MSSNY eNews: November 12, 2021- 61% of Physicians Reported Burnout in 2021, Survey Finds

Good News on the Vaccine Front

Colleagues:

It’s been a good couple of weeks on the vaccine front. Within the span of two days at the end of October, the U.S. Second Circuit Court of Appeals upheld Governor Hochul’s COVID-19 vaccine mandate for New York healthcare workers, and the FDA announced emergency use authorization of the Pfizer vaccine for children between the ages of 5 through 11.

Getting our children, grandchildren—and all adults—vaccinated against COVID-19 opens our path back to normalcy. And that cannot come soon enough for this grandfather. Last week my eight-year-old granddaughter and five-year-old twin grandson and granddaughter were excited to get their COVID-19 vaccinations. My daughter sent a picture of the three of them—and their excitement was apparent in their smiling faces and their flexed muscles. We all hope that they will see an end to this pandemic and a return to their normal childhood activities.

Likewise, our MSSNY delegates and our county medical societies have had in-person meetings curtailed for two years in a row.  We have missed out on celebrating the 200th anniversaries of several county medical societies. Despite the challenges, we have, at both the county and the state level, continued to do our work to support and protect the medical profession and patients we serve.

I look forward to the time soon when we can all meet in person and renew our bonds of friendship, to celebrate our achievements, and to plan for even more success in the future.

Joseph Sellers, MD, FAAP, FACP
MSSNY President


2021 Survey of America’s Physicians COVID-19 Impact Edition:
A Year Later

Physicians Foundation | June 2021

The Physicians Foundation released 2021 survey results examining how the COVID-19 pandemic has affected the nation’s physicians. The report is based on responses from 2,504 physicians collected between May 26 and June 9, 2021. The survey found that 61% of physicians reported experiencing burnout in 2021, up from 40% in 2018, prior to the pandemic. Some additional key survey findings include:

  • Slightly more employed physicians (64%) reported burnout compared to independent physicians (57%).
  • Primary care physicians were slightly more likely (66%) than medical and surgical specialists (59%) to report burnout.
  • A significant majority of female physicians (69%) reported often feeling burned out, compared to 57% of their male counterparts.

More than half of all physicians surveyed (57%) reported inappropriate feelings of anger, tearfulness or anxiety because of the COVID-19 pandemic, while 14% of physicians said they have received medical attention for a mental health problem and 20% of respondents reported knowing a colleague who has either considered, attempted or died by suicide during the pandemic.


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Are You Feeling Overwhelmed by Chronic Stress? MSSNY’s Peer-to-Peer Program is Here to Help
Stress and burnout among physicians have been well documented for years. The COVID-19 pandemic is exacerbating the public health problem of physician burnout in New York state. Throughout the pandemic, physicians and other health professionals have faced concerns about safety, overworking and feelings of loss.

Without an intervention, it is possible that a high number of physicians over the next few years may develop chronic stress reactions, anger, clinical depression, substance abuse, post-traumatic stress disorder and suicidality.

MSSNY’s P2P program Co-Chairs Dr. Frank Dowling and Dr. Charles Rothberg were interviewed recently about the program. Watch the interview here.

If you wish to become a trained peer supporter, please reach out to Cayla Lauder, Program Coordinator, at clauder@mssny.org. If you or someone you know is struggling with everyday life stressors, email  P2P@mssny.org or call 1-844-P2P-PEER (1-844-727-7337) to be connected with a peer supporter to help.


Healthcare Associations Continue to Press HHS to Revise Insurer-Biased Interpretation of “No Surprises Act”
MSSNY thanks the several members of the New York Congressional Delegation who joined a letter co-authored by Rep. Tom Suozzi (D-Long Island) and others to various federal agencies in response to the Interim Final Rule (IFR) implementing components of the No Surprises Act (NSA) passed by Congress last December.   The letter urges Congress to amend the IFR to synchronize the law’s implementation with the NSA. Instead of following the statutory language included within the NSA, HHS and other federal agencies designed an Independent Dispute Resolution (IDR) process for resolving out of network surprise medical bills that heavily favors health insurance companies in payment disputes by prioritizing health insurer median contract rates over other factors.

In addition to MSSNY, the rule has also been criticized by numerous national and state medical organizations, including the AMA, the American Hospital Association (AHA), and numerous specialty societies. The Congressional intent articulated in the NSA was to create an IDR process to protect patients that was appropriately balanced and did not favor either the insurer or the physician in claims disputes. Specifically, the final language adopted by Congress required that numerous factors be considered, including patient acuity or complexity of services, demonstrations of previous good faith efforts to negotiate in-network rates and previously contracted rates, in addition to the insurers’ median in-network rate, without specifying that one factor takes precedence over another.

Recently, the Texas Medical Association (TMA) filed a lawsuit in a federal district court in Texas, arguing that the federal agencies: 1) improperly failed to follow direction from Congress about how to implement the IDR process set forth in the NSA and 2) violated the Administrative Procedure Act by failing to appropriately solicit and incorporate comments from stakeholders. Other medical associations are strongly considering taking similar action.

Regardless of the outcome of this litigation, the provisions of the NSA creating an IDR process for non-state regulated surprise medical bills will take effect on January 1, 2022.  Moreover, there are many other components of the NSA that will take effect on 1/1/2022 that create significant new obligations on the health care industry, including enhanced requirements on medical practices to provide updated information to health insurers for their directories, as well as detailed disclosure requirements for providing Good Faith Estimate (GFE) of expected medical charges to patients who are insured or are self-pay.

Please remain alert for further updates. Following is information about these new requirements:

Requirements Related to Surprise Billing; Part II Interim Final Rule with Comment Period | CMS

Key Details of the No Surprises Act IFR (natlawreview.com)

Government Issues No Surprises Act Interim Final Rule with Comment Period (Part II) | Blogs | Health Care Law Today | Foley & Lardner LLP

Initial AMA Summary of Interim Final Rule (Part 2): Requirements Related to Surprise Billing | AMA (ama-assn.org)

The NY Delegation Members Who Signed the Suozzi-Wenstrup Letter

  1. Yvette Clarke (D- Brooklyn)
  2. Adriano Espaillat (D- Manhattan)
  3. Brian Higgins (D- Buffalo)
  4. Chris Jacobs (R- Western New York)
  5. John Katko (R- Central New York)
  6. Nicole Malliotakis (R- Staten Island)
  7. Carolyn Maloney (D- Manhattan)
  8. Sean Patrick Maloney (D- Newburgh)
  9. Grace Meng (D- Queens)
  10. Joe Morelle (D- Rochester)
  11. Tom Reed (R- Corning)
  12. Kathleen Rice (D- Long Island)
  13. Elise Stefanik (R- Plattsburgh)
  14. Tom Suozzi (D- Long Island)
  15. Ritchie Torres (D- Bronx)


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Contact Your Representatives of Congress to Prevent Staggering Medicare Cuts in 2022
With CMS announcing its final rule for the 2022 Medicare physician fee schedule last week, physicians are urged to contact their member of Congress to prevent payment cuts approaching 10%. Tell Congress to cancel Medicare cuts today!

Of significant consequence the 2022 Medicare conversion factor will be reduced by approximately 3.75% as a result of the expiration of an increase to the conversion factor enacted by Congress last December.  In addition, there is a 2% cut as a result of the scheduled re-implementation of the previously delayed Medicare sequester provisions, and imposition of a 4% Statutory PAYGO sequester resulting from passage of the American Rescue Plan Act. Should lawmakers fail to act, it will result in a cumulative Medicare payment cut of nearly 10%.

Earlier this fall, Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) circulated a “Dear Colleague” letter highlighting the financial uncertainty within the Medicare payment system and the dangers facing patient care if Congress fails to enact legislation to prevent this staggering cut. Within a matter of weeks 245 of their colleagues showed their support for fixing the problem of these extreme Medicare cuts by co-signing the letter, including many of the members of the New York Congressional delegation.

The 2022 payment rule also finalized provisions that extend coverage of services that were added to the Medicare telehealth list on an interim basis in response to the COVID-19 public health emergency until the end of 2023 and eliminated geographic barriers, allowing patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders. In addition, CMS announced plans to permanently increase payment for immunization administration, beyond COVID vaccines, and relied on information from the AMA and the RUC in developing the improved payment rates. CMS is also moving forward with the first round of seven MIPS Value Pathways (MVPs) that will be available, beginning with the 2023 performance year.

Text of the proposed rule (Tables 136 and 149 show the specialty-by-specialty impact of the payment rule).

CMS Press Release

Physician Fee Schedule Fact Sheet

Excel sheet of the added/deleted CPT codes with AMA’s recommendation for replacement codes


 

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AIDS Institute’s Office of the Medical Director for a Public Health Physician II
Health Research, Inc. (HRI) has a job opening within the AIDS Institute’s Office of the Medical Director for a Public Health Physician II. Please distribute this announcement widely through your networks. Interested individuals can apply for this position through the HRI website.