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2011 Scientific Assembly Call for Abstracts
The National Medical Association is currently accepting abstract submissions for its Annual Scientific Assembly in Washington, DC, July 23 – 27, 2011. Abstracts -- from all medical specialties and disciplines -- related to topics of health disparities are welcome.
Abstracts are due no later than Monday, November 1, 2010 but are reviewed on a rolling basis and early submissions are strongly encouraged.
To submit an abstract
NMA News
National Medical Association Receives Five-Year Award for the Act Against AIDS Leadership Initiative (AAALI)
The National Medical Association (NMA), one of 20 leading minority organizations, was recently awarded by the Centers for Disease Control and Prevention (CDC) funding to raise awareness to help reduce the disproportionate rates of HIV/AIDS among the African American community. The Act Against AIDS communication campaign is the first national campaign supported by the CDC in more than ten years. The NMA along with other minority organizations such as NAACP, National Council of Negro Women and the National Urban League will work together to deliver HIV/AIDS messages, membership education and awareness, and conduct community outreach activities.
For more information on the Act Against AIDS Leadership Initiative and NMA HIV/AIDS programs please visit www.cdc.gov/hiv/aaa or http://hiv.nmanet.org.
Help Your Patients Breathe
The National Medical Association(NMA) is expanding its education and outreach efforts through its Asthma and Allergy Rescue Project to reduce asthma disparities by enhancing the delivery of quality asthma care in African American communities. This expansion is made possible through a partnership with the National Asthma Control Initiative (NACI) through a grant from Academy for Educational Development (AED).
The NMA will provide toolkits for physicians and for patients with educational materials and other useful resources that reinforce the Guidelines Implementation Panel (GIP) messages. Click here. The NMA Asthma and Allergy Rescue Project would like to encourage NMA Members who have asthmatic patients to continue familiarizing themselves with the GIP messages. We also encourage you to share with patients the developed Asthma Action Plan www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf as it empowers them to vigilant of triggers, allergens and overall breathing health. The Principle Investigator for this project is Michael A. Lenoir, M.D., FAAAI. For more information please contact Cheryl Dukes at cdukes@nmanet.org or Roslyn Douglas at rdouglas@nmanet.org.
Apply for the Robert Wood Johnson Foundation Clinical Scholars® program
Application Deadline: Feb. 28, 2011
Resident physicians are invited to apply for the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program, which offers a master’s degree graduate-level study and research in a university-based, post residency training program. The program provides scholars with generous funding and involves two years of study with protected time for research.
The RWJF Clinical Scholars program fosters the development of physicians who will lead the transformation of Americans’ health and health care. These future leaders will conduct innovative research and work with communities, organizations, practitioners and policy-makers to address issues essential to the health and well-being of all Americans.
Program highlights include:
- leadership training;
- mentoring;
- protected research time;
- national networking;
- health policy, health services, and community-based research training; and
- financial support for research projects and professional travel.
Four participating institutions will be recruiting 20 scholars to begin their programs in July 2012: the University of California, Los Angeles; the University of Michigan; the University of Pennsylvania; and Yale University. The U.S. Department of Veterans Affairs will provide funding for the stipends and insurance for 10 of the Scholars through VA Medical Centers affiliated with these universities. The VA provides additional support through faculty time, clinical resources, and research databases.
To apply online or find more information visit www.rwjcsp.unc.edu. The deadline for all applications (and reference letters) is February 28, 2011.
Renew Early and Save!
Renew Your NMA Membership and Receive a $50 Discount – Discount expires February 1, 2011!
It’s time to renew your membership with the National Medical Association. Your membership is vital in our efforts to end health disparities and improve the quality of health care for minorities. With all of the important changes in health care – now more than ever, the NMA is dedicated to serving you and your professional goals. Don’t delay; take advantage of the $50 discount. Renew online today! Prefer to renew by phone? Contact Member Services at (202) 347-1895 ext. 220 or 224.
Practice Management News
'Oops, I Hired a Nightmare Employee'
Physicians Practice (08/10) Vol. 20, No. 13, Michael, Sara
When medical practices need to fill a job opening quickly, they should turn to an employment agency for a temporary worker or ask a former or current cross-trained employee to take over for awhile. Such a strategy avoids settling for a mediocre employee and gives the practice more time to find the right applicant. Practices also should clearly define the duties of the job and what skills and attributes are desired. Rather than ask traditional questions about strengths and weaknesses, practices should develop creative interview questions, asking applicants about the best traits of their last boss and what they liked or disliked about their previous position, for example. A case study from the practice should be presented to applicants, who must explain how they would handle the situation. Experts also encourage practices to schedule more than one interview or a second interview with a different team member to get to know the applicant better and underscore the importance of conducting credit, motor vehicle, criminal background, and reference checks.
Ins and Outs of Medical Practice Non-Compete Provisions
Physicians News Digest (08/17/10) Bernick, Daniel M.
Most physician contracts feature non-compete clauses to prevent departing associates from setting up practices within a certain distance of their former employers for a specified period of time, usually a couple of years. The idea behind these clauses is to protect the practice's patient base, but given that state rules governing them vary widely and generally are enforceable only when the geographic restrictions and time frames are not excessive, practices and their attorneys must take steps to strike a balance. Associates may not want to sign non-compete agreements that would force a relocation away from family, and young physicians looking to join a practice to avoid start up costs could decide to set up their own practices if the clause is too strict. In response, practices would be wise to offer non-compete clauses with a pre-agreed money buyout option. The clause must indicate a remedy in the event of a breach, which generally involves either a court injunction or money damages, and state law must be consulted. Non-compete clauses often are accompanied by non-solicitation/confidentiality covenants to prevent associates from setting up practices just outside the specified geographic boundary of the non-compete clause and soliciting the patients of their former employer.
Disclosing Errors, Offering Compensation May Keep Physicians Out of Court
Medscape (08/16/10)
The University of Michigan Health System (UMHS) has seen its rate of malpractice litigation and total liability costs drop dramatically nine years after it began disclosing medical errors to patients and offering to compensate them, according to a study published in the Annals of Internal Medicine. UMHS began implementing its program, in which it admitted fault and offered compensation when an internal inquiry revealed medical error, in 2001. At first, UMHS applied the policy to all new and pending malpractice claims, but it now relies on its own employees in addition to patients and their attorneys to identify cases of patient injury.
The authors of the study acknowledge two caveats, however, to concluding that the policy can be expanded systemwide. First, malpractice claims against Michigan physicians statewide were declining when UMHS was implementing its policy. The state had passed several tort reform measures in 1994, including a cap on noneconomic damages, which may have contributed to the trend. Second, a disclosure-and-offer program may achieve less results in healthcare organizations that operate differently than UMHS. The Michigan health system employs its physicians, pays for their malpractice coverage, and accepts responsibility for claims on a system-wide basis. As a result, individual UMHS physicians are rarely reported to the National Practitioner Data Bank.
EHR Adoption Rates and the Benefits of an Electronically Connected Profession
Dynamic Chiropractic (08/12/2010) Kraus, Steven
Research shows that 8 percent to 12 percent of small physician practices have implemented electronic health records (EHRs), with chiropractors boasting adoption rates near 19 percent. These physicians are leading the way, and some observers predict universal adoption could be a reality within five years. EHRs will allow health care information to be shared almost instantly, and storage is completely digital. Over the next five years, chiropractors will need EHRs because CD-ROMs and X-ray jackets to store images will become obsolete. Universal EHR adoption, electronic exchange of practice data, and data mining will enhance collaboration and show that chiropractors and other physicians are modern and willing to produce clinical data to prove their outcomes. However, ease of use, staff compliance, integration with billing and scheduling systems, and HIPAA compliance remain top concerns.
Many Doctors May Find Meeting 'Meaningful Use' Requirements a Challenge
iHealthBeat (08/05/10) Stack, Steven J.
While the cost of setting up an EHR system is a major obstacle to a medical practice’s adoption of the technology, the “meaningful use” requirement may be just as challenging for many. The American Medical Association worked with regulators to develop flexible requirements and a clear outline of what physicians need to do to receive federal incentives, but it will still be difficult for small and solo practices. In the final rule there are fewer requirements to meet in the initial stage of the program and lowered reporting volumes for several measures—the use of computerized physician order entry was reduced from 80 percent to 30 percent and applies only to medication orders, for example. The number of clinical quality measures that must be reported is now limited to those with electronic specifications, and doctors may select those measures that are relevant to their practice. But there are still significant challenges—there is no single system on the market that would allow physicians to meet all of the requirements for meaningful use, and while some may come to market this fall, that would allow less than a year to buy, implement, and meet the requirements with a new system. And even with fewer requirements to meet, 20 is still a lot for practices that are not tech-savvy, and practices that already have systems will have to upgrade them to meet the requirements.
How to Find Help Implementing an HER
Physicians News Digest (08/17/10) Frantz, Ken; Newman, Mark
Physician practices looking to take advantage of financial incentives for implementing electronic health records (EHRs) need to look for assistance now, as the final rule for "meaningful use" requirements has been issued and the first deadline is next year. Practices, especially small groups in underserved and poorer communities, can obtain assistance from Regional Extension Centers (RECs) created and funded by the American Recovery and Reinvestment Act. RECs can help practices choose the appropriate EHR system, charging a small fee or offering their services at no cost. Practices also can seek help from vendors, negotiating such assistance before purchasing the software; but those needing to integrate EHR with existing systems and medical devices might want to hire a consultant who understands their unique needs. Free or discounted selection tools, implementation guides, and advice can be obtained from medical specialty societies, and online resources have been made available by several professional organizations. Most importantly, practices need to set aside time for staff to learn the new systems to ensure a smooth implementation and increased efficiency.
Tighter Medical Privacy Rules Sought
New York Times (08/22/10) Pear, Robert
The U.S. Department of Health and Human Services (HHS) has pulled the final medical privacy rules it sent to the White House Office of Management and Budget in May due to concerns generated by federal lawmakers and consumer groups. The rules spell out when patients must be informed about security breaches involving medical records, which are on the rise due to expanded use of health IT, social media and the Internet. The temporary rules issued by HHS in August 2009 state that patients must be notified only when a privacy breach posed "significant risk of financial, reputational or other harm to the individual," as determined by risk assessments. Critics of the rules say it is difficult for healthcare providers and insurers to determine whether harm will result from improper disclosure. In response, HHS is rewriting the rules and hopes to issue a final regulation in the fall.
Implementing Contract Negotiations: Let the Games Begin
AAOS Now (08/10) Charkin, Susan E.
After sending proposal letters to payors, physician practices begin the process of negotiating higher reimbursement rates. They should emphasize any advantages to retaining their business over the long term, specifically how patient/employer satisfaction and preventive care can positively impact payouts in the future. They also should understand that the negotiation process is a game with several rules. As a result, they would be wise not to bypass first- and second-level contacts and go to the top decision-maker; understand that it could take several weeks for a counterproposal to be made but follow up with first-level negotiators in a timely manner; and allow billing directors or practice managers to participate in the initial negotiations before involving more senior managers. After the contract is received, they should review it to ensure the reimbursement rates and terms are up to date, and to ensure implementation, they should request a copy of the fully executed agreement.
Why Physicians Should Get to Know Google
Fierce Practice Management (08/24/10) Beaulieu, Debra
Google claims that 86 percent of doctors say they now regularly use the Internet on the job. Pediatrician Dr. Rahul K. Parikh cites a recent example where he looked up "retinitis pigmentosa" on the Google site while gathering a patient's medical history, and quickly used the information available to realize that annual vision checks would suffice for the patient. However, a 2006 study published in the British Medical Journal had physicians read the histories of 26 tough cases published in the New England Journal of Medicine and attempt to make a diagnosis by entering search terms into Google. The physicians in the study arrived at the right diagnosis 58 percent of the time, while Parikh got none correct when trying the experiment on his own. Search engine algorithms, which are not made public, may be part of the reason for the difficulty. "The solution for doctors [and everyone], I suspect, is best answered by taking note of that lack of transparency [of ranking algorithms] and by making it a professional priority to become search savvy," Parikh states. Google's "advanced search" feature can shrink the size of a search, as can using quotation marks for exact phrases and excluding words by putting a minus sign in front of them. Gaining expertise in Internet searching, especially in a world in which medical knowledge exponentially outpaces anyone's ability to know it all, is a valuable skill set for young doctors to gain.
Doctors Rely on iPhones to Guide Treatment
San Jose Mercury News (08/03/10) Boudreau, John
Physicians such as Kathy Corby at Hollister, Calif.'s Hazel Hawkins Memorial Hospital say the way they practice medicine is being transformed by the ability to instantly access data in any situation and via one-touch technology such as smartphones. IPhones and other devices loaded with medical applications remove the need to consult a thick manual or one's memory when confronted with an emergency situation. Experts say that doctors may eventually be able to access electronic patient records on their handhelds, and emergency rooms and other hospital areas are already being outfitted with iPads so medical staff can obtain critical information swiftly. Manhattan Research's Meredith Ressi says that doctors are three times more likely to use smartphones than the general adult U.S. population, while over 70 percent of U.S. doctors currently use advanced phones or personal digital assistants. Eighty percent of this segment say the devices are crucial to their work. There are some concerns that the use of smartphones and similar devices could lead to data overload, while other experts warn that the sharing of medical cases between doctors using smartphones could constitute a risk to patient privacy.
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Physicians: Get Over Your Fear of Electronic Messaging
HealthLeaders Media (08/03/10) Shaw, Gienna
Many physicians are concerned that e-mail communications with patients would take up too much of their time and expose them to liability. But a study—published in the July Health Affairs—of 35,423 people with diabetes, hypertension, or both, showed that the use of secure patient-physician e-mail messaging was associated with a statistically significant improvement in effectiveness of care during a two-month period. Physicians participating in the study said they were not overwhelmed by a large number of e-mails. On average, exchanges contained just slightly more than one patient message and one physician message, and 63 percent required clinical assessments or decisions, while 24 percent required clinical action such as ordering a lab test, showing that patients were not frivolous in their e-mails. E-mailing also cut down on unnecessary outpatient visits, thus improving the efficiency of care.
E-Prescription Use Grows, But Some Hurdles Remain
Post-Tribune (IN) (08/02/10) Taylor, Mark
Although the federal government will institute financial penalties for medical practices that do not electronically prescribe medications beginning in 2012, the Center for Studying System Change says less than 33 percent of practices nationwide have implemented e-prescribing systems. Of those with e-prescribing systems, the study found that many doctors fax the prescription instead of sending it electronically and do not take advantage of the system's ability to identify harmful drug interactions or cross-reference insurance formularies to determine whether the medicine will be covered by insurance. While cost and the fact that many pharmacies are unable to accept e-scripts play a role in low adoption rates, experts say e-prescribing poses some dangers. Alex Stemer, MD, of Medical Specialists Inc. in Munster, Ind., says "wrong-click" errors are possible, as systems present a list of drug names when physicians begin to key in the information, making it easy for them to mistakenly select a similarly spelled drug. In addition to the lack of black box warnings and the fact that pharmacies check e-mail only a few times on a daily basis, dosing errors are a concern. "One click above or below many mean a 50 percent dosage difference in the drug," says Stemer. "How does a pharmacist catch that?"
Health-Care Overhaul: Doctors Must Go Digital
Orlando Sentinel (FL) (08/09/10) Cevallo, Marissa
New federal requirements for medical practices to go paperless will affect about 1,400 doctors in Central Florida, offering financial incentives for those who make “meaningful use” of the technology and penalties for those who do not. Orlando Health and Florida Hospital now are meeting many of the 25 milestones and will meet the 2015 deadline, but some are concerned that smaller, older practices will not be able to comply and may shut their practices. Indeed, up to 30 percent of primary-care doctors are considering early retirement because of the requirements, according to family-practice physician John Littell. The University of Central Florida College of Medicine has received a $7.7 million stimulus grant to train doctors and their staffs on electronic health records systems in order to prevent many from retiring. While many say the systems will save lives as well as money, the cost of buying and implementing the systems is still a major barrier, and there are some fraud and privacy concerns as well. But many physicians say the challenges will be worth it, especially if it means receiving federal incentive payments.
Local Doctors Begin Charging Fees, Cutting Patients for 'Concierge' Medical Care, Some Severing Ties With Medicare
Huntsville Times (AL) (08/01/10) Doyle, Steve
Alabama physicians have started to adopt a "concierge model" and charge patients for greater access and more extensive treatment, or stop treating Medicare subscribers unless they pay a yearly fee. Most established family doctors and internists in Huntsville are refusing to accept new Medicare or Medicaid patients. Huntsville Hospital CEO David Spillers says experiments with concierge doctor services are being closely watched by local primary-care physicians, and he adds that he knows several doctors who are considering cutting out Medicare due to excessive paperwork and concerns that the Medicare program will greatly reduce doctor reimbursements. Spillers notes, however, that thousands of patients could be left to look for new primary-care doctors as large medical offices transition to smaller fee-for-access practices. He says that patients covered by private health insurance should be able to easily find new caregivers, while Medicare patients will have a tougher time and the search will be "almost impossible" for Medicaid patients. "Clearly, if there were a massive move by physicians [to become concierge providers], health care for Medicare and Medicaid patients is going to be delivered in the emergency rooms and urgent care centers," says Spillers. "We will be overrun." Across the United States there are an estimated 5,000 concierge-type practitioners, and among the factors driving concierge medicine are people who want the best care possible now because they are concerned the country is heading toward a nationalized health care system with long waits to see specialists.
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