The MSV Installs President Alice Coombs, MD, MPA, FCCP at 2023 Annual Meeting

Alice Coombs, MD, MPA, FCCP of Richmond, Virginia was installed as the fourth female and first black president of the Medical Society of Virginia (MSV) at the organization’s Annual Meeting on October 14, 2023, at Hilton Norfolk The Main. Dr. Coombs is a Board-certified Critical Care Specialist, Anesthesiologist, and Internist. She has been actively practicing medicine for more than 35 years in both Private and Academic settings.

In her inaugural speech, Dr. Coombs spoke of her experiences as a physician, the importance of the patient-physician relationship, advocating for effective and solution-focused healthcare policy, and her passion for the profession and her fellow physicians and PAs.

“Don’t miss your moment. Each of us is given finite time on this earth, to care for patients, to impact families and to care for our own families and for ourselves.

We are made of a unique fabric some silk, some wool, but the fibers of our lives have been woven into experiences that make us uniquely positioned to leave our mark. Don’t miss your moment!”

Her agenda for her presidency includes a focus on physician and PA mental health and wellness, developing and supporting new programs designed to better the lives of physicians and patients, and to uphold MSV’s overall goal to make Virginia the best place to practice medicine and receive care.

Dr. Coombs completed her medical training at the Massachusetts General Hospital in Internal Medicine and Anesthesiology and completed a MGH Critical Care Medicine fellowship and Tufts University Cardiothoracic fellowship.

Dr. Coombs is a Past President of the Massachusetts Medical Society. She is a Virginia Delegate to the American Medical Association (AMA) House of Delegates and currently serves on the AMA Council on Medical Services. She has served 2 terms as a commissioner on the Medicare Payment Advisory Commission, the body that makes recommendations to Congress annually regarding payment for Medicare beneficiaries.

Impact of a Federal Government Shutdown on Health Programs

The fall season brings with it the potential for government shutdown on October 1. We are seeing this play out this week as Congress has yet to pass any of the 12 FY2024 appropriations bills or a short-term spending bill (i.e., Continuing Resolution, or CR) to keep the government funded while Congress continues to work on a broader spending package. The Senate is expected to vote by Saturday on a CR that would fund the government until November 17. There are two CR proposals in the House—one to fund the government for 30 days and the other until January 11—but a vote has not been scheduled and may not be by the October 1 deadline.

Below are some highlights of the impact on key health policy areas in the event Congress does not pass a CR by midnight Saturday, September 30, and there is a government shutdown.

Congress

  1. Congressional offices will remain open.

Medicare and Medicaid

  1. The Centers for Medicare & Medicaid Services (CMS) will continue to process claims.
  2. Physicians would not have to hold claims until the CR passes, but there could be a delay in payment if the shutdown is prolonged and funding to Medicare Administrative Contractors is delayed.
  3. If the shutdown is prolonged, it is possible that the release of the Medicare physician fee schedule final rule, outpatient prospective payment system final rule, and other major regulations could be delayed.
  4. Medicare benefits will not be affected.
  5. Medicaid has full funding for the next three months.
  6. Approximately half of CMS employees would be deemed essential and continue to work, although many would be unpaid until the shutdown ends.
  7. CMS staffing levels may not be sufficient to respond to physicians’ questions about Medicare policies or scores under the Merit-based Incentive Payment System (MIPS).
  8. Center for Medicare and Medicaid Innovation (CMMI) staff may continue to develop new alternative payment models, but any new model that CMMI plans to formally announce would likely be delayed.

Department of Health and Human Services (HHS)

  1. HHS will use its authority under the Antideficiency Act (ADA) to maintain existing HHS activities, including research and vaccine and therapeutic development.
  2. CMS will maintain the staff necessary to make payments to eligible states for the Children’s Health Insurance Program (CHIP).
  3. CMS will continue Federal Exchange activities, such as eligibility verification, using Federal Exchange user fee carryover.
  4. The Substance Abuse and Mental Health Services Administration (SAMHSA) will continue substance abuse and mental health programs, including those that provide critical behavioral health resources in the event of a natural   or human-caused disaster such as Disaster Behavioral Health response teams, the 24/7 365 day-a-year Disaster Distress Helpline that provides crisis counseling to people experiencing emotional distress after a disaster, and the 988/Suicide Lifeline to connect people in crisis with life-saving resources.
  5. The Administration for Strategic Preparedness and Response (ASPR) will maintain the minimal readiness for all hazards, including COVID-19, pandemic flu, and hurricane responses.
  6. The National Institutes of Health (NIH) will continue research and clinical activities.
  7. The Food and Drug Administration (FDA) will continue to support drug and medical device reviews, as well as emergency use authorizations and countermeasures to fight the COVID-19 pandemic. FDA will also continue core functions to handle and respond to emergencies, such as monitoring for and quickly responding to outbreaks related to foodborne illness and the flu, supporting food and medical product recalls when products endanger consumers and patients, pursuing criminal and certain civil investigations when the public health is at risk, and screening the food and medical products that are imported to the U.S.
  8. HHS will continue to protect human life and property, such as monitoring for disease outbreaks conducted by the Centers for Disease Control and Prevention (CDC).
  9. CMS regulations and guidance related to the No Surprises Act, including the Independent Dispute Resolution process, could be delayed.
  10. The Health Resources and Services Administration (HRSA) will continue to oversee many direct health services and other activities funded through carryover balances, such as the Ryan White HIV/AIDS program – Parts A and B and Ending the HIV Epidemic.
  11. The Agency for Healthcare Research and Quality (AHRQ) will continue activities funded through the Patient-Centered Outcomes Research Trust Fund (PCORTF).
  12. Advanced Research Projects Agency for Health (ARPA-H) is under a three-year appropriation; all of ARPA-H activities would continue during a lapse of appropriation.
  13. The Indian Health Service (IHS) is under advance appropriations for FY 2024; the majority of IHS-funded programs will remain funded and operational in the event of a lapse of appropriation.

Miscellaneous

  1. Supplemental Nutrition Assistance Program (SNAP) will continue at least through October.
  2. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) could begin an immediate reduction in benefits a few days after the shutdown starts, although some states may be able to use extra funding to maintain funding for a week or two.
  3. Student loan payments: The beginning of a government shutdown could coincide with the restart of federal student loan payments in the U.S. on Oct. 1, but borrowers will still have to make payments to their loan service providers.

2023 Nominating Committee Report

The Nominating Committee met on July 31st to consider all eligible candidates for the upcoming term of office. The committee recommends the following slate for consideration by the society membership.

MSV Board of Directors
Term 2023-2024/2025

Officers (Elected for 1-year term)

President-Elect | Joel Bundy, MD

Speaker | Michele Nedelka, MD

Vice Speaker | Atul Marathe, MD

 

Directors (Elected for 2-year term)

District 1 | Bobbie Sperry, MD

District 3 | Carolyn Burns, MD

District 3 | Mark Townsend, MD

District 5 | Gary Miller, MD

District 7 | Peter Netland, MD

District 7 | Karen Rheuban, MD

District 9 | Jan Willcox, DO

MSV Foundation | José Morey, MD

Academic | Arturo Saavedra, MD (VCU)

 

Directors (Elected for 1-year term)

Resident | Pooja Gajulapalli, MD (VCU Peds)

Medical Student | Shreya Mandava (UVA)

 

Associate Directors (Elected for 2-year term)

District 1 | Andreya Risser, MD

District 3 | Sidney Jones, MD

District 5 | Jacqueline Fogarty, MD

District 7 | John Mason, MD

District 9 | Stephen Combs, MD

Academic | Lindsay Robbins, MD (EVMS)

 

Associate Directors (Elected for 1-year term)

Resident | Matthew Adsit, MD (VCU Ortho)

Medical Student | Elizabeth Ransone (VCU)

Virginia Delegation to the American Medical Association
Term 2024-2025

Elected for 2-year calendar year term
Delegates

Alice Coombs, MD

Claudette Dalton, MD

Cliff Deal, III, MD

Bhushan Pandya, MD

Cynthia Romero, MD

Sterling Ransone, MD

 

Alternate Delegates

Sandy Chung, MD

Mark Townsend, MD

Jan Willcox, DO

2023-2024 Nominating Committee

 

District 1 Sterling Ransone, MD

District 2 Stuart Mackler, MD

District 3 Hazle Konerding, MD

District 5 Bushan Pandya, MD

District 6 Cynda Johnson, MD

District 7 Claudette Dalton, MD

District 8 Carol Shapiro, MD

District 9 John Knarr, MD

District 10 William Hutchens, MD

Academic Cynthia Romero, MD (EVMS) (Chair)

AMA Advisor (Chair of the Virginia Delegation) Tom Eppes, MD

2021-2022 Former President Advisor | Mohit Nanda, MD

2022-2023 Former President Advisor | Harry Gewanter, MD

National Physician Suicide Awareness Day underscores urgent need to support physician wellness

National Physician Suicide Awareness Day (NPSA)—on Sept. 17—is a sobering reminder for physicians and others to ensure that we advocate for programs and initiatives to support physician health and wellness. Supporting physician wellness and reducing physician burnout are key elements of the AMA Recovery Plan for America’s Physicians.

Physicians have higher rates of death by suicide than the general population, and medical residents and students also experience depression at rates greater than the general population, according to the American Foundation for Suicide Prevention.

“AMA advocacy is focused on eliminating barriers that prevent physicians and medical students from seeking care for their own mental health,” said AMA President Jesse M. Ehrenfeld, MD, MPH. “National Physician Suicide Awareness Day is an important reminder of the tragedies in our profession—it is time, however, for licensing boards, health systems and credentialing organizations to take additional actions to ensure that we can support our physicians’ health and wellness and help prevent our colleagues from dying by suicide.”

Part of the AMA’s advocacy to support physician wellness has been direct engagement with state medical boards, hospitals and health systems to remove stigmatizing questions on applications related to mental health and substance use disorders. The AMA has worked with several dozen medical boards, hospitals and health systems alongside the Dr. Lorna Breen Heroes’ Foundation (PDF) and the Federation of State Medical Boards to urge boards and others to review, revise and/or remove all questions that may deter physicians from seeking treatment for mental illness or substance use disorder. In addition, the AMA has worked closely with the Medical Society of Virginia and Virginia Healthcare and Hospital Association to challenge all Virginia hospitals to ensure their credentialing applications are consistent with recommendations from the AMA, Federation of State Medical Boards and Dr. Lorna Breen Heroes’ Foundation…

Read the Full Article

Virginia Department of Health Declares Statewide Outbreak of Meningococcal Disease

via VDH

Dear Colleague:

The Virginia Department of Health (VDH) is declaring a statewide outbreak of meningococcal disease caused by the bacterium Neisseria meningitidis serogroup Y. The sequence type associated with this outbreak was first identified in eastern Virginia in September 2022 and has since been detected in central and southwest Virginia. This letter provides an update to the most recent notice to clinicians that was issued in March 2023.

Meningococcal disease is a rare, but very serious illness. From June 2022 to August 2023, there have been 27 cases of meningococcal disease caused by Neisseria meningitidis serogroup Y reported in Virginia, with most cases (20) occurring in the eastern region. All isolates available for sequencing (22 out of 27) were found to be highly genetically related. This strain is susceptible to ciprofloxacin and penicillin, unlike other serogroup Y strains previously detected in Maryland and northern Virginia, and is known to be circulating more widely across the United States.

Five case-patients associated with this outbreak have died from complications of meningococcal disease, indicating that this strain might have a higher case fatality rate (19% CFR) than is commonly observed in serogroup Y cases (source). The majority of case-patients (18) developed septicemia, and not meningitis, with common symptoms including fever, nausea, vomiting, and muscle aches.

VDH has not yet identified a common risk factor among the cases. The majority of cases have occurred in Black or African American adults between 30-60 years of age. Twenty-six case-patients were unvaccinated for serogroup Y.

Early identification and prompt public health follow up remain key to preventing further transmission. VDH responds to reports of suspected meningococcal disease by rapidly identifying close contacts for whom short-term antibiotics are recommended for post-exposure prophylaxis. VDH is dedicated to increasing access to meningococcal conjugate vaccine (MenACWY), which provides protection against serogroup Y. In areas that have reported an outbreak-associated case, MenACWY vaccine is being made available through the local health departments for people at increased risk of meningococcal disease due to certain medical conditions and residents of localized areas with increased transmission. Additionally, VDH is offering vaccine to outbreak-associated close contacts in an effort to vaccinate individuals who may be part of an unknown social network at increased risk for meningococcal disease serogroup Y.

Please consider the following actions:

  • Maintain a high index of suspicion for meningococcal disease while this outbreak continues. The majority of case-patients have presented with symptoms of septicemia; several case-patients presented with meningitis, citing neck stiffness and photophobia. A petechial rash with pink macules might also be observed. This rash may appear purple, dark brown, or black on darker skin tones.
  • Immediately notify your local health department (LHD) if meningococcal disease is suspected based on clinical findings or laboratory results of gram-negative diplococci or Neisseria meningitidis from a normally sterile site. Please coordinate with your LHD to send specimens/isolates for newly identified cases to Virginia’s state public health lab, the Department of General Services Division of Consolidated Laboratory Services (DCLS), for serotyping.
  • Ensure that all patients who are at increased risk for meningococcal disease are up to date on MenACWY vaccine. People at increased risk include: people with HIV, those whose spleen is damaged or removed, people with sickle cell disease, anyone with a rare immune condition called “complement deficiency” or people taking “complement inhibitors.” A MenACWY booster is recommended every five years for people with increased risk due to medical conditions.
  • Continue to encourage routine administration of MenACWY vaccine in adolescents. As a reminder, a dose of MenACWY vaccine is required for students enrolled prior to 7th and 12th grade.

Thank you for your attention and cooperation.

Sincerely,

Karen Shelton, MD
State Health Commissioner

Quality Insights Announces 50th Anniversary Grant Program Winners

Quality Insights, a healthcare organization committed to improving healthcare and promoting health equity, recently celebrated its 50th anniversary by launching a grant program aimed at supporting innovative projects. After reviewing submissions, Quality Insights selected six winners who will collectively receive more than $100,000.

Quality Insights CEO, Sven T. Berg, M.D., expressed his gratitude to all applicants while congratulating the winners and looking forward to the successful implementation of their grants.

“We were impressed with the quality of all the applicants. These decisions were difficult to make, but we are thrilled to support these innovative programs that will make a significant difference in health and healthcare,” said Berg.

The winners of the grant program include:

  • Lori’s Hands Charm City Scholars Initiative, Baltimore, MD, will create specialized, stipend internships for black, indigenous, people of color (BIPOC), low-income, and/or first-generation college students who are pursuing careers in healthcare. Interns will advance Lori’s Hands’ unique community health service learning model that provides instrumental and social support to community members.
  • The Medical Society of Virginia Foundation, SafeHaven™ Coaching Network, Richmond, VA, will bolster the health and wellness coaching resources available to the healthcare community, building a foundation of peer health and wellness coaches for and increasing access to confidential and protected well-being coaching services.
  • Literacy Delaware, Demystifying the Healthcare Journey, Wilmington, DE, will develop a health literacy education program for dialysis patients and their families to close the health equity gap.
  • Think Kids, West Virginia Wraparound Intensive Support in Enrollment (WV WISE), Charleston, WV, will create a model of person-centered benefits enrollment assistance that overcomes stigma and galvanizes local programs to address health disparities.
  • Grassroots Health, College Athlete Health Education Program for Middle School Students, Baltimore, MD/Philadelphia, PA, will recruit and train 100 college athletes to deliver weekly sports-based health education modules in under-resourced middle schools, an investment in both preventive health education for middle school youth and volunteer/peer training in a health-related field for college student volunteer program facilitators.
  • West Virginia Osteopathic School of Medicine, Women Interested in Staying Healthy (WISH), Lewisburg, WV, will provide support, encouragement, nutrition education, and exercise opportunities for women in Greenbrier County, incorporating a professional dietician, a professional strength trainer/exercise physiologist, and physician counseling on weight loss and healthy lifestyle.

The grant program is part of Quality Insights’ commitment to improving healthcare and closing the health equity gap. The organization believes that by investing in innovative programs, it can make a significant impact in the lives of individuals and communities.

About Quality Insights

Founded in 1973, Quality Insights is celebrating 50 years of using quality improvement science, education and collaboration to develop and bring best practices to healthcare settings and communities. Learn more at www.qualityinsights.org.

Support for Maui Wildfire Relief

The Medical Society of Virginia and its members’ hearts go out to the families and communities affected by the Maui Wildfires. Many of our members are asking how they can support the many communities impacted. Below is information, resources, and ways you can currently support.

The Hawaii Medical Association (HMA) has been doing regular updates on the situation, here.

Other Resources:

The MSV will update this page as we learn more.

Important Message for DEA-Registered Practitioners

As you may be aware, the new MATE law requires DEA-registered practitioners who are renewing their license or any first-time registrants to complete eight hours of training on the treatment and management of patients with opioid or other substance use disorders. 

The University of Virginia is pleased to provide an 8-hour training course that meets these requirements to Virginia-based providers at no cost.  This course, titled “Substance Misuse and Opioid Use Disorders – A National Problem: An Interprofessional Solution” will be available beginning July 31 on the UVA Continuing Education website at CMEVillage.com.  Participants may complete some or all of the eight (8) modules, based on their interests and needs.  Credit will be awarded based on participation, with one content hour per module.

This course is designed for Physicians, Advanced Practice Providers, Nurses, Psychologists, Social Workers, Pharmacists and other healthcare professionals who care for patients with substance abuse disorders.  

For more information on this course, including accreditation details and the MATE law requirements, please review the attached announcement for the course or contact [email protected]. 

Melina Davis, MSV’s CEO and EVP, Honored with Virginia Business Women in Leadership Award

via Virginia Business

Throughout her 35-year career, Melina Davis says that her favorite — and greatest — challenge has been learning to understand people’s motivations and goals.

“Whether we are in a family room or a boardroom, women have to command a leadership position to make sure progress continues,” she says. “Creative solutioning is a superpower for most women I know.”

Davis has imparted this wisdom to dozens of men and women she has mentored over the years while leading MSV, the professional association representing more than 30,000 physicians, residents, medical students, physician assistants (PAs) and PA students across Virginia.

“While it is important to be real about your capabilities and gaps as you learn and grow, it is imperative that we trust in ourselves and know we can figure elements out along the way and work with a team to fill in gaps we personally may not have,” she says. “Embrace your confidence, ladies, and be bolder.”

Previously serving as CEO of the American Lung Association of the Atlantic Coast, Davis also founded PlanG Holdings Inc., a consumer platform that allows people to donate to causes including schools, churches and charities.

She also serves on the media business Fast Company’s executive board and the American Medical Association’s Advocacy Resource Center’s executive committee. Additionally, she’s vice chair of the Virginia Credit Union and is governance chair for the Virginia Commonwealth University School of Business Foundation’s board.

Congratulations to Melina and to the 2023 class of Virginia Business Women in Leadership Award winners. Read more about them all here.

Money Matters: Unlocking Financial Literacy as a Medical Student or Resident

Written by MSV’s Partner, 1752 Financial

Embarking on a journey in medicine is exciting, but it also means facing unique financial challenges. As a medical student or resident, it’s essential to develop some financial know-how to handle your money wisely.

This post dives into three high-level key aspects of financial literacy: budgeting, insurance, and retirement planning. By grasping these concepts, you’ll be on your way to building a solid financial foundation for a successful future.

Related: Watch the Money 101 Webinar

Budgeting for Medical Students and Residents

Budgeting is the secret sauce to financial stability. As a medical student or resident, keep these budgeting tips in mind:

  1. Know Your Income and Expenses: Figure out how much money you have coming in every month from income, scholarships, grants, part-time gigs, etc. Then, identify your essential expenses like tuition, rent, utilities, and groceries. Tack on your less essential expenses like gym memberships and dining out, and you’ll have a good baseline for your budget. There are budgeting-specific apps, but a Google Spreadsheet is also a simple way to keep track of your monthly budget.
  2. Create an Emergency Fund: An emergency fund is money you set aside for unexpected expenses, like unanticipated illness or injury. Start by saving whatever you can, while working your way up to a fully funded emergency fund that can cover three to six full months of your expenses.
  3. Tackle Your Debt: Med school and residency often mean hefty student loans. Develop a plan to manage your debt responsibly. Look into income-driven repayment plans, loan forgiveness programs, or refinancing options to ease the burden over time. Many people have success with Dave Ramsey’s Debt Snowball for organizing and paying off debts from multiple sources.

Insurance

Insurance acts as a safety net, protecting you from unexpected financial hurdles. As a resident or medical student insurance is particularly important. Consider the following insurance types:

  1. Malpractice Insurance: Medical malpractice insurance shields you in case of a lawsuit related to medical negligence. It is often provided by the group or hospital that employs you, but you may need to seek out coverage if it’s not offered or you open your own practice.
  2. Disability Insurance: For residents, your ability to earn an income is one of your most important assets. Disability insurance pays you if you’re unable to work due to illness or injury. Residents should be looking for own-occupation coverage that protects you in your specific specialty, and a policy that moves with you if you change jobs. Many doctors have group coverage as an option from their employer and choose to add on an individual policy to fill in the gaps of the group coverage.
  3. Life Insurance: Life insurance provides essential protection if anyone relies on your income. Term coverage is the least expensive the younger you are, and can help your family pay their mortgage and expenses should you ever pass away.

Retirement Planning

Starting early with retirement planning offers significant benefits. Consider the following:

  1. Employer-Sponsored Plans: A 401(k) is a benefit that’s sponsored by your employer. The money you save is taken out of your paycheck and then invested within the retirement plan. Because the money is typically contributed before taxes are taken out, it can lower your current taxable income. Contribute at least the amount that your employer will match and increase your contributions as your income allows.
  2. Individual Retirement Accounts (IRAs): Traditional IRAs are retirement plans that allow your money to grow, tax-deferred, until you reach retirement age. They are similar to a 401(k), but they are not sponsored by your employer and have more flexibility in where your money is invested. Everyone can open a traditional IRA and there are yearly contribution limits. If you have a 401(k) from an old employer, you can often roll it over to an IRA to have better consolidation and control over the account.

Financial Literacy for Medical Students and Residents

By understanding budgeting, insurance, and retirement planning, you can build a strong financial foundation. The beginning of your career is a perfect time to take the time to learn about these topics, seek advice from financial professionals when needed, and make informed decisions that align with your financial goals. With a solid financial footing, you can focus on your medical career with confidence, knowing that you’re also setting yourself up for a prosperous financial future in the medical field.

If you have any questions about financial planning while in residency or medical school, don’t hesitate to contact the MSV or 1752 Financial. We specialize in helping medical professionals navigate their unique financial situations and can help equip you with tools necessary to make informed financial decisions that align with your long-term goals.