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Medigram - October 23, 2008


TOP STORY

Follow-up: Society policy ETH-004 elicits feedback

As reported in last week’s Medigram, the Society’s Board of Directors passed an updated version of policy ETH-004: The Relationship of The Profession to the Health Product Industry at its October 11 meeting. Society staff have received mostly positive feedback and numerous media inquiries on the update, often with specific follow-up questions. Articles like this one from The Capital Times have been published statewide. The following Q&A reflects the most common inquiries and may serve as a useful guideline for members who have questions about the policy.

Q: Can physicians accept lunches for themselves or staff in the office? How about meals at informational meetings provided by the health products industry?

A: The Society’s policy creates a bright line on the issue of accepting gifts from those who provide health products prescribed by physicians. The prohibition against accepting any gifts, including meals and other gifts of food, eases the burden of compliance, prevents biased decision making and the avoids patient distrust. To comply with the Society’s policy, a physician who has previously allowed drug company representatives to provide food to the physician’s staff should instruct the drug company representatives to immediately discontinue the practice of providing any food or other items to the physician and/or his or her staff.

When physicians attend meetings where free meals such as breakfasts, lunches or dinners are provided by members of the health products industry, physicians are encouraged to either refuse the meal or to pay for the cost of the meal. When the physician writes a check for the cost of the meal, he or she might retain a copy of the cancelled check and a notation of the date, time and place of the event for his or her own records. Physicians who attend conferences and other meetings can address the issue of paying for meals in advance by contacting the conference or meeting sponsor before the date of the event.

Q: Does the Society intend to expel or sanction physicians who fail to comply with the policy on the acceptance of gifts?

A: The Wisconsin Medical Society develops policies through its House of Delegates and Board of Directors to shape and guide the decisions and actions of physicians, policymakers, legislators, the media and others. Policies such as ETH-004: The Relationship of the Profession to the Health Product Industry, are adopted after robust debate and careful deliberation. The Society believes that ETH-004 serves the best interests of medicine as well as the interests of patients. Therefore, the Society hopes that physicians will adopt it into their practices and encourage their colleagues to do so. The Society seeks to unite, rather than divide physicians, even on policies that may appear to be controversial. Therefore the Society has traditionally used its efforts to educate and encourage physicians to comply with Society policies rather than expel them. Although the Society’s Bylaws set forth certain circumstances in which expulsion is appropriate, a physician's failure to adhere to a particular Society policy has generally not served as the basis for expulsion.

Q: When does the policy take effect?

A: The Board of Directors acts on behalf of the policy-setting House of Delegates in between annual meetings. The new policy took effect on October 11, the day of the Board's action on ETH-004.

If you have further questions about the policy, contact Mark Grapentine, JD.

NEWS BRIEFS

FTC delays enforcement of Red Flag Rules until May 1, 2009

The October 9 issue of Medigram featured this article about the Federal Trade Commission (FTC) regulations known as “Red Flag Rules.” The regulations require creditors (including many physician’s offices and clinics) to implement identity theft detection policies, and enforcement was scheduled to begin November 1. However, the FTC announced yesterday that it will delay enforcement until May 1, 2009. Click here to read the FTC’s statement on the delay.


IPFCF lawsuit update scheduled November 20 in Pewaukee

A special meeting to update members and others about the Society’s lawsuit to restore the $200 million raided from the Injured Patients and Families Compensation Fund will be held at the Country Springs Hotel in Pewaukee Thursday, November 20 at 5:30 p.m.

The agenda will feature a video presentation about the suit, a legal and financial update, and key messages to assist you in talking to your patients, community members and local media, followed by a Q&A. The event begins with a social featuring hors d'oeuvres and a cash bar, followed by the presentation at 6:30 p.m. Please RSVP to communications@wismed.org by November 14, 2008 if you plan to attend. If you have questions, e-mail Kendi Parvin.


Society joins letter to Leavitt, requests more time for ICD-10 implementation

The Wisconsin Medical Society joined other health care organizations in a letter to Health and Human Services Secretary Michael Leavitt requesting more time for the implementation of ICD-10. The current implementation schedule requires all health care professionals to be in compliance with ICD-10 by October 1, 2011. The letter expresses concern that the combination of implementing the new ICD-10 codes—which have five times the number of current codes—with requirements related to HIPAA electronic transaction standards (5010 version) does not account for the time and resources needed to implement both new rules. A study conducted by Nachimson Associates released this month indicates that the cost to implement ICD-10 is much greater than originally anticipated and that a practice of three physicians and two staff members would be required to spend as much as $83,290 in the first year of implementation.

The letter seeks to delay ICD-10 implementation until 60 months after the medical world is at 95 percent readiness to implement the new 5010 rule standards.


Board on Aging offers free education

The State of Wisconsin Board on Aging is offering training sessions on Medicare Advantage Plans, Part C and D, and Senior Care. The sessions are scheduled in Rhinelander, Rice Lake, Madison, Waukesha and Milwaukee. The training is free and space is limited.

NEWSMAKERS

Mental health parity law holds promise for addicted patients

Free podcast features Society member

Society member Michael Miller, MD, of Madison, is featured in a series of weekly audio podcasts from the hardcover book, White Coat Wisdom, by Stephen J. Busalacchi. During the audio excerpt, Dr. Miller discusses the extraordinary cost of not treating addictions, which are rampant in the United States, and how stigma within American society and even with American medicine has prevented alcoholics and drug addicts from getting the help they need to recover. He also explains the effectiveness of addiction treatment when done appropriately over two years.

With federal mental health and addiction parity legislation just signed into law, tens of millions of patients who suffer from addiction and other mental health illnesses should benefit from improved insurance coverage. The law bars commercial health policies from discriminating on co-pays, benefit levels and hospital stays and outpatient visits with respect to psychiatric and addictive disorders, as most do now.

Doctor Miller is president of the American Society of Addiction Medicine and has served for almost 20 years as Medical Director of the NewStart Alcohol/Drug Treatment Program at Meriter Hospital. He is a Society delegate to the AMA House of Delegates and a past Society Board member. He has also served as President of the Dane County Medical Society.

The 23-minute podcast, which is available for free download at www.whitecoatwisdom.com, is part of a weekly program featuring excerpts from each of the 36 Wisconsin physicians profiled in the Dr. C. Everett Koop-endorsed White Coat Wisdom. Busalacchi, the author, served as public relations director for the Wisconsin Medical Society from 1997-2006.


Roberts first woman to be elected President of AACDP



Society member Laura Roberts, MD, MA, is the first woman to be elected president of the American Association of Chairs of Departments of Psychiatry (AACDP). She is currently chairman and Charles E. Kubly Professor of Psychiatry and Behavioral Medicine at The Medical College of Wisconsin. Doctor Roberts is also professor of population health in the Medical College's Center for the Study of Bioethics. A National Institutes of Health (NIH) Career Scientist, she has secured more than $10 million in competitive research funding for empirical studies examining ethical issues related to clinical care, research and public policy concerning vulnerable populations. She has also conducted evidence-based studies of medical student and physician health care, rural health, stigma and professionalism education.

QUALITY & EFFICIENCY

What physicians should know about the WHIO Data Mart

Development of the Wisconsin Health Information Organization’s (WHIO) Data Mart is on target for its initial launch in early December 2008. WHIO participating organizations will be trained on how to access the data mart and its data in December. Meanwhile, the following bullet points highlight core information about the Data Mart that every physician in Wisconsin should know.
  • The initial data mart is comprised of administrative claims information representing 1.9 million fully insured and self-funded lives who received health care services in Wisconsin.
  • The administrative claims data was submitted by five insurance companies including Anthem BCBS, UnitedHealthcare, Humana, WEA Trust and Wisconsin Physicians Service. Three additional data sources, including Medicaid are committed to feeding data into the data mart in 2009.
  • The data mart will hold 27 months of member eligibility information and claims data, ranging from January 2006 through March 2008. The data mart will be refreshed twice/year always maintaining a rolling 27 months of data.
Click here to read more.

CAPITOL INSIDER

Campaign Focus: Senate Districts 8 and 18

Medigram has been highlighting the most competitive races for State Senate elections this November. For a recap of the previous articles, click here.

The Eighth State Senate District stretches from the northern tip of the city of Milwaukee to the North and West, reaching parts of Ozaukee, Waukesha and Washington Counties. This district hosts what is perhaps the most talked-about Senate race this year, with incumbent Sen. Alberta Darling (R-River Hills) facing Assembly Rep. Sheldon Wasserman, MD, (D-Milwaukee). Both candidates have a wealth of health care policy experience, and both have been extremely good friends of the Society and medicine generally.

Sen. Darling has been in the State Senate since first elected in 1992 after spending a bit more than one term in the State Assembly. She is married to long-time Society member Bill Darling, MD, an otolaryngologist. She currently sits on the Joint Committee on Finance, the legislature’s bipartisan, bicameral budget-writing committee.

On her Web site, Darling details her past work on health care issues, and has called for improvements in access and affordability. “Wisconsin needs health care reform that gives people more control of their coverage, their dollars and their medical decisions,” the site says. “The focus of Senator Darling’s health care agenda is to reduce the cost of medical care, increase access to affordable coverage, and improve the quality of health care services.”

Rep. Wasserman, an OB-GYN, has been in the State Assembly since 1994, and a Society member since 1991. One of only two physicians in the State Legislature (both in the Assembly), Dr. Wasserman has been the health care “go-to” person for Assembly Democrats. As such, he has been the ranking member on the Assembly Health and Health Care Reform Committee. He is giving up his seat in the Assembly to run for the Senate.

On his Web site, Dr. Wasserman includes lowering the cost of pharmaceutical drugs as one of the issues he will tackle in the Senate. “Patients should be able to fill a prescription knowing that they can afford it,” the site says. “I introduced legislation that would lower drug costs by exempting pharmaceutical medications from Wisconsin’s minimum markup law.”

The race will also be one of the most expensive in the state, with both candidates purchasing major television time in the expensive Milwaukee market. You can view Dr. Wasserman’s ads here and here. Darling’s ads can be seen here and here. A joint appearance on WISN-TV’s UPFRONT with Mike Gousha can be seen here.

Senate District 18
Retirement of longtime Sen. Carol Roessler (R-Oshkosh) earlier this year created an open seat in the 18th Senate District, which stretches from the northern reaches of Oshkosh and curls along the western shore of Lake Winnebago, reaching south to Fond du Lac and parts of Waupun.

The contest has two well-spoken and energetic candidates: radio station-owner Randy Hopper (R-Fond du Lac) and Oshkosh Common Council Member and Attorney Jessica King (D-Oshkosh).

King’s Web site concentrates on her educational background, various media coverage of the race and endorsements. It does not delve into specific issues. Hopper’s Web site states that “[o]ne of the most pressing issues facing both families and employers is the rising cost of health care. Every family deserves access to affordable, quality health care.”

Democrats currently control the Senate on an 18-15 margin and see this open seat as an opportunity to win a district that has been in the other party’s column for many years. Since Roessler was first elected to the Senate in 1987, the district has moved from solid Republican to closer to leans Republican, as highlighted in 2006 with the election of Oshkosh Democrat Gordon Hintz to the State Assembly.

For more information on these or other state legislative races, contact Mark Grapentine, JD, Jeremy Levin or Beth Alvin.

FOUNDATION FOCUS

IV League Supports Fellowships


Jessica Hawley (top right) with other members of a focus group planning committee exploring infant mortality among African Americans

As a significant step toward increasing its support for medical and health education, the Wisconsin Medical Society Foundation offered 10 Summer Fellowships in Government and Community Service to medical students in 2008. Fellowship recipient Jessica Hawley, a student at the UW School of Medicine & Public Health (UWSMPH), spent her summer working with a Madison and Dane County Public Health team under the guidance of her mentor, Thomas Schlenker, MD, MPH. Hawley joined the team as they began the initial stage of a three-year retrospective study to investigate why Dane County’s African American infant mortality rate has decreased significantly in the last decade. She reviewed reports on infant mortality rates from other counties around the nation to confirm that Dane County’s decrease is unprecedented and began working with a focus group of African American women to identify why the decrease has occurred.

“It was an experience that has helped me further define my career goals,” Hawley said. “I will continue to work on this project throughout my tenure at UWSMPH.”

The value of fellowship experiences like Hawley’s cannot be overstated. They can play a significant role in shaping the student’s career direction and, at the same time, provide valuable research or programs in communities around the state.

To continue to offer these fellowship opportunities, the Foundation needs your support and is launching a new group of donors—the IV League. The current focus of the IV League is to guarantee that the Foundation can continue to offer 10 Summer Fellowships in Government and Community Service to medical students each year.

With a gift of $1,000 or more, you can become a member of the IV League and enable the Foundation to continue offering opportunities to students like Hawley. IV League members will receive special recognition and will enjoy special opportunities that bring them closer to the fellowships supported. In 2009, the impact of your gift will extend well beyond the education that medical student recipients receive from our fellowships—you will also impact communities, individual patients and the physician mentors who provide guidance.

For more information on how you can become an IV League member, contact Melissa Breen at 866.442.3800. To view the Foundation Focus Fall 2008 newsletter with a special section on medical education click here.

QUALITY CORNER

AHRQ’s 2008 Guide to Clinical Preventive Services now available

The Agency for Healthcare Research and Quality has released the Guide to Clinical Preventive Services 2008, which highlights recommendations from the U.S. Preventive Services Task Force. The guide contains evidence-based recommendations that have been adapted for a pocket-size book, making it easier for clinicians to consult the recommendations in their daily practice. To download a copy of the guide, click here. A print copy of the guide is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.

FAQ

Question:
What is WisconsinPhysicianCareers.org?

Answer:
www.wisconsincareers.org is a new Web site exclusive to Wisconsin that lists only physician career opportunities. Sponsored by the Wisconsin Council on Medical Education and Workforce (WCMEW) and launched earlier this month, the site now lists more than 600 physician openings listed by more than 53 health care organizations.

WCMEW’s members include the Wisconsin Medical Society, the Wisconsin Hospital Association, the University of Wisconsin School of Medicine and Public Health, the Medical College of Wisconsin, the Rural Wisconsin Health Cooperative, and the Wisconsin Academy of Physician Assistants.

If you have questions or would like more information about the site, contact Kendi Parvin.