MSSNY eNews September 25, 2020 – Gender Equality in Medicine: The Next Step Forward

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Gender Equality in Medicine:  The Next Step Forward

September is Women in Medicine Month and a good time to reflect on gender equity in our organization and in healthcare as a whole.

The Medical Society of the State of New York was established in 1807. However, it was nearly 2 centuries later, in 2002 before a female, Dr. Ann Cea was elected as president of our society. Fortunately, this is proving to be a century of change with Dr. Leah McCormack elected in 2010 and my election in 2020.

Supreme Court Judge Ruth Bader Ginsburg died this week but her legacy lives on in her court decisions that push us closer to the attainable goal of societal gender equity.  When Justice Ginsburg attended Harvard Law School in the 1950s, she confronted gender barriers including faculty members suggesting she was “taking a man’s spot.” Although I graduated medical school more than 30 years after Justice Ginsburg graduated law school and my medical school class was nearly 50% female, I still encountered comments about “being pretty good for a female” and some 50 years later still heard some profess that “men have families to support” as justification for pay inequity. 

MSSNY Women Physicians Committee Addressing Issues and Concerns

In MSSNY over the last few years we have made strides forward with the formation of the Women Physicians Committee in 2018 which is tasked with addressing women physician’s issues and concerns, including women’s health issues, work/life balance, pay disparities, sexual harassment, representation in leadership roles, and family-friendly employment policies.  In 2019, the committee put forth two resolutions to our MSSNY House of Delegates, Resolution 216, Advancing Gender Equity in Medicine and 217 MSSNY Policy on Gender Equity in Medicine. 

The passage of these resolutions was a step forward but over the next few years the committee will be working on the even more difficult task of bringing these ideas and directives to fruition, putting appropriate structures in place, process measures, and developing and monitoring outcomes.

Justice Ginsburg through her legal prowess helped to move the needle away from gender bias and narrow, gender-based expectations.  It is now up to us to lead our medical society and profession in that same direction so that pronouns don’t define or limit our careers or our health.

Bonnie Litvack, MD
MSSNY President

Mandatory OPMC Signage Legislation Delivered to Governor; Please Urge Veto
All physicians are urged to contact Governor Cuomo to request that he veto legislation (S.6678-A/A.7991-A) requiring every physician’s “practice setting” to post a sign regarding how a patient can file a misconduct complaint with the OPMC.  The bill was delivered to Governor Cuomo’s desk today, which means he has until Wednesday, October 7 to sign or veto.  You can send a letter and tweet to the Governor opposing this baffling legislation here.

Let the Governor know that this proposal would create unnecessary distrust in the physician-patient relationship and unfairly singles out physicians for this requirement as opposed to any other type of professional. This legislation is also unnecessary because information regarding how best to file such a complaint is already easily available through a simple Google search.  Moreover, with nearly 10,000 complaints already made each year to OPMC (resulting in only a few hundred actual disciplinary actions), it is clear there is already strong public awareness of this oversight body.

MSSNY Weekly Legislative Podcast

Separately, we are urging all physicians to send a letter to the Governor urging him to veto adverse legislation that would require all physician practice settings to post a notice showing the weblink for how a patient can file a complaint with the OPMC.  The bill was delivered to the Governor today for his consideration.  You can send a letter here.

Cuomo Says Task Force Will Review Safety of Vaccines Prior to Distribution
A new independent task force will review the safety of all COVID-19 vaccines authorized by the federal government and will plan their distribution in New York, Gov. Andrew Cuomo said Thursday.

Key context: Cuomo, who has raised concerns that the Trump administration could prematurely advance a vaccine ahead of the November election, said the task force will guide New York’s next steps in procuring and administering vaccines it deems to be safe and effective against the coronavirus.

The details: Cuomo said the review committee will also come up with a vaccine distribution and implementation plan that looks at: Prioritization based on clinical guidance; distribution network; qualified administration; data and IT infrastructure; and public education and procurement.

The goal of the panel — headed by the Department of Health and composed of scientists, doctors and health experts — is to ensure that New York has the best vaccination program in the nation, the governor told reporters at a morning news conference.

“I think the way we have handled COVID has been a model for this country. I want New Yorkers to do the same thing with vaccines,” he said. “We should be the model vaccination program in the country. I also think there’s a tremendous advantage for any state that could be the first COVID-free state.”

Dr. William Valenti will be representing MSSNY on this Task Force. Dr. Valenti is Clinical Associate Professor of Medicine (Infectious Diseases) at the University of Rochester School of Medicine in New York. He is Chair of the Infectious Diseases subcommittee of the Medical Society of the State of New York and Fellow of the Infectious Disease Society of America. Dr. Valenti stated, “I am delighted and honored to represent MSSNY in this effort. “

Background: Cuomo said in late August that his administration was reviewing whether DOH would have the authority to overrule FDA approval of a COVID-19 vaccine that’s not fully vetted. The governor later doubled down on that assertion, saying New York would not endorse a federally backed Covid-19 vaccine until it was reviewed by state health officials. (Politico Pro, 9/24)

Commissioner’s Sept. 30 Medical Grand Rounds: NYSDOH Update on COVID-19
We are excited to share the marketing materials for a special session of our 2020-2021 Commissioner’s Medical Grand Rounds series, which will take place on Wednesday, September 30^th. This session, entitled NYSDOH Update on COVID-19: Current Knowledge and Best Practices for Primary Care During the COVID-19 Pandemic, we will bring together providers from various perspectives to discuss the unique and ongoing challenges in addressing primary care needs during a pandemic.

Two primary care physicians who responded to the COVID-19 crisis in some of the earliest and hardest-hit areas of New York will discuss their experiences, recommendations, and lessons learned. Our speakers will discuss the most up-to-date, evidence-based best practices for delivering care, addressing patient needs, and COVID-19 testing. A flyer is attached—please feel free to share liberally among your network.

This virtual session will take place on Wednesday, September 30^th from 1:30 – 3:00pm, and will be streamed via live webcast. The session will also be archived on the NYSDOH Website. The event is free-of-charge and open to all interested providers across New York State. The link to register can be found here.
Click here for the flyer.

Half of Physicians Report Anger, Anxiety Over Pandemic: 5 Survey Findings
The COVID-19 is placing a heavy burden on U.S. physicians, with many reporting feeling hopeless, angry or burned out, according to a survey from the Physicians Foundation.

The foundation surveyed 2,334 physicians nationwide Aug. 17-25 about how the pandemic has affected their well-being. Thirty-six percent of them practiced primary care, and 64 percent were in other specialties.

Five survey findings:

1. Half of physicians said they have experienced inappropriate anger, tearfulness, or anxiety over how the pandemic is affecting their practice or employment.
2. Thirty percent said they feel hopeless or that they have no purpose due to the pandemic’s effects on their practice or work.
3. Fifty-eight percent of physicians expressed feelings of burnout, up from 40 percent in 2018.
4. A majority of respondents (78 percent) cited the public’s lack of compliance with social- distancing measures or mask-wearing was their biggest source of frustration amid the pandemic.
5. Thirteen percent of physicians have sought care for mental health issues related to the pandemic.View the full survey here.

MSSNY is a signatory medical society member of The Physicians Foundation.

During COVID-19, Lung Cancer Screening Declined
The COVID-19 pandemic has caused disruption across cancer care, including the declines in lung cancer diagnoses across the US. As MSSNY’s physicians continue to balance treating COVID-19 patients and conducting routine health diagnostics, they may have noticed a decline in the number of patients receiving lung cancer screenings. Now more than ever, it is important to remind everyone to continue seeking care during COVID-19 because, even in the face of a global pandemic, cancer won’t wait.

To help raise awareness around the decline in lung cancer diagnoses and its impact on patient care, AstraZeneca has developed a toolkit of resources that physicians can use to communicate with individuals about the importance of continuing to seek care and keeping in close contact with their doctor teams during the pandemic.

It is crucial that everyone, particularly those at risk for lung cancer, remain watchful for any new symptoms and contact their health care provider for evaluation and treatment, if warranted. Recent data show that states have been experiencing declines in the number of lung cancer diagnoses by an average of 30%-60% as of May 2020 – (55% decline for New York in May 2020).

It is important to help people understand that this decline does not mean that fewer people are getting lung cancer. Rather, more people are going undiagnosed, many of whom will end up finally presenting with a more advanced stage of the disease when outcomes are poorer.  The toolkit can be accessed here.

Colleges Reopened: How Many COVID Cases Resulted? What New Study Found
Reopening colleges and universities for in-person instruction has been linked to tens of thousands of additional cases of Covid-19, according to a draft study released Tuesday. For the study, which was published preprint on medRxiv and has not yet been peer reviewed, researchers from the University of North Carolina-Greensboro, Indiana University, and the University of Washington and Davidson College examined whether the reopening of 1,400 U.S. colleges and universities affected rates of COVID-19, the disease caused by the new coronavirus, in the surrounding counties.

To determine the impact, the researchers examined cellphone GPS tracking data, county-level Covid-19 data, and campus reopening schedules from July 15 to Sept. 13, which is before and after students returned to their schools. The researchers focused their study on how colleges and universities implemented classes and not on student behavior.

The researchers found the reopening of colleges and universities for in-person instruction correlated with an increase in new cases of Covid-19, ranging from a minimum of nearly 1,100 extra cases per day to a maximum of 5,300 extra cases per day. The researchers estimated 3,200 additional Covid-19 cases per day—or 2.4 cases per 100,000 residents a day—as the midpoint range for the projected daily increase in infections.

The researchers found reopening one university alone for in-person instruction led to an additional 1.7 new cases per day per 100,000 residents in a county. However, the researchers said they found “[n]o such increase … in counties with no colleges, closed colleges or those that opened primarily online.”

According to the Journal, the researchers found a slight uptick in new Covid-19 cases in communities where students moved near their college campuses but took their classes online. When the researchers factored in whether students had traveled from places with high disease incidence rates, they found neighboring counties added 1.2 coronavirus cases per day per 100,000 residents, Kaiser Health News (KHN) reports.

Ana Bento—an assistant professor of infectious diseases at Indiana University, who co-authored the study—noted that, “[w]hile this study estimates around a 3,000 increase in daily cases, we have to take into account that this is actually likely an underestimate, because we still don’t see” people with Covid-19 who are asymptomatic.

Discussion

Some observers applauded the study, but others said it left many unanswered questions.

For example, the study did not determine whether cases spiked mainly as a result of students catching Covid-19 when they arrived at their campuses or if they were already unknowingly infected upon their return, KHN reports. In addition, Jason Christie, a pulmonologist and epidemiologist at the University of Pennsylvania’s Perelman School of Medicine, said the study may have missed some of the other underlying factors driving up infections rates, including trends unrelated to the reopening of college and university campuses.

Bento acknowledged some of the uptick in cases could be potentially attributed to increase in coronavirus testing in counties where students returned to campus for in-person instruction. However, in such an event, Bento said the researchers would have likely seen a quick rise in infections and then either a plateau or decline, instead of an increase two weeks after schools reopened and a continued surge.

Bento added that it would be “slightly unfair” to assume that cases spiked because students did not follow social distancing guidelines or engaged in other “bad behaviors.” Bento said, “I think it’s more this idea of when you see a huge influx from all over the country, or from different counties, into a college town that we know had a very low burden of COVID throughout the first months, all of a sudden we have this increased probability of infection, because we have a large community of individuals that were susceptible still.”

As colleges and universities prepare for the spring semester, Bento recommended administrators consider a variety of instructional approaches. “In order for you to open online, hybrid or meet face to face, there needs to be a different combination of strategies that allows you to catch [cases] early so you’re able to control community spread, which is the biggest problem here,” Bento said (McAuliff, Kaiser Health News, 9/23; Korn/Abbott, Wall Street Journal, 9/22; Budryk, The Hill, 9/22).

U.S. Medical School Applications Soar in COVID-19 Era
Global pandemic is prompting more young people to become doctors.

NYU said applications have jumped since it said in 2018 that it would make medical school free. Medical schools are reporting record application numbers as the coronavirus sparks a new wave of prospective students to become doctors.

Through the end of August, the number of applicants rose nearly 17% from a year earlier, marking an interest not seen in more than a decade, according to the Association of American Medical Colleges, which administers the main medical-school entry exam. Compared with past years, this year’s numbers are unprecedented, said Patrick Fritz, a senior director with AAMC.

Coronavirus has put a spotlight on health professions, prompting young people to apply to medical school earlier than they might have before, schools and admissions coaches said. Some applicants may be looking to take advantage of less strict application requirements this year. Many schools have dropped the Medical College Admission Test, or MCAT, exam requirement, or have pushed application deadlines further into the fall. In a year of massive job losses, some may be lured by what appears to be a stable career path. (WSJ Sept. 2)

CMS Unable to Disburse Incentive Payment Due to Inaccurate Billing Info
For the second year in a row, CMS is again unable to disburse the 5% APM incentive payment to some clinicians due to inaccurate or outdated billing information. This Medicare incentive payment should have been disbursed earlier this year to clinicians who participated in Advanced APMs and met all criteria to become “qualifying APM participants” under the 2018 Quality Payment Program.

Of the 183,306 clinicians who qualified nationally, CMS is unable to verify billing information for 22,256 clinicians, up from 2,767 last year. This number seems high and is very concerning. Of note, the incentive is paid in one lump sum and given the COVID-19 circumstances, I’m sure many clinicians desperately need that money. According to the attached QPP notice, CMS is giving clinicians until Nov. 10 to update their billing information and claim their incentive payment by email.

Please see the attached APM Incentive Payment Notice here.

Please see the excel spreadsheet for affected NPIs and names involved here.

Employee Sick Leave Requirements Go into Effect September 30 for 2021 Use
Earlier this year, the New York State Legislature enacted a new law that requires all New York employers to provide sick leave to employees. The legislation becomes effective next week, September 30. The amount of sick leave an employer is required to provide depends on the size and net income of the employer:

• Employers with 4 or fewer employees and a net income of $1 million or less in the prior tax year must provide employees with up to 40 hours of unpaid sick leave in each calendar year;
• Employers with 4 or fewer employees and a net income of greater than $1 million in the prior tax year must provide employees with up to 40 hours of paid sick leave in each calendar year;
• Employers with between 5 and 99 employees must provide up to 40 hours of paid sick leave in each calendar year; and
• Employers with 100 or more employees must provide up to 56 hours of paid sick leave in each calendar year.

Employees begin to accrue paid sick leave when the law goes into effect (September 30) or upon the employee’s date of hire, whichever is later. Although employees may begin accruing leave prior to January 1, 2021, employers are not required to begin to allow employees to take sick leave until January 1, 2021.

For summaries of this new law, click here: NEW YORK ENACTS PAID SICK LEAVE REFORM 
Into Effect September 30 for 2021 Use

Bassett Healthcare Network Appoints MSSNY Members to New Positions
The Bassett Healthcare Network CEO has made the following three appointments:

(Top-Left) Joseph Sellers, MD, will become the Physician Executive for the Bassett Medical Group (BMG). Dr. Sellers has been an attending physician at Bassett in Internal Medicine and Pediatrics since 1989. He became an area medical director for Primary Care in 1996, and in 2013 became the Eastern Region Medical Director with responsibility for 20 primary care sites and 90 practitioners.

In his role as physician executive for the BMG, Sellers will have oversight of all strategic and operational elements of the BMG and foster physician engagement while driving enhanced quality at all medical group practices. Dr. Sellers will also continue to see patients at Bassett’s Cobleskill primary care center. Dr. Sellers is the current President-Elect of MSSNY.

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(Top-Right) Henry Weil, MD, will take on the added responsibilities of Chief Academic Officer for Bassett Healthcare Network. The newly created CAO position is essential to Bassett Healthcare Network’s strategic development and will enhance an existing, strong academic and research foundation.

Dr. Weil is a professor of clinical medicine and senior associate dean for the Bassett affiliation at Columbia’s College of Physicians and Surgeons. He has served in a variety of other capacities including director of the Internal Medicine Residency Program, assistant physician-in-chief, medical director for inpatient services, director of medical informatics, and director of the intensivist and hospitalist programs.

In addition to his role as CAO, Dr. Weil will retain his responsibilities within the Columbia-Bassett Medical School program and work collaboratively with other Bassett leaders and educational and research partners to develop and implement plans for innovation and growth of the education and research missions at Bassett.

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(Bottom) Nicholas Hellenthal, MD, will take on the added responsibilities of Chief Medical Officer for the Bassett Medical Group in addition to continuing to serve as chief of surgery. Dr. Hellenthal has been with Bassett since 2010, has been chief of the Department of Surgery since 2015, and was interim chief since 2013.

In this part-time role as CMO, Dr. Hellenthal will work closely with the BMG physician executive to improve practitioner and patient experience and patient access. He will also be working with each of the medical chiefs to drive evidence-based protocols across all services and leveraging analytics to reduce clinical variation.

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Classifieds

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows. A world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.

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UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

Consult Room

Exam Room

 

 

 

Waiting Room

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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com