News

Legal expertise on your side

In January, a federal appeals court rejected a consumer group's attempt to use Medicare billing records to rate doctors. The nonprofit Consumers' Checkbook group had won a lower-court ruling in 2007 that directed the government to release Medicare physician payment records under the federal Freedom of Information Act. The AMA urged the U.S. Department of Health and Human Services (HHS) to challenge that decision.

The AMA argued that the use of raw Medicare claims data would not only have almost no bearing on the quality of medical services but would tend to mislead patients. And it shows nothing more than how many times a physician performs a procedure—not how well the procedure is done. It could potentially harm an existing patient-physician relationship and lead to poor health care decisions.

That's why the Litigation Center of the AMA and State Medical Societies stepped in and joined the HHS in an appeal. The Litigation Center is a powerful advocate for physicians and medical students. It's like having the nation's physicians right there with you in the courtroom. And such was clearly the case in Consumers' Checkbook v. United States.

In a judgment issued Jan. 30, a three-judge panel of the District of Columbia Circuit Court of Appeals ruled in favor of the AMA and the HHS. The majority opinion noted the significant right to privacy physicians have and concluded that the release of personal physician payment data does not meet the standards of the Freedom of Information Act.

Although a further appeal by Consumers' Checkbook is anticipated, most physicians who work with Medicare will benefit from this outcome. Transparency is important for both patients and physicians, and the AMA supports sharing appropriate quality data to help with health care decision-making. However, the AMA opposes the irresponsible dissemination of misleading data that can harm the patient-physician relationship.

This victory—marking a big win for physicians—came on the heels of another. Also in January, the Litigation Center, through the AMA, the Medical Society of the State of New York and the Missouri State Medical Association, helped resolve a lawsuit dating back to 2000 against UnitedHealth Group.

As part of this lawsuit settlement, United agreed to pay $350 million in restitution for using Ingenix to manipulate out-of-network reimbursement rates. This will be the largest monetary settlement of a class-action lawsuit against a single health insurer in the United States. The AMA has long fought to increase the transparency of the health insurance industry's payment system, and this settlement is a giant step toward achieving that goal. However, the court must still approve the settlement.

It's also related to a separate agreement, which surfaced in January, between United Health Group and New York Attorney General Andrew Cuomo. The AMA joined Attorney General Cuomo in announcing agreements between his office and United, Aetna, Cigna and WellPoint to pay a combined $90 million to settle accusations that they used Ingenix. You can read more about these agreements in a previous column I wrote.

In February, the AMA and several state medical associations joined physicians in filing separate class-action lawsuits against Aetna and Cigna, claiming that the companies used this same database to dramatically under-reimburse physicians. The two lawsuits were filed Feb. 9 in a New Jersey federal court and contend that for more than a decade the two health insurers used a corrupt system to underpay physicians for out-of-network medical services and force patients to pay an excessive portion of the costs.

In an unrelated case and victory just last week, an Arkansas state court ruled that Baptist Health, Arkansas' largest hospital system, acted improperly by inappropriately restricting hospital admitting privileges and interfering with the continuity of patient care. The Litigation Center, which provided substantial financial support, along with the Arkansas Medical Society, worked in support of the physicians who were subjected to Baptist Health's inappropriate credentialing policies.

The ruling in Baptist v. Murphy permanently prohibits an economic credentialing policy adopted by Baptist Health in 2003, which would have allowed the hospital system to interfere in the patient-physician relationship by denying hospital-admitting privileges to medical staff members based on financial concerns. This important court victory demonstrates that economic policies that restrict physician credentialing are really intended to prevent patients from choosing medical facilities that might compete with large hospitals. This case shows yet again that when doctors enlist the help of organized medicine, the best outcome for patients and doctors can be achieved.

The Litigation Center was established as a coalition in 1995 by the AMA and the state medical societies. It provides physicians with expertise, usually in the form of an amicus curiae, or “friend of the court,” brief, and financial assistance. All 50 state medical societies and the Medical Society of the District of Columbia are members.

Since its inception, the Litigation Center has lent the capabilities of its experienced health care attorneys to nearly 200 cases, many of which have addressed important specialty-specific issues and have involved the relevant specialty societies. This docket of cases ranges across the entire medical-legal landscape affecting physicians, including medical staff privileges, scope-of-practice matters, public health topics, and meritless medical liability lawsuits.

The Litigation Center selects cases depending on their importance to the medical profession and how likely they are to be precedent-setting. Involvement often comes at the request of a state medical society. At any time, the center has about 25 active cases. Forums range from administrative proceedings to cases before the U.S. Supreme Court.

If you or someone you know needs help with a legal issue that you think might be important to the medical profession, call the Litigation Center at (312) 464-4110 or send an e-mail explaining your circumstances. Visit the AMA Web site for a more detailed description of the Litigation Center and its work.

I also urge you to act today if your AMA membership is no longer active for this year—it is with your membership, that we can continue on our quest to provide constant, effective support for physicians nationwide.

E-mail comments, questions and replies to Dr. Nielsen

1) Physicians hail Arkansas court victory against Baptist Health
An Arkansas state court ruled last week that Baptist Health, Arkansas' largest hospital system, acted improperly by inappropriately restricting hospital admitting privileges and interfering with the continuity of patient care.

The ruling in Baptist v. Murphy permanently prohibits an economic credentialing policy adopted by Baptist Health in 2003, which would have allowed the hospital system to interfere in the patient-physician relationship by denying hospital-admitting privileges to medical staff members based on financial concerns.

“This important court victory demonstrates that economic policies that restrict physician credentialing are really intended to prevent patients from choosing medical facilities that might compete with large hospitals,” said Rebecca Patchin, MD, chair-elect of the AMA Board of Trustees. “Hospitals cannot use their financial interest to justify policies that interfere with patients' health care choices.”

The combined resources of organized medicine were brought to bear on this case through the Litigation Center of the AMA and State Medical Societies, which provided substantial financial support and, along with the Arkansas Medical Society, worked in support of the physicians who were subjected to Baptist Health's inappropriate credentialing policies.

“This case shows yet again that when doctors enlist the help of organized medicine, the best outcome for patients and doctors can be achieved,” said Dr. Patchin.

View an AMA news release on the details of this case's outcome.

View a copy of the court's decision (PDF).

2) AMA participates in White House summit on health care
AMA President Nancy H. Nielsen, MD, PhD, represented the nation's physicians and the AMA during a health care reform summit hosted earlier today by President Barack Obama at the White House. The AMA applauds the president's effort to tackle this issue.

"Improving the health care system for patients and physicians is a top priority of the American Medical Association, and I am honored to join President Obama as he works toward reform," Dr. Nielsen said. "His inclusion of physicians in the summit emphasizes the critical role those who provide health care play in the reform effort."

Dr. Nielsen will also be featured among a panel of three key stakeholders tonight at 6 p.m. EST on the lead segment of the NewsHour with Jim Lehrer. The panel will focus on health system reform and the health care reform summit held earlier today at the White House.

Visit the PBS Web site for more information on the NewsHour, including local times and channels.

3) Doctors heading to Capitol Hill
Hundreds of AMA members from around the country will unite next week at the National Advocacy Conference, to be held March 10–11 in Washington, D.C. The reason for their assembly is simple: to advocate for patients, the medical profession and the future of health care.

Prior to meeting with lawmakers and their staffs on March 11, participants will hear March 10 from political insiders, industry experts and members of Congress about health system reform efforts, and they'll take part in discussions that will help shape the AMA's advocacy efforts.

MSNBC anchor Chris Matthews will deliver the NAC's keynote address on March 10. Later that evening, veteran TV journalist Bill Kurtis will serve as master of ceremonies at the Dr. Nathan Davis Awards for Outstanding Government Service gala and celebration.

On March 9, the AMA Foundation will host its Excellence in Medicine Awards dinner, and the AMA Alliance will hold its Capitol Conference—Winter Session for physicians' spouses and their families.

4) Join colleagues for interactive communications training
Learn how to blend the craft of communication with the art of medicine this spring during the 29th annual Medical Communications Conference, which will be presented by the AMA from April 1–3 at the Hyatt Regency Tamaya Resort and Spa in Santa Ana Pueblo, N.M. The conference will offer more than 40 different workshops, case-study sessions, panels, roundtables and one-on-one critiques.

CNN's Sanjay Gupta, MD, a past participant of the conference, will accept a health communications achievement award and discuss his career as a practicing neurosurgeon and one of the best-known medical reporters in the world. And Allan Hamilton, MD, script consultant for Grey's Anatomy and Private Practice, will share how he uses stories from his vast experiences as an intern, resident and surgeon.

AMA members receive a special discount on registration. Send an e-mail to register.

5) March issue of Virtual Mentor covers challenged patient-physician relationships
In today's health care system, one-time patient-physician encounters and brief interactions may start to outnumber long-term patient-physician relationships. In the absence of enduring, therapeutic bonds, ethical decision-making takes place on less firm, less comfortable ground. The March issue of Virtual Mentor examines the integrity of the patient-physician relationship at a time when its traditional foundation is being increasingly challenged.

6) In JAMA: Drug-resistant influenza A virus poses potential threat to high-risk patients
According to a study to be published in the March 11 issue of Journal of the American Medical Association, a mutation of the influenza A (H1N1) virus that is resistant to the drug oseltamivir may pose a serious health threat to hospitalized patients who have a weakened immune system. Because of the public health importance, the study is being released early online.

Preview an editorial on this topic.

1) Gay and Lesbian Medical Association announces change in leadership
Joel Ginsberg recently resigned from his position as the director of the Gay and Lesbian Medical Association (GLMA). Ginsberg has held that title since 2003.

"Over the past five years, the AMA and GLMA have worked together to address the needs of GLBT physicians, medical students and patients while also educating physicians on the health issues faced by the population. Throughout this time, Joel Ginsberg's leadership has played an integral role in ensuring the success of our various joint initiatives," said Michael D. Maves, MD, AMA executive vice president and chief executive officer.

According to Jason Schneider, GLMA president, an interim executive director will be announced soon, with a national search for a new permanent executive director to follow.

1) Send in your e-mail address
AMA-IMG Section members interested in participating in the upcoming AMA-IMG Section Governing Council election must first consent to the use of their e-mail address to conduct AMA business.

Send your full name and e-mail address along with a short sentence of consent by March 30 to ensure that you receive your election ballot via e-mail. The online election will take place April 13–May 13.

Send an e-mail with your information and consent.

Contact Carolyn Carter-Ellis at (312) 464-5397 for more information.

2) Take part in an IMG patient-physician communication study
In an effort to expand the scientific understanding of patient-physician communication, a doctoral student at The Ohio State University would like to compare the experiences of international and U.S. medical graduates.

Those willing to participate are asked to complete a 15-minute questionnaire that explores communication patterns among doctors and their patients. Responses to the questions will be anonymous; by completing the survey, participants consent to take part in the research study voluntarily.

Although the AMA does not endorse or participate in the survey, it is promoted as an opportunity for AMA-IMG Section members. Please complete the survey by March 15.

E-mail Parul Jain or Professor Raup-Krieger with questions.

3) Participate in new AMA-IMG Section virtual congress
As part of the AMA-IMG Section’s new virtual congress format, resolutions submitted by April 3 for consideration during the section’s annual congress will be placed on the AMA-IMG Section Web site for review and online testimony submissions. This new format should increase the participation of AMA-IMG Section members and will allow the section’s resolutions to be included in the AMA House of Delegates handbook.

The AMA-IMG Section Governing Council and resolutions committee will review all submitted testimony and finalize resolutions by April 27. AMA-IMG Section members will vote between April 30 and May 7 to approve or not approve each resolution in its final form.

E-mail resolutions for consideration. Resolutions are due no later than April 3.

Visit the AMA-IMG Web site to view resolution writing guidelines. Call (312) 464-5397 with questions.

Brought to you by the AMA Section on Medical Schools

1) Check out the new FREIDA Online®
FREIDA Online®, the popular AMA Web site used by medical students and residents to research residency and fellowship programs, has a new look and improved functionality of its program listing pages, allowing users to tab to specific areas of listings. The newly enhanced Web site also provides more benefits for AMA members, with medical student and resident members now able to download and save selected data elements from the programs they search to create their own spreadsheets.

2) Sign up for AMA Morning Rounds
Keep in touch with the latest in important medical news and information with AMA Morning Rounds, the authoritative news digest written exclusively for AMA members. Don't lose this valuable members-only resource—one of the many benefits of AMA membership—and stay informed about what’s happening in medicine and health care.

Visit the AMA Web site or call AMA Member Relations at (800) 262-3211 to renew your membership.

Subscribe to AMA Morning Rounds.

3) In Medical Education Online: Early specialty preferences and eventual choice
According to a recent study (PDF), students with an early preference for person-oriented specialties were more likely to choose a person-oriented specialty, whereas students with an early preference for technique-oriented specialties were less likely to enter a technique-oriented specialty. The study, published in Medical Education Online, explored how early specialty preferences correspond to eventual specialty choice using the person-oriented versus technique-oriented taxonomy.

4) Take part in a patient-physician communication study
In an effort to expand the scientific understanding of patient-physician communication, a doctoral student at The Ohio State University would like to compare the experiences of international and U.S. medical graduates.

Those willing to participate are asked to complete a 15-minute questionnaire that explores communication patterns among doctors and their patients. Responses to the questions will be anonymous; by completing the survey, participants consent to take part in the research study voluntarily.

Although the AMA does not endorse or participate in the survey, it is promoted as an opportunity for its members. Please complete the survey by March 15.

E-mail Parul Jain or Professor Raup-Krieger with questions.

1) Get ready for Cover the Uninsured Week
The AMA-MSS will join a number of influential organizations as a national supporter of the Robert Wood Johnson Foundation's seventh annual Cover the Uninsured Week, March 22–28.

This involvement is part of the AMA-MSS's National Service Project and its ongoing dedication to covering the uninsured and protecting access to care. Last year more than 40 AMA-MSS chapters participated in Cover the Uninsured Week events, and local chapters are encouraged to participate this year.

Chapter involvement grants (CIGs) are available to AMA-MSS chapters to offset the costs of Cover the Uninsured Week events and to help pay for other student projects and recruitment events. Chapters are eligible for up to $1,000 per academic year, with a maximum of $500 per event.

Visit the Web site to apply for a CIG at least 30 days before your event.

Visit the Web site to read about last year's events and to learn how to get involved this year.

2) Submit your meeting ideas
Do you have an idea for an educational program or other event at the AMA-MSS meeting in June? If so, let them know about it and submit your idea by April 1. Because of limited time, there is no guarantee that your idea will be implemented.

Contact the AMA-MSS speaker or vice speaker with any questions.

Visit the Web site to fill out a submission form.

3) Apply now for AMA-MSS Convention Committees
Are you interested in becoming more involved in the AMA-MSS? If so, AMA student members are encouraged to apply for one of the various convention committees that expedite the conduct of business at each AMA-MSS Assembly Meeting.

Positions are available on the community service project committee, logistics and resources committee, reference committee, hospitality committee, and many other committees.

Applications are due April 2. The AMA-MSS Assembly Meeting will be held June 11–13 in Chicago.

Visit the Web site to apply for the committees.

4) Participate in a exciting media rotation with Discovery Health
Medical students are encouraged to apply for the AMA/Discovery Health internship, a four-week program during which one AMA medical student member will help develop a medical education program that will air on the Discovery Health Channel.

Available only to AMA medical student and resident and fellow members, this exciting opportunity provides hands-on experience in translating scientific data into an entertaining and informational program. The selected student will work primarily at Discovery Communications headquarters in Silver Spring, Md., and travel to relevant on-site and studio shoots for the program. A stipend of $3,000 will be provided to cover living expenses. Dates and length of the rotation are flexible. Applications are due April 17.

5) Income-based repayment and medical students
The College Cost Reduction and Access Act of 2007 eliminated a form of economic hardship deferment, the 20/220 pathway, and replaced it with an income-based repayment (IBR) plan. Any borrower with any amount of debt—subsidized or unsubsidized—is eligible for the IBR plan, in which payments are capped at 15 percent of a borrower's income that exceeds 150 percent of the federal poverty level. The IBR plan will take effect July 1.

After July 1, deferment under the 20/220 pathway will no longer be available. Under the 20/220 pathway, as many as two-thirds of first-year residents were eligible to defer making repayment on their loans. For residents who qualified under 20/220, the government paid interest on the subsidized portion of the federal loans for three years, and interest accrued only on unsubsidized loans.

Learn more about the IBR plan (PDF), including how the program will affect medical students.

6) What's ahead in health care?
Changes in medicine influence the delivery of patient care. That's why it's important to know what the issues and trends are.

2008 Health Care Trends, a newly updated publication from the AMA, details the issues and trends shaping medicine today and how they affect physicians and their patients. The report includes information on health status and demographics of the U.S. population, factors affecting health care spending, and changes in the physician work force. It also covers patient expectations and perceptions, the public health system, trends in technology, and changes in medical education and physician continuing professional development.

Visit the Web site for more information or to download this resource. Health Care Trends is updated every two years by the AMA Council on Long Range Planning and Development.

Brought to you by the AMA Minority Affairs Consortium

1) Trends in child health focus on disparities in child care
The Joint Center for Political and Economic Studies recently issued its first brief in a series analyzing data from the National Health Interview Survey for 1997–2006, which found health disparities between black and white children as it relates to child care.

The brief presented findings for non-Hispanic white children and non-Hispanic black children under age 18 on the following health indicators: low birth weight, health status as evaluated by a family member, recent unmet oral health needs, attention deficit/hyperactivity disorder diagnosis, lifetime asthma diagnosis, learning disability diagnosis and activity limitation.

For each health indicator, comparisons were made between children of the two racial groups first as a whole; then, black children and white children were compared in families with characteristics corresponding to nine socio-demographic variables.

2) CDC summer program planned for high school students
The National Center for Health Marketing's Global Health Odyssey Museum is offering an academic day camp where students will learn how the Centers for Disease Control and Prevention (CDC) safeguards the nation's health.

The CDC Disease Detective Camp is open to students who will be high school juniors and seniors during the 2009–2010 school year. Sponsored by the CDC and the Department of Health and Human Services, this free program will be offered twice this summer: June 22–26 and July 13–17. The deadline to apply is April 20.

1) AMA resource covers medical home recognition
A new resource from the AMA features a pair of incentive programs that are based on the medical home model, a concept that has attracted the attention of large employers, physician groups, insurers, states and the federal government, all of which are collaborating to explore a new way of delivering health care.

Last year the AMA adopted the "Joint Principles of the Patient-Centered Medical Home," joining the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association in endorsing the principles. The principles include guidelines for the coordination of care to improve the patient-physician relationship, quality and safety, access to care, and the payment model for coordinated services.

Along with public and private payers launching medical home pilots, Bridges to Excellence (BTE) recently partnered with the National Committee for Quality Assurance (NCQA) to offer an incentive program for physicians that is based on the medical home model. The AMA resource "Achieving medical home recognition" features the BTE and NCQA models, notes AMA policy regarding the medical home concept, and details other BTE and NCQA programs that are integral to physician practices being recognized as medical homes.

2) AMA offers guidance in developing code of conduct
The new Joint Commission Leadership Standard covering code of conduct, LD.03.01.01, took effect Jan. 1, 2009. The standard's Elements of Performance requires, among other things, that hospitals have a code of conduct that defines acceptable, inappropriate and disruptive behavior, and that leaders create and implement a process for managing disruptive and inappropriate behaviors.

In response to these actions, the AMA adopted policy that calls for medical staffs to develop and implement their own code of conduct in the medical staff bylaws. Under the policy, hospitals should also have a code of conduct applicable to members of the board, management and all employees.

To assist medical staffs with implementation of a code of conduct in accordance with AMA policy and consistent with the Joint Commission Leadership Standard, the AMA Office of the General Counsel, in conjunction with the AMA-OMSS, drafted a model code of conduct for insertion in medical staff bylaws.

In addition, AMA members can access the Physicians' Guide to Medical Staff Organization Bylaws (PDF), an excellent resource for medical staffs and their bylaws committees.

Contact Jim DeNuccio, director of the AMA-OMSS, by e-mail or call (312) 464-5597 with questions.

3) Save the date: 2009 AMA-OMSS Annual Meeting in Chicago
The AMA-OMSS Assembly Meeting will be held June 11–13 at the Hyatt Regency Chicago. Look for more information to come shortly in regard to this meeting.

Visit the Web site to view the full 2008 AMA-OMSS Interim Assembly Meeting summary and PowerPoint presentation for the AMA 2008 Interim Meeting, as well as its disposition of actions.

4) Download free copy of AMA-OMSS presentation for medical staffs, hospital boards
The AMA-OMSS developed two PowerPoint presentations—one for medical staffs and another for hospital boards—to provide information on the section and its mission, duties and past actions.

AMA members can visit the AMA-OMSS Web site to view and download these presentations free of charge.

5) AMA Annual Meeting webcasts added to archives
The AMA-OMSS is offering four 90-minute educational webcasts: "Transitioning to an improved hospital discharge," "Keys to the successful implementation of the revised Joint Commission Medical Staff Bylaws Standard MS.1.20," "Creating a new future for a new day with a revamped organized medical staff structure" and "Physician hospitals of America: Reclaiming quality patient care through physician leadership."

Three of these programs provide AMA PRA Category 1 Credit™. Visit the AMA-OMSS Web site to access these programs and learn more about each one.

Accreditation statement
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation statement
The American Medical Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

6) Align your bylaws with Joint Commission standards
Because medical staff bylaws are considered a contract and are legally binding in most states, it is extremely important that they are well-designed and well-written. The fourth edition of the Physician's Guide to Medical Staff Organization Bylaws contains practical guidance on bylaws development, model bylaw language, information on emerging issues and recent trends in medical staff re-engineering. The guide will be especially helpful to medical staffs as they update their bylaws to align with Joint Commission standards.

AMA members can download the guide (PDF) at no charge.

7) Resource helps strengthen physician-hospital relationship
A printable version of the "Principles for strengthening the physician-hospital relationship," developed by the AMA-OMSS and adopted by the AMA House of Delegates, is available online (PDF). These principles are designed to improve the working relationship between physicians and hospitals and ultimately foster better patient care and improve patient safety.

Send an e-mail to order a poster of the principles for your medical staff lounge.

1) Participate in exciting media rotation with Discovery Health
Medical students are encouraged to apply for the AMA/Discovery Health internship, a four-week program during which one AMA medical student member will help develop a medical education program that will air on the Discovery Health Channel.

Available only to AMA medical student and resident and fellow members, this exciting opportunity provides hands-on experience in translating scientific data into an entertaining and informational program. The selected student will work primarily at Discovery Communications headquarters in Silver Spring, Md., and travel to relevant on-site and studio shoots for the program. A stipend of $3,000 will be provided to cover living expenses. Dates and length of the rotation are flexible. Applications are due April 17.

2) Comment on IOM resident duty hours recommendations
The Accreditation Council for Graduate Medical Education (ACGME) is seeking resident physician feedback on the Institute of Medicine (IOM) recommendations for duty hours. All responses will be anonymous.

Visit the Web site to provide a response to ACGME.

Read or purchase the full text and executive summary of the IOM report.

View a summary table (PDF) of the report's recommendations.

3) AMA resource covers medical home recognition
A new resource from the AMA features a pair of incentive programs that are based on the medical home model, a concept that has attracted the attention of large employers, physician groups, insurers, states and the federal government, all of which are collaborating to explore a new way of delivering health care.

Last year the AMA adopted the "Joint Principles of the Patient-Centered Medical Home," joining the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association in endorsing the principles. The principles include guidelines for the coordination of care to improve the patient-physician relationship, quality and safety, access to care and the payment model for coordinated services.

Along with public and private payers launching medical home pilots, Bridges to Excellence (BTE) recently partnered with the National Committee for Quality Assurance (NCQA) to offer an incentive program for physicians that is based on the medical home model. The AMA resource "Achieving medical home recognition" features the BTE and NCQA models, notes AMA policy regarding the medical home concept, and details other BTE and NCQA programs that are integral to physician practices being recognized as medical homes.

4) Assessment and management of adult obesity
A compilation of 10 booklets addressing case studies in disease prevention and health promotion is now available. Developed in collaboration with the Department of Health and Human Services and produced with support from the Robert Wood Johnson Foundation, the compilation, Assessment and Management of Adult Obesity, offers practical recommendations for addressing adult obesity in the primary care setting.

Information in the booklets includes evaluating patients for current and potential health risks related to weight, including the body mass index, understanding medication and surgical options, improving communication and counseling, and making office environments more accommodating to obese patients.

Visit the Web site to download this resource.

1) Poll shows Americans skimp on medical care to save money
According to a recent poll by the Henry J. Kaiser Family Foundation, roughly 53 percent of Americans say their household has cut back on health care in some way during the past year.

The poll finds that the public is increasingly worried about the affordability and availability of health care, with patients postponing or skipping treatments because of cost during the past year. Thirty-five percent reported relying on home remedies or over-the-counter drugs instead of going to see a doctor, and 34 percent reported skipping dental care checkups. A full 27 percent reported that they had postponed getting health care that they needed.

The survey also suggests that one in five Americans has found themselves forced into serious financial straits recently because of family bills.

2) American Medical News expands online content for physicians
To better accommodate physicians' needs in the fast-changing world of health care news, the AMA's award-winning, physician-focused newspaper, American Medical News, is expanding its online presence and capabilities.

The print version of American Medical News is moving to a twice-a-month publishing schedule and will continue to provide in-depth coverage and practical advice for physician readers. The full content of the print edition will continue to be presented on the American Medical News Web site, which will also present fresh reporting and features every weekday throughout the year.

Brought to you by the AMA Women Physicians Congress

1) AMA president to serve as keynote speaker during women's health conference
AMA President Nancy H. Nielsen, MD, PhD (PDF), will present the keynote address during a conference to be held at the Washington University School of Medicine from March 4–6 in St. Louis.

The conference is one of four being held around the country by the National Institutes of Health Office of Research in Women's Health to better understand needs for women's health and to develop recommendations about specific kinds of research and studies needed over next decade. While important strides have been made in recognizing the need for gender-based research, turning that research into clinical applications is still in the beginning stages. It will take a combined effort of the public and private sectors to support further studies and resources that will improve the health care for women in the United States.

2) JAMA sponsors Author in the Room series
The next Author in the Room teleconference, to be held from 1–2 p.m. CST March 18, will feature Stephen A. Schroeder, MD, professor of health and health care at the University of California, San Francisco and author of a Journal of the American Medical Association (JAMA) article about smoking cessation in patients with psychiatric illness.

Sponsored by JAMA and the Institute for Healthcare Improvement, the Author in the Room series is designed to bring clinical evidence into practice by connecting clinicians to authors of articles published in the magazine.

Visit the Web site for more information and to sign up for the March 18 teleconference.

1) Save the date for the AMA-YPS Assembly Meeting in Chicago
Young physicians, mark your calendars. The 2009 AMA-YPS Annual Assembly Meeting will be held June 11–13 at the Hyatt Regency Chicago.

E-mail Jane Ascroft by May 1 to volunteer for the AMA-YPS reference, AMA House of Delegates handbook review and/or credentials committees and to submit an on-time resolution.

2) AMA Foundation names leadership award recipients
The AMA Foundation will honor 15 medical students, 10 residents/fellows and five early-career physicians from across the country at the annual Excellence in Medicine Awards on March 9 in Washington, D.C.

Presented in association with Pfizer Inc, the leadership awards recognize outstanding, nonclinical leadership skills in advocacy, community service, public health and education. The awards provide leadership development training to further strengthen their efforts toward advancing health care in America.

The AMA-YPS congratulates the following early career physician winners:

• Noel Deep, MD
• Apurv Gupta, MD
• Ryan Jense, MD
• Peter Kang, MD
• Shilpen Patel, MD

3) Take part in a patient-physician communication study
In an effort to expand the scientific understanding of patient-physician communication, a doctoral student at The Ohio State University would like to compare the experiences of international and U.S. medical graduates.

Those willing to participate are asked to complete a 15-minute questionnaire that explores communication patterns among doctors and their patients. Responses to the questions will be anonymous; by completing the survey, participants consent to take part in the research study voluntarily.

Although the AMA does not endorse or participate in the survey, it is promoted as an opportunity for AMA-IMG Section members. Please complete the survey by March 15.

E-mail Parul Jain or Professor Raup-Krieger with questions.

4) Community Service Award nominations due May 1
The AMA-YPS strives to recognize excellence in community service activities in young physicians and other doctors through its annual Community Service Award.

Recipients will be selected by the AMA-YPS Governing Council and honored for their work during the AMA-YPS Assembly Meeting on June 12. Nominees must be AMA members and must be nominated by May 1.

Visit the AMA-YPS Web site for more information and to submit a nomination electronically.

5) AMA resource covers medical home recognition
A new resource from the AMA features a pair of incentive programs that are based on the medical home model, a concept that has attracted the attention of large employers, physician groups, insurers, states and the federal government, all of which are collaborating to explore a new way of delivering health care.

Last year the AMA adopted the "Joint Principles of the Patient-Centered Medical Home," joining the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association in endorsing the principles. The principles include guidelines for the coordination of care to improve the patient-physician relationship, quality and safety, access to care and the payment model for coordinated services.

Along with public and private payers launching medical home pilots, Bridges to Excellence (BTE) recently partnered with the National Committee for Quality Assurance (NCQA) to offer an incentive program for physicians that is based on the medical home model. The AMA resource "Achieving medical home recognition" features the BTE and NCQA models, notes AMA policy regarding the medical home concept, and details other BTE and NCQA programs that are integral to physician practices being recognized as medical homes.