WAFP December 2019 Newsletter

Organizational Health

2020 ASA to Host Poster Competition

WAFP Foundation Streamlines Application Process for Awards

Family Medicine Advocacy Day Registration is Open

Submit your Nomination for Family Physician, FM Educator of the Year Awards Today!

Registration for Student & Resident Retreat Now Open

Members in the News

Advocacy

Rural Health, Workforce, Hospital Discharges and Vaping Discussed During Committee Days

King Introduces Senate Version of Primary Care Patient Protection Act

Health of the Public

Health in a Changing Climate Conference to be Held Dec. 7

2019-2020 Flu Season: Low Activity but On the Rise

DOH Bans Vaping Products Containing Vitamin E Acetate

Washington is the Latest to be Selected for CDC Program on Food Safety

Life Expectancy in the U.S. Falls for the Third Straight Year

Studies: Rural Residents Have Higher Pediatric Mortality Rate, Die More Frequently from Preventable Causes

Embracing Learners

AAFP Offering Two-Day Livestream for Rural Providers

Parental Leave in FM Residencies Varies Widely

Study Looks at Keys to Success for Rural Preceptors

Practice Enhancement

UW Psychiatric Consultation Line to Go to 24 Hours

MIPS Virtual Groups Deadline is Dec. 31

Should Fewer FPs Providing Hospital Care Cause Concern?

 

2020 ASA to Host Poster Competition

The WAFP will hold a poster competition for residents and students during the 2020 Annual Scientific Assembly. The competition aims to stimulate scholarship by medical students and family medicine residents at a venue designed for sharing innovative and effective educational programs. It also hopes to support conversations and networking among medical students, residents and WAFP community members. The four categories of submission are: research; case study or case series; quality improvement project; and educational program.

Winners of the poster competition will present their findings during a workshop at the ASA. ASA registrants attending the poster competition workshop will receive CME credit just as they would with other ASA workshops.

The 2020 Annual Scientific Assembly will be held May 8-9, 2020 at the Semiahmoo Resort in Blaine.

The last day for poster submissions is Jan. 15, 2020. For more information, please contact Simoné Mansor, director of engagement at simone@wafp.net.

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WAFP Foundation Streamlines Application Process for Awards

WAFP members who are interested in applying for awards from the WAFP Foundation now have a centralized location to do so.

The online form accepts submissions for the following:

  • Alfred O. Berg, MD, Award for Excellence in Family Medicine Research Scholarship (open to fourth-year medical students)
  • Diverse Constituencies Awards (open to first-year medical students)
  • Roy Virak Memorial Family Medicine Resident Scholarship (open to second-year residents)
  • Family Medicine Advocacy Summit travel award (open to one resident and one medical student; event is May 18-19, 2020, in Washington, DC)
  • National Conference of Constituency Leaders travel award (open to three second- or third-year residents; event is April 23-25, 2020, in Kansas City, MO)
  • Accountable Communities of Health participation stipends (open to practicing physicians)
  • Vision 2020 leadership development award (open to practicing physicians)

Some awards require the submission of a personal statement and/or letter of recommendation. Those documents, along with any questions, may be emailed to wafpfoundationawards@wafp.net.

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Family Medicine Advocacy Day Registration is Open

WAFP members may now register for Family Medicine Advocacy Day (formerly known as the Policy Advocacy Leadership Institute, or PALI) to be held Monday, Jan. 27, 2020, in Olympia.

The day typically begins with attendees in group discussions with elected officials and policy makers from the legislative and executive branches, as well as other speakers. WAFP priority issues will be also be discussed, and a light breakfast will be served. After an offsite lunch, attendees disperse to meetings with their legislators.

Register via WAFP’s website. Registrations must be received by Jan. 17, 2020.

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Submit your Nomination for Family Physician, FM Educator of the Year Awards Today!

The WAFP is now accepting nominations for the 2020 Family Physician of the Year (FPOY) and 2020 Family Medicine Educator of the Year (FMEOY). Both awards will be presented at the 2020 WAFP Annual Meeting at Semiahmoo Resort in Blaine on May 8.

Family Medicine Educator of the Year

Nominations for FMEOY are due Jan. 31, 2020. The WAFP Foundation Board of Directors selects the recipient, and considers the following in its deliberations:

  • Nominees’ recognition for exemplary teaching skills and outstanding progression of abilities over several years by medical students, residents, or peers; or
  • Nominees’ development and implementation of innovative curriculum, teaching model(s) or program(s) in a variety of educational spheres; and
  • Nominees’ membership in WAFP (nominees must be members to be considered).

All candidates must be either a full-time or part-time family physician who hold a regular faculty appointment, and teach and practice exclusively in an academic setting. Candidates may also be a volunteer family physician who do not practice in an academic setting but engage in volunteer teaching activities.

Nominations must include a 2020 nomination form; a copy of the nominee’s current curriculum vitae; and between three and five letters of recommendation. At least two of the letters of recommendation must be submitted from individuals who are current or former students/residents who have been taught by the nominee. Nominations should be emailed to info@wafp.net.

Family Physician of the Year

The Family Physician of the Year Award honors a physician who exemplifies, in the tradition of family medicine, a compassionate commitment to improving the health and well-being of people and communities throughout Washington.

Any WAFP member in good standing, with a few exceptions, is eligible for the award; current members of the WAFP Board of Directors and previous FPOY winners are not eligible. Previous nominees, if they have not won the award, are eligible. Likewise, any current WAFP member is welcome to submit a nomination.

Nominations for FPOY are due Jan. 31, 2020.

Nominees should exemplify the ideals of family medicine, including providing comprehensive, compassionate services on a continuing basis to his/her community, and possessing personal qualities that make him/her a role model to professional colleagues.

Nominations must include a 2020 nomination form; a current curriculum vitae; a head-and-shoulders photo of the nominee; and up to eight pages of supporting letters or documentation. Letters can come from colleagues or patients.

Nominations should be emailed to info@wafp.net.

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Registration for Student & Resident Retreat Now Open

Medical students and residents may now register for the 2020 Student and Resident Retreat, to be held Jan. 25-26 at the Hotel RL in Olympia.

Registration fees include materials and meals. When registering, please have your AAFP ID number handy; you’ll need it to register. If you’re not sure what it is, you can look it up here.

Attendees are encouraged to stay for Family Medicine Advocacy Day, which will take place on Monday, Jan. 27. Registration is also open for that event.

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Members in the News

  • Steven Alexander, MD, was the subject of a letter to the editor in the Lynden Tribune. The letter, from Gary Hall and Don Kok, the board chair and vice chair of the Christian Health Care Center in Lynden, wrote to congratulate Alexander on his 38 years of service as CHCC’s medical director. “For all of those years of service, dedication and caring for our family, friends and neighbors at CHCC, we are so grateful,” Hall and Kok wrote. “…Please join us in thanking Dr. Alexander and the entire team at Lynden Family Medicine for all they have done for Christian Health Care Center over the decades.”
  • Sara Cate, MD, was the featured speaker in a recent event in Yakima hosted by the League of Women Voters. Cate spoke about health and environmental effects of climate change. In the 1990s, she was the lead author of a study on a feasibility study of the health effects at the Hanford Site. For most of the past three decades, she has worked with underserved populations in Yakima and Ellensburg.
  • Juliette Erickson, MD, and her former office manager, Jan Dahl, formed a charity to help cancer patients in Grays Harbor County who are in dire financial straits. Earlier this month, that charity, Cancer Alliance of Grays Harbor, was awarded more than $16,000 by Harbor Women Who Care. Cancer Alliance began in 2008, but typically chose to remain anonymous. ““We took a leap of faith to unmask our ‘ninja charity’ and were overwhelmed by the enormous support we received from the event,” Erickson told The Daily World of Aberdeen. “With the donations we received, we will be able to support so many in need.”
  • Rachel Wood, MD, MPH, FAAFP (pictured above), retired from her position as health officer of Thurston County. The Olympian – which also ran public health columns from Wood – covered her retirement ceremony, which featured several WAFP members. “I think people are really going to miss Dr. Wood because she is so full of compassion and kindness, and that really shows up in her work as Health Officer in this community,” Public Health and Social Services Director Schelli Slaughter said, according to the newspaper. Wood will remain as Lewis County’s health officer, a position she has held since 2007.

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Rural Health, Workforce, Hospital Discharges and Vaping Discussed During Committee Days

Committees in the state legislature heard updates throughout November during what are colloquially known as “committee days”. Each Senate and House committee, as well as joint committees, met between Nov. 12 and Nov. 22. The health committees in each chamber were included.

Among other topics, the House Health Care & Wellness Committee heard presentations on rural health financing, workforce development and the Bree Collaborative:

  • Representatives from the Washington State Health Care Authority presented on rural health financing, most notably discussing a shift away from an annual reconciliation process used to ensure rural health clinics received their unique encounter rates. The new process disburses encounter rates through managed care organizations, cutting HCA out of the process – thereby eliminating the need for reconciliation.
  • Representatives from the Washington Workforce Training & Education Coordinating Board, as well as the University of Washington’s Center for Health Workforce Studies, presented information on health care workforce trends. Among community health centers, physician openings were cited as the most difficult to fill; rural recruitment remains difficult, as do the challenges posed by privileging/credentialing – a problem that also prevents hiring locums physicians to fill the gaps. The state overall needs more primary care providers, including physicians, as well as obstetrics providers, especially in rural areas.
  • Ginny Weir, MPH, and Amy Etzel from the Bree Collaborative presented an update on the group’s current areas of focus. Among the recommendations now being finalized: long-term opioid prescribing management; risk of violence toward others; palliative care; bundling prenatal, labor and delivery, and postpartum care into a single payment; and shared decision-making.

In the Senate, that chamber’s Health and Long-Term Care Committee received updates as well.

  • Bea Rector of the Washington State Department of Social & Health Services was one of several presenters on the topic of barriers to hospital discharge. She said that between July 1 and Oct. 30, 2019, 430 hospital patients across the state no longer met the threshold for medical necessity. Of those, 173 – or 40 percent – were still awaiting discharge. (All but two of the rest had been discharged.) Of the 173, nearly half were between 61 and 80 years old. The reasons a patient was not able to be discharged was because their previous situation was unsustainable (i.e., homelessness), because the patient had dementia or other causes for inappropriate or aggressive behavior, or because the patient was medically complex.
  • Kathy Lofy, MD, the state’s chief health officer, updated the committee on the Washington State Department of Health’s investigation into vaping-association lung injury. As of mid-November, 15 cases have been identified in the state, mostly around Puget Sound but in Spokane County also. Lofy also reviewed the executive action by Gov. Jay Inslee that sharply regulated vaping products and the proposed legislation that would further regulate vaping products.

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King Introduces Senate Version of Primary Care Patient Protection Act

Sen. Angus King (I-ME) has introduced legislation to modify requirements for high-deductible health plans to require no deductibles for the first two visits each year to a person’s designated primary care provider.

Sen. Thomas Carper (D-DE) is the lone cosponsor.

The bill is a companion to a House measure introduced by Reps. Brad Schneider (D-IL) and Elise Stefanik (R-NY). The House bill is currently under consideration by the House Ways & Means Committee.

“The American Academy of Family Physicians welcomes this legislation and we look forward to working with the Senate to support its passage,” AAFP President Gary LeRoy, MD, FAAFP, said in a statement. “By allowing two no-cost primary care visits each year for Americans with high-deductible health plans, the Primary Care Patient Protection Act helps ensure patients will get the care they need before they develop a condition that requires intensive, more costly attention.”

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Health in a Changing Climate Conference to be Held Dec. 7

Virginia Mason Medical Center in Seattle will host a conference, Health in a Changing Climate: Understanding Impacts and Opportunities for Action, on Saturday, Dec. 7, beginning at 9 a.m.

Gov. Jay Inslee has been invited to speak. Other confirmed speakers include Gary Kaplan, MD, chairman and CEO of Virginia Mason Health System; Jeremy Hess, MD, MPH, director of the University of Washington’s Center for Health and the Global Environment; and Jeff Duchin, MD, health officer for Public Health – Seattle & King County.

Registration is available online. The fee is $30 for general registration or $95 for the accredited program to earn CME credits.

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2019-2020 Flu Season: Low Activity but On the Rise

In its most recent report as of mid-November, the Washington State Department of Health reports low but increasing flu activity across the state.

One person – a patient in Franklin County older than 65 – has died.

Nationally, Puerto Rico and seven states – predominantly in the Deep South – report high flu activity, according to the Centers for Disease Control and Prevention.

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DOH Bans Vaping Products Containing Vitamin E Acetate

Expanding its emergency rule, the Washington State Department of Health has banned all vaping products containing vitamin E acetate, which has been a key component in vaping-related lung illness.

DOH, at the request of Gov. Jay Inslee, had banned flavored vaping products in late September.

“We are deeply concerned by a new [Centers for Disease Control and Prevention] study finding vitamin E acetate at the primary site of injury in patients’ lungs,” Secretary of Health John Wiesman, DrPH, MPH, said in a press release. “While we still need more research to identify a definitive cause, the evidence we have linking vitamin E acetate to the outbreak demands immediate action to protect the public’s health. Furthermore, we are very aware there may be more than one cause for these lung injuries associated with vaping.”

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Washington is the Latest to be Selected for CDC Program on Food Safety

A partnership between the Washington State Department of Health and the University of Washington has been chosen by the Centers for Disease Control and Prevention as an Integrated Food Safety Center of Excellence. The group was one of five selected nationwide and will serve the West Coast, part of the Mountain West, Alaska, Hawaii and Guam.

The center aims to strengthen foodborne illness outbreak detection and response.

The other four centers are located in Colorado, Minnesota, New York and Tennessee.

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Life Expectancy in the U.S. Falls for the Third Straight Year

In research published in the Journal for the American Medical Association, researchers from Virginia Commonwealth University found that Americans’ life expectancy has decreased in each of the past three years. Specific causes – notably drug overdoses, suicides and organ system diseases among young and middle-aged Americans – reversed the trend of increasing life expectancy, which had been consistent since at least 1959.

“[Rising death rates among working-age people is] supposed to be going down, as it is in other countries,” lead author Steven H. Woolf, MD, MPH, director emeritus of the Center on Society and Health at Virginia Commonwealth University, told The Washington Post. “The fact that that number is climbing, there’s something terribly wrong.”

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Studies: Rural Residents Have Higher Pediatric Mortality Rate, Die More Frequently from Preventable Causes

Recently published research further demonstrates the challenges rural Americans have in maintaining good health compared to their urban and suburban counterparts.

A study in Health Affairs found a higher pediatric mortality rate for children in rural areas. The researchers, from the University of South Carolina, note that non-Hispanic black infants and American Indian/Alaska Native children were particularly at risk. They recommend continued surveillance as well as policy interventions targeting the leading causes of death for these groups (unintentional injury and suicide).

Research published in the CDC’s Morbidity and Mortality Weekly Report found that rural Americans were dying more frequently from cancer, heart disease and chronic lower respiratory disease. Though the gap narrowed for unintentional injuries, the CDC attributed that to the sharp rise in urban areas in unintentional injuries, due mainly to the opioid crisis.

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AAFP Offering Two-Day Livestream for Rural Providers

AAFP is offering a livestream course May 14-16, 2020, aimed for rural family physicians. The two half-day courses offer as many as 18 Prescribed live credits, and the course can be accessed through any device.

Themes will include evidence-based guidelines on a range of topics specific to rural medicine, including patient management and decreasing needs for referrals. Learn more at: https://www.aafp.org/cme/cme-topic/all/rural-health-live/livestream.html

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Parental Leave in FM Residencies Varies Widely

Research published in the journal Family Medicine has found that most family medicine residencies offer fewer than six weeks of parental leave for residents or faculty members. Thirty percent of all programs offered no paid maternity leave, while 40 percent offered no paid paternity leave.

The authors, among them Andrea Wendling, MD, at Michigan State University, surveyed 478 family medicine residency directors across the country; 261 responded.

Only two programs offered 12 weeks or more of paid parental leave, Wendling and colleagues found.

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Study Looks at Keys to Success for Rural Preceptors

Researchers at the University of Alabama created a study focusing on understanding the support preceptors in rural areas need to teach medical students. The four themes that emerged were preceptor characteristics (motivation and commitment to teaching), student characteristics (rural background, enthusiasm), community support (attending events in community and reception by community) and institutional support (regular evaluations, regular communication).

“This is an optimal time for these findings to circulate,” said lead author John Wheat, MD, MPH. “The country is far behind — even negligent, in my opinion — in its attention to producing rural physicians, and it is important in the midst of the current heightened awareness to make solid advancements in that area. We know good preceptors — as well as the experiences young medical students have in rural communities — are major influences in their career decisions.”

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UW Psychiatric Consultation Line to Go to 24 Hours

Beginning in July 2020, the University of Washington will begin 24-hour service of  the UW Psychiatry Consultation Line (PCL). The service is meant to help eligible providers who are seeking advice regarding adult patients (18+) with mental health and/or substance abuse disorders.

Eligible primary care clinics, community hospitals/emergency departments, and county/municipal correctional facilities can call 877-WA-PSYCH (877-927-7924) to be connected to a psychiatrist. The psychiatrist can then send recommendations and documentation to the provider. This service is from 8 a.m. to 5 p.m. weekdays, though callers can leave a message during off hours to be returned within one business day.

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MIPS Virtual Groups Deadline is Dec. 31

The deadline is Dec. 31 to notify the Centers for Medicare and Medicaid Services of your intention to form a virtual group for the 2020 Merit-Based Incentive Payment System performance year.

Virtual groups allow small and solo practices another reporting option for MIPS.

According to AAFP, CMS defines a virtual group as:

  • one or more solo practitioners who are MIPS-eligible,
  • one or more groups consisting of 10 or fewer clinicians that include at least one MIPS-eligible clinician, or
  • a combination of solo practitioners and groups of 10 or fewer clinicians that elect to form a virtual group for a yearlong performance period.

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Should Fewer FPs Providing Hospital Care Cause Concern?

New research from the Robert Graham Center for Policy Studies in Family Medicine and Primary Care shows the provision of inpatient care by family physicians dropped by 26 percent from 2013 to 2017. This is cause for concern as continuity of care is often related to better health outcomes. Some of the factors related to decline could be individual preference, health system influences, community/population needs, and residency training. Researchers suggest further studies to investigate the complexity of this issue.