Link for Caregiver Renewal sessions

Save the Dates:

MedWebs: (Educational Webinars): To be held on the first Tuesday of every month at 7 PM by Zoom link. A variety of topics will be considered about things other than medicine that you need to know, including finances, investments, medical ethics, risk management, how to deal with insurance companies that don't pay, medico-legal issues, time management, office/staff management, best practice methods, types of practice, dealing with types of patients, dealing with barriers in patient care, etc.Links will be sent out 1-2 days before the webinar.

EVMS Grand Rounds: All students, residents and physicians in Tidewater are invited to these remarkably educational seminars on various medical topics where you can earn CMEs and stay up-to-date.

Caregiver Renewal: every Thursday evening at 7PM by Zoom.(See the Link above>

CVMS Dinner Meeting: Tentatively scheduled for Friday, September 18 at 6PM. Location TBD.

CVMS Will Present Proposals for Change at the Annual MSV Meeting this October

1. Opposition to raising the malpractice cap in Virginia.

2. Fighting against denials and delays for appropriate medical care from insurance companies.

3. Continual opposition to COPN Laws in Virginia.

4. Promotion of universal healthcare for all.

5. Promotion of greater independence and more physician involvement in public healthcare decisions.

6. Create solutions to problems that prevent access and cause barriers to healthcare in Virginia.

What are the Consequences of Raising the Malpractice Cap in Virginia?

A proposal being debated in Virginia would potentially raise the cap dramatically, in some versions up to $6 million. ([vacep.org][2])

The consequences of raising the malpractice cap could be significant and would likely affect several groups differently.

### Potential Positive Consequences

#### Greater compensation for severely injured patients

The strongest argument for increasing the cap is that some catastrophically injured patients currently cannot recover enough compensation to cover lifelong costs.

Examples include:

* severe birth injuries * permanent neurological damage * paralysis * lifelong custodial care for children or disabled adults

Under the current cap, even if a jury awards substantially more, the court reduces the award to the statutory maximum. ([Hollingsworth, PLLC][3])

Supporters argue that:

* inflation and healthcare costs have risen dramatically since the cap structure was created * families facing decades of care expenses may be undercompensated * the current cap can disproportionately affect younger patients with lifelong disabilities

#### Increased accountability

Some advocates believe higher caps:

* create stronger incentives for hospitals and providers to improve safety systems * discourage negligent behavior * increase transparency around medical errors

Critics of low caps argue that overly restrictive caps may weaken deterrence.

#### Better access to attorneys for complex cases

Medical malpractice litigation is extremely expensive because it requires:

* expert witnesses * extensive medical review * years of litigation

If potential recoveries remain capped at relatively low levels, attorneys may decline complicated but legitimate cases because costs exceed likely returns. Raising the cap could increase access to legal representation for injured patients.

---

### Potential Negative Consequences

#### Higher malpractice insurance premiums

This is the concern most frequently raised by physician groups, hospitals, and insurers.

If insurers face the possibility of larger payouts:

* malpractice premiums may rise * high-risk specialties could be affected most severely

Specialties likely most affected include:

* obstetrics * neurosurgery * trauma surgery * emergency medicine

Virginia physician organizations and hospital groups have warned that doubling the cap could significantly increase liability costs. ([ATRA][4])

#### Reduced physician recruitment and retention

Higher liability exposure can make a state less attractive for physicians, particularly in high-risk specialties.

Potential consequences could include:

* fewer physicians willing to practice in Virginia * earlier retirement of older physicians * consolidation into large health systems for liability protection * fewer independent practices

This concern is especially relevant in:

* rural Virginia * underserved urban communities * labor-and-delivery services

Hospitals argue these effects could worsen existing physician shortages. ([CBS 6 News Richmond WTVR][5])

#### Increased healthcare costs

Higher malpractice premiums may ultimately be passed along through:

* hospital charges * insurance premiums * healthcare system operating costs

Some economists argue the overall effect is modest, while others believe it contributes meaningfully to healthcare inflation.

#### More defensive medicine

Physicians may order:

* more tests * more consultations * more imaging * more admissions

primarily to reduce legal exposure rather than because they are medically necessary.

Defensive medicine is controversial because:

* some studies suggest it is widespread * others suggest malpractice fears are only one contributor

But physicians frequently report that litigation concerns influence practice patterns.

---

### Possible Impact on Virginia Specifically

Virginia has historically maintained a relatively physician-friendly malpractice environment compared with many states. That environment is often cited as helping:

* recruit physicians * stabilize malpractice premiums * preserve access in high-risk specialties

A major cap increase could shift Virginia toward a more plaintiff-friendly legal climate.

However, supporters argue Virginia’s cap is now unusually restrictive because it limits *all* damages rather than only pain-and-suffering damages, which many other states allow without limits. ([Lawsuit Information Center][6])

---

### The Central Policy Debate

The real debate is about balancing two competing priorities:

1. Patient advocates concerned about fair compensation and accountability; 2. Physicians/hospitals concerned about access to care and liability stability.

Both sides have legitimate concerns:

* catastrophic malpractice injuries can financially devastate families * excessive liability exposure can destabilize fragile healthcare systems

That is why many states try to find a middle ground:

* moderate caps * separate caps for non-economic damages only * periodic payments for catastrophic injuries * patient compensation funds * specialized medical courts or review panels

Virginia’s debate is becoming increasingly important because the state already faces:

* physician shortages * rural hospital financial stress * rising healthcare costs * growing dissatisfaction with malpractice limitations among patient advocates.

This may end up as a compromise in which neither party will be completely happy about.

References:

[1]: https://law.lis.virginia.gov/vacode/title8.01/chapter21.1/section8.01-581.15/?utm_source=chatgpt.com "§ 8.01-581.15. Limitation on recovery in certain medical ..." [2]: https://www.vacep.org/news-blog/medmal2026?utm_source=chatgpt.com "In a late-in-session move, a bill to raise the medical ..." [3]: https://hollingsworthpllc.com/understanding-virginias-cap-on-medical-malpractice-damages/?utm_source=chatgpt.com "Understanding Virginia's Cap on Medical Malpractice ..." [4]: https://atra.org/medical-liability- crisis-brewing-in-virginia/?utm_source=chatgpt.com "Medical Liability Crisis Brewing in Virginia" [5]: https://www.wtvr.com/news/local-news/virginia-medical-malpractice-cap-march-6-2026?utm_source=chatgpt.com "Injured by a medical mistake? Virginia considers doubling ..." [6]: https://www.lawsuit-information-center.com/virginia-medical-malpractice-cases.html?utm_source=chatgpt.com "Virginia Medical Malpractice Law and Settlement Value"

How Will AI Affect Healthcare in the U.S. Over the Next Ten Years?

Over the next 10 years, expect:

**1. Faster, more automated clinical work** AI will increasingly draft notes, summarize records, suggest diagnoses, flag abnormal imaging/labs, and help clinicians keep up with guidelines. Physicians are already adopting it rapidly; the AMA reported in 2026 that more than 80% of physicians use AI professionally. ([American Medical Association][1])

**2. Better diagnostics—but not automatic better care** Radiology, pathology, dermatology, cardiology, ophthalmology, and ICU monitoring will benefit from AI pattern recognition. FDA oversight is expanding; the FDA has issued guidance for AI-enabled device software and lifecycle management. ([U.S. Food and Drug Administration][2])

**3. Major administrative disruption** AI will take over parts of scheduling, billing, coding, documentation, referrals, appeals, call centers, and prior authorization. This could reduce burnout—but insurers may also use AI to deny or delay care faster, which could become a major political and regulatory fight.

**4. More patient self-triage** Patients will increasingly ask AI before calling a doctor. That may improve access for simple questions, but it also risks false reassurance, delayed care, and misinformation—especially in mental health and urgent symptoms.

**5. A new “digital front door” to care** Primary care may become hybrid: AI intake, symptom review, medication checks, home monitoring, then physician/NP/PA review. Done well, this could improve chronic disease care. Done poorly, it could become another depersonalized barrier.

**6. Workforce changes, not mass replacement** AI will not replace physicians broadly, but clinicians who use AI well may replace workflows that do not. Medical assistants, scribes, coders, utilization reviewers, and call-center roles may change significantly.

**7. More regulation and liability questions** The National Academy of Medicine released an AI Code of Conduct in 2025 emphasizing responsible, equitable, human-centered AI use. ([NAM][3]) Expect more rules around transparency, bias, audit trails, FDA review, privacy, and malpractice responsibility.

**8. Equity could improve — or worsen** AI could bring specialty-level guidance to rural and underserved areas. But biased data could worsen disparities in diagnosis, insurance approvals, maternal health, pain treatment, and risk scoring. Equity audits will be essential.

**Bottom line: AI will probably make U.S. healthcare faster, more data-driven, and more automated. Whether it becomes more humane, affordable, and accessible will depend less on the technology itself and more on who controls it: physicians and patients — or hospitals, insurers, vendors, and billing systems.

References:

[1]: https://www.ama-assn.org/practice-management/digital-health/more-80-physicians-use-ai-professionally-ama-survey?utm_source=chatgpt.com "More than 80% of physicians use AI professionally: AMA ..." [2]: https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-software-medical-device?utm_source=chatgpt.com "Artificial Intelligence in Software as a Medical Device" [3]: https://nam.edu/our-work/programs/leadership-consortium/health-care-artificial-intelligence-code-of-conduct/?utm_source=chatgpt.com "Health Care Artificial Intelligence Code of Conduct"

How Will AI Affect Employment Opportunities for College Graduates?

Here’s the bigger picture.

## Where AI is likely to reduce opportunities

AI is especially good at:

* Routine analysis * Drafting text * Basic coding * Data organization * Customer support * Research summarization * Administrative tasks

That means entry-level jobs built around those tasks are already changing.

Examples:

* Junior marketing copywriters * Basic legal research assistants * Entry-level programmers * Financial analysts doing repetitive reporting * Administrative assistants * Simple graphic production roles * Some customer service positions

In many companies, one experienced employee using AI can now do work that previously required several junior staff members.

This is important because historically, entry-level positions were how graduates learned industries. AI may shrink that “training ground.”

---

## But AI will probably NOT eliminate educated workers.

Historically, new technologies replace some tasks rather than entire professions.

For example:

* ATMs did not eliminate bank tellers entirely * CAD software did not eliminate architects * Electronic medical records did not eliminate physicians * Spreadsheet software did not eliminate accountants

Instead, jobs changed.

The same is likely with AI.

Graduates who combine:

* technical literacy, * communication, * creativity, * judgment, * leadership, * human interaction, * and domain expertise

will remain highly valuable.

---

## Fields likely to remain strong

Areas requiring human trust, judgment, physical presence, or complex decision-making are likely to remain resilient.

Examples include:

* Healthcare * Skilled trades * Engineering * Education * Scientific research * Mental health * Advanced manufacturing * Cybersecurity * AI oversight/governance * Project leadership * Entrepreneurship

Even in healthcare, AI will assist physicians and nurses rather than fully replace them. Human interaction, ethics, and decision-making remain critical.

For example, AI may read imaging studies or summarize charts, but patients still want a trusted clinician interpreting results and guiding care.

---

## The biggest shift: employers may value skills over degrees alone

A college degree by itself may become less powerful as a credential.

Employers increasingly want:

* Demonstrated skills * Real-world experience * Portfolio work * Adaptability * Ability to use AI effectively * Problem-solving * Collaboration

Graduates who know how to work *with* AI may outperform those who ignore it.

A marketing graduate who can use AI tools for campaign design, analytics, video creation, and customer targeting may be far more employable than someone trained only in traditional methods.

---

## Possible risks for society

There are legitimate concerns:

* Fewer entry-level white-collar jobs * Wage pressure for some professions * Greater inequality between highly skilled and lower skilled workers * Rapid disruption before education systems adapt * Concentration of wealth in large technology companies

This may force colleges to rethink education itself.

Future education may emphasize:

* interdisciplinary learning, * critical thinking, * entrepreneurship, * communication, * and lifelong retraining rather than static degrees.

---

## What students should do now

Students entering college today should probably:

1. Learn how AI tools work 2. Develop strong communication skills 3. Build practical experience early 4. Focus on problem-solving and adaptability 5. Combine technical and human-centered skills 6. Avoid relying solely on memorization-based learning 7. Build a portfolio of real projects

The graduates most at risk are those trained only to perform repetitive cognitive tasks that AI can cheaply automate.

The graduates most successful will likely be those who can:

* supervise AI, * interpret results, * connect ideas, * lead people, * and apply human judgment in complex situations.

---

One interesting possibility is that AI could actually increase demand for highly educated people in some sectors by dramatically accelerating innovation. If AI helps scientists, engineers, and physicians solve problems faster, entirely new industries and careers could emerge — much like the internet created jobs that barely existed 30 years ago.

The Pros and Cons of High School Students Shadowing Physicians

## What Is Physician Shadowing?

Physician shadowing allows students to observe doctors during their daily work. Students may follow physicians in:

* Primary care offices * Specialty clinics * Emergency departments * Surgical settings * Hospital inpatient units * Community health centers

The experience is observational rather than hands-on, allowing students to learn about patient care, communication, teamwork, and the realities of medical practice.

---

# Advantages of High School Physician Shadowing

## 1. Early Exposure to Healthcare Careers

Many students have only a television or social media understanding of medicine. Shadowing provides a realistic view of healthcare and helps students determine whether medicine is truly the right career path.

Students learn:

* The daily responsibilities of physicians * The pace and pressures of healthcare * The emotional rewards and challenges of patient care * Differences among medical specialties

This can help students make more informed educational and career decisions.

---

## 2. Encourages Interest in STEM Education

Shadowing often increases enthusiasm for science, technology, engineering, and mathematics (STEM). Students begin to see how biology, chemistry, anatomy, technology, and critical thinking are applied in real-life situations.

For many students, shadowing transforms abstract classroom science into something meaningful and practical.

---

## 3. Promotes Professionalism and Communication Skills

Observing physicians interact with patients teaches valuable lessons about:

* Professional behavior * Compassion * Listening skills * Teamwork * Ethics * Respect for confidentiality

Students often gain maturity and confidence from being exposed to professional healthcare environments.

---

## 4. Mentorship Opportunities

Positive mentoring relationships can develop between physicians and students. A physician mentor may:

* Offer career advice * Encourage academic excellence * Help students navigate pre-medical preparation * Inspire students from underserved communities

Mentorship can be especially valuable for students who may not otherwise have healthcare role models.

---

## 5. Improves Medical School and College Preparation

Students interested in healthcare careers often gain:

* Better understanding of college prerequisites * Motivation to maintain strong academic performance * Exposure to healthcare terminology and systems * Insight into the long educational journey ahead

Early exposure may help students prepare more effectively for future applications and interviews.

---

## 6. Humanizes Healthcare

Students witness the human side of medicine:

* Illness and recovery * Family interactions * Difficult conversations * Compassionate care * End-of-life issues

These experiences can help students appreciate the importance of empathy and patient-centered care.

---

# Disadvantages and Concerns

## 1. Patient Privacy and HIPAA Concerns

One of the biggest concerns involves patient confidentiality and privacy.

Patients may feel uncomfortable discussing personal medical issues in front of a student observer. Healthcare providers must carefully protect confidential information and obtain patient consent before allowing shadowing.

Some patients may decline participation, which must always be respected.

---

## 2. Emotional Exposure to Difficult Situations

Hospitals and clinics can expose students to:

* Serious illness * Trauma * Death * Emotional distress * Medical emergencies

Some high school students may not be emotionally prepared for these experiences. Without proper guidance, difficult situations can be overwhelming.

---

## 3. Limited Hands-On Experience

Shadowing is usually passive observation. Students may become frustrated because they cannot actively participate in patient care.

The experience may also vary greatly depending on:

* The physician’s teaching style * The clinical setting * Patient volume * Hospital policies

Some shadowing experiences are highly educational, while others involve mostly watching from a distance.

---

## 4. Liability and Safety Issues

Hospitals and clinics must consider:

* Infection control * Student safety * Legal liability * Insurance concerns

Students may be exposed to contagious illnesses or hazardous situations. Many hospitals have strict rules regarding minors in clinical areas.

---

## 5. Disruption to Workflow

Teaching and explaining medical care to students takes time. In busy practices, shadowing can occasionally:

* Slow workflow * Increase stress for staff * Add administrative requirements * Create scheduling complications

Some physicians enjoy teaching, while others may find it difficult during demanding clinical days.

---

## 6. Unequal Access to Opportunities

Students with family or social connections in healthcare often find shadowing opportunities more easily than others. This can create inequities for students from underserved or disadvantaged backgrounds.

Schools and healthcare organizations may need to develop structured programs to provide fairer access.

---

# Best Practices for Successful Shadowing Programs

Effective physician shadowing programs should include:

* Written parental consent * Patient permission before observation * HIPAA and confidentiality training * Clear behavioral expectations * Limited observation hours * Age-appropriate experiences * Mentorship and debriefing opportunities

Structured programs help maximize educational value while minimizing risks.

---

# Conclusion

Physician shadowing can be an outstanding educational experience for motivated high school students. It encourages interest in healthcare careers, strengthens STEM education, and teaches professionalism, empathy, and communication.

However, shadowing also presents challenges involving privacy, emotional maturity, liability, and equal access. Careful planning and responsible supervision are essential to ensure that the experience benefits students, physicians, and patients alike.

When thoughtfully organized, physician shadowing programs can inspire the next generation of compassionate and skilled healthcare professionals.

Krueger Medical Scholars Program

Incentives for Physicians to Participate in Student Shadowing Programs

## 1. Inspiring the Next Generation of Physicians

One of the strongest motivations is the opportunity to influence and inspire future healthcare professionals.

Many physicians remember mentors who helped guide them toward medicine and feel a responsibility to “pay it forward.” By exposing students to real-world patient care, physicians can:

* Encourage talented students to pursue healthcare careers * Help students make informed career choices * Promote compassionate, ethical medical practice * Shape future leaders in medicine

For many physicians, mentoring students is deeply meaningful.

---

## 2. Strengthening the Healthcare Workforce Pipeline

The United States faces growing physician shortages in many specialties and geographic areas, especially in:

* Primary care * Rural medicine * Geriatrics * Psychiatry * General surgery

Early exposure to medicine can increase interest in these fields. Physicians may see shadowing as an investment in the future healthcare workforce.

This is particularly important in underserved communities where recruiting future physicians is difficult.

---

## 3. Personal Satisfaction and Professional Fulfillment

Teaching and mentoring often renew physicians’ own sense of purpose.

Students frequently bring:

* Curiosity * Enthusiasm * Fresh perspectives * Appreciation for medicine

This can remind physicians why they entered healthcare in the first place and may help counter burnout or professional fatigue.

Many physicians enjoy explaining:

* Clinical reasoning * Patient interactions * Medical ethics * The “art” of medicine

---

## 4. Promoting Public Understanding of Medicine

Shadowing helps students better understand:

* The complexity of healthcare * Challenges physicians face * The realities of patient care * The demands of medical training

Physicians may view this as an opportunity to improve public appreciation for medicine and healthcare professionals.

---

## 5. Supporting STEM and Community Education

Many physicians participate because they value education and community outreach.

Shadowing programs:

* Encourage STEM learning * Support local schools * Promote health literacy * Create community engagement

Hospitals and medical societies sometimes partner with schools to create educational pipeline programs.

Organizations such as American Medical Association and regional medical societies often encourage mentorship and educational outreach.

---

## 6. Recruiting Future Employees or Trainees

Healthcare organizations sometimes use shadowing programs to:

* Identify promising future medical students * Encourage local students to remain in the area * Build relationships with future healthcare workers

Students who have positive experiences may later return as:

* Volunteers * Medical assistants * Nurses * Medical students * Residents * Physicians

---

## 7. Academic and Teaching Recognition

Physicians affiliated with:

* Teaching hospitals * Universities * Residency programs

may receive professional recognition for educational involvement.

In some settings, mentoring students supports:

* Academic promotion * Teaching portfolios * Leadership development * Community service goals

Teaching experience is often valued within academic medicine.

---

## 8. Enhancing Physician Communication Skills

Teaching students requires physicians to explain:

* Diagnoses * Procedures * Decision-making * Patient communication

This process can improve physicians’ own communication and reflective thinking skills.

Some physicians report that teaching makes them more thoughtful and intentional in their clinical practice.

---

# Potential Disincentives Physicians Must Balance

Despite these benefits, physicians also face challenges when participating in shadowing programs:

* Time constraints * Increased workload * Patient privacy concerns * Liability issues * Workflow disruption * Administrative requirements

Because of these pressures, successful programs usually require institutional support and clear guidelines.

---

# Conclusion

Most physicians who participate in student shadowing do so because they believe mentorship matters. They see value in inspiring young people, strengthening the future healthcare workforce, and sharing the human side of medicine.

Although shadowing requires time and effort, many physicians find that helping students discover medicine can be one of the most rewarding aspects of their profession.

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The Coastal Virginia Medical Society is a group of medical professionals in eastern Virginia who are concerned about where healthcare is heading and the role that physicians must play in the process. The challenges faced by patients and the healthcare team are many and are not easy to solve. They need to be brought to the attention of the public, the health institutions, and to those in the legislature who might be able to make the appropriate changes. We believe it IS possible to improve, but we can't do it individually. Doctors and patients in large numbers however, by raising their voices, learning more about the problems and providing their input, CAN make a difference...

2. For the Social networking we can bring into our lives - the collegiality and emotional support that can bring us out of isolation and loneliness into a much fuller life with more friends, companionship and enjoyment than we ever would have had otherwise. I am reminded about the benefits of this every time I attend the Old Doc's Luncheon at Gus and George's Restaurant. The conversation and the laughter are heartening and allow us to recharge these old batteries. I think the younger folks among us could use that as well. And...

3. Just for the Fun of it and the Betterment of us all.

Thank you!

I would also like to express our tremendous gratitude to all our soldiers who made such huge sacrifices so that we would have the freedom and the ability to express the opinions and editorials provided here.

Let us know if you wish to be involved in the CVMS organization as a director, officer, delegate, committee member, or volunteer, or if you would like to propose any resources or benefits that we could potentially provide for the membership.

Also, please let us know if you are having any problems with other organizations or concerns that you would like us to help you resolve. We are here to serve our members to the best of our ability.

The articles in this newsletter are written by the Editor unless otherwise indicated. The opinions expressed here are not necessarily those of MSV, other CVMS Board Members or the membership in general. Your constructive comments are always welcome.

Editor: Gregory J. Warth, MD