News

Promoting quality as a point of care

Physicians are committed to providing the highest quality of care to their patients, and the AMA is dedicated to helping physicians make that happen. Likewise, the Centers for Medicare & Medicaid Services (CMS) has played an integral role in this process.

As part of its 2009 Physician Quality Reporting Initiative (PQRI), CMS has developed several initiatives that provide information on quality of care across different settings, including hospitals, skilled nursing facilities, home health agencies and dialysis facilities. As PQRI participants, physicians can obtain useful information for quality improvement.

With the PQRI being a work in progress, the AMA is collaborating with CMS to make improvements to the program. One of the ways in which the AMA has made the quality reporting process more efficient—aside from urging early education and outreach, an appeals process and timely feedback reports—is through the creation of new physician participation tools. These tools, released in conjunction with the launch of the 2009 PQRI in January, can assist physicians in measure selection, and the capture of quality data within the claim form.

The PQRI was made permanent last July when the Medicare Improvements for Patients and Providers Act of 2008 (PDF) became law. The law authorized incentive payments through 2010 and increased PQRI incentive payments to 2 percent for successful reporting in the 2009 program. Unlike 2008, there is only one reporting period for the 2009 PQRI—Jan. 1, 2009, through Dec. 31, 2009.

There are 153 performance measures in the 2009 program which physicians can report. Of these 153 measures, 131 of them are available to be reported as individual quality measures via claims-based submission. In addition, CMS established "measure groups" which are defined as a subset of PQRI measures that have a particular clinical condition or focus in common. Physicians and other health care professionals may also choose to report through registries, in addition to the traditional claims-based reporting option.

The AMA's tools can help physicians report data through claims-based submission for either the six measures groups or the individual quality measures. The six measures group options for the 2009 program include back pain, chronic kidney disease, diabetes mellitus, perioperative care, preventive care and screening, and rheumatoid arthritis. These measures groups have two participation tools developed by the AMA to assist in reporting. The first, a measure description document, details the information required to report on the measures group and how frequently reporting is required. The second, a data collection sheet, provides a step-by-step analysis of how to record the required clinical information for the measures group and subsequently select the corresponding billing codes.

The AMA also created a set of participation tools for individual quality measures. These tools include a measure description document, a data collection sheet and a coding specifications resource. The measure description and data collection documents function just as the documents for measures groups. And the coding specifications resource offers a complete list of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Current Procedural Terminology® (CPT®) codes to identify patients eligible for the measure and a list of the quality data codes for each measure.

It's important to note that of the 153 measures in the 2009 PQRI, more than 70 percent were developed by the AMA–convened Physician Consortium for Performance Improvement® (PCPI), in collaboration with one or more medical specialty societies, and often in conjunction with the National Committee for Quality Assurance. The PCPI aims to enhance quality of care and patient safety. And it accomplishes this mission by proactively convening key stakeholders to develop, test and maintain evidence-based clinical performance measures and measurement resources for physicians.

The PCPI (PDF) brings together the expertise of physicians representing a vast range of specialties and several government agencies, including more than 100 national medical specialty and state medical societies; health care professional organizations (e.g., the American Nurses Association); the Council of Medical Specialty Societies; the American Board of Medical Specialties and its member boards; experts in methodology and data collection; the Agency for Healthcare Research and Quality; and CMS. In fact, the number and types of groups participating in the PCPI have more than doubled since it was established in 2000.

I'm proud to say that the PCPI has developed measures that now cover more than 40 clinical conditions and are applicable to multiple sites of care. It has expanded its work in advancing the science of performance measurement through increased testing of measures in various settings, including Federally Qualified Health Centers, academic health systems and physician offices. And its measures continue to evolve for use in electronic health records and registries, as well as through the administrative claims process.

On March 20 in Chicago, the PCPI will meet to discuss how it will further its work to support quality improvement initiatives and will hear from experts how various types of systems of care, such as group practices, integrated delivery systems and systems clinical integration, are using measurement to improve care and integrate quality across their organizations. And in October, they will reconvene in Washington, D.C., for the second of its biannual meetings. If you would like to read through some of the highlights of the PCPI's achievements over the past year and its strategic direction for 2009, check out its 2008 report (PDF) online.

If you have questions about the PQRI, visit the AMA Web site or the CMS Web site for more information. Also, contact the AMA with questions or comments about participation tools for the 2009 PQRI.

Please send comments, questions and replies to amaprez@ama-assn.org.

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

1) AMA supports president's decision on stem cell research funding
President Barack Obama's lifting of restrictions on federal funding for stem cell research earlier this week drew praise from the AMA.

"Stem cell research holds great promise to treat diseases that science has so far been unable to cure, and this change in policy will allow researchers to accelerate their efforts by applying for federal research funds," said AMA Board Chair Joseph Heyman, MD.

Visit the Web site to read more from Dr. Heyman.

2) AMA continues to advocate against "red flags" rule
The AMA continues to express opposition to applying "red flags" rule to physicians and recently received a response from the Federal Trade Commission (FTC) regarding this matter. The rules require creditors—broadly interpreted by FTC staff to include physicians who accept payment after a rendered service—to establish programs that can detect, prevent and mitigate medical identity theft.

In February, 99 state medical societies and national specialty societies and the AMA sent a letter to the FTC stressing that physicians are not creditors. They also urged the FTC to comply with the Administrative Procedure Act by issuing a new rule that provides an opportunity for physicians to comment.

In response, the FTC continues to assert that physicians who regularly bill their patients for services rendered, including copayments and coinsurance, are considered creditors and must develop and implement written identity theft prevention programs for their practices by May 1 to be in compliance with the "red flags" rule.

The AMA is developing an educational piece to provide guidance to physicians on this matter and will keep the physician community informed of continuing efforts opposing the application of the "red flags" rule to physicians.

Read the letter (PDF) sent to the FTC.

Read the response (PDF) from the FTC.

3) Eight honored by AMA for outstanding government service
At the National Advocacy Conference this week, the AMA honored eight recipients of the 2009 Dr. Nathan Davis Award for Outstanding Government Service—the organization's highest award for public officials. This year is the 20th anniversary of the award.

This year's honorees include:

• State Sen. Susan G. Paddack of Oklahoma
• Jeffrey William Runge, MD, assistant secretary for health affairs and chief medical officer, U.S. Department of Homeland Security
• Pamela S. Hyde, cabinet secretary, Human Services Department of New Mexico
• U.S. Rep. Nathan Deal of Georgia
• Melba R. Moore, health commissioner, city of St. Louis Department of Health
• D. Joe Boone, associate director for science, Division of Laboratory Systems, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention
• State Sen. Edward M. Kennedy of Massachusetts
• Texas Gov. Rick Perry

4) AMA Foundation awards research grants
Twenty-eight medical students and resident and fellow physicians recently received research grants from the AMA Foundation. With the $2,500 grant, winners will be able to conduct small basic science, applied and clinical research projects in the areas of cardiovascular/pulmonary diseases, HIV/AIDS, leukemia and neoplastic diseases.

The AMA Foundation's Seed Grant Research Program was established in 2001 to encourage more physicians to enter the field of research.

"We are excited to be able to help young physician investigators with their research endeavors," AMA Foundation President Jean Howard said. "The AMA Foundation is committed to supporting the discoveries and professional development of scientists at the start of their careers."

View (PDF) a list of this year's recipients.

Visit the AMA Foundation Web site for more information on the Seed Grant Research Program.

5) March issue of Disaster Medicine and Public Health Preparedness Journal now available
Gender-based violence and liability protection laws are among the topics highlighted in the March issue of the AMA's Disaster Medicine and Public Health Preparedness Journal, which is now available online.

One study found that Mississippi women who were displaced to other parts of the state by Hurricane Katrina faced increased sexual and physical violence following the disaster, while the other found public health emergency relief efforts in the United States may be hindered by unclear liability protection laws for medical emergency responders.

View a news release about the studies.

Visit the Journal's Web site to access the March issue.

6) 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.

Visit the AMA-OMSS Web site to access the AMA's model code of conduct.

In addition, AMA members can access the "Physicians' Guide to Medical Staff Organization Bylaws," an excellent resource for medical staffs and their bylaws committees. Visit the Web site to access this resource.

7) In JAMA: Tissue-cultured smallpox vaccine appears promising
A study published in the March 11 issue of the Journal of the American Medical Association (JAMA) reports that administration of a tissue-cultured smallpox vaccine showed signs of an effective vaccine response with no serious adverse events.

According to the report, the threat of smallpox bioterrorism has prompted reconsideration of the need for smallpox vaccination. Serious adverse events associated with first-generation vaccines such as the New York City Board of Health (Dryvax), Lister and Ikeda strains have raised obstacles to vaccination campaigns in the United States.

Visit the JAMA Web site to read the study.

1) 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 IHI Web site for more information and to sign up for the March 18 teleconference.

Read Dr. Schroeder's article.

2) 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.

Visit the Web site to access this resource.

1) Take a survey on physicians' perspectives of GLBT issues in health
In an effort to study physicians' perspectives on gay, lesbian, bisexual and transgender issues in health care, the AMA and the Gay and Lesbian Medical Association (GLMA) have developed a survey to collect information about physicians' experiences, practices and attitudes related to their GLBT patients, as well as their experiences of discrimination against themselves, their patients, and their colleagues.

The survey aims to understand physicians' experiences in order to develop policies and programs that best serve the needs of GLBT individuals. Physicians are encouraged to complete the online survey, which should take 10 to 15 minutes.

Visit the GLMA Web site to access the survey.

1) San Francisco medical center offers free surgery for uninsured
Several dozen uninsured patients were recently given free surgical care, including colonoscopies, hernia repairs and tonsillectomies, at Kaiser Permanente San Francisco Medical Center, according to a report in the San Francisco Chronicle. The event marked the fifth anniversary of a surgical marathon at Kaiser, and this year particularly reflected the growing uninsured population facing economic challenges.

According to the Chronicle, the medical services were donated by 84 Kaiser doctors, nurses and hospital technicians. The high-volume surgery was organized by Operation Access, a nonprofit organization launched 16 years ago to mobilize San Francisco-area hospitals, community clinics and medical volunteers to donate help to low-income people who need surgery but lack health insurance.

Visit the Operation Access Web site for more information about the program.

1) 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 its IMG Section members. Please complete the survey by March 15.

Complete the survey.

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

2) 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 Carolyn Carter-Ellis at (312) 464-5397 with questions.

3) Review the latest AMA-IMG work force report
A newly updated discussion paper that addresses physician shortages and misdistribution as well as statistics on IMGs is now available. The paper, International Medical Graduates in the U.S. Physician Workforce, offers information on international medical schools and recommendations for better use of the IMG work force. It is intended to spark open dialogue among IMGs and between IMGs and non-IMGs.

Download (PDF) a copy of this discussion paper.

Contact Carolyn Carter-Ellis at (312) 464-5397 or e-mail the AMA-IMG Section with any questions.

Brought to you by the AMA Section on Medical Schools

1) AMA Foundation names leadership award recipients
The AMA Foundation honored 15 medical students, 10 residents/fellows and five early-career physicians from across the country during the annual Excellence in Medicine Awards dinner and ceremony 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 efforts toward advancing health care in America.

The AMA-MSS congratulates the following AMA student members:

• Stephanie L. Andrus, State University of New York at Buffalo School of Medicine and Biomedical Sciences
• Manisha Bahl, University of California, San Francisco School of Medicine
• Richard Alan Brucker, Tulane University School of Medicine
• Enrico Castillo, University of Pittsburgh School of Medicine
• Erica Dommasch, UMDNJ–Robert Wood Johnson Medical School
• Jamie Soo-Moi Eng, Rosalind Franklin University of Medicine and Science/The Chicago Medical School
• Hayley Fischer, Brody School of Medicine–East Carolina University
• Jason Franasiak, University of Virginia School of Medicine
• Felicity L. Kelly, University of Texas Health Science Center at Houston
• Abimbola "Abi" Obafemi, UMDNJ–New Jersey Medical School
• Gina Porter, University of Missouri–Kansas City School of Medicine
• George Salloum, Wright State University Boonshoft School of Medicine
• Loren Riskin, Duke University School of Medicine

Download (PDF) a complete list of award recipients and more information about the award.

2) Health literacy resources available on the AMA Foundation Web site
A recent government study estimates that more than 89 million American adults have limited health literacy skills. The AMA was the first national medical organization to adopt policy in 1998 recognizing that limited patient literacy affects medical diagnosis and treatment.

As a result, the AMA Foundation provides free access to health literacy products on its Web site, and continuing medical education (CME) credit can be obtained by watching an instructional video and reading the manual for clinicians.

Visit the AMA Foundation Web site for more information about CME credit for this activity and to access resources.

3) 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.

Read the March issue of Virtual Mentor.

1) Cover the Uninsured Week: University of Miami Miller School of Medicine
The effects of the economic stimulus law on health care, the relationship of insurance status to the health care one receives and Florida's current health care legislation are among the topics to be discussed at the University of Miami Miller School of Medicine's Cover the Uninsured Week (CTUW) event. The school also has several other events planned during CTUW, March 22–28, including a community service project at the Miami Beach Community Health Center.

Last year, more than 50 AMA-MSS chapters participated in CTUW events, and chapter involvement grants (CIGs) are available to AMA-MSS chapters to help fund student projects and recruitment events. Chapters are eligible for up to $1,000 per academic year, with a maximum of $500 per event.

Apply for a CIG at least 30 days before your event.

Visit the Web site for more information on CTUW.

2) Don't forget the AMA-MSS Assembly Meeting deadlines
In preparation for the AMA-MSS Assembly Meeting, June 11–13 at the Hyatt Regency Chicago, please remember the following deadlines.

• Meeting ideas for educational sessions are due April 1.
• Convention committee applications are due April 2.
• Post-draft resolutions to the AMA-MSS Health Policy and News listserv are due April 10.
• Chapter of the Year Award applications are due April 30
• Final version of resolutions and checklist are due May 1.
• Meeting registration is due May 7.
• Governing council positions applications are due May 15.

The AMA-MSS will also hold its annual Medical Specialty Showcase, where physicians from specialty societies represented in the AMA House of Delegates will provide comprehensive information on medical specialties for students entering the residency selection process.

Stay tuned for more information on educational sessions, featured speakers and the national service project, "Covering the Uninsured and Protecting Access to Care."

Visit the Web site to learn more about the meeting.

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 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.

Visit the Web site for more information and to apply.

5) Mark your calendars for upcoming AMA-MSS region meetings
AMA-MSS regions 2 and 3 have upcoming meetings, and you're invited to attend.

• The AMA-MSS Region 2 meeting, "Forensics in medicine," will be held April 3–4 at the Kansas City University of Medicine in Kansas City, Mo.
• The AMA-MSS Region 3 meeting, "Back to the basics: A perspective on patients," will be held April 3–5 at the University of Arkansas for Medical Sciences College of Medicine in Little Rock, Ark.

Visit the AMA-MSS Web site for more information about these meetings, for a list of states in each region and to learn more about organizing a region meeting.

6) ACGME announces systematic review of duty hours
Thomas J. Nasca, MD, of the Accreditation Council for Graduate Medical Education (ACGME), recently issued and open letter to the graduate medical education community, announcing a systematic review of resident duty hours and the learning environment.

"In our well-meaning attempt to limit resident duty hours to improve their education and diminish the effects of acute and chronic sleep deprivation, we have placed many of our residents all too often in [an] ethical quandary," Dr. Nasca wrote in the letter. "We force them to choose between caring for their patients the way they know they should or satisfying a well-meaning standard. In other words, we compel them to lie if they do the right thing for their patients. I posit to you that this is unacceptable."

Read (PDF) the letter in full.

Visit the Web site to read more about this and other highlights from the March issue of the AMA's GME e-Letter.

7) Register for the American Physician Scientists Association Annual Meeting
The American Physician Scientists Association will hold its annual meeting in conjunction with the Association of American Physicians and the American Society for Clinical Investigation. Held April 24–26 at the Fairmont Hotel in Chicago, the meeting will enable interactions between students at all levels of training, including clinical and research faculty, public health advocates and leaders in industry. The deadline to register is April 10.

The meeting will include forums about funding and career development, panel discussions and a poster session during which students and residents can present their work.

Visit the American Physician Scientists Association Web site for more information.

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Brought to you by the AMA Minority Affairs Consortium

1) Indian Health Services offers special diabetes program
The Special Diabetes Program for Indians (SDPI) is funding a program that uses clinical, team-based case management to treat risk factors for cardiovascular disease. The Indian Health Service (IHS) has extended this program as a demonstration project that helps prevent disease and reduce cardiovascular disease risk among American Indians with diabetes.

The IHS's Division of Diabetes Treatment and Prevention will share the outcomes of the demonstration project with other American Indian health programs to help tribes start prevention efforts.

Visit the IHS Web site for more information about the Indian Health Services and the diabetes program.

2) Dietary tool helps Hispanics reduce their diabetes risk
The National Institutes of Health recently launched a new campaign, "It's more than food: It's life," a program designed to help Hispanics prepare healthy versions of their favorite recipes and control portion sizes, helping in reducing the risk of developing diabetes.

Access campaign materials in English and Spanish, and call (888) 693-6337 for more information.

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.

Visit the Web site to access this resource.

2) 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 2008 AMA Interim Meeting, as well as its disposition of actions.

3) 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.

4) 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.

5) 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 (PDF) the guide at no charge.

6) 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. These principles are designed to improve the working relationship between physicians and hospitals and ultimately foster better patient care and improve patient safety.

View and download (PDF) these guidelines.

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

1) Application deadline for Fieldman Award extended
There is still an opportunity to apply for the Jordan Fieldman, MD, Award, which recognizes residents and fellows interested and active in advocacy issues. The new application deadline is March 19.

Award recipients will be funded for travel to the AMA-RFS Annual Assembly Meeting in June, where they will be recognized.

Visit the AMA-RFS Web site for more information and to access an application.

2) ACGME announces systematic review of duty hours
Thomas J. Nasca, MD, of the Accreditation Council for Graduate Medical Education (ACGME), issued and open letter to the Graduate Medical Education community, announcing a systematic review of resident duty hours and the learning environment.

"In our well-meaning attempt to limit resident duty hours to improve their education and diminish the effects of acute and chronic sleep deprivation, we have placed many of our residents all too often in [an] ethical quandary," Dr. Nasca wrote in the letter. "We force them to choose between caring for their patients the way they know they should or satisfying a well-meaning standard. In other words, we compel them to lie if they do the right thing for their patients. I posit to you that this is unacceptable."

Read the letter in full.

Visit the Web site to read more about this and other highlights from the March issue of the AMA's GME e-Letter.

3) Help your residents understand Medicare
The Centers for Medicare & Medicaid Services Medicare Learning Network is now offering the revised Medicare Resident, Practicing Physician and Other Health Care Professional Training Program Facilitator's Kit. The kit includes instructions for facilitators, a customization guide, a PowerPoint presentation with speaker notes, pre- and post-assessments, master assessment answer keys, and evaluation tools.

Visit the Centers for Medicare & Medicaid Services Web site and scroll down to "Related Links Inside CMS" and select "MLN Product Ordering Page" to order the kit.

1) Get tested during colorectal cancer screening month
An estimated 90 million Americans may be at risk for developing colorectal cancer, which is why the Department of Health and Human Services (HHS) recommends colorectal cancer screening for Americans 50 years of age and older. Risk factors include a family or personal history of colorectal polyps or cancer, obesity, alcohol consumption and tobacco use.

"Colorectal cancer is the second-leading cancer killer in the United States and screening can save lives," said HHS Secretary Tommy G. Thompson.

Medicare can help pay for colorectal cancer screening tests for seniors age 65 and older.

Learn more about screenings at the Centers for Medicare & Medicaid Prevention Web site.

2) AMA-SPG developing national network of senior physician groups
The AMA-SPG Governing Council is working to actively engage senior physicians in the policy-making process to give them a more significant voice in the AMA. As part of that effort, the governing council is developing a national network of senior physician groups. The network's Web site includes more than 40 groups representing about 3,000 senior physicians.

Visit the AMA-SPG Web site to view the represented groups.

Contact Alice Reed with your contact information.

Brought to you by the AMA Women Physicians Congress

1) "Eat Right" for National Nutrition Month
The American Dietetic Association (ADA) has created an educational and informational campaign in observance of National Nutrition Month®. The campaign, themed "Eat Right," focuses on the importance of making informed food choices, eating a variety of healthy foods and the right amounts for essential nutrients needed to maintain good health.

Visit the campaign's Web site for tips from the ADA on practicing good nutrition.

2) In American Medical News: Higher incidence of stroke in women than men
According to an article published in the March 2 issue of American Medical News, women account for more than 60 percent of stroke deaths in the United States. The prevalence and incidence of strokes are expected to increase among both women and men as the population ages.

By the year 2050, mortality is expected to be 30 percent higher in women than in men. Some researchers have suggested this could be because women live longer than men.

Statistics from the American Heart Association show that stroke is the third leading cause of death in the United States, as well as a leading cause of long-term disability. Among women, three out of every five deaths are from stroke, with black women having a substantial higher death rate from stroke in 2002 than did white women.

Read the article.

1) Save the date: AMA-YPS Annual 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. Contact the AMA-YPS by May 1 to submit resolutions and volunteer for the following committees: reference, AMA House of Delegates handbook review and credentials.

E-mail Jane Ascroft for more information.

2) Pre-register for child care at the annual meeting
Physicians with children attending the annual meeting are encouraged to register for Camp AMA. Child care is available for children ages 6 months—12 years old and will include arts and crafts, games and activities from June 12—16 at the Hyatt Regency Chicago.

Camp AMA is provided by Accent on Children's Arrangements, Inc. and will be made available if a minimum number of children are registered by May 5.

Visit the Camp AMA Web site for more information and to register for Camp AMA.

3) Register now for AMPAC Campaign School
The AMA's Political Action Committee (AMPAC) will conduct its annual Campaign School April 15–19 in Pentagon City, Va. The school, which is organized around a simulated congressional campaign, is for AMA members, students and spouses who want to become involved in the political process as advocates or volunteers for medicine-friendly candidates. This year, for the first time, the program will include a focus on the role of social networking in political campaigns.

Attendance is free of charge, excluding transportation costs to the Washington, D.C., metro area.

E-mail Jim Wilson at for more information.

4) Apply for AMA-YPS community service awards
The AMA-YPS is accepting nomination forms for its annual community service awards. Through these awards, the group strives to not only recognize excellence in community service activities carried out by young physicians but to encourage similar efforts by other doctors. Nominations are due May 1.

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

Visit the AMA-YPS Web site for more information, to download a nomination form or submit a nomination electronically.