| call_for_nominations_2020_ama_mss_meeting_scholarships | Call for Nominations: 2020 AMA-MSS Meeting Scholarships | Latest_News | Shared_Content/News/Latest_News/2019/November/call_for_nominations_2020_ama_mss_meeting_scholarships | <div class="col-md-12">
<div class="col-md-5 pull-right"><img alt="" src="/images/News/AM_2018.10.241-645x425px.jpg" class="pull-right" /></div>
<h5>November 11, 2019</h5>
<h2>Call for Nominations: 2020 AMA-MSS Meeting Scholarships</h2>
<p>
The WSMA is accepting nominations for three medical student scholarships to attend the 2020 AMA Medical Student Section's annual (June 4-6 in Chicago) and interim (Nov. 12-14 in San Diego) meetings.
</p>
<p>
The scholarships provide funding to support three WSMA medical student members, one each from the University of Washington School of Medicine, the Elson S. Floyd College of Medicine at Washington State University, and the Pacific Northwest University of Health Sciences, to attend both meetings. The funding allocation is up to $1,000 per student, per meeting.
</p>
<p>
To qualify, nominees must:
</p>
<ul>
<li>Be an active WSMA and AMA member medical student in good standing at the time of nomination</li>
<li>Have the support of the WSMA's Medical Student Section governing council. </li>
<li>Demonstrate a strong interest and involvement in health care policy.</li>
<li>Possess excellent communication skills and willingness to advocate for patients and the profession.</li>
<li>Be committed and able to attend both meetings as a representative of the WSMA.</li>
<li>Be willing to provide a written report to the WSMA's executive committee and verbal report to WSMA Early Career Sections' governing councils about their experience at the AMA meetings.</li>
</ul>
<p>
Nominate yourself or a colleague using the online survey tool at the link below. You'll be prompted for a personal statement of interest and your CV; letters of recommendation are welcome but not required. The deadline for nominations is Wednesday, Nov. 27.
</p>
<p>
The WSMA Medical Student Section governing council will review all submissions and submit a slate of nominees to the WSMA executive committee for consideration and final decision at its February 2020 meeting.
</p>
<p><a href="https://www.surveymonkey.com/r/X63MV9C">Click here to apply</a></p>
</div> | 11/11/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |
| winter_wsma_leadership_courses_now_enrolling | Winter WSMA Leadership Courses Now Enrolling | Latest_News | Shared_Content/News/Latest_News/2019/November/winter_wsma_leadership_courses_now_enrolling | <div class="col-md-12">
<div class="col-md-5 pull-right"><img src="/images/Events/PLC-Swedish-Dec.%202019-645x425px.jpg" class="pull-right" alt="Physician Leadership Course" /></div>
<h5>November 6, 2019</h5>
<h2>Winter WSMA Leadership Courses Now Enrolling</h2>
<p>
Applications are now being accepted for two of our core leadership trainings scheduled for this winter: The popular WSMA Physician Leadership Course, our hybrid online/in-person education designed for busy physicians and physician assistants who want to learn more about leadership, and the WSMA Dyad Leadership Course, a three-day workshop for physicians and their administrative partners.
</p>
<h3>Physician Leadership Course</h3>
<p>
The <a href="[@]WSMA/Resources/Physician_Leadership/Physician_Leadership_Course/Physician_Leadership_Course.aspx">WSMA Physician Leadership Course</a> is a 40+ hour hybrid-distance leadership skills-development course for physicians and physician assistants who want to know more about health care leadership. Designed with a physician's busy schedule in mind, only three in-person classes are required; the remainder of the course is conducted online.
</p>
<p>
The winter 2020 Physician Leadership Course will be held Jan. 31-April 17. The in-person classes will be held Friday and Saturday, Jan. 31 and Feb. 1 in Seattle. Course participants will then have eight weeks of online instruction and interaction, finishing with a third in-person session on Saturday, April 17.
</p>
<p>
This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. Deadline for enrollment is Nov. 29.
</p>
<h3>Dyad Leadership Course</h3>
<p>
The <a href="[@]WSMA/Resources/Physician_Leadership/Dyad_Leadership_Course/Dyad_Leadership_Course.aspx">WSMA Dyad Leadership Course</a> is our three-day, in-person educational workshop for physicians and their administrative dyad partners who wish to improve team function and achieve greater operational success within their clinical system. The course is adapted to fit the specific clinical culture of participating teams.
</p>
<p>
The winter 2020 course will be held Feb. 14-March 13. The in-person classes will be held Friday and Saturday Feb. 14 and 15 in Seattle. Course participants will then have four weeks of online instruction and interaction, finishing with a third in-person session on Friday, March 13.
</p>
<p>
To enroll in the WSMA Dyad Leadership Course, physicians must first complete the WSMA Physician Leadership Course. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. Deadline for enrollment is Dec. 13.
</p>
</div> | 11/6/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |
| cognitive_dissonance | Cognitive Dissonance | Latest_News | Shared_Content/News/Latest_News/2019/November/cognitive_dissonance | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/Nov-Dec-2019-Reports-645x425px.jpg" class="pull-right" alt="WSMA Reports November/December 2019" /></div>
<h5>November 5, 2019</h5>
<h2>Cognitive Dissonance</h2>
<p>
</p>
<p>
By Pat Curry
</p>
<p>
For 10 years, Carl Berliner, MD, has been a solo family practitioner. He runs his practice out of a renovated house in Mt. Vernon, a community of 30,000 known for its annual tulip festival. His patients range in age from two days old to their late 90s. It brings him great joy, he says, to have delivered a third of them, many of whom call him "Dr. B."
</p>
<p>
Being a solo practitioner gives him what he calls "agency," the ability to control his day and his practice. A lot of physicians traded agency for better pay "and now they wish they hadn't," he says.
</p>
<p>
"It's just enormous, that ability to make extra time in your schedule and treat patients the way you think you should. … I always have this joke that I'm the last happy doctor in Washington. I live frugally enough that I weather these insanities. 'Cognitive dissonance' is the term I use."
</p>
<p>
The dissonance comes from trying to make enough money to keep the doors open.
</p>
<p>
"I don't like to talk about finances, but we are a business and have to pay bills and pay staff," he says. "We say we want healthy families, then make that almost impossible to happen. … Keeping up with the rules and fighting over every $14 charge is very discouraging. In the execution, you feel like you've been run over by a tractor."
</p>
<p>
And then there are the day-in and day-out challenges in getting approval from insurers to perform even the most standard levels of medical care.
</p>
<p>
"Prior authorization is an enormous time suck," he says, "and it's a reason why so many [physicians] are demoralized. At the end of the day, I don't leave with a smile because for six of the drugs I prescribed, I needed to click another radio button. I had a pregnant woman I prescribed prenatal vitamins for and the insurance company required prior authorization. On the form, I wrote, 'You are the worst insurance company ever.' "
</p>
<h3>Difficult decisions with few options</h3>
<p>
Without relief, some physicians have found that they have no choice but to shut down and go on someone else's payroll. In August, Cascade Family Medical Clinic in Centralia closed after more than 40 years.
</p>
<p>
Eric DeMun, MD, and Christopher Yarter, MD, posted on the clinic's website that the practice was "one of a shrinking group of small, independent primary care clinics that is suffering from increasing administrative burdens, rising costs of health care delivery, and a reimbursement system that has not kept pace with these costs. We have been unable to recruit physicians to partner with us in the face of these changes and have been unsuccessful in finding larger companies willing to buy the practice and keep it open."
</p>
<p>
Many physicians in small practices in Washington state face the same kind of gut-wrenching decisions. Eric Frankenfeld, MD, FACE, FACP, is an endocrinologist in solo practice in Bellingham, a physician-shortage area. This summer, he sweated out a lease renewal; the rent increase would determine if he stayed in business or retired. He negotiated a two-year lease instead of five years, enough for him to decide to keep at it a bit longer.
</p>
<p>
He's been aware for 25 years that it was "no way to make money," he says.
</p>
<p>
"I thought it was me, that I'm not enough of a hustler, not in a busy-enough practice, whatever," he says. "Then I talked to other colleagues over the years and found out they were doing worse than I was. You need a gimmick if you're going to make money in medicine. The gimmick is you perform a nice expensive procedure like endoscopy. Internists in general, and nonprocedural subspecialists without a gimmick, need to get themselves employed."
</p>
<p>
At 66, Dr. Frankenfeld says that as long as he can break even, fund his pension and his staff's pensions, he will continue to practice. He is ready to retire, though, from his second career as a hospitalist, which he has done half-time for 10 years.
</p>
<h3>The burden of fees and taxes</h3>
<p>
Working both as a solo practitioner and as a health system employee has been an eye-opener, he says, especially when it comes to state fees and taxes. With the state eyeing drastically increasing physician licensing fees, Dr. Frankenfeld wondered if it might be time for him to think about closing the doors on his private practice.
</p>
<p>
"This may be what does it for me," he says. "My reimbursements certainly haven't doubled in the last few years. How does a license become that valuable to me?"
</p>
<p>
He says the "biggest burr in my saddle" is the business and occupation, or B&amp;O, tax.
</p>
<p>
"I think that is the most unfriendly thing to small businesses," he says.
</p>
<p>
The B&amp;O tax, which is applied on a business' gross revenues, has been a long-standing point of contention for independent physicians, says Sean Graham, WSMA's director of government affairs. A bill passed last year added a 20 percent surcharge on certain industries with a significant number of highly educated workers, with the additional revenue going to higher education.
</p>
<p>
The fiscal impact of the tax increase on the physician community over the next two years is estimated at about $50 million, Graham says. Hospital systems were exempted from the tax surcharge as they are classified separately for the purposes of B&amp;O.
</p>
<p>
WSMA strenuously opposes the B&amp;O tax on all segments of health care and "vehemently" fought the surcharge, Graham says. Repealing the tax on physicians will be the "A-1 priority of WSMA for the 2020 legislative session," he says.
</p>
<p>
"It's simply a wrongheaded tax increase on a couple of levels, among them that it further increases the cost of health care," he says. "And it puts independent practices at a competitive disadvantage, jeopardizing access to care for patients in many communities."
</p>
<p>
The WSMA will be rolling out a broad advocacy campaign on repealing or ameliorating the B&amp;O tax in the next legislative session and will be asking our physician members for their help.
</p>
<p>
"We'll be working to raise awareness of the impact of the surcharge on patients and physicians, as well as to get physicians directly connected to their legislators," he said.
</p>
<p>
Mark T. Anderson, MD, a founding member of the independent Mill Creek Family Practice in Mill Creek, is one of the physicians who has volunteered to share his concerns with elected officials. His practice is "still doing OK," but faced with lower reimbursements, burdensome documentation and preauthorization requirements, and the B&amp;O tax increase, it's getting harder and harder to compete against hospital-based primary care clinics.
</p>
<p>
"We are one of the very few independent family practice clinics left," Dr. Anderson says. "We would like to continue to practice independently."
</p>
<p>
<em>Pat Curry is WSMA Reports' senior editor.</em>
</p>
<p>
<em>This article was featured in the November/December 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em>
</p>
</div> | 11/5/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |