UMass FMCH Tuesday Talk - September 7, 2021/CLINICAL
Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to [email protected].
Table of Contents
Upcoming Events
Focus of the Week - Clinical
Frankly Speaking Podcast
Department Member Recognition
Faculty Presentations/Publications
Clinical Services Spotlight
Message from the Chair
As the summer comes to a close, I hope you all found time to relax and enjoy family and friends. I want to re-extend my personal invitation to join us at “Septemberfest” on September 25th – see the details below. We hope for great weather and look forward to the chance to gather together as a community safely outdoors.
The new academic year starts in full this week with several events that highlight our extraordinary faculty. Convocation on Thursday will include recognition of Jennifer Reidy, and Frank Domino will be a keynote speaker at the White Coat Ceremony. Thank you all for sharing your expertise and passion with our learners in all the ways that you are engaged in the educational mission!
And finally, today is a huge day for the medical school, now UMass Chan Medical School. Details and celebration of the gift from the Chan family and their decision to support UMass will be shared in many ways today and in the coming weeks. I hope we can all take a moment to enjoy this occasion. The gift is a powerful statement of the stature that UMass has achieved, and of the school’s potential to do even more. It reflects the amazing faculty, staff, and learners that is UMass, and that of course is YOU!
Upcoming Events
FMCH Grand Rounds
Tuesday, September 14th, 12-1pm; Frank J. Domino, MD presents "Top 10: EBM Updates from the Medical Literature".
Meeting ID: 191 986 273 Password: FMCH

Department of Family Medicine and Community Health Septemberfest!
Hopkinton State Park, Saturday, September 25th,11:00 – 3:00pm.
Barbecue, activities for the kids, canoe, sailboat and kayak rentals
Don't miss out on the fun at Septemberfest. Please RSVP to Jennifer Masoud by Friday, September 10th to reserve your spot. Include the number and names of everyone in your party.
Carpooling is recommended as the parking lot fills up fast on weekends.

The WFMR is happy to announce a Fall Resident Retreat date
10/5/21 8am to 5pm at Camp Selah, Orange, MA
We appreciate faculty who will be doing additional service to allow the residents this important wellness and team building time. Also, residency faculty who are interested and able to be free are invited to join. Please mark your calendars and contact Hilda Alers for further details.

American Board of Family Medicine Maintenance of Certification
KSA (SAM) Workshop: “Care of Children”
Thursday, November 18, 2021, 8:00 – 10:00 AM
WEBINAR (no need to leave your desk) Link will be sent prior to 11/18/2021
We will complete the latest (just released) 60 question Care of Children KSA via a virtual CME event. You will record your answers while we work through the KSA, then after completion, log into your ABFM account and enter the results and claim your CME credits through the ABFM. Successful Completion of the Knowledge Self-Assessment (KSA) Module is eligible for up to 10 ABFM Credit Hours.
See the attached invitation for a WEBINAR to complete the ABFM KSA: Caring for Children. To register, please complete and follow the directions on the attached registration form.
Focus of the Week - Clinical

Massachusetts Medical Society
Are you a member of the Massachusetts Medical Society? 
  • Meetings will remain virtual until the end of the year. 
  • Are you looking for resources to support physician and staff well-being? These resources are available to everyone on the Massachusetts Medical Society website. 

Health Equity
  • Only a few more weeks before we end the count of annual equity project for 2021, "The Well Child Care Project."
  • The institution has reached the intended goal and we are aiming for the Reach goal. 
  • As a department we have done well and are anticipating that by the end of the month, we will reach our goals as well. 
  • As of 8/1/2021, we are close. Congratulations to those teams that have continued to close the gap!

GME Funding Review
PATH funding or "physicians at teaching hospital" billing was expanded during the Public Health Emergency. Massachusetts has extended the Public Health Emergency Period through the end of October and is expected to be further extended until December 31, 2021.
Historically, Medicare only pays for visits by a resident when the teaching physician is physically present except for the primary care clinic exception for primary care for certain E/M services.
  • During the pandemic, CMS allowed for a few expansions, 
  • Physician presence could be met through virtual presence.
  • The list of resident services that could be provided without a teaching presence was expanded.
  • Residents were given permission to interpret certain radiology and diagnostic test results.
  • Permitted virtual presence of the teaching physician for unique psychiatric services. 

  • The 2021 physician fee schedule will temporarily remain through the public health emergency (PHE) but permanently for rural residency programs outside the Metropolitan Statistical Area (MSA). 
  • At the time of the PHE expiration, the expansion of allowing the preceptor to precept virtually using audio/ visual interactive will also expire. 
  • While the PHE is in effect, teaching physicians are allowed to bill for services furnished by residents by telehealth and supervised by interactive telecommunications technology. In the State of Massachusetts, this includes the audio visit.
  • Medicare may also make payment for services billed by the teaching physician under the primary care exception.

Hepatitis C and General Hepatology
Project ECHO (Extension for Community Healthcare Outcomes)
You are invited to join an exciting virtual collaborative learning opportunity!
What? Hepatitis C ECHO, a virtual case-based tele-mentoring educational model
Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.)
Why? Tele-mentoring model that links specialists to primary care providers (PCPs) via video conferencing from any computer; Case based, iterative learning facilitated by specialists and related experts; through guided practice, PCPs become proficient in specialty care
When? A new cohort begins Friday, September 10th, 2021, 12:30 - 1:30pm ~ with 10 sessions held bi-monthly.
Curriculum content includes:
  • HCV screening
  • Acute HCV
  • Chronic HCV: Workup
  • Treatment of non-cirrhotic patients
  • Treatment of cirrhotic patients
  • Monitoring during treatment
  • Monitoring post treatment
  • "Topic by request"
  • Other hepatitides in the context of HCV/Hepatitis A&B
  • Treatment of special populations

UMass Family Medicine & Community Health Apparel Orders 2021
The pandemic has limited what we are able to order for Department gear, and thus the order form is changing significantly. Below is a Google Link, for which people can order Department gear from. Pricing will depend on quantity ordered. Please reach out to [email protected] with any questions. Submission Deadline: Tuesday, September 21st.

Program Dates: September 1st, 2021 to October 31st, 2021.
Using your smart phone and/or smart watch track the number of steps each week and enter it into the data base link that will be sent out at the end of each week by your designated team leader. You can choose your own team, designate a name for your team and a leader who can keep track of data by each team member using a smart link. Your team leader will complete the first sign up survey after which we will create a “team link” for you where each member of your team can enter their own numbers/data. It will take less than a minute for the whole week’s activity tracking. Incentive: Improve team bonding, improved physical activity, friendships among co-workers, recognition in the Tuesday Talk and system wide recognition at the end of the program.

Massachusetts Latent Tuberculosis Infection (LTBI) ECHO. Come join us!
What? Massachusetts Latent TB Infection ECHO, a virtual case-based telementoring educational model.
Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.).
Why? The USPSTF guidelines urge primary care teams to test high risk populations for TB & treat latent TB infection within primary care.
When? Thursday 12:15 - 1:15pm for 11 monthly sessions; 10/14/21, 11/18/21, 12/16/21, 1/13/22, 2/17/22, 3/17/22, 4/21, 5/26/22, 6/16/22, 7/21/22, 9/15/22.
This course is designed for beginners and more advanced practitioners. Those who are new to LTBI management will receive introductory material from our previous LTBI ECHO courses. We welcome previous course participants to join for new curriculum content and more advanced considerations in LTBI management.
Curriculum content includes:
  • Latent TB infection testing and treatment recap
  • Short course regimen considerations
  • Ruling out TB disease - advanced considerations
  • LTBI advanced testing and treatment considerations in special populations (i.e., pediatrics, pregnant people, liver disease)
  •  CME available

Teaching of Tomorrow (TOT)
January 7-8 and March 25-26, 2022
Registration is Open! 
For over 25 years, UMass faculty from the departments of Family Medicine and Community Health, Internal Medicine and Pediatrics have trained over 1,500 clinical faculty and preceptors from across the Northeast and beyond. TOT focuses on building and refining foundational skills for effective clinical teaching in both the inpatient and ambulatory settings. Preceptors from any specialty and discipline will enhance their clinical teaching skills through discourse and practice. TOT also provides valuable opportunities to network with other clinician educators. Our award-winning faculty utilize the principles of adult learning, drawing on participants’ experience and building knowledge through dialogue. The conference provides frequent opportunities to practice and assess new skills in a safe and fun environment.
  • Clinical educators – MDs, DOs, NPs, PAs, RNs, Behavioral Health, Pharmacists
  • Primary Care and Specialty providers
  • Teachers of students, residents, and advanced learners
  • Teachers in both In-patient and Ambulatory settings

Medical School Applicant Interviews
The School of Medicine is seeking raters for the Multiple Mini Interviews (MMI) to choose the next class of medical students. It is a great opportunity to meet enthusiastic MD applicants. Please forward any questions to Stacy Potts at [email protected] or Brenda Fusaro at [email protected]. Here is the doodle link for the training sessions:

Trying to Keep Up with the Literature?
The department pulls together the tables of contents (TOCs) for about 15 medical journals and distributes this bundle monthly to a select listserve that people can easily sign up for. The TOCs include 4-5 FM journals, JAMA, NEJM, AJPH, Health Affairs, Medical Care, JGIM, Am J Prev Med; etc. – lots of great articles that can easily be accessed through links within the bundle. We are also open to adding more journals if there’s an interest expressed! Take a look at what's been posted in the past several months by going to the department's web pages under the section on Research. You will see a tab in the left-hand margin for these TOC bundles that we post monthly (
If you’d like to be on the distribution list, please send an email to Judy Savageau ([email protected]). 
Frankly Speaking Podcast

A weekly Podcast series covering newsworthy topics in primary care medicine.

Join us to discuss whether you have considered continuous glucose monitoring (CGM) for your patients with suboptimally controlled type 2 diabetes mellitus (T2DM) on at least 3 injections of insulin per day? This session will give you the information you need to confidently initiate CGM in appropriate patients. You will walk away with a clear understanding of the different CGM options and the benefits and challenges of CGM. Guest: Jillian Joseph, MPAS, PA-C presents: Continuous Glucose Monitoring (CGM) for Type 2 Diabetes Mellitus (T2DM) - Frankly Speaking Ep 240.
Faculty Presentations/Publications

As part of the HRSA Training Grant on Oral Health Integration in Primary Care Training, several department members recently published on work they did developing and validating a tool for programs to assess their oral health curriculum and identify ways to enhance it with numerous resources provided.
Savageau JA, Sullivan K, Hargraves JL, Silk H. Oral Health Curriculum Evaluation Tool (OHCET) for Primary Care Training Programs. Journal of Dental Education 2021:1-8.

On August 26th, Dan Mullin, PsyD, MPH delivered a 4 hour workshop for the Texas Department of State Health Services entitled “Women, Addiction and SBIRT: Screening, Brief Intervention, and Referral to Treatment”. Workshop participants included family physicians, obstetricians, neonatologists, psychologists, social workers, nurses, and recovery coaches. 
Clinical Services Spotlight:

Mandatory Vaccination
  • All UMass Memorial Employees are required to have their first dose of vaccination by November 1, 2021.
  • Please send a copy of your vaccination card to employee health by emailing a photo of your vaccine card to [email protected].
  • And a reminder that the Med School has also required vaccination. Everyone must submit proof of vaccination in order to have badge access to school facilities.  For those who are using the clinical system’s ServiceNow, it can be difficult to get the school’s to work. Don’t try. You can either email a photo of both sides of your card to [email protected], or stop by the Faculty Conference Room with your card and they will take care of it for you. It only takes a couple of minutes.

  • Boosters are recommended if you are > 8 months since the first series.
  • The Biden administration is planning to begin booster shots the week of September 20th.
  • We await details from UMass Memorial as to the process for obtaining boosters.

  • Massachusetts has a 64% vaccination rate overall. 
  • Total confirmed COVID cases 714,691. Hospitalizations 609 with 162 in the ICU and 100 intubated. There are 17, 909 deaths total confirmed. 
  • 7-day average percent positivity 2.43%.

  • Hospitalized patients with COVID-19 across system- 60; at UMass Memorial- 39. Of the 60, 21 are among vaccinated individuals.
  • Worcester Stop-The-Spread test positivity is 5.8% (no change from last week).
  • In house test positivity is 19.9% for symptomatic patients and 1.1% for asymptomatic patients (down from 1.6% last week.)
  • Employees contracting COVID are continuing to increase
  • July = 30 (9 unvaccinated)
  • August = 86 (26 unvaccinated)
  • Sept to date = 30 (12 unvaccinated)

Health Alert CDC
Ivermectin has not been approved as a method to prevent COVID. 
  • There is no emergency use or approved use for ivermectin in the treatment or prevention of COVID.
  • Signs of ivermectin toxicity include nausea, vomiting, abdominal pain, and diarrhea, headache, blurred vision, dizziness, tachycardia, hypotension, visual hallucinations, altered mental status, confusion, loss of coordination and balance, central nervous system and depression.
Wellness Resources

The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or, [company code UmassMemorial]. More information is available on the Caring for the Caregiver page.
Working on Wellness
Yoga Classes with Dr. Liz Erban
Please join department members for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Erban for hosting these outstanding classes. Join Zoom Meeting
Zumba with Dr. Anna Zheng

Zumba Holiday
No class the week of September 6th.

Class resumes Monday, September 13th.
Please join department members Monday mornings at 6:00am over ZOOM, Thursday evenings at 6:15pm**(30 Anna Street, NEW tall, spacious indoor location), some Saturday mornings at 9:15am and get moving with Zumba. Please note details and any changes via webpage: ZOOM still possible for all classes.

Much appreciation to Dr. Anna Zheng for hosting these outstanding classes. Join Zoom meeting: pwd=bzVnY0xXdFNTQkpQQ1hmZkw3Snh6Zz09.