| ceo-rounds-oct-1-2024-showing-up-for-each-other-and-the-house-of-medicine | CEO Rounds: Oct. 1, 2024 - Showing Up for Each Other and the House of Medicine | Leadership | Shared_Content/News/ceo-rounds/2024/ceo-rounds-oct-1-2024-showing-up-for-each-other-and-the-house-of-medicine | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/ceo-rounds/ceo-rounds-article-graphic-bramhall-2024-645x425px.png" class="pull-right" alt="CEO Rounds logo, with John Bramhall, MD, PhD, WSMA President" /></div>
<h5>Oct. 1, 2024</h5>
<h2>Showing Up for Each Other and the House of Medicine</h2>
<p>
John Bramhall, MD, PhD, WSMA President
</p>
<p>
<em>John Bramhall, MD, PhD, on building community, relationships, and impact in his inaugural address before the WSMA House of Delegates on Sunday, Sept. 29. Read an edited transcription below. For a look at what WSMA's past year looked like, don't miss our <a href="https://vimeo.com/1012940949">Year in Review video</a> (keep an eye out for your colleagues and friends!).</em>
</p>
<p>
Here we are at 8 a.m. on a Sunday morning!
</p>
<p>
Thank you all for being here.
</p>
<p>
I know this is the traditional time for the incoming president's rite of passage, but wouldn't it be easier to face if we did it, say, at 8 p.m. after a cocktail reception?
</p>
<p>
We can only dream!
</p>
<p>
Ah well, thank you again for "showing up."
</p>
<p>
Showing up is so important.
</p>
<p>
The fact that I'm standing here, in front of you this morning, wearing both a gold medal and a tie is surely proof of Woody Allen's adage that 80% of success is just showing up!
</p>
<p>
I truly believe showing up yields three outcomes that matter to us, to the work at hand today, and in the work we do with the WSMA: <strong>community, relationships, and impact</strong>.
</p>
<p>
Let's talk about how showing up builds <strong>community</strong>. Look around-some 200 of you are here and highly engaged- just look at the energy levels in the reference committees yesterday! You are here to actively contribute, inform, and learn from each other, and to, quite literally, plot the future course of the WSMA.
</p>
<p>
Take a moment to look at your neighbor and thank them for showing up!
</p>
<p>
My own involvement with WSMA started with the simple act of showing up. Years ago, as I got settled in my work, a colleague and fellow countryman, Peter Dunbar, introduced me to the WSMA and to the Leadership Development Conference. Peter- and many of you know him directly- was president of the WSMA back then, very energetic, well-informed, and extremely well connected with state political leadership-he actually had quite a bit of influence on some decisions being made by then Gov. Christine Gregoire.
</p>
<p>
Seeing his influence on the house of medicine impressed me and the Leadership Development Conferences inspired me. Because I showed up for those and made my presence felt, in time, I was asked to join the WSMA board, then the EC, and here we are!
</p>
<p>
One of my favorite aspects of showing up is how doing so builds <strong>relationships</strong>. Across my WSMA journey, I've been fortunate to forge a wide range of relationships. I've come to know many physicians from all different walks of the profession. I hope to come to know many more of you during my year as president.
</p>
<p>
For those of you who don't know me yet, I'm a scientist by training and I've spent my entire career as an academic. Sorry! I studied biochemistry in the UK, came to the US as a Fulbright scholar, carried out research and teaching at UCLA and Stanford, got my medical education in La Jolla, and then came to Seattle for residency and stayed.
</p>
<p>
During clinical training, just like many of you, I found the team approach to problems- exemplified by "work rounds" and extensive collaboration was impressively effective. And, as I learned about anesthesia, I was really drawn to the OR environment-it's such a fascinating place. It's complicated. It's complex. A lot of stuff goes down day and night, and that appealed to me, that feeling of being part of a system that was humming.
</p>
<p>
And even though I'm a scientist at heart, I am also drawn to the overarching sense, really, of mystery in my work. We still are very unclear about the biophysical substrate of consciousness, the nature of awareness, so it stands to reason that we are even less clear about the exact mechanisms of chemical hypnosis. Anesthesia is a great example of safe, effective manipulation of processes that are incompletely understood. There is mystery, and that keeps me humble. This humility is not always an easy concept for physicians to introduce to patients.
</p>
<p>
I spent the past 30 years working primarily at Harborview where I was a medical director, an attending physician, and professor. It's been a privilege, in every way, to do this work. I stepped back from administrative work last month to allow time to serve as WSMA president but will maintain my toehold in clinical teaching and academics with the university.
</p>
<p>
I'm sure most of you have your own stories of how you came to be physicians, how you came to be here today; I'll look forward to finding out about some of these stories throughout the year.
</p>
<p>
Now let's consider how showing up creates <strong>impact</strong>.
</p>
<p>
Anyone wandering in and out of the reference committees yesterday would see the energy and focus of the WSMA being applied to a range of issues facing us: public health structure, AED distribution, access metrics, nano-plastic pollution, diaper access, air purification, firearm education- it's a really long list of issues that reflects our interconnectedness with, and concerns for, the well-being of Washingtonians.
</p>
<p>
Indeed, Washington state is a great place to live and it's also a pretty good place to be sick! We have first-rate emergency, medical, and surgical care provided by well-integrated teams. There's a long list of conditions where Washington leads the nation in quality of care and where physician practice is supported and sustained by state-of-the-art systems, and we attract smart doctors to the state.
</p>
<p>
But this is only part of the big picture. People can only benefit from our clinical excellence if they have access to it! There is a lot going on with our patients- nutrition, housing, gun violence, drug use, transmissible disease, mental health, relative poverty- a long list of problems that persist and are associated with poor health outcomes.
</p>
<p>
You've seen the distribution maps showing (to me, astonishing) the variation- to take one clear-cut example- in life expectancy between, and even within, various counties of our state. These local variations are also set in the context of an average US life expectancy that is already so much shorter than in other comparable advanced societies. Life expectancy is a complicated metric but it's a pretty objective, actuarial measure with robust data collection. Wherever you see this type of variation-for example in maternal mortality, or HIV infection rates-it's a sign that there are underlying local causes, causes that our members then want to identify and address, with a clear supportive role for the association in integrating, coordinating, and communicating.
</p>
<p>
Medicaid is relied upon by close to 2 million of our most vulnerable neighbors. We know access to care for patients on Medicaid is becoming more fragmented and we know the issues around that are more than complicated.
</p>
<p>
But decades of research and dozens of reports repeatedly show that evenly distributed, high-quality primary care for everyone improves health outcomes and life expectancy through more effective diagnosis, monitoring, management and coordinated prevention and treatment of conditions, reducing the need for more dangerous and costly care later on, particularly for vulnerable patients.
</p>
<p>
This is why our Medicaid Access Program is so vital. Your legislative team in Olympia is all over this now and will be all over it, redoubled, when the legislative session begins in January- notably, with newly restructured health care committees and many new state legislators. We will need all hands on deck to support our program and that includes all of you, along with all of our county and specialty societies. We will be looking for vocal support that calls out the Medicaid issue at every opportunity and at every legislator meeting. It's a state-level problem that will require an unrelenting state-level legislative effort.
</p>
<p>
In contrast, the problem with Medicare compensation is a national one. The Medicare physician fee schedule has a limited budget that does not include inflationary updates- the only Medicare fee schedule that does not receive them. MIPS, heavily dictated by Congress, is burdensome and resource intensive, leading to practices- especially smaller ones- being disproportionately penalized.
</p>
<p>
I don't think of the Centers for Medicare and Medicaid Services as an enemy. Medicare has a limited budget and must perform its mandated work within that budget and that budget structure is heavily controlled by Congress. Internal Medicare decisions are guided by smart epidemiologists, and the agency tries hard to optimize overall public health by directing funding to areas where it will prove most helpful. The CMS is also evidence-driven and rarely chooses expensive options without supporting evidence. There is a thread of utilitarian ethics that runs through these big decisions- the most good for the most people- that makes it tough for "special case" thinking.
</p>
<p>
Even so, the cuts to physician compensation, together with lack of inflation adjustments over the years are so clearly egregious, so impossible to justify, that we must seek action. The WSMA is coordinating outreach to the congressional delegation and our two senators on legislation that has been introduced, and there does seem to be a consensus that this is a problem that must be fixed.
</p>
<p>
What about the bane of our existence: prior authorization? This is a perennial WSMA issue- as evidenced by several resolutions that are under consideration at this year's House of Delegates - and we have made solid strides in reducing administrative burden for us all. That movement continues with proposed prior authorization process integration with EMRs, for example. Also, we have sympathy from local legislators as well as a national push again at the AMA level. We are striving to make practical headway and will align with others working to do the same, such as the hospital association, whose initiative analyzing denial rates from billing data aligns well with our concerns.
</p>
<p>
We will continue to focus on resisting scope expansion efforts-another constant, every year, all year, analyzing the many scope proposals and fighting those that jeopardize patient safety, as well as pushing back on disinformation and title misappropriation campaigns. We're the bear and we're always getting poked! The WSMA will continue to prioritize policy decisions that promote accurate diagnosis with safe and effective care for patients by ensuring that care is provided by people who have undergone appropriate training. It's just one more example of how the WSMA advances the cause of quality care for all Washingtonians.
</p>
<p>
On all of these issues, and more, we are asking you to show up.
</p>
<p>
Here's why all this really does matter.
</p>
<p>
I don't have to tell you that we have faced growing reputational challenges caused by partisan battles over the COVID-19 pandemic, science- and evidence-based care, and the prevalence of mis- and disinformation. All coupled with a more generalized societal distrust of "authority" and even scientific method. "Alternative facts!"
</p>
<p>
These challenges pose the risk of distracting us from what matters most: the care we provide to patients. Unfortunately, decisions made by others dramatically limit the time we can spend with our patients.
</p>
<p>
We know that time spent listening to, responding to, and treating patients is essential to providing the quality care patients deserve. We need time to build trust and provide the most effective care and treatment, and we'll continue to push back against time-based, RVU-based metrics imposed on us for evaluation of patient care.
</p>
<p>
In the year ahead, your WSMA is undertaking a campaign within which everything I've talked about will intersect. You see the campaign around you here today: Your Care Is at Our Core. We are undertaking this campaign to publicize how our members, you all, work with patients to make the best health care decisions and that <strong>their care is at our core</strong>.
</p>
<p>
We are strong when we stand together, and we are counting on you.
</p>
<p>
Thank you for the trust you've shown in me, thank you to Dr. Rue and Dr. Heshmati for leading the way to this day, and thank you all for showing up.
</p>
</div> | 10/1/2024 12:00:00 AM | 1/1/0001 12:00:00 AM |
| become-an-effective-board-member-with-wsma-effective-board-governance-course | Become an Effective Board Member with WSMA Effective Board Governance Course | Leadership | Shared_Content/News/Membership_Memo/2024/september-13/become-an-effective-board-member-with-wsma-effective-board-governance-course | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/september/effective-board-governance-course-645x425px.png" class="pull-right" alt="Effective Board Governance Course graphic" /></div>
<h5>Sept. 13, 2024</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Become an Effective Board Member with WSMA Effective Board Governance Course</h2>
<p>
<em>One-day virtual seminar, Nov. 15, 2024</em>
</p>
<p>The WSMA Effective Board Governance Course, led by Ed Walker, MD, is a full-day seminar providing in-depth education about governance: what it is, what boards do, why they exist, and how you can be an effective participant. This course is open to alumni and non-alumni of WSMA's leadership courses who are in a physician leadership role in their organization.</p>
<p>Now more than ever, physicians are being asked to serve on the board of their clinic, medical group, or integrated system. But to be an effective board member it is important to understand the difference between a constituency-based board and a representative board, what's expected of you in terms of fiduciary responsibility, who you are expected to represent, and how to be effective in communicating as a board member. Equipped with this knowledge, physicians can be even stronger leaders and bring a powerful voice and perspective to any board.</p>
<p><a href="[@]wsma/education/physician_leadership/effective_board_governance/wsma/physician_leadership/effective_board_governance/effective_board_governance.aspx?hkey=75c1d687-1473-49fa-bd43-4c1099f60072">Register for the course online</a>. The registration deadline is Tuesday, Oct. 15. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢.</em></p>
</div> | 9/13/2024 12:00:00 AM | 1/1/0001 12:00:00 AM |
| new-cme-program-transcending-clinical-excellence-mastering-emotional-intelligence | New CME Program: Transcending Clinical Excellence: Mastering Emotional Intelligence | Leadership | Shared_Content/News/Membership_Memo/2024/september-13/new-cme-program-transcending-clinical-excellence-mastering-emotional-intelligence | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/september/eqi-course-graphic-645x425px.png" class="pull-right" alt="Transcending Clinical Excellence: Mastering Emotional Intelligence course graphic" /></div>
<h5>Sept. 13, 2024</h5>
<h2>New CME Program: Transcending Clinical Excellence: Mastering Emotional Intelligence</h2>
<p>Embark on a transformative journey of self-discovery and interpersonal growth with a new CME course from the WSMA Foundation, Transcending Clinical Excellence: Mastering Emotional Intelligence. Whether you're seeking to enhance your leadership abilities, strengthen your clinical relationships, or simply enrich your personal life, this course offers a comprehensive toolkit for unlocking the power of emotional intelligence and fostering stronger connections with those around you.</p>
<h3>The course in brief</h3>
<p>Through interactive sessions and practical exercises, you'll cultivate the skills essential for fostering meaningful connections and resolving conflicts in the workplace empathetically. This course is longitudinal (your progress will be measured over time), and multimodal (the course features different methods of learning), giving learners multiple touchpoints on different aspects of emotional intelligence and allowing for deep understanding and opportunities to apply skills in practice.</p>
<h3>Who this course is for</h3>
<p>This course is available to WSMA member and nonmember physicians, physician assistants, nurse practitioners, and all other clinicians looking to increase their emotional intelligence (with a discount available for members). Whether you are already a leader or considering a leadership role, you can benefit from this course.</p>
<h3>Course details</h3>
<p>Beginning Friday, Jan. 31, sessions will be held virtually every Friday from noon-2 p.m. through March 21 (skipping Feb. 21 for midwinter break), with a final in-person session at the WSMA Seattle office on March 28.</p>
<h3>Instructors</h3>
<p>This course is led by Nina Willow, MD, and Amy Mohelnitzky, PA-C. Dr. Willow is a family physician who coaches health care professionals at all levels on enhancing patient satisfaction, clinical efficiency, and physician well-being. PA Mohelnitzky leads the Clinician-Patient Communication Program at Kaiser Permanente Washington.</p>
<p><a href="[@]wsma/foundation/physician-wellness/mastering-emotional-intelligence/wsma/foundation/physician-wellness/transcending-clinical-excellence-mastering-emotional-intelligence.aspx?hkey=d9d3ac56-9fc3-44da-93ed-8d253a568a35&amp;_zs=lfaFd1&amp;_zl=F1cn9">Register for the course online</a>. This activity has been approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>.</p>
</div> | 9/13/2024 12:00:00 AM | 1/1/0001 12:00:00 AM |