News

AMPAC: Making a difference on Capitol Hill

Last week's initial session of the 111th Congress and news reports of next week's inauguration of President-elect Barack Obama remind me of how interested I am—like many of you, I suspect—in how our newly elected officials will perform while in office.

For instance, will they be committed to reforming the nation's health care system in a way that is in the best interests of physicians and patients? Will they work to fix the fatally flawed Medicare physician payment system and protect seniors' access to care? And will they work with the AMA to promote quality improvement through appropriate guidelines designed by physicians, be champions for medical education and increase resources for primary care?

Time will tell. However, I'm optimistic that our legislators will make significant gains for medicine because of an increase in the number of physicians who are serving in Congress. Of the 30 physicians who ran for the U.S. Senate and House of Representatives in this past election, 14 were voted into office. And the American Medical Association Political Action Committee (AMPAC) played an important role in helping them get elected.

AMPAC participated in 430 federal races and spent more than $4.1 million in this past election cycle. Of the candidates AMPAC supported in the general election, 393 won their bid to be seated in Congress—a 95 percent win rate. More importantly, AMPAC-endorsed candidates won in 73 percent of the most competitive races.

AMPAC supports candidates for Congress who have demonstrated an understanding and willingness to fight for issues that are most important to physicians, and it uses the direct input of each respective state medical society when doing so. Working in concert with state medical society political action committees, AMPAC contributed more than $1.7 million to physician-friendly candidates for the Senate and House from both political parties.

AMPAC's support of pro-medicine candidates is not limited to direct financial contributions to their campaigns. Through independent expenditure efforts and "electioneering communications," AMPAC develops positive ads in a strategic and targeted manner that educate voters about a candidate's stance on health care issues without explicitly calling for the election of that candidate or the defeat of their opponents.

AMPAC also has trained dozens of physicians to run for office. In fact, 10 of the 30 physicians who ran for federal office in this past election are graduates of AMPAC's political education programs, two of which will be held in Pentagon City, Va., in the coming months.

The first of those programs to take place is the annual Candidate Workshop, which will be held Feb. 13-15. Designed for AMA members and their spouses who are considering a run for public office, the workshop includes training on campaign strategy and media advertising, as well as hands-on sessions in public speaking and fundraising.

The other is AMPAC's Campaign School, scheduled April 15-19 for AMA members who want to become involved in the political process as advocates and volunteers for medicine-friendly candidates. The school is organized around a simulated congressional campaign, where participants are put on campaign "staff" teams and attend daily lectures on campaign strategy, media advertising and political fundraising. Each team participates in nightly exercises such as creating a campaign strategy, taping a radio commercial and writing a political fundraising letter.

Both programs are meant to simulate the nonstop nature of a political campaign, so they include very rigorous schedules. All costs, other than transportation to the Washington, D.C., metro area, are covered by AMPAC, and all AMA members, their spouses and staff members of state medical societies are eligible to apply. That includes medical students, although there is limited space available for them. The deadline for medical students to apply for the Candidate Workshop has already passed, but students still can apply for the Campaign School until Jan. 21.

There's no questioning the value of these programs; just ask newly elected U.S. Reps. Phil Roe, MD, R-Tenn., and Bill Cassidy, MD, R-La., both of whom have attended them. If you have questions about either program, I invite you to contact Jim Wilson, the AMA's manager of political education programs, via e-mail or at (202) 789-7465.

What happens on Capitol Hill directly affects not just physician practices but our livelihood and the lives of our patients. If you're an AMA member and have an interest in politics, I encourage you to look into attending AMPAC's education programs. If you're not a member, I hope AMPAC's contributions to the practice of medicine will help you consider joining.

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

1) AMA claims victory with record-breaking settlement in case against insurer
The AMA, along with the Medical Society of the State of New York and the Missouri State Medical Association, claims victory with the settlement agreement reached today in the lawsuit against United Health Group. The $350 million settlement marks the largest monetary settlement of a class action lawsuit against a single health insurer in the United States.

"By using a flawed database to determine reimbursement rates for out-of-network care, insurers have increased profits at the expense of patients and physicians," said AMA President Nancy H. Nielsen, MD, PhD. "By agreeing to the settlement, United Health Group has recognized the importance of restoring its relationship with patients and physicians by ending use of a rigged database."

View a summary of the AMA's case against United.

2) Patients and physicians prevail over health insurers
Patients and physicians triumphed this week when New York Attorney General Andrew Cuomo reached agreements with health insurers United Health Group Inc., and Aetna following an industry-wide investigation into a scheme to defraud consumers by manipulating reimbursement rates.

At the center of the scheme is Ingenix, a wholly-owned subsidiary of United. The Ingenix database suffers from flaws that have resulted in patients and their physicians being undercompensated for out-of-network care. In his investigation, which was urged by the AMA, Cuomo found that having health insurers determine the “usual and customary” rate—a large portion of which the insurer then reimburses—creates an incentive for the insurers to manipulate the rate downward.

As part of these settlements, United and Aetna will cease using and marketing their Ingenix databases and pay $50 million and $20 million, respectively, to a qualified nonprofit organization that will establish a new, independent database to help determine fair out-of-network reimbursement rates for consumers throughout the United States. These settlements also call into question the validity of the insurance industry's continuing and past use of the flawed Ingenix database, which has been used for years to pay for out-of-network care.

The AMA applauds Cuomo's decisive action to lift the cloak of secrecy and bring to an end United's, Aetna's and the entire health insurance industry's conflict of interest in determining reimbursements. “The AMA appreciates the leadership of Attorney General Cuomo in initiating his investigation into the Ingenix database, and fully supports the attorney general's actions to have a not-for-profit institution create a new, reliable database that is fair to patients and physicians,” said AMA President Nancy H. Nielsen, MD, PhD, in a statement on the United settlement. In a related statement, Dr. Nielsen said that health insurers who truly recognize the importance of restoring their damaged relationships with patients and physicians should commit to the solution proposed by New York Attorney General Cuomo without delay.

3) House votes for kids' health care

The AMA applauded members of the U.S. House of Representatives this week for moving quickly to reauthorize the State Children's Health Insurance Program (SCHIP), the first step to getting more Americans health care coverage.

The AMA supports the reauthorization bill, which would be funded by an increase in the tobacco tax. However, the AMA opposes the inclusion of provisions that would place restrictions on physician ownership of hospitals, as these hospitals provide high quality care and patient satisfaction.

"Renewing SCHIP will ensure that millions of American children can see the doctor when they are sick and get needed preventive health care," said AMA President Nancy H. Nielsen, MD, PhD. "Making sure that all children have access to health care is an investment in America's future and will enable kids to have the best chance to learn, develop and succeed in life."

4) Learn about making the transition to Medicare Administrative Contractors
According to the Medicare Modernization Act of 2003, the Centers for Medicare & Medicaid Services (CMS) is required to more competitively select companies that process physician claims. A special edition of "MLN Matters," from the Medicare Learning Network, alerts fee-for-service physicians about what to expect as their carrier transitions its work to a new Medicare Administrative Contractor (MAC). Preparing for this process can help physicians minimize disruptions in their Medicare business.

"MLN Matters" is a series of national articles designed by CMS to inform physicians, providers and suppliers about the latest changes to the Medicare program.

New MACs are already at work in some states. Physicians in states where MACs soon will be in place might find the "MLN Matters" article helpful. For example, the article explains that physicians who receive Medicare reimbursements through an electronic funds transfer will need to complete a new form (form 588).

While the AMA continues to voice its significant concerns with these additional paperwork requirements, physicians are urged to learn about the requirements to avoid payment interruptions.

5) 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.

Contact Don Zeigler, the AMA's director of long range health care trends, at (312) 464-5320 for more information.

Contact Carrie Domangue at (312) 464-4391 for a free copy of the 2008 Health Care Trends CD.

6) New resources can help doctors with PQRI
Physicians participating in the Centers for Medicare & Medicaid Services Physician Quality Reporting Initiative (PQRI) have new resources at their disposal that can make it easier to report clinical performance data.

Developed by the AMA, these resources can help physicians report data for the six measures groups and the 131 individual quality measures that can be reported through claims-based submission. They include a data collection sheet that incorporates all of the individual measure-specific information in one step-by-step worksheet for clinical use and office and billing staffs.

Of the 153 measures in the 2009 PQRI, 112 were developed by the AMA-convened Physician Consortium for Performance Improvement®, oftentimes in collaboration with the National Committee for Quality Assurance and/or a medical specialty society.

Additionally, the AMA recently delivered an online educational program on the 2009 PQRI that detailed:

• New options for claims reporting in 2009, both for individual measures and measures groups
• Strategies to determine which measures apply to your practice
• Key elements of performance measures in the 2009 program, including how to use the specifications and other available resources
• Tips to facilitate more accurate reporting

7) Nation's psychiatrists explain mental health parity law
With new a mental health parity law on the books to expand access to mental health care for the 57 million Americans who struggle daily with mental illness, the American Psychiatric Association (APA) developed a fact sheet to help physicians and patients better understand how the law may affect them.

The law, which will take effect Jan. 1, 2010, was part of the economic bailout package that Congress approved and President Bush signed in October 2008. The AMA has long supported efforts to expand access to mental health care and has policy to that effect.

8) Virtual Mentor: Medical care for homeless individuals
The homeless—estimated to number between 2.3 and 3.5 million—are more likely than the general population to be diagnosed with obstructive lung disease, hepatic diseases, skin and orthopedic problems and infectious diseases, according to this month's issue of Virtual Mentor.

They are also more inclined to suffer from chronic physical and mental illnesses and have shortened life spans associated with the lack of adequate housing and nourishment.

The cases, commentaries and personal accounts inside January's Virtual Mentor address the medical and ethical challenges physicians face in helping this disparate community of people whose health problems are exacerbated by their homelessness. Topics for discussion include the needs of homeless veterans, treatment decisions of homeless patients and academic programs that introduce medical students to providing care for homeless patients.

9) In JAMA: Treadmill exercise improves walking endurance for patients with peripheral arterial disease
Patients with peripheral arterial disease (PAD) who participated in supervised treadmill exercise improved their walking endurance and quality of life, according to a study in the Jan. 14 issue of the Journal of the American Medical Association (JAMA). PAD can include symptoms such as pain in the legs. The treadmill exercise also improved walking performance for PAD patients without the classic symptoms of pain in the leg muscles.

View the JAMA Report video about this study.

1) In the Chicago Tribune: University of Chicago hospital to trim 7 percent of budget
The University of Chicago Medical Center is planning a restructuring that will cut $100 million in expenses, or nearly 7 percent of its annual budget, according to a report in the Chicago Tribune. Motivating factors include the economic downturn and unpaid Medicaid bills.

Initially, 15 senior executive positions will be eliminated and additional job cuts will likely follow. The hospital is moving forward with plans to open a new $700-million hospital pavilion in 2012. Other Chicago medical centers, including Loyola University Medical Center, have cut costs or postponed building or expanding facilities.

1) CDC data shows call for HIV testing has not caught on
Of the 1.1 million people already infected with the human immunodeficiency virus (HIV), one in five is unaware of that status, according to recent data from the Centers for Disease Control and Prevention (CDC). This data was presented at the 2008 National Summit on HIV Diagnosis, Prevention and Access to Care.

In a Jan. 5 article, American Medical News (AMNews) reported that the overall effort to expand testing has yielded only small results. "Those unaware of the infection are responsible for transmitting between 50 percent and 70 percent of new sexually transmitted diseases," said Veronica Miller, director of the Forum for Collaborative HIV Research.

While many believe that routine testing is possible and can connect those who need care to treatment, many still oppose routing testing due to time constraints and lack of funding.

1) Call for advisory committee nominations
The AMA is seeking nominations through March 2 for its Advisory Committee on Group Practice Physicians.

The committee is composed of 11 physician leaders from medical groups or faculty practice settings and is charged with advising the AMA Board of Trustees and staff on issues that directly affect the group practice community.

The committee meets twice per year prior to the Annual and Interim meetings of the AMA House of Delegates. Nominees must be leaders within their organizations—such as chief executive officer, chief operating officer, board chair or department chair—and active members of the AMA and organized medicine.

1) ECFMG to expand eligibility for participation in its IMG Advisors Network
The Acculturation Program of the Educational Commission for Foreign Medical Graduates (ECFMG) is expanding the eligibility criteria for IMGs to participate in its IMG Advisors Network.

This program connects via e-mail newly arriving IMGs with volunteer IMG advisors who are currently in or have recently completed accredited graduate medical education programs in the United States.

If you are an IMG who is currently in or has completed a U.S. graduate medical education program, consider volunteering to serve as an advisor.

2) AMA-IMG Section seeking candidates for its governing council
The 2009 AMA-IMG Section Nominating Committee is seeking qualified AMA-IMG Section leaders to apply for its 2009–2012 governing council, which has four expiring positions for practicing physicians.

Qualified candidates must be AMA members who are IMGs with relevant organized medicine leadership experience and ample time to commit to the work of a national governing group for three years; three incumbents are eligible to run for a second term. The main priority of the nominating committee is to select the most diverse and representative slate of election candidates.

Interested candidates should visit the AMA-IMG Web site to download the AMA-IMG Section nomination and biographical sketch forms. E-mail these items along with a headshot photo (JPG) no later than Feb. 20. Letters of organizational support are encouraged but not mandatory.

Online elections will take place in April. Send an e-mail or call J. Mori Johnson at (312) 464-5678 with questions about the election or nomination process.

Brought to you by the AMA Section on Medical Schools

1) Promote the AMA-SMS to your colleagues
The AMA-SMS Governing Council invites all academic physicians to join them in developing strategies that will strengthen the section and policies of the AMA. The section provides a voice in deliberations of the AMA House of Delegates and offers a forum for discussing policies on medical education, national research and health care issues.

A major goal of the AMA-SMS is to enhance communication among the medical education community and the AMA. Now more than ever, academic physicians are being asked to balance the roles of educator, researcher and clinician. Because each academic physician has unique interests and challenges, the AMA is working hard to provide members with the resources to carry out these responsibilities and to help transform and enhance the medical education continuum.

Encourage your colleagues to join the AMA-SMS—their creative energy is needed to keep academic medicine strong and thriving.

2) 2009 Joan F. Giambalvo Memorial Scholarship applications available online

Applications for the Joan F. Giambalvo Memorial Scholarship are due Feb. 16. The AMA Women Physicians Congress (WPC) established this scholarship with the goal of advancing the progress of women in the medical profession and strengthening the AMA's ability to identify and address the needs and interests of women physicians and medical students.

Send an e-mail to Michael Kutnick with questions.

3) In JAMA: Medical student enrollment is up but still falls short of meeting need
The growth in medical student enrollment includes a substantial increase in Latino medical students. But experts caution that this increase is not the only answer to meet future patient care needs in terms of the number and diversity of physicians, according to a Dec. 17 Journal of the American Medical Association (JAMA) article.

4) New report outlines opportunities for improving health care quality and curbing costs
The Dartmouth Institute for Health Policy and Clinical Practice recently released a white paper that contends that the United States can expand coverage to the uninsured without significantly increasing overall health care costs.

The paper, "An agenda for change—improving quality and curbing health care spending: Opportunities for Congress and the Obama administration," also recommends Medicare and Medicaid payment reform and supports the promotion and increased funding of more primary care physician training programs.

1) Apply for National Resident Match Program Board position by Jan. 31
The National Resident Match Program (NRMP) organizes the main residency match as well as many other fellowship matches for U.S. allopathic and osteopathic seniors and independent applicants. Sandeep Krishnan, from the University of Missouri-Kansas City School of Medicine, serves as the AMA student liaison on the NRMP board. Krishnan has an equal voice and vote on all board matters and represents the views of medical students and their concerns, and serves on the violations review committee, the finance and audit committee, the executive committee, and the nominating committee.

Among his many duties, Krishnan reviews match violations to determine if one occurred and, if so, what sanctions should be applied to a candidate. "Through my work on the violations review committee, I have learned a great deal about the match participation agreement, which many applicants in the main residency match too often make the mistake of not reading."

2) Register for Medical Student and Resident/Fellow Lobby Day

The 2009 Medical Student and Resident/Fellow Lobby Day will be held March 8–9 at the L'Enfant Plaza Hotel in Washington, D.C. Lobby Day is an excellent opportunity to increase your awareness of legislative issues affecting medicine, foster relationships with legislators through political involvement and gain real-life education in the practical aspects of physician advocacy.

Lobby Day activities include interactive educational sessions on effective advocacy and lobbying techniques, briefings on legislative issues that are before Congress and a full afternoon on Capitol Hill to meet with legislators and their staffs.

Registration is free. A limited number of free hotel rooms are available for AMA members.

3) Become an advocate for issues relevant to students, physicians and patients
Applications for the AMA Government Relations Advocacy Fellowship (GRAF) are due Jan. 31.

The GRAF, a yearlong paid fellowship opportunity from July 2009 to June 2010 in the AMA's Washington, D.C., office, offers medical students a unique opportunity to experience firsthand the intersection of organized medicine and the federal government as it relates to advocacy and policymaking.

"This is likely to be one of, if not the, most enriching year of your education," said Patrick Woodard, who is currently completing the fellowship.

E-mail Patrick Woodward for more information.

4) Chapter of the Week: Penn State College of Medicine participates in Ronald McDonald House Winter Festival
AMA-MSS chapter members from the Penn State College of Medicine stimulated children's creativity through winter-themed crafts and games and handed out health-related coloring books, as part of the Ronald McDonald House Winter Festival.

E-mail Brittany Massare for more information on this project.

5) Medicare project offers seniors free diabetes screenings
In 2007 a coalition of public, nonprofit and private organizations, including the AMA, launched the Medicare Diabetes Screening Project (MDSP). The MDSP seeks to create awareness among seniors and their caregivers of the diabetes screening benefits provided by Medicare, and encourages patients to ask their physicians whether they should be screened for diabetes.

The MDSP transpired after an analysis showed that Medicare diabetes screening benefits were being underutilized. In 2004 Congress authorized a new Medicare benefit that covers preventive screenings for diabetes. This legislation specified that beneficiaries, ages 65 and older with at least one additional risk factor for diabetes, could qualify for free annual diabetes screenings and follow-ups every six months if an impaired fasting glucose or tolerance test was found.

6) Submit research proposals on women physician issues for possible funding
Applications for the 2009 Joan F. Giambalvo Scholarship are due Feb. 15. This scholarship was established by the AMA Women Physicians Congress (AMA-WPC) with the goal of advancing the progress of women in the medical profession and strengthening the AMA's ability to identify and address the needs and interests of women physicians and medical students.

The AMA is looking for innovative research proposals that focus on professional work or practice issues that affect women physicians, including part-time working strategies, female physician practice patterns, frequency/duration/impact of physician dropout from the work force and profession re-entry issues.

Brought to you by the AMA Minority Affairs Consortium

1) In The Baltimore Examiner: Public health researcher takes on health disparities
A professor in health policy at Johns Hopkins School of Public Health is researching the gaps between different racial, ethnic and gender groups in health care access, quality, and outcomes, according to a Jan. 9 article in The Baltimore Examiner.

Thomas LaVeist, director of the Center for Health Disparities Solutions at Johns Hopkins School of Public Health, recently published a study on disparities in hypertension and the effect of environmental factors. In the study, LaVeist said his team tried to account for environmental differences by finding black and white people who were living in racially integrated communities—two communities right next to each other in Baltimore—that have similar income and education.

LaVeist and his colleagues found that they were able to account for about one-third of the race difference in hypertension that one might see in national studies, and the disparities are a lot smaller or in some cases nonexistent. " … in reality there aren't [genetic difference by race]," said LaVeist. "What you have is a higher frequency in a certain gene or gene mutation in one population or another and that gene mutation is associated with a health outcome."

2) Study: Racial and ethnic differences in the birth prevalence of spina bifida
An updated report from the Centers for Disease Control and Prevention (CDC) summarizes data on the prevalence of neural tube defects such as spina bifida and looks at racial and ethnic differences.

Since a 1998 law mandated that folic acid be added to cereal products to prevent neural tube defects, numbers show that from the early post-mandated period, 1999 to 2000, to the most recent surveillance period, 2003 to 2005, the prevalence of spina bifida decreased by 6.9 percent.

The analysis also showed significant decreases in prevalence among infants with non-Hispanic black mothers, but not among infants with non-Hispanic white mothers or Hispanic mothers. The report noted that additional public health efforts need to be targeted to find genetic and environmental risks contributing to these higher numbers.

1) View AMA-OMSS Interim Assembly Meeting materials
The AMA-OMSS is pleased with the positive and supportive outcomes of its assembly's resolutions and other items of business during the 2008 Interim Meeting of the AMA House of Delegates (HOD). The AMA-OMSS submitted a resolution on behaviors that undermine safety, which was adopted by the AMA-HOD as policy.

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

2) 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 Web site to view and download these presentations free of charge.

3) AMA Annual Meeting webcasts added to archives
The AMA-OMSS is offering four 90-minute educational webcasts, including "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 the webcasts provide AMA PRA Category 1 Credit™. Visit the AMA-OMSS Web site to access these webcasts 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.

4) 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.

5) 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 increase patient safety.

View and download these guidelines (PDF).

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

1) Apply for AMA Council on Legislation
The AMA-RFS is seeking applicants for a resident representative position on the AMA Council on Legislation. The council reports to the AMA Board of Trustees and reviews federal legislation to ensure consistency with AMA policy.

In the case of conflicts, the council recommends changes to legislation or policy. This group also reviews AMA legislative issues, anticipates future federal legislative needs and develops model legislation for states. This is a one-year appointed position with a maximum of eight terms.

Applications are due Feb. 6.

2) NBME seeking resident representatives
The AMA-RFS is seeking applicants for resident representative seats on the National Board of Medical Examiners (NBME). The NBME prepares and administers qualifying examinations and represents the academic, practice and licensing communities.

The board includes two resident representative positions appointed by the AMA-RFS Governing Council for four-year terms. Responsibilities include attending one three-day meeting per year; meeting expenses will be covered.

Applications are due Feb. 2.

3) In AMNews: A hospitalist's role needs to be defined
With the emergence of hospital medicine as a relatively new field, many physicians and nonphysicians are still unclear about what a hospitalist is and their role in patient care, according to a Jan. 12 American Medical News (AMNews) article.

4) Virtual Mentor: Challenges of medical care for homeless
Unknown to most of us are the medical and ethical challenges faced by physicians committed to helping the homeless, a disparate community of people whose health problems are exacerbated by their conditions. Virtual Mentor's January authors examine those challenges with compassion and determination to overcome them.

5) Register for Medical Student and Resident/Fellow Lobby Day
The 2009 Medical Student and Resident/Fellow Lobby Day will be held March 8–9 at the L'Enfant Plaza Hotel in Washington, D.C. Lobby Day is an excellent opportunity to increase your awareness of legislative issues affecting medicine, foster relationships with legislators through political involvement and gain real-life education in the practical aspects of physician advocacy. Lobby Day activities include interactive educational sessions on effective advocacy and lobbying techniques, briefings on legislative issues that are before Congress and a full afternoon on Capitol Hill to meet with legislators and their staffs.

Registration is free. A limited number of free hotel rooms are available for AMA members.

1) In JAMA: Use of over-the-counter medications can trigger dangerous drug interactions in older adults
According to a recent study in the Journal of the American Medical Association (JAMA), at least one in 25 older adults were at risk of a potential serious drug interaction, with half of these interactions involving the use of nonprescription drugs.

Results showed that the most common combination of nonprescription drugs for potential serious drug interactions was ginkgo biloba and aspirin. Taken together, the two can increase the risk of internal bleeding. The study was based on individuals, ages 57 through 85, from a representation of the U.S. population.

Since older adults are the biggest consumers of prescription and over-the-counter medications, they are the most vulnerable to the adverse effects of medication.

2) New retirement plan assists physicians
In today's economy, it's critical for physicians to find financially efficient ways to supplement their retirement savings plans. That's why AMA Insurance Agency, Inc., a subsidiary of the AMA, is informing physicians of a new program offered through Corporate & Endowment Solutions, Inc. (CES) called the Physicians Life Income Plan^SM (PLIP^SM).

During the 2008 Interim Meeting of the AMA House of Delegates, the AMA Insurance Agency hosted an educational session conducted by CES President Randy O'Brien.

CES also completed a due diligence process to become an approved member of AMA Insurance Agency's Trusted Source Network^SM. To learn more about PLIP^SM or CES, visit the Web site or contact Mike Hegwood, assistant vice president with the AMA Insurance Agency, at (312) 464-5247.

Brought to you by the AMA Women Physicians Congress

1) JAMA sponsors discussion of "clinical crossroads" case
An early release of the article, "A 51-year-old woman with bipolar disorder who wishes to quit smoking," is available for comment. The Journal of the American Medical Association (JAMA) promotes clinical evidence into practice by connecting clinicians to authors of articles published in its journal.

Read the case online and respond before Jan. 28. JAMA will review questions posed and post responses based on their timeliness and ability to address the patient's concerns.

Discussion of the case will be published in the Feb. 4 issue of JAMA.

2) Scholarship supports research on women in medicine
Researchers examining women physician work force trends and their effects on the quality and availability of health care in the United States should apply for the Joan F. Giambalvo Memorial Scholarship by Feb. 15.

The AMA Women Physicians Congress and the AMA Foundation have established the scholarship to advance the progress of women in the medical profession and help identify and address the needs and interests of women physicians and medical students.

1) Deadline extended for AMA-YPS Young at Heart Award nominations
Nominations for the 2008 AMA-YPS Young at Heart Award will be accepted through Jan. 30. If you are an AMA-YPS Assembly member, submit your nomination via e-mail, mail or fax by this date.

Nominees should be AMA members who are not eligible for AMA-YPS membership and whose support and guidance have strengthened the AMA-YPS through organizational aid, support of AMA-YPS issues in reference committees and causes (and on the floor of the AMA House of Delegates), or support of AMA-YPS leadership development.

Nominators must be members of the AMA-YPS Assembly.

E-mail your nomination; mail it to 515 N. State St., Chicago, IL, 60654; or fax it to (312) 464-5845.

Visit the Web site for more information or to submit a nomination.

2) Applications for the AMA-GLBT Advisory Committee and AMA-MAC Governing Council due Feb. 6
AMA-YPS positions on both the AMA Minority Affairs Consortium (MAC) Governing Council and the AMA Advisory Committee on Gay, Lesbian, Bisexual and Transgender (GLBT) Issues will become available this spring. The AMA-YPS has slotted seats on three AMA special group governing councils: the AMA-GLBT Advisory Committee, the AMA-MAC and the AMA Women Physicians Congress.

Complete the respective application materials and forward them to the AMA-YPS Governing Council no later than Feb. 6 to be considered for one of these positions.

Visit the AMA-GLBT Web site to apply for the AMA-GLBT Governing Council position.

Visit the Web site to apply for the AMA-MAC Governing Council position.

Send an e-mail with your application materials as well as any related questions.

3) Apply by Feb. 15 for Joan F. Giambalvo Memorial Scholarship
Researchers interested in exploring issues concerning women physicians are encouraged to apply for a 2009 Joan F. Giambalvo Memorial Scholarship by Feb. 15. Established by the AMA Foundation in conjunction with the AMA Women Physicians Congress, the scholarship provides funding to help researchers advance the progress of women in the medical profession and identify and address the needs of women physicians and medical students.

Visit the Web site to learn more and apply for up to $10,000 in funding.

4) With influenza season at its peak, immunize your patients through February
Now—during January and February—is when influenza season reaches its peak. Protect as many of your patients as possible by continuing to administer vaccinations now through the end of next month.

The number of flu vaccines given in physicians' offices is lower at this point in the 2008–2009 season than in the previous two influenza seasons, according to SDI's VaccineTrack™. As co-founders of the National Influenza Vaccine Summit, the Centers for Disease Control and Prevention and the AMA will continue to work to improve the supply and distribution of the vaccine.

5) Overactive bladder new topic for online CME newsletter written by top disease experts
The latest issue of AMA Therapeutic Insights, "Recognizing and managing overactive bladder," offers evidence-based treatment guidelines and actual prescribing patterns for overactive bladder.

This free online program highlights a new disease topic every quarter and features unique prescribing data for the conditions provided by IMS Health. Aimed at enhancing physician knowledge and practice, each newsletter is eligible for AMA PRA Category 1 Credit™.

Visit the Web site to access this issue as well as past issues on benign prostatic hyperplasia, pediatric asthma and osteoporosis.

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 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

6) Sign up for AMA-YPS policymaking committee
As a follow up to the town hall discussion at the 2008 AMA-YPS Interim Assembly Meeting, the AMA-YPS Governing Council would like to invite you to participate in one of three short-term policymaking committees.

The purpose of these committees is to study priority issues of the AMA-YPS, with the goal of developing resolutions on one or more of the following topics:

• Scope-of-practice issues
• Medical student loan debt
• Competition between nonprofit and for-profit hospitals.

Committees for each of these topics will operate between mid-February and the end of April. AMA-YPS staff anticipates two to three conference calls for each committee as well as electronic communications between calls.

E-mail Jane Ascroft by Jan. 30 with questions or to sign up for a committee.