Volume 114, No. 4Top
April 2018 Edition

They Said It...

"We feel truly blessed for the CHOP program, its staff and the great miracle we received for our family." Felicia Rodriguez, talking about the fetal surgery at CHOP that saved her son's life. The CHOP program is highlighted in the Spring magazine issue of Philadelphia Medicine, which you can view by clicking here.

In the News... 
PAMED Calls on Physicians to Oppose CRNP Bills A1

The Pa. Medical Society (PAMED) is calling on physicians to contact their Pa. representatives and senators to urge them to vote "no" on two bills that would allow CRNPs to practice "without the vital safety net of a collaborative agreement with a physician."

Nurse Practitioners have been lobbying for passage of HB 100 and SB 25, which would remove the physician as the leader of the health care team.

In an announcement to Pa. physicians, PAMED said such a move "would jeopardize the safety of your patients."

PAMED said the time to act is now, because renewed pressure from the CRNP lobby, has given new life to HB 100.

Click here to take PAMED's survey regarding CRNP independent practice. You will have to log in.

Time to Find out if You're MIPS Worthy A2

CMS has updated its Merit-based Incentive Payment System (MIPS). You can use it to check on your eligibility for this year. Go to https://qpp.cms.gov/participation-lookup/, then enter your National Provider Identifier (NPI) to find out if you need to participate this year.

You're excluded from participating if you billed $90,000 or less in Medicare Part B charges for covered professional services under the Physician Fee Schedule (PFS) or have covered professional services under the PFS to 200 or fewer Medicare part B enrolled beneficiaries.

Upcoming Webinar on Medicare Access and CHIP Reauthorization Act A3

America's Physician Groups (APG) with CMS is offering sessions that will provide physicians and physician organizations ways to implement Alternative Payment Models (APM). Each session will include Q&A time with the presenters.

The next session - "MIPS APMs to Advanced APMS: How to Make the Valuable Transition"

When: April 30, 2018, Noon - 1:30 PM
Register: http://eventcenter.commpartners.com/se/Rd/Rg.aspx?516875

DOH Says Disturbing Hikes in Syphilis Demand Special Testing A4

The Pa. Dept. of Health (DOH) is recommending special testing precautions for all pregnant women in Philadelphia, Bucks, Delaware and 16 other counties. Those counties have reported a case rate of Primary and Secondary (P&S) Syphilis of at least two cases per 100,000 population.

Philadelphia's rate is the worst in the state -- 29.28 -- almost three times higher than Dauphin County, which has the second worst rate. Although Philadelphia is on the DOH list for special testing, the county already requires all of its OB/GYN providers to perform syphilis testing on pregnant females.

Syphilis can be deadly if left untreated. It can also cause blindness, paralysis and dementia. Officials say the sexually transmitted disease's dramatic rise is another consequence of the opioid epidemic, as users trade sex for drugs.

Nearly five times as many babies across the country are born with syphilis as with H.I.V.

Physicians needing more information should call DOH's Division of TB/STD at 717-787-3981.

Pa. Sees a Jump in Escherichia coli O157:H7 A5

The Pa. Dept. of Health (DOH) says there are increased reports of this E. coli infection, and physicians should check for it in patients with gastroenteritis, and they should request laboratories to perform cultures to assist in the public health investigation.

Prime suspects are persons with diarrhea, especially bloody diarrhea, or with acute renal failure. Laboratories should be asked to perform cultures of suspected cases, not only culture-independent diagnostic tests.

Suspected cases should be reported to your local health department or to DOH at 1-877-PA-HEALTH.

Bcc Infections Found at an Acute Care Facility in Pa. A6

DOH is investigating a cluster of Burkholderia cepacia complex (Bcc) infections associated with a single acute care facility in the state. DOH has not released the name of the facility. Ten positive cultures have been identified from the following sources: urine (5), peritoneal fluid (2), wound (2), and sputum (1).

A similar cluster of infections has occurred at the same time in California. Both the Pa. and Calif. facilities identified links between cases and the Medline Remedy Essentials No-Rinse Foam, a widely-used product for skin and perineal care. Lots M05703/7235 and M06691/7256 have tested positive for Bcc.

It is not known which lots were used on the patients who developed infections. Health care facilities are being advised not to use the product until further information is available.

DOH requests that health care facilities that have used this product since November 2017, review microbiology laboratory records for Bcc infections among non-cystic fibrosis patients on or after January 1, 2018.

Federal, state and local health agencies continue to work with the FDA to gather additional information.

DOH urges health care facilities and health departments to notify the DOH Bureau of Epidemiology immediately, if similar Bcc clusters appear among non-cystic fibrosis patients. The number to call is 1-877-PA-HEALTH.

Mayor Kenney Says Safe Injection Sites Will Help Solve Opioid Problem A7

During a recent talk to representatives of the American Pain Association at Temple University's Katz School of Medicine, Mayor Kenney defended his administration's plans to create a supervised injection facility for drug users.

"I know it seems counterintuitive to a lot of people - but we're not encouraging drug use," Kenney said. "We're encouraging addiction counseling and treatment, and we can only do that, number one, if they're alive. Number two, we need to engage them in a space where they feel safe and they are safe."

The mayor has proposed safe injection sites that would be funded by private donations and support from nonprofits. They are part of a larger plan to reduce incarcerations for drug use.

"We regret the lives and families that were affected by incarceration as opposed to addiction counseling and services," the major said. "We're not going down that road again. We're not going to try to lock our way out of this problem. It's an addiction. It's an illness, and it needs to be treated medically."

Kenney blamed medical practices for causing the opioid epidemic but added that he sees the medical profession as a potential remedy to the problem.

Physicians needing more information should call DOH's Division of TB/STD at 717-787-3981.

Other Bills that Raise Serious Concerns... A8

PAMED is also calling on physicians to make their voices heard on SB 895 and SB 896. The bills would erode the supervisory role of the physician with physician assistants (PAs).

The bills would remove the requirement for physicians to review all PA records the first six to 12 months a PA is licensed or starts a new specialty. It also removes the requirement that the State Board must approve any deviation of a 100% record review after the first six to 12 months.

PAMED explained that "without this review, there would be no effective regulatory mechanism to determine appropriateness of the relationship or level of supervision between a physician and a PA. The current physician-physician assistant supervisory relationship helps to ensure patient safety."

For more information on how to help, contact knowledgecenter@pamedsoc.org, or call 855-PAMED4U.

When a Friend Says You Ought to Return that Loud Sweater A9

We have a better idea. On April 28, dispose of your old prescription drugs. That's when the Drug Enforcement Administration (DEA) holds its 15th annual "Take Back Day." It's the day when Americans can get rid of old prescription drugs in their house, by going to one of more than 5,000 drug stores and other facilities that will participate this year.

There are no questions asked. All you have to do is show up at one of the sites and throw out your unused drugs. The 2015 National Survey on Drug Use and Health reported that 6.4 million Americans abused controlled drugs that year. The study found that a majority of those who abused drugs obtained them from family and friends, often from the home medicine cabinet.

During last year's drive, Americans turned in more than 456 tons of prescription drugs.

There are 17 take back locations in Philadelphia. You can find the one near you by going to www.deatakeback.com.

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19 - Recent Updates in Hepatitis B Vaccine

Date: Thursday, April 19
Time: 12:00 PM - 1:30 PM
Place: SangKee Peking Duck House, 238 North 9th Street, Philadelphia PA

Join Hep B United Philadelphia for their annual Lunch and Learn. Guest Speakers include Randall Hyer, MD, PhD, MPH, Vice President, Clinical Development and Medical Affairs, Dynavax, and Nichole Dantzler, MBA(c), Philadelphia Department of Health, Adult Immunization Coordinator.

21 - The Philadelphia Psychiatric Society Annual Women's Health Brunch

Date: Saturday, April 21 
Time: 8:00 AM - 12:00 PM
Place: The Inn at Swathmore, 10 South Chester Rd, Swarthmore PA 19081

The Philadelphia Psychiatric Society will be holding its Annual Women's Brunch featuring speakers Anita Everett, MD, Elisabeth Kunkel, MD, and Barbara Wingate, MD.

23 - Grand Rounds: Immunizations

Date: Monday, April 23
Time: 6:00 PM - 7:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

This event will cover the burden of vaccine-preventable diseases, childhood and adolescent vaccine recommendations, the changing environment of adult immunization work, strategies to improve immunization coverage rates, system-based interventions and team approaches.

27 - 2nd Annual Role of Sex and Gender in Clinical Practice

Date: Friday, April 27
Time: 7:00 AM - 4:15 PM
Place: Jefferson Alumni Hall, 1020 Locust Street, Philadelphia, PA 19107

This annual conference takes a unique approach to patient care by zeroing in on sex differences in non-reproductive areas, such as gastroenterology, cardiology and endocrinology. By understanding these differences, clinicians will be able to tailor care for both men and women, avoiding delays in care and improving outcomes.

Members of the Philadelphia County Medical Society can receive a $25 discount by using the promo code PHLMEDSOC25 when registering.

28 - Clinical Approaches to the Patient with Gastrointestinal Illness

Date: Saturday, April 28
Time: 8:00 AM - 12:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

A Continuing Medical Education Program that should be attended by physicians, residents/fellows, medical students, nurses, physician assistants, psychologists and allied health care professionals. Topics include constipation and functional bowel disease, inflammatory bowel disease, end stage liver disease and pancreatic disease.

2 - Action Collaborative on Clinician Well-Being and Resilience

Date: Wednesday, May 2
Time: 8:00 AM - 5:15 PM
Art Show and Reception: 5:15 PM - 6:30 PM
Place: NAS Building, 2101 Constitution Avenue NW, Washington, DC 20418

This public meeting will provide an opportunity for the public to actively engage with the Action Collaborative and will feature expert panels on diversity, inclusion, and loneliness, with a session on workflow redesign to improve clinician well-being and enhance joy in practice.

8 - Philadelphia's 2nd Annual Conference on Hoarding Intervention

Date: Friday, June 8
Time: 8:00 AM - 4:15 PM
Place: Community Behavioral Health, 801 Market Street, 11th Floor, Philadelphia, PA 19107

Join the Philadelphia Hoarding Task Force for a variety of local and national experts on Hoarding Disorder and related issues.

16 - President's Installation and Awards Night

Date: Saturday, June 16
Reception: 6:00 PM
Program and Dinner: 7:00 PM
Place: The Philadelphia Country Club, 1601 Spring Mill Road, Gladwyne, PA 19035

Celebrating the Inauguration of Max E. Mercado, MD, as the 157th President of The Philadelphia County Medical Society.

Philadelphia County Medical Society | stat@philamedsoc.org
215-563-5343 | http://philamedsoc.org