Volume 15, No. 12: December 2019 EditionTop

They Said It...

"So, if you're concerned about public consumption, we'll bring it inside. If you're concerned about overdosing in front of your kids, we'll bring that inside. If you're concerned about drug litter, we'll bring that inside. We want to have a safe neighborhood for everyone." Ronda Goldfein, vice-president and secretary of Safehouse which wants to open a safe injection site in Philadelphia. Her comments are part of an article in the Fall/Winter issue of Philadelphia Medicine magazine. You can read it by clicking here.

In the News... 
Hahnemann, St. Christopher Bankruptcy Costing 1100 Physicians their Tail Coverage A1

About 1100 former Hahnemann University Hospital and Saint Christopher trainees and attending will soon lose their medical liability insurance. Their tail coverage through the Philadelphia Academic Risk Retention Group LLC (PA RRG) ends on January 10, 2020.

The coverage is ending due to the bankruptcy filed by the owners of Hahnemann and Saint Christopher. Because of the bankruptcy, Philadelphia Academic Health System LLC (PAHS) will not uphold its contractual obligation to purchase tail malpractice insurance for these trainees and attending.

That means that the 1100 physicians, depending on their practice, will have to pay anywhere from $5,000 to $85,000 for tail coverage that they were entitled to before the bankruptcy. PCMS has been working with PAMED, AMA, AAMC and ECFMG, to search for ways to help these physicians.

If you have any ideas that might help your fellow physicians hit with this huge financial crisis in the early stages of their careers, please let us know at this web page.

Drexel College of Medicine Assistant Professor Calls for Rescinding Award to Joel Freedman A2

Kevin D'Mello, MD, FACP, FHM, Drexel University College of Medicine assistant professor of medicine, wants the National Minority Quality Forum to take away the Lifetime Achievement Award it gave Joel Freedman in 2016.

Freedman is the venture capitalist who has shut down Hahnemann University Hospital. He received the Lifetime Achievement Award for investing in hospitals such as Hahnemann that are located in underserved communities.

Dr. D'Mello writes that Freedman "is not deserving of this kind of award from an organization like NMQF that is driven to advance the delivery of appropriate health care to minority communities, and to improve the quality and safety of health care."

Pa. Gov. Tom Wolf and Philadelphia Mayor Jim Kenney issued a joint statement on Freedman's actions: "The situation at Hahnemann University Hospital, caused by CEO Joel Freedman and his team of venture capitalists, is an absolute disgrace and shows a greed-driven lack of care for the community."

To leave a comment with the National Minority Quality Forum, go to their website at https://www.nmqf.org/contact.

Awards Season A3

Now is the time to take stock of your friends and colleagues and decide who should be nominated for one of the Philadelphia County Medical Society's Annual Awards. Here's the list:
  • Strittmatter Award - Honors a PCMS physician who has demonstrated the most valuable contributions to the healing art, surgical or medical. A physician colleague should submit a nominating letter that includes the candidate's current c.v.
  • Practitioner of the Year Award - Honors a PCMS member for excellence in patient care and community service. Nominating letters from physician colleagues, medical students or staff, should include examples of community service.
  • The Vanitha Appadorai Vaidya, MD Award for Humaneness in Medicine - Honors a PCMS resident/fellow physician who demonstrates exceptional skills in working with patients and their families, and understanding human as well as clinical needs. Nominating letters from physicians, professional staff or medical students, should include examples of nominee's humaneness.
  • The Cristol Award - Honors a PCMS member who enhances the educational, scientific and charitable goals of organized medicine. Physician colleagues should submit a nominating letter.
Nominating letters should be emailed to eryan@Philamedsoc.org, or faxed to 215-563-3627. For more information, call 215-563-5343, ext. 113. Deadline to submit Nominations is Friday, February 28, 2020.

Nominate a Colleague - 2020 Pennsylvania Medical Society Awards A4

Recognize physician colleagues for the great work they do for Pennsylvania patients. Nominations for PAMED's monthly Everyday Hero Award are being accepted now. The nomination period for the annual Distinguished Service, Top Physicians Under 40, and International Voluntary Service awards run from now through Jan. 13, 2020. Please click here for more information.

Phila. Dept. of Public Health Releases Health Alert on Salmonella A5

PDPH has announced an increase in Salmonella infections associated with health care facilities in Philadelphia.

Facilities should stop serving fresh-cut fruit mixes, cut fruits (cantaloupe, honeydew, pineapple, grapes) from Tailor Cut Produce. Physicians should check for Salmonella when patients have diarrhea, especially for those with fever or recent exposures to health care settings. A stool culture should be ordered for such cases.

Notify PDPH (business hours; 215-685-6742, after hours: 215-686-4515 of any patient with suspected or confirmed Salmonella and outbreaks of GI illness.

For more information go to: https://hip.phila.gov.

Pa. Dept of Health Issues Advisory on Human Milk for Infants A6

PADH is advising hospitals and health care facilities to review their procedures concerning human milk and infant feeding. Infants under the age of three months of who have an immunocompromising condition are at increased risk of harm from improperly prepared human milk.

PADH is reminding hospitals and health care facilities of the essential need to clean and disinfect feeding equipment. PADH is urging these facilities to review their infection prevention procedures.

Click here for more information.

Can Those Social Security Numbers A7

CMS is reminding physicians and other health care providers that starting on January 1, 2020, most Social Security-based Health Insurance Claim Number (HICN) Medicare transactions will be rejected.

If you do not use Medicare Beneficiary Identifiers (MBIs) on claims after January 1 you will get both electronic claims reject codes and paper claim rejections.

CMS has been transitioning to MBIs for 21 months. The new system is designed to protect patients from identity theft. If a patient does not have an MBI give them the Get Your New Medicare Card flyer.

See MLN Matters Article (PDF) for more information.

Governor Wolf Signs Tough New Opioid Bill A8

Governor Wolf said that Senate Bill 572 which he signed into law on November 27, is another mark of progress in the fight against opioid addiction.

The law requires prescribers to take several more steps before issuing a prescription for an opioid. The law's requirements kick in before a prescriber can issue a patient the first prescription in a single course of treatment for chronic pain with a controlled substance containing an opioid.

The new law requires the prescriber to determine whether an individual has taken or is currently taking a prescription drug to treat a substance use disorder, and have a talk with the patient about the risks of addiction, especially if the patient has a mental health condition or substance use disorder. The prescriber must also discuss with the patient non-opioid treatment options, and the dangers of taking a controlled substance containing an opioid with benzodiazepines, alcohol or other depressants.

The law exempts medical emergencies, management of pain associated with cancer, and use of palliative or hospice care.

CDC Issues new Guidelines on Zika, Dengue A9

The CDC is recommending that symptomatic non-pregnant patients not get tested for Zika or dengue. Asymptomatic non-pregnant patients should also not be tested. Asymptomatic pregnant women living in or with recent travel within the U.S. and its territories, should not be tested. Testing is also not recommended for asymptomatic pregnant women living in or with recent travel to an area with risk of Zika.

Symptomatic pregnant women should be tested as soon as possible.

The following diagnostic testing should be performed at the same time:
  • Dengue and Zika virus Nucleic Acid Amplification Test (NAAT) on a serum specimen, Zika virus NAAT on a urine specimen, and serum IgM testing for dengue only.
For more information on this issue, click here.

Compromise Inching Through Congress on Surprise Medical Bills A10

There is a new bi-partisan effort to pass a surprise medical bills piece of legislation. Senator Lamar Alexander (R-TN) along with a Democratic and Republican member of the House, have announced an agreement to end surprise medical bills.

The proposal would also raise the age to buy tobacco products to 21, and extend funding of federal health programs, such as community health centers. The backers of the bill hope to get it attached to an end-of-the year omnibus appropriations bill.

The bill would protect patients by limiting their out-of-pocket costs to amounts they would have owned had they been treated by an in-network physician. The AMA continues to oppose any bill that would resolve payment disputes between physicians and insurers by using a benchmark rate setting out-of-network payments at the median amount each insurer pays for in-network care. The new agreement includes a similar benchmark rating.

For more information go to the AMA home page.

PDPH Rooting for a Safe Army-Navy Game A11

The 120th annual Army-Navy game will take place this Saturday afternoon at Lincoln Financial Field in South Philadelphia. Because of the very public nature of the contest and its high military profile, federal, state and local agencies are collaborating to ensure a safe and secure game for those attending and the general public.

The Philadelphia Department of Public Health (PDPH) recommends that health care facilities review the emergency response and disaster preparedness plans for the potential for heightened terrorism. PDPH calls on health care facilities to review their disaster plans and make sure staff understands their roles in an emergency.

For more information contact PDPH at https://hip.phila.gov.

What do you know about Hepatitis B? A12

PCMS has been asked to assist the Philadelphia Department of Public Health's Viral Hepatitis Program in surveying our members about Hepatitis B. This survey information will be used to assist the Philadelphia Department of Public Health's Viral Hepatitis Program on project activities, community outreach, resource allocations, and continue the national conversation about this important public health issue.

The survey contains 14 questions, will take less than 5 minutes to complete and should be done without using any reference documents:


Calendar of EventsCalendar

22 - Fentanyl is Changing Everything

Date: Wednesday, January 22
Registration/Light Supper: 5:00 PM - 5:30 PM
Program: 5:30 PM - 8:30 PM
Place: Temple University Center City, Room 222, 1515 Market St, Philadelphia, PA 19102

This program will discuss the phenomenon of buprenorphine producing antagonist-causing precipitated withdrawal even upwards of 7 days of full-on fentanyl withdrawal among patients who have fentanyl dependence. This event will also describe the pharmacokinetics of fentanyl and how it interacts with a partial agonist such as buprenorphine and discuss ways that toxicologists have been addressing withdrawal symptoms and induction to safely and adequately treat opioid use disorder. Attend to learn more and share your experiences as best practices are being redefined as fentanyl has changed how patients respond to evidence based treatment.

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