Oct. 26, 2018 – Read MSSNY’s Scorecard Before Voting!

PRESIDENT’S MESSAGE Thomas J. Madejski, MD MSSNY President MSSNY eNews October 26, 2018 Volume 20  Number 40

Colleagues:

The MSSNY presidency involves a fair amount of travel.  I’m very thankful for the help of my other MSSNY officers, Vice President Bonnie Litvack, President Elect Art Fougner, and our Immediate Past President Charles Rothberg for their counsel and assistance in meeting some of the demands of the presidency.  It’s hard to be in two places at once!

Recently, traveling upstate, I met with County and District Medical Societies, and other Health system leaders.  I finished up Saturday morning with a conference in Albany.  The New York State Thruway can be a little monotonous at times and I will usually have media content to keep me company while on the road.  The back and forth made me think of an old radio comedy duo, Bob and Ray, who started out in the Mohawk Valley.  They mention a number of real and fictional Upstate towns and had an NPR radio show some years ago which featured a traveling reporter, Farley Gerard.  Here’s a link for, hopefully, your listening pleasure.

The allusion (traveling back and forth, meeting members and nonmembers, considering new information, reporting it to you, and incorporating that into our society’s efforts) came to me upon reflection about some of my weekly activity.

Tuesday

I started out Tuesday with a meeting in Monroe County with MCMS President Surinder  Devgun, and their Executive Director Chris Bell.  We had a general discussion on how the County and State Societies can work together to grow membership.  One of the successful programs that Monroe County has implemented is a social rounds, held periodically at a hot venue in the County.  MCMS is trying to reconnect physicians socially and encourage collegiality and mutual support.  I would encourage other counties to attempt to replicate this outreach effort.

Wednesday

I met with a friend, Dr. Tom Hughes, Chief Medical Officer, Optimum Physician Alliance (OPA).  OPA is a growing 600+ member physician network in Western New York.  We had a great discussion about our organizations’ mutual goals of improving the care of patients and the well-being and satisfaction of our physician members.  We discussed physicians’ personal health related to loss of a colleague from our area last year, and how our organizations can work together, particularly with the activity of MSSNY’s Physician Wellness and Resilience Committee to improve the practice environment and reach out to physicians who may be struggling for whatever reason.  I look forward to further discussions with Tom, our 8th District Leaders, and other healthcare groups to improve the lives of patients and their physicians in Western New York.

Thursday

Our Committee on Legislation met to review our 2019 Legislative advocacy program for presentation and approval by the MSSNY Council.  Reducing the hassle factor to improve the practice environment and liability reform are high on our priority list.

Friday

Friday evening I met with members from the 3^rd and 4^th Districts at their Annual Fall retreat.  I gave an informal update of MSSNY’s recent activity on a number of issues.  We had a spirited debate about how MSSNY should prioritize its’ advocacy efforts, and whether we should bother to advocate for, or against, various issues based on a perceived likelihood of success.  Shepherding our limited resources is one of my primary duties, and we do prioritize our efforts. Having said that, to just roll over, because the odds are against us is, in my opinion,an abdication of our responsibility as the major advocacy organization on behalf of physicians and patients in New York State. We also have greater resources than many of our opponents and some of our physicians realize.

Saturday

I participated in the Annual Meeting and Board Training of the Board of Professional Medical Conduct, of the New York State Department of Health.  Dr. Rothberg and I were invited to participate in the training sessions by Dr. Bob Catalano, Executive Secretary of the BPMC, Dr. Art Hengerer, current Board chair, and Keith Servis, Director of the Office of Professional Medical Conduct.  Our invitation was the result of discussion between MSSNY and some of the BPMC members on examining ways that we might be able to help physicians prior to having a situation that requires the OPMC to sanction a physician. MSSNY already does much of this activity through our Committee on Physicians Health.

Physician Wellness

Our Committee on Physician Wellness and Resiliency believes we can create programs such as a Peer to Peer counseling program to reduce the chance of impairment farther upstream and reduce the chances of a physician becoming impaired. I believe Dr. Rothberg and I were effective in convincing the physicians on the Board of the need to identify and intervene for struggling physicians before they become impaired, and to promote programs to address physician burnout.  Our Medical Director for CPH, Dr. Jeff Selzer gave an excellent review of assessment of physician burnout.  Jeff had two particular points that hit home to me:

• Physicians need to create positive disruption in the healthcare system: Civil disobedience for quality and patient concerns and to promote physician wellness which is associated with better patient care.
• We need to change a culture which hides defects and promotes isolation for fear of repercussions.

Driving home after the meeting Saturday morning, I tried to synthesize the varied information that came in this week.  We do need to prioritize our activities.  MSSNY and our County Medical Societies are the vehicle to promote positive changes for the physicians and patients of New York State. Our Physician Wellness programs, advocacy for liability reform to change a culture of silence, continued efforts to improve the practice environment, and engagement of fellow physicians at the local level are key to make the practice of medicine a joy for physicians and provide great healthcare for the citizens of New York State. We will continue to engage with interested (as well as adversarial) groups to move forward.

You can help.  Contact me at comments@mssny.org to discuss how.

Excelsior!

Thomas J. Madejski, MD
MSSNY President

Read the Records of Your Local Legislators!
With the elections coming up in 10 days, MSSNYPAC has created a number of tools to assist physicians in evaluating the records of their local legislators. Please click here to read the list of candidates endorsed by MSSNYPAC and here to view our legislative scorecard evaluating the voting and co-sponsorship records of legislators on several pieces of legislation supported and opposed by the physician community.  

Sexual Harassment Webinar:
The Impact on the Healthcare System and the Medical Profession*
When: November 15, 2018
Time: 12:00pm-1:00pm

REGISTER HERE

The issue of sexual harassment in the workplace has been the center of a staggering amount of media attention and of a surge in litigation activity. Consistent with this momentum, New York State recently mandated that all employers are required to have a sexual harassment policy containing specified criteria in place by October 9, 2018, and to conduct sexual harassment prevention training by October 2019. (New York City requirements are slated to take effect in April 2019.)

The issue of sexual harassment takes on particular significance for the healthcare industry, because there is an established nexus between disruptive behavior, which includes sexual harassment, and adverse patient outcomes and medical errors.

As general counsel to MSSNY, Garfunkel Wild is offering society members ONLY a complimentary training webinar on November 15th from 12:00pm-1:00pm. This program fully satisfies the New York State requirements, and the individual society member who registers for this program will receive a certificate of completion. 

Garfunkel Wild also offers individual or group training, on-site or off-site training, as well as “train-the-trainers” sessions that can serve to satisfy this new statutory mandate for your employees. If you would like to set up a personal training, please contact Andrew L. Zwerling at 516-393-2581 or azwerling@garfunkelwild.com.

By the conclusion you will know:

• How to identify the more subtle forms of sexual harassment
• Your responsibilities as an owner of or supervisor at your medical practice.
• The impact of sexual harassment on the quality of care and the victim.
• Practical advice on how to diminish and prevent sexual harassment at your practice.
• Guidelines on how to comply with statutory mandates relating to sexual harassment.

REGISTER HERE

*In addition, a “Train the Trainer” tutorial will soon be available to members on the MSSNY website www.mssny.org. Learn what the requirements of this mandate are, and then instruct your staff in sexual harassment prevention.  Look for more information on this on-demand program soon. The deadline for providing staff training is October 9, 2019.

NY Workers’ Compensation Board Launches State-Of-The-Art Virtual Hearings
After successful pilot, injured workers and other participants can now choose to attend hearings remotely, avoiding travel burden

This week, New York State Workers’ Compensation Board Chair Clarissa M. Rodriguez announced the Board has launched a first-in-the-nation initiative that allows injured workers and other participants to attend workers’ compensation hearings right from their homes or offices. The Board’s virtual hearings provide injured workers a way to move the claim process forward without the need to travel many miles for a hearing that may last only minutes, which is especially beneficial depending on the extent of their injuries.

The New York State Workers’ Compensation Board developed virtual hearings in partnership with the Office of Information Technology Services to give all parties involved the option of using a smartphone, tablet or computer to attend hearings. This is the first high definition, all access system for legal hearings in the nation, where multiple users in different locations log in once and then move from one hearing to another.

To participate in a virtual hearing, the party of interest needs only a smartphone, tablet or computer with a microphone and video camera, as well as a high-speed internet connection. All participants can see and hear each other on their respective screens. Additionally, workers’ compensation law judges can share claim documents with all involved parties. The system includes security.

The Board is also developing a mobile app, for future release, that parties may download and use to attend hearings.

Many workers’ compensation hearings last less than 10 minutes, but injured workers can still lose time from work and suffer inconvenience traveling to Board offices. Weather-related complications can also make these trips difficult. Virtual hearings are entirely optional though, and parties may now choose them over attending a hearing at a Board office. They can always choose to attend in-person if they prefer.

Virtual hearings were first tested in the Capital District Office in Menands in November 2017, then rolled out across the state. Since the beginning of the pilot, more than 33,000 hearings have included at least one party who appeared remotely, successfully connecting injured workers, law judges and representatives from all over New York and nationally. The Board has trained more than 780 participants on the system, including law judges and other staff, attorneys and legal representatives. Feedback has been overwhelmingly positive.

More information on virtual hearings, including instructional videos and other training materials, is at www.wcb.ny.gov/virtual-hearings.

Nine Physician Specialties See Jump in Compensation
Physicians in nine specialties saw increases in total cash compensation from 2017 to 2018, with those specializing in general cardiology seeing the biggest jump in pay, according to a survey from SullivanCotter.

The survey includes data on nearly 167,000 individual physicians and advanced practice providers, with nearly 750 participating hospitals, health systems and medical groups.

Reported total cash compensation generally increased from 2017-18, averaging 1 percent to 4 percent. Out of 10 specialties listed, surgery (general) was the only specialty that did not see an increase in total cash compensation.

Here is the percent change from 2017-18 in total cash compensation for the nine other specialties in the survey:

1. Cardiology (general): 4.4 percent increase
   2. Emergency medicine: 4.3 percent increase
   3. Pediatrics (general): 3.7 percent increase
   4. Orthopedic surgery (general): 3.2 percent increase
   5. Hospitalist: 2.2 percent increase
   6. Internal medicine: 2.1 percent increase
   7. Family medicine: 2 percent
   8. Psychiatry (general): 1.4 percent increase
   9. OB-GYN: 1.4 percent increase

Medicare Fraud-Settlement Tops $22M for Vascular Access Centers
The U.S. Attorney’s Office for the Southern District of New York said it reached a settlement with Vascular Access Centers and its related entities in a federal lawsuit alleging Medicare fraud. VAC agreed to pay at least $3.8 million and up to $18.3 million over five years. The settlement was approved Oct. 19 by a federal judge.

The lawsuit had named centers located in several cities in New Jersey, including Jersey City and West Orange, as well as in 11 other states and Washington, D.C., as defendants.

According to a complaint filed in U.S. District Court for the Southern District of New York, VAC Centers provided surgical procedures such as fistula grams and certain types of angioplasties to view patients’ arteries and restore blood flow. Patients had end-stage renal disease and were enrolled in Medicare. The complaint alleged “the VAC Centers routinely performed fistula grams and angioplasties on ESRD patients who did not have the requisite ‘diagnostically specific and appropriate indications,'” and that VAC submitted Medicare claims for those procedures in violation of the False Claims Act.

“For years, Vascular Access Centers cheated taxpayers out of millions of dollars by billing Medicare for treatments that were clearly non-reimbursable and in some cases by falsifying medical records to make it seem as if its billings were justified,” Manhattan U.S. Attorney Geoffrey Berman said in a statement. “Through this settlement, VAC is being made to account for its misconduct.” (Pulse 10/24)

New Flu Drug Approved for First Time in Twenty Years
On October 24, the FDA for the first time in nearly 20 years, approved a new antiviral influenza drug, Genentech’s Xofluza. The drug is a single-dose treatment intended to treat individuals ages 12 and older with acute uncomplicated influenza who have demonstrated symptoms for no longer than 48 hours.

CDC: Drug Overdose Deaths Fell Over Last 6 Months
Fatal drug overdoses have fallen nationwide over the last six months, according to a CDC report. However, health experts warn against early claims of the opioid and drug epidemic ending.

Here are four things to know:

1. In the CDC’s most recent data for the 12-month period ending in March 2018, the agency reported a 2.8 percent decline in overdose deaths — representing an estimated 71,073 people — compared to the 12-month period ending in September 2017.

“After 40 years of this predictable growth pattern, we can hope that the curve is finally bending downward for good,” Donald Burke, MD, dean of University of Pittsburgh’s Graduate School of Public Health, told STAT in an email. “But history tells us to interpret these wobbles cautiously.”

2. From April 2017 to March 2018, the number of fatal opioid overdoses declined by 2.3 percent compared to the 12 months ending in September 2017. The decline is attributed to a drop in the number of overdose deaths from heroin and prescription opioids.
3. The CDC’s analysis also shows signs of increased drug deaths not attributed to opioids. Cocaine and stimulants, such as methamphetamine, kill more 10,000 people a year, the agency found.
4. Researchers do not know what is driving the decrease in overdose deaths, but said policy initiatives at the local, state and federal level might have something to do with it.

Fun Fact: The Most-Googled Health Problems by State
The medical condition U.S. patients Googled most frequently in 2018 was attention deficit hyperactivity disorder, or ADHD, with nine states searching for this condition more than any other health concern, a report from eligibility.com found.

Medicare Health Plans identified the most frequently searched medical conditions over the last year using Google Trends. The report authors then listed each of these conditions and ran them through Google Trends again to determine which states and the District of Columbia had the most searches for each condition.

Here are the most-Googled health problems by state for this year: Alabama — pneumonia; Alaska — UTI; Arizona — Hashimoto’s disease; Arkansas — endometriosis;
California — syphilis; Colorado — syphilis; Connecticut — quarter-life crisis; District of Columbia — HIV/AIDS; Delaware — hypertension; Florida — HIV/AIDS; Georgia — syphilis;
Hawaii — Hashimoto’s disease; Idaho — Escherichia coli; Illinois — syphilis; Indiana — ADHD; Iowa — binge drinking; Kansas — diabetes; Kentucky — hepatitis A; Louisiana — HIV/AIDS; Maine — rabies; Maryland — ADHD; Massachusetts — ADHD; Michigan — endometriosis; Minnesota — hemorrhoids; Mississippi — genital herpes; Missouri — ADHD; Montana — hypertension; Nebraska — anorexia; Nevada — skin cancer; New Hampshire — ADHD; New Jersey — breast cancer; New Mexico — PTSD; New York — breast cancer; North Carolina — ADHD; North Dakota — ear infection; Ohio — syphilis; Oklahoma — diabetes; Oregon — HIV/AIDS; Pennsylvania — syphilis; Rhode Island — lupus; South Carolina — endometriosis; South Dakota — insomnia; Tennessee — strep throat; Texas — ADHD; Utah — Hashimoto’s disease; Vermont — opioid use disorder; Virginia — ADHD; Washington — body dysmorphia; West Virginia — porn addiction; Wisconsin ADHD; Wyoming — flu

Amazon, Apple Opening On-Site Clinics for Employees
More large companies are opening on-site medical clinics for employees as they aim to control their healthcare spending, according to an employer survey conducted by Mercer and the National Association of Worksite Health Centers.

The survey results showed growth in the prevalence of on-site clinics providing health services for employees, particularly among large companies. Thirty-three percent of companies with 5,000 or more employees offer general medical clinics at their worksite, and an additional 11 percent of employers of this size are considering adding a clinic by 2019. That represents a significant increase from 2012, when 24 percent of large companies offered on-site clinics.

Amazon is reportedly launching a primary care clinic for a small number of employees at its headquarters in Seattle. After considering outsourcing clinic operations and hearing proposals from vendors, Amazon decided to develop the clinics internally. Meanwhile, Apple is hiring for AC Wellness, a group of health clinics for its employees and their families. Amazon, Apple and other large companies are opening clinics as a way to control healthcare costs. The majority (89 percent) of those who responded to the Mercer and NAWHC survey said their top objective for their clinics is having better control of their overall healthcare spending. (Becker’s Hospital Review, Sept.)

“Cybersecurity: A Daily Threat for Healthcare” CME webinar on Nov. 14, 7:30am
Registration now open
Is your office protected against a cybersecurity event?  Studies show that 88% of all ransomware attacks in 2017 occurred within the healthcare industry and 89% of studied healthcare organizations experienced a data breach.  Learn how to protect yourself, your patients and your workplace on November 14^th at 7:30am.  Register here for Medical Matters: Cybersecurity: A Daily Threat for Healthcare.  Mahesh Nattanmai, Deborah Sottolano, PhD of New York State Department of Health and Peter Bloniarz of the New York State Cyber Security Advisory Board will serve as faculty for this program.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

• Describe vulnerabilities within medical practices, hospitals and daily life
• Identify methods to increase protection from cyberattacks
• Review methods for reporting and responding to a cybersecurity incident

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Reminder: Register Today for the Physician Compare National Provider Call
CMS will host a MLN Connects® National Provider Call about Physician Compare on October 30, 2018 at 1:30 – 3:00 PM ET. Learn more about Physician Compare and the public reporting of 2017 Quality Payment Program performance information. The Physician Compare preview period allows clinicians and groups to review their performance information before it is publicly reported on the Physician Compare website.

This webinar will describe:

• What to expect during the upcoming 30-day preview period and
• How to navigate previewing your performance information

There will be a question and answer session after the presentation, during which attendees will have a chance to ask the Physician Compare team questions about Physician Compare.

Register today

If you have any questions, please contact us at PhysicianCompare@Westat.com