AMA eVoice Weekly Newsletter

Taking ownership for patients

This is my final column as AMA president. Thanks to all of you who've read and reacted to my musings, and in particular, thanks to those of you who took the time to e-mail me. It has been a joy and a privilege to serve you and our profession.

The year has been extraordinarily busy, with opportunities and challenges that were not anticipated. The stories you've shared with me about your practices, your lives and your aspirations for our profession have been heartwarming. And your disappointments and struggles to do the best for your patients have given me strength and resolve during the never-ending parade of interviews and appearances. You are what the AMA is about—you and your patients.

As I ready my last speech for the House of Delegates, I've been struck by how seemingly minor things can sometimes have enormous impact. Maybe it's because they tap into dissatisfaction, or reveal unspoken truths, or maybe just because the country has reached the proverbial "tipping point." One such occurrence was an article that appeared early this month in The New Yorker, written by the Harvard surgeon Atul Gawande, MD. He is a gifted communicator and an astute observer. You may know his books, "Complications" and "Better." He is widely respected in the areas of quality and patient safety.

Dr. Gawande described the tale of two cities, in a way, as he detailed variations in health care patterns in two Texas border towns. His observations were searing, and troubling. He didn't accuse, he didn't ascribe motives to others, he didn't lay blame. But he did describe patterns that should concern us deeply. And if we aren't concerned, others are. And those others have the power to affect us, our practices and our patients profoundly.

I won't tell you more about the article, as I can't do it justice. Please read it. And then let's decide what we physicians are going to do about dramatic practice variations. Let's not spend a lot of time arguing over whether all the variations are justified, based on patient needs. The enormity of the swings are too great to be explained away easily, and we don't understand all the causes anyway. When there is relative certainty about a needed action or procedure, such as beta blockers in myocardial infarctions, there is very little practice variation. It's when there's more uncertainty, more discretion, less consensus, that the wide variations occur.

And let's be honest about a few who work every angle to be sure that the reimbursement system that rewards volume maximizes their volume. How hard is that to understand? But it has caught the attention of policymakers throughout the country. According to The New York Times on June 9, Dr. Gawande's article was discussed at length by President Obama and U.S. Senate leadership, and there's discussion of lowering payments across the country to that paid in areas with good outcomes and the lowest cost.

That isn't in anyone's best interests. We should take ownership of this issue, figure out why such variations exist and determine what should be done about them in a way that best serves our patients' interests.

Make no mistake; this is not an appeal for "cookbook medicine." On the contrary, it's a call for us to respect each patient's needs and put them before our own—and use the best scientific evidence to determine how to meet those needs. We need the freedom to prescribe and to do what is appropriate for each patient. To maintain that freedom, we need to be accountable.

How do we accomplish this? We accomplish this not by being controlled by government or health plans, but by learning from each other and sharing best practices. And always, always be dedicated to doing what's right for our patients.

Many thanks for the privilege of serving you.

In the words of a well known song,

"I am strong when I am on your shoulders. You lift me up to more than I can be."

E-mail comments, questions and replies to Dr. Nielsen

1) Obama to address AMA House of Delegates
President Barack Obama will speak at the Annual Meeting of the AMA House of Delegates on June 15 in Chicago about the nation's need for health system reform.

White House press secretary Robert Gibbs told reporters Wednesday in Washington, D.C., that Obama will stress the immediacy of reforming the health care system this year "to bring down costs that are crushing families, businesses and government." He said the president also will address the importance of making sure that reform doesn't add to the nation's deficit, and what can be done to strengthen what works in the U.S. health care system in an effort to provide the best care at the lowest cost.

"President Obama has made health reform a top domestic priority, as has the AMA," AMA President Nancy H. Nielsen, MD, PhD, said. "President Obama's speech to AMA physicians shows that he values the input of those who dedicate their lives to caring for patients. We have a historic opportunity for health care reform this year, and the AMA is committed to improving the system so that it works better for patients and physicians.

"We are honored to welcome President Obama to our annual meeting, where physicians develop the policies that guide the AMA's advocacy."

Read more from Dr. Nielsen about Obama's scheduled appearance at the Annual Meeting.

2) AMA Annual Meeting begins
Events surrounding the 2009 Annual Meeting of the AMA House of Delegates are under way in Chicago. The policymaking meeting kicked off today with gatherings of AMA sections and special groups that include educational programming, networking sessions and more. Physicians and medical students from around the country will debate and set policy on issues in science, ethics and medicine, including many topics related to the ongoing health system reform debate.

Tomorrow, June 12, physicians and students will turn their focus toward the uninsured and medicine's donors. The AMA Medical Student Section—as part of its national service project "Covering the uninsured and protecting access to care"—will mobilize at Navy Pier along Chicago's lakefront to distribute information about the importance of access to care, health system reform and the availability of safety net health coverage and services in the Chicago area through Medicaid, Illinois' All Kids program, and various free clinics and subsidized providers in the city. That evening the AMA Foundation will host its donor reception from 6 to 7:30 p.m. to pay tribute to the generosity of its donors.

President Barack Obama will be in attendance June 15 to speak to the House of Delegates about health system reform.

On June 16, J. James Rohack, MD, a cardiologist from Temple, Texas, will begin his term as the 164th president of the AMA.

Visit the Annual Meeting Web site to view daily meeting highlights.

3) AMA leaders discuss Medicare physician payment with senators
In a meeting with members of the U.S. Senate Finance Committee last week in Washington, D.C., AMA President Nancy H. Nielsen, MD, PhD, and AMA President-elect J. James Rohack, MD, stressed the importance of permanently repealing Medicare's sustainable growth rate (SGR) formula for establishing updates to physician payments as part of health system reform. The Senate Finance Committee plans to mark up health system reform legislation later this month.

In addition, the AMA recently commented on three policy papers from Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, and Sen. Charles Grassley, R-Iowa, the committee's ranking Republican, that contain options for comprehensive health system reform. The first paper outlines proposals to reform the health care delivery system and addresses key physician policy issues such as Medicare physician payment. The second paper addresses options for expanding insurance coverage. And the third discusses potential sources for financing reform efforts.

Read the AMA's summaries of and comments on each paper.

4) Webinar to cover Health IT provisions of federal economic stimulus law
According to the American Recovery and Reinvestment Act, Medicare physicians who implement and report meaningful use of electronic health records will be eligible for an initial incentive payment of up to $18,000 beginning in 2011. Early adopters could receive a five-year bonus of up to $44,000.

To learn more about these health information technology (Health IT) incentive provisions, view the webinar "Overview: American Recovery and Reinvestment Act Health Information Technology Provisions," a live broadcast of an educational session to be presented at 8 a.m. June 15 during the Annual Meeting of the AMA House of Delegates. David Hunt, MD, chief medical officer for the Office of the National Coordinator for Health Information Technology, will discuss the Health IT incentive provisions and what physicians should do to prepare. AMA Board of Trustees member Steven Stack, MD, will moderate the session.

Register for the webinar.

5) New AMA-Microsoft collaboration to enhance physican-patient communication
Through a collaboration between the AMA and Microsoft, physicians and their patients will be able to exchange vital health care information by connecting through Microsoft's HealthVault, a platform developed by Microsoft to store and maintain health and fitness information. This collaboration will enable physicians to access self-reported patient health information at the point of care while enabling patients to access vital information that has been entered through the physician's office.

With patient consent, physicians will be able to access a patient's HealthVault record through a new physician Web-based portal the AMA is developing with Covisint, a subsidiary of Compuware. The AMA portal, which is currently in beta testing, will provide physicians access to practice-related products, services and resources in a single location. The AMA plans to launch its new portal nationally in early 2010.

"The use of electronic medical records, and health information technology overall, holds great promise for improving patient care and increasing practice efficiency," AMA President-elect J. James Rohack, MD, said. "The addition of Microsoft's HealthVault on our AMA portal will enable patients using HealthVault to share more comprehensive health information with their physicians. Having ready access to patient information can help physicians make treatment decisions and reduce the time spent gathering this information resulting in more face-to-face time with patients."

6) Are you being paid promptly?
Did you know that health insurers are required to pay claims within a specific number of days? According to the WellPoint/Anthem, Health Net and Humana settlement agreements, these health insurers must mail a check or make an electronic fund transfer within 30 calendar days of receiving a paper claim. Claims submitted electronically must be paid within 15 calendar days.

If you're waiting longer to receive payment for your services, visit the AMA Web site to learn more about what you can do.

Learn about the compliance dispute process.

AMA members who are experiencing payment delays by another health insurer can check out their state's prompt-pay laws.

If a health insurer isn't paying within the required time, learn about filing a complaint with your state's department of insurance.

7) Column by AMA Board chair covers Health IT
A column posted today on physician blog KevinMD.com by AMA Board Chair Joseph Heyman, MD, highlights what the AMA is doing to help physician practices adopt new technology. In his column, which is part of an ongoing monthly collaboration between the AMA and KevinMD.com, Dr. Heyman also discusses his own experience using health information technology (Health IT) in his medical practice.

KevinMD.com is the Web's most-read physician blog and is authored by Kevin Pho, MD, a primary care specialist in New Hampshire. Dr. Pho's insights into the practice of medicine and his thoughts on health system reform have been featured in major media, including the Wall Street Journal and CNN, and he is a contributing editorial writer at USA Today.

8) AMA Insurance Agency offering new temporary insurance for gaps in health coverage
As a physician, you know how important it is to have health insurance. Yet because of the turbulent economy, health insurance is a need that sometimes gets overlooked. That's why AMA Insurance Agency Inc. is offering a short-term medical coverage plan to physicians, their practice staff, and their family and friends. This plan can help:

• Recent graduates
• People who are in between jobs
• Those who are waiting for employer benefits to begin
• People who no longer are on their parents' insurance plan
• Temporary or seasonal employees

This short-term medical coverage plan is underwritten by Time Insurance Company, an Assurant Health member company, and is not available in Connecticut, Hawaii, Massachusetts, New Jersey, New York or Vermont.

Visit the AMA Insurance Web site to apply or learn more.

9) In JAMA: Dose-reduction techniques associated with decreased amount of radiation exposure from cardiac scans without impairing image quality
An intervention that includes techniques to reduce the amount of radiation from cardiac computed tomography angiography, which is scanning used to diagnose coronary artery disease, was associated with decreasing patient exposure to radiation without significantly changing the quality of the images, according to a study in the June 10 issue of the Journal of the American Medical Association (JAMA).

1) In Oncology Nursing News: Conference highlights challenges facing LGBT patients
A story published May 27 by Oncology Nursing News documents a presentation—made during the 34th annual Oncology Nursing Society Congress—about information and strategies to help health care providers deal with some of the problems that are common to the sexual-minority population. Among the points made in the story is that although cancer patients who are lesbian, gay, bisexual or transgender (LGBT) face many of the same challenges as their heterosexual counterparts, many other obstacles are specific to their sexual-minority status.

2) Interview covers behavioral health and nicotine addiction within LGBT community
The National LGBT Tobacco Control Network recently interviewed Erik Augustson, a researcher at the National Institutes of Health National Cancer Institute, about issues related to behavioral health and nicotine addiction, with a special focus on the high smoking rates in the lesbian, gay, bisexual and transgender (LGBT) community. The National LGBT Tobacco Control Network is a group focused on supporting local tobacco control advocates in helping to eliminate tobacco health disparities for all LGBT individuals.

3) In the Advocate: Tennessee schools allow access to LGBT Web sites
According to a story published June 4 by the Advocate, school officials in Knox County, Tenn., say they have made adjustments to filtering software that prevented district computers from accessing lesbian, gay, bisexual and transgender (LGBT) Web sites. The story, which cites a report aired on WBIR-TV, notes that the change comes after the American Civil Liberties Union filed a federal lawsuit in May charging that the schools’ filtering software constituted viewpoint discrimination.

1) AMA-IMG section agenda book available online
If you’re not attending this week’s AMA-IMG Section meetings in Chicago, use the section’s meeting agenda book to keep up with items of business.

And it’s not too late to attend the section’s meetings, which begin tomorrow, June 12, and run through June 15. Visit download the section’s public meeting schedule.

Also, the section still is accepting donations to its fourth annual Desserts From Around the World Reception and for the IMG Honor Fund. Send an e-mail or call (312) 464-5397 for more information.

2) AMA-IMG members featured in San Antonio Medicine
Three AMA-IMG section members—governing council Vice Chair Jayesh Shah, MD; past governing council Chair Rajam Ramamurthy, MD; and Vijay Koli, MD, who represents Texas in the AMA House of Delegates—contributed to the April issue of San Antonio Medicine, which features articles and studies on international medical graduates.

Send an e-mail if you know of other articles that would be of interest to your colleagues.

Brought to you by the AMA Section on Medical Schools

1) Promote the AMA-SMS to your colleagues
The AMA-SMS Governing Council invites all academic physicians to join the AMA-SMS to help develop strategies that will strengthen the section and policies of the AMA. The section offers a forum for discussing policies on medical education and national research and health care issues. A major goal of the AMA-SMS is to enhance communication between the medical education community and the AMA.

Now more than ever, academic physicians are asked to balance the roles of educator, researcher and clinician. Because each academic physician has unique interests and challenges, the AMA is working hard to provide members with the resources to carry out these responsibilities and to help transform and enhance the medical education continuum.

Encourage your colleagues to join the AMA-SMS. Their creative energy is needed to keep academic medicine strong and thriving.

Send an e-mail for an informational packet about the AMA-SMS or for application details.

2) In the AMA GME e-Letter: Duty hour limits making headlines again
A recent study in the New England Journal of Medicine estimated that it would cost $1.6 billion per year to implement the Institute of Medicine’s recommendations in its December duty hours report. Further, the authors state that the patient safety implications are unknown.

More headlines will be made this month as the Accreditation Council for Graduate Medical Education holds a congress on duty hours. The AMA Council on Medical Education will be among the organizations providing testimony during the congress.

Learn more about this subject in the June issue of the AMA’s GME e-Letter.

3) AMA journal study analyzes new method to evaluate disaster readiness of U.S. cities
An innovative computer-based modeling approach for rare public health emergencies can help with disaster planning and medical response efforts in metropolitan areas, according to findings published last week by the AMA’s Disaster Medicine and Public Health Preparedness journal.

View an AMA news release about the study.

View the June issue of the journal.

1) AMA-MSS meeting is under way
The AMA-MSS Assembly meeting began earlier today and will run through June 13 at the Hyatt Regency Chicago. The meeting’s keynote speaker, Geoff Tabin, MD, professor of ophthalmology and visual sciences at the University of Utah and the John A. Moran Eye Center in Salt Lake City, and co-director of the Himalayan Cataract Project, will speak June 13 about eradicating world blindness.

The AMA-MSS Assembly will consider 26 items of business, and the AMA-MSS will host more than 30 educational programs, covering topics such as leadership, residency, thriving during your training years and medical education. In addition, the section’s Medical Specialty Showcase will feature more than 40 specialties represented in the AMA House of Delegates.

The AMA-MSS Assembly also will elect its 2009-10 governing council at this meeting. At the close of the meeting, Chair-elect Hans Arora will assume his position as chair, and Justin Mahida will begin his term as student trustee.

2) Apply to serve on an AMA-MSS standing committee
Each year the AMA-MSS Governing Council appoints AMA medical student members to serve one-year terms on its standing committees. Applications for 2009-10 standing committee positions are due June 26. Committee positions will be selected next month.

Visit the AMA-MSS Web site to learn more about these committees and to apply for a seat on one of them.

3) June issue of Virtual Mentor focuses on medicine and the environment
Recognition that the environment affects human health goes back to the time of Hippocrates, when ills were thought to be caused by interactions among the sick person’s internal “humors,” lifestyle and environment. Recently, society has learned about the harmful effects that treating illness imposes on the environment, creating, in turn, new health hazards.

This month’s issue of Virtual Mentor examines the connection between health and the environment and, specifically, the duty of physicians to understand how humans and their environment can harm each other.

4) AMA Foundation names Minority Scholars Award recipients
In an effort to promote diversity and help with the rapidly rising cost of medical education, the AMA Foundation recently presented 12 outstanding medical students from across the country with $10,000 Minority Scholars Awards.

The awards recognize scholastic achievement, financial need and personal commitment to improving minority health among first- or second-year medical students in groups defined as “historically underrepresented” in the medical profession. Less than 7 percent of U.S. physicians fall within these groups, which include African-American/black, American Indian, Native Hawaiian, Alaska Native and Hispanic/Latino.

The Minority Scholars Awards are given in collaboration with the AMA Minority Affairs Consortium, with support from Pfizer Inc. The National Business Group on Health added support to this scholarship program by starting an endowment honoring the late Ronald M. Davis, MD, immediate past president of the AMA. This specific Minority Scholars Award is granted to a minority medical student who has an interest in becoming a primary care physician.

Congratulations to the AMA-MSS member Minority Scholars Award recipients:

• Rashad Belin—University of Chicago, Pritzker School of Medicine
• Marlene Martin—Stanford University School of Medicine
• Elizabeth Phillips—Case Western Reserve University School of Medicine
• Manuel Tapia—University of California, Davis, School of Medicine

View a complete list of this year’s recipients.

5) JAMA: just one benefit of being an AMA member
Are you hungry for more knowledge? Would you like to take a break from textbooks and read new articles from physicians in the field? Your AMA benefits are bringing that resource to your front door.

Look in your mailbox for the Journal of the American Medical Association (JAMA), the most comprehensive resource for original research, reviews, commentaries, editorials, essays, medical news and correspondence. An international peer-reviewed general medical journal published 48 times annually, JAMA is the most widely circulated medical journal in the world. Since 1883, physicians and health care professionals around the world have turned to JAMA for groundbreaking research and insightful commentary from leaders across the broad spectrum of health care.

Online content includes PowerPoint image downloads, the ability to save and organize your favorite articles, and JAMA authors discussing their articles—live or via podcast.

You can choose to receive the weekly print version, or just access it online. Don’t forget about this valuable resource the AMA provides.

View the JAMA Web site.

If you’re an AMA member, don’t lose valuable resources such as JAMA. Renew your membership. If you’re not a member, join the AMA today and begin receiving them.

Brought to you by the AMA Minority Affairs Consortium

1) Study examines sexual risk behaviors among African-American men who have sex with men
A study published in the Journal of Urban Health investigates the sexual mixing patterns and partner characteristics of African-American men who have sex with men (MSM) in relation to sexual risk taking.

The study explored whether differences in sexual mixing patterns and partner characteristics could explain high rates of HIV incidence among this population. The study’s findings suggest that sexual risk behaviors of African-American MSM differ across partner type and by the characteristics of their sexual networks. The article concludes that effective prevention strategies are needed to address distinct sexual and behavioral risk patterns presented by different sexual partnerships reported by African-American MSM.

2) AMA-MAC caucus set for tomorrow
Plan to attend the AMA-MAC caucus, which will take place from 4 to 6 p.m. tomorrow, June 12, at the Hyatt Regency Chicago preceding the Annual Meeting of the AMA House of Delegates. Hector Castro, MD, medical director of the Latino Health Institute of New York, will speak about the institute’s mission to improve the health status of New York City’s Hispanic community by overcoming cultural, language and economic barriers to quality health care.

Send an e-mail to reserve a seat at the caucus.

1) Webinar breaks down Patient Safety Act
Learn more about the Patient Safety and Quality Improvement Act of 2005—also known as the Patient Safety Act—by viewing “Physician Leadership In Patient Safety Organizations,” a free webinar offered through June 30 by the AMA-OMSS.

In the webinar, Michael Callahan, a partner in the firm Katten, Muchin, and Rosenman, explains the scope of the Patient Safety Act; describes the two entities—patient safety evaluation systems and patient safety organizations—created by the Patient Safety Act; offers insight on the reporting process; and explains the junctures between other mandatory reporting requirements and the Patient Safety Act’s voluntary reporting process.

2) AMA-OMSS meeting is under way
The AMA-OMSS Assembly meeting is taking place through June 13 at the Hyatt Regency Chicago. On-site registration is open until 9 a.m. June 13. The meeting handbook and supplement are posted on the AMA-OMSS Web site, and a hard copy and/or CD is available at the meeting.

Access the handbook.

Access the handbook supplement.

3) AMA makes strides on PPO front
After several years of work, the AMA last fall successfully advocated for the National Conference of Insurance Legislators—composed of lead state legislators who handle insurance issues—to adopt model legislation to regulate the rental network preferred provider organizations (PPO) market and prohibit silent PPOs.

The AMA has worked with state medical associations to implement rental network PPO reform in several states. Colorado passed groundbreaking legislation in 2007, and Connecticut, Florida, Indiana and Ohio all passed laws in 2008. Georgia and Utah passed rental network PPO reform laws earlier this year, and Oregon, Rhode Island, Tennessee, Texas and Vermont have bills pending.

AMA members can visit the AMA Web site to learn more about this issue.

4) Interim Meeting webcasts added to archives
The AMA-OMSS has posted a pair of 90-minute educational webcasts to its Web pages: “Physicians as Targets and How to Avoid Being One” and “Organized Medical Staffs and Disruptive Behavior.” Both of these programs provide AMA PRA Category 1 Credit™.

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

1) AMA-RFS meeting is under way
The AMA-RFS Assembly meeting begins today and will run through June 13 at the Hyatt Regency Chicago. Visit the AMA-RFS Web site to learn more about the meeting and to download the meeting handbook.

2) Apply for Fund for Better Health grant
The AMA Foundation is accepting applications for its Fund for Better Health grants. With support from the AMA Alliance, the foundation provides seed grants for grassroots public health projects that target healthy lifestyles. A maximum grant of $5,000 will be awarded to organizations that support healthy lifestyle programs that address such topics as nutrition and physical fitness; alcohol use; substance abuse and smoking prevention, including smoking cessation; and violence prevention, including domestic violence, Internet safety and bullying. Applications are due by July 15.

Visit the AMA Foundation Web site to learn more about the Fund for Better Health and to download a grant application.

3) In the AMA GME e-Letter: Duty hour limits making headlines again
A recent study in the New England Journal of Medicine estimated that it would cost $1.6 billion per year to implement the Institute of Medicine’s recommendations in its December duty hours report. Further, the authors state that the patient safety implications are unknown.

More headlines will be made this month, as the Accreditation Council for Graduate Medical Education holds a congress on duty hours. The AMA Council on Medical Education will be among the organizations providing testimony during the congress.

Learn more about this subject in the June issue of the AMA’s GME e-Letter.

4) The CPT^® Assistant newsletter: just one benefit of being an AMA member
How well do you understand the intricacies of coding? You might not have tackled coding during residency or fellowship, but as a practicing physician, you will be responsible for the accurate coding of services. As an AMA member, the CPT^® Assistant newsletter can help you with coding issues.

The CPT^® Assistant newsletter brings you detailed articles, commentaries, updates and other timely facts. Read specific clinical vignettes that offer insight into confusing codes or view anatomical illustrations, charts and graphs for quick reference. A subscription to the newsletter is available to AMA members at a discounted price.

Visit the AMA Bookstore to read more about the CPT^® Assistant newsletter and to subscribe to it.

Send an e-mail to order a free sample of the CPT^® Assistant newsletter.

If you’re an AMA member, don’t lose valuable resources such as the discounted CPT^® Assistant newsletter subscription rate. Renew your membership. If you’re not a member, join the AMA today and begin receiving them.

1) Annual Meeting program to discuss competency, recertification and the value of experience
The AMA-SPG is jointly sponsoring a continuing medical education program titled “Keeping Senior Physicians in Practice: Issues of Competency, Recertification and the Value of Experience” from 1 to 2:30 p.m. June 13 during the Annual Meeting of the AMA House of Delegates.

John A. Fromson, MD, assistant clinical professor of psychiatry at Harvard Medical School, will help attendees understand the value that senior physicians bring to a practice, the most common age-related issues to be aware of, and practical solutions and environmental adjustments to address those issues.

The program also is sponsored by the AMA Organized Medical Staff Section and the AMA Advisory Committee on Group Practice Physicians.

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

2) Senior physician liaison meeting set for tomorrow
Plan to attend the AMA-SPG liaison meeting from 4 to 5 p.m. tomorrow, June 12, at the Hyatt Regency Chicago preceding the Annual Meeting of the AMA House of Delegates. The AMA-SPG is seeking representation from each state on senior-oriented programs that can be presented for discussion at House of Delegates meetings. Any state medical society staff member who is interested in senior physician issues also is welcome to attend.

For more information or to verify a contact member for your state, contact Alice Reed by e-mail or call (312) 464-5523.

Brought to you by the AMA Women Physicians Congress

1) AMA-WPC caucus set for June 13
Plan to attend the AMA-WPC caucus, to be held from 5:30 to 7:30 p.m. June 13 at the Hyatt Regency Chicago as part of the Annual Meeting of the AMA House of Delegates.

During the caucus, the 2008 recipients of the Joan F. Giambalvo Memorial Scholarship will present results of their research. Sue Yom, MD, will report on the results of her study, “Why do they leave? Female faculty retention and the costs of academic attrition,” and Maurice Clifton, MD, will present preliminary findings from his study, “Defining obstacles to the practice of medicine in rural areas by women physicians.”

The caucus also will include a special celebration in recognition of the 30th anniversary of the AMA’s Women in Medicine Program.

2) WPC liaisons: Annual breakfast meeting to be held June 15
The AMA-WPC Liaison Breakfast will be held from 7:30 to 8:45 a.m. June 15 at the Hyatt Regency Chicago as part of the Annual Meeting of the AMA House of Delegates. Liaisons are asked to reserve a seat at the breakfast by sending an e-mail or calling (312) 464-4743.

WPC liaisons are appointed by executive directors of state and specialty medical societies. If you are unaware if one of your organizations has a liaison or would like more information about how to become a liaison, contact the AMA-WPC.

1) AMA-YPS meeting is under way
The AMA-YPS Assembly handbook is available for download. The AMA-YPS Assembly meeting began today at the Hyatt Regency Chicago and will run through June 13.

2) AMA-YPS announces community service award winners
The following physicians will receive AMA-YPS Community Service Awards tomorrow, June 12, during the AMA-YPS Assembly meeting:

• Robert F. Melendez, MD, for his work with the Juliette RP Vision Foundation
• Brent R. Middlestaedt, DO, for his work with Photos for the Forgotten
• Michael S. Provenghi, MD, for his work with the Mobile Clinic Program

Through its annual Community Service Award, the AMA-YPS strives to not only recognize excellence in community service activities carried out by young physicians but to encourage similar efforts by other doctors. Congratulations to this year’s winners.

3) June issue of Virtual Mentor focuses on medicine and the environment
Recognition that the environment affects human health goes back to the time of Hippocrates, when ills were thought to be caused by interactions among the sick person’s internal “humors,” lifestyle and environment. Recently, society has learned about the harmful effects that treating illness imposes on the environment, creating, in turn, new health hazards.

This month’s issue of Virtual Mentor examines the connection between health and environment and, specifically, the duty of physicians to understand how humans and their environment can harm each other.

4) In the AMA GME e-Letter: Duty hour limits making headlines again
A recent study in the New England Journal of Medicine estimated that it would cost $1.6 billion per year to implement the Institute of Medicine’s recommendations in its December duty hours report. Further, the authors state that the patient safety implications are unknown.

More headlines will be made this month, as the Accreditation Council for Graduate Medical Education holds a congress on duty hours. The AMA Council on Medical Education will be among the organizations providing testimony during the congress.

Learn more about this subject in the June issue of the AMA’s GME e-Letter.