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.

Healthcare Leaders Urge a NO Vote on Question 4

Posted in Public Health on October 31st, 2016 by MMS Communications – Comments Off on Healthcare Leaders Urge a NO Vote on Question 4

recreationalmarijuana_ballotquestion_image_990x450The leaders of the Massachusetts Medical Society, the Massachusetts Health & Hospital Association, the Organization Nurse Leaders of Massachusetts, Rhode Island, New Hampshire, and Connecticut, and the American Nurses Association of Massachusetts today issued a joint statement urging voters to cast a “no” vote on Question 4 that would permit the legalization of recreational marijuana.

The statement was signed by MMS President James S. Gessner, M.D., MHA President and CEO Lynn Nicholas, ONL CEO Amanda Stefancyk-Oberlies, and ANAMass. President Cathleen Colleran Santos, D.N.P., R.N.

The statement called attention to a “misleading video advertisement and direct mail piece” directed to voters, implying that the ballot question is related to medical marijuana and that Question 4 has broad support from the healthcare community.  Neither is accurate.

Medical marijuana is already permitted in the Commonwealth, under strict regulations issued by the Department of Public Health, and Question 4 is unrelated to medical marijuana and pertains only to recreational marijuana.  Major health care organizations in the Commonwealth, including the MMS, have explicitly stated their opposition to Question 4, outlining the dangers to public and individual health and pointing out serious failings in the ballot question itself.

The complete statement issued this morning by the four organizations:

“As four of the state’s leading healthcare provider organizations, representing hospitals, health systems, doctors, nurses, and other healthcare providers, we stand firmly against Question 4 on the November 2016 ballot. Question 4 seeks to legalize the commercial sale of marijuana in Massachusetts, and poses a direct threat to the public health and safety of our patients and communities. We are proud to be part of an even larger coalition of healthcare, business, and community leaders – joined by a bipartisan group of state and local leaders – all aligned with the Campaign for a Safe & Healthy Massachusetts to oppose Question 4.

The corporate interests promoting Question 4 recently issued a misleading video advertisement and direct mail piece sent to voters across the Commonwealth. Both pieces incorrectly imply that this ballot question is about medical marijuana, which is already legal in Massachusetts, and also inappropriately indicate the question has broad healthcare community support.  Considering the comprehensive alignment of the state’s major healthcare organizations in opposition to Question 4, these advertisements are deceptive and inaccurate.  As healthcare leaders, we believe it is important for voters to know that healthcare professionals and organizations throughout the Commonwealth have a clear and unified message –Vote NO on Question 4.

Other healthcare organizations urging your opposition to Question 4 include: the Conference of Boston Teaching Hospitals, the Association of Behavioral Healthcare, Massachusetts Chapter of the American Academy of Pediatrics,  Massachusetts Chapter of the American College of Physicians, Massachusetts Academy of Family Physicians, Massachusetts Psychiatric Society, Massachusetts College of Emergency Physicians, Massachusetts Society of Anesthesiologists, Massachusetts Section of the American Congress of Obstetricians and Gynecologists, Massachusetts Gastroenterology Association, Massachusetts Society of Neurosurgeons, Massachusetts Association of Practicing Urologists, Massachusetts Orthopaedic Association, the Massachusetts School Nurse Organization, and the Health Foundation of Central Massachusetts.”

 

 

Senior Volunteer Physicians Discuss Free Health Care

Posted in Uncategorized on October 27th, 2016 by MMS Communications – Comments Off on Senior Volunteer Physicians Discuss Free Health Care

The MMS Committee on Senior Volunteer Physicians convened its 13th Annual Fall Forum for Free Health Care Programs on October 26, with nearly 100 attendees discussing their experiences in helping burgeoning populations that visit free clinics throughout the Bay State.

In her welcoming remarks, Committee Chair Helen Cajigas, M.D. urged attendees to assist the committee with ongoing administrative needs to foster better communication between the free clinics.

Delivering the keynote address was Massachusetts Department of Health Commissioner (DPH) Monica Bharel, M.D., who spoke about BP shot“The Intersection Between Massachusetts Free Health Care Programs and the DPH.” Her remarks were followed by a question and answer session with Kevin Cranston, assistant commissioner at DPH.  Cranston, who also serves as director of the Bureau of Infection Disease and Laboratory Sciences, provided information and answered questions about the growing threat of Zika.

Dr. Bharel, in acknowledging that the ages of the forum’s attendees ran the gamut from retired physicians to medical students and residents, said she was heartened that everyone seemed eager to learn from one another.

“My father is a doctor in New York,” she said, “and I learned about medicine by helping him in his practice when I was a young girl. He inspired me and my two siblings, and all three of us today are pursuing careers in medicine. It’s good for medical students to get started early and to work together with mentors to give back to the community.”

Dr. Bharel noted that while Massachusetts citizens are among the healthiest in the nation, there is an ongoing need to examine data compiled by clinics, hospitals, and other state agencies to “target services to better impact outcomes, eradicate inequities, and to identify what the social determinants are that prevent those who need health care services from obtaining them.”

Interviews with many of the attendees identified various areas of concern with regard to delivering health care to unserved and underserved populations.

Several attendees identified homelessness as an issue of growing concern. Jessica Peters, M.D., a volunteer physician with Health Care Without Walls, said the program, founded in 1999 by Roseanna H. Means, M.D., increasingly is in need of volunteer nurses and physicians to treat the growing population of women and their children, many of whom are also struggling with issues of domestic violence.

Another group identified in need of health care is undocumented immigrants, who also face language barriers. Patients visiting the statewide clinics come to Massachusetts from such far flung locales as Brazil, Ghana, the Philippines, Uganda, India, Bangladesh, and Puerto Rico.

Gracia Perez-Lirio, M.D., who hails from the Philippines, said she and her colleagues are reviving the Philippine Medical Association’s free clinic, which had been dormant in recent years due to the influx of Filipino immigrants.

Other attendees who serve as language interpreters at walk-in clinics said they are aware that patients often commute from great distances within Massachusetts and adjacent New England states in their quests to obtain free medical help.

Cynthia Akagbosu, a fourth year medical student at Tufts University School of Medicine, said she helps patients by volunteering with the Sharewood Project in Malden by providing interpretive services. Born in Nigeria, schooled in England and Florida, Ms. Akagbosu is fluent in Spanish.

The MMS Committee on Senior Volunteer Physicians uses the experience and skills of retired physicians to address common interests and community needs on a voluntary, part-time basis. Anyone interested in participating in the committee’s work or volunteering at a free health clinic should contact Chew-Hoong Koh at ckoh@mms.org  or 781-434-7312.

–Robert Israel

 

 

 

 

 

 

 

 

 

 

 

 

MMS Website Service Restored

Posted in Uncategorized on October 20th, 2016 by MMS Communications – Comments Off on MMS Website Service Restored

The MMS website is now back in operation, after a brief “downtime” period for the installation of a new member database. Members please note that the first time you log into the website, you will be required to reconfirm your password.  You may enter the same password you are currently using, and you will be asked to reconfirm it OR you may enter a new password, and you will likewise be asked to confirm it. This process should take less than one minute.  After logging in, you may continue to use the rest of the site.

If you have any questions, or if you need assistance, please contact our Customer Service Department by phone at 800-843-6356 or by e-mail at webmaster@mms.org.

Thank you for your patience and understanding during this period.

MMS 2017 State of the State’s Health Care Leadership Forum: The Election’s Impact on Health Care?

Posted in Affordable Care Act, Health Policy, Health Reform, State of State Forum on October 20th, 2016 by MMS Communications – Comments Off on MMS 2017 State of the State’s Health Care Leadership Forum: The Election’s Impact on Health Care?

The outcome of the national election on November 8 and its potential to shape – either positively or negatively — the healthcare agenda in Washington and locally in years to come was on the minds of the moderators and presenters as they addressed nearly 150 attendees at MMS’s 17th annual State of the State’s Healthcare Leadership Forum held at MMS headquarters on October 19.

Moderators James Braude and Margery Eagan, co-hosts of WGBH’s Boston Public Radio, noted during opening remarks that the-white-house-at-dc-thconstructive discussions of healthcare have been largely absent from the presidential debates and during most national campaign appearances by both candidates. Braude said that the candidates seemed bent to “shed blood” rather than to engage in vigorous fisticuffs about how to control the costs of prescription medicines, for example, or how to improve the Affordable Care Act. Yet many voters, if not most, he observed, collectively worry about these issues.

Ray Campbell, the newly appointed executive director of the Massachusetts Center for Health Information and Analysis (CHIA), said that Massachusetts remains a “bright spot” in this dark national political landscape. In the Bay State, he emphasized, “we have strong bi-partisan support that has transcended party lines” when it comes to providing quality health care for all citizens. Unlike the negative rhetoric that has surface nationally during election-year discussions of Obamacare, Campbell remarked, “there is no talk of a repeal or replacement of Massachusetts’ healthcare reform.” Campbell further noted that CHIA and other state agencies must continue to aggregate data and to use it as fodder to better manage spending, which this year is at a 4.1 percent increase, exceeding the previous year’s benchmarks. “We are exploring ways to do a better job to use the data we collect to shed a light on spending in Massachusetts,” he said, “so we can institute statewide efforts to better control it.”

capitol-dcKate Walsh, president and chief executive officer at Boston Medical Center (BMC), said that while BMC has grown “out of adolescence” by celebrating its 20th anniversary this year, “we still need to improve so we can fulfill our mission, namely to provide ‘exceptional care without exception.’” Toward that end, Walsh said, “we have to earn our patients’ trust and invest in a rigorous quality improvement agenda.” Tailoring programs at the hospital to respond to patients’ needs, such as BMC’s program to treat opioid use and abuse, is just one example of how Walsh envisions BMC to be “part of the solution do to a better job because our patients deserve it.” The challenge facing healthcare institutions in Massachusetts is to “remove barriers” and to “empower patients” to take firmer control of their health.

Michael Dowling, president and chief executive officer of Northwell Health, a conglomerate of 21 hospitals and over 450 patient facilities and physician practices in New York and New Jersey, echoed this theme of empowerment, urging the audience to define it as a movement not just for patients but also for health care providers. “Too often,” Dowling said, “we as health care professionals play the victim. We must take pride in our work, to be optimistic, and face the reality that our business is changing. We must not become prisoners of the past, we must embrace change. One way of doing this is by becoming leaders in the digital world. Otherwise, we run the risk of becoming “Uber-ized,” as someone else will find a way of doing what we do better.” Toward this end, Dowling encouraged his listeners to adapt to the needs of the consumer/patient who, he said, are increasingly more educated, with more access to technology than ever before. He concluded: “We must ask ourselves what skills we will need in the next 5 to 10 years, since our world is always changing, and health care is in a transformative stage.”

Robert J. Blendon, professor of health policy and political analysis at Harvard’s Chan School of Public Health, brought the forum full circle by sharing research he and his colleagues have conducted on the 2016 election, revealing strong partisan views with regards to health policy. Harvard researchers asked, “How Has the ACA Impacted the Country?” They found that 66 percent of Democrats responded that Obamacare has had a positive impact, while 72 percent of Republicans responded by saying ACA has a negative impact. Overall, he noted, healthcare surfaced as the third most important policy issue nationally, with the economy/jobs ranking as the primary issues, and terrorism/national security the secondary issues of importance. Blendon concluded that we will all have to wait for the outcome of the impending election to determine where healthcare emerges in our nation’s priorities.  He concluded, “Major changes in health policy only occur when one party holds the presidency and both houses of Congress.”

–Robert Israel

 

 

 

 

MMS Website Inaccessible from 6 – 9:00 a.m. on Oct. 20

Posted in Uncategorized on October 20th, 2016 by Will Oliver – Comments Off on MMS Website Inaccessible from 6 – 9:00 a.m. on Oct. 20

Due to the installation of a new member database system, the Massachusetts Medical Society’s website will temporarily be inaccessible from approximately 6-9:00 a.m. on Thursday, Oct. 20.

After 9:00 a.m., the website will once again be accessible.

MMS Responds to TV Ad on Question 4

Posted in Uncategorized on October 17th, 2016 by MMS Communications – 1 Comment

The Yes on 4 group advocating for the legalization of recreational marijuana in the Commonwealth has announced a television ad featuring a physician urging passing of the referendum.  In response,  Dr. James Gessner, President of the Massachusetts Medical Society, has issued the following statement:

“The television ad represents one physician’s perspective and is attempting to confuse the recreational marijuana issue with medical marijuana, which is governed by strict regulations set down by the Department of Public Health.  Question 4 lacks any public health oversight of recreational marijuana and has no provision for health education, prevention, or treatment programs.   The Massachusetts Medical Society and 10 state physician specialty societies believe Question 4 would result in bad public health policy, and have stated their overwhelming opposition to the ballot question because of the multiple public health dangers it presents: the risk of addiction, impaired cognition, and damage to the developing brains of adolescents.”

James S. Gessner, M.D.
October 17, 2016

Related: The President’s Podium: The Real Issue of Question 4 

 

The President’s Podium: The Real Issue of Question 4

Posted in Health, Health Policy, Public Health on October 12th, 2016 by MMS Communications – Comments Off on The President’s Podium: The Real Issue of Question 4

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

Citizens thinking about how to vote on Ballot Question 4 – whether or not to legalize recreational marijuana – should ask some important questions before casting their ballot.

How would our health and safety, and especially that of our children, be affected should recreational Dr. James S. Gessner, MMS President '16-'17_editedmarijuana become legal?  What affect will it have on our highway and occupational safety?  Should Massachusetts allow ready access to a substance with a potential for addiction when we are fighting an epidemic of opioid abuse that is already disrupting and destroying too many lives?

These are critical questions, because this referendum, more than anything else, is really about public health and safety.

Marijuana is not harmless. Its main ingredient – tetrahydro-cannabinol (THC) – is a mind-altering substance, and the amount of THC has been increasing steadily over the years. The THC content in marijuana today is four times stronger than it was in the 1980s.

We know that a risk of addiction exists with marijuana. According to the National Institute of Drug Abuse (NIDA), approximately 9 percent of those who use marijuana will become addicted. The rate jumps to 17 percent, or about 1 in 6, for those starting to use it in their teens and rises to 25–50 percent among daily users.

We also know its use contributes to cognitive impairment, presents a risk during pregnancy, poses a threat to highway and occupational safety, and can damage the developing brains of adolescents – the last being one of marijuana’s most troubling effects.

A 2014 article in the New England Journal of Medicine by NIDA Director Dr. Nora D. Volkow and her colleagues reviewed the current state of the science on the adverse health effects of recreational marijuana. Here is part of what they concluded:

Marijuana use has been associated with substantial adverse effects, some of which have been             determined with a high level of confidence…. As policy shifts toward legalization of marijuana, it is   reasonable and probably prudent to hypothesize that its use will increase and that, by extension, so will the number of persons for whom there will be negative health consequences.

In summary: the legalization of marijuana will lead to more marijuana use and more use will lead to more people with poorer health.

Physicians are especially concerned about the impact of this law on children and adolescents, despite a proposed ban on sales to anyone under 21.  An age restriction doesn’t work with tobacco and alcohol; it won’t work with marijuana. In Colorado, where legalization occurred in 2012, the state has seen an increase in marijuana use by youth 12-17 that is now 56 percent higher than the national average.

Adding to the concern is that teen perception of the risks of marijuana has decreased over the past decade, largely due to efforts to legalize medical and recreational marijuana.  The American Academy of Pediatrics has warned that increasing the availability of marijuana for adults, regardless of restrictions, expands access for youth and persuades them that it’s not dangerous – and that’s a wrong message to send to our young people.

Legalization will also likely to lead to greater danger on our highways, because the skills needed for driving – alertness, concentration, coordination, reaction time – are impaired with marijuana use.  In Washington state, where voters approved recreational marijuana in 2012, the number of fatal crashes involving drivers who recently used marijuana doubled in one year, according to a study by the AAA Foundation for Traffic Safety. Colorado has likewise seen a jump – 48 percent – in marijuana-related traffic deaths.

Those are compelling reasons against legalization. But the ballot question itself gives us more reasons to vote no on Question 4.

First, the referendum permits the sale of marijuana edibles, such as cookies, candies, snack foods, and drinks, which are especially appealing to children.

Second, it lacks any provision for public health oversight or authority in the development of regulations that would guide implementation of the law. And third, it has no allowance for any revenue from the sale of the drug to be earmarked for health education, prevention, or treatment programs.  These are serious failings.

A careful read of this ballot question reveals that this was created by and for the marijuana industry, without regard for public health in the Commonwealth.

The Massachusetts Medical Society and 10 physician specialty groups, representing a wide variety of medical specialties, including pediatrics, primary care, emergency medicine, obstetrics, and psychiatry, have stated their opposition to Question 4 for the reasons listed above.

We think preventing possible addiction, guarding our public health and safety, and protecting children and adolescents are far more important and valuable than the commercialization of marijuana and the “recreational” use of a substance capable of causing harm. We hope our patients think so, too.

The President’s Podium appears periodically on the MMS blog, offering Dr. Gessner’s commentary on a range of issues in health and medicine.  Versions of the above have been distributed to newspapers across the Commonwealth for publication as commentary. 

 

 

 

Update: Opioid Education Surpasses 20,000 Courses

Posted in Board of Medicine, Drug Abuse, opioids on October 7th, 2016 by MMS Communications – Comments Off on Update: Opioid Education Surpasses 20,000 Courses

RXMonitoringOne of the major efforts MMS has engaged in to address the opioid epidemic in the Commonwealth has been prescriber education.  Our Opioid Therapy and Physician Communication Guidelines, developed by the MMS Task Force on Opioid Therapy and Physician Communication and issued in May of 2015, laid the groundwork in providing guidance to physicians in prescribing opioids to patients.  Those guidelines have been adopted by the Massachusetts Board of Registration in Medicine and incorporated into its comprehensive advisory to physicians on prescribing issues and practices.

Another major contribution by MMS in addressing the epidemic has been the offer of free continuing medical education courses in opioids and pain management for all prescribers. That effort also began in May of last year. A total of 18 courses and modules are available.

A previous blog post in August has discussed how this activity is having a positive impact, helping to reduce opioid prescribing rates across the Commonwealth.  Three separate studies, released in June, July, and August, have catalogued a decline in prescribing rates.

MMS today can report that since the offer of free courses began on May 26, 2015, the number of courses taken has surpassed 20,000.  As of October 7, a total of 20,249 courses have been taken by 7,084 individuals.

October Physician Focus: Telemedicine

Posted in behavioral health, Health, Health IT, Physician Focus, Primary Care on September 30th, 2016 by MMS Communications – Comments Off on October Physician Focus: Telemedicine

Technology has been rapidly changing the practice of medicine, and one of the fastest growing areas is telemedicine, using such means as video platforms, text messaging, patient portals, and health “apps” that permit communication between physician and patient.

From left: Dr. Dale Magee, Dr. Adam Licurse, Dr. Steven Locke

From left: Dr. Dale Magee, Dr. Adam Licurse, Dr. Steven Locke.

The October edition of Physician Focus takes a look at this emerging area of medicine with Adam Licurse, M.D., a primary care physician and Associate Medical Director of Brigham and Women’s Physicians Organization and Partners Population Health Management, and psychiatrist Steven Locke, M.D., Chief Medical Officer and Co-Founder of iHope Network and member of the MMS Committee on Information Technology.  Hosting this edition is Dale Magee, M.D., a past president of MMS.

The discussion examines the impact of telemedicine on physicians and patients, its advantages and shortcomings, how the field of mental health has acted as a pioneer in the field, how it can help to ease the stigma that prevent patients from getting care, and the concerns clinicians still have with the application of telemedicine in patient care.

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.