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December 13, 2007

eVoice^®

Dec. 13, 2007

AMA eVoice is your regular update on the most important health care issues and recent AMA activities.

The AMA is committed to communication. We encourage you to help us spread the word by forwarding AMA eVoice to your colleagues.

Your news interests
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Faculty practice physician issues
1) December issue of Virtual Mentor now available
2) In Pediatrics: Academic medical centers counter pharmaceutical influence on physicians
3) First woman appointed dean of Duke University School of Medicine

Gay, lesbian, bisexual, transgender physician issues
1) U.S. HIV/AIDS rate may have been underestimated by 35 percent
2) Program ideas sought for 2008 Annual Meeting caucus

Group practice physician issues
1) JAMA sponsors "Author in the room" teleconference
2) Just in time for the holidays, get a $15 Amazon gift card to jumpstart your earnings on Sermo
3) AMA practice tip: Selecting a billing software vendor for your practice

International medical graduate issues
1) NRMP IMG board member applications due Dec. 21
2) Know your options for participating in Medicare in 2008

Medical school news
1) Save the date: AMA-SMS June meeting
2) Can health care engineering really revolutionize health care?
3) AMA convenes meeting on medical education financing, student debt
4) In AMNews: Doctors gain insight from theater training

Medical student issues
1) Save the date: AMA-MSS Region 6 Meeting, Feb. 1–2
2) AMA offers health policy opportunities for medical students
3) Apply to the National Institutes of Health/Fogarty International Clinical Research Scholars Program
4) AMA convenes meeting on medical education financing, student debt

Minority health issues and professional concerns of minority physicians
1) Report: Disparities in death rates among youth
2) In AMNews: Trained interpreters—a necessary expense

Organized medical staff issues
1) Make your voice heard on key issues affecting medical staffs
2) 2007 AMA-OMSS Interim Assembly Meeting materials now online
3) Listen to Joint Commission conference calls on MS.1.20 and new leadership standards

Resident and fellow issues
1) AMA convenes meeting on medical education financing, student debt
2) In Resident & Staff Physician: Focus on U.S. health care in the 2008 presidential primaries
3) Study shows physicians in solo and two-physician practices drop

Senior physicians issues
1) JAMA sponsors "Author in the room" teleconference

Women physician and women's health issues
1) In JAMA: Predicting risk of hip fracture in postmenopausal women
2) Joan F. Giambalvo Scholarship Fund seeks applications

Young physician issues
1) Know your options for participating in Medicare in 2008
2) Nominations for AMA-YPS Young at Heart Award due Dec. 31
3) 2008 nominations to AMA councils sought

General AMA news:
1) Crunch time on Medicare payment issue
2) Beware Aetna's out-of-network payment practices
3) Deadline extended for AMA Foundation award nominations
4) Latest issue of AMA Therapeutic Insights spotlights depression
5) Earn CME credit through the AMA's free online video series
6) On Sermo: Doctors share opposing views on electronic prescribing
7) In JAMA: Geriatric care intervention appears to provide some benefits for low-income seniors

Your news interests
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Faculty practice physician issues

1) December issue of Virtual Mentor now available
December's Virtual Mentor investigates how physicians can best carry out their public health-related duties without compromising their obligation to put the patient's interest first or endangering the trust that is essential to the patient-physician relationship. The clinical case commentaries explore school-based initiatives to monitor student obesity, one state's controversial Medicaid program with wellness incentives, and the fear of deportation that prevents immigrants from seeking health care. John Stuart Mill, the author of On liberty, asked, "Where does the authority of society begin?" This month,Virtual Mentor takes up the search for an answer—at least in the sphere of patient-physician relationships.

View this month's issue.

2) In Pediatrics: Academic medical centers counter pharmaceutical influence on physicians
A recent study published in the journal Pediatrics found that even modest efforts by academic medical centers to restrict drug-company access to trainees can loosen the ties between doctors and industry. The greatest impact occurred when medical schools banned all contact with company representatives, and even requiring medical students or residents to participate in one hour of training had an impact on the relationship. Despite a dramatic increase in direct-to-consumer advertising, 90 percent of industry sales efforts still target physicians.

Read the AMA's ethical position on gifts to physicians from industry.

3) First woman appointed dean of Duke University School of Medicine
Nancy C. Andrews, MD, an internationally renowned researcher and dean for basic sciences and graduate studies at Harvard Medical School, is the first woman to be appointed dean of Duke University School of Medicine and the only woman to lead one of the nation's top 10 medical schools. Dr. Andrews is a pediatric hematologist/oncologist by training. She succeeds R. Sanders Williams, MD, who was recently promoted to senior vice chancellor for academic affairs after serving as dean since April 2001.

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Gay, lesbian, bisexual, transgender physician issues

1) U.S. HIV/AIDS rate may have been underestimated by 35 percent
Federal health officials are revising their estimate of how many people are infected by the human immunodeficiency virus (HIV) each year, and advocacy groups say the number could rise by 35 percent or more.

The Centers for Disease Control and Prevention has been estimating about 40,000 new HIV cases occur in the nation each year. However, at a national HIV prevention conference in Atlanta this week, advocates claimed the new estimate is 55,000 or higher.

View the article from the Associated Press.

2) Program ideas sought for 2008 Annual Meeting caucus
The AMA Advisory Committee on GLBT Issues has started planning for the 2008 Annual Meeting of the AMA House of Delegates in Chicago. Currently, members are discussing ideas for the caucus and reception, which will be held on the evening of either June 12 or 13, prior to the opening session of the AMA House of Delegates. Committee members would like to hear from you regarding program ideas.

Send an e-mail if you have an idea or know of a speaker the committee may want to consider.

>>Return to your news interest contents

Group practice physician issues

1) JAMA sponsors "Author in the room" teleconference
December's "Author in the room" teleconference, part of a series sponsored by the Journal of the American Medical Association (JAMA) and the Institute for Healthcare Improvement (IHI), features Dena M. Bravata, MD, author of "Using pedometers to increase physical activity and improve users' health." The teleconference is scheduled from 1 to 2 p.m. CST, Dec. 19, and is part of a series aimed at closing the gap between clinical knowledge and action in practice. There is no fee to participate but enrollment is required.

View Dr. Bravata's review beforehand.

Please sign up for the teleconference in advance to listen.

Visit the Web site for additional information on the "Author in the room" teleconference series from Catherine D. DeAngelis' online editorial, featured on the JAMA Web site.

2) Just in time for the holidays, get a $15 Amazon gift card to jumpstart your earning on Sermo
Want to speak out about insurance-company bureaucracy and looming Medicare payment cuts? Have a medical insight or observation worth sharing with colleagues? Join the 40,000 physicians on Sermo who are learning from one another and creating a new voice in medicine. You'll even get paid for participating. Sermo is offering physicians a $15 Amazon gift card for joining—that's just the beginning. Sermo is always free and for physicians only. Please note: Type "AMA2" in the promotion box when you join Sermo by Dec. 31 to receive your $15 Amazon gift card.

Log on or join Sermo.

3) AMA practice tip: Selecting a billing software vendor for your practice
Purchasing medical billing software for a physician practice can be a daunting task and may result in added costs. To help physicians, the AMA Private Sector Advocacy unit and the Kentucky Medical Association have developed "How to select a billing software vendor for the physician practice." This resource provides the physician practice with a proactive approach to determining the specific needs of the practice.

Members can access this educational resource.

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International medical graduate issues

1) NRMP IMG board member applications due Dec. 21
The AMA Resident and Fellow Section and AMA-IMG Section are accepting applications for the National Resident Matching Program (NRMP) Board of Directors. There are two resident positions available, including one whom must be an international medical school graduate (IMG). The NRMP Board of Directors governs and oversees the Main Residency Match and the Specialties Matching Service, ensures all match participants abide by match policies and informs the medical education community about trends in graduate medical education. New board members attend an orientation in June and meet three times each year—usually in October, February and May. Board members also serve on one or more committees which may entail additional travel.

Visit the Web site for more information about the matching program and NRMP policies as well as examples of recent board activities. The term of the position is two years. IMGs may e-mail nomination forms, statements of interest and curricula vitae to with the subject line "NRMP Nominee."

Download (Word, 114KB) an application.

2) Know your options for participating in Medicare in 2008
With a steep 10.1 percent cut in Medicare physician payments scheduled to take effect Jan. 1, 2008, physicians may want to review their Medicare participation options.

The AMA Medicare Participation Options document offers members a brief overview of the current situation with respect to the Medicare payment update for 2008 and the various participation options that are available to physicians. Physicians may sign a PAR agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients up to 9.25 percent more than the Medicare payment for unassigned claims. Lastly, they may become a private contracting physician, agreeing to bill all Medicare-eligible patients directly and forego any payments from Medicare for two years. The deadline to make changes in participation status is Dec. 31, 2007. This decision will be binding for the entire year. Those considering a status change should first make sure they are not bound by any contractual arrangements with hospitals, health plans or other entities that require them to be PAR physicians. Laws in some states prohibit physicians from balance billing their patients.

View (PDF, 56KB) the AMA Medicare Participation Options document.

>>Return to your news interest contents

Medical school news
(Brought to you by the AMA Section on Medical Schools)

1) Save the date: AMA-SMS June meeting
The next AMA-SMS meeting will be held June 13–15 at the Hyatt Regency Hotel in Chicago. This meeting will provide medical education colleagues an opportunity to network, help develop AMA policy and discuss issues affecting medical education.

Visit the Web site in mid-January or send an e-mail to Jackie Drake for meeting details.

2) Can health care engineering really revolutionize health care?
Former AMA-SMS Governing Council member and professor of surgery at the University of South Florida, Peter J. Fabri, MD, recently earned a doctorate in industrial engineering. He decided to enter the doctoral program when he realized that the majority of health care problems are systems and process problems, not management and finance. Dr. Fabri is currently on sabbatical at Northwestern University and is in the process of developing a four-course certificate program in health care engineering to assist physicians and advanced nurses in being able to identify, model and solve the most complex system problems. According to Dr. Fabri, such individuals are essential for solving the current health care crisis in the United States.

Dr. Fabri recently gave a presentation to AMA staff. View (PDF, 188KB) slides from his presentation.

3) AMA convenes meeting on medical education financing, student debt
In November, the AMA brought together major stakeholders in medical education at its Washington, D.C., office to discuss issues related to medical student debt and career choice as well as funding to support undergraduate and graduate medical education (GME). The goal of the meeting was to develop specific proposals to address the identified problems and develop a common advocacy platform.

In attendance were 40 individuals representing the Association of American Medical Colleges and American Osteopathic Association, as well as state and specialty medical societies and staff from the offices of two members of Congress.

The wide-ranging discussion covered topics ranging from Title VII funding, loan forgiveness and deferment, service in medically underserved areas, and cultural competence to the GME cap, growth in GME slots in Department of Veterans Affairs programs, and the current reimbursement system's bias towards procedures versus primary care.

The AMA will work closely with these and other key stakeholders as it advances its advocacy agenda and continues to monitor relevant legislation.

4) In AMNews: Doctors gain insight from theater training
Resident physicians at Virginia Commonwealth University in Richmond, Va., have learned how to read body language to improve patient care. The art of effective communication, considered a key attribute of a good physician, is one aspect of medical training that often is not dealt with explicitly, according to an article in the Dec. 3 issue of American Medical News (AMNews). Pilot program results, that were published in the August issue of the Journal of General Internal Medicine, show that training made a difference in physician-patient communication.

View the AMNews article.

>>Return to your news interest contents

Medical student issues

1) Save the date: AMA-MSS Region 6 Meeting, Feb. 1–2
The 2008 AMA-MSS Region 6 Meeting—"Students today, physicians tomorrow: The new face of medicine"—will be held Feb. 1–2 at Temple University in Philadelphia. Exciting speakers, educational workshops, and a great service project are scheduled, along with fun social activities to meet new friends and hang out with old ones.

Visit the Web site for more information and registration details. Registration is due Jan. 6.

2) AMA offers health policy opportunities for medical students
The AMA Department of Medical Student Services, in conjunction with the AMA's Washington, D.C., office, is pleased to offer assistance to students seeking to increase their involvement and education in national health policy and in the national legislative activities of organized medicine. The AMA Government Relations Advocacy Fellowship (GRAF) is a yearlong, paid fellowship opportunity in the AMA's Washington, D.C., office. GRAF offers medical students a unique opportunity to experience firsthand the intersection of organized medicine and the federal government as it relates to advocacy and policymaking. The application deadline for GRAF is Jan. 31, 2008.

Visit the Web site for more information.

The AMA is also pleased to offer the Government Relations Internship Program (GRIP), an opportunity for medical student members of the AMA to enhance their medical education through work in health care policy. Students must arrange their own six- to eight-week internships (between June and August) in advance. The application deadline for GRIP is Feb. 15, 2008.

Visit the Web site for more information.

3) Apply to the National Institutes of Health/Fogarty International Clinical Research Scholars Program
Applications are now being accepted for the Association of American Medical Colleges (AAMC)-administered National Institutes of Health (NIH)/Fogarty International Clinical Research Scholars Program, a clinical research training experience for graduate-level U.S. students in the health professions. The program offers one year of clinical research training to students in medical, osteopathic or dental schools, as well as to students enrolled in doctorate-level programs in schools of public health, optometry, nursing, pharmacy or veterinary medicine. Participants will experience mentored research training at top-ranked NIH-funded research centers in a diverse group of countries. Applications are due Dec. 14.

Please contact the AAMC Division of Biomedical and Health Sciences Research by sending an e-mail to Katy Carkuff, or visit the Web site for more information.

4) AMA convenes meeting on medical education financing, student debt
In November, the AMA brought together major stakeholders in medical education at its Washington, D.C., office to discuss issues related to medical student debt and career choice as well as funding to support undergraduate and graduate medical education (GME). The goal of the meeting was to develop specific proposals to address the identified problems and develop a common advocacy platform.

The AMA will work closely with these and other key stakeholders as it advances its advocacy agenda and continues to monitor relevant legislation.

>>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) Report: Disparities in death rates among youth
A report published in the Centers for Disease Control and Prevention's Nov. 16 issue of the Morbidity and Mortality Weekly Report finds that during 1979–2004, diabetes death rates for black youths were approximately twice those for white youths. The authors of the study note that further research is needed in order to discern the specific reasons for increased diabetes mortality in black youths.

2) Joan F. Giambalvo Scholarship Fund seeks applications
Applications for the 2008 Joan F. Giambalvo Scholarship Fund are due Feb. 1, 2008. This scholarship was established by the AMA-WPC with the goal of advancing the progress of women in the medical profession and strengthening the AMA's ability to identify and address the needs and interests of women physicians and medical students.

Visit the Web site for additional information and to download an application.

>>Return to your news interest contents

Young physician issues

1) Know your options for participating in Medicare in 2008
With a steep 10.1 percent cut in Medicare physician payments scheduled to take effect Jan. 1, 2008, physicians may want to review their Medicare participation options. The AMA Medicare Participation Options document offers members a brief overview of the current situation with respect to the Medicare payment update for 2008 and the various participation options that are available to physicians.

View (PDF, 56KB) and download the AMA Medicare Participation Options document. The deadline to make changes in participation status is Dec. 31, 2007.

2) Nominations for AMA-YPS Young at Heart Award due Dec. 31
Don't delay—nominations for the 2008 AMA-YPS Young at Heart Award must be submitted by Dec. 31. Nominees should be AMA members who are not eligible for section membership and whose support and guidance have strengthened the AMA-YPS through: 1) organizational aid; 2) support of AMA-YPS issues in reference committees/causes and on the floor of the AMA House of Delegates; or 3) support of AMA-YPS leadership development.

Nominations will be accepted from AMA-YPS Assembly members only—either via e-mail, letter or fax—until Dec. 31.

Visit the Web site for more information and to submit a nomination electronically.

3) 2008 nominations to AMA councils sought
The AMA is currently soliciting nominations to AMA councils for 2008. The AMA's elected councils are: the AMA Council on Constitution and Bylaws; the AMA Council on Ethical and Judicial Affairs; the AMA Council on Medical Education; the AMA Council on Medical Service; and the AMA Council on Science and Public Health. The AMA's appointed councils are: the AMA American Medical Political Action Committee; the AMA Council on Legislation; and the Council on Long Range Planning and Development.

Visit the Web site for more information and instructions on the nomination process.

>>Return to your news interest contents

General AMA news

1) Crunch time on Medicare payment issue
Time is running out to stop a steep 10.1 percent cut in Medicare physician payments scheduled to take effect Jan. 1, 2008. Lawmakers need to hear from physicians—as well as patients, office staff and all concerned—about how important it is that Congress take action to stop the pending Medicare physician payment cuts before they go home for the holidays.

Even if you have contacted your members of Congress already, call the AMA Grassroots Hotline at (800) 833–6354 to be connected to their offices. Urge them to ask their leadership to pass legislation that provides positive Medicare physician payment updates and does not increase the cost of future physician payment interventions.

>>Return to your general news contents

2) Beware Aetna's out-of-network payment practices
The Pennsylvania Medical Society (PMS) has alerted the AMA that Aetna is attempting to determine the amount of payment that an out-of-network physician may receive–and may be providing false information to physicians who dispute payment amounts.

Aetna is paying out-of-network claims at 125 percent of the Medicare rate and stating on the patient's explanation of benefits (EOB) that the patient has no obligation to pay the physician the difference between the physician's charge and the amount Aetna has paid.

Additionally, Aetna has sent form letters from their Lexington, Ky., office to out-of-network physicians who have appealed payment amounts, stating that Pennsylvania has a "maximum state mandated rate," which is inaccurate. It appears that in the appeal process Aetna is providing erroneous information to Pennsylvania physicians.

EOBs that state the physician may not bill the patient for the difference may be a violation of the Aetna Multi-District Litigation Settlement Agreement. Section 7.21 of the Aetna agreement states, "Consistent with the desire that Plan Members receive accurate communications that do not disparage Non-Participating Physicians, each such EOB shall indicate the amount for which the Physician may bill the Member and state ‘Physician may bill you' such amount, or contain language to substantially similar effect, and shall not characterize disallowed amounts as unreasonable."

Aetna is also applying this policy to pay out-of-network claims at 125 percent of Medicare in North Carolina, New York and Kentucky.

A similar issue occurred in New Jersey, which resulted in its Department of Banking and Insurance to fine Aetna $9,475,000 in July.

AMA members who experience this are encouraged to contact the AMA Practice Management Center via e-mail, by phone at (800) 262–3211 or by faxing supporting documentation to (312) 464–5541.

You may also contact the Aetna compliance dispute facilitator (CDF) directly to determine if you have a compliance dispute. The Aetna CDF, Cameron Staples, can be reached via e-mail or by phone (203) 821–2000.

AMA members can access the AMA's toolkit for out-of-network services and learn more about addressing out-of-network issues.

>>Return to your general news contents

3) Deadline extended a few more days for AMA Foundation award nominations
Do you know a physician who exemplifies the medical profession's values of altruism, compassion and dedication to patient care? Nominate your colleague for one of the 2008 AMA Foundation Excellence in Medicine Awards before it's too late. The nomination deadline has been extended to Dec. 17 for the following honors:

The Pride in the Profession Awards recognize physicians who work in underserved areas or devote their time to volunteerism or public service. The AMA Foundation honors up to four physicians each year with these awards.
The Dr. Nathan Davis International Award in Medicine recognizes a domestic physician whose work abroad has a positive impact on an international patient population.
The Jack B. McConnell, MD, Award for Excellence in Volunteerism recognizes the work of a senior physician (55 or older) who provides treatment to U.S. patients who lack access to health care.

The awards are presented in association with the Pfizer Medical Humanities Initiative.

Learn more and download nomination forms.

>>Return to your general news contents

4) Latest issue of AMA Therapeutic Insights spotlights depression

Read an excerpt from the latest issue of AMA Therapeutic Insights on managing depression in primary care.

Major depression affects approximately one in six Americans during their lifetimes. It is also the leading cause of disability in the U.S. in individuals aged 15 to 44, and is predicted to be the second leading cause of disability worldwide by 2020, second to cardiovascular disease.

The latest issue of AMA Therapeutic Insights updates primary care physicians on approaches to the detection and management of major depressive disorder and offers unique, unprecedented views of prescribing data for this condition. Using a case-study format, this issue applies recent findings from the Sequenced Treatment Alternatives to Relieve Depression trial, funded by the National Institute of Mental Health.

AMA Therapeutic Insights, a free online quarterly newsletter offering continuing medical education (CME) credit, highlights one disease state per issue and features state and national prescribing data, along with evidence-based guidelines for treatment. The newsletter aims to enhance physician knowledge and practice, and improve the quality of patient care.

Access this issue as well as previous issues, covering type 2 diabetes, migraine and dyslipidemia.

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 1.0 AMA PRA Category 1 Credit^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

>>Return to your general news contents

5) Earn CME credit through the AMA's free online video series
**Editor's note: An article in the Dec. 6 issue of AMA eVoice reported the incorrect number of CME credits that can be earned through the AMA's Educating Physicians on Controversies in Health series. A maximum of 1 AMA PRA Category 1 Credits^™ can be earned for watching the five webcasts and answering the programs' online evaluation questions. We apologize for the error.

The AMA's online educational series, Educating Physicians on Controversies in Health, now offers five easily accessible programs to earn continuing medical education (CME) credit online. Each webcast presents strategies to address health care disparities in your medical practice and enhance your skills and knowledge on vital public health issues in medicine.

To earn CME credit, view the five webcasts and answer the self-assessment and program evaluation questions using the online form. Allow approximately one hour to review the materials and answer the questions.

A new online educational program from the AMA and included in the five webcasts, "Paying attention to preventing cardiovascular disease among racial and ethnic minorities," aims to better educate physicians on why racial and ethnic minority patients, particularly African American patients, are more at risk for heart disease and stroke and how the medical community can address this growing problem.

View the latest program as well as the entire series and obtain CME credit.

Accreditation statement
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

>>Return to your general news contents

6) On Sermo: Doctors share opposing views on electronic prescribing
Electronic prescribing, or e-prescribing, a relatively new trend in medicine, is prompting many physicians to question the benefits of such a system and evaluate the pros and cons of its use.

In a Sermo post earlier this year, a physician who has already adopted e-prescribing posed this question: "I wonder why more docs are not migrating over to using [e-prescribing] more quickly?"

And a Sermo post on Nov. 30 called attention to the recommendation by the American Health Information Community to U.S. Department of Health and Human Services Secretary Mike Leavitt that e-prescribing be mandated for providers participating in the Medicare program. If e-prescribing is intended to make the prescribing process easier, improve office efficiency, enhance patient safety, and even save the industry money, "Why aren't doctors prescribing electronically today?"

In the online discussion, physicians offer a wide array of reasons about why they have chosen to defer from or switch to an e-prescribing method. "I don't get paid to do this extra work," one physician on Sermo said. "Pens and paper are much faster, and all I have to sell is time. If I am paid for this extra time, I would consider it."

Another physician said, "I work in a large clinic system that transitioned to EMR [electronic medical records] about 4 years ago. I love [e-prescribing]." And another said, "E-prescribing for me is very beneficial. It's easy, it's effective. It's fast."

Log on to Sermo, participate in a survey about this topic, or join Sermo.

Visit the AMA Web site to learn more about health information technology, including e-prescribing, and some of the issues and concerns surrounding its adoption.

>>Return to your general news contents

7) In JAMA: Geriatric care intervention appears to provide some benefits for low-income seniors
A home-based geriatric care program for low-income seniors resulted in higher-quality medical care, improvement in quality of life and fewer emergency department visits, but did not appear to prevent decline in physical functioning, according to a study in the Dec. 12 issue of the Journal of the American Medical Association (JAMA). In an accompanying editorial, an author shares an emerging vision of optimal health care delivery for older people with chronic disease.

View the study.

Preview the editorial.

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Feedback
If you have specific comments on this edition of AMA eVoice, simply reply to this message. For more general feedback on AMA eVoice, send an e-mail to evoice@ama-assn.org and alert the editor of your comments and concerns. Do you have general questions about the AMA? Call the AMA Unified Service Center at (800) 262-3211.

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Thank you for your AMA membership! The AMA's strength comes from its numbers. That strength grows when our membership increases — please urge your fellow physicians and medical students to join our cause by calling (800) 262–3211 or visiting the AMA Web site.

Last updated: Dec 13, 2007
Content provided by: Member Publications