This page will provide updates on medical news you need to know regarding our healthcare system, healthcare delivery, interesting articles, meeting updates, events, and even some entertainment. If you have an article you would like to share or a thoughtful, constructive concern or opinion, please send it to cvmedsoc@gmail.com so we can publish it here.
"Knowledge has power. It controls access to opportunity and advancement."
--Peter Drucker
10% of US Internists admitted having suicidal thoughts and another 6% didn't want to admit it, compared to 0.5% of the adults in the general population -according to a recent study by the National Institute of Mental Health, as reported by this article in Medscape. 1% of internists have actually attempted suicide.
This section provides information about medical and non-medical education that are likely to be of interest to the members of CVMS.
Great News! Our application for a change in name from Norfolk Academy of Medicine to Coastal Virginia Medical Society has been approved and confirmed by the Virginia State Corporation Commission! From now on, we will be known as the Coastal Virginia Medical Society. However, we will continue to remain cognizant of our history and our duty to serve all of the physicians and medical providers in Virginia Beach, Chesapeake, and Norfolk.
So here we are once again, the local healthcare system creating barriers to adequate efficient health care. My minimally symptomatic 92 yo patient with slow GI blood loss due to an AV malformation in the colon and a Hgb of 7.3 needs an urgent iron infusion and/or a transfusion of PRCs if it drops below 7. There are only two outpatient infusion centers available and the soonest appointment for her is 20 days into the future. So now we will have to send her to the ER where she will likely wait for hospital bed for many hours if not days, costing many thousands of healthcare dollars to get a transfusion that could have been provided expeditiously on an outpatient basis for much less. Yet we have physical therapy establishments on every street corner.
The problem is there is no one managing the healthcare needs of our local communities. Is there a way in which the medical societies composed of providers in the trenches who know what the needs are, can collaborate with the larger companies who can afford to build these facilities, so we can provide better and faster care to those who need it?
Medical burnout is a complex issue that can arise when healthcare professionals experience prolonged and excessive job stress, leading to physical, mental, and emotional exhaustion. It is a moral dilemma because it raises questions about the responsibilities and duties of healthcare professionals to provide care to their patients while also taking care of their own well-being.
On one hand, healthcare professionals have a moral obligation to provide the best care possible to their patients, which may require long hours, emotional labor, and physical demands. However, when healthcare professionals are experiencing burnout, they may not be able to provide the same level of care, which could compromise patient safety and quality of care.
On the other hand, healthcare professionals also have a moral obligation to take care of themselves and prioritize their own well-being. When healthcare professionals are burnt out, they may be at risk of making mistakes, becoming emotionally detached from patients, and experiencing negative consequences such as depression, anxiety, and even suicide.
The moral dilemma arises when healthcare professionals must balance their responsibilities to their patients with their own well-being. It is important to recognize that addressing burnout is not only beneficial to the individual healthcare professional but also to the patients they care for. Therefore, it is crucial to create a supportive work environment that promotes self-care, work-life balance, and access to resources such as counseling and mental health support.
Overall, addressing medical burnout is a moral imperative that requires a multifaceted approach that acknowledges the complex nature of the issue and promotes the well-being of healthcare professionals and patients alike. The leaders of our healthcare systems must be aware of this and take steps to reduce the overwhelming workloads and to improve the work-life balance of their medical professionals
The official CVMS newsletter of Norfolk, Chesapeake and Virginia Beach.
Enjoy the benefits of membership. These are connections to corporate partners who provide benefits to our members in return for advertising.
Currently, many prescriptions written by prescribers are initially rejected by pharmacies because insurance companies require a prior authorization primarily to help decrease costs. However, these are frustrating for patients, burdensome for providers, and are often unnecessary. Most of them are approved from 1-3 days later, but this results in a delay in treatment, which can be harmful in urgent situations. This just adds to the inefficiency, the burden, and the barriers that are the hallmark of our current healthcare system. Changing this to make it happen more efficiently would be difficult to implement but ultimately worth doing.
Continue reading "Prior Authorizations Should be Easier and More Efficient"
Philosophy of patient care, a blend of art and science.
(Continued from earlier post) Healthcare Providers should maintain a high index of suspicion for IMD. Immediately notify your local health department (LHD) of clinical findings or laboratory results of gram-negative diplococci or Neisseria meningitidis from a normally sterile site. Your LHD can coordinate sending specimens/isolates from newly identified cases to the Division of Consolidated Laboratory Services (DCLS) for serotyping. Ensure that all individuals who are high-risk for meningococcal disease are up-to-date on the MenACWY vaccine. Continue to encourage routine administration of the MenACWY vaccine in younger children and adolescents, as required for students enrolled in the 7th and 12th grades.
Increase in Invasive Group A Strep Infections
The Centers for Disease Control and Prevention (CDC) have noted an increase in invasive group A Streptococcus (iGAS) infections in children in the United States. Although the number of iGAS cases reported in children in Virginia is not above average for this time of year, we are observing increased activity in general. Group A Streptococcus bacteria can cause a range of illnesses; severe iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome and require immediate treatment, including appropriate antibiotic therapy.
VDH responds to reports of suspect iGAS infections by rapidly identifying close contacts for whom short-term antibiotics are recommended for prophylaxis, and urgently investigating clusters of GAS infections, especially in high-risk settings such as among residents of long-term care facilities and school aged children.
Please consider the following actions:
Consider iGAS as a possible cause of severe illness, including in children and adults with concomitant viral respiratory infections. Be mindful of potential alternative agents for treating confirmed GAS pharyngitis in children due to the shortage of amoxicillin suspension. Offer prompt vaccination against influenza and varicella to eligible persons. Educate patients, especially those at increased risk, on signs and symptoms of iGAS requiring urgent medical attention, especially necrotizing fasciitis, cellulitis and toxic shock syndrome. Notify your local health department (LHD) as soon as possible about severe iGAS cases affecting minors or clusters of any iGAS infections. All cases of Streptococcal disease, Group A, invasive or toxic shock should be reported within 3 days to VDH. Laboratories in Virginia are required to submit GAS isolates to DCLS when cultured from a normally sterile site.
Thank you for your attention and partnership.
Sincerely,
Laurie Forlano, DO, MPH
Acting State Epidemiologist and Director
Office of Epidemiology
Continue reading "Meningococcal Outbreak in Eastern Virginia -II"
VA_SealCOMMONWEALTH of VIRGINIA
Department of Health
Meningococcal Disease Outbreak Update, Invasive Group A Strep Infections
March 6, 2023
Dear Colleague:
I am writing to provide you with important updates on several emerging conditions of public health significance.
Meningococcal Disease Outbreak in Eastern Virginia
The Virginia Department of Health continues to respond to a community outbreak of meningococcal disease in the eastern region of Virginia. Twelve cases of invasive meningococcal disease (IMD) serogroup Y have been reported since June 2022 in eastern Virginia, a doubling of cases since VDH notified eastern region providers in September 2022. Most case-patients have presented with symptoms of IMD meningococcemia, including fever, chills, nausea, and vomiting. All isolates available for sequencing (9 out of 12) were genetically related and susceptible to ciprofloxacin and penicillin. VDH has not identified a common risk factor; we suspect the cases are connected by asymptomatic community transmission. Case-patients are all residents of Hampton Roads and most are Black or African American adults between 30-60 years of age. Eleven case-patients are unvaccinated for serogroup Y, and one is partially vaccinated. Three case-patients have died from complications associated with the disease, indicating this outbreak strain may have a higher case fatality rate (25% CFR) than is commonly observed in serogroup Y cases. This strain is believed to be circulating more widely, both in Virginia and other states.
VDH responds to reports of suspect meningococcal disease by rapidly identifying close contacts for whom short-term antibiotics are recommended for prophylaxis and recommending one dose of the meningococcal conjugate vaccine (MenACWY) to all outbreak-associated close contacts who are identified as high-risk for meningococcal disease.
(continued on the next post)
Continue reading "Meningococcal Outbreak in Eastern Virginia - I"
This thoughtful article by Daniel Stone, an internal Medicine physician in California says it all...
Continue reading "How has American Healthcare Gone So Wrong?"
US Department of Justice Drug Enforcement Administration Diversion Control Division
Lunch & Learn Web-Series: “Strengthening Our Partnerships”Stimulant Use in the United States & Reports of ShortagesThursday, March 16, 2023| 1:30PM EST WebEx Events Platform
The Washington Division of the Drug Enforcement Administration (DEA) is pleased to continue their Lunch and Learn Web-Series “Strengthening Our Partnerships”. Join us every month for these 30-minute LIVE sessions where DEA speakers and Special Guests present and review information, regulations and procedures related to the proper handling, dispensing, manufacture, distribution and prescribing of Controlled Substances to prevent diversion and help reduce drug overdoses and deaths in the District of Columbia, Maryland and Virginia (DMV).
Topic: Stimulant Use in the United States & Reports of Shortages
Moderator: Justin G. Wood, Diversion Program Manager, DEA Washington Division
Speaker: Matthew Strait, Deputy Assistant Administrator, Office of Diversion Control Regulatory, Diversion Control Division- DEA Headquarters
Registration is required. There is no registration fee, and capacity is limited to the first 1,000 attendees. This is a LIVE event and not recorded. This program is informational and not for credit.
Register for Thursday, March 16, 2023, using the link below.
Any questions regarding this event may be directed to the Diversion Outreach Coordinator via email to WashingtonDiversionOutreach@dea.gov.
Update!
Coastal Virginia Medical Society has connected with Professional Risk, a company that partners with multiple top-rated medical liability insurance carriers. They can provide a number of resources to our healthcare providers including but not limited to liability coverage for independent practices or large groups, cybersecurity, and human resources. Subscribe to their Blog (https://www.profrisk.com/blog) to stay updated on what they have available that may help or improve your practice. They may even be able to reduce your malpractice costs.
Dear Healthcare Professional:
As of December 29, 2022, and pursuant to Section 1262 of the Consolidated Appropriations Act of 2023, federal law no longer requires prescribers to obtain a DATA-Waiver or X-Waiver to prescribe medications, like buprenorphine, to treat patients with opioid use disorder. In response, the relevant boards within the Department of Health Professions will amend their regulations to remove any reference to the DATA-waiver. The Department of Medical Assistance Services (DMAS or Medicaid) will also be amending its regulations and provider manuals to remove requirements related to the DATA-waiver. In the meantime, because of the change in federal law, these relevant state regulations that require a DATA-waiver for the prescribing of buprenorphine for opioid use disorder will not be enforced. Accordingly, a prescriber who has a current license to practice and a Drug Enforcement Administration (DEA) registration authorizing the prescribing of Schedule III drugs may prescribe buprenorphine for the treatment of opioid use disorder or pain management. Medicaid fee-for service and Medicaid managed care organizations (MCOs) will update their pharmacy billing systems to allow appropriate prescriptions for buprenorphine to be dispensed without requiring prescribers to hold a DATA-Waiver. DMAS will also not enforce requirements that Preferred Office-Based Addiction Treatment (OBAT) providers hold a DATA-waiver.
The federal law created new training requirements for prescribers that will go into effect on June 21, 2023. The DEA and the Substance Abuse and Mental Health Services Administration (SAMHSA) have indicated they are actively working on guidance regarding the training requirements and will communicate information on the subject when available. Healthcare professionals are encouraged to consult SAMHSA and DEA sources for additional information.
Respectfully,
Nelson Smith
Commissioner, DBHDS Cheryl Roberts
Director, DMAS Arne Owens
Director, DHP
Business Plan for the Coastal Virginia Medical Society
Continue reading "Business Plan for the Coastal Virginia Medical Society"
Proposed new Bylaws for Coastal Virginia Medical Society for 2023
Prevent Verbal Abuse in the Workplace!
Delegate Rob Bell has introduced HB 1835, which will help protect all healthcare workers from verbal threats in their workplace. The bill has passed the House of Delegates, passed out of the Senate Judiciary Committee, and is now headed to the Senate floor!
Presently, Virginia only has increased protections for healthcare workers from threats of violence if they are working in a hospital or emergency room. Virginia’s current laws do not protect healthcare workers from threats of violence in doctor’s offices, urgent care centers, health clinics, pharmacies, or when treating patients in the field.
With threats against providers on the rise, these protections are necessary to strengthen Virginia’s workforce.
Tell your Senator that NOW is the time to protect ALL healthcare workers!
Protect All Providers from Threats!
Click the link below to email your Senator!
"The majority of doctors attributed their burnout to too many bureaucratic tasks, although more than one-third said it was because their co-workers treated them with a lack of respect."
Continue reading "1 in 4 Physicians Are Experiencing Depression"
Here is an email received from the Virginia Board of Medicine regarding two topics:
1. Treatment of Substance Abuse Disorder
2. Postpartum Depression in Women
"Dear Colleague:
You are receiving this email from the Virginia Board of Medicine to bring two important items to your attention.
The first is an action taken by the US Congress to enhance access to life-saving treatment for opioid use disorder. You can read the posting from the US Substance Abuse Mental Health Services Administration website and the Board's decision NOT to enforce a section of its regulations on the prescribing of buprenorphine.
Update on Substance Use Disorder
The second is an updated article on depression in women, with emphasis on perinatal depression.
I hope you find both of these items helpful to you in the care of your patients.
With kindest regards,
William L. Harp, MD
Executive Director
Virginia Board of Medicine"
This next article also mentioned in the above email was first published in the November 2020 Board Briefs. The core information is still applicable with these additional excerpts from a recent webinar by Anita H. Clayton, MD & Jennifer L. Payne, MD of UVA Psychiatry.
Perinatal Depression in Women
PLEASE BE ADVISED - we are cancelling the Lobby Day scheduled for February 13th. We apologize for the abrupt change. We will not be hosting additional lobby days during this short GA session.
Simply put, we have only a select few bills and budget items left on our agenda, and our focus is on fewer than 15 General Assembly members at this point in time. We have an enormous number of registrations for this lobby day, and it would be unproductive for both MSV member and policymaker time to setup dozens of meetings with legislators to whom we have no business in front of.
To reiterate, the February 13th Lobby Day is CANCELLED.
We thank you so much for your interest and support. If you have any questions, please contact me directly.
Best,
------------------------------
Andrew Densmore
Political Advocacy Manager
Medical Society of Virginia
Richmond, VA
804-377-1029
------------------------------
Medical Society of VirginiaPublic Health
Feb 6, 2023
HQI has developed sets of patient QR code resources for blood pressure and vaccination. These are intended to provide patients with quick access to information and resources and help in patient engagement. Information is available in English or Spanish. QR codes provide a way for patients to have access to information after they leave the office on their devices.
Click on the link below to get to the webpage where you can access this information and get the available QR codes. Pick what you think would be most beneficial to your patients and display them as you'd like (i.e. on handouts, in waiting rooms, in a binder to show patients, newsletters, etc.). Sample topics available include:
Blood Pressure
High Blood Pressure Calculator Tool
Controlling High Blood Pressure
The DASH Diet
Making the Most of Your AppointmentAnd More!
Vaccines
Find COVID Vaccines Near You
Find Flu Vaccines Near You
Flu or COVID 19?
Myths and Facts about COVID-19 Vaccines
And More!
More topics will be coming. What topics would be most beneficial to you and your practice?
------------------------------Amy SwierczewskiAssistant Director, MSVF ProgramsMedical Society of VirginiaRichmond VA804-377-1053------------------------------
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.
Things You Need to Know