Welcome to the sixth edition of the CVMS Bulletin bringing you updates on the status of healthcare in Eastern Virginia. We hope you find it interesting, informative and enjoyable. Please let us know if there is anything we can do to make it better.
Our name change from Norfolk Academy of Medicine to the Coastal Virginia Medical Society has finally occurred and CVMS is now recognized by the State Corporation Commission. A letter has been requested from the IRS to confirm its acknowledgement of CVMS as a non-profit 501(c)6, which we should receive in a few weeks.
What is a 501(c)6 non-profit?
Section 501(c)6 of the Internal Revenue Code provides for the tax exemption of business leagues, chambers of commerce, real estate boards, and boards of trade, which are not organized for profit and no part of the net earnings of which inures to the benefit of private individuals or insiders of the group. Contributions to 501(c)6 organizations are not deductible as charitable donations, but they may be deductible as a trade or business expense if ordinary and necessary in the conduct of the taxpayer's business. Dues that are paid by members are tax exempt to the extent that the funds are used for promotion of common interests as long as a substantial portion of the dues are not used for political purposes. 501(c)(6) organizations are allowed to attempt to influence legislation that is related to the common business interests of its members, but not to fund political campaigns of specific individuals.
Our first in-person official Board meeting has been scheduled for June 1, 2023, the minutes of which will be posted on the website. *The agenda for this meeting is posted below.
As previously mentioned, our plans for the year will include:
1. Our advocacy plans will focus initially on price transparency and Certificate of Need (CON) issues.
2. We would like to consider at least one dinner meeting for all the members before the end of the year.
3. We will begin setting up CME programs for our members hopefully at least once a month.
4. We will work on establishing more member benefits and keep you informed on our progress.
5. We will select one or more delegates to attend the Medical Society of Virginia's Annual Meeting in October, please let us know at 757-816-8399.
5. All members will receive an invitation letter to officially join (or rejoin) our new Medical Society in the near future. We truly hope you will seriously consider being a part of this new endeavor to make a difference in improving healthcare in eastern Virginia. There is strength in numbers. The more members we have, the stronger we become, and the louder voice we will have.
Protocols for diagnosis or treatment can be helpful as guidelines for us to remember what to do in certain situations. When a patient comes in to the ER with a particular ailment like community-acquired pneumonia, it is nice to have a protocol already written up and all you have to do is check off what you want to order. The same goes for when you have the diagnosis of pulmonary embolism, the protocol tells you what to do. They are based on solid evidence-based medicine, from randomized controlled studies that tell us that when a patient is a certain age and when they have a completely normal heart and kidney function and if they are not bleeding elsewhere, this is what you do. But what if you have a patient with a pulmonary embolism, acute CHF, renal failure, and an active GI hemorrhage, who has aspirated and now has pneumonia as well, and is developing respiratory failure. Is there a protocol for that? Where is the study that tells us what to do here? There is no study that contains patients like that.
What about when the patient goes home, assuming s/he gets better? As you are doing the discharge orders, you are getting alerts from the computer saying that this person has CHF and you are not using an ACE inhibitor, and this person had an acute pulmonary embolism and you are not using the full dose of Eliquis. These are hard-stops that you have to get around somehow to convince this non-thinking computer why you are not following protocol. Sometimes, later, the pharmacist who doesn't know the patient will call and ask why I am not using the full dose of Eliquis.
Protocols are nice, but they rarely work in real life with real people without modification. And they sometimes keep us from thinking.
My cardiology professor , Dr. Charles Whooley at Ohio State, used to say in 1973, "A monkey can follow a protocol." Situations with real patients require some thinking.
Protocols are man-made guidelines that may be useful but they are not to be followed strictly when situations demand otherwise. Nor should they always be considered "standards of care", particularly in the presence of contraindications. The standard of care should be when a thinking, knowledgeable physician weighs the multiple pros, cons and all the nuances involved in the care of a real patient and then makes his or her best judgement under the current circumstances. We should not be criticized for not following protocol in every case.
On the surface, requiring prior authorizations for certain prescriptions appear to be just another way to torture physicians. When we look deeper, however, we find that requiring prior authorizations is still is just another way to torture physicians.
Here are the reasons that are commonly reported when asked why some prescriptions require prior authorization:
The biggest downside of prior authorizations is the inability of patients to get needed medications urgently. I'm sure we can all recall situations when we prescribe an antibiotic, a pain medication, or a cardiac medication on a Friday and the soonest the patient can get it is Tuesday due to delays caused by requiring prior authorizations. I wonder what the morbidity and mortality rates are across the country because of this delay. I'm sure it's not zero. Any other number is unacceptable.
To provide better patient access and optimize office scheduling, physicians can consider the following strategies:
By implementing these strategies, physicians can enhance patient access, reduce waiting times, and improve overall satisfaction with their practice.
A. Call to Order
1. Introduction
2. SCC and IRS Documentation Update
B. Old Business
1. Formal Approval of:
a. Bylaws
b. Business Plan
c. Articles of Incorporation
2. Continue collaboration with neighboring medical societies. Establish connection with EVMS. Invite med students to join for free.
C. New Business
1. Google Workspace
2. Board Vacancies
3. Dues/Finances/Budget/Towne Bank Checking Account
4. Establish monthly or weekly CME programs, webinars, seminars.
5. Advocacy for patients and providers (List of concerns)
* Higher Priority
a. CON*
b. Price Transparency*
c. Prior Authorizations
d. “Peer to Peer” reviews with insurance companies
e. Reducing physician workload/paperwork/computer work, or get paid for it.
f. Easier communication with patients and colleagues- encrypted.
g. Physician burnout and depression issues – moral dilemma*
h. Office scheduling and practice management seminars to improve patient access and patient-centric routines.
i. Better Patient Care / Access to care /*
j. Public/patient mental health issues.*
k. Firearm concerns
l. Connect with American College of Physicians Advocacy Program
m. Selection of Delegate(s) to attend MSV Annual Meeting in October. Will need delegates on standby for the August 10 2nd district caucus. MSV will begin working on delegate count allotments in July. Reach out to MSNVA for collaboration and “learning the ropes”.
n. Working with external forces – hospital policies, pharmacies, allied professionals
o. Poor Medicare reimbursement for this area.
p. Staff shortages physicians and nurses.
q. “Scapegoats” for opioid crisis – lack of specialists and community resources.
r. Pain management.*
s. Fact checking service. Dispelling myths and medical misinformation.
t. Inpatient vs observation – incentivizes longer hospital stays.
u. 3-day stay for patients who require rehab
v. Requirement for us to discharge patient when the hospital wants to discharge them.
x. Need to regain respect as leaders in the healthcare system*
6.
Membership
Benefits
a. Mental Health Programs for Providers * – Group discussions, lectures, etc.
b. Non-medical educational programs – Leadership, practice development, business, accounting, etc.
c. Corporate Partnerships – vetted professionals – accountants, attorneys, banks, etc.
d. Regular lectures or webinars on practice improvement.
e. Discounts for local museums, shows, plays, symphonies, etc.
7. Advisory Board (Non-voting)
a. Karen Greenhalgh, State Delegate
b. Charlotte Dunn, Professional Risk
8. Collegiality Programs
a. Dinner and Program for the membership once a year (Sept-Dec)
b. Networking lunches or smaller special interest meetings, journal clubs, etc.
c. Leisure-time activities, hobbies, golf outings, etc.
9. What’s Next
a. Create your own ideas.
b. Quarterly, monthly, bimonthly meetings? First Thursday of the month?
c. Implement plans and programs.
d. Delegates for August caucus and October MSV meeting
D. Adjournment:
Board of Directors
Our current Board of Directors is as follows:
Greg Warth, MD, President and Communications Director, Newsletter Editor
Keith Berger, MD, Vice President and Advocacy Director
_______________Secretary/Treasurer - and Finance Director - open position
Lisa Barr, MD, Collegiality/Networking Director
Alexandria Berger, MD, Director of Better Patient Care
Jerome Blackman, MD, Director of Mental Health
Cynthia Romero, MD, Director of Education, Liaison to EVMS and ODU
Joel Bundy, MD, Director-Liaison to Sentara
_______________Director of Marketing, Benefits, and Services - open
Brenda Musto, Executive Director, non-voting
Advisory Board (non-voting):
Please note there are two important vacancies on the Board - one for Secretary-Treasurer, which actually could be two positions on its own, and one for Director of Marketing, Benefits and Services. Here is your opportunity to become a leader in the community, to actually make a difference in improving healthcare in eastern Virginia. If you are at all interested in either of these positions, please let us know.
Contact us:
Email: cvms@cvmedicalsociety.org
Phone: 757-816-8399
FAX: 757-486-2208
Nov 13, 24 05:55 AM
Nov 04, 24 06:05 AM
Oct 30, 24 09:04 AM
Continuing Education Requirements from the Board of Medicine
Informed CMEs for Virginia Physicians
Get Stroke Smart Materials for your practice.
Severn Leadership Group Fellows Program
Here is your chance to let us know what is on your mind. What problems with healthcare in this area are you most concerned about? What benefit or service can we provide to help you the most with regard to your well being or that of your patients?
Please be sure there are no typos in your email address. Otherwise we won't be able to reply.
We hope you enjoyed this new edition of the CVMS Bulletin. If you have any questions, concerns or comments, let us know at cvms@cvmedicalsociety.org. If you wish to provide an article or your own story to put in this newsletter, send it in. Watch the "What's New" link in the upper left Navigation Menu for updates in between the monthly newsletters. Let us know if you wish to be involved in the CVMS organization process or if you know of any resources or benefits we could potentially provide for the membership.
Thank you for subscribing to the CVMS Bulletin.
Nov 13, 24 05:55 AM
Nov 04, 24 06:05 AM
Oct 30, 24 09:04 AM
Things You Need to Know
The Roman Fasces was a symbol of strength and power occurring as a result of many binding together. It was made of multiple elm or birchwood rods about 5 feet long tied together and sometimes including an axe. It was carried by attendants to soldiers or powerful figures in ancient Rome. For us, it symbolizes that we are stronger and more powerful if we bind together in supporting our goals.
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Pfizer COVID-19 Training Sessions and Additional Vaccine Information
Includes a section on what to tell your patients
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