The 2024 issue of the Virginia Medical News MSV Member Magazine is available here.
Articles cover topics such as:
Richmond, VA – The Alliance for Innovation (AFI) has joined forces with the Medical Society of Virginia (MSV) to address pressing mental health challenges by sharing and adapting programs proven effective in Virginia. Leaders from both organizations convened in Norfolk, Virginia, to discuss mental health programs, including innovative approaches and strategies to address and support post-traumatic stress disorder (PTSD) and other behavioral health concerns. This partnership aims to bring impactful initiatives to Poland, adapting Virginia programs to local needs and fostering international collaboration on mental health.
“This collaboration represents a critical step forward in addressing mental health challenges on both sides of the Atlantic. Our joint efforts will focus on delivering immediate, practical solutions for PTSD, provider burnout, and patient stress, and we are committed to ensuring that these initiatives create tangible improvements in mental health treatment for both Poland and the United States,” said Marcin Hańczaruk, Co-Chairman of AFI Poland.
The Virginia Mental Health Access Program (VMAP), the HealthHaven programs and SafeHaven have been recognized as transformative resources for mental health support. VMAP connects primary care providers with mental health specialists, ensuring timely and effective care for patients. HealthHaven programs include solutions targeted toward chronic health issues, substance use disorders and more. SafeHaven focuses on combating provider burnout by offering greater confidentiality for healthcare professionals seeking mental health support.
These initiatives, combined with MSV’s dedication to improving mental health for healthcare providers and patients, serve as a model for addressing similar challenges in Poland.
“We are thrilled to collaborate with the Alliance for Innovation on this vital mission. The mental health crisis knows no borders, and by sharing knowledge and resources, we can make a meaningful difference in the lives of patients and providers alike. Programs like these have the potential to provide much-needed relief and inspire innovative approaches internationally,” said Melina Davis, CEO and EVP of the Medical Society of Virginia.
The partnership between AFI and MSV underscores a shared commitment to improving mental health outcomes through collaboration, innovation, and cultural exchange. By bringing these types of efforts to Poland, both organizations aim to address the unique challenges faced by healthcare providers and patients in their communities.
The Medical Society of Virginia is a professional association with 10,000 members. The MSV is the only association representing all medical doctors, doctors of osteopathy and PAs, regardless of specialty or type of practice setting, in Virginia. Dedicated to Virginia’s physicians, PAs, and their patients, the MSV provides administrative, membership, and legislative services to its members, as well as serving as the liaison between local, national, and specialty medical organizations.
As physicians face another year of cuts stemming from the Medicare Physician Fee Schedule, 41 Senators cosigned a letter urging the Senate to address cuts before end of year. Text of the letter below. View full PDF with signatures.
Dear Majority Leader Schumer and Minority Leader McConnell:
We write to request that you urgently address the 2.8 percent cut to Medicare payments that will go into effect on January 1, 2025. Failure to address these cuts will threaten the continued ability of physicians and other healthcare providers to care for their patients.
On November 1, 2024, the U.S. Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2025 Medicare Physician Fee Schedule (MPFS) Final Rule, which includes provisions subjecting all physicians and other clinicians treating Medicare patients in the outpatient setting to a 2.8 percent payment cut. The scheduled cut represents the fifth consecutive year that CMS has issued a fee schedule lowering payments to physicians and other clinicians.
Persistent instability in the health care sector- due, in part, to consistent payment cuts —impacts the ability of physicians and clinicians to provide the highest quality of care. These continued payment cuts undermine the ability of independent clinical practices especially in rural and underserved areas to care for their communities. Some practices have limited the number of Medicare patients they see, or the types of services offered.
In addition to addressing the looming 2.8 percent payment cut, Congress must develop long-term legislative solutions to reform the Medicare Access and CHIP Reauthorization Act (MACRA), such as enacting targeted reforms to statutory budget neutrality requirements and payment updates reflective of inflationary pressures. These efforts are critical to supporting patient access to high-quality Medicare-covered services and bolstering our healthcare workforce.
On behalf of patients and healthcare providers, we look forward to working together to address the 2.8 percent payment cut and create stability in the Medicare program for our nation’s seniors.
We appreciate your attention to this critical matter.
via VDH
Dear Colleague:
This letter provides updates on increases in pneumonia and pertussis in Virginia.
Since September 2024, the Virginia Department of Health (VDH) has observed a significant rise in emergency department and urgent care visits involving diagnosed pneumonia. During the week of November 10-16, 2024, there were 2,029 emergency department and urgent care visits with diagnosed pneumonia among children aged 0-17 years. This is more than triple the weekly peak observed in the past two years. There are also increases in visits among adults aged 18-64 years. In addition to this upward trend, numerous K-12 schools have reported clusters of students with pneumonia and unspecified respiratory illness. Laboratory testing has identified a variety of pathogens, primarily rhinoviruses/enteroviruses as well as Mycoplasma pneumoniae.
Rhinovirus infections are the most frequent cause of the common cold. Rhinovirus infections can exacerbate chronic respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD). Enteroviruses have a broad spectrum of clinical presentations that can range from mild upper respiratory symptoms to more severe. It is uncommon for these viruses to cause pneumonia, so additional testing is being performed to type and analyze infecting viruses.
M. pneumoniae infections are generally mild and mostly present as a chest cold but may also present as pneumonia. Symptom onset is typically gradual and can include fever, cough, and sore throat. The Centers for Disease Control and Prevention (CDC) recently released a bulletin about a national increase in M. pneumoniae infections, especially in children 2-4 years of age. This differs from previous years in which most infections were observed among school-aged children and adolescents.
Providers are encouraged to:
For more information, please see CDC’s Pneumonia and M. pneumoniae webpages.
VDH continues to respond to an increase in cases of pertussis (whooping cough). This trend was first reported in August and is linked to outbreaks in group settings, including universities, schools, religious communities, and childcare settings.
Providers are encouraged to:
Thank you again for your continued partnership in keeping Virginians safe from respiratory illnesses. Although influenza, COVID-19 and RSV activity is currently stable in Virginia, we expect these trends to increase in the coming weeks. Please visit the VDH website for current public health guidance on respiratory diseases in Virginia and other information.
Sincerely,
Karen Shelton, MD
State Health Commissioner
RICHMOND, VA – SafeHaven®, a program of the Medical Society of Virginia (MSV), announce the launch of a podcast for clinicians focused on solving the challenges of today’s medical practice environment. Titled “JoyMed,” and hosted by MSV CEO and Executive Vice President Melina Davis, the podcast is intended to help medical leaders share experiences and solutions while exploring ways to bring joy back into everyday life and the practice of medicine.
“In today’s environment, stress and burnout are very real issues for healthcare professionals of all kinds — from physicians and nurses to pharmacists and even students,” says Davis. “This podcast is an extension of our SafeHaven program, which provides confidential support to healthcare professionals, addressing career fatigue and other mental health challenges. It’s critical that we encourage healthcare professionals at all levels to seek the help they need, and provide the tools and resources to create a culture of care and support, so they can reclaim their work-life balance and joy at home and in the work they do.”
“It’s important for medical professionals to take be cared for so they can care for others”
Davis continues. “By bringing important issues to light, and encouraging honest and meaningful dialogue that focuses on solutions, the JoyMed podcast is one more way we’re helping healthcare professionals reinforce and rediscover their purposeand joy, and ensuring those who care for us are cared for as well.”
The JoyMed podcast will delve deeper into the unique challenges faced by healthcare professionals, explore strategies for resilience, and highlight the support systems available to them. Each podcast episode will feature expert insights, personal narratives, and practical tools to help foster a healthier and more supportive environment for our healthcare heroes.
The podcast’s first three episodes were released on Spotify and Apple Podcasts on October 17. Episode 1 highlights MSV’s SafeHaven program and its origin. Episode 2 features a PA’s experience with burnout. Episode 3 takes a look at the future of medicine from the perspective of both a medical and physician assistant student.
Additional JoyMed episodes will release on a monthly schedule.
SafeHaven was founded by the Medical Society of Virginia (MSV) after recognizing a greater need to provide clinicians the support to stay well and prevent burnout. SafeHaven ensures clinicians can seek support for burnout, career fatigue, and mental health reasons without the fear of undue repercussions to their medical license. Protections vary by state.
The Medical Society of Virginia is a professional association with 10,000 members. The MSV is the only association representing all medical doctors, doctors of osteopathy and PAs, regardless of specialty or type of practice setting, in Virginia. Dedicated to Virginia’s physicians, PAs, and their patients, the MSV provides administrative, membership, and legislative services to its members, as well as serving as the liaison between local, national, and specialty medical organizations.
On Nov. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies under the Medicare Physician Payment Schedule (PFS) and Other Changes to Part B Payment and Coverage Policies final rule. The rule includes proposals related to Medicare physician payment and the Quality Payment Program (QPP).
These policies will take effect on January 1, 2025, unless otherwise noted.
The AMA Final Rule Summary detailing the payment updates and proposals is available here.
Physician pay is decreasing while the cost of a medical education continues to increase. What’s to be done? Can physician loan repayment programs make a difference? Specifically, are physician loan repayment programs good for primary care? Considering there is a projected shortage of 68,020 full-time primary care physicians by 2036, improvements to the primary care workforce are critical to our nation’s healthcare delivery.
Let’s take a closer look.
Becoming a doctor is an investment, and 70 percent of medical students borrow money to attend medical school. According to the Association of American Medical Colleges (AAMC), in 2023 the average medical school debt was more than $200,000 — which with interest can balloon to $300,000 over the life of the loan.
Four years of medical school costs between $268,476 for public medical school and $363,836 for private medical schools, according to the AAMC. And that doesn’t include costs like living expenses, textbooks, or supplies. It also doesn’t include the cost of an undergraduate education.
Undergraduate tuition is going up, and has been for the last two decades. In 2023-24, the average cost of attending a 4-year, in-state public college was $28,840, compared to $60,420 at a private institution, with out-of-state public colleges costing 62 percent to more than 100 percent more than in-state. The average cost of an undergraduate education increased for 2024-25 academic year for both public and private schools, according to a new report from U.S. News. Once again, that cost doesn’t factor in room, board, and textbooks, which can add thousands more to the bill. It’s worth noting that grants and other aid can reduce the costs of an undergraduate education.
Bottom line: Despite incurring substantial costs — and debt — to become a physician, the upward trajectory for education costs unfortunately isn’t matched by physician pay.
After several years of modest or declining growth, average pay for physicians increased by 5.9 percent in 2023, according to Doximity’s “2024 Physician Compensation Report” published this past May. At first glance this appears to be positive step forward, especially considering 2022 saw a drop of 2.4 percent.
Unfortunately inflationary pressures continue to negatively impact physicians’ real income. Plus Medicare physician payment has decreased 22 percent since 2001. And in addition to the Centers for Medicare and Medicaid Services (CMS) cutting overall physician pay 1.25 percent in 2024, a proposed new CMS payment rule could see Medicare reimbursement fall by an average of 2.9 percent next year.
Bottom line: Inflation plus declining reimbursements combine to create contracting physician pay, with primary care physicians already making significantly less than specialists — and nearly $100,000 less per year than the average for all physicians.
Increasing debt and declining physician pay combine to create and exacerbate risks — like the physician shortage, specialty gaps, and physician stress and burnout, which comes from overwork, among other factors. The ultimate loser is patient care.
Can physician loan repayment programs make a difference? Specifically, are physician loan repayment programs good for primary care? The answer to both is “yes.” They can certainly make an impact on a physician’s debt — which then has an impact on decisions like specialty as well as where a physician decides to practice.
Offered as a recruiting incentive, educational loan repayment is an attractive benefit. In exchange for an employment commitment, a recruiting hospital or other facility will pay a physician’s medical loans. An April article by the American Medical Association (AMA) cites 2023 stats from recruiting firm AMN Healthcare’s Physician Solutions division indicating 18 percent of searches included loan repayment benefits. The average amount in 2022-23 was $98,665, and most applicants were required to stay in their position for 3 years or more. The range of incentive amounts offered varied from $10,000 to $400,000.
Other opportunities for physician loan repayment also are available — and specifically for primary care. Due to the exceptional need for primary care physicians, loan forgiveness programs are more widely available for these fields than other specialties.
Through the Health Resources & Services Administration (HRSA), the National Health Service Corps (NHSC) offers loan repayment to licensed primary care physicians in exchange for serving at least 2 years at an NHSC-approved site in a Health Professional Shortage Area (HPSA). HPSAs can be defined by geography, population, or facility type, like private medical facilities, correctional facilities, or Federally Qualified Health Centers (FQHCs). In fact, this April the HRSA increased loan repayment amounts by 50 percent for primary care providers who commit to practicing in high-need and rural areas.
Public Service Loan Forgiveness (PSLF) programs are also an option. Physicians must complete full-time public service employment by a 501(c)3 tax-exempt nonprofit or public institution, and includes working in areas that are underserved or have a high need for medical professionals. In this program, borrowers must make monthly payments for 10 years during PSLF-qualified work, after which the federal government will forgive their remaining debt.
Military programs are another option. Military branches offer tuition assistance for students who are service members, but even doctors who have already graduated and are practicing can enroll in military service to get student loan assistance. Programs vary by branch.
For state programs, the Association of American Medical Colleges (AAMC) maintains a searchable database of loan repayment and other programs for students and residents.
Although loan repayment programs are obviously a benefit more geared toward younger physicians, as established physicians have a higher likelihood of having paid off their debt and have already selected their area of specialty, they can be a terrific way to reduce large portions of debt early in a physician’s career. They can also encourage physicians to specialize in high-need areas, as well as serve high-need populations — specifically in primary care.
SafeHaven is growing and expanding – and our providers report that they’re seeing the benefits.
Get the 2024 SafeHaven Impact Report to learn more about the SafeHaven Movement and history, the program’s expansion, and the latest data on participant engagement and outcomes.
Dear Colleague:
This letter provides an update to the Clinician Letter that the Virginia Department of Health (VDH) sent on October 21, 2024, regarding the disruption in production of IV solutions as a result of Hurricane Helene on the Baxter International Inc. North Cove manufacturing facility in Marion, North Carolina.
Per an update from Baxter on October 28, 2024, the manufacturer has received Food and Drug Administration (FDA) authorization to extend the use dates of 50+ IV and irrigation codes to provide up to an additional 12 months of expiry. Products now have a 24-month expiry period from the date of the manufacture. This extension only applies to products manufactured prior to the end of September 2024. Details have been communicated directly to customers per the manufacturer. Please continue to monitor manufacturer notices or guidance related to expiration dates of products and imported solutions at your facility.
Baxter has information regarding the Peritoneal Dialysis (PD) allocations and support in the above update. For additional peritoneal dialysis questions or support in Virginia, please contact Quality Insights Renal Network at [email protected], [email protected].
Conservative strategies and measures remain important and effective to mitigate the potential impacts of manufacturing disruption. VDH is requesting all health care providers continue to implement conservation measures and guidance from FDA for temporary policies for compounding parenteral drug product.
The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) on October 12, 2024 with recommendations for healthcare providers, pharmacists, and healthcare facility administrators in healthcare facilities. Current data indicates some supply stabilization with the use of conservation strategies.
VDH continues to work closely with the Virginia Hospital & Healthcare Association (VHHA), Virginia Health Care Association (VHCA), Quality Insights Renal Network, Virginia’s EMS Councils, and other health care organizations, alongside our federal partners, to closely monitor this situation and will continue to provide updates as soon as available.
https://www.baxter.com/baxter-newsroom/hurricane-helene-updates
https://meded.baxter.com/hurricane-helene-clinical-resources
https://emergency.cdc.gov/han/2024/han00518.asp
https://www.fda.gov/news-events/press-announcements/fda-roundup-october-11-2024https://www.vdh.virginia.gov/news/hurricane-helene-post-storm-response/#Clinician
https://www.hhs.gov/about/news/2024/10/24/statement-secretary-xavier-becerra-iv-fluid-increase.html
https://www.vdh.virginia.gov/news/hurricane-helene-post-storm-response/#Clinician
Dialysis Management and Conservation:
https://www.baxter.com/sites/g/files/ebysai3896/files/2024-10/10-1_RenalMedical%20Information%20Letter.pdf
List of Parenteral Drug Products in Shortage:
Hurricane Helene: Baxter’s manufacturing recovery in North Carolina | FDA
Products authorized for temporary importation:
https://meded.baxter.com/sites/g/files/ebysai4096/files/2024-10/Temporary%20Importation%20Report%2010.24.24_Final.pdf
Expiration Dating Extensions:
https://meded.baxter.com/sites/g/files/ebysai4096/files/2024-10/ExtendedExpDatesIVSolutions%20v2.pdf
Additional Resources:
Sincerely,
Karen Shelton, MD
State Health Commissioner
RICHMOND, Va., October 30, 2024 – The Virginia Department of Behavioral Health and Developmental Services (DBHDS) and Medical Society of Virginia (MSV) are launching a resource aimed to help adults struggling with substance use disorders (SUDs).
The Adult Psychiatric Access Line (APAL), a program of HealthHaven, is a statewide care navigation and consultation program that provides adults affected by SUDs access to specialized behavioral health services. The initiative equips healthcare providers – specifically primary care and emergency clinicians – with tools and consultation with addiction specialists to diagnose, prescribe and assist patients seeking care. The first APAL hub, housed at the Master Center for Addiction Medicine, is now active and taking calls from PCPs across the commonwealth.
“For over 10 years, the leading cause of unnatural death in Virginia has been drug overdoses, and this trend is even worse by the dangers of opioids and fentanyl,” DBHDS Commissioner Nelson Smith said. “We want to make sure healthcare providers know how to effectively help a patient struggling with substance use disorders. APAL builds on the big successes of the Virginia Mental Health Access Program (VMAP) for children and will ensure that primary care providers have the resources they need to help their patients recover from substance use disorders.”
APAL features three main components.
Primary care providers (PCP) calling HealthHaven’s APAL program will be directed to a regional hub operator to provide intake information to a Licensed Psychological Practitioner (LPP) or care navigation team member. Within 30 minutes, an addiction medicine consult team will contact the PCP for support, and if needed, the PCP then will be connected to a care navigation team to work directly with the patient to assess next steps based on the region and services available.
“Since 2016, Master Center has delivered addiction treatment to 10,000 Virginians with substance use disorder. We are prepared to equip primary care physicians with the tools to address this critical public health crisis,” said Anna McKean, CEO of the Master Center for Addiction Medicine. “We are proud of our work with MSV and DBHDS in the development of this life-saving initiative.”
“Substance use in Virginia mirrors what we’re seeing nationally: The problem isn’t going away,” said Melina Davis, CEO and EVP of the Medical Society of Virginia. “VMAP is helping to better equip our primary care providers seeing pediatric patients with tangible ways to make a difference. With all of Virginia’s localities designated as mental health professional shortage areas, APAL will bridge the access gap across the state for PCPs seeing adults with substance use disorder.”
Both APAL and VMAP are important efforts in Virginia Gov. Glenn Youngkin’s Right Help, Right Now initiative to reform Virginia’s behavioral health system, support individuals in crisis and support Virginians before, during and after a behavioral health crisis occurs.
* * *
APAL is a statewide consult and care navigation program designed for adults struggling with substance use disorders to access specialized behavioral health services and prepare primary care and emergency clinicians to support patients’ behavioral health needs through trainings and education.
The Department of Behavioral Health and Developmental Services (DBHDS) seeks to promote dignity, choice, recovery and the highest possible level of participation in work, relationships and all aspects of community life for individuals with mental illness, developmental disabilities or substance-use disorders. DBHDS operates 12 state facilities and partners with 40 locally-run community services boards and hundreds of private providers statewide. For more information, please visit www.dbhds.virginia.gov, and find DBHDS on Facebook, LinkedIn, Instagram or YouTube.
The Medical Society of Virginia strives to advance high-quality care and make Virginia the best place to practice medicine and receive care. We provide relevant insurance coverage options and benefits, and the administrative, membership, and legislative services to the over 30,000 physicians and PAs in the Commonwealth so they can focus on what they love, caring for patients.
