- Study finds 20 percent of global deaths linked to high blood pressure
- Large insurers drop barriers to prescribing medications for opioid use disorder
- Registration now open for 2017 Western Health Care Leadership Academy
- U.S. District Court blocks Anthem-Cigna merger
- ACIP issues updated immunization schedules for children, adolescents and adults
- Survey finds Americans unaware of important heart health numbers
- Q2 resolutions now open for testimony
- CMA shares tools and resources on diabetes prevention
- Have an opinion? CMA wants to share your story
Important Dates & Deadlines
- 2/22/17: Webinar: Paying Employees Correctly: Wage and Hour Laws for Health Care Employers
- 2/28/17: Medicare EHR payment adjustment reconsideration deadline
- 2/28/17: STLRP Applications Due
- 3/5/17: CURES 1.0 Taken Offline
- 3/13/17: PQRS EHR reporting deadline
- 3/13/17: 2016 meaningful use attestation deadline
- 3/13/17: Deadline to Submit Q2 Testimony
- 4/18/17: CMA's 43rd Annual Legislative Advocacy Day
Dr. Leonard Glass launched an online curriculum to help retrain medical specialists in adult outpatient primary care. (Photo by Rebecca Ostrander, Wall Street Journal.)
#CMAdocs: Leonard Glass, M.D.
Being a primary care doctor is medicine at its finest, but many doctors lose sight of that purpose after practicing a specialty for decades. We help doctors get back to the root of why they went to medical school in the first place: to take care of people." Read More
Featured member benefit:
IMQ Online CME: The Institute for Medical Quality (IMQ) offers online continuing medical education (CME) through its IMQ Online Education portal. IMQ Online Education offers physicians a growing selection of courses, including many needed to maintain licensure, accessible at any time and from any internet-enabled device. Members receive discounted rates on the entire catalog of online CME. Read More
(Photo courtesy of Lauren Silverman/KERA)
Quotable: According to the AMA, today there are about 280,000 international medical graduates in the U.S. That's about 1 in 4 doctors practicing here. Some are U.S. citizens who've gone abroad for medical school, but most aren't. Read More
Physicians in the News
- Trump Travel Ban Spotlights U.S. Dependence On Foreign-Born Doctors
California Healthline - 2/16/17
- Influence Of GOP Doctors Caucus Grows As Congress Looks To Replace Health Law
Kaiser Health News - 2/15/17
- A Look Into An ACA-Created Teaching Health Center
Capital Public Radio - 2/15/17
- ‘Who treats you matters’: Some ER doctors three times more likely than others to prescribe opioids
Stat - 2/15/17
- Will They Or Won't They? Physician Participation In End Of Life Option Act
Capital Public Radio - 2/8/17
1. Trump's "travel ban" would impact thousands of physicians and medical students
One week after taking office, President Donald Trump issued an executive order barring Syrian refugees from the United States indefinitely and banning the entry of visa-holders from six other Muslim-majority countries. Although federal courts have since taken action to block implementation of the order, as of February 21 the Trump Administration had indicated a revised executive order in the near future, perhaps as early as this week.
The California Medical Association (CMA), is urging the Trump Administration to focus on solutions that preserve patient access to care, alleviate our nation’s physician shortage and support health care workforce diversity.
The ban would have included physicians, medical students and other skilled professionals who contribute to the American workforce. Although this executive order was framed as a national security measure, when a quarter of practicing physicians in the U.S. are foreign-born or educated and more than 10,000 come from the seven affected countries, this overly-broad ban could have had harmful effects on the health and welfare of Americans across the nation.
“The Hippocratic Oath demands that physicians ‘first, do no harm,’ but this ban would have indeed been harmful,” said California Medical Association (CMA) President Ruth Haskins, M.D. “Medical staff, students and physicians are focused on saving lives and heralding medical advancements. We applaud the court for recognizing that it would have been unreasonable to disrupt their studies or care for patients in their attempts to achieve the American Dream.”
The executive order was introduced at a time when the country is already facing a growing physician shortage. The U.S. is projected to have 95,000 fewer physicians than the country needs by 2025. U.S. training hospitals posted 27,860 job listings for new medical graduates last year alone, but American medical schools only produced 18,668 graduates.
International medical graduates help offset our nation’s physician shortage, and the President’s ban could have further exacerbated that shortage – putting over 750,000 American patients at risk. President Trump’s executive order could have also disrupted thousands of medical students and graduates from foreign medical programs from being matched with U.S. residency programs in March 2017, which could have created serious staffing problems in major U.S. hospitals.
In California, much like the rest of the nation, international physicians are crucial to providing quality care to underserved populations. International medical students come from diverse cultural backgrounds and often speak multiple languages. In Los Angeles alone, over 185 languages are spoken and more than 50 percent of Los Angeles residents speak a language other than English in the home.
“There is no doubt that a robust and well-trained workforce is essential to meeting the health care demands for all Californians – we can’t afford to ban qualified physicians who already adhere to rigorous U.S. legal and medical licensing requirements,” said Dr. Haskins. “CMA will continue to support international medical students and residents and their families.”
2. Study finds 20 percent of global deaths linked to high blood pressure
The number of people in the world with high blood pressure has doubled in the past two decades, putting billions at increased risk for heart disease, stroke and kidney disease, according to a study published in the Journal of the American Medical Association (JAMA).
Individuals with systolic blood pressures above 110 mm Hg grew worldwide from 73,119 for every 100,000 people in 1990 to 81,373 per 100,000 in 2015. At the same time, it also became more common for people to have systolic blood pressures over 140 mm Hg (17,307 for every 100,000 people in 1990 versus 20,526 in 2015).
Deaths are on the rise too, with over 19 percent of all deaths worldwide in 2015 linked to high blood pressure. Deaths from high blood pressure grew by an average of 1.6 percent per year between 1990 and 2015.
The researchers noted that the burden of high blood pressure remains high despite the availability of preventive interventions and low-cost, effective antihypertensive medications.
Closer to home, the number of Americans diagnosed with high blood pressure is cause for concern as America observes American Heart Month. According to the Centers for Disease Control and Prevention (CDC), 29 percent of Americans have high blood pressure. The CDC’s numbers translate into 75 million Americans with the condition – and show that only slightly more than half (54 percent) have it under control.
“This finding is concerning because we know that high blood pressure and heart attacks or chronic heart failure are so closely related,” said John Meigs, Jr., M.D., president of the American Association of Family Physicians. “According to the CDC, seven out of 10 people who have a first heart attack have high blood pressure. Seven out of 10 people who develop chronic heart failure have high blood pressure. So it’s important that people know what their blood pressure is and work with their family physician to treat it.”
On a more positive note, the CDC notes that more people – especially those over the age of 60 – are aware of and being treated for the condition. Still, CDC data shows that one in five don’t know they have the condition. Dr. Meigs recommends observing American Heart Month by taking steps to prevent heart disease.
“Get your blood pressure checked. If you have high blood pressure, work with your doctor to treat it and lower your risk factors,” he says. “That same advice applies to knowing what your blood cholesterol levels are. You can work with your family physician to prevent or reduce the risk factors that lead to heart disease. Learn about heart health and what you can do in your everyday life to stay healthy.”
For more Heart Month coverage from the California Medical Association, follow @cmaphysicians on Twitter and Facebook, and don't forget to check out the "Heart Health" keyword here on our website for the latest updates.
Three of the nation's largest insurers—Aetna, Cigna, and Anthem Blue Cross—have in recent months announced that they will no longer require physicians to seek prior approval before prescribing medication to treat opioid use disorder.
These policy changes come as more than 2.2 million people meet the diagnostic criteria for an opioid use disorder. Treatment of opioid use disorder with opioid maintenance therapies has been shown to be cost-effective, safe and successful when used appropriately.
Increasing access to treatment is crucial to addressing opioid misuse and overdose, and the California Medical Association urges all insurers to make patient care a priority over administrative hurdles. Prior authorization often has a negative impact on patient care when there is a delay or interruption in ongoing treatment due to a health plan utilization authorization.
According to the American Medical Association, 75 percent of surveyed physicians described prior authorization burdens as high or extremely high. More than a third of physicians reported having staff that work exclusively on prior authorization.
Nearly 60 percent of physicians reported that their practices wait, on average, at least one business day for prior authorization decisions, and more than 25 percent of physicians said they wait three business days or longer.
Contact: Samantha Pellon, (916) 551-2887 or firstname.lastname@example.org.
The California Medical Association, along with our national presenting sponsor, The Physicians Foundation, is pleased to announce that we are now accepting registrations for the 2017 Western Health Care Leadership Academy. This outstanding event—ideal for physicians, nurses, medical practice managers, hospital chiefs of staff, medical and specialty society officers and executives, and more—will take place May 5-7 at the Marriott Marquis San Diego Marina.
Register today with the VIP Upgrade and enjoy special benefits, including express conference check-in, preferred seating, and "up close and personal" experiences with select keynote speakers, where you will have the chance to ask questions face-to-face in an exclusive setting.
The 2017 Western Health Care Leadership Academy continues its mission of providing information and tools needed to succeed in today’s rapidly changing health care environment. Attendees will hear from the experts and leaders of change. The conference will examine the most significant challenges facing health care today and present proven models and innovative approaches to transform your organization’s care delivery and business practices.
For more information and to register, visit www.westernleadershipacademy.com.
A federal judge has blocked the $48 billion mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). The ruling favored the U.S. Department of Justice (DOJ) and 11 states, including California, who argued that the Anthem-Cigna merger would limit price competition and lower the quality of care that Americans receive.
“The California Medical Association (CMA) has opposed the Anthem-Cigna mega-merger since day one because it would hurt patients and increase health care costs,” said CMA President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract with fewer physicians, resulting in patients facing higher premiums and longer wait times for referrals – not to mention forcing many patients to pay out-of-pocket to see out-of-network doctors.”
Seventy-one percent of the nation’s metropolitan areas already lack competitive commercial health insurance markets. A merger between Anthem and Cigna would have further diminished competition in 121 metro areas throughout the 14 states where Anthem is licensed to provide commercial coverage.
“We are pleased that Judge Berman Jackson ruled in favor of providing patients with the affordable, quality care they deserve,” said Dr. Haskins. “Maintaining competition in California’s health insurance markets is essential – it gives patients more choice in managing their health care while keeping costs low.”
Last month, another federal court blocked Aetna Inc.’s proposed merger with Humana on the grounds that it violated anti-trust law. CMA, which represents 43,000 physicians across all modes of practice, also opposed this $34 billion mega-merger, which would have disproportionately affected the accessibility and affordability of health care for millions of vulnerable seniors.
In March 2016, a CMA-backed survey of California physicians revealed that an overwhelming 85 percent opposed the Anthem-Cigna merger and 83 percent opposed the Aetna-Humana merger. Out of the 989 physicians surveyed from practices across the state, the majority expressed worries that health insurer consolidations could narrow physician networks (82 percent), force physicians to provide fewer services (90 percent) and pressure physicians into refraining from aggressive patient advocacy (75 percent).
On February 1, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) published updated immunization schedules for children, adolescents and adults.
The 2017 child and adolescent immunization schedule includes several updates including influenza, human papillomavirus (HPV), hepatitis B, Haemophilus influenzae type B (Hib), pneumococcal, meningococcal and diphtheria and tetanus toxoids and acellular pertussis vaccines (DTap).
Changes to the 2017 adult immunization schedule include new or revised recommendations for influenza, human papillomavirus, hepatitis B, and meningococcal vaccines.
This Heart Month, a new survey shows that few Americans know their numbers when it comes to basic risk factors for cardiovascular disease like blood pressure or cholesterol levels.
For the study, conducted by the Cleveland Clinic, researchers contacted a representative sample of 1,002 adults by phone in September 2016. The survey found that while most people know the numbers that are key to their financial wellbeing, they do not know the numbers that are key to their heart health. Nearly half (46 percent) knew their bank account balance, while only 18 percent could state their body mass index (BMI) and only 38 percent knew their blood pressure.
What Americans know (and don’t know) about blood pressure is surprising. A majority knew that uncontrolled high blood pressure could lead to a heart attack (75 percent), stroke (74 percent), heart failure (62 percent) and death (60 percent). However, fewer were aware that uncontrolled high blood pressure can also cause aneurisms (45 percent). Only four in 10 (40 percent) Americans understood that a normal blood pressure reading is less than 120 (systolic) and 80 (diastolic).
“Studies have suggested the majority of coronary artery disease events can be prevented by addressing treatable risk factors,” said Steve Nissen, M.D., chairman of cardiovascular medicine at the Cleveland Clinic in Ohio. “That means a little knowledge regarding risk factors and ‘numbers’ could go a long way to a healthy heart and avoiding future problems.”
Researchers also found that people were confused about how cholesterol levels influence the risk of heart disease. Only 12 percent of them knew screening for cholesterol should start in early adulthood, and most people incorrectly identified triglycerides as cholesterol when they are a type of fat in the blood.
Other survey findings:
- Only one-third (34 percent) of Americans knew that fat in the stomach region (an “apple-shaped body”) is most dangerous for heart health. In addition, only 36 percent knew their waist circumference was an important factor in determining heart disease risk.
- The survey also revealed that many Americans want to use supplements to enhance their heart health, even though there is little evidence that supplements do any good. Nearly seven in 10 (67 percent) Americans surveyed say they have taken one or more type of supplements regularly to enhance their heart health. The most commonly taken supplements are multivitamins (46 percent).
- Many Americans don’t understand the strong connection between diabetes and heart disease. Most respondents (73 percent) didn’t realize the leading cause of death for people with diabetes is heart disease. The most popular response (35 percent) was kidney disease/failure.
To read the survey, click here.
As part of its policy-making process, the California Medical Association (CMA) allows members to submit resolutions for debate and discussion throughout the year. These resolutions will be considered by the standing Councils and Subcommittees, and will be presented to the Board of Trustees for consideration to be adopted as policy for the association.
There are now nine new resolutions online for consideration in the second quarter of 2017. They are posted at www.cmanet.org/hod and will be available for testimony until March 13, 2017.
After testimony closes, the resolutions and all the testimony will be forwarded to the appropriate CMA council or subcommittee for consideration. Member testimony and feedback will be considered by the councils and subcommittees as they make policy recommendations to the Board of Trustees. The trustees will then take action on the recommendations at their next meeting, in the second quarter of 2017.
Please click here to access the discussion portal for year-round resolutions. You will need to log-in with your CMA web account. Before providing testimony, please take a moment to read any background materials and/or analyses, which can be found in the upper right corner of each resolution page.
Resolutions to be considered in Q2 include:
- 102-17: Improving Implementation of Legalized Cannabis
- 103-17: Medically Supervised Injection Facilities as Harm Reduction to Address Opioid Crisis
- 104-17: Simplifying When Physicians Must Access the Cures Database
- 206-17: Restoring CMA Support for the Non-Contracted Independent Physician
- 207-17: Saving Private Practice
- 208-17: Medical Scribe to Help Physicians
- 304-17: CMA Annual Financial and Membership Report
- 305-17: Specialty Delegation Administration and Composition
- 601-17: Interstate Medical Licensure Compact and Uniform Application for State Licensure
How to submit a resolution
If you are interested in submitting a resolution for consideration in the third quarter of 2017, the submission deadline is April 22, 2017. You are encouraged, however, to submit to email@example.com well in advance of the deadline to ensure that your policy idea is considered promptly.
Please read the guidelines before submitting a resolution. Resolutions that do not follow the guidelines will be rejected.
Contact: CMA member service center, (800) 786-4262 or firstname.lastname@example.org.
The California Medical Association (CMA) has developed a resource page to share tools and resources on diabetes prevention and to help providers connect their patients with diabetes prevention programs recognized by the Centers for Disease Control and Prevention (CDC).
CMA’s resource page shares information on the AMA’s Prevent Diabetes STAT toolkit, which providers and care teams can use to identify patients with prediabetes and refer eligible patients to evidence-based diabetes prevention programs approved by the CDC’s National Diabetes Prevention Program.
CMA will continue to update this page, highlighting existing programs and other information of assistance to members. You may visit the diabetes prevention resource page at www.cmanet.org/diabetesprevention.
The California Medical Association (CMA) Center for Strategic Communications is currently working on earned media and op-ed placements on a number of issues of critical importance to the physicians of California:
- Governor Brown's appropriation of Proposition 56 tobacco tax funds
- Graduate medical education funding cuts in the state budget
- The future of the Deferred Action for Childhood Arrivals (DACA/Dreamers) program, particularly with respect to the physician workforce
- President Trump's travel ban and its impact on health care
- Health equity (as it relates to access to care, cultural competency in the physician workforce and health disparities)
- Issues surrounding aging and end-of-life care
If you have a passion for or personal experience with any of these topics and would like to share your story, please contact CMA's Vice President of Communications, Laura Braden Quigley, at email@example.com.
IMQ Online CME: The California Medical Association’s Institute for Medical Quality (IMQ) offers online continuing medical education (CME) through its IMQ Online Education portal. The IMQ Online Education portal provides physicians with a diverse selection of CME courses, including many needed to maintain licensure. These courses are accessible on-demand at any time and from any internet-enabled device. Members receive discounted rates on the entire catalog of online CME.
IMQ Online Education offers courses in a variety of formats, lengths and credit levels, organized by subject category for easy browsing. The system is convenient: start a course and complete it later or return to review it again at a later date. Credits are issued immediately upon successful completion of each course, eliminating the need to wait. The online system also offers easy and convenient tracking of course participation and credit.
To browse the IMQ Online Education catalog, visit http://imq.inreachce.com.
Contact: CMA member help center, (800) 786-4262 or firstname.lastname@example.org.