Local, state and national news of interest to the physician community

January 24, 2024

Senator Jennifer Boysko has introduced SB 351, which will permanently dissolve the Joint Boards of Medicine and Nursing and allow Advanced Practice Registered Nurses (APRNs) to be overseen and disciplined by the Board of Nursing without physician input.

SB 351 is expected to be heard by the Senate Education and Health subcommittee on Health Professions THIS FRIDAY.

The Joint Boards exist because APRNs can diagnose and prescribe, meaning by Code, they are practicing medicine. And thus, the Board of Medicine is a critical part of that oversight. Patients deserve the diverse expertise nurses and physicians bring to the Joint Boards of Nursing and Medicine. The Joint Boards holds all healthcare providers who practice medicine to the same standards of care and must be preserved.

Dissolving the Joint Boards would create different disciplinary bodies—and thus, different standards—for the practice of medicine. Having two separate bodies will, by its nature, create disparate decisions, judgments, and analyses when it comes to important aspects of the practice of medicine such as diagnosing and prescribing.

Tell your Senator that the Joint Boards are necessary to ensure a consistent standard of care for Virginia's patients and to OPPOSE SB 351!

Again, the bill will be heard by the Senate Education and Health Subcommittee this Friday, January 26th at 8:30 a.m. in the Senate Subcommittee Room, 3rd Floor, GAB. The Medical Society of Virginia would like to fill the room with White Coats and send a strong message that we oppose this bill. Please attend this subcommittee meeting if you can!

Reach out to Scott Castro at MSV at with any questions. ([email protected]; 443-668-9566)

Stop SB 493!

State Senator William M. Stanley, Jr. has filed SB 493, which would eliminate the medical malpractice cap for cases in which the patient is less than 10 years of age.

Many providers working on the front lines of public health are already strained, dealing with career fatigue and other mental health issues.

Removing or modifying the medical malpractice cap in any way could significantly increase the cost of providing and receiving healthcare in the Commonwealth of Virginia.

In 2010 and 2011, Virginia’s healthcare providers worked with the Virginia Trial Lawyers Association to reach a consensus on updates to the cap, and the General Assembly ultimately passed legislation for an increase of $50,000 per year until 2032. This model was created to create stability and certainty for all stakeholders. The Medical Society of Virginia and the Virginia Trial Lawyers Association support Virginia's current medical malpractice laws.

Urge your Senator to OPPOSE SB 493 today!

RAM members came out in force this week to lobby at the General Assembly and advocate for their patients and their profession. Joining with the Medical Society of Virginia, the Physician Assistant Studies Program at Randolph-Macon College, and others in yesterday's White Coats On Call medical advocacy day, we met with Virginia legislators to discuss bills and issues dealing with prior authorization, scope of practice, COPN, the medical malpractice cap, physician loan repayment, Medicaid reimbursement, preservation of the Joint Boards of Medicine and Nursing, and maintaining equal standards for independent healthcare providers, among others.

A special thank you from the Academy to the following for taking the time to participate yesterday:

• Scott Armistead, MD
• Deborah Barron, MD
• Owen Brodie, MD
• Carolyn Burns, MD
• Benjamin Chopski, MD
• Alice Coombs, MD

• Harry Gewanter, MD
• Erich Grant, PA 
• Stephen Jaffe, MD
• Amber Jenkins, MD
• Hazle Konerding, MD
• Craig Pinsker, MD
• Kenneth Qui, MD

• Jonathan Schaaf, MD
• Bruce Silverman, MD
• Tovia Smith, MD
• Richard Szucs, MD
• Mark Townsend, MD
• Donny Wade, MD

Check out some pictures here! Make plans to join us for our final lobby day of the session on Monday, February 19, and reach out to Lara at [email protected] with questions.

LAST CHANCE TO REGISTER!!

A new, accurate blood test could identify Alzheimer's disease before symptoms even present, doing away with costly brain scans, CNN reports.

The ALZpath pTau217 test will be clinically available in the U.S. later this month (as ALZpath Dx), and a study published Monday confirms that the plasma assay, which screens for a protein called phosphorylated tau, "accurately identified" biological Alzheimer’s disease, The Hill reports.

"Notably, the assay demonstrated high accuracy in identifying tau pathology within amyloid-beta-positive individuals," researchers wrote. "This is particularly important as anti-amyloid therapies may be less effective in patients with advanced tau pathology," MedPageToday says.

Besides immeasurable heart-breaking effects shouldered on loved ones, there are more quantifiable financial impacts caused by the opioid epidemic. A recently released study co-authored by VCU's Center on Society and Health and the Virginia Department of Health delves into its economic impact on Virginia.

In 2021 alone, total opioid-related costs in the state reached an estimated $5 billion. Employers and households held the lion's share of the burden. Total costs in the city of Richmond alone were nearly $408.7 million. Perhaps even more eye-opening is the per capita price tag of $1,796 per person. Check out the page for an interactive map that tracks costs across state localities, as well as Axios Richmond's analysis.

These figures have been released as federal lawmakers lobby for increased oversight over opioid settlements. "The opioid cash comes from more than a dozen drugmakers, pharmaceutical distributors, and retail pharmacies that have agreed to pay more than $50 billion over 18 years," KFF Health News reports. A new bill has been proposed "to ensure that these funds are used for [treatment, prevention, education, and enforcement] and not as a piggy bank for other projects."

IN RELATED OPIOID NEWS...

• Gabapentinoid use increases as experts warn they may be the next widely abused chronic pain meds. (MedPageToday)
• The risk of congenital malformations appears to be lower with buprenorphine than with methadone when taken during the first trimester of pregnancy for opioid use disorder (OUD). (MedPageToday)

There is cause for both celebration and concern in the fight against cancer: The American Cancer Society's annual report reveals how far we've come yet also highlights a troubling trend.

Since 1991, four million deaths have been prevented as the cancer death rate has dropped. Three key factors were credited: declines in smoking, early detection and greatly improved treatments, The New York Times reports. A crowning achievement is the much-improved treatment of metastatic breast cancer, which even 30 years ago was a virtual death sentence.

More people may be surviving cancer, but, frustratingly, more people are having to fight it. Axios notes that new cancer diagnoses are expected to reach record highs this year. Most troubling is "a worrying rise in some cancers at the same time doctors are trying to figure out why they're seeing more young patients with cancer." Indeed, colorectal cancer (as reported last week) has become a top cause of death for people under 50, NBC News reports. The cause for this baffles researchers but overdiagnosis has been floated as one contributing factor. "As a nation, we’ve dropped the ball on cancer prevention,” one researcher told The Wall Street Journal.  

IN RELATED NEWS...

• Increasing frequency of breast cancer screenings to yearly lowers risk of death. (Fox News)
• Inhalable lung cancer test could one day detect early-stage tumors. (Reuters)
• HPV-related cervical cancer is on the rise in women in their 30s and 40s (NBC News).
• Thyroid cancer is twice as likely to develop in patients with prior HPV infection. (Nature).
• Relatives of patients with myelodysplastic neoplasia, acute myeloid leukemia, or acute lymphoblastic leukemia have an increased risk of developing cancer. (Cancer Epidemiology).
• Medical advances have increased lifespans by "turning fatal illnesses into chronic ones," yet the number of years Americans live in good health is declining (WSJ).

The Atavist Magazine recently published an article delving into the horrific experiences suffered by patients of Dr. Javaid Perwaiz, a Chesapeake-based OB/GYN who was convicted of health care fraud related to his performing illegal hysterectomies and other surgeries and forging paperwork without patient consent in 2021, acts that made him a fortune. It's as much a cautionary tale as it is a work of body horror, and the investigative journalism reveals how so many in the system failed to act or shirked responsibility for their involvement in Dr. Perwaiz' schemes. In the end, the most his patient victims were able to claim was satisfaction knowing he faced justice for his criminal breeches of trust. It's a long read but one sure to leave an impression.

After reviewing reports of malignancies possibly tied to CAR-T cell therapies, the FDA has announced it will require new boxed warnings that "the treatments themselves may cause cancers," the New York Times reports.

Drug manufacturers will be required to state "mature T-cell malignancies, including CAR-positive tumors, may present as soon as weeks following infusion, and may include fatal outcomes" in new prescribing information.

The agency, however, notes that "the overall benefits...continue to outweigh their potential risks for their approved uses," MedPageToday reports, and one expert says that "physicians might be more cautious, but it most likely won’t change much in their practice," NBC News reports.

Richmond-based United Network for Organ Transplantation (UNOS) quietly updated the number of records affected by a December 2023 data breach from 1.2 million to 1.5 million on its website, the Richmond Times-Dispatch reports.

"The affected data includes Social Security numbers, dates of birth and medical procedure information. It did not include identifiers such as names and addresses," the newspaper reports. "UNOS said it does not believe patient data was misused, and the data was not compromised by a cyber-attack. It did not affect the matching or allocation of organs to patients."

Meanwhile, Bon Secours Mercy Health, along with medical transcription services vendor Perry Johnson & Associates, is facing a lawsuit after last year's data breach that may have exposed the personal information of millions of patients, Healthcare Dive reports. The health care system has responded claiming the lawsuit is without merit.

IN RELATED NEWS... Cyber-attacks continue to jeopardize patient safety and are driving new government-issued security standards. (Financial Times)

RAM Events & News

Lunch on Tuesday

Tuesday, February 6

12:30 - 1:30 p.m.

Join us for our Lunch on Tuesday program as James Brookes, PhD, Melanie Trent De Schutter Library Director, Virginia Museum of History & Culture (VMHC), discusses his research into soldiers' art from the Civil War, with a focus on the VMHC's collection of wartime visual culture.

Medi¢: The Business of Medicine

Medicare Merit-based Incentive Payment System (MIPS) measures are wrongly penalizing physicians, says the AMA. Real-world examples show why CMS must take action now.

Other Medical Business News:

• How has the primary care physician's workload changed since before the pandemic? Find out here.
• Federal judge strikes down 2021 copay accumulator rule; insurers will now have to count drug copay coupons toward deductibles and caps in most cases. (MM+M)
• Ozempic and Mounjaro are among 775 brand-name drugs whose prices have been raised by drugmakers since January 1. (WSJ)
• At what point could sickle cell gene therapy be cost-effective? Under $2 million. (MedPageToday)
• More examples of private equity buyout consequences for small communities, as well as legislative efforts to fight back. (Stateline)
• Medical scrubs company Careismatic file for bankruptcy. (Reuters)
• New manufacturing lapses uncovered by U.S. inspectors at Eli Lilly plant. (Reuters)

• JN.1 variant now responsible for 86% of new American cases (Reuters). It doesn't appear to be leading to more severe disease, however (CBS News).
• Wastewater surveillance reveals surging COVID wave; up to one in three Americans expected to contract COVID by end of February. (Stateline)
• Novel antiviral simnotrelvir shortens illness by about 1.5 days and lowers viral loads. (MedPageToday)
• Blood protein changes could help identify and lead to treatments for long COVID. (NBC News; MedPageToday)
• COVID vaccination during pregnancy is safe for baby's brain development. (MedPageToday; CIDRAP)
• Chinese scientists mapped SARS-CoV-2 two weeks before Beijing shared information with the world, congressional investigation reveals. (WSJ)

Global Perspective

• New GSK malaria vaccine, Mosquirix, rolls out in Africa. (Stat)

National News

• Congress avoids shutdown; passes stopgap measure to fund FDA, HHS until March. (Richmond Times-Dispatch)
• Looming Supreme Court decision on "Chevron deference" could potentially curtail federal agency authority. How would this affect health care? (Axios)
• Why didn't the FDA issue recall of Philips breathing machines sooner after hundreds of complaints? Congress and GAO are investigating. (ProPublica)
• "Pharma Bro" Martin Shkreli's lifetime ban from pharma industry upheld by appeals court. (CNBC)

Drug, Tech & Vax News

• Up to 56% of patients maintained their weight or continued losing weight a year after ending semaglutide (Wegovy) or liraglutide (Saxenda), a new study finds. (Axios)
• Osteoporosis drug denosumab receives FDA boxed warning for risk of severe hypocalcemia in patients with advanced chronic kidney disease (CKD). (MedPageToday)
• Beyfortus shortage continues even as peak of respiratory virus season approaches. (The 19th)
• Narcan's shelf-life extended from three years to four. (FDA)
• A 3D printing method can produce customized tiny blood vessels with endothelia to prevent blood clots. (Reuters)
• New pig liver experiment continues research into the potential of xenotransplants. (AP)

FDA Approvals

The agency set a new record in 2023 with 71 approved therapeutic drugs. (Nature)

• Erdafitinib (Balversa), for locally advanced or metastatic urothelial carcinoma in patients with susceptible FGFR3 genetic alterations who have previously been treated with at least one line of systemic therapy, including a PD-1/L1 inhibitor. (FDA)
• Stentra, a personalized 3D-printed oral stent solution, to help direct radiation to the target tumor area in head and neck cancer patients while reducing harmful effects to the surrounding tissue. (Kallisio)
• First-of-its-kind AI-powered device designed to non-invasively detect skin cancer in the primary care setting. (CBS News; MedPageToday)

Medical Miscellany

• CDC advises clinicians to conduct more blood tests for PFAS chemicals. (Becker's Hospital Review)
• Taking a daily multivitamin may help prevent memory loss and slow cognitive aging in older adults. (The Mercury News)
• A mysterious new link between arthritis and increased male fertility may have been uncovered. (MedPageToday)
• Migraines may increase the risk of irritable bowel disease (IBD). (MedicalNewsToday)

Pathogen Report

• New measles case identified in Atlanta. (Georgia Department of Public Health)
• What is behind the multiple measles outbreaks across several states? MedPageToday investigates. ALSO: UK surge prompts calls for vaccinations (AP)...European measles cases rise 45-fold (BBC).
• Winter and spring breaks in schools reduce community spread of influenza. (CIDRAP)
• Salmonella cases related to charcuterie meat trays double; 47 cases across 20 states; 10 hospitalizations. CDC expands warning. (The Hill) ALSO: Cantaloupe outbreak declared over. (CBS News)
• The scourge of diphtheria has returned to Africa due to vaccine hesitancy. (NPR)
• Mpox can be tracked via wastewater surveillance, government report says; method to be expanded to track other diseases (AP) including Norovirus (CIDRAP).
• Zika virus can reinfect people, a study finds. (CIDRAP)

FUN FACT OF THE WEEK

Genetic analysis has uncovered the origins of multiple sclerosis: Researchers reveal it is "the result of a genetic adaptation to certain environmental conditions that occurred back in our prehistory and which has endured in our DNA, even though the environmental conditions have changed hugely in the time between then and now," MedPageToday reports. Immune-related genes, passed down by steppe peoples who benefited from their protection against livestock-borne illnesses, also happened to contain the MS risk genes. Today, we don't have to worry about those illnesses, but MS is still with us.

Thanks for reading The Leg.Up!



I appreciate all of your feedback! Thanks to several readers for their recent kind comments. Per their suggestion, The Leg.Up is striving for a punchier, more streamlined form. Please let me know your thoughts!

[email protected].

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Scott C. Matthew

RAM Director of Communications

Richmond Academy of Medicine

www.ramdocs.org

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