AMA eVoice Weekly Newsletter

Domestic violence: a national epidemic

You may have heard about the horrific crime that occurred in my hometown of Orchard Park, N.Y., a few weeks back. A wife with an order of protection against her estranged husband was beheaded, allegedly by him, in the TV station they co-owned.

While this fatality was grisly, it’s undeniably true that domestic violence occurs throughout our country every day—and most of the time, it’s not even reported to authorities. When it is reported, women are the victims by a large preponderance. However, if one looks at survey results, the incidence of violent acts is more gender-egalitarian, though the serious acts are most often perpetrated by men.

Women experience about 4.8 million intimate partner-related physical assaults and rapes (PDF) each year, while men are the victims of about 2.9 million intimate partner-related physical assaults. Domestic violence, or intimate partner violence (IPV), is an issue that touches the lives of many throughout our nation. This important problem deserves national attention and will require collaboration among all partners, especially physicians, to address it.

Domestic violence includes physical, psychological, sexual, economic and emotional abuse, and it can occur in all age groups. The physical injuries and emotional harms of violence are often acknowledged. However, violence is also linked to harmful health behaviors and is increasingly being linked to chronic health conditions.

Every doctor knows about violence among intimate partners, about child abuse and about elder abuse. If we work in emergency departments or as trauma surgeons, we are sometimes frontline witnesses. But the much more common presentation of domestic violence is bound up in vague symptoms—depression, fatigue, sleeplessness, alcohol or drug abuse—and those present to us in our offices.

While studies show that patients would like their health care providers to ask them privately about IPV, only 10 percent of primary care physicians routinely screen for IPV during new patient visits, and only 9 percent routinely screen during periodic checkups. As physicians, our goal is simple: We must help stop domestic violence.

A remarkable seminar on domestic violence occurred in Buffalo several weeks ago. It was a collaborative project of my county medical society and the local bar association, and a standing-room only audience of physicians and attorneys learned how to recognize and help in IPV. We have to ask questions in non-threatening ways, establish trust and be supportive. We need to encourage patients to examine their options, and we have to recognize that it may take a number of encounters for someone to get up the courage to protect themselves by going to the authorities.

So don’t get irritated if your patient doesn’t follow through right away. It takes trust, understanding and a knowledge of what resources exist in your community. Your county medical society should be able to help catalog those resources. We learned about a centrally located resource in our community where physicians, attorneys, law enforcement officers and social workers are all present at one site. We heard poignant real-life stories of abuse relayed by victims (some were professionals themselves). We watched a 20/20 clip of a local woman brutally abused by her husband while their 13-year-old son videotaped it all. How tragic is that? 

Violence begets violence. I learned that when former AMA President J. Edward Hill, MD, and I served on a national commission to prevent youth violence. Those who witness violence in the home, even when they are not themselves the victims, are statistically more likely to become perpetrators of domestic violence later on. What a horrible legacy to pass from one generation to another.

The AMA can help us and has already taken the lead in doing so. The AMA’s Council on Science and Public Health and Council on Ethical and Judicial Affairs (CEJA) have produced several reports and ethical standards on topics about violence and abuse. CEJA continues to revise and update these standards.

At the 2007 Interim Meeting, the AMA House of Delegates adopted CEJA’s amendment to Opinion E-2.02, “Physicians’ Obligations in Preventing, Identifying and Treating Violence and Abuse” in order to more thoroughly address physicians’ roles in assessment, prevention and reporting of violence and abuse, and to more accurately reflect current standards of practice.

In addition, the AMA has more than 80 policies related to violence and abuse in its compendium,  and the AMA provides countless educational resources and links to guide physicians on this issue. The AMA’s most recent addition to its Educating Physicians on Controversies and Challenges in Health series explores patient exposure to family violence and outlines specific steps physicians should be taking in preparation to best intervene.

That’s not all. We’ve convened a council of more than 35 state and specialty medical societies, advisory federal agencies and national advocacy groups to actively encourage physicians and other health care providers to learn more about all forms of violence and abuse and to support prevention and treatment. The AMA’s National Advisory Council on Violence and Abuse, founded in 1991, met last month in Washington, D.C., to emphasize another issue associated with the impact of domestic violence on patient health—the cost it imposes on health care. 

The council convened violence prevention and health experts to brief members of Congress and congressional staff about greater costs and more frequent health care access in victims exposed to violence and abuse. David Corwin, MD, chair of the council, and other experts told congressional staff that physical, sexual and psychological violence can have a significant impact on victims’ long-term health, and that effective intervention and prevention strategies can decrease the health care costs associated with abuse paid by private and public insurers. He pointed out that as health care reform advances, violence prevention needs to be an integral part of the discussion.

The council specifically asked Congress to commission the Institute of Medicine to study the impact and health care costs of violence and abuse and encouraged federal agencies to conduct research on the cost savings resulting from health interventions. In addition, the council advocated for full funding of the health and prevention titles of the Violence Against Women Act and for the appropriation of funds to create the Health Child Abuse Research, Education and Services Network.

While requests for the federal government to act are being considered, there are things you can do today in your practice. First, be alert to vague symptoms, to bruises in peculiar places, to hesitant answers to questions. And you never know when you’re going to have an impact. One of my patients, an anesthesiologist, told me years later that my simple question—“Do you feel safe at home?”—gave her the courage to confront the physical abuse she was enduring.

Another former AMA president, Robert McAfee, MD, was an eloquent spokesperson on this issue. At one AMA meeting he arranged for a theater troupe to depict short vignettes of verbal and physical abuse. In the audience was a physician who was stunned to watch snapshots of her own troubled marriage. She retreated to a restroom and broke down in tears. Afterward she sought out Dr. McAfee and said, “We have to talk.” That was her critical first step in ending an abusive relationship.

Like Dr. McAfee, you may be surprised when something you do or say impacts and empowers a patient or a friend. Stay alert—it could be you who makes the crucial difference. I hope it is.

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

1) AMA and other health groups pledge to reduce rate of growth in health spending
The AMA and five other stakeholder organizations met with President Barack Obama on May 11 at the White House to discuss their shared goal of reducing the growth in health care spending by 1.5 percent annually over the next 10 years. The health organizations did not strike a deal with the Obama administration on a health system reform plan, but they came together to demonstrate their commitment to doing their part to help pave the way toward a financially sustainable health care system.

The groups identified initiatives such as administrative simplification and standardization, transparency to support effective insurance markets, coordinated care, adoption of best practices and disease prevention among those that promise to make heath care costs more sustainable. AMA President-elect J. James Rohack, MD, and Chair-elect Rebecca Patchin, MD, represented the AMA. Other organizations at the table included the Advanced Medical Technology Association, American’s Health Insurance Plans, the American Hospital Association, Pharmaceutical Research and Manufacturers of America, and Service Employees International Union.

“The AMA is committed to action to help achieve greater value from our nation’s health care spending,” Dr. Rohack said. “We want to help bend the spending curve and move forward on health reform.”

Visit the AMA Web site to learn more.

View text of a letter the stakeholder groups sent to the president.

2) Register today for free stimulus webinar series
Are you ready to maximize American Recovery and Reinvestment Act (ARRA) opportunities in your practice? The AMA’s new stimulus webinar series can help—and it’s free. 

This series, comprised of three one-hour meetings, is designed to:

• Help physicians learn the basics of health information technology (Health IT) provisions and the latest on the framework for the development and adoption of a nationwide Health IT infrastructure.
• Support physician practices as they prepare for a new health care environment.
• Connect physicians with practices that use electronic health records systems and explain how they made the transition.

All webinars will be held at noon CST. Catch one, two or all three in the series, which begin next week. Programs include “Stimulus 101: Basics of the health information technology provisions” on May 21; “Stimulus 102: Update on health information technology provisions” on June 9; and “Stimulus 103: Real world practice perspectives” on June 14.

Visit the Health IT Web site to learn more and register.

3) AMA announces collaboration with physician blogger KevinMD.com
AMA President-elect J. James Rohack elaborates at KevinMD.com on this week’s White House meeting aimed at “bending the health care spending curve” to help achieve health care reform this year. Dr. Rohack’s column is the first in a new monthly collaboration between the AMA and KevinMD.com.

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 for USA Today.

4) Commission outlines key priorities to end health care disparities
Sixty-five national health and medical profession organizations recently drafted and ratified a letter to President Barack Obama and his administration during the AMA’s and National Medical Association’s (NMA) Commission to End Health Care Disparities spring meeting in Los Angeles. The letter, which was sent to Obama and his health reform team April 28, outlined what should be key priorities in health care reform to eliminate health care disparities.

During the two-day meeting—themed “Latino population in health care disparities: Challenges and solutions”—the organizations collaborated on strategic goals to unify efforts to achieve quality care for racial and ethnic minorities. AMA President and Commission Co-chair Nancy H. Nielsen, MD, PhD, conducted business, along with Commission Co-chair and NMA Past President Sandra Gadson, MD.

The AMA, NMA and the National Hispanic Medical Association together serve as secretariat for the commission.

5) Downcoded claim payments are unacceptable—file a compliance dispute
Are you concerned about a health insurer not adhering to accurate and timely payment or fair business practices? If so, there’s something you can do about it.

A variety of enforcement mechanisms are available to physicians for the WellPoint/Anthem, Health Net, Humana and Blue Cross Blue Shield settlements. Under these settlements, health insurers are not permitted to automatically downcode any evaluation and management (E/M) code for covered services, except to reassign a new patient as an established patient based on AMA CPT® codes, guidelines and conventions.

If your practice is experiencing downcoding of E/M codes, consider filing a compliance dispute. Visit the Health Insurer Settlements Web page to access checklists of key terms of the settlements and to learn more about the simple and free compliance dispute process.

6) AMA encourages hospitals to promote transparency in pricing
Physician resources often are used to help find and negotiate hospital pricing for uninsured, underinsured and cash-paying patients, and the AMA believes those patients deserve transparency from hospitals regarding pricing.

With that, the AMA acknowledges and appreciates efforts by the American Hospital Association (AHA) to encourage transparent pricing, develop patient information explaining individual hospital billing processes and discounts available, and to educate patients about their bill-paying rights and responsibilities. To enhance communication, the AMA encourages hospitals to make patient education information on their pricing and billing policies available to their medical staff members.

Visit the AHA Web site to view AHA policies and guidelines on billing, collections, tax-exempt status and community health.

Learn more about the AHA’s Patient Care Partnership, which informs patients about what they should expect during their hospital stay regarding their rights and responsibilities.

7) Guidance on evaluating incentive plans: just one benefit of being an AMA member
What incentive plans make the most sense for you and your patients? Do you know what you should consider before entering a pay-for-performance program?

Seek answers by reading the AMA members-only article, “Physician’s guide to evaluating incentive plans.” This resource, developed by the AMA’s Practice Management Center (PMC), encourages physicians to evaluate incentive plans for their potential to improve health care quality and their ability to operate in an ethical and fair manner. And it provides questions and observations that can be useful when looking at common properties of pay-for-performance and other physician incentive programs.

View other resources from the PMC.

Visit the AMA Web site to renew your AMA membership, or to join the AMA and have access to valuable resources such as this.

8) Ethics in brief: physician responsibilities in an epidemic
As swine influenza A, or H1N1, becomes a global epidemic, physicians must be cognizant of their ethical obligations to provide urgent medical care to individual patients—even in the face of greater-than-usual risks to their own safety, health or life. And physicians must be aware of their duties to protect the public’s health.

In the event that quarantine and isolation measures are needed, physicians should ensure that the least restrictive measures are employed in a manner that does not discriminate against particular socioeconomic, racial or ethnic groups. Physicians also should educate patients about personal and public benefits and encourage patients to comply voluntarily. And when a patient refuses to comply with recommended isolation or quarantine, physicians should support mandatory measures. All the while, physicians should protect patient confidentiality to the greatest extent possible, consistent with any mandated public health reporting.

Physicians have a responsibility to protect their own health to ensure that they can continue to provide needed medical services and should take steps to minimize the risk of physician-to-patient transmission. In addition to acquiring and maintaining relevant knowledge, frontline physicians should avail themselves of safe, effective protective and preventive measures (including appropriate vaccination), seek medical evaluation and treatment, and adhere to sound public health practices.

For more information on a physician’s responsibilities in an epidemic or other disaster, view the AMA Code of Medical Ethics opinions “Physician Obligation in Disaster Preparedness and Response and “The Use of Quarantine and Isolation as Public Health Interventions.”

9) In JAMA: Diet and exercise intervention helps older, overweight cancer survivors reduce functional decline
A home-based diet and exercise program reduced the rate of functional decline among older, overweight long-term survivors of colorectal, breast and prostate cancer, according to a study in the May 13 issue of the Journal of the American Medical Association (JAMA).

Visit JAMA to view the study.

1) In the New York Times: White House under pressure to act on flood of gay issues
According to a story published May 6 by the New York Times, the Obama administration is under pressure to address a host of gay-related issues that have emerged recently, including the president's pending Supreme Court nomination, his new global health initiative and the debate about same-sex marriage.

View the story.

2) Obama's selection of AIDS chief draws praise
AIDS advocates are praising President Barack Obama's nomination of Eric Goosby, MD, to serve as the State Department's global AIDS coordinator. Dr. Goosby brings more than 25 years of experience with HIV-related issues, ranging from his early years treating patients at San Francisco General Hospital to serving in the Clinton administration as deputy director of the National AIDS Policy Office and director of AIDS policy in the Department of Health and Human Services.

3) In American Medical News: Maintain a regularly updated fee schedule, experts advise
You might know what health plans or Medicare will pay, but what are your fees? In a story published May 4 by American Medical News, practice management experts say that your fee schedule should be set carefully and updated regularly. Even if you end up discounting from your fee schedule in nearly all cases, you should know what your breaking points are, such as when a discount means you would not make a profit and when it would mean you would lose money.

View the story.

1) Register to attend the AMA-IMG Section meeting
Mark your calendars for the AMA-IMG Section Assembly meeting, which will take place June 12–15 at the Hyatt Regency Chicago. Scheduled events include:

• The AMA-IMG Section Congress on June 12, with a keynote address by James Hallock, MD, president of the Educational Commission for Foreign Medical Graduates (ECFMG), who will speak about the state of the ECFMG.
• The AMA-IMG caucus June 13 and June 15.
• The Busharat Ahmad, MD, Leadership Program, featuring Dr. Hallock, on June 15.

In addition, the fourth annual Desserts From Around the World and IMG Honor Fund Reception will take place at 9:30 p.m. June 13 at the Hyatt Regency Chicago. Cultural attire is encouraged, and guests will have an opportunity to make a difference in the lives of the uninsured by supporting the IMG Honor Fund in partnership with the AMA Foundation.

Submit your registration form before May 22 by e-mail or fax it to (312) 464-5845.

Visit the AMA-IMG Web site for the assembly meeting's full schedule and to register to attend.

Contact J. Mori Johnson at (312) 464-5678 or send an e-mail if you have questions or if you wish to give an organizational report during the AMA-IMG Section Congress.

Brought to you by the AMA Section on Medical Schools

1) AMA-SMS seeks resolution and report reviewers
Members attending the AMA-SMS meeting in June are asked to participate in the review of resolutions and reports. Reviewers develop a consent calendar of recommended actions and present the recommendations to the section for a consensus vote. These actions guide the AMA-SMS delegate, alternate delegate and other representatives who testify in reference committee hearings. A review meeting will be held from 8:30 to 10:30 a.m. June 12 at the Hyatt Regency Chicago.

Send an e-mail to Jackie Drake if you are interested in participating.

2) AMA research collaborative receives federal funding
The AMA Innovative Strategies for Transforming the Education of Physicians (ISTEP) research collaborative has received $250,000 as part of the National Institute on Drug Abuse's Centers of Excellence for Physician Information program. The AMA and the eight medical schools participating in the program will use this money to refine and develop educational resources on substance abuse prevention, diagnosis and treatment.

The ISTEP research collaborative has completed the resident component of the Sound Prescribing study, a randomized trial to assess the educational efficacy of Web-based interventions designed to help physicians address industry marketing and promotional influences on their prescribing decisions. A continuing medical education offering based on the study will be available free for physicians in late June.

3) Physicians of Tomorrow scholarship nominations due May 29
Twelve $10,000 Physicians of Tomorrow scholarships from the AMA Foundation are available for third-year medical students who are entering their fourth year of study. Nominations are due by May 29. Recipients will be selected based on academic achievement and financial need.

In addition, the Audio-Digest Foundation and the Johnson F. Hammond, MD Fund are both funding separate Physicians of Tomorrow scholarships. Medical schools may submit one nomination for each of the three scholarship opportunities.

Visit the AMA Foundation Web site to learn more about the Physicians of Tomorrow scholarships and to download an application form and nomination instructions.

4) In the New York Times: Medical schools, students preparing for health system reform
A recent story by the New York Times looks into how the nation's medical schools and students and preparing for "challenges associated with health system reform given the recent expansion of medical school enrollment.

View the New York Times story.

1) Apply for a position on the AMA-MSS Governing Council
Are you interested in a national leadership position with the AMA-MSS? The section is accepting applications for the following positions on its governing council: vice chair, delegate, alternate delegate, at-large officer, speaker and vice speaker. The AMA-MSS Governing Council acts as the "board for the section in that its members direct the programs and activities of the AMA-MSS on a national level. The deadline to apply is tomorrow, May 15.

Download an application form.

2) Help the AMA-MSS select a new national service project
As part of the AMA's commitment to help medical students impact the communities in which they live and learn, every two years the AMA-MSS selects a national service project around which to focus its community service activities. The current service project, "Covering the uninsured and protecting access to care, expires this year, so all AMA medical student members are being asked via an e-mail survey to help select a new project for 2009–2011.

If you are an AMA student member, check your e-mail for the survey. If you have not received the e-mail, contact the AMA-MSS by e-mail with your name, school and e-mail address. The deadline to complete the survey is May 22.

3) AMA advocacy: just one benefit of being an AMA member
During your time as a medical student, who's got your back? AMA advocacy is a benefit that is always in your corner. Whether or not you're actively involved in AMA activities, your membership supports advocacy at the national and grassroots level.

The AMA-MSS has developed recommendations for legislative and administrative remedies to resolve the medical education debt crisis. And the section is a national supporter of Cover the Uninsured Week and a national partner of the Robert Wood Johnson Foundation's Covering Kids and Families project. Just by being a member, you are giving the AMA-MSS the fuel to fight on your behalf and for causes that you can believe in.

Visit the AMA Web site to renew your AMA membership or to join the AMA.

4) Chapter of the week: Wright State University Boonshoft School of Medicine hosts events for uninsured
Medical students at Wright State University Boonshoft School of Medicine organized a series of events last month as part of the ongoing AMA-MSS national service project, "Covering the uninsured and protecting access to care.

Events included a panel discussion about the issue of the uninsured, which featured physicians, business representatives, patient advocates and health system reform experts. Students also held a fundraiser for a local free clinic and participated in a community health fair, where they distributed information about free and low-cost health insurance options for the uninsured.

Cover the Uninsured Week may have passed, but it's never too late for your chapter to hold an event aimed at covering the uninsured and protecting access to care. The AMA-MSS has a number of resources to help you plan a great event, including chapter involvement grants (CIG). Chapters are eligible for $1,000 per academic year with a maximum of $250 to $500 per event.

Visit the Web site to learn how to get involved and plan an event at your chapter.

Visit the Web site to apply for a CIG at least 30 days before your event.

5) AMA GME e-Letter: Medical work force on congressional agenda
The Obama administration and Congress have started to recognize that to achieve major health care reform and cover the uninsured, the medical work force—particularly in primary care—must be bolstered, according to the May issue of the AMA GME e-Letter.

One recent proposal in this regard is the Resident Physician Shortage Reduction Act, which would increase the number of Medicare-supported residency/fellowship positions by 15 percent. The bill also targets expansion of residency positions in primary care, general surgery and nonhospital settings.

1) Campaign to help raise awareness of infant mortality, health disparities
Physicians and medical students are invited to learn about "A Healthy Baby Begins with You, a national campaign by the Department of Health and Human Services' Office of Minority Health to raise awareness about infant mortality with an emphasis on the African-American community. The campaign is an effort to end health disparities among racial and ethnic minorities.

Visit the Office of Minority Health Web site to learn more about the campaign.

2) Learn about efforts to fight lupus
With World Lupus Day having been observed May 10, the Lupus Foundation of America invites physicians and medical students to learn about what organizations worldwide are doing to help combat this often debilitating disease.

Visit the Lupus Foundation of America Web site to learn more.

3) Dermatologists highlight need for cancer screening
This month the American Academy of Dermatology (AAD) is encouraging people to screen themselves and those they love for skin cancer, part of the AAD's observation of May as Melanoma/Skin Cancer Detection and Prevention Month^®. Performing regular skin self-examinations is an easy way to detect suspicious moles that could be cancerous, and research shows that involving a partner in the process can help detect skin cancer earlier.

Visit the American Academy of Dermatology Web site to find out how to perform a self-exam, download a body mole map or find free skin cancer screenings held at locations across the country.

1) AMA-OMSS meeting fast approaching
Registration is ongoing for the 53rd annual AMA-OMSS Assembly meeting, which will be held June 11–13 at the Hyatt Regency Chicago. The deadline to register for the meeting is June 5.

Send late resolutions to James DeNuccio by 4 p.m. CST June 11.

Visit AMA-OMSS Web site to register and make travel arrangements for the meeting. The AMA-OMSS Assembly Meeting Handbook will be available online by May 22, and a hard copy and/or CD of the handbook will be available at the meeting.

2) 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.

3) Align your bylaws with Joint Commission standards
Because medical staff bylaws are considered a contract and are legally binding in most states, it is extremely important that they are well-designed and well-written. The fourth edition of the "Physician's guide to medical staff organization bylaws" contains practical guidance on bylaws development, model bylaw language, information on emerging issues and recent trends in medical staff re-engineering. The guide will be especially helpful to medical staffs as they update their bylaws to align with Joint Commission standards.

AMA members can download this resource.

4) Resource helps strengthen physician-hospital relationship
A printable version of the "Principles for strengthening the physician-hospital relationship," developed by the AMA-OMSS and adopted by the AMA House of Delegates, is available online. These principles are designed to improve the working relationship between physicians and hospitals and ultimately foster better patient care and improve patient safety.

Send an e-mail to order a poster of the principles for your medical staff lounge.

1) AMA-RFS meeting right around the corner
Did you register for the AMA-RFS Assembly meeting? If not, you can still do so at the meeting, which will take place June 11–13 at the Hyatt Regency Chicago. Don't miss this unique opportunity to take part in networking, policy making and educational sessions.

There is still time to reserve a room at the Hyatt Regency Chicago, but don't delay. The deadline to reserve a room is May 18.

Visit the AMA-RFS Web site to reserve a hotel room and for more details about the meeting.

2) New ACGME award to honor residents for improving graduate medical education
The Accreditation Council for Graduate Medical Education (ACGME) is accepting nominations for the inaugural David C. Leach, MD, Award, which will recognize residents and resident teams for improving graduate medical education.

The award, named in honor of the ACGME's former chief executive officer who retired in 2007, will be given to residents or resident teams—residents, fellows, faculty, program coordinators or allied health professionals—who have developed a project or activity that improves graduate medical education in one or more of the following areas:

• Fostering innovation and improvement in the learning environment
• Increasing the program's emphasis on educational outcomes
• Increasing efficiency and reducing non-educational burden
• Improving communication and collaboration in education and patient care within the program or institution
• Advancing humanism in patient care and among health care professionals

Residents and teams may be nominated by program directors, designated institutional officials, program coordinators, ACGME review committees or chief executive officers of teaching hospitals. Five awards will be given to residents or resident teams. The awards will be presented at the ACGME's annual educational conference in March 2010. Nominations are due July 1.

3) Programs increase residents' prescription knowledge for elderly
Innovative programs that teach medical students and residents to more carefully prescribe medications for older patients—including elderly patients taking multiple medications—can lead to safer prescribing practices, according to a pair of studies presented last month during the American Geriatrics Society's annual Scientific Meeting.

4) AMA GME e-Letter: Medical work force on congressional agenda
The Obama administration and Congress have started to recognize that to achieve major health care reform and to cover the uninsured, the medical work force—particularly in primary care—must be bolstered, according to the May issue of the AMA's GME e-Letter.

One recent proposal in this regard is the Resident Physician Shortage Reduction Act, which would increase the number of Medicare-supported residency/fellowship positions by 15 percent. The bill also targets expansion of residency positions in primary care, general surgery and nonhospital settings.

5) AMA Morning Rounds: just one benefit of being an AMA member
Have you been reading your daily dose of government and medicine, public health and pharmaceutical news? If this doesn't ring a bell, then you haven't been reading AMA Morning Rounds.

The authoritative news briefing written exclusively for AMA members, AMA Morning Rounds provides concise summaries of the day's most important developments in health care. Have the latest stories in government and medicine, the medical-legal landscape, health care coverage and access, public health, and pharmaceutical and medical device news waiting for you in your e-mail inbox every weekday morning.

Subscribe to AMA Morning Rounds.

Visit the AMA Web site to renew your AMA membership, or to join the AMA and have access to valuable resources such as this.

1) Volunteer initiative helping New Jersey's uninsured
The AMA encourages senior physicians to learn more about the Bergen Volunteer Medical Initiative, where volunteer physicians, nurses and other health care professionals provide free primary care to patients in New Jersey's Bergen County who meet certain income levels but have neither health insurance nor the means to pay for care. In addition, the AMA encourages all senior physicians groups to work to help uninsured patients in their respective communities.

Visit the Bergen Volunteer Medical Initiative Web site to learn more about the Bergen Volunteer Medical Initiative.

2) In American Medical News: Accommodating elderly patients
A story published May 4 by American Medical News looks at the increase in the number of elderly patients that physicians will see as a result of the rising tide of baby boomers and offers tips from experts to help doctors meet the treatment needs of those patients.

View the story.

Brought to you by the AMA Women Physicians Congress

1) Study finds that women are 10 times more likely to do breast self-exams correctly with intervention program
A brief intervention program consisting of one counseling session and two follow-up phone calls boosted by tenfold the number of women correctly performing breast self-exams, according to a recent Kaiser Permanente Center for Health Research study. Funded by the National Cancer Institute, the study is one of the first to show that intervention programs can be effective in increasing breast self-exams.

Visit Kaiser Permanente Center for Health Research to learn more about the study.

2) AMA president to speak at Connecticut State Medical Society conference
AMA President Nancy H. Nielsen, MD, PhD, will be the keynote speaker at the "Connecticut Women in Medicine: Strategies for Success program, hosted by the Connecticut State Medical Society, on May 20 in Farmington, Conn. This daylong conference will feature workshops on the role that women physicians have played in organized medicine, strategies for communication and negotiation in the work place, and career paths for physicians and their effect on life choices.

For more details about this event, contact Christi Holmes at (203) 865-0587.

1) AMA-YPS meeting fast approaching
Young physicians, mark your calendars: This year's AMA-YPS Assembly meeting will be held June 11–13 at the Hyatt Regency Chicago.

Visit the Web site to register for the meeting.

View the draft agenda.

Send an e-mail to Jane Ascroft to submit resolutions and to volunteer for reference, AMA House of Delegates handbook review and credentials committees.

2) Submit testimony on AMA-YPS items of business
Members of the AMA-YPS are encouraged to comment on reports and resolutions using the section's online, interactive work space. Testimony will be accepted until noon CST June 2 and will be reviewed by the AMA-YPS Reference Committee. Delegates also will be able to testify in person during the June 12 AMA-YPS Assembly meeting.

Visit the Web site to comment on AMA-YPS reports and resolutions.

Send an e-mail to Jane Ascroft if you are unable to access the online work space.

3) Apply for AMA-YPS Governing Council positions
Candidates interested in a position on the AMA-YPS Governing Council are encouraged to submit nominations by June 1. Open positions include chair-elect, who serves a three-year term as chair-elect, chair and immediate past chair; speaker, who serves a two-year term; alternate delegate, who serves a two-year term; and member at-large, who serves a two-year term.

All terms begin at the close of the Annual Meeting of the AMA House of Delegates. After June 1, nominations will only be accepted from the floor at the June 12 AMA-YPS Assembly meeting. Candidates whose nomination forms are received before June 1 will be posted on the AMA-YPS Web site.

Download a nomination form.

Learn more about AMA-YPS Governing Council positions and duties.

View candidate profiles online.