Ronald M. Davis, MD
CHAMP Act wins House approval
The U.S. House of Representatives passed an important piece of legislation yesterday that—if it becomes law—would have a significant impact on access to care for millions of America's children and seniors.
This bipartisan bill—the Children's Health and Medicare Protection (CHAMP) Act—would reauthorize the State Children's Health Insurance Program (SCHIP) and provide increased funding for health insurance coverage for children of low–income families. It also would replace two years of cuts in Medicare physician payments, including a 10 percent cut scheduled for 2008, with two years of positive updates. I'd like to thank all those who contacted their U.S. representatives urging them to vote for this bill.
The funding mechanism attached to this legislation is one the AMA has been advocating for the past few months—an increase in federal tobacco taxes, which would have the additional benefit of decreasing smoking. The bill also calls for reducing excess payments to insurance companies, thereby establishing a level playing field between the traditional (fee–for–service) Medicare program and private Medicare Advantage plans. In support of this legislation, the AMA launched a major advertising campaign that included Internet ads, e–mails, letters, phone calls and direct mail brochures in an effort to reach tens of thousands of physicians and patients across the country.>>Read more
Please send comments, questions, and replies to amaprez@ama-assn.org
eVoice®
August 2, 2007
AMA eVoice is your regular update on the most important health care issues and recent AMA activities.
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Your news interests
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Faculty practice physician issues
1) Medical students can get involved through the AMA
2) Intel chairman addresses chronic care summit
Group practice physician issues
1) Register for AMA audio conference on hiring and retaining top–performing employees
2) In AMNews: Google plans health care advisory group
International medical graduate issues
1) Mark your calendar: AMA–IMG Section resolution deadline Sept. 28
Medical school news
1) AMA–SMS adds new faculty membership category to its bylaws
2) Coalition releases recommendations on disaster preparedness
3) Commonwealth Fund report assesses health reform proposals
Medical student issues
1) Special travel and hotel rates offered for 2007 AMA–MSS Interim Meeting
2) Mark your calendar: 2007 AMA–MSS Interim Meeting deadlines
3) NASA thanks physicians for support
Minority health issues and professional concerns of minority physicians
1) In AMNews: Racial fatigue—minority doctors feeling the pressure
News for senior physicians
1) ) Just launched: News for senior physicians in AMA eVoice
Organized medical staff issues
1) Study suggests that poor health literacy increases risk of death
2) AMA–OMSS to provide new online “announcement” listserv, message board
3) It's Hawaii—plan now to attend 2007 AMA–OMSS Assembly Interim Meeting
Resident and fellow issues
1) Represent resident and fellow physicians in the AMA House of Delegates
2) Become a leader on the AMA–RFS Governing Council
3) Clinical faculty look at resident work-hour reductions
Women physician and women's health issues
1) In JAMA: Diet high in fruit, vegetables and fiber doesn't necessarily reduce risk of breast cancer recurrence
2) Mark your calendar: Mentor recognition program nominations due Sept. 1
Young physician issues
1) Speak with your AMA–YPS leaders
2) Make reservations for 2007 AMA–YPS Assembly Interim Meeting, Nov. 9–10
3) Be "in the know" when it comes to legislative issues
General AMA news:
1) Aetna ordered to cease unfair limitation of Medicare payments
2) Ethics in brief: Once a doctor, always a doctor
3) News for senior physicians now included in AMA eVoice
4) Free clinics awarded funding to help the 45 million uninsured
5) On Sermo: Expert witnesses, fee schedules, irony and more
6) In JAMA: Rates of child maltreatment in enlisted soldiers’ families are greater during combat–related deployments
Your news interests
Sign up to receive customized AMA eVoice messages.
Faculty practice physician issues
1) Medical students can get involved through the AMA
The AMA offers scholarship, internship/fellowship, award, grant and leadership opportunities for medical students. Educational opportunities through the AMA can be as diverse as serving as a medical editor for the Journal of the American Medical Association to spending a year as a paid staff member in the Washington, D.C., office. Scholarships are also available to cover the cost of tuition.
Learn more about various opportunities offered to medical students through the AMA.
2) Intel chairman addresses chronic care summit
Intel Chairman Craig Barrett addressed a summit on chronic care in July—Chronic Care at the Crossroads: Exploring Solutions for Chronic Care Management—and acknowledged that technology has not been fully embraced in reforming the current health care system. At the conference, Barrett discussed his view that customers need to demand change from health care and to have electronic medical record technology enacted more quickly. The summit included speakers from several industries, including physicians, insurers, researchers and family caregivers. According to an article in Healthcare IT News, Barrett sees health care focusing on acute care more than preventive care.
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Group practice physician issues
1) Register for AMA audio conference on hiring and retaining top–performing employees
The AMA will host an Oct. 4 audio conference, titled "Hiring and retaining top–performing employees for better customer service and patient care." The session covers topics, such as assessing the impact of having the right staff, interviewing to hire the best talent, keeping good people after they are hired, and maintaining harmony and discipline. Registration for AMA members is $35 ($75 for nonmembers).
Visit the Web site to learn more, register or order previously recorded audio conferences. This program is geared toward practice managers in small– to medium–sized group practices. Featured faculty are from the Coker Group, a nationally recognized consulting firm specializing in practice management.
2) In AMNews: Google plans health care advisory group
Internet giant Google is forming a committee of health care leaders to "help us better understand the problems consumers and providers face every day and offer feedback on product ideas and development," per an article in the July 23/30 issue of American Medical News (AMNews). Google is focusing its Internet–based health care system as a resource—meeting the needs of both patients and physicians. Google’s latest health care venture could affect the health system itself, based on its Web–based software ventures advocating for personal health care records. AMA Chief Operating Officer Bernie Hengesbaugh will serve on the council. Along with physicians, representatives will include organized medicine representatives, medical executives and nonprofit leaders.
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International medical graduate issues
1) Mark your calendar: AMA–IMG Section resolution deadline Sept. 28
Resolutions for the 2007 AMA–IMG Section Interim Meeting are due Sept. 28. The section's events will be held in conjunction with the 2007 Interim Meeting of the AMA House of Delegates in Honolulu, Nov. 10–13.
Learn more about resolution–writing guidelines.
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Medical school news
(Brought to you by the AMA Section on Medical Schools)
1) AMA–SMS adds new faculty membership category to its bylaws
The AMA–SMS bylaws were recently amended to add a new membership category by which any AMA member who designates himself or herself as having a faculty appointment (full–time, part–time or volunteer) at a medical school accredited by the Liaison Committee on Medical Education or the American Osteopathic Association would be eligible to join the AMA–SMS. Tell your colleagues about this unique opportunity for faculty to have a voice in the AMA House of Delegates deliberations and to discuss and develop policies on medical education and national research and health care issues.
Send an e–mail with all faculty appointment letters if interested. Questions can be directed to Jackie Drake by calling (312) 464-4389.
2) Coalition releases recommendations on disaster preparedness
A coalition of 18 health organizations led by the AMA and American Public Health Association (APHA) released a consensus report with 53 strategic recommendations for legislators, government officials and organizational leaders to more effectively prepare for and respond to catastrophic emergencies. >>Learn more
3) Commonwealth Fund report assesses health reform proposals
A new Commonwealth Fund analysis of major health reform bills before Congress concludes that while several could lead to significant improvements in quality and efficiency, each falls well short of a comprehensive strategy for overhauling the nation's health care system.
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Medical student issues
1) Special travel and hotel rates offered for 2007 AMA–MSS Interim Meeting
The 2007 AMA–MSS Interim Meeting will be held Nov. 8–10 in Honolulu. The AMA has reserved a block of rooms at a discounted rate for AMA–MSS Interim Meeting attendees at the Doubletree Alana Hotel–Waikiki. A special room rate will be available until Oct. 7 or until the group block is sold out.
Visit the Web site to learn more and reserve your room.
The AMA also has teamed up with United Airlines to offer 2007 AMA–MSS Interim Meeting attendees a 10 percent discount (and an extra 5 percent discount if you make your reservation at least 30 days in advance).
Visit the Web site to learn more and make your reservation.
2) Mark your calendar: 2007 AMA–MSS Interim Meeting deadlines
The 2007 AMA–MSS Interim Meeting will be held Nov. 8–10 at the Hawaii Convention Center, Honolulu. Please join us for an exciting meeting, including policymaking sessions, educational sessions, a research poster session and more. The AMA–MSS is planning programs for this meeting and would like your ideas.
Visit the Web site to obtain an online form and submit your ideas.
Please keep the following deadlines in mind:
- Sept. 7—Convention committee applications due
- Sept. 21—Resolution submissions due
- Sept. 21—AMA–MSS Research Poster Symposium abstracts due
- Oct. 1—Meeting registration due
- Oct. 1—AMA Board of Trustees/chair–elect applications due
- Oct. 1—Regional delegate applications due
Visit the Web site to learn more about the meeting and obtain applications.
3) NASA thanks physicians for support
The National Aeronautics and Space Administration (NASA) thanked the AMA for its support of human space travel. Resolution 502, "AMA Support for manned space exploration of the moon and Mars that will promote medical advances and enhance patient care," was introduced by the AMA–MSS and adopted as amended at the AMA Annual Meeting in June.
View NASA’s July 17 press release.
Learn more about how to submit a resolution for the AMA–MSS.
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Minority health issues and professional concerns of minority physicians
(brought to you by the AMA Minority Affairs Consortium)
1) In AMNews: Racial fatigue—minority doctors feeling the pressure
The July 23/30 issue of American Medical News (AMNews) explores the topic of "racial fatigue," or racism, experienced by many minority doctors.
View the AMNews article and learn more about how racial fatigue can undermine careers and erode job satisfaction.
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News for Senior Physicians
1) Just launched: News for senior physicians in AMA eVoice
As a senior physician, you are now subscribed to receive news for senior physicians as part of your AMA eVoice, the electronic update you receive from the AMA each week. This new category of news includes the latest opportunities for involvement in the AMA, as well as resources surrounding volunteerism, travel, financial issues and more. Learn more about the AMA Senior Physicians Group 50–year recognition program, how to prepare for a carefree retirement and updates on AMA advocacy surrounding liability laws that affect volunteer doctors.
If you'd prefer not to receive these updates as part of your customized AMA eVoice, simply visit (insert link to subscribe to sections of eVoice) to update your news choices.
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Organized medical staff issues
1) Study suggests that poor health literacy increases risk of death
Last week, several municipal publications reported that a study published in the Archives of Internal Medicine showed that "patients 65 and older who could not understand basic written medical instructions were much more likely to die within six years than those who had no problems grasping the information. The difference in the death rates remained substantial even when researchers considered differences in the patients' health at the outset." The study involved 3,260 Medicare beneficiaries from managed–care plans in Cleveland, Houston, Tampa, Fla., and Fort Lauderdale, Fla./Miami. Each participant was asked to partake in a face–to–face home interview in 1997. Over the six–year period that followed, 815 participants died.
Learn more about the AMA's efforts to improve health literacy.
2) AMA–OMSS to provide new online "announcement" listserv, message board
Coming soon is a new listserv and online forum/message board for the AMA–OMSS for participants to weigh in on issues of interest and priority to the section. Because users will be notified through the listserv when new issues and/or documents for discussion are posted to the message board, one must be subscribed to the listserv to participate. Initial issues for discussion and feedback include a credentialing survey, principles for strengthening the physician–hospital relationship, and Joint Commission Standard MS.1.20.
All AMA eVoice subscribers will soon be given an opportunity to subscribe to this service.
Send an e–mail with questions.
3) It's Hawaii—plan now to attend 2007 AMA–OMSS Assembly Interim Meeting
It's not too early to make plans to attend the Interim Meeting of the 50th AMA–OMSS Assembly in Honolulu, Nov. 8–11. Mark your calendar and reserve a room at the Hilton Hawaiian Village, Honolulu.
Learn more about the development and submission of resolutions. The deadline for resolution submissions is Sept. 28.
Send an e–mail with all resolution submissions.
>>Return to your news interest contents
Resident and fellow issues
1) Represent resident and fellow physicians in the AMA House of Delegates
Become a leader that has a direct impact on the policies of the AMA for resident and fellow members by applying for an AMA–RFS delegate or alternate delegate position. As an AMA–RFS delegate or alternate delegate, you will caucus with your endorsing society, testify on important issues, and assist the AMA–RFS Governing Council delegate and alternate delegate with representing the voice of residents and fellows in the AMA House of Delegates. Ten sectional delegates and 10 alternate delegates will be elected for a one–year term at the AMA–RFS Assembly Interim Meeting Nov. 8–10 in Hawaii.
Obtain an application.
2) Become a leader on the AMA–RFS Governing Council
The AMA–RFS is now accepting applications for the position of AMA–RFS Governing Council chair–elect. In this position, you will learn from the current AMA–RFS Governing Council chair how to set agendas, lead governing council meetings, represent the section at outside events, and work with staff to accomplish the goals and objectives of our members and the section. Other responsibilities of chair–elect include assisting other officers in the discharge of their duties and ensuring that the transition for the governing council is fluid when you assume chair. The chair–elect has a two–year commitment—six months as chair–elect, one year as chair and six months as immediate past chair—and will be elected at the AMA–RFS Interim Assembly Meeting Nov. 8–10 in Hawaii.
Visit the Web site to download an application.
3) Clinical faculty look at resident work–hour reductions
In the July issue of the Archives of Internal Medicine, faculty members reflect on the effects of duty–hour restrictions. According to the article, while many faculty members believe that the well-being of the resident physician has improved with duty–hour restrictions, they also believe that these restrictions "correlated with a decrease in didactic teaching, bedside teaching, resident execution of procedures, resident autonomy, and overall resident education." They also believe that the “residents under the duty–hour restrictions were less accountable for their patient care and did not develop as good physician–patient relationships as unrestricted residents in years past.”
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Women physician and women's health issues
(brought to you by the AMA Women Physicians Congress)
1) In JAMA: Diet high in fruit, vegetables and fiber doesn't necessarily reduce risk of breast cancer recurrence
Women with early–stage breast cancer who adopted a diet very high in vegetables, fruit and fiber and low in fat did not have a lower risk of breast cancer recurrence compared with women who followed a diet of five or more servings a day of fruit and vegetables (the “5–A–Day” diet), according to a study in the July 18 issue of the Journal of the American Medical Association (JAMA).
2) Mark your calendar: Mentor recognition program nominations due Sept. 1
In the AMA–WPC’s first annual Physician Mentor Recognition Program, the AMA–WPC would like to recognize those who have made a difference in our professional lives. Tell the AMA–WPC about a professional colleague or teacher who had an influence on your work or career. The AMA–WPC will issue nominees a special certificate, celebrate them during September’s Women in Medicine Month and highlight their contributions through various AMA vehicles, such as AMA eVoice and the AMA Web site. In addition, the AMA–WPC will recognize your mentor through a special display at the AMA–WPC gala reception Nov. 9 at the 2007 Interim Meeting of the AMA House of Delegates at the Hilton Hawaiian Village, Honolulu.
Obtain a nomination form. Entries are due Sept. 1.
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Young physician issues
1) Speak with your AMA–YPS leaders
The AMA–YPS Governing Council seeks to facilitate greater interaction and communication between the governing council and other AMA young physician members. To that end, there will be a conference call from noon to 1 p.m. (CDT) during the section’s Aug. 4 meeting in Chicago. Young physicians are encouraged to call in and discuss their concerns, AMA priorities and AMA–YPS projects at that time.
Send an e–mail to R.S.V.P.
Members can visit the Web site to learn more.
2) Make reservations for 2007 AMA–YPS Assembly Interim Meeting, Nov. 9–10
This year's 2007 AMA–YPS Assembly Interim Meeting is scheduled for Nov. 9–10 at the Hawaii Convention Center, Honolulu, and guests will stay at the Hilton Hawaiian Village, Honolulu. The meeting will offer AMA–YPS members the opportunity to network with colleagues from across the country, attend educational sessions, and determine AMA–YPS positions on AMA House of Delegates reports and resolutions. The AMA–YPS encourages all young physician members to participate in the meeting. >>Learn more
3) Be "in the know" when it comes to legislative issues
If you're not already familiar with the AMA Grassroots Action Center, the AMA–YPS encourages you to explore it. This center includes updated analyses of various legislative issues affecting medicine, prepared e–mail template messages to modify and send to your legislator on key AMA priorities, voting records of your officials on selected health–related issues, and quick contact information for all elected officials—both federal and local. >>Learn more
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General AMA news
1) Aetna ordered to cease unfair limitation of Medicare payments
In a victory for physicians around the country and a strong message to health insurers nationwide, the New Jersey Department of Banking and Insurance (DOBI) fined Aetna Health Inc. almost $9.5 million for an attempt to pay certain out–of–network providers what it deemed a "fair" amount—125 percent of Medicare—rather than the providers' billed charges. According to the DOBI ruling, Aetna must directly pay the affected providers' billed charges, in reparation, for certain services rendered out–of–network.
The $9,457,500 total penalty is among the largest that DOBI has ever levied against a health care insurer. The penalties include:
- $650,000 for misrepresenting its obligations in letters sent to 130 providers (amounting to $5,000 per offending letter)
- $7,747,500 for not attempting, in good faith, to effectuate prompt, fair and equitable satisfaction of the claims for certain services
- $530,000 for not providing its Health Maintenance Organization members and patients the right to be free of balance billing by providers for medically necessary services that were authorized or covered
Richard J. Scott, MD, president of the Medical Society of New Jersey, credited DOBI Commissioner Steven M. Goldman for the ruling.
"DOBI's order demonstrates that [he] understands the hardships New Jersey's physicians and their patients can suffer because of the actions of health care companies," Dr. Scott said. "We commend DOBI for its response to Aetna's actions, and we appreciate the time the commissioner has taken during the year to listen to what New Jersey's physicians have to say."
Aetna has 30 days to object to DOBI's order.
Read more about the DOBI ruling (PDF, 25KB).
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2) Ethics in brief: Once a doctor, always a doctor
The U.S. surgeon general is charged with educating the public on health matters and advocating for effective health programs and activities. As a high–profile official who is appointed by the President of the United States, the surgeon general's role may present conflicts with his or her role as a physician. Recent testimony before Congress by several former surgeons general brought to light many problems faced by physicians who are pressured to make decisions that are influenced by those without the same medical training and judgment, and whose goals may be quite different from their own.
Whether the case involves politics for public servants, financial concerns for those in health–related industries, or any other non–medical considerations, physicians are still obligated to act ethically when making decisions that rely on their medical training. Recent policy adopted by the AMA House of Delegates makes this clear: "The ethical obligations of physicians are not suspended when a physician assumes a position that does not directly involve patient care."
So long as patients are affected by the decisions of a physician, the health of individuals and communities should be the physician's primary concern.
Read (Word, 67KB) the Council on Ethical and Judicial Affairs' report on physicians in administrative or other non–clinical roles.
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3) News for senior physicians now included in AMA eVoice
AMA eVoice now offers a new category of content for its readers who are retired or approaching retirement—news for senior physicians. This section of eVoice provides updates about the latest opportunities for involvement in the AMA, resources surrounding volunteerism, travel, licensure and more. Learn more about the AMA Senior Physicians Group (SPG) 50–year recognition program, how to prepare for a carefree retirement and updates on AMA advocacy surrounding liability laws that affect volunteer doctors.
Visit (Meg, insert link to subscribe to sections of eVoice) to customize your AMA eVoice to include news for senior physicians.
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4) Free clinics awarded funding to help the 45 million uninsured
Physicians are helping to address the issue of the uninsured around the country by opening free health care clinics that offer free or low cost health care services to low–income, uninsured and underinsured patients.
In an effort to support these clinics and recognize their efforts, the AMA Foundation has presented 10 free clinics with grants ranging from $15,000 to $25,000, as part of the Healthy Communities/Healthy America program.
AMA member Charles A. Rau, MD, a Columbus, Ind., family physician and medical director of the Volunteers in Medicine Clinic of Bartholomew County, received a Healthy Communities/Healthy America grant for his free clinic. "In the long run, we hope to provide chronic care that is preventive and proactive," said Dr. Rau. "Our goal is to enable people to live longer, healthier lives—and ultimately, we want to keep people out of emergency rooms and hospitals."
Recipients of the Healthy Communities/Healthy America grants are:
- Community HealthCare Center, Inc.—Savannah, Ga.
- The Free Clinic of Doylestown—Doylestown, Pa.
- Greenville Free Medical Clinic—Greenville, S.C.
- Lafayette Community Health Care Clinic—Lafayette, La.
- Parker Family Health Center—Red Bank, N.J.
- Partners for Healing—Tullahoma, Tenn.
- Traverse Health Clinic and Coalition—Traverse City, Mich.
- Volunteers in Medicine Clinic of Bartholomew County—Columbus, Ind.
- Volunteers in Medicine Clinic of the Cascades—Bend, Ore.
- West Virginia Health Right, Inc.—Charleston, W.Va.
Learn more about these and other award opportunities.
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5) On Sermo: Expert witnesses, fee schedules, irony and more
The same group of physician expert witnesses are involved in 90 percent of published medical liability cases across the country, according to an article referenced on Sermo, the online community for physicians. "Is our current system of battling experts the best way to get medical knowledge in the courts?" asks one physician, as part of a debate about whether or not the medical profession should be doing more to regulate how medical standard care is presented by expert witnesses in the courtroom. Enter Sermo and view this discussion.
Another discussion on Sermo covers whether physicians charge too little or too much for their services, or are being paid less than they deserve. Join a conversation about the basics of fees and fee schedules.
Have you ever treated a patient with attention deficit hyperactivity disorder named Patience? Join the conversation about ironic situations in which doctors often find themselves.
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6) In JAMA: Rates of child maltreatment in enlisted soldiers' families are greater during combat–related deployments
Children of enlisted soldiers experience greater rates of neglect and maltreatment during periods of combat–related deployments, according to a study in the Aug. 1 issue of the Journal of the American Medical Association (JAMA), a themed issue on violence and human rights.
Preview the article.
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