Volume 112, No.11 
November 2016 Edition
They Said It...
"Most patients do not know how or when they were infected." Alex Shirreffs, viral prevention coordinator for the Philadelphia Department of Public Health, on the need for persons born between 1945 and 1965 to be tested for hepatitis C. Shirreffs's article on the state law that pushes for such testing, appears in the fall edition of Philadelphia Medicine magazine.

PAMED Makes the Move to CIN CityA1

The Pa. Medical Society's (PAMED's) House of Delegates has overwhelmingly approved a landmark practice options initiative to create clinically integrated networks (CINs).

CINs are collections of health care providers, such as physicians - that organize as a group to improve patient care, reduce health care costs, and maintain a degree of autonomy in their work. It also gives physicians a safe harbor to perform collective bargaining.

Along with CINs, the practice options initiative will create a management services organization that will help physicians deliver value-based care, by providing practice options and clinical autonomy.

PAMED members can get much more information on this groundbreaking movement, by contacting Dennis Olmstead, PAMED's senior advisor of health economics and policy, at dolmstead@pamedsoc.org or by calling 855-726-3348.

Local and State Officials Creating Health Enterprise Zone in North PhiladelphiaA2

The Pa. Dept. of Human Services (DHS) has announced a coordinated local and state effort to try to improve the health of North Philadelphia residents. DHS, along with the Pa. Dept. of Education, Philadelphia Mayor Jim Kenney, Einstein Medical Center, Hahnemann University Hospital, Temple University and the Chamber of Commerce for Greater Philadelphia, have announced the creation of the Health Enterprise Zone (HEZ) for North Philadelphia.

"Is there a better way to provide health care for the residents of North Philadelphia?" DHS Secretary Ted Dallas, asked. "That's the question that the HEZ is designed to answer." By bringing together local, state agencies and hospitals, and other community organizations in the city neighborhood, Dallas says he hopes the HEZ will "increase access, improve quality, and reduce health disparities for North Philadelphia families."

Dallas said the HEZ will try new innovative community-based approaches to health care, instead of the traditional medical model. For more details on the HEZ, visit www.dhs.pa.gov.

Pa. Joins 17 Other States on the Interstate Medical Licensure Compact A3

Pa. Governor Tom Wolf has signed into law Act 112, which establishes a streamlined application process for physicians looking to practice in more than one state. The act is expected to make it easier for physicians to reach patients in rural areas that border more than one state.

"It is my hope Act 112 of 2016 will make quality healthcare more accessible and affordable for Pennsylvanians," said chief sponsor of the bill, Republican State Rep. Jesse Topper. "Especially those in underserved areas, and that it lays the groundwork for more use of telemedicine across state lines."

The bill of rights include:
  • Physicians should have autonomy in clinical decision-making.
  • Physicians should not be required to agree to any unreasonable none-compete clauses.
  • Physicians should be provided paid sick leave exclusive of personal or vacation days, as provided to other employees.
For the full list go to pamedsoc.org.
PAMED Wants a Fairer, Less Burdensome Maintenance of Certification (MOC) ProcessA5

The House of Delegates approved a resolution that calls on the American Medical Association to analyze the finances of the American Board of Internal Medicine (ABIM). Critics of the ABIM-run certification system argue that it's outdated and overpriced.

The delegates also adopted a position favoring the acknowledgement of an alternative certification board, the National Board of Physicians and Surgeons.

House of Delegates Addresses Opioid CrisisA6

The delegates supported liability protection for schools that use naloxone, an increase in the availability of such rescue drugs, and removing social barriers for patients seeking addiction treatment.

PAMED has also called for more standardization and transparency by insurers for observation status, and the development of clinical pathways. PAMED also wants an end to the retrospective denial of payment for appropriate medical studies, procedures and testing.

PAMED's New President from Montgomery CountyA7

The House of Delegates witnessed the October 22nd inauguration of Charles Cutler, MD, MACP, an internal medicine physician who practices in Norristown, as PAMED's 167th president. During his inaugural address, he singled out the medical students at the meeting.

"First, you are embarking on a career that you will never regret," Dr. Cutler said. "And second, the day will come when you agree with me that you are a member of a divine profession." Dr. Cutler was elected to a one year term.

PAMED Enters the Fracas over Fracking...A8

PAMED has called for a moratorium on new shale gas extraction in Pennsylvania, know n as fracking. PAMED also urges the state to fund an independent health registry, and mandate research studies on the health effects of shale gas development.

Dr. Walter Tsou, executive director of Physicians for Social Responsibility/Philadelphia, and a PCMS member, wrote the resolution that was approved by PAMED. "Three years ago the Medical Society turned down a similar resolution," Dr. Tsou said, "however, in the last three years growing evidence has shown its (fracking's) increasing deleterious effects outweigh any economic benefit."

PAMED pointed out that the Pa. legislature has not set up a health registry, or done anything else to create a comprehensive study of the health effects of fracking. The Medical Society resolution reported that preliminary in-state studies of the health problems stemming from fracking, include worsening asthma, premature births, and neurological and mental symptoms.

You can find more information on PAMED's annual House of Delegates meeting by going to pamedsoc.org. You can also get an in-depth look at the House of Delegate decisions in our next edition of Philadelphia Medicine magazine. That issue should reach your mailbox in January.

CMS Offers Another Chance to Join Innovative Care ProgramsA9

The programs are designed to improve care and help doctors earn an incentive payment through the quality payment program (QPP) of the Medicare Access and CHIP Reauthorizaton Act of 2015 (MACRA). CMS says it expects to reopen applications for new practices and payers for 2018, in the Comprehensive Primary Care Plus model, and new participants in the Next Generation Accountable Care Organization.

For more information on how to sign up visit cms.gov.

The AMA is also offering several educational opportunities to help physicians understand the requirements of the new QPP created by MACRA. The sessions are designed to give physicians an overview of what the final rule means for their practice and what they need to do as part of the QPP.

PCMS is hosting an informational meeting on MACRA. It has the ominous title, "MACRA Final Rule Released. Will Your Practice Survive?" To get an answer to that question come to the PCMS building at 2100 Spring Garden Street, on Thursday, November 17, from 6:30-8 PM. See our Dating Service below for more information.

Temple Study Questions the Benefits of Long-Term Oxygen Treatment for Some COPD PatientsA10

The study, the largest of its kind to evaluate the effectiveness of home oxygen treatment for patients with chronic obstructive pulmonary disease (COPD) and moderately low levels of blood oxygen, found that oxygen did not improve survival or reduce hospitalizations.

Temple University was one of 14 study sites in the country for the research funded by the National Heart, Lung and Blood Institutes of Health-and the Centers for Medicare and Medicaid Services. Dr. Gerard Criner, professor and chair of the Department of Thoracic Medicine and Surgery at Temple's Lewis Katz School of Medicine, led the study.

The study's results have been published in the current online issue of the New England Journal of Medicine.

And the Nominees Are...A11

It's time to look around you for the men and women in our profession who deserve a special shoutout. PCMS is seeking nominations for several prestigious awards it hands out each year. They are:
  • Cristol Award - Singles out a PCMS member who has enhanced the educational, scientific and charitable goals of the society.
  • Vanitha Appadorai Vaidya, MD, Award for Humaneness in Medicine
  • Practitioner of the Year Award - Honors a PCMS member for excellence in patient care and community service.
  • Strittmatter Award - Honors a PCMS physician who has demonstrated a valuable contribution to the healing art, surgical or medical.
Submit your nominating letters to eryan@Philamedsoc.org, or fax to 215-563-3627, or call Eileen at 215-563-5343, ext. 113.

Dating ServiceA12


3 - Type 2 Diabetes Education Program

Date: Thursday, November 3
Time: 7:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130 

The Philadelphia County Medical Society invites you to join your colleagues and Janssen Pharmaceuticals, Inc. for a free dinner and presentation by Guest Speaker Michael Cooperman, MD, an expert in the field of Endocrinology, Diabetes and Internal Medicine, about Invokana®, an individualized approach to the treatment of adults with Type 2 Diabetes.

Click Here to Register   

9 - Informational Medicare Seminar

Date: Wednesday, November 9
Time: 11:30 AM - 1:30 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130 
The government's Medicare program, Original Medicare Parts A & B, has helped millions of Americans and seniors gain access to health care. That is good news. The bad news is that it's complicated to understand. Come to an informational seminar about Medicare, where you will learn about Original Medicare, Medicare advantage plans, and prescription drug coverage.

Click Here to Register 

17 - MACRA Final Rule Released; Will Your Practice Survive?

Date: Thursday, November 17, 2016
Time: 6:30 PM - 8:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130 
The program has been scheduled to give physicians an understanding of what the final rule means for their practice and what they need to do as part of the Quality Payment Program (QPP). Please attend to learn the different options you have for participation in 2017. 

Click Here to Register 

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