to the <em>Code</em> by submitting your opinions through Jan. 15 via the online <a href="http://www.ama-assn.org/ama/pub/community/forums.page?plckForumPage=ForumCategory&plckCategoryId=Cat:a0145272-f48b-4c03-ad56-ad76c28c04bc" target="_blank">Council on Ethical and Judicial Affairs Forum</a> (log in) or by sending an <a href="mailto:bette.crigger@ama-assn.org" rel="nofollow">email</a> to the AMA with comments.</p> <p> I’m proud of the AMA’s history as a leader in medical ethics, including being a founding member of the WMA, which was established just after the horrors of World War II. As part of the organization, we as physicians are represented in a global way—striving for the best possible health care for all, with no limits or boundaries.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9b0f73c3-bdf6-424a-87a4-53b167dd092f Improve care with new clinical networks: Submit by Nov. 20 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_improve-care-new-clinical-networks-submit-nov-20 Tue, 18 Nov 2014 21:01:00 GMT <p> If your practice has an existing relationship with physician networks, it’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/840-million-will-fund-improved-care-via-new-clinical-networks" target="_blank">eligible to participate in a new $840 million initiative</a> to improve care via clinical networks. Optional letters of intent are due to the Centers for Medicare & Medicaid Services (CMS) by Nov. 20, and the application deadline is Jan. 6.</p> <p> As a new model of the CMS Innovation Center, the <a href="http://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/" target="_blank" rel="nofollow">Transforming Clinical Practice Initiative</a> will award $840 million for the creation of evidence-based, peer-led collaboratives and practice transformation networks to support physicians in providing high-quality care. Large group practices, medical associations, quality improvement organizations, regional health collaborative and other organizations that have existing relationships with multiple clinician practices can apply.</p> <p> The networks, which will be announced in the late spring, are expected to support 150,000 clinicians beginning May 1. Anticipated strategies include giving physicians better access to patient information, expanding how patients can communicate with their health care team and improving coordination of care.</p> <p> Submit a <a href="http://innovationgov.force.com/tcpiloi" target="_blank" rel="nofollow">letter of intent</a> on the CMS website. Submission of a letter of intent is highly encouraged, but not required. Learn more about the letter of intent with a CMS <a href="http://innovationgov.force.com/tcpiloi/resource/1414069798000/TCPI_Instructions" target="_blank" rel="nofollow">frequently asked questions document</a>. CMS will use the letter of intent to plan its review process for applications.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Practice_Models/1" target="_blank">Read more</a> about innovative practice models at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:872ce19e-8fe0-4377-a0da-952ef14c17af Physicians outline 6 key provisions for network adequacy http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-outline-6-key-provisions-network-adequacy-1 Mon, 17 Nov 2014 21:02:00 GMT <p> Physicians, hospitals and other health care providers urged the National Association of Insurance Commissioners (NAIC) in a <a href="http://www.ama-assn.org/resources/doc/arc/x-pub/2014-11-16-naic-sign-on-letter-network-adequacy.pdf" target="_blank">letter</a> (log in) sent Monday to adopt model legislation that would give patients access to the care and physicians they need.</p> <p> The letter includes six key provisions that would serve as a template for many state policymakers considering revision of their network adequacy standards. More than 115 groups signed onto the letter, sent to Kansas Insurance Commissioner Sandy Praeger and Wisconsin Commissioner Ted Nickel, who chair key committees at NAIC.</p> <p> The six provisions of model network adequacy legislation are:</p> <ol> <li> Provider networks must include a full range of primary, specialty and subspecialty providers for all covered services for children and adults.</li> <li> Regulators must actively review and monitor all networks using appropriate quantitative and other measurable standards. Determinations of network adequacy must be the responsibility of regulators, utilizing strong quantitative and objective measures that take into consideration geographic challenges and the entire range of consumers’ health care needs. </li> <li> Appeals processes must be fair, timely, transparent and rarely needed. Model legislation must make clear that out-of-network arrangements and procedures are not an acceptable alternative to plans having an adequate network. </li> <li> The use of tiered and narrow provider networks and formularies must be regulated. Specific patient protections must be included in the Model Act for networks that are tiered or are limited in scope and number of providers in order to prevent unfair discrimination based on health status. </li> <li> Insurers must be transparent in the design of their provider networks. It is critical that consumers have clear information regarding the design of their plan’s provider network. </li> <li> Provider directories must be accurate and up-to-date. Consumers must have access to robust provider directories to enable them to determine which providers are in-network when they purchase their plans, and, in the event their medical needs change, when they need new providers. </li> </ol> <p> “By adopting provisions consistent with the principles outlined in this letter, we believe lawmakers and regulators can adapt the model act to establish reasonable, meaningful standards, while still allowing for market flexibility and choice,” the letter said.</p> <p> The letter aligns with <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-policy-calls-adequate-networks-patient-access-choice" target="_blank">policy adopted</a> at the 2014 AMA Interim Meeting, which calls for health insurers to make any changes to their provider networks before the open enrollment period gets underway each year. Implementing changes to provider networks at this time will help prevent patients from being stuck with plans that drop their physicians after they already have enrolled.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:29638090-5cc3-4813-993b-99c220ad2f31 New research outlines women academic physicians’ challenges http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-research-outlines-women-academic-physicians-challenges Mon, 17 Nov 2014 20:23:00 GMT <p> Women in medicine have come a long way since the days of Elizabeth Blackwell—at least one-half of all medical school classes today are women. But significant disparities remain in academic medicine. New research uncovers the experiences of former women chief residents and why they stay in—or leave—this field of medicine.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/15/fee3d2ec-028c-4707-8f0e-596a4836ae50.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/15/fee3d2ec-028c-4707-8f0e-596a4836ae50.Large.jpg?1" style="float:right;margin:10px;" /></a>As a 2013 recipient of the AMA Foundation’s <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/joan-f-giambalvo.page?" target="_blank">Joan F. Giambalvo Fund for the Advancement of Women</a>, Juliet Lee, MD (pictured right), and her team surveyed women chief residents in surgery, emergency medicine and internal medicine for the last 10 years.</p> <p> Dr. Lee, director of undergraduate surgical education, division director of surgical education in the department of surgery and the associate program director of the general surgery residency program at the George Washington University School of Medicine and Health Sciences, said she wanted to investigate the culture of academic medicine for women.</p> <p> “Even in 2014, sexism exists in medicine,” she said. “It’s not as overt as in the past, but this undercurrent of gender inequity affects salary, benefits, career advancement and satisfaction.”</p> <p> Women still hold lower academic positions than men, Dr. Lee said. Studies also show that even though more women are entering academic medicine than men, they aren’t advancing at the same rate.</p> <p> Dr. Lee’s research found that, for women who previously served as chief residents:</p> <ul> <li> <strong>Education and teaching were the primary—but not the only—reasons for choosing their current positions.</strong> Respondents who stayed in academic medicine, either as faculty or voluntary faculty, said they enjoyed the collegial environment, the chance to stay at the forefront of medicine and the intellectual challenges of teaching.</li> <li> <strong>Reasons for leaving academic medicine have more to do with professional factors than personal considerations.</strong> Respondents who left said they felt unsupported by their institutions, or needed more direction from mentors.</li> <li> <strong>Personal considerations start to impact those considering leaving academic medicine.</strong> Some respondents pointed to work-life imbalance, and others said having a family and working in academic medicine is like having two full-time jobs.</li> <li> <strong>Women have inadequate mentorship, are uncomfortable talking to superiors and uncertain of how to meet promotion criteria.</strong> Respondents said they need more direction and did not feel confident in tackling advancement opportunities.</li> <li> <strong>Challenges continue to exist, including backlash, unclear policies and a lack of role models.</strong> Respondents said they needed more mentorship, from both men and women, and felt the institutions’ cultures mattered greatly in how women are viewed.</li> </ul> <p> Dr. Lee said there are some things that need to be changed, including providing salary equity, protected time for administrative or scholarly activities, and alternative pathways to promotion. But to take immediate action, individuals can participate in formal mentoring programs.</p> <p> “I hope formal mentoring programs can be developed for both men and women to give faculty in their early years an understanding of what it takes to advance,” Dr. Lee said. “This may mean more intensive mentoring …. How these mentoring programs would develop would be dependent on the institution and the resources an institution can invest.”</p> <p> Learn more about how the AMA aims to increase the number and influence of women physicians in leadership roles through 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>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6c573f6a-722a-43f2-9579-7653cdb25f64 How to reconcile patient misconceptions, evidence-based medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_reconcile-patient-misconceptions-evidence-based-medicine Mon, 17 Nov 2014 20:21:00 GMT <p> Imagine: You’re a practicing physician, and your patient presents with the common cold. The patient demands antibiotics, but antibiotics aren’t the recommended treatment for a cold. What do you do?</p> <p> That was one of the scenarios that played out at a special session for medical students during <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">the 2014 AMA Interim Meeting</a>. The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a> (MSS) Committee on Scientific Issues presented common situations physicians in training may face in practicing evidence-based medicine while also helping patients feel satisfied with their experiences.</p> <p> In the case of the common cold, committee members suggested reinforcing the fact that you believe your patient is sick but offering alternative non-antibiotic treatments. Other suggestions include using the term “cold” instead of “infection” and educating patients on how over-prescribing antibiotics could be detrimental in the long-term.</p> <p> “Medicine is not just about keeping patients [physically] healthy,” said Christina Kratschmer, a fourth-year medical student at Albert Einstein College of Medicine and chair of the committee. “You also want to keep patients happy because mental health plays into physical health. If your patient walks out the door happy and satisfied, it’s a lot better for you both.”</p> <p> A few other common misconceptions the session addressed—along with practical suggestions for dealing with them in a way that leads to good medical care and satisfied patients—included:</p> <p> <strong>Patient misconception: “I can stop antibiotics when I feel better.”</strong><br /> <br /> Tips:</p> <ul> <li> Ask your patient to explain why they believe their medication is necessary. Then, ensure the patient understands what the drug will do and how to take it by asking them to repeat back their instructions.</li> <li> Using electronic alerts to remind patients to take their medication also can be helpful.</li> <li> Make sure the patient understands that not finishing a course of antibiotics can lead to the evolution of drug-resistant microbes.</li> </ul> <p> <strong>Patient misconception: “Giving my daughter the vaccine for human papillomavirus will encourage promiscuity.”</strong></p> <p> Tips:</p> <ul> <li> Share the latest research with the patient and her parent or guardian. For instance, a recent study compared 500 vaccinated girls with 900 girls who had not been vaccinated, finding no statistically significant difference in the occurrence of teen pregnancy or sexual transmitted diseases.</li> <li> Inform the patient and the parent that the vaccine should be given before any sexual activity to be most effective.</li> <li> Emphasize your confidence in the vaccine to make patients feel secure, and remind parents that the series requires three shots.</li> </ul> <p> <strong>Patient misconception: “The measles, mumps, rubella vaccine will give my child autism.”</strong></p> <p> Tips:</p> <ul> <li> Ask about and acknowledge any concerns your patient’s parent or guardian may have.</li> <li> Make your conversation personal—some people will be swayed by facts, while others will need evidence of the horrors of vaccine-preventable disease. Tailor your conversation to each person.</li> </ul> <p> <strong>What’s worked for you? </strong>Share your tips and techniques for patient communication in a comment on <em>AMA Wire</em>® or on the <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">AMA-MSS Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:abc92aa4-ae7b-49e3-9475-f4fbd9020be2 Learn which of your patients is at high risk for diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-of-patients-high-risk-diabetes Mon, 17 Nov 2014 11:21:00 GMT <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> One in three Americans has prediabetes, the precursor to type 2 diabetes, and certain patient populations are more susceptible to developing this disease. Use National Diabetes Month this November to learn which of your patients may be at higher risk—and what you can do about it.</p> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> Recently released <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-diabetes-guidelines-screen-patients-aged-45-older" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">draft diabetes screening guidelines</a> suggest screening certain racial or ethnic minority groups for prediabetes, including patients who are African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander. Meanwhile, studies show low-income populations suffer disproportionately from poor health outcomes associated with prediabetes. Obesity and lack of physical activity also are risk factors.</p> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> In addition to these factors, the American Diabetes Association (ADA) has compiled <a href="http://care.diabetesjournals.org/content/36/8/2430" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">socioecological perspectives</a> physicians should consider when talking to patients about prediabetes and type 2 diabetes.</p> <ul style="font-size:13px;margin-bottom:1.1em;margin-top:0px;margin-left:1.25em;padding-left:1.25em;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> <li style="list-style:disc outside;margin:0px 0px 0.5em 5px;"> <span style="font-weight:700;">The “built” environment.</span> Homes, schools, workplaces, highways and neighborhoods all have an effect on how your patients access amenities. Research shows that disadvantaged groups—including racial and ethnic minorities, people in rural areas and other underrepresented populations—tend to live in communities where there is residential segregation, inadequate housing transportation and limited access to education and health care.</li> </ul> <ul style="font-size:13px;margin-bottom:1.1em;margin-top:0px;margin-left:1.25em;padding-left:1.25em;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> <li style="list-style:disc outside;margin:0px 0px 0.5em 5px;"> <span style="font-weight:700;">Access to healthy food.</span> Food deserts disproportionately affect lower-income, minority and rural neighborhoods, while access to fast food restaurants is higher in lower-income and minority communities. At the same time, food insecurity—limited or uncertain access to food because of insufficient financial resources—is associated with a twofold risk of diabetes compared with those without food insecurity.</li> </ul> <ul style="font-size:13px;margin-bottom:1.1em;margin-top:0px;margin-left:1.25em;padding-left:1.25em;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> <li style="list-style:disc outside;margin:0px 0px 0.5em 5px;"> <span style="font-weight:700;">Walkability and safe “green” spaces.</span> Areas that aren’t easy to navigate on foot, and locations that don’t have safe parks or recreation areas, don’t encourage exercise. According to the ADA, an analysis reported a 6 percent increase in likelihood of obesity with each additional hour spent in a car per day. Meanwhile, there is a 4.8 percent decrease in likelihood of obesity with each additional kilometer walked per day.</li> </ul> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> While physicians may not be able to radically alter the socioecological problems in their patients’ communities, physicians can be knowledgeable of community resources that can help patients at high risk for prediabetes. The ADA’s <a href="http://www.diabetes.org/in-my-community/?loc=imc-slabnav" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">community resources</a> Web page can connect physicians and patients to local programs.</p> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">Improving Health Outcomes</a> initiative, the AMA is working with the YMCA of the USA to explore 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 style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> The YMCA’s program is part of the CDC’s National Diabetes Prevention Program, which offers an evidence-based lifestyle change program that <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-builds-proven-practical-approaches-improve-health-nationwide" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">has been proven to help patients</a> prevent or delay the onset of diabetes. <a href="http://www.cdc.gov/diabetes/prevention/recognition/registry.htm#program" rel="nofollow" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;">Find a CDC program in your community</a>.</p> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> Learn <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/determine-whether-patients-prediabetes" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">how to determine</a> whether your patients have prediabetes</p> <p style="font-size:13px;margin-bottom:15px;margin-top:0px;overflow:hidden;word-wrap:break-word;color:rgb(26, 20, 20);font-family:Gotham, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> Get more information at <em>AMA Wire</em>® about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/National_Diabetes_Month/1" style="color:rgb(0, 102, 204);cursor:pointer;word-wrap:break-word;overflow:hidden;" target="_blank">National Diabetes Month</a> and ways you can help your patients take action to prevent diabetes.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cda6e1da-6ed8-4b6a-899d-4cd1fb4d15d5 What hospital medical staff need to know about new Medicare rule http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hospital-medical-staff-need-new-medicare-rule Fri, 14 Nov 2014 23:10:00 GMT <p> A final rule issued by the Centers for Medicare & Medicaid Services (CMS) in May revised the conditions of participation for hospitals and made two major changes to the hospital governance structure. Find out what hospital medical staffs need to know so you’re ready when this rule is implemented at your hospital.</p> <p> The rule addresses allowing multi-hospital systems to have a unified, system-wide medical staff rather than a medical staff at each hospital. Under the May regulations, a medical staff may become part of a unified multi-hospital medical staff only if the medical staff affirmatively votes to do so. Meanwhile, medical staffs incorporated into a unified structure may “opt out” by vote at any time and re-establish a separate, hospital-specific staff.</p> <p> The final rule also includes a new requirement for the hospital governing body to consult with an “individual assigned responsibility for the medical staff” at least two times per year.</p> <p> 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> (OMSS) hosted a special session about the final rule during the <a href="http://www.ama-assn.org/sub/meeting/index.html">2014 AMA Interim Meeting</a>.</p> <p> Some of the key issues to consider include:</p> <p> <strong>Update your medical staff bylaws. </strong>CMS regulations require that the hospital board meet with the “individual assigned responsibility for the medical staff.” Your medical staff’s bylaws should specify who this person is—ideally, the president of the medical staff or the person who has been elected by staff members to lead the medical staff.</p> <p> The rule also requires the hospital board and medical staff to consult twice a year, at a minimum. Staff bylaws should address this communication as well.</p> <p> <strong>Be familiar with the rule’s requirements. </strong>Know the potential benefits and disadvantages if you unify with other medical staffs within the system or remain an individual medical staff.</p> <p> A unified system-wide medical staff could mean a stronger organization, with clinical standards developed across a greater number of peers and patients. On the other hand, unification could reduce each medical staff’s connection with or representation on the governing body. It also may mean new ways of considering community standards or hospital-specific services. If the system spans multiple states, a unified medical staff may have to make a choice of laws to determine which peer review protections will apply.</p> <p> <strong>Get the resources and assistance you need. </strong>The AMA-OMSS offers <a href="http://www.ama-assn.org/resources/doc/omss/x-pub/cops.pdf">resources</a> (log in), including issues to consider before your medical staff votes to become part of a unified system-wide medical staff as well as sample bylaw language. Medical staffs also can contact the AMA-OMSS via <a href="mailto:keith.voogd@ama-assn.org" rel="nofollow">email</a> to seek assistance with questions that arise as a result of these regulations.</p> <p> The AMA, along with more than 80 other medical associations, sent CMS a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctors-tell-cms-put-brakes-new-medical-staff-rules">letter</a> on the final rule in July, asking the agency to give the rule more thought and institute an immediate delay before implementation. The AMA continues to advocate for regulations to protect the autonomy of medical staffs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a0203485-9c63-4d05-b612-4d4401ef5145 Physician medical liability funds protected from state raids http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-medical-liability-funds-protected-state-raids Fri, 14 Nov 2014 23:09:00 GMT <p> Five years after the state government took $100 million from a special medical liability fund in Pennsylvania, a settlement has been reached that provides key protections against future diversion and returns $200 million in overpayments to physicians and other health care providers.</p> <p> The origins of the settlement go back to 2009 when the Pennsylvania government took $100 million from the Mcare Fund, a state-run medical liability fund that helps cover liability pay-outs. The funds come from annual assessments physicians and other health care providers pay.</p> <p> Rather than using year-end balances to reduce the next year’s assessment, the state let money in the fund accrue for several years. Then, contrary to state law that established Mcare as a means of keeping medical liability costs in check, the government took $100 million from that special fund to use for general state purposes.</p> <p> The Pennsylvania Medical Society (PAMED), with assistance from the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page">Litigation Center of the AMA and State Medical Societies</a>, took the state to court for this unlawful action.</p> <p> The case was settled a few weeks ago with both retrospective and prospective relief for physicians, totaling $200 million:</p> <ul> <li> $139 million will be returned to physicians and other health care providers who paid into the fund for assessment overpayments.</li> <li> <span style="font-size:12px;">$61 million will go toward reducing assessments in 2015.</span></li> <li> <span style="font-size:12px;">The Mcare fund will be “pay-as-you-go” in future years, so physicians won’t be required to put money in the fund until it is needed.</span></li> <li> <span style="font-size:12px;">The state will not be permitted to build up substantial reserves in the fund or consider that money as general revenue that can be diverted to elsewhere.</span></li> </ul> <p> “PAMED is grateful for the considerable assistance that the AMA Litigation Center provided, including its substantial monetary contribution to offset our legal expenses and the amicus curie brief in support of our cause in the Pennsylvania Supreme Court,” PAMED President Karen A. Rizzo, MD, said. “Both these actions helped position PAMED to settle the litigation on favorable terms.”</p> <p> <strong>Setting a precedent for other states</strong></p> <p> A number of states across the country have similar medical liability funds to the one in Pennsylvania. This settlement confirms the constitutionality of making sure those funds are used solely for medical liability purposes and not as a kind of “physician tax.”</p> <p> As the AMA Litigation Center noted in its friend-of-the-court <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/pms-v-pa.pdf">brief</a> (log in) filed with the Pennsylvania Supreme Court, cases previously arose in New York, New Hampshire and Wisconsin under “remarkably similar circumstances.” Each of the states’ high courts found the governments’ raids of the funds unconstitutional.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/taxation-physicians.page?">Learn more</a> about the cases in New Hampshire, Wisconsin and Pennsylvania and related cases in which the AMA Litigation Center has been involved.</p> <p> <strong>Claiming a refund</strong></p> <p> Any physician practicing in Pennsylvania who paid into the Mcare Fund for 2009, 2010, 2011, 2012 or 2014 is eligible for a refund from the settlement. (Calculations determined that overpayments were not made in 2013.) Physicians who have since retired or relocated to another state remain eligible.</p> <p> Refund checks will be mailed to the most recent address on file with the Pennsylvania physician licensing boards, so physicians should make sure their mailing addresses on record are up to date. <a href="http://www.pamedsoc.org/updatingyouraddress" rel="nofollow">Learn how</a>.</p> <p> Refunds are not expected to be distributed until 2016 as a result of the complex nature of the calculations. Additional information about the settlement is available on the <a href="http://www.pamedsoc.org/MainMenuCategories/Laws-Politics/Analysis/Laws-Analysis/Mcare/Mcare-call.html" rel="nofollow">PAMED website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:33b761a8-c002-4936-9644-5003ec09366d Residents: How would you transform GME? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_residents-would-transform-gme Thu, 13 Nov 2014 18:32:00 GMT <p> Now that the consortium of schools in the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative are making transformative improvements to undergraduate medical education (UME), it’s time to move onto graduate medical education (GME)—and input from residents is crucial to the process.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/29bbfe18-d1ac-4efb-ba7e-fb44fb532435.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/29bbfe18-d1ac-4efb-ba7e-fb44fb532435.Large.jpg?1" style="float:left;margin:10px;" /></a>“What’s happening in UME is spreading to GME, and vice versa, so the line between the two is really blurring,” Susan Skochelak, MD, AMA group vice president of medical education (pictured left), said at a special session for residents and fellows during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>. “You’re leaders already, you’re leaders in the system you’re working in. And all the things you see, all the things that you wish for—you can contribute that to the national dialogue.”</p> <p> Dr. Skochelak gave residents an update on the AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-schools-can-expect-future" target="_blank">progress in medical education transformation</a>, discussing how the consortium has spent the last year developing and implementing new ideas to change the way future physicians are trained. The schools are working on things like competency-based assessment, incorporating systems-based practice and team-based care teachings into curriculum, and focusing on diversity and health care disparities. Using new techniques and technologies, the schools hope to create adaptive, lifelong learners.</p> <p> None of these changes will happen in a vacuum, Dr. Skochelak said. Any change at the undergraduate level will affect residency programs as well.</p> <p> For example, if UME can be competency-based, and students can progress at their own rate through school and potentially graduate early, what happens with timing of the Match? Would med school graduates need to wait until July to start residency, or could they start at different points in the year?</p> <p> “The answer’s not there right now, but we do have to start asking the questions,” Dr. Skochelak said.</p> <p> Residents at the session shared what they believe to be challenges, including:</p> <ul> <li> More education in business and economics at the UME level</li> <li> New ideas for decreasing the amount of paperwork residents must complete during their work or training for how to do this more efficiently</li> <li> How to standardize assessment, given that UME programs could change dramatically</li> </ul> <p> The AMA’s consortium will spend the next year developing ways to involve GME in its work.</p> <p> Further, AMA policy calls on the association to work with key external stakeholders, including the Accreditation Council for Graduate Medical Education and National Resident Matching Program, to investigate the continuum of medical education through development of pilot projects. Read more in the AMA Council on Medical Education’s <a href="http://ama-assn.org/resources/doc/council-on-med-ed/x-pub/cme-rpt4-a-14.pdf" target="_blank">report</a> (log in).</p> <p> <strong>Share your ideas to transform residency training: </strong>Post your comments below at <em>AMA Wire</em>® or on the AMA Resident and Fellow Section <a href="https://www.facebook.com/amaresidentsandfellows" target="_blank" rel="nofollow">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ec8b708c-1d00-4c52-a282-b7274182808b CMS to conduct ICD-10 claims acceptance testing next week http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-conduct-icd-10-claims-acceptance-testing-next-week Thu, 13 Nov 2014 18:20:00 GMT <p> During the first of three special testing weeks, the Centers for Medicare & Medicaid Services (CMS) will be conducting testing to determine whether physicians’ ICD-10 claims will be accepted into the Medicare claims processing system, Nov. 17-21. Physicians who participate will receive real-time help desk support.</p> <p> Medicare Administrative Contractors (MAC) will be facilitating the testing. While registration is not required to participate, physicians can contact their MACs for more information about how to submit test claims.</p> <p> Physicians who use a clearinghouse or billing service should contact them to learn more about their plans for testing with Medicare and determine how they will receive test results for their claims.</p> <p> Two additional ICD-10 claims acknowledgment testing weeks will take place next year:</p> <ul> <li> March 2-6</li> <li> June 1-5</li> </ul> <p> Participation in testing will help physician practices 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> Although acknowledgement testing is important for identifying any issues with claims being accepted by Medicare, physicians will not be able to test the complete processing of the claim or determine final payment at this time. CMS will be conducting more robust end-to-end testing with a limited number of physicians and other health care providers next year. More information can be found on the AMA <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>, which the AMA will be updating as additional details become available.</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 physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:796f93c0-77e5-42cf-ba68-0bd598f3a9de 10 Medicare payment policy revisions you need to know http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_10-medicare-payment-policy-revisions-need Thu, 13 Nov 2014 17:00:00 GMT <p> Chances are you haven’t been able to read through the nearly 1,200 pages that constitute the 2015 Medicare Physician Fee Schedule <a href="https://www.federalregister.gov/articles/2014/11/13/2014-26183/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-clinical-laboratory" rel="nofollow" target="_blank">final rule</a> released Oct. 31 and published Thursday in the <em>Federal Register</em>. Here are the 10 top payment policy changes discussed in this mammoth document that you need to know about.</p> <p style="margin-left:.25in;"> <strong>1.   </strong><strong>The sustainable growth rate (SGR) formula calls for a 21.2 percent cut to physician payments, effective April 1. </strong>While this is a steep reduction, it is a considerable drop from the nearly 30 percent cut projected just a few years ago. The reduction is thanks to nearly flat growth in utilization of physician services over the past several years. The AMA continues to press Congress to repeal the SGR formula to eliminate the perennial payment cut threats and temporary legislative patches.</p> <p style="margin-left:.25in;"> <strong>2.   </strong><strong>Continuing medical education (CME) will not be reported under the Physician Payments Sunshine Act. </strong>The Centers for Medicare & Medicaid Services (CMS) proposed including CME activities in reports of physicians’ financial interactions with medical device and drug manufacturers in the new “Open Payments” public database. The AMA led dozens of other medical associations in calling on the agency to eliminate this requirement because it would “chill physician participation in independent [continuing education] programs.”</p> <p style="margin-left:.25in;"> <strong>3.   </strong><strong>Proposed penalties under the value-based payment modifier (VBM) will be scaled back. </strong>CMS intended to increase payment penalties under the modifier from 2 percent to 4 percent, beginning in 2017. The AMA strongly objected to this proposal, noting in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-call-changes-medicare-payment-policy-proposals" target="_blank">comment letter on the proposed rule</a> that some physicians would be vulnerable to payment cuts totaling more than 11 percent as a result of the VBM and other Medicare reporting programs—a move that could mean some of Medicare’s sickest patients would lose access to their doctors.</p> <p style="margin-left:.25in;"> While the final rule still maintains a potential pay cut of 4 percent for larger medical groups, practices with fewer than 10 physicians will not be subject to more than a 2 percent VBM penalty.</p> <p style="margin-left:.25in;"> <strong>4.   </strong><strong>The Physician Quality Reporting System (PQRS) becomes a penalty-only program next year. </strong>Physicians must successfully report in 2015 to avoid PQRS and VBM penalties in 2017. Among other things, they’ll have to report on at least nine quality measures that cover three “domains.” In addition, the final rule requires physicians to report on at least one of the 18 new “cross-cutting measures.”</p> <p style="margin-left:.25in;"> CMS originally said physicians would be obligated to report on at least two cross-cutting measures but cut that requirement in half after the AMA urged the agency not to create additional mandates that physicians would struggle to meet.<br /> <br /> The agency also had planned to shorten the period physicians have to review their feedback reports to just 30 days. Following AMA lobbying, CMS decided to leave the review period at 60 days.</p> <p style="margin-left:.25in;"> <strong>5.  </strong><strong>The Physician Compare website will continue to expand—but not as much as planned. </strong>Continued pressure from the AMA has led CMS to commit to better prevention and correction of errors on this website that has been riddled with problems. The agency also will notify physicians when they can preview their reports.</p> <p style="margin-left:.25in;"> While the agency’s plans to post benchmarks to the site have been put aside for now, the website will show physicians’ performance under PQRS, the electronic health record meaningful use program and Medicare accountable care organizations.</p> <p style="margin-left:.25in;"> <strong>6.  </strong><strong>Chronic care management services will be supported by a monthly payment. </strong>Beginning next year, CMS will pay $42.60 per month for these services when CPT code 99490 is reported. This policy change reflects several years of advocacy by the AMA, the CPT Editorial Panel and 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). The groups will continue to urge the agency to also adopt higher values and pay for multiple complex chronic care coordination services so that patients have ongoing access to this important care.</p> <p style="margin-left:.25in;"> <strong>7.  </strong><strong>Four services now are eligible for telehealth payment. </strong>These services are Medicare’s annual wellness visit (coded with HCPCS G0438 and G0439), prolonged evaluation and management services (reported with CPT codes 99354 and 99355), family psychotherapy (CPT codes 90846 and 90847) and psychoanalysis (CPT code 90845).</p> <p style="margin-left:.25in;"> <strong>8.  </strong><strong>Surgical global periods will change from 10- and 90-day periods to 0-day periods. </strong>Despite strong opposition from the AMA and many medical specialty societies, CMS will be transitioning all services with a 10-day global period to a 0-day global period by 2017. All 90-day global periods will be shifted to 0-day global periods by 2018.</p> <p style="margin-left:.25in;"> <strong>9.  </strong><strong>There are 350 CPT codes identified as new, revised or potentially misvalued—318 of these changes were based on physician input. </strong>These changes represent 86 percent of those recommended by the RUC, a group of more than 300 participants that includes physician advisers from every medical specialty and a dozen other health care professionals. The group provides input on values based on their highly technical expertise.</p> <p style="margin-left:.25in;"> <strong>10. </strong><strong>The timeline for submitting new codes and revaluations of services will shift. </strong>The deadline for receiving all code and value recommendations for the following year’s payment policies will be February to allow more time for public comment. This change will take place for the 2017 Medicare Physician Fee Schedule. CPT and RUC timelines will be modified to accommodate the new process, thereby ensuring physicians continue to have strong input on appropriate values for services.</p> <p> You can read more about these and other components of next year’s Medicare payment policies by downloading an <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/2015-medicare-fee-schedule-final-rule-highlights.pdf" target="_blank">AMA summary</a> (log in) or viewing <a href="http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets.html" rel="nofollow" target="_blank">fact sheets</a> from CMS.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ad8176c4-5822-4250-95e8-70e2a57ffec0 Get one online tool for all your coding needs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-online-tool-coding-needs Wed, 12 Nov 2014 21:48:00 GMT <p> With the arrival of the new 2015 codebooks, now is the time to get a single tool that integrates all coding resources—the <a href="http://info.commerce.ama-assn.org/ama-coding-online" target="_blank">AMA Coding Online</a> suite of products.</p> <p> AMA CodeManager<sup>®</sup> Online gives access to thousands of codes, plus AMA-exclusive content. With this tool, you can integrate up to 30 coding resources, and content is automatically updated every month.</p> <p> Four online medical coding resources—each a stand-alone, subscription-based product—come together to create your personal digital coding library, regardless of your coding platform. All resources integrate seamlessly with AMA CodeManager<sup>®</sup> Online.</p> <p> The reference products include:</p> <ul> <li> <strong><em>CPT® Changes Online</em></strong><strong>:</strong> Search each edition of <em>CPT Changes: An Insider’s View</em> to see every code and guideline change since 2000.</li> <li> <strong><em>CPT Assistant Online</em></strong><strong>:</strong> Get the full content of every <em>CPT Assistant</em> newsletter and access every article since 1990.</li> <li> <strong><em>RBRVS DataManager Online</em></strong><strong>:</strong> Accurately calculate and report claims based on the Medicare Physician Fee Schedule.</li> <li> <strong><em>Clinical Examples in Radiology Online</em></strong>: Rely on this authoritative radiology coding reference, co-published with the American College of Radiology.</li> </ul> <p> To learn more, schedule a <a href="http://cta-service-cms2.hubspot.com/cs/c/?&cta_guid=b4415391-0598-4c25-a005-1cca38335e85&placement_guid=96b09f84-c4f6-457c-bb62-e53e95a045c2&portal_id=281020&redirect_url=xIyEcv1Jzm7O/da6ml48yLhdbJKugXbWbxvtgUmMPJl4vQA02mumehAhVT6RZKdaYjXtvq1oOkItDz7YMf7JBfXZI%2BC8vqERvpHDe0H3hNYDE9pKPgtzDQSt3GYoU74CLTLha4hyCymB2FzV4%2BjSyKkrEelWnQIAT%2BCR1Bo8qmBB3ZVl/Z%2Bw%2Bf9j2o0/MmBT2%2BXwRVPBF8aFzRqeWwsvaiVhcDOGMck5yViLAh34q1UYCr%2BuH5aHjXR9F0vdicXTGr3uGtQAqIo%3D&iv=kxVOA8Z3VdY%3D&hsutk=ec9a088ed801a28c0c39cf1d1c8d619d&utm_referrer=http%3A%2F%2Finfo.commerce.ama-assn.org%2Fama-coding-online&canon=http%3A%2F%2Finfo.commerce.ama-assn.org%2Fama-coding-online" target="_blank" rel="nofollow">product demo</a>, or get a <a href="http://cta-service-cms2.hubspot.com/cs/c/?&cta_guid=9d3a6129-05bd-43e2-8f41-7bf312658a69&placement_guid=3493422b-7cf5-4c82-8aa1-12b70c5421a3&portal_id=281020&redirect_url=C2uHv80WDzbsPW86bmzb0kJ%2BF%2ByvBQWqNY4HjOsJX59GHZ7xEOd3x3rU/%2B1TpWn9fDjNbT1maJxi6ue/xruT5HxPgv6raIv/E11XUkavuWvSvFKguAZ2Kn2R23igvStSggC6fi%2B39B6sfajmCnpzHGzi5z1yYPlZxnDoo0ZKEHRs1P55PvlIiroECzIgsW6MK6hCZeAcT73Zp2XKZpwk8T5pXDfJgrKc0P8sm9PGu8BRqRgVn8sWspIU896A0QNQV9NjzozfX6PDhnRdgQda8dt1gWTcy8OFbltsG/xc3U5MtdG6uQekYw%3D%3D&iv=Ln3izVoiaZs%3D&hsutk=ec9a088ed801a28c0c39cf1d1c8d619d&utm_referrer=http%3A%2F%2Finfo.commerce.ama-assn.org%2Fama-coding-online&canon=http%3A%2F%2Finfo.commerce.ama-assn.org%2Fama-coding-online" target="_blank" rel="nofollow">free trial</a>.</p> <p> AMA members receive lower prices on products from the AMA Store. 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:e7440462-7cf9-40b9-a4b4-a38b6d2229be From Ebola to MOC: Top 10 stories from AMA Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ebola-moc-top-10-stories-ama-interim-meeting Tue, 11 Nov 2014 19:00:00 GMT <p> Here are the top stories from the 2014 AMA Interim Meeting in Dallas. See <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1">full coverage</a> of the meeting at <em>AMA Wire</em>®.</p> <p> <a href="https://www.youtube.com/watch?v=RnP_HIJy9PU" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/14/882c2568-7763-4d23-9e1e-c47d578606b0.Large.jpg?1" style="margin:15px;float:left;" /></a><strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/video-cdc-expert-tells-physicians-prepare-ebola">CDC expert tells physicians how to prepare for Ebola</a></strong><br /> In a special address at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2014 AMA Interim Meeting</a>, an expert from the Centers for Disease Control and Prevention (CDC) told physicians that the chance of encountering patients with Ebola in ambulatory settings is very low—but physicians need to be prepared nonetheless.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-adopts-principles-maintenance-of-certification"><strong>AMA adopts principles for maintenance of certification</strong></a><br /> Physicians voted Monday to update the AMA’s policy on maintenance of certification. The adopted policy outlines principles that emphasize the need for an evidence-based process that is evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-urge-expanded-access-medicaid"><strong>Physicians urge expanded access to Medicaid</strong></a><br /> The nation’s physicians voted to support Medicaid expansion and encourage lawmakers to identify realistic coverage options for adults currently in the coverage gap, even if states choose not to adopt the Medicaid expansion outlined in the Affordable Care Act.</p> <p> <a href="http://www.youtube.com/watch?v=_E8BBUW2QYA" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/8/65c8e2fe-de09-4b8f-b84e-7b98e01d0092.Large.jpg?1" style="margin:15px;float:right;" /></a><strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/va-secretary-need-physicians">VA secretary: We need physicians’ help</a></strong><br /> The U.S. Department of Veterans Affairs (VA) is working to right wrongs, reframe perceptions and enhance care for veterans—and it needs the help of physicians, VA Secretary Robert A. McDonald told the AMA House of Delegates Saturday at the 2014 AMA Interim Meeting in Dallas.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ebola-e-cigarettes-delegates-pass-public-health-policy"><strong>From Ebola to e-cigarettes, delegates pass public health policy</strong></a><br /> Delegates this week weighed in on a number of timely public health issues. They reinforced support for regulatory oversight of electronic cigarettes, and called on the AMA to continue to be a trusted source of information and education on epidemics or pandemics.</p> <p> <a href="http://www.youtube.com/watch?v=4N4d44u-WHk" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/13/76f8ddaf-0d66-4184-8d79-f3443febe8a3.Large.jpg?1" style="margin:15px;float:left;" /></a><strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-president-discusses-anticipating-problems-finding-solutions-1">AMA president: We are anticipating problems, finding solutions</a></strong><br /> In an address during Saturday’s opening session of the 2014 AMA Interim Meeting, AMA President Robert M. Wah, MD, told physicians how the AMA is anticipating problems and working on solutions to give doctors nationwide a new hope in practicing medicine.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-backs-interstate-compact-streamline-medical-licensure"><strong>AMA backs interstate compact to streamline medical licensure</strong></a><br /> A special compact designed to facilitate a speedier medical licensure process with fewer administrative burdens for physicians seeking licensure in multiple states received the support of the AMA House of Delegates this week.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-policy-calls-adequate-networks-patient-access-choice"><strong>New policy calls for adequate networks for patient access, choice</strong></a><br /> As open enrollment for health insurance exchanges begins this weekend, physicians have adopted new policy aimed at addressing inadequate provider networks so patients have access to the care they need and the physicians they rely on.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/delegates-ask-suspension-of-meaningful-use-penalties"><strong>Delegates ask for suspension of meaningful use penalties</strong></a><br /> Delegates at the Interim Meeting this week renewed their request that the Centers for Medicare and Medicaid Services suspend penalties for failure to meet meaningful use criteria.</p> <p> <a href="https://www.youtube.com/watch?v=hQr43yhfKmU" rel="nofollow" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/13/3a4ef779-a1b0-4f01-8ddb-54a10b1c6b6f.Large.jpg?1" style="margin:15px;float:right;" /></a><strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/mission-provides-map-improve-medicine-ama-ceo">AMA CEO: Mission provides a map to improve medicine</a></strong><br /> Throughout history, the AMA has always followed its mission: to promote the art and science of medicine and the betterment of public health. The association will continue to follow its mission—its moral compass and road map—into the future, AMA Executive Vice President and CEO James L. Madara, MD, said in his address to the House of Delegates.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:969f97f9-fdfc-40bc-856a-c457d0a5e7d4 Physicians take on prior authorization rules that hinder care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-prior-authorization-rules-hinder-care Tue, 11 Nov 2014 00:46:00 GMT <p> New policy adopted Monday at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> calls for limiting the use of prior authorization of health care services so that physicians are not prevented from giving patients the safe, high-quality care they deserve.</p> <p> Citing how prior authorization often unnecessarily interrupts the delivery of care and places undue administrative and financial burdens on physicians, the new policy directs the AMA to further address this obstacle to high-quality, affordable care:</p> <ul> <li> Mitigate the burden of preauthorization and other utilization review efforts</li> <li> Conduct a study that quantifies the administrative burden of prior authorization, authorizations and denials of authorization appeals. This will include the time taken away from patient care activities. The study is expected to take place next year, and results will be made available early in 2016.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:76750857-4024-4c02-88bf-6ebf529ccc7a Physicians urge expanded access to Medicaid http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-urge-expanded-access-medicaid Tue, 11 Nov 2014 00:41:00 GMT <p> The nation’s physicians voted Monday to support Medicaid expansion and encourage lawmakers to identify realistic coverage options for adults currently in the coverage gap, even if states choose not to adopt the Medicaid expansion outlined in the Affordable Care Act.</p> <p> Physicians at the <a href="http://www.ama-assn.org/sub/meeting/index.html">2014 AMA Interim Meeting</a> in Dallas approved a report that would encourage states not participating in the Medicaid expansion to develop waivers that support expansion plans that best meet the needs and priorities of their state’s low-income adults. The AMA calls on the Centers for Medicare & Medicaid Services to approve waivers that are consistent with the goals and spirit of expanding insurance coverage.</p> <p> “The AMA is sensitive to state concerns about expanding Medicaid in a traditional manner, but we believe they must find ways to expand health insurance coverage to their uninsured populations, especially as coverage disparities continue to grow between expansion and non-expansion states,” said AMA Immediate Past Board Chair David O. Barbe, MD. “We encourage states that would otherwise reject the opportunity to expand their Medicaid programs to develop expansion waivers that help increase coverage options for their low income residents.”</p> <p> Get more news on policy from the 2014 AMA Interim Meeting at <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1"><em>AMA Wire</em></a>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8eda3a94-4771-4677-9455-d7cd0a3be785 New report calls for Medicaid pay parity beyond 2014 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-report-calls-medicaid-pay-parity-beyond-2014 Tue, 11 Nov 2014 00:39:00 GMT <p> A policy adopted Monday outlined in a report by the AMA Council on Medical Service directs the AMA to continue its efforts to extend a Medicaid payment increase that has been in effect since 2013 so low-income patients continue to have access to essential primary care services to stay healthy.</p> <p> The report explains that without the federally mandated payment increase, which makes Medicaid rates for certain primary care services 100 percent of Medicare rates, current rates in the state-based program average 66 percent of Medicare rates. Such low rates are “insufficient to ensure access to care for Medicaid patients and adequate payment to physicians providing care to these patients,” the report states.</p> <p> A number of states are unlikely to continue the increased rates next year when federal funds that make up the payment increase no longer are available.</p> <p> In addition to calling for a continuation of the Medicaid primary care payment increases, the policy also states that obstetricians and gynecologists should be eligible to receive the payment increase for evaluation and management codes as well as vaccine administration codes.</p> <p> The AMA already has <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/bill-seeks-sustain-higher-medicaid-payments" target="_blank">supported a federal bill</a> introduced in July that would extend the Medicaid primary care payment increase and will continue to support measures to ensure patients have access to the care they need.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fb93e4ca-ef9b-4ca9-bf69-422b853136b5 Initiative minimizes barriers to providing high-quality care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_initiative-minimizes-barriers-providing-high-quality-care Tue, 11 Nov 2014 00:00:00 GMT <p> Now that studies have made the reasons behind physicians’ professional satisfaction clear, it’s time to implement solutions that let physicians get back to doing what they want to do most—give high-quality care to patients.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/5a75aeff-0196-411b-9ec9-3839b7299ef6.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/5a75aeff-0196-411b-9ec9-3839b7299ef6.Large.jpg?1" style="float:right;margin:15px;" /></a>That’s what Group Vice President of Professional Satisfaction and Practice Sustainability Michael Tutty, PhD (pictured right), told physicians at a special session Saturday during the <a href="http://www.ama-assn.org/sub/meeting/index.html">2014 AMA Interim Meeting</a>.</p> <p> Through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA has investigated the things that make it difficult to provide high-quality care. An <a href="http://www.rand.org/pubs/research_reports/RR439.html" rel="nofollow">AMA-RAND study</a> released last fall revealed that physicians who feel overworked, overscrutinized or overburdened with unfulfilling tasks can suffer continually from a growing sense that they are neglecting the professional priorities that really matter—their patients. </p> <p> Factors that lead to dissatisfaction include regulatory burdens, competing professional priorities and burdensome electronic health records (EHR).</p> <p> Now that the AMA knows what’s behind dissatisfaction, it’s raising the issue in the public sphere and implementing solutions.</p> <p> Tutty explained that through the next year, the AMA will:</p> <ul> <li> Engage vendors to incorporate needed changes into future EHR design, training and implementation, and work with other stakeholders to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable">improve EHR usability</a></li> <li> Continue to advocate for greater flexibility in the EHR meaningful use program and other <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent">regulatory programs</a></li> <li> Re-craft the physician-hospital relationship of the future promoting an integrated leadership structure</li> <li> Investigate new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/840-million-will-fund-improved-care-via-new-clinical-networks" target="_blank">practice and payment models</a>, starting with another study with the RAND Corporation, which will look at how payment models affect physicians’ practices</li> <li> Develop ways to provide leadership training for physicians in new practice models</li> </ul> <p> In the meantime, physicians have some ways to improve their professional satisfaction and quality of patient care right now. Beta testing has begun for the first four modules in the AMA’s new online platform <a href="https://www.steps-forward.com/" rel="nofollow" target="_blank">STEPS Forward™</a>, which stands for Solutions Toward Effective Practice. These initial modules will help physicians address common clinical challenges. </p> <p> The solutions offered address pre-visit planning, prescription renewals, empowering staff to handle more during patient visits and collaborative documentation. The AMA is looking for physician feedback of the beta site. A robust collection of content building on these initial modules will be forthcoming in 2015.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4d43b94b-2376-4f15-8719-86ec4422b28a From Ebola to e-cigarettes, delegates pass public health policy http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ebola-e-cigarettes-delegates-pass-public-health-policy Mon, 10 Nov 2014 23:55:00 GMT <p> Delegates at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas this week weighed in on a number of timely public health issues. At the meeting, physicians:</p> <ul> <li> Called for the AMA to continue to be a <strong>trusted source of information and education</strong> on urgent <strong>epidemics or pandemics</strong> affecting the U.S. population. The policy was enacted in the wake of the Ebola outbreak in West Africa.</li> <li> Reinforced its <strong>support for regulatory oversight of electronic cigarettes</strong>. Delegates also supported regulations that would establish the minimum legal purchase age for electronic cigarettes to be 18 years old, place marketing restrictions on manufacturers, and prohibit claims that electronic cigarettes are effective tobacco cessation tools.Supported efforts to <strong>give the U.S. Food and Drug Administration authority and funding</strong> to effectively oversee the manufacturing, marketing and sale of <strong>dietary supplements</strong>.</li> <li> Urged the <strong>increased use of sobriety checkpoints</strong> and called for state medical societies to overturn bans on using them to deter driving under the influence.</li> <li> Passed policy <strong>recognizing the important role of pharmacists in vaccinating target populations</strong> that lack access to a medical home or that otherwise are unlikely to receive immunizations through physician practices. The policy affirms that health professionals who administer vaccines have shared responsibilities to ensure that vaccination administration is documented in the patient medical record. Further, it calls on physicians and pharmacists to work together in the community to <strong>encourage patients to follow up with a primary care physician</strong> to ensure continuity of care.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:58d35d13-17bf-46a8-bc48-4e2fb91b3306 AMA backs interstate compact to streamline medical licensure http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-backs-interstate-compact-streamline-medical-licensure Mon, 10 Nov 2014 23:39:00 GMT <p> A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-licensure-streamlined-under-new-interstate-compact" target="_blank">special compact</a> designed to facilitate a speedier medical licensure process with fewer administrative  burdens for physicians seeking licensure in multiple states received the support of the nation’s physicians with a new policy adopted Monday at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>.</p> <p> The <a href="http://www.fsmb.org/Media/Default/PDF/Advocacy/Interstate%20Medical%20Licensure%20Compact%20(FINAL)%20September%202014.pdf" rel="nofollow" target="_blank">model legislation</a> was developed by the Federation of State Medical Boards (FSMB) to make it easier for physicians to obtain licenses in multiple states while providing access to safe, quality care.</p> <p> Under the new policy, the AMA will work with interested medical associations, the FSMB and other  stakeholders to ensure expeditious adoption of the compact and the creation of an Interstate Medical Licensure Commission.</p> <p> “At least 10 state medical boards have adopted the compact, which streamlines the licensing process for physicians seeking licenses in multiple states and increases patient access to telemedicine services,” AMA President Elect Steven J. Stack, MD, said in a news release. “We encourage more states to sign on to the compact so that we can ensure standards of care are maintained, whether treatment is provided in-person or via telemedicine.”</p> <p> The compact, which was released in July, 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>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6323cd44-6cf2-4b97-a5d8-4f7d2c3415a7 New policy calls for adequate networks for patient access, choice http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-policy-calls-adequate-networks-patient-access-choice Mon, 10 Nov 2014 23:39:00 GMT <p> As open enrollment for health insurance exchanges begins this weekend, physicians have adopted new policy aimed at addressing inadequate provider networks so patients have access to the care they need and the physicians they rely on.</p> <p> The new AMA policy, which is part of a <a>new report</a> by the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-service.page" target="_blank">Council on Medical Service</a>, calls for health insurers to make changes to their provider networks before the open enrollment period gets underway each year. Implementing changes to provider networks at this time will help prevent patients from being stuck with plans that drop their physicians after they already have enrolled.</p> <p> The policy also reiterates the need for health insurers to provide patients with an accurate, complete directory of participating physicians through multiple media outlets. These lists also should identify physicians who are not accepting new patients.</p> <p> “Patients deserve to have an honest look at their coverage options—including the physicians, hospitals and medications they will have access to as well as cost-sharing—so that they can make an informed choice,” AMA President Robert M. Wah, MD, said in a <a>news release.</a></p> <p> Inadequate networks could lead to interruptions in patient care, delayed care and undue harm, Dr. Wah said. “They can also prevent patients who are newly insured from being able to access the physicians that suit their needs in a timely manner.”</p> <p> Other provisions of the new policy include:</p> <ul> <li> Promoting state regulators as the primary enforcers of network adequacy requirements. These regulators can ensure compliance with state network adequacy laws and regulations that are intended to make sure patients have access to adequate provider networks throughout the plan year.</li> <li> Calling for insurers to submit quarterly reports to state regulators. These reports should provide data on several measures of network adequacy, including the number and type of physicians who have joined or left the network, the provision of essential health benefits, and consumer complaints received.</li> <li> Calling on insurers to treat patient visits to out-of-network physicians the same as in-network visits if the plan’s provider network is deemed inadequate.</li> <li> Supporting regulation and legislation that require out-of-network expenses to count toward a patient’s annual deductibles and out-of-pocket maximums when a patient is enrolled in a plan with out-of-network benefits or is forced to go out of network as a result of network inadequacies.</li> </ul> <p> “Patients who need to seek care out of network should not be punished financially,” Dr. Wah said. “If patients find themselves in networks that are deemed inadequate, there should be adequate financial protection in place to ensure they can access the care they need and deserve.”</p> <p> The new policy is part of the AMA’s ongoing efforts to secure patient access to adequate networks of care. Nationally, the AMA has urged the Centers for Medicare & Medicaid Services to strengthen network adequacy requirements for health insurance plans being sold through the health insurance exchanges. The association also has advocated for transparency in Medicare Advantage plans to ensure patients are aware of any changes to physician networks before the open enrollment period.</p> <p> On the state level, the AMA has created an Affordable Care Act state implementation <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/state-advocacy-campaigns/state-health-reform.page?" target="_blank">toolkit</a> that contains four model bills addressing tiered and narrow networks and access to accurate provider directories. The AMA also has worked with state medical associations to support state legislation requiring out-of-network transparency and to implement more stringent network adequacy standards than those outlined in federal requirements.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6c840f64-87bc-413e-848d-3719e7a49ea3 Doctors debate care continuity, competence at ethics forum http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-debate-care-continuity-competence-ethics-forum Mon, 10 Nov 2014 23:38:00 GMT <p> Physicians had the chance to share their opinions on continuity of care in complex health care systems and the ethical obligation to provide competent care during an <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs/ceja-open-forum.page?">open forum</a> of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs.page">AMA Council on Ethical and Judicial Affairs</a> (CEJA), held Monday at the 2014 AMA Interim Meeting.</p> <p> Attendees also received an update on the project to critically review and update the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?"><em>Code of Medical Ethics</em></a>. Physician can continue to review and comment on changes to the <em>Code</em> through Dec. 31 via the online <a href="http://www.ama-assn.org/ama/pub/community/forums.page?plckForumPage=ForumCategory&plckCategoryId=Cat:a0145272-f48b-4c03-ad56-ad76c28c04bc">CEJA Forum</a> (log in) or by sending an <a href="mailto:bette.crigger@ama-assn.org" rel="nofollow">email</a> with comments.</p> <p> CEJA’s updates to the <em>Code</em> have been conservative, and attendees were reminded of this in discussion about continuity of care.</p> <p> “The comments [in the <em>Code</em>] about continuity of care are unchanged since 1992,” said CEJA member James E. Sabin, MD. “Since 1992, there have been major changes in the health system, and there’s no suggestion any of this is stopping soon …. There’s reason to think the changing system creates new challenges to continuity of care and new opportunities.”</p> <p> Physicians touched on a variety of obstacles to care continuity, including patients not having continuous health care coverage, difficulty in patients making appointments and problems with electronic health records that prevent communication between physicians.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/e92fbb07-1ac4-4a93-9550-fb4d46359eb4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/e92fbb07-1ac4-4a93-9550-fb4d46359eb4.Large.jpg?1" style="float:left;margin:15px;" /></a>Joseph Selby, MD, a professor of family medicine at West Virginia University School of Medicine, said providing interpersonal continuity of care in today’s environment is “virtually impossible as medicine interfaces with business models.” He said it’s difficult for physicians in hospital systems to comply with hospital mandates and patient volumes.</p> <p> Discussion also covered the issue of competence, specifically how to self-assess competence in a variety of situations. CEJA Vice-Chair Stephen L. Brotherton, MD (pictured left), highlighted the many ways in which a physician’s competence may be deteriorating.</p> <p> “Your skills may fade, and you’re not really aware that’s happening,” he said, pointing to age, number of hours worked, lack of sleep and other factors that could have an effect on competence.</p> <p> Other physicians made comments on the necessity of defining competence exactly, which CEJA admitted was a challenge.</p> <p> CEJA will evaluate all comments from the open forum as it moves forward in its work.</p> <p> <strong>What do you think? </strong>Share your opinions on continuity of care and competence with a comment below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:720f03d3-99d2-4955-adc8-f7dc16574f57 Physicians vote to exercise conscience in medical care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-vote-exercise-conscience-medical-care Mon, 10 Nov 2014 23:37:00 GMT <div> Physicians voted in favor of new policies during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas, focusing on physicians’ exercise of conscience and physician civil discourse.</div> <div>  </div> <div> Nearly 500 delegates voted to pass policy that supports high standards of civility and respect among physicians, stating that different beliefs, aspects of conscience and ethical views are essential to the improvement of medicine. </div> <div>  </div> <div> Also adopted was policy outlined in a report by the AMA Council on Ethical and Judicial Affairs on physicians’ exercise of conscience. This policy supports giving physicians’ latitude to practice in accordance with their own well-considered, deeply held beliefs that are central to their self-identities. </div> <div>  </div> <div> Physicians are expected to provide care in emergencies, honor patients’ decisions to refuse treatment, respect basic civil liberties and not discriminate against individuals. At the same time, policy also recognizes that physicians have an interest in maintaining personal integrity.</div> <div>  </div> <div> According to the new policy, to responsibly follow the dictates of conscience, physicians should:</div> <div>  </div> <div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Consider whether and how significantly an action will undermine the physician’s personal integrity, create emotional or moral distress for the physician, or compromise the physician’s ability to provide care for the individual and other patients.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Make clear that there are interventions or services the physician cannot in good conscience provide because they are contrary to the physician’s deeply held personal beliefs before entering into a patient-physician relationship. In particular, the physician should focus on interventions or services a patient might otherwise reasonably expect the practice to offer.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Take care that their actions do not discriminate against or unduly burden individual patients or patient populations and do not adversely affect patient or public trust.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Be mindful of the burden their actions may place on fellow health care professionals.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Uphold standards of informed consent and let the patient know about all relevant options for treatment, including options to which the physician morally objects.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>In general, physicians should refer a patient to another physician to provide treatment the physician declines to offer. When a deeply held, well-considered personal belief leads a physician to also decline to refer, the physician should offer impartial guidance to patients about how to inform themselves regarding access to desired services.</div> <div style="margin-left:40px;">  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Continue to provide other ongoing care for the patient or formally terminate the patient-physician relationship in keeping with ethical guidelines.</div> </div> <div>  </div> <div> Get more news on policy from the 2014 AMA Interim Meeting at <em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">AMA Wire</a></em>®.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4fc8bff1-50c8-4bb2-bf9a-2cf42c75de83 AMA adopts principles for maintenance of certification http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-adopts-principles-maintenance-of-certification Mon, 10 Nov 2014 23:30:00 GMT <div> <p> Physicians voted Monday to update the AMA’s policy on maintenance of certification (MOC) during the <a href="http://www.ama-assn.org/sub/meeting/index.html">2014 AMA Interim Meeting</a> in Dallas. The adopted policy outlines principles that emphasize the need for an evidence-based process that is evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice.</p> <p> The MOC principles will now include:</p> <ul> <li> MOC should be based on evidence and designed to identify performance gaps and unmet needs, providing direction and guidance for improvement in physician performance and delivery of care.</li> <li> The MOC process should be evaluated periodically to measure physician satisfaction, knowledge uptake, and intent to maintain or change practice.</li> <li> MOC should be used as a tool for continuous improvement.</li> <li> The MOC program should not be a mandated requirement for licensure, credentialing, payment, network participation or employment.</li> <li> Actively practicing physicians should be well-represented on specialty boards developing MOC.</li> <li> MOC activities and measurement should be relevant to clinical practice.</li> <li> The MOC process should not be cost-prohibitive or present barriers to patient care.</li> </ul> <p> The policy encourages specialty boards to investigate alternative approaches to MOC and directs the AMA to report annually on the MOC process.</p> <p> The American Board of Medical Specialties (ABMS) is the organization responsible for developing the MOC process. ABMS works with its 24 member boards in the ongoing evaluation and certification of physicians.</p> <p> AMA policy supports physician accountability, life-long learning and self-assessment. The AMA will continue to work with the appropriate organizations to ensure the MOC process does not disrupt physician practice or reduce the capacity of the overall physician workforce.</p> <p> In June, the AMA and ABMS <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-abms-convene-stakeholders-discuss-moc-exam">convened stakeholders in Chicago</a> to discuss Part III of the MOC exam, focusing on the value of MOC Part III and innovative concepts that could potentially enhance or replace the current thinking around the secure exam requirement of MOC.</p> <p> Get more news on policy adopted at the 2014 AMA Interim Meeting at <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1"><em>AMA Wire</em></a>®.</p> </div> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a2ebd97e-707a-420b-94b7-f12c8b607031 Delegates ask for suspension of meaningful use penalties http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_delegates-ask-suspension-of-meaningful-use-penalties Mon, 10 Nov 2014 23:29:00 GMT <p> At the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> this week, delegates renewed their request that the Centers for Medicare and Medicaid Services suspend penalties for failure to meet meaningful use criteria.</p> <p> The new policy comes on the heels of the recent release of new attestation numbers showing only 2 percent of physicians have demonstrated Stage 2 meaningful use so far this year. In response to the new figure, the AMA <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/data-doesnt-lie-meaningful-use-needs-change-now" target="_blank">joined with other health care leaders</a> to urge policymakers to take immediate action to fix the meaningful use program by adding more flexibility and shortening the reporting period to help physicians avoid penalties.</p> <p>  “The whole point of the meaningful use incentive program was to allow for the secure exchange of information across settings and providers, and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control,” AMA President-Elect Steven J. Stack, MD, said.  “Physicians want to improve the quality of care and usable, interoperable EHRs are a pathway to achieving that goal.”</p> <p> In addition to calling for EHRs to be more interoperable, physicians also are recommending that policymakers ease regulations to allow for EHRs to become more usable.</p> <p> An AMA-RAND <a href="http://www.ama-assn.org/ama/pub/news/news/2013/2013-10-09-rand-study-physician-satisfaction.page">study</a> released in 2013 cited EHRs as a major source of dissatisfaction for physicians. The report found that physicians want to embrace technology, but they’re frustrated that regulatory requirements are forcing them to do clerical work and distracting them from paying close attention to their patients. Physicians also raised concerns about interoperability in the study, saying that the inability of EHRs to "talk" to each other prevents the transmission of patient medical information when it’s needed.</p> <p> The AMA continues to work aggressively to improve medical practice, including the usability of EHRs, so physicians can focus on their patients. By working toward delivery systems that support physician success, the AMA strives to enhance patient care, make delivery more efficient, and reduce unnecessary costs or burdens 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.</p> <p> As part of that effort, the AMA provided the Office of the National Coordinator for Health IT (ONC) and CMS with a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint</a> for improving the meaningful use program as well as a framework outlining <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight priorities</a> for more usable EHRs. Physicians want to use high-performing, interoperable technology in a way they see best fit to help them care for their patients. Modifying the meaningful use program will help to meet these goals.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:369b45eb-bff6-43fb-b1b7-0d9181a96c0d Honoring veterans: Physician voice crucial to ensuring care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_honoring-veterans-physician-voice-crucial-ensuring-care Mon, 10 Nov 2014 20:30:00 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/5/9/d54fa3e2-c02e-4506-a9bc-6bc2b6512edd.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/9/d54fa3e2-c02e-4506-a9bc-6bc2b6512edd.Large.jpg?1" style="margin:15px;float:left;" /></a>As a physician and having served on active duty in the U.S. Navy for more than two decades, I believe Veterans’ Day is one of the most important days of the year—perhaps even more than usual this year. Here’s why.</p> <p> This past year, thousands of our nation’s veterans faced an access-to-care crisis. The men and women who gave so much for our country were unable to obtain the timely access to medical care that they needed and deserved.</p> <p> I’m proud that the AMA stepped up, passing policy at the 2014 AMA Annual Meeting. This policy asked President Obama to make sure eligible veterans received the timely care they are entitled to and urged Congress to pass long-term solutions so veterans wouldn’t have to face this crisis again.</p> <p> In August, Congress did just that by adopting a <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">veterans’ health care reform law</a>, which the AMA helped shape.</p> <p> We also worked with state and local medical societies as they developed registries of physicians who were ready and willing to care for veterans in their private practices. These registries then were provided to local communities and facilities of the U.S Department of Veterans Affairs (VA) across the country.</p> <p> Now, at the 2014 AMA Interim Meeting, veterans’ issues are at the forefront again. In a special address Saturday, VA Secretary Robert McDonald <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/va-secretary-need-physicians" target="_blank">asked for our help</a>.</p> <p> He told us that the VA needs physicians—both to work for the system and accept the many veterans who may need to go outside of the VA health system for care. He also asked for our advice and opinions on how he can improve the VA structure.</p> <p> You can watch Secretary McDonald’s address on the <a href="http://www.ama-assn.org/sub/meeting/livestream.html" target="_blank">Interim Meeting website</a>.</p> <p> I’ve always thought the military and the AMA have a lot in common—both are keepers of rich traditions, and both are courageous in the face of trying new things. In both medicine and the military, training often focuses on preparing for the unexpected. And in both, we rely on teamwork and trust.</p> <p> This Veterans Day, a grateful nation and I I thank those who have served our country. I think of the many physicians in the U.S. Armed Forces who have dedicated their skills to caring for those in active service—including AMA Board of Trustee Member LCDR Jesse M. Ehrenfeld, MD, U.S. Navy Reserve, who is currently deployed in the Middle East. And I think of the many men and women who have sacrificed their time and put their lives in danger for us both at home and overseas.</p> <p> Members of the military and their families are making great sacrifices every day. The physician community will do what we can to make sure access to health care is not another sacrifice they’ll have to make. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:88db4761-d7e4-4f24-98d5-98021a077dec Seizing the moment to fix Medicare during the lame duck session http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_seizing-moment-fix-medicare-during-lame-duck-session Mon, 10 Nov 2014 19:30:00 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/9/7/c9d7ba16-b07d-44b1-a7d3-8dbc621df73f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/7/c9d7ba16-b07d-44b1-a7d3-8dbc621df73f.Large.jpg?1" style="margin:15px;float:left;" /></a>Support is growing to finally move Medicare into the 21<sup>st</sup> century by employing practical solutions to problems that have plagued the system for years, including repealing the flawed sustainable growth rate (SGR) that has been a failure since it was first enacted. The lame duck session in Congress is a perfect opportunity to end the broken cycle of temporary patches by repairing our Medicare system and make significant improvements for future generations.</p> <p> Momentum is building with a growing number of bipartisan members of congress in both the House and the Senate, including the congressional “doc” caucus, declaring their support for immediate action on SGR reform. The bipartisan, bicameral bill developed last spring is the remedy to fix the defective policy.</p> <p> If Congress does not seize the moment to act now during the lame duck session all of the hard bipartisan, bicameral work that went into building that framework will be for naught, and the process of negotiating a solution will start all over again. The current legislation is a remedy to improve care for patients through new health care delivery and payment systems that promise to create the stable environment that is needed for physicians to innovate.</p> <p> Eliminating SGR would also free physicians to make the investments needed to implement new models of health care delivery and payment systems that are already proving successful in reducing costs and increasing access to high-quality care in pilot programs across the country.</p> <p> Patient-centered medical homes that enable physicians to better manage chronic diseases and coordinate patient care, and shared savings arrangements that incentivize physicians to redesign care delivery to reduce total spending are just two examples of new approaches that are quickly creating a blueprint for the future of a reformed Medicare system.</p> <p> Yet year after year the SGR has created an unpredictable environment that makes those innovative changes impossible by calling for unmanageable annual rate cuts for physician services and forcing increasingly expensive legislative patches to preserve access to care for millions of Medicare patients. Congress has agreed and continues to agree that the SGR is a defective policy. To date, Congress has spent a staggering $169 billion on 17 short term patches to shore up the ailing system it created, all while the gap between what Medicare pays and the actual cost of caring for patients has grown ever wider.</p> <p> As a country, we simply cannot afford to continue to perpetuate a system that is not meeting the needs of the American public. Fixing the system now will cost less than what has already been spent on the 17 previous patches that did not fix the real problem. Patients and their physicians should not continue to be collateral damage caused by a failure to correct a flawed policy initiated by Congress.</p> <p> America is relying on its elected leaders to secure high-quality, cost-effective health care for Medicare patients now and in the future. Medicare can have brighter future if Congress will finally focus on doing what’s right for patients.</p> <p> It’s a no-brainer. The American Medical Association urges policymakers to finish this by continuing to pursue good faith, bipartisan efforts to end the SGR once and for all. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6d093729-fadc-45fb-bdaf-107e5177e518 Watch on demand: How to fight Ebola in the U.S. http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_watch-demand-fight-ebola Mon, 10 Nov 2014 18:11:00 GMT <p> <object align="right" data="http://www.youtube.com/v/RnP_HIJy9PU" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/RnP_HIJy9PU" type="application/x-shockwave-flash" vspace="15" width="375"><param name="movie" value="http://www.youtube.com/v/RnP_HIJy9PU" /><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/RnP_HIJy9PU" type="application/x-shockwave-flash" vspace="15" width="375" wmode="transparent"></embed></object>If you missed this weekend’s live streaming of an official update on Ebola, you don’t have to be the only one without the latest information. An <a href="http://www.youtube.com/watch?v=RnP_HIJy9PU&feature=youtu.be" rel="nofollow" target="_blank">archived recording</a> of this address made at the 2014 AMA Interim Meeting now is available for on-demand viewing.</p> <p> Watch Arjun Srinivasan, MD (right), an expert from the Centers for Disease Control and Prevention (CDC) and captain in the U.S. Public Health Service, discuss how physicians can prepare for and manage Ebola patients in hospital and ambulatory care settings.</p> <p> <a href="http://www.ama-assn.org/resources/doc/public-health/x-pub/medical-personnel-preparedness-for-ebola.pdf" target="_blank">Slides of the presentation</a> (login) also are available for download.</p> <p> <strong>Looking for additional Ebola information?</strong> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> for convenient access to materials created by the CDC and other public health experts for physicians and the public.</p> <p> In addition, an <a href="http://www.youtube.com/watch?v=_E8BBUW2QYA" rel="nofollow" target="_blank">archived recording</a> now is available of U.S. Secretary of Veterans Affairs Robert McDonald’s report on how the nation is making sure that veterans have timely access to the health care they need. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:52afd591-633e-4a5b-9047-742e27e4f112 Video: CDC expert tells physicians how to prepare for Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_video-cdc-expert-tells-physicians-prepare-ebola Mon, 10 Nov 2014 01:39:00 GMT <div> <object align="right" data="http://www.youtube.com/v/RnP_HIJy9PU" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/RnP_HIJy9PU" type="application/x-shockwave-flash" vspace="5" width="450"><param name="movie" value="http://www.youtube.com/v/RnP_HIJy9PU" /><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/RnP_HIJy9PU" type="application/x-shockwave-flash" vspace="5" width="450" wmode="transparent"></embed></object>In a special address at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, an expert from the Centers for Disease Control and Prevention (CDC) told physicians that the chance of encountering patients with Ebola in ambulatory settings is very low—but physicians need to be prepared nonetheless.</div> <div>  </div> <div> Arjun Srinivasan, MD, associate director for health care-associated infection prevention programs at the CDC and captain in the U.S. Public Health Service, provided an update on the current Ebola outbreak in West Africa and gave information about the cases treated in the United States.</div> <div>  </div> <div> “Without question, we’ve learned that the care of patients with Ebola virus disease in U.S. hospitals and health care settings is enormously complex and very challenging,” Dr. Srinivasan said. “We’ve also learned this can be done safely and effectively if we have strong quality and safety systems in place.”</div> <div>  </div> <div> Dr. Srinivasan gave physicians information about:</div> <div>  </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Opportunities for human-to-human transmission of the virus</div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>How the virus presents in various body fluids and transmission dynamics</div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>The onset of symptoms over time</div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Laboratory findings </div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>How to detect and diagnose the virus</div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Lessons learned about personal protective equipment</div> <div style="margin-left:40px;"> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Clinical management of Ebola patients</div> <div>  </div> <div> He stressed to physicians that it is unlikely a patient with Ebola would come to an ambulatory setting, particularly because of the monitoring plans currently in place for people with potential exposures.</div> <div>  </div> <div> Still, physicians should have plans in place, including aggressive screening at clinic points of entry. If a patient comes to a clinic with potential Ebola exposure and exhibiting symptoms, physicians should immediately place the patient in a private room and call their local health department to arrange for the patient’s transfer.</div> <div>  </div> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/979a9ad2-c1bc-41bb-a0e1-51f2e1a7704d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/979a9ad2-c1bc-41bb-a0e1-51f2e1a7704d.Large.jpg?1" style="margin:15px;float:left;" /></a></p> <div> Physicians can use the CDC’s <a href="http://www.cdc.gov/vhf/ebola/pdf/ambulatory-care-evaluation-of-patients-with-possible-ebola.pdf" rel="nofollow" target="_blank">ambulatory care evaluation guidance</a> to learn how to prepare their practices. The CDC also has resources specifically for <a href="http://www.cdc.gov/vhf/ebola/children/index.html" rel="nofollow" target="_blank">pediatric physicians</a>.</div> <div>  </div> <div> Dr. Srinivasan also outlined how emergency departments and hospitals should prepare for Ebola patients. While the CDC is preparing specific hospitals for treatment of Ebola patients, all hospitals should know how to screen for Ebola patients.</div> <div>  </div> <div> “We’re eager to partner with you, to collaborate with you,” Dr. Srinivasan said. “This is a fast-evolving situation … things are changing as we learn.”</div> <div>  </div> <div> You can <a href="http://www.youtube.com/watch?v=RnP_HIJy9PU&feature=youtu.be" target="_blank" rel="nofollow">watch</a> Dr. Srinivasan’s entire presentation online and <a href="http://www.ama-assn.org/resources/doc/public-health/x-pub/medical-personnel-preparedness-for-ebola.pdf" target="_blank">download the slides</a> (log in). The on-demand recording includes questions and comments from physicians. </div> <div>  </div> <div> The AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> offers up-to-date Ebola materials developed for physicians and the public by the CDC and other national experts. </div> <div>  </div> <div> Physicians who are interested in volunteering to treat Ebola patients in West Africa can <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-helping-stop-spread-of-ebola" target="_blank">learn more</a> in a recent post at <em>AMA Wire</em>®.</div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:57a76e43-6257-4bbd-a81e-0737af237dc5 Lawmakers say SGR repeal closer than ever http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_lawmakers-say-sgr-repeal-closer-ever Sun, 09 Nov 2014 23:52:00 GMT <div> <table align="left" cellpadding="1" cellspacing="1"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/4/a038e46d-cd73-420f-b488-6a600ed0b278.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/4/a038e46d-cd73-420f-b488-6a600ed0b278.Large.jpg?1" style="height:220px;width:300px;float:left;" /></a></td> <td>   </td> </tr> <tr> <td> <span style="font-size:12px;"><em>"The clock is ticking," said Rep. Kevin Brady, R-Texas.</em></span></td> <td>  </td> </tr> </tbody> </table> Congress is closer than ever to passing broadly supported legislative policy that would eliminate Medicare’s flawed sustainable growth rate (SGR) formula—and a permanent solution would come not a moment too soon.</div> <div>  </div> <div> “You are in a state where less than half of family physicians can afford to see new Medicare patients,” Rep. Kevin Brady, R-Texas, told attendees at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas during a special forum Saturday about efforts to repeal the SGR formula. “The clock is ticking.”</div> <div>  </div> <div> In March, the U.S. Senate voted in favor of the 17th Medicare payment patch, spending more taxpayer money on another temporary fix instead of solving the SGR problem for good. The patch extended the current 0.5 percent payment update through the end of the year and froze payment rates from January to March of 2015.</div> <div>  </div> <div> With Congress heading into a lame duck session before newly elected members take office, there could be a solution—if both chambers and parties can work together.</div> <div>  </div> <div> “Most of the hard work has been done,” Rep. Michael Burgess, MD, R-Texas, said during the same Saturday session at the AMA meeting. “I’m optimistic that … there could be a new SGR ending in site.”</div> <div>  </div> <div> <table align="right" cellpadding="1" cellspacing="1"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/9/1e04bd82-0236-4fdd-8903-08a30c5f83dc.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/9/1e04bd82-0236-4fdd-8903-08a30c5f83dc.Large.jpg?1" style="height:213px;width:300px;float:right;" /></a></td> </tr> <tr> <td>  </td> <td> <span style="font-size:12px;"><em>“Most of the hard work has been done,” said<br /> Rep. Michael Burgess, MD, R-Texas.</em></span></td> </tr> </tbody> </table> “We’ve passed [a patch for] so many years, the assumption is we’re just going to do it again,” said Rep. Brady. “We have to break that stereotype.”</div> <div>  </div> <div> Physicians recently paid <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctors-advocate-sgr-repeal-during-lame-duck-session" target="_blank">house calls</a> to members of Congress, urging their U.S. senators and representatives to make SGR repeal a priority. The AMA will continue to work with Congress and other medical societies toward eliminating the formula that has caused serious uncertainty in the Medicare program for years. Read <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Medicare_Reform/1" target="_blank">full coverage</a> of these efforts at <em>AMA Wire</em>®.</div> <div>  </div> <div> Physicians should contact their U.S. senators and representatives to encourage them to repeal the SGR formula during the lame duck session. Visit the <a href="http://fixmedicarenow.org/physician-toolkit/" rel="nofollow" target="_blank">Fix Medicare Now website</a> to access materials that can help these advocacy efforts.</div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d97fdebc-3f4e-4a37-a327-baf90ab44e50 How one physician is helping stop diabetes among her patients http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-physician-helping-stop-diabetes-among-her-patients Sun, 09 Nov 2014 23:50:00 GMT <div> A family practice physician participating in a diabetes prevention screening pilot is seeing how standardization in treatment can help patients stop the progress of prediabetes. </div> <div>  </div> <div> Meghan Buhler, MD, is one of four physicians in a hospital-owned family practice in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/southwest-florida-takes-diabetes-prevention" target="_blank">Venice</a>, a town in southwest Florida. The average age of Venice residents is 73.</div> <div>  </div> <div> “It’s a huge retirement area,” Dr. Buhler said. “Most of [my patients] would be candidates for this program.”</div> <div>  </div> <div> That program is the YMCA’s Diabetes Prevention Program. Venice is one of <a href="http://www.ymca.net/news-releases/y-launches-project-to-test-cost-effectiveness-of-ymcas-diabetes-prevention-program-among-qualifying-medicare-enrollees" rel="nofollow" target="_blank">17 communities</a> in the United States where Medicare beneficiaries can participate in this program at no cost until June of next year, thanks to an award from the Center for Medicare and Medicaid Innovation.</div> <div>  </div> <div> Dr. Buhler is 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. A pilot in collaboration with the YMCA of the USA is helping physician practices in five of the CMMI communities explore a process for screening patients for prediabetes, referring eligible patients to participate in a local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.</div> <div>  </div> <div> The YMCA’s program is part of the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program, which offers an evidence-based lifestyle intervention that <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. That’s important in an area like Venice, where an estimated 35 percent of local adults has prediabetes, the precursor to type 2 diabetes.</div> <div>  </div> <div> Before the pilot program, Dr. Buhler said her practice had no standardized protocol in place to screen for prediabetes. Now, she’s using tools from the AMA collaboration to screen her patients and refer at-risk patients to the local YMCA. One patient who recently started the program already has lost five pounds.</div> <div>  </div> <div> “[The patient] told me last week, ‘Thank you; it’s really enjoyable, and I’m glad you sent me there,’” she said. </div> <div>  </div> <div> Dr. Buhler uses a BMI chart from the AMA to show patients what their ideal weight is, which opens the door to talking about how weight loss can reduce their chances of developing type 2 diabetes.</div> <div>  </div> <div> She discusses the YMCA prevention program with patients when they are in her office reviewing their labs. Otherwise, she’ll have a nurse tell them about the program when the nurse calls to discuss lab results.</div> <div>  </div> <div> Her patients are unique, she said—most are retired, and have a lot of time to dedicate to a prevention program. But there still are challenges.</div> <div>  </div> <div> “My patients have the time, and they’re into taking care of themselves,” she said. “But I also think they’re scared of [admitting they have prediabetes].”</div> <div>  </div> <div> She said she understands patients’ fear. Recent studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives. But Dr. Buhler explains that prediabetes can be reversed and that participating in the YMCA program can help.</div> <div>  </div> <div> <strong>Use these tools to help your patients understand their diabetes risk:</strong></div> <div>  </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>American Diabetes Association <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/ada-risk-test.pdf" target="_blank">type 2 diabetes risk test</a> (log in)</div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>CDC diabetes prevention <a href="http://www.cdc.gov/diabetes/pubs/factsheet11.htm" rel="nofollow" target="_blank">fact sheet</a></div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>AMA prediabetes <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/iho-dpp-poster.pdf">awareness poster</a> (log in)</div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>AMA <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/guide-to-refer-patients-to-the-ymca-diabetes-prevention-program.pdf" target="_blank">guide to refer patients</a> to the YMCA program (log in)</div> <div>  </div> <div> Get more information at <em>AMA Wire</em>® about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/National_Diabetes_Month/1">National Diabetes Month</a> and ways you can help your patients take action to prevent diabetes.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4ae612e4-d29c-43c7-b2b2-3b2ba9201bf4 Med school deans, faculty debate policy: AMA-SMS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-school-deans-faculty-debate-policy-ama-sms-meeting-highlights Sun, 09 Nov 2014 21:26:00 GMT <div> At the 2014 Interim Meeting of the AMA Section on Medical Schools (SMS), participants, comprising deans and faculty from a wide range of medical schools nationwide, voiced their opinions and reached decisions on several reports and resolutions to be acted upon by delegates at the AMA Interim Meeting in Dallas. The AMA-SMA meeting was held Nov. 6-7 in Chicago.</div> <div>  </div> <div> Their work will guide the section delegate and alternate delegate in the discussions and voting during the AMA meeting. Issues covered included:</div> <div>  </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Medical students’ use of electronic health records </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Emphasis on the social determinants of health in medical school curricula </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>Funding of graduate medical education</div> <div>  </div> <div> The AMA-SMS plays a key role in ensuring that AMA policy on medical education reflects the input and expertise of academic physicians. This role was highlighted in a presentation by AMA-SMS alternate delegate Kenneth B. Simons, MD, senior associate dean for Graduate Medical Education and Accreditation at the Medical College of Wisconsin. </div> <div>  </div> <div> In his talk, Dr. Simons also emphasized the many <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page" target="_blank">professional leadership opportunities</a> available for AMA members to serve on national organizations in medical education, including the Accreditation Council for Graduate Medical Education and American Board of Medical Specialties.</div> <div>  </div> <div> AMA-SMS chair Cynda Ann Johnson, MD, MBA, President and Founding Dean of Virginia Tech Carilion of School of Medicine and Research Institute, welcomed the many new and returning AMA-SMS members and other attendees. Along with Susan Skochelak, MD, MPH, Group Vice President of Medical Education at the AMA, Dr. Johnson covered such topics as:</div> <div>  </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>The AMA’s <a href="http://www.changemeded.org/" rel="nofollow" target="_blank">Accelerating Change in Medical Education initiative</a></div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>The AMA’s Academic Leadership Program, which offers membership discounts to medical schools at which the dean and at least five lead faculty are AMA members</div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>The AMA-SMS endorsement of the candidacy of Donald Eckhoff, MD, AMA-SMS delegate, for election to the AMA Council on Medical Education in June 2015 </div> <div> •<span class="Apple-tab-span" style="white-space:pre;"> </span>The ongoing strategic planning process of the AMA-SMS, including a proposed name change to the Academic Physicians Section (APS). </div> <div>  </div> <div> Meeting attendees also enjoyed a guided tour of the AMA's new headquarters, housed in a building designed by internationally renowned architect Ludwig Mies van der Rohe, as well as a networking reception for academic physicians, featuring views of the Chicago skyline from the AMA’s 47th floor.</div> <div>  </div> <div> The AMA-SMS is the AMA member section that represents all academic physicians, educators and faculty/leadership of U.S. medical schools. The section currently comprises 634 members.</div> <div>  </div> <div> The next meeting of the AMA-SMS is in Chicago on June 5-6, 2015, in conjunction with the Annual Meeting of the AMA HOD.</div> <div>  </div> <div> Learn more about the SMS at the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page" target="_blank">section website</a>.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:91f29476-b3ad-45fe-b26e-e083bfc098e9 Community outreach, educational programs: AMA-MAS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_community-outreach-educational-programs-ama-mas-meeting-highlights Sun, 09 Nov 2014 21:09:00 GMT <div> The AMA Minority Affairs Section (MAS) Governing Council held three programs in conjunction with its section business meeting and reception.</div> <div>  </div> <div> The AMA-MAS conducted a successful <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/doctors-back-school.page?" target="_blank">Doctors Back to School</a>™ (DBTS) visit at Harry Stone Montesorri Academy. The program reached out to nearly 400 fourth through and eight graders, presenting healthy lifestyle choices (diet, physical activity, and reducing alcohol and tobacco use) and showing how medicine is an attainable profession. The DBTS program is a tangible way that physicians and medical students introduce and inspire minority children to consider careers in medicine. </div> <div>  </div> <div> Rodney Stapp, MD, chief executive officer of the Urban Inter-Tribal Center of Texas, was the keynote speaker at this year’s AMA-MAS section business meeting. His highly engaging presentation addressed issues in urban Indian health and changing the narrative when we talk about racial and ethnic disparities in health care. The meeting also featured an open forum on AMA House of Delegates reports and resolutions that impact minority physicians and patients.</div> <div>  </div> <div> The AMA-MAS, in collaboration with other AMA sections and special groups and the AMA’s Improving Health Outcomes (IHO) department, hosted a CME educational program. Christopher Holliday, PhD, a representative from IHO, described how the AMA is seeking to improve health outcomes by strengthening links between health care clinics and communities. </div> <div>  </div> <div> Christopher Berry, MD, discussed how his health center is using population health approaches to improve patients’ health outcomes and reduce racial and ethnic health disparities. Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page" target="_blank">section website</a> to learn more about MAS news and initiatives.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:39b83207-3924-4793-a8a7-17a20c3d8434 Growing healthier while growing older: AMA-SPS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_growing-healthier-growing-older-ama-sps-meeting-highlights Sun, 09 Nov 2014 20:53:00 GMT <div> The AMA Senior Physicians Section (SPS) Assembly sponsored a presentation by Kenneth H. Cooper, MD, founder of The Cooper Institute, entitled, "Grow Healthier as You Grow Older.” </div> <div>  </div> <div> At this well-attended program, Dr. Cooper addressed the challenges and opportunities that senior physicians face in maintaining their health and well-being.  The assembly included discussion of business items for the AMA House of Delegates and future AMA-SPS activities.  SPS Chair Paul H. Wick, MD, from Tyler, Texas, presented information on elections for the SPS Governing Council that will open in early 2015.  </div> <div>  </div> <div> The AMA-SPS Governing Council met Nov. 7 to complete its strategic planning for the coming year.  Members of the SPS council bring a clear voice to physicians over the age of 65, for both the policymaking and programming of the organization.  </div> <div>  </div> <div> The SPS transmitted the revised internal operating procedures to the Council on Constitution and Bylaw for their approval at the Interim Meeting. </div> <div>  </div> <div> For more information, see the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page?" target="_blank">section website</a>.</div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8e63d833-3ace-4690-a550-c48c46c5c907 Research Symposium winners: IMG Section highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_research-symposium-winners-img-section-highlights Sun, 09 Nov 2014 20:28:00 GMT <div> The AMA International Medical Graduates Section (IMGS) celebrated its 17th Interim Meeting beginning with the 12th annual AMA Research Symposium, held Nov. 7 in collaboration with the Medical Student Section and Resident and Fellows Sections. </div> <div>  </div> <div> This Research Symposium offered live networking and educational opportunities for all research symposium  participants.  The AMA Research Symposium <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/future-physicians-present-research-largest-ama-symposium" target="_blank">winners</a> selected among physicians awaiting residency who are certified by the Educational Commission for Foreign Medical Graduates  included:  Osama Siddique, MD, podium winner, and Vaibhav Goswami, MD, poster winner.  Research by both presenters was based on health policy/medical education.  </div> <div>  </div> <div> The IMGS Congress Reception and Business meeting featured Todd Askew, AMA director of congressional affairs, who provided a Washington update.  During the IMGS business meeting, delegates reviewed items to be considered for the AMA House of Delegates.</div> <div>  </div> <div> On Nov. 9, the section held its Busharat Ahmad, MD, Leadership Development Program - “Leading an accountable care organization toward a successful outcome.” Michael Deegan, MD, and Harbhajan Ajrawat, MD, spoke about the role of physicians in accountable care organizations.</div> <div>  </div> <div> The section meeting ended Nov. 10 with a joint IMGS and Minority Affairs Section Caucus.</div> <div>  </div> <div> For more information, visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page" target="_blank">section website</a>. </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:340549d2-14e1-4001-b3fc-14fe18846050 Networking, practical education sessions: AMA-RFS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_networking-practical-education-sessions-ama-rfs-meeting-highlights Sun, 09 Nov 2014 19:22:00 GMT <p> 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) Interim Meeting, held in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas, got off to a strong start Nov. 6 with a welcome reception in which more than 200 residents, fellows and medical students networked and shared advice.</p> <p> Attendees took advantage of the excellent opportunity to network with their peers, and residents and fellows offered guidance to medical students on their upcoming transition to residency and give insights into becoming members of the AMA-RFS.</p> <p> Education sessions took place Nov. 7 and 8, including:</p> <p style="margin-left:.5in;"> ·  <strong>Address by AMA President Robert M. Wah, MD.</strong> This dynamic presentation emphasized the importance of the section, highlighting the innovation and enthusiasm the AMA-RFS brings as the future of the AMA.</p> <p style="margin-left:.5in;"> ·  <strong>How to get involved.</strong> The AMA-RFS Membership Committee explained the benefits of membership in the section and highlighted opportunities for residents and fellows to be engaged with the AMA and take advantage of leadership opportunities.</p> <p style="margin-left:.5in;"> ·  <strong>Loan repayment and debt management.</strong> This hot topic was hosted by the AMA-RFS Committee on Business and Economics. Application points will be shared in a forthcoming post at <em>AMA Wire</em>®.</p> <p style="margin-left:.5in;"> <em>·  </em><strong>Conducting research and getting published. </strong>Edward H. Livingston, MD, deputy editor of clinical content for <em>JAMA </em>gave tips for physicians in training.</p> <p style="margin-left:.5in;"> ·  <strong>Update on AMA’s Accelerating Change in Medical Education initiative. </strong>During this engaging presentation, residents were able to ask questions and offer ideas and anecdotes about what is and isn’t working in their training programs. Key points from this session will be shared in a forthcoming post to <em>AMA Wire</em>.</p> <p> The AMA-RFS Assembly also passed eight resolutions and one report at its business meeting Nov. 8, covering such topics as:</p> <p style="margin-left:40px;">    ·  Applying principles of research on human subjects to online research projects</p> <p style="margin-left:40px;">    ·  Responding to epidemics and pandemics</p> <p style="margin-left:40px;">    ·  Encouraging protocols to assist with the management of obese patients</p> <p style="margin-left:40px;">    ·  Mitigating physician performance metrics on trainee autonomy and education</p> <p> Two resolutions were referred:</p> <p>                 ·  Reorganization of AMA-RFS regions to mimic HOD caucuses</p> <p>                 ·  Establishment of an AMA-RFS quality improvement forum</p> <p> The AMA-RFS immediately forwarded a resolution on the AMA’s response to epidemics and pandemics to the AMA House of Delegates. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6189c63c-9397-41e1-a6bf-d190636c289a Protecting your online reputation: AMA-YPS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_protecting-online-reputation-ama-yps-meeting-highlights Sun, 09 Nov 2014 19:12:00 GMT <p> Young physicians from across the country discussed priority issues and worked on shaping AMA policy during this year’s AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section.page?" target="_blank">Young Physicians Section</a> (YPS) meeting, held Nov. 6-8 in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</p> <p> After reviewing the AMA House of Delegates handbook, the AMA-YPS Assembly identified items of particular relevance to the section and developed testimony for reference committee hearings and on the House floor. Details of all AMA-YPS positions can be found on the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section.page" target="_blank">AMA-YPS Web page</a>.</p> <p> The AMA-YPS C. Clayton Griffin, MD, Memorial Luncheon was based on the theme “Protect your online reputation.”  The luncheon featured Ravi Goel, MD, former AMA-YPS chair and instructor at the Wills Eye Hospital. This informative session provided attendees with an opportunity to learn techniques to improve their online presence in light of various physician rating sites and the growth in social media use.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7a8568fb-b847-47dd-bf59-e882257a1c93 Effective communication in medicine: AMA-WPS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_effective-communication-medicine-ama-wps-meeting-highlights Sun, 09 Nov 2014 19:04:00 GMT <p> 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) hosted its business meeting and reception Nov.8-9 in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. Participants heard a featured presentation by Juliet Lee, MD, one of the 2013 recipients of the Joan F. Giambalvo, MD, Fund for the Advancement of Women.</p> <p> Dr. Lee shared results from her study, “The experience of chief residents who have remained in and who have left academic medicine.”</p> <p> The business meeting concluded with a review of the AMA House of Delegates handbook. The AMA-WPS Governing Council reviewed its positions on various items of business before the AMA House of Delegates that focus on issues of concern to women physicians, medical students and patients. 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> for details about all of the section’s positions on these topics.</p> <p> A luncheon and business meeting for section liaisons took place Nov. 9. Highly regarded by attendees, this event featured updates about what state and specialty medical societies are doing to address important issues related to women physicians around the country. Members of the AMA-WPS Liaisons Network participated in a roundtable discussion on advancing women in health care leadership positions.</p> <p> Finally, the section sponsored the education session “Communication as a conflict management tool,” led by Andrea Jones, executive director of the E-Women Network of Dallas/Fort Worth.</p> <p> This engaging presentation provided insights on how physicians can identify factors that hinder effective communication, examine ways poor communication and conflict can impact professional effectiveness, and implement effective communication techniques for conflict management.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4f1ce79d-3982-48fd-8982-be5b7e9acc60 Key developments for medical staff: AMA-OMSS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_key-developments-medical-staff-ama-omss-meeting-highlights Sun, 09 Nov 2014 19:00:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section.page?" target="_blank">Organized Medical Staff Section</a> (OMSS) held its 31st interim assembly meeting Nov. 6-8, in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. The section hosted five continuing medical education programs during the meeting.</p> <ul> <li> “How patient satisfaction scores and physician ratings are affecting physician compensation,” presented by Brad Pancratz and Eric Passon.</li> <li> “Medical staff engagement of community physicians,” presented by Jennifer Fragapane.</li> <li> “A hospital’s success through physician-led quality improvement initiatives,” presented by Erin DuPree, MD, and Michael Shabot, MD.</li> <li> “Centers for Medicare & Medicaid Services Hospital Conditions of Participation: What medical staff members need to know about the final rule,” presented by Elizabeth Snelson.</li> <li> “Improving Health Outcomes: National trends and local perspectives,” presented by Christopher Berry, MD, and Christopher Holiday, PhD. This session was co-sponsored by the AMA sections and special groups and the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative.</li> </ul> <p> The section also hosted an update on the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, presented by Michael Tutty, PhD, and James Rohack, MD.</p> <p> AMA Senior Vice President for Advocacy Rich Deem addressed the section on the implications of the recent congressional elections, the status of Medicare payment reform efforts, recent revisions to the Medicare conditions of participation for hospitals and other AMA advocacy efforts in the nation’s capital.</p> <p> The OMSS Assembly considered 11 items of business on a range of issues, including the effects on the medical profession of trends in physician employment, drug costs and maintenance of licensure. The section transmitted six resolutions to the AMA House of Delegates for consideration.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cfd09efc-cf04-4d47-81f6-6c37c17ad0f2 Innovative businesses, integrated care: AMA-IPPS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_innovative-businesses-integrated-care-ama-ipps-meeting-highlights Sun, 09 Nov 2014 18:57:00 GMT <p> Experts discussed emerging relationships between large employers and integrated practices Nov.7 during the <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) Interim Meeting, held in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</p> <p> Still a new AMA section, the AMA-IPPS enjoyed a 40 percent increase in attendance at this meeting.</p> <p> Lukas Forney of Intel Corporation spoke about how his company’s culture of constant innovation and its goal to have the healthiest workforce on the planet drives innovation in its relationships with physicians and other health care providers. Consequently, Intel has direct contracts with integrated systems across its sites in western states.</p> <p> Intel’s model focuses on medical neighborhoods with high-performing specialists, in which payment is tied to decreased cost, evidence-based medicine, access to care and patient satisfaction. This program was chaired by David Bronson, MD, of the Cleveland Clinic.</p> <p> Members of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/integrated-physician-practice-section/about-us/governing-council.page" target="_blank">IPPS Governing Council</a> co-led the break-out sessions with Forney and two other speakers: Michael Glenn, MD, chief medical officer of Virginia Mason Medical Center, and Bill Kramer of the Pacific Business Group on Health. </p> <p> The afternoon program on engaging physicians in integrated care was presented in collaboration with the American Medical Group Association. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:168499af-6b2b-4cd6-8d5f-e15c57d29f8e Contemporary context of family building: LGBT meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_contemporary-context-of-family-building-lgbt-meeting-highlights Sun, 09 Nov 2014 18:51:00 GMT <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee.page?" target="_blank">Advisory Committee on Lesbian, Gay, Bisexual and Transgender (LGBT) issues</a> hosted a special LGBT and Allies Caucus and reception Nov. 7 in conjunction with the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. The focus of the caucus was the contemporary context of family building.</p> <p> The committee changed the name of the caucus to include health care allies in order to be as inclusive as possible.</p> <p> Participants enjoyed a panel presentation about the contemporary context of family building options. Andy Miller, co-founder of the Handsome Father, presented an overview of the current context of family building, including such options as gestational and traditional surrogacy, adoption, assisted reproduction, guardianship and fostering.</p> <p> Miller also reviewed the various obstacles to successful family building and the important role of the physician during all phases of the family building process. Physicians were cautioned not to make assumptions about their patients or focus on the sexual orientation, presumed gender roles, age or marital status of the parents. Rather, physicians should focus on the health and well-being of the infant or child involved.</p> <p> The highlight of the panel presentation was the personal stories. Dorothy Sippo, MD, and Terrance Hines, MD, shared their personal journeys with in vitro fertilization and adoption.</p> <p> Medical students, residents and physicians who are interested in subscribing to the LGBT list serve can do so by <a href="mailto:lgbt@ama-assn.org" rel="nofollow">sending an email</a> to the advisory committee.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0a932cf2-fb7a-40dd-8630-6da99bd7e55d VA secretary: We need physicians’ help http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_va-secretary-need-physicians Sun, 09 Nov 2014 05:00:00 GMT <p> The U.S. Department of Veterans Affairs (VA) is working to right wrongs, reframe perceptions and enhance care for veterans—and it needs the help of physicians, VA Secretary Robert A. McDonald (pictured below) told the AMA House of Delegates Saturday at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/10/e76875a9-f845-4cd2-aa7b-d1ac06368efe.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/10/e76875a9-f845-4cd2-aa7b-d1ac06368efe.Large.jpg?1" style="margin:15px;float:right;" /></a>Citing recent access-to-care issues for veterans, McDonald told physicians about the VA’s “Blueprint for Excellence,” which seeks to:</p> <ul> <li> Improve performance of the VA health care system</li> <li> Reset the VA’s culture to place value on job performance</li> <li> Transition from “sick care” to “health care”</li> <li> Develop efficient, transparent processes to support the VA’s span of care, services and programs</li> </ul> <p> McDonald pointed to 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 initiative</a> as a good example of the work the VA needs to undertake to manage its massive patient base—there were more than 90 million scheduled appointments in 2013.</p> <p> “Right now, one of the biggest challenges we face is the shortage of clinicians,” McDonald said. “The demand for VA care will not decrease any time soon. The nation’s been at war for over a decade, and we’ll continue to be caring for many of our severely wounded and ill veterans for decades to come.”</p> <p> To mitigate this, he’s visiting U.S. medical schools to recruit students to work for the VA. He discussed the Veterans Access, Choice and Accountability Act—a law the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physician-voice-helps-shape-veterans-health-care-reform-law" target="_blank">AMA helped shape</a>—which will give authorities funding and other tools to better serve veterans in the short term.</p> <p> This week, more than 30,000 vets who live more than 40 miles from a VA medical facility received their Choice Cards, which allows them to secure care in the private sector. By the end of the month, another 370,000 vets who face waits longer than 30 days for VA care also will receive the cards.</p> <p> “We need to configure the Choice program in a way that enables all doctors caring for veterans to work as teams, no matter who is paying the bill,” McDonald said. “We need you to participate in the program, and we know you won’t if it’s too much trouble.”</p> <p> McDonald asked the physicians at the meeting, and those watching the live stream of his address, to give their input and advice on the VA’s Choice Act and its future plans.</p> <p> “VA cannot accomplish its mission as a stand-alone system,” he said. “We’re part of a larger community facing the same challenges you face.”</p> <p> <object data="http://www.youtube.com/v/_E8BBUW2QYA" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/_E8BBUW2QYA" type="application/x-shockwave-flash" width="450"><param name="movie" value="http://www.youtube.com/v/_E8BBUW2QYA" /><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:505dbf9e-13a1-4d00-99ab-e99a5eb2acaa Mission provides a map to improve medicine: AMA CEO http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_mission-provides-map-improve-medicine-ama-ceo Sun, 09 Nov 2014 01:54:00 GMT <div> Throughout history, the AMA has always followed its mission: to promote the art and science of medicine and the betterment of public health. The association will continue to follow its mission—its moral compass and road map—into the future, AMA Executive Vice President and CEO <a href="http://www.ama-assn.org/resources/doc/about-ama/bio-madara.pdf" target="_blank">James L. Madara, MD</a>, (pictured below) said in his address Saturday at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>.</div> <div>  </div> <div> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/15/35ac373e-3fad-478c-afde-9ce224e0f3f4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/15/35ac373e-3fad-478c-afde-9ce224e0f3f4.Large.jpg?1" style="margin:15px;float:right;" /></a>The AMA mission has charted the course for how the association expands its work in its three focus areas:</div> <div>  </div> <div> <strong><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 initiative</a></strong></div> <div> Dr. Madara announced that beta testing has begun for the first four modules in the AMA’s new online platform to help physicians address common clinical challenges. The platform is called <a href="https://www.steps-forward.com/" rel="nofollow" target="_blank">STEPS Forward™</a>, which stands for Solutions Toward Effective Practice. </div> <div>  </div> <div> He also discussed how the AMA is working to understand and improve new payment models, ensure physician leadership in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/840-million-will-fund-improved-care-via-new-clinical-networks" target="_blank">new practice models</a> and working to improve the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">usability of electronic health records</a> (EHR).</div> <div>  </div> <div> <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank"><strong>Accelerating Change in Medical Education initiative</strong></a></div> <div> The 11 schools that received grants from the AMA to innovate changes to medical school curriculum are making strides, Dr. Madara said. From embedding patient navigators into health systems to using authentic clinical data in curriculum, the consortium of schools is transforming how to teach physicians of tomorrow. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Changing_MedEd/1" target="_blank">Read more</a> about these medical education innovations at AMA Wire®.</div> <div>  </div> <div> <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank"><strong>Improving Health Outcomes initiative</strong></a></div> <div> The AMA led pilots in both <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ymca-physicians-join-prevent-diabetes-florida-community" target="_blank">diabetes prevention</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/better-blood-pressure-added-burden-one-practices-story" target="_blank">hypertension</a> initiatives over the past year, and is turning its attention to spreading effective strategies to help more physicians manage these conditions in their practices. </div> <div>  </div> <div> Dr. Madara said the AMA has let its mission guide its work for the past 167 years—from winning the fight against “widespread quackery” in the 19th century to the Flexner Report, from the war on tobacco in the mid-20th century to the compassionate treatment of AIDS patients.</div> <div>  </div> <div> “Call it leadership, call it altruism, call it doing the right thing,” Dr. Madara said. “When we are true to our mission, we earn the public’s respect, we gain influence with policymakers, and we gain stature with thought leaders and doers across the spectrum of health care and beyond.”</div> <div>  </div> <div> “Together, we are breathing new life into our mission statement for each other, for the next generation of physicians, for our patients and for a healthier nation.”</div> <div>  </div> <div> <object data="http://www.youtube.com/v/hQr43yhfKmU" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/hQr43yhfKmU" type="application/x-shockwave-flash" width="450"><param name="movie" value="http://www.youtube.com/v/hQr43yhfKmU" /><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></div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c864dc64-4922-4dd0-8f09-59cd370bb6cd AMA president discusses anticipating problems, finding solutions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-president-discusses-anticipating-problems-finding-solutions-1 Sun, 09 Nov 2014 01:49:00 GMT <div> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/12/9e61fbcf-b2f8-4cba-ac5e-0dcd34224667.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/12/9e61fbcf-b2f8-4cba-ac5e-0dcd34224667.Large.jpg?1" style="height:315px;width:350px;margin:15px;float:right;" /></a>In an address during Saturday’s opening session of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, AMA President Robert M. Wah, MD, told physicians how the AMA is anticipating problems and working on solutions to give doctors nationwide a new hope in practicing medicine.</div> <div>  </div> <div> Dr. Wah gave examples of how the AMA and physicians across the country have led important changes to make it easier and more satisfying to practice medicine and serve the nation’s patients, including:</div> <div>  </div> <ul> <li> <span style="font-size:14px;">Striving to calm the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">“tsunami” of regulatory penalties</a> physicians will face over the next decade by urging the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT to make the meaningful use, Physician Quality Reporting System and Value-Based Modifier programs more simple and streamlined.</span></li> <li> <span style="font-size:14px;">Advocating for widespread adoption of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">telemedicine</a>, including expanding coverage and payment and lifting geographic restrictions.</span></li> <li> <span style="font-size:14px;">Achieving a framework to repeal and replace Medicare’s sustainable growth rate formula with bipartisan and bicameral support, and continuing to work with Congress and other medical societies toward repeal. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Medicare_Reform/1" target="_blank">Read full coverage</a> of this effort at<em> AMA Wire</em>®.</span></li> </ul> <div> “Recognizing potential problems is the first step toward overcoming them,” Dr. Wah said. “We’ve taken that step … with positive action on behalf of our physicians and our patients.”</div> <div>  </div> <div> He also discussed problems with electronic health records (EHR) and how the AMA is working to solve those problems, outlined in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">new framework</a> developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives.</div> <div>  </div> <div> ”We cannot let the technology rule us,” he said. “We must rule the technology. … We can’t rely on it solely. We need to continue to use our own senses, training and clinical acumen.”</div> <div>  </div> <div> The AMA is working with EHR vendors and urging policymakers to create institutional health IT policies. The association also is partnering with researchers to better understand EHR usability.</div> <div>  </div> <div> <object data="http://www.youtube.com/v/4N4d44u-WHk" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/4N4d44u-WHk" type="application/x-shockwave-flash" width="450"><param name="movie" value="http://www.youtube.com/v/4N4d44u-WHk" /><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></div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:34061488-c95b-45a7-9eee-838d9724f039 Future physicians present research at largest AMA symposium http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_future-physicians-present-research-largest-ama-symposium Sat, 08 Nov 2014 21:27:00 GMT <div> Seven young medical researchers claim the distinction of being named Saturday as winners of the 2014 <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>, one of the most competitive and largest symposiums in the event’s 12-year history.</div> <div>  </div> <div> Competing among more than 400 of the country’s brightest medical students, residents, fellows and international medical graduates (IMG) awaiting residency, the seven overall winners were selected based on the outstanding quality of their work. </div> <div>  </div> <div> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/5/da7579b5-3a42-44e2-a5ab-249954429327.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/5/da7579b5-3a42-44e2-a5ab-249954429327.Large.jpg?1" style="margin:15px;float:right;height:267px;width:365px;" /></a>Overall winners for the AMA Medical Student Section are:</div> <div>  </div> <ul> <li> <span style="font-size:14px;">Vlad Codrea, poster presentation</span></li> <li> <span style="font-size:14px;">Megan Beck, podium presentation</span></li> </ul> <div>  </div> <div> Overall winners for the AMA Resident and Fellow Section are: </div> <div>  </div> <ul> <li> <span style="font-size:14px;">Oral Waldo, MD, poster presentation</span></li> <li> <span style="font-size:14px;">Justin Fiala, MD, Clinical vignette podium presentation</span></li> <li> <span style="font-size:14px;">Stephen Chun, MD, Clinical medicine podium presentation</span></li> </ul> <div>  </div> <div> Overall winners for the AMA IMG Section are:</div> <div>  </div> <ul> <li> <span style="font-size:14px;">Osama Siddique, MD, poster presentation</span></li> <li> <span style="font-size:14px;">Vaibhav Goswami, MD, podium presentation</span></li> </ul> <div>  </div> <div> The symposium, which took place Friday night as part of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas, included hundreds of poster presentations and about 37 presentations as part of the oral competition. View the <a href="https://download.ama-assn.org/resources/doc/mss/x-pub/abstract-book.pdf" target="_blank">abstracts</a> (log in) of the research by this year’s participants. </div> <div>  </div> <div> This year also was the first time judges were able to contribute remotely.</div> <div>  </div> <div> Lauren Lamb (pictured above), a second-year medical student at Meharry Medical College, said she was participating in the symposium not only to present her own research but also learn from others—and later pass her experiences onto others as well.</div> <div>  </div> <div> “I want to do research as a clinician,” Lamb said. “This gives me experience. It helped me a lot to prepare, and I can help other students prepare, like my mentor did for me.”</div> <div>  </div> <div> Participants presented research spanning a broad range of topics, including the effects of music on anesthesia, explorations of diagnostic dilemmas, marijuana’s effect on pregnancy and more.</div> <div>  </div> <div> Sumit Dahal, MD, a first-year internal medicine resident at Interfaith Medical Center in Brooklyn, New York, presented his findings on how socioeconomic characteristics of nodal Hodgkin’s lymphoma patients may affect whether health care is managed in academic versus non-academic centers.</div> <div>  </div> <div> “The whole process [of research] is satisfying and fascinating,” Dr. Dahal said. “Life as a resident can be all about work—this gives a broader aspect that goes behind your everyday thing.”</div> <div>  </div> <div> The AMA Research Symposium is organized by the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a>, the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section.page?" target="_blank">Resident and Fellow Section</a> and the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/international-medical-graduates.page?" target="_blank">AMA-IMG Section</a>. This year’s event was the third time to include a category for IMGs who are certified by the Educational Commission for Foreign Medical Graduates and awaiting residency.</div> <div>  </div> <div> Darlyne Menscer, MD, clinical associate professor of family medicine at Carolinas Medical Center in Charlotte, North Carolina, has been a judge for the symposium for about five years.</div> <div>  </div> <div> “The quality [of projects] is amazing,” said Dr. Menscer, chair-elect to the AMA Council on Medical Education. “I like talking to the people who did the work. I think the thought behind these projects is really better than what you might estimate.”</div> <div>  </div> <div> In addition to the overall awards, winners were selected for each category in the medical student and resident and fellow competitions:</div> <div>  </div> <div> Resident and fellow winners: </div> <div>  </div> <ul> <li> <span style="font-size:14px;">Ayesha Bibi, MD, clinical vignette</span></li> <li> <span style="font-size:14px;">Harmony Tyner, MD, clinical medicine</span></li> </ul> <div> Medical student winners:</div> <div>  </div> <ul> <li> <span style="font-size:14px;">Xiaowen Wang, biochemistry/cell biology</span></li> <li> <span style="font-size:14px;">Kevin Qin, cancer biology</span></li> <li> <span style="font-size:14px;">Jenny Wang, clinical outcomes and health care improvement</span></li> <li> <span style="font-size:14px;">Luis Diaz-Aguilar, immunology/infectious disease/inflammation</span></li> <li> <span style="font-size:14px;">Patrick Davis, neuroscience/neurobiology</span></li> <li> <span style="font-size:14px;">Johanna Kreafle, public health and epidemiology</span></li> <li> <span style="font-size:14px;">Jeffrey Fujimoto, radiology/imaging</span></li> <li> <span style="font-size:14px;">Nikita Consul, surgery/biomedical engineering</span></li> </ul> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9801a778-aad2-4fb5-a7cf-c4e485bc5a3d Boston doctor wins AMA award for efforts after marathon bombings http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_boston-doctor-wins-ama-award-efforts-after-marathon-bombings Sat, 08 Nov 2014 21:00:00 GMT <div> A Boston physician who managed triage efforts after the Boston marathon bombings was awarded the AMA Medal of Valor Saturday during the opening session of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. The award is made to an AMA member or members who demonstrate courage under extraordinary circumstances in non-wartime situations.</div> <div>  </div> <div> Andrew S. Ulrich, MD, executive vice chairman of the department of emergency medicine at the Boston Medical Center, directed and coordinated the immediate care and resuscitative efforts for 28 patients, who ranged in age from 5 to 78 years old. Dr. Ulrich swiftly assessed the needs of each victim and identified eight patients with life-threating injuries, arranging the operations they required within 40 minutes of their arrival.</div> <div>  </div> <div> Also at the Interim Meeting, the AMA presented Peter N. Bretan, Jr., MD, with the Benjamin Rush Award for Citizenship and Community Service. The award recognizes physicians who have gone above and beyond their professional call of duty to make an outstanding public service contribution.</div> <div>  </div> <div> Dr. Bretan, a California urologist and transplant surgeon, was chosen by the AMA for his exceptional work as an innovator in renal transplant surgery and urology, in addition to his unwavering disaster relief efforts around the globe to help save lives. He is the founder of Life Plant International, a charitable organization that promotes disaster preparedness, organ donation and early disease screening worldwide.</div> <div>  </div> <div> The AMA also presented four Medical Executive Lifetime Achievement Awards at the meeting. Recipients are:</div> <ul> <li> Nancy J. Adams, executive director of the Monroe County Medical Society and New York Chapter 1 of the American Academy of Pediatrics</li> <li> Thomas M. Donoghue, former senior vice president of communications and marketing for the Medical Society of the State of New York</li> <li> Scott Hunt, former CEO of the Endocrine Society</li> <li> James H. Scully, Jr., M.D., former medical director and CEO of the American Psychiatric Association</li> </ul> <div> The Medical Executive Lifetime Achievement Award honors a medical executive of a county medical society, state medical association or national medical specialty society who has contributed substantially to the goals and ideals of the medical profession.</div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:49cf2964-0d5d-46a3-bf65-51439fc271f4 700 students discuss policy, attend ed sessions: MSS meeting highlights http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_800-students-discuss-policy-attend-ed-sessions-mss-meeting-highlights Sat, 08 Nov 2014 19:00:00 GMT <div> More than 700 medical students discussed 44 items of business and participated in 13 education programs Nov. 6–8 during this year's <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">AMA Medical Student Section</a> (MSS) Interim Assembly Meeting.  </div> <div>  </div> <div> The AMA-MSS debated a wide range of topics, and supported policies addressing medical student involvement in handoffs and mobile medical applications. </div> <div>  </div> <div> Education programs covered a range of issues and included a new track schedule which focused on Leadership Development, Health Care Legislation and Advocacy, Innovation in Medical Education and Public Health and Improving Health Outcomes. </div> <div>  </div> <div> The assembly elected William Pearce of the University of South Florida Health Morsani College of Medicine as AMA-MSS chair-elect, and Dina Marie Pitta of the University of Wisconsin of Medicine and Public Health as AMA trustee. Their terms will begin in June after the 2015 Annual Meeting of the AMA House of Delegates.</div> <div>  </div> <div> The section also held its 12th annual Research Symposium in conjunction with the AMA Resident and Fellow Section (RFS) and the International Medical Graduates Section (IMG). More than 200 students participated in the event. Here are the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/future-physicians-present-research-largest-ama-symposium" target="_blank">winners</a> in the following eight categories:</div> <div>  </div> <div> • Biochemistry/cell biology – Xiaowen Wang, Duke University School of Medicine</div> <div> • Cancer biology – Kevin Qin, University of Toledo College of Medicine</div> <div> • Clinical Outcomes and Healthcare Improvement – Jenny Wang, New York University School of Medicine</div> <div> • Immunology/infectious disease/inflammation – Luis Diaz-Aguilar, UCLA Geffen School of Medicine Los Angeles</div> <div> • Neurobiology/neuroscience – Patrick Davis, Indiana University School of Medicine South Bend</div> <div> • Public Health and Epidemiology Johanna Kreafle, University of Miami Miller School of Medicine</div> <div> • Radiology/Imaging – Jeffrey Fujimoto, UCLA Geffen School of Medicine Los Angeles</div> <div> • Surgery/biomedical engineering – Nikita Consul, Columbia University College of Physicians and Surgeons</div> <div>  </div> <div> Vlad Codrea, University of Texas Medical Branch Galveston, was the overall winner of the poster competition and Megan Beck, Medical College of Wisconsin, was the overall podium winner.  Congratulations to these winners and all who participated for their impressive research.  </div> <div>  </div> <div>  </div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3f1cff62-ac96-4445-8931-b429fd21cebd Emmy-winning director gives sneak peek at physician documentary http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_emmy-winning-director-gives-sneak-peek-physician-documentary Sat, 08 Nov 2014 01:45:00 GMT <p> Physicians got an exclusive advance preview of the AMA-sponsored PBS documentary <em>Rx: Hope for Health Care in the U.S.</em> Friday night at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</p> <p> The documentary’s award-winning director, writer, producer and cinematographer <a href="http://www.grubin.com/" rel="nofollow" target="_blank">David Grubin</a> answered questions during a session moderated by Edward H. Livingston, MD, deputy editor of clinical content for <em>JAMA</em>.</p> <p> <object align="right" data="http://www.youtube.com/v/gOfpzj4-d04?list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/gOfpzj4-d04?list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/gOfpzj4-d04?list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" /><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/gOfpzj4-d04?list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object>The film is about the physician experience, and the powerful relationships and patient encounters physicians have. Grubin’s father and grandfather were physicians, among others in his family.</p> <p> “[My father] forged profound connections with his patients that, in my mind, made him a hero in the high drama of his medicine,” Grubin said. “As a child, I remember looking at that black bag and just thinking of it being filled with miracles.”</p> <p> The film looks beyond technology and medicine, and explores a health care model focused on medicine's fundamental mission: to promote health, prevent sickness and help people live long, productive lives. One theme of the film is the team-based care model.</p> <p> “It’s a very stressful job, and when you had a team to talk to, and you had other eyes on the situation, the burden wasn’t all yours,” Grubin said of his experiences filming physicians around the country.</p> <p> The documentary places patients and caregivers within the context of innovative practices. It explores how physician practices foster affordable health care while encouraging intimacy, inclusion, trust and healing. Among the film’s subjects are a primary care center in Anchorage run by Alaskan natives, a family physician in a small town in Maine and an innovative medical education program at Hofstra North Shore-LIJ School of Medicine.</p> <p> Grubin hopes the film will show non-physicians how much high-quality doctoring is happening around the country, in contrast to what may be portrayed on television shows, on the nightly news or in Hollywood movies.</p> <p> “How do you treat chronic disease? It’s difficult to make a film about it,” Grubin said. “That’s what you haven’t seen on television. It’s all about the relationship you have with that patient, and that’s what I’m trying to represent on the film, so people see doctors really working in a way they haven’t seen before.”</p> <p> The film will be released next year.</p> <p> Grubin has produced more than 100 films and won many awards in the field of documentary television, including 10 Emmy awards. His five-part series for PBS, <em>Healing and the Mind with Bill Moyers</em>, won numerous awards, and the companion book for which he was executive editor rose to No. 1 on <em>The New York Times</em> Best Sellers list, remaining there for 32 weeks.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ea91be3-6a66-4578-8b3f-e47445bab364 How medical schools are redefining the basic sciences http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-redefining-basic-sciences Thu, 06 Nov 2014 21:34:00 GMT <p> Part of transforming undergraduate medical school curriculum means shifting the way educators and medical students think about the basic sciences. What do tomorrow’s physicians need to know to treat patients in the future?</p> <p> Physicians must have strong foundations in both basic sciences—including cell and molecular biology, biochemistry, pharmacology and physiology—and clinical sciences, which means mastering a large body of knowledge. Some of the schools in the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative are devising new ways to incorporate basic sciences into the curriculum to ensure tomorrow’s physicians not only have the right information but know how to apply it and adapt to it.</p> <p> At Vanderbilt University School of Medicine, there’s movement toward a hub-and-spokes model, with the hub being the core basic science content and the spokes being a variety of different clinical settings where students can apply their basic science knowledge.</p> <p> For example, the core of the cancer course includes molecular drivers of cancer, screening and imaging for the disease. The spokes include medical oncology, intervention, pediatric oncology, genetics—all different settings within Vanderbilt University Medical Center where students can get hands-on experience applying what they’ve learned. The integrated course model allows students not only to advance their knowledge and skill in a basic science core but also to do “deep dives” into specific topics if they are interested.</p> <p> The Vanderbilt model also allows student to see how different <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/making-case-interprofessional-education" target="_blank">clinical teams</a> take on various parts of treatment, which is crucial for physicians of the future.</p> <p> “You’re not necessarily an expert in any particular area all the time, in every single field,” said Lourdes Estrada, PhD, assistant professor of cancer biology at Vanderbilt. “You’re really dependent on what your team provides for that care. We’re trying to revisit the question, ‘Do you need to know everything there is to know about these foundational sciences?’”</p> <p> Similarly, the University of California San Francisco School of Medicine is redefining basic science by expanding the notion about which sciences are foundational to the practice of medicine and assessing what it means to “master” a science.</p> <p> “It’s not sufficient to have knowledge of how the body works,” said Catherine Lucey, MD, vice dean for education at UCSF. “You have to understand the sciences that help us [make sense of] the patient’s approach to illness, impact on environment, how patients make decisions … the complex problems that face physicians and patients today require knowledge in at least six domains of science.”</p> <p> Those six domains include:</p> <ul> <li> Biomedical science or the “traditional” idea of basic science</li> <li> Social and behavioral science, including addiction, medication adherence and lifestyle changes</li> <li> Clinical and translational science, which encompasses how biological principles are applied to real-world environments</li> <li> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/two-schools-embracing-new-science-medical-education" target="_blank">Systems engineering</a>, or the science around safe, reliable and consistent delivery of high-quality, patient-centered care</li> <li> The <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">science of learning</a>, so students understand how to continue to learn and adapt throughout their careers</li> <li> Population science and public health</li> </ul> <p> “If all you know is just one of those ‘arms,’ you’re not going to be very well-suited to solve the complex challenges in front of us,” Dr. Lucey said.</p> <p> By thinking about the basic sciences in a different way, the educators that are part of the Accelerating Change in Medical Education consortium of schools hope to train physician leaders that have foundational knowledge. These physician leaders also will know how to ask appropriate questions, filter and apply data and cultivate a habit of inquiry—in short, to know how to think like scientists who continually progress in a rapidly changing health care environment.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1b43e907-11d6-462b-aaa9-e9cf659d1a96 Time running out to apply for a meaningful use exemption http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_time-running-out-apply-meaningful-use-exemption Thu, 06 Nov 2014 21:30:00 GMT <p> Physicians have less than a month to <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/HardshipExtension_Application.pdf" target="_blank" rel="nofollow">apply for a hardship exception</a> for the federal electronic health record (EHR) meaningful use program. Apply by Nov. 30 to avoid next year’s payment adjustments for not demonstrating meaningful use.</p> <p> Physicians who have never participated in the meaningful use program may find this opportunity particularly helpful because they will face penalties in 2015 if they did not attest by Oct. 1.</p> <p> The Centers for Medicare & Medicaid Services recently reopened the submission period for hardship exception applications as a result of AMA advocacy. Previously, the hardship application deadline was April 1 for hospitals and July 1 for physicians.</p> <p> If you’re unsure whether you have met all the requirements to demonstrate meaningful use this year, be sure to apply for the exception by the end of the month.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cms-reopens-period-apply-meaningful-use-hardship-exemption" target="_blank">how to submit an application</a> and the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/last-chance-apply-july-1-avoid-meaningful-use-pay-penalty" target="_blank">hardship exemption categories</a> at <em>AMA Wire</em>®.</p> <p> The AMA continues to seek greater flexibility in the meaningful use program and has outlined <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">four key changes</a> in a blueprint for Stage 3 of the program.</p> <p> The AMA also <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/meaningful-use-hr5481-letter-18sept2014.pdf" target="_blank">supports H.R. 5481</a> (log in), legislation that would shorten the 2015 reporting period for the meaningful use program from one year to 90 days. In addition, the AMA continues to push for program revisions that include no longer compelling physicians to meet 100 percent of the program’s requirements in order to avoid a penalty and seeking ways to simplify the various Medicare quality reporting requirements.</p> <p> The association also is working to address the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight top challenges to EHR usability</a> as part of its Professional Satisfaction and Practice Sustainability initiative.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2b608999-2495-40ec-96dd-40c2048d84c0 Travel abroad in 2015 with AMA physicians http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_travel-abroad-2015-ama-physicians Thu, 06 Nov 2014 17:49:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/12/7ebc3e1a-bbd4-4b27-8ca4-18b0ebec24d7.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/12/7ebc3e1a-bbd4-4b27-8ca4-18b0ebec24d7.Large.jpg?1" style="border-width:0px;border-style:solid;margin-right:15px;margin-left:15px;float:right;height:310px;width:300px;" /></a></p> <p> The AMA MVP Program is pleased to offer 18 new trips next year to international travel destinations, sponsored through AHI Travel.</p> <p> Travelers have the opportunity to spend time with fellow AMA physicians on <a href="https://ama.ahitravel.com/TripSearchResults.aspx?view=paged" target="_blank" rel="nofollow">land- or cruise-based travel excursions</a> to such countries as Switzerland, Bhutan and Greece. Tours range from eight to 14 days and include optional excursions to add at your leisure.</p> <p> Trips can sell out six months in advance of departure, so sign up today. Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program/mvp-ahi-travel.page" target="_blank">travel Web page</a> to learn more about AHI’s educational and leisure travel destinations.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f0a508a4-46a3-4f3b-8ae6-011c7bf79dbe Early retirees choose locum tenens work http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_early-retirees-choose-locum-tenens-work Thu, 06 Nov 2014 17:46:00 GMT <p> For physicians who are not ready to retire but want to scale down their work hours, locum tenens opportunities provide an excellent alternative to full-time practice.</p> <p> Physicians can enjoy more reasonable hours while combining work and travel time in a new location. Find locum tenens and volunteer opportunities through the <a href="http://www.jamacareercenter.com/index.cfm" rel="nofollow" target="_blank">JAMA Career Center</a><sup>®</sup>. This service will put physicians in touch with both domestic and international locum tenens and volunteer opportunities through which they can share their time and expertise.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:6e097029-6f69-4edb-b320-37f611103931 2014 AMA Interim Meeting gets underway--follow daily updates http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_2014-ama-interim-meeting-gets-underway-follow-daily-updates Thu, 06 Nov 2014 17:27:00 GMT <p> The nation’s doctors and physicians in training are gathering Nov. 8-11 in Dallas to weigh new AMA policy that will help shape a better health care system for all Americans.</p> <p> During the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, all the nation’s physicians will be represented via delegations from the 50 states, along with the District of Columbia, Guam, Puerto Rico and the Virgin Islands. In addition, other groups with one or more seats in the House include the federal services (e.g., U.S. Air Force and Public Health Service), national medical specialty societies, professional interest medical associations, AMA sections and other groups.</p> <p> AMA sections and special groups will meet Thursday through Saturday to discuss proposed AMA policy and attend education sessions. </p> <ul> <li> Hundreds of medical students, residents and international medical graduates will present their original research beginning at 4 p.m. Central time Friday during 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>.</li> <li> Attendees will get a sneak peek of the PBS documentary <em>Rx</em>, for which the AMA is a premiere sponsor<em>. </em>The film looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</li> <li> A special Ebola update will take place from 4:30 p.m. to 6 p.m. Central time Sunday, during which the Centers for Disease Control and Prevention’s associate director for health care associated infection prevention programs will discuss how to prepare for and manage Ebola patients in hospital and ambulatory care settings. This session will be <a href="http://www.ama-assn.org/sub/meeting/livestream.html" target="_blank">live streamed</a> for those who can’t attend the meeting in person.</li> </ul> <p> The AMA House of Delegates will convene Saturday afternoon, when delegates will hear from both the AMA president and the AMA CEO about the state of affairs in medicine and the association. U.S. Secretary of Veterans Affairs Robert McDonald also will address attendees regarding veterans’ health care. His update will begin at 3:15 p.m. Central time and will be <a href="http://www.ama-assn.org/sub/meeting/livestream.html" target="_blank">live streamed</a> as well.</p> <p> Dozens of proposed <a href="http://www.ama-assn.org/sub/meeting/reportsresolutions.html" target="_blank">policies and reports</a> on a range of important issues also will be considered. They include:</p> <ul> <li> Expansion of safe disposal sites for prescription drugs</li> <li> Promoting improved electronic health records</li> <li> Facilitating state licensure for telemedicine services</li> <li> The role of pharmacists in improving immunization rates</li> <li> Timing of the USMLE Step 1</li> </ul> <p> You can find meeting news in a variety of places. Beginning Friday night, look for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">daily updates</a> at <em>AMA Wire</em>®, and check the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">Twitter</a> (#AMAmtg) news feeds.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cf142754-a14d-489d-8e63-f5ed5bfb3fbd View live: Preparing for Ebola, improving veterans’ health care http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_live-preparing-ebola-improving-veterans-health-care-1 Thu, 06 Nov 2014 05:59:00 GMT <div> Make sure you’re equipped with the latest information about two pressing health care issues—view <a href="http://www.ama-assn.org/sub/meeting/livestream.html" target="_blank">live streaming</a> of critical updates to be delivered at the 2014 <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">AMA Interim Meeting</a> this weekend.</div> <div>  </div> <div> <strong>Nov. 8: Improving access to care for American veterans</strong></div> <div> U.S. Secretary of Veterans Affairs Robert McDonald will give an update on how the nation is making sure that veterans have timely access to the health care they need. This address is scheduled to begin between 3 p.m. and 3:15 p.m. Central time.</div> <div>  </div> <div> <strong>Nov. 9: Infection control for Ebola—an update from the field</strong></div> <div> Arjun Srinivasan, MD, an expert from the Centers for Disease Control and Prevention (CDC) and captain in the U.S. Public Health Service, will discuss how physicians can prepare for and manage Ebola patients in hospital and ambulatory care settings. This session will include time for attendees to ask questions. Live streaming will take place from 4:30 p.m. to 6 p.m. Central time.</div> <div>  </div> <div> Don’t miss this special opportunity to prepare your practice and earn continuing medical education credit for the Ebola session. The AMA designates this live activity for a maximum of 1.5 <em>AMA PRA Category 1 Credits</em>™.</div> <div>  </div> <div> Claim your CME credit by Dec. 19: Visit the AMA <a href="https://cme.ama-assn.org/Education.aspx" target="_blank">Online Learning Center</a>, then sign in with your AMA login or create a free account. Select the activity “I-14—Infection Control of Ebola: An Update from the Field” from the list and use code “4344” when registering.</div> <div>  </div> <div> Additional information and resources created by the CDC and other public health experts is easily accessible to physicians and the public through the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a>.</div> <div>  </div> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e1c09455-0de3-42b3-b56d-a6f1cedd48e5 This month in medical ethics, it’s all about sex http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_this-month-medical-ethics-its-sex Wed, 05 Nov 2014 20:32:00 GMT <p> The <a href="http://virtualmentor.ama-assn.org/2014/11/toc-1411.html" target="_blank">November issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal, isn’t as racy as it sounds. But the issue warrants attention by physicians in practice and training alike as they seek to navigate their role in commenting on sexual behavior in the context of clinical conversations.</p> <p> Beyond treating dysfunction in human sexual reproduction, medicine has acquired a normative role—alongside the law and religion—in commenting on sexual behavior. This month’s issue of the ethics journal looks at how physicians got that role, how well they function in validating norms of sexual conduct, and their actual and possible advisory roles<em>.</em></p> <p> Among other topics, contributors to the issue discuss the profession’s formal guide to sexual disorders—the <em>Diagnostic and Statistical Manual of Mental Disorders</em> (DSM)—and propose ways in which physicians can improve how they talk with patients about sex-related concerns.</p> <p> Highlights this month include:</p> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/11/ecas1-1411.html" target="_blank">Interviewing a patient about intimate partner violence</a>.” Charles Moser, MD, PhD, argues that in the same way that physicians learn about normal variations in blood pressure, they need to learn about “normal” variations in sexual interests and practices.</li> </ul> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/11/stas1-1411.html" target="_blank">Will risk compensation accompany pre-exposure prophylaxis for HIV?</a>” Jill Blumenthal, MD, and Richard H. Haubrich, MD, discuss how an intervention that reduces the perceived risk of a given behavior may cause a person to increase risky behavior.</li> </ul> <ul> <li>  “<a href="http://virtualmentor.ama-assn.org/2014/11/msoc1-1411.html" target="_blank">Medicine, sexual norms and the role of the DSM</a>.” Leonore Tiefer, PhD, writes that every physician should know that erotic pleasures occur in more diverse situations than one can imagine and that gender identity is a complicated idea.</li> </ul> <p> Don’t forget to listen to this month’s <a href="http://virtualmentor.ama-assn.org/site/ethicstalk.html" target="_blank">special podcast</a> featuring Drew Pinsky, MD, commonly known as “Dr. Drew,” who discusses educating the public about love, sex and relationships.</p> <p> And this month’s <a href="http://virtualmentor.ama-assn.org/site/current.html" target="_blank">ethics poll</a> asks readers to weigh in on a practical question: “Do you think the medical profession should take public positions on topics having to do with sexual behavior and sex education?”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:379dc508-da1a-4465-8f57-fbe00a1ee81b Hot topics that could affect how residents practice medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hot-topics-could-affect-residents-practice-medicine Wed, 05 Nov 2014 20:29:00 GMT <p> More than 500 physicians, residents and medical students will meet this week in Dallas to weigh new AMA policy that will affect both the medical profession and the patients they serve. Here are the top issues residents should watch for during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 8-11.</p> <ul> <li> <strong>Equal paternal and maternal leave for residents. </strong>One resolution asks the AMA to amend current policy to extend new parent leave rights to fathers as well as mothers.<br />  </li> <li> <strong>Alleviating excessive computer time for medical students, residents and fellows.</strong> Another resolution encourages the nation’s medical schools and residency and fellowship programs to teach trainees effective ways to use electronic devices both in exam rooms and at the bedside. The goal is to make sure technology use enhances, rather than impedes, the physician-patient relationship. The resolution asks the AMA to work with the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education on this endeavor.<br />  </li> <li> <strong>Latest guidance on Ebola from CDC expert. </strong>Learn how to prepare for and manage Ebola patients in hospital and ambulatory care settings by participating in a continuing medical education session led by an expert from the Centers for Disease Control and Prevention (CDC). This session can be attended in person or viewed remotely via live streaming. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cdc-expert-share-latest-ebola-guidance-live-nov-9" target="_blank">Learn more</a>.<br />  </li> <li> <strong>Reducing medical student debt.</strong> A report from the AMA Board of Trustees asks the association to explore the development of an affinity program through which trainees could apply for new student loans and consolidate existing loans.<br />  </li> <li> <strong>Population health approaches to improving patient care.</strong> An education session will discuss the various definitions of population health—a term often used but imprecisely defined—and how the AMA is improving health outcomes by strengthening the links between physicians and the communities in which they practice. A Dallas-based physician and one of his patients will share their experiences and insight into what worked well to improve the patient’s health. The session will be offered from 11:30 a.m. to 12:35 p.m. Nov. 8 in Senators Lecture Hall.</li> </ul> <p> Check out <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-set-enact-change-dallas" target="_blank">more hot topics</a> to follow during the meeting. Beginning Friday night, look for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">daily updates</a> at <em>AMA Wire</em>®, and check the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" target="_blank" rel="nofollow">Twitter</a> (#AMAmtg) news feeds for the latest information coming out of the meeting.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:749da7f2-a6a1-4be6-84df-c85dbba08c2d How physicians are helping stop the spread of Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-helping-stop-spread-of-ebola Wed, 05 Nov 2014 20:27:00 GMT <p> Nearly 5,000 people in the West African countries of Guinea, Liberia and Sierra Leone have died from Ebola. The Centers for Disease Control and Prevention (CDC) has emphasized that stopping the virus in these areas is essential to aiding the people in that region and curbing spread of the disease to the United States.</p> <p> While there are signs of progress in West Africa, “it’s going to be a long, hard fight and the assistance of health care workers from around the world will be [essential to] stopping it at the source,” CDC Director Tom Frieden, MD, said in a <a href="http://www.cdc.gov/media/releases/2014/t1027-ebola-response-interim-guidance.html" target="_blank" rel="nofollow">press conference</a> last week.</p> <p> “With so many … falling ill, the entire health system in West Africa has essentially shut down,” said Adam Levine, MD, director of the global emergency medicine fellowship at the Warren Alpert Medical School of Brown University and a member of the International Medical Corp Ebola Treatment Unit in Liberia.</p> <p> Groups like <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/ebola" target="_blank" rel="nofollow">Medecins Sans Frontieres</a> (Doctors Without Borders), <a href="http://internationalmedicalcorps.org/ebola-emergency-response" target="_blank" rel="nofollow">International Medical Corps</a> and <a href="http://act.pih.org/page/content/ebola-recruitment" target="_blank" rel="nofollow">Partners in Health</a> are sending health professionals to the area. The CDC offers an <a href="http://www.cdc.gov/vhf/ebola/hcp/safety-training-course/index.html" target="_blank" rel="nofollow">Ebola safety training course</a> for workers who will be going to West Africa.</p> <p> “There is risk involved in this work, certainly,” Dr. Levine said. “But the risk can be mitigated with the proper training and personal protective equipment. And the benefit to humanity far outweighs the risk to individual clinicians.”</p> <p> Physicians heading to West Africa also should know it’s about more than just treating the sick, said Edward O’Neil, Jr., MD, founder of <a href="http://www.omnimed.org/" target="_blank" rel="nofollow">Omni Med</a>, a health volunteerism and ethical leadership organization.</p> <p> “What do you need to do to properly prepare?” Dr. O’Neil said. “Take a critical look at the forces of disparities …. Why do we see Ebola ripping through the incredibly impoverished countries?”</p> <p> Dr. O’Neil said physicians should keep in mind the long-term solution of helping the Ebola-ravaged West African countries: building up infrastructure.</p> <p> “We stress the larger piece of examining the underlying forces,” he said. “[If you’ve thought about these things,] your expectations and performance are going to be different.”</p> <p> Dr. O’Neil said he doesn’t think West Africa is the best place for a first-time volunteer to go right now—but he also said he understands there is a severe need for workers.</p> <p> “To think we’re going to be isolated from any of these infectious diseases is just not true, so intervening in developing countries now to build up infrastructure is important,” he said. “It’s part of the ethos of who we are—the medical profession does not take a national perspective, it is very much transnational. … It’s part of the DNA of who we are as health providers.”</p> <p> <strong>U.S. monitoring of people exposed to Ebola</strong></p> <p> The CDC recently released <a href="http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html" target="_blank" rel="nofollow">interim guidance</a> for how people exposed to Ebola—including health care workers—should be monitored and in what ways their travel should be restricted, depending on a new system of risk levels.</p> <p> “Continued volunteer efforts of nurses, physicians and other health care workers is fundamental to international efforts to contain the outbreak in West Africa and to stop the spread of this virus,” the AMA, American Hospital Association and American Nurses Association said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-28-joint-statement-cdc-interim-guidance-ebola.page" target="_blank">news release</a>.</p> <p> “This guidance appropriately safeguards public health without unduly burdening those who have heroically cared for Ebola patients,” the organizations said.</p> <p> Additional information about the guidance is available in <a href="http://www.cdc.gov/vhf/ebola/exposure/qas-monitoring-and-movement-guidance.html" target="_blank" rel="nofollow">frequently asked questions and answers</a> posted to the CDC website earlier this month.</p> <p> <strong>Preparing to volunteer</strong></p> <p> If you’re interested in volunteering your medical services, the following resources are good places to start your preparations.</p> <ul> <li> The U.S. Agency for International Development <a href="http://www.usaid.gov/ebola/volunteers" target="_blank" rel="nofollow">connects medical volunteers</a> with reputable volunteer organizations.</li> <li> Learn about the <a href="http://www.usaid.gov/ebola/medevac" target="_blank" rel="nofollow">care and evacuation</a> of international responders treating Ebola in West Africa.</li> <li> Get the CDC’s <a href="http://wwwnc.cdc.gov/travel/page/advice-humanitarian-aid-organizations-ebola" target="_blank" rel="nofollow">advice for treating Ebola</a> for humanitarian aid organizations.</li> <li> Watch online training to learn the <a href="http://www.cdc.gov/vhf/ebola/hcp/ppe-training/index.html" target="_blank" rel="nofollow">correct ways to don and doff personal protective equipment</a>.</li> <li> Learn more about <a href="http://www.cdc.gov/vhf/ebola/hcp/non-us-healthcare-settings.html" target="_blank" rel="nofollow">Ebola in non-U.S. health care settings</a>.</li> </ul> <p> Additional volunteer opportunities—including several that are tied to affected countries—are posted on the <a href="http://www.jamacareercenter.com/volunteer_opportunities.cfm" target="_blank" rel="nofollow">JAMA Network Career Center</a>.</p> <p> <strong>Other resources for physicians</strong></p> <p> For physicians who are preparing for Ebola in their own communities, the AMA will be live streaming a special presentation by CDC expert Arjun Srinivasan, MD, who will discuss how to prepare for and manage Ebola patients in hospital and ambulatory care settings. <a href="http://www.ama-assn.org/sub/meeting/livestream.html" target="_blank">Watch live</a> from 4:30 p.m. to 6 p.m. Central time Nov. 9.</p> <p> In addition, the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> offers up-to-date Ebola materials developed for physicians and the public by the CDC and other national experts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5f1b3e77-51b2-44f4-8b5b-29fa27ae02c2 Data doesn’t lie-meaningful use needs to change now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_data-doesnt-lie-meaningful-use-needs-change-now Wed, 05 Nov 2014 20:23:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) Tuesday released the latest data detailing how many physicians and hospitals have successfully attested to the electronic health record (EHR) meaningful use program this year. The results have been met by disappointment but little surprise, prompting health care organizations to call for immediate changes to the program.</p> <p> The <a href="http://www.healthit.gov/facas/sites/faca/files/HITPC_EHR_Incentive_Programs_2014-11-04_0.pptx" target="_blank" rel="nofollow">data report</a> reveals that only 11,478 physicians and other eligible providers had attested to Stage 2 of meaningful use by Nov. 1—that’s just 2 percent. While physicians who have already participated in the meaningful use program have until Feb. 28 to attest to meeting requirements this year, the final numbers are not expected to be overwhelmingly higher. Hospital attesters also were in the minority, totaling just 840, or 17 percent.</p> <p> These abysmal numbers highlight the difficulty of the program requirements and foretell continued struggles in the coming year, even as CMS is busy developing Stage 3 requirements.</p> <p> The results are “disappointing yet predictable,” the AMA, College of Healthcare Information Management Executives, Healthcare Information and Management Systems Society and Medical Group Management Association said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-11-04-meaningful-use-data-prompts-call-for-action.page" target="_blank">joint news release</a> shortly after CMS released the data. The associations are calling on CMS to take “immediate action.”</p> <p> More than 260,000 eligible professionals and 3,900 hospitals will be required to meet Stage 2 measures and objectives in 2015, beginning Jan. 1. Anyone who began participating in meaningful use in 2014 or earlier must use a 365-day reporting period next year and beyond. The only physicians who will be allowed to use a 90-day reporting period are those who are participating in meaningful use for the first time.</p> <p> “In addition to a shortened reporting period, CMS must end its one-size-fits all approach to achieve the goals of the meaningful use program, which are to create a secure and interoperable infrastructure,” said AMA President-Elect Steven J. Stack, MD.</p> <p> The AMA recently released a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/4-key-changes-needed-ehr-meaningful-use-program" target="_blank">blueprint</a> outlining ways to improve the meaningful use program and a framework that details <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight priorities</a> for moving toward more usable EHR systems.</p> <p> “We believe the stringent pass/fail requirement for meeting meaningful use—combined with a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">tsunami</a> of other overlapping regulations—are keeping physicians from participating in the meaningful use program,” Dr. Stack said.</p> <p> The AMA and more than a dozen other national health care associations in September <a href="http://www.cio-chime.org/advocacy/resources/download/Letter_to_Burwell_2015_EHR_Reporting_Period_Concerns_Final.pdf" target="_blank" rel="nofollow">sent a letter</a> to U.S. Department of Health and Human Services Secretary Sylvia Burwell, highlighting that a shortened reporting period and flexibility on the measures for transitioning care, viewing, downloading and transmitting data are necessary changes to help physicians meet meaningful use requirements.</p> <p> In addition, the AMA has <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/meaningful-use-hr5481-letter-18sept2014.pdf" target="_blank">supported H.R. 5481</a> (log in), legislation that would shorten next year’s reporting period from one year to 90 days. The AMA also continues to push for program revisions that include no longer compelling physicians to meet 100 percent of the program’s requirements in order to avoid a penalty and seeking ways to simplify the various Medicare quality reporting requirements.</p> <p> <strong>Apply by Nov. 30 for hardship exception:</strong> CMS has reopened the submission period for hardship exception applications, allowing more physicians to avoid next year’s payment penalty for not demonstrating meaningful use. The new deadline is Nov. 30. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cms-reopens-period-apply-meaningful-use-hardship-exemption" target="_blank">Read more</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1f62c395-dc67-49e2-a545-1ea1829fd327 State high court rules for patient safety in liability case http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_state-high-court-rules-patient-safety-liability-case Tue, 04 Nov 2014 22:26:00 GMT <p> The recent decision of a state supreme court upholds a state law requiring the confidentiality of peer review, a process intended to keep patients from harm and ensure continued quality improvement in the care provided.</p> <p> In <em>Allred v. Saunders</em>, the Utah Supreme Court weighed in on an earlier court ruling that required a physician’s peer review files to be produced as evidence in determining medical liability, contrary to a law passed in 2012 that explicitly protects that information in order to preserve the integrity of peer review proceedings.</p> <p> “Peer and care review panels, as well as committees that evaluate physicians’ credentials, work only because participants are assured that anything they say will be kept confidential,” an <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/allred-v-saunders.pdf" target="_blank">amicus brief</a> 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> and the Utah Medical Association states (log in).</p> <p> “The goal of these review meetings has always been to improve patient care and to improve quality care processes,” the brief states. “These reviews reduce the chance that adverse outcomes will recur, and help all to learn from challenges that others have experienced.”</p> <p> Read more about this case and other recent cases regarding <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/peer-review.page?" target="_blank">peer review</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4626d13b-f735-4fec-91f3-4c66b7067fbd Physicians set to enact change in Dallas http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-set-enact-change-dallas Tue, 04 Nov 2014 22:23:00 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 </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page" target="_blank"><em>Barbara L. McAneny, MD,</em></a><em> chair of the AMA Board of Trustees.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/0/900d4bf5-da92-40a7-80db-090ca459a2cd.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/0/900d4bf5-da92-40a7-80db-090ca459a2cd.Large.jpg?1" style="margin:10px;float:right;height:140px;width:100px;" /></a>I’m getting ready to join more than 500 physicians, residents and medical students Nov. 8-11 in Dallas for the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, where we’ll come together for activities and policy debate that will help shape the future of health care.</p> <p> Whether you’re attending the meeting in person or following our coverage, here are some highlights not to miss:</p> <ul> <li> Hundreds of medical students, residents and international medical graduates will present their original research beginning at 4 p.m. Friday during 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>.</li> </ul> <ul> <li> At 6:30 p.m. Friday, we’ll get a sneak peek of the sneak peek of the PBS documentary <em>Rx</em>, for which the AMA is a premiere sponsor<em>. </em>The film looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</li> </ul> <ul> <li> The Council on Ethical and Judicial Affairs will host an open house from 10-11:30 a.m. Saturday, during which members can ask questions about the council’s project to modernize the AMA <em>Code of Medical Ethics</em>. AMA members can log in to see the <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/ceja-discussion-forum.page" target="_blank">draft modernized <em>Code</em> online</a>. The <em>Code</em> will be presented the House of Delegates at this meeting.</li> </ul> <ul> <li> Robert McDonald, U.S. secretary of Veterans Affairs, will speak at the House of Delegates opening session Saturday afternoon. His update on access to care for America’s veterans will be <a>streamed live</a>, starting at 3:15 p.m. Central time.</li> </ul> <ul> <li> Two U.S. congressmen will give insights into efforts to repeal Medicare’s physician payment formula during a special session Saturday afternoon, following the meeting’s opening session.</li> </ul> <ul> <li> A special Ebola update will take place from 4:30 p.m. to 6 p.m. Central time Sunday, during which Arjun Srinivasan, MD, the Centers for Disease Control and Prevention’s associate director for health care associated infection prevention programs, will discuss how to prepare for and manage Ebola patients in hospital and ambulatory care settings. This session also will be <a>streamed live</a> for those who aren’t able to attend in person.</li> </ul> <p> Additional educational sessions and forums cover a variety of timely topics, including how new hospital regulations will affect you and your staff and how to effectively use electronic payments. Get information on educational sessions at the <a href="http://www.ama-assn.org/sub/meeting/cme.html" target="_blank">meeting website</a>, or download the <a href="http://www.ama-assn.org/resources/doc/hod/x-pub/i14-speakers-letter.pdf" target="_blank">Speakers’ Letter</a> (log in) for even more detail. If you’re planning to arrive early, check out the section meetings being held Thursday and Friday for additional educational activities.</p> <p> Dozens of proposed <a href="http://www.ama-assn.org/sub/meeting/reportsresolutions.html" target="_blank">policies and reports</a> on a range of important issues also will be considered. They include:</p> <ul> <li> Expansion of safe disposal sites for prescription drugs</li> <li> Promoting improved electronic health records</li> <li> Facilitating state licensure for telemedicine services</li> <li> The role of pharmacists in improving immunization rates</li> <li> Timing of the USMLE Step 1</li> </ul> <p> Even if you aren’t attending the meeting this year, you still can stay connected to your peers in Dallas. Beginning Friday night, look for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">daily updates</a> at <em>AMA Wire</em>®, and check the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">Twitter</a> (#AMAmtg) news feeds.</p> <p> If you are attending, I look forward to working with you to effect change on the future of health care. See you in Dallas.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2e89ee16-9e1e-479d-8c93-65d7170a7a75 Prepare for ICD-10 with one-day workshop http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prepare-icd-10-one-day-workshop Tue, 04 Nov 2014 22:07:00 GMT <p> Get help preparing for and transitioning to the ICD-10-CM code set with a one-day workshop offered in multiple locations. You’ll be just in time to ready your practice for the Oct. 1, 2015, ICD-10 implementation deadline.</p> <p> The ICD-10-CM Workshop teaches participants how to code from every section of the ICD-10-CM codebook. The event includes a self-assessment of your readiness for the new code set, a printed attendee guide with case studies and exercises, and a copy of the ICD-10-CM 2015 codebook.</p> <p> The workshop will help you:</p> <ul> <li> Understand coding guidelines</li> <li> Learn correct coding practices</li> <li> Review the necessary documentation for accurate coding</li> </ul> <p> This one-day workshop is offered in five locations:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510011&navAction=push" target="_blank">Atlanta, Georgia</a>: Dec. 9</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510010&navAction=push" target="_blank">Newark, New Jersey</a>: Dec. 9</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510013&navAction=push" target="_blank">Baltimore, Maryland</a>: Dec. 12</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510012&navAction=push" target="_blank">Las Vegas, Nevada</a>: Dec. 12</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510014&navAction=push" target="_blank">San Antonio, Texas</a>: Dec. 16</li> </ul> <p> Review the <a href="https://commerce.ama-assn.org/catalog/media/icd-10-2015-workshop-agenda-december.pdf" target="_blank">workshop agenda</a> (log in) for more information.</p> <p> In addition, a one-and-a-half day workshop will be offered Nov. 18-19 in <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500018&navAction=push" target="_blank">Chicago</a>. Use promo code “FOQNOV” to attend the Chicago location and save $100. Registration closes Nov. 11.</p> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:64ecc5ac-c226-492e-8f04-fb0265028653 How patients are benefiting from innovative quality projects http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_patients-benefitting-innovative-quality-projects Mon, 03 Nov 2014 17:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1"><em>AMA Viewpoints </em></a><em>post by AMA Immediate Past President Ardis Dee Hoven, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9ede158-69ba-409c-ba5d-866f322d9f16.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9ede158-69ba-409c-ba5d-866f322d9f16.Large.jpg?1" style="float:left;margin:10px;" /></a>I recently spent two days in Detroit at the Henry Ford Health System—and what I learned there is too exciting not to share. The system has hosted an annual <a href="http://www.henryford.com/body.cfm?id=60795&fr=true" rel="nofollow" target="_blank">Quality Exposition</a> for 23 years, during which health care teams from throughout its integrated system demonstrate new ways to make patient care safe, patient-centered, timely, efficient, effective and equitable.</p> <p> There were 88 projects in all, and each one solved a problem or a challenge to providing high-quality care.</p> <p> Some projects were simple but produced profound results, such as improving antimicrobial management by using a physician assistant instead of a physician to do screening and triage work. This saves money, gives the physician more time to treat patients and improves health outcomes.</p> <p> Some projects were diversity-focused, including one that put trained community health workers in Detroit clinics to improve outcomes around diabetes. Other projects were tech-focused, such as a project that improved acquisition of oncology drugs for cancer patients by using electronic health records.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/9/306466ab-d3da-43ac-992e-f4bdd5d8353b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/9/306466ab-d3da-43ac-992e-f4bdd5d8353b.Large.jpg?1" style="float:right;margin:10px;" /></a>All of these projects were of the highest caliber, carried out by small teams using very scientific, evidence-based approaches and measures.</p> <p> I was impressed with the pride and enthusiasm evident in every participant. These are people who take ownership in their work to improve patient outcomes and quality of care. The energy is infectious.</p> <p> The leadership support was tremendous as well: From the CEO down through the system, everyone associated with the Henry Ford Health System clearly supported the projects and encouraged innovation in the way they delivered care. The system’s leaders recognize the value of this work because, at the end of the day, it improves the care they’re able to provide patients.</p> <p> Henry Ford’s model shows initiative, consistency and commitment, and it’s a model that any hospital system and most medical practices can use to advance health care quality in their own settings.</p> <p> At the AMA, we’re encouraging innovation in similar ways. Our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative is seeking to reduce the incidence of hypertension and type 2 diabetes. The quality projects like those coming out of Henry Ford are important components of making changes within the community that will lead to stronger outcomes around these two chronic diseases.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/3/30643b17-1f44-413e-a389-5c498e0ec53f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/3/30643b17-1f44-413e-a389-5c498e0ec53f.Large.jpg?1" style="float:left;margin:10px;" /></a>We also know from 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 that physicians are most satisfied when they are able to provide high-quality care to their patients. The advancements coming out of Henry Ford likely will contribute to physicians being able to do just that.</p> <p> I’m looking forward to seeing the continued care improvements from these projects and hope more health systems commit to helping physicians take leadership in developing new ways to deliver high-quality patient care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:08093291-66e5-4263-a5b6-bfe0cfb86c4f Get expert study tips and strategies--free session Nov. 13 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_expert-study-tips-strategies-session-nov-13 Mon, 03 Nov 2014 16:55:00 GMT <p> Take a break from studying and get targeted free test-taking advice from an expert by participating in an hourlong webinar at 7:30 p.m. Eastern time Nov. 13. <a href="https://cc.readytalk.com/cc/s/registrations/new?cid=bricejcaijca" target="_blank" rel="nofollow">Register now</a>.</p> <p> M1 students will discover how to study smarter by learning which areas to focus on for exams. M2 students will get advice and snapshots of what to expect on the United States Medical Licensing Examination (USMLE) Step 1.</p> <p> Josh Brooks, PhD, expert faculty from Kaplan Medical, will present:</p> <ul> <li> Tips on time and stress management</li> <li> How to use resources to your advantage</li> <li> Strategies for attacking each style of question on the Step 1 exam</li> </ul> <p> Get more tips on <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-ways-prepare-usmle" target="_blank">preparing for the USMLE</a> and the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/top-5-apps-modern-medical-student" target="_blank">best apps for studying</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b16958e5-4e6b-48a1-a214-1062454156ae How AMA Foundation is advancing U.S. public health, med ed http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-foundation-advancing-public-health-med-ed Fri, 31 Oct 2014 19:49:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/3a35b7ae-ab32-4448-8edb-284a5beaa1aa.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/14/3a35b7ae-ab32-4448-8edb-284a5beaa1aa.Large.jpg?1" style="float:right;margin:10px;" /></a>Physicians, residents and medical students are making inroads into improving public health and promoting excellence in medical education through the AMA Foundation. Here’s how this physician group is helping create a healthier country and paving the way for the next generation of physicians.</p> <p> <strong>Helping the next generation of physicians</strong><br /> Today’s medical students and residents face greater financial pressures than ever before—and a large debt load may discourage future physicians from practicing in underserved areas. To help trainees afford medical school, the AMA Foundation has given more than $60 million to outstanding students with financial need. The Physicians of Tomorrow Program awarded scholarships to 21 outstanding medical students this year.</p> <p> For minority medical students, the foundation has partnered with the AMA Minority Affairs Section to award scholarships to those who show a commitment to eliminating health care disparities and have strong leadership and community involvement. Since 2004, 123 recipients of the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/minority-scholars-award.page?" target="_blank">Minority Scholars Award</a> have been able to continue their medical education.</p> <p> <strong>Ensuring care for the underserved</strong><br /> The AMA Foundation has helped 313 nonprofit organizations develop school and community-based solutions to behavioral health challenges—such as medication safety, physical activity and obesity—through its <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 program</a>. Established in 2002, the program has awarded nearly $1 million to improve the health of communities across the country.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/5/f8d88031-2f89-4650-a528-860ed06d5dc3.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/5/f8d88031-2f89-4650-a528-860ed06d5dc3.Large.jpg?1" style="float:left;margin:10px;" /></a>In the clinical setting, the foundation has given more than $1.4 million to 74 free clinics, helping physicians at these clinics provide quality, affordable health care through with funding from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-communities-healthy.page" target="_blank">Healthy Communities/Healthy America</a> grants. Most recently, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/underserved-communities-preventing-diabetes" target="_blank">eight free clinics</a> received financial aid to implement diabetes prevention programs and improve health outcomes in their communities.</p> <p> Beside injecting money into the free clinics, the foundation’s involvement helps garner extra support—more than one-half of recipients have been able to obtain grants and contributions from new funders as a direct result of receiving Healthy Communities/Healthy America grants.</p> <p> <strong>Poised for continued success</strong><br /> Heading into the future, the AMA Foundation will continue to expand its public health programming and medical student reach. Leading the efforts is <a href="http://www.ama-assn.org/resources/doc/ama-foundation/x-pub/amaf-release-barkley-payne-executive-director.pdf" target="_blank">new executive director</a> (log in) R. Barkley Payne, who joins the AMA Foundation this month.</p> <p> Recognize physicians who are dedicated to meeting pressing health needs by nominating an inspirational physician for the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards.page" target="_blank">Excellence in Medicine Awards</a> by Jan. 20. Recipients will be named at the 2015 AMA Annual Meeting.</p> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page?" target="_blank">AMA Foundation Web page</a> to donate or learn more about scholarship and grant opportunities.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a234d246-58a3-4f17-bb3e-14639e50b03c 3 easy ways to engage patients during National Diabetes Month http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-easy-ways-engage-patients-during-national-diabetes-month Fri, 31 Oct 2014 18:51:00 GMT <p> One out of every three of your patients likely has prediabetes—and it’s even more likely that they don’t even know they are at an elevated risk for type 2 diabetes. Use National Diabetes Month this November to educate your patients about their risks and encourage them to be screened.</p> <p> Studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives. Physician practices can screen and test their patients to prevent type 2 diabetes before it starts. New <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/new-diabetes-guidelines-screen-patients-aged-45-older" target="_blank">draft guidelines</a> from the U.S. Preventive Services Task Force recommend screening adults aged 45 and older for prediabetes and type 2 diabetes, and also specify other patient groups that should be screened.</p> <p> At-risk patients may be able to attend a local lifestyle change program that is a part of the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program, which offers an evidence-based lifestyle intervention that <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.</p> <p> Here’s what you can do this November:</p> <ul> <li> Hang a <a href="https://download.ama-assn.org/resources/doc/about-ama/x-pub/iho-dpp-poster.pdf" target="_blank">prediabetes awareness poster</a> (log in) in your office.</li> <li> Ask patients to complete a diabetes risk test <a href="http://www.diabetes.org/are-you-at-risk/diabetes-risk-test" rel="nofollow" target="_blank">online</a> or <a href="http://www.ama-assn.org/resources/doc/about-ama/x-pub/ada-risk-test.pdf" target="_blank">in your office</a> (log in).</li> <li> Direct patients to the <a href="http://www.cdc.gov/diabetes/prevention/recognition/registry.htm#program" rel="nofollow" target="_blank">CDC’s National Diabetes Prevention Program Web page</a> to see whether there’s an evidence-based lifestyle change program in their area.</li> </ul> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the AMA is working with the YMCA of the USA to explore a process for physicians to screen and test 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. The YMCA’s program is based on the CDC’s evidence-based program.</p> <p> Watch <em>AMA Wire</em>® throughout the month of November for more information about ways you can help your patients take action to prevent diabetes.</p> <p> <strong>How do you improve outcomes around diabetes in your practice? </strong>Tell us in the comments below at <em>AMA Wire</em> or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c1d6914d-0165-42c2-a5dc-b2d7df546152 4 key factors for reducing Rx abuse and overdose http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-key-factors-reducing-rx-abuse-overdose Fri, 31 Oct 2014 18:46:00 GMT <p> Authorities who deal with state efforts to monitor and clamp down on misuse of controlled substances just got an important reminder that the solution to the nation’s growing prescription drug abuse and overdose problem lies in a comprehensive public health approach that emphasizes treatment.</p> <p> Law enforcement professionals, state regulators and officials who oversee prescription drug monitoring programs (PDMP) at the National Association of State Controlled Substance Authorities annual conference at the end of October were urged to pursue comprehensive measures to reduce drug abuse, diversion, overdose and death.</p> <p> “There are many interrelated policy and practice components to effectively combat prescription drug abuse and diversion,” AMA Board of Trustees Member Patrice A. Harris, MD, said during a presentation to this influential group.</p> <p> “That is why a public health focus—and ongoing collaboration with all stakeholders—is essential to helping reduce overdose and death, increase treatment and prevention, and ensure that patients needing access to pain medication are not adversely affected,” Dr. Harris said.</p> <p> As the director of Health Services for Atlanta and the entirety of Fulton County, Georgia, Dr. Harris is no stranger to public health. She highlighted four components of an overall strategy for addressing prescription drug misuse that will help make a difference.</p> <p> <strong>Enhanced education. </strong>Dr. Harris said there is a pressing need to help prescribers, dispensers and patient identify the risks of inappropriate drug use to prevent overdose and death.</p> <p> On the physician side, the AMA has been sharing best practices and guidelines, and working with other medical associations to help ensure that everyone can benefit from the most recent information about safe and effective prescribing of controlled substances. In particular, Dr. Harris stressed that education must be targeted to physician practices and must start at the onset of every health care professional’s career.</p> <p> <strong>Increased access to treatment. </strong>A necessary part of preventing unintentional overdoses is ensuring that people with substance use disorder have access to the treatment they need.</p> <p> <strong>Overdose intervention measures. </strong>Prevention efforts also must include legislative and public health initiatives that enable intervention at the time of overdose. That includes making the opioid overdose reversal drug naloxone available and enacting “Good Samaritan” provisions that allow others to aid an overdose victim. At least nine states this year have enacted such laws.</p> <p> <strong>Clinical decision-making support. </strong>Dr. Harris also explained how PDMPs that have been appropriately funded and successfully integrated into physician practices can be effective in helping identify potential drug-seeking behaviors. Physicians then are able to provide additional counseling and referral services as needed. The AMA supports the use of such PDMPs as a part of the clinical decision-making process.</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</a> to learn more about the association’s efforts on this important issue.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9f7fa5f1-c87b-49fc-9eab-c25ab4640147 CDC expert to share latest Ebola guidance on Nov. 9: View via live streaming http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-expert-share-latest-ebola-guidance-live-nov-9 Thu, 30 Oct 2014 21:25:00 GMT <p> Learn how to prepare for and manage Ebola patients in hospital and ambulatory care settings by participating in a continuing medical education session led by an expert from the Centers for Disease Control and Prevention (CDC). Taking place Nov. 9 during the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, this session can be attended in person or viewed remotely via live streaming.</p> <p> The session will be held from 4:30 p.m. to 6 p.m. Central time Nov. 9 in the Trinity Ballroom of the Hilton Anatole in Dallas. Live streaming also will be available for those unable to attend in person. Watch <em>AMA Wire</em>® for details on how to watch the session online.</p> <p> Arjun Srinivasan, MD, associate director for health care- associated infection prevention programs at the CDC, will discuss:</p> <ul> <li> The epidemiology of Ebola disease</li> <li> Best practices in Ebola disease prevention and management in hospital and ambulatory care settings</li> <li> Current risk assessment and risk communication guidance</li> <li> Available resources for patients and health professionals</li> </ul> <p> Ample time will be allocated for questions and interactive discussion with Dr. Srinivasan.</p> <p> The AMA designates this live activity for a maximum of 1.5 <em>AMA PRA Category 1 Credits</em>™.</p> <p> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> to easily access up-to-date Ebola materials developed for physicians and the public by the CDC and other national experts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e4fea4f2-9f31-42e2-b8a1-935318a35f02 Real-time tracker puts education decisions into students’ hands http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_real-time-tracker-puts-education-decisions-students-hands Thu, 30 Oct 2014 19:44:00 GMT <p> A new real-time data tracker from Oregon Health and Science University School of Medicine will help medical students know exactly how well they are meeting educational objectives, and a mobile app component will allow busy students to input information on the go.</p> <p> The school’s REDEI system (Research and Evaluation Data for Educational Improvement) will let medical students, their coaches and school leaders immediately input and track evaluation information, displaying a snapshot of each student’s performance in real time.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/65fde8a0-662d-4edb-946c-17fb181166d7.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/65fde8a0-662d-4edb-946c-17fb181166d7.Large.jpg?1" style="float:left;margin:10px;" /></a>Patricia Carney, PhD, professor of family medicine and professor of public health and preventive medicine at the OHSU (pictured left), presented the system at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> “We really wanted to be able to help students navigate their educational experiences and provide information to the coaches and learners that would help develop faculty and develop the students as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">master adaptive learners</a>,” Dr. Carney said.</p> <p> Having data on tests, quizzes and instructional quality will allow students to immediately reflect on areas they need to improve upon—a necessary skill for lifelong learners.</p> <p> The mobile app component of the system will allow students to enter data about their clinical experiences, which will upload into an educational portfolio.</p> <p> “The learners have no time to do anything—that’s why we created the phone app, so they can just do a tap and enter,” Dr. Carney said. “We wanted them to enter the data when they were working with their preceptors and not have to keep it in their heads until they got home.”</p> <p> Giving students access to this information will help them navigate their educational experiences.</p> <p> Students “can choose settings and other experiences that they have not yet explored to be sure their training is very comprehensive and tailored to meet their educational goals,” Dr. Carney said. “Our primary goal at OHSU is customized education. Thus, the REDEI system is key to allowing this to happen while ensuring that our physician graduates are the best they can be.”</p> <p> Dr. Carney and George Mejicano, MD, senior associate dean for education at OHSU, are working with the AMA and the Accelerating Change in Medical Education consortium schools to keep the system open-source and exportable, potentially allowing other schools to build similar systems.</p> <p> This post is the final installment in a brief series on new medical education technology published at <em>AMA Wire</em>® over the last few weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a>, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank">second post</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-giving-med-students-real-world-experience" target="_blank">third post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:38b92aa6-5ae4-41b2-b20f-f0f1321953f0 JAMA Highlights: Traumatic brain injury may increase dementia risk in older adults http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-traumatic-brain-injury-may-increase-dementia-risk-older-adults Thu, 30 Oct 2014 19:42:00 GMT <p> <strong>Genetic predisposition to elevated LDL-C associated with narrowing of aortic valve</strong><br /> In an analysis that included approximately 35,000 participants, genetic predisposition to elevated low-density lipoprotein cholesterol (LDL-C) was associated with aortic valve calcium and narrowing of the aortic valve. These findings support a causal association between LDL-C and aortic valve disease, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1919440" target="_blank" rel="nofollow">study</a> appearing in <em>JAMA</em>. The study is being released to coincide with its presentation at the Canadian Cardiovascular Congress. </p> <p> <strong>Initial choice of oral medication to lower glucose in diabetes patients examined</strong><br /> Patients diagnosed with diabetes and initially prescribed metformin to lower their glucose levels were less likely to require treatment intensification with a second oral medicine or insulin than patients treated first with sulfonylureas, thiazolidinediones or dipeptidyl peptidase 4 inhibitors, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1918925" target="_blank" rel="nofollow">study</a> published online by <em>JAMA Internal Medicine</em>.</p> <p> <strong>Traumatic brain injury may increase dementia risk in older adults</strong><br /> Traumatic brain injury appears to be associated with an increased risk of dementia in adults 55 years and older, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1919070" target="_blank" rel="nofollow">study</a> published online by <em>JAMA Neurology</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:53c86ded-0cb8-40e1-b73e-78acbe02dea1 Improve quality, avoid penalties using clinical data registries http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_improve-quality-avoid-penalties-using-clinical-data-registries Wed, 29 Oct 2014 19:24:00 GMT <p> Physicians providing care to Medicare patients this year will face a 2 percent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent" target="_blank">payment penalty</a> in 2016. As the AMA works to lessen this burden, you can take advantage of a new reporting option to improve patient outcomes while simultaneously lessening your chances of incurring penalties.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/5-things-clinical-data-registries" target="_blank">Clinical data registries</a> have the potential to provide meaningful clinical information to improve quality and value of health care, according to a <a href="http://www.ama-assn.org/resources/doc/cms/x-pub/a14-cms-report8.pdf" target="_blank">recent report</a> (log in) from the AMA Council on Medical Service. The <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/nqrn.page" target="_blank">National Quality Registry Network</a> (NQRN), a voluntary network of organizations that operate registries and others interested in using registry information, is coordinating the nation’s 100-plus registries to ensure they are used appropriately and the collected data is readily available to physicians in a useful format.</p> <p> Registries differ depending on the intended use of the data they collect, but generally they are used to:</p> <ul> <li> Monitor the quality of care that individual patients receive</li> <li> Track clinical and cost effectiveness of treatments</li> <li> Measure processes and outcomes of care</li> <li> Report performance to clinicians and payers</li> <li> Support clinical research</li> </ul> <p> In an NQRN registry landscape survey of 32 registries, more than three-quarters of the registries collected national-level data related to a specific disease or condition. Most registry stewards use the data for performance improvement and comparative effectiveness research.</p> <p> “Well designed and managed clinical data registries can provide physicians with critical information to help them provide quality care to their individual patients,” the report said.</p> <p> The AMA has been actively engaged in efforts to advance the use of clinical data registries. Through its work, the AMA helped shape language in the American Taxpayer Relief Act of 2012 that allows for the Centers for Medicare & Medicaid Services (CMS) to add the reporting option of a Qualified Clinical Data Registry to fulfill the Physician Quality Reporting System (PQRS) reporting requirement.</p> <p> Under this option, those eligible to participate in PQRS are able to report measures selected by the Qualified Clinical Data Registry as a substitute to the traditional PQRS list of measures with the intent of providing physicians credit for their quality improvement activities and reduce the PQRS reporting burden. Get a <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2014QualifiedRegistries.pdf" rel="nofollow" target="_blank">list of CMS’ Qualified Clinical Data Registries</a>.</p> <p> Through the NQRN, the AMA will continue to encourage the development of clinical registries to facilitate quality improvement and research that result in better health care, improved population health and lower costs.</p> <p> It’s good news that CMS is willing to accept participation in Qualified Clinical Data Registries as an alternative pathway for PQRS. The relationship with CMS “creates a unique opportunity to promote and expand the use of registries as a physician-led alternative to data collection and quality reporting mechanisms developed by government regulators,” the report said.</p> <p> Physician leadership is crucial to ensuring these registries continue to grow. With input from practicing physicians, registries will be designed and used in the best ways to enhance patient care and the physician-patient relationship. By adopting the report as policy, the AMA encourages national medical specialty societies, state medical associations and other physician groups to join the NQRN to advance the development and use of clinical data registries. The policy also supports multi-stakeholder funding of registries, and calls for flexibility in registry development and implementation.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f76f6607-c19c-475d-9f6c-b961774063a9 Get published: Ethics journal now accepting articles for peer review http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_published-ethics-journal-now-accepting-articles-peer-review Wed, 29 Oct 2014 19:21:00 GMT <p> The AMA’s online ethics journal, <a href="http://virtualmentor.ama-assn.org/" target="_blank"><em>Virtual Mentor</em></a>, now offers an outstanding opportunity for physicians and physicians in training to be part of an important discussion and get their peer-reviewed articles published. Expand your professional horizons: <a href="https://www.rapidreview.com/AMA/CALogon.jsp" rel="nofollow" target="_blank">Submit your article</a> for publication in this MEDLINE-indexed journal today.</p> <p> <em>Virtual Mentor</em> is a student- and resident-driven journal published online monthly; it is advertisement-free and open-access. For the first time in its 15-year history, the journal is accepting unsolicited manuscripts for peer review and consideration through its online manuscript submission and review system.</p> <p> The journal accepts article submissions on all medical ethics topics, from those of ongoing interest to those on a current event or recent debate in the medical ethics world. The editorial focus is on commentaries and articles that offer practical advice and insight for medical students, residents and physicians.</p> <p> Review <a href="http://virtualmentor.ama-assn.org/site/archives.html" target="_blank">archived issues</a> of <em>Virtual Mentor</em> to see past topics.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f11e3ea3-ccf6-48bc-8a90-023e368e993a Halloween ICD-10 codes help prep for scary season http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_halloween-icd-10-codes-prep-scary-season Wed, 29 Oct 2014 18:00:00 GMT <p> Be prepared for the spookiest season of the year. With ICD-10 implementation coming Oct. 1 of next year, here are the ICD-10 diagnosis codes you may need for Halloween.</p> <ul> <li> If one of your patients is unlucky enough to cross paths with a surly black cat, ICD-10 allows you to code for a bite from a cat (W55.01). The equivalent ICD-9 code didn’t allow for distinction by animal, so potential complications from a bite could be easier to monitor under the new code set.<br />  </li> <li> Watch that neck: An encounter with a vampire could result in ICD-10 code S11.83, which denotes puncture wounds to a specified part of the neck.<br />  </li> <li> Did your patient’s hand slip while carving a pumpkin? If you’re dealing with a finger cut, ICD-10 has codes for the left hand versus right hand and the exact finger that is injured.</li> </ul> <p> <br /> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/10/a887ad14-3fb3-438d-aaa4-2c813b78fbaa.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/10/a887ad14-3fb3-438d-aaa4-2c813b78fbaa.Large.jpg?1" style="float:right;margin:15px;" /></a>While the minute detail of these codes could be silly, the ICD-10 code set is no trick. ICD-10-CM has 68,000 codes—a five-fold increase from the approximately 13,000 diagnosis codes in ICD-9. Physicians have less than a year to transition to the code set.</p> <p> The AMA continues to urge regulators to ease this physician burden, citing the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> of ICD-10, coupled with an already onerous regulatory environment.</p> <p> However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Physicians should begin preparing for implementation by working with software vendors and testing their systems, if they haven’t already. The AMA offers <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now">resources</a> to make the transition easier.</p> <p> The Centers for Medicare & Medicaid Services recently announced three weeks that will be dedicated to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/will-icd-10-claims-accepted-cms-designates-testing-weeks" target="_blank">helping physicians test</a> whether their claims will be accepted in the Medicare claims processing system. The first testing week will be from Nov. 17-21.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d7645457-7492-43fd-bf6a-3a159de97482 Where you should practice: New tool reveals lay of the land http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_should-practice-new-tool-reveals-lay-of-land Tue, 28 Oct 2014 18:00:00 GMT <p> The United States has more than 6,000 designated health professional <a href="http://www.hrsa.gov/shortage/find.html" rel="nofollow" target="_blank">shortage areas</a> in primary care alone. A new mapping tool from the AMA lets you find out which regions are most in need of physicians in your specialty and would be served best if you establish or expand your practice there.</p> <p> With the <a href="http://www.ama-assn.org/ama/priv/advocacy/state-advocacy-arc/health-workforce-mapper-a.page" target="_blank">AMA Health Workforce Mapper</a> (log in), an interactive tool released Tuesday, you and your staff can determine locations to establish or expand your practice based on regional needs for access to care, geographic features and the existing health care workforce.</p> <p> The tool helps AMA members make wise practice decisions and meet pressing patient access needs by giving a map view of layered geographic information, health data, and practice locations of physicians and other health care providers—down to medical specialty and practice type.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/3/5d33d482-90a1-4c94-b373-6e434512014d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/13/3/5d33d482-90a1-4c94-b373-6e434512014d.Large.jpg?1" style="margin:15px;float:right;" /></a>For instance, an OB-GYN group practice located in St. Louis that is interested in expanding to another practice site in the state could select Missouri as the location, choose OB-GYN as the class of physicians they want to see on the map, and overlay that with nurse midwives and other health care professionals in the field.</p> <p> The resulting map would demonstrate where physicians and other providers involved in women’s health care are located and show the areas of greatest need with the ratio of patients to health care professionals. The practice then could choose to see where other group practices, hospitals and medical schools are in relation to the areas they’re considering for a new practice site. Physicians who are not AMA members have access to a <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/health-workforce-mapper-b.page" target="_blank">reduced view of the tool</a> that does not include physician data.</p> <p> Physicians in training and those already in practice can use this tool to:</p> <ul> <li> Identify and prioritize underserved areas for practice expansion or establishment</li> <li> Create and display ratios of physicians to population in any given region</li> <li> Map the practice locations of physicians and other clinicians in specific states or regions</li> <li> Select and compare across multiple categories of physician specialty types</li> <li> Identify shortage areas, hospital locations, population indicators and relevant health policy data</li> <li> View geographic features, including highways, mountain ranges and waterways</li> </ul> <p> <strong>Exclusive access:</strong> While a <a href="http://www.ama-assn.org/ama/pub/advocacy/state-advocacy-arc/health-workforce-mapper-b.page" target="_blank">reduced view</a> of this tool is open to anyone who wishes to view basic regional information and detailed non-physician provider data, AMA members get exclusive access to layered physician data that drills down to medical specialty and practice type and overlays the other mapping data for a complete picture of the selected location.</p> <p> If you’re not an AMA member, <a href="http://www.ama-assn.org/ama/pub/membership.page" target="_blank">join today</a>.</p> <p> <strong>Want to learn more? </strong><a href="https://www2.gotomeeting.com/register/783349514" rel="nofollow" target="_blank">Register today</a> to participate in a live demonstration at 1 p.m. Eastern time Nov. 14.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cee2ec45-c555-461b-a380-2c7532d5740b Why health insurance competition matters http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-insurance-competition-matters Tue, 28 Oct 2014 16:33:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/11/3338a171-6adf-4758-ab0f-11120ab1f472.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/11/3338a171-6adf-4758-ab0f-11120ab1f472.Large.jpg?1" style="float:left;margin:10px;" /></a>In my travels I often hear the concerns and successes physicians and patients across the country face every day. Perhaps one of the most concerning challenges in today’s health care environment is health insurance competition.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/10-top-states-health-insurers-dominate-new-study" target="_blank">newest edition</a> of the AMA’s <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets</em>, which provides a picture of competition in 388 metropolitan areas, all 50 states and Washington, D.C., gives us a measure of just how concerned we should be.</p> <p> In 17 states, and in 41 percent of metropolitan areas, a single health insurer had more than one-half of the commercial market. In 45 states, only two health insurers had a combined commercial market share of one-half or more. In nearly three-quarters of the metropolitan areas studied, there is a significant absence of health insurer competition.</p> <p> WellPoint Inc. had the largest market share in 82 of the metropolitan areas studied, Health Care Services Corp. dominated 37 areas and UnitedHealth Group led 35 metropolitan areas.</p> <p> Market power of big health insurers increases the risk of anti-competitive behavior. That means higher prices for patients and more pressure on physicians, and it presents a significant barrier to the market success and innovation of of smaller insurance rivals.</p> <p> The point of the study isn’t merely to raise alarm. It’s a way to inform researchers, policymakers and regulators about where mergers and acquisitions among health insurers could harm patients and physicians. The AMA regularly keeps these groups in the loop about the state of health insurance competition to help them make wise decisions to make sure America’s patients have the access to care they need.</p> <p> AMA members can access the study for free through the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560005&navAction=push" target="_blank">AMA Store</a>. It’s also available for purchase to nonmembers. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:93f29870-b871-42f2-9ffe-73c8dca113e5 Seminar gives guidance on changes to CPT® 2015 codebook http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_seminar-gives-guidance-changes-cpt-2015-codebook Tue, 28 Oct 2014 16:31:00 GMT <p> Looking for a comprehensive way to review changes to the 2015 CPT® codebook? Attend a one-day seminar, offered in five locations, to keep up to date with new procedural terminology.</p> <p> The CPT® Changes 2015 Workshop gives attendees access to leading CPT experts and information on changes to the code set, including guidelines, modifiers and E/M codes. Participants in this workshop will receive:</p> <ul> <li> An introduction to and overview of CPT changes that include added, revised and deleted codes</li> <li> A detailed explanation of rationale behind added, revised and deleted codes and guidelines</li> <li> Expert-led, interactive training</li> <li> A copy of the <em>CPT® 2015 Professional Edition </em>codebook and a copy of <em>CPT® Changes 2015: An Insider’s View</em></li> </ul> <p> The one-day workshop will take place in five states:</p> <ul> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510005&navAction=push" target="_blank">Newark, New Jersey</a>: Dec. 8</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510006&navAction=push" target="_blank">Atlanta, Georgia</a>: Dec. 8</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510008&navAction=push" target="_blank">Baltimore, Maryland</a>: Dec. 11</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510007&navAction=push" target="_blank">Las Vegas, Nevada</a>: Dec. 11</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2510009&navAction=push" target="_blank">San Antonio, Texas</a>: Dec. 15</li> </ul> <p> Review the <a href="https://commerce.ama-assn.org/catalog/media/cpt-changes-2015-workshop-agenda-december.pdf" target="_blank">workshop agenda</a> (log in) for more information. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:af5a4c42-fba2-468e-865e-9745fd91a591 Physicians’ ethical considerations in emergencies http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-ethical-considerations-emergencies Mon, 27 Oct 2014 19:25:00 GMT <p> As flu season approaches and public health outbreaks are making headlines, physicians and health systems across the country are reviewing disaster preparedness procedures. The <em>AMA Code of Ethics</em> and physician-authored articles provide guidance on ethical deliberations the medical community should consider regarding public health and disaster preparedness.</p> <p> The <em>Code</em> gives <a href="http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9067.page" target="_blank">guidance on physician obligation in epidemics</a> and other public health emergencies, stating that “individual physicians have an obligation to provide urgent medical care during disasters.” It also states that physicians “should take appropriate advance measures to ensure their ability to provide medical service at the time of disasters, including keeping current on relevant knowledge and skills.</p> <p> Outside of the <em>Code</em>, there are further discussions when it comes to ethics in public health emergencies, including:</p> <ul> <li> “<a href="http://www.tandfonline.com/doi/abs/10.1080/15265160701307613?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&#.VEgmkvnF_ng" rel="nofollow">Ethics and public health emergencies: Encouraging responsibility</a>.” It’s extremely difficult to predict whether people and institutions will live up to their responsibilities in a crisis and plan accordingly. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors’ responsibilities.</li> <li> “<a href="http://www.tandfonline.com/doi/abs/10.1162/152651604773067497?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#.VEgmsPnF_ng" rel="nofollow">When pestilence prevails … Physician responsibilities in epidemics</a>.” Physicians’ responses to epidemics throughout history suggest an evolving acceptance of the professional duty to treat contagious patients. This article suggests that a renewed embrace of physicians’ duty to treat patients during epidemics—despite conditions of personal risk—might improve capacity to prepare for threats such as bioterrorism and new epidemics.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2006/04/ccas3-0604.html">Should I stay or should I go? The physician in time of crisis</a>.” In the face of an epidemic, where do physicians’ obligations lie? The ethical definition of obligation often provides little guidance for how one should behave in the face of conflicting duties.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2004/05/ccas1-0405.html">Duty to treat versus personal safety</a>.” In becoming a professional, a physician takes an oath to be a healer and serve the sick. There is an implied contract between patients and clinicians, which must be considered in determining whether to treat a patient or care for one’s own personal safety.</li> <li> “<a href="http://www.tandfonline.com/doi/full/10.1080/15265160601021256#.VEgnSvnF_ng" rel="nofollow">Ethics and public health emergencies: Rationing vaccines</a>.” A recent U.S. shortage of annual influenza vaccine, combined with the threat of pandemic flu, has given policymakers an opportunity to think about rationing in very concrete terms. </li> </ul> <p> In addition, the AMA’s online ethics journal <em>Virtual Mentor</em> has an <a href="http://virtualmentor.ama-assn.org/2006/04/toc-0604.html" target="_blank">issue</a> dedicated to ethics questions raised by emerging epidemics.</p> <p> <strong>Looking for more ethics discussions? </strong>Visit the <a href="http://virtualmentor.ama-assn.org/" target="_blank"><em>Virtual Mentor</em></a> website.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cbaa5711-3935-47a0-9d50-a257a735a0d1 How med students handle uncertainty could predict career future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-students-handle-uncertainty-could-predict-career-future Mon, 27 Oct 2014 19:20:00 GMT <p> Medical students’ level of tolerance for ambiguity may be closely tied to how they deal with stress and where they will practice, according to a recent <a href="http://www.ncbi.nlm.nih.gov/pubmed/25250742" rel="nofollow" target="_blank">study</a> in <em>Academic Medicine</em>.</p> <p> Researchers surveyed nearly 14,000 entering medical students as part of the Association of American Medical Colleges (AAMC) matriculating student questionnaire. The survey asked incoming students to rate how they agreed with statements such as, “I don’t like to work on a problem unless there is a possibility of getting a clear-cut and unambiguous answer.”</p> <p> The survey found that high tolerance for ambiguity was associated with students’ intention to work in underserved areas and with lower levels of perceived stress.</p> <p> Tolerance for ambiguity—or the tendency to perceive uncertain situations as more desirable than threatening—is an important competency for physicians. For instance, the AAMC includes tolerance of and adaptation to stressful or changing environments as part of its core competencies for entering medical students.</p> <p> The organization also deems “comfort with ambiguity” as a professional activity believed essential for graduated medical students entering residency. Similarly, the Accreditation Council of Graduate Medical Education considers tolerance for ambiguity an essential milestone for residents in certain specialties.</p> <p> “Medical schools committed to addressing [underserved populations] may consider prioritizing personal characteristics, such as tolerance for ambiguity, in the admission process to enhance the likelihood that the future health care workforce will better address disparities in health care access,” the study said.</p> <p> The survey also found that tolerance for ambiguity was higher in men and older students.</p> <p> “If tolerance for ambiguity can be taught or strengthened through the learning environment, medical schools will need to develop evidence-based curricular and pedagogical approaches to nurture this quality in their students,” the study said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0b18a9b5-dbfd-4625-a8d9-c3c55aa25b0f Underserved communities to get help preventing diabetes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_underserved-communities-preventing-diabetes Mon, 27 Oct 2014 18:00:00 GMT <p> Fifteen free and charitable clinics across the country will receive funding to help reduce the incidence of type 2 diabetes as part of two grant programs from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page?" target="_blank">AMA Foundation</a> and <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-28-americares-ama-preventing-diabetes-underserved-areas.page" target="_blank">AmeriCares</a>.</p> <p> An estimated 86 million American adults have prediabetes, but only one in 10 of these people knows they are at risk of developing type 2 diabetes. The patients served by these clinics are generally low-income populations that suffer disproportionately from poor health outcomes associated with prediabetes and are at the highest risk of developing clinical diabetes.</p> <p> Each clinic awarded a grant will receive $10,000 over the next two years to implement the lifestyle change program that is part of the Centers for Disease Control and Prevention’s (CDC) <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a>. A recent <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/benefits-of-diabetes-prevention-program-long-lasting-study" target="_blank">study</a> showed that such lifestyle change programs have long-lasting benefits for participants through preventing or delaying progression to type 2 diabetes.</p> <p> The AMA Foundation <a href="https://download.ama-assn.org/resources/doc/ama-foundation/x-pub/healthy-community-healthy-america-press-release.pdf">awarded grants</a> (log in) to eight free clinics through its <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/healthy-communities-healthy.page" target="_blank">Healthy Communities/Healthy America program</a>, and AmeriCares awarded grants to seven free clinics through its Transforming Prediabetes Care Initiative. Staff members at each clinic will receive training on how to deliver the CDC’s program to clinic patients.</p> <p> Both grant programs will build upon work the AMA has been accomplishing through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative. The AMA joined with the YMCA of the USA over the past year to increase referrals to the YMCA’s Diabetes Prevention Program, which is part of the CDC’s National Diabetes Prevention Program.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at their local YMCAs. Participating physicians receive updates on their patients’ progress to incorporate into their care plans. The free clinics will use prediabetes screening and enrollment tools based on those that the AMA created for its work with these physician practices.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c42efbee-7a4a-4bd0-b21f-7f43a71822ef Comment on draft guidelines for assessing late-career practitioners http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-draft-guidelines-assessing-late-career-practitioners Mon, 27 Oct 2014 15:00:00 GMT <p> <a href="http://cppph.org/" target="_blank" rel="nofollow">California Public Protection and Physician Health</a> (CPPPH) is seeking comment on a draft guideline related to policies and procedures for age-based screening. The guideline was developed by a workgroup of members from the California Medical Association, the California Hospital Association Center for Hospital Medical Executives and the CPPPH.</p> <p> The workgroup members believe that hospitals and health care organizations themselves are best equipped to design and implement such a policy about late-career practitioners, and they are making this guideline available to assist in that process.</p> <p> For organizations that choose to develop and implement a policy for privileging late-career practitioners, this document can provide important background information and discussion of the core concepts involved. It also can serve as an example of policies and procedures as each organization prepares its own versions, taking into account the organization’s own particular needs.</p> <p> Before this guideline is made final, it is being circulated to all interested parties for review and comment:</p> <ul> <li> Access the <a href="https://cppphdotorg.files.wordpress.com/2011/02/assessing-late-career-practitioners-policies-and-procedures-for-age-based-screening-draft-21-8-22-14.pdf" target="_blank" rel="nofollow">draft guideline</a>.</li> <li> Submit comments via email to <a href="mailto:CPPPHInc@gmail.com" rel="nofollow">CPPPHInc@gmail.com</a>. </li> </ul> <p> Comments received by Nov. 14 will be considered as the workgroup prepares the next draft of this guideline. Workgroup members are grateful for your interest in this project and look forward to receiving your responses.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8bb33bc0-1926-4e2f-bb99-9f0a4ba1f6ef Attend AMA-SPS meeting taking place Nov. 8 in Dallas http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_register-ama-sps-meeting-taking-place-nov-8-dallas Mon, 27 Oct 2014 15:00:00 GMT <p> Attend the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/senior-physicians-section.page" target="_blank">Senior Physicians Section</a> (SPS) meeting, 11:30 a.m. to 1:30 p.m. Nov. 8, taking place in conjunction with the 2014 AMA Interim Meeting in Dallas.</p> <p> The keynote presentation, "Grow healthier as you grow older," will be delivered by Kenneth H. Cooper, MD, known as the “father of aerobics.” Dr. Cooper was an U.S. Air Force physician who became interested in the role of exercise in preserving health and has since founded the Cooper Institute. He will discuss some of his lifelong experience focused on wellness and longevity.</p> <p> Participants in the AMA-SPS Assembly business meeting also can introduce new items of business related to the section’s mission and review items in the AMA House of Delegates handbook. AMA members 65 years of age or older, as well as anyone interested in senior physician issues, is encouraged to attend.</p> <p> If you have questions, please contact Alice Reed of the AMA via <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">email</a> or at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ef3d48cc-6b57-49f0-b36e-bce21b38d863 Attend the 2014 OMSS Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_attend-2014-omss-interim-meeting Mon, 27 Oct 2014 15:00:00 GMT <p> The 2014 OMSS Interim Meeting will be held Nov. 6-8 at the Hilton Anatole in Dallas. Onsite registration opens Nov. 6 at 10:30 a.m. in the Chantilly Foyer. On this year’s <a href="http://www.ama-assn.org/resources/doc/omss/x-pub/i14-agenda.pdf" target="_blank">meeting agenda</a> (log in) are a number of valuable opportunities.</p> <p> In addition to policymaking sessions and networking opportunities, the meeting will include education programs on the following topics:</p> <ul> <li> CMS hospital conditions of participation: What medical staff members need to know about the new regulations</li> <li> A hospital’s success through physician-led quality improvement initiatives</li> <li> Medical staff engagement of community physicians</li> <li> How patient satisfaction scores and physician ratings are affecting physician compensation</li> <li> The AMA’s advocacy efforts: Physicians’ voice in Washington</li> <li> Update on AMA’s strategic focus area: Professional Satisfaction and Practice Sustainability</li> </ul> <p> Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/organized-medical-staff-section/meetings.page?" target="_blank">OMSS Interim Meeting webpage</a> for complete meeting details.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c04967db-72a7-446c-be40-e438a5c50148 State high court to rule on expert witnesses in medical liability http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_state-high-court-rule-expert-witnesses-medical-liability Fri, 24 Oct 2014 19:43:00 GMT <p> Should testimony about standards of care be permitted in medical liability cases if the expert witness does not practice in a similar specialty as the defendant physician? A state supreme court is considering the question.</p> <p> The Florida Supreme Court is taking up <em>Edwards v. Sunrise Ophthalmology ASC</em>, in which a lower court had excluded the testimony of an infectious disease specialist, which was offered regarding the standard of care the plaintiff received from her ophthalmologist related to surgery on her lower eyelid.</p> <p> Under current law in the Sunshine State, expert medical opinion must come from a medical expert who practices in the “same specialty” or “similar specialty” to the physician defendant.</p> <p> “Physicians facing medical [liability] claims must be held to the standards of care in the specialty for which they are qualified and trained,” the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?" target="_blank">Litigation Center of the AMA and State Medical Societies</a> and the Florida Medical Association stated in a friend-of-the-court brief filed Sept. 30. “They should be judged by others who are trained in the same standards of care.”</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/412ed6d7-7bc8-4a31-ac29-c9f5483426de.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/412ed6d7-7bc8-4a31-ac29-c9f5483426de.Large.jpg?1" style="float:left;margin:10px;" /></a>This policy “reduces the likelihood of unreliable testimony from experts with differing standards of care, and it assures consistency in standards in the courtroom and operating room,” the brief states.</p> <p> The brief also argues that allowing expert testimony from health care professionals who do not practice the same specialty as the defendant also would lead to “expert shopping.” One of the purposes of the Florida law on expert testimony is to prevent plaintiffs from looking “for a ‘hired gun’ to issue that testimony” if they cannot find a person in a similar specialty who will attest to a breach in standard of care.</p> <p> “Assuring that specialists are judged in litigation based on their standards of care and by individuals trained and experienced in those standards of care will help protect the integrity of medical [liability] claims,” the brief states.</p> <p> According to a <a href="http://www.ama-assn.org/resources/doc/health-policy/x-ama/prp-piaa-2013-final.pdf" target="_blank">recent AMA study</a> (log in), nearly two-thirds of medical negligence claims ultimately are dropped, withdrawn or dismissed without any payment. At the same time, the average expense of defending against a medical liability claims—regardless of its merits or success—is $50,000.</p> <p> “This cost comes at the expense of affordable and available care,” the brief states.</p> <p> Read more about the AMA’s recent work around <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Medical_Liability/1" target="_blank">medical liability reform</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:921d222b-75d4-45c2-95ec-9f723411aceb Video: Facing tough choices, how one physician brought peace http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_video-facing-tough-choices-one-physician-brought-peace Fri, 24 Oct 2014 19:40:00 GMT <p> Physicians face difficult decisions every day, and some of the results of these decisions leave their marks long after the patient has been treated. One physician recently shared his feelings around some tough choices—and how those choices made him a better doctor.</p> <p> William Lynn Weaver, MD, senior associate dean at Ross University School of Medicine Dominica campus, told a story about a very sick patient he helped during the AMA’s recent Inspirations in Medicine event.</p> <p> <object align="right" data="http://www.youtube.com/v/jXoPXY5QciU" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/jXoPXY5QciU" type="application/x-shockwave-flash" vspace="10" width="375"><param name="movie" value="http://www.youtube.com/v/jXoPXY5QciU" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/jXoPXY5QciU" type="application/x-shockwave-flash" vspace="10" width="375" wmode="transparent"></embed></object>The patient’s small intestines were dead, and he later lost the pulse in both his legs. Dr. Weaver did his best but still felt he had failed the man after having to amputate the patient’s legs and remove a large portion of his intestines.</p> <p> “I have a patient who walked into the hospital, and who now has no intestines and no legs,” Dr. Weaver said. “What had I done? I had not done what I had trained to be, which was compassionate and caring.”</p> <p> Seeking to ease his conscious, Dr. Weaver went to the patient’s room late one night. He wondered if he had really helped the patient at all.</p> <p> “The patient said, ‘Dr. Weaver, I am so glad you did not let me die,’” Dr. Weaver said. “’What you have done for me is that you have given me what everybody wants—just a little more time to say what I did not say or do before.’”</p> <p> “I realized I had failed to do what I thought was the most important thing—to save his life or make him better,” Dr. Weaver said. “But what I had done was to give some peace to him and his family.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" target="_blank" rel="nofollow">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b00d194f-8ff7-4a6d-a97a-d5e714bbe130 $840 million will fund improved care via new clinical networks http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_840-million-will-fund-improved-care-via-new-clinical-networks Thu, 23 Oct 2014 21:48:00 GMT <p> A new initiative announced Thursday is expected to deliver stronger health outcomes by giving medical practices the technical assistance and peer-level support they need to deliver efficient patient-centered care.</p> <p> As a new model of the Centers for Medicare & Medicaid Services (CMS), the <a href="http://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/" rel="nofollow" target="_blank">Transforming Clinical Practice Initiative</a> will award $840 million for the creation of evidence-based, peer-led collaboratives and practice transformation networks to support physicians in providing high-quality care.</p> <p> “The Transforming Clinical Practice Initiative will achieve a number of important goals,” said AMA Board Chair Barbara L. McAneny, MD, who participated in a CMS call announcing the initiative. “It will foster collaboration among a broad community of practices of various sizes, including collaboration between primary care physicians and specialists. It will also develop a network for sharing information among medical societies as well as multi-stakeholder regional collaboratives to support practice transformation.”</p> <p> The networks, which will be announced in the late spring, are expected to support 150,000 clinicians beginning May 1. Anticipated strategies include giving physicians better access to patient information, expanding how patients can communicate with their health care team and improving coordination of care.</p> <p> CMS is encouraging large group practices, medical associations, quality improvement organizations, regional health collaboratives and other organizations that have existing relationships with physician networks to apply. Optional letters of intent are due Nov. 20, and the application deadline is Jan. 6.</p> <p> The AMA has been urging CMS to assist physician practices in their efforts to adopt new payment and delivery models under physician leadership, a primary goal of this new model.</p> <p> “We strongly believe that practice transformation can lead to improvements in the quality of care for patients, control health care costs and enhance practice sustainability as physicians embrace innovative new models,” Dr. McAneny said.</p> <p> This federal effort aligns with the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, which promotes sustainable practices that can result in improved health outcomes for patients and greater professional satisfaction for physicians.</p> <p> The AMA is committed to identifying and supporting current and emerging payment and care delivery models that work best for physicians across a variety of practice settings to help them provide high-quality care and achieve professional satisfaction.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:43d82ec7-fe3a-4e9f-8631-6ccf7cd92a01 How health IT is giving med students real-world experience http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-giving-med-students-real-world-experience Thu, 23 Oct 2014 20:40:00 GMT <p> A new “teaching electronic health record” (tEHR) from Indiana University School of Medicine will give medical students a chance to learn clinical decision-making and system-based care using real data.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/15/4f651980-dcd3-47cd-8f4d-41d75edc6190.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/15/4f651980-dcd3-47cd-8f4d-41d75edc6190.Large.jpg?1" style="float:right;margin:10px;" /></a>IU cloned its health system’s existing EHR system and scrambled patient data to create the tEHR, then enhanced the design so the technology will send students reminders and information that can affect their clinical decisions.</p> <p> Blaine Takesue, MD, assistant professor of clinical medicine at the IU School of Medicine (pictured right), presented the tEHR at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> For example, a student may be undergoing a training activity in which they are using patient data and the tEHR. If a patient in the training activity has renal problems and a student orders a test that could harm the patient’s kidneys, a traditional EHR with clinical decision support would send a warning about the test. But with the tEHR, the student would receive educational content—a video, some text or a link to an outside resource—to help him or her understand why the warning would be sent in the first place.</p> <p> The tEHR reflects the regulations and constraints that current EHRs offer. That means students will get exposure to things like the meaningful use program and the ICD-10 code set.</p> <p> “If you’re going to be evaluated based on quality measures, and you don’t understand the qualities of data, you’re going to have to play a lot of catch up,” Dr. Takesue said. “There’s no reason why during medical school we can’t teach our students some of these concepts. We need to impart to our students what EHRs can do, what they can’t do, and what their strengths and weaknesses are.”</p> <p> The school’s faculty will be able to look at user logs to see how individual students use the tEHR in different patient care scenarios. Because the tEHR uses real data, students also will be able to compare how their clinical decisions matched up with what real physicians actually did in caring for the same patients.</p> <p> “By using real medical data, one of the lessons we’ll impart to our students is that [health care] decisions can be complicated, and things are sometimes done for different reasons,” Dr. Takesue said.</p> <p> Dr. Takesue is working with the AMA and the Accelerating Change in Medical Education consortium schools to potentially adapt the tEHR for use at additional medical schools.</p> <p> This post is the third in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank">second post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2efba236-7a32-4e91-9601-692554dadf14 JAMA Highlights: Health services pricing availability linked to lower total claims payments http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-health-services-pricing-availability-linked-lower-total-claims-payments Thu, 23 Oct 2014 16:00:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/c0Of05gXAKU" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/c0Of05gXAKU" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/c0Of05gXAKU" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" quality="best" src="http://www.youtube.com/v/c0Of05gXAKU" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA: <em>Hospitals switching from non-profit to for-profit improve serving poor and minority patients</em>.</span></td> </tr> </tbody> </table> <p> <strong>Making health services pricing available linked to lower total claims payments</strong><br /> Searching a health service pricing website before using a medical service was associated with lower payments for clinical services, such as advanced imaging and laboratory tests, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1917438" rel="nofollow" target="_blank">study</a> in the Oct. 22/29 issue of <em>JAMA.</em></p> <p> <strong style="font-size:12px;">Hospitals switching from non-profit to for-profit improve serving poor and minority patients</strong></p> <p> A study of hospitals converting from non-profit to for-profit status found the conversion was associated with improvements in financial margins but not associated with differences in quality or mortality rates, or with the proportion of poor or minority patients receiving care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1917437" rel="nofollow" target="_blank">study</a> in the Oct. 22/29 issue of <em>JAMA</em>. Watch a <a href="http://youtu.be/c0Of05gXAKU" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Reports of impulse control disorders associated with dopamine agonist drugs</strong><br /> During a 10-year period, there were 1,580 adverse drug events reported in the United States and 21 other countries that indicated impulse control disorders in patients, including 628 cases of pathological gambling, 465 cases of hypersexuality and 202 cases of compulsive shopping. The total included 710 events associated with dopamine receptor agonist drugs (used to treat Parkinson disease, restless leg syndrome and hyperprolactinemia) and 870 events for other drugs, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916909" rel="nofollow" target="_blank">study</a> in <em>JAMA Internal Medicine</em>.</p> <p> <strong>Cigarette purchases accompany prescription refills at pharmacies</strong><br /> Patients using medication to treat certain respiratory conditions or high blood pressure, or using oral contraceptives often purchased cigarettes while filling prescriptions at pharmacies, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916908" rel="nofollow" target="_blank">research letter</a> in <em>JAMA Internal Medicine</em>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b0b379e1-bed1-40d2-8061-5e61e3e4ee30 4 top tips for presenting research http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-top-tips-presenting-research Wed, 22 Oct 2014 19:52:00 GMT <p> Get advice on how to present your research, both in poster and podium presentations, from those in the know: past winners and judges of the AMA Research Symposium.</p> <ol> <li> <strong>Be clear and concise. </strong>“Judges only have a short time to review each poster or presentation, so be clear with any important takeaway points and how [your work] may influence or impact future research or clinical management,” said Tracey Henry, MD, a health policy fellow at Georgetown University Medical Center who presented winning research at the AMA Research Symposium in 2013.<br /> <br /> Former judge Carol Berkowitz, MD, executive vice chair in the department of pediatrics at Harbor-UCLA Medical Center and professor of clinical pediatrics at the David Geffen School of Medicine at the University of California Los Angeles, said she looks for the “succinct presentation of the case, what was unique about it, what the take-home message is and how this message can be applied to other patients.”<br /> <br /> Former judge Jacqueline Bello, MD, director of neuroradiology at Albert Einstein College of Medicine, said she looks for presentations that are sharply focused, structured well and “as simple and straightforward as possible.”<br /> <br /> She added that the results should be “clearly communicated, in terms of their importance, potential implementation and further exploration.”<br />  </li> <li> <strong><a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/114d21f9-6490-4a96-acea-e40d2432efb5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/1/12/114d21f9-6490-4a96-acea-e40d2432efb5.Large.jpg?1" style="float:right;margin:10px;" /></a>Show enthusiasm for your work. </strong>“Be natural and animated,” said Gbolahan Ogunbayo, MD, an internal medicine resident at Rochester General Hospital, who presented winning research at the AMA Research Symposium in 2013. “It’s difficult to combine both, but you want to be animated without making [the judges] feel like you’re being fake. You have to show some enthusiasm and excitement about your work.”<br />  </li> <li> <strong>Practice, practice, practice.</strong> “You should practice presenting to your colleagues or someone with expertise in your topic of research to prepare for the kind of questions you may be asked by the judges,” Dr. Henry said.<br /> <br /> You also should practice how you’ll show the judges that you’re engaged and knowledgeable, said Dr. Ogunbayo. He added, “make a determined effort to try and connect with your audience. Make them feel like they’re in the scenario you’re describing in your case.”<br />  </li> <li> <strong>Follow the rules and be prepared. </strong>“Arrive early to set up your poster or to load your presentation on the computer and make sure it plays,” said Dr. Henry. “Follow the guidelines and stay within the allotted timeframe for your presentation. Don’t lose points because you didn’t adhere to the guidelines.”</li> </ol> <p> More than 300 students, residents, fellows and international medical graduates (IMG) will present their original research at the 12th annual AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/research-symposium.page" target="_blank">Research Symposium</a> Nov. 7 in Dallas. The research competition submissions will be on display during the 2014 AMA <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">Interim Meeting</a>.</p> <p> The competition consists of two components: Podium presentations will take place from 4 p.m. to 5 p.m., followed by poster presentations from 5 p.m. to 6 p.m. All meeting participants and physicians in the local area are invited to attend.</p> <p> <strong>You tell us: </strong>What are your best research presentation tips? Comment below at <em>AMA Wire</em>® or on the AMA-RFS <a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c94abb09-cd4b-4a77-b70b-8531b26071e7 How med schools are tackling challenges in health disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-schools-tackling-challenges-health-disparities Wed, 22 Oct 2014 19:23:00 GMT <p> A <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">Google Hangout</a> featuring academic physicians and students Monday took a close look at how medical schools are taking on two huge challenges: addressing health disparities and focusing on diversity in how they train physicians.</p> <p> Panelists from the University of California Davis School of Medicine, Howard University College of Medicine, and Chicago Medical School at Rosalind Franklin University of Medicine and Science shared their insights into developing a diverse student body that is prepared for tomorrow’s patient population. William McDade, MD, PhD, chair of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education.page?" target="_blank">AMA Council on Medical Education</a> and deputy provost for research and minority issues at the University of Chicago, moderated the hangout.</p> <p> Here are some real-world solutions these schools have implemented to tackle health disparities:</p> <ul> <li> Howard offers a preliminary academic reinforcement program, which gives conditional acceptance to certain disadvantaged medical school applicants. These students take a six-week pre-matriculation program and benefit from retention counseling and mentoring to enhance their academic success.</li> </ul> <ul> <li> UC Davis’ new three-year primary care program, called ACE-PC, includes an innovative admissions and recruitment strategy to select students from diverse backgrounds. The goal is to help these students go on to practice in underserved communities as primary care physicians. One-half of the students admitted into the first class of the program are from groups historically underrepresented in medicine. The program is part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page">Accelerating Change in Medical Education</a> initiative</li> </ul> <p style="margin-left:40px;"> “It’s important that these sorts of curricula last for four years, or three years in our case, and are not one-off or what you do only at orientation or only in this one rotation,” said Tonya Fancher, MD, associate professor of internal medicine at UC Davis. “That’s an important commitment that the school makes to this type of work.”</p> <ul> <li> Chicago Medical School at Rosalind Franklin University of Medicine and Science is located in an area with a dense Mexican American population, so students have the option to do their second-year preceptorships at predominantly Spanish-speaking clinics. Some students also developed a student-run course in medical Spanish.</li> </ul> <p style="margin-left:40px;"> The focus on Spanish exemplifies the “school’s willingness to take student feedback and actually input it into the med school curriculum,” said Jalia Tucker, a second-year student at Chicago Medical School and a 2014 AMA Foundation Minority Scholar. “We’ll be able to better serve the patients we see at our student-run clinic.”</p> <ul> <li> To give students experience in culturally sensitive health care delivery, Howard has developed special case vignettes that put students face-to-face with culturally diverse patients.</li> </ul> <p style="margin-left:40px;"> “Keep in consideration that culturally responsive health care takes into account ethnicity as well as race,” said Walter Bland, MD, associate dean of student affairs and admissions at Howard. “A person may identify as black or Hispanic, but culturally their experiences will differ depending on their ethnicity. … It’s important that we ask questions about health practices and beliefs that might be important to specific populations we’re working with.”</p> <ul> <li> Mentoring and counseling can help students as well as faculty, said Dr. McDade. The University of Chicago’s Bowman Society brings medical students, residents and faculty together to focus on minority community health care and provide career development to these groups. The program has helped keep minority physicians in academic medicine, Dr. McDade said.</li> </ul> <p> Watch the <a href="https://www.youtube.com/watch?v=KG6GCc3Pu2s&list=PL7ZHBCvG4qsf4HalVXnQ-cdg48xlLgz3S" rel="nofollow" target="_blank">hangout</a> broadcast to hear even more about how these schools are approaching issues in health care disparities and diversity. The AMA shared more information and solutions in health disparities in a recent Tweet Chat hosted by Finding Answers: Disparities Research for Change. Read the highlights at the AMA’s <a href="https://storify.com/AmerMedicalAssn/equitychat" rel="nofollow" target="_blank">Storify</a>.</p> <p> The AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section.page?" target="_blank">Minority Affairs Section</a> also is addressing similar issues. The section’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/doctors-back-school.page?" target="_blank">Doctors Back to School program</a> connects minority physicians and medical students with local schools to introduce kids to professional role models and strengthen the pipeline of future doctors. The AMA also is a founding member of the <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities.page?" target="_blank">Commission to End Health Care Disparities</a>, which is seeking to better understand and address these disparities in ambulatory clinical practices.</p> <p> <strong>How do you think medical education should address health care disparities? </strong>Share your thoughts by commenting below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:aed87054-7eba-4b40-94cd-af167d905620 Learn how to make ICD-10 transition smoother: CMS call http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-icd-10-transition-smoother-cms-call Wed, 22 Oct 2014 19:23:00 GMT <p> With less than a year remaining to transition to the ICD-10 code set, the Centers for Medicare & Medicaid Services (CMS) is hosting a call at 1:30 p.m. Eastern time Nov. 5 to give insights into implementation issues, opportunities for testing and available resources. <a href="http://www.eventsvc.com/blhtechnologies/register/47c7acca-9e8a-46d0-a13f-247c9cf6acb8" target="_blank" rel="nofollow">Register now</a>.</p> <p> CMS experts will discuss:</p> <ul> <li> National implementation of ICD-10</li> <li> Medicare fee-for-service testing</li> <li> Partial code freeze and annual code updates</li> <li> Home health conversions</li> <li> Claims that span the implementation date</li> </ul> <p> The call also will include a question-and-answer session. <a href="http://www.eventsvc.com/blhtechnologies/register/47c7acca-9e8a-46d0-a13f-247c9cf6acb8" target="_blank" rel="nofollow">Register</a> by noon Eastern time Nov. 5 to participate.</p> <p> The AMA continues to urge regulators to ease the physician burden of ICD-10 implementation, which has <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> and is coupled with an already onerous regulatory environment.</p> <p> However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Learn about what <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now">physicians can do to prepare</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:784f5b64-c80a-43aa-9717-8dd7d4d291e4 Get the how-to guide for ICD-10 documentation http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_guide-icd-10-documentation Tue, 21 Oct 2014 20:15:00 GMT <p> Learn how to navigate the new documentation complexities for diagnosis codes in the ICD-10-CM code set. An updated publication from the AMA Store provides guidance just in time to prepare for the Oct. 1, 2015, ICD-10 implementation deadline.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2480013&navAction=push" target="_blank"><em>ICD-10-CM Documentation 2015: A How-To Guide for Coders, Physicians and Healthcare Facilities</em></a> has updated approaches and tools to provide ICD-10-CM documentation improvement, including:</p> <ul> <li> A basic comparison of the ICD-9-CM and ICD-10-CM code sets</li> <li> A general overview of the documentation requirements</li> <li> The official ICD-10-CM guidelines</li> <li> The requirements for specific conditions, diseases and disorders</li> <li> End-of-chapter quizzes</li> </ul> <p> Save 30 percent with promo code “FQB” through Oct. 31. AMA members receive a discount on products from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:07b76408-7484-46d5-a257-257685eaba12 Contribute to our unified voice across medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_contribute-unified-voice-across-medicine Tue, 21 Oct 2014 20:09:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD</em><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/1902c474-4545-47e4-b5d2-deda45920c4f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/5/1902c474-4545-47e4-b5d2-deda45920c4f.Large.jpg?1" style="float:left;margin:10px;" /></a>Now that fall is here, we’re all busy with a variety of medical association meetings. I’ve just returned from the World Medical Association meeting in South Africa, and I’ve spent much of the last two months attending meetings of a dozen different international, national, state and local medical associations.</p> <p> I enjoy these meetings because of the lively discussions that take place surrounding medicine’s most important topics. The upcoming <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 8-11 in Dallas, will be no exception.</p> <p> More than 500 representatives in the AMA House of Delegates will join me in Dallas to debate and make policy that will affect the future of medicine. These students, residents and physicians will come from every state and territorial medical society, 118 medical specialty societies, and the AMA sections, along with the American Medical Women’s Association, the National Medical Association and the five federal services.</p> <p> It’s exciting to hear physicians from so many locations and backgrounds discuss such varied issues, and it’s a true testament to the power of physician collaboration around common goals to support patients and the profession. Through the AMA, we speak with a unified voice.</p> <p> If you’re an AMA member, you can add your voice to ours by weighing in on reports and resolutions to come before the House during the meeting. Just <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">log in to the Online Member Forums</a> to review items, sorted by reference committee, and submit comments on any item.</p> <p> Although the forums will be open until just before the start of the meeting, make your comments by 7 p.m. Eastern time Nov. 2 to ensure your opinions are included in the comment summaries that will go to each reference committee and will be posted on the Interim Meeting website.</p> <p> The Online Member Forums make it easy to contribute from wherever you are, even if you aren’t able to attend the meeting or aren’t a delegate. The forums give anyone a chance to participate in the democratic process and contribute to the AMA’s powerful voice.</p> <p> I look forward to hearing and reading all of the thoughtful, informed debate at the Interim Meeting. Be sure to follow <em>AMA Wire® </em>for daily <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Meeting/1" target="_blank">meeting coverage</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1eac8d6-883a-47a7-962a-5e60584d9ad6 Regulatory penalties tsunami could cut doctors’ pay by 13 percent http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_regulatory-penalties-tsunami-could-cut-doctors-pay-13-percent Tue, 21 Oct 2014 15:00:00 GMT <p> Physicians providing care to Medicare patients could face a “tsunami” of regulatory penalties over the next 10 years, potentially seeing payments cut by more than 13 percent by the end of the decade. The AMA urged the Centers for Medicare & Medicaid Services (CMS) to streamline the competing laws and regulations that threaten access to care in a <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/medicare-incentive-program-letter-21oct2014.pdf" target="_blank">letter</a> (log in) sent Tuesday.</p> <p> Next year, some physicians could face cuts of more than 6 percent under the Medicare sequester cut and penalties from overlapping regulatory programs, including the meaningful use electronic health record (EHR) program, the Physician Quality Reporting System (PQRS) and the Value-Based Modifier program (VBM).</p> <p> <a href="http://www.ama-assn.org/resources/images/washington/medicare-sgr-penalties-850x1100.jpg" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/14/0705d606-ea16-417f-8e4c-c189f3233851.Large.jpg?1" style="float:right;margin:15px;" /></a>“Physicians want to provide our patients with the best care possible, but today there are confusing, misaligned and burdensome regulatory programs that take away critical time physicians could be spending to provide high quality care for their patients,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-21-regulatory-nightmare-threatens-seniors.page" target="_blank">news release</a>. “Government leaders should take the necessary steps to eliminate this regulatory nightmare and ensure America’s seniors can continue to receive the high-quality care they deserve.”</p> <p> The AMA told CMS these programs make it difficult for physicians to invest in health IT and payment and delivery reforms necessary to improve patient care. The AMA urged CMS to simplify and align incentive programs to ensure there is one streamlined process in place for physicians to meet a single set of quality reporting requirements, rather than the three separate sets of requirements that currently exist.</p> <p> “No other segment of the health care industry faces penalties as steep as these, and no other segment faces such challenging implementation logistics,” the letter said. “The tsunami of rules and policies surrounding the penalties are in a constant state of flux due to scheduled phase-ins and annual changes in regulatory requirements. In fact, the rules have become so convoluted that no one, including the staff in charge of implementing them, can fully understand and interpret them.”</p> <p> The letter discusses three Medicare programs with penalties that impact physicians:</p> <p> <strong>EHR meaningful use: </strong>CMS should adopt a more flexible approach for meeting meaningful use, instead of the program’s current all-or-nothing requirements, the letter said. The agency also should make optional measures that are out of physicians’ control, such as those based on interoperability. The letter also asks CMS to reduce burdensome technology requirements that stifle EHR usability and innovation.</p> <p> <strong>Physician Quality Reporting System: </strong>Without public, aggregate information on the number of physicians who successfully and unsuccessfully participated in PQRS, there’s no way to assess the program in a timely manner, the letter said.</p> <p> CMS should release aggregate PQRS data for 2013 so physicians can evaluate the program. The agency should create a more formal appeals process to give physicians more than 30 days to seek correction of any inaccurate information. Finally, CMS should maintain a more robust set of claims-based measures and reporting options to reduce reporting costs.</p> <p> <strong>Value-Based Modifier: </strong>The VBM program should be repealed, or at least limited in its implementation, the letter said. If it isn’t repealed, more time is needed to gauge its results on large physician groups before penalties are ratcheted up and extended to small and solo practices.</p> <p> “The current strategy of plowing ahead with policies that place an ever-increasing burden on both CMS and physicians—combined with the flawed roll-out of the Medicare claims data release and Open Payments program and the problems with these programs—is causing serious damage to the agency’s image and to physician confidence in the government’s stated goal of achieving a health care system that delivers more value for the dollar,” the letter said.</p> <p> The AMA will continue to advocate for needed changes to these and other regulatory programs.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3cf3b826-7ce7-4ce6-ad4e-d18ef92ea084 CDC issues new Ebola guidelines to protect health professionals http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-issues-new-ebola-guidelines-protect-health-professionals Tue, 21 Oct 2014 14:04:00 GMT <p> The Centers for Disease Control and Prevention (CDC) Monday released <a href="http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html" target="_blank" rel="nofollow">tightened guidance</a> on use of personal protective equipment (PPE) for U.S. health care workers to ensure they are better prepared to treat Ebola patients.</p> <p> The guidance focuses on specific PPE health care workers should use and offers detailed, step-by-step instructions for how to put the equipment on and take it off safely. The CDC also released a <a href="http://www.cdc.gov/media/releases/2014/fs1020-ebola-personal-protective-equipment.html" target="_blank" rel="nofollow">fact sheet</a> on the changes in the PPE guidance.</p> <p> The original guidelines “were developed by experts at CDC with consultation and approval from infectious disease control experts around the United States and consistent with World Health Organization guidelines,” said CDC Director Tom Frieden, MD. They “have been used successfully before. “Even a single health care worker infection is one too many.”</p> <p> The enhanced guidelines center on three principles:</p> <ul> <li> All health care workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner.</li> <li> No skin is exposed when PPE is worn.</li> <li> All workers are supervised by a trained monitor who watches each worker taking PPE on and off.</li> </ul> <p> The guidance reflects recent experience from safely treating patients with Ebola at Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center.</p> <p> “The greatest risk in Ebola care is in the taking off of whatever equipment the health care worker has on—whether there’s skin exposed or not,” Dr. Frieden said. “One of the critical aspects of these guidelines is a very structured way of doing that step by step” under supervision, making it ritualized and done with standardized equipment.</p> <p> The CDC urged health care workers to ask any patient with a fever if that patient has traveled in the past 21 days.</p> <p> “Every health care worker needs to know how to screen a patient who may have Ebola,” Dr. Frieden said. “CDC is increasing training offerings for health care staff across the country and we'll be developing materials and videos, but really there's no alternative to hands-on training.”</p> <p> <strong>Looking for additional expert information about Ebola?</strong> Get the facts from credible sources via the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a>. Watch <em>AMA Wire</em><sup>®</sup> for ongoing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">Ebola coverage</a> provided by the AMA.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f76a8a53-a580-42b1-88d9-de14938754b7 Ways students can control residency application costs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ways-students-can-control-residency-application-costs Mon, 20 Oct 2014 21:27:00 GMT <p> If you’re a medical student in the process of applying for residency positions, you’re probably discovering that the costs associated with applications, interviews and fees are adding up. Here are some ways you can manage those costs.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/d082dfd0-7884-452a-9de4-3918474051db.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/d082dfd0-7884-452a-9de4-3918474051db.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>Budget for the application costs. </strong>The <a href="https://www.aamc.org/services/eras/" rel="nofollow" target="_blank">Electronic Residency Application Service</a> (ERAS) sends applications, letters of recommendation, transcripts and other credentials to the programs you are interested in. ERAS fees vary by how many applications you submit, but they quickly can reach into the hundreds of dollars.</p> <p> <strong>Don’t forget the additional fees.</strong> It costs $75 to send your USMLE transcript to residency programs. You’ll also need to pay the National Resident Matching Program fee to participate in the Match at a cost of $60 for the first 20 programs to which you apply.</p> <p> <strong>Mitigate interview costs as best as possible. </strong>Travel, lodging and incidental costs related to interviews will be a huge chunk of your residency application costs. Think about how to take frugal shortcuts.</p> <p> For example, Jason Hall, a fourth-year medical student at the University of Alabama at Birmingham School of Medicine, said he started accumulating frequent flier miles well in advance and scheduled his residency interviews back-to-back in specific locations. Hall is interviewing for anesthesia residencies.</p> <p> “I knew because of the field I’m going into that no [program] would be paying for my flights or hotel rooms, and I knew it was going to be expensive,” Hall said. “The only thing I can attempt to control is to schedule as few trips as possible. I have three interviews back-to-back in New York, and I’m on the waitlist for a fourth interview to avoid a second trip.”</p> <p> You might also consider working through your medical school or undergraduate school’s alumni office or social networking groups to see whether any alumni who live in the area would be able to host you, instead of paying for a hotel.</p> <p> Get more ideas on how to keep interview costs down at the <a href="https://www.aamc.org/services/first/first_factsheets/94396/cost_of_applying_for_medical_residency.html" rel="nofollow" target="_blank">Association of American Medical Colleges website</a>.</p> <p> <strong>Try not to rely on credit cards. </strong>Robert Yermish, financial advisor in Philadelphia who works with AMA Insurance as a member of their Physicians Financial Partners program, frequently works with residents and young physicians. He said it’s difficult to budget for the fourth year of medical school and the uncertainty it can bring, but students shouldn’t rush to charge everything to credit cards. If you are going to incur more debt, it should be smart debt—and credit cards often have much higher interest than medical school loans.</p> <p> “The right answer is that you stop the credit cards, because a lot of people end up trying to use credit cards as a tool to get through medical school or residency,” Yermish said. “Which form of debt would I prefer? I’d rather see it from a med loan than a Visa.”</p> <p> AMA members can take advantage of the <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program/education-financing.page" target="_blank">Wells Fargo <em>MedCAP-XTRA</em></a> loan, which offers low interest, to help cover expenses related to residency interviews. You also can ask your school’s financial aid office for resources.</p> <p> <strong>How are you managing your money? </strong>Tell us in a comment below at <em>AMA Wire</em>®, or post your thoughts on the AMA Medical Student Section <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cede35fc-ddf3-47c6-811c-d13e4f314f40 How to grow healthier as you grow older: Register by Oct. 31 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_grow-healthier-grow-older-register-oct-31 Mon, 20 Oct 2014 21:00:00 GMT <p> Join the AMA Senior Physicians Section (SPS) Nov. 8 in Dallas to hear keynote speaker Kenneth Cooper, MD, a former U.S. Air Force physician and director of the Aerospace Medical Laboratory. As a leading pioneer of preventive medicine, Dr. Cooper will discuss some of his lifelong experiences focusing on health and wellness and how they link to longevity and quality of life<strong>. </strong>Join your senior physician colleagues for this time of learning and fellowship.</p> <p> The AMA-SPS business meeting will be held from 11:30 a.m. to 12:30 p.m., followed by the keynote presentation from 12:30 p.m. to 1:30 p.m. in the Peacock Terrace Room. A luncheon will be served at 11:30 a.m. on a first-come, first-served basis.</p> <p> Advanced registration is appreciated. <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144180E&TID=cQGPLA3hGE6boUwT4nFrLQ%253d%253d&OID=130" target="_blank">Register online</a> (log in) by Oct. 31. If you have questions about the meeting or registering, please contact Alice Reed of the AMA via <a href="mailto:alice.reed@ama-assn.org" rel="nofollow">email</a> or at (312) 464-5523.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5249d5ba-5924-4bd2-809b-6c150e59d528 Apply for senior physician excellence in volunteerism award http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_apply-senior-physician-excellence-volunteerism-award Mon, 20 Oct 2014 21:00:00 GMT <p> The Jack B. McConnell, MD, Award for Excellence in Volunteerism recognizes the work of senior physicians who provide treatment to U.S. patients who lack access to health care. After a full career of practice, these physicians remain dedicated to the future of medicine through the spirit of volunteerism.</p> <p> Nominees must have volunteered a significant portion of their medical services while over the age of 55 and have demonstrated their commitment to health care access by assisting underserved U.S. patients. The application deadline is Jan. 20 at 6 p.m. Eastern time. <a href="http://www.ama-assn.org/resources/doc/ama-foundation/x-pub/excellence-named-award-application.doc" target="_blank">Download an application</a> (log in) today.</p> <p> Last year’s recipient, Samuel A. Cassell, MD, has spent much of his post-retirement career as founding chair of the Bergen Volunteer Medical Initiative. Inspired by participating in medical trips to the Far East and Haiti, Dr. Cassell and a team of dedicated individuals in 2009 created a five-day-a-week health center that offers free health care to working low-income, uninsured residents of Bergen County, New Jersey.</p> <p> Five years into its existence, the Bergen Volunteer Medical Initiative has 65 medical volunteers and staff who care for some 1,000 patients during 6,000 medical visits annually.</p> <p> Learn more about the volunteerism award and others that are a part of the AMA Foundation’s <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/public-health/excellence-medicine-awards.page?" target="_blank">Excellence in Medicine Awards</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:0e6bbefd-72b1-4fc8-9e47-329bebb54da9 New hospital accreditation chapter puts heightened focus on safety http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-hospital-accreditation-chapter-puts-heightened-focus-safety Mon, 20 Oct 2014 21:00:00 GMT <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:"">The Joint Commission has released a </span><a href="http://www.jointcommission.org/patient_safety_systems_chapter_for_the_hospital_program/" target="_blank" rel="nofollow"><span style="font-size:10.0pt;font-family:"">new chapter</span></a><span style="font-size:10.0pt;font-family:""> on patient safety systems in the <em>2015 Comprehensive Accreditation Manual for Hospitals</em>. The purpose of the chapter is to inform and educate hospital leaders about the importance and structure of an integrated patient-centered system that aims to improve quality of care and patient safety.<p></p></span></p> <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:""> </span></p> <p style="margin:0in;margin-bottom:.0001pt;"> <span style="font-size:10.0pt;font-family:"">“A solid foundation for patient safety is a safety culture,” Ana Pujols McKee, MD, executive vice president and chief medical officer of the Joint Commission said in a </span><a href="http://www.jointcommission.org/new_hospital_accreditation_chapter_puts_heightened_focus_on_safety/" target="_blank" rel="nofollow"><span style="font-size:10.0pt;font-family:"">news release</span></a><span style="font-size:10.0pt;font-family:"">. “For leaders, our hope is they will study this chapter and use it as a tool to build or improve their safety culture program.” <p></p></span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1f4336e0-050b-4f17-a5cf-a20ab8ee09cc Comment on Code of Medical Ethics revisions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-code-of-medical-ethics-revisions Mon, 20 Oct 2014 20:12:00 GMT <p> As the process to update the <em>Code of Medical Ethics</em> moves forward, AMA members can <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/ceja-discussion-forum.page" target="_blank">comment</a> (log in) on the updated draft language that will serve as the ethical guide for physicians in the future.</p> <p> The AMA Council on Ethical and Judicial Affairs (CEJA) is in the final stages of modernizing the 167-year-old <em>Code</em>, last comprehensively updated more than 50 years ago. CEJA hosted an open forum at the 2014 AMA Annual Meeting to receive feedback on the draft <em>Code</em>, and also considered feedback from AMA members submitted to its online forum between January and the end of June.</p> <p> The modernized <em>Code</em> will appear as CEJA Report 3-I-14 in the Delegates Handbook for the 2014 AMA Interim Meeting. Comments posted online will be available to the Reference Committee on Amendments to Constitution and Bylaws.</p> <p> In its six-year project to modernize the <em>Code, </em>the council reviewed ethical opinions for relevance, timeliness, clarity and consistency across topics and incorporated feedback from the medical community to produce an updated <em>Code</em> with a more intuitive chapter structure. CEJA then revised the <em>Code</em>, working conservatively to ensure the only changes were those that were absolutely necessary for the guidance to remain relevant in the face of changes in biomedical science and conditions of medical practice.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e7269b6d-280e-48c5-9690-ec6031db72a7 Better blood pressure, no added burden: One practice’s story http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_better-blood-pressure-added-burden-one-practices-story Mon, 20 Oct 2014 18:53:00 GMT <p> A Chicago-area physician has achieved a 90 percent control rate for his hypertension patients in the past year by working with his medical assistant, nurse and other staff members to execute standardized blood pressure protocols in the practice.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/90aee340-a790-4331-8848-f213ac50be25.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/90aee340-a790-4331-8848-f213ac50be25.Large.jpg?1" style="float:right;margin:10px;" /></a>Family medicine physician Michael K. Rakotz, MD (pictured right), is using a team-based care approach to improve hypertension control in his office. Dr. Rakotz is part of a pilot program of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, which involves physicians and their teams at multiple clinic sites in two states. Participating practices are incorporating evidence-based principles into their workflows to control hypertension.</p> <p> Since the start of the pilot, Dr. Rakotz’s practice has seen a double-digit leap in the number of hypertensive patients who have their blood pressure controlled, moving from 78 percent to 90 percent in 12 months. He attributes the practice’s success to the work of his practice staff, who have been trained in a standardized <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctor-quickly-improved-patients-blood-pressure-readings" target="_blank">checklist approach</a> to measuring blood pressure.</p> <p> Dr. Rakotz’s medical assistant (MA) follows a procedure to measure accurately. If an initial automated reading shows that blood pressure is elevated, she follows a specified protocol using an automated machine that takes multiple readings over six minutes, with no staff in the room to reduce the “white coat” effect on the patient’s blood pressure. If these readings indicate the patient has high blood pressure, the MA flags this information for Dr. Rakotz.</p> <p> “All of this occurs before the physician enters the room, so the system is very efficient,” Dr. Rakotz said. “It does not add any burden to the physician.”</p> <p> The practice also has a strong home-monitoring program for patients whose blood pressure management requires more clinical data. Practice staff give these patients a special checklist that explains how to properly position themselves for measurement as well as when and how often they should be measuring their blood pressure. Staff can validate and check the accuracy of patients’ personal blood pressure machines or lend patients machines that record a week’s worth of blood pressure readings.</p> <p> Practice staff enters all data from patients’ home monitoring into the practice’s electronic health record system.</p> <p> “This brings actionable information to the physician before the physician even walks into the exam room,” Dr. Rakotz said. “Those kinds of little innovations, little empowerments of the staff, make the system function really well.”</p> <p> He also employs a nurse to take charge of patient outreach.</p> <p> The challenge up front is training staff to understand and appropriately implement checklists and protocols. After that, “it’s autopilot,” Dr. Rakotz said.</p> <p> “Physicians are so overwhelmed with meaningful use criteria, insurance authorizations, paperwork and forms—all this nonclinical care,” he said. “Anything our staff can do to help us is huge. The more time I have to care for patients, the better. I want [my staff] to be smart and follow protocols using common sense. If someone has high blood pressure, I want my staff to know what to do. I want them to follow a set of guidelines.”</p> <p> The AMA pilot is working with researchers at Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop test protocols, including the one Dr. Rakotz uses. The tools are being refined before being made available to physicians across the country.</p> <p> “Even if you’re in a more rural, smaller practice, the more time you invest in training your staff up front, the more dividends you’re going to get on the back end in quality of care,” Dr. Rakotz said. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1a5e919a-05e5-4c69-b24e-abacd64fce17 Video: How physicians can see patients’ “unvisible” problems http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-can-see-patients-unvisible-problems Fri, 17 Oct 2014 23:05:00 GMT <p> Medicine gives physicians ways to see the invisible through X-rays, CAT scans and microscopes. But how can physicians see the “unvisible”—the uncomfortable topics that patients might need to discuss? One physician recently shared how physicians can uncover the details.</p> <p> <object align="right" data="http://www.youtube.com/v/uKlAV-RH-po" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/uKlAV-RH-po" type="application/x-shockwave-flash" vspace="15" width="365"><param name="movie" value="http://www.youtube.com/v/uKlAV-RH-po" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="15" quality="best" src="http://www.youtube.com/v/uKlAV-RH-po" type="application/x-shockwave-flash" vspace="15" width="365" wmode="transparent"></embed></object>Stacy Tessler Lindau, MD, director of the University of Chicago Medicine’s program in integrative sexual medicine, <a href="http://youtu.be/uKlAV-RH-po" rel="nofollow" target="_blank">discussed her work</a> to help identify, treat and prevent sexual health problems in female cancer patients at the AMA’s recent Inspirations in Medicine event.</p> <p> One of Dr. Lindau’s female patients, Mrs. Jones, who had been a widow for years, had endometrial cancer. After Mrs. Jones’ family left for the day, she shared a secret with Dr. Lindau: She had a male companion that her children didn’t know about, and the patient feared her condition would worsen and her companion wouldn’t get the news.</p> <p> “Here she is at a critical moment in her life, and she couldn’t even share with her family …. She couldn’t share the relationship, nor could she gain the full benefit of that relationship,” Dr. Lindau said.</p> <p> Dr. Lindau explained how oncologists need to treat cancer, and other specialists need to focus on the patient’s illness that relates to that specialty, but it’s also important to understand other issues plaguing patients, including their sexual health. That should not be limited to the clinical aspect of sexual health but include how sexuality relates to health, such as how important Mrs. Jones’ partner was at this critical moment in her life, or how cancer treatment might affect a patient’s sex life.</p> <p> Physicians can “address the issue of sexuality, and give women information so they can know if they experience a problem, and it’s not just in their heads,” Dr. Lindau said. “Patients [need to] know they’re not alone if they experience these symptoms.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" rel="nofollow" target="_blank">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b46be3d-3757-4b0f-8cfb-d4deccdeb41f Is the U.S. ready for Ebola? JAMA Network authors comment http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ready-ebola-jama-network-authors-comment Fri, 17 Oct 2014 22:55:00 GMT <p> A <a href="http://jama.jamanetwork.com/article.aspx?articleid=1918850" rel="nofollow" target="_blank">new Viewpoint</a> in <em>JAMA</em> looks at how the United States has handled Ebola screening, prevention and treatment thus far and touches on how best to control the international spread of the virus.</p> <p> The <em>JAMA</em> Viewpoint covers management of the Dallas Ebola cases, health system preparedness, isolation and quarantine, public health emergencies, international travel screening, and risk reduction.</p> <p> A <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1918461" rel="nofollow" target="_blank">second Viewpoint piece</a>, published in <em>JAMA Pediatrics</em>, examines what health care professionals need to know about Ebola when working with children. The article looks at transmission of Ebola to children, manifestations of the virus in children and specific considerations for pediatric professionals.</p> <p> <strong>Looking for additional expert information about Ebola?</strong> Get the facts from credible sources via the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bc8827e-7356-466d-ac54-613e867d0845 Make an impact on an upcoming election: AMPAC shows you how http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_impact-upcoming-election-ampac-shows Fri, 17 Oct 2014 22:44:00 GMT <p> Physicians, residents and students who want to actively influence health care policy can do so in a big way with help from AMPAC, the AMA’s bipartisan political action committee. Whether it’s running for public office or campaigning for a candidate who supports issues that are important to medicine, AMPAC offers programs to help physicians and doctors in training meet their political goals.</p> <p> <strong>Training for a successful candidacy</strong></p> <p> For AMA members or their spouses considering a run for public office, the <a href="http://www.ampaconline.org/political-education/ampac-candidate-workshop/" target="_blank" rel="nofollow">AMPAC Candidate Workshop</a> taking place Feb. 20-22 in Arlington, Virginia, helps physicians make the leap from the exam room to the campaign trail. The workshop provides training in campaign strategizing, media advertising, public speaking and fundraising.</p> <p> At the workshop, political veterans will share their advice about politics and explain the sacrifices required to run a competitive campaign. Attendees also will learn the secrets of effective fundraising, how to become a better public speaker and how to handle campaign crises, among other skills.</p> <p> In the 2012 elections, 13 graduates of the workshop were elected to state and federal offices. Thus far in 2014, 14 graduates have won primary elections.</p> <p> “The AMPAC program helped immeasurably,” anesthesiologist Steve Dickerson, MD, said. He won a seat in the Tennessee Senate in November 2012 after attending the AMPAC Candidate Workshop in 2007.</p> <p> “While I had always had an interest in politics, I had never been exposed to the nuts and bolts in any manner,” Dr. Dickerson said. “The program gave me an overview and provided the foundation for what I learned subsequently.”</p> <p> <strong>Learning the ropes of campaigning</strong></p> <p> For AMA members, spouses and state medical association staff who want to become more involved in campaigning for their candidates, the <a href="http://www.ampaconline.org/political-education/ampac-campaign-school/" target="_blank" rel="nofollow">AMPAC Campaign School</a> offers hands-on training.</p> <p> This five-day “boot camp” for politics centers around a simulated congressional campaign, during which attendees are trained in advertising, public speaking and fundraising and participate in such practical exercises as recording radio ads and writing fundraising letters. The campaign school takes place April 15-19 in Arlington, Virginia.</p> <p> Excluding travel, AMPAC covers all expenses for applicants who are accepted to one of these programs—an excellent value for AMA membership.</p> <p> <a href="http://www.ampaconline.org/political-education/apply/" target="_blank" rel="nofollow">Apply today</a> to participate in one of these education programs so you can influence an upcoming election for the better. If you’re not an AMA member, now is the time to <a href="https://commerce.ama-assn.org/membership/" target="_blank">join</a>.</p> <p> <strong>Special application deadlines for medical students: </strong>Student admission to these educational programs is limited, so applicants are selected based on a 500-word essay about why they would like to attend and what they hope to gain from participating. The deadline for medical student applications for the Candidate Workshop is Dec. 12, and the application deadline for the Campaign School is Jan. 23.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e0159a37-940e-4a9a-a459-aa0578ca14c0 Preparing for Ebola: How physicians are taking action http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_preparing-ebola-physicians-taking-action Fri, 17 Oct 2014 22:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/9/5fff8609-1f70-4ffe-995a-66463dabae6b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/9/5fff8609-1f70-4ffe-995a-66463dabae6b.Large.jpg?1" style="margin:15px;float:left;" /></a><em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> As a physician and frequent international traveler, the recent Ebola developments have been on my mind. Despite the increasing attention from the media, we as physicians know that this is not a time to panic but a time to prepare.</p> <p> The AMA has created an online <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> to provide physicians with the expert information they need to understand Ebola, prepare their hospitals or practices, screen and diagnosis for the virus, and treat patients. Key resources and information for the public also are included.</p> <p> Having the most up-to-date information from the leading voice—the Centers for Disease Control and Prevention—and other expert sources can help us answer questions and assess patients who could present with symptoms. The resource center, available at <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">ama-assn.org/go/ebola</a>, will be regularly updated as new resources are released, so bookmark the page for your quick reference and share it with your colleagues and staff.</p> <p> Physicians globally are making sure their communities are prepared. I just returned from the general assembly of the World Medical Association in Durban, South Africa, where delegates from nearly 50 national medical associations passed an <a href="http://www.wma.net/en/30publications/10policies/30council/cr_19/index.html" rel="nofollow" target="_blank">emergency resolution</a> calling for comprehensive tactics to prevent and treat the Ebola virus, including adequate equipment, training and aid. Clearly, this is a hot topic that is getting the attention it deserves from physicians around the world.</p> <p> Follow <em>AMA Wire</em>® for <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">ongoing coverage</a> of what you need to know about the virus.</p> <p> <em>Editor's note:</em> <a href="http://www.cbsnews.com/videos/was-the-u-s-health-care-system-prepared-to-handle-ebola-cases/" target="_blank" rel="nofollow">Watch Dr. Wah's appearance</a> on CBS' Face the Nation Sunday discussing efforts to prevent the spread of Ebola in the United States.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:36d25c89-1ae8-4946-8a24-c4a69f754a77 JAMA Highlights: Study estimates 14 million major smoking-related U.S. medical conditions http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-estimates-14-million-major-smoking-related-medical-conditions Thu, 16 Oct 2014 18:03:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/qNcpltuYwKY" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/qNcpltuYwKY" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/qNcpltuYwKY" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" quality="best" src="http://www.youtube.com/v/qNcpltuYwKY" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA <em>video: Two widely used quality metrics for obstetric care are not associated with severe complications for mothers and babies.</em></span></td> </tr> </tbody> </table> <p> <strong>Study indicates need for more obstetric quality-of-care measures at hospitals</strong><br /> In an analysis of data on more than 100,000 deliveries and term newborns from New York City hospitals, rates for certain quality indicators and complications for mothers and newborns varied substantially between hospitals and were not correlated with performance measures designed to assess hospital-level obstetric quality of care, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1915608" target="_blank" rel="nofollow">study</a> in the Oct. 15 issue of the <em>Journal of the American Medical Association</em> (<em>JAMA</em>)<em>.</em> Watch a <a href="http://youtu.be/qNcpltuYwKY" target="_blank" rel="nofollow">video</a> on the study.</p> <p> <strong>Better performance for skilled nursing facilities may not result in better patient outcomes</strong><br /> Among fee-for-service Medicare beneficiaries who received care at a skilled nursing facility following hospital discharge, better performance on various measures of quality of care was not consistently associated with a lower risk of hospital readmission or death at 30 days, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1915609" target="_blank" rel="nofollow">study</a> in the Oct. 15 issue of <em>JAMA.</em></p> <p> <strong>Study estimates 14 million major smoking-attributable medical conditions in U.S.</strong><br /> Adults in the United States suffered from approximately 14 million major medical conditions attributable to smoking. Smoking is the leading cause of preventable disease in the United States. Cigarette smoking harms nearly every organ and organ system in the body. The authors of the <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1915870" target="_blank" rel="nofollow">study</a> in <em>JAMA Internal Medicine</em> estimated major medical conditions (morbidity) attributed to smoking in 2009.</p> <p> <strong>No association seen between physical activity, depressive symptoms in adolescents</strong><br /> A <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1911003" target="_blank" rel="nofollow">study</a> of teenagers in <em>JAMA Pediatrics </em>suggests there is no association between physical activity and the development of depressive symptoms later in adolescence.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d80623ad-373f-4eb4-a578-089fcb6ace48 AMA assembles Ebola resources for physicians and public http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-assembles-ebola-resources-physicians-public Wed, 15 Oct 2014 23:50:00 GMT <p> The Centers for Disease Control and Prevention (CDC) on Sept. 30 confirmed the first U.S. case of Ebola, and developments associated with the virus continue to unfold. Prepare your practice and your patients with resources developed by Ebola experts and assembled by the AMA in one convenient location.</p> <p> Visit the AMA’s online <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/ebola-resource-center.page" target="_blank">Ebola Resource Center</a> for information from the CDC and other public health groups. Resources cover:</p> <ul> <li> Understanding the virus</li> <li> Preparing your hospital or practice</li> <li> Screening and diagnosing Ebola</li> <li> Treating patients with the virus</li> </ul> <p> The resource center will be updated regularly to give you, your practice staff and your patients the most up-to-date information you need. Save <a href="http://www.ama-assn.org/go/ebola" target="_blank">ama-assn.org/go/ebola</a> to your favorites for an easy reference.</p> <p> Watch <em>AMA Wire</em><sup>®</sup> for ongoing <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Ebola/1" target="_blank">Ebola coverage</a> provided by the AMA.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:db0a244b-8967-4f36-8d26-a4011d6434b2 Ways residents have found to conquer burnout http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ways-residents-found-conquer-burnout Wed, 15 Oct 2014 20:28:00 GMT <p> Emotional exhaustion, feelings of cynicism, detachment from patients—do these symptoms sound familiar? They can signal professional burnout, which studies show is more prevalent among physicians than other professionals. Experienced residents and fellows offer advice on what you can do to avoid burnout during training and become a more satisfied, resilient physician.</p> <p> Medical students and residents are more likely to be burned out, depressed or fatigued compared to similarly aged college graduates pursuing other careers, according to a recent <a href="http://journals.lww.com/academicmedicine/Citation/2014/03000/Burnout_Among_U_S__Medical_Students,_Residents,.25.aspx" rel="nofollow" target="_blank">study</a> in <em>Academic Medicine</em>.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/6cefac80-74ac-4dfa-81a4-779993757afb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/6cefac80-74ac-4dfa-81a4-779993757afb.Large.jpg?1" style="float:right;margin:10px;" /></a>“I think that intern year can be quite intimidating and overwhelming, and everyone feels like they are starting to burn out,” said Anna Piotrowski, MD, chief resident of the adult psychiatry residency program at the University of Chicago. “At that point, medicine becomes a job and a routine that you have to get through every day, instead of something engaging and enjoyable.”</p> <p> When that feeling crept in, Dr. Piotrowski said her solution was to maintain perspective and make time to relax and unwind.</p> <p> Tina Shah, MD, a pulmonary and critical care fellow at the University of Chicago and chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section.page" target="_blank">Resident and Fellow Section</a> (RFS), echoed Dr. Piotrowski’s advice.</p> <p> “I tried not to isolate myself when I was feeling burned out and let off steam with my co-residents, who understood what I was going through,” Dr. Shah said. “When I was really motivated, exercising helped me feel less burned out.”</p> <p> Dr. Shah also recommends having a specific hobby.</p> <p> “Whether it’s running, playing video games or routine dinners with friends, this one activity will help you let go of the stress at work,” she said.</p> <p> “It’s important to remember you are a human being with wants, needs and desires, rather than just someone in medical training,” Dr. Piotrowski said.</p> <p> To prevent burnout before it sets in, many medical schools and residency programs are investigating and implementing resiliency training, teaching trainees to prioritize self-care and how to effectively manage their emotions.</p> <p> Most graduate medical education programs have wellness resources, both for physical and mental issues. These resources range from stress management programs to help centers and exercise programs.</p> <p> Although stress is inevitable, burnout is preventable. Make sure to identify coping strategies that work for you, and seek help if you need it.</p> <p> “Burnout is dangerous, both for ourselves and for our patients,” Dr. Piotrowski said. “When you are an exhausted and unhappy medical student or resident, you may not be very good at taking care of your patients. You can get ahead of the situation and prevent it.”</p> <p> <strong>You tell us: </strong>What methods do you use to beat burnout? Comment below at <em>AMA Wire</em><span style="font-size:12px;">®</span><em style="font-size:12px;"> </em><span style="font-size:12px;">or on the AMA-RFS </span><a href="https://www.facebook.com/amaresidentsandfellows" rel="nofollow" style="font-size:12px;" target="_blank">Facebook page</a><span style="font-size:12px;">.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1094dea0-b71f-46af-af26-c87f64280d0b 5 things to know about clinical data registries http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-things-clinical-data-registries Wed, 15 Oct 2014 20:00:00 GMT <p> As more federal regulations require reporting via clinical data registries, it’s important to understand what these registries are and how they work. Here are five things you need to know about clinical data registries and why they matter.</p> <ol> <li> <strong>Clinical data registries record information about patients’ health status and the care they receive over time. </strong>These registries typically focus on patients who share a common reason for needing care, allowing physicians to see what treatments are available and how patients with different characteristics respond to certain treatments.</li> <li> <strong>Different types of registries track specific aspects of care.</strong> A registry may focus on a disease or condition, a procedure, or a medical device. The registry defines a patient population, then recruits physicians and other health care professionals to submit data on a representative sample of those patients.</li> <li> <strong>Data are used in treatment analyses.</strong> Studying attributes of the population in the registry—and finding patterns—can help identify particular outcomes. Because all of the factors that might have an impact on outcomes are not necessarily known at the time of data collection, the data are stored and can be revisited to evaluate previously unrecognized associations.</li> <li> <strong>Data are collected via secure online portals or electronic health record (EHR) systems. </strong>As data enter the clinical data registry, quality checks are performed to ensure that the data are correct and complete. If something is missing or outside of the expected range, registry staff ask the submitting physician to review and verify the data.</li> <li> <strong>Registries help improve health care quality and safety.</strong> Registries are used for comparing the effectiveness of different treatments, evaluating different approaches to a procedure, and monitoring the safety of implanted devices. Information from registries is also increasingly employed to ensure that payment is adjusted based on the quality of care provided, or to give patients the information they need to make better choices.</li> </ol> <p> The <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/nqrn.page" rel="nofollow" target="_blank">National Quality Registry Network</a>, a voluntary network of organizations that operate registries, offers more detailed information about clinical data registries.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:080747b2-7e4f-4d10-8485-a2c3d600290a Record release law for medical liability suits upheld in court http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_record-release-law-medical-liability-suits-upheld-court Wed, 15 Oct 2014 19:18:00 GMT <p> A federal appeals court has upheld a state law that requires plaintiffs to release their relevant protected health information before proceeding with allegations of medical liability.</p> <p> In <em>Murphy v. Dulay</em>, the appeals court overturned a lower court ruling that said a Florida law requiring the release of relevant health information was impermissible under the federal Health Insurance Portability and Accountability Act (HIPAA).</p> <p> The state law requires authorization from a person seeking to bring a medical liability lawsuit so that the prospective defendant may obtain documents and conduct interviews with the plaintiff’s other medical professionals on matters pertinent to the liability claim.</p> <p> The appeals court found that the written authorization form required by the Florida law “is fully compliant with the HIPAA statute and its regulations.”</p> <p> This state law is patterned after a Texas law passed in 2003 that has enabled information sharing during early stages of medical liability claims. The purpose of the law is to screen out frivolous lawsuits and promote early settlement of claims that do have merit.</p> <p> As a result of that law, “the frequency of meritless claims has dropped substantially,” the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?">Litigation Center</a><a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page?" target="_blank"> of the AMA and State Medical Societies</a> said in a <a href="http://www.ama-assn.org/resources/doc/legal-issues/x-pub/murphy-v-dulay.pdf" target="_blank">friend-of-the-court brief</a> (log in) submitted in this case. Other parties in the brief include the Florida Medical Association and the Texas Medical Association.</p> <p> Other benefits the brief highlights are improved access to care, an increase in physicians generally, and a greater number of specialists serving at-risk patients and rural communities.</p> <p> Visit the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/professional-liability.page" target="_blank">Litigation Center Web page</a> to learn more about this case and other key medical liability cases in which it has been involved.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8024f28d-e3a0-4ae9-9bf9-01a6901f585d 4 key changes needed for EHR meaningful use program http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_4-key-changes-needed-ehr-meaningful-use-program Tue, 14 Oct 2014 20:10:00 GMT <p> Challenges with electronic health record (EHR) systems are widespread, and the meaningful use program has only compounded those problems. Physicians this week called on the government to make four essential changes to meaningful use so EHR technology can become a tool for practice efficiency and enhanced patient care.</p> <p> In a 31-page <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/2014-10-14-meaningful-use.pdf" target="_blank">comment letter</a> (log in) submitted Tuesday to the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT, the AMA provided a blueprint for the future of the meaningful use program ahead of the announcement of Stage 3 requirements expected later this year.</p> <p> The four chief changes the letter outlines are:</p> <p style="margin-left:.25in;"> <strong>1. </strong><strong>Adopting a more flexible approach for meeting meaningful use. </strong>Among the components the letter identifies for achieving this flexibility are eliminating the concept of menu versus core requirements, revising the measures list to meet the needs of specialists and requiring physicians to meet no more than 10 measures under Stage 3.<br /> <br /> The letter also reiterates the AMA’s recommendation that CMS abandon the program’s all-or-nothing approach by adopting a 50 percent threshold for incurring a penalty and a 75 percent threshold for earning an incentive in Stages 1 and 2.<br /> <br /> Making the program more flexible “will also help mitigate challenges physicians are facing from factors outside of their control, such as EHR interoperability, usability issues and meeting measures that are contingent upon patient action,” the letter states.</p> <p style="margin-left:.25in;"> <strong>2. </strong><strong>Expanding hardship exemptions for all stages. </strong>Eligibility for an exemption for quality measures should include successful participation in the Physician Quality Reporting System (PQRS) and a broader list of “unforeseen circumstances” that prevent physicians from meeting meaningful use requirements. The letter also calls for exemptions for physicians close to retirement and hospitalists, who have little control over the technology available to them.<br /> <br /> <em>Note: If your practice needs a hardship exemption for 2014, CMS </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cms-reopens-period-apply-meaningful-use-hardship-exemption" target="_blank"><em>recently announced</em></a><em> that physicians have until Nov. 30 to apply.</em></p> <p style="margin-left:.25in;"> <strong>3. </strong><strong>Improving quality reporting. </strong>In particular, the letter urges CMS to build a sufficient quality infrastructure and continue to allow physicians to report on a menu of quality measures.<br /> <br /> The letter also stresses that EHRs must be made interoperable so physicians can focus more on outcomes and longitudinal tracking of patient care. That includes developing standards for sharing data between EHRs and clinical data registries.</p> <p style="margin-left:.25in;"> <strong>4. </strong><strong>Addressing physician EHR usability challenges. </strong>Citing the increasing dissatisfaction with this technology as evidenced in the <a href="http://www.rand.org/pubs/research_reports/RR439.html" target="_blank" rel="nofollow">AMA-RAND study</a> released last year, the letter points to how today’s EHRs are characterized by poor usability, time-consuming data entry, interference with face-to-face patient care, insufficient health information exchange and degradation of clinical documentation.<br /> <br /> “There is growing awareness across stakeholders that the meaningful use vendor certification process should be streamlined to enable higher performing products that focus on interoperability, quality measurement reporting and privacy/security,” the letter states.<br /> <br /> In addition, “EHRs should facilitate interoperability among various facilities that comprise our health care system, including hospital inpatient, ambulatory settings, lab and pharmacies.”</p> <p> “The whole point of the EHR incentive program was to build an interoperable health information technology infrastructure that would allow for the routine exchange of important medical information across settings and providers and put medical decision-making tools in the hands of physicians and patients, yet that vision is not being realized,” AMA President Robert M Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-14-ama-blueprint-improve-meaningful-use.page" target="_blank">statement</a>. “Physicians should not be required to meet measures that are not improving patient care or use systems that are decreasing practice efficiencies.”</p> <p> The AMA’s advocacy on this topic is supported by a <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) for EHR usability released last month. Developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives, the framework offers <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight top challenges and solutions</a> that can leverage the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:bfa4ca9a-ba2d-4dfa-bf4d-138b6596c2db Interactive, on-demand training helps prepare for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_interactive-demand-training-helps-prepare-icd-10 Tue, 14 Oct 2014 20:06:00 GMT <p> Get help transitioning from the ICD-9 to ICD-10 code sets with interactive training that fits with your schedule.</p> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2440007&navAction=push" target="_blank"><em>3M™ ICD-10 Education Program: Physician Practice Package</em></a> provides Web-based training delivered in the specific context needed for different job functions and matches trainees to the appropriate education track. The training covers 19 specialties and includes:</p> <ul> <li> Physician documentation videos, with samples of documentation improvement and tips</li> <li> <span style="font-size:12px;">ICD-10 modules split between diagnostic and procedural coding that include printable references, case studies, practice questions and self-assessment tests by job function</span></li> <li> <span style="font-size:12px;">Two awareness courses—one for administrative staff, and a more advanced course for ancillary staff</span></li> </ul> <p> Access the training from any location, at any time, as often as you need.</p> <p> The deadline to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-year-countdown-icd-10-begins-start-transition-now" target="_blank">comply with ICD-10</a> is less than a year away. While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8bb65b6c-f48d-42bc-a181-995606a3c0a7 Culturally competent physicians can reduce disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_culturally-competent-physicians-can-reduce-disparities Tue, 14 Oct 2014 20:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/9/6a5cf07b-7997-4575-a9e1-eac5b8df2fc4.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/9/6a5cf07b-7997-4575-a9e1-eac5b8df2fc4.Large.jpg?1" style="float:left;margin:10px;" /></a>Last week, I wrote about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-tackling-health-care-disparities" target="_blank">what physicians are doing</a> to tackle health care disparities. One of the ways we can reduce health care disparities is to ensure we’re promoting diversity in the health care workforce. As an educator, this is important to me.</p> <p> Diversity and cultural competency are aspects of physician training that some of the schools awarded grants from the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative are working on. Schools are moving to competency-based curriculum, which can potentially reduce the time needed for medical school, meaning it’s less expensive. They’re also focusing on population health in their local communities.</p> <p> For example, the University of California Davis School of Medicine’s new three-year primary care program, ACE-PC, has developed an innovative admissions and recruitment program to select students from diverse backgrounds, with the goal of these students going on to work in underserved communities as primary care physicians. Half of the students admitted into the first class of the program are from groups historically underrepresented in medicine.</p> <p> We, as physicians, should ensure we’re an accurate reflection of the population we serve. A broad spectrum of backgrounds and experiences can unite us in improving health care overall and in our local communities. This starts with attracting and retaining a diverse medical school body.</p> <p> To dive further into this topic, the AMA is hosting an online Google Hangout to discuss the most important factors in attracting a medical student body that reflects a diverse patient population.</p> <p> Experts, educators and physicians in training will hang out online from 8 p.m. to 9 p.m. Eastern time Oct. 20 Anyone can watch the event live or stream it later. To participate in the live-streaming event, simply visit the <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Hangout page</a>. If you would like to post questions for the panelists to answer, you will need to be a Google user. Participate in the discussion on Twitter and Facebook using #AMAHangout.</p> <p> Tonya Fancher, MD, UC Davis’ associate director for curriculum, will be answering questions as a panelist. Dr. Fancher will join Walter Bland, MD, associate dean for student affairs and admissions at the Howard University College of Medicine, and Jalia Tucker, a second-year medical student at the Chicago Medical School at Rosalind Franklin University of Medicine and Science. William McDade, MD, chair of the AMA Council on Medical Education and deputy provost for research and minority issues at the University of Chicago, will moderate the hangout.</p> <p> I hope you’ll join the hangout, or just listen to the discussion, about what medical schools can do to ensure students have the appropriate cultural competencies. The hangout is being jointly organized by the Accelerating Change in Medical Education initiative and the AMA Minority Affairs Section.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:acbee702-378d-41bc-be5c-353bbdd7c70f CDC bolstering efforts to equip health care workers for Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-bolstering-efforts-equip-health-care-workers-ebola Tue, 14 Oct 2014 20:00:00 GMT <p> <em>Updated at 8:39 a.m. Oct. 15 to include more information.</em></p> <p> Physicians and hospitals should be prepared to care for Ebola patients, Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, said Tuesday. His comments came after a Dallas nurse who had cared for the first Ebola patient in the United States was diagnosed with the virus.</p> <p> The nurse contracted Ebola despite wearing personal protective equipment. On Wednesday, the CDC <a href="http://www.cdc.gov/media/releases/2014/s1015-texas-second-health-care-worker.html" target="_blank" rel="nofollow">announced</a> a second health care worker at the Dallas hospital that treated the initial patient had also tested positive for Ebola.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/462d32ce-60eb-4a3a-955a-d9b5c2395c89.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/5/462d32ce-60eb-4a3a-955a-d9b5c2395c89.Large.jpg?1" style="float:right;margin:10px;" /></a>“I’ve been hearing loud and clear from health care workers from around the country that they’re worried, that they don’t feel prepared to take care of a patient with Ebola,” Dr. Frieden said. “Every hospital in the country needs to be ready to diagnose Ebola. … Anyone who cares for someone with a fever or signs of infection needs to ask, ‘Where have you been in the past month?’”</p> <p> Dr. Frieden said the CDC will ramp up webinars, conference calls and other outreach to U.S. health care workers to ensure physicians and hospital staff are prepared.</p> <p> The CDC is establishing an Ebola response team that will be dispatched to any hospital in the country that has a confirmed case of Ebola. The team will include experts in infection control, laboratory science, personal protective equipment and management of Ebola units.</p> <p> “We will put a team on the ground within hours,” Dr. Frieden said.</p> <p> He also said that health care workers should seek care immediately if they feel even a slight sore throat or headache. “We would much rather see a false alarm than someone who lets their illness go on for a day and potentially get sicker and expose it to others,” he said.</p> <p> The CDC offers a <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">special Web page</a> with resources for physicians to prepare for patients who might have the disease. The CDC and U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response have asked physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations. Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/screen-ebola-cdc-offers-resources" target="_blank">how to screen for Ebola</a> at <em>AMA Wire</em>®.</p> <p> “What we are dealing with is a disease that’s unfamiliar in the United States,” Dr. Frieden said. “Caring for Ebola can be done safely—but it’s hard. We want to make sure the protocol we have and the support we have for health care workers is there on the ground so we can assist.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:40eb3e73-70c7-4a82-97ce-1623e407bc55 What medical schools can expect in the future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-can-expect-future Tue, 14 Oct 2014 15:00:00 GMT <p> A special consortium of medical schools has spent the last year developing and implementing innovative ideas to transform the way future physicians are trained, and soon the medical education environment will experience the benefits of their efforts. In year two of its work, the consortium is testing and tweaking curriculum changes that other medical schools will be able to implement.</p> <p> “We’re shaping the physician of the future,” said Susan Skochelak, MD, group vice president for medical education at the AMA. “We’re creating the components of the medical school of the future, and our beacon that we’re working toward relates to readiness for practice. We want our physicians to hit the ground running.”</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/14/46e2075f-6d35-4cfc-9e6f-0a506b3e677a.Full.jpg?1" style="font-size:12px;" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/14/46e2075f-6d35-4cfc-9e6f-0a506b3e677a.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>Looking back</strong><br /> In January 2013, the AMA announced its intent to fund five to 10 medical schools to implement bold innovations in medical education. More than 80 percent of the country’s 141 eligible medical schools submitted proposals, a sign that schools were eager for widespread change. The AMA chose to fund 11 schools, each receiving a $1 million grant over five years in its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page">Accelerating Change in Medical Education</a> initiative.</p> <p> After initial planning, the 11 schools began to implement new tools and ideas in September 2013. Since then, each school has worked both autonomously and with the input from the other consortium schools and the AMA, sharing new ideas and methods with one another in special meetings. The schools first convened in October 2013 at the AMA’s Accelerating Change in Medical Education conference in Chicago, and have also come together at the University of Michigan Medical School and Vanderbilt University Medical School.</p> <p> <strong>Current work</strong><br /> So far, schools have taken deep dives into specific education areas and are working on new ways to test and evaluate future physicians. Overall, the initiative seeks to ensure learner readiness to succeed in the health care system of today and tomorrow, and to implement sustainable medical education transformation. As their work continues, the schools will make their discoveries available to other medical schools, making it easier to enact widespread change.</p> <p> The consortium’s work is focused in a few areas:</p> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-education-explores-competency-based-assessment" target="_blank"><strong>Competency-based assessment</strong></a><strong>.</strong> New assessment frameworks will allow students who show competence earlier in certain areas to move ahead more quickly or focus more time on other areas that need more instruction. Oregon Health and Science University School of Medicine is moving toward a learner-centered, competency-based curriculum, with progress based on predetermined milestones. The University of Michigan’s trunk-and-branches model is giving students a foundational “trunk” of knowledge, with different “branches” for students to pursue different courses of study that appeal most to them. Students’ pace through their program is based on achievement of specific milestones.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/two-schools-embracing-new-science-medical-education" target="_blank"><strong>Systems-based practice.</strong></a> Students will learn to navigate systems of care, quality improvement and population health—all which fall under the umbrella of the science of health care delivery—to optimize outcomes and cost. Pennsylvania State University College of Medicine will give students a 19-month program in systems-based practice topics, beginning in the first months of medical school and ending just before students enter clinical rotations. Students at Penn State also will become patient navigators linked with local clinics to gain experience in actually dealing with the health care system.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank"><strong>Adaptive, lifelong learners.</strong></a> The health care system is constantly changing, and new information is available every day. In the future, physicians will need to be adaptable and flexible, and to think critically about where and how to find information. Vanderbilt is instilling these qualities in its medical students with a special learning platform that lets students set their own learning goals, complete self-assessments and track their performance data.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-team-based-care" target="_blank"><strong>Team-based care.</strong></a> Future care delivery systems will require physicians to work on interprofessional teams. The Warren Alpert Medical School of Brown University incorporated interprofessional care into its curriculum, pairing medical students with students from other health profession schools to create patient care plans in special workshops. The workshops give medical students the chance to negotiate the role they play on teams and learn when to take the lead.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-school-curriculum-changes-aim-eliminate-health-care-disparities" target="_blank"><strong>Diversity and health care disparities.</strong></a> Diverse physicians will be necessary to meet the needs of underserved communities and address workforce gaps. The University of California Davis School of Medicine is choosing students from economically challenged backgrounds in the hopes that these students will work in underserved communities.</li> </ul> <ul> <li style="margin-left:0.25in;"> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/real-clinical-data-gives-medical-students-new-perspectives" target="_blank"><strong>Technology.</strong></a> Schools will use mobile apps, learning platforms, databases and more to give students instant access to information. New York University School of Medicine used large, open clinical data sets to create virtual patient panels, giving students access to information about the health care system and de-identified patient data. Indiana University School of Medicine created a teaching electronic health record, populated with de-identified patient data that updates in real-time.</li> </ul> <p> Curriculum changes alone aren’t enough for transformative change. Medical school faculty must be prepared to teach and develop these new ideas, and that’s why <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/faculty-development-crucial-med-ed-innovation" target="_blank">faculty development</a> also is a core part of the consortium’s work. The Brody School of Medicine at East Carolina University and Mayo Medical School are educating faculty on new competencies and working on how to incentivize faculty development.</p> <p> Finally, large-scale change is enormously difficult, so some schools are looking at how to smoothly transition to new curriculum at their institution and across the medical education environment. The University of California San Francisco is taking the lead in <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/project-gets-underway-ensure-sustainable-med-school-innovations" target="_blank">change management</a>, applying principles of business organizational change to medical schools. </p> <p> <strong>Moving forward</strong><br /> There’s been much progress in a year of implementation—but there’s a lot more to do. Heading into 2015, the schools will increase activation and adoption of their new curriculum models so other schools can begin enacting change, too.</p> <p> The consortium will also be moving on to new challenges, including how to involve graduate medical education.</p> <p> “Students are asking, ‘Is this going to get me the residency I want?’” said Bonnie Miller, MD, senior associate dean for health sciences education and associate vice-chancellor for health affairs at Vanderbilt. “I think we need to make sure that along the continuum, our efforts are focused on improving care delivery. … To sustain our successes, we need to think about other phases of education.”</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Changing_MedEd/1" target="_blank">Read more</a> about the Accelerating Change in Medical Education initiative at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a10f56c6-3bce-474d-b782-618c45547a92 AMA members serve as leaders in organized medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-members-serve-leaders-organized-medicine Tue, 14 Oct 2014 15:00:00 GMT <p> These AMA members were recently appointed by external organizations to leadership positions. These individuals were nominated by the AMA to the respective organizations. Each organization made the final appointment decision from among the candidates it received.</p> <p style="margin-left:.5in;"> <strong>Carol D. Berkowitz, MD</strong>, Rancho Palos Verde, California, has been appointed to the <strong>Accreditation Review Committee on Education for the Physician Assistant</strong> for a second term, effective January 2015. Dr. Berkowitz has also been appointed to the <strong>National Resident Matching Program</strong> Board of Directors, effective July 2014. Dr. Berkowitz has been an AMA member for 17 years.</p> <p style="margin-left:.5in;"> <strong>Anita K. Blanchard, MD</strong>, Chicago, has been appointed to the <strong>Obstetrics and Gynecology Review Committee of the Accreditation Council for Graduate Medical Education (ACGME)</strong>, effective July 2014. Dr. Blanchard has been an AMA member for two years.</p> <p style="margin-left:.5in;"> <strong>Donald W. Brady, MD</strong>, Nashville, has been appointed to the <strong>ACGME </strong>Board of Directors, effective September 2014. Dr. Brady has been an AMA member for three years.</p> <p style="margin-left:.5in;"> <strong>Dona S. Buchter, MD</strong>, Atlanta, has been appointed to the <strong>Pediatrics Review Committee of the ACGME</strong>, effective July 2015. Dr. Buchter has been an AMA member for one year.</p> <p style="margin-left:.5in;"> <strong>Tarah L. Castleberry, DO</strong>, Galveston, Texas, has been appointed to the <strong>Preventive Medicine Review Committee of the ACGME</strong>, effective July 2015. Dr. Castleberry has been an AMA member for seven years.</p> <p style="margin-left:.5in;"> <strong>Sharon P. Douglas, MD</strong>, Madison, Mississippi, has been appointed to the <strong>Liaison Committee on Medical Education Council</strong> for a second term, effective July 2015. Dr. Douglas has been an AMA member for 17 years.</p> <p style="margin-left:.5in;"> <strong>George W. Elgart, MD</strong>, Miami, has been appointed to the <strong>Dermatology Review Committee of the ACGME</strong>, effective July 2015. Dr. Elgart has been an AMA member for 14 years.</p> <p style="margin-left:.5in;"> <strong>Linda M. Famiglio, MD</strong>, Danville, Pennsylvania, has been appointed to the <strong>Accreditation Council for Continuing Medical Education (ACCME) Accreditation Review Committee </strong>for a third term, effective January 2015. Dr. Famiglio has been an AMA member for 15 years.</p> <p style="margin-left:.5in;"> <strong>James I. Fann, MD</strong>, Stanford, California, has been appointed to the <strong>American Board of Thoracic Surgery</strong>, effective October 2014. Dr. Fann has been an AMA member for 19 years.</p> <p style="margin-left:.5in;"> <strong>Gerald A. Isenberg, MD</strong>, Philadelphia, has been appointed to the <strong>Colon and Rectal Surgery Review Committee of the ACGME</strong>, effective July 2015. Dr. Isenberg has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Rohit K. Katial, MD</strong>, Denver, has been appointed to the <strong>Allergy and Immunology Review Committee of the ACGME</strong>, effective July 2015. Dr. Katial has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Natalie C. Kerr, MD</strong>, Memphis, Tennessee, has been appointed to the <strong>Ophthalmology Review Committee of the ACGME</strong>, effective July 2015. Dr. Kerr has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Jeffrey B. Matthews, MD</strong>, Chicago, has been appointed to the <strong>Surgery Review Committee of the ACGME</strong>, effective July 2014. Dr. Matthews has been an AMA member for 21 years.</p> <p style="margin-left:.5in;"> <strong>William A. McDade, MD</strong>, Chicago, has been appointed a member of the <strong>National Board of Medical Examiners</strong>, effective June 2014. Dr. McDade has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Darlyne Menscer, MD</strong>, Charlotte, North Carolina, has been appointed by the AMA Board of Trustees to serve as AMA representative to the <strong>Coalition for Physician Accountability</strong>. Dr. Menscer has been an AMA member for 34 years.</p> <p style="margin-left:.5in;"> <strong>Lynn Parry, MD</strong>, Denver, has been appointed to the <strong>ACCME Accreditation Review Committee</strong>, effective January 2015. Dr. Parry has been an AMA member for 33 years.</p> <p style="margin-left:.5in;"> <strong>Carla M. Pugh, MD</strong>, Madison, Wisconsin, has been appointed to the <strong>American Board of Medical Specialties (ABMS) Research and Education Foundation</strong>. Dr. Pugh has been an AMA member for 13 years.</p> <p style="margin-left:.5in;"> <strong>Liana Puscas, MD</strong>, Durham, North Carolina, has been appointed to the <strong>ABMS Research and Education Foundation</strong>. Dr. Puscas has been an AMA member for 22 years.</p> <p> AMA members can apply for AMA nomination for leadership positions with other organizations. To be considered for nomination by the AMA, visit the Council on Medical Education’s <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-education/leadership.page?%5d." target="_blank">leadership opportunities Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:15787353-6e4c-4133-aaaf-f42e5d85cb07 Medical school’s From Tots to Docs event earns recognition http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_medical-schools-tots-docs-event-earns-recognition Tue, 14 Oct 2014 15:00:00 GMT <p> The University of Florida College of Medicine’s weeklong From Tots to Docs event, in which the local AMA Medical Student Section (MSS) hosted educational sessions for kids, earned the school an AMA Section Involvement Grant (SIG) Event of the Month award.  </p> <p> The section partnered with the local Salvation Amy and their annual Vacation Bible School elementary camp to host five, 45-minute educational sessions focused on child safety topics, including gun safety, road safety, water safety and poison control, and the importance of preventive health measures such as immunizations and healthy eating habits. The Vacation Bible School campers enjoyed learning about safety and preventive health from the medical students and participating in the activities.</p> <p> The AMA provided funding for the equipment and supplies that the local section will reuse for future programs. Visit the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/event-of-the-month.page" target="_blank">Event of the Month Web page</a> for a detailed description. The AMA SIG Event of the Month showcases recruitment, community service, education and AMA-MSS National Service Project events coordinated by individual AMA medical student sections.</p> <p> Is your AMA medical student section holding similar events? Submit a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/frequently-asked-questions-about-chapter-involvement/sig-follow-up.page" target="_blank">SIG Recap Form</a> and photos within 30 days of your event to be eligible for the Event of the Month nomination, which the AMA selects each month. At the end of the school year, all monthly awards will be showcased in June at the AMA-MSS Annual Assembly Meeting and be voted on by students for one Event of the Year winner.</p> <p> Through the SIG program, the AMA-MSS provides an opportunity for local AMA medical student sections to:</p> <ul> <li> Educate students about the AMA and provide an opportunity for students to get more involved</li> <li> Help put AMA policy into action by providing a service to medical school campuses or communities</li> <li> Engage in activities that focus on AMA's top priorities</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6f09322-dec3-4db2-8f40-124f5d67bdbc AMA to consider policy on key med ed topics at upcoming meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-consider-policy-key-med-ed-topics-upcoming-meeting Tue, 14 Oct 2014 15:00:00 GMT <p> Greater emphasis on social determinants of health in medical school curriculum, and equal paternal and maternal leave for medical residents are two of the hot topics the AMA House of Delegates will discuss at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas, Nov. 8-11</p> <p> More medical education topics to be considered for adoption as possible AMA policy include:</p> <ul> <li> Combatting sex-linked discrimination of denying special request for lactation during medical board examination</li> <li> Promoting education of electronic health records in undergraduate medical education</li> <li> USMLE Step 1 timing</li> </ul> <p> All AMA-member physicians are invited to weigh in on these items prior to the meeting. <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">Log in now</a>  to express your views on these and other items of business to come before the House.</p> <p> These items of business will be reviewed during the Reference Committee K hearing at the meeting. The Reference Committee will consider the testimony presented during the hearing and then forward to the House its recommended actions on these resolutions. If approved by the House, the resolved clauses in these resolutions would become AMA policy, and serve to direct the work of the Association now and in the future.</p> <p> In addition, a number of educational sessions will be presented during the meeting, many of which will offer physician attendees the opportunity to earn CME credit. View the list of CME opportunities and educational sessions at the 2014 Interim Meeting <a href="http://www.ama-assn.org/sub/meeting/cme.html" target="_blank">website</a>.</p> <p> Finally, all physicians with an academic appointment are invited to attend the Academic Medicine Caucus during the meeting. The caucus will be held at 9:30 a.m. Nov. 10 in the Senators Lecture Hall.</p> <p> Attendees will discuss issues of mutual concern and interest pertaining to academic medicine and review the report of Reference Committee K. Come network with your colleagues and share your ideas on how the AMA can continue to provide leadership in medical education.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:34ee142b-6e5b-4a3e-b246-b0af5a92f465 How does the AMA develop policy? Find out Nov. 6 in Chicago http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-develop-policy-out-nov-6-chicago Tue, 14 Oct 2014 15:00:00 GMT <p> All academic physicians are invited to learn how the AMA develops policy and understand the role of the AMA Section on Medical Schools (SMS) during a special session at the AMA-SMS meeting Nov. 6 in Chicago. <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=SMSI12E&TID=INaoed0Ms5%2fD15CGT%2bWIjg%3d%3d&OID=130" target="_blank">Register now</a> (log in) to attend the AMA-SMS meeting, from 4:30 to 7:30 p.m., which is being held this year in conjunction with the annual meeting of the Association of American Medical Colleges.</p> <p> During the session, “The AMA and the AMA-SMS: What we do and how we do it,” participants will hear how the relationships between the various AMA sections, councils, caucuses and reference committees support the AMA House of Delegates.</p> <p> Other topics for the session include:</p> <ul> <li style="margin-left:18.75pt;"> How the section makes an impact on AMA policy</li> <li style="margin-left:18.75pt;"> How to be nominated to professional leadership opportunities in many key national organizations in medical education (via the AMA Council on Medical Education)</li> <li style="margin-left:18.75pt;"> How the House of Delegates accomplishes its work</li> </ul> <p> <a href="https://extapps.ama-assn.org/mtgreg/register/search?EID=SMSI12E&TID=INaoed0Ms5%2fD15CGT%2bWIjg%3d%3d&OID=130" target="_blank">Register now</a> so that you can also:</p> <ul> <li style="margin-left:18.75pt;"> Voice your opinions on proposed AMA policy related to medical education, to be reviewed at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas.</li> <li style="margin-left:18.75pt;"> Get a guided tour of the AMA's new headquarters, housed in a building <a href="http://www.chicagoarchitecture.info/Building/1043/AMA-Plaza.php" target="_blank" rel="nofollow">designed</a> by internationally renowned architect Ludwig Mies van der Rohe.</li> <li style="margin-left:18.75pt;"> Enjoy a networking reception with your academic physician colleagues, with 360-degree views of Chicago from the AMA’s 47<sup>th</sup> floor.</li> </ul> <p> Review the <a href="https://www.signup4.net/Upload/AMER44A/SMSI12E/i14-sms-agenda.pdf" target="_blank" rel="nofollow">draft agenda</a> and be sure to check out <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/meetings/sms-past-meetings.page?" target="_blank">highlights from past section meetings</a>.</p> <p> If you’re not already a member of the <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools.page" target="_blank">AMA-SMS</a>, learn how to <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/section-medical-schools/members.page?" target="_blank">become a member</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1e37d9a9-8563-4a69-a090-3154e1a2102d Recognizing educational myopia, accepting feedback http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_recognizing-educational-myopia-accepting-feedback Tue, 14 Oct 2014 15:00:00 GMT <p> <em>A </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page?plckTag=MedEd_Innovation" target="_blank"><em>Spotlight on Innovation</em></a><em> post by Bonnie Miller, MD (pictured left), associate vice-chancellor for health affairs and senior associate dean for health sciences education at Vanderbilt University School of Medicine. This appeared in the October 2014 </em>AMA MedEd Update<em>, a monthly medical education newsletter.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/0/75300966-438f-4ac2-b0cc-e4fa1a9d2dd4.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/0/75300966-438f-4ac2-b0cc-e4fa1a9d2dd4.Large.jpg?1" style="float:left;margin:10px;" /></a>Medical educators across the continuum are currently debating the importance and potential impact of learning portfolios. At Vanderbilt, we <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">developed a platform called VSTAR</a> that provides a robust electronic home for each medical student’s portfolio, comprised of competency-based assessments, experience logs, written reflections, coach-guided summaries and student-generated learning goals.</p> <p> The effort and resources required for a project of this magnitude put us at risk for a form of educational myopia. Those of us intimately involved with design, development and implementation have celebrated the fact that the system is online and the gears are moving. While we are tempted to proclaim success, feasibility alone does not prove that the system is meaningful for learners and valuable for the learning process.</p> <p> We were reminded of this recently when we held student and faculty focus groups on the first year of experience with the VSTAR portfolio. Aside from a few operational issues that could be expected with such a complex launch, the respondents indicated that the system had functioned in the ways for which it was designed. Beyond that, many students became highly engaged in the process of integrating multi-source competency-based assessments into meaningful learning objectives.</p> <p> However, a subset of students was not as fully engaged as we had hoped. These students gave voice to a more traditional understanding of the roles of students and teachers. Portfolios force learners to move from being passive recipients of performance information (e.g., grades) to true professionals-in-training who use feedback as a starting point for reflection, goal-setting and improvement. Not all of our students are ready for this transition.</p> <p> A second group also emerged. These students wondered whether the system was primarily about their learning, or whether it was really about faculty research, or a tool for measuring organizational effectiveness.</p> <p> Both groups challenge us to remember the importance of student development, of proactively preparing our students with an understanding of the theoretical and practical rationales for these educational innovations so that they can become wise, effective and activated users. While student representatives sit on all of the committees that oversee these projects, we must find creative ways to communicate the purpose to the broader student body of the school.</p> <p> Finally, the feedback from the focus groups reminded us that students must always remain an integral part of the ongoing evolution of our educational systems. Students must engage with the system not only as users, but also as members of the improvement team. We cannot reach our ultimate goals any other way. And, if we are really lucky, we will nurture the next generation of creative educators in the process.</p> <p> <em>Get AMA MedEd Update</em> <a href="http://www.ama-assn.org/ama/pub/news/subscribe-newsletters.page" target="_blank"><em>sent to your inbox</em></a><em> monthly to see this column and more medical education news.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e9bd1398-8b5f-4bc8-974f-d1bb3e5cf457 New diabetes guidelines: Screen patients aged 45 and older http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-diabetes-guidelines-screen-patients-aged-45-older Mon, 13 Oct 2014 20:44:00 GMT <p> New <a href="http://www.uspreventiveservicestaskforce.org/Page/Name/us-preventive-services-task-force-opportunities-for-public-comment" rel="nofollow" target="_blank">draft guidelines</a> from the U.S. Preventive Services Task Force (USPSTF) recommend screening adults aged 45 and older for prediabetes and type 2 diabetes. The recommendation could mean identifying and treating undiagnosed diabetes in millions more people, preventing complications and improving quality of life.</p> <p> An independent expert panel under the U.S. Agency for Healthcare Research and Quality, the USPSTF makes evidence-based recommendations about clinical preventive services. It issued its updated recommended guidelines for prediabetes and type 2 diabetes screening last week. The guidelines are open for <a href="http://www.uspreventiveservicestaskforce.org/Comment/Collect/Index/RecommendationStatementDraft/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus" rel="nofollow" target="_blank">public comment</a> through Nov. 3.</p> <p> The recommendation calls for screening everyone beginning at 45 years of age and patients who meet one or more of these criteria:</p> <ul> <li> Younger adults with risk factors, including obesity</li> <li> Younger adults with a first-degree relative with diabetes</li> <li> Women with a history of gestational diabetes or polycystic ovarian syndrome</li> <li> Certain racial or ethnic minority groups, including African Americans, American Indians/Alaskan Natives, Asian Americans, Hispanics/Latinos and Native Hawaiians/Pacific Islanders</li> </ul> <p> The guidelines recommend the use of hemoglobin A1c testing as a primary method for screening at-risk individuals, which provides a rapid and accurate method of testing for both prediabetes and diabetes.</p> <p> An estimated 86 million Americans have prediabetes, but only one in nine of these people knows they are at risk of developing type 2 diabetes. Studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives.</p> <p> The AMA is working to prevent diabetes through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, partnering with the YMCA of the USA to increase referrals to the YMCA’s Diabetes Prevention Program. The program is an evidence-based lifestyle intervention that is part of the Centers for Disease Control and Prevention’s (CDC) <a href="http://www.cdc.gov/diabetes/prevention/" rel="nofollow" target="_blank">National Diabetes Prevention Program</a>.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at their local YMCAs. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.</p> <p> If the USPSTF adopts the draft guidelines, adults who meet the specified criteria would be eligible for screening, and most insurers would eventually be required to cover the screening. The guidelines would be more closely aligned with those of the American Diabetes Association, and the primary care professional societies that follow USPSTF guidelines would align their screening criteria as well.</p> <p> “For the first time, the USPSTF is recognizing value in screening for prediabetes,” said AMA President Robert M. Wah, MD. “Consequently, millions more patients at risk could ultimately be identified and helped by diabetes prevention programs recognized by the CDC through its National Diabetes Prevention Program.”</p> <p> Physicians can <a href="http://www.uspreventiveservicestaskforce.org/Comment/Collect/Index/RecommendationStatementDraft/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus" rel="nofollow" target="_blank">comment</a> on the draft guidelines through Nov. 3.</p> <p> <strong>You tell us: </strong>How do you think the new guidelines recommended by the USPSTF will help your patients? Leave a comment below at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cab84fd0-5804-43f8-a26f-7e7fad69a3e1 How these med students transformed their summer http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-students-transformed-their-summer Mon, 13 Oct 2014 20:36:00 GMT <p> Medical students at the University of Toledo College of Medicine and Life Sciences spent their summer vacation in a unique situation: delivering care to more than 600 patients in León, Nicaragua, one of the poorest countries in Latin America. In the process, they also gained valuable perspective and experience.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/0/0eaefb39-c565-4231-80a7-5494463c213b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/0/0eaefb39-c565-4231-80a7-5494463c213b.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;">Erik Rotterman, a fourth-year medical student at the University of Toledo College of Medicine and Life Sciences, treats a mother and child in León, Nicaragua during the school's trip in August 2014.</span></em></td> </tr> </tbody> </table> <p> U.S. medical students increasingly are seeking international experiences such as this. According to data from the Association of American Medical Colleges (AAMC), more than 65 percent of incoming medical students want to pursue global learning opportunities.</p> <p> “Cultural sensitivity, identifying community needs, fairness in the distribution of resources, robust public health systems and improving health care for everyone—these are goals medical students identify with because of our extensive humanistic training,” said Divya Sharma, a second-year medical student at Rutgers New Jersey Medical School and chair of the AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section.page" target="_blank">Medical Student Section</a> (MSS) Committee on Global and Public Health. “Global health issues impact all of us.”</p> <p> Students from the University of Toledo team—an interdisciplinary group of 28 people, including medical, physician assistant, pharmacy, dental and physical therapy students—saw firsthand the impact their care had on the León community.</p> <p> <strong>Acquiring a unique perspective</strong><br /> For these students, the eight-day experience in August spurred a new look at what it means to be a physician.</p> <p> “This trip provided a perspective on health care that is unlike anything we experience in the states,” said Kelsey Smith, a third-year medical student at the University of Toledo. “Not only do patients have a unique perspective on the concepts of sickness and medicine, but their culture and language differences challenged the members of our team to be creative and inventive during patient interviews.”</p> <p> At some of the more rural clinics, patients lack access to health care, and it’s difficult for patients to even get transportation to a medical facility. The team heard a story about one of the major causes of poor dental hygiene in local young children.</p> <p> “Mothers cannot afford fresh water for baby formula,” Smith said. “Instead, these parents mix their children’s formula with Coca-Cola because it is prepared with filtered water and is less expensive than fresh, bottled water.”</p> <p> At the same time, patients in urban community centers brought prescriptions for blood pressure or diabetes control medication that they couldn’t afford. Smith said the students return to the United States with an “extreme sense of humility.”</p> <p> <strong>Gaining new experiences</strong><br /> The team had to provide care in a variety of settings, from windowless sheds to outdoor pavilions. Students were required to rely on their history-taking and physical exam skills.</p> <p> “There is no way to get a CT scan on a patient with abdominal pain or a CBC in a patient with unexplained fatigue,” Smith said. “In this way, our trip exposed students to the most fundamental parts of medical practice.”</p> <p> The team leaders, including Smith, were responsible for obtaining and organizing all medications and supplies before the trip, and directed flow at the clinics. Students rotated through pediatric, adult and women’s health services, and assisted at dental clinics.</p> <p> <strong>Getting involved</strong><br /> Students interested in learning more about global health and participating in international experiences can check with their medical schools for resources. The AMA-MSS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/our-leaders/standing-committees.page" target="_blank">Committee on Global and Public Health</a> also can help students find more information about international health opportunities.</p> <p> The AAMC’s <a href="https://www.aamc.org/services/ghlo/" rel="nofollow" target="_blank">Global Health Learning Opportunities</a> collaborative, a network of medical schools in the United States and abroad, can help students in their final year of medical school find clinical, research or public health-related international opportunities.</p> <p> <strong>You tell us: </strong>Have you participated in an international medical trip? If not, would you? Share your thoughts and experiences by commenting below or on the <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">AMA-MSS Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:73595969-092b-4f43-877b-7a87946ec040 Plan to attend the AMA Women Physicians Section Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-ama-women-physicians-section-interim-meeting Mon, 13 Oct 2014 18:30:00 GMT <p> Participate in the AMA Women Physicians Section (WPS) Interim Meeting, November 8 in Dallas, for a unique opportunity to network with other women physicians from across the United States and meet with leaders from state and specialty societies, as well as from the AMA.</p> <p> This year’s meeting offers a variety of events, including policy discussions and education sessions. The AMA-WPS will host a session, “Communication as a Conflict Management Tool” from 12:15 p.m. to 1:45 p.m. Nov. 8 in the Governors Lecture Hall, presented by Andrea Jones, executive managing director of eWomen Network Dallas/Fort Worth. This session is approved for 1.5 <em>AMA PRA Category 1 Credits™</em>.</p> <p> The AMA-WPS Business Meeting and Reception will be from 5:30 p.m. to 7 p.m. Nov. 8 in the Wedgewood Room and will include a presentation by 2013 Giambalvo Fund for the Advancement of Women winner Juliet Lee, MD, and a review of the AMA House of Delegates Handbook and AMA-WPS items of business.</p> <p> Attend the AMA-WPS liaisons lunch from 12:30 p.m. to 2 p.m. in the Madrid Room to meet the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/about-wps/wps-liaisons.page" target="_blank">liaisons</a> from other medical societies.</p> <p> More details about the meeting and surrounding events are available on the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/wps-meetings.page" target="_blank">Meetings and events</a> Web page. Registration closes Saturday, November 1; <a href="http://www.ama-assn.org/go/i14registration" target="_blank">log in</a> and register today.</p> <p> The AMA is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3b08f1bd-2f7d-4094-90e2-59b76abf33a7 Oral arguments begin in patient safety case before U.S. Supreme Court http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_oral-arguments-begin-patient-safety-case-before-supreme-court Mon, 13 Oct 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/13/dfbd1614-6850-499f-bdec-cc6ce951ee1b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/13/dfbd1614-6850-499f-bdec-cc6ce951ee1b.Large.jpg?1" style="margin:15px;float:right;" /></a>The nation’s highest court Tuesday will hear arguments in a case that will decide whether the Federal Trade Commission (FTC) can second-guess the work of state medical licensure boards.</p> <p> The Supreme Court of the United States is hearing oral arguments in <em>North Carolina State Board of Dental Examiners v. FTC</em>, a case previously decided by a federal appeals court that ruled in favor of the FTC’s claim that state licensure boards should be subject to federal antitrust laws. The decision of the appeals court could effectively limit the ability of these boards to regulate their health care professions and shield patients from unlawful practices.</p> <p> The AMA and other health care organizations filed an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/patient-safety-stake-case-before-supreme-court" target="_blank">amicus brief</a> expressing support for the plaintiffs in this case, stating fear that if the court ruled for the FTC, it would have a chilling effect on state medical and dental boards to the detriment of public health.</p> <p> In June, physicians at the open forum of the <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page" target="_blank">Litigation Center of the AMA and State Medical Societies</a> heard both sides of the case argued in a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/attorneys-argue-patient-safety-case-mock-hearing" target="_blank">mock court session</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8b543812-35ab-46ca-8b08-6faa9e9b1870 Ethics journal discusses tensions in reproductive medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ethics-journal-discusses-tensions-reproductive-medicine Fri, 10 Oct 2014 20:39:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9fc65af-0f53-4dc0-8a94-1bbd327de6ec.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/10/c9fc65af-0f53-4dc0-8a94-1bbd327de6ec.Large.jpg?1" style="margin:15px;float:right;" /></a>In reproductive medicine, advances in medical science and technology often outpace society’s opportunity for due deliberation about their ethical use. Physicians and other experts in the field explore these ethical considerations in the <a href="http://virtualmentor.ama-assn.org/" target="_blank">October issue</a> of <em>Virtual Mentor</em>, the AMA’s online ethics journal.</p> <p> Employing pre-implantation genetic diagnosis followed by embryo selection to choose the sex (and potentially other traits) of a child is just one topic of debate. <em>Virtual Mentor</em> contributors discuss the many questions and tensions that surround evolving technologies and practices—from those that prevent or enable conception to those used in hospital labor wards.</p> <p> Highlights include:</p> <ul> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/msoc1-1410.html" target="_blank">Judicial, legislative and professional attempts to restrict pregnant women’s autonomy</a>.” Ruth Macklin, PhD, writes that she believes physicians may—and should—make recommendations to women for maintaining a healthy pregnancy, but until the time a baby is born, the pregnant woman alone should have the last word in deciding what happens to her fetus.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/oped1-1410.html" target="_blank">Natural childbirth—A global perspective</a>.” Lauri J. Romanzi, MD, argues that industrialized nations could benefit from strategies emerging in developing nations, such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.</li> <li> “<a href="http://virtualmentor.ama-assn.org/2014/10/ecas1-1410.html" target="_blank">Informing patients about declining fertility</a>.” In this commentary, Marc M. Beuttler, Kara N. Goldman, MD, and Jamie A. Grifo, MD, write about how respect for informed, autonomous decision-making demands women be made aware of useful, if anxiety-provoking, information about age-related decline in fertility.</li> </ul> <p> Be sure to take this month’s <a href="http://virtualmentor.ama-assn.org/site/poll.html" target="_blank">ethics poll</a> (“What do you think about using in vitro fertilization to select the sex of a child for the purpose of ‘balancing’ the family?”), and check out the October <a href="http://virtualmentor.ama-assn.org/podcast/ethics-talk-october-2014.mp3" target="_blank">podcast</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:46f9b6a8-d9af-428d-86a8-894e6e97ad23 Shape policy on key issues in medicine: Comment now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_comment-proposed-ama-policy Fri, 10 Oct 2014 20:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/40f86c46-aaa2-4a4c-adfa-101d2d6c5a94.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/13/40f86c46-aaa2-4a4c-adfa-101d2d6c5a94.Large.png?1" style="margin:15px;float:right;" /></a>Weigh in on future AMA policy via the <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/reference-committee.page" target="_blank">Online Member Forums</a> (log in), now open in advance of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 8 to 11 in Dallas.</p> <p> All items of business from the initial reports and resolutions are posted in the forums, sorted by reference committee. Any AMA member can comment on any item of business. The forums will be open until just before the start of the meeting, but any comments posted after 7 p.m. Eastern time on Nov. 2 may not be captured in the comment summaries that will be posted on the Interim Meeting website.</p> <p> Online forums have allowed AMA members to weigh in on key policy issues facing medicine from the comfort of their homes or offices. They have permitted physicians and medical students, delegates and non-delegates alike to add their voices to the AMA policy discussion at their convenience.</p> <p> Resolutions and reports up for discussion at the 2014 AMA Interim Meeting address such topics as:</p> <ul> <li> U.S. Food and Drug Administration regulation of off-label drug promotion</li> <li> Physician unionization and collective bargaining</li> <li> Equity in telemedicine payments</li> <li> The role of pharmacists in improving immunization rates</li> <li> Timing of the United States Medical Licensing Examination Step 1</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f9d4024c-d86c-48ad-b7f3-d73f02ca1b08 How one physician helped a young patient realize her dream http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-physician-helped-young-patient-realize-her-dream Fri, 10 Oct 2014 18:58:00 GMT <p> Physicians are in the unique and privileged position to understand the dreams of their patients—and to help patients achieve those dreams. It’s this ability to impact that makes being a physician so inspirational, one physician recently explained.</p> <p> Robert Alan Probe, MD, chair of the board of Scott and White’s integrated medical group and chair of the department of orthopedic surgery, <a href="http://youtu.be/_tifHRYGfmg" rel="nofollow" target="_blank">shared his story</a> at the AMA’s recent Inspirations in Medicine event.</p> <p> <object align="left" data="http://www.youtube.com/v/_tifHRYGfmg" height="350" hspace="15" id="ltVideoYouTube" src="http://www.youtube.com/v/_tifHRYGfmg" type="application/x-shockwave-flash" vspace="15" width="450"><param name="movie" value="http://www.youtube.com/v/_tifHRYGfmg" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="15" quality="best" src="http://www.youtube.com/v/_tifHRYGfmg" type="application/x-shockwave-flash" vspace="15" width="450" wmode="transparent"></embed></object>A young, bubbly girl named Maddy came to him with an unusually shortened humerus, and the growth plate at the top end of the bone had shut down asymmetrically. Because of this, Maddy couldn’t fulfill her dream of playing basketball.</p> <p> “In 25 years of practice, I can’t remember a patient where the art and science of medicine came together [like this], where we were understanding this girl’s dreams and doing something about it,” Dr. Probe said.</p> <p> Through an intense and long treatment plan, Dr. Probe was able to lengthen the bone and help the girl get back to the sport she loved.</p> <p> “What started it? This little girl, with a dream to be with her friends on the basketball team,” Dr. Probe said. “Because of her willpower, because of 21st-century medicine, because of the human spirit and the partnership between the patient and physician, she realized her dreams.”</p> <p> “Medicine is in chaos now,” Dr. Probe said. “The one thing that cannot change, that should not change, is that relationship of understanding your patients’ dreams, having a part in their life and doing what you can to help them.”</p> <p> <strong>Get inspired: </strong>Watch this <a href="https://www.youtube.com/playlist?list=PL7ZHBCvG4qseJLCrtJU6uCt49G2xYuhnl" rel="nofollow" target="_blank">Inspirations in Medicine video</a> and others on the AMA’s YouTube channel.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2913aac8-545a-415b-b828-bf307e6840ac 10 top states where health insurers dominate: New study http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_10-top-states-health-insurers-dominate-new-study Thu, 09 Oct 2014 19:30:00 GMT <p> An annual analysis of commercial health insurance markets revealed the 10 most competitive and 10 least competitive states among health insurers. Find out where your state ranks.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/1/92894b2e-7b32-4576-812d-cf964d1f8e87.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/1/92894b2e-7b32-4576-812d-cf964d1f8e87.Large.jpg?1" style="float:right;margin:10px;" /></a>In order of most competitive, the 10 top states are:</p> <ol> <li> Oregon</li> <li> Wisconsin</li> <li> Pennsylvania</li> <li> New York</li> <li> Colorado</li> <li> Missouri</li> <li> Washington</li> <li> Ohio</li> <li> California</li> <li> Florida</li> </ol> <p> The 10 states with the least competitive commercial health insurance markets are:</p> <ol> <li> Alabama</li> <li> Hawaii</li> <li> Michigan</li> <li> Delaware</li> <li> Louisiana</li> <li> South Carolina</li> <li> Alaska</li> <li> Illinois</li> <li> Nebraska</li> <li> North Dakota</li> </ol> <p> At No. 8, Illinois makes its first appearance in the top 10 least competitive markets this year, displacing Rhode Island from last year’s list. Louisiana entered the top five, moving from ninth on last year’s list.</p> <p> The 2014 edition of the AMA’s <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets</em> reports commercial health insurance market shares and federal concentration measures for 388 metropolitan markets as well as all 50 states and the District of Columbia. The study is based on 2012 data captured from commercial enrollment in fully insured and self-insured health plans, and includes participation in consumer-driven health plans.</p> <p> More findings include:</p> <ul> <li> In 72 percent of the metropolitan areas studied, there is a significant absence of health insurer competition. These markets are rated “highly concentrated,” based on the guidelines used by the U.S. Department of Justice and Federal Trade Commission to assess the degree of competition in a given market.</li> <li> In 17 states, a single health insurer had a commercial market share of 50 percent or more.</li> <li> In 45 states, two health insurers had a combined commercial market share of 50 percent or more.</li> <li>  In 90 percent of metropolitan areas, a single health insurer has at least a 30 percent share of the commercial health insurance market.</li> </ul> <p> This AMA report is intended to help researchers, lawmakers, policymakers and regulators identify markets where mergers and acquisitions among health insurers may cause competitive harm to patients, physicians and employers.</p> <p> “The AMA is greatly concerned that in 41 percent of metropolitan areas, a single health insurer had at least a 50 percent share of the commercial health insurance market,” said AMA President Robert M. Wah, MD in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-09-wellpoint-competition-health-insurance-market.page">news release</a>. “The dominant market power of big health insurers increases the risk of anti-competitive behavior that harms patients and physicians, and presents a significant barrier to the market success of smaller insurance rivals.”</p> <p> <strong>What insurers have the largest market shares?</strong><br /> WellPoint Inc. is the largest private health insurer by market share in more than one in five metropolitan areas.</p> <p> Soon to be renamed Anthem Inc., WellPoint has a bigger geographic footprint than any other private health insurer in the country, and it holds a market share advantage in more than double the number of metropolitan areas as the next two insurers. Health Care Service Corp. was second, with a market share lead in 37 metropolitan areas, followed by UnitedHealth Group, with a market share lead in 35 metropolitan areas.</p> <p> A <em>Competition in Health Insurance: A Comprehensive Study of U.S. Markets </em>is available for purchase through the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560005&navAction=push" target="_blank">AMA Store</a>; AMA members can access it for free. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:67cf65c5-b007-404b-a2ac-85190096882f Real clinical data gives medical students new perspectives http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_real-clinical-data-gives-medical-students-new-perspectives Thu, 09 Oct 2014 18:22:00 GMT <p> Medical students now can use real clinical data to examine patient populations and the value of health care with new, free tools from New York University School of Medicine.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/6/d6bb82f4-1107-4373-a6bb-6c8c325f873d.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/6/d6bb82f4-1107-4373-a6bb-6c8c325f873d.Large.jpg?1" style="float:right;margin:10px;" /></a>NYU used publicly available, open clinical data sets and local data from NYU Langone Medical Center’s electronic health records (EHR) to develop <a href="http://education.med.nyu.edu/ace" rel="nofollow" target="_blank">two new educational clinical data tools</a>. Marc Triola, MD (pictured left), director of the Institute for Innovations in Med Education at NYU and associate dean of educational informatics presented the tools at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative. The schools met at Vanderbilt University in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes in medicine.</p> <p> NYU used <a href="http://education.med.nyu.edu/ace/clinicaldata/" rel="nofollow" target="_blank">real clinical data</a> from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS)—more than 2.5 million patient-level records that include every inpatient discharge from 226 hospitals in New York—to create an interactive website.</p> <p> Students can sift through diagnosis-related group codes, providers or hospitals to answer a variety of questions. For example, a student could investigate whether severity of illness correlated with length-of-stay for patients with drug and alcohol dependence, or how much charges vary across hospitals for the same payer and a given diagnosis-related code.</p> <p> “We didn’t want to tell our students what they had to ask—if students were passionate about adolescent medicine or substance abuse or different types of surgeries, they could follow whatever path they wanted,” said Dr. Triola. “This instantly inspires students to want to delve deeper, and it means something to them because they know these hospitals.”</p> <p> The school also created a <a href="http://education.med.nyu.edu/ace/practice/" rel="nofollow" target="_blank">simulated health care group</a> that consists of three different types of practices. Combining de-identified data from NYU Langone Medical Center’s EHR, payer and demographic information from SPARCS, patient level lab data and more.</p> <p> Once students become familiar with the practice group, they complete an exercise: If they worked in this practice group, what quality improvement project would they propose for a $1 million grant?</p> <p> “It’s incredibly powerful stuff,” Dr. Triola said. “The students are thrilled because it’s real data—it’s not an exercise, it’s not their biostats textbook. It is authentic clinical data and it allows them to really follow their own personal interests.”</p> <p> Dr. Triola is working with the AMA and the Accelerating Change in Medical Education consortium schools to potentially adapt the tools for use at additional schools. The school is looking for more public data sources to expand the tools in the future.</p> <p> This post is the second in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks. See the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-medical-school-created-student-gps" target="_blank">first post</a> at <em>AMA Wire.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3d89e654-728c-4b9e-9579-68e2e391ba9a JAMA Highlights: Antimicrobial use in hospitals appears to be common http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-antimicrobial-use-hospitals-appears-common Thu, 09 Oct 2014 18:20:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/nLz21BXr4qs" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/nLz21BXr4qs" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/nLz21BXr4qs" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" quality="best" src="http://www.youtube.com/v/nLz21BXr4qs" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;">JAMA <em>video: Nearly one-half of patients receive at least one antibiotic while hospitalized.</em></span></td> </tr> </tbody> </table> <p> <strong>Antimicrobial use in hospitals appears to be common</strong><br /> A one-day prevalence survey of 183 hospitals found that approximately 50 percent of hospitalized patients included in the survey were receiving antimicrobial drugs, and that about one-half of these patients were receiving two or more antimicrobial drugs, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911328" rel="nofollow" target="_blank">study</a> in the Oct. 8 issue of the <em>Journal of the American Medical Association </em>(<em>JAMA</em>), a theme issue on infectious disease. Most antimicrobial use was for infection treatment. Watch a <a href="http://youtu.be/nLz21BXr4qs" rel="nofollow" target="_blank">video</a> about the study.</p> <p> <strong>Studies examine vaccination strategies for prevention, control of avian flu</strong><br /> Two randomized trials in the Oct. 8 issue of <em>JAMA</em> examine new vaccination strategies for the prevention and control of avian influenza, often referred to as “bird flu.” One <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911327" rel="nofollow" target="_blank">study</a> looks at safety and immunogenicity of different doses of a specific vaccine, and the other <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911325" rel="nofollow" target="_blank">study</a> looks at how previously receiving an older vaccine could affect a newer vaccine.</p> <p> <strong>Public health in the age of Ebola</strong><br /> A <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916610" target="_blank" rel="nofollow">new Viewpoints piece</a> in <em>JAMA Internal Medicine</em> examines the Ebola outbreak in West Africa as a “Black Swan” event.</p> <p> <strong>Study looks at cardiometabolic risk, schizophrenia and antipsychotic treatment</strong><br /> The duration of psychiatric illness and treatment for patients after first-episode schizophrenia spectrum disorders appears to be associated with being fatter and having other cardiometabolic abnormalities, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1911294" rel="nofollow" target="_blank">study</a> in<em> JAMA Psychiatry</em>.</p> <p> <strong>Prenatal BPA exposure associated with diminished lung function in children</strong><br /> Prenatal exposure to bisphenol A (BPA, a common chemical used in some plastics) appears to be inconsistently associated with diminished lung function and the development of persistent wheeze in children, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1913573" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics</em>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5c649a8b-03c3-4aa9-a5cf-c9d51fb6cbd2 How to screen for Ebola: CDC offers resources http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_screen-ebola-cdc-offers-resources Wed, 08 Oct 2014 21:04:00 GMT <p> As the first patient diagnosed with Ebola in the United States died Wednesday morning in Dallas, a <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">special Web page</a> from the Centers for Disease Control and Prevention (CDC) offers the resources you need to be prepared for patients who might have this disease.</p> <p> The CDC and U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) have asked physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations.</p> <p> The CDC suggests that emergency departments screen for:</p> <ul> <li> Fever, headache, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite. In some cases, bleeding also is a symptom.</li> <li> Travel to West Africa within 21 days (3 weeks) of symptom onset. Countries include Guinea, Liberia, Nigeria, Senegal, Sierra Leone and other places where Ebola virus disease transmission has been reported by the World Health Organization.</li> </ul> <p> If both criteria are met, the patient should be moved to a private room with a bathroom. Standard, contact and droplet precautions should be followed during further assessment.</p> <p> The agencies have issued a <a href="http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf" rel="nofollow" target="_blank">hospital checklist for Ebola preparedness</a>. In addition, physicians can watch a <a href="http://www.phe.gov/Preparedness/responders/Pages/ebola-healthcare-webinar.aspx" rel="nofollow" target="_blank">webinar</a> from the CDC and ASPR on Ebola preparedness for the U.S. health care system. The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care workers</a> offers more information about testing, diagnosis and protection, as well as guidance on how to safely manage patients with the virus. Additional resources can be found on the <a href="http://www.phe.gov/preparedness/Pages/default.aspx" rel="nofollow" target="_blank">ASPR website</a>.</p> <p> “Our calls from doctors have increased tenfold since the first case was diagnosed,” said CDC Director Tom Frieden, MD, in a <a href="http://www.cdc.gov/media/releases/2014/t1007-ebola-confirmed-case.html" rel="nofollow" target="_blank">press briefing</a> Tuesday. “There’s a lot of awareness, and we’re working to increase that even further …. We want to make sure any lessons we learn from Dallas are rapidly incorporated into the practice of health departments around the country.”</p> <p> The virus is spread through contact with bodily fluids of a person who is sick with or has died from Ebola, and the chances of a widespread outbreak in the United States are unlikely, Dr. Frieden said last week. </p> <p> In addition, the <em>Journal of the American Medical Association </em>and Kaiser Family Foundation created a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1911333" rel="nofollow" target="_blank">visual snapshot</a> of the 2014 Ebola outbreak, including key facts about Ebola, the number of cases in the current outbreak and a summary of the key U.S. agencies responding to the crisis.</p> <p> A new <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1916610" target="_blank" rel="nofollow">Viewpoint piece</a> in <em>JAMA Internal Medicine</em> also looks at public health in the age of Ebola.</p> <p> On Tuesday, the National Institutes of Health (NIH) said it <a href="http://www.nih.gov/news/health/oct2014/od-07.htm" rel="nofollow">discharged a physician</a> who had been exposed to the virus and had been kept in isolation at the NIH’s Clinical Center. The physician was admitted to an isolation unit in Bethesda, Maryland, Sept. 28 after returning from Sierra Leone, where he was a volunteer in an Ebola unit and had been exposed to the virus by a needle stick injury.</p> <p> Patients can get more information about Ebola on the <a href="http://www.cdc.gov/vhf/ebola/index.html" rel="nofollow" target="_blank">CDC website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:98da53be-9044-4734-a172-689f657aca97 PQRS incentive payments now available http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_pqrs-incentive-payments-now-available Wed, 08 Oct 2014 20:24:00 GMT <p> Incentive payments for the Physician Quality Reporting System (PQRS) now are available for eligible professionals and group practices who successfully met the program’s reporting criteria for Medicare Physician Fee Schedule Part B services furnished in 2013.</p> <p> Physicians can access their 2013 feedback reports in two ways:</p> <ul> <li> <strong>National Provider Identifier (NPI)-level reports.</strong> These reports can be requested through the CMS <a href="https://www.qualitynet.org/portal/server.pt/community/communications_support_system/246" target="_blank" rel="nofollow">communication support page</a> by creating an NPI-level feedback report request. The report will be sent electronically in two to four weeks to the email address provided in the request.</li> <li> <strong>Taxpayer Identification Number (TIN)-level reports.</strong> These reports contain NPI-level detail and are available for download via CMS’ <a href="https://www.qualitynet.org/portal/server.pt/community/pqri_home/212" target="_blank" rel="nofollow">quality reporting portal</a>. An “Individuals Authorized to Access CMS Computer Services” (IACS) account is required to access a TIN-level report through the portal. To request an IACS account, consult the <a href="https://www.qualitynet.org/portal/server.pt/gateway/PTARGS_0_207_374_212_229_43/http%3B/pdpqap42-app.sdps.org%3B7087/publishedcontent/publish/pqri_content/pqri_guest_community/userrefguide.html" target="_blank" rel="nofollow">IACS quick references guides</a>. </li> </ul> <p> For more information about the PQRS incentive payments, review CMS’ <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html" rel="nofollow">analysis and payment</a> Web page. For more information about interpreting the data in the report, view the <a href="http://cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2013_PQRSFeedbackReportUserGuide_F04-02-2014.pdf" target="_blank" rel="nofollow">2013 PQRS feedback report user guide</a> or the <a href="http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ERxIncentive/Downloads/2013_eRxFeedbackReportUserGuide_F04042014.pdf" target="_blank" rel="nofollow">2013 eRx incentive program feedback report user guide</a>.</p> <p> Physicians can contact the QualityNet Help Desk for assistance 8 a.m.-8 p.m. Eastern time Monday through Friday at (866) 288-8912 or <a href="mailto:qnetsupport@hcqis.org" rel="nofollow">qnetsupport@hcqis.org</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b8363ac3-2326-43e8-9404-708eab3fb730 Plan to attend PCPI meeting Oct. 22-23 in Chicago http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-pcpi-meeting-oct-22-23-chicago Wed, 08 Oct 2014 20:14:00 GMT <p> Learn how organizations are engaging patients to develop meaningful, patient-reported outcomes at the AMA-Convened Physician Consortium for Performance Improvement® (PCPI) <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement/pcpi-members/meetings.page" target="_blank">Membership and Committee Meeting</a>, Oct. 22 to 23 in Chicago.</p> <p> This meeting convenes the membership of the PCPI, as well as other experts in quality improvement and performance measurement.  A panel of PCPI member organizations will discuss ways specialty societies are responding to changes in reporting systems and the need for measures. Attendees also will learn about strategies to engage their members in important national and organizational outcomes like the Physician Quality Reporting System. </p> <p> <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144646E&TID=jJ3zaAmIfGM1jPdU904ESA%253d%253d&OID=130" target="_blank">Register</a> (log in) for the meeting and reserve a hotel room online by 1 p.m. Eastern time Oct. 20. Learn more about the PCPI on its <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement.page?" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:316662b3-2744-4fc4-a234-ead9d292e0be Learn what med schools are doing to increase diversity http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_learn-med-schools-doing-increase-diversity Wed, 08 Oct 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/5/b3659f2b-c1a0-45e1-a519-2875c20e7fa9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/5/b3659f2b-c1a0-45e1-a519-2875c20e7fa9.Large.jpg?1" style="float:right;margin:10px;" /></a>What are the most important factors in attracting a medical student body that reflects a diverse patient population? Hang out with experts, educators and physicians in training from 8 p.m. to 9 p.m. Eastern time Oct. 20 to share your ideas and learn what others think.</p> <p> Join the online <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Google Hangout</a> to listen, watch and share ideas on:</p> <ul> <li> Innovative ideas to attract medical students from underrepresented groups</li> <li> New ways medical schools are preparing current students for an increasingly diverse patient population</li> <li> How institutions teach and collect feedback on racial and ethnic health care disparities</li> </ul> <p> Panelists from the University of California Davis School of Medicine, Howard University College of Medicine and Chicago Medical School at Rosalind Franklin University of Medicine and Science will share their insights into developing a diverse student body that is prepared for tomorrow’s patient population. William McDade, MD, chair of the AMA Council on Medical Education and deputy provost for research and minority issues at the University of Chicago, will moderate the hangout.</p> <p> To participate in the live-streaming event, simply visit the <a href="http://goo.gl/buIcVY" rel="nofollow" target="_blank">Hangout page</a>. If you would like to post questions for the panelists to answer, you will need to be a Google user. Participate in the discussion on Twitter and Facebook using #AMAHangout.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:372b939b-ed28-4e06-b596-c1eeefe97cb1 CMS reopens period to apply for meaningful use hardship exemption http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-reopens-period-apply-meaningful-use-hardship-exemption Tue, 07 Oct 2014 22:18:00 GMT <p> The Centers for Medicare & Medicaid Services (CMS) announced Tuesday it would reopen the submission period for hardship exception applications in the electronic health record (EHR) meaningful use program, allowing more physicians to avoid next year’s payment adjustments for not demonstrating meaningful use. The new deadline is Nov. 30.</p> <p> Previously, the hardship application deadline was April 1 for hospitals and July 1 for physicians. This new opportunity is particularly helpful for physicians who have never participated in the meaningful use program, as they will face penalties in 2015 if they did not attest by Oct. 1. The agency reopened the submission period as a result of AMA advocacy.</p> <p> “Giving physicians more time to file for a hardship exemption provides necessary relief as many physicians are struggling to meet a number of reporting mandates to avoid multiple penalties,” said AMA President Robert M. Wah, MD, in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-07-statement-meaningful-use.page" target="_blank">statement</a>. “The AMA remains committed, however, to ensuring that the meaningful use program requirements are in fact meaningful and deliver the intended improvements in patient care and practice efficiencies. We look forward to continuing to work with the Administration to make the program requirements <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/proposed-rule-improves-meaningful-use-but-doesnt-far-enough" target="_blank">more flexible</a> and ensure physicians have certified products that better support their practices and patients’ needs.”</p> <p> The reopened hardship exemption application submission period is for physicians and hospitals that both:</p> <ul> <li> Have been unable to fully implement 2014 Edition certified EHR technology due to delays in availability of such technology</li> </ul> <p> And</p> <ul> <li> Who were unable to attest by Oct. 1 (for physicians) or July 1 (for hospitals) using the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">flexibility options CMS implemented in September</a> that allow physicians to use older certified EHR technology for attestation</li> </ul> <p> CMS will only consider these circumstances for the reopened application submission period.</p> <p> Physicians who seek to avoid the 2015 penalty can read more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/last-chance-apply-july-1-avoid-meaningful-use-pay-penalty" target="_blank">hardship exemption categories</a> at <em>AMA Wire</em>®.</p> <p> CMS’ decision to reopen the hardship reporting period for physicians in this situation represents an important chance for Medicare physicians who have not yet participated in the meaningful use program to avoid a financial penalty in 2015. Any physician who wants to attest for a 90-day reporting period to obtain an incentive for 2014 can still do so—the deadline is Feb. 28—and can apply for a hardship exemption as a back-up plan.</p> <p> Find more information on CMS’ <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html" target="_blank" rel="nofollow">payment adjustments and hardship exceptions Web page</a>.</p> <p> View a <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/PaymentAdj_HardshipExcepTipSheetforEP.pdf" target="_blank" rel="nofollow">CMS tip sheet</a> about the meaningful use payment adjustments and hardship exceptions and the 2014 certified EHR technology hardship exception <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CEHRT2014_HEGuidance_EPs.pdf" target="_blank" rel="nofollow">guidance document</a> to learn more.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b6b4f903-a610-46d7-a829-3a919c899865 Coding cards can help prepare for ICD-10 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_coding-cards-can-prepare-icd-10 Tue, 07 Oct 2014 21:05:00 GMT <p> Physicians have one year to comply with implementation of the ICD-10 code set. Get ready with new coding cards from the AMA Store.</p> <p> <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500016&navAction=push" target="_blank">ICD-10-CM 2015 Snapshot Coding Cards: Multiple Specialties</a> provide the most commonly reported diagnostic codes and associated guidelines for a specialty, including the specificity required to improve documentation. These reference cards include:</p> <ul> <li> Guidelines and tips to make coding more accurate and complete</li> <li> An alphabetical layout to quickly locate the code that accurately reflects a patient’s condition</li> <li> Tailor-made content for a particular specialty</li> <li> Portability—the cards fit into the codebook</li> </ul> <p> For hospital inpatient settings, the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500027&navAction=push" target="_blank">ICD-10-PCS 2015 Snapshot Coding Card Collection</a> includes a collection of cards to help build understanding around how to build an inpatient procedural code.</p> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now.</p> <p> Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:47ba20fc-ba46-455e-b118-a0d09c83337b How playing games can change medicine’s future http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_playing-games-can-change-medicines-future Tue, 07 Oct 2014 21:02:00 GMT <p> In the health care system of tomorrow, physicians and patients will be playing many more games, according to some speakers with innovative ideas at TEDMED 2014, which took place last month in San Francisco and Washington, D.C.</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/07557238-e837-4d66-a04f-87e1f8974dbe.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/0/07557238-e837-4d66-a04f-87e1f8974dbe.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;"> <em><span style="font-size:11px;">“The act of play, overcoming these challenges through trial and error, recalibrates our perceptions,” said Howard Rose.</span></em></td> <td>  </td> </tr> </tbody> </table> <p> Giving medical students the opportunity for some hands-on gaming, particularly simulations, is part of the future, said Carla Pugh, MD, vice chair of education and patient safety at the University of Wisconsin School of Medicine and Public Health and clinical director of the University of Wisconsin Health Clinical Simulation Program.</p> <p> Dr. Pugh found the lack of haptic experience offered in medical school and residency to be challenging, so she researched the use of sensor and data acquisition technology to measure and characterize the sense of touch. Her E-Pelvis is an electronic pelvic mannequin attached to a computer monitor. Students practice pelvic exams on the device, and instructors can see the location and intensity of the students’ touch.</p> <p> “Reading about how to do a pelvic exam and then actually trying to do it, there’s so much that’s lost in translation,” Dr. Pugh said. “I think that everybody’s ready to kind of change the direction and the way in which we train and learn, and there’s so many things that are available right now. We just need to embrace them.”</p> <p> Physicians in training aren’t the only ones to benefit from games—simulations can help patients in ways other therapies sometimes can’t, said Howard Rose, president of Firsthand Technology, a 3D game and simulation developer.</p> <p> Mental health patients are using games to confront phobias, such as a fear of spiders, by placing patients into virtual situations with their fears. Patients with severe burns can play a therapeutic game that immerses them in a snowy, cold environment. Immersive simulations, such as a game set in Iraq, lets veterans return to virtual battle to reduce post-traumatic stress disorder.</p> <p> “The act of play, overcoming these challenges through trial and error, recalibrates our perceptions,” Rose said. “It’s time for us to embrace this technology and use this opportunity for health. … What if instead of prescribing drugs to mask pain or poor health habits, you prescribe virtual reality games for building resilience, bringing relief and changing health habits?”</p> <p> Video gaming may be useful to improve health outcomes, said Brian Primack, MD, associate professor of medicine, pediatrics, and clinical and translational science at the University of Pittsburgh School of Medicine. In his talk, Dr. Primack said the current state of technology is only scratching the surface of gaming’s potential to improve health.</p> <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/9/b684c274-3b62-468d-89f7-78bb93413adb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/9/b684c274-3b62-468d-89f7-78bb93413adb.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;"> <em><span style="font-size:11px;">"There is huge potential here,” said Brian Primack, MD. "We’re going to need to get much more serious about games."</span></em></td> </tr> </tbody> </table> <p> “The video game industry is really good at getting people to perform certain tasks and stick with them for the long haul,” Dr. Primack said. But it won’t be easy, he added.</p> <p> “There is huge potential here,” he said. “We’re going to have to carefully apply principles. We’re going to need to get much more serious about games.”</p> <p> <strong>Watch these speakers give their talks at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the appropriate video:</p> <ul> <li> For the beginning of Dr. Pugh’s talk, find the “Play is not a waste of time” video and go to 32:59.</li> <li> For the beginning of Rose’s talk, find the “Play is not a waste of time” video and go to 1:28:47.</li> <li> For the beginning of Dr. Primack’s talk, find the “Stealing smart – San Francisco stage” video and go to 02:24.</li> </ul> <p> View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1176c528-209b-4562-a807-d8667b63167a How physicians are tackling health care disparities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-tackling-health-care-disparities Tue, 07 Oct 2014 21:00:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/12/4b2df375-6642-49be-bcd2-e8036d887a34.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/12/4b2df375-6642-49be-bcd2-e8036d887a34.Large.jpg?1" style="float:left;margin:10px;" /></a>Recently I attended the National Indian Health Board’s annual meeting, where about 1,000 people from 500 tribes across the country met to discuss Native American health care issues, advocacy and policy. I was able to learn about the unique challenges Native American physicians and their patients face.</p> <p> One physician stood up and said that he spent 30 years practicing on a reservation, and that he believed Native Americans’ health issues stem primarily from poverty. Native communities continue to lag far behind other communities in basic resources and services. This means that though Native Americans face the same prevalent health issues as the rest of the country—diabetes and cardiovascular disease—their problems are magnified. And this can’t simply be addressed in our mainstream health care. We need different, customized strategies that acknowledge the particular challenges our patient populations face.</p> <p> I also recently attended the Korean American Medical Association meeting, and heard about one of their prime issues— gastric cancer in Asian American populations. There is no guideline for early gastric cancer screening in our country for this population, but in Korea, early detection and survival are much better because of screening at early age. Making a similar change here will require education, policy and payment changes.</p> <p> As physicians, we all see disparities like this in our own work. We know there are racial and ethnic disparities in chronic diseases and health care, and we’re working to better understand and address these disparities in ambulatory clinical practices through the <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities.page?" target="_blank">Commission to End Health Care Disparities</a>, which met last month in Chicago.</p> <p> The commission is determining better ways to collect and use patient-level data, including patient race, ethnicity, preferred language and LGBT status, which will be helpful in improving the quality of care we provide for all patients. It’s also working to educate organized medicine on why a diversified health care workforce is crucial to eliminating disparities, as studies show that minority health professionals are more likely to serve minority and medically underserved populations.</p> <p> Health care disparities can feel like an overwhelming problem for the average physician, but there are things we are doing to make progress towards more equitable care. As an educator, I firmly believe that teaching our medical students about the disparities that exist, and ways to counteract these disparities, is the best first step.</p> <p> Our country also made forward strides in expanding health care coverage to more Americans, giving many more patients access to the care they need. In caring for our patients, physicians should be aware that racial and ethnic disparities exist, and that we can support policy and advocacy efforts aimed at eliminating these disparities.</p> <p> The commission has <a href="http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/commission-end-health-care-disparities/reports-resources-cehcd.page?" target="_blank">resources for physicians</a> to learn more about health care disparities.</p> <p> <strong>You tell me: </strong>How are you addressing health care disparities in your practice? Post a comment below at <em>AMA Wire</em>® or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c0ec48fe-5fb1-4af7-b8e3-d72f6a9133f3 What MS4 students wish they had known about medical school http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ms4-students-wish-known-medical-school Mon, 06 Oct 2014 20:00:00 GMT <p> First-year medical students, and even those farther along in their education, may be feeling a bit overwhelmed. Hear tips from seasoned fourth-year students on what they wish they had known about medical school that would have helped them.</p> <p style="margin-left:40px;"> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/9535c117-e07e-4024-8460-8a3c2a0f2ea5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/4/9535c117-e07e-4024-8460-8a3c2a0f2ea5.Large.jpg?1" style="float:right;margin:10px;" /></a><strong>1. Your study style may need to change. </strong>“I remember treating my first anatomy test as I had done several of my tests in my undergraduate program: type up my notes, study those notes and then take the test,” said Laura Stone McGuire, a fourth-year medical student at the University of Miami Miller School of Medicine. “But I soon discovered that this study strategy did not work for anatomy. Be aware that you may have to try new study methods in order to succeed in your classes.”</p> <p style="margin-left:40px;"> McGuire said she found she had a kinesthetic learning style and that typing and reading her notes wasn’t enough for her to understand the material. “I needed to work hands-on in the lab to best learn anatomy,” she said. “I discovered something similar when I studied for Step 1, and I used multiple channels of leaning: I watched videos, listened to audio recordings, worked with models and studied from the book. To be adaptive and to readily assess what works best for you is important.”</p> <p style="margin-left:40px;"> <strong>2. Remember that your personal wellness is important. </strong>“Take advantage of study breaks when you can,” said John Lesko, a fourth-year medical student at Eastern Virginia Medical School. “It’s very easy to burn out early if you don’t find a balance. Find something—be it exercise, friends, involvement in a group—that gives you exposure to life beyond medical school.”</p> <p style="margin-left:40px;"> Ravi Shah, a fourth-year medical student at Rutgers New Jersey Medical School, shared similar advice about not neglecting your own health. “Always have exercise built into your schedule,” he said. “Tomorrow is another day.”</p> <p style="margin-left:40px;"> <strong>3. Look for research opportunities early. </strong>“Even if you’ve never done [research] and haven’t decided on a specialty, simply ask a department or individual, and most are very happy to help,” said Tessa Stamile, a fourth-year medical student at the University of Oklahoma College of Medicine. “The earlier you start, the better your chances will be to complete the project and get published.”</p> <p style="margin-left:40px;"> <strong>4. Participate in opportunities outside the classroom. </strong>“Take opportunities to explore your career and embrace your education by getting involved in extracurricular activities in the local and global community,” said Shannon Brockman, a fourth-year medical student at the University of Florida College of Medicine. “From student-run, free clinics to medical mission trips, it’s amazing how much you can learn when you experience medicine outside of the classroom.”</p> <p style="margin-left:40px;"> <strong>5. Take advantage of your “last summer.” </strong>“You may hear people talk about your ‘last summer’ between MS1 and MS2 years,” said Stone McGuire. “Well, it’s true that this is your last substantial amount of free time during your medical career, so do something fun, worthwhile and meaningful. Consider all the great possibilities out there: research, community service, travel and more.”</p> <p> <strong>What do you wish you had known about medical school? </strong>Share your tips for medical students on the AMA Medical Student Section <a href="https://www.facebook.com/amamss" rel="nofollow" target="_blank">Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b0700d80-7bef-4ba7-8b5d-c2f9897ddfd2 Make your voice heard on important topics to residents http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_voice-heard-important-topics-residents Mon, 06 Oct 2014 17:55:00 GMT <p> AMA members will debate some of the hottest issues in medicine at the AMA Resident and Fellow Section (RFS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/meetings-events/rfs-meetings.page?" target="_blank">Interim Meeting</a>, Nov. 6 to 8 in Dallas. Make sure your voice is heard: Even if you can’t attend the meeting, you can contribute your opinions on these key topics in the AMA-RFS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/rfs-reference-committee.page" target="_blank">Virtual Reference Committee</a> (log in), which is open through Oct. 17.</p> <p> Residents who participate in the meeting will discuss 13 different policy resolutions. Here are a few key issues up for debate:</p> <ul> <li> <strong>Opposition to proposed caps on Public Service Loan Forgiveness Amounts.</strong> One resolution discusses the importance of keeping medical student debt at a minimum and encouraging work in underserved areas or lower paying specialties, asking the AMA to oppose any budgetary proposals or legislation seeking to stop or reduce the <a href="https://studentaid.ed.gov/repay-loans/forgiveness-cancellation/charts/public-service#what-is-the-public" target="_blank" rel="nofollow">Public Service Loan Forgiveness Program</a>.</li> <li> <strong>Establishment of a quality improvement forum. </strong>Both individual residents and residency programs implement unique and innovative quality improvement interventions without a mechanism in place to discuss or share ideas. This resolution asks the AMA to establish a forum where resident members can discuss local quality improvement projects and outcomes in order to facilitate more rapid improvement across training programs.</li> <li> <strong>Response to epidemics and pandemics. </strong>With the current Ebola epidemic continuing to make front page news, global epidemics and pandemics are a very real and relevant topic. This resolution asks the AMA to work with the Centers for Disease Control and Prevention and international health organizations to provide organizational assistance to curb epidemics, including calling on American physicians to provide needed resources such as human capital and patient care-related supplies, as well as providing timely and regular updates to its constituents.</li> <li> <strong>Two-way communications between AMA members. </strong>This resolution asks the AMA to provide a communications platform for members that allows for the unrestricted exchange of ideas among individuals without time delay that is easy to access and allows for direct member-to-member discussion.</li> </ul> <p> AMA-RFS members can comment on resolutions through Oct.17 through the <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/rfs-reference-committee.page" target="_blank">Virtual Reference Committee</a> or in-person before the Reference Committee at the Interim Meeting. Learn more about resolutions and the policymaking process on the AMA-RFS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/resident-fellow-section/advocacy-policy.page?" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b694a2aa-8f8b-4460-8194-398af43c400a Ruling could impede efforts to improve patient safety http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ruling-could-impede-efforts-improve-patient-safety Mon, 06 Oct 2014 17:54:00 GMT <p> Physicians and patient safety groups are petitioning a state supreme court to overturn a recent ruling that would force disclosure of peer review documentation and potentially bring ongoing efforts to improve the quality and safety of patient care to a halt.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center.page" target="_blank">Litigation Center of the AMA and State Medical Societies</a>, the Kentucky Medical Association and more than two dozen patient safety and health care quality groups from around the country have filed a brief with the Kentucky Supreme Court, arguing that the appeals court ruling in <em>Tibbs v. Bunnell</em> would hamper open discussions that are essential to maintaining and improving patient safety.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/8/2be6198f-2971-4188-a8ef-f88b5458cdcb.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/8/2be6198f-2971-4188-a8ef-f88b5458cdcb.Large.jpg?1" style="float:left;margin:10px;" /></a>The brief calls out the errors of the ruling, which said that any medical records and reports required to be collected and maintained under state law should be subject to disclosure, even if they are confidential documents. The ruling identified peer-review, credentialing and pharmacy records as examples of information that cannot be protected from discovery.</p> <p> “It is therefore no surprise that numerous hospitals, patient safety organizations and other stakeholders are already expressing fear that the decision will effectively put an end to the confidential sharing of adverse events, peer review documents and other information relating to patient safety activities,” the brief states. “[This] sharing has proven so valuable in improving patient outcomes in Kentucky.”</p> <p> In particular, the ruling would undermine federal Patient Safety Act, which is intended to promote a protected space in which to conduct frank conversations about patient safety and exchange reports and analyses that have broad implications.</p> <p> “Unless the decision is modified or clarified, it will significantly impair and undermine efforts by hospitals, physicians and other providers to improve the quality of health care to patients in the Commonwealth of Kentucky,” the brief states.</p> <p> Visit the AMA <a href="http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/peer-review.page" target="_blank">Litigation Center’s Web page</a> to learn more about this case and others related to peer review.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:87e251d4-eea2-4ff2-b133-5964c099bfbe Nobel Prize awarded for “inner GPS” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_nobel-prize-awarded-inner-gps Mon, 06 Oct 2014 15:04:00 GMT <p> The 2014 Nobel Prize in Physiology or Medicine was awarded to three scientists for their discoveries of cells that constitute a positioning system in the brain.</p> <p> The Nobel laureates have discovered an “inner GPS” in the brain that makes it possible to orient ourselves in space, demonstrating a cellular basis for higher cognitive function. The discovery can help answer how humans know where they are, how they find the way from one place to another and how they store this information in such a way that it can be immediately found.</p> <p> The Nobel Assembly at Karolinska Institutet announced the award Monday. One half will be awarded to John O’Keefe, PhD, an American-British professor of cognitive neuroscience and the director of the Sainsbury Wellcomme Centre in Neural Circuits and Behavior at the University of London. The other half will be awarded to two Norwegian scientists—May-Britt Moser, PhD, a professor of neuroscience and the director of the Centre for Neural Computation at the Norwegian University of Science and Technology, and her husband Edvard Moser, PhD, also a professor at the university and the director of the Kavli Institute for Systems Neuroscience.</p> <p> Read more about the winners and their discoveries at the <a href="http://www.nobelprize.org/nobel_prizes/medicine/laureates/2014/press.html" target="_blank" rel="nofollow">Nobel Prize website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8419a26b-7d1b-4350-944d-c060f5d78c8e Plan to attend AMA Young Physicians Section Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_plan-attend-ama-young-physicians-section-interim-meeting Mon, 06 Oct 2014 14:00:00 GMT <p> Take advantage of a unique opportunity to network with other young physicians from across the United States and meet with leaders from the AMA and your state and medical specialty societies: Participate in the AMA Young Physicians Section (YPS) Interim Meeting, to take place Nov. 6-8 in Dallas.</p> <p> This year’s meeting, which will take place at the Hilton Anatole in Dallas, offers a variety of events, including leadership training, policy discussion and education sessions.</p> <p> Details about the meeting and surrounding events are available on the AMA-YPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events.page?" target="_blank">meetings and events Web page</a>. Registration closes Nov. 1; <a href="https://apps.ama-assn.org/mtgreg/register/search?EID=20144452E&TID=vCIaLRgK%252bYeYYFMXecjotQ%253d%253d&OID=130" target="_blank">log in</a> to register today.</p> <p> The AMA-YPS Online Discussion Forum will open Oct. 13. Testimony from AMA-YPS members will be accepted until 1 p.m Eastern time Oct. 27. To participate in the AMA-YPS online discussion forum, you will need your physician login credentials (username and password).  Click on the link above and log in on the left side of the screen. Visit the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/yps-reference-committee.page" target="_blank">Web page</a> for a link to the forum.</p> <p> If you don’t have an AMA username and password, you can obtain them using the right side of the screen to create an account. If you’ve forgotten your password or username, click on the “Forgot your password?” link for recovery assistance.</p> <p> Please consider <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/meetings-events/ama-yps-assembly-meeting-service-opportunities.page" target="_blank">volunteering</a> for the section’s reference, handbook review or credentials committees. To do so, send an email with your committee preference to the <a href="mailto:YPS@ama-assn.org" rel="nofollow">AMA-YPS</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c6752637-e6d4-4e97-b9b2-a96f13030cdb Joint Commission releases updated sentinel events data http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_joint-commission-releases-updated-sentinel-events-data Mon, 06 Oct 2014 14:00:00 GMT <p> Nearly 59 percent of sentinel events since 2004 have resulted in patient deaths, according to recently updated <a href="http://www.jointcommission.org/Sentinel_Event_Statistics/" target="_blank" rel="nofollow">sentinel event statistics</a> from the Joint Commission. The updated statistics include 2014 summary data for Jan. 1 through June 30.</p> <p> A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof, including any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Data from the 8,275 incidents reviewed from 2004 through the first half of 2014 show a total of 8,495 patients have been affected by these events, with 58.7 percent resulting in the patient’s death, 9.4 percent resulting in loss of function and 31.9 percent resulting in unexpected additional care and/or psychological impact. The Joint Commission reviewed a total of 394 sentinel events during the first half of 2014.</p> <p> The Joint Commission learns of sentinel events either voluntarily from accredited organizations, or through other mechanisms such as the complaint process or media coverage. It is estimated that fewer than 2 percent of all sentinel events are reported to the Joint Commission and that only about two-thirds of these are voluntarily reported by the organization. As these data are not an epidemiologic data set, no conclusions should be drawn about the actual relative frequency of events or trends in events over time.</p> <p> The Joint Commission Sentinel Event database is designed to increase the general knowledge about sentinel events, their contributing factors, and strategies for prevention. For more information, visit the Joint Commission sentinel event <a href="http://www.jointcommission.org/sentinel_event.aspx" target="_blank" rel="nofollow">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:2278c565-2af3-4dfe-ac6e-442e6230e83f Doctors advocate for SGR repeal during lame duck session http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_doctors-advocate-sgr-repeal-during-lame-duck-session Fri, 03 Oct 2014 20:23:00 GMT <p> Members of Congress received house calls from physician leaders last month urging their U.S. senators and representatives to make repealing Medicare’s sustainable growth rate (SGR) formula a priority for the lame duck session.</p> <p> Members of the AMA Board of Trustees, leaders of four national specialty organizations, the AMA Council on Legislation and attendees of the annual AMPAC Federation meeting conducted more than 100 meetings on Capitol Hill. Physicians asked Congress to pass H.R. 4015/S. 2000, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which garnered bipartisan, bicameral support earlier this year.</p> <p> At the same time, the New Democrat Coalition held a briefing for its members and staff regarding the need for SGR repeal, during which the flaws of the formula and the negative impacts of perennial SGR patches were explained.</p> <p> All physicians should contact their U.S. senators and representatives while Congress is on recess over the next several weeks to encourage them to repeal the SGR formula during the lame duck session. Visit the <a href="http://fixmedicarenow.org/physician-toolkit/" rel="nofollow" target="_blank">Fix Medicare Now</a> website to access materials that can help these advocacy efforts.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:355906da-c337-4c3c-be36-846e3e7b9157 My journey to Bemidji: Doctors’ views of EHRs, regulatory burdens http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_journey-bemidji-doctors-views-of-ehrs-regulatory-burdens Fri, 03 Oct 2014 18:51:00 GMT <p> <em>An </em><em> </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physician-wellness-global-issue" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President-Elect </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/steven-stack.page" target="_blank"><em>Steven J. Stack, MD</em></a><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/2/94b14771-008b-4c6a-82d2-c092c37da246.Full.jpg?1" target="_blank"><img alt="Steven J. Stack, MD" src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/2/94b14771-008b-4c6a-82d2-c092c37da246.Large.jpg?1" style="float:left;margin:10px;" /></a>Among the many privileges of serving as a president-elect of the AMA is traveling the country to meet fellow physicians in their own backyards. A couple weeks ago, those travels brought me to Bemidji, a small town of roughly 13,500 residents in rural upstate Minnesota. Bemidji is Paul Bunyan country (you know, the big lumberjack with the big blue ox), lying along the headwaters of the Mississippi River.</p> <p> Richard Stennes, MD, a fellow emergency physician and longtime AMA delegate, graciously hosted me and introduced me to the joys of small-town America: great people, great hospitality and great community. People there know each other and look after one another. It was a genuine pleasure to have this small glimpse into the special glue that holds folks together.</p> <p> While in Bemidji, I spoke with physicians from a variety of specialties and backgrounds and was struck by both the similarities to and differences from what I see and hear from other doctors across the country. Among the most common topics we discussed were the challenges of our rapidly changing health care system, the crushing burden of excessive government mandates and regulations, and the unique aspects of health care in rural America.</p> <p> Even in this delightful corner of America, they are not sheltered from the challenges all physicians face in this country.</p> <p> One family physician revered by his colleagues told me that after 40 years of loving the practice of medicine, he recently pulled up to his office and didn’t want to get out of his car. For the first time, he felt dread at the prospect of starting his day. He hadn’t lost any of the joy in his relationships with his patients, but the excessive paperwork and the painful burden of his cumbersome electronic health record (EHR) system had robbed him of being able to focus on his patients.</p> <p> Within the next few months, this doctor will hang up his stethoscope for good. His retirement clearly was a sad occasion not only for him but also for his colleagues and the other hospital staff with whom he works.</p> <p> Similarly, an anesthesiologist specializing in pain management told me how a recent change in Medicare payment policy dropped payment for key procedures by 40 percent, putting him out of business. He explained that more than 140 new patients were waiting to be seen, but he had to shutter his practice and tell them they would have to seek care elsewhere—many miles away from Bemidji. It simply was no longer possible to sustain his practice.</p> <p> If these were isolated occurrences, they would be bad enough. But they are not. I hear these kinds of stories from physicians of all ages and in a variety of specialties.</p> <p> Excessive regulations and mandates are crushing physicians and their ability to care for their patients. We know this from personal stories like these as well as from broader research, such as the <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdf" rel="nofollow" target="_blank">AMA study</a> conducted last year by the Rand Corporation. It is in large part because of this crisis that the AMA is devoting so much attention to our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, one of our three strategic focus areas.</p> <p> As part of this initiative, we are using research, data and analytics to identify effective care delivery and payment models that can improve the quality of patient care, reduce health care costs for the nation and increase professional satisfaction for physicians.</p> <p> We’re also committed to improving the dire state of EHRs and redoubling our efforts to persuade the government that its EHR meaningful use program is undermining—not improving—the practice of medicine in our nation. In fact, just last month we released a framework of <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight key EHR usability priorities</a> to guide our work.</p> <p> As you can see in the comments dozens of physicians shared in response to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tell-ehr-improvements-would" target="_blank">my last AMA Viewpoints post</a>, doctors want to embrace EHR systems and other health IT that can help them in their practices, but the meaningful use program with its excessive mandates and merciless rigidity is turning physicians into data entry clerks rather than the healers they are trained to be.</p> <p> As a physician just entering the middle stage of my career, I know this path is unsustainable. We are committed to supporting physicians in patient care, preserving the special bond of the patient-physician relationship and restoring joy to the practice of medicine.</p> <p> We’ll keep up our efforts here at the AMA. In the meantime, please know you’re not alone. And thank you for all you do for our patients.</p> <p> Please share your own comments and stories with us in the comment section below to help advance our efforts on your behalf. Simply select the button at the bottom of this page to either sign in with your AMA credentials or create an account to post a comment.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:864b4e70-8ad3-41a5-b6c3-76d5e6b43b58 YMCA, physicians join to prevent diabetes in Florida community http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ymca-physicians-join-prevent-diabetes-florida-community Fri, 03 Oct 2014 18:48:00 GMT <p> Physicians in a Florida community are getting help with screening patients for type 2 diabetes and improving outcomes around the disease.</p> <p> St. Petersburg, a southwest Florida coastal town, is the fifth location to be announced in a collaborative pilot program taking place among physician practices, the YMCA of the USA and the AMA. Part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, this pilot is exploring a process for physicians to screen patients for prediabetes, refer eligible patients to participate in the local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.</p> <p> An estimated one-third of adults in Pinellas County, where St. Petersburg is located, have prediabetes. Fortunately, local residents who receive Medicare benefits can attend the YMCA Diabetes Prevention Program at no cost.</p> <p> “Diabetes prevention is vital to the future of medicine, and to the wellbeing of our patients,” said Miguel Faña Jr., MD, president of the Pinellas County Medical Association and a pilot participant. “Education is particularly important when combating this disease and the YMCA has been an invaluable resource for our community.”</p> <p> Based on the Centers for Disease Control and Prevention’s (CDC) evidence-based National Diabetes Prevention Program, the YMCA lifestyle intervention program <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-builds-proven-practical-approaches-improve-health-nationwide" target="_blank">has been proven to help patients</a> prevent or delay the onset of diabetes. To date, more than 650 participants have enrolled in the program in Pinellas County. Nationally, participants in the program achieve weight loss of about 6 percent, which significantly reduced their risk for developing type 2 diabetes.</p> <p> The AMA pilot will establish a process for physicians to routinely screen for prediabetes, refer patients to the YMCA and receive updates to incorporate into their patients’ care plans. The AMA last month announced another southwest Florida pilot site, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/southwest-florida-takes-diabetes-prevention" target="_blank">Venice</a>. Other locations include the state of Delaware, Indianapolis and Minnesota’s Twin Cities.</p> <p> Visit the CDC’s <a href="http://www.cdc.gov/diabetes/prevention/recognition/registry.htm#program" target="_blank" rel="nofollow">National Diabetes Prevention Program</a> website to find out whether an evidence-based diabetes prevention program is available in your community. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a0d90e30-3296-4385-be0b-b77a69482b1b JAMA Highlights: Study finds information lacking on implanted medical devices http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-finds-information-lacking-implanted-medical-devices Thu, 02 Oct 2014 21:00:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <object data="http://www.youtube.com/v/ugCU0_46LZo" height="350" id="ltVideoYouTube" src="http://www.youtube.com/v/ugCU0_46LZo" type="application/x-shockwave-flash" width="365"><param name="movie" value="http://www.youtube.com/v/ugCU0_46LZo" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" quality="best" src="http://www.youtube.com/v/ugCU0_46LZo" type="application/x-shockwave-flash" width="365" wmode="transparent"></embed></object></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;"> <p> <span style="font-size:11px;">JAMA</span><em><span style="font-size:11px;"> video: Providing team-based care after hospital discharge did not reduce readmission rates or deaths</span></em></p> </td> </tr> </tbody> </table> <p> <strong>Following hospital discharge, use of a "virtual ward" model of care does not reduce readmissions, risk of death</strong></p> <p> In a trial involving patients at high risk of hospital readmission or death, use of a virtual ward model of care (using some elements of hospital care in the community) after hospital discharge did not significantly reduce the rate of readmission or death up to a year following discharge, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1910109" rel="nofollow" target="_blank">study</a> in the October 1 issue of the <em>Journal of the American Medical Association (JAMA)</em>. Watch the <a href="http://youtu.be/ugCU0_46LZo" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Study examines medical professional liability claims related to esophageal cancer screening</strong></p> <p> An analysis of liability claims related to esophageal cancer screening finds that the risks of claims arising from acts of commission (complications from screening procedure) as well as acts of omission (failure to screen) are similarly low, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1910097" rel="nofollow" target="_blank">study</a> in the October 1 issue of JAMA.</p> <p> <strong>Study finds information lacking from FDA on implanted medical devices</strong></p> <p> Information is lacking on most implanted medical devices cleared by the U.S. Food and Drug Administration (FDA) despite a legal requirement that companies submit scientific evidence about the devices’ substantial equivalence to other devices already on the market, according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1910556" rel="nofollow" target="_blank">study</a> in JAMA Internal Medicine.</p> <p> <strong>Post-approval studies to assess safety, efficacy of devices after FDA OK</strong></p> <p> Small sample sizes and delays on agreement of protocol may hinder the clinical usefulness of post-approval studies (PASs) on medical devices ordered by the U.S. Food and Drug Administration (FDA), according to a <a href="http://archinte.jamanetwork.com/article.aspx?articleid=1910557" rel="nofollow" target="_blank">study</a> in JAMA Internal Medicine.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a14e4c7c-4439-41fc-a62c-5762f446e7a9 How one medical school created a “student GPS” http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-medical-school-created-student-gps Thu, 02 Oct 2014 19:35:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/2/e81b171c-ee9d-4989-82e8-a7aee271a83f.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/2/e81b171c-ee9d-4989-82e8-a7aee271a83f.Large.jpg?1" style="float:right;margin:10px;" /></a>Medical schools across the country are developing new tools and technology to improve the way they educate tomorrow’s physicians. At Vanderbilt University School of Medicine, a new program is tracking where and how students learn, gathering data on a variety of metrics to provide students with a real-time snapshot of their progress through medical school.</p> <p> Collecting this data will help Vanderbilt chart students’ personalized learning routes and help students figure out where they’d like to head in their future careers.</p> <p> “All of a sudden, we’ve got some serious power to do some incredible analysis—to GPS our students and to GPS our programs,” said Anderson Spickard III, MD (pictured right), assistant dean of educational informatics and technology at Vanderbilt.</p> <p> Dr. Spickard presented Vanderbilt’s new system at a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/med-schools-preparing-students-rapid-changes" target="_blank">special consortium meeting</a> of 11 medical schools that received AMA grants as part of the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative. The consortium schools met at Vanderbilt in September to discuss the progress they’re making in preparing tomorrow’s physicians for the rapid changes to come.</p> <p> Each student is assigned a portfolio coach for the entirety of their education. Teachers who elect to become portfolio coaches each work with 10 students. Students meet with their coaches three times a year to review their educational data and determine what areas they need to work on.</p> <p> Together, the learner and coach determine whether the student has developed the competencies necessary to move up to the next level of training. In this way, Vanderbilt is implementing competency-based education in its medical school. Promotion to the next phase isn’t based on grades but on individual students’ understanding and developing skill sets.</p> <p> The system behind this intense tracking is called “<a href="https://vstar.mc.vanderbilt.edu/" target="_blank" rel="nofollow">VSTAR</a>,” the school’s integrated learning platform. The software follows all the moving parts behind the medical school’s curriculum to provide broader snapshots of classes, groups and individual students over time.</p> <p> Because the software is open-source, it’s ready for other medical schools to tweak and apply to their own settings. Vanderbilt is continuing to refine VSTAR and investigate ways students can take their data with them after they graduate and move on to their residency programs.</p> <p> Vanderbilt and the other 10 medical schools participating in the AMA’s Accelerating Change in Medical Education initiative are working through new ways to train students. This consortium will identify best practices and rapidly disseminate them to other medical schools throughout the country.</p> <p> This post is the first in a brief series on new medical education technology to be published at <em>AMA Wire</em>® over the coming weeks.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9c0e3275-dd33-4a0c-915e-f3cd3a2b6fb8 CDC gives physicians guidance on Ebola screening http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cdc-gives-physicians-guidance-ebola-screening Wed, 01 Oct 2014 21:35:00 GMT <p> Following detection of the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-need-first-case-of-ebola" target="_blank">first case of the Ebola virus</a> in the United States, the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) are asking physicians to place <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screening criteria</a> in all emergency departments, ambulances and other “first contact” locations.</p> <p>  “Every healthcare organization should ensure it can detect a patient with Ebola, protect healthcare workers so they can safely care for the patient, and respond in a coordinated fashion,” the agencies said in an email. </p> <p> The CDC suggests that emergency department screen for:</p> <ul> <li> Fever, headache, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite, and in some cases bleeding.</li> </ul> <p> And:</p> <ul> <li> Travel to West Africa (Guinea, Liberia, Nigeria, Senegal, Sierra Leone or other countries where Ebola virus disease transmission has been reported by WHO) within 21 days (3 weeks) of symptom onset.</li> </ul> <p> If both criteria are met, then the patient should be moved to a private room with a bathroom, and standard, contact and droplet precautions followed during further assessment.</p> <p> The agencies also have issued a <a href="http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf" rel="nofollow" target="_blank">hospital checklist for Ebola preparedness</a>. In addition, physicians can watch a <a href="http://www.phe.gov/Preparedness/responders/Pages/ebola-healthcare-webinar.aspx" rel="nofollow" target="_blank">webinar</a> from the CDC and ASPR on Ebola preparedness for the U.S. health care system.</p> <p> The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care providers</a> offers more information on diagnosis and testing, protection and how to safely manage patients with the virus. Additional resources can be found on the <a href="http://www.phe.gov/preparedness/Pages/default.aspx" rel="nofollow" target="_blank">ASPR website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ca73ca2d-7182-4098-a3da-230587ddb1fb What physicians need to know about the first U.S. case of Ebola http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-need-first-case-of-ebola Wed, 01 Oct 2014 21:00:00 GMT <p> The Centers for Disease Control and Prevention (CDC) <a href="http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/united-states-imported-case.html" rel="nofollow" target="_blank">confirmed Tuesday</a> that the first case of Ebola has appeared in the United States. Here’s what physicians need to know.</p> <p> The virus is spread through contact with bodily fluids of a person who is sick with or has died from Ebola, and the chances of a widespread outbreak in the United States are unlikely, said CDC Director Tom Frieden, MD. And the CDC issued <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank">screen guidelines</a>.</p> <p> “I have no doubt that we will control this case of Ebola so that it does not spread widely in this country,” Dr. Frieden said. “It is certainly possible that someone who had contact with this individual could develop Ebola in the coming weeks … but there is no doubt in my mind that we will stop it here.”</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:318px;"> <tbody> <tr> <td> <a href="http://www.cdc.gov/vhf/ebola/pdf/evd-screening-criteria.pdf" rel="nofollow" target="_blank"><img alt="Download CDC's Ebola screening guide" src="http://pluck.ama-assn.org/ver1.0/Content/images/store/5/2/557ed50e-92f8-4398-82de-52182f78d965.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;"> <em><span style="font-size:11px;"><strong>See related story:</strong> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/cdc-gives-physicians-guidance-ebola-screening" target="_blank">CDC gives physicians guidance on Ebola screening</a></span></em><br />  </td> <td>  </td> </tr> </tbody> </table> <p> The individual, who is not a health care worker, traveled from Liberia on Sept. 19 and arrived in the United States on Sept. 20, according to the CDC. The patient began developing symptoms of the virus on Sept. 24 and initially sought care on Sept. 26, but was not admitted to the hospital until Sept. 28, when he was placed into isolation at Texas Health Presbyterian Hospital in Dallas.</p> <p> Initial Ebola symptoms are often non-specific. The CDC is encouraging physicians to take patient travel histories. The <a href="http://www.cdc.gov/vhf/ebola/hcp/index.html" rel="nofollow" target="_blank">CDC website for health care providers</a> offers more information on diagnosis and testing, protection and how to safely manage patients with the virus.</p> <p> The patient will remain at Texas Health Presbyterian. Edward Goodman, MD, an epidemiologist at the hospital, said the hospital has had an Ebola preparedness plan in place for some time.</p> <p> “In the week before this patient presented, we had a meeting of stakeholders who might be involved,” Dr. Goodman said. “Because of that, we are well prepared to deal with this crisis.”</p> <p> “Virtually any hospital in this country that can do isolation, can do isolation for Ebola,” Dr. Frieden said. “We don’t see a need from either a medical or an infection control standpoint to try to move the patient.”</p> <p> Health workers have begun tracing people who may have had direct or indirect contact with the patient. Meanwhile, patients can get more information about Ebola on the <a href="http://www.cdc.gov/vhf/ebola/index.html" rel="nofollow" target="_blank">CDC website</a>.</p> <p> “Ebola is a virus, it’s a virus that’s easy to kill by washing your hands, it’s easy to stop by using gloves and barrier precautions,” Dr. Frieden said. “The issue is not with Ebola that it’s infectious. The issue with Ebola is that the stakes are so high.”</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:1a246023-17c7-4795-a949-c1b41fe539f3 One-year countdown to ICD-10 begins: Start transition now http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_one-year-countdown-icd-10-begins-start-transition-now Wed, 01 Oct 2014 19:33:00 GMT <p> With just a year left to transition to the ICD-10 code set, practice management experts advise physicians to begin preparing for implementation by working with software vendors and testing their systems, if they haven’t already. See what physicians can use to make the switch to this costly code set a bit easier.</p> <p> Originally scheduled for implementation in 2014, a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/its-official-icd-10-compliance-date-now-oct-1-2015" target="_blank">final rule issued in August</a> gave physicians an extra year to prepare for implementation of the costly code set, developed by the World Health Organization and adapted for use in the United States by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services (CMS). </p> <p> The AMA continues to urge regulators to ease this physician burden, citing the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-implementation-costs-much-disruptive-new-study" target="_blank">dramatically high implementation costs</a> of ICD-10, coupled with an already onerous regulatory environment. However, practice management experts caution that physicians need to allow sufficient time to prepare their practices for the transition to ICD-10. Here are some resources that can help make this transition a bit easier:</p> <ul> <li> <strong>Free </strong><a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank"><strong>planning tools and resources</strong></a><strong>. </strong>Increase your practice’s readiness for ICD-10 with help from an action plan, checklists and templates. Use the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tip-sheet-series-can-ease-transition-icd-10" target="_blank">free tip sheet series</a> to complete an impact assessment, talk to your vendors and complete thorough testing.</li> <li> <a href="https://commerce.ama-assn.org/store/catalog/subCategoryDetail.jsp?category_id=cat1150010&navAction=push" target="_blank"><strong>Guides and training</strong></a>. Get a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" target="_blank">downloadable data file</a> of the complete ICD-10 2015 code set to use in testing your practice management system. A <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1250085&navAction=push" target="_blank">documentation guide</a>  provides essential training. In addition, a <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank">pocket-sized reference</a> and <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-codebooks-can-practices-gear-up-2015-compliance" target="_blank">new codebooks</a> can help your practice make this major transition.</li> <li> <strong>System testing</strong>. CMS <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/will-icd-10-claims-accepted-cms-designates-testing-weeks" target="_blank">announced three weeks</a> that it will dedicate to helping physicians test whether their claims will be accepted in the Medicare claims processing system: Nov. 17-21, 2014; March 2-6, 2015; and June 1-5, 2015. But physicians don’t need to wait for these specific testing weeks; physicians should begin testing with their Medicare Administrative Contractors as soon as their practices are ready. Experts urge physicians to test internal and external systems as often as possible to ensure a smoother transition.</li> </ul> <p> CMS will host a call from 1:30 p.m. to 3 p.m. Eastern time Nov. 5 to discuss transitioning to ICD-10. Experts will cover implementation issues, opportunities for testing, code updates, how claims that span the implementation date will be handled and other important topics. <a href="http://www.eventsvc.com/blhtechnologies/register/ab900ea8-4d82-4d4e-99fa-4fd69a977483" target="_blank" rel="nofollow">Register</a> by noon Eastern time Nov. 5.</p> <p> For more information about ICD-10, visit <a href="http://www.cms.gov/Medicare/Coding/ICD10/index.html" target="_blank" rel="nofollow">CMS’ website</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b2069282-8b67-47f4-bd88-5200ac340cdd Symposium to showcase research of students, residents, IMGs http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_symposium-showcase-research-of-students-residents-imgs Wed, 01 Oct 2014 19:31:00 GMT <p> View the exciting original research of medical students, residents and international medical graduates (IMG) at the 12th annual AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/research-symposium.page" target="_blank">Research Symposium</a> Nov. 7 in Dallas.<br /> <br /> The research competition submissions will be on display during the 2014 AMA <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">Interim Meeting</a>. The competition consists of two components: Podium presentations are from 4 p.m. to 5 p.m., followed by poster presentations from 5 p.m. to 6 p.m. All meeting participants and physicians in the local area are invited to attend.<br /> <br /> Research will be presented in the following categories:</p> <ul> <li> Eight categories for medical student participants: biochemistry and cell biology; cancer biology; clinical outcomes and health care improvement; immunology, infectious disease and inflammation; neurobiology and neuroscience; public health and epidemiology; radiology and imaging; and surgery and biomedical engineering.</li> <li> Two categories for resident and fellow participants: clinical vignette and clinical medicine (this includes quality improvement, health policy, clinical research and medical education).</li> <li> Three categories for IMG members of the AMA who are certified by the Educational Commission for Foreign Medical Graduates: clinical medicine/clinical vignette, health policy and medical education, and basic science.</li> </ul> <p> Consider serving as a judge during the presentations. <a href="http://www.ama-assn.org/ama/no-index/about-ama/research-symposium-judges.page" target="_blank">Sign up</a> now to judge.</p> <p> Following the display and judging, enjoy a sneak preview of a PBS documentary supported by the AMA at 6:30 p.m. Nov. 7 at the Hilton Anatole in Dallas.</p> <p> The film, <em>Rx: Hope for Health Care in the U.S.: How frontline innovators are creating dramatically higher-value health care solutions, </em>looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</p> <p> After the preview, AMA Research Symposium winners will be announced, followed by a reception with light hors d’oeuvres and beverages.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:fbe01c08-2e44-4ada-b0fa-6005a967523f Interested in research? Apply for grant money by Dec. 5 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_interested-research-apply-grant-money-dec-5 Wed, 01 Oct 2014 19:28:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/11/68848b2e-3513-400b-8b32-123f0fa0d319.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/11/68848b2e-3513-400b-8b32-123f0fa0d319.Large.jpg?1" style="float:right;margin:10px;" /></a>Residents, fellows and medical students interested in entering the research field can apply for grants of up to $5,000 from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a> to conduct small research projects. Apply by 6 p.m. Eastern time Dec. 5.</p> <p> The <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/seed-grant-research.page" target="_blank">Seed Grant Research Program</a>, now in its 14th year, will provide trainees with funds to conduct research in these areas:</p> <ul> <li style="margin-left:0.25in;"> Cardiovascular and pulmonary diseases: up to $2,500</li> <li style="margin-left:0.25in;"> Pancreatic cancer: up to $2,500</li> <li style="margin-left:0.25in;"> Neoplastic diseases: up to $5,000</li> </ul> <p> John Evankovich, MD, received a seed grant during the first year of his pulmonary and critical care medicine research residency at the University of Pittsburgh Medical Center to investigate how a protein commonly found in most cells contributes to inflammation and cellular damage.</p> <p> “Receiving the seed grant has certainly been a positive experience for me as a medical resident,” Dr. Evankovich said. “While physicians in training cannot participate in full-time research, it is important to stay involved with research projects, and this is exactly the type of program that allows this to happen. Undoubtedly, having this award as part of my career development will show my dedication to a career in academic medicine.”</p> <p> Past research topics have included:</p> <ul> <li style="margin-left:0.25in;"> Evaluation of innate immune signaling in HIV immunological non-responder monocytes</li> <li style="margin-left:0.25in;"> Changing knowledge, attitudes and behaviors regarding cervical cancer screening</li> <li style="margin-left:0.25in;"> Mechanisms underlying remote ischemic pre-conditioning in children undergoing cardiac surgery</li> </ul> <p> “Being a successful physician scientist means one needs to be able to justify study rationale to others to obtain funding to support his or her research,” said Sherry Yan, a fourth-year medical student at Columbia University College of Physicians and Surgeons, and a 2014 seed grant recipient. “Applying to the AMA Seed Grant provided just that experience for me. And receiving the grant is even more rewarding.”</p> <p> Learn about eligibility, funding restrictions and how to apply on the AMA Foundation <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/seed-grant-research.page?" target="_blank">Web page</a>. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:721f3303-9787-4b4f-b2db-1302bba92883 Hot topics covered at CME sessions during AMA Interim Meeting http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hot-topics-covered-cme-sessions-during-ama-interim-meeting Wed, 01 Oct 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/bc6d539a-de0c-4665-91be-ef694e8663ab.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/12/1/bc6d539a-de0c-4665-91be-ef694e8663ab.Large.jpg?1" style="float:right;margin:10px;height:75px;width:200px;" /></a>Don’t miss educational events in trending health care topics at the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a>, Nov. 7-10 in Dallas. Learn from experts about your role as a physician during in-flight medical emergencies, a recently reversed medical liability case, issues in population health and more.</p> <p> All sessions will be held at the Hilton Anatole, and several are continuing medical education (CME) activities, including:</p> <ul> <li style="margin-left:0.25in;"> <strong>Improving Health Outcomes: National and local approaches to population health</strong>. Learn about the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, the implications of population health on the practice of medicine and how one practice is improving health outcomes. This session will be offered from 11:30 a.m. to 12:45 p.m. Nov. 8 in Senators Lecture Hall.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>How new hospital regulations will affect you and your staff</strong>. Participants will learn about a new <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/doctors-tell-cms-put-brakes-new-medical-staff-rules" target="_blank">Medicare rule revising conditions of participation</a> for hospitals that could impact physicians’ role in hospital governance and patient care activities. This session will be offered twice: from 9:15 a.m. to 10:15 a.m. Nov. 8 in Grand Ballroom D-E, and from 3:30 p.m. to 4:30 p.m. Nov. 9. in Grand Ballroom A-B.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>A hospital’s success through physician-led quality improvement initiatives</strong>. This session will be held from 8 a.m. to 9 a.m. Nov. 8 in Grand Ballroom D-E.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Communication as a conflict management tool</strong>. Andrea Jones, executive managing director of eWomen Network Dallas/Ft. Worth, will present. This session will be held from 12:15 p.m. to 1:45 p.m. Nov. 8 in the Governors Lecture Hall.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Litigation Center Open Meeting</strong>. Hear a physician discuss a recent medical liability lawsuit brought against him and how his state medical society and the Litigation Center of the AMA and State Medical Societies helped reverse an adverse ruling. The event also will feature a panel discussion of <em>Wollschlaeger v. Governor of Florida</em>, which considers whether a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/law-limiting-physician-speech-upheld-doctors-call-rehearing" target="_blank">Florida statute</a> restricting the ability of physicians from discussing gun ownership with their patients is valid under the first amendment. This session will be offered from 3 p.m. to 5 p.m. Nov. 9 in the Wedgewood Ballroom.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Trends worth watching</strong>. Learn how current and emerging trends in health care could affect your patients and practice, with a focus on eight sectors of the health care system: health economics, public health infrastructure, health care resources and physician payment, science and technology in medicine, global health care, health status of the U.S. population, medical practice and quality, and medical education. Presented by the Council on Long Range Planning and Development, this session will be held from 9 a.m. to 10 a.m. Nov. 10 in Grand Ballroom C.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Council on Ethical and Judicial Affairs open forum</strong>. Physicians who attend can introduce issues to be considered for possible inclusion in the AMA <em>Code of Medical Ethics</em>, including topics specifically dealing with continuity of care in complex health care systems and the ethical obligation to provide competent care. This session will be offered from 9:30 a.m. to 11 a.m. Nov. 10 in Grand Ballroom D-E.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Stop paying to get paid: </strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/footing-bill-insurers-pay-methods-shouldnt-fall-doctors" target="_blank"><strong>Effective electronic payments</strong></a>. A national expert will help physicians understand how to avoid unnecessary fees and hassles in receiving payment from health insurers. This session will be held from 10 a.m. to 11 a.m. Nov. 10 in Grand Ballroom A-B.</li> </ul> <p> Participants do not need to be AMA members to claim credit, but an AMA username and password are required to complete the CME activity evaluation forms and save certificates in the AMA <a href="https://cme.ama-assn.org/Education.aspx" target="_blank">Online Learning Center</a>. Have your AMA login information ready if you are attending the 2014 AMA Interim Meeting. No paper evaluation forms will be available.</p> <p> If you have questions regarding your AMA username and password, or if you need to create a username and password before the meeting, contact the AMA Unified Service Center at (800) 621-8335.</p> <p> Other educational sessions of interest include:</p> <ul> <li style="margin-left:0.25in;"> <strong>In-flight medical emergencies</strong>. Learn about the pathophysiologic considerations of in-flight medical emergencies, the role of the flight crew and the legal implications for physicians who provide medical care during such situations. This session will be offered from 3 p.m. to 5 p.m. Nov. 9 in Senators Lecture Hall.</li> <li style="margin-left:0.25in;"> <strong>An update on the AMA Accelerating Change in Medical Education initiative</strong>. This session will take place from 8:45 a.m. to 9:30 a.m. Nov. 8 in Grand Ballroom A-B.</li> <li style="margin-left:0.25in;"> <strong>An update on the AMA </strong><a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank"><strong>Professional Satisfaction and Practice Sustainability</strong></a><strong> initiative.</strong> This session will take place from 10:30 a.m. to 11:30 a.m. Nov. 8 in Grand Ballroom D-E.</li> </ul> <p> For more information, consult the <a href="http://www.ama-assn.org/resources/doc/hod/x-pub/i14-speakers-letter.pdf" target="_blank">2014 Interim Meeting Speakers’ Letter</a> (log in).</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:08f6779a-b281-4983-a43f-4a4c0fc5a0f7 Health IT questions? These resources have the answers http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_health-questions-resources-answers Tue, 30 Sep 2014 23:00:00 GMT <p> Get help with your health IT needs using resources from the AMA Store to tackle the meaningful use electronic health record (EHR) program and the Health Insurance Portability and Accountability Act (HIPAA).</p> <p> Primary care physicians seeking to navigate the complexities of the meaningful use program can use <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240066&navAction=push" target="_blank"><em>A Guide to Achieving Meaningful Use: Leverage Your EHR to Redesign Workflows and Improve Outcomes</em></a>, with details on Stages 1 and 2 of the program, and some early guidance on Stage 3.</p> <p> The resource offers a roadmap for clinical quality improvement as well as patient and caregiver engagement in the care decision process, helping you approach your work flow redesign with the goal of providing the most effective patient care—not just meeting an EHR vendor’s application design.</p> <p> If you need more guidance around HIPAA, look to <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1240031&navAction=push" target="_blank"><em>HIPAA Plain and Simple: After the Final Rule</em></a>. This resource includes the latest information and tools to implement systems and ensure compliance, helping you understand the complex regulation of HIPAA and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.</p> <p> For an even deeper understanding of HIPAA, use the <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod1230027&navAction=push" target="_blank"><em>Handbook for HIPAA-HITECH Security</em></a>. This quick-reference tool also provides step-by-step guidance to implement and maintain compliance with the latest regulations and federal laws. The handbook and accompanying CD-ROM offer the support you’ll need, including case studies, question-and-answer sections and customizable checklists to document your compliance activities.</p> <p> In addition, you can reference information on key topics in health IT on the AMA’s health IT <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology.page" target="_blank">Web page</a>.</p> <p> AMA members receive a discount on a wide range of products from the <a href="https://commerce.ama-assn.org/store/" target="_blank">AMA Store</a>. If you’re not a member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:af7ccfd0-9890-4f13-a40b-d41735740af6 How we’re making it easier to get paid http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_were-making-easier-paid Tue, 30 Sep 2014 22:59:00 GMT <p> <em>An </em><em> </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/barbara-mcaneny.page" target="_blank"><em>Barbara L. McAneny, MD,</em></a><em> chair of the AMA Board of Trustees.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/10/90584091-8714-403a-9adb-0c37eb68a86b.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/10/90584091-8714-403a-9adb-0c37eb68a86b.Large.jpg?1" style="float:left;height:140px;width:100px;margin:10px;" /></a>As managing partner of my practice, I know firsthand the many challenges physicians face in the day-to-day business of keeping a medical practice afloat.</p> <p> One of the biggest consumers of time and resources is securing claims payments from health insurers. And it’s a process that has become even more taxing thanks to a relatively new form of payment that puts money back into health insurers’ pockets at our expense.</p> <p> The entire claims payment process is a challenging one. At my practice, we have 22 billing staff to support the clinical work of 17 physicians. They’re busy not only submitting claims but trying to figure out what’s happening to them once they’re out the door—we don’t always know whether the claims were received, where they are in the process or why they are denied. Then there’s the challenge of addressing claims that were paid incorrectly—an all-too-common problem with many insurers.</p> <p> The AMA continues its aggressive efforts to improve these issues by advocating for key changes before the federal government and with standard-setting bodies.</p> <p> At the moment, one of the most pressing issues is virtual credit cards, a payment form that is gaining popularity among insurers over the standard electronic funds transfer (EFT) transaction and paper checks.</p> <p> The problem is that while insurers get cash-back rewards from paying this way, we physicians are charged fees per transaction—typically 3-5 percent of the total payment. So an insurer may owe $5,000. But if it’s paid with a virtual credit card, the physician could lose up to $250 in fees. Whether you’re a practice owner or an employed physician for whom payments impact productivity calculations, these fees can add up quickly.</p> <p> At the same time, these payments take practices more time to process. They require manually entering information, correcting entry errors and reconciling the payment with a separate claims remittance advice.</p> <p> We recently explained this situation in <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/ncvhs-virtual-cards.pdf" target="_blank">testimony</a> (log in) to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS). And we’re pressing HHS to issue additional guidance. Just a few weeks ago, we sent a <a href="http://www.ama-assn.org/resources/doc/psa/x-pub/joint-virtual-card-letter-hhs.pdf" target="_blank">letter</a> (log in) alongside three other leading organizations, calling on the agency to prohibit insurers from forcing physicians to accept this form of payment.</p> <p> We also urged the agency to require insurers to give full upfront disclosures of associated fees, obtain physician authorization before implementing virtual card payments and ensure an easy opt-out process if a physician later chooses not to accept this form of payment.</p> <p> While we’re working on this issue, you can take action now to protect your practice. It’s your right to request insurers to pay via the EFT standard transaction, which works like direct deposit and can cut down the time your staff spends on processing paper checks. There are two easy ways to learn more:</p> <ul> <li> Our <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/electronic-transactions-toolkit/eft-toolkit.page?" target="_blank">EFT toolkit</a> gives guidance about physicians’ rights regarding electronic payments, the effects of virtual credit card payments, and the ins and outs of EFT payments.</li> <li> A continuing medical education session, “Stop paying to get paid: Effective electronic payments,” will take place at 10 a.m. Nov. 10 as part of the <a href="http://www.ama-assn.org/sub/meeting/index.html" target="_blank">2014 AMA Interim Meeting</a> in Dallas. Among the speakers will be a national electronic payments expert.</li> </ul> <p> If you aren’t familiar with these issues, now’s the time to learn more. It will save your practice time and money that can be better invested in patient care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3879df28-5580-4093-a2b2-894e8b1df70c What physicians are saying about EHR improvements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-saying-ehr-improvements Tue, 30 Sep 2014 21:09:00 GMT <p> Last month, an AMA-convened panel of experts outlined the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable">eight top challenges and solutions for improving electronic health records</a> (EHR). Physicians weighed in on which EHR improvements would help them the most.</p> <p> Here’s a sampling of what physicians had to say:</p> <p style="margin-left:.5in;"> <u>claudia koppelman</u>: Refocus “ALL” to the real purpose of a medical record—patient care ... NOT data collection for statisticians and insurance/payers, and the quality of care as well as outcomes will improve with resultant decrease in costs.</p> <p style="margin-left:.5in;"> <u>jmilammd</u>: Congrats, Steve, et. al., on an excellent document! After 2500+ deliveries, and 25 yrs. in private practice, you will be able to add my name to the list of those retiring early because the EHR and MU costs are not worth the cost of the lost time and sleep that I have experienced the last 5 months in my new job as a data entry clerk. Item #1 resonates the most w/ me since I feel no more enhanced today than I did last spring. The other posters have identified a variety of important issues; they’re not just whining. I hope CMS is listening!</p> <p style="margin-left:.5in;"> <u>dlmyers</u>: Unfortunately, the EHR companies figured out first that they could sell a product, but there were and mostly still are no national standards to use in their design. That is how we got the mess we have now, by getting the cart before the horse.</p> <p style="margin-left:.5in;"> <u>buttery</u>: All records should conform to a standard database lexicon so that records can be exchanged between physicians and hospitals, and allow research on health outcomes from use of medications and procedures.</p> <p style="margin-left:.5in;"> <u>cbschug</u>: I am an emergency physician, have been the lead for a hospital roll out of Cerner Millennium and currently work with Epic. … Care will be better because of the EMR; I am living that daily. But it seems that many hospital admins / EMR companies are happy to stop with the basic function and meaningful use dollar, not the functional improvements that we docs need to be better doctors.</p> <p style="margin-left:.5in;"> <u>lorenzl</u>: It would be nice for an EMR to actually help us practice cost-effective medicine .... I would love an EMR that is linked to the patient’s health insurance that could show me exactly what a particular medication and/or test would cost that patient in out-of-pocket expense. Seems a very simple thing for a computer system to do. That way, I could pick the most cost effective treatment for a patient’s problem, and let the patient know the likely out-of-pocket cost.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/tell-ehr-improvements-would">Read more comments</a> at <em>AMA Wire</em>®.</p> <p> <strong>Join the discussion:</strong> Which of the priorities resonates the most with you? Share your opinion in a comment below or on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow">Facebook</a> page.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:52d2d0b6-ed6c-499c-bbca-678825a524d6 Discuss breast cancer with patients this October http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_discuss-breast-cancer-patients-this-october Tue, 30 Sep 2014 18:00:00 GMT <p> October is Breast Cancer Awareness Month, a perfect time for physicians to talk to patients about screening and prevention of breast cancer.</p> <p> Every year, more than 200,000 women get breast cancer, and more than 40,000 women die from the disease, according to the <a href="http://www.cdc.gov/cancer/dcpc/resources/features/BreastCancerAwareness/" target="_blank" rel="nofollow">Centers for Disease Control and Prevention</a>. Although uncommon, about 2,000 men also get breast cancer, and about 400 men die from the disease. While most breast cancers are found in women who are 50 years old or older, young women are also affected. About 11 percent of all new cases of breast cancer in the United States are found in women younger than 45 years of age. </p> <p> It is important that patients are aware of the symptoms of breast cancer, understand measures that can be taken to lower their risk and undergo necessary screenings, such as self-breast exams and mammograms. </p> <p> <a href="http://my.chicagotribune.com/#section/504/article/p2p-81477947/" target="_blank" rel="nofollow">New technologies</a> have made it possible for large numbers of women to find out whether they carry genetic mutations that increase their risk of breast cancer — a development welcomed by many experts in the field.  Some of the mutations detected in those panels are relatively rare and scientists do not yet know how much additional risk they carry. A patient who has learned that they have one of those mutations can cause the unintended consequence of concern and anxiety with little information on making an informed decision on the next course of action.</p> <p> However, knowing the likelihood that someone who carries a certain mutation will actually develop breast cancer can help the physician and patient decide whether it is appropriate to take certain <a href="http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA" target="_blank" rel="nofollow">risk-reduction steps</a>. These steps may include:</p> <ul> <li> More intensive screening, such as an annual MRI in addition to mammography</li> <li> Chemoprevention, including taking a drug that blocks the effect of estrogen on the breasts</li> <li> Prophylactic surgery, such as removal of the fallopian tubes and ovaries</li> <li> Mastectomy</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:05445071-c678-4641-8c66-07cf9075362e Hydrocodone reclassification takes effect Oct. 6: Are you ready? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_hydrocodone-reclassification-takes-effect-oct-6-ready Mon, 29 Sep 2014 19:23:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/b779f44f-cc1a-407d-9d78-ee72fd51cac9.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/13/b779f44f-cc1a-407d-9d78-ee72fd51cac9.Large.jpg?1" style="float:right;margin:10px;" /></a>A <a href="https://www.federalregister.gov/articles/2014/08/22/2014-19922/schedules-of-controlled-substances-rescheduling-of-hydrocodone-combination-products-from-schedule" rel="nofollow" target="_blank">new rule</a> from the Drug Enforcement Administration (DEA) taking effect Oct. 6 reclassifies hydrocodone combination products as Schedule II controlled substances, establishing restrictions that will require considerable changes to prescribing practices.</p> <p> Here are the steps you need to take to ensure your patients who need these medications to alleviate pain don’t have to go without them:</p> <ul> <li style="margin-left:0.25in;"> <strong>Be prepared to issue new prescriptions.</strong> The new rule does not permit refills for prescriptions written after Oct. 6. While the rule does allow prescriptions issued before Oct. 6 to be refilled through April 8, 2015, many pharmacies may not be able to process refills because of computer system limitations.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Issue only hard-copy prescriptions or eScripts. </strong>Pharmacies will be prohibited from filling prescriptions delivered over the phone or via fax, with the exception of a limited quantity for emergency treatment only.<br /> <br /> Note that eScripts can be used only if state law permits and the prescriber is certified to ePrescribe Schedule II substances. Pharmacies also must be certified to accept eScripts for controlled substances.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Determine whether your allied health professionals will be able to write prescriptions. </strong>Depending on your state’s restrictions around Schedule II substances, non-physician members of your team who have prescriptive authority may not be able to continue issuing prescriptions for hydrocodone combination products. If that is the case, you also may need to modify your collaborative practice agreements accordingly.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Notify your patients of the new requirements and processes. </strong>Make sure your patients understand that their new prescriptions will not be refilled and are aware of the procedures they will need to follow going forward.</li> </ul> <p> For a convenient handout or office reference, download the AMA’s <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/rescheduling-hydrocodone-products.pdf" target="_blank">printable fact sheet</a> (log in) containing this information and additional details for physicians, patients and pharmacists.</p> <p> The AMA and other groups have <a href="https://download.ama-assn.org/resources/doc/washington/x-pub/dea-hydrocodone-comment-letter-28april2014.pdf" target="_blank">warned the DEA</a> (log in) about the potential unintended consequences of reclassifying hydrocodone combination products since the agency made the proposal early last year. Eliminating phoned-in prescriptions and refills could make it difficult for some patients to get the pain relief they need, especially patients in nursing homes and those with persistent pain and disabilities.</p> <p> Visit the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/combating-prescription-drug-abuse-diversion.page" target="_blank">Web page on combating prescription drug abuse and diversion</a> under “federal agency and administration activities” to learn more about this advocacy work.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:c5b0f406-1cee-4b50-b8fa-96b06222a591 Students weigh in on improving patient handoffs, GME and more http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-weigh-improving-patient-handoffs-gme Mon, 29 Sep 2014 19:20:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/f298d3e7-44f2-43f4-96aa-0a06abd420ea.Full.png?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/2/6/f298d3e7-44f2-43f4-96aa-0a06abd420ea.Large.png?1" style="float:right;margin:10px;" /></a>AMA members will debate some of the most talked about issues in medicine at the AMA Medical Student Section (MSS) <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/mss-meetings.page" target="_blank">Interim Meeting</a>, Nov. 6 to 8 in Dallas. Make sure your voice is heard: Even if you can’t attend the meeting, you can contribute your opinions on these key topics in the AMA-MSS <a href="http://www.ama-assn.org/ama/pub/community/forums/interim-2014/mss-reference-committee.page" target="_blank">Virtual Reference Committee</a> (log in), which is open through Oct. 17.</p> <p> Students who participate in the meeting will discuss 40 different policy resolutions. Here are a few key issues up for debate:</p> <ul> <li style="margin-left:0.25in;"> <strong>Medical student involvement in handoffs.</strong> One resolution seeks to elevate the importance of medical student involvement in patient handoffs, asking the AMA to support and advocate for student training in using electronic health record (EHR) systems to improve involvement in handoffs.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Mobile medical apps. </strong>An estimated 97,000 <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/mobile-health-app-harmful-helpful" target="_blank">mobile health apps</a> are available for download across major app stores, but only a small portion have been approved by the Food and Drug Administration (FDA) or otherwise proven through scientific studies, according to a <a href="http://www.ama-assn.org/resources/doc/csaph/x-pub/a14csaph5-fulltext.pdf" target="_blank">new report</a> (log in) by the AMA Council on Science and Public Health. This resolution asks the AMA to support establishing proper protocols of such apps, including disclosure of conflicts of interests and patient privacy protections.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Factors that contribute to medical students not matching into residency programs. </strong>With graduate medical education (GME) <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/gme-reform-essential-but-proceed-experts-debate" target="_blank">reform on the horizon</a> and an impending physician shortage, the number of medical students to residency positions is a hot topic. This resolution asks the AMA to collaborate with the Association of American Medical Colleges on a study to investigate common reasons for failures to match to residency slots, and suggests studying potential pathways for those who fail to match to reengage in the medical field.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Removing barriers to cross-state telemedicine. </strong>This resolution asks to support the development and enactment of an <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/medical-licensure-streamlined-under-new-interstate-compact" target="_blank">interstate licensure compact</a> or uniform act that will give physicians who wish to practice in multiple states a speedier licensure process with fewer administrative and financial burdens. Such a compact would make it easier to practice <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-telemedicine-bolster-care-delivery" target="_blank">telemedicine</a>.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Special category in Federal Direct Student Loan Program.</strong> Another resolution discusses the possibility of creating a “medical student” category in federal loans to ease medical student debt. This proposed category would include interest rates that are properly risk-adjusted and reduced, which would account for medical students’ earning potential and, in turn, the lowered risk of lending to medical students.</li> </ul> <ul> <li style="margin-left:0.25in;"> <strong>Encouraging diversity in medical school. </strong>This resolution is intended to help refine efforts to recruit medical students from underrepresented backgrounds. It asks the AMA to study the economic and non-economic factors that discourage the entry of graduates from underrepresented groups into medicine.</li> </ul> <p> AMA-MSS members can comment on resolutions through Oct. 17. Learn more about resolutions on the AMA-MSS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/policies-procedures/resolutions.page" target="_blank">Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:add5123e-c9d3-470d-b5ef-4a2bd7e6adea Rate of diagnosed diabetes may be slowing but still too high http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_rate-of-diagnosed-diabetes-may-slowing-but-still-high Mon, 29 Sep 2014 19:15:00 GMT <p> The rate of diagnosed diabetes cases could be plateauing, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906616" target="_blank" rel="nofollow">new report</a> by the Centers for Disease Control and Prevention—but the numbers of diagnosed cases still are alarmingly high.</p> <p> The nationally representative data, published in the <em>Journal of the American Medical Association</em>, suggest a potential slowing in the diabetes epidemic. However, incidence rates continue to rise among some groups, including Hispanic and non-Hispanic black adults and people with less than a high school education.</p> <p> Despite a slowing of diagnosed cases, studies suggest diabetes prevalence has as much as <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/diabetes-prevalence-tripled-just-two-decades-study" target="_blank">tripled in recent decades</a>, and data show about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/40-percent-of-americans-will-develop-diabetes-new-study" target="_blank">two in five Americans will develop type 2 diabetes</a> at some point in their lives. An estimated 86 million Americans have prediabetes, but only one in nine of these people knows they are at risk of developing type 2 diabetes.</p> <p> “While this news is encouraging, our work is more important now than ever,” said Ann Albright, PhD, director of the CDC’s Division of Diabetes Translation. “These evolving trends show we’re moving in the right direction, but millions of people are still diagnosed with diabetes yearly. We need to fortify our efforts to see a real, sustained decrease in new cases of diagnosed diabetes.”</p> <p> The report includes this recommendation: “In light of the well-known excess risk of amputation, blindness, end-stage renal disease, disability, mortality and health care costs associated with diabetes, the doubling of diabetes incidence and prevalence ensures that diabetes will remain a major public health problem that demands effective prevention and management programs.”</p> <p> The AMA is working to prevent diabetes through its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, partnering with the YMCA of the USA to increase referrals to the YMCA’s Diabetes Prevention Program, an evidence-based lifestyle intervention that is part of the <a href="http://www.cdc.gov/diabetes/prevention/" target="_blank" rel="nofollow">CDC’s National Diabetes Prevention Program</a>.</p> <p> Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at a local YMCA. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.</p> <p> Another <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/benefits-of-diabetes-prevention-program-long-lasting-study" target="_blank">recent study</a> found that diabetes prevention program participants continued to see the benefits of the program long after they participated. Overall, participants saw a 27 percent reduction in the rate of type 2 diabetes even 15 years after they started the program.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d44b7d7d-4a8b-408e-9eaa-0dc327f8c638 3 questions you should know how to answer by Sept. 30 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_3-questions-should-answer-sept-30 Mon, 29 Sep 2014 11:00:00 GMT <p> Physicians’ financial data under the Physician Payments Sunshine Act, also known as the “Open Payments” program, will be released to the public Tuesday. While your data might not make it into the local news, chances are your patients or others you know will ask you about it. Learn the three common questions you’ll hear—and how to answer them.</p> <p> Questions from confused patients are especially likely, given that the online database is not expected to offer much context for the financial interactions it reports between physicians and manufacturers of medical devices and drugs. While the Centers for Medicare & Medicaid Services (CMS) is required by law to provide such context—a key to true transparency—the agency has been unresponsive to AMA calls for greater public education.</p> <p> Here are three questions you’ll most likely hear and sample talking points for giving a thoughtful response:</p> <p style="margin-left:40px;"> <strong>1. </strong><strong>Why do physicians get money or items of value from the industry?</strong><br /> <br /> Physicians interact with the industry in many ways, including as consultants, speakers, researchers or recipients of “items of value.” These interactions generally benefit patients. For instance, physicians often receive items of value, such as medical journal reprints or certain patient education materials.</p> <p style="margin-left:40px;"> <strong>2. </strong><strong>Don’t relationships with the industry influence physicians’ decisions and recommendations?</strong></p> <p style="margin-left:40px;"> The medical profession always is aware of the potential for conflicts of interest. But a relationship with the industry doesn’t automatically mean that a physician’s judgment has been influenced inappropriately. Industry support for research and development has been essential for developing new interventions and technologies to improve patient care and reduce health care costs.</p> <p style="margin-left:40px;"> <strong>3. </strong><strong>How could individual physicians be justified in accepting large sums of money from the industry?</strong></p> <p style="margin-left:40px;"> While there probably are some instances when physicians received money that, in retrospect, they should not have accepted, there are legitimate reasons that a physician could be listed as having accepted a large sum of money. For instance, many physicians receive funds to support clinical trials, an essential component of advancing medical knowledge around specific conditions and treatments.</p> <p> You can download more detailed <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/sunshine-act-talking-points.pdf" target="_blank">talking points</a> (log in) from the AMA website to help inform your conversations.</p> <p> <strong>Data accuracy concerns</strong><br /> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/0/6657c0eb-c7e8-4bc4-9031-88b03920ac83.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/0/6657c0eb-c7e8-4bc4-9031-88b03920ac83.Large.jpg?1" style="margin:15px;float:right;" /></a>If you weren’t able to review your data by the Sept. 11 deadline to flag any disputed information in the initial public data release, you should do so now. CMS is withholding one-third of the data from the initial public release as a result of concerns about accuracy. Much of the remaining two-thirds of data that will be released in the public database has yet to be verified by physicians and other covered recipients.</p> <p> Physicians still have until Dec. 31 to file disputes for any inaccurate information that should be corrected in the next data release. View instructions for doing so on the AMA’s <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page" target="_blank">Sunshine Act Web page</a>.</p> <p> <strong>Want to know what the AMA has been doing about this issue?</strong> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-advocated-sunshine-act-implementation-overhaul" target="_blank">Read</a> how the AMA has been advocating for an overhaul of how the Sunshine Act has been implemented.</p> <p> In addition, the AMA issued a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-30-media-guide-for-reporting-open-payments-data.page" target="_blank">media guide</a> ahead of the Sept. 30 data release and is encouraging the media to make sure their reports about this data are presented in an accurate and informative way.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:800d5153-1778-4caa-b3f9-8fcd1cb15ca3 How AMA has advocated for Sunshine Act implementation overhaul http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_ama-advocated-sunshine-act-implementation-overhaul Mon, 29 Sep 2014 11:00:00 GMT <p> As the Centers for Medicare & Medicaid Services (CMS) rolls out the online database of physicians’ financial interactions with manufacturers of drugs and medical devices Tuesday, troubling questions remain about the accuracy of the data and the lack of context with which it is being presented.</p> <p> Although the AMA supports transparency as originally intended in the Physician Payments Sunshine Act (which CMS is calling the “Open Payments” program), safeguards are needed to ensure that information is depicted correctly and given context to be useful for patients and fair to physicians.</p> <p> Publishing inaccurate data can lead to misinterpretations, harm reputations and cause patients to question their trust in their physicians. Inaccurate data also can unfairly impact physicians’ ability to obtain or keep research grants and other employment opportunities that require disclosure.</p> <p> The AMA repeatedly has urged the federal government to adopt sensible measures to ensure that the information released is accurate. But CMS’ Open Payments program has been plagued by significant shortcomings.</p> <p> Recent AMA advocacy efforts on this front have included:</p> <ul> <li> <strong>Calling for a delay of the data release. </strong>In addition to accuracy issues CMS needed to address, the Open Payments portal had numerous technical problems that prevented physicians from reviewing and disputing their data. A delay in the data release would have allowed more physicians to review their information and CMS to correct errors that have characterized the program’s implementation. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-ask-cms-postpone-sunshine-act-data-release" target="_blank">Read more</a>.</li> <li> <strong>Reporting physicians’ troubles with the portal to CMS.</strong> An informal AMA survey of more than 200 physicians found that more than two-thirds of physicians had a poor registration experience overall. <a href="mailto:OpenPayments@ama-assn.org" rel="nofollow">Email the AMA</a> to share your experience with registering via the Open Payments portal. Your responses will be used in the AMA’s ongoing advocacy efforts. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/time-running-out-review-sunshine-data-isnt-very-accurate" target="_blank">Read more</a>. </li> <li> <strong>Urging CMS to exclude continuing medical education activities, medical textbooks and peer-reviewed medical journals from reporting. </strong>Requiring the industry to report funding for these educational activities could harm patient care by impeding ongoing efforts to improve quality through timely medical education. <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-medical-groups-urge-hhs-overturn-cms-policy-sunshine-act" target="_blank">Read more</a>.</li> <li> <strong>Providing guidance for physicians to review and dispute their data.</strong> Although CMS failed to adequately communicate with physicians about roll-out of the Open Payments program, the AMA created an <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page">online toolkit</a> for physicians and provided timely updates about the latest developments, deadlines and tips for navigating the problematic Open Payments portal. View past <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/Sunshine_Act/1" target="_blank">Sunshine Act coverage</a> in <em>AMA </em><em>Wire</em>®.</li> <li> <strong>Educating reporters about the data release. </strong>Ahead of the Sept. 30 data release, the AMA has been encouraging the media to make sure their reports about the data release are presented in an accurate and informative way. View the AMA’s <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-30-media-guide-for-reporting-open-payments-data.page" target="_blank">media guide</a>.</li> </ul> <p> <strong>Be prepared to answer questions about the data release: </strong><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/3-questions-should-answer-sept-30" target="_blank">Read more</a> at <em>AMA Wire</em> about the three questions you’ll most likely hear from patients and others you know—and how to answer them. </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:dadf4651-64d7-401e-a463-80eb6962d761 5 superforces that are radically changing medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_5-superforces-radically-changing-medicine Fri, 26 Sep 2014 20:18:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/3/a897545d-318a-43c0-a318-cb39528c65ae.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/8/3/a897545d-318a-43c0-a318-cb39528c65ae.Large.jpg?1" style="float:right;margin:10px;" /></a>It’s no secret that the health care environment and the way physicians practice medicine today is vastly different from only a few years ago—but what’s to come in the future? Jay Walker, TEDMED curator, shared what he believes are the five superforces that will radically change the practice of medicine. Walker discussed these superforces during TEDMED 2014, which took place earlier this month in San Francisco and Washington, D.C.</p> <ol> <li> <strong>How we see things.</strong> The future of medicine goes beyond X-rays and MRIs. “We cannot see a cancer tumor until it’s been growing inside us for at least six years,” Walker said. “Soon, we’ll spot them in six days. We’re going to have to reimagine what it means to see disease and, even more challenging, how we respond to what we see.”</li> <li> <strong>All the new data in the world.</strong> “Every second, our bodies generate new cells,” Walker said. “Imagine printing a brand new encyclopedia every minute, 10,000 pages long, all about you. Big data: We’re going to have to reimagine how we learn about our medical choices and how we deal.”</li> <li> <strong>Connected data streams.</strong> Telemedicine, global patient communities, real-time feedback of health—all are powerful and will affect how physicians practice. “We’re going to reimagine the speed, scale and scope of medicine,” Walker said.”</li> <li> <strong>People.</strong> “We’ve reached a critical mass of human brain power,” Walker said. “We’re going to reimagine how power and responsibility get distributed in health and medicine.”</li> <li> <strong>Synthetic biology. </strong>For the past 3 billion years, biological evolution was the only way life on this planet evolved or changed—until now. “Scientists and amateurs called ‘biohackers’ have the software that controls every form of life on earth,” Walker said. “[They’re] creating artificial DNA in labs, doing things evolution could never have done and never prepared us to deal with.”</li> </ol> <p> In a later talk, Walker mentioned one more superforce that has the power to change the practice of medicine, and the one that is at the heart of every TEDMED talk: Imagination.</p> <p> “[Imagination is] the unique ability of the human mind to visualize what does not yet exist,” Walker said. “We are not a community of specialists. We are a community that imagines.”</p> <p> <strong>Watch Walker give his talks at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the “Vision Talk” video for Walker’s introductory talk. View his second talk by finding the “I was just thinking too small” video and advance to 1:22:10. View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cc8b25d3-63dd-4164-9178-fc3bd84e12b6 Corrected deadlines: Time running out to meet meaningful use requirements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_corrected-deadlines-time-running-out-meet-meaningful-use-requirements Thu, 25 Sep 2014 21:04:00 GMT <p> Physicians participating in the electronic health record (EHR) meaningful use program have limited time to meet requirements as attestation deadlines fast approach. Meanwhile, the majority of physicians are struggling to successfully participate in the program.</p> <p> <strong>Physicians participating in meaningful use for the first time</strong><br /> According to the latest numbers from the Centers for Medicare & Medicaid Services (CMS), nearly one-half of physicians haven’t yet started the meaningful use program.</p> <p> All physicians—including those who are new to the program this year—have until Feb. 28, 2015, to attest to any 90-day reporting period in 2014 to earn an incentive payment. However, Medicare physicians who are participating in meaningful use for the first time this year must attest by Oct. 1 if they want to avoid a penalty of up to 2 percent in 2015.</p> <p> A recent rule from CMS allows physicians to use older certified EHR technology, a combination of old and new technology, or just new technology. But the agency’s attestation system won’t be able to process reporting from physicians who aren’t using version 2014 certified EHR technology until mid-October. Unfortunately, this will not allow physicians who are new to the meaningful use program and using older software to avoid a penalty because it is after the Oct. 1 compliance date.</p> <p> The AMA is aggressively trying to get more time for these physicians by urging CMS to extend the Oct. 1 deadline. This discrepancy has prompted two members of Congress—Reps. Renee Ellmers, R-North Carolina, and Jim Matheson, D-Utah—to send a <a href="http://ellmers.house.gov/uploads/CMS%20EHR%20Portal%20Letter%20to%20CMS%20Final.pdf" target="_blank" rel="nofollow">letter</a> to CMS asking for more time for physicians using older technology to attest.</p> <p> CMS made several changes to Stage 1 in a rule published in 2012. A complete list of these changes is available in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/summary-table-stage-2-measures.pdf" target="_blank">chart</a> (log in) developed by the AMA that outlines Stage 1 and Stage 2 requirements.</p> <p> <strong>Physicians who have participated in meaningful use before</strong><br /> For physicians who have already been participating in the meaningful use program, the deadline to attest to meaningful use is Feb. 28. However, the last day to start reporting is Oct. 3 if they are to meet the 90-day requirement, which must be concluded by Dec. 31.</p> <p> <strong>Meaningful use changes</strong><br /> CMS’ new final rule published this month gives physicians more options to meet meaningful use requirements.</p> <p> Some physicians will be allowed to use older certified EHR technology, a combination of old and new technology, or just new technology to meet requirements, depending on roadblocks they encountered for implementing new technology. The rule also allows some physicians who were scheduled to meet Stage 2 requirements to continue meeting Stage 1 measures this year.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">Read more</a> about who qualifies for these additional options.</p> <p> However, the final rule didn’t adjust a major problem with the program: the 100 percent pass/fail policy, which places physicians at risk for financial penalties, even if all they fail to meet is a single measure.</p> <p> Learn more about demonstrating meaningful use on the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/medicare-medicaid-incentive-programs.page" target="_blank">AMA’s Web page</a>.</p> <p> In addition to its advocacy around the meaningful use program, the AMA also is calling for an EHR overhaul to make sure this technology has improved usability to meet the needs of physicians and their patients. Learn more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight primary challenges and solutions</a> identified by an expert panel, announced last week.</p> <p> <strong>Meaningful use deadlines for physicians to avoid penalties in 2015</strong></p> <ul> <li style="margin-left:0.25in;"> July 1–Sept. 30: The last 90-day reporting period in 2014 for Medicare physicians new to meaningful use program to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 1: The last day for Medicare physicians new to the program to attest to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 3–Dec. 31: The last 90-day reporting period for any Medicare physicians who have participated in meaningful use to obtain 2014 incentive</li> <li style="margin-left:0.25in;"> Feb. 28: The last day for Medicare physicians who have participated in meaningful use before to attest and obtain 2014 incentive</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:486f77f6-9a5e-4743-adc7-1b2ecb2a40f2 Get exclusive sneak preview of AMA-sponsored PBS documentary http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_exclusive-sneak-preview-of-ama-sponsored-pbs-documentary Thu, 25 Sep 2014 20:04:00 GMT <p> Attendees of the 2014 AMA Interim Meeting will enjoy a sneak preview of a PBS documentary supported by the AMA at 6:30 p.m. Nov. 7 at the Hilton Anatole in Dallas.</p> <p> The film, <em>Rx: Hope for Health Care in the U.S.: How frontline innovators are creating dramatically higher-value health care solutions, </em>looks beyond technology and medicine, and explores a health care model focused on medicine’s fundamental mission to promote health, prevent sickness and help people live long, productive lives.</p> <p> The documentary is a moving series of patients and caregivers, placed within the context of innovative practices. It explores how physician practices foster affordable medicine while encouraging intimacy, inclusion, trust and healing.</p> <p> The documentary also looks at the hard facts about health care in America, placing these personal accounts within the context of the current American health care system. <em>Rx: Hope for Health Care in the U.S.</em> is scheduled to air on PBS in late spring/early summer 2015.</p> <p> The preview event will include a question-and-answer session with award-winning director, writer, producer and cinematographer <a href="http://www.grubin.com/" target="_blank" rel="nofollow">David Grubin</a>, who has produced more than 100 films. The session will be moderated by Edward H. Livingston, MD, deputy editor of clinical content for the <em>Journal of the American Medical Association</em>.</p> <p> After the Q&A session, this year’s AMA <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/research-symposium.page" target="_blank">Research Symposium</a> winners will be announced, followed by a reception with light hors d’oeuvres and beverages.  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7f98809f-0060-4c1a-a00e-9124c20a0669 JAMA Highlights: Study examines adverse health effects of climate change http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-study-examines-adverse-health-effects-of-climate-change Thu, 25 Sep 2014 19:50:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/TChRQ9RGCsU" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/TChRQ9RGCsU" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/TChRQ9RGCsU" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/TChRQ9RGCsU" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Study examines adverse health effects of climate change</strong><br /> An examination of the evidence over the past 20 years indicates that climate change can be associated with adverse effects on various health conditions, including heat-related and respiratory disorders, and a projected increase in days with extreme heat could exacerbate various health issues, according to an <a href="http://jama.jamanetwork.com/article.aspx?articleid=1909928" target="_blank" rel="nofollow">article</a> the Sept. 24 issue of the <em>Journal of the American Medical Association</em> (<em>JAMA</em>). The study is being released early to coincide with the UN Climate Summit 2014. The authors note that substantial health and economic benefits could be associated with reductions in fossil fuel combustion.</p> <p> <strong>Women who receive detailed prenatal testing information less likely to undergo those tests</strong><br /> Full implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906614" target="_blank" rel="nofollow">study</a> in <em>JAMA</em>. Watch a <a href="http://youtu.be/TChRQ9RGCsU" target="_blank" rel="nofollow">video</a> on the study.</p> <p> <strong>Rate of diabetes in U.S. may be leveling off</strong><br /> Following a doubling of the incidence and prevalence of diabetes in the United States from 1990 to 2008, new data suggest a plateauing of the rate between 2008 and 2012 for adults. However, the incidence continued to increase in Hispanic and non-Hispanic black adults, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1906616" target="_blank" rel="nofollow">study</a> in <em>JAMA.</em></p> <p> <strong>Statins associated with better outcomes in hospitalization for brain hemorrhage</strong><br /> Hospitalized patients who took statins after a stroke caused by an intracerebral hemorrhage appeared to have better 30-day survival and were more likely to be discharged to their home or an acute rehabilitation facility than patients who did not use statins or whose statin use was discontinued in the hospital, according to a <a href="http://archneur.jamanetwork.com/article.aspx?articleid=1905923" target="_blank" rel="nofollow">study</a> in <em>JAMA Neurology</em>.</p> <p> <strong>Cytomegalovirus in infants with very low birth weights linked to maternal breast milk</strong><br /> The primary source of postnatal infection with cytomagelovirus (CMV) in infants with very low birth weights appeared to be maternal breast milk because no infections were linked to transfusions of CMV-seronegative and leukoreduced blood products, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1906021" target="_blank" rel="nofollow">study</a> in <em>JAMA Pediatrics.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7a702aa1-b140-485c-9039-b4346f539a29 Med schools preparing students for rapid changes http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_med-schools-preparing-students-rapid-changes Thu, 25 Sep 2014 19:47:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/7/6b599255-8a0c-4279-8774-f51eee9b0883.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/11/7/6b599255-8a0c-4279-8774-f51eee9b0883.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <span style="font-size:11px;"><em>Martin Pusic, MD, PhD, New York University School of Medicine, discusses medical education at a special consortium meeting at Vanderbilt University Medical School in Nashville.</em></span></td> </tr> </tbody> </table> <p> How will physicians practice medicine in 2050—and how can medical schools train today’s students to be prepared? Physician educators tackled this question earlier this week during a special consortium meeting at Vanderbilt University Medical School in Nashville, where the 11 medical school recipients of AMA grants discussed how the changes they’re making are preparing tomorrow’s physicians for the rapid changes to come.</p> <p> “Whatever 2050 throws at you, you cannot just cope and survive,” said Martin Pusic, MD, PhD, director of the division of education quality and analytics at the Institute for Innovations in Medical Education and assistant professor in the department of emergency medicine at New York University School of Medicine. “You must in fact become the physician 2050 needs and get better and better—not just survive but thrive.”</p> <p> All 11 schools participating in the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page" target="_blank">Accelerating Change in Medical Education</a> initiative are working through new ways to train students. Some of these approaches include:</p> <ul> <li> Switching from time-based to competency-based progression and assessments</li> <li> Implementing electronic portfolios that give students and educators real-time feedback and follow students through their careers</li> <li> Developing tools to analyze big data and better understand health populations</li> </ul> <p> At the heart of all these changes is teaching students how to be skilled learners. With so much data and rapidly changing information, it’s critical for students to learn how to identify and weed out the information they don’t need while also investigating and implementing the information they do need. And the consortium schools are discovering that achieving this aim of training “<a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/training-adaptive-learners-will-essential-med-ed" target="_blank">master adaptive learners</a>” isn’t easy.</p> <p> “We are trapped in a knowledge dilemma,” said Mark Quirk, EdD, professor in the department of family medicine and community health at the University of Massachusetts Medical School.</p> <p> “We have to introduce new competencies to address the needs of the new physician,” Quirk said. “[Today’s] clinical reasoning is taught by apprenticeship—pattern recognition with little reflection. The primary excuse is that we have insufficient time … but time is always going to be a factor.”</p> <p> The goal is to train students to move into the next phases of their careers with a set of self-regulated, self-directed learning skills. That way, tomorrow’s physicians will be equipped to adapt and thrive in the constantly changing health care environment.</p> <table align="left" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/3/aeb74085-4c17-4478-93a2-80f5f2776e15.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/3/aeb74085-4c17-4478-93a2-80f5f2776e15.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td style="text-align:left;vertical-align:middle;height:35px;"> <p> <span style="font-size:11px;"><em>Fourth-year Vanderbilt University School of Medicine students Brian Heiniger, Katie Guess and another student present their research poster during the school's Medical Education day, held concurrent with the AMA's special consortium meeting.</em></span><br />  </p> </td> <td>  </td> </tr> </tbody> </table> <p> Students also recognize that skills in “learning how to learn” are necessary.</p> <p> “We have to learn to navigate all the electronic resources at our fingertips … and we have to be knowledgeable about the false information out there,” said Katie Guess, a fourth-year medical student at Vanderbilt. “‘Dr. Google’ is going to be playing a role, and we have to manage that.”</p> <p> Brian Heiniger, also a fourth-year medical student at Vanderbilt, echoed Guess’ thoughts.</p> <p> “There are so many resources available, and so much information, that it is easy to get bogged down,” Heiniger said. “We need to know where and how to access information and to use it efficiently.”</p> <p> The consortium of schools, now a full year into implementing new programs and tools, spent time outlining its goals through 2015. In the coming year, the group, facilitated by the AMA, hopes to increase activation and adoption of some of the innovations it has spawned, potentially bringing other schools on board and disseminating ideas for wider use.</p> <p> “Curriculum change is not just schedule change. That would actually be very easy,” said Bonnie Miller, MD, senior associate dean for health sciences education and associate vice-chancellor for health affairs at Vanderbilt. “What we’re really talking about is culture change, and culture change of this magnitude is very difficult. We can’t do it alone.”</p> <p> Watch <em>AMA Wire</em>® for additional coverage of the consortium meeting and updates about the work of the 11 medical schools.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:cf52d597-9597-420e-ab2f-ce8e0da411c7 New pilot to fight hepatitis C uses telemedicine, collaboration http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-pilot-uses-telemedicine-collaboration-fight-hepatitis-c Wed, 24 Sep 2014 20:34:00 GMT <p> Primary care physicians are getting assistance in making an early diagnosis and providing timely treatment for the hepatitis C virus (HCV) infection, which affects about 3 million patients in the United States.</p> <p> The <a href="http://www.healthit.gov/buzz-blog/health-innovation/pilot-helps-battle-hepatitis-c-health-telemedicine/" rel="nofollow" target="_blank">pilot program</a>, with funding from the Centers for Disease Control and Prevention (CDC), will implement Project ECHO, a telemedicine approach designed to increase primary care capacity for treatment of HCV and access to HCV care in rural and underserved areas.</p> <p> The CDC is working with the AMA-convened Physician Consortium for Performance Improvement® (PCPI) and the Office of the National Coordinator for Health Information Technology (ONC) to support the pilot program by facilitating integration of three measures from the <a href="http://www.qualitymeasures.ahrq.gov/browse/by-organization-indiv.aspx?objid=26194" rel="nofollow" target="_blank">PCPI hepatitis C measure set</a> into electronic health records. The program will develop eMeasures and corresponding clinical decision support tools.</p> <p> So far, 66 primary care physicians in Arizona and Utah, predominately from rural settings, have received training through the program. Almost none of the participants had prior experience in the care and treatment of HCV infection.</p> <p> The participating physicians interacted with specialists via videoconference each week, allowing them to collaborate on HCV infection treatments and exchange clinical information and advice on patient management practices. Through the project, nearly one-half of the involved patients received antiviral treatment, suggesting that the pilot is an effective model that can be used to expand primary care capacity to treat HCV populations.</p> <p> Annual health care costs for HCV-infected patients are five times higher than those for other patients, according to the ONC.</p> <p> “The hope is to facilitate not only measurement of provider performance but improvement in access to care for underserved and other populations facing barriers to HCV testing, care and treatment,” the ONC said.</p> <p> <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-consortium-performance-improvement.page" target="_blank">Learn more</a> about the PCPI, a national physician-led program dedicated to enhancing quality and patient safety.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:31b33372-ca57-4ccc-b3de-dcac05d2fb14 Time running out to meet meaningful use requirements http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_time-running-out-meet-meaningful-use-requirements Wed, 24 Sep 2014 20:00:00 GMT <h3> <strong>Editor’s note:</strong> Some of the deadlines noted in an earlier version of this story were inaccurate. This updated version contains all the correct information. We apologize for the error.</h3> <p> Physicians participating in the electronic health record (EHR) meaningful use program have limited time to meet requirements as attestation deadlines fast approach. Meanwhile, the majority of physicians are struggling to successfully participate in the program.</p> <p> <strong>Physicians participating in meaningful use for the first time</strong><br /> According to the latest numbers from the Centers for Medicare & Medicaid Services (CMS), nearly one-half of physicians haven’t yet started the meaningful use program.</p> <p> All physicians—including those who are new to the program this year—have until Feb. 28, 2015, to attest to any 90-day reporting period in 2014 to earn an incentive payment. However, Medicare physicians who are participating in meaningful use for the first time this year must attest by Oct. 1 if they want to avoid a penalty of up to 2 percent in 2015.</p> <p> A recent rule from CMS allows physicians to use older certified EHR technology, a combination of old and new technology, or just new technology. But the agency’s attestation system won’t be able to process reporting from physicians who aren’t using version 2014 certified EHR technology until mid-October. Unfortunately, this will not allow physicians who are new to the meaningful use program and using older software to avoid a penalty because it is after the Oct. 1 compliance date.</p> <p> The AMA is aggressively trying to get more time for these physicians by urging CMS to extend the Oct. 1 deadline. This discrepancy has prompted two members of Congress—Reps. Renee Ellmers, R-North Carolina, and Jim Matheson, D-Utah—to send a <a href="http://ellmers.house.gov/uploads/CMS%20EHR%20Portal%20Letter%20to%20CMS%20Final.pdf" rel="nofollow" target="_blank">letter</a> to CMS asking for more time for physicians using older technology to attest.</p> <p> CMS made several changes to Stage 1 in a rule published in 2012. A complete list of these changes is available in a <a href="http://www.ama-assn.org/resources/doc/washington/x-pub/summary-table-stage-2-measures.pdf" target="_blank">chart</a> (log in) developed by the AMA that outlines Stage 1 and Stage 2 requirements.</p> <p> <strong>Physicians who have participated in meaningful use before</strong><br /> For physicians who have already been participating in the meaningful use program, the deadline to attest to meaningful use is Feb. 28. However, the last day to start reporting is Oct. 3 if they are to meet the 90-day requirement, which must be concluded by Dec. 31.</p> <p> <strong>Meaningful use changes</strong><br /> CMS’ new final rule published this month gives physicians more options to meet meaningful use requirements.</p> <p> Some physicians will be allowed to use older certified EHR technology, a combination of old and new technology, or just new technology to meet requirements, depending on roadblocks they encountered for implementing new technology. The rule also allows some physicians who were scheduled to meet Stage 2 requirements to continue meeting Stage 1 measures this year.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/rule-offers-meaningful-use-program-changes-but-not-enough" target="_blank">Read more</a> about who qualifies for these additional options.</p> <p> However, the final rule didn’t adjust a major problem with the program: the 100 percent pass/fail policy, which places physicians at risk for financial penalties, even if all they fail to meet is a single measure.</p> <p> Learn more about demonstrating meaningful use on the <a href="http://www.ama-assn.org/ama/pub/advocacy/topics/health-information-technology/medicare-medicaid-incentive-programs.page" target="_blank">AMA’s Web page</a>.</p> <p> In addition to its advocacy around the meaningful use program, the AMA also is calling for an EHR overhaul to make sure this technology has improved usability to meet the needs of physicians and their patients. Learn more about the <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">eight primary challenges and solutions</a> identified by an expert panel, announced last week.</p> <p> <strong>Meaningful use deadlines for physicians to avoid penalties in 2015</strong></p> <ul> <li style="margin-left:0.25in;"> July 1–Sept. 30: The last 90-day reporting period in 2014 for Medicare physicians new to meaningful use program to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 1: The last day for Medicare physicians new to the program to attest to avoid 2015 penalty</li> <li style="margin-left:0.25in;"> Oct. 3–Dec. 31: The last 90-day reporting period for any Medicare physicians who have participated in meaningful use to obtain 2014 incentive</li> <li style="margin-left:0.25in;"> Feb. 28: The last day for Medicare physicians who have participated in meaningful use before to attest and obtain 2014 incentive</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8ffa88ad-fa40-4d27-bfc0-a44c85e96668 How admitting mistakes may improve medicine http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_admitting-mistakes-may-improve-medicine Wed, 24 Sep 2014 18:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/0/aa991688-1bcd-4ce9-90f3-77202a973711.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/10/0/aa991688-1bcd-4ce9-90f3-77202a973711.Large.jpg?1" style="float:right;margin:10px;" /></a>As a resident or fellow, have you ever made a mistake—and kept quiet? One physician opened up about her experience as a medical trainee during TEDMED 2014, which took place earlier this month in San Francisco and Washington, D.C.</p> <p> “I nearly killed a patient—and I never told a soul,” said Danielle Ofri, MD, PhD (pictured right), at the <a href="http://www.tedmed.com/" rel="nofollow" target="_blank">TEDMED 2014</a> event earlier this month.  In her talk, Dr. Ofri—now a physician at Bellevue Hospital, professor at New York University School of Medicine and editor-in-chief of the <em>Bellevue Literary Review</em>—shared how she overlooked a patient’s intracranial bleed.</p> <p> “It could have been a death,” Dr. Ofri said. “I was horrified at myself for not having done due diligence … in the end, this was a near-miss. But I had still made the error.”</p> <p> The culture in Dr. Ofri’s residency wasn’t an open one. “The message we got was that anything short of perfection was failure,” she said.</p> <p> And if the culture in an academic medical center is to remain tight-lipped about mistakes, that attitude will be instilled into residents. According to a <a href="http://journals.lww.com/academicmedicine/Fulltext/2014/03000/Role_Modeling_and_Medical_Error_Disclosure___A.30.aspx" rel="nofollow" target="_blank">2014 survey of medical trainees</a> published in <em>Academic Medicine</em>, most trainees had made or observed a harmful medical error, and role-modeling in the academic medical center has a strong effect on trainees’ attitudes and behaviors surrounding medical errors. For example, negative role models for responding to errors may impede trainees from disclosing them. </p> <p> But the sheer number of decisions a physician must make every day—diagnosis, prognosis, treatment guidelines, medications, side effects and interactions, to name a few—means it’s nearly impossible to be perfect all the time, Dr. Ofri said.</p> <p> “A certain percentage will always fall short—these are part of our native behavioral flora,” she said. “To think of them as foreign is to misunderstand the nature of error. If we can accept that errors are indigenous to the behavioral biome, then our goal is not some impossible expectation of sanitizing away all medical error, but rather to gather this collective ecology and shift it in our patients’ favor.”</p> <p> The good news is that the culture is changing. Identifying medical errors and advocating for system improvements are part of the Accreditation Council for Graduate Medical Education’s core competencies for residents.</p> <p> Beside oversight of academic medicine, individual physicians and residents can be more open and accepting that mistakes happen, and they can help determine processes to improve.</p> <p> “If we hear from the titans of medicine that errors are a reality in medicine … we might be able to redefine our definition of perfection,” Dr. Ofri said. “Patients are ill-served by an impossible ideal of perfection that gives patients unrealistic expectations and keeps doctors and nurses from coming forward with errors because of shame.”</p> <p> <strong>Watch Dr. Ofri give her talk at TEDMED 2014:</strong> Visit the <a href="http://tedmed.com/event/tedmedlive?ref=about-tedmedlive" rel="nofollow" target="_blank">TEDMED 2014 website</a> and enter invitation code “TMLicAMA14.” Once you’ve logged in to the on-demand streaming, find the “Turn it upside down–D.C. Stage” video and go to 1:07:43 for the beginning of Dr. Ofri’s talk. View additional talks by other physicians, health care leaders and innovators through Oct. 10.</p> <p> The AMA is a Global Institution Partner of TEDMED 2014, an association that makes this complimentary access to on-demand streaming possible.</p> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/TEDMED_2014/1" target="_blank">Read more TEDMED coverage</a> at <em>AMA Wire</em>®.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:a9018aff-150a-4cbd-b030-7cba295bd89a Is your mobile health app harmful or helpful? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_mobile-health-app-harmful-helpful Tue, 23 Sep 2014 20:16:00 GMT <p> A new report explores the largely unregulated mobile health app industry and provides some insight into whether the apps you and your patients use have been approved for use or otherwise proven to be helpful.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/8/34891d00-532e-424d-b805-62e36171fa39.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/4/8/34891d00-532e-424d-b805-62e36171fa39.Large.jpg?1" style="float:right;" /></a>Mobile health apps—from fitness support to disease management—deliver health-related services via mobile phones, smartphones or tablets. An estimated 97,000 mobile health apps are available for download across major app stores, but only a small portion have been approved by the Food and Drug Administration (FDA) or otherwise proven through scientific studies, according to a <a href="http://www.ama-assn.org/resources/doc/csaph/x-pub/a14csaph5-fulltext.pdf" target="_blank">new report</a> (log in) by the AMA Council on Science and Public Health.</p> <p> Most mobile health apps are targeted to patients to assist in their own health management, but there are some targeted to physicians and other health care professional as tools to improve patient care, including apps that:</p> <ul> <li> Provide access to medical textbooks and references, or offer training materials for physicians</li> <li> Give general patient education</li> <li> Allow patients to track symptoms</li> <li> Use GPS data to alert patients or track movement</li> <li> Offer preventive screening information</li> </ul> <p> Certain diabetes and weight loss apps have proven effective in clinical practice, such as the WellDoc Diabetes Management system, a software-based patient-coaching and clinical decision support system. With this app, a patient can upload blood glucose readings and other diabetes-related information and receive real-time feedback from a physician or member of WellDoc’s research team. After a year, a clinical trial group saw its A1c decrease by 1.9 percent and also experienced improvements in diet, medication adherence and exercise.</p> <p> The WellDoc app is approved by the FDA, one of only a small subset of health apps that the FDA will oversee. The agency is regulating mobile apps that act as medical devices and could pose a risk to patient safety if used incorrectly or if they malfunction. Included among these apps are ones that:</p> <ul> <li> Use a sensor or lead that connects to a mobile platform to measure and display heart rhythm</li> <li> Create a stethoscope</li> <li> Generate controlled tones for audiologic testing</li> <li> Use an attachment to a mobile platform to measure blood oxygen saturation, alter the function or setting of an infusion pump, or allow remote perinatal monitoring</li> </ul> <p> The FDA also is exercising “<a href="http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm368744.htm" rel="nofollow" target="_blank">enforcement discretion</a>” for some other mobile medical apps that function as medical devices but have little risk, including apps that provide periodic reminders or motivational guidance, or apps that use a checklist of common symptoms to provide a list of possible medical conditions. <a href="http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm368784.htm" rel="nofollow" target="_blank">Examples of mobile health apps</a> approved by the FDA are available on the agency’s website.</p> <p> Still, the mobile health market has no way of measuring the quality of mobile health apps, or whether these apps help patients or physicians achieve their intended purposes. A number of systematic app reviews found that most mobile health apps lacked overall quality, and only limited advice is available to help guide users’ choices of apps that may be more reliable and useful.</p> <p> A process, private certification or evaluation platform is needed to sort through the huge amount of mobile health apps that won’t be subject to FDA approval, the report said.</p> <p> The FDA and other regulatory bodies will work toward greater oversight in the future. The FDA, along with the Federal Communications Commission and the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology, are collaborating to produce a <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-monitoring-crucial-patient-safety" target="_blank">risk-based, regulatory framework for health IT</a>. Part of this proposal includes creating a safety center to monitor patient safety problems with health IT. However, it is unclear whether this safety center would play a role in evaluating mobile health apps.</p> <p> The AMA will work with stakeholders to identify guiding principles for promoting a vibrant, useful and trustworthy mobile health app market, the report said.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1b60f21-146a-472a-91c3-a01102f272a3 Physician wellness is a global issue http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physician-wellness-global-issue Tue, 23 Sep 2014 19:58:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Large.jpg?1" style="float:left;margin:10px;" /></a>As physicians, we went into this profession because we prioritize the health of others above all else. But what about our own health? I know that personally, my own wellness can get lost in the shuffle of my everyday life.</p> <p> There are so many facets to physician health: physical, mental, emotional, personal and professional. At the same time, physicians juggle many responsibilities and pressures—our patients, our practice, our family and friends, keeping up with important medicine news and regulations, maintaining personal interests and a social life, the constant buzz of our mobile devices. So taking time to focus on our personal health is quite a challenge.</p> <p> But if we’re in poor health, how can we counsel our patients on improving their health? Poor physician health affects us all—from our peers to our trainees, patients and the health care system as a whole, not to mention our own families.</p> <table align="right" border="1" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/80659c3f-6954-43ac-a8be-e1085b3ad5d0.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/0/8/80659c3f-6954-43ac-a8be-e1085b3ad5d0.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">The three presidents: AMA President Dr. Wah joined Professor the Baroness Ilora Finlay, president of the British Medical Association, and Dr. Chris Simpson, president of the Canadian Medical Association, at the International Conference on Physician Health.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> Attendees from 13 countries came to discuss the particular stressors surrounding our different career stages. From medical school through residency, practice and retirement, the things that ail us may change. Despite our different countries, backgrounds and health care systems, the thing that stood out to me was how much in common I have with physicians around the world when it comes to stress, burnout and the struggle for a work-life balance.</p> <p> In my welcome remarks, I reminded the audience that as physicians, we see one especially important patient every day: It’s the face in the mirror. We have to take care of this patient so that we can be at our best to take care of all our other patients.</p> <p> Over and over I’ve heard about the need for systematic and cultural changes in medicine in order to support the physical, mental and emotional health of physicians. Lucky for us, the AMA is working on systematic and cultural changes in its three strategic focus areas:</p> <ul> <li> Through our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/accelerating-change-in-medical-education.page?" target="_blank">Accelerating Change in Medical Education</a> initiative, we’re working with 11 medical schools to implement innovative curriculum. It’s important that medical education include such skills as coping mechanisms and business management so future physicians are equipped to have more satisfaction in their professional and personal lives.</li> <li> In our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/improving-health-outcomes.page" target="_blank">Improving Health Outcomes</a> initiative, our goal is to reduce prediabetes and high blood pressure—which is difficult if we’re on the path to these diseases ourselves. For the sake of ourselves and our patients, we need to be good role models. We’re developing prototypes to embed screening and prevention into our daily processes. </li> <li> Professional satisfaction can be a huge determinant of overall wellness. The study of physician satisfaction we conducted last year with the RAND Corporation found that having an impact on the health of our patients is at the top of the list of satisfiers for physicians. <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page?" target="_blank">Our Professional Satisfaction and Practice Sustainability</a> initiative is working to put the joy back into medicine and help you do what you do best: care for patients.</li> </ul> <p> The knowledge shared at the International Conference on Physician Health—such as how increasing numbers of young doctors are seeking help for mental health and how unfair treatment of medical students is potentially being underreported—will inform how I take care of myself, my trainees and my patients. You can view webcasts of the conference and get additional highlights and news on the <a href="http://bma.org.uk/icph2014" rel="nofollow" target="_blank">BMA’s website</a>.</p> <p> The next conference, to take place in 2016, will be hosted by the AMA in the United States. <a href="http://www.ama-assn.org/ama/pub/physician-resources/physician-health/international-conference-physician-health.page?" target="_blank">Stay tuned</a> for more information on the location and how you can participate.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e9ed5ff0-f8c2-46aa-bb13-ba10c016af3f Prepare for ICD-10 compliance with pocket-sized reference http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_prepare-icd-10-compliance-pocket-sized-reference Tue, 23 Sep 2014 19:31:00 GMT <p> The deadline to comply with implementation of the ICD-10 code set is nearly one year away, making it the perfect time to get up to speed on proper documentation. A pocket-sized, tabular reference from the AMA Store can help you prepare for ICD-10 and better understand ICD-9.</p> <p> The <a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2560004&navAction=push" target="_blank"><em>Pocket Guide to Understanding ICD-10-CM Documentation</em></a> helps physicians understand new and established documentation concepts, and can improve documentation practices when coding with ICD-9. Helpful features of this reference include:</p> <ul> <li> A small profile—it fits in a pocket and is ideal for quick reference at the point of care</li> <li> Information on the importance of conducting a clinical documentation assessment</li> <li> At-a-glance convenience</li> </ul> <p> While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now. Read more about <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" target="_blank">how the AMA is working</a> to help ease ICD-10 implementation for physicians. Additional education and planning resources are available on the AMA’s <a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" target="_blank">ICD-10 Web page</a>.</p> <p>  </p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:150f401a-3c4a-40aa-87a3-41e0a8d83675 Report ranks top residency programs--see how yours stacks up http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_report-ranks-top-residency-programs-see-stacks-up Mon, 22 Sep 2014 21:53:00 GMT <p> Where are the top residency programs in the country? A new ranking based on a large physician survey lists the top 10 programs for 20 specialties.</p> <p> Physician network Doximity and <em>U.S. News & World Report</em> surveyed more than 17,000 U.S. physicians evaluating 3,691 residency training programs based on more than 50,000 peer nominations. The survey asked each physician to name up to five residency programs in their specific medical specialty that offer the best clinical training.</p> <p> After weighing each nomination to account for regional differences in response rates and the proportion of physicians who are Doximity users, the network ranked the top 10 programs in each specialty for its new <a href="https://www.doximity.com/residency_navigator/programs" rel="nofollow" target="_blank">Residency Navigator</a> tool.</p> <p> Some highlights include:</p> <ul> <li> <strong>Family practice. </strong>At the top of the list are Ventura County Medical Center, University of Washington and John Peter Smith Hospital.</li> <li> <strong>Emergency medicine.</strong> The best rankings were given to Indiana University School of Medicine, University of Cincinnati Medical Center and the University of Southern California.</li> <li> <strong>Pediatrics.</strong> Listed best of class are Children’s Hospital of Philadelphia, Children’s Hospital/Boston Medical Center and Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine.</li> </ul> <p> The University of California–San Francisco placed in the top 10 lists for 16 medical specialties and was ranked No. 1 in three of those specialties. Johns Hopkins University placed in the top 10 lists for 14 specialties and was ranked No. 1 in four specialties.</p> <p> The Residency Navigator tool is free to browse by specialty. </p> <p> <strong>Looking into residency program possibilities? </strong>The AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page" target="_blank">FREIDA Online</a> tool allows medical students to search graduate medical education (GME) programs and narrow down their choices. Additional information to help students find a residency position on the AMA’s <a href="http://www.ama-assn.org/ama/pub/education-careers/finding-position.page?" target="_blank">GME Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:e030e53e-3b8d-4aeb-9eb0-2c1ddc08286d CMS conducting end-to-end ICD-10 testing; apply by Oct. 3 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_cms-conducting-end-end-icd-10-testing-apply-oct-3 Mon, 22 Sep 2014 21:49:00 GMT <p> <span style="font-size:12px;">In advance of ICD-10 implementation scheduled for Oct. 1 of next year, the Centers for Medicare & Medicaid Services (CMS) plans to conduct end-to-end testing in January to identify issues in the system that need to be addressed. Physicians who are interested in participating should apply by Oct. 3.</span></p> <p> CMS announced Friday that it will select approximately 850 volunteers to participate in a cross-sectional sample of those who submit claims for Medicare payment. The testing will be conducted with Medicare Administrative Contractors (MAC) and Medicare’s common electronic data interchange contractor.</p> <p> <span style="font-size:12px;">CMS had not originally planned to conduct testing of the new code set until the AMA pressed the agency, emphasizing the complexity behind adopting the new code set and the unpreparedness of many vendors and practices.</span></p> <p> <span style="font-size:12px;">This testing week, which will take place Jan. 26-30, is intended to determine whether physicians and others are able to successfully submit claims with ICD-10 codes to Medicare’s fee-for-service claims systems.</span></p> <p> <span style="font-size:12px;">The testing also should show whether CMS’ software changes to support ICD-10 can adjudicate claims appropriately and produce accurate remittance advice. CMS says it plans to address any issues identified during testing and develop educational materials for physicians and others who will be submitting claims with ICD-10 codes.</span></p> <p> <span style="font-size:12px;">If you’re interested in participating, visit your </span><a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Contractor-Directory-Interactive-Map/" rel="nofollow" style="font-size:12px;" target="_blank">MAC website</a><span style="font-size:12px;"> to access the volunteer form and submit it by Oct. 3. CMS will review applications and notify volunteers who have been selected to participate by Oct. 24.</span></p> <p> <span style="font-size:12px;">Additional information about CMS’ approach to ICD-10 testing is available in a recent </span><a href="http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1409.pdf" rel="nofollow" style="font-size:12px;" target="_blank"><em>MLN Matters</em>® article</a><span style="font-size:12px;">.</span></p> <p> <span style="font-size:12px;">Visit the AMA’s </span><a href="http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page" style="font-size:12px;" target="_blank">ICD-10 Web page</a><span style="font-size:12px;"> for a variety of free resources to help physicians prepare for testing and implementation of the new code set. In addition, the AMA Store offers the </span><em style="font-size:12px;">ICD-10 2015 Data File</em><span style="font-size:12px;">, available via </span><a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2500012&navAction=push#usage-tab" style="font-size:12px;" target="_blank">CD-ROM</a><span style="font-size:12px;"> or </span><a href="https://commerce.ama-assn.org/store/catalog/productDetail.jsp?product_id=prod2540010&navAction=push" style="font-size:12px;" target="_blank">instant download</a><span style="font-size:12px;">, for physicians who still need to upload the latest codes into their electronic systems.</span></p> <p> <span style="font-size:12px;">While the AMA continues to raise physicians’ significant concerns regarding implementation of the ICD-10 code set with federal policymakers, practice management experts advise physicians to start preparing for implementation now. Read more about </span><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/icd-10-financially-disastrous-physicians-ama-tells-hhs" style="font-size:12px;" target="_blank">how the AMA is working</a><span style="font-size:12px;"> to help ease ICD-10 implementation for physicians.</span></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:97350653-60ce-4c28-8f6a-0912a0a548d2 New journal JAMA Oncology to debut in 2015 http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_new-journal-jama-oncology-debut-2015 Mon, 22 Sep 2014 21:43:00 GMT <p> The JAMA Network will launch the new journal <em>JAMA Oncology</em> early next year featuring cancer-related research.</p> <p> When <em>JAMA Oncology</em> premieres in early 2015, it will be the 11th journal in the JAMA Network, which includes the <em>Journal of the American Medical Association</em> (<em>JAMA</em>) and nine other specialty journals. All of the <em>JAMA Oncology</em> content–research, reviews and opinions–will be published <a href="http://oncology.jamanetwork.com/" target="_blank" rel="nofollow">online</a> every Thursday and then printed in a monthly paper issue. <em>JAMA Oncology</em> will be the first new journal to be launched by the JAMA Network since 1999.</p> <p> <em>JAMA Oncology</em> will address all aspects of medical, radiation and surgical oncology and its subspecialties. The journal will be a leader in the high-impact field of cancer research, where the volume of work and innovative discoveries have accelerated at a remarkable pace in an effort to keep up with the expected increase in patients diagnosed with cancer.</p> <p> “<em>JAMA Oncology</em> presents an important new initiative for the JAMA Network—our first new journal in many years,” said Howard Bauchner, MD, editor-in-chief of <em>JAMA</em> and the JAMA Network. “The worldwide research effort in oncology is substantial, including lab, translational, clinical and health services research, and there are many important evolving clinical and policy issues.”</p> <p> “<em>JAMA Oncology</em> will include original investigation, opinion (viewpoints, editorials, and invited commentaries) and clinical reviews,” Dr. Bauchner said. “And we could not be more fortunate than to have Nora Disis, MD, as our inaugural editor-in-chief. She is an internationally renowned investigator and a superb clinician.”</p> <p> As the journal’s founding editor, Dr. Disis brings extensive experience to her new role. In addition to serving as a professor of medicine, she is director of the Center for Translational Medicine in Women’s Health and director of the Institute of Translational Health Sciences at the University of Washington. Dr. Disis, who specializes in breast and ovarian cancer and immunotherapy, has been deputy editor of translational oncology for the <em>Journal of Clinical Oncology</em> and has served on the advisory board for Science Translational Medicine.</p> <p> Existing customers will have free access to <em>JAMA Oncology</em> in 2015. Individual physicians and other health care professionals also will be eligible to access content for free on the <a href="http://app.jamanetwork.com/" target="_blank" rel="nofollow">JAMA Network Reader</a>. AMA members enjoy unlimited access to the JAMA Network. Not a member? <a href="https://commerce.ama-assn.org/membership/" target="_blank">Join</a> today.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:f34e71ff-973a-446a-961a-2d22c3247777 What people are saying about AMA’s EHR priorities http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_people-saying-amas-ehr-priorities Mon, 22 Sep 2014 21:36:00 GMT <p> A <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">new framework</a> for electronic health record (EHR) usability was issued last week. Developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives, the framework focuses on leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs.</p> <table align="left" border="1" cellpadding="1" cellspacing="15" style="width:315px;"> <tbody> <tr> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/6/57033708-a7d2-4b8a-9651-18627ab6c37a.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/7/6/57033708-a7d2-4b8a-9651-18627ab6c37a.Large.jpg?1" /></a></td> <td>   </td> </tr> <tr> <td> <em><span style="font-size:12px;">Examples of some Twitter posts praising the AMA's leadership on putting forth the EHR priorities.</span></em></td> <td style="text-align:left;vertical-align:middle;height:35px;">  </td> </tr> </tbody> </table> <p> The release of <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">eight solutions</a> (log in) to address the challenges physicians face in using EHRs was well received by both the media and physician community. Here’s a summary of what these influential people are saying about the AMA’s EHR priorities.</p> <p> “As Secretary of Health and Human Services, I saw firsthand the big picture challenges that this [poses]—and those issues the commenters are raising. Hopefully, the AMA’s efforts will help focus all of the relevant players in the health system to adopt seamless, effective EHRs that are as useful and as available as a patient’s bank accounts. This isn’t a cure-all, of course, but it is a welcome addition to the efforts to benefit patients.”</p> <p> —<strong>Tommy G. Thompson, former governor of Wisconsin secretary of the U.S. Department of Health and Human Services (HHS)</strong></p> <p> “We applaud the AMA for speaking out on this,” said<strong> Jacob Reider, MD, a family physician </strong>who formerly worked in EHR development. “It will take a few years before we will see an iPhone-like EMR. We’ll get there, but it’s primarily in the hands of the developers.”</p> <p> —“<a href="http://online.wsj.com/articles/ama-urges-overhaul-of-electronic-records-1410840063#livefyre-comment" rel="nofollow" target="_blank">AMA urges overhaul of electronic medical records</a>,” <em>The Wall Street Journal</em></p> <p> “We support the AMA’s efforts to improve EHRs for the end user—the health care providers who use these products to treat their patients,” said <strong>Peter Ashkenaz, spokesman for the Office of the National Coordinator for Health Information Technology at HHS</strong>.</p> <p> —“<a href="http://www.washingtonpost.com/national/health-science/frustrated-ama-calls-for-and8216action-plan-on-digital-records/2014/09/16/deccc96a-3dc5-11e4-a430-b82a3e67b762_story.html" rel="nofollow" target="_blank">Frustrated AMA pitches ‘action plan’ on digital records</a>,” <em>Washington Post</em></p> <p> “The American Medical Association …  has taken matters into its own hands, issuing an eight-point framework to impose EHR usability. AMA is willing to work with the agencies, but will no longer wait for the agencies to do the job and require improvements.”</p> <p> —“<a href="http://www.fierceemr.com/story/faux-mu-flexibility-rule-ghost-no-matter-what/2014-09-18" rel="nofollow" target="_blank">The ‘faux’ MU flexibility rule: A ghost no matter what</a>,” <strong>Marla Durben Hirsch</strong>, <strong>editor of <em>Fierce EMR</em></strong></p> <p> “Timely and important. I am glad that the AMA is going to bat for this. We need them to be louder, clearer and more forceful.”</p> <p> —<strong>Joe Flower, author and columnist for the American Hospital Association</strong></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:9707b56f-b31f-43f7-8ffe-b7a32daaf12b Case could leave doctors vulnerable to repeat, delayed lawsuits http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_case-could-leave-doctors-vulnerable-repeat-delayed-lawsuits Fri, 19 Sep 2014 20:30:00 GMT <p> A case coming before the Supreme Court of the United States holds in the balance whether lawsuits and heavy fines can be brought indefinitely against physicians who provide services under Medicare and other federal health care programs.</p> <p> In <em>KBR v. United States of America Ex Relator Benjamin Carter</em>, petitioners are seeking to overturn earlier court decisions that would eliminate the existing six-year limit on pursuing “false claims” under the federal False Claims Act and would allow repeat lawsuits to be filed.</p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/8/3f0aaa24-0f33-467e-b8ea-0498309c7fe5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/15/8/3f0aaa24-0f33-467e-b8ea-0498309c7fe5.Large.jpg?1" style="margin:15px;float:right;" /></a>The AMA filed a friend-of-the-court brief alongside four other organizations, calling on the U.S. Supreme Court to consider the ramifications of earlier court rulings on the matter.</p> <p> “If affirmed, the combined effect of these rulings will invite private plaintiffs and the government to pursue indefinitely and repeatedly any claim involving alleged fraud against the government,” the brief states. “This elimination of all repose is not only contrary to law but would impose significant burdens on businesses, hospitals and other health care providers.”</p> <p> The brief points out that physicians could be “forced to defend against stale, repetitive and frequently meritless claims.” This task would require significant costs in maintaining records for an indefinite period, planning for unknown contingencies and defending against inappropriate suits.</p> <p> For physicians who don’t have sufficient documentation to mount a proper defense or who otherwise decide to settle, the financial damages are considerable.</p> <p> Under the federal False Claims Act, the penalty for each claim is between $5,000 and $10,000, adjusted for inflation, plus three times the amount of damages “sustained by the federal government.” If information was misrepresented on multiple Medicare claims, for instance, penalties would apply to each claim—regardless of how small the billed amount was.</p> <p> The case is expected to be argued this winter.</p> <p> The AMA long has expressed concern over ambiguities in the False Claims Act, a Civil War-era statute being used to raise inappropriate claims, and previously has filed several court briefs reflecting concerns over this law.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:56c35b41-4339-40c2-853a-13cf920df950 21 students selected as outstanding doctors of tomorrow http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_21-students-selected-outstanding-doctors-of-tomorrow Fri, 19 Sep 2014 20:23:00 GMT <p> A group of outstanding fourth-year medical students from across the country were announced earlier this month as recipients of the Physicians of Tomorrow Awards from the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page" target="_blank">AMA Foundation</a>.</p> <p> The 21 honored students, chosen for their academic excellence and financial need, will each receive $10,000 to assist with their medical school tuition. The 2014 scholarship recipients are:</p> <ul> <li> Matthew Alvin, Case Western Reserve University School of Medicine</li> <li> Joshua Bakhsheshian, Chicago Medical School at Rosalind Franklin University of Medicine and Science</li> <li> Italo Brown, Meharry Medical College</li> <li> Elias Dayoub, University of Michigan Medical School</li> <li> Jennifer Girard, University of Illinois at Chicago College of Medicine</li> <li> Konstantin Grigoryan, University of Cincinnati College of Medicine</li> <li> Mickey Ising, University of Louisville School of Medicine</li> <li> Corbin Jacobs, University of Texas Southwestern Medical Center at Dallas</li> <li> Mariya Kalashnikova, Keck School of Medicine of the University of Southern California</li> <li> Jimin Kim, University of Chicago Pritzker School of Medicine</li> <li> Matthew Murphy, Loyola University Chicago Stritch School of Medicine</li> <li> Raja Narayan, University of California Irvine School of Medicine</li> <li> Alexander Nguyen, University of California Davis School of Medicine</li> <li> Derek Rogalsky, Georgetown University School of Medicine</li> <li> Taylor Stanton, University of Illinois College of Medicine at Rockford</li> <li> Tatiana Thema, Wake Forest School of Medicine</li> <li> Ryan Uselman, University of Minnesota Medical School</li> <li> Stephen Villa, University of California San Francisco</li> <li> LaBianca Wright, Loyola University Chicago Stritch School of Medicine</li> </ul> <p> In addition, two students each received $10,000 for their commitment to careers in medical journalism:</p> <ul> <li> Anna Garcia, Vanderbilt University School of Medicine</li> <li> Daniel Leifer, University of California Davis School of Medicine</li> </ul> <p> Read more about this year’s winners on the <a href="http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/our-programs/medical-education/physicians-tomorrow-scholarships.page?" target="_blank">Physicians of Tomorrow Awards Web page</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:96570cd4-3907-4d1f-a773-f4ab255f1380 Tell us: Which EHR improvements would help you most? http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_tell-ehr-improvements-would Thu, 18 Sep 2014 21:11:00 GMT <p> <em>An </em><a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank"><em>AMA Viewpoints</em></a><em> post from AMA President-Elect </em><a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/board-trustees/our-members/steven-stack.page" target="_blank"><em>Steven J. Stack, MD</em></a><em>.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/14/99b40cb0-11be-4562-8ef9-10274b13df05.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/14/99b40cb0-11be-4562-8ef9-10274b13df05.Large.jpg?1" style="margin-right:15px;margin-left:15px;float:left;" /></a></p> <p> <br /> An AMA-convened panel of experts this week called for electronic health record (EHR) overhaul, outlining the eight top challenges and solutions for improving EHR usability. As chair of this committee, I ask you to share your thoughts with the AMA: Which of these eight priorities would make the biggest impact on your practice? Please share your thoughts in the comment section of this post.</p> <p> Click the button at the bottom of this page to either sign in with your AMA credentials or create an account to post a comment below. Tell us which of the following priorities resonates the most with you:<br />  </p> <ul> <li> Enhance physicians’ ability to provide high-quality patient care</li> <li> Support team-based care</li> <li> Promote care coordination</li> <li> Offer product modularity and configurability</li> <li> Reduce cognitive workload</li> <li> Promote data liquidity</li> <li> Facilitate digital and mobile patient engagement</li> <li> Expedite user input into product design and post-implementation feedback</li> </ul> <p> <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/8-top-challenges-solutions-making-ehrs-usable" target="_blank">Read more</a> about each of these priorities in an <em>AMA Wire</em><em>® </em>post from earlier this week.</p> <p> I look forward to hearing from you as we move forward with this important work and other efforts within the AMA’s <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:4d1c0ffa-729b-4aec-a4a1-9564dce679ea JAMA Highlights: Waistlines of U.S. adults continue to increase http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_jama-highlights-waistlines-of-adults-continue-increase Thu, 18 Sep 2014 20:47:00 GMT <p> <strong><object align="right" data="http://www.youtube.com/v/UWw42-fon64" height="350" hspace="10" id="ltVideoYouTube" src="http://www.youtube.com/v/UWw42-fon64" type="application/x-shockwave-flash" vspace="10" width="365"><param name="movie" value="http://www.youtube.com/v/UWw42-fon64" /><param name="quality" value="best" /><param name="bgcolor" value="#ffffff" /><param name="wmode" value="transparent" /><param name="allowScriptAccess" value="always" /><param name="flashvars" value="playerMode=embedded" /><embed allowscriptaccess="always" bgcolor="#ffffff" height="350" hspace="10" quality="best" src="http://www.youtube.com/v/UWw42-fon64" type="application/x-shockwave-flash" vspace="10" width="365" wmode="transparent"></embed></object>Waistlines of U.S. adults continue to increase</strong><br /> The prevalence of abdominal obesity and average waist circumference increased among U.S. adults from 1999 to 2012, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1904816" rel="nofollow" target="_blank">study</a> in the Sept. 17 issue of the <em>Journal of the American Medical Association </em>(<em>JAMA</em>)<em>.</em></p> <p> <strong>Combination therapy for COPD associated with better outcomes</strong><br /> Among older adults with chronic obstructive pulmonary disease (COPD)—particularly those with asthma—newly prescribed long-acting beta-agonists (LABAs) and inhaled corticosteroid combination therapy, compared with newly prescribed LABAs alone, was associated with a lower risk of death or COPD hospitalization, according to a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1904829" rel="nofollow" target="_blank">study</a> in <em>JAMA</em>. Watch a <a href="http://youtu.be/UWw42-fon64" rel="nofollow" target="_blank">video</a> on the study.</p> <p> <strong>Multiple-birth infants use more resources, spotlight on reproductive technology</strong><br /> Hospital costs are higher and the odds of complication and death are greater for multiple-birth infants than singleton births, and some of this clinical and economic burden can be alleviated through single-embryo transfer in assisted reproductive technology, according to a <a href="http://archpedi.jamanetwork.com/article.aspx?articleid=1903018" rel="nofollow" target="_blank">study</a> in <em>JAMA Pediatrics.</em></p> <p> <strong>PTSD symptoms associated with increased food addiction</strong><br /> Symptoms of posttraumatic stress disorder (PTSD) were associated with increased food addiction, especially when individuals had more symptoms or the symptoms occurred earlier in life, according to a <a href="http://archpsyc.jamanetwork.com/article.aspx?articleid=1904804" rel="nofollow">study</a> in <em>JAMA Psychiatry</em>.</p> <p>  </p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:b9aebf7b-f12b-401f-bf15-f7fdcd73fca6 Physicians share insights into how med schools are changing http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_physicians-share-insights-med-schools-changing Thu, 18 Sep 2014 20:22:00 GMT <p> Take a closer look at unique programs medical schools across the country are testing with first-person perspectives from academic physicians on cutting-edge programs at their schools.</p> <p> Faculty at the 11 schools participating in the AMA’s <a href="http://changemeded.org/" target="_blank" rel="nofollow">Accelerating Change in Medical Education</a> initiative are sharing their thoughts on the changes their schools are making, the challenges they’re overcoming and the results they hope to achieve.</p> <p> At the Brody School of Medicine of East Carolina University, the incoming students of the class of 2018 heard a real-life story of a patient tragedy, inspiring them to put the patient first. Danielle Walsh, MD, a clinical associate professor at Brody, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/one-school-really-putting-patient-first" target="_blank">outlines other ways</a> the school is thinking differently, including its Teachers of Quality Academy.</p> <p> Two faculty at Oregon Health and Science University School of Medicine <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/health-used-school-investigates-competencies" target="_blank">shared how informatics</a>—the use of technology to better care for patients—is embedded into the school’s new curriculum. William Hersh, MD, chair of the school’s department of medical informatics and clinical epidemiology, and George Mejicano, MD, the senior associate dean for education at the school of medicine, explain how the school figured out the best ways to incorporate related topics, and how students will be evaluated.</p> <p> Finally, Paul George, MD, associate director of preclinical curriculum at the Warren Alpert Medical School of Brown University, <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/dual-degree-program-targets-new-type-of-physician" target="_blank">explains Brown’s new dual degree program</a> aimed at cultivating a new type of physician. The program is designed to give students background in primary care and population medicine, including training in areas such as health disparities, health systems and leadership skills.</p> <p> The consortium of schools participating in the AMA’s initiative will meet this month at Vanderbilt University School of Medicine in Nashville to work through the each of the schools’ progress and determine future goals. Watch <em>AMA Wire</em>® for more coverage.</p> <p> Additional insights from faculty involved in the AMA’s Accelerating Change in Medical Education initiative will be posted to <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/MedEd_Innovation/1"><em>AMA Wire</em></a> over the coming months. You also can sign up for <a href="http://www.ama-assn.org/ama/pub/news/newsletters-journals/med-ed-archive.page"><em>AMA</em> <em>MedEd Update</em></a>, the AMA’s monthly e-newsletter with updates on the latest innovations in medical education.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ed7f333e-833e-4e75-b9b9-19b98832cd70 Gender role in residency burnout, faculty promotion under scrutiny http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_gender-role-residency-burnout-faculty-promotion-under-scrutiny Thu, 18 Sep 2014 15:00:00 GMT <table align="right" border="0" cellpadding="1" cellspacing="15" style="width:365px;"> <tbody> <tr> <td>   </td> <td> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/15/59da0c26-ca56-4452-af66-061e3516c5a5.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/9/15/59da0c26-ca56-4452-af66-061e3516c5a5.Large.jpg?1" /></a></td> </tr> <tr> <td>  </td> <td style="text-align:right;vertical-align:middle;height:35px;"> <em><span style="font-size:12px;">Elizabeth H. Ellinas, MD (left), and Sneha Harshad Shah, MD (right), will examine  the role gender may play in key components of the medical profession as the winners of this year’s Joan F. Giambalvo Fund for the Advancement of Women.</span></em></td> </tr> </tbody> </table> <p> Two studies will be taking on questions about the role gender may play in key components of the medical profession, including empathy and burnout in residency and faculty promotion and retention at medical schools. The projects are the winners of this year’s Joan F. Giambalvo Fund for the Advancement of Women, announced Wednesday in conjunction with <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page" target="_blank">Women in Medicine Month</a>.</p> <p> The theme “Innovators and Leaders Changing Health Care” for this year’s Women in Medicine Month will be seen in action through these timely research projects. They’re being spearheaded by two women physicians:</p> <ul> <li style="margin-left:0.25in;"> Elizabeth H. Ellinas, MD, assistant dean for faculty affairs at the Medical College of Wisconsin, will be collaborating with colleagues to study how to enhance the position of female faculty in academic rank and leadership positions. The study will look at gender differences in seeking promotion and leadership and intent to leave.<br />  </li> <li style="margin-left:0.25in;"> Sneha Harshad Shah, MD, associate program director of the Emergency Medicine Residency Program at the University of Massachusetts Medical School, will be studying gender differences in empathy and burnout among emergency medicine residents. Her study also will test the effectiveness of an empathy training curriculum for residency.</li> </ul> <p> “The gap between women and men undeniably exists in the house of medicine,” said Dr. Shah. “I applied for this fund because it supports projects that raise awareness of gender inequalities so that women can persevere and rise through their professional careers.”</p> <p> “We are proud to recognize two outstanding members of the medical community, whose work is raising awareness about these issues,” AMA President Robert M. Wah, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-18-research-grants-study-women-in-medicine.page" target="_blank">news release</a>. “Their work will help propel the AMA’s advocacy efforts on the advancement and understanding of women in medicine.”</p> <p> The Joan F. Giambalvo Fund for the Advancement of Women was established by the AMA Women Physicians Section (WPS) and the AMA Foundation. This unique program offers funding specifically for health care researchers to identify and address issues that affect women physicians and medical students. Previous research topics have included flexible work options, gender differences in practice patterns, and promotion and retention of diversity in medical education.</p> <p> Celebrate Women in Medicine Month by learning more about women in the profession:</p> <ul> <li style="margin-left:15pt;"> Look for the #WIMmonth hashtag on the AMA’s <a href="https://www.facebook.com/AmericanMedicalAssociation" rel="nofollow" target="_blank">Facebook</a> and <a href="https://twitter.com/AmerMedicalAssn" rel="nofollow" target="_blank">Twitter</a> feeds, where the AMA is honoring innovative women all month.</li> <li style="margin-left:15pt;"> Listen to members of the AMA-WPS share their stories and reflections in a <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/women-medicine-history.page?" target="_blank">new video series</a>.</li> <li style="margin-left:15pt;"> Learn about the <a href="https://download.ama-assn.org/resources/doc/wps/x-pub/profile-history-women-in-medicine.pdf" target="_blank">history of women physicians</a> (log in)—and what the future may bring.</li> <li style="margin-left:15pt;"> Get <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/governing-council-inspirations.page" target="_blank">insight into the mentors</a> who have driven women leaders.</li> <li style="margin-left:15pt;"> Check out the honorees of the AMA-WPS <a href="http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/women-physicians-section/mentor-recognition.page?" target="_blank">Inspirational Physician Awards</a>.</li> </ul> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:5bc763a9-ff7e-4e68-92ea-44bbc0c914a2 How students and residents are saving GME http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_students-residents-saving-gme Wed, 17 Sep 2014 19:09:00 GMT <p> <a href="https://storify.com/AmerMedicalAssn/savegme-week-2014" target="_blank" rel="nofollow"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/b6e8c889-d2ea-4440-b20f-101f2bfa1892.Large.jpg?1" style="float:right;margin:10px;" /></a>Medical students and trainees took to social media last week, calling for Congress to support graduate medical education (GME) and bringing attention to the impending physician shortage during Save GME Week.</p> <p> Students and residents used #SaveGME on <a href="https://www.facebook.com/amamss" target="_blank" rel="nofollow">Facebook</a> and <a href="https://twitter.com/AMA_MSS" target="_blank" rel="nofollow">Twitter</a>, posting facts about why more GME positions are crucial for the future of medicine and the health of the nation. Many also leveraged the <a href="http://savegme.org/take-action/" target="_blank" rel="nofollow">online advocacy tools</a> at SaveGME.org to contact their lawmakers directly, urging them to save GME.</p> <p> “A tremendous amount of medical care in the United States is delivered by residents and fellows, and that’s why it’s so important for trainees to participate in Save GME Week,” said Maya Babu, MD, the resident member of the AMA Board of Trustees. “Residents and fellows train in teaching hospitals, which provide a diverse range of critical health care services, including complex trauma care, burn units and neonatal intensive care units. These services are provided round-the-clock, seven days a week and heavily rely on the resident and fellow workforce.”</p> <p> The weeklong grassroots campaign needs student and resident involvement to be successful, said Sam Mackenzie, a third-year MD/PhD student at Upstate Medical University and a member of the AMA Board of Trustees, on a special Save GME episode of the medical student and trainee podcast <a href="http://radiorounds.org/savegme-the-ama-responds-to-the-iom/" target="_blank" rel="nofollow"><em>Radio Rounds</em></a>.</p> <p> “Medical school requires a lot of focus, and I think it can be difficult for students to get their heads out of their books sometimes and participate in some of these bigger picture processes of change going on around them,” said Mackenzie,. “Certainly health care reform comes to mind, but in the more immediate future, students really need to be active on the subject of GME.”</p> <p> Workforce experts predict a shortage of more than 45,000 primary care and 46,000 specialty physicians in the United States by 2020, and medical schools are producing more graduates to prepare for this expected shortage. At the same time, the number of residency positions has remained capped, meaning some students may not match to training positions, which could exacerbate the shortage.</p> <p> Meanwhile, physician maldistribution throughout the United States has led to a lack of doctors in underserved areas, both in primary care and in specialties. Mackenzie is planning to specialize in pediatric neurology, and said it can be difficult for patients to see pediatric neurologists.</p> <p> “At my institution, the waiting time just to see one of these few attending physicians that we have in child neurology is between four to six months,” he said. “There have been some pretty unfortunate barriers to expansion, thanks to a federal cap [on residency positions] … The cap very simply exacerbates the physician maldistribution in this country.”</p> <p> Check out what students and residents across the country <a href="https://storify.com/AmerMedicalAssn/savegme-week-2014" target="_blank" rel="nofollow">had to say about Save GME Week</a>, and learn more at <a href="http://savegme.org/" target="_blank" rel="nofollow">SaveGME.org</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:8f70e327-5ad7-43df-9d6f-a768e373225f See how your cash flow compares to other practices http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_see-cash-flow-compares-other-practices Wed, 17 Sep 2014 19:06:00 GMT <p> What’s your practice’s cash flow score? Learn how your practice compares against industry benchmarks in setting payment expectations and supporting front and back office billing processes. A free interactive webinar from 1 p.m. to 2 p.m. Eastern time Sept. 25 shows you how. <a href="https://www1.gotomeeting.com/register/962271185" target="_blank" rel="nofollow">Register now</a>.</p> <p> Participants will receive on-the-spot results regarding how their practices compare to others  and will learn about:</p> <ul> <li style="margin-left:0.25in;"> Maintaining patient engagement</li> <li style="margin-left:0.25in;"> Following up with patient payments</li> <li style="margin-left:0.25in;"> Using a collection agency</li> </ul> <p> Participants will be prepared to incorporate tools into their practices’ processes and increase their cash flow.</p> <p> This webinar will be presented by Angie Slayton, director of marketing for <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program/mvp-transworld-systems.page" target="_blank">Transworld Systems</a>, a cash flow management service that is a part of the AMA <a href="http://www.ama-assn.org/ama/pub/membership/membership-benefits/member-value-program.page?" target="_blank">MVP Program</a>.</p> <p> <em>This webinar is provided for information and planning purposes. It is not intended to be, nor should it be substituted for, legal or compliance advice, which turn on specific facts.</em></p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:7162022c-8b06-4344-9875-bdc6ea19ddb3 All I want for Health IT Week is an EHR overhaul http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_want-health-week-ehr-overhaul Tue, 16 Sep 2014 18:40:00 GMT <p> <em>An <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/blog/AMA_Viewpoints/1" target="_blank">AMA Viewpoints</a> post by AMA President Robert M. Wah, MD.</em></p> <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/3/6/530b2d8b-1122-4ebd-a6a1-947080bf4850.Large.jpg?1" style="float:left;margin:10px;" /></a>If I had to capture the main shortcoming of electronic health record (EHR) technology in one word, this would be it: Usability.</p> <p> As we’re observing <a href="http://www.healthit.gov/healthitweek/" rel="nofollow">National Health IT Week</a> through Friday, I can’t think of a better time to call for EHR systems that better serve physicians and our patients. That’s why the AMA just released a new framework for improving EHR usability.</p> <p> As a chief medical officer for a health IT company and a former deputy national coordinator in the Office of the National Coordinator for Health Information Technology, I understand the complexities of what’s required to make EHRs first and foremost usable systems for the medical practice. When I say “all” I want for Health IT Week is an EHR overhaul, I realize that’s no simple request.</p> <p> But it is a basic request. Usability should be the driving quality of all health IT. Unless health IT functions in a way that makes our practices more efficient and facilitates improvements in our patient care, it isn’t doing what it was intended to do.</p> <p> As my colleague Steven J. Stack, MD, AMA president-elect, has said, most physicians are stuck with technology that <em>interferes</em> with their ability to provide first-rate medical care. And that’s reflected in physicians’ professional satisfaction.</p> <p> In the AMA’s <a href="http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/quality-of-patient-care-primary-driver-of-physician-satisfaction-study" target="_blank">study</a> with the RAND Corporation released last fall, we identified that the primary driver of physician dissatisfaction was EHR technology that put up barriers to delivering high-quality patient care.</p> <p> As part of our <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, we convened an external advisory committee of noted health IT experts and practicing physicians to develop priorities that should illuminate the path for improving the usability of EHR technology to benefit physicians and their patients.</p> <p> Dr. Stack chaired this committee, which was responsible for developing the <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) we released this week. The framework outlines key challenges physicians face with EHRs and eight priorities that should be national priorities for improving the usability of this technology:</p> <ul> <li style="margin-left:0.25in;"> Enhance physicians’ ability to provide high-quality patient care</li> <li style="margin-left:0.25in;"> Support team-based care</li> <li style="margin-left:0.25in;"> Promote care coordination</li> <li style="margin-left:0.25in;"> Offer product modularity and configurability</li> <li style="margin-left:0.25in;"> Reduce cognitive workload</li> <li style="margin-left:0.25in;"> Promote data liquidity</li> <li style="margin-left:0.25in;"> Facilitate digital and mobile patient engagement</li> <li style="margin-left:0.25in;"> Expedite user input into product design and post-implementation feedback</li> </ul> <p> The framework is particularly important in that it was developed by a combination of practicing physicians and noted experts, researchers and executives in the health IT field. So we were looking at how to improve EHR technology from a variety of perspectives, and the concepts offered are ones that can be executed.</p> <p> To that end, we will be working with all stakeholders—physicians, vendors, federal and state policymakers, institutions, health care systems and researchers—to take these principles from ideas to realities. I look forward to witnessing the progress we’ll make by this time next year.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:3a679c5d-9abd-4bb9-8723-c5b572fc2388 16 states let doctors get CME for state licensure at the JAMA Network http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_16-states-let-doctors-cme-state-licensure-jama-network Tue, 16 Sep 2014 17:56:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/a6082777-3f8e-4766-922f-5fe2975dfb58.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/6/2/a6082777-3f8e-4766-922f-5fe2975dfb58.Large.jpg?1" style="float:right;margin:10px;height:75px;width:200px;" /></a>Physicians in 16 states can fulfill continuing medical education (CME) requirements for state medical licensure in one expert online resource: The JAMA Network. And for AMA members, this service is entirely free. Find out whether you’re in one of these states.</p> <p> The JAMA Network offers hundreds of CME activities related to studies published in its journals. For physicians in the following 16 states, their CME requirements for licensure can be met through these offerings:</p> <ul> <li style="margin-left:0.25in;"> California</li> <li style="margin-left:0.25in;"> Connecticut</li> <li style="margin-left:0.25in;"> Florida</li> <li style="margin-left:0.25in;"> Iowa</li> <li style="margin-left:0.25in;"> Massachusetts</li> <li style="margin-left:0.25in;"> Mississippi</li> <li style="margin-left:0.25in;"> Nevada</li> <li style="margin-left:0.25in;"> New Jersey</li> <li style="margin-left:0.25in;"> New Mexico</li> <li style="margin-left:0.25in;"> Oklahoma</li> <li style="margin-left:0.25in;"> Oregon</li> <li style="margin-left:0.25in;"> Pennsylvania</li> <li style="margin-left:0.25in;"> Rhode Island</li> <li style="margin-left:0.25in;"> Tennessee</li> <li style="margin-left:0.25in;"> Texas</li> <li style="margin-left:0.25in;"> Vermont</li> </ul> <p> Visit the JAMA Network CME site to <a href="http://jama.jamanetwork.com/cme.aspx?browsestate=true" rel="nofollow" target="_blank">view the CME activities</a> offered for your state (included under the “all CME courses” tab toward the bottom of the page).</p> <p> If your state isn’t one of these 16, it might not have any specific requirements, or it could require that CME activities are relevant to each physician’s specialty. Contact your state’s licensing board if you have questions about requirements.</p> <p> AMA members have free access to unlimited CME activities via the JAMA Network. Simply read an article and complete a brief quiz to obtain <em>AMA PRA Category 1 Credit</em><em>™</em>.</p> <p> The JAMA Network’s <a href="http://jama.jamanetwork.com/cme.aspx" rel="nofollow" target="_blank">online CME center</a> makes what otherwise can be an expensive and cumbersome process convenient. Here physicians easily can:</p> <ul> <li style="margin-left:0.25in;"> Search by journal, topic, year or state to find activities of interest.</li> <li style="margin-left:0.25in;"> Participate in activities related to a certain topic from several different journals.</li> <li style="margin-left:0.25in;"> View and print CME certificates.</li> <li style="margin-left:0.25in;"> Save partially completed quizzes and return to them later.</li> <li style="margin-left:0.25in;"> Keep track of CME credits in one place.</li> </ul> <p> While <a href="http://store.jamanetwork.com/productDetails.aspx?productCodeID=65" rel="nofollow" target="_blank">CME tokens</a> can be purchased for five or 10 quizzes, AMA members receive full access to the JAMA Network online and unlimited access to its CME offerings.</p> <p> If you aren’t an AMA member, <a href="https://commerce.ama-assn.org/membership/" target="_blank">join today</a>.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:ce28e005-b8a9-489f-910c-b87f1db283c7 8 top challenges and solutions for making EHRs usable http://www.ama-assn.org/ama/pub/ama-wire/ama-wire.page_8-top-challenges-solutions-making-ehrs-usable Tue, 16 Sep 2014 15:00:00 GMT <p> <a href="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/1/ce2195e5-a40c-478f-819a-608ca8ff18ad.Full.jpg?1" target="_blank"><img src="http://pluck.ama-assn.org/ver1.0/Content/images/store/14/1/ce2195e5-a40c-478f-819a-608ca8ff18ad.Large.jpg?1" style="margin:15px;float:right;" /></a>It’s no secret that many physicians are unhappy with their electronic health record (EHR) systems, thanks in large part to cumbersome processes and limited features that get in the way of patient care. Now a panel of experts has called for EHR overhaul, outlining the eight top challenges and solutions for improving EHR usability for physicians and their patients.</p> <p> This <a href="http://www.ama-assn.org/resources/doc/ps2/x-pub/ehr-priorities.pdf" target="_blank">new framework</a> (log in) for EHR usability—developed by the AMA and an external advisory committee of practicing physicians and health IT experts, researchers and executives—focuses on leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. Here are the eight solutions this group identified to address the biggest challenges:</p> <p> <strong>1. Enhance physicians’ ability to provide high-quality patient care. </strong>Poor EHR design gets in the way of face-to-face interaction with patients because physicians are forced to spend more time documenting required information of questionable value. Features such as pop-up reminders, cumbersome menus and poor user interfaces can make EHRs far more time consuming than paper charts.</p> <p> Instead, EHRs should be designed to enable physician-patient engagement. Technology should fit seamlessly into the practice and be based on work flow needs.</p> <p> <strong>2. Support team-based care.</strong> Current technology often requires physicians to enter data or perform tasks that other team members should be empowered to complete. EHR systems instead should be designed to maximize each person’s productivity in accordance with state licensure laws and allow physicians to delegate tasks as appropriate.</p> <p> <strong>3. Promote care coordination.</strong> Transitioning patient care can be a challenge without full EHR interoperability and robust tracking. EHR systems need to automatically track referrals, consultations, orders and labs so physicians easily can follow the patient’s progression throughout their care.</p> <p> <strong>4. Offer product modularity and configurability.</strong> Few EHR systems are built to accommodate physicians’ practice patterns and work flows, which vary depending on size, specialty and setting. Making EHR systems more modular would allow physicians to configure their health IT environment to best suit their work flows and patient populations. Allowing vendors to focus on specialized applications also would produce the tailored technology physicians need.</p> <p> <strong>5. Reduce cognitive work load. </strong>Although physicians spend significant time navigating their EHR systems, many physicians say that the quality of the clinical narrative in paper charts is more succinct and reflective of the pertinent clinical information. A lack of context and overly structured data capture requirements, meanwhile, can make interpretation difficult.</p> <p> EHRs need to support medical decision-making with concise, context-sensitive real-time data. To achieve this, IT developers may need to create sophisticated tools for reporting, analyzing data and supporting decisions. These tools should be customized for each practice environment.</p> <p> <strong>6. Promote interoperability and data exchange.</strong> Data “lock in” is a common problem. EHR systems should facilitate connected health care across care settings and enable both exporting data and properly incorporating data from other systems. The end result should be a coherent longitudinal patient record that is built from various sources and can be accessed in real time.</p> <p> <strong>7. Facilitate digital patient engagement.</strong> Most EHR systems are not designed to support digital patient engagement. But incorporating increased interoperability between EHR systems and patients’ mobile technologies and telehealth technologies would be an asset for promoting health and wellness and managing chronic illnesses.</p> <p> <strong>8. Expedite user input into product design and post-implementation feedback. </strong>The meaningful use program requires physicians to use certified EHR technology, but many of these products have performed poorly in real-world practice settings. EHR systems should give users an automated option to provide context-sensitive feedback that is used to improve system performance and safety.</p> <p> “Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus,” AMA President-Elect Steven J. Stack, MD, said in a <a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-09-16-solutions-to-ehr-systems.page" target="_blank">news release</a>.</p> <p> As part of its <a href="http://www.ama-assn.org/ama/pub/about-ama/strategic-focus/enhancing-professional-satisfaction-and-practice-sustainability.page" target="_blank">Professional Satisfaction and Practice Sustainability</a> initiative, the AMA will use this framework to work with physicians, vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance the delivery of high-quality, affordable care.</p> Blog:e38cf47a-fc5f-473b-9234-c9e714c1c8f0Post:d1ed0e7a-406d-43e6-8a49-216785ec57db