
eVoice®
July 19, 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 GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
2) AMA launches new journal on public health preparedness and disaster response
Group practice physician issues
1) AMA practice tip: Automate your practice and reap savings
2) CMS reports physician groups improve quality and generate savings under Medicare physician
pay-for-performance demonstration
International medical graduate issues
1) Poster informs patients about flaws in physician profiling programs
Medical school news
1) Participate in the AMA Initiative to Transform Medical Education
2) AMA seeks qualified candidates for employment position
3) In GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
Medical student issues
1) AMA-MSS National Service Project covered in AMNews
2) Save the date: 2007 AMA-MSS Interim Meeting, Nov. 810
3) 200708 Government Relations Advocacy Fellow announced
4) Chapter Project of the Week: Case Western Reserve University/Cleveland Clinics "Medical journals to
Iraq"
5) Contact new AMA-MSS leadership
Minority health issues and professional concerns
of minority physicians
1) In AMNews: CME and eliminating disparities
Organized medical staff issues
1) Revisions to Joint Commission Standard MS.1.20 approved
Resident and fellow issues
1) Call for applications for AMA-RFS Poster Symposium Committee
2) AMA supports the Higher Education Affordability and Equity Act of 2007
Women physician and women's health issues
1) New online tools help physicians participate in Medicare quality reporting program
2) Mark your calendar: Attend the WIO Leadership Summit
Young physician issues
1) Talk with your AMA-YPS leaders
2) Save the date: AMA-YPS Interim Meeting, Nov. 910
3) In GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
General
AMA news:
1) Maine and Minnesota get House Calls on Medicare physician payment
2) New AMA ad calls for tobacco tax increase to fund kids health insurance
3) AMA and coalition partners push for better disaster response planning
4) Updated kit from AMA Foundation can help improve health literacy
5) On Sermo: How accurate is your medical chart?
6) In JAMA: Diet high in fruit, vegetables and fiber doesnt necessarily reduce risk of breast cancer recurrence
Your news interests
Sign up to receive customized
AMA eVoice messages.
1) In GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
Highlights from the July issue of the
GME e-Letter, a leading source of news and information on graduate medical education (GME),
include:
Subscribe to this free monthly e-mail newsletter. Residency/fellowship program directors and medical education administrators and educators call the GME e-Letter "clear, concise and relevant," and "the best way to share cutting-edge news regarding GME."
2) AMA launches new journal on public health preparedness and disaster response
In late June, the AMA launched the first comprehensive, peer-reviewed journal to emphasize public
health preparedness and disaster response for all health care professionals. Disaster Medicine and
Public Health Preparedness is a quarterly publication that will include best practices and guest
commentaries from global leaders in disaster medicine, as well as advocacy, policy and education. The
editor-in-chief, James J. James, MD, notes that it is an academic field for all health and response
personnel, saying "the evolution of this concept clearly brings us to the intersection of medicine...it
also appreciates the necessary contributions of others from the commercial, academic, charitable and
government sectors, as well as community support organizations, to ensure effective responses."
Register for a free trial period.
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1) AMA practice tip: Automate your practice and reap savings
The movement by physicians, payers and vendors to streamline health care delivery through the adoption
and use of information technology solutions strives to create a more efficient claims management
revenue process for all involved. By eliminating significant parts of the manual processes in an
offices routine, physicians can free their practice staff to perform other revenue-enhancing
functions.
AMA members can download (PDF, 154KB, requires Adobe® Reader®) the educational resource "Information technology solutions: Consider the potential savings."
2) CMS reports physician groups improve quality and generate savings under Medicare
physician pay-for-performance demonstration
The Centers for Medicare & Medicaid Services (CMS) recently announced that physician groups
participating in the first year of the three-year Medicare Physician Group Practice Demonstration,
improved the clinical management of diabetes patients. The project is specifically aimed at
coordinating and managing the overall health care needs of Medicare patients with chronic conditions in
multispecialty group practices with 200 or more physicians.
Participating groups achieving benchmark or target performance on at least seven of the 10 diabetes clinical quality measures include: Billings Clinic, Everett Clinic, Dartmouth-Hitchcock Clinic, Forsyth Medical Group, Geisinger Clinic, Middlesex Health System, Marshfield Clinic, Park Nicollet Health Services, St. Johns Health System and the University of Michigan Faculty Group Practice. Two physician groups, Forsyth Medical Group and St. Johns Health System, met all 10 benchmarks.
View the July 11 CMS press release.
View the Marshfield Clinic press release.
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1) Poster informs patients about flaws in physician profiling programs
Some insurance companies are conducting physician profiling programs that conflict with the AMAs
established principles to measure physician performancerating physicians based on cost, rather
than quality of care. This type of profiling is inaccurate and unfair, and it is important as
physicians to educate patients about this practice.
The AMA, in conjunction with the Kentucky Medical Association and several other medical societies, created postersavailable nowpointing 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. AMA members can view (PDF, 118KB, requires Adobe® Reader®) the poster.
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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1) Participate in the AMA Initiative to Transform Medical Education
The AMA Initiative to Transform Medical Education is a broad-based, three-phase effort to promote
excellence in patient care by reforming the current medical education and training system. Phase 1
(20052006) identified strengths in the preparation of physicians, as well as gaps and opportunities
for improvement. Phase 2 (20062007) created strategies within the medical education system to address
specific gaps in preparation, and also identified barriers to be overcome and stakeholders to involve
in bringing about change.
Now in Phase 3 (20072010), ITME is working with appropriate collaborators in implementing the recommendations for change, identifying best practices and creating model programs.
View (PDF, 311KB, requires Adobe® Reader®) the June 2007 ITME report.
2) AMA seeks qualified candidates for employment position
The AMA is seeking qualified candidates for the position of director of the AMAs Undergraduate Medical
Education and secretary to the AMA Liaison Committee for Medical Education (LCME). The position will
provide overall vision, leadership and direction for the AMAs undergraduate medical education
activities and serve as the AMAs primary secretariat to the LCME. Minimum of a doctoral degree is
required, with a doctor of medicine degree and board certification in a specialty of medicine
preferred. The search is being conducted by Tuft & Associates.
Send an e-mail or call (847) 869-2562 to obtain a detailed position description.
3) In GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
The latest issue of AMAs GME
e-Letter highlights graduate medical education (GME) funding, as well as:
Subscribe to this free monthly e-mail newsletter.
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1) AMA-MSS National Service Project covered in AMNews
As a part of the AMA-MSS National Service Project, "Covering the Uninsured and Protecting Access to
Care," more than 30 medical students and four physicians participated in a health fair at the Miracle
Center located on Chicagos Northwest Side. Held during the AMA-MSS 2007 Annual Meeting, more than 100
community members attended the event, where participants provided basic health screenings, enrollment
in the State Childrens Health Insurance Program, physical activities and more.
This event was the subject of a recent article in American Medical News (AMNews).
Learn more about signing up for online access to AMNews.
2) Save the date: 2007 AMA-MSS Interim Meeting, Nov. 810
The 2007 AMA-MSS Interim Meeting will be held Nov. 810 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.
The special room rate will be available until Oct. 7 or until the group block is sold out. Rooms are
sure to go fast, so please make your hotel reservation soon.
Learn more and reserve your room.
Tune in to future issues of AMA eVoice for more information about the 2007 AMA-MSS Interim Meeting.
3) 200708 Government Relations Advocacy Fellow announced
The AMA-MSS is proud to introduce Kunal Mitra, a student at the Duke University School of Medicine, as
the 200708 Government Relations Advocacy Fellow. Working out of the AMAs Washington, D.C., office,
Mitra will assist with research, support the AMA Council on Legislation and work on various legislative
advocacy projects that help physicians help patients. Among many other duties, Mitra will also write
the "Medical Student Insider," a column that keeps the section abreast of legislative and advocacy
developments of interest to medical students.
Send an e-mail or call (202) 789-7424 with questions or concerns regarding legislative or advocacy issues.
4) Chapter Project of the Week: Case Western Reserve University/Cleveland Clinics "Medical
journals to Iraq"
In conjunction with "Help for Healthcare in Iraq," an organization of active and retired military
personnel, the Case Western Reserve University/Cleveland Clinic AMA-MSS chapter collected thousands of
copies of recent, well-respected medical journals (e.g., the Journal of the American Medical
Association and the New England Journal of Medicine). Next month, the chapter will hold a
recruitment event at which medical students will sort, pack and ship 2,000 medical journals to Iraq.
The chapter will provide lunch for students who attend, and will speak to students about what the
AMA-MSS does and how it can help them achieve their goals as students and future physicians.
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.
5) Contact new AMA-MSS leadership
The first meeting of the 200708 AMA-MSS Governing Council will be held Aug. 35. During the meeting,
the council will set its goals for the yearthe AMA-MSS invites you to provide your input on these
goals.
Obtain contact information for the newly elected governing council officers.
Share your ideas with the AMA-MSS via the governing council action form.
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1) In AMNews: CME and eliminating disparities
An article in the
July 16 issue of American Medical News (AMNews) looks at the growing number of state
legislatures and health plans that see physicians as an integral part of eliminating disparities. It
also examines how cross-cultural care is becoming an increasing part of continuing medical education
curriculum.
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1) Revisions to Joint Commission Standard MS.1.20 Approved
At its June meeting, the Joint Commission Board of Commissioners approved revisions to Standard
MS.1.20, which addresses medical staff bylaws, rules and regulations, and policies. These standard
revisions are supported by The Joint Commissions Corporate Member Organizations, American Hospital
Association, American Medical Association, American College of Surgeons, American College of Physicians
and the American Dental Association. These revisions were written with the intent of supporting and
reinforcing a productive working relationship between the organized medical staff and the governing
bodyconsistent with the requirements of the new Leadership Chapterwhile minimizing disruptions
to the hospital, including its medical staff. All of the requirements in Standard MS.1.20 must be
jointly approved by the organized medical staff (or the medical staff executive committee, if so
delegated by the organized medical staff) and the governing body.
The main revisions to Standard MS.1.20 are as follows:
The revised standard seeks to resolve several important issues. First, it addresses situations in which a medical staff believes that its medical staff executive committee is not representing its views on issues of patient safety and quality of care. The revised standard now states that the medical staff bylaws must indicate what authority the medical staff has delegated to the medical staff executive committee, and how that authority is delegated and removed. Also, the revised standard now states that the medical staff has the ability to adopt medical staff bylaws, rules and regulations, and policies and propose them directly to the governing body, even if the subject matter had been delegated to the medical staff executive committee. While the revised standard does not state what a medical staff should do if it does not agree with an action taken by its medical staff executive committee, the Introduction to the standard urges the medical staff to consider in advance what action it would take if such a situation occurred.
The revised standard also seeks to allow for an efficient process, for the hospital and its medical staff, for creating and maintaining medical staff bylaws, rules and regulations, and policies. To do this, the standard indicates what must appear in the medical staff bylaws, and what must appear either in the bylaws, or in rules and regulations or policies. The requirements in Elements of Performance (EPs) 9 through 33 must appear in the medical staff bylaws. However, the procedural details associated with the processes listed in EPs 26 through 33 must appear either in the medical staff bylaws, or in rules and regulations or policies (see text of standard below). The organized medical staff may, if it desires, delegate to its medical staff executive committee approval of the procedural details associated with the processes listed in EPs 26 through 33, when these procedural details are placed in rules and regulations or policies.
To understand these requirements, the difference between "process" and "procedural detail" needs to be explained. A process is a series of steps taken to accomplish a goal. A procedural detail describes in detail how each step in the process is to be carried out. For example, the process for credentialing licensed independent practitioners (see EP 26) can be stated in several steps such as collecting information on a physician, evaluating the information, and making a decision about the information. That process will be contained in the medical staff bylaws. The procedural details associated with this process might include who collects the information, how files are kept, what organizations need to be contacted to collect all the necessary information, etc. For EPs 26 through 33, the medical staff decides whether such procedural details will be retained in the medical staff bylaws (which must be approved by the entire organized medical staff), or in rules and regulations or policies (whose approval may be delegated to the medical staff executive committee).
Revised Standard MS.1.20 becomes effective July 1, 2009. The Joint Commission is allowing two years for the field to make any changes to medical staff bylaws that may be necessary to bring organizations into compliance with the revised standard. In the meantime, the current version of Standard MS.1.20 will be in effect.
View the Joint Commissions message and the revised M.S.120.
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1) Call for applications for AMA-RFS Poster Symposium Committee
The AMA-RFS Poster Symposium Committee will plan the fourth annual symposium, which will be held at the
2007 AMA-RFS Interim Meeting in Honolulu. The responsibilities of the committee include reviewing
abstract submissions, making decisions of acceptance and reviewing posters.
E-mail a copy of your curriculum vitae to apply for the committee.
Learn more about the AMA-RFS Research Poster Symposium. The deadline to apply is July 25.
2) AMA supports the Higher Education Affordability and Equity Act of 2007
The Higher Education Affordability and Equity Act of 2007 would help residents facing student loan debt
by addressing the tax deductibility of student loan interest. Provisions of the bill would expand the
student loan interest deduction by repealing the current dollar limitation of $2,500 and increasing the
phase-out beginning point to $100,000. Assisting resident and fellow physicians to better manage their
high debt burden is one of the AMAs top legislative priorities.
Read (PDF, 46KB, requires Adobe® Reader®) the AMAs letter to Congress.
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1) New online tools help physicians participate in Medicare quality reporting
program
The AMA has posted new tools on its Web site that physicians can use to participate in the Centers for
Medicare & Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI). On July 1, CMS
launched the PQRIa voluntary program to encourage quality of care improvement through the use of
74 performance measures on a variety of clinical conditions. Under the PQRI, physicians who
successfully report a designated set of quality measures on claims for dates of service from July 1 to
Dec. 31, 2007, may earn a bonus payment of up to 1.5 percent of their total allowed charges for
Medicare physician fee schedule services.
View the online tools designed to assist those who choose to participate. These include worksheets to assist physicians and their staff to code each measure.
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. 25, in Sedona, Ariz.
The summit will feature the art of persuasion, negotiations and workshops for all women physicians.
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1) Talk 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 its 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. >>Learn more
2) Save the date: AMA-YPS Interim Meeting, Nov. 910
The 2007 AMA-YPS Interim Meeting is scheduled for Nov. 910 at the Hawaii Convention Center and the
Hilton Hawaiian Village Hotel in Honolulu. The AMA-YPS meeting will offer 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 Assembly meeting is a wonderful opportunity
for members to influence policy related to early career physicians, to ensure the young physician
perspective is represented in AMA policy, and to become involved in organized medicine. The AMA-YPS
encourages all young physician members to participate in its meeting.
>>Learn
more
3) In GME e-Letter: Graduate medical education a "public good" and should be funded
accordingly
The following are a few highlights from the July issue of the GME e-Letter, a
leading source of news and information on graduate medical education (GME):
Subscribe now to this free monthly e-mail newsletter. Find out why residency/fellowship program directors and medical education administrators and educators call the GME e-Letter "clear, concise and relevant," and "the best way to share cutting-edge news regarding GME."
>>Return to your news interest contents
1) Maine and Minnesota get House Calls on Medicare physician payment
The AMA National House Call campaign made multiple stops this week in Maine and Minnesota to sound the alarm about 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 the need for Congress to stop the cuts.
AMA President-elect Nancy H. Nielsen, MD, joined Maine Medical Association President Kevin Flanigan, MD, at a July 17 news conference in Portland to show how the cuts will affect patients. Maines 220,000 Medicare patients represent 17 percent of the population, the second highest percentage in the country.
In Minnesota, AMA Trustee Rebecca J. Patchin, MD, along with Minnesota Medical Association President G. Richard Geier Jr., MD, made stops in Minneapolis, St. Paul and Rochester. If next years 10 percent cut takes place, nearly 654,000 of Minnesotas seniors who depend on Medicare will be adversely affected. The three-day series of stops included a news conference, editorial board meetings and several media interviews.
The AMA is working with its local, state and national medical society partners to urge patientsand doctorsto contact their members of Congress to stop Medicare physician payment cuts and provide physicians with a payment update in line with increases in the costs of caring for patients. A recent AMA Member Connect® Survey showed that 60 percent of physicians will be forced to limit the number of new Medicare patients they accept if the government cuts Medicare physician payments 10 percent next year, as scheduled under current law.
Members of the AMA can read more detailed information in the latest issue of the AMA Advocacy Update.
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2) New AMA ad calls for tobacco tax increase to fund kids health insurance
![]() View the ad (PDF, 90KB) |
For SCHIP to continue to provide substantial benefits to our nations children, Congress must find a way to pay for covering the millions of kids the program will protect, said AMA President Ronald M. Davis, MD. We hope this ad will show how an increase in the federal tobacco tax can serve as a key funding source for childrens health care, and help deter current and future Americans from using tobacco.
According to a recent poll by the Campaign for Tobacco-Free Kids, two-thirds of American voters strongly support a larger per-pack increase in the federal cigarette tax to expand health coverage to Americas uninsured children.
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3) AMA and coalition partners push for better disaster response planning
![]() AMA President Ronald M. Davis, MD, speaks at a news conference about the coalitions disaster response recommendations. |
The proposed recommendations are aimed at coordinating a national agenda for strengthening health system preparedness for terrorism and other disasters through increased funding, greater integration, continued education and training, and ensured legal protections for responders. Nine of these recommendations were named critical for legislators, government officials and organizational leaders to more effectively prepare for and respond to catastrophic emergencies.
"Most disasters are unplanned, but the response shouldn't be," said AMA President Ronald M. Davis, MD. Whether disasters are natural or man-made, infectious disease pandemics or terrorist attacks, physicians, health care professionals and public health workers must be prepared to respond to emergencies and aid in the recovery efforts that follow."
The AMA/CDC Second National Congress for Health System Readiness is a three-day event to bring public health and health care delivery sectors together to improve influenza pandemic preparedness at the community level. Participants recognized four communities in Oregon, Minnesota, Arizona and Virginia for their outstanding efforts in disaster planning.
Learn more and obtain a copy of the coalitions full report.
Learn more about the AMA/CDC summit.
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4) Updated kit from AMA Foundation can help improve health literacy
According to a recent government study, more than 89 million American adults are estimated to have limited health literacy skills. Health literacy is a patients ability to obtain, process and understand basic health information and services. This knowledge, in turn, helps patients make better-informed decisions about their health. People with limited health literacy often make unnecessary doctor visits, have more frequent and longer hospital stays, and fail to comply with medication regimens because they are usually too ashamed or intimidated to ask for help, and their physicians assume that they understand their explanations and instructions.
The AMA Foundations newly updated health literacy kit, Health literacy and patient safety: Help patients understand, has garnered broad recognition as an effective way to educate health care professionals and the public about this important issue. The kit offers tools that demonstrate the general scope of health literacy and provides materials to help improve the way doctors communicate with patients. It includes:
Learn more and order a health literacy kit for $35.
Accreditation statement:
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation statement:
The American Medical Association designates this educational activity for a maximum of 2.5 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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5) On Sermo: How accurate is your medical chart?
Its not easy for patients to know what their doctors are thinkingor writing downwhile being examined. This week on Sermo, physicians are discussing the documentation of symptoms and diagnoses on patients charts and their varying levels of accuracy.
One physician writes, I had recently been to the ER at the hospital where I work. I saw the note that was written by the ER doc and was surprised to see that the history and ROS were not what I had told him, and key points, like fever and chills, were documented incorrectly.
Many physicians on Sermo say they have discovered inaccuracies in their own medical chartsleading them to wonder how this affects the general patient population. What factors lead to inaccurate charts and how can these affect patient care?
Enter Sermo and join the discussion.
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6) In JAMA: Diet high in fruit, vegetables and fiber doesnt 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 to 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).
Preview an editorial on this topic.
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