Last chance to apply: Health Systems Science Scholars Program

Presented by the American Medical Association in collaboration with the AMA Accelerating Change in Medical Education Consortium, the AMA Health Systems Science Scholars Program focuses on the implementation of health systems science curricula in undergraduate and graduate medical education.

Apply now!

The program will provide an overview of how to design, implement and evaluate health systems science curriculum with particular interest on how health systems science can promote health equity. If you have responsibility—or anticipate having responsibility—for implementing or teaching topics related to health systems science, we invite you to apply for this unique learning experience.

Successful applicants will participate in a year-long longitudinal experience beginning Dec. 2 with a virtual kick-off session. This will be followed by a dynamic two-day in-person workshop May 7–8, 2023, and culminate with a graduation in December 2023. Throughout the year program scholars will participate in webinars, virtual gatherings and mentorship sessions with national experts.

Submission information
Faculty from both consortium and non-consortium institutions are welcome to apply. Applicants will be asked to submit a concrete project, which will serve as part of their focus during the program’s workshop. Applicants must be nominated by their department chair or dean. We encourage early submissions as space is limited—the deadline for submission is 5 p.m. Central time, Aug. 8.

Please share this opportunity with colleagues. Questions? Email [email protected] for more information.

Click here to apply.

New Resources from the AMA

Private Practice Playbook

This new, free the AMA STEPS Forward® resource is full of information to help physicians determine if opening a private practice is the right move for them, including guidelines for running a private practice and strategies to help grow a practice into a successful healthcare facility. LEARN MORE and then DOWNLOAD THE PLAYBOOK.

Accelerating and Enhancing Behavioral Health Integration through Digitally Enabled Care

Tuesday, August 2 | 12:00 pm CT

This live webinar co-hosted by the AMA and Manatt Health shares examples from innovators and researchers applying practical solutions for supporting the widespread adoption of sustainable behavioral health integration. REGISTER HERE.

Social Determinants of Health

Tuesday, August 9 | 12:00 pm CT

Join us for this live AMA STEPS Forward® webinar and hear panelists from Rush University Health System present on how to engage your practice in addressing Social Determinants of Health. REGISTER HERE.

Mind the Gaps: Digital Health Issues and Opportunities

Wednesday, August 30 | 11:00 am CT

In this Telehealth Immersion Program virtual event, Mayo Clinic leaders showcase efforts to advance digital health across three functional teams – strategy, research, and clinical informatics. REGISTER HERE.

AMA Private Practice Simple Solutions

This series of rapid learning cycles designed to increase efficiency in your private practice is free and open to all. Each 8-week learning session focuses on one topic area, and busy physicians can access pre-recorded content at a pace that works best for them. LEARN MORE.

BHI Immersion Program

The BHI Collaborative is launching a free initiative where selected practices will participate in a 12-month curriculum designed and taught by industry experts on how to effectively implement behavioral health integration. Applications accepted through Aug. 5. APPLY NOW.

International Conference on Physician Health

Oct. 13-15 | Orlando, Fla.

Join us at this year’s International Conference on Physician Health and connect with physicians from all over the world about how to engage organizations to achieve cultural change. REGISTER HERE.

Documenting time for each task during outpatient visits

The most recently published myth in the AMA’s Debunking Regulatory Myths Series tackles whether or not physicians and other qualified health professionals are required to document the time spent on each specific task associated with an outpatient visit. LEARN MORE HERE.

COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with Certain Limits

The FDA issued an emergency use authorization (EUA) for PAXLOVID (nirmatrelvir co-packaged with ritonavir) for the treatment of mild-to-moderate COVID-19 in certain adults and pediatric patients at high risk for progression to severe COVID-19, including hospitalization or death. On July 6, the FDA revised the EUA to let pharmacists prescribe and dispense PAXLOVID to eligible patients without seeing a doctor or other clinician.

More Information:

Read the full news update from CMS here.

AMA Update: Department of Health and Human Services (HHS) Enforcement of the Emergency Medical Treatment and Active Labor Act (EMTALA)

This week Secretary Becerra sent a letter to all hospitals and healthcare providers reminding them of their obligation to comply with EMTALA.  The Secretary’s letter clarifies that EMTALA requirements preempt any state laws that restrict access to stabilizing medical treatment, including abortion procedures and other treatments that may result in the termination of a pregnancy.

Read the letter here.

CMS also released an updated guidance to hospitals reinforcing that EMTALA requirements apply to all hospitals in all states regardless of the state law to the contrary.

Yesterday, CMS held a conference call with stakeholders on these communications.  There were a number of questions about preemption.  CMS officials repeatedly stated that EMTALA would preempt state law and would be a defense for criminal prosecutions.  The American Medical Association (AMA) staff fully anticipate that this issue will end up in the courts.

The AMA has been and will remain in touch with the Federation about EMTALA and other emerging issues as a result of Dobbs. 

Physician Shortage: Solutions to Protect Physicians, Patients, and Healthcare Delivery

Within 12 years, the U.S. faces a physician shortage of between 37,800 and 124,000 physicians — which balloons to between 102,400 and 180,400 if underserved populations had healthcare-use patterns similar to those with fewer access barriers.

These shortage projections by the Association of American Medical Colleges include between 17,800 and 48,000 primary care physicians, and between 21,000 and 77,100 non-primary care physicians.

Unfortunately, the shortage is already very apparent. Despite the fact that the number of U.S. physicians is on the rise, there aren’t enough physicians today to meet needs. Physician numbers just aren’t growing fast enough to keep up with population growth and the healthcare demands of an aging population — the top two factors driving the physician shortage. The U.S. Health Resources and Services Administration specifically reports significant shortages in both primary care and psychiatry today, as well as general surgeons in rural communities.

The COVID pandemic and physician burnout has only exacerbated this shortage. According to the AMA, one in five physicians say it is likely they will leave their current practice within two years. Also, about one in three doctors and other health professionals say they intend to reduce work hours in the next 12 months

Unless results-focused solutions are put in place to address this crisis, these shortages will drastically change the face of healthcare in our country. One thing is clear: It’s more important than ever before to support solutions to protect physicians and healthcare delivery in all communities in our nation, large and small, urban and rural, and everything in between.

Impact of the Physician Shortage

For patients, the primary impacts of a physician shortage are access to and quality of care. The consequences of a physician shortage for patients include:

  • Reduced routine care visits
  • Reduced continuity of care
  • Reduced doctor-patient interaction time
  • Reduced doctor-patient relationships
  • Reduced preventative care and screenings
  • Increased wait times before consultations
  • Increased consultation prices
  • Increased frustration and dissatisfaction

In addition, because the supply of primary care physicians is linked to better health outcomes, a shortage in this particular specialty puts the health of our communities at risk, affecting overall health, life expectancy, and mortality from all causes.

There is also a toll for physicians. Patient care and access issues contribute to increasing the stress levels of physicians, who are focused on providing the best care possible for their patients and their communities. In addition to these critical care and access concerns, physicians also face increased workloads in a shortage — further exacerbating their stress levels.

A final issue that doesn’t often get the spotlight: economic impact. Physicians not only contribute to the health of their communities by caring for patients, but they also contribute to their community’s economic health. Physicians rent and buy office space. They create jobs by hiring roles within their practices. They support job creation in the community by directly buying goods and services. And they keep the community healthier, so more people are able to participate in the workforce. When physician practices disappear, so do their economic value and contributions.

Solutions for the Physician Shortage

There is no single solution for the physician shortage. Addressing the shortage will require a multi-faceted approach. Let’s highlight a few key solutions here.

In line behind the top two factors driving the physician shortage, population growth and an aging population, is the aging physician population. In the next five years, 35 percent of our physician workforce will be of retirement age. Burnout is also prompting many to consider early retirement, which would further amplify the shortage.

Addressing physician burnout is an issue of high importance, not just because of the shortage, but because of protecting physicians’ well-being. Luckily more attention is now being paid to physician burnout and mental health. As it relates to the shortage, however, addressing burnout will prevent more physicians from leaving their practices or reducing their hours — two repercussions of burnout that have a direct impact on patient access to care.

Healthcare reform is another focus area to address the physician shortage. One example on the table is improving the prior authorization process to both reduce administrative burden and improve the continuity and timeliness of patient care. Another example is permanently updating telehealth regulations to increase access and reimbursement options beyond temporary adjustments that were made during the pandemic. Both of these items are something the Medical Society of Virginia is continuously advocating and working on to support physicians and patients.

Technology is another piece of the solution puzzle, including improving access to and use of telehealth, electronic referrals and consults, and asynchronous patient care and monitoring. On the physician side of the technology solution, training for new and current physicians is essential to adopting and adapting to increased use of technology in daily practice. Current physicians would need to embrace and be supported in adjusting to changes in patient interaction and care delivery. The short-term training and implementation cycle would have a direct impact on improving long-term patient access to care and potentially addressing burnout factors as well.

There are many additional options being discussed and evaluated to address the shortage, including among them: reducing costs of medical education and related financial burdens, initiating Medicaid reform, improving distribution of physicians to rural communities via incentives and other strategies, increasing physician recruitment, reducing immigration barriers for foreign-born physicians, and encouraging more medical students to consider primary care.

To address and resolve the physician shortage, it’s imperative to support solutions to protect physicians and healthcare delivery in our communities. The need is urgent, the solutions are many, and the timing is now.

How are you contributing to being part of the solution, and in what ways can the Medical Society of Virginia support you in your efforts? Let us know by emailing me at [email protected].

Jenny Young
Associate VP of Membership and Engagement
The Medical Society of Virginia

The information contained in this article is for educational purposes only and does not constitute health care advice.

Proposed Physician Payment Schedule Rule

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2023 Medicare physician payment schedule. While American Medical Association (AMA) staff will analyze and develop a summary of the 2,000+ page proposal, they wanted to make physicians aware of three key issues. Notably, the 2023 Medicare conversion factor would be reduced by about 4.5% from $34.6062 to $33.0775. This is largely a result of the expiration of a 3% increase to the conversion factor at the end of calendar year 2022 as required by law. The AMA will strongly advocate that Congress avert this significant cut and extend the 3% increase for 2023. Please note that the impact table in the proposed rule does not seem to include the 3% reduction in the conversion factor.

CMS would adopt changes to several evaluation and management (E/M) code families, including hospital, emergency medicine, nursing facility and home visits, as recommended by the CPT Editorial Panel and AMA/Specialty Society RVS Update Committee (RUC). These changes are estimated to require an additional reduction of about 1.5% to the 2023 Medicare conversion factor due to statutory budget neutrality requirements. In addition, under the Medicare Access and CHIP Reauthorization Act (MACRA), the final performance year that physicians are eligible to earn the 5% Advanced Alternative Payment Model (APM) incentive payment and $500 million Merit-based Incentive Payment System (MIPS) exceptional performance bonus is 2022, which will affect payment adjustments made in 2024. Therefore, the proposed rule does not contain any estimates of MIPS participants exceeding the exceptional performance threshold in 2023 or Advanced APM participants earning 5% incentive payments.

The confluence of these cuts, coupled with the 0% payment update that fails to account for significant inflation in practice costs, is creating long-term financial instability in the Medicare physician payment system and threatening patient access to Medicare-participating physicians. The AMA and our partners in organized medicine have developed a set of principles to guide advocacy efforts on Medicare physician payment reform. This is part of the AMA’s Recovery Plan for America’s Physicians and represents our ongoing work to establish a rational Medicare physician payment system that provides financial stability through positive annual payment updates, improves the financial viability of physician practices, and eases administrative burdens.

Finally, services that were going to be covered via telehealth only through the end of the COVID PHE would now be covered for an additional five months after the PHE ends, including the CPT codes for telephone visits.

Read the full text of the proposed rule here. 

Additional resources:

Monkeypox Outbreak Update

The Virginia Department of Health (VDH) needs your help to contain the current monkeypox outbreak that is growing rapidly in the United States and across the globe. To date, Virginia has three reported monkeypox cases. Other suspected cases have been reported, investigated, and ruled out with testing conducted at Virginia’s Division of Consolidated Laboratory Services (DCLS).

Healthcare providers working in outpatient clinics are at the front lines of this response and may be the first to suspect monkeypox. These include providers working in primary care, urgent care, emergency medicine, sexually transmitted infection clinics, dermatology, gynecology, and oral health. Here are key points to be aware of:

  • Many patients have mild symptoms that might be confused with sexually transmitted infections or varicella zoster virus. Rash lesions can begin on the genitals, perianal region, or oral cavity and might be the first or only sign of illness.
  • Co-infection with sexually transmitted infections have been reported.

To contain this outbreak, it is critical that providers recognize and report suspected cases immediately to their local health department (LHD).

  • With timely reporting, LHD staff can facilitate monkeypox testing, which is currently only available at certain public health laboratories, but likely to expand soon to certain commercial laboratories.
  • LHD staff can also ensure that people with monkeypox isolate safely and have access to treatment if they have or are at high risk for severe illness; monitor their close contacts; and offer post exposure prophylaxis to close contacts with high-risk and intermediate-risk exposures.
  • Review VDH’s Monkeypox Infection Prevention and Control Recommendations for Healthcare Settings to prepare your facility for potential cases.

Resources from CDC and VDH are available to help providers recognize and report suspected cases:

Time is of the essence to control this outbreak. Please share this information broadly both within your healthcare network and with any colleagues or facilities where frontline healthcare is provided.

Thank you for all your efforts to identify, report, and prevent monkeypox in Virginia.

21 Men’s Health Tips for Your Patients

There’s a “hack” for everything these days, and the internet has no shortage of hacks claiming to improve health. Some “health hacks” have value, although many do not.

As a physician, you know you can’t hack good health. Maintaining good health is being intentional about making a series of everyday choices and decisions, including managing risk factors like age and family history of diseases.

Your male patients also know they can’t hack their health — though their actions might say otherwise. To help you help your male patients stay as healthy as they can, we’ve put together a list of 21 men’s health tips for your patients. And they start with going to the doctor.

For convenience, we’ve written the rest of this article so that you can share it directly with your patients.

GO TO THE DOCTOR

Men just don’t go to the doctor like women do. Studies show as many as half of men don’t go for their regular check-ups, and about three-quarters would rather do household chores — like cleaning the bathroom — than go to the doctor. Is that you?

The truth is you have to go to the doctor if you want to be healthy and stay healthy. Though there’s a lot more to seeing the doctor than your annual physical, that’s the best place to start, and so it’s the #1 tip in our list of 21 men’s health tips.

  1. Get Your Annual Physical. Even if you’re feeling great, you should see your doctor every year for a check-up. Do not skip or postpone these visits! Your doctor will monitor things like blood pressure, cholesterol, and blood sugar — which may not cause symptoms when out of whack. Your doctor will also help you monitor and manage your risks for health problems that are specific to you. Your annual physical is your first line of defense!
  2. Get Your Screenings. Your primary care physician can guide you as to what regular screenings are right for you, based on things like your age, lifestyle, ethnicity, age, family history, and symptoms. You may be a candidate for an annual full-body skin exam, or you may need to get a regular colonoscopy. Another example: About 1 out of every 100 breast cancers diagnosed in the U.S. is found in a man — are you at risk?
  3. Make Mental Health a Priority. Whether for stress, depression, or thoughts of self-harm, get the help you need from a mental health professional. Though men and women share the same mental health conditions, men may have different symptoms. Men are also more likely to die by suicide. If you’re in crisis, get help immediately. The National Suicide Prevention Hotline is 1-800-273-TALK (8255).
  4. Don’t Procrastinate. If your health changes or something seems off, see your doctor right away. The sooner the better! Maybe it’s a change in your bathroom habits or a sore spot on your skin. Early detection is critical to successfully treating many conditions, diseases, and cancers. If fear is keeping you away from the doctor, remember this: you might find out what you’re dealing with is minor, and save yourself a lot of stress and worry.
  5. Be Honest. Sometimes it’s hard to be honest about things that may be embarrassing or make you feel shame. But your doctor depends on your honesty to effectively treat you. From your family history, to your sex life, to your symptoms, to whether and how often you may use drugs, and more, your doctor needs to know everything.
  6. Check In Before Changing. Before starting any new diet or weight loss regimen, adding a supplement to your diet, or trying a new exercise plan, check with your doctor to make sure it’s the right fit for you and your health. Challenges with hormones like cortisol and insulin can impact your ability to lose weight. Supplements can interfere with prescribed medications. And, of course, heart health is always a consideration for exercise.
  7. Keep Your Eyes Healthy. Unless you already wear glasses or contacts, many men just don’t think about their eye health — until they have a problem. Many vision problems are avoidable, and some are symptomless. Your eye doctor can also help address things like eye strain and screen exposure, which can impact other areas of your health. To keep your eyes healthy, get an eye exam every year.
  8. Don’t Forget Your Teeth. Regular dental visits, typically every 6 months, are important for maintaining your dental health. Prevention strategies will help keep your mouth healthy, and your dentist can identify anything that needs to be addressed. Poor dental health can cause other problems, from bad breath and difficulty eating to headaches and heart disease.
  9. Beware Dr. Google. The internet can be a great tool to search symptoms and guidance, but it can be as hurtful or even scary as it can be helpful. Google is not a substitute for a diagnosis or a treatment plan. If you have questions or concerns, consult with your doctor.

MORE MEN’S HEALTH TIPS

Honestly, a comprehensive list of men’s health tips could fill a book — a book you don’t have time to read. So, here’s a list of top tips that will apply to men of most ages and stages. As with all medical advice, it’s best to run tips by your own doctor before you dive in, of course.

  1. Reduce your sodium
  2. Know the signs and symptoms of stroke and heart attack, which can be different in men
  3. Drink more water
  4. Stay active, which includes exercising — like walking
  5. Get good sleep, most adults need at least 7 hours
  6. Eat more whole grains, fruits, and vegetables
  7. Make time for “you time,” to relax and do things you enjoy
  8. Watch your waistline, men with a waist over 40 inches are at higher risk for heart disease and Type 2 Diabetes
  9. Wear sunscreen
  10. Brush and floss daily
  11. Be safe and follow recommended safety precautions like wearing a seatbelt and using safety equipment on the job as well as off
  12. Wash your hands!

If you have any questions about these 21 men’s health tips, or any questions about your health, your own doctor is always your best resource.

Mark Monahan, MD
Urologist

The information contained in this article is for educational purposes only and does not constitute health care advice.

We Must Take Positive Steps to Address Gun Violence

Violence against children, nurses, doctors, healthcare workers, or any individual in our workplaces, our communities, our houses of worship, and most certainly our schools, cannot be tolerated. The MSV is appalled at the recent attacks in Buffalo, Uvalde, and Tulsa. Gun violence is unacceptable and something must be done to address it.

MSV stands in support of all physicians, PAs, and healthcare providers who have dedicated their lives to healing. We recognize the extraordinary challenges they face on a daily basis especially when dealing with violence in the workplace. Today, we call on people and leaders across the Commonwealth to come together and take positive steps to address this public health crisis. We also encourage people to demonstrate empathy, and to show support and care to Virginia’s healthcare providers and to others in our lives.

For all healthcare colleagues, here are some resources that may help you navigate these challenges:

SafeHaven™ was founded in 2020 after recognizing a greater need to provide physicians and PAs the support they need to stay well and prevent burnout. Learn more about SafeHaven™.

The Joint Commission’s Workplace Violence Prevention Compendium of Resources

Threats, intimidation against doctors and health workers must end, Gerald E. Harmon, MD, AMA President, 2021-22 President

Richmond Times-Dispatch Names the Medical Society of Virginia a Winner of the Greater Richmond Area Top Workplaces 2022 Award

The Medical Society of Virginia (MSV) has been awarded a Top Workplaces 2022 honor by Richmond Times-Dispatch Top Workplaces. The list is based solely on employee feedback gathered through a third-party survey administered by employee engagement technology partner Energage LLC. The anonymous survey uniquely measures 15 culture drivers that are critical to the success of any organization: including alignment, execution, and connection, just to name a few.

“During this very challenging time, Top Workplaces has proven to be a beacon of light for organizations, as well as a sign of resiliency and strong business performance,” said Eric Rubino, Energage CEO. “When you give your employees a voice, you come together to navigate challenges and shape your path forward. Top Workplaces draw on real-time insights into what works best for their organization, so they can make informed decisions that have a positive impact on their people and their business.”

“Being recognized as a top workplace, based solely on employee feedback is a true honor,” said Melina Davis, CEO and EVP of the MSV. “The last few years have been difficult for everyone, but our entire team has worked hard to ensure that the MSV is thriving. I am so grateful to everyone at our organization working to create a positive and resilient work culture, especially given the special challenges our members and team have faced during the pandemic.”

The MSV is excited to see what this next year will bring. This is a new and wonderful opportunity to not only celebrate, but to continue growing and changing as an organization.

About The Medical Society of Virginia

The Medical Society of Virginia (MSV) is the professional association that serves as the voice for more than 30,000 physicians, residents, medical students, PAs, and PA students in all regions of the Commonwealth. The MSV strives to advance high-quality care and make Virginia the best place to practice medicine and receive care. To learn more, visit www.MSV.org.

About Energage

Making the world a better place to work together™.

Energage is a purpose-driven company that helps organizations turn employee feedback into useful business intelligence and credible employer recognition through Top Workplaces. Built on 14 years of culture research and the results from 23 million employees surveyed across more than 70,000 organizations, Energage delivers the most accurate competitive benchmark available. With access to a unique combination of patented analytic tools and expert guidance, Energage customers lead the competition with an engaged workforce and an opportunity to gain recognition for their people-first approach to culture. For more information or to nominate your organization, visit energage.com or topworkplaces.com.