The President’s Podium:  Education Is Key to Opioid Battle       

Posted in Drug Abuse, opioids, Physician Focus, Public Health on April 14th, 2016 by MMS Communications – Be the first to comment

by Dennis M. Dimitri, M.D., President, Massachusetts Medical Society

Multiple efforts have been taken by many people all over the Commonwealth during the last year to curtail the state’s opioid epidemic.  We’ve seen Dr.DimitriMMS (4)Governor Charlie Baker’s Opioid Working Group present 65 recommendations to attack the crisis,  law enforcement officials offer treatment instead of arrest, Department of Public Health work on improving the Prescription Monitoring Program, and the deans of the state’s four medical schools establish core competencies in opioids and pain management for medical students.

Our own medical society has been at the forefront of addressing the crisis, with prescribing guidelines, free pain management CME’s to all prescribers, public service campaigns for patients, and collaboration with state and public health officials on a variety of initiatives.

Our latest effort is yet another cooperative endeavor with the Department of Public Health. I am privileged to appear as a guest with Monica Bharel, M.D., M.P.H., Commissioner of the Massachusetts Department of Public Health, on Crisis in the Commonwealth: Opioid and Prescription Drug Abuse, the most recent edition of our monthly patient education television series, Physician Focus, produced in cooperation with HCAM-TV in Hopkinton.

Hosted by Lynda Young, M.D., Professor of Pediatrics at UMass Medical School and a past president of MMS, the show is intended to educate citizens across the Commonwealth, providing perspectives about many aspects of the opioid crisis: the origins of the epidemic, the impact on patients and families; the roles of prescriber and patient; actions taken by medical, state, and public health agencies; and the provisions of the new state law recently signed by Governor Baker to address the epidemic.

The half-hour program is being distributed to public access television stations across the state, within reach of citizens in some 275 communities, and it is also being posted online at several sites. The video also includes a public service announcement and a listing of local and national resources about substance abuse, opioids and pain medicines, and prevention and treatment options.

While the efforts of many have led to some progress over the last year, the opioid epidemic is a difficult one to attack, as evidenced by recent headlines: Middlesex County saw 20 deaths from overdoses in just three weeks, and an analysis by the Massachusetts Health Policy Commission revealed that opioid-related visits to hospitals nearly doubled from 2007 to 2014, reaching 57,000 in 2014.

The opioid crisis has been the Medical Society’s number one priority for the last year, and it will remain at the top of the list.  The video produced with the Department of Public Health is another initiative by physicians and targets what we believe to be one of the keys to success:  education for both patients and prescribers, current and future. As Dr. Bharel states early in the video discussion, “It’s so important that we talk about this and make sure we’re educated and understand the scope of the problem.”

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

 

April Physician Focus: The Opioid Crisis

Posted in Department of Public Health, Drug Abuse, opioids, Physician Focus, Public Health on April 14th, 2016 by MMS Communications – Be the first to comment

The Massachusetts Medical Society, in cooperation with the Department of Public Health, has taken another step in its efforts to address the publicOpioids_edited health crisis of opioid and prescription drug abuse affecting residents of the Commonwealth.

The April edition of Physician Focus, Crisis in the Commonwealth: Opioid and Prescription Drug Abuse, examines multiple aspects of the opioid epidemic with MMS President Dennis M. Dimitri, M.D. (photo, center) and DPH Commissioner Monica Bharel, M.D., M.P.H., (right), two physicians who have been at the forefront of addressing the problem over the last year.

Hosted by Lynda Young, M.D., (left) Professor of Pediatrics at UMass Medical School and a past president of MMS, the program represents another initiative by the physician community and seeks to educate prescribers, patients, and citizens about the crisis and what steps they can take to help to curtail the abuse.

Among the topics of conversation are the origins of the opioid crisis; the roles of prescribers and patients; actions taken by medical, state, and public health agencies to reduce the abuse; and the provisions of a new state law created specifically to fight the epidemic.  The video also contains a public service announcement recorded by the guests and a list of local and national resources about substance abuse, opioids and pain medicines, and prevention and treatment options.

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.massmed.org/physicianfocus, www.physicianfocus.org/opioids, and on YouTube.

AG Healey: Curbing Gun Violence Requires “Partnership” with Physicians

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by Erica Noonan – Be the first to comment

Curbing the epidemic numbers of deaths and injuries from firearms in the United States  will require a “spirit of partnership” among law enforcement officials, health care providers and community leaders, said Massachusetts Attorney General Maura Healey.

“This is a public health issue, and we are not going to be able to prosecute our way out of this,” she said.  “We need to reframe the conversation and retake the issue for the good of our country.”

Healey was a featured speaker at 12th Annual MMS Public Health Leadership Forum – Firearm Violence: Policy, Prevention & Public Health on April 5 at MMS Headquarters in Waltham.

The forum was convened to discuss the latest information on firearms violence, including how physicians can reframe the debate about firearms in order to encourage strategies that support gun violence prevention policies, research and programs.

Expert faculty includes Georges Benjamin, MD, executive director of the American Public Health Association, David Rosmarin, MD, director of the Forensic Psychiatry Service at McLean Hospital, the Rev. Jeffrey Brown, longtime anti-violence activist and founder of RECAP, and many more distinguished speakers.

Healthy defended the right of physicians to speak to their patients about guns, noting that physicians in Florida were recently prohibited by an appeals court from doing so.

She also urged support for policies that would require gun manufacturers and dealers to be held more accountable for the estimated 33,000 deaths per year across the country.  “Guns are the only consumer products that enjoy full immunity (from lawsuits)” she said.

Healey drew parallels between the guns and the issue of opioid abuse, an issue on which the MMS and state officials have collaborated extensively.  “This crisis requires renewed focus and persistence,” she said. “I hope collectively we can work together and make an impact.”

–Erica Noonan

Public Health Keynote: 91 deaths a day, 33,000 a year

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by MMS Communications – Be the first to comment

The numbers represent a “true epidemic,” said Georges Benjamin, M.D., as he tallied the number of deaths per day and the number of deaths per year from gun violence in the United States in delivering the keynote address April 5 at the 12th Annual Public Health Leadership Forum, Firearm Violence: Policy, Prevention and Public Health.  The forum was attended by approximately 120 physicians, health care leaders and public health and government officials.

The numbers represent a public health crisis, and the grim statistics prove the point: on an average day, 91 Americans are killed by guns, with more than 33,000 dying every year.  In an average month, 51 women are shot to death by their intimate partners, and seven children and teens each day are killed by guns.

Dr. Benjamin, Executive Director of the American Public Health Association, had three objectives in his keynote: (1) to define the societal toll of firearm injury; (2) to articulate a public health approach to reducing injury and death from firearm violence; and (3) to offer a broad approach to reducing firearm-related injuries and deaths.

“Guns are part of our culture,” said Dr. Benjamin, noting that the U.S. has more guns than people, “and we have the fundamental belief that firearms protect us.” Yet, he said, far too often the result is death and injury. Mass shootings, like the one at Sandy Hook, Connecticut, remain a persistent issue, with the U.S. experiencing more days with mass shootings than without.

“The protective safety of guns is overestimated,” said Dr. Benjamin. “In homes with firearms, homicide is three times more likely and suicide is five times more likely.”

Dr. Benjamin argued that through technology and education we can make guns safer and make people safer with their guns.  And it is an issue, he says, that physicians should embrace.  “Why should physicians care about this?  If it hurts people, if it kills people,” he said, “physicians should care.”

— Richard P. Gulla

Dr. Benjamin’s slide presentation, A Public Health Approach to Reducing Firearm Injury, may be viewed here.

Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Posted in gun control, Public Health, Public Health Leadership Forum on March 31st, 2016 by Erica Noonan – Comments Off on Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Massachusetts Attorney General Maura Healey will speak to leaders in public health and medicine at MMS’s Public Health Leadership Forum on Firearm Violence on April 5.  MMS Public Health Manager Robyn Alie spoke with Attorney General Healey recently about firearm violence and how it affects physicians and the public.

MMS:  You have called the epidemic of gun violence a public health problem. Why?

AG HEALEY: I think what’s really important is we talk about this as a public health crisis and as a moral issue for our country.   In far too many places, across this country, people are fearful of sitting outside on their porch, fearful of letting their kids walk to school. We have too many victims of domestic violence, subject to incredible mental anguish given that their abusers have guns and are able to wield all sorts of power.

Guns have a significant impact on the health and wellbeing of families and of the community at large. The fact of the matter is that having a gun in your home does not make it a safer place to be, and actually makes it more dangerous. It’s not that people aren’t entitled to exercise their second amendment rights and to keep a gun at their house, but the risk of suicide is five times as high. Death of a household member is three times more likely. With a gun in the home, a woman’s risk of intimate partner homicide is seven times as great.

MauraHealey42

MMS: Last year, a physician at Brigham and Women’s Hospital was fatally shot by a patient’s family member. What are your thoughts about how to protect health professionals?

AG HEALEY: It was so tragic. He was shot to death in the hospital doing his job. In the wake of that event, we reached out to the hospitals to find out how we can be helpful, and we learned that hospitals need to find the right balance, between providing secure spaces for their workers and patients, and at the same time providing a place that’s welcoming and inviting for family members and for visitors, and it’s tough. It’s a delicate balance, and one that requires the use of best protocols and policies to ensure that no one’s in harm’s way.

But I still see instances where the availability of guns has made it far too easy for someone who’s set on doing harm to obtain guns and be able to go out and cause harm.

MMS:  We have seen that mental health is often implicated in gun violence events, but research has shown that the proportion of gun violence perpetrated by people with mental illness is actually quite small, and those with mental illness are actually more likely to be victims. What are your thoughts about policies related to mental health and gun violence?

AG HEALEY: I would never want our gun violence blamed on mental health problems. We shouldn’t use this issue to create greater stigma around mental health and behavioral health. But, I think it is an opportunity to recognize that those services need to be more robust. That’s why we need true mental health parity when it comes to coverage and access. We need to focus on the reality that 62% of gun deaths are suicides. Also, we do need to provide care and treatment to those folks. How are we looking to intersect with them so that we have an opportunity to intercede? Again, here’s where I think health care and medical professionals have that opportunity. And why their involvement and engagement are so important. Because we should be doing everything we can to make sure that people who are a danger to themselves or a danger to others, who might harm themselves are not able to access guns in a way that’s going to enable them to harm themselves or someone else.

MMS: What about issues of patient privacy?

AG HEALEY: It’s an issue where I know there has been some differences across the states. There’s a law in Florida that actually prohibits physicians from asking their patients about gun ownership. That law is now being challenged in the courts. And I think it should be challenged for all the reasons we just talked about. Gun violence is a public health issue and I don’t think that doctors should be restricted from asking their patients about an issue that could affect their health. The NRA has long pushed for these kinds of laws in part because they know how influential physicians can be. I think that’s where we need to have doctors more involved in addressing this question. I don’t think doctors should be in any way prohibited from asking patients about an issue that in any way could affect their health. This is one. Obviously there are appropriate ethics that apply when it comes to physicians becoming aware that someone may do immediate harm to themselves or others, and they should act appropriately there, according to their ethical obligations.

Learn more about the 12thAnnual MMS Public Health Leadership Forum, Firearm Violence: Policy, Prevention & Public Health, on April 5 from 1:00 to 5:00 p.m.

 

March Physician Focus: Common Skin Disorders

Posted in Uncategorized on March 22nd, 2016 by MMS Communications – Comments Off on March Physician Focus: Common Skin Disorders

The skin is the largest organ in the human body and serves to regulate our body temperature and provide protection from bacteria and SKIN DISORDERS EDITED 3_editedviruses.  Yet the skin is subject to a number of diseases and conditions – from acne to eczema, rashes to rosacea, to various types of skin cancer.

The latest edition of Physician Focus features representatives from the Massachusetts Academy of Dermatology discussing the most common skin conditions and what patients can do to protect their skin.

Guests are Ira L. Skolnik, M.D., Ph.D., (photo, right) president of the Massachusetts Academy of Dermatology, and a physician with Family Dermatology in Concord, Mass., and Pamela Weinfeld, M.D., (center) vice president of the Academy and founder of Dermatology and Skin Care Associates in Wellesley. Hosting this edition is family physician Mavis Jaworski, M.D.(left).

The conversation includes the risk factors for skin disease, including the dangers of tanning; differences among the three most common types of skin cancer; and the causes and treatments of acne and eczema.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and online at www.physicianfocus.org, www.massmed.org/physicianfocus, and YouTube.

Download Your Copy of the MMS Physicians’ Guide to Social Media

Posted in Uncategorized on March 21st, 2016 by Erica Noonan – Comments Off on Download Your Copy of the MMS Physicians’ Guide to Social Media

social media guide coverThe evidence is clear: Your patients are seeking, and often sharing, health information across a variety of platforms on the Internet.

Physicians can use the new platforms and communities to share valuable information, provide context to health stories in the popular media, and even dispel dangerous health myths.

In doing so, physicians who are active in social media will simultaneously strengthen their own online reputation and digital footprint, as well as that of their practice or employer.

The MMS Committee on Communications  has created a new guide to help physicians engage in and manage social media tools in ways that will provide optimal benefit to their patients and practices.

Download the 28-page .pdf free of charge here.

Erica Noonan

The President’s Podium: MMS Grassroots Advocacy Leads to Another Positive Step in the Opioid Battle

Posted in Drug Abuse, Leadership, opioids, Public Health on February 26th, 2016 by MMS Communications – Comments Off on The President’s Podium: MMS Grassroots Advocacy Leads to Another Positive Step in the Opioid Battle

by Dennis Dimitri, M.D., President, Massachusetts Medical Society

Dr. Dennis Dimitri, MMS PresidentLed by two members of the Massachusetts congressional delegation, another encouraging step has been taken in the battle against opioid abuse, and it is a prime example of the value and effectiveness of the Massachusetts Medical Society’s grassroots physician advocacy.

In a bipartisan effort, Senator Elizabeth Warren and Representative Katherine Clark, along with Senator Shelley Moore Capito (R-West Virginia) and Representative Steve Strivers (R-Ohio), have filed legislation in Congress to allow the partial filling of opioid prescriptions.

The Reducing Unused Medications Act would permit prescriptions for pain medications to be partially filled at the request of the physician or patient. The goal of the bill is simple: to reduce the amount of unused pain pills, thereby limiting the number of drugs that can be diverted.

It is a critically important goal. One of the major factors contributing to the opioid epidemic is the availability of prescription medications. Physicians have come to realize that, in their efforts to reduce pain, too many prescriptions have been written. This overprescribing has led to the diversion of medications, so much so, in fact, that the majority of individuals – estimates are about 70 percent – who misuse or abuse pain medications get them from prescriptions written for friends or family. The number of Americans 12 years of age and older who report using prescription pain medications for nonmedical use approaches 12 million.

A partial-fill prescription would help patients balance the need to relieve pain with an adequate supply of pain medication by only filling part of the prescription. Should they need additional pain relief, patients will be able to return to the pharmacy to fill the remaining portion of their prescription. Partial-fill prescriptions can be a useful tool for physicians, many of whom find it genuinely hard to know how much pain medication to prescribe.

The idea of partial-fill prescriptions began within our own medical society, with the concept first surfacing at a Worcester North District Medical Society meeting with my predecessor, Dr. Rick Pieters. With MMS advocating for its adoption, the idea caught the attention of elected officials at both the state and Federal levels.

Massachusetts State Senator John F. Keenan (D-Quincy), who served as Vice Chair of the Special Senate Committee on Opioid Addiction Prevention, Treatment and Recovery Options, included a provision for it in a bill the Senate passed last year, and Senator Warren and Representative Clark have now filed a bill in Congress.

Questions remain, however, about the legality of partial-fill prescriptions. Current Drug Enforcement Administration regulations allow for partial fills for Schedule III, IV, and V, but prohibit them, with few exceptions, for Schedule II.

The legislation filed by Senator Warren and Representative Clark (which follows an effort last year by both legislators, supported by the entire Massachusetts Congressional delegation and dozens of others members of Congress, urging DEA to allow such prescriptions) elevates the importance of this step in the fight against opioid abuse. Most importantly, the bill would provide clarity from the DEA about the legality of partial-fill prescriptions and permit states to act.

MMS strongly supports partial-fill prescriptions and believes they can be an important tool in fighting opioid abuse. Last year, at the Massachusetts State House we testified in support of House Bill 1929, legislation permitting partial-fill prescriptions, with the caveat that the bill allow for the remainder of the partial-filled prescription to remain valid.

Improving the way prescription painkillers are prescribed can reduce the number of people who misuse, abuse, or overdose from these powerful drugs, while making sure patients have access to safe, effective treatment. The partial-fill concept is one way to do that, and we are encouraged by and strongly endorse the action of Senator Warren and Representative Clark.

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

February Physician Focus: Concussions

Posted in Physician Focus, Public Health on February 24th, 2016 by MMS Communications – Comments Off on February Physician Focus: Concussions

The severity and potential of long-term health effects of concussions are now recognized at all levels of sports, from the professional ranks to youth leagues.

To add to the public awareness of this injury, the February episode of Physician Focus features Dr. Ann McKee (photo, seated), Chief of Neuropathology at the VA Boston Healthcare System, Professor of Neurology and Pathology and Director of the Chronic Traumatic Encephalopathy Center at the Boston University School of Medicine, and one of the nation’s foremost experts on the effects of concussion and head trauma. Hosting this edition is Dale Magee, M.D. (photo, standing), a past president of the Massachusetts Medical Society.

While acknowledging the multiple benefits that young people gain by participating in sports, Dr. McKee offers valuable, basic information on what she characterizes as an “invisible injury,” one that carries no recognizable signs of harm such as bleeding or pain.

The conversation includes information on many aspects of the injury: its symptoms, difficulty of diagnosis, what to do with a player when a concussion is suspected, gender differences in susceptibility to the injury, as well as the dangers of second and multiple concussions, “sub-concussive” impacts to the head, and the development of “skill sets” by athletes to reduce the risk of concussion in sports.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and online at www.physicianfocus.org, www.massmed.org/physicianfocus, and YouTube.

Is Telemedicine in Your Future? Many Physicians Say the Answer is Yes

Posted in practice management, webinar on February 18th, 2016 by MMS – 2 Comments

telemedicine concept

More and more, patients are looking for convenient ways to access health care services when they are unable to be physically present for a traditional office exam.

Over the past couple of years, many physician practices across the country have started using telemedicine technologies in innovative ways to increase patients’ access to services.

What is telemedicine? The Institute of Medicine defines it as “The use of electronic information and communications technology to provide and support health care services when distance separates participants.”

A successfully implemented telemedicine service can increase access to care, but could also improve the operational efficiency of the practice, and improve the patient experience.

However, there have been a number of concerns raised about telemedicine. These include reimbursement, identifying appropriate patients for telemedicine visits, the ease of use of the technology, and maintaining continuity of care.

Despite these concerns, many physicians nationally and locally are starting to pilot telemedicine in their practices, and are deciding whether leveraging the technology may make sense for their practice.

Join the MMS for a webinar on February 24 to learn more about the impact telemedicine has on the health care system, and how to leverage these technologies to improve your practice operations and your patients’ experience.

Register at www.massmed.org/telemedweb

– Kerry Ann Hayon