MMS Oration

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.


Annual Oration: Doctors Need to Reshape the Value Agenda

Posted in Affordable Care Act, Health Reform, Interim Meeting 2015, MMS Oration on December 4th, 2015 by Erica Noonan – Comments Off on Annual Oration: Doctors Need to Reshape the Value Agenda

Physicians need to take a leadership role in reshaping the approach to value in health care reform for the system to see more cost-savings and quality improvements, said Ashish K. Jha, MD, MPH, in his 2015 Annual Oration address, delivered Friday at the 2015 MMS Interim Meeting.

The prevailing wisdom among policymakers that providers are being reimbursed incorrectly has driven a set of value metrics that have not yet resulted in significant improvements, he said.    jha2

Current approaches to value — such as measuring hospital readmission rates and mortality rate — have not markedly improved outcomes for patients. Furthermore, some of the measurement have penalized hospitals that care for the sickest and poorest patients, said Dr. Jha.

“There will winners and losers in a value-based world, depending on how you define value,” he said.

His address, “Getting to Value in High-Value Health Care,” was the 204th MMS Annual Oration, a Society tradition that dates back to 1804.

Accountable Care Organizations and Medicare’s Shared Savings Program are still quite new, but so far have also not showed the impact on cost and quality that many health care reformers had hoped. “If these are going to work, it’s going to take a lot more time,” Dr. Jha. “It is not going to be the panacea to fix American health care.”

To get better value measurements, physicians must be active in advocating for measures “that matter.”  They must refocus the conversation around patients and engage policymakers who are too often making decisions without enough input from practicing physicians.

“We are on a long journey towards higher value health care,” said Dr. Jha.

Watch video of the Annual Oration here.

Erica Noonan

2014 Annual Oration: Medical Education Across The Continuum

Posted in Interim Meeting 2014, MMS Oration on December 5th, 2014 by Erica Noonan – Comments Off on 2014 Annual Oration: Medical Education Across The Continuum

This year’s Annual Oration, Medical Education Across The Continuum: A Snapshot in Time, focused on changes in medical school curriculum have impacted residency training, how residency training influences change in practice, and how clinical practice now informs continuing medical education.

The speaker Michele P. Pugnaire, MD, professor of Family Medicine and Community Health and Senior Associate Dean for Educational Affairs at the University of Massachusetts Medical School, spoke of the changes in the medical education process over the past century. “We are what I am calling `forever learners’ because that is what is expected by the public, our patients and our students,” said Dr. Pugnaire.

There are four drivers in medical educational change: team-based learning, practice-based learning/simulations, outcome-based learning, and improvement based learning, said Dr. Pugnaire. Today’s medical schools are embracing all of them, and some programs are switching from timeline-based programs to more flexible curriculum that judges competency rather than time spent in a classroom, she said.

The future will inevitable cause the educational driving forces to converge on a shared goal  for learning: patient safety and quality medical care, she said.

“We are training the next generation of future physicians – our replacements. They will be taking care of us and our families, so we had better do a very good job,” she said.

The MMS Annual Oration dates back to 1804 when Dr. Isaac Rand delivered his dissertation entitled, On Phthisis Pulmonalis, and the Use of the Warm Bath.  For more than 200 years, MMS orators have addressed a wide spectrum of topics germane to the evolving practice of medicine.


2013 MMS Oration: Engage Patients to Transform Health Care

Posted in Health Reform, Interim Meeting 2013, MMS Oration on December 6th, 2013 by Erica Noonan – Comments Off on 2013 MMS Oration: Engage Patients to Transform Health Care

Moving from a provider-centric delivery system to one that engages and activates patients is key to transforming health care in the United States, said David L. Longworth, M.D.

The transition to a new paradigm of care requires many changes in practice — from working in more collaborative physician-led teams to better use of predictive analytic data by physicians to guide care decisions, said Dr. Longworth, Associate Chief of Staff for Clinical Integration Development at the Cleveland Clinic.

But the most crucial  step left for physicians is to better motive patients to stay as healthy as possible, he said.

“We have a unique opportunity as a physicians to fix what has been broken for so many years,” he said. “Patients are (now) partners with us. No longer are we delivering care to passive individuals.”

Dr. Longworth delivered the Massachusetts Medical Society’s Annual Oration, “The Imperative of Patient Engagement in the Era of Healthcare Reform and Practice Transformation”  at the organization’s 2013 Interim Meeting on Dec. 6.

The Oration is a Society tradition dating back more than 200 years, and features a physician-leader speaking on an issue pertinent to current medical practice.

Dr. Longworth said that engaged and activated patients are more likely to accrue fewer health care costs, experience fewer hospitalizations, emergency room visits and hospital readmission.

These better outcomes are quality measures that physicians can’t ignore under new value-based compensation systems, he said.

Not only must physicians engage their patients  more effectively, they must also improve their interpersonal and coaching skills.  Patients who rated their physicians as more empathetic, had better health outcomes in managing chronic disease, Dr. Longworth said.

— Erica Noonan

Moving Medicine from a Guild to an Enterprise: 2012 MMS Oration

Posted in Interim Meeting 2012, MMS Oration on November 30th, 2012 by Erica Noonan – Comments Off on Moving Medicine from a Guild to an Enterprise: 2012 MMS Oration

Physicians are watching their profession rapidly transform from the guild-oriented practice of medicine to a an enterprise-oriented  industry one might call ”Big Med,” said H. Eugene Lindsey, M.D., president and CEO of Atrius Health.

“One could say that we are now a guild under siege,” said Dr. Lindsey, who delivered the 2013 MMS Annual Oration, titled “Working Together: From Guild to Enterprise” on Friday as part of the Society’s two-day long Interim Meeting.

H. Eugene Lindsey, M.D., president and CEO of Atrius Health

Atrius has been preparing itself for accountable care and global payments for many years, Lindsey said, but is still struggling to solve the problems plaguing virtually all modern health care organizations:  increasing accountability, reducing costs and practice variations, eliminating waste  and maintaining physician satisfaction levels.

“We have not been able to progress as far or as fast as we hoped,” he said.  Atrius and other organizations will have to innovate quickly to stay ahead of the consequences of expected cuts in reimbursement rates and prevent loss of care quality, he said.

Another crucial objective is to improve physician happiness through improved management performance and standardization of work so that physicians have more time for patient care and critical thinking work.  Among the challenges his organization will face is a predicted shortage of PCPs.  By 2025, more than 130,000 physicians nationwide – more than half of them PCPs – are expected to complete retirement.

“Improving the experience of practice remains a great challenge,” said Lindsey. “We must move guild thinking into a new environment.”

                                                  – Erica Noonan

2011 MMS Oration: Powerful Messages on Physicians and Health Care

Posted in Health, Health Policy, Health Reform, Interim Meeting 2011, Medicine, MMS Oration on December 2nd, 2011 by MMS Communications – 1 Comment

“Within my lifetime, our profession has changed profoundly.  The practice of  medicine is exciting but extremely complicated – scientifically, technologically, financially and academically.  And we are at a breaking point.”

So began the 200th Annual Oration of the Massachusetts Medical Society, delivered by Sean Palfrey, M.D., professor of pediatrics and public health at the Boston University School of Medicine and a practicing pediatrician at Boston Medical Center, at the MMS 2011 Interim Meeting on Friday, December 2.

His presentation carried some powerful messages, not only for his physician colleagues in attendance, but also for other leaders in health care.

Encouraging a renewal of the human touch along with a “necessary discipline” to use modern technology appropriately, Dr. Palfrey said “We are at a very difficult juncture, a point where we have an embarrassment of scientific and technological riches that we need to learn to use optimally, yet we provide health care outcomes that compare poorly with the rest of the world.  So this is a moment of huge opportunity as well as serious crisis.”

Dr. Palfrey’s Oration expanded on his viewpoint of how physicians should practice medicine today, first brought forward in a Perspective article, Daring to Practice Low-Cost Medicine in a High-Tech Era, published in the New England Journal of Medicine in March.

Above all, Dr. Palfrey has a dual message for physicians.  First, doctors should reconsider how they treat every patient and think about the cost and value of what they do.  “Despite huge reservoirs of human warmth and dedication,” he says, “doctors are distancing themselves from their patients. Our ability to heal our patients depends both on our clinical skills and on our understanding of science and technology.  Our patients are not simply the sum of their data, as vast as that might be, they don’t really exist inside a computer, and we need to keep reminding ourselves that it is our cognitive skills as physicians that really make us good healers.”

Second, physicians must advocate for what’s right for their patients and their practices and work collaboratively with others to improve the health care system.  “We all need each other and should not see ourselves as competitors.  Just as we should be partnering with lawyers to solve the huge malpractice challenges, we need to work with nursing and many other health professional administrations to solve the country’s massive staffing and personnel shortages. We should be welcoming and eager to partner with them so that each of us can be using our knowledge and training most effectively and be more satisfied in our clinical roles.  This is not simply an issue of efficiency or financial resources or the national economy. It’s the future of quality health care.”

Dr. Palfrey’s perspective is worth the read. You may find the text of his Oration here.

Annual Oration Opens Window to the World of Gender-Based Violence

Posted in Interim Meeting 2010, MMS Oration on December 3rd, 2010 by MMS Communications – Comments Off on Annual Oration Opens Window to the World of Gender-Based Violence

The Annual Oration at the MMS Interim Meeting is intended to focus on compelling medical issues, and this year’s presentation certainly delivered. With her presentation Friday afternoon before some 200 physicians, Dr. Gloria White-Hammond opened a window to a world many people never get – or perhaps even wish – to see.

Dr. White-Hammond, a pediatrician at Boston’s South End Community Health Center since 1981 and  Co-Founder and Co-Pastor of Bethel African Methodist Episcopal Church in Boston, described the prevalence of gender-based violence around the globe in her presentation, Gender-Based Violence in Armed Conflicts, Sudan as a Case Study.

Stark pictures from her work against violence in Sudan supported her talk, which covered descriptions of the victims and the perpetrators, the many and varied forms of violence, the motivations behind the violence, and the physical and psychological consequences for those affected.

Such violence is “alive and well, worldwide and timeless” said Dr. White-Hammond. “It occurs in all places and at all times. There are no sanctuaries.”  Gender-based violence is occurring in 61 counties around the globe, she said, and while it affects mostly women, boys and men are also targets.

Dr. White-Hammond, who is also the Founding Co-Chair of the Massachusetts Coalition to Save Darfur and Chairwoman of Save Darfur Coalition’s “Million Voices for Darfur” campaign, also had a message for physicians, telling them they have a “unique opportunity and urgent obligation” to take the lead in addressing this issue.

“There’s no time to waste,” she said, concluding her presentation. “Lives are at stake, communities are at stake. Let’s get busy.”

View Dr. White-Hammond’s presentation, along with other resources for violence assessment and prevention, at the MMS website here.