CVMS Bulletin January 2026

Download the PDF file of the January Newsletter to your computer: 

https://acrobat.adobe.com/id/urn:aaid:sc:US:f60b8815-0d1b-42e7-a2d9-04e227ab66d2

Happy New Year!

As we welcome the New Year, the Coastal Virginia Medical Society extends its warmest wishes to our members and their families for a happy, healthy, and fulfilling year ahead. We are deeply grateful for your dedication to patient care, your commitment to our community, and your support of the Society. May the coming year bring renewed purpose, professional fulfillment, and continued collaboration as we work together to advance medicine and improve the health of those we serve. Happy New Year!

CVMS Update

Dinner Meeting

Unfortunately, we had to postpone the dinner meeting we were planning for January 23. It is now scheduled for March 20, 2026. We will be sending out formal invitations in February so keep a close eye on your email. Dr. Harry Gewanter, former President of the Medical Society of Virginia, will be speaking on the topic of "What Physicians Need to Know about the Healthcare System but Don't."

Annual Dues / Referrals

Our second-notice invoices went out yesterday. We have decreased dues by $40 this year to try to increase membership. If you refer one of your physician colleagues who then joins the Society, we will reduce your 2026 dues by half. If you have already paid your dues, we will reimburse you half of what you paid.

Burnout and Renewal

Keith Berger and Susan Hopkins are developing a one-day educational course on a Saturday in the near future to discuss how burnout happens, how to prevent it and how to renew yourself if you have it. This will be sponsored by the Coastal Virginia Medical Foundation (CVMF). You will receive a notice in your email regarding the date and time.

Education Committee

We have established an Education Committee to focus on educational projects for the membership and the community. One of the first plans of the committee is to develop free webinars on a regular basis regarding various medical and non-medical topics that would be of considerable interest to physicians. The second plan is to meet with Medical Students and Residents of EVMS regularly to discuss topics related to what to do and what's possible after medical training is completed (ie., starting or joining a medical practice, evaluating contracts, dealing with insurance companies, etc.).

Sponsorships

CVMS and CVMF are both looking for sponsors that may help (1) reduce our operating costs and (2) help local young physicians to establish practices in this area, and (3) provide emergency funding for medical students in acute financial stress. We would like to find a financial institution that would help us put together a package for residents who are finishing their training, that would include a low interest credit line, accounting and legal services, establishing their business with the state corporation commission, obtaining a business license, recruiting employees, finding a suitable office, etc. - basically everything that's needed to establish their practice locally.

Our Current Medical Concerns

Vaccines

We remain dismayed about the reduction in vaccine recommendations and usage and the Federal control of CDC advisories to the public with inaccurate and invalid information, backed by whims and conjecture and no longer based on century-old medical evidence. The only sure thing that will happen as a result of this policy is that people will die unnecessarily.

Removal of USAID

USAID was chainsawed at the beginning of this administration in order to save a small fraction of the Federal budget. Many thousands, if not millions, of people around the globe will die as a result.

Shortage of Physicians and other Health Professionals

This is causing major problems with lack of access to care. Patients have to wait months for cancer surgery, cardiac evaluations, and other urgent problems. Sentara, ODU and EVMS have taken steps to help the situation, but will take years to bear fruit.

Government in the Exam Room

Banning abortion to save the life of the mother is a complex medical decision that requires a trained professional in each individual case all of which are different. There should not be an authoritarian ruling to eliminate ALL abortions. The consequences of these laws will include the deaths of many women caused by complications of pregnancy, and by abortions performed by charletons in back alleys. Another consequence is the birth of severely damaged children requiring institutional care for the rest of their lives. Criminalization of physicians who provide appropriate evidence-based care to save the life of the mother should not be mandated. These are truly controversial, personal, and sometimes religious-based issues, that should not be decided by black-and-white, non-personal, non-individualized laws, but rather by experienced physicians in conjunction with their patients. Abortion for convenience is one thing, but abortion to save the mother is another. (My opinion - not necessarily that of other members of CVMS - Ed.)

Universal Healthcare: Would it work for us?

We should enter into a nationwide discussion on how universal healthcare could be implemented in this county. There are many people who can't get health insurance for one reason or another. They have to be treated differently than the ones who do have insurance. They don't get the same tests or the same medicine. Their access to care is delayed and limited. There are not enough providers to take care of all of them. Rural healthcare is suffering the most. 

Lack of Mental Healthcare

While in private practice, I was constantly dismayed by the difficulty we had in finding mental health consultants in our area, particularly psychiatrists. The ones that were here were not available to take new patients. The one mental health hospital was helpful for acute mental crises, but not for long term care of severely mentally ill patients. So these were left in the care of primary care physicians. State supported mental institutions are required to take care of these patients, where they receive regular meals, they are safe, not sleeping in the streets, and removed from society where they cannot function. Inadequate attention to this problem, I suspect, is one of the major reasons we have so many mass shootings.

Lack of Medical Pain Management

There are a number of offices that specialize in pain management, but mostly they are physicians who perform injections. There are very few physicians willing to care for chronic pain patients who have failed all the injections, all the physical therapy, and all the non-opiate management. Most of these patients are not drug addicts although they are labeled as such by local emergency rooms and urgent care centers. Once again, these patients end up in primary care offices and emergency rooms because they have nowhere else to go. Many times they end up taking street drugs and/or alcohol and ultimately die of overdoses because their opiate and fentanyl use is not controlled and supervised. When these people fall back on their PCPs, we end up being severely scrutinized and sometimes punished by the state medical boards for something that is due to lack of proper service and care within the current system. 

Huge HealthCare and Insurance Systems

They suck up Medicare dollars, increase the overall cost of healthcare, don't do much to support local physicians, decrease competition, drive early discharges, deny life-saving coverage, deny and delay payments to physicians whenever possible, make millions of dollars despite being non-profit companies, charge high premiums even for high deductible policies, and are the major cause of bankruptcies in this country.

Decreasing Dollars for Research

Medical grants for research are drying up. Current healthcare leaders don't see the value in supporting this. As a result, the one thing we are leading most countries in, medical research, is going by the wayside.We remain at the bottom of the list of all the developed countries in healthcare overall.

Lack of Primary Care

Medicare cuts continue to plague primary care physicians (PCPs). This is one of the lowest paying specialties, and perhaps the hardest working. Medical students know this and therefore are reluctant to join the ranks of primary care after graduation. This further lowers access to care. If a patient doesn't know what's wrong with him, that's the first place they want to go. But if PCPs are not available, the patient ends up in the ER, causing constant overcrowding and further delays in care.

Too much Computer Time, Paperwork, Phone work, Prior Authorizations, Forms to Fill Out - All without Reimbursement

When payment is connected to the length and quality of progress notes, that chore tends to become important. Just recently, however, time spent with the patient has gained somewhat in importance, thank goodness.

Deaf Ears

Most of our complaints fall on deaf ears. We don't have the clout, the money, the legal recourse, or anything else with teeth that we can use to fight back with. We can't go on strike. We won't do anything that might compromise the care of our patients, and rightly so. We have to rely on our voices and our writings to get the word out and any action beyond that is totally dependent upon the sympathy of the listener.

Physician Acceptance

Physicians in general tend to just accept what's thrown at them and adapt to it. We don't like to fight for ourselves nor do we have the time to do so. That's what medical societies are for.

Independent Practice is Difficult

We applaud the physicians who are able to make ends meet in the confines of a private and independent practice. No other entrepreneur has the constraints on income that we have. We are dependent on payments from Medicare and insurance companies, and cannot charge what we are worth. Most of us have not been able to keep the lights on (pay the overhead) as an independent entity, so we have had to join hospitals or private equity organizations in order to survive. As a result, we have lost our autonomy and feel trapped in organizations that require that we see so many patients per day and spend no more than 15 minutes on each patient. There is a way to get out of this. It's called direct patient care.

Going It Alone

Cancelling our seat at the World Health Organization prevents us from seeing the concerns and the progress other countries might be developing regarding infectious diseases, which respect no boundaries. Isolating our country from health matters on the world stage is a bad idea. We need more communication with other countries, not less.

Burnout

Physicians are more subject to burnout and depression than most other professions because we work hard, don't make the income we should for what we do and often feel trapped in situations we can't get out of. Suicide is the answer that some of us have resorted to. There is more of that in our profession than in any other. The other answer is retire early or change careers, which are not good answers for most of us. We will be offering a Burnout and Renewal Course in the near future. Watch your email for the date and time.

Toxic Traits that Lead to Burnout: https://www.medscape.com/viewarticle/physician-toxic-traits-what-got-you-through-med-school-may-2026a100010p?ecd=wnl_tp10_daily_260124_MSCPEDIT_etid8050928&uac=22419HG&impID=8050928

Member Benefits

The invoices for the Annual Dues were sent out recently. Thank you so much to those who have paid already.

Sometimes it helps to be reminded what we are paying for when spending our hard-earned money on organizations like this. Is it really worth it?

Our mission is twofold:

1. Professional Advocacy
2. Professional Collegiality

Within those parameters, we strive to provide as many benefits as we can with the funds we receive from dues, sponsors and donations. The following is a list of  some of those benefits:

Advocacy

Considering the current difficulties in practicing medicine these days as outlined in the previous article, We try to bring awareness to our members and to the public about what is happening behind the scenes in our healthcare system. Many of us just struggle along taking care of patients as best we can despite the inefficiencies we face every day, not to mention the difficulties that many of our patients have to deal with. CVMS tries hard to find solutions to these problems. The all-volunteer Board meets for 60-90 minutes every month to discuss these things and create proposals that we ultimately present to the Medical Society of Virginia at their Annual Meeting every year in October. We attend several other local and statewide advocacy summits with other medical societies during the year. We travel to Richmond every month to to attend the Virginia Task Force to discuss out local problems with others and try to provide some influence to lawmakers regarding the need to improve our declining healthcare system. We meet with local officials and lawmakers whenever possible to let them know our opinions. We attend meetings at Sentara related to these issues. Sometimes, we make a difference; sometimes not much happens as a result. But we have to be there. We have to be at the table offering input on behalf of our physicians. The business leaders and attorneys are focused primarily on finances and solvency which is fine, but there has to be an equal representation from physicians whose concerns are centered on improving patient care, access to care, patients who are falling through the cracks, high cost of care to the patients as well as our own difficulties as mentioned above. We have to speak up for the patients and for ourselves at these tables. Nobody else will. CVMS is your only voice where it matters. 

Education

We provide educational resources for our members both medical and non-medical. We have had multiple excellent speakers at our meetings to discuss various topics like telemedicine presented by the UVA professor who started the program, local and world finances by a renowned national expert on the subject, the problems with Pharmacy Benefit Managers by a former president of the MSV, a webinar on the use of cannabis in medical practice, presentations of different methods of practice such as direct patient care and concierge medicine, updates in cardiology, and how to implement artificial intelligence into your practice to help with record keeping and help in monitoring patients with chronic diseases. A presentation on physician burnout and renewal was particularly interesting and we intend to create a full one-day course on that subject in the near future. We link to free CME programs to satisfy your requirements by the Commonwealth to maintain your licenses. Our newsletter contains a considerable number of articles and links to articles intended to provide education and new knowledge about medicine and healthcare delivery. We provide commentary about current issues related to medicine, pharmacy, and healthcare delivery. We always offer places where you can provide your own comments in every newsletter and on the website. We have many free virtual webinars planned for this year. We are developing a series of meetings with EVMS medical students and residents to introduce them to the business of medicine. We want to develop a relationship with young students and physicians in training. We are having discussions with local banks to provide a package for them to make it easier to set up practice in this area when they are ready.

Socialization

We provide dinner meetings discounted for members at least twice a year where you can get together with friends and colleagues that you may not have seen for many years. We usually have at least one speaker on a topic of interest to physicians and spouses. These are great networking opportunities to help grow your practice. Fellowship with like-minded physicians can be a great help in preventing burnout and disillusionment with the world in general. This is not nothing. It is more important than you think.

Resources

We can provide many resources and services including finding lost old medical records on patients, legal, financial and accounting referrals, help in establishing a practice, and basically any other service you can think of that would help you or your practice. We will stand behind you or with you in disagreements with insurance companies. We can refer patients to you and advertise for you. We can find or provide educational courses for almost any topic you can think of. We can make referrals for your patients to medical centers. Our website and newsletters contain links to multiple resources that can help you and your practice. Just look at all the links on each side of this page.

Special Interest Groups

Being a member of CVMS offers the opportunity to develop special interest groups within the society. For example, we could develop a group of golfers, an investment club, a journal club, photography, exercise, how to start a side business, charity groups, etc. If you can think of it , we can do it. 

Discounts

If we have enough members, we could get discounts at local restaurants, museums, shows, Tides games, etc.

More...

In addition to these benefits, you may want to see even more listed on our website at https://www.cvmedicalsociety.org/member-benefits.html.

So what do you think? Is it worth $200/year? $16/month? 50 cents a day?

Medical Pearls

Medscape AI - A wealth of medical information that could be used at the point of care. I would verify it from at least one additional source however.

UpToDate - Best medical reference online. Expensive, but worth it in my opinion.

Diagnosis is 80% history, 15% exam, 5% everything else.

Uncommon Presentations of common diseases are much more likely than uncommon diseases.

Epigastric pain in a diabetic is an acute MI until proven otherwise.

Any woman of childbearing age with abdominal pain is pregnant until proven otherwise. Check beta hcg.

If you don't know, just say you don't know.

Respect your colleagues. None of us know everything.

When all else fails, go look at the patient.

Treat the patient not the disease.

The care of the patient requires caring for the patient.

Always maintain patience and integrity.

It's okay not to know everything. Get help when you need it.

Always listen carefully to the patient. They will tell you the diagnosis most of the time.

Medical Snippets

Coffee and Atrial Fibrillation

Most doctors advise not drinking coffee if you have atrial fibrillation. However, a study published in JAMA, by Wang,CX, Nov. 9, 2025 showed that drinking one cup of caffeinated coffee per day actually reduced documented atrial fibrillation and atrial flutter in 200 adult patients with a history of these arrhythmias (47% vs. 64%) requiring cardioversion.

YouTube Instruction for Inhaler Usage

Demonstration of proper use of an inhaler is important for patients who are new to the device and takes some time. After their own demonstration, many clinicians find it helpful to recommend YouTube videos so that patients can watch them repeatedly if necessary until they can learn the proper technique. 99% of these YouTube videos were found to be of at least moderate or excellent in reliability and quality. J Allergy Clin Immunol Pract Oct 13, 2025.

Routine Use of Peripheral IV lines "Just in Case": Are they Really Needed?

They are probably doing more harm than good. About a quarter of them are never used and many of them contribute to patient discomfort, phlebitis and bloodstream infection. They account for more than one-third of Staphylococcus aureus bacteremias, less than central lines but still not insignificant. A third of them fail before hospital treatment has completed. Multiple studies have demonstrated that there is no difference in survival or neurologic outcomes whether peripheral IV lines are present at the onset of cardiac arrest or not. Kennis, et al, "Things We Do for No Reason," J Hosp Med, Oct 6, 2025.

Follow up of Overdose Patients Should Include Peer Support

Peer support services (recovery coach, peer support, peer advocate) consist of people who have experienced addition and undergone specialized training in resource navigation and emotional support can provide 24/7 support for 90 days after ER intervention. Post- ER contact with these patients in New York City has shown a 50% reduction in overdose deaths in the year following their overdose. Am J Public Health, Jan 2026.

Job Postings in Your Specialty: Fast. Free. NEJMCareerCenter.org

Your Comments

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Newsletter

Stay up to date on issues and news you need to know. The CVMS Bulletin is published monthly and will list concerns that local physicians have expressed about healthcare in Coastal Virginia and how we can make it better. We will provide potential solutions and let you know what is happening behind the scenes to help solve these problems. Membership is not currently required to receive the newsletter.