News

Working to revamp re-entry options

Imagine taking a leave of absence from clinical practice. After several years, you decide you want to start practicing again. But before you can, you must pass a written examination of 3,000 questions—only six of which pertain to your specialty. If you don’t pass the test, you won’t be allowed to re-enter clinical practice, at least for the time being.

This is one situation—required tests for clinical practice re-entry that aren’t specialty-specific—of many that have become all too common and real for physicians nationwide. And these unreasonable requirements couldn’t come at a more inopportune time.

Studies show that an increasing number of physicians are taking a leave of absence from practice at some point during their careers. Here’s why: according to the Journal of the American Medical Association, almost half of medical school graduates in 2007–08 were women, and women are more likely than their male counterparts to take time off during their careers to tend to family responsibilities.

While this trend is expected to continue, studies show that re-entry issues are not exclusive to women. They’re relevant to men, too. Physicians take a leave of absence from clinical practice for reasons other than family, such as personal health, career dissatisfaction, administrative responsibilities, military service or alternate careers.

The inescapable reality is that many physicians are eligible to re-enter, but haven’t done so. Every state has different requirements for re-entry. Barriers, include accessibility and cost, as well as inconsistent requirements. There is a lack of standardized curricula and no officially recognized accreditation process for re-entry programs. Some states mandate completion of a re-entry program following a leave of two years, some four years and some have no time limit at all. Others require a written test examination, as I explained in my opening scenario.

One of my colleagues, Claudette Dalton, MD, an anesthesiologist from Harrisonburg, Va., and chair of the AMA Council on Medical Education, is an example of a physician who has left medical practice. As the medical director of surgical and academic programs at Rockingham Hospital in Harrisonburg, Dr. Dalton has been in academia for years. If she ever decides to practice anesthesiology again, she will face accessibility and cost barriers to re-enter. That’s because her closest program—since very few formal re-entry programs in the country exist—is Drexel University’s Drexel Medicine® Physician Refresher/Re-Entry Course in Philadelphia.

Other programs in the United States include the Center for Personalized Education for Physicians in Denver; the Interinstitutional Re-entry Program at Oregon Health & Sciences University in Portland, Ore.; and the Physician Re-entry Project at the John Peter Smith Health Care Consortium in Fort Worth, Texas.

Physician re-entry programs, such as the four I mentioned previously, ensure physicians have retained their clinical competence after an extended leave of absence. Although it’s sometimes misconstrued as a remediation or formal retraining, physician re-entry is neither of those things. Each issue is distinct. An AMA Council on Medical Education report—originally submitted by the AMA Young Physicians Section to the AMA House of Delegates and passed at the 2008 Annual Meeting—defines physician re-entry as "a return to clinical practice in the discipline in which one has been trained or certified following an extended period of clinical inactivity not resulting from discipline or impairment."

This report marks the first step of many the AMA has taken to heighten awareness of this issue. The AMA developed Guiding Principles for a Physician Re-entry System, which are described in the Council on Medical Education report. These principles provide direction as the process of developing a physician re-entry program system moves forward. The 10 guidelines include creating a system which is accessible by geography, time and cost; is flexible in structure in order to maximize program relevancy; offers mechanisms for assessment and openness to evaluation and a funding scheme to ensure financial stability over the long-term; and much more.

In addition to these principles, the AMA established a strong presence in the American Academy of Pediatrics’ (AAP) Physician Re-entry into the Workforce Project. We actively participate in the project’s four workgroups. And through this project, the AMA works with the Association of American Medical Colleges (AAMC) and other medical associations to field cross-sectional surveys which have generated data on the exiting and re-entry patterns of pediatricians over the age of 50.

The AMA will continue collaborations with partners, such as the AAP, AAMC, American Board of Medical Specialties and Federation of State Medical Boards, to hold conferences on re-entry, to research the need for and effectiveness of re-entry programs, and to establish a re-entry database that is accessible and useful. And through the AMA’s Initiative to Transform Medical Education and with partners, we’re developing model program standards that will be presented to the AMA House of Delegates at the 2009 Interim Meeting.

This is only the beginning. We must prepare now to meet the needs of physicians and patients for the future. That’s why we’re working to establish specific priorities and next steps in the study of physician re-entry into clinical practice. With predictions of the physician shortage reaching 85,000 by 2020, we need to facilitate the re-entry of our already trained, competent and safe physicians who want to re-enter the work force.

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

1) AMA calls on Congress to act on permanent Medicare physician payment reform
In testimony to the U.S. House Committee on Small Business on March 18, the AMA emphasized that permanent Medicare physician payment reform is needed this year to ensure long-term access to care for seniors. The AMA also noted that the realistic forecast of future Medicare spending on physician services in the federal budget makes such reform economically feasible.

"The administration made clear in its budget that it does not expect Medicare physician payment cuts to occur, and we encourage Congress to seize this opportunity for permanent action to fix the physician payment formula," AMA Board Chair Joseph M. Heyman, MD (PDF), said.

View the press release to read more from Dr. Heyman.

2) Lawmaker joins forces with AMA on balance billing legislation
The AMA recently worked with Rep. Tom Price, MD, R-Ga., to facilitate the introduction of legislation that would allow physicians to balance bill for the full value of their services under Medicare and for certain non-Medicare patients.

The legislation, known as H.R. 1384, would allow physicians who elect "non-participating" status in Medicare to balance bill patients by removing the current 115 percent limiting charge on the non-participating Medicare fee schedule amount. It would also preempt state laws that prohibit balance billing.

At the last week's National Advocacy Conference, the AMA urged attendees during their visits to Capitol Hill to ask their representatives to cosponsor H.R. 1384. The bill has been referred to the U.S. House Committee on Ways and Means and the House Committee on Energy and Commerce.

3) Applications for $1.5 billion in recovery law funds now available
The National Institutes of Health recently announced that applications for $1.5 billion in grants funded by the American Recovery and Reinvestment Act are now available. The grants will fund scientific research, construction and improvement of research facilities, and the purchase of scientific equipment.

4) Are you experiencing inappropriate discounting of procedures and services?
Have you experienced any of the following payer tactics to inappropriately discount procedures and services you have appropriately reported?

• Networks or payers taking inappropriate discounts on appropriately submitted procedures or services performed
• Networks that you do not contract with sending unsolicited agreements via fax; credentialing requests; W-2 requests; or National Provider Identifier, known as NPI, requests
• Payers sending expedited fee agreements that delay payment

The AMA Practice Management Center would like to learn more about the extent of these payer tactics to assist in its advocacy efforts to address this issue. Please send examples and supporting documentation to the AMA's Practice Management Center via e-mail or by fax to (312) 464-5541.

5) Establish an internal collections policy for your practice
An important part of managing a physician practice is addressing outstanding patient balances and taking the necessary steps to receive that balance before sending the patient account to an outside collection agency.

That's why the AMA and the Ohio State Medical Association (OSMA) developed the educational resource "Internal collections in the physician practice," which discusses the importance of collecting from the patient at the time of service and provides useful tips and recommended steps for implementing a collections policy. It also includes sample template letters and practice policies to assist in developing physician practice policies.

AMA members can access this resource (PDF).

6) Ethics-in-brief: Doctor found to have fabricated 21 pain studies
A Massachusetts anesthesiologist has been accused of fabricating 21 medical studies that claimed to show positive benefits from painkillers. The work of Scott S. Rueben, MD, has been considered significant in establishing a standard of care for post-operative pain by, for example, encouraging doctors to combine the use of certain name-brand painkillers for patients undergoing such common procedures as knee and hip replacements.

According to Baystate Medical Center, where Dr. Rueben worked, he faked data published in various anesthesiology journals from 1996 to 2008. Baystate has asked the medical journals in which those studies were published for retraction.

The AMA Code of Medical Ethics mandates that physicians be involved in the study, application and advancement of scientific knowledge, but also requires physicians to be honest in all professional interactions. According to the AMA ethics policy on clinical investigations, a physician should participate in a clinical investigation only to the extent that the activities are part of a scientific program competently designed to produce data that are scientifically valid and significant.

7) In JAMA: Narcolepsy drug used to improve cognitive performance affects brain dopamine activity
A study published in the March 18 issue of the Journal of the American Medical Association (JAMA) reports that preliminary research in healthy men suggests that the narcolepsy drug modafinil, increasingly being used to enhance cognitive abilities, affects the activity of dopamine in the brain in a way that may create the potential for abuse and dependence.

Modafinil, a wake-promoting drug used in the treatment of sleep disorders, may enhance cognition and is used off-label for the treatment of cognitive dysfunction in psychiatric disorders such as schizophrenia and attention-deficit/hyperactivity disorder.

Correction
The March 12 edition of eVoice included an incorrect title for U.S. Sen. Edward M. Kennedy, D-Mass.

1) In the Wall Street Journal: Physicians protest Chicago hospital cuts
According to an article in the Wall Street Journal, more than 190 physicians from numerous specialties at the University of Chicago Medical Center signed a letter to trustees protesting plans to reduce the number of beds available to emergency patients.

According to the Journal, the physicians wrote that the administration plans announced are an unnecessarily risky undertaking that will lead to unsafe conditions for patients. Although hospital administrators said the planned cutbacks were partly economic moves, they are now re-examining all these actions.

1) Take a survey on physicians' perspectives of GLBT issues in health
The Gay and Lesbian Medical Association (GLMA) and the AMA are working together to study physicians' perspectives on gay, lesbian, bisexual and transgender issues in health care.

A survey has been developed 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 to best serve the needs of GLBT individuals.

2) Gay & Lesbian Medical Association launches new health digest
The LGBT Health Digest, a weekly electronic newsletter about health care issues affecting lesbian, gay, bisexual and transgender (LGBT) individuals, is the newest resource launched by the Gay & Lesbian Medical Association (GLMA).

The digest will be distributed each Tuesday and will be a free service of the GLMA, highlighting issues, events, publications and other newsworthy items pertinent to LGBT health.

Contact the GLMA to receive the digest.

1) New AMA resource: How to keep your practice competitive
In response to the increased need for physicians to compete in the today's marketplace, the AMA has released the second edition of the booklet, “Competing in the Marketplace: How physicians can improve their value in the health care market through medical practice integration” (PDF).

Physicians are often under pressure to collect, track and report data about the quality of the care they provide in order to compete. As a result, more physicians are opting to collaborate with other independent—even competing—colleagues to respond to these pressures. In some cases, physician collaboration may allow physicians to jointly contract with health insurance companies and other third-party payers.

The booklet provides guidance on integration issues and outlines various strategies for physician practice integration—including physician practice mergers, financial integration and clinical integration. This resource can help physician practices stay competitive while complying with antitrust laws.

2) Wal-Mart enters EMR market
According to a report in the Wall Street Journal, Wal-Mart Stores Inc. is planning to sell electronic medical records (EMR) systems to small doctor groups.

Under a partnership with Dell Inc., the software maker of eClinical Work, the new systems are expected to be available in the spring and will cost $25,000 for the first installed system, $10,000 for each additional system, and $4,000 to $5,000 a year in maintenance costs, according to the Journal.

The more complex systems cost about $40,000 for the first installation in a small physician group. Experts agree that while picking the hardware is a significant task, the harder part is connecting electronically to labs, other physician networks, pharmacies and image centers, according to the Journal.

1) Submit resolutions for upcoming AMA-IMG Assembly meeting
Resolutions for the June 12 AMA-IMG Assembly meeting are due April 3 and can be sent via e-mail. Submissions received by the deadline will be placed online for review and with testimony submissions.

The AMA-IMG Section Governing Council and resolutions committee will serve as the reference committee by reviewing all submitted testimony and finalizing resolutions by April 27. AMA-IMG Section members may vote between April 30 and May 7 to approve or not approve each resolution in its final form.

View the resolution writing guidelines. Call Carolyn Carter-Ellis at (312) 464-5397 with questions.

2) 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 from April 13–May 13.

Contact AMA-IMG to send your information and consent.

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

Brought to you by the AMA Section on Medical Schools

1) Save the date: 2009 AMA-SMS Annual Meeting in Chicago
The next AMA-SMS meeting will be held June 12–14 at the Hyatt Regency Chicago. This meeting will provide medical education colleagues an opportunity to network, help develop AMA policy and discuss issues affecting medical education.

On June 12, the AMA-SMS will hold a joint educational session with the AMA Medical Student Section on mentoring medical students. The section will also hold a joint educational program with the Council on Medical Education on resident duty hour limits. On June 13, the AMA-SMS will present a panel on inter-professional collaboration in health care and the implications for medical schools and graduate medical education.

Meeting registration and hotel reservation information were mailed to all section representatives last week. If you have not received these materials by April 3, Jackie Drake or call the section office at (312) 464-4655.

2) ACGME announces systematic review of duty hours
In an open letter to the graduate medical education community, Thomas J. Nasca, MD, of the Accreditation Council for Graduate Medical Education (ACGME), announced 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. “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 more about this and other highlights from the March issue of the AMA's GME e-Letter.

3) Review new medical student work force report
A report recently released by the Robert Graham Center, with support from the Josiah Macy Jr. Foundation, highlights medical student career choice. “Specialty and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices?” provides an analysis of medical student career choice based on a 20-year review of factors associated with the location and specialty choice of graduates.

The study team is comprised of many of the country's leading work force policy scholars. The data, observations and recommendations of this report make an evidentiary contribution to ongoing discussions about health care reform.

4) News report says medical schools increasing despite slow economy
According to a story by the Associated Press, medical school expansion continues despite the economic downturn. In response to warnings of a physician work force shortage, existing schools are increasing enrollment, and new schools are opening or are under development in cities such as El Paso, Texas, and Kalamazoo, Mich.

1) Cover the Uninsured Week: The Ohio State University
As part of Cover the Uninsured Week (CTUW), the AMA-MSS chapter at The Ohio State University School of Medicine has organized a series of events to raise awareness of and promote solutions to the issue of the uninsured. The school has several events planned during CTUW, March 22-28, including educational lectures by physicians, health policy experts and lawmakers, and a 5K fun run/walk to raise money for a local free clinic.

Last year, more than 50 AMA-MSS chapters participated in CTUW events. 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.

2) Mark your calendars: AMA-MSS Assembly meeting deadlines
In preparation for the AMA-MSS Assembly meeting, June 11-13 at the Hyatt Regency Chicago, please keep the following deadlines:

• Meeting ideas for educational sessions are due by April 1
• Convention Committee applications are due by April 2
• Post draft resolutions to the MSS Health policy and News listserv are due by April 10
• Chapter of the Year Award applications are due by April 30
• Final resolutions and checklist are due by May 1
• Meeting registration is due by May 7
• Governing council position applications are due by 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.”

Information and applications for the meeting can be found on the AMA-MSS Web site.

3) 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, 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.

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.

5) AMA Foundation awards research grants
Twenty-eight medical students and resident and fellow physicians recently received research grants as part of the AMA Foundation's Seed Grant Research Program. 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 established the Seed Grant Research Program 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 a list of this year's recipients.

6) 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.

Brought to you by the AMA Minority Affairs Consortium

1) The American Diabetes Alert Day is March 24
The American Diabetes Association (ADA) is sponsoring a nationwide “wake-up” call March 24 to raise awareness of the seriousness of diabetes. As part of American Diabetes Alert Day, the ADA encourages people to take its Diabetes Risk Test and find out if they or their loved ones are at risk for developing type 2 diabetes. African-Americans, Latinos and Native Americans are at an increased risk for type 2 diabetes.

Read an ADA handout titled “Are You at Risk?” (PDF).

2) Study finds racial and ethnic disparity in end-of-life care costs
A study published in the AMA's Archives of Internal Medicine found that African-American and Hispanic patients more often than not have a higher end-of-life care cost than white patients.

The study reviewed 160,000 Medicare patients on their treatment in the last six months of life and noted that more than half of the cost differences are related to geographic, sociodemographic and mobility differences. The other reason noted was greater use of life-sustaining intervention.

1) 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.

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 AMA-OMSS 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.

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

AMA members can view and download these presentations free of charge.

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 visit 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,” (PDF) 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.

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

1) Apply now for AMA-RFS Governing Council
Are you interested in becoming a leader in the largest national organization of residents and fellows? The AMA-RFS is accepting applications for the following positions on its governing council: vice chair, speaker, vice-speaker, delegate, alternate delegate, and membership and outreach officer. Applications are due by May 14.

As the guiding force of the AMA-RFS, the governing council is responsible for directing the section's programs and activities, appointing ad hoc committees, setting both the Annual and Interim Assembly meeting agendas, and monitoring resolutions and reports during governing council meetings, which are held four times a year.

Visit the Web site for more information about governing council duties.

2) In the Wall Street Journal: Resident and fellow physicians protest Chicago hospital cuts
According to an article in the Wall Street Journal, more than 190 resident and fellow physicians from numerous specialties at the University of Chicago Medical Center signed a letter to trustees protesting plans to reduce the number of beds available to emergency patients.

The physicians wrote that the administration plans announced are an unnecessarily risky undertaking that will lead to unsafe conditions for patients. Although hospital administrators said the planned cutbacks were partly economic moves, they are now re-examining all these actions.

3) Review new medical student work force report
A report recently released by the Robert Graham Center with support from the Josiah Macy Jr. Foundation highlights medical student career choice. “Specialty and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices?” provides an analysis of medical student career choice based on a 20-year review of factors associated with the location and specialty choice of graduates.

The study team is comprised of many of the country's leading work force policy scholars. The data, observations and recommendations of this report make a evidentiary contribution to the health care reform discussions now taking place.

4) AMA Foundation awards research grants
Twenty-eight medical students and resident and fellow physicians recently received research grants as part of the AMA Foundation's Seed Grant Research Program. 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 established the Seed Grant Research Program 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 a list of this year's recipients (PDF).

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) Participate in exciting media rotation with Discovery Health
Residents and fellows are encouraged to apply for the AMA/Discovery Health internship (PDF), 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.

1) AMA Foundation honors physician with Jack B. McConnell, MD Award for Excellence in Volunteerism
The AMA Foundation honored senior physician Richard Baylor, MD, with the Jack B. McConnell, MD Award for Excellence in Volunteerism during last week's Excellence in Medicine Awards dinner and ceremony.

Dr. Baylor recently stepped down from his position as medical director at Northern Neck Free Health Clinic in Kilmarnock, Va., where he has provided health care to thousands of low-income patients. At the age of 85, he remains a daily presence at the clinic and works tirelessly to treat patients and ensure the development of programs and procedures that assure continuity of quality of care.

Presented in association with Pfizer Inc, the Excellence in Medicine Awards honor a select group of physicians, residents, fellows and medical students who exceed standards of volunteerism, public service and leadership.

2) Most insured Americans worried about health care costs
According to a March 9 article in Healthday News, more than three-quarters of adult Americans who have health insurance are worried about paying more for their medical care.

Among those 65 years of age and older and Medicare eligible, 62 percent said they worry about paying for the care they need. In addition, one in five insured adults skipped filling a prescription because of the cost. These numbers increased to 30 percent for those without health care insurance.

Brought to you by the AMA Women Physicians Congress

1) JAMA accepting papers to use in medical education issue
The Journal of the American Medical Association invites authors to submit manuscripts on topics relevant to medical education for its theme issue to be published in December.

Topics of interest include diversity in medical education, career choices and the physician work force, and teaching quality improvement. To receive highest priority, submissions should be original research papers, systematic reviews and scholarly commentaries addressing medical education. Manuscripts received by May 31 will have the best chance of consideration.

Visit the JAMA Web site for more information and guidelines for submission.

2) Take advantage of the AMA-WPC work practice reading list
For physicians exploring work practice options, the AMA-WPC has compiled a diverse reading list intended to serve as a starting point for those seeking information on the topic.

The materials are from a variety of sources and focus on job-sharing models, benefits for part-time employees and compensation surveys. Included in the materials are news releases, letters, and lists of resources from within the U.S. and internationally.

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 reference, AMA House of Delegates handbook review and credentials committees.

E-mail Jane Ascroft for more information.

2) Apply for AMA-YPS community service awards
The AMA-YPS invites nomination forms for its annual community service awards. Through these awards, the section strives to not only recognize excellence in community service activities carried out by young physicians, but to also 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 Web site for more information, to download a nomination form or submit a nomination electronically.

3) 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 to 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.

4) New AMA resource: How to keep your practice competitive
In response to the increased need for physicians to compete in the today's marketplace, the AMA has released the second edition of the booklet, “Competing in the Marketplace: How physicians can improve their value in the health care market through medical practice integration” (PDF).

Physicians are often under pressure to collect, track and report data about the quality of the care they provide in order to compete. As a result, more physicians are opting to collaborate with other independent—even competing—colleagues to respond to these pressures. In some cases, physician collaboration may allow physicians to jointly contract with health insurance companies and other third-party payers.

The booklet provides guidance on integration issues outlines various strategies for physician practice integration—including physician practice mergers, financial integration and clinical integration. This resource can help physician practices stay competitive while complying with antitrust laws.

5) ACGME announces systematic review of duty hours
In an open letter to the graduate medical education community, Thomas J. Nasca, MD, of the Accreditation Council for Graduate Medical Education (ACGME), announced 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,” said Dr. Nasca. “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 more about this and other highlights from the March issue of the AMA's GME e-Letter.