Dr. Dorkin offers clarification on new medical aid-in-dying policy

Posted in Uncategorized on January 25th, 2018 by MMS Communications – Be the first to comment

At the beginning of December, the MMS House of Delegates – the Medical Society’s policy-making arm – voted to rescind our long-standing policy of opposition to what we previously called “physician-assisted suicide.”

This was not an easy decision, of course. We represent 25,000 physicians and medical trainees, and each of those members has strong opinions based on unique factors such as their professional experiences, personal and family histories, faith identification, and more.

What made this decision possible was that on an overcast New England Saturday – concluding a year-long process of research and analysis –  hundreds of MMS members debated, discussed, and word-smithed until we felt that we had come together on a statement of policy that clearly delineated a position of “neutral engagement” on medical aid-in-dying as well as an explanation of what that means – and what its limitations are.

As the president overseeing this Interim Meeting of the House of Delegates, I was proud to watch a core group of senior physicians, physicians in practice, resident physicians, and medical students gather to debate the intricacies of language and complexities of the role of the physician in various forms of end of life care.

Unfortunately, despite this impressive collaboration, the robust parliamentary procedure that followed, and the vote of the full House of Delegates, there appears to remain some confusion regarding our policy. On this page, I’d like to provide a few thoughts regarding what the House of Delegates laid out in our newly adopted policy and how the Medical Society is moving forward on that policy.

In assuming the term “neutral engagement,” the House of Delegates stipulated that the MMS serve “as a medical and scientific resource to inform legislative efforts that will support patient and physician shared decision making regarding medical aid-in-dying, provided that physicians shall not be required to provide medical aid-in-dying that involves prescribing lethal doses of medication if it violates personally held ethical principles.”

The second point – that physicians shall not be compelled to assist patients with this particular form of medical aid-in-dying – is, of course, important. It allows physicians to maintain their autonomy and choose what level of care to provide to their patients.

But the first part is also important. It makes clear that in withdrawing our opposition, we are not assuming a position of support for legislative efforts regarding this particular form of medical aid-in-dying. Instead, we are promising to play an educational role to ensure that any such legislative efforts do not inadvertently put our patients at unintended risk of any sort. The Medical Society could weigh in on legislation per this policy, if, hypothetically, a bill were filed that did not provide assurances of patient capacity, or if clinical research showed that certain requirements of a mental health evaluation are particularly important to provide adequate safeguards in any pending bill.

In all things advocacy-related, we bring our physicians’ perspective to policy considerations and speak on behalf of patients when it is appropriate for us to provide medical insight.

The updated policy also states that the MMS “will support its members regarding clinical, ethical, and legal considerations of medical aid-in-dying, through education, advocacy, and/or the provision of other resources, whether or not members choose to practice it.”

Again, this is important. We are not at the present time promising to support this particular form of medical aid-in-dying, as that would contradict our position of neutral engagement.

We recognize, however, that just as the MMS is an advocacy organization, it is also a member-focused educational organization. If at a future time it is appropriate for our members to learn about the complex considerations associated with this form of medical aid-in-dying, we will work with relevant experts to create resources for our members to make informed decisions about their own practices – again, taking into account their own personal and professional histories and priorities.

The MMS members who brought their voices to the creation of this policy did so in the interests of positioning the Medical Society to support our members and their patients without asserting a particular legislative position in the future. I cannot emphasize enough the commitment that they showed.

That’s why it is imperative that this very carefully crafted policy be referenced accurately, and not be misinterpreted to suggest that at the present time, the MMS is taking a particular pro or con position in order to  influence the legislative process.

I’ll close with one final comment: the updated policy also makes clear that palliative, hospice, and compassionate care are essential parts of end-of-life care. We will continue to educate our members and their patients about the steps that patients can take to get the care that is right for them at the end of their lives

  • Henry L. Dorkin, MD, FAAP, President, Massachusetts Medical Society

Statement on HHS Conscience and Religious Freedom Division

Posted in Uncategorized on January 24th, 2018 by MMS Communications – Comments Off on Statement on HHS Conscience and Religious Freedom Division

As physicians, we have an obligation to ensure patients are treated with dignity while accessing and receiving the best possible care to meet their clinical needs.  We will not and cannot, in good conscience, compromise our responsibility to heal the sick based upon a patient’s racial identification, national or ethnic origin, sexual orientation, gender identity, religious affiliation, disability, immigration status, or economic status. In view of this, the Massachusetts Medical Society is disappointed in and concerned by the Department of Health and Human Services’ formation of a ”Conscience and Religious Freedom” Division.

-Henry L. Dorkin, MD, FAAP, President, Massachusetts Medical Society

Ten Tips for Making It Through a Massachusetts Winter

Posted in Uncategorized on December 27th, 2017 by MMS Communications – Comments Off on Ten Tips for Making It Through a Massachusetts Winter

By Susan Moynihan, MD, and Shreekant Vasudhev, MD

With falling temperatures signifying the inevitable change of the season, many New Englanders have begun preparing for another unpredictable winter. In our retirement years, winter can be a difficult and dangerous few months. If you’re retired,  or if you have senior family, friends, and neighbors —that means all of us — we can work together to help keep everyone healthier and safer. Many of the following tips are useful for everyone, regardless of our age and health:

1          Check in on each other. Taking care of one another starts with checking regularly on elderly neighbors during the winter months, especially before, during, and after storms in which a power outage has occurred.

2          Get vaccinated. Winter can exacerbate pre-existing medical conditions. Those conditions, including heart failure, Chronic Obstructive Pulmonary Disease (COPD), asthma, influenza, and even the common cold, can lead to serious health consequences. One of the most important things you can do to protect your health in the winter is to get a flu vaccination. You may also want to talk with your physician about a pneumonia vaccination.

3          Always carry your cell phone. The outdoor elements can be a significant source of danger. Take precautions with every outdoor activity, from shoveling snow to simply walking to the mailbox. Call for help if needed. You can get additional protection from a commercial medical-alert system, which you can wear and activate to signal for help in an emergency.

4          Shovel slowly, or ask for help with shoveling. A sudden increase in physical activity — especially in the cold — can aggravate conditions like heart failure, asthma, and COPD. If you’re sick or have physical limitations, don’t hesitate to ask a friend or neighbor for help with shoveling snow.

5          If you fall, call for help immediately. Walking on snow or ice comes with the risk of a slip-and-fall accident. Falls can be potentially life-threatening, especially if you have osteoporosis. Getting help quickly greatly increases the chances of you making a satisfactory recovery from any injuries.

6          Wear boot grips or cleats. A couple of precautions can reduce your risk of slipping and falling. Over-the-sole slip-on cleats can improve traction on slippery surfaces. Fit them onto your snow boots at the start of the season and keep your boots by a chair near the door.

7          Stay physically active. A regular fitness routine can help, too. Regular, moderate physical activity can help maintain your muscle strength, which will subsequently improve balance and your ability to catch yourself if your start to slip.

8          Check out home heating resources. Be thoughtful too about your safety at home. If your home isn’t adequately heated, there’s a risk of hypothermia. Winter heating can be costly; if you’re concerned, it is critically important that you know about helpful resources.  Check with your local Council on Aging or senior center for information on free or reduced heating fuel for seniors.

9          Eat well. Proper nutrition through the winter is also important. It may be harder to get to the store, especially if you live alone, and living on canned foods isn’t a great fix (for example, they’re high in sodium). Most communities or regions have programs that can help seniors tap into nutrition-based services like meal delivery and transportation to local grocery stores. Again, check with your local Council on Aging or senior center.

10        Watch our show. For more on winter safety for the elderly, go online to watch Physician Focus, the public access TV show produced by the Massachusetts Medical Society and HCAM-TV. Visit massmedical.org and go to “News and Publications” to watch Winter is Coming, the current episode, featuring more winter survival strategies.

 

Dr. Susan Moynihan practices with North Shore Physicians Group. Dr. Shreekant Vasudhev is a physician at Baystate Medical Center.

 

 

ICYMI: Dr. Dorkin pens pro-SIF piece for Stat

Posted in Uncategorized on December 18th, 2017 by MMS Communications – Comments Off on ICYMI: Dr. Dorkin pens pro-SIF piece for Stat

Massachusetts Medical Society president Henry L. Dorkin, MD, FAAP last week authored a piece for the health care-focused media outlet, Stat News, during which he outlined the organization’s stance on the need to pilot a supervised injection facility in the Commonwealth.

“As we continue to look for ways to increase access to recovery programs for those with opioid use disorder, we must remember that in order to get people into recovery, they must first stay alive,” Dr. Dorkin wrote at the conclusion of his opinion piece.

You can read the entire column, here.

MMS: 37,000 free opioid and pain management classes taken by prescribers

Posted in Uncategorized on November 21st, 2017 by MMS Communications – Comments Off on MMS: 37,000 free opioid and pain management classes taken by prescribers

The Massachusetts Medical Society  announced that more than 13,000 individuals have taken one or more of its 19 opioid and pain management-focused continuing medical education courses, which have been available free to all prescribers since May of 2015.

To date, 37,000 courses have been completed.

Of the more than 13,000 users who have taken advantage of the resource since its launch, 84 percent were physicians and 62 percent of the unique users practice in Massachusetts.

Topics covered within the online courses include safe prescribing for chronic pain, screening for opioid abuse disorder, managing pain without overusing opioids, and therapies that can serve as an alternative to the prescribing of opioids.

“Reversing the trend of the opioid epidemic is of utmost importance to the Massachusetts Medical Society,” Society President Henry L. Dorkin, M.D., FAAP, said. “Certainly, we are encouraged by the response and usage rate of the continuing medical education courses. Continuous, data-based education of prescribers is unquestionably a critical component of what needs to be a multi-pronged attack on the epidemic, and I’m proud that we are able to and will continue to offer this resource to our peers not only in Massachusetts, but across the nation.”

The Society last week supported Governor Charlie Baker’s opioid-combatting “CARE Act” and has deployed its membership base of 25,000 toward reducing harm caused by opioid abuse disorder by backing the state’s prescription drug-monitoring program and through its opioid-prescribing guidelines, which were developed by the organization’s Task Force on Opioid Therapy and Physician Communication.

 

 

MMS thoughts on Gov. Baker’s “Opioids 2.0 Bill”

Posted in Uncategorized on November 15th, 2017 by MMS Communications – Comments Off on MMS thoughts on Gov. Baker’s “Opioids 2.0 Bill”

Statement from Massachusetts Medical Society President Henry L. Dorkin, MD, FAAP, on “An Act Relative to Combatting Addiction, Accessing Treatment, Reducing Prescriptions and Enhancing Prevention”:

“The Massachusetts Medical Society applauds Governor Baker for his leadership and drive toward curbing the opioid crisis that continues to plague the Commonwealth, and commends the Legislature for its recognition that this public health crisis must be met with urgency and multi-faceted, data-backed tactics and measures. We appreciate the Commonwealth’s commitment to and investment in prevention and we stand in support of the intent of the proposed bill.

“We are gratified by the Governor’s continued support of a partial-fill law which will allow patients and physicians to reconnect upon completion of an initial course of treatment and determine whether further use of such pain medication is warranted and safe, or whether the remainder of the prescription need not be filled.

“The partial-fill approach to opioid prescribing remains a vital component in reducing opportunities for unused pain medication to be transferred from a patient to those who suffer from opioid abuse disorder or may be at risk of developing an opioid use disorder.

“Evidence-based prevention approaches to protect school-aged children from opioid abuse are essential tools, and we applaud the Governor for the provision establishing the Trust Fund for Prevention.

“The Medical Society commends the important discourse relative to the electronic prescribing of controlled substances. We appreciate the intent and the spirit of the provision promoting greater adoption of e-prescribing of controlled substances, and look forward to engaging with the administration on details of the proposal. A well-functioning, easy-to-use form of electronic controlled substance prescribing that improves and facilitates the physician’s ordering of such medication would be a boon to all concerned.

“We are optimistic and heartened by the decline in Schedule II opioid prescriptions, but recognize more work remains in the effort to reduce overdoses. Our goal, like the Governor’s, is an overdose mortality rate of zero.

“The Massachusetts Medical Society appreciates the opportunity to express our views and reiterates its appreciation to Governor Baker, his Department of Health and Human Services, and the Legislature for taking vital action on behalf of the Commonwealth, and we look forward to continuing to partner with the Governor and lawmakers on solutions designed to reduce the harm caused by the opioid epidemic.”

The Norfolk South District Medical Society 19th Annual Anti-Tobacco Program: “Smoking – Don’t Go There”

Posted in Uncategorized on November 6th, 2017 by MMS Communications – Comments Off on The Norfolk South District Medical Society 19th Annual Anti-Tobacco Program: “Smoking – Don’t Go There”

Physician members of the Massachusetts Medical Society and the Norfolk South District Medical Society are once again volunteering their time to help spread the word on the dangers of tobacco use and cigarette smoking by talking to adolescents in communities throughout the South Shore.

This year marks the 19th annual presentation of the Norfolk South District Medical Society’s anti-smoking program “Smoking – Don’t Go There.”

This public service effort is held in conjunction with the Great American Smokeout, scheduled for Thursday, Nov. 16.  The program, approximately 45 minutes, includes a question-and-answer session and visual tools like “tar in the jar” and pig lungs that depict a healthy lung compared to a smoker’s lung.

The effort is led by Dr. Mary Delaney, longtime volunteer in the program and a member of the Norfolk South District Medical Society. Dr. Delaney is an internist and endocrinologist with Harbor Medical Associates in South Weymouth, a primary care and specialty services medical practice serving the South Shore.

Dr. Delaney has participated in the program since its inception.

banner image for GASO 2017 that says "When Trying to Quit Smoking, Support Can Make All the Difference. #GASO"

Schools participating again this year include the Abigail Adams Intermediate School in Weymouth, Hull Middle School, Broad Meadow School and Sterling Middle School in Quincy.  Schools new to the program this year include St. Francis Xavier School and South Shore Christian Academy in Weymouth.

Medical Society officials state such prevention programs have become increasingly important as the state has drastically cut back on tobacco control and education programs and as tobacco use remains the leading cause of preventable death and illness in Massachusetts and the nation.

Statistics released by the Campaign for Tobacco-Free Kids call attention to the declining funding levels for anti-tobacco efforts across the nation and in Massachusetts, despite the 1998 landmark settlement of $246 billion with tobacco companies.

Each day, about 3,500 kids in the United States try their first cigarette, and each day 1,000 other kids under 18 become daily smokers. Ninety percent of all adult smokers begin while in their teens or earlier, and two thirds become daily smokers by the time they are 19.

According to the Centers for Disease Control and Prevention, youngsters who smoke are three times more likely than nonsmokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is also associated with numerous other high-risk behaviors, including fighting, engaging in unprotected sex, and carrying weapons.

The Norfolk South District Medical Society, with nearly 400 local physician members throughout southern and southeastern Massachusetts, is one of 20 local district medical societies throughout the Bay State that comprise the Massachusetts Medical Society.

 

 

MMS signs joint letter supporting medication assisted treatment for incarcerated individuals

Posted in Uncategorized on November 2nd, 2017 by MMS Communications – Comments Off on MMS signs joint letter supporting medication assisted treatment for incarcerated individuals

The Massachusetts Medical Society is proud to be included in a coalition of organizations that on Nov. 1 sent to Massachusetts lawmakers, including House Speaker Robert DeLeo, the Joint Committee on the Judiciary and the Joint Committee on Mental Health, Substance Abuse and Recovery, a letter advocating for the implementation of medication-assisted treatment (MAT) for inmates with opioid abuse disorder who are incarcerated within the Department of Corrections or the county sheriff system.

The coalition based its collective stance on the matter on research that indicates that a combination of MAT and behavioral therapies can successfully treat substance use disorders and help sustain recovery.

The coalition’s position is in line with Massachusetts Medical Society policy, which states that “the MMS will work with other appropriate public and private entities to increase access to services for opiate treatment.”

You can view that letter here.

Statement on opioid crisis declaration

Posted in Uncategorized on October 26th, 2017 by MMS Communications – Comments Off on Statement on opioid crisis declaration
October 26, 2017 – Henry L. Dorkin, MD, FAAP, President of the Massachusetts Medical Society, released the following statement:

“The opioid crisis, which is taking the lives of friends, neighbors, and family members across the country, should rightly be declared a public health emergency. However, in order to truly stem the tide of this epidemic, the declaration must be matched by a coordinated federal effort that is equivalent to what is already being done at the state level.

“This crisis knows no borders, and it impacts people from all walks of life, of all ages, across the United States. Here in Massachusetts, despite having had a wide range of public and private efforts underway for several years, we saw roughly 2,000 opioid-related overdose deaths just last year.

“Our experience has demonstrated the value of patient-focused partnership between the medical community and elected officials at all levels.   The Commonwealth’s 2014 declaration of the opioid epidemic as a public health crisis helped lead to a dramatic increase in the use of the state’s prescription drug monitoring system, MassPAT. Governor Baker’s commitment to make the system a true clinical tool for physicians has had a major impact.    According to data from the Department of Public Health, while MassPAT searches increased by 500 percent between the first quarter of 2015 and the first quarter of 2017, the number of Schedule II opioid prescriptions written dropped by 23 percent and the number of individuals receiving prescriptions dropped by 24 percent. But there is still much work to be done in implementing change that saves lives – a goal that we should all share.

“Massachusetts has been an innovator and a leader in identifying and implementing state and federal policies that slow the spread of opioid use disorder and improve the ability of affected patients to get the care that they need in pursuit of recovery. For this, we thank our elected leaders, including local officials; Governor Baker, state lawmakers and public health officials; and members of our Congressional delegation, who have fought successfully for legislation that has addressed the crisis nationally.

“The data from Massachusetts confirm that policy changes can help make a difference in slowing the growth of the crisis and the countless tragic deaths that it causes. While we appreciate the effort from the Administration to bring to bear the strength of the federal government, we also believe that this crisis requires the allocation of adequate federal resources to make a meaningful difference in the lives of the people impacted by opioid use disorder.”

 

MMS supports new gun violence research organization, Stop the Bleed

Posted in Uncategorized on October 13th, 2017 by MMS Communications – Comments Off on MMS supports new gun violence research organization, Stop the Bleed

The Massachusetts Medical Society, in its continued efforts to understand the causes of and lead in the prevention of gun violence, this week announced it will “support the mission and goals of the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) in so far as AFFIRM reflects the stated policies of the MMS as it reaches out to private and charitable funders to achieve its research aims.”

AFFIRM is an independent, physician-led organization – 501(c)(3) status pending – with a stated mission to raise monies from the private sector to fund firearm injury prevention research and to support professional guideline groups in the development of evidence-based, best practice recommendations for health care providers to reduce the incidence and health consequences of firearm-related violence.

The MMS policy relevant to this relationship with AFFIRM, adopted in May of 2013, states, “The MMS is guided by the principles of reducing the number of deaths, disabilities, and injuries attributable to guns; making gun ownership safer; promoting education relative to guns, ammunition, and violence prevention, for physicians and other health professionals as well as for the public; encouraging research to understand the risk factors related to gun violence and deaths.”

At the suggestion of MMS Immediate Past President Dr. James Gessner, AFFIRM was introduced to the MMS presidential officers by Dr. Christopher Barsotti, emergency physician at Berkshire Medical Center and Chair of the Trauma and Injury Prevention Section at the American College of Emergency Physicians.

AFFIRM is led by a Steering Committee of renowned experts in firearm-related harm reduction, including Dr. John Burress, Vice Chair of the MMS Committee on Public Health and Dr. Eric Goralnick, Chair of the MMS Committee on Preparedness.

Related, MMS amended and reaffirmed its Emergency Medical Services policy with language specific to the “Stop the Bleed” initiative, which includes, “the Massachusetts Medical Society promote widespread population awareness of the ‘Stop the Bleed’ initiative to control severe hemorrhage in disaster and trauma events.”

Drs. Goralnick and Barsotti tied in AFFIRM’s mission and the Stop the Bleed campaign as “part of the arc of prevention and care” related to trauma and disaster situations.

Launched in October of 2015 by the White House, Stop the Bleed is a national awareness campaign and a call to action. Stop the Bleed is intended to cultivate grassroots efforts that encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.