Volume 114, No. 2Top
February 2018 Edition

They Said It...

"In 2014, my Mom was given a formal diagnosis of 'dementia, Alzheimer's type' three months after my father died of an aggressive blood cancer called Multiple Myeloma." Philadelphia social worker, Patti Cruz, describes what she and her siblings have faced in trying to help her mother, in a touching and revealing account of one family's battle with Alzheimer's disease. You can read the story in the latest issue of the magazine version of Philadelphia Medicine.

In the News... 
We're in the Middle of the Worst Flu Season in Nine Years A1

The 2017-18 flu season has been the heaviest since the 2009 pandemic.

The Philadelphia Dept. of Public Health has reported five confirmed deaths in the city from influenza during this flu season, three during the third week of January. Seventy-eight people have been hospitalized for severe influenza. The Pa. Dept. of Health reports that the flu is now widespread in the state. There have been 47 flu deaths reported in the state this season.

Influenza A(H3N2) is the most common form, making up 90 percent of flu cases. Flu seasons where A(H3N2) is dominant, usually have more hospitalizations and deaths in persons 65 years and older and in young children. Vaccine effectiveness against this strain also tends to be lower.

As of January 27, this influenza season has been the heaviest for A(H3N2) since case-based flu surveillance began in 2003.

The Pa. Dept. of Health recommends that everyone get a flu shot. The website https://vaccinefinder.org/ is a useful tool for finding where you can get the vaccine.

City Plan for Safe Injection Sites Stirs Debate A2

In an effort to cut into the number of overdoses in the city, Mayor Kenney wants to create places where people with drug addictions can shoot up with medical professionals on hand. Dr. Thomas Farley, Philadelphia Public Health commissioner, told the Associated Press that "we know from other centers that they save lives." But he admitted it poses community and legal concerns.

The city has the highest opioid death rate of any large U.S. city. More than 1,200 people died of overdoses in Philadelphia in 2017.

City officials plan to speak to organizations interested in operating or funding such facilities, and plan to get feedback from neighborhoods on the issue. Seattle, so far, is the only U.S. city to set aside money for such a program. It has not opened a site. Injection sites operate in Canada, Australia and Europe. No one has died at Sydney's Medical Supervised Injecting Centre, although more than 5,900 people have overdosed since it opened in 2001.

City Councilwoman Maria Quinones-Sanchez, whose district includes the Kensington neighborhood at the center of the city's opioid crisis, said she isn't opposed to safe injection sites, but argues that they should be part of several comprehensive reforms to fight the epidemic.

"There's no plan," Sanchez said, adding that the city's official presentation on the proposal looked "like an intern gave it to them."

AMA Calls on Congress to Reject Medicare Extenders Proposal A3

The AMA says a Medicare extenders package tacked onto the most recent federal budget proposal is bad for both doctors and patients.

The AMA says the package would create across-the-board cuts that would result in permanent reductions to all physician fee schedule payments. The changes would also undermine efforts to improve Medicare as envisioned by the Medicare Access and CHIP Reauthorization Act of 2015.

The AMA is urging physicians to contact their senators and U.S. representatives and tell them to vote against the proposal.

Form letters will be posted on the AMA grassroots website, at https://physiciansgrassrootsnetwork.org/.

Pa. Dept. of Health Wants Info on Your Acute Flaccid Myelitis (AFM) Cases A4

The number of AFM cases in Pennsylvania and across the country, has jumped in recent years. In 2016, 144 persons in 37 states had confirmed cases of AFM. That's a dramatic increase from 2015, when only 21 cases were confirmed in the country. Five of the 2016 cases were in Pennsylvania. The state's victims were between one and four years old.

Clinicians should report suspected AFM cases to the Pa. Dept. of Health (DOH) through the PA-NEDS online application at https://www.nedss.state.pa.us.

Clinicians should collect specimens from patients suspected of having AFM as early as possible. They should collect : CSF; whole blood; serum; stool; upper respiratory tract specimens, preferably nasopharyngeal or nasal mid-turbinate plus oropharyngeal swabs ( https://www.cdc.gov/acute-flaccid-myelitis/hcp/specimens.html).

Information to help clinicians and public health officials manage care of persons with AFM that meet CDC's case definition was posted in 2014 and can be found at: http://www.cdc.gov/acute-flaccid-myelitis/downloads/acute-flaccid-myelitis.pdf.

AFM is a type of acute flaccid paralysis characterized by an acute or subacute onset of flaccid limb weakness, sometimes accompanied by cranial nerve dysfunction such as facial drooping or difficulty speaking.

Getting Those Walking Papers in Step with the Feds and Other States A5

Starting on February 20, patients being treated in licensed ambulatory surgery centers and facilities (ASCs and ASFs) in Pennsylvania will be able to stay at those facilities for up to 24 hours.

The change aligns Pennsylvania with other states and with federal guidelines released by the Centers for Medicare and Medicaid Services (CMS).

The old Pa. Dept. of Health regulations limited stays at ASC/ASF centers to a total of four hours for operating time and four hours for recovery.

For more details go to the CMS website, at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/ASCs.html.

ACA Enrollment Extended for Hard-Hit Puerto Rico and Virgin Islands A6

The victims of Hurricane Maria in Puerto Rico and the U.S. Virgin Islands now have until March 31 to sign up for health care under the Affordable Care Act (ACA).

About 2,000 of these Americans have come to Pennsylvania since the hurricane.

Pa. Acting Insurance Commissioner Jessica Altman said she's pleased that the Special Enrollment Period has been extended for hurricane victims. "Our department is ready to assist consumers with navigating health coverage options, as well as questions and concerns about all forms of insurance."

Those interested in getting more information can call 1-800-318-2596, or go to www.healthcare.gov, or www.insurance.pa.gov.

A Way to Cut Your Medical School Loans A7

The Primary Health Care Practitioner Program is designed to ensure that Pennsylvania has enough primary care practitioners willing to work in what are called health professional shortage areas.

The program includes school loan repayments, visa waivers, and a path to permanent residency status. You can get information on the program by going to https://nhsc.hrsa.gov/loanrepayment/studentstoserviceprogram/index.html, or https://nhsc.hrsa.gov/scholarships/index.html.

The New Medicare Card - It's Almost in the Mail A8

The Centers for Medicare and Medicaid Services (CMS) will start mailing the new Medicare card to recipients in April. It will take a full year to get the new card to everyone. The card will have a unique Medicare Beneficiary Identifier (MBI) in place of a social security number. There's nothing Medicare beneficiaries need to do, unless they have recently moved. In that case they should contact the Social Security Administration at https://www.ssa.gov/myaccount/.

CMS has new materials available to help recipients understand the changes. They are at https://www.medicare.gov/, and https://www.medicare.gov/forms-help-and-resources/your-medicare-card.html.

Look Around You, Then Send in a Name A9

The Pa. Medical Society (PAMED) is seeking nominations for its third annual "Top Physicians Under 40" program. PAMED's new tradition of honoring top docs under the age of 40 in Philadelphia and the rest of the state, is designed to single out excellence and also demonstrate to these doctors the professional and personal advantages of spending their careers in Pennsylvania.

PAMED President Theodore Christopher, MD, said many of these early career physicians are outstanding community leaders and patient advocates. He said the program has been able to find, "amazing early career medical talent anywhere from big cities to rural communities."

PAMED will accept online nominations from patients and medical professionals at www.pamedsoc.org/Awards. A committee of physicians has been created to review all nominations. Names should be submitted by no later than April 13.

Betting's Fun... When You Win A10

PAMED president, Dr. Christopher, made a Super Bowl bet with his counterpart at the Massachusetts Medical Society that will now pay off handsomely. The Eagles' win means that Dr. Christopher will get a Boston lobster roll, compliments of the Massachusetts Med Society president, Dr. Henry Dorkin.

If Dr. Christopher lost he would have treated Dr. Dorkin to a Philadelphia cheesesteak. There's no word on when Dr. Christopher will get his lobster roll.

More Super News... A11

You are welcome to use the PCMS parking building and lot if you're coming to the city on Thursday for the Eagles' Super Bowl parade. The parking spaces will be available on a first come, first serve basis, but you need to contact Robert Miyamoto at (215) 563-5343 x 102 if you're interested.

Fly, Eagles, fly!

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13 - Tax Cuts and Jobs Act: How The New Tax Code Will Affect You and Your Practice

Date: Tuesday, February 13, 2018
Time: 6:30 PM - 8:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

PCMS will host an informational program to help its members gain insight on the Tax Cuts and Jobs Act, a sweeping $1.5 trillion tax-cut package that fundamentally changes the individual and business tax landscape, and its impact on physicians.

15 - Introduction to Medical Marijuana in Pennsylvania

Date: Thursday, February 15, 2018
Time: 6:30 PM - 8:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

The Pennsylvania Department of Health is in the process of implementing the state's Medical Marijuana Program, signed into law on April 17, 2016. When fully implemented in early Spring of 2018, the Medical Marijuana Program will provide access to medical marijuana for patients with a serious medical condition.

The PCMS intro to medical marijuana program is informational only and seeks to provide physicians, resident/fellows and medical students with additional information and resources to better understand the program.

23 - Regional Overdose Prevention Coalition Conference

Date: Friday, February 23, 2018
Time: 10:00 AM - 2:00 PM
Place: Newtown Campus of Bucks County Community College, 275 Swamp Road, Newtown, PA 18940.

Hosted by Bucks County, this conference is a discussion on what the Governor's opioid disaster declaration means for counties and county-level organizations. Topics covered also include: First Responder Safety, Recovery, Payer Collaboration, and Communication with Legislators. Lunch and parking will be provided.

For information, please contact David McKeighan at delcomedsoc@comcast.net or (610) 892-7750.

Click Here to Register (RSVP by February 16)

24 - Medical Cannabis Certification

Date: Saturday, March 24, 2018
Time: 8:15 AM to 12:45 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

Physicians who want to recommend medical cannabis to patients and medical professionals and pharmacists who will be employed in dispensaries must take this approved training. With Pennsylvania's Medical Marijuana program now operating, all healthcare professionals are encouraged to become educated on the program, qualifying serious health conditions, potential drug-drug interactions, and safety and risk information to discuss with patients.

21 - The Philadelphia Psychiatric Society Annual Women's Brunch: "Breaking Through: Equal, Empowered, Effective Female Physicians"

Date: Saturday, April 21, 2018
Time: 8:00 AM to 12:30 PM
Place: The Inn at Swathmore, 10 South Chester Rd, Swarthmore PA 19084

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

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