Ronald M. Davis, MD
Sense and nonsense from Sicko
Last weekend, my family and I went to see Sicko, Michael Moore's documentary about the state of our nation's health care system. The movie addresses some of the core issues the AMA has been working on for years, especially the plight of the uninsured and the abuses of corporations that put profits over patients.
The film resonated with the audience, which enjoyed Moore's unique brand of humor and applauded after his most poignant jabs at our nation's health care system. The power of the documentary comes from disturbing stories of patients who were disenfranchised by our health care system. Health insurers and managed care plans bear the brunt of Moore's criticism for excluding patients with pre-existing conditions, for paying bonuses to claims adjusters for high denial rates, for outrageous executive salaries, and so on.
The chief flaw of the movie—and it's a huge one—is the repeated omission of key facts that undermine or contradict Moore's message. For example, Sicko condemns the AMA for its opposition to "socialized medicine" more than 40 years ago, but does not mention the AMA's leadership during the past decade in developing a sound proposal (PDF, 302KB) for expanding health coverage and choice. Nor does Moore mention that the AMA has joined forces with 15 diverse national organizations—through the Health Coverage Coalition for the Uninsured—in proposing a mix of public- and private-sector strategies to help cover the country's uninsured, beginning with children in low-income families. In a media campaign to begin this fall, the AMA will ask patients and the public to add their voices to the chorus of those demanding action by Congress. >>Read more
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July 6, 2007
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International medical graduate issues
1) 2007–08 AMA-IMG Section Governing Council announced
Medical school news
1) AMA Annual Meeting highlights
2) Should resident duty hours be refined?
3) In GME e-Letter: Five rules for success in medicine
Medical student issues
1) Apply for AMA-MSS leadership opportunities
2) 2007 AMA-MSS Annual Meeting Highlights and Summary of Actions now Available
3) Arkansas wins AMA-MSS Chapter of the Year Award
4) In the AMA GME e-Letter: Five rules for success in medicine
Minority health issues and professional concerns
of minority physicians
1) Trust in patient-physician relationship is focus of new online video
Organized medical staff issues
1) Medical staff wins appeal in legal battle over bylaws
2) Highlights from the 49th Annual Assembly of the AMA-OMSS
Resident and fellow issues
1) In AMNews: Medicaid seeks to cut contribution to GME funding
2) Latest online Code Blue article highlights the AMA's Initiative to Transform Medical Education
3) Debate continues on resident work hours
Women physician and women's health issues
1) Women leaders share their insights
2) Mark your calendar: Attend the WIO Leadership Summit
Young physician issues
1) AMA-YPS 2007 Assembly Meeting wrap-up
General
AMA news:
1) AMA deeply concerned about new Medicare payment rule
2) Poster informs patients about flaws in physician profiling programs
3) Web-based CME course introduces pharmacogenomics
4) July 16 is deadline to make changes to NPI information before CMS makes it public
5) On Sermo: Medical practice staffing challenges
6) In JAMA: A little dark chocolate may reduce blood pressure
Your news interests
Sign up to receive customized
AMA eVoice messages.
International medical graduate issues
1) 2007–08 AMA-IMG Section Governing Council announced
During the AMA-IMG Section Caucus, the 2007-08 AMA-IMG Section Governing Council was ratified as follows:
- Keith I. Adams, MD, vice chair
- Hugo A. Alvarez, MD, delegate
- Mitra B. Kalelkar, MD, member at-large
- Sarala A. Rao, MD, alternate delegate
- Venkat Rao, MD, immediate past chair
- Jayesh B. Shah, MD, member at-large
- Nirav Shah, MD, resident
- Gamini Soori, MD, chair
The AMA-IMG Section Governing Council looks forward to working with the AMA-IMG Section members. Send an e-mail with any questions or concerns.
Visit the Web site for more news and information from the 2007 Annual Meeting of the AMA House of Delegates.
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Medical school news
(Brought to you by the AMA Section on Medical Schools)
1) AMA Annual Meeting highlights
At its recent Annual Meeting, the AMA House of Delegates set new policies on access to care, public health issues, covering the uninsured and much more.
Read highlights for June 23 (PDF, 173KB, requires Adobe® Reader®).
Read highlights for June 24 (PDF, 128KB).
Read highlights for June 25 (PDF, 124KB).
Read highlights for June 26 (PDF, 132KB).
Read highlights for June 27 (PDF, 121KB).
Read highlights of section and special group meetings (PDF, 136KB).
Read highlights of reference committees (PDF, 52KB).
2) Should resident duty hours be refined?
An article in the June 28 issue of the New England Journal of Medicine discusses the delicate balance of residents' work hours and the continuity of care and the need for further study of this issue. The Accreditation Council for Graduate Medical Education is urging residency programs to submit proposals for pilot projects to study the effects of innovative schedules and other changes.
3) In GME e-Letter: Five rules for success in medicine
What are the five rules for physicians to avoid becoming a "white-coated cog" in the health care machine? Will future surgery residents have to pay tuition? Are psychiatrists especially beholden to the wealth of consulting fees and research grants flowing from pharmaceutical companies?
How is the AMA working to stop physician recruiters from unsolicited calling or paging of residents/fellows in the workplace?
For the answers to these and other questions about graduate medical education (GME), read the latest issue of the AMA's GME e-Letter.
Read the June issue.
Subscribe to this free monthly e-mail newsletter.
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Medical student issues
1) Apply for AMA-MSS leadership opportunities
The AMA-MSS is accepting applications for its standing committees, such as those on public health, legislative affairs, and international health and policy, among others. Please visit the Web site for a list and descriptions of the committees and to complete an application. The deadline is July 16.
2) 2007 AMA-MSS Annual Meeting Highlights and Summary of Actions now Available
Download the AMA-MSS Annual Meeting highlights (PDF, 19KB, requires Adobe® Reader®).
Download the AMA-MSS Annual Meeting Summary of Actions (PDF, 56KB).
We hope to see you for the AMA-MSS Interim Meeting, Nov. 8–10, 2007, in Honolulu.
3) Arkansas wins AMA-MSS Chapter of the Year Award
Congratulations to the University of Arkansas for Medical Sciences College of Medicine for being named Chapter of the Year, and the University of Colorado School of Medicine and the University of Pittsburgh School of Medicine for being named finalists for the award. The honor was presented during the AMA-MSS Annual Assembly in Chicago. The section received applications from many chapters that took part in various activities throughout the year focusing on membership, community service, advocacy, chapter growth and many other issues.
These chapters took advantage of the Chapter Involvement Grants (CIG) that are available to help put student projects and recruitment events into action. Chapters are eligible for $1,000 per academic year with a maximum of $500 per event. If your chapter has a project that it would like to get started, please visit the Web site to apply for a CIG.
4) In the AMA GME e-Letter: Five rules for success in medicine
What are the five rules for physicians to avoid becoming a "white-coated cog" in the health care machine? Will future surgery residents have to pay tuition? Are psychiatrists especially beholden to the wealth of consulting fees and research grants flowing from pharmaceutical companies? How is the AMA working to stop physician recruiters from unsolicited calling or paging of residents/fellows in the workplace? For the answers to these and other questions on graduate medical education (GME), read the June issue of the AMA's GME e-Letter.
For the answers to these and other questions about graduate medical education (GME), read the latest issue of the AMA's GME e-Letter.
Read the June issue.
Subscribe to this free monthly e-mail newsletter, and find out why GME program directors and medical education administrators and educators call it "clear, concise, and relevant" and "the best way to share cutting-edge news re: GME."
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Minority health issues and professional concerns of minority physicians
(brought to you by the AMA Minority Affairs Consortium)
1) Trust in patient-physician relationship is focus of new online video
Trust is an important aspect of patient-physician communication, and lack of trust can lead to an increase in health disparities. A new online educational program from the AMA, "Role of trust in physician interactions with minority patients"—part of the AMA's Educating Physicians on Controversies in Health series—calls physicians' attention to the importance of patient trust in the patient-physician relationship and helps physicians recognize and overcome common barriers to strengthening this important relationship. The video also aims to show physicians how they can incorporate methods of cultural communication into their practice to strengthen the patient-physician relationship.
View this and other videos in the series.
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Organized medical staff issues
1) Medical staff wins appeal in legal battle over bylaws
An opinion issued recently by the Florida District Court of Appeal upheld a state court ruling that a special law designed to override medical staff bylaws is unconstitutional, protecting the rights of the medical staff at Lawnwood Regional Medical Center in St. Lucie County, Fla.
The case centers on a law, passed by the Florida Legislature in 2003 and applying only to hospitals within St. Lucie County, that allowed the hospital to unilaterally amend medical staff bylaws that had been duly adopted by the staff and governing board of the hospital.
With the help of the AMA Litigation Center and the AMA Organized Medical Staff Section, Lawnwood's medical staff has restored the viability of its bylaws and regained control over medical staff privileging, patient care quality and peer review. The AMA Litigation Center provided both substantial financial support and, along with the Florida Medical Association, filed an amicus curiae, or "friend of the court," brief in support of the medical staff. In addition, an attorney retained by the AMA Litigation Center participated in the oral argument on appeal.
View the case.
2) Highlights from the 49th Annual Assembly of the AMA-OMSS
The AMA-OMSS held its 49th Assembly to discuss and shape policy on a variety of issues affecting the medical staff. The section considered 43 items of business, including those on the need for: 1) legislative relief from antitrust constraints; 2) policy regarding the types of personal proprietary information hospitals can request for "conflict of interest" disclosure; 3) AMA leadership in addressing the nursing shortage as a patient safety concern; 4) a model "Centers for Medicare & Medicaid Services-compliant" informed consent form; 5) medical staff authority in approving hospital/managed care organization hospitalist programs; 6) improved two-way communication between hospitalists and primary care referring providers as well as legible and timely data entry and transmittal; and 7) public policy, liability insurance and current procedural terminology (CPT) codes for post-operative care related to medical outsourcing abroad.
With the adoption of the AMA-OMSS Transformation Task Force Report, the section will seek to be more inclusive and improve hospital communications to increase membership, participation and interaction with other AMA sections and external organizations.
The AMA-OMSS also sponsored nine education sessions on topics such as universal health care, medical staff leadership roles, medical staff and trustee engagement, physician-hospital relationships, work force issues, market influences related to physician-hospital affiliation, and Medicare reimbursement and the benefits of coding correctly.
View the summary of the AMA-OMSS meeting and the Disposition of Actions.
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Resident and fellow issues
1) In AMNews: Medicaid seeks to cut contribution to GME funding
A proposed rule change by the Centers for Medicare & Medicaid Services would cut teaching hospitals' training budgets by 15 to 30 percent. The Department of Health and Human Services says that education is not a part of the cost of treating patients and is not justified under the Medicaid statue. The AMA opposes this cut, which could cost teaching hospitals as much as $1.78 billion per year.
Read the article in American Medical News (AMNews).
2) Latest online Code Blue article highlights the AMA's Initiative to Transform Medical Education
Kelly Caverzagie, MD, vice chair of the AMA-RFS Governing Council, wrote an article updating the progress of the AMA's Initiative to Transform Medical Education in promoting excellence in patient care by reforming the medical education and training system to meet the needs of the changing health care system. Dr. Caverzagie also presented the initiative as an educational session at the AMA-RFS Annual Meeting.
Read the Code Blue article in Resident and Staff Physician.
3) Debate continues on resident work hours
Four years after limits on resident work hours were mandated, the debate continues on whether work-hour limits should be tightened or relaxed. Although studies have documented decreased clinical performance and an increase in errors when residents are fatigued, there isn't reliable national data on the effectiveness of work-hour limits for preventing medical errors or reducing patients' rates of death.
Read an article on this topic in the New England Journal of Medicine.
>>Return to your news interest contents
Women physician and women's health issues
(brought to you by the AMA Women Physicians Congress)
1) Women leaders share their insights
Former AMA President Nancy W. Dickey, MD, and former U.S. Surgeon General Antonia C. Novello, MD, shared sage advice with those attending the AMA-WPC session, "Physician leadership: Reconciling professional standards with political demands" during the AMA's Annual Meeting. Dr. Novello shared many of the principles she follows that led her to become U.S. surgeon general, including not being afraid to take risks and not forgetting to give back once you get to the top. Dr. Dickey gave an inspiring message reflecting back on the many obstacles women in medicine have faced and continue to face in their careers. Both women encouraged all attendees to be leaders and to create their own pathway to success.
2) Mark your calendar: Attend the WIO Leadership Summit
All AMA-WPC members are invited to attend the Women in Ophthalmology's (WIO) Leadership Summit, featuring AMA President-elect Nancy H. Nielsen, MD, PhD, Aug. 2–5, in Sedona Ariz. The summit will feature the art of persuasion, negotiations and workshops for all women physicians.
>>Learn
more
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Young physician issues
1) AMA-YPS 2007 Assembly Meeting wrap-up
The AMA -YPS had a successful meeting in Chicago. Young physicians from across the country met to network with colleagues, provide direction to their AMA-YPS delegate, and shape AMA policy.
View the final actions of the Assembly and learn about all the AMA-YPS meeting events.
The AMA-YPS Assembly adopted several resolutions that have public health implications and were forwarded to the AMA House of Delegates (HOD). Also, the AMA-YPS proposed a new innovative delegate structure for its Assembly.
The AMA-YPS elected Devdutta Sangvai, MD, a family physician from North Carolina, as chair-elect. Also, the AMA-YPS re-elected Patricia Turner, MD, a surgeon from Maryland, as alternate delegate and elected Ravi Goel, MD, an ophthalmologist from New Jersey, and John Ratliff, MD, a neurosurgeon from Pennsylvania, as members at-large. Gary Katz, MD, will chair the Governing Council. Other members include Tripti Kataria, MD, delegate, and Brigitta Robinson, MD, immediate past chair.
The AMA-YPS honored Samuel Solish, MD, a former AMA-YPS chair, with its Young At Heart Award. Lastly, the AMA-YPS presented its Community Service Awards to: Joseph Cangas, MD; Randolph Capone, MD; Britt Hatfield, MD; and Rahul Jandial, MD.
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General AMA news
1) AMA deeply concerned about new Medicare payment rule
In response to this week’s release of a rule that specifies a cut in payments to doctors of 10 percent in 2008, AMA Trustee Cecil B. Wilson, MD, said the news serves as yet another reminder of the need for congressional action to stop scheduled payment cuts to physicians.
He also pointed out that Congress last year set aside $1.35 billion that could be used to reduce the scheduled 2008 pay cut. The AMA and 85 other organizations strongly urged the administration to use this money to help Medicare physician payments keep pace with increases in practice costs. The Medicare Payment Advisory Commission made a similar recommendation. With the rule, the Centers for Medicare & Medicaid Services has chosen to spend all of the money to provide just 1.5 percent to 2 percent to physicians who report on certain quality measures.
“The AMA is extremely disappointed in this short-sighted decision,” said Dr. Wilson. “Today, Medicare pays doctors the same as it did in 2001. More than 60 percent of doctors say they will be forced to limit the number of new Medicare patients they can treat when the cut goes through. Seniors’ access to health care is in jeopardy.”
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2) Poster informs patients about flaws in physician profiling programs
Some insurance companies are conducting physician profiling programs that conflict with the AMA’s established principles to measure physician performance—rating physicians based on cost, rather than quality of care. This type of profiling is unfair, and it is important that physicians educate patients about this practice.
The AMA, in conjunction with the Kentucky Medical Association and several other medical societies, created posters—available now—pointing out the truth about many of these poorly constructed programs. Posters are free to all AMA members and can be used for patient display and education.
Members can view the poster (PDF, 118KB).Call (800) 621-8335 and ask for poster number NC424607 to order your free copy today.
Send an e-mail or call (312) 464-4367 for more information.
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3) Web-based CME course introduces pharmacogenomics
Developed by the AMA and the Food and Drug Administration, a new online continuing medical education (CME) course introduces pharmacogenomics and the influence of a patient's genetic background on drug response. “Pharmacogenomics and Personalized Medicine” is designed for physicians who have had little exposure to the topic in clinical practice or who want to better understand the current levels of pharmacogenomic information in prescription drug labeling. Beginning with a review of concepts in genetics and pharmacology, the course addresses the genetic control of drug metabolism and response, pharmacogenomic information in drug labels, and clinical examples of drugs whose action is influenced by the patient's genetic background. The course outlines some tests available to aid in prescribing certain drugs whose disposition or action is affected by a patient's genetic background.
Complete the course. Registration is required.
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Medical Association designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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4) July 16 is deadline to make changes to NPI information before CMS makes it public
Much of the information physicians have supplied in their National Provider Identifier (NPI) applications will be made public, according to the Centers for Medicare & Medicaid Services (CMS).
While the AMA has significant concerns about CMS’ interpretation of what information on a physician’s NPI application can be released to the public, and is exploring ways to mitigate the effects of this, the AMA encourages physicians to review the information they submitted to the NPI enumerator on their NPI application. CMS originally planned on making much of this information available to the public through an online NPI registry at the end of June. However, due to significant pushback by the AMA, the agency decided to postpone the release of the information until Aug. 1.
The AMA strongly encourages physicians to:
- Review the information supplied on their NPI application, which CMS has said it is permitted to disclose, to ensure it is accurate and make any necessary changes.
- Ensure that the address furnished is the business address, not a home address.
- Review the information they supplied that CMS has deemed “optional” and delete any “optional” information they do not wish to share with the public.
The information CMS has said it will not release to the public in the NPI online registry includes a physician’s SSN, ITIN (Tax ID numbers), date of birth, state and country of birth, and “contact” information. (The address section, however, will be released).
CMS has created the document “Information on FOIA-Disclosable Data Elements in NPPES” that spells out which information CMS feels it is permitted to release to the public in the online NPI registry. Visit the Web site (under "Downloads") to read it.
Physicians can make changes online using their user name and password or they can make changes on an NPI change of information form, which CMS recently revised. Visit the Web site to download the new form No. 10114, which will be accepted starting July 10 by CMS. The old form will be accepted by the NPI enumerator if it is postmarked by July 13, but that form is only available by calling (800) 465-3203. The last day for physicians to make changes or deletions to their NPI information is July 16.
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5) On Sermo: Medical practice staffing challenges
In an era of stagnant or declining payments for many medical services, can physicians afford to provide annual salary increases to medical office staff members? “Everybody wants a raise, but I haven’t had a raise in the last five years,” writes one physician on Sermo, the online community for physicians.
Physicians with a wide variety of perspectives have weighed in on Sermo about this and many other small-business issues doctors face. How many full-time employees per physician is the right number? Enter Sermo and view this discussion.
What is the typical rate of turnover in a medical practice? View the conversation about staff turnover.
Is a raise every year realistic for medical practice employees? View the conversation about annual raises.
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6) In JAMA: A little dark chocolate may reduce blood pressure
Eating about 30 calories a day of dark chocolate was associated with a lowering of blood pressure, without weight gain or other adverse effects, according to a study in the July 4 issue of the Journal of the American Medical Association (JAMA).
Preview the study.
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