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Weekly Rounds
News and insights from WSMA CEO Jennifer Hanscom.

Weekly Rounds

A newsletter from WSMA CEO Jennifer Hanscom, sent to health care industry leadership and WSMA members.

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weekly_rounds_july_15_2019_wsma_is_growing_and_on_the_moveWeekly Rounds: July 15, 2019 - WSMA Is Growing and on the MoveWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_july_15_2019_wsma_is_growing_and_on_the_move<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>July 15, 2019</h5> <h2>WSMA Is Growing and on the Move</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> <strong>New vistas and another record-breaking membership year</strong> </p> <p> While I spend most of my time focused on representing the physician community in our state, just a couple weeks ago, I was in Spain and saw the Organización Médica Colegial de España. It reminded me that physicians everywhere need representation and a voice. </p> <p> Medical associations around the globe have a strong and lengthy heritage, with forward-thinking physicians seeking to better the profession and build its future. As we stand on the shoulders of those who've gone before, protecting the profession remains our specialty, even if the societies of today look quite different than they did in the past. </p> <p> WSMA's membership is more diverse than ever before in terms of age, gender, specialty, and practice setting. And our strategies, structure, and brand are changing as well, to better reflect who we are today and who we want to be tomorrow. Perhaps you've even noticed that this email has an updated design that ties in with our new logo and branding. </p> <p> Even better, I'm proud to note that the WSMA has had another record-breaking membership year. With membership reaching nearly 11,300 members, we've grown more than 2 percent over last year and achieved a 16 percent increase since 2015. </p> <p> Some of that recent growth is thanks to the investment decisions Washington Permanente Medical Group and Rockwood MultiCare made to fund physician and physician assistant memberships in the WSMA. These organizations join many other groups who value their medical teams and recognize the importance of direct physician involvement in advocacy and leading change. </p> <p> With this growth, our membership is trending younger, as we strive to cultivate a new generation of engaged members. In fact, the early career segment of our membership (students, residents, fellows, and physicians under 40 or in the first 10 years of practice) has grown 214 percent over the past five years. </p> <p> There truly is strength in numbers, which enables the WSMA to have a powerful collective voice when speaking up for what matters to physicians. I'm grateful to all the groups and individuals who invest in WSMA membership. By doing so, you're making a direct investment in professional fulfillment and leadership development that, ultimately, is an investment in quality care and better patient outcomes. </p> <p> At the heart of all of this work is you, our members. As a member-driven organization, it's critical that we hear from you. I'm ever mindful of how busy you are. I know that WSMA news about what we're working on and how that work impacts you, your patients, and your practice may get overlooked. </p> <p> That's why we use every communication channel available to keep you filled in on the good work we're doing on your behalf. We reach out to you in print with our flagship—and newly redesigned—publication, we have several digital channels (website, email, Twitter, Facebook, LinkedIn, webinars, videos) and events (annual meeting, leadership conference and courses, legislative summit, advocacy council, large-group meetings). </p> <p> But in addition to all of that, we are taking WSMA on the road this summer, visiting three cities in Washington state—Spokane, Vancouver, and Bellingham—so that we can meet face to face with our members in those communities. </p> <p> If you're in or near any of those cities, we hope you will join us at these free events scheduled on Thursday evenings from 6-8 p.m. In addition to fun, food, and frosty beverages, we'll offer brief WSMA updates; but, more importantly, we'll listen to you about your concerns in daily life as a medical professional. Your input ensures that we are working on what matters most to you and helps us shape a meaningful strategy for the future. </p> <p> This will be a great chance to meet and mingle with WSMA and your colleagues. Let us know that you plan to join us by registering today to reserve your spot at these free events. The WSMA Road Trip visits Spokane on Thursday, Aug. 22 (<a href="https://www.eventbrite.com/e/wsma-road-trip-to-spokane-registration-64261748620?utm_term=eventname_text">register online</a>); Vancouver on Thursday, Aug. 29 (<a href="https://www.eventbrite.com/e/wsma-road-trip-to-vancouver-registration-64379109650">register online</a>); and Bellingham on Thursday, Sept. 5 (<a href="https://www.eventbrite.com/e/wsma-road-trip-to-bellingham-registration-64988291730?utm_campaign=new_event_email&utm_medium=email&utm_source=eb_email&utm_term=viewmyevent_button">register online</a>). We'll see you there! </p> <p> Another way to inform us about issues of concern to you is to engage with us via our members-only virtual reference committees and general discussion forum in advance of the WSMA Annual Meeting. It's easy to post your ideas or comment on the ideas of others. Simply <a href="https://wsma.org/WSMA/Membership/Discussion_Forums/Reference_Committees_and_General_Forum.aspx">click here</a> to get started. </p> <p> All of this to say…as a membership-driven organization your viewpoints and opinions matter, regardless of your specialty, your geography, and/or whether you are working within a large integrated group or small private practice. You matter. Let us hear from you, and I hope to personally greet you in Spokane, Vancouver, or Bellingham this summer. </p> </div>7/15/2019 9:45:22 AM7/15/2019 9:40:11 AM7/15/2019 12:00:00 AM
weekly_rounds_june_17_2019_hard_won_change_is_worth_the_effortWeekly Rounds: June 17, 2019 - Hard-won Change Is Worth the EffortWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_june_17_2019_hard_won_change_is_worth_the_effort<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>June 17, 2019</h5> <h2>Hard-won Change Is Worth the Effort</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Last week, I was in Chicago attending the AMA annual meeting. After all these years it's still a thrill to witness the incoming president's swearing in, but this year's oath of office felt like the most momentous one ever. In fact, it was an historic moment as the organization's first female African-American president put her hand on Bibles belonging to her great-grandfather and aunt and repeated the time-honored words of the oath. </p> <p> As Patrice Harris, MD, stepped up to that podium (<a href="https://www.facebook.com/AmericanMedicalAssociation/videos/853283701704193/?notif_id=1559682244507710&notif_t=live_video_schedule_broadcaster">view it here</a> at timestamp 48:45), she did so as only the fifth female president in the organization's 174 years. Notably, as she gave her presidential address, she did so 100 years after the first female physician was seated in the AMA House of Delegates. Also? Dr. Harris was preceded by another female president, Dr. Barbara McAneny, and she will be followed by Dr. Susan Bailey, who was elected AMA president-elect. </p> <p> Seeing these brilliant women leading in medicine today was a powerful reminder to me that change takes time—sometimes longer than we wish, but progress comes nonetheless. And as the AMA House of Delegates debated numerous issues—including health system reform, hospital consolidation, and gender inequity in medicine—we saw that democratic progress in action. </p> <p> The House narrowly voted to continue its opposition to a single-payer health system, adopting new policy instead to push for universal coverage by supporting improvements to the Affordable Care Act, including: </p> <ul> <li>Eliminating the subsidy "cliff," thereby expanding eligibility for premium tax credits beyond 40 percent of the federal poverty level.</li> <li>Increasing the generosity of premium tax credits.</li> <li>Expanding eligibility of cost-sharing reductions.</li> </ul> <p> Of particular interest to Washington state (in light of the WSMA's recent work to eliminate the personal and philosophical exemption to the MMR vaccine), the House passed a resolution to support state policies that would allow minors to override their parents' objections to vaccinations. In a separate resolution, the delegates directed the AMA to develop model legislation for mature minor consent to vaccinations. </p> <p> Your WSMA delegates took several issues to the AMA including: </p> <ul> <li>The concept of offering state employee health plans to every state resident and making the federal employee health benefits program health insurance plans available to everyone (referred for further study).</li> <li>Alignment of federal privacy law and regulations with HIPAA for the purposes of treatment, payment, and health operations, while ensuring protections are in place against the use of "Part 2" substance use disorder records in criminal proceedings (amended to reference applicable state laws).</li> <li>Universal access for essential public health services (alternative language adopted).</li> <li>An AMA study and report on the conditions under which our country could successfully eliminate the manufacture, distribution, and sale of combustible cigarettes and other combustible tobacco products (referred for decision).</li> </ul> <p> Here's a shout-out and special thanks to WSMA delegates and alternates to the AMA, for their passion and concern for the future of the profession. The delegation includes: </p> <ul> <li>Rod Trytko, MD, MBA, MPH, chair of the delegation</li> <li>Matthew Grierson, MD, vice chair</li> <li>Peter Dunbar, MD</li> <li>Nariman Heshmati, MD</li> <li>Erin Harnish, MD</li> <li>Shane Macaulay, MD</li> <li>Beth Peterson, MD</li> <li>Sheila Rege, MD</li> </ul> <p> Policy-making matters not only to the profession, but to patients. And as Dr. Harris noted in her keynote address, "There is strength in our collective voice." I couldn't agree more. If you're interested in proposing policy or serving as a delegate at the 2019 Annual Meeting of the WSMA House of Delegates meeting (Oct. 12-13 at the Hilton Seattle Airport & Conference Center), here's some helpful information you'll need to know. </p> <p> Resolutions, one of the key policy drivers for the association, are considered by the House of Delegates at their annual meeting each fall. Learn more about <a href="https://wsma.org/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136">how to write a resolution</a> and take note of these dates: </p> <ul> <li>Aug. 16: Deadline to submit your resolution for publication in the delegate handbook, the compilation of resolutions and other business to be considered by the House of Delegates. </li> <li>Aug. 30: Delegate handbook will be available for download from the WSMA website. </li> <li>Sept. 13: Final deadline to submit resolutions. To be considered, resolutions received after this date require consent of two-thirds of the House at the opening session.</li> </ul> <p> You can also circulate your ideas and engage in conversation before the meeting by posting your thoughts on WSMA's password-protected, members-only <a href="https://wsma.org/WSMA/Membership/Discussion_Forums/Reference_Committees_and_General_Discussion/WSMA/Membership/Discussion_Forums/Reference_Committees_and_General_Forum.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647">online discussion forum</a>. </p> <p> The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county or state specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2019 WSMA Annual Meeting, contact your local county or state specialty society. </p> <p> Getting involved at this level means bringing influence and insight to the policy-making process of your state medical association. It means being a leader in your profession and making a difference in the lives and health of your patients. As Dr. Harris said: "We don't run away from problems ... physicians run towards them!" </p> <p> Won't you join me in running toward the problems, and help me affect change for the better in our profession in Washington? </p> </div>6/17/2019 10:24:35 AM6/17/2019 10:22:15 AM6/17/2019 12:00:00 AM
weekly_rounds_may_27_2019_brand_new_brand_newsWeekly Rounds: May 27, 2019 - Brand New Brand NewsWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_may_27_2019_brand_new_brand_news<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>May 27, 2019</h5> <h2>Brand New Brand News</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Think about a couple of your favorite brands, and then think about how they make you feel. For me that means Starbucks (consistent, caffeinated), Apple (easy to use, good quality), and Alaska Airlines (convenient, reliable, and homegrown). </p> <p> A brand is more than just a logo. It is the set of emotions and recognition of values people have when they interact with an organization. A strong brand elicits not only thoughts and feelings from its audience, but also loyalty, passion, and motivation for action—all of which happen for me with the brands noted above. </p> <p> Many of you know that I've been with the WSMA for many years, and for the last six as CEO. So last week at our incredibly diverse WSMA Leadership Development Conference when a member told me that they had "always thought of the WSMA as an old, white, male club," I was dismayed. Are we still up against that stereotype? </p> <p> Thankfully, we've already been working on transforming the WSMA organization and brand to more appropriately represent our diverse membership of today! </p> <p> In the way of organizational change, we reorganized our association according to the express needs of our members, sharpening our focus on <a href="https://wsma.org/WSMA/News_Publications/Newsletters/WSMA_Advocacy_Report.aspx">advocacy</a> and <a href="https://wsma.org/WSMA/Advocacy/Legislative___Regulatory/WSMA/Advocacy/Legislative_Regulatory/Legislative_Regulatory.aspx?hkey=c0dc6e7c-4385-497a-99db-4a6b6f4e56bd">policy development</a>. We are tackling administrative burden and wellness through our <a href="https://wsma.org/WSMA/Resources/Administrative_Simplification/Healthy_Doctors__Healthier_Patients/WSMA/Resources/Administrative_Simplification/Healthy_Doctors__Healthier_Patients/Healthy_Doctors__Healthier_Patients.aspx?hkey=886d7bb3-8e52-4b07-9f38-541f3ca3e080">Healthy Doctors, Healthier Patients initiative</a>, and our <a href="https://wsma.org/WSMA/About_Us/WSMA_Foundation/WSMA/About/WSMA_Foundation/WSMA_Foundation.aspx?hkey=5695f210-6aa1-4eaf-94f0-ddea2e6c6261">foundation</a> is focusing its work on bringing joy back to medicine and striving to improve physician wellness. Further, we developed <a href="https://wsma.org/WSMA/Resources/Physician_Leadership/WSMA/Resources/Physician_Leadership/Physician_Leadership.aspx?hkey=de41060f-7888-4692-92da-9acc972257d3">courses</a> and <a href="https://wsma.org/WSMA/Resources/Physician_Leadership/Medical_Officer_Collaborative/Medical_Officer_Collaborative.aspx">networking opportunities</a> to engage and equip physician leaders, supporting them at every stage of their professional careers. </p> <p> But we didn't stop with structural change, we also looked at our brand. We started with our flagship publication, <em>WSMA Reports</em>. I hope you've noticed the huge change since the March/April issue. We wanted our flagship publication's visual aesthetic to reflect the dynamic membership of our association, to represent our members more fully within its pages, and to implement an engaging and interactive editorial approach. </p> <p> This magazine is a must-read for any physician, physician assistant, or health care leader in Washington state, and it is available for free to WSMA members. Recent issues have reported in depth on the silent suffering of burnout and how artificial intelligence can serve doctors, not replace them. Up next, with our July/August edition we'll feature in-depth reporting on how climate change is impacting the health of Washingtonians and what's being done about it. </p> <p> Through this publication and all of our communications channels, we're reporting on issues that impact Washington state physicians and their patients. We publish news that is tailored specifically for—and only available to—WSMA members. </p> <p> Beyond all that, we are in the midst of launching a new look and feel to our entire brand. While our brand is no substitute for the work we do or the interactions we have, it does help broaden our reach, strengthen our purpose, create connections across our programs, and reinforce a powerful sense of our mission and vision. Implementation of these new visuals is in progress and will be an evolution, but I'm sure you'll notice aspects of our new logo and brand in the weeks ahead. </p> <p> As always, thanks for your interest in, and support of, the WSMA. I'm all in on the WSMA brand and I hope you are too. And now, I think a Starbucks venti Americano is calling my name… </p> </div>5/28/2019 9:51:49 AM5/28/2019 9:43:28 AM5/27/2019 12:00:00 AM
weekly_rounds_may_13_2019_members_speak_we_listenWeekly Rounds: May 13, 2019 - Members Speak, We ListenWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_may_13_2019_members_speak_we_listen<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>May 13, 2019</h5> <h2>Members Speak, We Listen</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> I recently heard from a member who is frustrated and disappointed with the recent <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190508/state_budget_includes_mental_health_investments_b_and_o_increase_passes">20 percent business and occupation (B&O) tax increase</a> passed by the state Legislature, as well as the <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190508/the_good_and_bad_of_new_opioid_legislative_policy">new IT requirements mandated as part of the omnibus opioid prescribing bill</a>. Here at the WSMA, we share his distress. These are not the results we had hoped for this legislative session. But with Democrats sweeping into control of the Legislature after several years of tight partisan splits, we knew that pocketbook/professional issues would face an uphill climb in the 2019 session. </p> <p> This member, who operates in an independent practice of five physicians and two nurse practitioners, will be particularly hard hit. That was a point I articulated <a href="https://www.seattletimes.com/opinion/public-health-wins-but-physician-practices-lose-in-2019-legislative-session/">in my recent editorial in The Seattle Times</a>. He put an even finer point it, saying, "This may be a game changer for our clinic trying to stay independent." </p> <p> His is the voice legislators need to hear. Yours are the stories we need to tell. These are the connections we need to make. If we—all of us—don't loudly, clearly, and aggressively make legislators understand the impact they have on patient care and patient choice in their communities, then the deck will continue to be stacked against us. </p> <p> I am grateful that this physician reached out to me to share his frustration, because through our exchange, I invited him to let us help connect him with his legislators so he can share his story directly. I'm delighted that he agreed. We are working now to connect him to his local legislators at his practice, where they can see firsthand how decisions they make directly impact patients, who are also their constituents. This is the value of each of you being engaged in your professional society. </p> <p> Friends, our work is far from done; this is a long game. The WSMA will use our influence during the interim (the time between legislative sessions) to prepare for next year's session where we'll fight to roll back the B&O tax and advance better payment for physicians. We won't give up, and I implore you not to either. You need to stand with us to help advocate on behalf of the profession and our patients. This work is never done. </p> <p> Right now, we are actively working to connect members with their local legislators so that they can invite them in and share their stories. If you'd like to be part of this effort, email me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. In addition, the board of directors of WSMA's political action committee, WAMPAC, will be meeting next week to develop our giving strategy as it relates to legislators and candidates who support our professional agenda. Stay tuned for more on this effort. </p> <p> In the meantime, let's not overlook that we had some good wins this session! WSMA's Olympia team will be debriefing members on these wins and other session results during a free lunchtime webinar on May 15—<a href="https://wsma.org/WSMA/Events/WSMA_Legislative_Wrap_Up_Webinar/WSMA/Events/wsma_legislative_wrap_up_webinar.aspx?hkey=9e9d7843-853f-47d0-bae4-7d2595f5c86b">register for the event online</a>. </p> <p> In addition, we are also working on our annual WSMA legislative wrap-up report, which provides an in-depth look at legislative session outcomes and new policies impacting medical practices, and features a "report card" on how your local legislators voted on WSMA's priority issues. Look for this in your mailbox later this summer. </p> <p> Keep the comments and suggestions coming. You can email me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. I'm happy to come and meet with you individually or as a group, and our other WSMA leaders are as well. </p> <p> And also of note, later this summer we will launch a WSMA "road tour," traveling to Spokane, Bellingham, and Vancouver to hear from you directly. I hope you and your colleagues will join us at these events. We are a member-driven organization, and your involvement drives our agenda as we strive to achieve our mission of providing strong leadership and advocacy that shapes the future of medicine and provides access to care for all Washingtonians. </p> </div>5/13/2019 9:29:06 AM5/13/2019 9:26:00 AM5/13/2019 12:00:00 AM
weekly_rounds_apr_29_2019_your_service_matters_become_a_leader_at_the_wsmaWeekly Rounds: Apr. 29, 2019 - Your Service Matters: Become a Leader at the WSMAWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_apr_29_2019_your_service_matters_become_a_leader_at_the_wsma<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>April 29, 2019</h5> <h2>Your Service Matters: Become a Leader at the WSMA </h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Leadership is one of WSMA's strategic priorities; perhaps an obvious choice as we strive to influence and shape the future of the medical profession. And we've heard, loud and clear, from our members that leadership development is one aspect of our work that they value highly. That's another reason why we work so hard to bring top-ranked educational opportunities to the medical community, through our <a href="https://wsma.org/WSMA/Resources/Physician_Leadership/Physician_Leadership.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&hkey=de41060f-7888-4692-92da-9acc972257d3">leadership courses and conference</a>. </p> <p> I spend a fair amount of time thinking about leadership and what it takes to be a leader. I'm inspired by this quote from <a href="https://www.psychologytoday.com/us/blog/artificial-maturity/201402/is-everyone-leader">Tim Elmore</a>, president of Growing Leaders, an international nonprofit that works to develop emerging leaders: </p> <p> <em>"Leadership is a calling on every one of us, to some degree. It's about becoming the person we were meant to be. It is less about position and more about disposition. It is not so much about superiority but about service in the area of our strengths. It has less to do with a set of behaviors and more to do with a perspective with which we view life."</em> </p> <p> What resonates with me in that quote is the emphasis on service. It reminds me of the Rotarian motto, "service above self." In my experience working with physicians, I've seen how they embody service and leadership in everything they do, from providing care to contributing expertise, experience, knowledge, vision, and wisdom to their patients, teams, and communities. </p> <p> Now, more than ever, we need strong physician leadership across all aspects of the profession. With challenges in the house of medicine, the shifting landscape of health care, the unpredictable direction of federal legislation, and the need to emphasize the quadruple aim in medicine, physicians must be directly involved in leadership in order to navigate a better way forward for the profession and patients. </p> <p> The WSMA depends upon strong physician leadership to represent the voice of physicians and patients as we seek to shape the future of health care in Washington state. We need your voice, your leadership, your service. </p> <p> I'm personally inviting you to consider being part of that leadership by nominating yourself or a colleague for consideration for a position on the WSMA board of trustees or executive committee. I'm highlighting this today because we have just extended the deadline for nominations to May 10. As a leader in the profession, your voice and service within the WSMA matters. </p> <p> I urge you to take a moment just now to consider this. More information about the desired qualifications, a roster of current board members, a nomination form, conflict of interest disclosure statement, and <a href="https://wsma.org/Shared_Content/News/Advocacy_Report/2019/Nominations_for_WSMA_Leadership_Due_April_30">candidate information sheet are available here</a>. </p> <p> Further, here are a few things to note about the nomination process: </p> <ul> <li>The WSMA nominating committee meets in early June to prepare a slate of nominees.</li> <li>The slate is presented to the House of Delegates at its 2019 Annual Meeting, scheduled for Oct. 12-13 at the Hilton Seattle Airport and Conference Center. </li> <li>The deadline for nominations is Friday, May 10, although additional nominations may be made from the floor of the House of Delegates.</li> <li>In considering yourself or colleagues for nominations, consider whether you or they are: <ul> <li>Well-informed</li> <li>Forward thinking</li> <li>Committed to the future of the profession</li> <li>Committed to service and the profession above oneself </li> <li>Experienced, enthusiastic, credible, and open-minded</li> <li>Able to put the WSMA above personal desires or agenda</li> <li>Capable of serving as a future president of our state medical association</li> </ul> </li> </ul> <p> It takes bold leadership and a strong sense of service to tackle the challenges facing the profession, your patients, and our communities. If you believe in our mission to provide strong physician leadership and advocacy to shape the future of medicine and advance quality of care for all Washingtonians, I hope you will consider this opportunity. </p> </div>4/29/2019 10:14:58 AM4/29/2019 9:33:38 AM4/29/2019 12:00:00 AM
weekly_rounds_apr_15_2019_taking_action_makes_a_differenceWeekly Rounds: Apr. 15, 2019 - Taking Action Makes a DifferenceWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_apr_15_2019_taking_action_makes_a_difference<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>April 15, 2019</h5> <h2>Taking Action Makes a Difference</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> As I write today's Weekly Rounds, I am on a plane headed to San Francisco to represent the WSMA and all of you at a Physicians Foundation board meeting. Even as I write, things are heating up in Olympia as we draw near to the scheduled end of session (April 28). The WSMA team there is working nonstop to protect the interests of our members, their patients, and the profession. </p> <p> In short, there's a lot going on! I'll highlight just five things here for now: </p> <p> First, as you've likely seen, we've sent several urgent calls to action on multiple topics recently: wrongful death expansion, business and occupation (B&O) tax increase, and the public option bill. Thank you for taking the time to contact your legislators on these important matters. Your emails and calls do make a difference and we need you to continue to be engaged. April 17 is the cutoff for bills to be voted out of the opposite chamber (i.e. for <a href="https://vimeo.com/album/5835487">House bills to pass the Senate</a>). Our team in Olympia is working hard to salvage our priority bills and shut down attempts to move bad policy bills forward. </p> <p> Next, after many years of negotiation, the WSMA has reached an agreement on balance billing legislation that protects patients from unexpected bills and is fair for the physician community. The bill, which has passed both the House and the Senate and will soon be headed to the governor for his signature, includes: </p> <ul> <li>No statutory reimbursement rate or mechanism for out-of-network payment subject to the bill, requiring carriers to reimburse out-of-network physicians at a commercially reasonable rate.</li> <li>Physician-friendly dispute resolution process with no reference to Medicare rates as an arbitration criterion, and claims bundling allowed over a two-month timeframe.</li> <li>Addressing the ERISA problem with an ability for self-insured health plans to opt in to complying with the law, and a mechanism for physicians to verify the nature of a health plan (i.e. whether it complies with the law and/or whether a patient can be balance billed). </li> <li>Direct payment from carriers to physicians (prohibiting carriers from routing payment through patients).</li> <li>Strengthened network adequacy requirements for carriers.</li> <li>Workable requirements for physician groups pertaining to transparency and enforcement of the law.</li> </ul> <p> I want to acknowledge the good work of Sean Graham, WSMA's director of legislative and political affairs, and all the physicians who worked with him to find a path forward for addressing this difficult issue. We know this law—however physician-friendly—poses challenges for the physician community. We're committed to helping practices implement the law and will continue to advocate during the rulemaking process to make the law as fair to physicians as possible. </p> <p> Third, last week's WSMA e-newsletter, Membership Memo, featured updates on what's happening in Olympia, including news that Gov. Jay Inslee signed one of WSMA's priority pieces of legislation: raising the age of sale for tobacco and vapor products in Washington state from 18 to 21. This is a major victory for public health and for physician advocacy in our state. As WSMA President Tom Schaaf, MD, noted in our press release, "This is the fifth legislative session where Washington's physicians have fought for policy to raise the tobacco and vaping purchasing age. In this instance, the fifth time's the charm. It's a reminder to all of us that the health and well-being of our patients, families, and loved ones is worth fighting for, no matter how long and hard the fight." The new law takes effect on Jan. 1, 2020. </p> <p> Next, the WSMA Foundation received a year-long grant from the Physicians Foundation to pilot a practice transformation initiative at several sites throughout Washington state. Congratulations to Allegro Pediatrics, EvergreenHealth Medical Group, Family Care Network, Kaiser Permanente, MultiCare Health System, The Everett Clinic, UW Valley Medical Center, and Virginia Mason for being chosen to participate with the WSMA, the AMA, and the Physicians Foundation on this journey to advance research and promote evidence-based solutions that improve patient care by enhancing professional fulfillment and reducing clinician burnout. </p> <p> Finally, more than 10 years ago, the WSMA recognized the unique needs of physician medical executives in the hospital setting. We partnered with the Washington State Hospital Association to create a joint chief medical officers workgroup. Since that time, the group has evolved to include medical officers at large independent clinics. Our <a href="http://medicalofficercollaborative.org/home/">Medical Officer Safe Table Learning Collaborative</a> offers a forum for medical officers to engage with and learn from each other on topics such as patient safety and quality; wellness, burnout, and impairment; leadership development; policy; culture change; and other shared challenges all CMOs face. The group meets three times a year and all medical officers are encouraged to attend. For more information, contact Jessica Martinson at <a href="mailto:jessica@wsma.org">jessica@wsma.org</a>. </p> <p> This quick rundown barely scratches the surface of all we're doing just now, but you're busy and my plane is about to land, so I'll wrap this up. Thanks for your engagement with the WSMA, and for taking time to read about our work. </p> </div>4/29/2019 10:14:30 AM4/15/2019 9:32:47 AM4/15/2019 12:00:00 AM
weekly_rounds_apr_2_2019_standing_strong_for_patients_and_the_professionWeekly Rounds: Apr. 2, 2019 - Standing strong for patients and the professionWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_apr_2_2019_standing_strong_for_patients_and_the_profession<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>April 2, 2019</h5> <h2>Standing Strong for Patients and the Profession</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Last Saturday was Doctors' Day, and if you follow the WSMA (or me) on social media, then you saw our video tribute to you—our members. While we celebrate you every day, we had fun putting it together to show how much we value your commitment not only to your patients, but to the WSMA as well. In case you missed it, <a href="https://vimeo.com/325487847">I've linked to it here so you can enjoy</a>. </p> <p> Speaking of commitment, I want to give a special shout out to several of our members for their efforts supporting the WSMA and the profession. Last Friday, Chelsea Unruh, MD, and Mary Anderson, MD, traveled with me to Olympia to testify against the business and occupation (B&O) tax increase included in the House budget proposal (see more about that below). All three of us testified at the hearing, and you can <a href="https://vimeo.com/327962785">watch our testimonies here</a>. And this week, WSMA President Tom Schaaf, MD, and president-elect Bill Hirota, MD, are taking time away from their practices to travel with me to Washington, D.C., where we will advocate for WSMA's federal priorities. </p> <p> Taking the time out of your busy lives to engage on behalf of the profession and patients is not easy or convenient, but it truly does make a difference in shaping the future of medicine and health care in Washington state. Thank you! </p> <p> We are heading into the home stretch of the legislative session. Budget writing is underway with the release of both the House and Senate budgets. WSMA's priorities for the budget are securing an increase in Medicaid reimbursement, behavioral health funding, and staving off an increase to the B&O tax on physician services. </p> <p> Here's a rundown on what you need to know from the two budgets. </p> <h3>Highlights of the House budget</h3> <p> The House Democrats' package is a $52.8 billion budget that would increase state spending by 19 percent and rely on $1.4 billion in new taxes. Among the tax hikes being proposed is a 20 percent increase in the B&O service tax paid by physicians and other professionals, raising an estimated $427 million over the next two years, with the revenue going to fund new investments in higher education. </p> <p> The House budget makes numerous investments in behavioral health, including $225 million for the construction and staffing of a new teaching hospital at the University of Washington with the aim of strengthening the state's behavioral health workforce, including new psychiatric physician residency positions ($600,000). Multiple operating and capital investments are made to increase bed capacity for behavioral health services. There's also $3.6 million to create a tele-behavioral health video call center to provide physicians with on-demand access to psychiatric and substance-use disorder clinical consultation. </p> <p> The House plan provides roughly $15 million for a Medicaid payment increase for health, behavior, and psychotherapy codes, but not at a rate reflected in <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181226/governors_2019_budget_proposal_the_good_the_good_and_the_ugly">Gov. Inslee's budget proposal released in December</a>. </p> <p> The House spending plan also provides no funds for increasing Medicaid payments for adult and pediatric primary care <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181226/governors_2019_budget_proposal_the_good_the_good_and_the_ugly">as featured in the governor's budget</a>. Increasing Medicaid reimbursement is a priority for the WSMA, with a goal of increasing physician participation in the program while ensuring practice solvency. </p> <p> New public health funding proposals include $22 million for foundational public health services, continuing and expanding the state's maternity mortality review panel, and funding to implement Initiative 1639, which voters approved last year to address firearm safety. The budget also assumes passage of legislation to <a href="https://wsma.org/Shared_Content/News/Latest_News/2018/September/Heal_the_business_of_care_with_fair_Medicaid_compensation">increase the purchase age</a> for tobacco and vapor products to 21, as well as legislation to <a href="https://wsma.org/Shared_Content/News/Advocacy_Report/2019/Strengthening_Washington_state_s_immunization_policy">remove the personal and philosophical exemptions</a> for the MMR (measles, mumps, and rubella) vaccine—both priority policies for the WSMA. </p> <p> Elsewhere, funding is maintained for medical education victories from past budget cycles, including physician residencies and health professional student loan repayment. Reconciliation of Medicaid payments for rural health care facilities is retroactively addressed, holding clinics harmless for the 2011-13 timeframe and holding action on subsequent years until the 2020 session at the earliest. And an $18.8 million appropriation is made from the state's health professions account, composed of licensure fees from physicians and other health care professionals, for a new licensing system. This comes at a time when physicians are facing <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190227/medical_commission_releases_timeline_and_workshop_for_proposed_fee_increases">a substantial fee increase that the WSMA is opposing</a>. </p> <h3>Toplines from the Senate budget</h3> <p> Senate Democrats unveiled their spending plan Friday afternoon. The $52.2 billion proposal is similar in many regards to the House budget, making considerable investments in behavioral health and assuming the establishment of a state capital gains tax. One key difference between the two proposals is that the Senate did not include a B&O tax increase on physician services. </p> <p> Notable items in the Senate budget include stepped-up investments in medical education, with a new $2 million mental health scholarship program for behavioral health practitioners, on top of maintaining medical residency funding and increasing funding for health professional student loan repayment. A new tax on vapor products would go toward funding tobacco prevention and foundational public health. And like the House budget, there are numerous items intended to improve the delivery of mental health care, including increasing bed capacity and establishing a Partnership Access Line for schools. </p> <p> Of concern in the Senate budget is $150 million in assumed savings for the state's Medicaid program, making reference to increased oversight of fraud, waste, and abuse of the system. At this point, it is unclear what impact the proposal would have on physicians and on access to care for Medicaid enrollees. And unfortunately, neither the Senate nor the House budgets include meaningful Medicaid reimbursement increases, making it likely that the legislature will once again fail to address this important issue. </p> <h3>What's next</h3> <p> When budget proposals are aligned on an issue, it's a strong sign that it will be included in the final budget agreement. That's promising for the prospect of legislation to increase the purchase age for tobacco and vapor products to 21, a top priority of the WSMA (<a href="https://app.leg.wa.gov/billsummary?BillNumber=1074&Year=2019&Initiative=false">House Bill 1074</a>). That bill has passed out of both houses, and its next stop is the governor's desk for his signature. </p> <p> There's also funding in both budgets to extend and expand the state's maternity mortality review panel, a program that the WSMA helped establish in 2016. </p> <p> With four weeks to go in the 2019 legislative session, focus will turn to ironing out wrinkles in policy proposals and reconciling differences between the budget proposals. Chief among the items the WSMA will focus on is working to prevent a B&O tax increase on physician services, and policy bills pertaining to vaccine exemptions, the creation of a state public insurance option, and addressing the opioid epidemic. As ever, your WSMA advocacy team will be at the capitol full time, ensuring that the voice of the physician community is well represented. </p> <p> Check out our <a href="https://vimeo.com/327807687">latest advocacy update video here</a>, and stay tuned for more in the days and weeks ahead. And when you receive a call to action from the WSMA, please click the button to "take action." It matters. </p> </div>4/8/2019 11:35:28 AM4/2/2019 10:10:45 AM4/2/2019 12:00:00 AM
Weekly_Rounds__Mar._18__2019_-_A_Public_Option_that_Works_for_Patients_and_PhysiciansWeekly Rounds: Mar. 18, 2019 - A Public Option that Works for Patients and PhysiciansWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/Weekly_Rounds__Mar._18__2019_-_A_Public_Option_that_Works_for_Patients_and_Physicians<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>March 18, 2019</h5> <h2>A Public Option that Works for Patients and Physicians </h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p><a href="#note">[Update April 10, 2019]</a></p> <p>As we head into week 10 of our 15-week legislative session, I can't help but reflect on the incredible work of our team in Olympia. We often say to our members that while they go about their daily business of saving lives, our team is on the frontlines of protecting their interests so they can continue to do just that…save lives.</p> <p>Already in this session, the team in Olympia has rigorously reviewed around 2,000 bills. Thus far, they’ve identified nearly 300 that could impact the profession—for better or for worse. They have aggressively monitored, testified, reported out, and lobbied for or against as guided by WSMA policy and leadership.</p> <p>Your team on the ground has been working around the clock to influence state policies that benefit not only our profession and the groups you practice in, but also your patients.</p> <p>It’s a challenging job. I’m sure you can appreciate how difficult it is to navigate complex issues while advocating on topics where a broad range of stakeholders have opposing concerns.</p> <p>We know that physicians are looking for market stability, predictability, and access to care. That’s why we soldier on in this work, defending them and the profession for the health and well-being of all Washingtonians.</p> <p>A case in point is the issue of a public option plan.</p> <p><a href="https://app.leg.wa.gov/billsummary?BillNumber=1523&Year=2019&Initiative=false">House Bill 1523</a> would create a public option insurance plan procured by the Health Care Authority and offered to the public on the Washington Health Benefit Exchange. The plan’s benefit design would be standardized to decrease cost-sharing requirements for enrollees, with reimbursement capped at Medicare rates. The WSMA has been vocal in our opposition to setting rates in statute, particularly at the Medicare level.</p> <p>Thankfully, on the Senate side, legislators listened and responded to our concerns. Last week the Senate voted to approve an amended version of its public option plan, <a href="https://app.leg.wa.gov/billsummary?BillNumber=5526&Initiative=false&Year=2019">Senate Bill 5526</a>, with a bipartisan vote of 36-13. Importantly, the bill was amended to remove the rate-setting component, so physicians will have the opportunity to negotiate with carriers on their terms of participation in the plan.</p> <p>The amended bill maintains the standard plan design components that are intended to limit patient cost-sharing. Also, in lieu of a reimbursement rate cap addressing premium costs, it substitutes an active purchaser structure that will enable the Health Care Authority to negotiate with carriers on appropriate premium rates for the plans. Carriers would then, in turn, negotiate with physicians and facilities to build provider networks.</p> <p>In other areas, SB 5526 was amended to mirror the changes that were recently made to its House companion, HB 1523. Most notable for our purposes, it includes a requirement that utilization review processes employed in the plan meet national accreditation standards, align with HCA-published criteria, and focus on care that has high variation, high cost, or low evidence of clinical effectiveness.</p> <p>Last week the WSMA executive committee voted to support SB 5526<a href="#note">*</a> in its current form as a means to expand access to affordable coverage for our state’s uninsured, while not crippling the viability of a medical practice.</p> <p><em>[*<a name="note"></a>Update April 10, 2019: Since this article was published, SB 5526 has been amended to cap reimbursement to physicians at a percentage of Medicare (150 percent, based on a carrier’s aggregate reimbursement to health care providers and facilities); to direct a study of how physician participation in the plan could be mandated in future years; and finally, to remove a provision limiting how much insurance carriers can profit from offering the plan—meaning that only physicians and hospitals would be asked to sacrifice to make the public option viable. The WSMA is now opposing SB 5526 in this amended form. The WSMA supports building off of the approach in the companion public option bill currently before the Senate (HB 1523), which is a more realistic and responsible approach to addressing affordability. That approach has garnered support from physicians, hospitals and health plans<em>—</em>the entities necessary to ensuring the public option is a success<em>—</em>as well as support from senators on both sides of the aisle.]</em></p> <p>As the bill continues its journey in the Legislature, the WSMA will hold fast in our opposition to any rate setting in this public option plan—a position reaffirmed by the executive committee at its March meeting.</p> <p>The WSMA is working in partnership on this issue with the Washington State Hospital Association. But you may not know that <strong>the WSMA is the only physician/provider organization participating in behind-the-scenes negotiations on this issue in Olympia</strong>. And that is exactly the intersection where your support of the WSMA really matters and enables us to do this work on behalf of all physicians and patients.</p> <p>As always, we are grateful for your support of the WSMA and count it a privilege to represent the physician voice. Together, our efforts are helping ensure that Washington is, indeed, the best place to practice medicine and receive care.</p> </div>4/10/2019 6:44:02 PM3/18/2019 9:18:19 AM3/18/2019 12:00:00 AM
weekly_rounds_2019_03_04_bad_legislation_yields_unintended_consequences_for_access_to_careWeekly Rounds: Mar. 4, 2019 - Bad Legislation Yields Unintended Consequences for Access to CareWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_2019_03_04_bad_legislation_yields_unintended_consequences_for_access_to_care<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>March 4, 2019</h5> <h2>Bad Legislation Yields Unintended Consequences for Access to Care</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> When my boys were younger, I often turned to the principles of the popular book, "Parenting with Love and Logic." I didn't adopt all of its teachings, but one point that resonated and helped as I raised three strong-willed children was the principle that there are natural consequences to your actions. If you want to go outside without a coat and it's 27 degrees outside, you will be cold. If you want to go on a date, you'll need gas in your car—gas costs money, you get money when you do your chores. </p> <p> I liken that story and its principles to much of our advocacy work at the WSMA. Often, our work is built on a foundation of helping policymakers and legislators understand the natural consequences of their decisions, and the potential impact those decisions have on the current health care system. </p> <p> The prevailing attitude in Olympia—and a laudable one at that—is a desire to make health care more affordable, to reduce the number of people who are uninsured, and to ensure that all Washingtonians have access to care in their local communities. Clearly those are goals that the WSMA supports as well. </p> <p> And so, I'm puzzled about why there are some bills moving during this session that—without a doubt—fly in the face of achieving those goals. </p> <p> The legislature is debating several bills that get in the way of this vision: increasing the B&O tax, setting a public option at Medicare rates, advancing bills that expand medical liability. Today, let's look at the latter: expanding liability and awards under the state's wrongful death statutes. </p> <p> Without question, every wrongful death, by its very nature, is a tragedy. But for a decade, Washington state law has provided a stable paradigm that strikes a delicate—and critical—balance, providing justice and compensation for financially dependent family members affected by wrongful death, while including limits where there is no financial dependence. </p> <p> Two bills this session, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1135&Year=2019&Initiative=false">HB 1135</a> and <a href="https://app.leg.wa.gov/billsummary?BillNumber=5163&Initiative=false&Year=2019">SB 5163</a>, would undo this balance by drastically expanding liability. That expansion would prompt significant consequences, such as destabilizing the practice environment, exacerbating an already stressed workforce as physicians elect to leave practice, and reducing access to care as some physicians reconsider treating complex patients or performing high-risk services. </p> <p> The WSMA and our partner, Physicians Insurance A Mutual Company, are united against liability expansion. Together with the Washington State Hospital Association, the Liability Reform Coalition, and others, we strongly oppose these bills that broaden the current legal standard for wrongful death liability from "financially dependent" to "substantial involvement" in the life of the decedent, greatly expanding who may sue and increasing the number of claims (by as much as 20 percent, according to state estimates). </p> <p> The legislation would expand awards beyond economic damages to include non-economic damages, with the resulting higher payouts ultimately passed on as cost increases to taxpayers—and as higher insurance premiums. The legislation would also apply the law retroactively, applying to pending lawsuits and those filed prior to the statute of limitations expiring. </p> <p> Equally disturbing is another bill, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1965&Initiative=false&Year=2019">HB 1965</a>, which would allow individuals to seek qui tam action on behalf of the state if employers violate various statutes pertaining to workplace law, including, but not limited to, health care facility employee overtime, safety in health care settings and health care whistleblower retaliation protection. The WSMA and our coalition partners oppose this bill, which remains alive in the House Appropriations Committee. </p> <p> These bills are emotionally charged; however, we need a fair court system that doesn't unfairly cripple physicians, hospitals, and local governments financially just because they have "deep pockets." </p> <p> Expanding liability and awards results in unintended consequences for the very people we are trying to help by providing affordable care. It adds additional costs into the system by necessitating a rise in insurance premiums, which impacts everyone's insurance rates, co-pays, and deductibles. And that's just on the medical side. Let's not forget the impact that rising insurance premiums have on the cost of housing, increased taxes, and limited community services. </p> <p> All of this makes Washington a less attractive place to practice medicine, thereby reducing the number of physicians in our community to provide care. And that's a natural consequence that we shouldn't have to endure. </p> </div>3/4/2019 2:38:51 PM3/4/2019 2:36:23 PM3/4/2019 12:00:00 AM
weekly_rounds_2019_02_18_5_things_you_may_have_missed_while_shoveling_the_snowWeekly Rounds: Feb. 18, 2019 - 5 things you may have missed while shoveling the snowWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_2019_02_18_5_things_you_may_have_missed_while_shoveling_the_snow<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>February 18, 2019</h5> <h2>5 Things You May Have Missed While Shoveling the Snow </h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> We've all got our stories of the "snowmaggedon" of 2019, and I'm no exception. Feeling optimistic on one of the early days, I went to the office as usual. Midway through the day, I looked up from my work to see a complete whiteout outside our office windows in Belltown. That's when I decided it was time for the team to head home. Three hours later, that's where I was after a harrowing drive that usually takes an hour. Here's hoping your stories are no more eventful than mine! </p> <p> And here are a few things you may have missed during our arctic blast: </p> <h3>Dr. Nathan Schlicher informs legislators what is, and isn't, effective in addressing the opioid crisis</h3> <p> In recent years, physician-led efforts have been crucial to <a href="https://wsma.org/Shared_Content/News/Press_Releases/2018/Public-private_safe_prescribing_initiative_results_in_reductions_in_Medicaid_opioid_prescriptions">reforming opioid prescribing practices</a>. This year is no different, as the WSMA pushes for increased access to treatment for opioid use and substance use disorder through reimbursement, workforce availability, and access to non-opioid treatments. Recently, Nathan Schlicher, MD, JD, and 1st vice president of the WSMA, highlighted positive components of <a href="https://app.leg.wa.gov/billsummary?BillNumber=1331&Year=2019&Initiative=false">House Bill 1331</a>, while presenting our strong <a href="https://vimeo.com/314317059">opposition to the bill's prescription monitoring program mandate</a>. This mandate, which would require the integration of electronic medical record systems with the state's prescription monitoring program, would place an unfair financial burden on small- to medium-sized medical practices in the state who will face cost and operational barriers to integrating. </p> <h3>WSMA board members sound the alarm about measles</h3> <p> Two WSMA board members and passionate public health advocates—in practice and in retirement—spoke up this week regarding the current measles outbreak and the proven safety of vaccines. Alan Melnick, MD, director of public health for Clark County, was <a href="https://www.npr.org/2019/02/07/692466295/washington-public-health-official-discusses-measles-outbreak-in-pacific-northwes">interviewed by National Public Radio's Ari Shapiro</a> about the measles outbreak in the Pacific Northwest. As I write, Clark County has more than 50 confirmed cases. And Gary Goldbaum, MD, former Snohomish County public health officer, testified in support of <a href="https://app.leg.wa.gov/billsummary?BillNumber=1638&Initiative=false&Year=2019">House Bill 1638</a>, which would eliminate the personal and philosophical exemption for children's measles, mumps, and rubella vaccine. <a href="https://vimeo.com/316211857">Watch Dr. Goldbaum's testimony</a> as part of our Doctors Making a Difference series. The WSMA is also supporting <a href="https://app.leg.wa.gov/billsummary?BillNumber=5841&Initiative=false&Year=2019">Senate Bill 5841</a>, which would eliminate the personal and philosophical exemption for all child immunization requirements. At the time of this writing, SB 5841 has been scheduled for a hearing this Thursday—the WSMA will be present and in full support of this bill, which aligns with WSMA House of Delegates policy. </p> <h3>Nearly 100 WSMA members wearing white coats "take to the Hill" in Olympia</h3> <p> On the eve of the snowstorm, hardy physicians, physician assistants, and practice managers from throughout the state put on their white coats to rally on behalf of medicine <a href="https://wsma.org/Shared_Content/News/Press_Releases/2019/Washington_physicians_in_Olympia_on_Feb._7_to_talk_to_lawmakers_on_behalf_of_patients_and_profession.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">at the annual WSMA Legislative Summit</a>. WSMA members talked with legislators about issues important to their patients and their profession, including strengthening vaccination policy, increasing access to care for behavioral and mental health, preventing tax increases that threaten the sustainability of physician practices, and raising the age of the sale of tobacco and vapor products. For those WSMA members who braved inclement weather to come to the Capitol for the Summit—thank you! Check out <a href="https://vimeo.com/316595702">our video</a> featuring highlights from the day and a special message from WSMA President Tom Schaaf, MD. </p> <h3>Dr. Mika Sinanan testifies in opposition to expanding the scope of naturopathy </h3> <p> Mika Sinanan, MD, and 2nd vice president of the WSMA, took time out of his busy surgical practice to drive from Seattle to Olympia in order to testify against yet another legislative effort to expand a naturopath's scope of practice, and to uphold a recent House of Delegates reaffirmation of support for clarity regarding the use of the title "doctor" (or in this bill's case, "physician") by practitioners. "[This bill] changes the meaning of what a naturopath and what a physician is, and it's an opportunity to confuse patients," Dr. Sinanan said during testimony. </p> <p> The proposal, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1630&Initiative=false&Year=2019">House Bill 1630</a>, would: </p> <ul> <li>Allow a naturopath to prescribe any legend drug or Schedule III-V controlled substance as necessary in the practice of naturopathy.</li> <li>Expand the naturopathic scope of practice. </li> <li>Allow naturopaths to be known as naturopathic physicians.</li> </ul> <p> Dr. Sinanan testified before the House Health Care and Wellness committee last Wednesday, noting WSMA's strong opposition to the bill. <a href="https://vimeo.com/317177088">Watch Dr. Sinanan's testimony</a>. </p> <p> Note: At the national level the AMA created the "Truth in Advertising" campaign to help ensure patients know the education, training, and qualifications of their health care professionals. <a href="https://www.ama-assn.org/delivering-care/patient-support-advocacy/truth-advertising">Learn more</a>. </p> <h3>HCA clarifies exceptions to new home health and DME physician requirement</h3> <p> In response to concerns expressed by the WSMA and physician community, the Health Care Authority has issued a clarification on its <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181226/wsma_seeks_delay_in_potentially_burdensome_hca_change_to_home_health_and_dme_orders">recent Medicaid program policy change</a> requiring physician review for all home health and durable medical equipment orders. In a Jan. 29 "Dear Provider" letter, the HCA provides an update on drug-related and respiratory supplies that do not require a physician signature/co-signature when ordered. They include: </p> <ul> <li>Supplies and equipment necessary for or ancillary to the administration of pharmaceuticals.</li> <li>Respiratory supplies and equipment necessary for or ancillary to the administration or monitoring of medications.</li> </ul> <p> <a href="https://www.hca.wa.gov/assets/govdelivery-clarification-health-home-20190129.pdf" target="_blank">Read the letter for details on these exceptions</a>, including an anticipated update of the relevant provider billing guides. </p> <p> Thank you to our members who braved the weather to represent the WSMA, the profession, and our patients' interest during the snowstorm. As the snow turns to slush, then sun, and possibly back to snow…bundle up to stay safe and warm out there. </p> </div>2/20/2019 10:06:45 AM2/19/2019 9:37:35 AM2/18/2019 12:00:00 AM
weekly_rounds_2019_02_04_wanted_bold_voices_willing_to_speak_upWeekly Rounds: Feb. 4, 2019 - Wanted: Bold voices willing to speak upWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_2019_02_04_wanted_bold_voices_willing_to_speak_up<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>February 4, 2019</h5> <h2> Wanted: Bold Voices Willing to Speak Up </h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> As the days of legislative session march on, it's easy to feel removed from the grind of policymaking in the halls of the Capitol. But the actions of legislators and the resulting laws have the potential to seriously impact your daily lives, whether it's how much you are reimbursed, the health of your patients, your ability to treat your patients successfully, or any number of other direct impacts. </p> <p> On health care topics, there is no voice more powerful or insightful than from those of you on the frontlines of care. The physician perspective is unique and grounded in what is best for patients, their families, and their communities. Making your voice heard is more important than ever in order to influence the future of health care. </p> <p> The measles outbreak happening in our state right now is a case in point. Community immunity is frighteningly diminished for this disease. As Alan Melnick, MD, WSMA board member and public health director for Clark County, said recently in The Seattle Times: "<a href="https://www.seattletimes.com/seattle-news/40-confirmed-victims-in-northwest-measles-outbreak/">[The outbreak] raises concerns that this can go on for a long time, become geographically larger than it is and more cases over weeks and months.</a>" </p> <p> Vaccines are safe and effective, and they save lives. They don't just protect the individual; they protect our entire society. Childhood vaccinations are among the most effective ways to protect kids against serious and preventable illnesses, some of which have no cure or treatment. We have a duty to help protect one another. The pain of a small prick of inoculation is a small price to pay to ensure the health of our communities. </p> <p> But getting to that point will take bold voices like Dr. Melnick's to remove barriers on the road to immunizations. Your voice can help counter inaccurate information perpetuating myths about vaccines—myths that pose a real threat to public health. </p> <p> Supporting the WSMA's policy to end the philosophical or personal objection exemption to childhood vaccines in Washington state law literally could save lives. Speaking to your patients about the most effective ways they can protect their children and others in the community from disease could make the difference between life and death. </p> <p> The physician perspective is critical in the exam room but advocating for patient-centered policy is vital as well. The physician-specific collective voice is what differentiates the WSMA as the largest professional association in the state that represents physicians across the board. </p> <p> More than 65 percent of our members are now employed in large medical groups, and the majority of those are in medical groups that cover the dues so that individually—and collectively—physicians have an active voice in our association. </p> <p> That investment is one way employers support and invest in their staff. The WSMA values that investment greatly. But as a member-driven organization, we rely on your voice, involvement, and participation to help set our agenda, advocate for the profession, and to speak out on important health issues like a measles outbreak. </p> <p> To be a strong and effective organization, we need your individual engagement. Remember the words of philosopher and psychologist William James: "Act as if what you do makes a difference. It does." </p> <p> P.S. If you'd like to see your fellow physicians speaking up in Olympia, check out the WSMA's video series from this year's legislative session called "<a href="https://vimeo.com/album/5729481">Doctors Making a Difference</a>." </p> <p> P.P.S. If you haven't yet renewed your membership with the WSMA, now is the time! <a href="https://wsma.org/Shared_Content/Contacts/Sign_In.aspx?LoginRedirect=true&returnurl=%2FWSMA%2FMembership%2FJoin_Renew%2FJoin_Renew_Auth.aspx%3FWebsiteKey%3Dc182ff6d-1438-4899-abc5-614681b54927">You can renew online</a>—and thank you! </p> </div>2/20/2019 9:40:14 AM2/4/2019 9:52:15 AM2/4/2019 12:00:00 AM
weekly_rounds_2019_01_28_a_new_year_and_5_new_things_to_knowWeekly Rounds: Jan. 28, 2019 - A new year and 5 new things to knowWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_2019_01_28_a_new_year_and_5_new_things_to_know<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>January 28, 2019</h5> <h2>A New Year and 5 New Things to Know </h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> I've seen reports that say 80 percent of New Year's resolutions fail by the second week of February. As January winds up, I'm aware of my lack of commitment to my own resolution of reading more. I'm guessing I may be in good company. </p> <p> Regardless, WSMA's perennial commitment to provide strong physician leadership and advocacy to shape the future of medicine and advance care for all Washingtonians remains paramount throughout the entire new year. </p> <p> Here's a quick rundown of new happenings and opportunities at the WSMA as well as a new idea bubbling up in Olympia. </p> <ol> <li><strong>WSMA launches new policy-focused department</strong><br /> <p> Our members have spoken and we listened. The WSMA's advocacy work is ranked as a top priority by our members and we want to do more in that space. To that end, we are implementing a new policy department to more deeply inform our legislative and regulatory priorities, as well as our advocacy agenda. This includes implementation of policies and programs at state and federal levels and encompasses advocacy with commercial payers. The policy team will assist our government affairs team with analysis of issues related to medicine and the profession. </p> </li> <li><strong>A new design for WSMA Reports</strong><br /> <p> With the March/April edition of WSMA Reports, you'll notice a new magazine-style redesign. We wanted our flagship publication's visual aesthetic to reflect the dynamic membership of our association, to represent our members more fully within its pages, and to implement an engaging and interactive editorial approach. We want to hear from you! When the new publication crosses your desks in early March, I hope you'll take a close look and let me know your thoughts about it. </p> </li> <li><strong>WSMA Foundation wins new wellness grant</strong><br /> <p> We've just been notified that the WSMA Foundation will be awarded grant funding from the Physicians Foundation to explore the state of professional satisfaction and practice sustainability and to identify strategies and resources for addressing both. The funds will be used to identify pilot practices that will measure and test on-site practice efficiency initiatives and guided practice transformation efforts that get at the heart of clinician burnout or lack of professional fulfillment. The effort is supported by the Physicians Foundation and the AMA's Transformation Initiative: Solutions to Increase Joy in Medicine. The mission of the initiative is to advance research and promote evidence-based solutions that improve patient care by enhancing professional fulfillment and reducing clinician burnout. The WSMA Foundation is crafting an RFP for interested practices. If you'd like your practice to be considered, contact Jessica Martinson at <a href="mailto:jessica@wsma.org">jessica@wsma.org</a>. </p> </li> <li><strong>New LDC scholarship opportunities</strong><br /> <p> As you'll read in the new WSMA Reports, WSMA member and Washington Physicians Health Program Executive Medical Director Chris Bundy, MD, notes: "Physicians are often accidental leaders. They are good doctors who are respected by colleagues for their clinical acumen and their emotional intelligence, who want to serve the profession and essentially volunteer to be in leadership roles, for which they have little training or experience."</p> <p>Another WSMA priority is providing leadership training and development via many course offerings, including our annual <a href="https://wsma.org/WSMA/Events/Leadership_Development_Conference/WSMA/Events/LDC/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222">Leadership Development Conference</a>. We have a limited number of scholarships available for this year's conference, scheduled for May 17-18 at Campbell's Resort on Lake Chelan. </p> <p> The scholarship application form is <a href="https://www.surveymonkey.com/r/2019LDCScholarship">available online</a>. Apply by this Wednesday, Jan. 30, to be considered. </p> </li> <li><strong>New horizons ahead</strong> <p> With Gov. Jay Inslee spending much of last week in New Hampshire, it's apparent that he's moving forward with a presidential bid. With his sights set on new horizons, does that mean Washington will be an incubator for his new ideas? Perhaps. Just before the start of the state legislative session, the governor, along with democratic lawmakers, announced their intention to introduce legislation establishing a public health insurance option in Washington state. The legislation has now been introduced and is scheduled for a hearing this week. Here's the basic framework for the plan (called "Cascade Care"): The state Health Care Authority will contract one or more insurers to offer "standardized" plans within the state's health benefit exchange to ensure that all counties in the state have available insurance options on the individual market; standardized plans will have consistent and transparent deductibles, co-pays, and co-insurance; and physician and provider reimbursement rates will be capped at Medicare rates. For details, the legislative language can be read in full: <a href="https://app.leg.wa.gov/billsummary?BillNumber=1523&Initiative=false&Year=2019">House Bill 1523</a> and its companion <a href="https://app.leg.wa.gov/billsummary?BillNumber=5526&Initiative=false&Year=2019">Senate Bill 5526</a>. </p> <p> Our team in Olympia will be hand to testify at the hearing Friday. They will communicate WSMA's goal of ensuring that patients have access to affordable coverage in their communities, while also expressing deep concern with pegging physician and provider reimbursement rates at Medicare rates. Establishing Medicare rates as the default payment for a public option guarantees that many physician practices will not be able to serve patients enrolled in it, despite the desire they may have to do so. </p> </li> </ol> <p> Stay tuned on this and more. For up-to-date legislative news on our priorities, visit <a href="https://wsma.org">wsma.org</a> and follow us on <a href="https://twitter.com/WSMA_update">Twitter</a>. </p> <p> Thank you for your continued membership in the WSMA. Our strength is rooted in your voice and participation. If you haven't yet <a href="https://wsma.org/WSMA/Membership/Join_Renew/Join_Renew_Auth.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">renewed</a>, please make that today's resolution—it's one worth completing. </p> </div>2/20/2019 9:40:51 AM1/28/2019 10:19:01 AM1/28/2019 12:00:00 AM
weekly_rounds_2019_01_14_whats_ahead_for_2019_fending_off_fee_and_tax_increasesWeekly Rounds: Jan. 14, 2019 - What's ahead for 2019? Fending off fee and tax increasesWeekly_RoundsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_2019_01_14_whats_ahead_for_2019_fending_off_fee_and_tax_increases<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>January 14, 2019</h5> <h2>What's Ahead for 2019? Fending Off Tee and Tax Increases</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Are you still reeling from the hefty price increase on your Washington car-tab renewals? I know I am. Mine nearly quadrupled, and each year when the bill arrives, I find I am still suffering from sticker shock. </p> <p> Well, fasten your proverbial seat belt, because if you are a <strong>MD or PA, your licensing fees may be increasing—54 and 96 percent, respectively</strong>. The Washington Medical Commission proposes to raise physicians' renewal fees from $657 to $1012 and physician assistants' renewal fees from $202 to $396 (fees cover the two-year cycle). </p> <p> <strong>It's unclear when the commission will move forward with this proposal, so we need you to act now by making your voice heard directly. Take a moment today to let them know how this would impact you—and tell them you endorse <a href="https://www.informz.net/WSMA/data/images/Documents/WMC_Fee_increase_ltr_112818.pdf" target="_blank">WSMA's formal comment letter</a> expressing strong opposition to the fee increases. Email them at <a href="mailto:medical.rules@wcm.wa.gov">medical.rules@wmc.wa.gov</a>.</strong> </p> <p> The WSMA has been quite vocal with commission leadership about our opposition to the staggering increase. Your WSMA board of trustees gave <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181226/wsma_pushes_back_on_state_plans_to_raise_physician_licensure_fees">direct and real-time feedback during a recent meeting</a>, and WSMA President Dr. Tom Schaaf addressed our collective concerns via the aforementioned letter to the commission. Even so, adding your opinion to the conversation makes a difference. Please take a moment to make your voice heard today. </p> <p> In other news, today is the opening day of the state's legislative session. Here's how the first week of session is shaping up: </p> <ul> <li>Today's opening will be notable, considering that nearly 20 percent of the legislators are new this year, and they'll all be sworn in today. </li> <li> Tuesday, we can look forward to Gov. Jay Inslee's "state of the state" address. </li> <li> During the week, there will be work sessions in committees aimed at getting legislators and stakeholders up to speed on issues. In fact, on Wednesday, WSMA Past President Dr. Donna Smith and Woodcreek Healthcare CEO James Hudson will present access-to-care insights to the Senate Health & Long-Term Care Committee. </li> <li> And as always, our team on the ground in Olympia will be busy providing testimony even this week on issues such as raising the age for tobacco purchase, whistleblower legislation, and more. </li> </ul> <p> Looking ahead, we know that our profession will face some challenging issues during session, including: </p> <ul> <li> A potential <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181226/governors_2019_budget_proposal_the_good_the_good_and_the_ugly">B&O tax increase</a>.</li> <li> A public option offered on the state's health benefit exchange that <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190109/gov_inslee_previews_public_option_bill">caps reimbursements to physicians and other providers at Medicare rates</a>.</li> <li> Attempts to expand wrongful death liability.</li> <li> A move to ban balance billing.</li> </ul> <p> As bills are introduced and hearings held, we will keep you informed of what transpires. I anticipate that we will be turning to our membership frequently with calls to action. With no physicians in the state legislature, we need to ensure that the medical community's voice is heard and that the implications of legislation are thoughtful and absent of unintended consequences. We will all need to engage if we are to advocate for a strong care community that serves our patients and communities. Our mantra holds fast: <strong>When ensuring that all Washingtonians have access to care in Washington state, we must not do so at the detriment of those providing the care.</strong> </p> <p> <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190109/a_look_at_wsmas_advocacy_agenda_on_eve_of_state_legislative_session">Click here</a> to read more about the WSMA's 2019 legislative agenda. </p> <p> Another great way to make your voice heard is to attend our 2019 Legislative Summit, scheduled for Feb. 7 in Olympia. No one knows better than our members the challenges in providing care, and we rely on them to enlighten legislators about how these issues truly affect the practice of medicine and patients—who, by the way, are constituents! </p> <p> Your opinions and perspectives matter to state legislators and policymakers. The event is free and provides an opportunity for you to come to the state capital, gain insight into how we translate WSMA policy into real action with legislators, and to meet with lawmakers directly. </p> <p> Don your white coat and join us! The visual message of physicians, physician assistants, and medical students united in support of the profession and patients is a powerful one. </p> <p> <a href="https://wsma.org/WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454">Register for the Legislative Summit today</a>. </p> <p> A special thanks to our <a href="https://wsma.org/legislative-summit#partners">corporate partners</a>—exclusive premier partner <a href="https://www.phyins.com/">Physicians Insurance A Mutual Company</a>, and silver partners <a href="https://www.premera.com/wa/visitor/">Premera Blue Cross</a>, <a href="https://www.fchn.com/">First Choice Health</a>, <a href="https://www.hallrender.com/">Hall Render</a>, and <a href="https://www.wpmgcareers.org/">Washington Permanente Medical Group</a>—for helping the WSMA make this event free for our members and for members of Washington State Medical Group Management Association. </p> <p> We're already working this year to make Washington the best place to practice medicine and receive care. Thank you for your support, involvement, and membership in the WSMA. Your engagement is what enables us to do this work on your behalf. (Haven't joined or renewed your membership for 2019 yet? <a href="https://wsma.org/Shared_Content/Contacts/Sign_In.aspx?LoginRedirect=true&returnurl=%2FWSMA%2FMembership%2FJoin_Renew%2FJoin_Renew_Auth.aspx%3FWebsiteKey%3Dc182ff6d-1438-4899-abc5-614681b54927">Click here</a> right now to fix that! Thank you.) </p> <p> P.S. If you still need convincing, <a href="https://vimeo.com/310886915">here's WSMA's director of legislative affairs, Katie Kolan, JD</a>, on why it's important for the physician community to come to Olympia on Feb. 7. Join us! </p> </div>2/20/2019 9:41:49 AM1/14/2019 9:44:45 AM1/14/2019 12:00:00 AM
weekly_rounds_2018_12_18_this_feb_7_bring_your_white_coat_and_medical_perspective_to_olympiaWeekly Rounds: Dec. 18, 2018 - This Feb. 7, bring your white coat and medical perspective to OlympiaWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_12_18_this_feb_7_bring_your_white_coat_and_medical_perspective_to_olympia<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>December 18, 2018</h5> <h2> This Feb. 7, Bring Your White Coat and Medical Perspective to Olympia</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> The 2019 state legislative session begins in less than a month, and the recent release of Gov. Inslee's budget gives us a preview of topics that will be center stage for health care and medicine. </p> <p> As expected, the governor proposed a budget that supports integrating behavioral health with primary care, with $675 million aimed at addressing mental and behavioral health treatment. Specifically, the monies aim to improve state mental and behavioral health facilities and provide additional beds for patients with mental, behavioral health, and substance use disorders. Funds, if approved, would also be used to create five new psychiatric residencies at the University of Washington. </p> <p> On the primary care side, the governor included $56.6 million in state funds and $142.9 million in federal funds to support an increase in Medicaid payments for adult and pediatric primary care. This proposal appears to mirror the two-year primary care reimbursement rate increase our state saw under the Affordable Care Act in 2013-14 and reflects an increase at 83 percent of Medicare, according to the governor's office. The budget also includes $9.1 million in state funds and $27.7 million in federal funds to increase the Medicaid rate paid for mental and behavioral health and psychotherapy codes. </p> <p> Related to public health, the governor proposes an additional $22 million to help stabilize public health, $100,000 to improve the prescription monitoring program, and $8.9 million to cover the projected revenue shortfall if the Legislature raises the legal age for tobacco products to 21. The WSMA supports all of these initiatives. </p> <p> That said, the fact that Gov. Inslee's funding package comes at a cost to our profession is significantly troubling. The budget proposes $3.7 billion in tax increases, including, most notably for the WSMA, an increase in the business and occupation tax from 1.5 percent to 2.5 percent—a whopping 67 percent increase. Obviously, such a tax proposal is a non-starter for the WSMA, and we will work aggressively to defeat it. If the governor is seeking to raise taxes to support his budget priorities, heHo needs to look at a general tax increase that is universally applied, rather than over-burdening the business and professional community. </p> <p> Effectively opposing tax increases is a tall order. But you can count on the WSMA's dedicated staff of professional lobbyists in Olympia to make the physician voice heard loud and clear. </p> <p> You may not realize that there are no physicians currently serving in the Legislature. In addition to hearing from our staff, it will be critical that lawmakers hear from you as well. Only our members—with direct and lived experience—can make house-of-medicine issues "real" for lawmakers. Only you can provide real-life examples of how legislative issues impact the practice of medicine. </p> <p> The <a href="https://wsma.org/WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454">WSMA Legislative Summit</a>, our annual "lobby day on the Hill" for the physician community, is scheduled for Feb. 7 in Olympia. This is an opportunity to don your white coats and join your fellow physicians, physician assistants, medical students, and practice staff at the Capitol to talk about issues of concern to the profession and your patients. </p> <p> The Summit is your chance to humanize the WSMA's advocacy agenda for lawmakers. Hearing directly from a physician or provider constituent with firsthand expertise on complex issues helps educate lawmakers and helps ensure the physician and patient perspective is considered as policy is being made. WSMA executive committee member and outgoing WAMPAC board chair Nariman Heshmati, MD, puts it well by saying: "We sometimes don't realize how much our opinions, voiced in unison, matter. It's a trusted opinion and we have to utilize that to make positive changes." </p> <p> During the Summit's morning session, attendees hear from state health officials, policy makers and legislative leaders, as well as WSMA legislative staff on the issues being debated in the Legislature that stand to impact the house of medicine. Attendees will also receive coaching on how to meet with their legislators to effectively deliver our message during legislator meetings in the afternoon. (Note: these meetings are pre-arranged on your behalf by WSMA staff.) </p> <p> What is the WSMA Legislative Summit experience like? Check out this <a href="https://vimeo.com/304230432">brief video</a> to find out and to hear why Katie Kolan, JD—WSMA's legislative lead and Summit presenter—thinks you should join us on Feb. 7 at the state Capitol. </p> <p> <a href="https://wsma.org/WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454">Register to attend the 2019 WSMA Legislative Summit today</a>. The event is free for WSMA and WSMGMA members. Working together, we will make Washington the best place to practice medicine and receive care. </p> <p> P.S. For more on WSMA's legislative agenda and how to be a physician advocate, keep an eye on your mailbox for the January/February edition of WSMA Reports, which covers it all! </p> </div>2/20/2019 9:42:21 AM12/18/2018 3:03:58 PM12/18/2018 12:00:00 AM
weekly_rounds_2018_12_03_making_sure_new_credentialing_requirements_are_working_for_youWeekly Rounds: December 3, 2018 - Making sure new credentialing requirements are working for youWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_12_03_making_sure_new_credentialing_requirements_are_working_for_you<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>December 3, 2018</h5> <h2>Making Sure New Credentialing Requirements Are Working for You</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> A couple of years ago, several WSMA members reached out to us to ask for help on improving credentialing processes. They reported that the process was taking as long as six months, causing needless and costly delays, not to mention sidelining and frustrating physicians who were ready to get to work and start caring for patients. Other physicians, speaking on behalf of their staff, told us about the complexities of having to complete multiple applications for every insurer they contracted with—a time-consuming and inefficient process. </p> <p> Hearing these concerns, the WSMA took action on this issue as part of our <a href="https://wsma.org/WSMA/Resources/Administrative_Simplification/Healthy_Doctors__Healthier_Patients/Healthy_Doctors__Healthier_Patients.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">Healthy Doctors, Healthier Patients initiative</a>. We <a href="https://wsma.org/WSMA/Resources/Administrative_Simplification/Healthy_Doctors__Healthier_Patients/Healthy_Doctors__Healthier_Patients.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">advocated for successful legislation</a> in 2016 that—for the first time in our state's history—streamlines and standardizes the turnaround time and process for insurers to approve or deny those requests. (Note: These standards don't apply to hospitals or medical groups with delegated credentialing authority, or to health plans not regulated by the state Office of the Insurance Commissioner). </p> <p> In June of 2018, that new law, <a href="http://apps2.leg.wa.gov/billsummary?BillNumber=2335&Year=2015&Initiative=false&BillNumber=2335&Year=2015&Initiative=false">House Bill 2335</a>, went into effect, requiring insurers to credential physicians and providers within 90 days (even better, by 2020, insurers will be required to meet a 60-day average for all applications). The law also stipulated that insurers, physicians, and providers must use <a href="https://www.onehealthport.com/credentialing-overview">ProviderSource</a> to submit and process credentialing applications. </p> <p> Unfortunately, as is the case with most legislation, HB 2335 is not perfect; it doesn't include an enforcement mechanism. We are learning that while most insurers doing business in our state have signed up to pull applications from ProviderSource, they are not actually pulling credentialing applications from the database. </p> <p> As I often write in this space, our members and their concerns drive our work. Our effort to improve the credentialing process is an example of how we work on your behalf. But it's important for us to know how things are working for you. Is the new law meeting its intended goal of reducing the time it takes to be credentialed? Are insurers using ProviderSource as directed by law? </p> <p> At this point, the best way to reduce time and hassle—for you and your staff—is to upload your information to ProviderSource and direct insurers to go there to retrieve the information. To assist you in your communication with the insurance companies, here's a <a href="http://wsma.informz.net/z/cjUucD9taT04MTQ0Nzk3JnA9MSZ1PTEwNzgxMDgzNjEmbGk9NjA4ODYxNjE/index.html">sample letter</a>, developed by the WSMA and the Washington State Medical Group Management Association, you could use for that purpose. </p> <p> As someone wise once said: "Willing is not enough; we must do." If you want to limit the credentialing hassles your practice is facing, go with this one-and-done approach. And let me know how it's working for you. </p> <p> P.S. This work—advocating on your behalf—is made stronger when we stand together. This is the value of membership in the WSMA, now more than 11,000 members strong. Thanks in advance for renewing your membership today! Your investment with us makes our efforts not only possible, but successful. <a href="https://wsma.org/WSMA/Membership/Join_Renew/WSMA/Membership/Join_Renew/Join_Renew.aspx?hkey=37a820cf-9d05-4812-b9dd-c29b9a75356d">Renew online</a> or by mailing in your dues statement upon receipt. For personal assistance, email <a href="mailto:membership@wsma.org">membership@wsma.org</a> or call 206.441.9762. </p> </div>2/20/2019 9:42:54 AM12/3/2018 9:33:09 AM12/3/2018 12:00:00 AM
weekly_rounds_2018_11_19_difficult_news_that_must_be_deliveredWeekly Rounds: November 19, 2018 - Difficult news that must be deliveredWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_11_19_difficult_news_that_must_be_delivered<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>November 19, 2018</h5> <h2>Difficult news that must be delivered</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> As physicians, you're no strangers to having to dispense difficult news. It's a burden you carry with grace, compassion, and empathy. As I write today's column, that aspect of your caring profession weighs heavy on my mind. In thinking about it, I came across <a href="https://www.medicalnewstoday.com/articles/318067.php">this quote</a> on the topic, from Steven Pantilat, MD, founding director of the Palliative Care Program at the University of California-San Francisco Medical Center: "No matter how well you deliver bad news, it's still bad. You can't make it somehow OK for the patient, but it's important not to make it worse." </p> <p> These thoughts have been with me as I've considered all the ways we can make sure you're aware of how opioid prescribing rulemaking from House Bill 1427, passed by the Legislature in 2017, will ultimately impact you. Despite our efforts, the rules—which, for most of you, will be effective starting in January—are complicated and will be a challenge for some practices to implement. </p> <p> Here's some background: Combatting the opioid epidemic is a top priority for the WSMA. Over the past several years, we have advanced both <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/multi_pronged_efforts_seek_to_make_a_difference_in_opioid_epidemic">legislative</a> and <a href="https://wsma.org/Shared_Content/News/Press_Releases/2018/Public-private_safe_prescribing_initiative_results_in_reductions_in_Medicaid_opioid_prescriptions.aspx">patient-safety strategies</a>, partnering with the Washington State Hospital Association, the governor's office, the state Department of Health, and the state Health Care Authority. </p> <p> You'll recall that over the last year, we've <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180912/medical_commission_finalizes_opioid_prescribing_rules.aspx">regularly</a> <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180808/Last_chance_to_comment_on_rules_impacting_the_way_you_prescribe_opioids">communicated</a> our <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180228/doh_seeks_comments_on_draft_opioid_prescribing_rules_final_public_meeting_on_march_14">efforts</a> regarding the rulemaking on this bill. It's been an exceedingly rough road, as five separate medical commissions proposed varying—and sometimes conflicting—rules, over many iterations. Throughout the process, our team in Olympia has heroically had your backs, and has been unceasingly vigilant in working to protect you from undue burden and your patients from unintended consequences. </p> <p> At the same time, as a leading voice for the physician community, the WSMA has advocated for policies that reduce the amount of inappropriate prescriptions in our communities while ensuring access to medications for patients that need them. </p> <p> House Bill 1427 became the primary vehicle for many interventions, including opioid prescribing rules and data sharing by the state to improve opioid prescribing practices. After a year-long process, the boards and commissions that regulate prescribers in Washington state have finalized their rules. For allopathic physicians and physician assistants, Washington Medical Commission's final rules go into effect this Jan. 1 (read the final rule <a href="https://wmc.wa.gov/sites/default/files/public/documents/Ruleswithcoverpage.pdf" target="_blank">here</a>). For osteopathic physicians and PAs, Board of Osteopathic Medicine and Surgery rules went into effect on Nov. 1 (read that final rule <a href="https://www.doh.wa.gov/Portals/1/Documents/2300/2018/WSR-18-20-087.pdf" target="_blank">here</a>). </p> <p> As medical leaders, you will want to note the prescribing professions' differing requirements, given HB 1427 allowed each regulatory body to adopt new rules under its own authority. At the request of several leaders, we are working to create a rules overview slide deck that will help you prepare your care teams for these new requirements (we expect the slides to be ready in December). </p> <p> For now, together with Washington State Hospital Association and the Health Care Authority, we are recommending three key strategies for success in this new opioid prescribing environment: </p> <ul> <li><a href="https://wsma.org/WSMA/Resources/Clinical_Quality/Opioid_Clinical_Guidance/Opioid_Clinical_Guidance.aspx#rules">Prepare for new opioid prescribing rules</a>.</li> <li><a href="https://wsma.org/WSMA/Resources/Clinical_Quality/Opioid_Clinical_Guidance/Opioid_Clinical_Guidance.aspx#data">Leverage available data to understand prescribing patterns and receive alerts for patients who have experienced an overdose</a>. </li> <li><a href="https://wsma.org/WSMA/Resources/Clinical_Quality/Opioid_Clinical_Guidance/Opioid_Clinical_Guidance.aspx#pmp">Integrate your electronic health record with the state's prescription monitoring program</a>. </li> </ul> <p> The links above contain details on these strategies and recommendations. You will need to develop a comprehensive strategy for engaging in this work, and I know it won't be easy. I'm chagrined at being one of the messengers on this news, but I appreciate your response to the opioid epidemic. </p> <p> I hope you know that we are fully committed caring for, and protecting you, just as you do for your patients. We'll keep working hard to prevent well-intentioned, yet problematic concepts for patient care. </p> <p> Thank you for all you do on behalf of Washington patients. </p> </div>11/20/2018 8:49:51 AM11/19/2018 10:04:33 AM11/19/2018 12:00:00 AM
weekly_rounds_2018_11_5_collective_effort_drives_effective_changeWeekly Rounds: November 5, 2018 - Collective effort drives effective changeWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_11_5_collective_effort_drives_effective_change<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>November 5, 2018</h5> <h2>Collective effort drives effective change</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Late last week, the power of our collective voice and the clout of organized medicine became tangibly evident. As noted in the <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_09_03_five_things_you_need_to_know_this_week">Sept. 3 edition of Weekly Rounds</a>, the WSMA and 170 other physician and health care organizations united to vehemently oppose a proposal to collapse Medicare payment rates for office and outpatient visit services. And then, thanks to the house of medicine speaking out in full force, the Centers for Medicare and Medicaid Services delayed implementation of the proposed changes for two years. </p> <p> In the past few days, the American Medical Association—which led the effort to oppose the payment changes—reported that CMS "acknowledged the work of the AMA's CPT/RUC Workgroup on E/M and has <strong>postponed any coding and payment-related changes for E/M office visit services until CY2021</strong>." </p> <p> This delay in implementation allows the CPT Editorial Panel to "consider the Workgroup's proposal in February of 2019 prior to prompt consideration by the AMA/Specialty Society RVS Update Committee (RUC)." </p> <p> In further good news, CMS did finalize several changes to E/M documentation guidelines, which were strongly supported by organized medicine. These changes will take effect January 1: </p> <ul> <li>Eliminating the requirement to document medical necessity of furnishing visits in the home rather than the office. </li> <li>Physicians will no longer be required to re-record elements of history and physical exam when there is evidence that the information has been reviewed and updated. </li> <li>Physicians must only document that they reviewed and verified information regarding chief complaint and history that is already recorded by ancillary staff or the patient.</li> </ul> <p> Other Coding/Payment Proposals Related to E/M </p> <ul> <li>The following policies were also opposed by the AMA and will not be implemented by CMS:</li> <li>Payment reductions by 50 percent for office visits that occur on the same date as procedures (or a physician in the same group practice). </li> <li>CMS proposed to no longer allow for podiatry to report CPT codes 99201-99215 and instead would use two proposed G-codes for podiatry office visits. CMS also proposed a new prolonged service code that would have been implemented to add-on to any office visit lasting more than 30 minutes beyond the office visit (i.e. hour-long visits in total).</li> <li>Condensed practice expense payment for the E/M office visits, by creating a new indirect practice expense category solely for office visits, overriding the current methodology for these services by treating Office E/M as a separate Medicare Designated Specialty. This change would also have resulted in the exclusion of the indirect practice costs for office visits when deriving every other specialty's indirect practice expense amount for all other services that they perform, which would have resulted in large changes in payment for many specialties (e.g., a greater than 10 percent payment reduction for chemotherapy services). </li> </ul> <p> For CY 2021, CMS conveyed its intention to propose two basic payment rates for office visit services, one for straightforward visits and another for complex visits. In addition, CMS noted its intent to propose add-on codes for primary care and inherently complex specialty E/M visits. </p> <p> CMS noted they will also consider input from the AMA and the CPT/RUC Workgroup on E/M as well as input from across the medical community. </p> <p> We're grateful to the AMA for its quick analysis of the E/M sections of the final rule, and for leading the nationwide coordinated effort to oppose the problematic proposals offered by CMS. </p> <p> If you are in the position of deciding whether to renew/join the AMA, consider this as just one example of how organized medicine works on your behalf. Changes like these don't happen because of one individual's comment or one medical group's response. This type of high-level change requires the power of 170 organizations together in a critical mass that demands attention and forces policy makers to take notice and act. </p> <p> I hope this prompts <strong>you</strong> to act. Your membership in the AMA and the WSMA really does matter. There is no doubt that together we are stronger. </p> </div>11/5/2018 11:27:59 AM11/5/2018 10:41:26 AM11/5/2018 12:00:00 AM
weekly_rounds_2018_10_29_working_together_for_the_good_of_health_careWeekly Rounds: October 29, 2018 - Working together for the good of health careWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_10_29_working_together_for_the_good_of_health_care<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>October 29, 2018</h5> <h2>Working together for the good of health care</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Just over a week ago, hundreds of WSMA members convened at the Historic Davenport Hotel in Spokane for the annual meeting of our House of Delegates. It's always energizing to connect face-to-face with our members and to hear from them about issues of concern. </p> <p> The conversations I had at our meeting echoed other discussions I've had lately, including at a recent dinner with physicians from all over the country. Our broad-ranging dialog covered familiar ground: How do we engage today's physicians in our organizations, and how do we engage our members in the larger health care conversation? </p> <p> A full-blown crisis is often a catalyst to motivate like-minded folks to act. There's nothing like an immediate or impending threat to get people organized, engaged, and mobilized. Even recent history bears this out, if you think about public health concerns like lead in the water in Michigan; or longer ago, smallpox and flu epidemics, HIV/AIDS, polio, etc. </p> <p> A recent New York Times article, "<a href="https://www.nytimes.com/2018/10/06/opinion/sunday/climate-change-global-warming.html">Stopping Climate Change Is Hopeless. Let's Do It</a>," opined that "if the human species specializes in one thing, it's taking on the impossible." In that article, Auden Schendler and Andrew P. Jones wrote that: "…we must realize that real progress comes from voting, running for office, marching in protest, writing letters, and uncomfortable but respectful conversations with fathers-in-law. This work must be habitual. Every day some learning and conversation. Every week a call to Congress. Every year a donation to a nonprofit advancing the cause. In other words, a practice." </p> <p> That admonition applies to any situation where we must work to advance change, whether for the good of society, or in WSMA's case, the good of patients and the profession. Real change in health care comes about slowly, takes practice, and takes engagement. And it shouldn't take a crisis to motivate us to action. It should be an everyday ritual. </p> <p> Advancing change is exactly where "slow and steady wins the race" is the approach that works. The WSMA provides the structure for that approach to succeed. Day in and day out, our sole purpose is to advance an agenda that benefits the profession and the patients you treat. But to advance a meaningful agenda—one that will have a true impact on health care and medicine—we need your direction, feedback, expertise, and engagement. And we need your voice not just once, and not just on an issue that pertains solely to your specialty or practice setting. We need all physicians working together all the time to advance what's best for medicine. </p> <p> Members drive our work. It is our members who advise us on practical and workable solutions to balance billing and opioid prescribing. Our members charge us to take a leading role to address gun violence and suicide, clean air, and social determinants of health. Members inform us on what hinders quality patient care and depletes the joy of practice. And it's our members who are willing to stand up and challenge unnecessary care and waste in the system. </p> <p> That input drives our agenda, and from there it is WSMA's job to bring your voice to the forefront of debate on these issues. </p> <p> In the coming months, lawmakers will be making critical decisions that could have enormous implications to physicians and patients. </p> <p> Just as teamwork is a key part of health care, teamwork is also key to our efforts representing you. In effect, we are your dyad partner, working to represent your interests while soliciting your feedback and direction. </p> <p> The WSMA's superpower is its ability to bring specialties together, bridge generational divides, unite diverse perspectives, and democratically balance it all to find solutions to challenges faced by the profession, patients, and communities. We saw this in action at the House of Delegates in mid-October—see this work for yourself by <a href="https://wsma.org/WSMA/About_Us/Leadership/House_of_Delegates/WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx?hkey=e2c50002-384d-4ff7-9116-5ce7a51116e7">reviewing the policies adopted by delegates the 2018 WSMA Annual Meeting</a>. </p> <p> Your voice matters to us and to the profession. This is our strength that ensures a positive working and care environment and leads us to our vision of making Washington the best place to practice medicine and to receive care. </p> <p> Thanks for standing with us in this work. It really does matter. </p> </div>10/29/2018 9:59:22 AM10/29/2018 9:55:43 AM10/29/2018 12:00:00 AM
weekly_rounds_2018_10_18_if_physicians_do_not_lead_someone_else_willWeekly Rounds: October 18, 2018 - If physicians don't lead, someone else willWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_10_18_if_physicians_do_not_lead_someone_else_will<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/weekly_rounds_tom_schaaf.jpg" class="pull-right" /></div> <h5>October 18, 2018</h5> <h2>If physicians don't lead, someone else will</h2> <p> Tom Schaaf, MD, WSMA President </p> <p> <em>On Sunday at the 2018 Annual Meeting of the WSMA House of Delegates, we inaugurated our new incoming president, Tom Schaaf, MD, MHA. For those of you who couldn't be with us, we wanted to be sure you had an opportunity to read his speech, so I've invited him to be our guest columnist for Weekly Rounds. - Jennifer Hanscom, WSMA executive director/CEO</em> </p> <p><strong> Tom Schaaf, MD, WSMA 2018-19 incoming president's speech, Sunday, Oct. 14, 2018, 9 a.m. at the Historic Davenport Hotel in Spokane.</strong> </p> <p> I'd like to thank you all for being here today. It's a significant chunk of time to be away from your families, your practices and your weekend, and I know it's tough to sit inside—even in the Davenport Hotel—on a classic fall day in Spokane. I'd also like to say a special thanks to my family, friends, and colleagues from Providence for their support this morning. </p> <p> I'm grateful to you for allowing me the privilege of representing you as president of the WSMA as we face challenging times in the house of medicine. </p> <p> Many of these issues you experience every day: </p> <ul> <li>The rise—and then the disruption—of the Affordable Care Act along with complicated programs for value-based payment causing anxiety about our economic futures. </li> <li>EMRs brought us access to overwhelming amounts of information—or no useful information at all—while drawing our attention to the ever-demanding keyboard and away from our patients. </li> <li>Prior authorization, pharmacy benefit managers, and CMS-mandated visits to approve care are maddening. </li> <li>The relationship with our patients has fractured as health plans change, practices are purchased, internet medicine expands, and convenience becomes the key driver of the health care "consumer." </li> <li>And the opioid crisis has led to increasing regulation and oversight of our care, in addition to becoming another point of distrust between our patients and ourselves. </li> </ul> <p> Through all these challenges, the WSMA is working to advocate on your behalf, educate the public and our civic leaders, and bring you the tools to cope, and hopefully thrive, as we all navigate the journey ahead. </p> <p> Now, my day-to-day job title may make some of you skeptical about my ability to represent you in this work. First of all, I work for Providence St Joseph Healthcare. While many folks here actually work for Providence, Swedish, or Kadlec, some of you in the audience may view our employers skeptically. My role there is the chief medical officer for home and community care. </p> <p> I realize that for some of you that is the epitome of "going to the dark side." In fact, one of my WSMA colleagues has even given me a hairless cat statue to bolster my "Dr. Evil" cred. </p> <p> My hope this morning is to share some insight into why I pursued leadership roles, why physician leadership roles are critical to the future of the house of medicine, and why leaderships skills are worth learning. </p> <p> I'd like to share a bit about my background. My father was a practicing family doctor for almost 60 years. When I was a youngster, his office was in our home. My earliest memories are of driving to the hospital with him to make rounds, and playing with the models of hearts, brains, and knees in his office. When I was older, I even answered the phone and made appointments. </p> <p> I was the kind of kid who read everything. I still have a 1926 edition of "Microbe Hunters" on my bookshelf. The scientists profiled in that book were my heroes growing up. Koch, Pasteur, and Ehrlich not only saved lives, they also had to work against tradition and engrained practices. I was inspired by the possibilities, the adventure, the potential that adapting to change can bring to improving health and life. To me this was exciting stuff. A job as diener and phlebotomist as a high school student pushed me to commit to a pre-med course of studies at Whitworth. </p> <p> At UCLA, I enjoyed nearly every clinical rotation I did, leading me to a family medicine residency. My scope narrowed a bit when I joined my dad's geriatric practice at Laguna Hills Leisure World. It was fun to be a practicing physician at the hospital where I had been a phlebotomist in high school. It took a while to overcome the "what are you doing?" reactions! </p> <p> Eventually, I left southern California, returning to the Northwest where I spent more than 20 years with Group Health. During that time, I became involved in quality programs, process improvement, and system redesign. In 1996, I had the opportunity to create the hospitalist program that still serves Kaiser patients at Providence Sacred Heart, and I moved from the outpatient clinic to a hospitalist role. </p> <p> That experience was pivotal for me. Clinically, I had to adapt my practice from mostly outpatient geriatrics to purely inpatient. From a leadership perspective, I had to learn a thousand things in a short timeframe. </p> <p> One of the key things I learned was to shut up and listen to people trying to cope with a changing world. I also learned to be humble in the presence of people of who often knew more than I did. But they did need help fixing broken systems and adapting to a changing environment. </p> <p> After some time, I became regional medical director for the Group Health clinics in Spokane and Couer d'Alene, leaving in 2014 when they laid off a number of physician leaders. </p> <p> At that point in my career I was 55, a bit salty about the layoff, and had to figure out what I really wanted to do when I grew up. It was clear that our health care system was not going to fix itself, and that physicians were needed to lead the effort to get things on track. I realized that my on-the-job training in leadership wouldn't be sufficient if I wanted to be a useful part of the solution. </p> <p> I spent two years getting my Master of Health Administration at University of Washington with Dr. Ed Walker and his crew, while also working as a hospitalist at Sacred Heart and at St. Joseph Care Center. I realized that the skills we learn as clinicians are necessary—but not sufficient—to influence CEOs, CFOs, and other health system administrators. Understanding their perspective and the business financials is a necessity in communicating with them. Knowledge of law and health care policy is also helpful to effectively advocate for appropriate policy decisions. Administrators tend to speak a different language than physicians, which makes it hard for them to understand us. But when we effectively translate the language of medicine and tell the story of patients and doctors to non-clinicians in leadership, we can shape the outcome of decisions that dramatically affect our lives. </p> <!-- div class="col-md-5 pull-leftt" style="text-align: center;"><img alt="" src="/images/News/2018-10-WSMADrSchaaf-1.jpg" /></div --> <p> The outcome of my MHA efforts, combined with my clinical work in geriatrics, led to me creating the CMO role at Providence Home and Community Care. This role includes working with administrative and clinical staff to improve care in skilled nursing, home health, and hospice services. It also involves working with Providence system leaders to improve the way care flows across inpatient, outpatient, and continuum services. I'm privileged to work with incredibly creative and committed folks to improve care for the elderly across the whole Providence system, and it is really fun work. There are few other systems where I can have that much impact on a daily basis, and the heart of that work is to make it easier for physicians and nurses to give great care to our patients. </p> <p> I do still have a stethoscope, and I still know how to use it. I see hospice patients in Olympia every week, and I help out with patients in King County and Everett when they are short staffed. It's no surprise that this work grounds me in the real world of patient care and helps me understand the systems I'm working to fix. Those who do hospice care know that it is the ultimate in team-based care, and the privilege of caring for people in their homes is hard to describe if you've never done it. </p> <p> I am fortunate to be in this leadership role and still get to see patients. Some physician leaders aren't so fortunate. Those physicians who have had to give up direct patient care to help lead our health systems should have our respect and support. I know this idea might be uncomfortable for some of you, but when we scorn our peers who become full time CMOs and leaders, we overlook the fact that they are making a sacrifice to work on issues and systems that affect us all. </p> <p> This is all to say, here is my real request of you today: Embrace the leadership roles that come your way, even if—at a minimum—that means embracing the role of clinical leader that is implicit in being a physician working with nurses and support staff. </p> <p> Our choice isn't whether we are leaders, it is whether we are good ones or not. Be a good one. The WSMA has tools and classes to help. Attend the Leadership Development Conference in Chelan. Take the leadership courses we run with Dr. Ed Walker. Read books. Look for opportunities to work on committees and to push physician knowledge and experience into the "dark areas" of the hospital and your health system. </p> <p> If we don't lead, we will be led by folks who may be talented—and even well-meaning—but who don't know what it means to stand at the bedside and care for patients the way we do. </p> <p> It's easy to assume that someone else will do this work and to complain about what they do. If we want to fix what makes us angry, what makes it hard to do good work, what steals our hope, we have to lean in. </p> <p> You are leaders. Get even better at it and then do good with what you know. You have a hand in creating the future of medical practice. Most of us will be practicing in that future world. My son, Liam, is applying to medical school this year, and I look forward to him practicing in a better world than we tolerate now. And soon enough, all of us will become patients in that world. </p> <p> Thank you for hearing me out and thank you for accepting my service as your president. I look forward to working with you, with the board, and with Jennifer and the staff. I am anxious to hear from you, to learn from you, and am honored to be able to serve you. </p> </div>10/19/2018 2:18:46 PM10/19/2018 9:42:40 AM10/18/2018 12:00:00 AM
weekly_rounds_2018_09_17_a_time_to_care_a_time_to_speak_upWeekly Rounds: September 17, 2018 - A time to care, a time to speak upWeekly_RoundsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_09_17_a_time_to_care_a_time_to_speak_up<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>September 17, 2018</h5> <h2>A time to care, a time to speak up</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Perhaps, like me, you've seen numerous #SuicidePreventionMonth messages scrolling past on your social media feeds since the beginning of the month. I've been thinking a lot about this issue lately, and not only because I wrote about physician depression <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/physician_depression_its_time_to_care_for_our_own">in this column recently</a>. </p> <p> Knowing that an <a href="https://emedicine.medscape.com/article/806779-overview">estimated 400 physicians take their lives every year</a>, this topic weighs heavily on my mind and heart. Just last week, the statistics became more than mere numbers when I learned about the suicide of a physician known by many of our members. </p> <p> Physicians do die by suicide, but it is rarely discussed. And yet, as above, I imagine there are few degrees of separation between those who have taken this most tragic step and ourselves. In fact, when physician and author Abraham Verghese, MD, asked attendees <a href="https://med.stanford.edu/news/all-news/2017/10/good-leadership-self-compassion-key-to-tackling-physician-burnout.html">at a conference</a> if they knew fellow physicians who had killed themselves—nearly all raised their hands. He said: "We rarely expose our emotions. There's a fear of showing weakness." </p> <p> It's time for that to change, and we shouldn't need a special month to remind us to take care of ourselves and watch out for others. With suicide rates in Washington state rising, and knowing our very own members, friends and colleagues may be in pain, I urge you to be mindful not only of yourself and your patients, but also your colleagues. </p> <p> We also <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180912/september_is_suicide_prevention_month">covered this topic recently in our Membership Memo</a>. The statistics reveal a tragic irony: Physicians, who devote their lives to easing the suffering of others, die by their own hands at higher rates than the general population. </p> <p> We can take heart by taking action. </p> <p> A national campaign, <a href="http://www.bethe1to.com/">#Bethe1To</a>, centers on five steps people can take to help prevent suicide: </p> <ol> <li> ASK: Be the one to ask the tough question. If someone you know shows warning signs: "Are you thinking about killing yourself?" </li> <li> KEEP THEM SAFE: Do they have access to medications, firearms or other means of suicide? Ask if they've thought about how they would do it and separate them from anything they could use to hurt themselves. Learn more from Washington's <a href="https://makeitasafehome.org/">Safe Homes Coalition</a>. </li> <li> BE THERE: People thinking about suicide can feel they are a burden to their loved ones. Listen to their concerns with compassion and empathy and without judgement. <a href="https://www.nowmattersnow.org/">Now Matters Now</a> has videos from people who have experienced suicidal thoughts speaking about what friends can do to help manage those thoughts. </li> <li> HELP THEM CONNECT: Help your friend connect to a support system so they have a network for help, whether it's 800.273.TALK (8255), the crisis text line (text "HEAL" to 741741) family, friends, faith-based leaders, coaches, co-workers, health care professionals or therapists. The <a href="https://win211.org/">Washington 2-1-1 online database</a> is another way to find local resources. </li> <li> FOLLOW UP: Check in with the person you care about on a regular basis. Contacting a friend in the days and weeks after a crisis can make a difference in keeping them alive. </li> </ol> <p> And remember: If you want to connect with help anonymously, call the National Suicide Prevention Lifeline at 800.273.8255 or text "HEAL" to 741741 to text with a trained crisis counselor. More information on suicide prevention in Washington and the state's <a href="https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention/SuicidePreventionPlan">Suicide Prevention Plan</a> is online. </p> <p> Let's not only care for our patients, let's break through the culture of silence and the stronghold of stigma so we can care for each other. </p> </div>9/17/2018 10:13:26 AM9/17/2018 10:08:00 AM9/17/2018 12:00:00 AM
 

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