Annual Meeting 2015

The President’s Podium: “Physicians Really Are Different”

Posted in Annual Meeting 2015, Leadership, workforce on May 8th, 2015 by MMS Communications – Comments Off on The President’s Podium: “Physicians Really Are Different”

Dr. Dennis Dimitri 300 ppiBy Dennis Dimitri, M.D., President, Massachusetts Medical Society

Editor’s Note: On Friday, May 1, 2015, Dennis Dimitri, M.D. was installed as the 133rd president of the Massachusetts Medical Society. His inauguration address, while reflecting on personal experiences and acknowledging the help and support of those closest to him, also carried an important message for physicians, as they practice in a dramatically changing and increasingly burdensome health care system. Here are excerpts of his inauguration speech.

“There is really no other career that for most of us could have brought so much personal reward while doing so much professional good.

“We’re very privileged in the sense that our patients come to us, sharing openly all of their own difficult circumstances, be they medical, personal, social, or economic issues that created their difficulties. They look to us to help them overcome these problems, yet over and over lately, we hear about physician burnout and the loss the joy in practice.

“Yes, it can be stressful and overwhelming to be faced by our professional demands at times. Often, the healthcare delivery system seems to add more roadblocks rather than make it easier for us.

“Yet we must not lose sight of the privilege we are afforded in return for our willingness and our professional mandate to put our patients’ interests before ours. Many of us often decry the loss of some types of physician autonomy, as well as the sense of the loss of respect for the profession, yet, over and over, polls of the public indicate that they want a physician to be the provider of their health care, and that medicine remains at the top of the list of respected professions.

“So, yes, we now practice more and more often as part of a team or in an integrated system, but the unique role of physician leadership of that team and physician impact on those systems remains fundamental to our patients’ well-being.

“And as to that loss of joy in practice…. Well, recent studies of physicians indicate, not surprisingly, that what gives us the greatest satisfaction is providing good care to our patients.

“When we feel burned out by dealing with our EMR’s, the prior authorization forms, and the delays in payments from insurers … when we have to stop to check the prescription monitoring program, or search for a course to fulfill our risk management CME’s, we should try to remember this: We helped some patients today.

“We should think for a moment about the impact we have on our patients’ lives, how much we become a part of their families, often without even realizing it.

“My point is that physicians really are different. Every day we have the potential to be involved in awesome life-and-death decision-making. We do our best to make those decisions, based not just on the whimsy of the day, but on scientific evidence, and then we take the feedback of the outcome of those decisions and use it to improve the quality of our next decision, be it for the current patient or the one we might see the next time.

“It’s what our patients expect, it’s what we like to be able to do, and it’s what we should remember on those days when the frustration mounts.

“So in this coming year, I plan to try to remember we are here to take care of patients, to improve the quality of care we deliver, to husband the resources needed to provide that quality of care, and to pay attention to … improving the work life of physicians and their staffs.

“I believe such an effort is reflected in the time-honored mission statement of the Medical Society: Maintaining the highest professional and ethical standards, while promoting medical institutions that are formed on liberal principles for the health, benefit, and welfare of the citizens of the Commonwealth. I shall endeavor to continue to make it so with the help of all of you.”

Watch Dr. Dimitri’s remarks here:

2015 Shattuck Lecture: CDC’s Dr. Tom Frieden on the Current and Future States of Public Health

Posted in Annual Meeting 2015, Drug Abuse, HIV, opioids, Public Health on May 2nd, 2015 by MMS Communications – Comments Off on 2015 Shattuck Lecture: CDC’s Dr. Tom Frieden on the Current and Future States of Public Health

Describing public health as the means that will “account for most of our health progress in the years to come,” Director of the U.S. Centers for Disease Control Dr. Tom Frieden spoke of the achievements and challenges in public health in delivering the 2015 Shattuck Lecture at the Massachusetts Medical Society’s annual meeting on Friday, May 1.

In a talk that was both entertaining and instructive and supported with statistical data, Dr. Frieden touched on a myriad of subjects, including antibiotic resistance, the opioid epidemic, the state of HIV care, tuberculosis, the impact of vaccines, the threats and improvements in cardiovascular care and hypertension, the continuing and new dangers of tobacco and nicotine delivery systems such as e-cigarettes, and the public health actions of a responsive government.

Among the highlights from his address:

On infection and the spread of drug-resistant bacteria: “The obsession to increase the population impact of our efforts is routinely complicated by infection, which could eventually undermine much of modern medicine. Our Antibiotic Resistance Initiative could reduce many infections over the next five years.”

On clinical care working with public health: “The intersection of clinical health care and public health is one of the essential concepts that underlie public health, and all too often they are going in different directions. There’s a lot we can learn from each other.”

On the Ebola crisis: “We learned two big lessons from the Ebola crisis. Every country needs to have a core public health capacity and the world has to move faster with outbreaks and epidemics.”

On the role of government: “The appropriate role of government is getting people to make healthy choices, with free and open information, by protecting individuals from harm caused by others, and by taking societal action to protect and promote health. These are the public health actions of a responsive government.”

On the responsibilities of individuals, providers, and government: “Until we have a collective responsibility for health-inducing environments, we will continue to have challenges.”

On the main goal of the CDC: “The goal of the CDC is a safer U.S and a safer world, to prevent avoidable catastrophes, to detect threats early, and to respond rapidly and effectively.”

Slides from Dr. Frieden’s presentation are available here.

A video of the full talk is available here:

MMS Ethics Forum Examines Pain Management

Posted in Annual Meeting 2015, Ethics Forum, opioids on April 30th, 2015 by MMS – 1 Comment

The opioid epidemic continues to grow, here in Massachusetts as well as the nation.  In its latest tally, the state has recorded more than 1,000 opioid-related deaths in 2014, 33 percent higher than just two years earlier.

In announcing the figure on Wednesday, Governor Charlie Baker cited research showing that four out of every five heroin addicts got hooked on opioids through pain medications, many starting with legally prescribed medicine, according to a report by The Boston Globe.

While some point to the overprescribing by physicians as part of the problem, the opioid epidemic – and what can be done to reduce the abuse – has been a priority topic for physicians. The MMS’s 2015 Public Health Forum focused on the topic, and Dr. Richard Pieters’ President’s Report to MMS members delivered earlier today recounted some of the Society’s accomplishments in addressing the issue.

Today’s MMS Ethics Forum continued the Society’s emphasis on the topic. Presented by the Committee on Ethics, Grievances, and Professional Standards, the 2015 forum explored the ethical and legal consideration in pain management. Among the topics included were responsible prescribing, the complexity of pain as a clinical issue , and the ethical problems associated with undertreatment and overtreatment, and the balance between a physician’s obligations to the patient and obligations to public health.

Participants include Seven Adelman, M.D., director of Physician Health Service; Dr. Richard Pels, Director of Graduate Medical Education at Cambridge Health Associates; and Mark Eisenberg, M.D., Unit Chief of Adult Medicine at Massachusetts General Hospital-Charlestown Health care Center.

Visuals from the presentations may be viewed here.