2014 Annual Meeting Recap: Helping Physicians Adapt to Change

As the rate of change in our health care system—and our medical practices—continues to accelerate, more doctors are feeling the weight of blame for costs, outcomes, and quality, says Karen Rizzo, MD, FACS, newly installed president of the Pennsylvania Medical Society (PAMED).

Dr. Rizzo, an otolaryngologist/ENT from Lancaster, was sworn in as the 165th president of PAMED on Oct.18 during our annual statewide meeting in Hershey. Several other Pennsylvania physicians also were elected to PAMED’s Board during the meeting.

“The cost of health care rests squarely on their [physicians’] backs as their burden,” she said, along with the blame for poor outcomes, ordering too many tests, and not spending enough time with patients.

Dr. Rizzo told the more than 300 delegates attending the PAMED House of Delegates and Annual Education Conference, Oct. 18-19, that instead of carrying that blame, they must adopt physician-led solutions to address the changes happening all around us.

While continuing to support PAMED’s strong advocacy agenda, she will advocate for three strategic directions during her year in office:

  • Promote PAMED programs that help physicians learn about and respond to all the changes taking place around them;
  • Develop and then implement an intentional, thoughtful strategy to engage with insurance companies to understand how they measure our performance, how they measure quality, and how they measure the costs we generate to their covered lives;
  • Develop our vibrant and enthusiastic young physician community by creating a Leadership Academy for Young Physicians.

2014 House of Delegates Actions:
As a result of deliberations at the 2014 House of Delegates, PAMED’s already robust agenda for the coming year will add important issues such as:

  • Maintenance of Certification (MOC) — Ask the American Medical Association (AMA) to:
    • Work with the American Board of Medical Specialties (ABMS) to eliminate practice performance assessment modules as currently written from the requirements of MOC.
    • Develop and disseminate a public statement, with simultaneous direct notification to the American Board of Internal Medicine (ABIM) and other ABMS sponsoring boards, that their current MOC program appears to be focused too heavily on enhancing ABIM revenues and fails to provide a meaningful, evidence-based, and accurate assessment of clinical skills.
    • Investigate and/or establish alternative pathways for MOC.
    • Report back to the House of Delegates at the Annual AMA Meeting in June 2015.

The PAMED Board was asked to study a recommendation to then ask the AMA to revoke its support for MOC if no action is taken by the ABMS in working with the AMA to make MOC requirements less onerous.

PAMED will continue to support efforts to create a reasonable and economical assessment process that provides physicians with the information necessary to improve the quality and efficiency of their practices.

  • E-Cigarette advertising/endorsementAsk the AMA to work through an appropriate federal process to prohibit e-cigarette companies from paying for product placement in films and hiring celebrity spokespersons, and to prohibit e-cigarette advertising on television.
  • Ebola preparedness— Continue to provide Pennsylvania physicians with important information, such as local and state guidelines, how to put on and remove personal protective equipment, identification of containment facilities, and access to sensitive and specific surveillance tools. PAMED will continue to work with the Pennsylvania Department of Health and other state preparedness partners to ensure that health care facilities are prepared in the event that Pennsylvania faces an Ebola i.
  • Medicare coverage of vaccines—Aggressively petition the Centers for Medicare and Medicaid Services (CMS) to include tetanus and Tdap at both the “Welcome to Medicare” and Annual Medicare Wellness visits, and other clinically appropriate encounters, that allows for coverage and payment of these vaccines to Medicare recipients who have not been vaccinated within the past 10 years.
  • Barriers to getting health care—Work with insurers to provide payments to physicians and physician-supervised designees for medications, vaccines, and their administration, without the burden of prior-authorization or any other administrative barriers.
  • Telemedicine—Work with stakeholders to evaluate the different applications and uses of electronic technology to adopt standard definitions of what constitutes telemedicine, identify standards for coverage and payment for the use of telemedicine, and work to establish policy in Pennsylvania for the licensure of providers and payment for services.
  • Urgent care clinics—Work to educate urgent and retail clinics on the importance of transmission of point of service patient medical records to primary care physicians and specialists, and investigate any complaints of non-disclosure of medical records by a facility due to alleged financial and network associations.
  • Single national narcotic provider number—Ask the AMA to continue to work with the Drug Enforcement Administration (DEA) and Congress to move toward a system in which individual physician DEA registration numbers are person-specific rather than site-specific within a state.
  • Unification of GME accreditation standards—Seek legislation to: 1) drop the licensure requirement for DOs to do at least one AOA approved year; and 2) make the number of required GME years the same, whether for DOs or MDs, to get a full, unrestricted license.
  • Independent practice access to facilities and insurance program participation— Seek legislation to provide access to participation in insurance networks and hospital facilities for independent physicians that meet the accepted quality measures.
  • Hospital privileges for private practice physicians—Pursue legislation concerning the enforcement of the Community Benefit Standard in Pennsylvania; research ways to provide legal support to aid PAMED member physicians who are impacted by hospitals’ exclusionary tactics; and work to maintain  private physician health care network relationships.
  • Contracts with insurers— Pursue fairer insurer contracts and consider support of legislation to provide for contracts between insurers and networks to assure access to care with a level of insurance coverage for patients.
  • Universal Patient Transfer FormWork with state government agencies and hospitals to develop a Universal Patient Transfer Form (UPTF) and an understanding of how it will work in Pennsylvania.
  • Membership dues—The PAMED Board, working with the Membership Task Force, will be studying alternative dues models. At the annual meeting, members provided a lot of good feedback and ideas that will be incorporated into the task force’s discussion.

Watch for more information on these issues from PAMED in the Daily Dose and other member communications.