Ronald M. Davis, MD
A win-win proposal for children's health
 View ad (PDF, 212KB) |
You might have seen this colorful ad in the newspaper last week. Financed in part by the AMA, the ad is sponsored by Americans for Children's Health, a new coalition calling for congressional reauthorization of the State Children's Health Insurance Program (SCHIP)—a successful public program that covers more than 6 million children whose parents can't afford coverage.
Millions of children like these, on playgrounds across the country, are seriously at risk because they have no health insurance. That's why last month the AMA approved policies that would improve, adequately fund, and raise enrollment of SCHIP—a valuable safety net of care for America's children. It's because of SCHIP that millions of kids can see the doctor when they're sick and get routine check-ups, hearing and vision screenings, and prescription drugs, so it's critical that this important program be reauthorized.
The problem is that lawmakers have yet to decide how to pay for the 8 to 9 million children the program will protect, including the 2 million who currently are eligible for SCHIP but not enrolled. The solution? Raising federal tobacco taxes, a move the AMA and more than 60 diverse stakeholders in health care are urging Congress to make.
Considering what we know about the dangers of smoking, this makes perfect sense. Smoking remains the No. 1 preventable cause of death in the U.S., killing roughly 1,200 Americans every day. Each year tobacco use is responsible for almost $90 billion in U.S. health care expenditures. Every day, 4,000 children start smoking—and 1,500 become daily smokers. Meanwhile, studies show that for every 10 percent increase in the price of cigarettes, youth smoking is reduced by 7 percent, and overall consumption by 4 percent. A tobacco tax increase would act as a deterrent to both young and potential smokers.>>Read more
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eVoice®
July 12, 2007
AMA eVoice is your regular update on the most important health care issues and recent AMA activities.
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Faculty practice physician issues
1) In AMNews: New medical school seeks funding for first class of medical students
2) In AMNews: President Bush vetoes stem cell bill
Gay, lesbian, bisexual, transgender physician issues
1) AMA welcomes new members of AMA Advisory Committee on GLBT Issues
2) Gay and Lesbian Medical Association and the National Center for Transgender Equality acknowledge AMA's adoption of transgender nondiscrimination policies
3) Study notes neurosyphilis' re-emergence among HIV-positive gay, bisexual men
Group practice physician issues
1) Earn CME credit for July AMA audio conference on insurance business practices
2) AMA Group Practice Advisory Committee hosts lively meeting
International medical graduate issues
1) Successful AMA-IMG Section leadership focus group held
2) Trust in patient-physician relationship is focus of new online video
Medical school news
1) AMA-SMS member to receive the AMA 2007 Distinguished Service Award
2) July issue of Virtual Mentor focuses on physician accountability
3) In AMNews: New medical school wants to give first class free tuition
Medical student issues
1) Apply to serve on 2007–2008 AMA-MSS Standing Committees
2) Meet your 2007–2008 AMA-MSS Governing Council
3) July issue of Virtual Mentor now available
4) Chapter Project of the Week: Morehouse School of Medicine's Doctors Back to School
Minority health issues and professional concerns
of minority physicians
1) In JAMA: Minority youth and incidence of type 2 diabetes
2) In AMNews: Expert panel gives very heavy children a new label
3) Trust in patient-physician relationship is focus of new online video
Organized medical staff issues
1) CMS, AMA, others develop tools for Physician Quality Reporting Initiative
2) It's Hawaii—plan now to attend 2007 Interim AMA-OMSS Assembly
3) AMA Litigation Center provides update on medical staff–related cases
4) AMA president shares his perspective on Michael Moore film
Resident and fellow issues
1) Call for abstracts for fourth annual AMA-RFS Research Poster Symposium
2) Resident physicians can receive free AMA PRA certificate
3) Better protection and education can reduce needlestick injuries
Women physician and women's health issues
1) In AMNews: A "silent" cancer speaks with four symptoms
2) Mark your calendar: Attend the WIO Leadership Summit
Young physician issues
1) Young physicians elected to lead AMA-WPC and AMA-MAC
2) Apply for AMA Foundation public health grants by July 16
3) Sign up for group and faculty practice educational series on practice management
General
AMA news:
1) AMA makes House Call to Oregon on Medicare physician payment
2) Ethics in brief: To quarantine or not?
3) New AMA resources explain Medicare Advantage plans
4) Legislation would foster workplace wellness programs
5) Virtual Mentor examines the rise in physician accountability
6) In JAMA: Prophylactic antibiotic treatment for children with initial urinary tract infection is not associated with reduced risk of recurrence
Your news interests
Sign up to receive customized
AMA eVoice messages.
Faculty practice physician issues
1) In AMNews: New medical school seeks funding for first class of medical students
Construction of a new medical campus for the University of Central Florida is now under way, along with a public campaign aimed at providing funding for free tuition to the incoming class of 40 students. School administrators are looking to raise $6.4 million to help in this effort. Although recruiting for students has not begun yet, the school hopes to eventually increase its enrollment to 120 students. The school's appeal is not only to offer medical students an opportunity to graduate debt free, but also to attract high-achieving students to the new school. The medical school is looking to hire up to 25 faculty members by year's end.
View the July 9 American Medical News (AMNews) article.
2) In AMNews: President Bush vetoes stem cell bill
According to the July 9 issue of American Medical News (AMNews), President George W. Bush vetoed the Stem Cell Enhancement Act of 2007 on June 20. The bill would have ended his ban for using federal funding for research on new human embryonic stem cell lines that had been in place since 2001. President Bush has also issued an executive order, instructing the U.S. Department of Health and Human Services' secretary to develop a plan to support research using alternative methods of deriving pluripotent stem cell lines. Although polls indicate that American scientists would likely support human embryonic stem cell research, it has often raised moral concerns among some. Depending on how the question is phrased in polls, public support of embryonic stem cell has wavered consistently.
>>Return to your news interest contents
Gay, lesbian, bisexual, transgender physician issues
1) AMA welcomes new members of AMA Advisory Committee on GLBT Issues
Members of the 2007–2008 AMA Advisory Committee on GLBT Issues began their term upon the completion of the 2007 Annual Meeting.
Visit the Web site for a list of committee members.
2) Gay and Lesbian Medical Association and the National Center for Transgender Equality acknowledge AMA's adoption of transgender nondiscrimination policies
The AMA amended its nondiscrimination policies to include transgender persons at the Annual Meeting of the AMA House of Delegates in Chicago, which ended June 27. The comprehensive change in policy affects all aspects of the functioning of the AMA, including relations with patients, employment issues and insurance coverage. It also will affect accreditation of medical schools.
Read the July 5 article from the Bay Area Reporter, acknowledging the AMA's adoption of transgender nondiscrimination policies.
3) Study notes neurosyphilis' re-emergence among HIV-positive gay, bisexual men
According to a study from the Centers for Disease Control and Prevention's June 29 Morbidity and Mortality Weekly Report, men who are human immunodeficiency virus (HIV) positive and have sex with other men have shown an increase in syphilis cases during the past five years. The study found that, if left untreated, these specific cases lead to mental confusion, blurred vision, difficulty walking or other serious neurological complications in about one in 50 HIV-positive men. Furthermore, the study showed that one in 200 persons who develop neurosyphilis symptoms continue to have complications even six months after treatment. "Neurosyphillis essentially disappeared in the United States after the introduction of penicillin treatment for syphilis in the late 1940s but reappeared in the 1980s among persons with HIV infection," according to the report.
>>Return to your news interest contents
Group practice physician issues
1) Earn CME credit for July AMA audio conference on insurance business practices
The AMA will host an audio conference, "Don't give your discounts away: The unregulated secondary discount market," to educate physicians and administrators on little-known health plan payer business practices in the secondary discount market.
The presenter, Tammy Banks—from the AMA Private Sector Advocacy unit—will discuss the AMA's advocacy initiatives currently under way to address these practices and will provide examples on how to identify basic tools to prevent and uncover inappropriate leasing of the physician's discount. The program is scheduled at 1 p.m. CDT July 26. Upon completion of the program, participants will be able to:
- Describe the secondary discount market and the impact of this market on the physician practice and the patient.
- Locate and hold accountable rental network preferred provider organizations (PPOs) to their contract previsions.
- Distinguish between the roles of the rental network PPO, data integrator, repricer and payer in the secondary discount market.
Visit the Web site to register. Registration for AMA members is $35 ($75 for nonmembers) and includes 1.5 AMA PRA Category 1 Credits™.
Send an e-mail or call (312) 464-5523 with any questions.
2) AMA Group Practice Advisory Committee hosts lively meeting
The AMA Advisory Committee on Group Practice Physicians met June 22 to discuss a wide variety of issues with a focus on pay for performance. Committee member Jeffrey Levin-Scherz, MD, provided an update on tiered networks, and Michael Kitchell, MD, another committee member, presented an update on his recent attendance at the meeting of the Physician Consortium for Performance Improvement®. The committee also hosted a working lunch in collaboration with the Mayo Health Policy Center, including Mayo Clinic President and Chief Executive Officer Denis Cortese, MD. Committee members Don Chaplin, MD, Jon Christofersen, MD, Norman Chenven, MD, and Ben Knecht, MD, completed their service on the committee and were recognized for their contributions.
The committee sponsored an educational program on the Centers for Medicare & Medicaid Services' (CMS) new Physician Quality Reporting Initiative as it relates to group practices. Keynote speakers included CMS' Thomas Valuck, MD, followed by a reaction panel consisting of Henry Ford Health System Chair and Chief Executive Officer Mark Kelley, MD, and North Ohio Heart Center's John Schaeffer, MD. More than 100 group practice physicians attended.
Learn more about the committee and AMA group practice activities.
>>Return to your news interest contents
International medical graduate issues
1) Successful AMA-IMG Section leadership focus group held
On June 23, an AMA-IMG Section leadership focus group convened to mentor and educate international medical graduate physicians interested in pursuing leadership positions. Physicians leaders, including AMA President-elect Nancy Nielsen, MD, PhD, California Medical Association President and Fremont Surgery Center Medical Director Anmol Mahal, MD, former AMA-IMG Section Chair and Council on Legislation member AppaRao Mukkamala, MD, and Chicago Physicians Associates' Shastri Swaminathan, MD, were among the physicians who shared their insights and wisdom with attendees.
2) 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.
>>Return to your news interest content
Medical school news
(Brought to you by the AMA Section on Medical Schools)
1) AMA-SMS member to receive the AMA 2007 Distinguished Service Award
At the recent AMA Annual Meeting, the AMA House of Delegates approved the AMA Board of Trustees nomination of Richard Allen, MD, AMA-SMS member and past chair of the AMA Council on Medical Education, as the recipient of the 2007 Distinguished Service Award. Dr. Allen will be presented the award at the AMA Interim Meeting in Hawaii.
Dr. Allen is an assistant dean for graduate medical education and adjunct professor at the Department of Obstetrics and Gynecology, Oregon Health and Science University School of Medicine. He distinguished himself in regard to graduate and postgraduate medical education and helped revolutionize the criteria by which physicians are evaluated, emphasizing the need to focus on professionalism, ethics and lifelong learning. Dr. Allen is currently leading efforts in re-entry education for physicians who have left the work force or a part of the work force and now want to return to their practices.
Congratulations to Dr. Allen for this well-deserved honor.
2) July issue of Virtual Mentor focuses on physician accountability
The latest issue of Virtual Mentor, the AMA online journal of ethics, investigates the principles and professional initiatives—proposed and in place—to assess physicians' day-to-day competence and judgment. These range from full-informed consent and second opinions to use of evidence-based practices, pay for performance and retrospective audits of charts. The op-ed writer asks, "Is it fair to expect doctors to practice what they preach?"
3) In AMNews: New medical school wants to give first class free tuition
The University of Central Florida is trying to raise $6.4 million to provide scholarships for its initial class of 40 students, according to an article in the July 9 issue of American Medical News (AMNews). The scholarships will cover the students' annual tuition bill as well as living expenses.
>>Return to your news interest contents
Medical student issues
1) Apply to serve on 2007–2008 AMA-MSS Standing Committees
Are you interested in getting more involved in the AMA-MSS or working with a group of like-minded individuals for a cause you care strongly about? Then you may be interested in serving on AMA-MSS Standing Committees, serving as the work force of the AMA-MSS. They produce reports, letters and educational materials, help coordinate programs, and work to advance the advocacy agenda of the section. Standing Committee members serve one-year terms, and most communication is done via e-mail and phone. AMA-MSS Standing Committees include Community Service, Long Range Planning, Membership Recruitment and Retention, Legislation and Advocacy, Minority Issues, Scientific Issues, International Health and Policy, Medical Ethics, Medical Education and Public Health. Additionally, this year the AMA-MSS transformed the House of Delegates Coordinating Committee into an AMA-MSS Standing Committee.
Learn more about each AMA-MSS Standing Committee and apply. Applications are due July 16.
Please contact Rana Yehia, AMA-MSS Governing Council Chair, by e-mail or call (352) 682-5710 with questions or concerns.
2) Meet your 2007–2008 AMA-MSS Governing Council
The 2007–2008 AMA-MSS Governing Council was elected at the 2007 AMA-MSS Annual Meeting:
- Mark Pascua, Thomas Jefferson University, Jefferson Medical College, vice chair
- Justin Mistovich, Wright State University Boonshoft School of Medicine, delegate
- Peter Ragusa, Medical School at the University of Minnesota, alternate delegate
- Meltem Zeytinoglu, Indiana University School of Medicine, at-large officer
- Kristie Appelgren, Medical University of South Carolina, speaker
- Laura Gephart, Loma Linda University School of Medicine, vice speaker
- Rana Yehia, University of Florida College of Medicine, elected as chair-elect at the 2006 AMA-MSS Interim Meeting and is now the AMA-MSS Governing Council chair
Learn more about the new AMA-MSS Governing Council members and the duties of each position.
Access the Governing Council Action Form, or contact the AMA-MSS Governing Council by e-mail with subject line, "Question for Governing Council," to relay any questions or concerns.
3) July issue of Virtual Mentor now available
State licensing boards and the legal justice system protect the medical profession and the public from patently bad doctors. But, short of egregious misconduct or malpractice, how do we hold physicians accountable for, say, rudeness or encouraging patients to undergo optional surgery? The July issue of Virtual Mentor tackles this question by investigating the principles and professional initiatives—proposed and in place—to assess physicians' day-to-day competence and judgment. These range from full-informed consent and second opinions to use of evidence-based practices, pay for performance and retrospective audits of charts. The op-ed writer asks, "Is it fair to expect doctors to practice what they preach?"
4) Chapter Project of the Week: Morehouse School of Medicine's Doctors Back to School
In conjunction with the AMA Minority Affairs Consortium, Morehouse School of Medicine's AMA-MSS chapter is instituting the second installment of its Doctors Back to School program—a program that aims to raise awareness of the need for more minority physicians and to encourage children from underrepresented minority groups to look at medicine as a career option. Through Doctors Back to School, physicians and medical students across the country visit schools and community organizations to help young minority children realize they, too, can follow the same path. With support from a local YMCA, the Morehouse AMA-MSS chapter will conduct daily workshops for children attending YMCA summer camps. In addition to teaching campers basic facts about anatomy and physiology, medical students will introduce campers to the endless list of careers in the health sciences and will offer campers "career counseling."
This project was funded by an AMA-MSS chapter involvement grant (CIG). CIGs are available to AMA-MSS chapters 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.
Apply for a CIG.
>>Return to your news interest contents
Minority health issues and professional concerns of minority physicians
(brought to you by the AMA Minority Affairs Consortium)
1) In JAMA: Minority youth and incidence of type 2 diabetes
According to a study in the June 27 issue of the Journal of the American Medical Association (JAMA), non-Hispanic, white youth have the highest rate of diabetes of all racial/ethnic groups for children in the United States. The study also notes that type 2 diabetes mellitus was relatively infrequent, but the highest rates were documented among 15- to 19-year-old minority groups, including American Indian youth, followed by African American, Asian-Pacific Islander and Hispanic youth.
View the news release.
2) In AMNews: Expert panel gives very heavy children a new label
In early June the Expert Committee on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity released recommendations that include labeling children whose size puts them at or above the 95th percentile on the pediatric growth charts, or who have a body mass index higher than 30, as obese. This committee was first convened in 2005 by the AMA, the Health Resources and Service Administration, and the Centers for Disease Control and Prevention and includes representatives from 15 medical societies.
Read more about the recommendations in the July 9 American Medical News (AMNews) article.
3) 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.
>>Return to your news interest contents
Organized medical staff issues
1) CMS, AMA, others develop tools for Physician Quality Reporting Initiative
On July 1, the Centers for Medicare & Medicaid Services (CMS) launched the Physician Quality Reporting Initiative (PQRI)—a voluntary reporting program that encourages quality improvement through the use of clinical performance measures on a variety of clinical conditions. Physicians and other eligible professionals who successfully report on a designated set of quality measures through claims submitted for services provided from July 1 to Dec. 31, 2007, may earn a bonus payment, subject to a cap, of 1.5 percent of total allowed charges for covered Medicare physician fee schedule services.
Carefully review the PQRI instructions and frequently asked questions if you are considering participating in the program.
A set of tools has been developed to assist those participating in the program. The tools will help physicians select measures, establish links to background information on quality measures—including both the rationale and evidence base for each measure—and collect data required to report clinical performance data.
2) It's Hawaii—plan now to attend 2007 Interim AMA-OMSS Assembly
It's not too early to make plans to attend the 50th AMA-OMSS Assembly in Honolulu, Nov. 8–11. Mark you calendar and reserve a room at the Hilton Hawaiian Village Hotel.
Reserve a room.
The deadline for resolutions is Sept. 28. Learn more about the development and submission of resolutions. Send an e-mail with all resolution submissions.
3) AMA Litigation Center provides update on medical staff–related cases
The AMA has prepared a summary of cases involving medical staff issues in which the AMA Litigation Center has been involved during the last six months.
View a summary of cases (PDF, 47KB, requires Adobe® Reader®).
4) AMA president shares his perspective on Michael Moore film
In case you missed last week's "From the president" column, AMA President Ronald M. Davis, MD, gave AMA eVoice readers his take on the new Michael Moore film Sicko. "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," writes Dr. Davis. "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."
>>Return to your news interest contents
Resident and fellow issues
1) Call for abstracts for fourth annual AMA-RFS Research Poster Symposium
The AMA-RFS is currently accepting abstract submissions for the fourth annual AMA-RFS Research Poster Symposium. The categories for submission are basic science research, clinical medical research, public health/health policy/medical education, and clinical vignettes. The accepted abstracts will be presented as posters at the AMA-RFS Interim Meeting in Honolulu. The AMA-RFS is also accepting applications for the poster symposium committee.
Visit the Web site to obtain an application and learn more about the symposium and submitting abstracts.
2) Resident physicians can receive free AMA PRA certificate
AMA resident members who have completed one, two or three years of residency can receive an AMA Physician's Recognition Award (PRA) certificate at no charge as a benefit of AMA membership ($58 for nonmembers). The certificate is accepted by many state licensing boards, hospitals and other professional medical organizations as evidence of meeting continuing medical education (CME) requirements. Thirty-eight states and territories accept the PRA certificate in lieu of CME requirements for your license registration.
Download an application (PDF, 600KB, requires Adobe® Reader®).
3) Better protection and education can reduce needlestick injuries
A study in the June 28 issue of the New England Journal of Medicine found that 582 of almost 700 surgeons-in-training at 17 U.S. medical centers had experienced a needlestick injury; some involving high-risk patients with hepatitis or human immunodeficiency virus (HIV). Of the 578 most recent incidents, 297 cases had not been reported to an employee health service. Using safer equipment, mandatory checklists, and providing appropriate and timely surgical systems can help address the problem.
View the July 9 HealthDay article.
>>Return to your news interest contents
Women physician and women's health issues
(brought to you by the AMA Women Physicians Congress)
1) In AMNews: A "silent" cancer speaks with four symptoms
An article in the July 9 issue of American Medical News (AMNews) reports on a June 13 consensus statement by the American Cancer Society, the Society of Gynecologic Oncologists and the Gynecologic Cancer Foundation, indicating that the presence of a cluster of symptoms can serve as an early warning sign for ovarian cancer which begins deep within the pelvis. The symptoms include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and a frequent or urgent need to urinate.
2) Mark your calendar: Attend the WIO Leadership Summit
All AMA-WPC members are invited to attend the Women in Ophthalmology (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) Young physicians elected to lead AMA-WPC and AMA-MAC
During the 2007 AMA Annual meeting, several young physician members were named as leaders of the AMA Women Physicians Congress (WPC) and the AMA Minority Affairs Consortium (MAC).
Jolie Holschen, MD, an emergency physician from Michigan, was elected as the vice chair of the AMA-WPC Governing Council. Physician Erin Tracy, MD, will continue to chair the AMA-WPC Governing Council for the coming year.
Ada Stewart, MD, a family medicine physician from South Carolina, was elected as the vice chair of the AMA-MAC Governing Council. Physician Diana Ramos, MD, will continue to serve as chair of the AMA-MAC for the coming year.
2) Apply for AMA Foundation public health grants by July 16
Individuals and organizations are eligible to apply for grants which further the charitable and educational purposes of the AMA Foundation. Grants made in 2007 will support programs addressing three public health issues: healthy lifestyles, public and patient safety, and the uninsured/underinsured. A maximum of $2,000 will be distributed to each grant recipient.
>>Learn
more and apply
Applications are due July 16.
3) Sign up for group and faculty practice educational series on practice management
The AMA will host an audio conference, "Don't give your discounts away: The unregulated secondary discount market," on July 26.
Health plan payers utilize a number of payment reduction strategies, ranging from relatively straightforward methods to extremely complicated transactions that involve several layers of entities. In many instances, there are intermediaries that are completely unknown to the physicians but, nevertheless, take a slice of the physicians' reimbursement.
These practices, coupled with a "take it or leave it" stance on physician contracts and refusal to disclose payment methodologies, make it nearly impossible for physicians to manage their finances. This session will educate physicians regarding health plan payer business practices that includes the use of the well-established secondary discount market and also discuss the AMA's advocacy initiatives that are currently underway to address these practices.
The registration fee for AMA members is $35 ($75 for nonmembers) and includes 1.5 AMA PRA Category 1 Credits™. Registration will be accepted through July 24.
Register now.
>>Return to your news interest contents
General AMA news
1) AMA makes House Call to Oregon on Medicare physician payment
With more than half a million Medicare patients in Oregon, the AMA National House Call campaign visited Portland and Salem this week in an effort to stop looming cuts in Medicare physician payments. The National House Call is a series of coordinated local publicity activities in states around the country to draw public attention to Medicare physician payment and urge Congress to stop the cuts.
AMA House of Delegates Speaker Jeremy A. Lazarus, MD, joined Oregon Medical Association (OMA) President Klaus Martin, MD, and OMA President-elect Monica Wehby to draw attention to the state’s dwindling access to its below-average physician-to-population ratio—with just 19 practicing physicians per 1,000 Medicare beneficiaries. Together, the AMA and OMA are urging patients to contact Oregon’s congressional delegation to stop the Medicare physician payment cuts and provide physicians with a payment update in line with increases in the costs of caring for patients. Dr. Lazarus also pointed to results of a recent AMA Member Connect® Survey that showed 60 percent of physicians will be forced to limit new Medicare patients if the government cuts Medicare physician payments 10 percent next year. The day included a news conference and visits with editorial boards of local newspapers.
The Oregon visit marked the third AMA National House Call this year, with AMA representatives carrying the message to Arkansas and Utah last month. The campaign will visit Maine and Minnesota next week.
>>Return to your general news contents
2) Ethics in brief: To quarantine or not?
Recently, a man from Atlanta with drug-resistant tuberculosis (TB) created a national stir when he boarded a plane bound for Europe and then five more international flights, potentially exposing many fellow passengers to this serious and sometimes fatal infection. The patient is now in isolation, but his travels have raised questions about using quarantine to protect public health.
Quarantine—separating healthy people who might have been exposed to an infectious disease from the larger population—is a rarely used public health tool. It presents two conflicting obligations of physicians: respect for patients’ personal liberties and protecting the public health. So, when should quarantine be used?
For the airline passengers traveling with the Atlanta man, quarantine is not warranted. TB, including the drug-resistant variety, is not highly transmissible unless the infected person has respiratory symptoms, and the patient did not, so the passengers’ risk of infection is very low. Moreover, if any of the airline passengers were exposed to the TB mycobacterium, they would not be infectious in the short term, so they pose no immediate risk to the population while they are being tested for TB. However, when an infectious disease, such as SARS, has the possibility of spreading easily and has a high mortality rate, some types of quarantine might be appropriate. From a public health standpoint, the danger that potentially infected individuals might present to the public can outweigh their rights to move freely among the population. At the same time, physicians must always keep in mind that people in quarantine are patients, not criminals, so the least restrictive means of quarantine should be used.
As part of its online video series Educating Physicians on Controversies and Challenges in Health, the AMA produced “Physicians on the front line: Quarantine as public health strategy.” View the brief video.
Read AMA ethics policy related to this issue (PDF, 31KB, Adobe® Reader®).
>>Return to your general news contents
3) New AMA resources explain Medicare Advantage plans
With the number of Medicare Advantage patients growing each year, it is important for physicians to understand the specifics of these plans, how they are funded and how they pay physicians.
The AMA has posted two new educational brochures on its Web site to help educate physicians about Medicare Advantage plans. Established by the Medicare Modernization Act of 2003, Medicare Advantage Special Needs Plans (SNP) exclusively or disproportionately enroll a select patient population which may include institutionalized, dual-eligible or chronically ill beneficiaries—as detailed in the “Medicare Advantage: Special needs plans” brochure. The brochure also provides basic information on the risk-adjusted payment methodology used in calculating SNP funding and how this methodology may affect physicians treating SNP enrollees.
The “Medicare Advantage: Health plan funding and physician reimbursement” brochure provides information on how insurer payment is determined, explains the differences in physician reimbursement under Medicare Advantage versus the traditional Medicare program, and contains reimbursement information regarding the different types of Medicare Advantage plans—including common terminology used and what actions can be taken for claims that have been inappropriately denied, down-coded or bundled by the insurer.
Members can visit the Web site to download copies of the brochures. Send an e-mail or call (312) 464-4367 to request hard copies.
>>Return to your general news contents
4) Legislation would foster workplace wellness programs
The AMA applauded the introduction of bipartisan legislation this week to improve employee health through workplace wellness programs that promote health education and healthy lifestyles.
At a news conference on Capitol Hill, AMA President Ronald M. Davis, MD, voiced the AMA’s strong support of the new Healthy Workforce Act of 2007. The bill, sponsored by Sens. Tom Harkin, D-Iowa, and Gordon Smith, R-Oregon, would encourage businesses to provide more opportunities to keep their employees healthy and would offer a tax credit to qualified businesses that provide workplace wellness programs.
“Hardworking Americans often miss out on the preventive health care they need,” said Dr. Davis. “The AMA is committed to keeping Americans healthy, and improving employee access to wellness programs will help us better fulfill this goal.”
Read a news release from Sen. Harkin about the legislation.
>>Return to your general news contents
5) Virtual Mentor examines the rise in physician accountability
The July issue of Virtual Mentor, the AMA’s online ethics journal, examines the gradually changing role of physicians in society and how these changes may have an effect on physicians’ responses based on their own limitations, biases and conflicts of interest.
This issue covers such topics as making decisions about whether surgery is necessary now, assessing physician performance by objective measures and competing for physicians’ attention after hours. Other subjects include state medical boards’ attempts to censure physician communication styles, accountability via chart audits, and the diagnosis and treatment of viral meningitis.
>>Return to your general news contents
6) In JAMA: Prophylactic antibiotic treatment for children with initial urinary tract infection is not associated with reduced risk of recurrence
The use of prophylactic antibiotics, which involves daily administration of antibiotics to children after an initial urinary tract infection, is not associated with reduced risk of recurrent urinary tract infections, but is associated with an increased risk of resistant infections, according to a study in the July 11 issue of the Journal of the American Medical Association (JAMA).
>>Return to your general news contents
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