Notice of Website Maintenance

Posted in website on July 7th, 2015 by MMS – Be the first to comment

The MMS website will be temporarily offline starting at 5:00 p.m. EDT today for maintenance purposes. We apologize in advance for any inconvenience.

CMS, AMA Announce Help with ICD-10 for Physicians

Posted in Electronic health records, Health IT, Health Policy on July 6th, 2015 by MMS Communications – Be the first to comment

With the October 1 deadline for the implementation of ICD-10 looming, The Centers for Medicare & Medicaid Services road 1 icd(CMS) and the American Medical Association (AMA) today jointly announced some good news – and relief – for physicians.

The two organizations have reached agreement on important elements of a “grace period” for the implementation of version 10 of the new International Classification of Diseases that includes some 68,000 codes. The medical codes, used for diagnosis and billing, have not been updated in more than 35 years.

Among the major steps announced by CMS and the AMA:

• For a one-year period beginning October 1, Medicare claims will not be denied or audited solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes.
• To avoid potential problems with mid-year coding changes in CMS quality programs for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores. CMS will continue to monitor implementation and adjust the duration if needed.
• CMS will establish an ICD-10 Ombudsman to help receive and triage physician and provider problems that need to be resolved during the transition.
• CMS will also establish an ICD-10 communications and coordination center, to identify and resolve issues arising from the transition.
• CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.

The organizations also said they will reach out to providers across the county, with webinars, on-site training, and educational articles to help them learn about the new codes and prepare for the transition. The free help from CMS also includes the Road to 10, The Small Physician Practice’s Route to ICD-10, a website aimed specifically at smaller physician practices to help them with the transition.

Today’s CMS/AMA joint announcement may be read here. More information on ICD-10 is available at this CMS site and from this post by AMA President Steven J. Stack, M.D., which contains links to additional information and resources.

July Physician Focus: Guns and Public Health

Posted in gun control, Physician Focus, Public Health on July 2nd, 2015 by MMS Communications – Be the first to comment

Deaths and injuries from firearms continue to shine a spotlight on gun violence as a public health issue. The latest mass shooting at a church in South Carolina joins a list that includes tragedies in Newtown, Connecticut, at Virginia Tech, and in the Colorado communities of Columbine and Aurora. These shocking incidents receive great attention because of the numbers of people killed and injured, the young ages of the shooters, and where they take place (schools, a church, a movie theater).

Those incidents, however, are just a few of  the total number, with many of them taking place at schools. Since the Newtown, Connecticut tragedy in 2012 that resulted in the deaths of 20 children and 6 adults, an additional 127 school shootings have occurred in the U.S., 73 of them in grades K-12, according to Everytown for Gun Safety, which tracks such data.

Physicians have since become some of the most vocal advocates for gun safety. In April, seven physician organizations, the American Public Health Association, and the American Bar Association issued a call to action, saying “Deaths and injuries related to firearms constitute a major public health problem in the United States.”

To continue to highlight this important topic, the July episode of Physician Focus features a discussion with Michael Hirsh, M.D., (photo, right) Surgeon-in-Chief of UMass Memorial Children’s Medical Center and Medical Director of the Public Health Department in Worcester, Mass., and Robert Sege, M.D., (center) Vice President of Health Resources in Action in Boston and a member of the American Academy of Pediatrics Committee on Child Abuse and Neglect. Hosting this edition is primary care physician Bruce Karlin, M.D. (left).

Among the topics of conversation: what parents can and should do to make a home with guns safer for children, how guns in the home can lead to homicide or suicide, how technology can help to make firearms safer, the physician perspective on ‘gag laws’ preventing doctors from discussing gun safety with their patients, and gun buyback programs as a way to reduce the violence.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org,www.massmed.org/physicianfocus, and on YouTube.

MMS Statement on Today’s Supreme Court Decision Upholding ACA Subsidies

Posted in Uncategorized on June 25th, 2015 by Erica Noonan – Be the first to comment

 

Statement from Massachusetts Medical Society President Dennis M. Dimitri, MD, on King v. Burwell:

The Massachusetts Medical Society welcomes today’s Supreme Court decision safeguarding access to crucial health care service for millions of patients, said Massachusetts Medical Society President Dennis M. Dimitri, MD.

“The physicians of the Massachusetts Medical Society applaud the decision to uphold Affordable Care Act subsidies in states that do not have their own health care exchanges,” said Dr. Dimitri. “Patients across the United States will not lose access to the care they need and deserve.”

 

Sports Medicine: Emerging Technologies and Procedures

Posted in Uncategorized on June 24th, 2015 by Erica Noonan – Be the first to comment

 

By Nicholas Sargent, MMS Communications Staff

 Brian McKeon, MD, the Chief Medical Officer and Head Team Physician for the Boston Celtics opened his presentation at the 2015 MMS Men’s Health Symposium last week by discussing how rapidly the technology of medicine has advanced.

“This is a totally different talk than I would have given in January,” said Dr. McKeon. Still, even with medical technologies advancing as quickly as they are, he did not see an end to the simple problem of human aging and wearing out the body anytime soon. Because of modern medicine, people are living longer than ever before, instead of “struggling to 42, then getting eaten by a bear.”

People are lasting longer, but we’re still wearing out our bodies, and because of this the need for orthopedic surgery has skyrocketed in recent years, and it won’t slow down anytime soon, he said. The demand for knee arthroplasties is expected to grow 673% by 2030, and modern medicine can’t do much to stop the decay and loss of cartilage, especially the meniscus cartilage in the knee.

mckeon

Surgery, Dr. McKeon said, can only do so much. Patient dissatisfaction with meniscus surgery reaches 100% after 10 years, and repeat surgeries can’t do much to help if the tissue is completely worn away.  He said the most attractive prospect is a new implant, invented by a team in Israel, which imitates the meniscus and can be inserted with a very simple procedure.

He said another problematic surgery is patching up rips in the rotator cuff. Clinical studies show that there is a 30 to 50% chance of a rotator cuff repair failure, either from the patient re-opening the tear or from lack of blood flow to the affected tissue, which slows the healing  process.

Dr. McKeon has begun using stem cells to promote tissue growth at the site of the surgery, with great success. While the cells can be harvested from the patient’s own bone marrow and mixed with graft material, the best results are had with amniotic stem cells.

Amniotic cells are currently expensive due to the limited number of companies that provide them, but Dr. McKeon was confident that this will change within a decade. “They’ll be popping up all over the place.”

See slides From Dr. McKeon’s presentation here.

Governor’s Opioid Task Force: A Smart, Comprehensive Approach

Posted in Drug Abuse, opioids on June 22nd, 2015 by MMS – Be the first to comment

By Dennis M. Dimitri, MD
MMS President

Dr. Dennis Dimitri 300 ppiWe welcome today’s report from the Governor’s Opioid Working Group. It is a smart, comprehensive approach to an extremely complex problem, and we pledge to pledged to continue to work with public and private officials to combat the opioid overdose epidemic.

We appreciate that the working group addressed many of the issues we have discussed with the Governor Baker, Attorney General Healey, Secretary Sudders and their staffs. We agree that because of the opioid crisis, we need a different approach to the prescribing and management of opioid medications. That is why we’ve taken a proactive approach to the issues, and launched a comprehensive program to educate physicians, other prescribers and the public last month.

We especially support the recommendations to improve the state’s online prescription monitoring program; increasing access to naloxone by encouraging it to be co-prescribed with opioid medications; allowing the partial filling of opioid prescriptions without additional co-payments; expanding education for prescribers and the public; expanding access to intervention and treatment; and taking steps to destigmatize addiction.

Our program to fight opioid overdoes, called “Smart Scripts MA,” was launched in May 2015. It has three components:

Prescribing Guidelines: The guidelines are designed to help physicians make the right decisions for their patients. They were developed by a task force of physicians from a broad range of specialties, and derived from similar work conducted in other states and by several state and national medical specialties.

The guidelines first emphasize that physicians and patients should discuss family and personal histories of substance abuse disorders and behavioral health concerns, before the prescription is written. The guidelines also encourage patients and physicians to mutually develop agreements that outline the expectations and goals of the treatment, along with the conditions for continuing opioid therapy after initial treatment.

Free Education in Pain Management: The MMS has made its online medical education courses in pain management available free to all prescribers until further notice. Five courses are currently available; several more courses will be published later this week, and more courses are planned for later this year. These courses are available for Continuing Medical Education credit. Physicians have been required to obtain CME credits on this topic as a condition of licensure and re-licensure since January 2012.

Public Education Program: The MMS has also launched a public education program to inform patients and their families about the safe storage and proper disposal of their opioid medications, in an effort to reduce the supply of medications in the community. According to the CDC, more than 80% of people who abuse prescription drugs are using medications that were prescribed for someone else. Safe storage and disposal will reduce or eliminate this source of misused prescription medications.

 

MMS Talks to Dr. Andrew Kowal: Addiction and Men’s Health

Posted in Uncategorized on June 16th, 2015 by Erica Noonan – Be the first to comment

In advance of the 13th Annual Symposium on Men’s Health on June 18 from 8:00 a.m. to 4:00 p.m. at the Massachusetts Medical Society in Waltham, we reached out to several of the panelists and faculty who will be attending for interviews about their areas of expertise. Here is the fourth of a series of short interviews with the event’s presenters.

Dr.  Andrew G. Kowal, director of Pain Management Center, Lahey Hospital & Medical Center, will present a panel on pain management and addiction.

 

By Katherine Schauer

MMS Communications Staff

 

MMS: Pain management is not usually seen as a gender-specific condition, are there any complications or issues that only arise in men? Are men more likely to suffer from chronic pain?

Dr. Kowal:  Men are not more likely to suffer chronic pain; however it can be more difficult to diagnose chronic pain syndromes in men; for example fibromyalgia. Also high dose chronic opiates affect them {men} even more negatively than women secondary to their effect on hormones such as testosterone.

 

MMS: What is your stance on medical marijuana regarding pain management?    Kowal

Dr. Kowal:  Medical marijuana with pain management is not a good idea. We will go into great detail and review this at the symposium.

 

MMS: What do you hope to achieve at the symposium?

Dr. Kowal: I will highlight THC and opiates in the context of chronic pain management and recent evidence about both, or lack thereof! I will also briefly cover new opioid guidelines.

 

MMS: Is there any message you want to be sure everyone attending the symposium hears?

Dr. Kowal: The message I want everyone to hear is that opioids do not help chronic pain; they cause more problems and dangers with escalating chronic use.

 

MMS: What’s the next frontier in the field of pain management?

Dr. Kowal: The next frontier is using functional imaging studies of the central nervous system to diagnose/guide therapies. Also there are new non-opiate pain medications on horizon.

 

Dr. Kowal is clinical assistant professor of anesthesiology at the Tufts School of Medicine in Boston and director of the Interventional Pain Management Center at Lahey Clinic. Dr. Kowal spent 10 years in active duty for the United States Army Medical Corps where he was involved in leading the development and implementation of Department of Defense clinical practice guidelines for pain management.

Read more about the event’s program and panelists.

Register here to attend the 13th Annual MMS Symposium on Men’s Health on June 18.

 

MMS Talks to Dr. Brian P. McKeon: Men’s Health and Orthopedics

Posted in Uncategorized on June 15th, 2015 by Erica Noonan – Be the first to comment

In advance of the 13th Annual Symposium on Men’s Health on June 18 from 8:00 a.m. to 4:00 p.m. at the Massachusetts Medical Society in Waltham, we reached out to several of the panelists and faculty who will be attending for interviews about their areas of expertise. Here is the third of a series of short interviews with the event’s presenters.

Dr. Brian P. McKeon, chief medical officer and head team physician to the Boston Celtics, will present a panel on orthopedics, sports medicine and sports related injuries.

 

By Katherine Schauer

MMS Communications Staff

 

MMS:  Sports medicine is a broad topic and I understand you will discuss knee and shoulder injuries. Will you cover your work with the Boston Celtics?

Dr. McKeon:  I think I’ll bring up relative issues but by contract and by my agreement I’m not allowed to name any players or their specific issues. But part of my talk is going to pertain to some of the latest things that we are doing for all sorts of people, to get everyone to heal better. Also to understand the anatomy better, basically trying to understand the loads on the tissue and to try and get the tissue to heal.

MMS: Do you feel a lot of pressure working for a high profile sports team?

Dr. McKeon:  You know I think part of being a doctor in this situation is pressuring. I’ve been doing it for 17 years now so I’ve developed a comfort level. But I mean I try to turn it around and make it more fun but I know I am under tremendous scrutiny. How I take care of a pro athlete is kind of my template for how I take care of everybody else, to some degree. And I think it has made me a much better doctor.

 MMS: What have you learned through your time with the Celtics?      mckeon

Dr. McKeon:  I have learned that you can take the human body to another level, you can push it. But you can also manage the stress with techniques like proper rest, hydration, etc. There’s always a false sense (from fans) that were doing something special back there in the training room, but we’re really not. It’s just the ABCs of general healthcare and trying to create good habits

MMS: What can a basketball player do before practice or a game to prevent injuries?

Dr. McKeon:  I’d stick to the basic principles. The biggest issue I see is that people get tired, they just aren’t strong enough. You cannot avoid traumatic injury, if a guy just plows you over then fine that’s bad luck. But most injuries are strains and pulls, injuries that can be avoided based on an athlete listening to his or her body. It’s all about getting the right rest, staying hydrated and a lot of pre-game strengthening.

MMS: What is your opinion on concussions and professional sports? What do you tell players that have suffered from too many concussions?

Dr. McKeon:  I think that the professional leagues have done a lot to handle concussions. The NBA was the last to follow because it’s not a contact sport like hockey or football. Concussions are a lot more objective now, especially in professional sports. It’s no longer a fuzzy line or a game time decision. To me it’s about bringing in the right consultant, getting the right help to make the decision with the very powerful baseline testing that we have. If I had a high school kid come in with several past concussions but he says he still wants to play, I would say ‘You’re done, you’re really done.’ You can have 15 normal MRIs, 10 normal CAT scans and you can even do some functional testing. But it’s the unknown, what is another hit going to do to the kid long term? It really isn’t worth it at that age.

MMS: What do you hope to achieve at the symposium?

Dr. McKeon: To define what a stem cell is, in the perspective of an orthopedic surgeon. It is one of the most misunderstood words. And I have been using stem cells now in treating patients for quite some time and I want to define application and the potential benefits there are relative to orthopedics. And there’s an issue of insurance. Some people have the same injury and I can help one with stem cells and another one I can’t.

MMS: What’s the next frontier in the field of sports related medicine or orthopedic surgery in general?

Dr. McKeon: Tissue engineering. Arthritis is a disease that affects the whole world. Medical doctors are good at keeping us alive; controlling our blood pressure and making our hearts work. But the big issue is maintaining the frame. People’s bodies are breaking down but their organs are fine. The challenge for us is finding a way to keep the body mobile. Looking at arthritis, I don’t think we are going to cure it in my life time but we can try to have a better understanding of it. And the key is earlier intervention. I am going to highlight all of this at the symposium.

 

Dr. McKeon currently participates in clinical trials and funded research studies related to articular cartilage and synovitis. His primary clinical interests lie in sports medicine and the treatment of sports-related injuries, with an emphasis on performing minimally invasive surgery on shoulders, knees, elbows, and ankles.

 

Read more about the event’s program and panelists.

Register here to attend the 13th Annual MMS Symposium on Men’s Health on June 18

MMS Talks to Dr. Peter C. Albertsen: Men’s Health and Prostate Cancer Screening

Posted in Uncategorized on June 12th, 2015 by Erica Noonan – Be the first to comment

 

In advance of the 13th Annual Symposium on Men’s Health on June 18 from 8:00 a.m. to 4:00 p.m. at the Massachusetts Medical Society in Waltham, we reached out to several of the panelists and faculty who will be attending for interviews about their areas of expertise. Here is the second of a series of short interviews with the event’s presenters.

Dr. Peter C. Albertsen, chief and program director at the University of Connecticut Health Center in the Department of Surgery (Urology), will present a panel on prostate cancer screening.

By Nicholas Sargent

MMS Communications Staff

MMS: Your topic is prostate cancer screenings. What do you hope to discuss regarding this cancer specifically?

Dr. Albertsen:  We will be discussing the United State Preventative Services Task Force’s suggestion that physicians not perform prostate-specific antigen (PSA) testing and deciding where we should go next. The Task Force’s decision was based on the PSA tests being overly sensitive or not specific enough.  This does not happen all the time, or a majority of the time, but it has happened a sufficient number of times to become a problem. While I respect the USPSTF and the effort they put into reviewing all the literature, I disagree with their decision to stop PSA testing altogether. We need to identify the correct men who will benefit from PSA testing and go from there.

MMS: Do you feel that enough men are getting screened for prostate cancer?    Albertsen headshot

Dr. Albertsen:  Too many older men are getting a PSA that they don’t need, and young men are not getting tested enough. Ideally, men would start getting tested in their late 40s and early 50s.

MMS: What do you hope to achieve at the conference?

Dr. Albertsen:  I want to help people have a more sophisticated understanding of PSA tests—people see it as a miracle screening, but the story is a lot more complicated than that.

MMS: What’s the next frontier in the field of prostate cancer or urology in general?

Dr. Albertsen: I’ll be discussing this in more detail during the panel, but genomic testing and MRI imaging to test for cancers has begun recently. It’s not being done everywhere, but it is definitely on the horizon.

 

Dr. Albertsen has an international reputation for his work on prostate cancer and is the author of numerous publications. He is on the editorial board of several journals and frequently reviews manuscripts for the major urological journals. He is a trustee of the American Board of Urology and a member of the Residency Review Committee of ACGME for Urology.

Read more about the event’s program and panelists.  Click here to read an interview with Dr. Lawrence Jay Epstein on sleep apnea in men.

Register here to attend the  13th Annual MMS Symposium on Men’s Health on June 18.

 

 

 

MMS Talks to Dr. Lawrence Epstein: Sleep Apnea and Men’s Health

Posted in Uncategorized on June 11th, 2015 by Erica Noonan – Be the first to comment

 

In advance of the 13th Annual Symposium on Men’s Health to be held June 18 from 8:00 a.m. to 4:00 p.m. at the Massachusetts Medical Society in Waltham, we reached out to several of the panelists and faculty who will be attending for interviews about their areas of expertise.  Here is the first of a series of short interviews with the event’s featured presenters.

Dr. Lawrence Jay Epstein, the program director of the Sleep Medicine Fellowship and an associate physician in the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, will present “Achieving Healthy Sleep in Men,” about  men’s health and sleep apnea.  

 

By Nicholas Sargent, MMS Communications Staff

MMS:  Sleep apnea is not usually seen as a gender-specific condition, but you’re presenting information about it at a men’s health focused event. Why? Are there any complications or issues that only arise in men with sleep apnea? Are men more likely to suffer from it?

Dr. Epstein: Obstructive sleep apnea (OSA) is more common in men with rates 2-10X greater in men compared to premenopausal women, with the differential decreasing post-menopausally.  In addition, OSA is more severe in men compared to women of the same body mass index.  The rate of cardiovascular complications related to OSA is higher in men than women as well.

MMS: What do you hope to achieve at the conference?  Epstein

Dr. Epstein: Increase awareness of the health risks of poor sleep in men, before they suffer from obstructive sleep apnea and sleep deprivation.

MMS: Is there any message you want to be sure everyone attending the conference hears?

Dr. Epstein: Sleep disorders are common, easily recognizable and treatable. Getting insufficient sleep, whether voluntarily or due to sleep disorders, carries significant health consequences.

MMS: What’s the next frontier in the field of sleep apnea, or just sleep medicine in general?

Dr. Epstein: The field is evolving new methods for diagnosing and treating disorders.  For OSA in particular, care based on the specific pathophysiological mechanism contributing to airway collapse is being developed and tested.  New sleep modulating pharmacotherapy is being developed based on discoveries of brain pathways and neurotransmitters regulating sleep.  Better understanding of the circadian sleep/wake system is giving insight into problems of difficulty getting to sleep and decreased alertness.

Dr. Epstein has specialized in sleep medicine since 1992 and served as the military consultant on sleep disorders to the Air Force surgeon general. He was president of American Academy of Sleep Medicine from 2005 to 2006. He co-authored the Harvard Medical School Guide to a Good Night’s Sleep.

Read more about the event’s program and panelists.

Register here to attend the  13th Annual MMS Symposium on Men’s Health on June 18.