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state-agencies-seek-physicians-for-positionsState Agencies Seek Physicians for PositionsLatest_NewsShared_Content/News/Membership_Memo/2024/june-14/state-agencies-seek-physicians-for-positions<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/june/wa-state-flag-capitol-645x425px.png" class="pull-right" alt="Washington state flag flying in front of capitol building" /></div> <h5>June 14, 2024</h5> <h2>State Agencies Seek Physicians for Positions</h2> <p>Positions are available at Washington Medical Commission and Department of Labor & Industries for interested physicians from nearly all specialties.</p> <h3>Washington Medical Commission</h3> <p>The commission has announced two vacancies, one in Congressional District 8 and another in Congressional District 10. All MDs with an active license, who have been licensed in Washington for at least five years, and reside in these districts are welcome to apply for one of these positions.</p> <p>The commission establishes, monitors, and enforces qualifications for physician (MD) and physician assistant licensure, consistent standards of practice, and continuing competency. The commission is seeking practitioners willing to use their medical expertise to study the issues and make decisions in the best interest of the public.</p> <p>The WMC consists of 21 members appointed by the governor and meets at least four times per year. For an MD member, the minimum time commitment would be around 20 hours per month.</p> <p>To apply, complete and submit an <a href="http://govforms.dynamics365portals.us/application-form/">online application to the Office of the Governor</a> with a curriculum vitae by June 21, 2024.</p> <h3>L&I contracting opportunities available </h3> <p>The Department of Labor & Industries is asking physicians to consider contracting as medical consultants to provide forensic file reviews and comprehensive peer review services for injured workers in our state. A <a href="javascript://[Uploaded files/News and Publications/newsletters/2024/omd-medical-consultant-rfqq-info-5-22-24.pdf]">request for quotes and qualifications</a> has been issued, with a due date for new bids of Wednesday, July 10.</p> </div>6/14/2024 12:00:00 AM1/1/0001 12:00:00 AM
webinar-on-artificial-intelligence-and-employment-considerationsWebinar on Artificial Intelligence and Employment ConsiderationsLatest_NewsShared_Content/News/Membership_Memo/2024/june-14/webinar-on-artificial-intelligence-and-employment-considerations<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/june/ai-645x425px.jpg" class="pull-right" alt="artificial intelligence illustration" /></div> <h5>June 14, 2024</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Webinar on Artificial Intelligence and Employment Considerations</h2> <p><em>Tuesday, July 16, noon-1 p.m.</em></p> <p>Artificial intelligence is increasingly being used in the workplace, including to assist with traditional human resource functions. While employers hope to increase efficiency and productivity through the use of AI, they must also be mindful of an evolving legal landscape, including interaction with employment-related laws.</p> <p>Join Physicians Insurance Vice President of Risk Management Anne Flitcroft as she hosts Justin Steiner, an attorney who specializes in employment law. Steiner will be sharing his experience on the challenges and benefits of AI as it relates to employment practices. This presentation will discuss the ways AI is being used, legal concerns and risks, and best practices as it relates to employment-related laws. <a href="https://go.phyins.com/risk-factors-july2024">Register online</a>.</p> </div>6/14/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-board-votes-to-oppose-initiative-2117WSMA Board Votes to Oppose Initiative 2117Latest_NewsShared_Content/News/Membership_Memo/2024/june-14/wsma-board-votes-to-oppose-initiative-2117<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/june/istock-472323425-cropped-645x425px.jpg" class="pull-right" alt="illustration of Earth in a life preserver ring" /></div> <h5>June 14, 2024</h5> <h2>WSMA Board Votes to Oppose Initiative 2117</h2> <p>The WSMA board of trustees voted to support the <a href="https://no2117.com/">No on 2117 campaign</a>, which opposes the state ballot initiative to prohibit state agencies from imposing carbon tax credit trading and repeal legislation establishing a "cap and invest" program to reduce greenhouse gas emissions. The board's decision was made pursuant to WSMA <a href="https://wsma.org/wsma/about/policies/whats_our_policy/environmental-health/clean-air.aspx?_zs=B3aFd1&_zl=QObf9">policy adopted in 2018</a> that specifically supports investments in clean energy via a fee on large suppliers of CO2-emitting products. That policy was adopted by the WSMA House of Delegates in response to a then-pending ballot initiative that would have established a cap-and-invest system, a precursor to <a href="https://app.leg.wa.gov/billsummary?BillNumber=5126&Initiative=false&Year=2021">Senate Bill 5126</a> from 2021, which created the Climate Commitment Act.</p> <p>Initiative 2117 is also in direct opposition to WSMA policy that acknowledges climate change as a critical public health issue. The WSMA's House of Delegates, since 2016, has adopted policies that urge the association to work on solutions that both reduce pollution and address the issue of climate change to promote healthier, sustainable communities.</p> <p><a href="[@]Shared_Content/News/Press_Release/2024/statement-from-washington-state-medical-association-opposing-initiative-2117?_zs=B3aFd1&_zl=SObf9">Read WSMA's statement opposing Initiative 2117</a>.</p> </div>6/14/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-presents-to-the-universal-health-care-commission-on-administrative-burdenWSMA Presents to the Universal Health Care Commission on Administrative BurdenLatest_NewsShared_Content/News/Membership_Memo/2024/june-14/wsma-presents-to-the-universal-health-care-commission-on-administrative-burden<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/june/administrative-burden-645x425px.jpg" class="pull-right" alt="administrative burden illustration" /></div> <h5>June 14, 2024</h5> <h2>WSMA Presents to the Universal Health Care Commission on Administrative Burden </h2> <p>During the June 4 meeting of the state's <a href="https://www.hca.wa.gov/about-hca/who-we-are/universal-health-care/universal-health-care-commission">Universal Health Care Commission</a>, WSMA Director of Policy Jeb Shepard joined WSMA member and family physician Diana Huang, MD, to share challenges physician practices face with administrative burden created by insurance carrier and government program compliance requirements. Challenges discussed include the human impact in terms of physician burnout and moral injury leading to workforce challenges, and negative impacts on patient care. Given the financial toll administrative burden takes on physician practices, the impact on total cost of care was underscored.</p> <p>The information will also be considered by the state's Health Care Cost Transparency Board as it considers policy recommendations around lowering the cost of care in Washington state to the Legislature in 2025. The presentation closed by noting that reducing the cost of health care without addressing the system in which administrative burden is perpetuated will have a devastating effect on physician practices and patients.</p> <p>Dr. Huang and Shepard were later joined on a panel by representatives from the Association of Washington Health Plans and Evergreen Treatment Services for a conversation around root causes and solutions to administrative challenges.</p> </div>6/14/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-responds-to-governors-directive-regarding-emergency-abortion-care-in-washingtonWSMA Responds to Governor's Directive Regarding Emergency Abortion Care in WashingtonLatest_NewsShared_Content/News/Press_Release/2024/wsma-responds-to-governors-directive-regarding-emergency-abortion-care-in-washington<div class="col-md-12"> <div class="col-sm-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>June 11, 2024</h5> <h2>WSMA Responds to Governor's Directive Regarding Emergency Abortion Care in Washington</h2> <p> The Washington State Medical Association, representing nearly 13,000 physicians, physician assistants, resident physicians, and medical students, today issued the following statement from Nariman Heshmati, MD, MBA, an OB-GYN in Everett and president of the WSMA: </p> <p> "The WSMA stands firmly in support of the governor's <a href="https://medium.com/@GovInslee/inslee-directs-department-of-health-to-affirm-availability-of-emergency-abortion-care-at-washington-d271cb25c291">directive</a> protecting emergency abortion care in Washington state. The WSMA has a long history of supporting Washingtonians' right to reproductive health care, including abortion, and we oppose attempts to restrict access to these services. We believe the governor's directive, together with our state's other forward-thinking actions on reproductive shield law and Uniform Discipline Act protections, sends a clear message that Washingtonians staunchly oppose the criminalization of reproductive medicine and the chilling effect it has on the delivery of care." </p> <p> For more information contact: </p> <p> Graham Short<br /> WSMA Director of Communications<br /> <a href="mailto:gfs@wsma.org">gfs@wsma.org</a> / 206.329.6851 cell/text </p> <h3>About the Washington State Medical Association</h3> <p> The WSMA represents nearly 13,000 physicians, physician assistants, resident physicians, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care. </p> </div>6/11/2024 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-june-7-2024-five-things-to-know-as-the-sun-arrivesWeekly Rounds: June 7, 2024 - Five Things to Know as the Sun ArrivesLatest_NewsShared_Content/News/Weekly_Rounds/2024/weekly-rounds-june-7-2024-five-things-to-know-as-the-sun-arrives<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo with Jennifer Hanscom, WSMA CEO" /></div> <h5>June 7, 2024</h5> <h2>Five Things to Know as the Sun Arrives</h2> <p>Jennifer Hanscom, CEO</p> <p> It's been a busy week and as we emerged into sunshine after two wildly windy "atmospheric rivers," I headed to Chicago for the American Medical Association's annual meeting. During the next several days, there will be lots going on there, including an election for the AMA Council on Science and Public Health. Your WSMA president, Nari Heshmati, MD, is running for that council and I hope you'll join us in pulling for a win on that next week! </p> <p> In the meantime, with so much going on, I wanted to flag five key items you need to know about while you're enjoying the sunshine. </p> <h3>Prior authorization bill expected to be introduced on June 11</h3> <p> An updated version of the Improving Seniors' Timely Access to Care Act, bipartisan legislation to streamline and standardize the use of prior authorization within Medicare Advantage, will be introduced in the House and Senate on June 11. The WSMA has joined the AMA and other organizations in supporting the latest version of this bill sponsored by several representatives, including Washington <a href="https://delbene.house.gov/">Rep. Suzan DelBene</a>, Democrat from the 1st Congressional District. </p> <p> During the 117th Congress (2021-2022), the act garnered more than 378 total bipartisan co-sponsors in the House and Senate and passed the full House of Representatives. In addition, the legislation secured endorsements from more than 500 organizations, including the AMA and numerous national and state medical societies. Unfortunately, the version of this bill that passed the House in the 117th Congress was never considered in the Senate because of its $16 billion "score," or anticipated fiscal impact, from the Congressional Budget Office, thus necessitating modifications to lessen the bill's cost. </p> <p> While <a href="https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f">electronic prior authorization rules</a> that were finalized by the Biden administration in <a href="https://www.ama-assn.org/press-center/press-releases/ama-applauds-new-prior-authorization-regulation">January 2024</a> lowered the score substantially, the forthcoming bill that will be introduced in the 118th Congress has been amended to ensure it has minimal fiscal impact. Among other provisions, the legislation is intended to advance real-time prior authorization decisions for routinely approved services. </p> <p> We will keep you up to date on this bill's journey through Congress. In the meantime, it's worth noting that Washington was one of the first states to pass legislation to modernize prior authorization along the lines of the federal bill. During the 2023 state legislative session, the WSMA successfully championed <a href="https://app.leg.wa.gov/billsummary?BillNumber=1357&Year=2023&Initiative=false">House Bill 1357</a> to facilitate the transition to electronic prior authorization processes and shorten processing timelines across state-regulated insurance plans for both health care services and prescription drugs. </p> <p> You can read more about the new state rules in place as of January 2024 on our <a href="[@]wsma/resources/Administrative_Simplification/prior-authorization.aspx?hkey=753be15f-bb92-4091-9bf5-a1e45ddda525&WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=PObf9">Prior Authorization resources page</a>. </p> <h3>WSMA board votes to oppose Initiative 2117</h3> <p> At its May meeting, the WSMA board of trustees voted to support the "No on 2117" campaign, pursuant to WSMA <a href="[@]wsma/about/policies/whats_our_policy/environmental-health/clean-air.aspx?_zs=B3aFd1&_zl=QObf9">policy adopted in 2018</a> that specifically supports investments in clean energy via a fee on large suppliers of CO2-emitting products. The policy was adopted by the WSMA House of Delegates in response to a then-pending ballot initiative that would have established a cap-and-invest system, a precursor to <a href="https://app.leg.wa.gov/billsummary?BillNumber=5126&Initiative=false&Year=2021">Senate Bill 5126</a> from 2021, which created the Climate Commitment Act. </p> <p> Initiative 2117 is also in direct opposition to WSMA policy that acknowledges climate change as a critical public health issue. The WSMA's House of Delegates, since 2016, has adopted policies that urge the association to work on solutions that both reduce pollution and address the issue of climate change to promote healthier, sustainable communities. </p> <p> You can read WSMA's statement opposing Initiative 2117 <a href="[@]Shared_Content/News/Press_Release/2024/statement-from-washington-state-medical-association-opposing-initiative-2117?_zs=B3aFd1&_zl=SObf9">on our website</a>. </p> <h3>WSMA Foundation seeks board members</h3> <p> The <a href="[@]wsma/foundation/wsma-foundation/about-the-foundation.aspx?_zs=B3aFd1&_zl=TObf9">WSMA Foundation for Health Care Improvement</a>, a 501(c)(3), has several openings on its board. This fall, foundation membership will be voting on applicants for two physician-at-large positions as well as a position designed for a member of the WSMA board of trustees. </p> <p> The WSMA Foundation's 2024 strategic plan focuses on: </p> <ul> <li>Strengthening physician wellness and restoring the joy of practice.</li> <li>Advancing health equity in all communities.</li> <li>Honoring peoples' goals, values, and preferences.</li> </ul> <p> In particular, the foundation has launched a <a href="https://foundation.wsma.org/?_zs=B3aFd1&_zl=UObf9">Scholarship and Diversity Advancement Fund</a> to build a more diverse physician population in Washington state by supporting students who are underrepresented in medicine. </p> <p> If you are interested in serving on the WSMA Foundation board, <a href="mailto:jen@wsma.org">send your cover letter and CV to me</a>. </p> <h3>Do you have a chief wellness officer?</h3> <p> This week's "Pearl of the Week" from the AMA focuses on the practice environment and, in particular, the role of the chief wellness officer. A health care organization's chief wellness officer has a significantly different role than those in other industries. In health care, the chief wellness officer focuses on the unique needs of health care professionals and works to improve the efficiency of their practice environment. Critical areas include reducing EHR burden, building leadership skills that foster a culture of wellness, and improving workflows and team functions. </p> <p> Access the AMA's toolkits on the topic below: </p> <ul> <li><a href="https://edhub.ama-assn.org/steps-forward/module/2767739?j=2368846&sfmc_sub=368087502&l=5497_HTML&u=46989448&mid=515000152&jb=76&utm_source=SFMC&utm_medium=email&utm_term=632024&utm_content=24-9986+POW+W142+06-03-24&utm_campaign=PS2_Email_Newsletter_STEPSForward_Pearl&utm_uid=&utm_effort=RENPS2">Establishing a Chief Wellness Officer Position</a></li> <li><a href="https://edhub.ama-assn.org/steps-forward/module/2767764?j=2368846&sfmc_sub=368087502&l=5497_HTML&u=46989450&mid=515000152&jb=76&utm_source=SFMC&utm_medium=email&utm_term=632024&utm_content=24-9986+POW+W142+06-03-24&utm_campaign=PS2_Email_Newsletter_STEPSForward_Pearl&utm_uid=&utm_effort=RENPS2">Chief Wellness Officer Road Map</a></li> </ul> <p> Through its Wellness Action Committee, the WSMA Foundation is currently working on the development of organizational-level intervention plans to reduce burnout and improve wellness within medical practices and systems. </p> <p> The best practices document will be unveiled at a WSMA Foundation CEO-CMO Wellness Summit on Oct. 16, 2024. CEOs, CMOs, and wellness leaders from medical groups, health care organizations, and systems will gather to learn about the new criteria and pledge to meet it. The summit will be held at SeaTac Conference Center. For details contact <a href="mailto:alyssa@wsma.org">Alyssa Crawford</a>. </p> <h3>Now available: WSMA podcast meets new health equity CME mandate</h3> <p> In response to the new state health equity CME mandate, the WSMA developed a four-part audio miniseries, "Health Equity in Medicine." The podcast features host Edwin Lindo, JD, who covers the history of racism in medicine and the impacts of the medical profession on health equity. He shares how your colleagues tackled these complicated issues-both structurally and individually-and provides ideas on how to incorporate equity principles into practice. The series is free for WSMA members, and nonmember pricing is also available. </p> <p> This engaging educational series, available only on the WSMA website, fulfills the Washington state requirement of two hours of health equity education at least once every four years. The requirement is the result of <a href="https://lawfilesext.leg.wa.gov/biennium/2021-22/Pdf/Bills/Session%20Laws/Senate/5229-S.SL.pdf?q=20240307094750">Senate Bill 5229</a> passed by the Washington State Legislature in 2021 and implemented in 2024 after a period of rulemaking by the Washington State Department of Health. </p> <p> The entire four-part program totals two and a half hours, which meets the state requirement. Episodes include: </p> <ul> <li>Episode 1: Definitions and Background</li> <li>Episode 2: Impact of Medical Profession on Health Equity</li> <li>Episode 3: Individual Interventions with Estell Williams, MD</li> <li>Episode 4: Structural Interventions with Mabel Bodell, MD, and Bindu Nayak MD</li> </ul> <p> WSMA members may <a href="[@]wsma/foundation/health-equity/health-equity-in-medicine-podcast.aspx?_zs=B3aFd1&_zl=aObf9">access the episodes on the WSMA website</a>. This activity is approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. </p> <p> Everything we do here at the WSMA is to support our members and the physician community. We'll never stop on that count, but we are always grateful for your engagement. Thanks for everything you do! </p> </div>6/7/2024 12:00:00 AM1/1/0001 12:00:00 AM
is-direct-primary-care-right-for-youIs Direct Primary Care Right for You?Latest_NewsShared_Content/News/Latest_News/2024/is-direct-primary-care-right-for-you<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/may-june-2024-reports-cover-645x425px.jpg" class="pull-right" alt="cover of March-April 2024 issue of WSMA Reports" /></div> <h5>June 3, 2024</h5> <h2>Is Direct Primary Care Right for You?</h2> <p> By Rita Colorito </p> <p> Like many owners of direct primary care practices, Jlyn Pritchard, DO, a family medicine doctor in Spokane, had struggled for years with the constraints and burdens of working in a fee-for-service model. </p> <p> "It was an 8-to-5, no negotiation, no wiggle room," says Dr. Pritchard. As a mother of three young children, that meant she often missed being there when they were sick or had a special event. "The corporate system of medicine is a tough business. And it doesn't really allow moms, in particular, to really show up," she says. </p> <p> To achieve the autonomy she values, Dr. Pritchard opened her direct primary care practice, Thread Health Clinic, in October 2022. And she's never looked back. </p> <p> Direct primary care is a membership- based practice model where the physician contracts directly with the patient instead of with an insurance company. For a small but growing number of physicians in Washington, direct primary care presents an attractive option to sidestep the headwinds facing traditional primary care practices today. And they are substantial: shrinking reimbursements from government payers, high overhead costs, high rates of physician burnout, ever- increasing administrative burdens from insurance carriers, and, as Dr. Pritchard faced, schedules not conducive to a work- life balance. It's no wonder interest in primary care specialties among medical students continues to decline. </p> <p> Those headwinds convinced Kim Ha Wadsworth, DO, to start Essential Direct Primary Care in Olympia in January 2022. During her locum tenens assignment immediately after residency in Yakima only six months earlier, she saw some 30 patients a day. </p> <p> "We are supposed to do no harm, and yet I looked around at the lack of continuity, gaps in care, not having readily available appointments for patients to follow up ... I just looked at that and said I don't want to practice medicine this way. It seems like I would do more harm than not," says Dr. Wadsworth. </p> <h3>The state of innovation</h3> <p> Washington state is the birthplace of the direct primary care model, with the Legislature codifying it into law in 2007. Since the beginning, the WSMA has supported physicians' ability to choose the model of care delivery that fits their career needs. "The WSMA does not express a preference for any one practice model but supports the availability of a variety of practice options for physicians to meet the diverse care needs of the state and to create a strong health care system," says WSMA President Nariman Heshmati, MD, MBA, FACOG. </p> <p> In recent years the care model has gained traction. There are 81 direct practices registered in Washington state, a net increase of 25 over the previous year, according to the December 2023 Direct Practice Report by the Office of the Insurance Commissioner. "That's a significant increase," says Dr. Heshmati, "particularly in our current health care landscape, when you consider that the number of independent fee-for-service practices is dwindling." </p> <p> So far, direct primary care practices in Washington have yet to gain a significant market share. Out of an estimated 7.9 million Washington state residents, only 0.4% are enrolled in a direct primary care practice, up from 0.31% in 2022, according to the OIC report. "A big part of the lack of utilization likely has to do with how many residents are familiar enough with direct primary care to seek its services," says Dr. Wadsworth, a point echoed by other direct primary care practitioners. </p> <p> There's also a question of whether regulatory hurdles contribute to this slow growth, unlike the notable expansion seen in states like Colorado. The WSMA has heard from members of the direct primary care community who have pointed to onerous annual reporting requirements from the OIC, for example. To that end, the WSMA House of Delegates in 2023 passed a resolution, spearheaded by Dr. Wadsworth, to approach the OIC about these regulatory hurdles for direct primary care practices, with the goal of supporting the ability of physicians to utilize the practice model. </p> <h3>Benefits and challenges</h3> <p> When the 2007 legislation was passed, many theorized that the direct primary care model would help relieve problems caused by a shortage of primary care physicians. Today, proponents are more likely to see the model as helping to further the Quadruple Aim: enhanced patient experience, improved population health, reduced cost, and a more fulfilling and balanced life for doctors. </p> <p> "Direct primary care is an incredible model, but it doesn't address the physician shortage," says Dr. Pritchard. "What it does address is the patient backlog that often happens when people can't access care ... Urgent cares are great. But they were created because people couldn't get in to see their PCP. So, we sort of transition that relationship back to what it should have been all along." </p> <p> Among Dr. Wadsworth's first direct primary care patients were two she had seen in residency. They made the switch to Essential Direct Primary Care, she says, because they could not get timely appointments with their physician. </p> <p> "They were always seeing the PA or nurse practitioner. They were tired of getting handed off to whoever happened to be there that week," says Dr. Wadsworth. They now travel from Yakima to Olympia twice a year for checkups and via telehealth or call otherwise. </p> <p> Running a direct primary care practice comes with its own set of challenges. The promised one-on-one patient-physician relationship means physicians are on call as needed. </p> <p> Dr. Pritchard now works more hours than she did in a fee-for-service practice. "I view it as a time exchange," she says. "I have the ability to show up to the things that are really important in my life ... instead of being obligated to someone else's schedule." </p> <p> Most of her patients have been very respectful of her time, says Dr. Wadsworth. In the last two years, she's only needed to go into the office twice on a weekend for an urgent patient issue. </p> <p> "I have to almost pull teeth to say, hey, you know, you could have called me about that," she says. "It brings back the joy of medicine, that we can really take care of patients when they need us." </p> <p> Direct primary care practices charge a set monthly fee for all primary care services, regardless of the number of visits or care provided. Setting pricing that's affordable but factors in resources, time, and care needs of your patient population is a major challenge, says Dr. Pritchard. </p> <p> Direct primary care tends to attract patients with complex conditions who often aren't getting what they need in the traditional care system, says Dr. Pritchard. "Time management, resource management, as well as just expectation management from people has been a challenge," she says. </p> <h3>Solutions to care</h3> <p> Physicians practicing direct primary care pride themselves on offering patients same-day or next-day appointments for urgent medical issues. Under a direct primary care model, Dr. Pritchard says she's able to offer creative solutions that fit her patients' needs. </p> <p> On one recent morning, she had a young father scheduled for osteopathic manual therapy. His wife texted to say their two kids were sick. Dr. Pritchard suggested he bring them in during his appointment so she could see what was going on. </p> <p> "It really didn't take a whole lot of extra effort on my part to see them," she says. Under a fee-for-service model, says Dr. Pritchard, everyone would need separate appointments, if they could get them that day, or use urgent care-the default when patients can't get in to see their primary care physician. </p> <p> The direct primary care model allows physicians much more time with their patients so they can practice to their full scope, says Dr. Wadsworth. This, in turn, she says, also helps alleviate pressure on specialists. </p> <p> "They have waiting lists three to six months out. So, they really appreciate it when we, as family physicians, take care of a lot of that initial workup," says Dr. Wadsworth. "I'm not sending patients right away to a specialist because there are many things that I can do in house first." </p> <h3>Physician autonomy</h3> <p> Getting rid of insurance burdens for the care they provide appeals to many primary care physicians. </p> <p> "I get to make decisions about how to take care of my patients, as opposed to being beholden to whatever rules the insurance company imposes on me," says Dr. Wadsworth. "I often joke that the insurance companies are practicing without a medical license." </p> <p> Under a direct practice model, physicians opt out of insurance billing, significantly reducing the administrative overhead involved in reimbursement from insurance payers. But that doesn't mean direct primary care physicians avoid all insurance paperwork. Drs. Wadsworth and Pritchard often need to write prior authorizations for medications, labs, or imaging. </p> <p> Dr. Wadsworth, for example, has a patient on Cosentyx who needs prior authorization for refills. "There's no way she can afford that without her insurance," she says. Because the patient can't get in to see a rheumatologist for another nine months, Dr. Wadsworth manages her arthritis care in the meantime. </p> <p> "To have that autonomy ... It's worth something that I'm not burnt out five years from now," says Dr. Wadsworth. </p> <h3>Affordability</h3> <p> Cost and affordability are common criticisms of the direct primary care model. One fundamental misunderstanding: That direct primary care is concierge care-very low patient panels and very high cost. </p> <p> More than half of direct primary care practices reported average monthly fees between $61 and $120. The most expensive monthly fee, at $1,253, belonged to the Bellevue location of a multistate, self-described "luxury concierge" group. </p> <p> "I have yet to meet a direct primary care doc who wasn't first and foremost focused on affordability and accessibility," says Dr. Wadsworth. "I like to say that direct primary care is concierge without the Cadillac prices." </p> <p> Essential Direct Primary Care charges tiered monthly membership fees by age group, each tier priced at less than $100 per person per month. Thread Health offers individual, family, and employer- paid memberships at different price levels, depending on patients' needs. </p> <p> The direct primary care model gives physicians latitude to provide additional discounts to patients who are struggling financially, says Dr. Wadsworth, who has several patients on Medicare and Medicaid. "If I were to see that same Medicaid patient and bill Medicaid, I can't make exceptions to their rules, because I have to treat all the patients the same." </p> <p> For care outside their practice, direct primary care physicians spend considerable time negotiating reduced prices on ancillary services, such as medication, lab work, and imaging. "We pride ourselves on finding the best deals," says Dr. Wadsworth. "I can get patients $41 X-rays now. I worked two years on that deal." </p> <p> For lab work, Thread Health works with a group-purchasing organization. "They negotiate prices on our behalf to offer the cheapest rates to our patients," says Dr. Pritchard. Most of the time, typical labs are a fraction of what patients might pay with insurance: a lipid panel costs less than $4. </p> <p> Some critics worry direct primary care practices will worsen the physician shortage in rural areas. Dr. Pritchard argues the direct primary care model may incentivize physicians to move to underserved communities. </p> <p> "There are hundreds of direct care practices across the country that are located in these rural locations that are serving patients in a completely different capacity," she says. In Washington state, direct primary care practices operate in 20 counties, many in rural areas. </p> <h3>A tough sell</h3> <p> Attracting and retaining patients is a constant concern when running a direct primary care practice. It's the reason why Rebecca Hoffman, MD, shuttered her Vancouver direct primary care practice, New West Family Care, in 2012 after two years. </p> <p> The misconception that direct primary care only caters to the wealthy may be one of the reasons the care model hasn't taken off, says Dr. Hoffman. "It's a tough sell. People in this country aren't used to paying retainer fees," she says. "You have to know your market and who you're drawing from. It requires constant promotion." </p> <p> Another reason for the lack of marketplace traction: Some patients use direct primary care as a waystation, says Dr. Hoffman. It's why one colleague recently closed his direct primary care practice. "After doing this for several years, he wasn't getting many long-term patients. They were in it for a bit but would leave when they got a new job," she says. </p> <h3>Making ends meet</h3> <p> Many direct primary care practices have adjusted their business from a direct- practice-only-or-bust approach. In 2023, only 49% of direct primary care practices reported that 100% of their business is direct practice. Twenty-one direct primary care practices reported also participating as in-network providers in a health carrier's network in 2022, a significant change from 2007 when all reporting practices performed direct primary care exclusively. </p> <p> Neither Dr. Wadsworth nor Dr. Pritchard practice direct primary care exclusively. Dr. Wadsworth also offers fee- based osteopathic manipulative therapy (OMT). Dr. Pritchard also works for a Washington-based clinic doing telehealth part-time, and offers fee-based OMT, a guided weight loss program, and lifestyle counseling (included in Thread Health's advanced and deluxe memberships). </p> <p> Having a hybrid practice, suggests Dr. Hoffman, who had both a direct primary care and a fee-for-service practice, may help transition patients who would otherwise leave once they got a job or health insurance. "Then you can still see them and that will be great for continuity of care," she says. </p> <p> "This model is not for everyone," says Dr. Pritchard. "But what it has gifted me is the ability to show up for my family, to be seen as a human being, and to interact with patients the way I have always hoped ... and to give patients back the ability to feel heard." </p> <p> <em>Rita Colorito is a freelance writer specializing in health care.</em> </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>6/3/2024 12:00:00 AM1/1/0001 12:00:00 AM
statement-from-washington-state-medical-association-opposing-initiative-2117Statement from Washington State Medical Association Opposing Initiative 2117Latest_NewsShared_Content/News/Press_Release/2024/statement-from-washington-state-medical-association-opposing-initiative-2117<div class="col-md-12"> <div class="col-sm-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>June 3, 2024</h5> <h2>Statement from Washington State Medical Association Opposing Initiative 2117</h2> <p> At its May meeting this year, the board of trustees of the Washington State Medical Association voted to support the "No on 2117" campaign, pursuant to <a href="https://wsma.org/wsma/about/policies/whats_our_policy/environmental-health/clean-air.aspx">WSMA policy adopted in 2018</a> that specifically supports investments in clean energy via a fee on large suppliers of CO2-emitting products. The policy was adopted by the WSMA House of Delegates in response to a then-pending ballot initiative establishing a cap-and-invest system, a precursor to <a href="https://app.leg.wa.gov/billsummary?BillNumber=5126&Initiative=false&Year=2021">Senate Bill 5126</a> from 2021, which created the Climate Commitment Act. </p> <p> Initiative 2117 is also in direct opposition to WSMA policy that acknowledges climate change as a critical public health issue. The WSMA's House of Delegates, since 2016, has adopted policies that urge the association to work on solutions that both reduce pollution and address the issue of climate change to promote healthier, sustainable communities. </p> <p> As noted in WSMA policy, climate change is a critical public health issue: </p> <ul> <li>Potential effects of climate change on human health include higher rates of respiratory and heat-related illness, increased prevalence of vector-borne and waterborne diseases, food and water insecurity, and malnutrition. Persons who are elderly, sick, or poor are especially vulnerable to these potential consequences.</li> <li>The WSMA supports educating the medical community on the potential adverse public health effects of global climate change and incorporating the health implications of climate change into the spectrum of medical education, including topics such as population displacement, heat waves and drought, flooding, infectious and vector-borne diseases, and potable water supplies.</li> <li>We recognize the importance of physician involvement in policymaking at the state, national, and global levels, and support efforts to search for novel, comprehensive, and economically sensitive approaches to mitigating climate change to protect the health of the public; and recognize that whatever the etiology of global climate change, policymakers should work to reduce human contributions to such changes.</li> <li>We encourage physicians to adopt programs for environmental sustainability in their practices, share these concepts with their patients and their communities, and to serve as role models for promoting environmental sustainability.</li> <li>We encourage physicians to work with local and state health departments to strengthen the public health infrastructure to ensure that the global health effects of climate change can be anticipated and responded to more efficiently.</li> <li>We support epidemiological, translational, clinical, and basic science research necessary for evidence-based global climate change policy decisions related to health care and treatment.</li> </ul> <p> <em>Note: WSMA policy is set at the association's annual House of Delegates meeting. Delegates to the meeting include WSMA board members, representatives from county medical societies, state specialty societies, and special sections. More about WSMA's House of Delegates and the association's policies can be found at <a href="https://wsma.org">www.wsma.org</a></em>. </p> <p><em>For more information contact WSMA Director of Communications Graham Short, 206.329.6851 (cell/text), <a href="mailto:gfs@wsma.org">gfs@wsma.org</a>.</em></p> <p><strong>About the Washington State Medical Association</strong></p> <p>The WSMA represents nearly 12,500 physicians, physician assistants, resident physicians, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.</p> </div>6/3/2024 12:00:00 AM1/1/0001 12:00:00 AM
wearable-device-technology-in-health-careWearable Device Technology in Health CareLatest_NewsShared_Content/News/Latest_News/2024/wearable-device-technology-in-health-care<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/may-june-2024-reports-cover-645x425px.jpg" class="pull-right" alt="WSMA Reports May/June 2024 cover" /></div> <h5>May 30, 2024</h5> <h2>Wearable Device Technology in Health Care</h2> <p> By Sharon Hall, RN </p> <p> Wearable technology has advanced beyond federal Food and Drug Administration-approved medical devices to monitor acute or chronic health conditions. Ask someone today if they are familiar with wearable health care technology and the chances are they'll think of wearable "smart" devices that are also capable of tracking wellness parameters. </p> <p> A 2019 National Trends Survey of 4,100 participants revealed that about 30% of respondents used a wearable device, and of these adopters, 46% had shared the data with their physician or practitioner. While studies to validate the predictive quality of wearables are mostly lacking, that isn't stopping consumers from using wearables to track their wellness. </p> <p> Should a physician or health care professional consider providing care to patients incorporating wearable data? Let's consider some of the benefits-and some of the risks. </p> <h3>About our smart devices</h3> <p> Common types of wearables today include smartwatches, smart bracelets, and smart glasses. They are not usually approved by the FDA. The data collected by wearables include metrics such as pulse, blood pressure, temperature, blood oxygenation, glucose levels, sleep patterns, and movement. Wearables often track identified metrics continuously to identify a baseline and reveal trends over time, with the resulting data potentially used by the individual's physician or health care practitioner to aid in diagnosis and treatment or changes in care. </p> <p> Some examples: Continuous monitoring of glucose levels may allow a patient to adjust their diet and activity in real time, leading to more consistent blood-sugar levels and fewer in-person practitioner visits. Smart watches with EKG capabilities may lead to considering the diagnosis of atrial fibrillation. Pairing another application with a smartwatch may detect an infection such as the onset of COVID-19 before symptoms become obvious. </p> <p> Other potential benefits of wearable technology include improved motivation in activities such as quitting smoking, managing diabetes, and exercising; higher patient activation as data demonstrates how choice influences health; better management of chronic diseases through shared decision-making; and improved patient engagement in preventative care, resulting in fewer office visits. </p> <h3>Practitioner risks and responsibilities</h3> <p> When patients share health data from wearables, questions arise about a physician's or health care practitioner's responsibility to accept this data, act on it, and incorporate it into the patient's medical record. Both patient and practitioner expectations for wearable use and monitoring should be clear from the outset. </p> <p> Current resources do not suggest existing case law involving wearables, so it's not clear whether monitoring a patient's personal wearable device creates a physician- patient relationship requiring a duty of care. However, when wearables are part of the patient's plan of care, a duty may exist, and physicians and practices can minimize malpractice risks through planning and documentation. Risks include inappropriate patient selection, limited usability of the device to monitor selected parameters, failure to educate or train patients and staff, data management issues, communication issues, privacy, and security. </p> <h3>Choosing patient candidates</h3> <p> Patient selection is an important component when considering a plan of care that involves remote monitoring using a wearable. Not all individuals are appropriate candidates, nor do all medical conditions lend themselves to remote monitoring. Consider the following when determining if your patient is an appropriate candidate for remote monitoring using a wearable device: </p> <ul> <li><strong>Equity and inclusion: </strong>If the patient's insurer does not pay for the wearable, can the patient afford to purchase the device and any necessary accessories?</li> <li><strong>Accessibility:</strong> Does the patient have a smartphone if one is required by the wearable? Does the patient have internet access and sufficient internet speed to transmit data? If the objective is to monitor a health condition or well-being through the device and the patient cannot transmit the data, the device may not be helpful for that patient.</li> <li><strong>Compliance:</strong> Is the patient comfortable and capable of operating the wearable correctly? Physicians and health care professionals recommending the wearable can improve patient compliance through a shared-decision- making informed-consent process. The informed consent should include an explanation of the wearable, patient responsibilities, benefits and risks of using the wearable, the technology's limitations, and possible alternatives. Consent should also address the rights of the practitioner and patient to discontinue use of the wearable. As with telehealth, confidentiality and potential security issues are also important to discuss.</li> <li><strong>Service and support:</strong> Who maintains the device? How is troubleshooting conducted if the device fails to function properly? Who addresses potential device recalls?</li> <li><strong>Usability:</strong> Since wearables are generally not FDA approved, they may not be as accurate or dependable as approved devices. Does the wearable have a good track record for safety and reliability, which impact data integrity? Can data easily be retrieved and transmitted? For non-FDA- approved devices, we recommend investigating the medical community's consensus and reviewing scientific evidence for the acceptance of the proposed off-label use for the patient's condition.</li> </ul> <h3>Training of staff and patients</h3> <p> Physicians and health care professionals must ensure they are trained in the use of any new technology and must be prepared to teach patients. For FDA-approved wearables, the manufacturer may offer or require training; otherwise, instruction may be offered in accompanying product materials. Designate staff experienced in the setup, use, and remote monitoring of security and privacy issues for wearables to provide patient training. Document the patient's training on the device in the patient record. </p> <p> Patient training should include setup, use, maintaining, troubleshooting, and sending data from their wearable. Training should include scheduling and determining the frequency for review of data by the physician or office. </p> <h3>Be specific in documentation</h3> <p> Medical record documentation of the wearable technology should include the specific technology and model number, patient training, informed consent, plan of care to reflect use of the device, data transmitted, and any actions taken related to data transmission. Lack of adherence to the plan of care should be noted, as well. Device-specific informed consent should be obtained for wearable devices that generate real- time data. Patient responsibilities should be defined, including a responsibility to follow up after a data-point deviation has been transmitted and becomes known to the patient. </p> <h3>Administrative considerations</h3> <p> Remote-monitoring technology references should be added to your notice of privacy practices. Include wearables in the organization's security and product-recall procedures. Be aware of manufacturer warnings, FDA alerts (if applicable), or recalls of patient wearables. If you have any wearable vendor or subcontractor contracts, there may be a need for business- associate agreements. Recommendations for using specific wearables may fall under federal fraud and abuse guidelines. A health care practitioner cannot accept anything of value in exchange for recommending the use of a wearable medical device. </p> <h3>The future is wearable</h3> <p> Given the potential risks, why should a physician or health care professional consider providing care to patients incorporating wearable data? Because there are benefits for patient involvement in their care and compliance, and it's very likely that patients will be sharing their health data with you. Plus, more companies are seeking FDA approval for their wearable products. </p> <p> While many health care practitioners consider wearables to be fun consumer gadgets, many are currently changing their viewpoint. Wearables can be used as a motivational tool to facilitate shared decision-making regarding a patient's condition and have the potential to be utilized as a predictor of health and even lead to improved health outcomes. </p> <p> <em>Sharon Hall, RN, MPH, ARM, is a senior clinical risk consultant with Physicians Insurance.</em> </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>5/30/2024 12:00:00 AM1/1/0001 12:00:00 AM
member-spotlight-dave-cundiff-md-mphMember Spotlight: Dave Cundiff, MD, MPHLatest_NewsShared_Content/News/Latest_News/2024/member-spotlight-dave-cundiff-md-mph<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/member-spotlight-website-image-dave-cundiff-645x425px.png" class="pull-right" alt="WSMA Member Spotlight: Dave Cundiff, MD graphic" /></div> <h5>May 29, 2024</h5> <h2>Member Spotlight: Dave Cundiff, MD, MPH</h2> <p> <strong>Works at:</strong> Discover Recovery, Long Beach; Smart Moves Health, Ilwaco (under development). </p> <p> <strong>How long in practice:</strong> 41 years.</p> <p> <strong>Specialties:</strong> Public health; addiction medicine. </p> <p> <strong>Why WSMA: </strong>In a time when the most powerful players in health care are oriented toward money, power, and control, the WSMA presses for physicians' ability to survive, serve our patients, and thrive. Besides, it's fun! Organized medicine includes some of the smartest, most idealistic people I know. WSMA involvement is one of the best ways to give back to the profession that has given me so much. </p> <p> <strong>Why I became a physician: </strong>Three big contributing factors: I was raised by a World War II veteran who found joy in serving our country. I was probably saved from long-term disability and early death by the pediatrician who diagnosed and treated my rheumatic fever. I find joy in learning and teaching-the word "doctor" comes from the Latin word for "teacher"-and physicians' teaching role remains extremely valuable. </p> <p> <strong>Best advice received: </strong>"If you're winning all your battles, maybe you're not fighting all the right battles." In the WSMA House of Delegates, and in the American Medical Association, sometimes I've been part of an overwhelming majority. And sometimes I've been in a very small minority. It's all good, as long as we're all committed to the future of our profession and the well-being of those we serve. Good leaders make sure that everyone who cares about the group is heard. </p> <p> <strong>Why rural Washington:</strong> Many things about Ilwaco remind me of the Pennsylvania town of 500 people where I grew up. In a small city, you know a lot of people and they know you. If you want to serve, you can. You can make as big a difference here as you can anywhere! </p> <p> <strong>What people might not know about me: </strong>I majored in Spanish in college, and I've used it off and on through life. My wife and I hope to open a bilingual integrated care clinic in the old Ilwaco Medical Building, welcoming many who aren't as well-served now as they should be. </p> <p> After Russia invaded Ukraine, I also started studying Ukrainian on Duolingo. Ukrainian is hard for me, both because I didn't start earlier and because the Cyrillic alphabet is hard to learn from scratch. You get fluent by actually using a language, and I haven't found anyone in Ilwaco who speaks Ukrainian. We recently visited a Ukrainian grocery in Fife, where I was able to try out, "Thank you," and "You're welcome," with an employee I thought might speak Ukrainian. You should have seen her smile! Learning someone else's language, even if you speak it poorly, is still a big sign of respect in much of the world. </p> <p> <strong>Final thoughts:</strong> Being a physician is one of the greatest privileges in the world. People allow us to touch their bodies, minds, and spirits in ways other careers don't. When we do this work respectfully and put the best interest of the patient first, last, and always, we are compensated in many ways and we are respected in our communities. </p> <p> In a world where others try to reduce us to technicians and pretend we're interchangeable, it's important to remember that medicine is about relationships, professionalism, and service. Others may forget this, but we can't. That's one reason we need each other, in the WSMA and elsewhere. </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>5/29/2024 12:00:00 AM1/1/0001 12:00:00 AM
its-time-for-equal-acceptance-of-comlex-and-usmleIt's Time for Equal Acceptance of COMLEX and USMLELatest_NewsShared_Content/News/Latest_News/2024/its-time-for-equal-acceptance-of-comlex-and-usmle<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/heartbeat-website-image-katina-rue-645x425px.png" class="pull-right" alt="Heartbeat: Katina Rue, DO graphic" /></div> <h5>May 28, 2024</h5> <h2>It's Time for Equal Acceptance of COMLEX and USMLE</h2> <p> By Katina Rue, DO </p> <p> It's been a few years since I was a doctor of osteopathic medicine student, but I still remember the anxiety and stress I felt as I moved through the medical school and residency process. These feelings increased tenfold as I prepared to take the Comprehensive Osteopathic Medical Licensing Examination-the three-level nationally standardized examination for licensure to practice osteopathic medicine. </p> <p> Fast forward to today. As the program director of Trios Health Family Medicine Residency Program in Kennewick, I've noticed a troubling trend among DO residents. To improve their chances of matching, DO students are taking both the COMLEX and the United States Medical Licensing Examination-the equivalent three-step licensure exam for allopathic physicians (MDs). By contrast, their MD colleagues are only taking the USMLE. In fact, more than half (56%) of graduate medical education programs that consider DOs mandate the USMLE-meaning DO students wishing to attend those programs are required to take both exams. </p> <p> As physicians, we all know how significant and exciting the time we spend in both medical school and residency is. It shapes who we become as physicians, the specialties we choose, and the care we ultimately deliver. While we all know how deeply important this experience is, we also know how uniquely challenging, even grueling, it can be. This seminal period in a physician's development should not be additionally burdened with unnecessary challenges. </p> <p> And make no mistake: This is a burden to osteopath students, and the burden isn't limited to the 32 hours of exam time required to take two exams. DO students foot the bill to take both of these exams. The price to complete all three levels of the COMLEX currently stands at $2,340. The price to complete all three levels of the USMLE is $2,265. These figures do not include the cost of travel to the test sites (transportation, lodging, etc.), preparation costs, rescheduling fees, and other factors. Altogether, DO students spend more than $3,000 to take an exam that is not designed for the osteopathic profession or necessary for licensure. </p> <p> Medical school and residency are challenging enough. We don't need to make it harder. Let's remove the additional barriers currently facing our DO students. </p> <p> In 2018, the American Medical Association passed policy to encourage equal acceptance of the COMLEX and the USMLE. I and other physicians working as mentors in residency programs across the state are uniquely positioned to educate our colleagues on the COMLEX and advocate for removing this unnecessary barrier for DO students. </p> <p> We are all acutely aware of the unique physician workforce shortages we face, and DO students are critical to meeting these challenges. In 2023, 55.9% of DO seniors went into primary care. Moreover, 43% of graduating 2021-2022 osteopathic medical students plan to practice in a medically underserved or health shortage area; of those, 40% plan to practice in a rural community. More than 73% of DOs practice in the state where they do residency training, so additional barriers impact rural and primary care access. </p> <p> I encourage you to learn more about your residency program's requirements and advocate for removing duplicative and unnecessary requirements for DO students. Lifting these barriers will enable DOs to more effectively pursue their preferred residency programs and serve the communities that need them most. </p> <p> <em>Katina Rue, DO, FAAFP, FACOFP, is the program director of Trios Health Family Medicine Residency Program in Kennewick and the immediate past president of the WSMA.</em> </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>5/28/2024 12:00:00 AM1/1/0001 12:00:00 AM
did-the-ldc-inspire-you-more-leadership-development-from-the-wsmaDid the LDC Inspire You? More Leadership Development from the WSMALatest_NewsShared_Content/News/Membership_Memo/2024/may-24/did-the-ldc-inspire-you-more-leadership-development-from-the-wsma<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/948862699"><img alt="" src="/images/Newsletters/MembershipMemo/2024/may/ldc-2024-thank-you-vid-image-645x425px.png" class="pull-right" /></a></div> <h5>May 24, 2024</h5> <h2>Did the LDC Inspire You? More Leadership Development from the WSMA</h2> <p>WSMA members attending this past weekend's Leadership Development Conference praised the content, staff preparation, and support (and enjoyed resort and wine-country amenities to boot). For a glimpse of the event, watch our <a href="https://vimeo.com/948862699">thank you video from WSMA President Nariman Heshmati, MD</a>, and be sure to mark your calendars for next year's conference, May 16-17, again in Chelan.</p> <p>If you couldn't attend the conference, or for those physicians and physician assistants wanting to continue their leadership development outside of the weekend conference, take note of the following opportunities from the WSMA's Center for Leadership Development.</p> <h3>All-Virtual Physician Leadership Course</h3> <p>The WSMA offers an all-virtual option for the <a href="[@]wsma/education/physician_leadership/physician_leadership_course/wsma/physician_leadership/physician_leadership_course/physician_leadership_course.aspx?hkey=efdc4ad1-ff20-4089-ab51-caafbe73572b">Physician Leadership Course</a>, our popular leadership "boot camp." This is a course for physicians and physician assistants who want to know more about health care leadership and develop the core leadership competencies necessary to thrive in today's health care environment. Many physicians and physician assistants who take this course will go on to further training and become leaders and managers in their local clinical care settings.</p> <p>The course, led by Edward A. Walker, MD, MHA, will be held October-December 2024. The first two live virtual sessions are Friday and Saturday, Oct. 4 and 5. Course participants will then have 11 weeks of online instruction and interaction, finishing with a third live virtual session on Friday, Dec. 13. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. <a href="[@]wsma/education/physician_leadership/physician_leadership_course/wsma/physician_leadership/physician_leadership_course/physician_leadership_course.aspx?hkey=efdc4ad1-ff20-4089-ab51-caafbe73572b">Learn more and register</a>.</p> <h3>Leadership Masterclass</h3> <p>The WSMA Leadership Masterclass an intensive three-day adaptive-learning course that examines the complex challenges faced by seasoned physician leaders and provides the tools necessary to solve them. The course examines the challenges physician leaders will encounter and provides the tools needed to solve those challenges. The course provides an individualized framework building on each leader's style and gifts in order to help them achieve a delicate, but deliberate, management approach. Course dates are Sept. 19-21, 2024. This activity has been approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. <a href="[@]wsma/education/physician_leadership/leadership_masterclass/wsma/physician_leadership/leadership_masterclass/leadership_masterclass.aspx?hkey=b3ffc0a4-6cad-4a06-98aa-6e1a5e1e64b2">Learn more about course eligibility</a>.</p> <h3>Leadership Enhancement and Development (LEAD) Program </h3> <p>WSMA's new LEAD Program offers tailored, 1:1 leadership coaching-with a twist. Physician leaders need two sources of information to be successful: A mentor who makes sure that they have the required knowledge and skills of leadership, and a coach to help you formulate and think through your options for leading your organization. Traditional leadership coaching focuses only on process. The LEAD Program instead provides an integrated model moving between coaching and mentoring as needed so you can achieve the largest effect in a reasonable amount of time.</p> <p>The LEAD Program is available to all MDs, DOs, and physician assistants at any stage of their career. LEAD Program coaches and mentors are Edward A. Walker, MD, MHA; Joanne Roberts, MD; and Tom Norris, MD. <a href="[@]wsma/education/physician_leadership/lead-program/wsma/physician_leadership/lead-program.aspx?hkey=bac99eac-247a-4e08-afcc-64eb397fafc8">Learn more and sign up</a>.</p> </div>5/24/2024 12:00:00 AM1/1/0001 12:00:00 AM
federal-bill-expanding-clinical-training-sites-draws-support-from-wsma-and-state-osteopathicFederal Bill Expanding Clinical Training Sites Draws Support from WSMA and State OsteopathicLatest_NewsShared_Content/News/Membership_Memo/2024/may-24/federal-bill-expanding-clinical-training-sites-draws-support-from-wsma-and-state-osteopathic<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/may/smiling-docs-645x425px.jpg" class="pull-right" alt="smiling doctors" /></div> <h5>May 24, 2024</h5> <h2>Federal Bill Expanding Clinical Training Sites Draws Support from WSMA and State Osteopathic Medical Association</h2> <p>The WSMA and Washington Osteopathic Medical Association issued a joint letter to our congressional delegation urging their support for <a href="https://www.congress.gov/bill/118th-congress/house-bill/7258/text?s=1&r=5">H.R. 7258-the Community Training, Education, and Access for Medical Students (Community TEAMS) Act</a>. The Community TEAMS Act is intended to increase the number of available clinical training sites for medical students.</p> <p>Addressing health care workforce challenges is a priority for both medical associations. The WSMA recently issued a set of <a href="[@]wsma/advocacy/health-care-workforce-recommendations/wsma/advocacy/health-care-workforce-recommendations.aspx?hkey=53c92487-1366-48d5-a4c4-bcad733217cd">workforce recommendations</a> that align with H.R. 7258's goal of increasing additional clinical training sites. Creating additional clinical training sites is integral to facilitating medical education and postgraduate physician employment in medically underserved areas of Washington. Accordingly, passing H.R. 7258 would represent an important step toward shoring up Washington's physician workforce pipeline, particularly in areas where the need for physicians is greatest.</p> </div>5/24/2024 12:00:00 AM1/1/0001 12:00:00 AM
in-your-mailbox-32-page-wsma-legislative-report-detailing-legislative-outcomesIn Your Mailbox: 32-Page WSMA Legislative Report Detailing Legislative OutcomesLatest_NewsShared_Content/News/Membership_Memo/2024/may-24/in-your-mailbox-32-page-wsma-legislative-report-detailing-legislative-outcomes<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/may/cover-2024-wsma-legislativereport-645x425px.jpg" class="pull-right" alt="2024 WSMA Legislative Report cover" /></div> <h5>May 24, 2024</h5> <h2>In Your Mailbox: 32-Page WSMA Legislative Report Detailing Legislative Outcomes</h2> <p>Keep an eye on your mailbox: WSMA members will soon be receiving the <a href="[@]wsma/advocacy/legislative___regulatory/wsma_legislative_report/wsma/advocacy/legislative_regulatory/wsma_legislative_report/wsma_legislative_report.aspx?hkey=cbef4d49-c104-4c3a-96b4-ac866dcbf5e0">2024 WSMA Legislative Report</a>, our 32-page overview of policy outcomes from the state legislative session. The publication includes bill and budget details, and a narrative to help connect the dots on our work in Olympia on behalf of physicians, physician assistants, and the practice of medicine in Washington state. In it, you'll find information on such policy successes as:</p> <ul> <li>Expanded funding for primary care physician residencies.</li> <li>Defeating multiple scope of practice bills that failed to contain appropriate patient safety guardrails.</li> <li>Licensing of anesthesiologist assistants.</li> <li>Creating certification for MRI technologists.</li> <li>Updating the definition of "vaccine" to facilitate operation of the state's Childhood Vaccine Program.</li> <li>Adopting another set of bills to address gun violence.</li> </ul> <p>You'll also find updates on our ongoing work to increase Medicaid investments, pass important wellness program confidentiality protections, and much more. Since it's an election year, the report also features our <a href="[@]wsma/advocacy/wampac/wampac_legislator_report_card/wsma/advocacy/wampac/wampac_legislator_report_card.aspx?hkey=11823ee2-e48a-4214-af1a-fcad1da9d502">WAMPAC Legislator Report Card</a>, which provides a look at how state lawmakers voted on priority WSMA legislation.</p> <p>The WSMA Legislative Report is a members-only publication offered as benefit of your membership and as a demonstration of how your dues dollars and direct engagement make our legislative advocacy possible. Thank you for your membership and for helping us make Washington state the best place to practice medicine and receive care.</p> </div>5/24/2024 12:00:00 AM1/1/0001 12:00:00 AM
seattle-times-publishes-wsma-op-ed-on-washingtons-outpatient-challengesSeattle Times Publishes WSMA Op-Ed on Washington's Outpatient ChallengesLatest_NewsShared_Content/News/Membership_Memo/2024/may-24/seattle-times-publishes-wsma-op-ed-on-washingtons-outpatient-challenges<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/may/female-doc-patient-645x425px.png" class="pull-right" alt="female doctor with female patient" /></div> <h5>May 24, 2024</h5> <h2>Seattle Times Publishes WSMA Op-Ed on Washington's Outpatient Challenges</h2> <p>In case you missed it, the Seattle Times published an <a href="https://www.seattletimes.com/opinion/cant-get-into-your-doctors-office-youre-not-alone/">op-ed</a> this week from the WSMA drawing attention to the challenges faced by our outpatient practice community in Washington state and the resulting impact on practice viability and patient care. Titled "Can't get into your doctor's office? You're not alone" and authored by WSMA President Nariman Heshmati, MD, and WSMA CEO Jennifer Hanscom, the column responds to recent reporting on our state's hospital systems' financial struggles to make the case for similar attention to our outpatient community-the "other half of the story" for care delivery in Washington. The column also tees up our continued support for Medicaid investments through a covered lives assessment as we head into the next legislative session.</p> <p>The op-ed is a part of WSMA's efforts to highlight the physician voice in our media and to increase public and policymaker understanding of the systemic issues impacting the practice of medicine and access to care. Thank you to the physician practices mentioned in the op-ed for their willingness to help us shed light on these issues and to the many physicians who have helped to inform our media advocacy. If you have a story on challenges in your local community that you think is suitable for your local media, we'd like to hear from you. Reach out to WSMA Director of Communications Graham Short at <a href="mailto:gfs@wsma.org">gfs@wsma.org</a>.</p> </div>5/24/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-supports-limited-prescriptive-authority-for-midwives-in-rules-final-formWSMA Supports Limited Prescriptive Authority for Midwives in Rule's Final FormLatest_NewsShared_Content/News/Membership_Memo/2024/may-24/wsma-supports-limited-prescriptive-authority-for-midwives-in-rules-final-form<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/may/rx-bottle-doctor-laptop-645x425.jpg" class="pull-right" alt="Physician holding up a pill bottle" /></div> <h5>May 24, 2024</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>WSMA Supports Limited Prescriptive Authority for Midwives in Rule's Final Form </h2> <p>During the 2022 legislative session, lawmakers approved Senate Bill 5765, which created a limited prescriptive license for licensed midwives to prescribe family planning methods and treat common prenatal and postnatal conditions. This bill was the result of a positive sunrise review from the state Department of Health. The WSMA and Washington Chapter of the American College of Obstetricians and Gynecologists worked closely with the Midwives Association of Washington State to apply appropriate patient safety protections to the bill during both the legislative process and sunrise review.</p> <p>In April of 2023, the Midwifery Advisory Committee released draft language implementing the rules. The draft rules were riddled with inconsistencies and out of compliance with the authorizing legislation, specifically regarding the training required to insert and remove intrauterine devices and implants. WSMA President Nari Heshmati, MD, and WA-ACOG's Sarah Prager, MD, worked with the advisory committee to apply training requirements more aligned with clinical guidance.</p> <p>The WSMA also requested parameters around the prescription of nifedipine. Nifedipine is used to treat preterm labor or hypertension, both of which are outside of the "…the prevention and treatment of common prenatal and postpartum conditions" this rulemaking is specific to. The WSMA and the advisory committee agreed to new language that allows a licensed midwife to prescribe nifedipine pending a patient's transport to emergency care.</p> <p>The WSMA supported the final version of the <a href="https://content.govdelivery.com/attachments/WADOH/2024/05/09/file_attachments/2873719/CR-103P.pdf" target="_blank" rel="noreferrer">limited prescriptive authority rulemaking</a> that will take effect on June 6. Should you have questions on this rulemaking, please contact <a href="mailto:billie@wsma.org">WSMA Associate Policy Director Billie Dickinson.</a></p> </div>5/24/2024 12:00:00 AM1/1/0001 12:00:00 AM
doctors-making-a-difference-andrea-kalus-mdDoctors Making a Difference: Andrea Kalus, MDLatest_NewsShared_Content/News/Latest_News/2024/doctors-making-a-difference-andrea-kalus-md<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/dmd-website-image-andrea-kalus-645x425px.png" class="pull-right" alt="Doctors Making a Difference: Andrea Kalus MD graphic" /></div> <h5>May 22, 2024</h5> <h2>Doctors Making a Difference: Andrea Kalus, MD</h2> <p> Andrea Kalus, MD, a dermatologist practicing at UW Medicine, is working to make specialty care more accessible to all Washington patients, in the short term through volunteering with the Seattle King County Clinic, which provides free medical care to anyone who needs it, and long term by advocating for an increase in Medicaid rates in Washington (earlier this year, she participated in a WSMA media briefing on raising Medicaid reimbursements). She talks with WSMA Reports about why specialty care is essential care, and why raising Medicaid rates is a key component of ensuring patients get the specialty care they need. </p> <p> <strong><em>WSMA Reports: </em>There is sometimes a misconception that specialty care isn't as "essential" as primary care. As a dermatologist, why do you see specialty care as essential care?</strong> </p> <p> <em>Dr. Kalus: </em>Before going into dermatology, I trained in internal medicine and practiced in a primary care clinic for a short period of time. Primary care is so important for patients and physicians in primary care can manage a wide and deep number of diagnoses. But when the diagnosis is not clear, or a procedure like a biopsy is needed for diagnosis, or the condition doesn't respond to the usual treatments, patients need access to specialists. </p> <p> Seeing a dermatologist is not simply a luxury. It means having your psoriasis finally get better, treating a blistering skin disease, controlling eczema so a child can sleep and focus on school instead of itching, determining what allergens a hair stylist is reacting to so they can work, and managing autoimmune diseases like lupus to decrease permanent scarring and hair loss. In my experience as a primary care physician, I knew what I could manage and what I needed help with. I really valued the input from specialists when my patients needed it. </p> <p> <strong>How is raising Medicaid rates an essential component of making specialty care more accessible?</strong> </p> <p> Studies show Medicaid rates are a factor that determines access, and addressing this disparity is an issue of equity. Our state has one of the lowest reimbursement rates in our nation! The current reimbursement doesn't cover the cost of care. It's important to understand-this isn't about physician salaries, it's about covering the cost of staff like MAs and RNs, rent, and materials needed for the visit. When these costs are not covered, physicians limit or stop taking patients with Medicaid. </p> <p> This has an echoing impact on the health of people in our state. Our patients can't find care, their condition worsens, it impacts employment; on and on the echo goes. Sadly, the echo eventually fades away and these patients are forgotten. </p> <p> At UW, where I practice, we still take Medicaid insurance and I have patients who are forced to travel across the state to get care. Wait times for dermatology are way up because people have to queue to get care in the few places that still take Medicaid. </p> <p> <strong>Have you faced barriers in your own practice in terms of having to limit Medicaid patients?</strong> </p> <p> Our practice would not be sustainable if we only saw patients with Medicaid since it doesn't cover the cost of care. We have to balance numbers of patients with private and public insurance because the reality is the reimbursement from patients with private insurance is covering the gap in reimbursement for patients with Medicaid. As more and more dermatology practices in our state stop accepting patients with Medicaid, our wait times go up. For physicians, this adds to moral distress when we know we have the skill to help but we can't see patients who need us either because Medicaid doesn't cover the cost of care or the list of patients waiting is insurmountable. </p> <p> <strong>What did your volunteer experience with the Seattle King County Clinic tell you about needing to make specialty care more accessible?</strong> </p> <p> The Seattle King County Clinic is a wonderful project of the Seattle Center Foundation that hosts a four-day clinic each year offering free medical, dental, and vision care. Many of the patients we see have jobs and some insurance but high deductibles, high copays, or lack of access to physicians who will accept their insurance. </p> <p> My work at the free clinic feeds my drive to advocate for better approaches that support patients in our state to get the care they need. The work of the clinic highlights the gaps we have in our state. I hope as the years go by fewer and fewer patients come see us at the SKCC because they can get care when they need it. </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>5/22/2024 12:00:00 AM1/1/0001 12:00:00 AM
how-ai-will-reshape-medicineHow AI Will Reshape MedicineLatest_NewsShared_Content/News/Latest_News/2024/how-ai-will-reshape-medicine<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/may-june/may-june-2024-reports-cover-645x425px.jpg" class="pull-right" alt="cover of March-April 2024 issue of WSMA Reports" /></div> <h5>May 20, 2024</h5> <h2>How AI Will Reshape Medicine</h2> <p> By John Gallagher </p> <h5> <em>Members only; sign-in required.</em> </h5> <p> The heart of medicine is the relationship between physician and patient. So, it's no wonder that the potential impact of artificial intelligence may strike many physicians as unsettling and even a little frightening. The idea that a computer program, no matter how advanced, can take data, analyze it, and produce something that could change the way medicine is practiced is unnerving. </p> <p> "The models are basically algorithms, and we don't know what's in them," says John Scott, MD, an infectious disease physician and chief digital health officer at UW Medicine in Seattle. "We ask a question and get a result, but that middle box is totally opaque to us. It makes a lot of people uncomfortable." </p> <p> But the potential benefits of AI are significant. AI can sort swiftly through massive amounts of data and discover patterns with implications for diagnosis and treatment. Moreover, the technology can assist with some of the administrative tasks eating up physicians' time and contributing to their burnout. </p> <p> The benefits of AI and its inevitability make knowing about the technology a requirement for every practice in the future. "Every physician needs to know about AI," says Dr. Scott. "This isn't a technology you can just avoid and hope will go away." </p> <p> AI is already a part of practically every part of medicine, whether it's acknowledged as such or not. AI has been useful in helping to read images for several years. Many of the most current versions of chatbots rely on AI. The first scientific paper to accurately project the spread of COVID-19 relied upon AI for its predictions. </p> <p> "It's absolutely everywhere," says Teresa Girolami, MD, internal medicine physician in solo practice with BelRed Internal Medicine in Redmond. "I'm following an algorithm by checking a box every time I do an MRI or get a preauthorization." </p> <p> What is different is that the technology has taken a giant leap forward in the past several years. "The latest models are really ready to transform medicine and a lot of things we do in our everyday life," says Dr. Scott. "The big thing that's different is generative AI, models that have been trained on a suite of data but can then predict what can happen in a set of contexts. It's brought up applications in a lot of things a typical physician can do." </p> <p> Even physicians who were originally doubters about the hype around AI have come to embrace its potential once they look at it more closely. "I've reviewed a few use-case scenarios," says Áine Kelly Yore, MD, an emergency medicine physician with North Sound Emergency Medicine in Mill Creek. "I was a skeptic, but now I'm all in for its promise and utility." </p> <h3>The hope for improving diagnosis and outcomes</h3> <p> Clinically, AI has been in use to some extent for more than five years in radiology. With thousands upon thousands of images to learn from, AI had a treasure trove of data to draw upon to learn to identify abnormal results. </p> <p> "We have used a handful of machine- learning algorithms for four or five years now," says Scott Henneman, MD, a neuroradiologist in charge of clinical informatics at TRA Medical Imaging in Tacoma. The first use of AI was simply assigning location values between scans taken at different times. Because of slight differences between each scan, parts of the anatomy don't precisely correspond from scan to scan, making the process of comparing lesions tedious and time consuming. </p> <p> "Radiologists used to match up everything manually," says Dr. Henneman. "The algorithm matches up everything automatically, so we can quickly see what has changed and what is the same. It was useful right out of the gate." </p> <p> Since then, says Dr. Henneman, TRA has looked into other AI applications. One identifies large vessel occlusions, which by itself is something radiologists can do but which is incredibly helpful in an emergency setting. </p> <p> "Essentially, the algorithm grabs a CT scan of the head, knows the typical distribution of vessels and does a quick analysis," says Dr. Henneman. "It can then alert the entire team." </p> <p> Another algorithm detects head bleeds. Because of the shortage of radiologists, it can take time before images get read. The advantage of the technology is that it immediately flags the possible bleed so that the radiologist sees the exam ahead of the other exams, and the patient can get attention quickly. "The ability to detect isn't greater than ours, but it's incredibly helpful for triage," says Dr. Henneman. </p> <p> Dr. Henneman's experience illustrates how Dr. Yore can see practical applications for her work as an emergency room physician. "AI is good at pattern recognition," she notes. "When I'm looking at a patient and talking to a patient, I'm coming up with a working theory about what is wrong. If it's chest pain, I'm really good at thinking it could be a heart attack or a blood clot." </p> <p> However, if AI had access to a patient's electronic health records, it might recognize something that a physician might not immediately consider. "If AI is getting the same info from the EMR, it could say, based on this medical and family history, you should think about a dissection of the aorta. I see a lot of potential to help in the diagnosis at bedside," says Dr. Yore. </p> <p> Dr. Yore cautions that a lot of AI technology still needs to undergo rigorous testing before it's ready for the market. "If you have a medical diagnosis test that is 99% accurate, we consider that very good," she says. "If an autopilot lands a plane 99% of the time, that's not very good. We need to consider AI applications more like autopilot and less like lab tests. We're not there yet, but we're surprisingly close." </p> <p> Dr. Yore does express some concern that by itself AI still doesn't have enough nuance to understand what is a legitimate concern and what is not. "For example, if a patient comes in with abdominal pain and might have a little twinge in their chest, a computer may say having chest pain opens up a whole new diagnostic tree." </p> <p> Still, for all the advantages that AI has shown, some physicians are still wary. Dr. Henneman notes that the practice did a three-month trial of another algorithm, which had the potential to reduce the noise in scans. "Normally, in an MRI, you are scanning the entire body part of interest at the same time," he says. "You get a ton of noise and not much info. You have to scan and scan until you get more and more of a signal." The algorithm used statistical inference to get rid of typical noise artifacts, reducing the amount of scanning time by half. </p> <p> However, uncertainty among some radiologists about just what was behind the algorithm has resulted in the technology not being adopted. "These types of algorithms are a black box," says Dr. Henneman. "The radiologists thought the picture looked pretty good, but because of this black box they were concerned that maybe it was erasing lesions." In fact, says Dr. Henneman, a check of the images showed that the AI images hadn't erased any lesions. </p> <p> While he understands those concerns, he believes that the speed of adoption of AI will eventually overcome them. At conferences he attends, the volume of AI technology is exploding, citing potential uses for pulmonary emboli and triaging collapsed lungs. "The space is large and they are working on so many things." </p> <h3>Relieving time-consuming tasks</h3> <p> Where many physicians may see AI first is where they most need relief. "I'm seeing its first-use case has to do with a lot of administrative tasks," says Dr. Scott. "A lot of tasks we do are slow and not a good use of our time. A lot of physicians want to get away from the computer and get back to taking care of patients. The first couple of use cases are trying to address physician burnout and reduce the administrative burden we're facing right now." </p> <p> In fact, some systems are employing AI to take on these tasks. "There are large academic health systems that are already using AI to respond to portal messages and to help write their notes," says Dr. Scott. </p> <p> For physicians, one of the most promising AI models is a scribe. "If I have a 10-minute conversation with a patient, I have to write that down right away," says Dr. Yore. "If you match an AI with a voice recognition system, AI can listen to the conversation and distill it into a reasonable history." </p> <p> Dr. Yore says that the technology is evolving so rapidly that before last year she would have predicted it was at least five years away from the market. Now she believes it will be ready within a year. "I've seen the work in prototype," she says. "It seems like magic." </p> <p> There are other ways AI can help with office work. Even with an electronic health record, it can take physicians a while to find what they want. AI could help streamline that process. "One thing AI seems pretty good at is summarizing and distilling a large corpus of material," says Dr. Yore. "If I have a patient coming in, and I ask for echo results and history, AI could spit out a nice narrative. That's incredible. From my perspective of taking care of patients I don't know, the ability to provide me with relevant information almost instantly is amazing." </p> <p> Dr. Henneman says TRA has been using AI to help radiology reports for more than two years now. The reports generally have two sections, one for the findings, and another called the impressions, which is the summary or actions for the patient's physician. "The impression contains no new information," says Dr. Henneman. "It's just a recategorization of some of the important information in the findings." AI can look at the findings and generate an impression on that basis. "For a complicated exam with lots of findings, it's not just used for time savings but to make sure you don't miss anything," he says. "It's very popular among radiologists using it." </p> <p> Even a task as mundane as a job posting can be made easier with the help of AI. Dr. Girolami used ChatGPT to help write an ad for a nurse practitioner. "It was surprisingly good," she says. </p> <h3>Complicated questions</h3> <p> Even as physicians grapple with how AI may change the way they practice, health plans are already making use of the technology. Not all the uses may be beneficial for physicians or their patients, who are already used to rising cases of prior authorizations and rejections. </p> <p> Multiple lawsuits have been filed against health plans, including UnitedHealthcare, Cigna, and Humana, alleging that AI was used to deny coverage for necessary treatment. In general, the lawsuits allege that AI allows the plans to eliminate the need for physicians to make a determination about the claim, relying instead on algorithms that determine what a patient meeting a similar profile would need. The issue of denied claims was concerning enough for the Centers for Medicare and Medicaid Services to issue guidelines in February saying that health plans cannot rely solely on AI when denying claims for Medicare Advantage patients. </p> <p> When it comes to implementing AI, "the insurance companies are already ahead of physicians," says Dr. Scott. "They're going to have better models because they have more money." The lack of transparency in the algorithms is concerning for many physicians, particularly in cases like these when AI is used by insurers for determinations. </p> <p> The problem of how other stakeholders in health care may use AI is just one concern. Another worry is the possibility of bias in AI itself. The problem of bias, no matter how unconscious its origin, could be exponentially worse in a technology whose premise is to extract patterns from large amounts of data. </p> <p> "If you have biased information going into your model, you are going to get magnified bias in the results," says Dr. Scott. "That has the potential to worsen health inequities." </p> <p> "We already have tons of data on how implicit biases by physicians can leave people of color with pain poorly managed or missed diagnoses," says Dr. Yore. "When you take a large model that's been fed biases, you don't know how that will impact patients." </p> <p> It's not just physicians who are worried about bias. Dr. Girolami has connections with one large firm at the cutting edge of AI technology, and even AI architects worry about how bias may affect how AI interprets data. "There is inherent bias in AI," says Dr. Girolami. "As much as you try to screen it out, you can never really do so. Some little hint of it will be there because there are humans behind the algorithms." </p> <p> Dr. Scott notes other potential pitfalls around AI, including patient privacy. Models may want to use patient identifiable information, which Dr. Scott says should be discouraged. Dr. Scott says that patients are rightly going to be concerned about how AI is going to be used. "We need to be very transparent about how their information is going to be used and not used," he says. </p> <p> There's also an issue of intellectual property. Data is valuable, and controlling the data could be lucrative. "That's one of the big ethical questions in medicine," says Dr. Scott. "They really need a massive amount of data. I don't think we've really decided as a society and as a medical community who owns the data. There needs to be a very considered response to that question." </p> <p> To consider some of these thorny issues, as well as the upsides of AI, the WSMA formed an AI work group in January. (Dr. Scott, Dr. Girolami, and Dr. Yore are members of the work group.) The group's goal is to review and update WSMA's existing principles on AI and provide expert perspective on AI-related issues. Among the issues the work group will help with are ensuring nondiscriminatory use of AI in medicine and counseling WSMA staff and leadership on issues under consideration by the Legislature. </p> <p> "One of the hopes of this work group is that we can educate all the physicians in the state about the use cases and the pitfalls so that they can practice in the 21st Century and have a better quality of life doing so," says Dr. Scott. </p> <h3>Physicians in the driver's seat</h3> <p> Ultimately, as helpful as AI may be, it will still require physicians to oversee the final product. </p> <p> "The analogy I use is semiautomated cars," says Dr. Scott. "You're still going to have to be behind the steering wheel and pay attention. You're still going to have to review the note that goes out to the patient before it's finalized. But it's going to take away 80 to 90% of the time you spend on it." </p> <p> Just as importantly, AI will never change the fundamental relationship at the heart of medicine: the relationship between patient and physician. </p> <p> "Who really makes the decisions here?" says Dr. Girolami. "It's not going to be ChatGPT. It should be the physician and patient together." </p> <p> If anything, the skill and humanity of a physician simply can't be duplicated by technology. </p> <p> "It's going to be really hard to remove the human element to understand the context and vocal cues that might escape a computer," Dr. Girolami says. "You can read a person in a way that a computer is not able to. AI will never be able to supply your uncanny sense of what you think you should do next or the compassion required for healing." </p> <p> "There is a place for AI," continues Dr. Girolami, "but you can never substitute for the experience of physicians." She knows that from firsthand experience. She was at a party with a group of AI architects when she suddenly needed to perform the Heimlich maneuver on a guest who was choking. After successfully doing so on the first try, Dr. Girolami thought to herself, "Let's see AI do that." </p> <p> <em>John Gallagher is a freelancer specializing in health care.</em> </p> <p> <em>This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine</em> </p> </div>5/20/2024 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-may-17-2024-campaign-season-has-begun-candidates-need-to-hear-from-youWeekly Rounds: May 17, 2024 - Campaign Season Has Begun: Candidates Need to Hear From YouLatest_NewsShared_Content/News/Weekly_Rounds/2024/weekly-rounds-may-17-2024-campaign-season-has-begun-candidates-need-to-hear-from-you<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo with Jennifer Hanscom, WSMA CEO" /></div> <h5>May 17, 2004</h5> <h2>Campaign Season Has Begun: Candidates Need to Hear From You</h2> <p>Jennifer Hanscom, CEO</p> <p> The 2024 campaign season here in Washington state is now in full swing after the May 10 filing deadline for candidates intending to run for statewide and local offices. After that, candidate fundraising kicks into high gear, and last week I attended a fundraiser in Olympia for insurance commissioner candidate Sen. Patty Kuderer. </p> <p> While there, I had the pleasure of talking with several physicians who happen to work in direct primary care practices. According to a recent Office of the Insurance Commissioner report, between 2022 and 2023, this practice model saw a 31% increase with 81 direct practices now operating in Washington state (numbers are based on those registered in Washington state). </p> <p> Over the past year, the WSMA also has seen a rising interest in the practice model among our members. Last year, the WSMA House of Delegates passed a resolution which seeks to support the growth and development of physician-led innovative primary care practice models, such as direct primary care, as part of the overall solution to the health care system problems. </p> <p> Further, in the May/June issue of <em>WSMA Reports</em>, which all members should have received in the mail, you can read more on this topic as we feature two physicians who own DPC practices. Both share their experiences on what led this to entrepreneurial approach to practice and how they are faring. I encourage you to give it a read. </p> <p> Speaking of good reads, the WSMA's annual Legislative Report will soon land in your email and mailboxes. The report details WSMA's priority agenda and includes a voting tracker to help you consider who to support this fall in light of their positions on issues concerning the house of medicine. </p> <p> That publication also notes the physicians who testified on behalf of medicine this session. There were a good many, and I want to give a shoutout to all who took time to raise up the physician voice on various bills of import, including: </p> <p> Medicaid rate increases (House Bill 2476) </p> <ul> <li>Sung-Won Kim, MD, Olympia ENT</li> <li>Douglas Seiler, MD, Vashon radiologist</li> <li>Beth Ebel, MD, Seattle pediatrician</li> </ul> <p> Physician wellness program confidentiality (House Bill 2122) </p> <ul> <li>Katina Rue, DO, Yakima family physician and WSMA immediate past president</li> <li>Tamara Chang, MD, Tacoma pediatric hematologist/oncologist</li> <li>Jennifer Chin, MD, Redmond OB-GYN</li> <li>Anne-Marie Amies Oelschlager, MD, Seattle adolescent medicine physician and OB-GYN</li> </ul> <p> Washington Physicians Health Program (House Bill 1972) </p> <ul> <li>Nariman Heshmati, MD, MBA, FACOG, Mukilteo OB-GYN and WSMA president</li> <li>Christopher Bundy, MD, MPH, Seattle psychiatrist</li> </ul> <p> Statutory definition of vaccine (Senate Bill 5982/House Bill 2157) </p> <ul> <li>Nariman Heshmati, MD, MBA, FACOG, Mukilteo OB-GYN and WSMA president</li> <li>Beth Harvey, MD, Olympia pediatrician Pharmacist prescriptive authority (HB 2116)</li> <li>Katina Rue, DO, Yakima family medicine physician and WSMA immediate past president</li> </ul> <p> Anesthesiologist assistants (Senate Bill 5184) </p> <ul> <li>Tim Clement, MD, Wenatchee anesthesiologist</li> <li>Cassie Gabriel, MD, Vancouver anesthesiologist</li> </ul> <p> POLST access (House Bill 2166) </p> <ul> <li>Wendy McGoodwin, MD, Seattle palliative medicine physician</li> <li>Bruce Smith, MD, Issaquah retired palliative medicine physician</li> <li>James deMaine, MD, Seattle retired pulmonary/critical care physician</li> </ul> <p> Anesthesia gases (House Bill 2073) </p> <ul> <li>Annemarie Dooley, MD, Seattle nephrologist</li> </ul> <p> Psychologist prescriptive authority (Senate Bill 6144) </p> <ul> <li>Robin Berger, MD, Seattle child and adolescent psychiatrist</li> <li>Ravi Ramasamy, MD, Seattle child and adolescent psychiatrist</li> <li>Scott Ferguson, MD, on behalf of the American Medical Association</li> <li>Petros Levounis, MD, on behalf of the American Psychiatric Association</li> <li>Marsha Haley, MD, on behalf of the Physicians for Patient Protections</li> </ul> <p> While WSMA staff regularly advocate on your behalf, testimony provided by physicians is extremely powerful, as legislators place emphasis on your firsthand experiences and professional expertise. </p> <p> Over the coming months, you'll have an opportunity to personally meet with congressional, statewide, and legislative candidates in a more informal capacity by attending their fundraising events. I urge you to make time to attend these events. I can't emphasize strongly enough how important it is for candidates to hear from physicians with firsthand experience about the need for increased reimbursement, decreased administrative regulation and policies that improve patient safety and care. </p> <p> Now is the time to lay the groundwork with candidates for office and solidify existing relationships with incumbents to ensure the voice of the physician community remains respected and influential. More and more interest groups are vying for their attention in order to gain a foothold on health care policy issues-your voice matters and needs to be heard. </p> <p> For the first time in more than a decade, we'll see elections for a new governor, attorney general, and insurance commissioner. Also, all 98 seats in the House of Representatives and more than half of the Senate are up for election and there will be a new chair of the House Health Care Committee for the third time in four years. A lot of change is ahead and we need to do the work now to ensure our relationships are strong. </p> <p> If you have questions about how you can lend your support, contact Alex Wehinger, director of WAMPAC, WSMA's nonpartisan campaign arm that identifies and supports candidates for political office whose priorities align with the house of medicine. <a href="[@]wsma/advocacy/wampac/wsma/advocacy/wampac/wampac.aspx?hkey=269c3c03-cf72-4568-be5b-7893557300a7&_zs=B3aFd1&_zl=ncid9">Make a contribution to WAMPAC or join the Diamond Club today</a> to support our work on campaigns. </p> <p> WAMPAC will be sharing more information about future fundraising events over the coming months. I know many of you are also holding fundraisers for individuals you're supporting. Be sure to <a href="mailto:alex@wsma.org">share this information</a> with Alex. </p> <p> I look forward to seeing many of you at these upcoming events. In the meantime, thank you for your engagement and support of WSMA and WAMPAC. </p> </div>5/17/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-wsma-annual-meeting-how-to-propose-policy-or-serve-as-a-delegate-deadlines-and-more2024 WSMA Annual Meeting: How to Propose Policy or Serve as a Delegate, Deadlines, and MoreLatest_NewsShared_Content/News/Membership_Memo/2024/may-10/2024-wsma-annual-meeting-how-to-propose-policy-or-serve-as-a-delegate-deadlines-and-more<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/may/venticinque-230924-4025-645x425px.jpg" class="pull-right" alt="WSMA House of Delegates session" /></div> <h5>May 10, 2024</h5> <h2>2024 WSMA Annual Meeting: How to Propose Policy or Serve as a Delegate, Deadlines, and More</h2> <p>Mark your calendars: The 2024 Annual Meeting of the WSMA House of Delegates will take place Sept. 28-29 at The Historic Davenport in Spokane. This yearly conference is WSMA's primary policymaking and networking event, when our approximately 175 voting delegates gather to elect new officers and consider new policy for the association. The WSMA Annual Meeting is open to all and is free for members, and registration will be announced shortly. For now, WSMA members wishing to engage in the policymaking opportunities offered at the meeting or for those interested in serving as a delegate at the meeting, here's what you need to know in anticipation of the event.</p> <h3>How to serve as a WSMA delegate</h3> <p>Delegates are expected to be available for one year of service from the beginning of the House of Delegates meeting until the House of Delegates meeting the following year. Delegates are expected to:</p> <ul> <li>Be familiar with the WSMA.</li> <li>Review the official actions of the previous House of Delegates and the WSMA policy compendium (included in the delegate handbook, distributed prior to the Annual Meeting).</li> <li>Seek feedback on WSMA programs and policies.</li> <li>Communicate your society's or your individual recommendations for the establishment of WSMA policies or programs through the introduction of a resolution.</li> <li>Be thoroughly familiar with the reports and resolutions contained in the delegate handbook.</li> <li>Work with your delegation.</li> </ul> <p>If you are interested in serving as a delegate representing your county or specialty, contact your county medical society or state specialty society. If you are unsure who to contact, email the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. Learn more about service as a delegate by visiting <a href="[@]wsma/about_us/who_we_are/house-of-delegates/wsma/about/who_we_are/house-of-delegates.aspx?hkey=c5e98d40-6e37-4bc0-9bda-a7aa66e67919">House of Delegates</a> on the WSMA website.</p> <h3>How to propose policy</h3> <p>As a WSMA member, you can help guide the direction of the association and raise awareness of issues of importance to the practice of medicine in Washington by authoring a resolution-a proposal asking the WSMA to take a position or act on an issue.</p> <p>For a brief primer on resolutions, watch this <a href="https://vimeo.com/730122009">five-minute video</a>. If you think you may want to submit a resolution for consideration by the House, it's important to follow these first steps:</p> <ol> <li>Check for existing policy.</li> <li>Check for health equity impact.</li> <li>Discuss with other WSMA members.</li> </ol> <p>For guidance on each step, visit <a href="[@]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> on the WSMA website. After taking these initial steps, you must follow these requirements:</p> <ol> <li>Organize your proposal into the required resolution format. For details on how to format your proposal using the five basic elements of a resolution, review our <a href="[@]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#howto">detailed instructions</a>. A template is provided.</li> <li>Identify sponsors. Resolutions must be submitted in writing and sponsored by at least two WSMA delegates, alternate delegates, or members of the board of trustees.</li> </ol> <p>WSMA members are encouraged to work with their specialty society or their local county society to discuss the merits of the resolution and to identify sponsors. The WSMA can also work with you to develop your resolution idea and find a sponsor. Contact us at <a href="mailto:hod@wsma.org">hod@wsma.org</a> or 206.441.9762 for assistance. Resolutions must be submitted to the WSMA at <a href="mailto:hod@wsma.org">hod@wsma.org</a> for review by the relevant deadlines (below).</p> <h3>Join the community forum dedicated to discussing WSMA policy</h3> <p>To help hone your resolution idea or to engage with other highly engaged and policy-focused WSMA members, including the WSMA House of Delegates, join our new WSMA Virtual Reference Committees and Policy Community, one of our new private, secure, and convenient online communities. Accessible using email, website, or mobile app, the discussion forum allows you to post and share resources, connect one-on-one via private chat, see member profiles, and receive updates tailored to your specifications. <a href="https://community.wsma.org/registrations/groups/95445">Request to join the WSMA Virtual Reference Committees and Policy Community</a>.</p> <h3>Important 2024 WSMA Annual Meeting deadlines</h3> <ul> <li>Aug. 9: Reports and resolutions due for inclusion in the delegate handbook.</li> <li>Aug. 28: Deadline to make room reservations at The Historic Davenport in Spokane.</li> <li>Aug. 29: Final deadline for reports and resolutions. Resolutions received after this date must have the consent of two-thirds of the House of Delegates at the opening session in order to be considered.</li> <li>Sept. 6: Delegate handbook will be available for download.</li> <li>Sept. 28-29: 2024 WSMA Annual Meeting.</li> </ul> <h3>More information</h3> <ul> <li><a href="[@]wsma/events/annual_meeting/wsma/events/annual_meeting/annual_meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">WSMA Annual Meeting</a></li> <li><a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">How to Write a Resolution</a></li> <li><a href="[@]wsma/about/policies/whats_our_policy/policy_index.aspx">What's Our Policy?</a> - <em>make sure your resolution isn't already a policy!</em></li> </ul> <p>Should you have additional questions on the meeting or resolution drafting, please contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> </div>5/10/2024 12:00:00 AM1/1/0001 12:00:00 AM
 
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