November 15, 2019
Vol. 26, No. 20
MSDC President Promises "A New Day Is Here"
Newly installed MSDC President J. Desiree Pineda, MD, FACP, shared a message to the membership this past week. It recaps MSDC's advocacy agenda and outlines a comprehensive physician wellbeing program for District physicians, promising that help is coming soon. Dr. Pineda, MSDC's first Latina president, encourages members to get engaged in the many new initiatives underway at the Medical Society because "changes in medicine should be structured by all of us involved in medical care." For more information, contact 202-466-1800 or   hay@msdc.org .
Committee on Health Holds Hearing o n MSDC-supported Biosimilar Bill
This week, the Committee on Health held a public hearing on a number of health-related bills. Most importantly, B23-430, The Access to Biosimilars Amendment Act of 2019 , received a hearing as DC tries to join 49 other states in regulating biosimilars and allowing physicians and patients to work together on affordable drugs. Dr. Angus Worthing presented MSDC's testimony in favor of the bill. A robust discussion was held on various aspects of the bill but there looks to be momentum towards options to help residents receive affordable prescription drugs . For more on that and other colorful topics like women's health and nutrition CME and testimony by MSDC members Drs. Neal Barnard and Andrea Anderson, read more .

If you are interested in participating at a hearing or learning more about MSDC advocacy, please contact Robert Hay Jr.
CMS Green Lights DC's Behavioral Health Expansion
The District received approval for the Section 1115 Waiver effective January 1, 2020. This paves the way for broader array of behavioral health services, supports a continuum of behavioral health conditions and provides funding for the District to address the opioid epidemic through its Live. Long. DC opioid strategic plan. Read more.
ACT NOW: Time is Running Out to Secure Physician Payment Updates
Time is running out for Congress to take action on improving Medicare Access and CHIP Reauthorization Act (MACRA) before the end of the year. MACRA got rid of the flawed Sustainable Growth Rate formula and took a step in the right direction towards shoring up physicians' ability to care for Medicare patients, but there is still work to be done.

If Congress does not act physicians will face another year without a positive update! Help us send a powerful message throughout the halls of Congress that physicians are united in urging lawmakers to take immediate action now!  
Physician Input Requested on Government Proposals
The Centers for Medicare & Medicaid Services is seeking comment from physicians on several proposals in the coming months. You are encouraged to provide physician perspective on regulations that are relevant to your practice. If you have questions, please read more below or contact Robert Hay Jr .

The 2019 AMA Interim Meeting is underway. Here are 7 issues to watch .
MSDC eNewsline
Pia R. Duryea
202-355-9414 (direct)
202-466-1800 (main)
For previous editions, visit eNews Archives

MSDC Media
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Board of Directors
Susanne Bathgate, MD
Chair of the Board, At-large

J. Desiree Pineda, MD, FACP
President, AMA Alternate Delegate

E.W. Emanuel, MD

Raymond Tu, MD, MS, FACR
Immediate Past President, AMA Alternate Delegate

Joseph E. Gutierrez, MD
Treasurer, AMA Delegation Chair

Peter E. Lavine, MD
AMA Delegate

Julian Craig, MD

Laurie Duncan, MBBS, MS

Anthony Ibe, MD

Barry L. Lewis, MD, MBA

Yavar Moghimi, MD

Kirstiaan Nevin, MD

Theresa Stone, MD

Dock Winston, MD

Robert Hay Jr., CAE
Executive Vice President
Patients Attitudes Towards the U.S Health Care System
The Physicians Foundation has released the 2019 Survey of America's Patients , a biennial survey that reveals the biggest hurdles facing Americans today in our country’s expensive and hard to navigate health care system. Several insights included:
• 73% of Americans are concerned about their ability to pay for medical treatment if they were to get sick or injured and half of Americans say they feel they are one sickness away from being in serious financial trouble.
• 86% of Americans say cost and 72% say waiting for insurance pre-approvals negatively impact patient care.
• 55% of Americans are more likely to vote for a presidential candidate who advocates for expanding private insurance reforms.
• 53% of Americans say pharmaceutical companies are most responsible for the opioid epidemic.

The Physicians Foundation President Gary Price, M.D., said that the survey "also shows that patients want their physicians to assume greater leadership roles in advocating for solutions to these pressing issues.” Read more .
Tell Us What You Want in a Political Advocacy Event
MSDC is pleased to be working with the Medico-Chirurgical Society of DC (Med Chi) on a political advocacy event that will take place this winter. The event will connect physicians and thought leaders on the major public health topics of the day. We're looking for your input with a quick 3-question survey.
Member Benefit: Free CME Dinner Next Week
On November 21 and March 24, the Physicians Committee for Responsible Medicine will host a CME dinner at Maggiano's Little Italy. The CME event will cover nutrition’s powerful role in tackling obesity and chronic diseases as well as reviewing the surprising applications of nutrition for cancer prevention, chronic pain, Thyroid Disease, and Alzheimer’s Disease. MSDC members are invited by PCRM President and incoming AMA Delegate Neal Barnard, MD, to attend for free. Read more .
Event Planning for 2020
In addition to the political advocacy event, MSDC is planning its 2020 calendar for other member sections and groups. Given the success of MSDC's Women in Medicine section, Bright Young Docs and Practice Managers group, MSDC is requesting member input on topics, activities or programs that you would like to see in 2020. Please contact Pia Duryea (202-355-9414) if with suggestions or if you are interested in participating.
MSDC Office Closure
MSDC offices will be closed on November 28 and 29 in observance of the Thanksgiving holiday.

MSDC Board Meeting
MSDC will hold its next board meeting on December 9, 2019, at 6:30 PM, with dinner at 6:00 PM, at MSDC headquarters. Members in good standing may request an invitation from  Robert Hay Jr.   
DC Health Information Exchange Update
From CRISP DC, an MSDC Corporate Partner
Earlier this month, CRISP DC, DC's local health information exchange (HIE) held its first annual user conference with more than 100 participants in attendance. Attendees were invited to participate in a range of breakout sessions from an ‘Intro to CRISP Tools’ to ‘Understanding an HIE’s Role in Transitions of Care.’ Deputy Mayor Wayne Turnage shared very insightful remarks on the future on HIE in the District. 
As a reminder, CRISP is completely free  to ambulatory providers. We encourage all providers to take advantage of their free services! 
To get started all you need to do is reach out to CRISP DC by emailing Executive Director Ryan Bramble at ryan.bramble@crisphealth.org and we will get you started. We look forward to working with you and hopefully seeing you at our second annual user conference next year!
Public Health
CDC: This Flu Season Not As Bad As Feared (So Far)
USA Today reports the CDC said that the early part of this flu season has not been as bad as previously feared, but the agency urged people to get their flu vaccines. The agency “reported two flu-related pediatric deaths this season, with influenza activity remaining low, though it has increased of late.” The article says that much of the fear preceding this year’s flu season “was this year’s outbreak in Australia” as well as “the presence of the H3N2 strain.” 
.....Still, Now’s the Time for Flu Vaccination
​It is best for your patients to get vaccinated before influenza viruses start to spread in their community. There are many flu vaccine options , but the most important thing is that patients get vaccinated.  
Hot Topic: E-cigarette or Vaping product use-Associated Lung Injury (EVALI)
The Latest Numbers from the CDC
2,172 : # of lung injury cases associated with the use of e-cigarette, or vaping, products
42 : # of confirmed deaths from vaping-related lung injury
49+ : # of states, plus the District of Columbia and 1 U.S. territory, that have reported cases
The CDC figures above are as of November 14, 2019. For more, see the CDC's " Outbreak of Lung Injury Associated with E-cigarette use or Vaping "

See more about EVALI and local reporting guidance.
Thank You To Our Corporate Supporters
MSDC 1817 Society
CDC: Adult Smoking Hits Record Low in U.S., But Vaping Is on the Rise
According to Time , "tobacco use in the U.S. is changing." The article cites a CDC report that cigarette smoking among adults has fallen to a new low of 13.7%. While cigarette use has fallen, e-cigarette use has risen from 2.8% to 3.2% among adults. It should be noted this data is from 2018 and it is unclear how the recent EVALI outbreak will affect these trends.
November is Diabetes Awareness Month
How Prediabetes Exacts a $43 Billion Toll on U.S. Economy
We know the numbers of U.S. adults with prediabetes. But what toll does the burden of prediabetes have on the U.S. economy? Read more from the AMA.
CME from the AMA: Improving Diabetes Care
In recognition of World Diabetes Day, gain a better understanding of this disease with knowledge of the latest innovations to help your patients with this course. Start learning with the AMA.
Diabetes Awareness Month Resources
Diabetes is one of the leading causes of disability and death in the United States. Nine out of ten individuals don't know they are at risk. That's why it's important to raise awareness of diabetes, which disproportionately impacts DC residents. These CDC resources for health providers provide useful guidance for physicians. In addition, the AMA has resources to prevent diabetes STAT (Screen Today Act Today).
Corporate Partners
Practice Management
HICN CLAIMS REJECT ... CMS: Use the New Medicare Beneficiary Identifier!
We are 50 days out from the end of the Medicare Beneficiary Identifier (MBI) transition period. The Centers for Medicare and Medicaid Services ( CMS) wants physicians to use MBI on Medicare claims and other transactions now , if they aren't alread y . Starting January 1, regardless of the date of service :
  • CMS will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions
  • CMS will reject all eligibility transactions submitted with HICNs
See the MLN Matters Article to learn how to get and use MBIs.
AMA: Five Things Doctors Need to Know About the 2020 Medicare Physician Fee Schedule
The 2020 Medicare physician payment schedule contains news about coding revisions for outpatient evaluation and management (E/M) services that promise to greatly reduce administrative burdens for physicians in 2021. But the 2,475-page document also contains information on a multitude of tweaks to the Medicare Quality Payment Program (QPP) and a plethora of other details affecting how physicians will be paid by Medicare starting Jan. 1.

The AMA's experts have prepared a summary of the 2020 changes to QPP and Medicare physician payment. Here are five things physicians need to know .
Help Wanted: Practice Manager Opening
The Barnard Medical Center is seeking a medical practice manager for their growing primary care practice focused on integrating plant-based nutrition education and disease prevention into medical care. If you have at least three years of experience in practice management, apply today ! https://www.pcrm.org/about-us/careers/medical-practice-manager
Be Prepared: Protecting Vaccine Supplies Before, During and After a Disaster
From MSDC Corporate Partner Atlantic Health Partners

The old adage "By failing to prepare, you are preparing to fail," has been used throughout history and it still rings true today.
There's little room for failure in clinical care. Preparation is an important aspect of everyday practice management and success, and it is never more critical than when a disaster strikes. The Centers for Disease Control and Prevention  (CDC) recommends that all practices have a plan in place to keep their vaccine supply safe during an emergency. Common disasters that affect vaccine supply, include national vaccine shortages, as well as severe weather and other events that cause loss of electric power. 
Emergency preparedness for these situations means being ready with concrete plans in advance to ensure that both providers and staff are ready to handle a future crisis and provide needed support to patients. Read more .
Early Career Physicians
Medical Residents: Here's How Burnout Affects Your Marriage
New research explores the impact that residents’ high-stress existence has on their loved ones. Learn how residents' husbands and wives believe that things can be improved. Read more from the AMA.
Physician Contracting: Understanding letters of intent
What is a letter of intent? And what types of things should be included in yours? Learn about what to expect and when you should retain an attorney during the contracting process. Read more from the AMA .
Medical Real Estate Listings
Brought to you by MSDC Corporate Partner GZ Medical Realty. Contact Pete Papantoniou for your real estate needs.  
Office Sublet Available
600 square foot sublet available on 19th Street NW between Farragut North and Dupont Circle Metro. Brand new build out with separate suite number, entrance, waiting area. One office and one exam room with large window. One smaller office without windows. Sublet space is connected to an established private internal medicine practice. Price negotiable . Contact Dr. Alice Fuisz if interested. alicefuisz@aol.com

University Medical Building
2141 K Street NW
Washington, DC 20037
University Medical Building is conveniently located in the heart of DC with easy access to Metro stations. Please contact Peter Papantoniou at 301-961-1941 or see the online listing for more information
Part Time/Full Time Office Space Available
3 Washington Circle
Washington, DC 20037
Part time/full time office space available immediately at 3 Washington Circle. This includes a large consultation room, fully equipped examination room, lab drawing facility onsite, EKG machine, space for receptionist, space for medical records, shared use of copier, telephone system, wireless internet and waiting room. Ideal for general internist, medical subspecialist or surgeon. If interested, please call Mark Sklar, MD. 202-887-4769 or email mmsklar@gmail.com .
Boutique Townhouse Medical Office for Rent Across From GWU Hospital/ Medical School
900 New Hampshire Ave., NW
Washington, DC 20037
Boutique townhouse medical office for rent across from G.W.U. Hospital & School of Medicine. Very close to Foggy Bottom Metro. Three rooms, one on entry level with powered table/chair & overhead surgical light. Consultation room, reception/waiting room, & possibility of 2 additional rooms. Two-car driveway. Call/text Sheldon K. Gottlieb, MD, 301-509-3319, or email skgottliebmd@comcast.net .
Woodburn Medical Park
3229 Woodburn Road
Merrifield, VA 22003

Woodburn Medical Park is located within walking distance of INOVA hospital directly off Capital Beltway. Common area has recently been upgraded. Contact Peter Papantoniou at 301-961-1941 or see the online listing for more information .
Full Time/ Part Time Office Space Available
Well-designed and attractively decorated office of three general internists has additional consulting room/exam room suite available. Looking for another general internist to share space and overhead in fully staffed and equipped internal medicine office. Shared call coverage is possible. Contact Alan Stone, MD, 202-466-8118 or aws.md@verizon.net
Medical Society of the District of Columbia
1250 23rd Street NW, Ste 270
Washington, DC 20037