Public Health Forum: The Social Determinants of Health

Posted in Health, Health Policy, Public Health, Public Health Leadership Forum on March 9th, 2017 by MMS Communications – Be the first to comment

MMS President Dr. James S. Gessner

Good health includes much more than access to care. Research has demonstrated that a range of factors – such as environmental conditions, education, employment, and social and economic status – play key roles in a person’s health.

These factors – the “social determinants of health care” – will be the focus of the Medical Society’s 13th annual Public Health Leadership Forum taking place on Tuesday, April 4, 2017 from 1 – 5 p.m.

“Access to care and our health care system are certainly essential to good health,” says James S. Gessner, M.D., President of the Massachusetts Medical Society, “but a host of other factors come into play that contribute to healthy behaviors and prevent premature death. It’s important for the medical community to recognize all those elements and how they affect a patient’s health, and to be prepared to counsel their patients in a way that reflects social factors.”

The forum, entitled Social Determinants of Health: Improving Population Health Through Prevention- Based Care, will examine what policy makers and the medical community can do to acknowledge the impact of these factors on health.

Hosted by Dr. Gessner and Steven Ringer, M.D., chair of the MMS Committee on Public Health, the forum will be moderated by Harold Cox, Associate Dean for Public Health Practice at the Boston University School of Public Health.

Featured Speakers are Thea James, M.D., Vice President of Mission and Associated Chief Medical Officer at Boston Medical Center, who will deliver the keynote address, and Monica Bharel, M.D., M.P.H., Commissioner of the Massachusetts Department of Public Health, who will speak during the second half of the program.  The program also includes panel discussions with local experts on the topic.

For the complete agenda and to register for the event, click here.

 

 

The President’s Podium: Physicians and Gun Violence II

Posted in Public Health, violence on February 13th, 2017 by MMS Communications – Comments Off on The President’s Podium: Physicians and Gun Violence II

by James S. Gessner, M.D., President, Massachusetts Medical Society

Last June, I devoted a President’s Podium to the subject of physicians and gun violence, noting our long-standing policy on firearm violence and the more recent efforts MMS has made to address this growing public health crisis.

Our latest activities include the creation of continuing medical education courses, based on content from our 2016 Public Health Leadership Forum, and a dedicated website at www.massmed.org/firearms, offering a variety of resources on firearm violence and gun safety.

Today I had the privilege of standing with Massachusetts Attorney General Maura Healey and Massachusetts law enforcement officials to announce new initiatives in enhancing provider-patient relationships regarding firearms. I take this space to share my remarks from the press conference with you.

Madam Attorney General, on behalf of the physicians of Massachusetts, I thank you for the invitation to co-sponsor and participate in today’s event.  It is an honor to stand here with you, other health care leaders, and law enforcement officials to remind everyone what has been evident for some time:  that gun violence is a major public health threat.

That physicians are collaborating in this event and are taking a stand against gun violence alongside law enforcement should not be considered unusual. For more than 20 years, our state medical society has been engaged in efforts to reduce violence in many forms. 

The physicians of our Committee on Violence Intervention and Prevention since 1995 have provided resources for both physicians, health care providers, and patients in such areas as intimate partner violence, bullying, child abuse, and human trafficking.  Gun violence has been prominent among those topics.


Physician efforts at gun violence have been directed at reducing deaths and injuries, making gun ownership safer, promoting education among health providers, and encouraging research to understand the risk factors related to gun violence.

The numbers alone make it abundantly clear that firearm violence is indeed a public health issue: more than 130 mass shootings have occurred in 39 states since 2009; more than 36,000 persons die from firearm injuries in the United States every year with 64 percent being suicides and 33 percent homicides; on an average day, more than 90 Americans are killed with guns, including seven children and teenagers; and for every person killed by a gun, two more are injured.  The number of deaths from firearms are rivaling those from motor vehicle accidents and in many states have surpassed vehicle fatalities.

Massachusetts, however, stands out, with the lowest gun death rate in the country for 2015, the last year for which statistics are available.  We may pride ourselves on having the lowest death rate, but let us remember that 213 people in Massachusetts still lost their lives to firearms in that year.    

Strong firearm laws have contributed to the state’s low death rate.  But awareness and education must also play important roles, and the Massachusetts Medical Society is pleased to continue its educational efforts in collaboration with Attorney General Healey’s office and law enforcement leaders across the state in educating individuals about safe storage and disposal of firearms, and in encouraging health care providers to talk to their patients about gun safety.  These efforts complement our Society’s continuing medical education courses on firearm violence.

Increasingly, physicians are making their voices heard about gun violence.

Two years ago, more than one dozen physician organizations, along with the American Public Health Association and the American Bar Association, issued a call to action, declaring that deaths and injuries from firearms are a major public health problem in the United States.  Last year, the American Medical Association adopted a policy calling gun violence in the United States a “public health crisis.”

Also last year, our medical society sponsored a public health forum on firearm violence, featuring community leaders and public health and law enforcement officials, and Attorney General Healey was kind enough to accept our invitation to be the keynote speaker for that event.

In her remarks, she highlighted the importance of physician participation in curbing gun violence, and said it will require a “partnership” with physicians.  Physicians agree, Ms. Healey, and I will conclude my remarks by saying “You can count on that.”  

The President’s Podium appears periodically on the MMS blog, offering Dr. Gessner’s commentary on a range of issues in health and medicine.

Pictured: Covers of brochures for patients and physicians/health care providers provided by the Massachusetts Office of the Attorney General and the Massachusetts Medical Society and endorsed by the Massachusetts Chiefs of Police Association and the Massachusetts Major City Chiefs of Police. Available free via download from www.massmed.org/firearms

 

January Physician Focus: Too much medicine?

Posted in Uncategorized on January 3rd, 2017 by MMS Communications – Comments Off on January Physician Focus: Too much medicine?

 

The conventional wisdom in medicine says that more care leads to better health, as annual physicals and regular screenings may lead to the early detection of diseases.  Research shows, however, that many medical tests and procedures are unnecessary and in some cases, can cause harm.

Dr. Dale Magee (l), Dr. H. Gilbert Welch

Dr. Dale Magee (l), Dr. H. Gilbert Welch

The January edition of Physician Focus examines the subject of ‘too much medicine’ with Dr. H. Gilbert Welch, a general internist, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, and author of Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care.  Hosting this edition is MMS Past President Dale Magee, M.D., Professor Emeritus of Obstetrics and Gynecology at UMass Medical School.

Dr. Welch acknowledges that the screening of at-risk populations makes sense and that it’s a good thing to see a physician when something is wrong, but cautions that, amid a push for more testing in medicine today, “all treatments have some harms” and that the downside of early detection can be “a recipe for turning well people into patients unnecessarily.”  He urges patients to be cautious, to talk to their physicians, and to inform themselves about the pros and cons of testing and screening.

Physician Focus is distributed to public access television stations throughout Massachusetts, reaching residents in more than 275 cities and towns. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

Editor’s Note: In November, Dr. Welch delivered the 41st Annual Garland Lecture, “Less Medicine, More Health,” at the Francis A. Countway Library of Medicine.  Video of his lecture is available at the above link.

December Physician Focus: Superbugs

Posted in Uncategorized on December 9th, 2016 by MMS Communications – Comments Off on December Physician Focus: Superbugs

The spread of “superbugs” – germs, bacteria, fungi, and parasites that are resistant to the medications intended to kill them – is a rising concern in medicine. Each year in the United States, two million people become infected with drug-resistant bacteria, and some 23,000 die as a result of those infections.

Dr. Bruce Karlin (l); Dr. Alfred DeMaria Jr.

Dr. Bruce Karlin (l); Dr. Alfred DeMaria Jr.

The December edition of Physician Focus discusses “superbugs” with Alfred DeMaria Jr., M.D., Medical Director and State Epidemiologist of the Bureau of Infectious Disease and Laboratory Sciences for the Massachusetts Department of Public Health.

Among the topics of conversation are how these bugs originate, how severe the threat is, what public health officials are doing to address these conditions, what patients can do to protect themselves, and the importance of the proper use of antibiotics in curbing the spread of these infections.

Physician Focus is distributed to public access television stations throughout Massachusetts, reaching residents in more than 275 cities and towns. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

IM-16 Annual Oration: Zika – Responding to the Challenges of an Emerging Infection

Posted in Health, MMS Oration, Public Health on December 5th, 2016 by MMS Communications – 1 Comment
Dr. Alfred DeMaria Jr.

Dr. Alfred DeMaria Jr.

In delivering the Annual Oration at the Interim Meeting, Alfred DeMaria, Jr., M.D., Medical Director for the Bureau of Infectious Disease of the Massachusetts Department of Public Health, urged physicians to understand the origins of the Zika virus and to grasp its symptoms and dangers   to become better prepared to treat patients should they become infected. He also encouraged physicians to stay abreast of ongoing research into the virus’ symptoms. While there is currently no known vaccine or medicine for Zika, medical researchers are striving to develop better preventive and treatment methods.

Dr. DeMaria said that Zika was first discovered over 70 years ago by medical researchers in Uganda. It was limited in its scope of infection to a few cases, most in that region. Since 2007, however, due in large part to global travel, Zika has become an emerging infection that has spread and infected millions worldwide.

Spread mostly by the infected Aedes aegypti mosquito that bites humans during the day and night, Zika can be passed from a pregnant woman to her fetus. Infection that occurs during pregnancy can cause certain birth defects, including microcephaly. Dr. DeMaria noted that 40 percent of all calls to the state’s epidemiology information telephone line are Zika related. The state has also set up an informational website. Because Massachusetts already tracks mosquitos for West Nile virus and Eastern equine encephalitis, the state is prepared to respond to the emerging virus and very few cases have been reported in the state.

Dr. DeMaria’s presentation may be viewed here.

 

IM-16 Town Hall Forum: All about MACRA

Posted in Uncategorized on December 5th, 2016 by MMS Communications – Comments Off on IM-16 Town Hall Forum: All about MACRA

The Town Hall Forum with the Presidential Officers held Friday evening as part of IM-16 occupied a singular subject: MACRA, the Medicare Access and CHIP Reauthorization Act, which MMS President James S. Gessner, M.D. characterized as “perhaps the most revolutionary change in Medicare reimbursement since the inception of Medicare.”

Alex Calcagno

Alex Calcagno

The 2,400-page rule was the object of MMS advocacy on both the Federal and state levels, and MMS comments on the proposals amounted to more than 22 pages. Many of the comments were incorporated into the final document.

The Forum was a presentation by MMS staff member Alex Calcagno, Director of Advocacy, Government and Community Relations and the primary liaison between MMS and the federal government, and had three goals:  (1) presenting a general overview of the provisions of the rule; (2) outlining the time frame of implementation and the choices physicians have in participating; and (3) citing resources available for physicians to help them through the process.

The MMS has established a dedicated webpage for MACRA at www.massmed.org/MACRA, which provides information and resources on the rule. Additional information is available from the website of the Centers for Medicare and Medicare Services.  Members are urged to check the sites frequently, as information is added as it becomes available.

Ms. Calcagno’s presentation may be viewed here.

 

IM-16 Ethics Forum: Challenges of the Employed Physician

Posted in Ethics Forum on December 5th, 2016 by MMS Communications – Comments Off on IM-16 Ethics Forum: Challenges of the Employed Physician

As more physicians become employed, and more attention is paid to cost control in health care, physicians are faced with ethical challenges: should a physician’s care and treatment of a patient take into consideration cost controls, or should a physician do everything in his or her power to care for the patient without regard to cost?

Dr. James Sabin

Dr. James Sabin

The main presenter for this session was James E. Sabin, M.D., Clinical Professor of Population Medicine and Psychiatry at Harvard Medical School and Director of the Harvard Pilgrim Health Care Ethics Program. As Director of the Harvard Pilgrim Health Care Ethics Program, Dr. Sabin is responsible for a nationally recognized, highly innovative organizational ethics program firmly based in a managed care system. He was joined by Karen Wood, M.D., of Harvard Vanguard, and Andrew Levin, M.D. , who practices in Holyoke, Mass.

Discussion centered on the conflicts inherent in practicing medicine as an employed physician and the employed physician’s role as a steward of health care resources. Dr. Sabin’s presentation included a focus on the American Medical Association’s Code of Ethics, which defines the ethical responsibilities for physicians and physician-administrators.  Among the topics of conversation were how to help physicians apply, and patients accept, cost-conscious medical practice; how to achieve access and affordability for all patients; and how to recognize the need to share resources and the inevitable need for limits on care. More information on organizational ethics in health care is available from Dr. Sabin’s blog.

 

 

Statement from MMS President on Passage of Question 4

Posted in Drug Abuse, Health Policy, Public Health on November 9th, 2016 by MMS Communications – 1 Comment

“It is disappointing that the commercial interests of marijuana have won out over the health and safety of citizens in the Commonwealth.  Physicians will continue their advocacy to warn citizens about the dangers of recreational marijuana and pledge to work with state officials to ensure that public health oversight, protections for teens and adolescents, and provisions for education, treatment and recovery are included as the law is implemented.”

James S. Gessner, M.D.
President, Massachusetts Medical Society
November 8, 2016

MMS Restates the Risks of Marijuana

Posted in Health, Health Policy, Public Health on November 4th, 2016 by MMS Communications – Comments Off on MMS Restates the Risks of Marijuana

The following statement from MMS President James S. Gessner, M.D. was issued November 4 in response to a press conference held by proponents of Question 4 and featuring physicians who advocate for the legalization of recreational marijuana.  Coverage of the event may be read here.

“Presenting recreational marijuana as something most physicians believe is beneficial to health is deceiving and dishonest.  Massachusetts already has a program for medical marijuana, strictly regulated by the Department of Public Health.  Question 4 provides no public health oversight and directs no revenue to health or substance abuse education or treatment.

The facts are that marijuana presents a real risk of addiction. Its use damages the developing brains of young people, risks pregnancy, and increases the risk of accidents.

We urge voters to read the ballot question carefully.  Question 4 is bad policy and bad for public health.  Those are the reasons why the Massachusetts Medical Society, 11 physician specialty organizations, hospital and nursing associations, and other health care groups in the state are strongly opposed to Question 4.”

The public health dangers of recreational marijuana are further outlined in this commentary by Dr. Gessner and in this essay by five health care professionals from McLean Hospital.  More information on marijuana and the risks it presents is available on the MMS website and at the National Institute of Drug Abuse.

 

 

MMS Responds to Column on Question 4

Posted in Drug Abuse, Health, Health Policy, Public Health on November 3rd, 2016 by MMS Communications – Comments Off on MMS Responds to Column on Question 4

In a column entitled Countering the anti-pot hysterics with a ‘yes’ on Question 4 published October 28 online in The Boston Globe, WGBH’s Margery Eagan took the opponents of recreational marijuana to task, labeling them as “hysterics” who are engaged in “reefer madness.”

In the column, she accuses the MMS of “shameful” behavior in its opposition to marijuana (both medical in 2012 and recreational in 2016).recreationalmarijuana_ballotquestion_image_990x450

MMS responded to the column October 31 in a letter to the editor from MMS President James S. Gessner, M.D. As of this posting, the letter has not appeared, so we publish it here for our members to read.

Marjorie Eagan may believe that opposing marijuana is “shameful” behavior by physicians, but her willingness to ignore the public health effects of legalization and discount the threat to children in favor of having a “really fun time” is simply irresponsible. (Countering the anti-pot hysterics with a ‘yes’ on Question 4, Oct. 28). Marijuana is not the harmless substance she and the proponents of Question 4 claim it to be. 

Today’s marijuana has four times the amount of the mind-altering THC substance it had in years past, and its use can lead to addiction, impair cognition, risk pregnancy, and damage the developing brains of adolescents.  Those are the facts, not reefer madness hysteria. Question 4 also offers no public health oversight and provides no resources for prevention, education, or treatment.  It represents bad policy, and physicians take pride in advocating for public health over the ready access to a substance that can cause harm.

MMS and 11 physician specialty societies in Massachusetts have stated their strong opposition to Question 4 for a host of reasons. We urge voters to visit the National Institute on Drug Abuse and MMS websites for information on recreational marijuana and watch the October 30th CBS 60 Minutes report on the effects of recreational marijuana in Colorado. All three indicate that marijuana is not the harmless substance many people think it is.