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.

 

Senator Markey Headlines MMS Opioid Summit

Posted in Health, Health Policy, opioids, Public Health, Uncategorized on November 1st, 2016 by MMS Communications – Comments Off on Senator Markey Headlines MMS Opioid Summit

On October 31, MMS sponsored a leadership summit on opioid addiction, Medication Assisted Treatment: Improving Access to Evidence-Based Care, an event intended to raise awareness of the need for medication assisted treatment for substance use disorder. The summit was attended by nearly 200 health care professionals at MMS headquarters in Waltham.

U.S. Senator Edward J. Markey, in his keynote address, said, “If we are going to reduce the supply for heroin, fentanyl, and illicit prescription opioids, we have to reduce the demand through treatment.”

“I will not stop fighting for legislative support on this issue,” Sen. Markey added, noting that despite his efforts and those of his colleagues, Congress has repeatedly rejected bills that would financially support addiction recovery programs.

He decried the rising numbers of deaths in Massachusetts due to overdoses  — doubling in number in the Bay State in one year — and warned that due to the potent influx of fentanyl from China and Mexico, “we are poised to lose even more lives.”

Gathered for the Opioid Summit: Dr. Dennis Dimitri, Dr. Monica Bharel, Sheriff Peter Koutoujian, Senator Edward Markey, MMS President Dr. James Gessner, MMS President-Elect Dr. Henry Dorkin, MMS Vice President Dr. Alain Chaoui

Gathered for the Opioid Summit: Dr. Dennis Dimitri, Dr. Monica Bharel, Sheriff Peter Koutoujian, Senator Edward Markey, MMS President Dr. James Gessner, MMS President-Elect Dr. Henry Dorkin, MMS Vice President Dr. Alain Chaoui

“Fentanyl is like a Class 5 hurricane making landfall,” Sen. Markey said. “It is the Godzilla of opioids. It is trending too quickly. It is so dangerous that first responders insist on wearing HazMat suits when they arrive at a scene of an overdose for fear they will become contaminated if exposed to it. We just don’t know how dangerous it is, and it’s coming to every street in America.”

Combatting the opioid epidemic requires vigilance coupled with “aggressive data collection, surveillance, increased prescriber and patient education, and the passage of aggressive new laws,” he said, that are aimed at controlling the influx and consumption of opioid drugs.

Markey alerted attendees to a report by U.S. Surgeon General Dr. Vivek Murthy on opioids due to be released early in 2017.

“The Surgeon General’s report on opioids will have a great societal impact,” Sen. Markey said, “similar to when the former Surgeon General years ago released the report about the health hazards of cigarette smoking. History will judge us, because now is our opportunity to respond to the greatest public health crisis in the 21st century.”

Several speakers, including Massachusetts Public Health Commissioner Monica Bharel, M.D., Middlesex County Sheriff Peter J. Koutoujian, and others called for a unified effort to destigmatize those who struggle with substance abuse.

“Treatment works, recovery is possible,” Koutoujian said. He described treatment programs sponsored by the Bay State’s criminal justice system that are helping inmates to return to society after incarceration better able to control their drug habits.

Dr. Bharel reminded the capacity audience to commit to viewing substance abuse addiction through the lens of the #StateWithoutStigMA campaign, launched last year by Governor Charlie Baker’s Opioid Working Group. The statewide campaign aims to eradicate the negative stereotype of drug misuse by declaring it to be a treatable illness.

MMS gathered more than a dozen national and local experts on the topic for this summit to speak to such topics as the treatment of addiction as a disease, the importance of psychological treatment and behavioral support, models of care, and supporting physicians and providers in treating opioid use disorders. It was hosted by MMS President James S. Gessner, M.D. and moderated by Dennis M. Dimitri, M.D., immediate past president and Chair of the MMS Task Force on Opioid Therapy and Physician Communication.

Presentations by the participants may be viewed here.  For highlights and photos from the event visit the MMS Twitter page.

November Physician Focus: Choosing Your Care

Posted in Uncategorized on October 31st, 2016 by MMS Communications – Comments Off on November Physician Focus: Choosing Your Care

Health care is undergoing rapid change today, affecting hospitals, physicians, and patients alike in many ways.  These changes are making the health care system increasingly complex, raising questions and confusion for patients. How to simplify the process, get questions answered, limit the confusion, and obtain good, quality care are key elements that patients should consider when choosing their care.  The November edition of Physician Focus examines those areas and others in discussing the important factors patients should consider when choosing their health care.

Dr. Bruce Karlin, Dr. Barbara Spivak

Dr. Bruce Karlin, Dr. Barbara Spivak

The guest for this program is Barbara Spivak, M.D., a primary care physician with Mount Auburn Medical Associates in Cambridge and Chair of the MMS Committee on Quality of Medical Practice. Dr. Spivak is also president and Chair of the Board of the Mount Auburn Cambridge Independent Practice Association and Vice Chair of Massachusetts Health Quality Partners.  Hosting this program is Bruce Karlin, M.D.

Among the topics of conversation are the best ways to select a physician, online sites that rate physicians, the trend to team-based care and how it affects patients, and what patients should do if they decide they don’t like their doctor.

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.