WAFP January 2020 Newsletter

Organizational Health

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

WAFP Members, Staff Named to AAFP and State Commissions

Donate to the WAFP Foundation Auction

Family Medicine Advocacy Day Registration Deadline: Jan. 17

WAFP Foundation Streamlines Application Process for Awards

2020 ASA to Host Poster Competition

Members in the News

Advocacy

O’Ban Legislation Would Exempt Small Private Practices from B&O Tax

More Than 100 Bills Prefiled Ahead of 2020 Legislative Session

Inslee Releases Supplemental Budget Proposal

Health of the Public

Flu Activity Increasing in Washington State

Mental Health and OUD Event to be Held Jan. 22-23

Bree Collaborative Releases Palliative Care, Shared Decision Making Recommendations

State’s Health Systems Join Forces in Washington Health Care Climate Alliance

Embracing Learners

RISE Program Aims to Increase Number of Native American Physicians

By 14 Votes, Pullman Voters Reject Bond Measure; Residency Planning Continues

Well-Being Program in Residency Offers Hope for Combating Burnout

Practice Enhancement

UW to Host Perinatal Mental Health Webinar, In-Person Training in Richland

Bree Collaborative Announces Dates for Implementation Webinars

54 Percent of HCA Payments are Value Based, Besting Goal

Medicare Home Health Changes Take Effect on Jan. 1

 

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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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WAFP Members, Staff Named to AAFP and State Commissions

Three people affiliated with WAFP were appointed to statewide and national bodies in recent weeks.

Megan Guffey, MD, MPH, FAAFP, of Chelan, has been appointed to the state’s Maternal Mortality Review Panel. The panel, created by 2016 legislation and overseen by the Washington State Department of Health, seeks to identify ways to lower the current ratio of 11 pregnancy-related deaths per 100,000 live births.

Ying Zhang, MD, of Seattle, has been appointed to the AAFP Commission on Governmental Advocacy. Zhang is an assistant professor at the University of Washington Department of Family Medicine and medical director for the Harborview Family Medicine Clinic.

Brian Hunsicker, WAFP’s director of external affairs, has been appointed as the chapter staff representative to the AAFP Commission on Health of the Public and Science. Hunsicker oversees public health efforts, as well as advocacy and communications for the Academy.

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Donate to the WAFP Foundation Auction

The WAFP Foundation seeks donation for its annual auction. Monetary donations are accepted in addition to prizes and experiences.

Let us know your donation by filling out our online form. Thank you for supporting the WAFP Foundation!

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Family Medicine Advocacy Day Registration Deadline: Jan. 17

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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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.

This website 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 or letter of recommendation. Those documents, along with any questions, may be emailed to wafpfoundationawards@wafp.net.

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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 the venue to share 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. Attendees 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 submissions is Jan. 15, 2020. For more information, please contact Simoné Mansor, director of engagement at simone@wafp.net.

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Members in the News

  • Andy Castrodale, MD, pictured at left, was the subject of a feature in The Star of Grand Coulee for his work with medical students. The story also featured third-year University of Washington medical student Erin Boland, also a WAFP member. The story tracks Castrodale — who has received the outstanding rural health practitioner award from the Washington Rural Health Association — as well as his training and return to rural Eastern Washington. Family medicine was a clear choice for him during medical school. “It’s usually happy medicine,” he told The Star. “I have the ability to build relationships with entire families, from newborns to their grandmothers.”
  • William Phillips, MD, MPH, FAAFP, was named the 2019 Maurice Wood Awardee for Lifetime Contributions to Primary Care Research by the North American Primary Care Research Group (NAPCRG). Phillips received the award at the NAPCRG’s annual meeting Nov. 18 in Toronto. The award is give annually to honor a researcher who has made outstanding contributions to primary care research over the course of a lifetime, according to NAPCRG.

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Rep. Steve O'Ban (R-Pierce County)O’Ban Legislation Would Exempt Small Private Practices from B&O Tax

Sen. Steve O’Ban (R-Pierce County) has introduced legislation that would repeal the business and operations (B&O) tax for small private medical practices and other independent health care providers.

“The increase will undermine access to health care for many people who count on small-practice physicians and other independent medical providers who do not work for large health-care companies,” O’Ban said in a press release. “Medicaid reimbursements are too low even now, so doctors already lose money when treating patients on Medicaid. With this tax increase looming, some doctors are already deciding not to treat those patients at all.”

Money from the tax was to be directed to a new higher education fund, which would help train Washington students for jobs that require a postsecondary credential, according to Washington State Wire.

Rep. Drew Hansen (D-Bainbridge Island), who sponsored the bill that created the new B&O tax, told the Tacoma News Tribune that the businesses affected by the tax would also benefit. He cited a finding that 800 students were turned away from nursing programs at community colleges because of an instructor shortage due to low pay.

“If there’s an issue with Medicaid reimbursement rates being too low, then we should raise Medicaid reimbursement rates so that it is easier for physicians to treat families without a lot of income,” Hansen told the newspaper. “The solution is not to just exempt specialized surgeons and others from helping fund the education for the next generation of nurses, lab technicians and doctors.”

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More Than 100 Bills Prefiled Ahead of 2020 Legislative Session

Washington state legislators have already filed numerous bills to be taken up in January’s legislative session.

Among those of interest to WAFP members:

  • HB 2252 by Rep. My-Linh Thai (D-Bellevue) would mandate the availability of abortion care for those covered by a student health plan.
  • SB 6801 by Sen. Marko Liias (D-Lynnwood) would clarify that the earnings of employees of both a medical school and affiliated faculty group practice include the combined compensation from each entity.
  • SB 6086 by Sen. Bob Hasegawa (D-Seattle) would stipulate that providers may only prescribe a two-week supply of legend drugs or controlled substances to patients who received evidence-based opioid use disorder treatment at the location of the provider.
  • SB 6088 by Sen. Karen Keiser (D-Kent) would create a five-person panel to investigate high-priced drugs or those that have rapidly increased in price. The board would also be required to set a price ceiling for those drugs in state-purchased health plans.

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Inslee Releases Supplemental Budget Proposal

Replacing lost federal Title X funding is among the highlights of Gov. Jay Inslee’s proposed 2020 supplemental budget.

Inslee set aside $8.4 million to continue family planning services in the state, as Title X funds may no longer be used for family planning.

More than $10 million was set aside for foundational public health services, and there is additional funding to reduce suicide rates and lower tobacco and vaping use.

Other highlights include:

  • Money to replace federal grants that helped support the prescription drug monitoring program.
  • Funding to maintain the HEAL-WA web portal, which has seen an increasing number of users.
  • Money to cover the costs of screenings for spinal muscular atrophy, which was recently added to the list of diseases in the mandatory newborn screening panel.
  • Money to launch a program to warn young people about the dangers of fentanyl use.

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Flu Activity Increasing in Washington State

The Washington State Department of Health reports that flu level is increasing across the state, with Influenza B the predominant type so far in the 2019-20 flu season.

As of DOH’s most recent report, five deaths have been confirmed as being associated with influenza. The deaths were spread across the state (in Franklin, Grant, Kittitas, Pierce and Thurston counties) with all five being at least 50 years old.

Since then, however, Public Health—Seattle & King County has reported the death of an elementary-school-aged child on Dec. 15. It was the first pediatric flu death in the county in a decade. On Dec. 23, the Tacoma-Pierce County Health Department confirmed the death of a child under 5 from the flu; it was the county’s second death this season.

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Mental Health and OUD Event to be Held Jan. 22-23

The Washington Summit for Mental Health and Opioid Use Disorder will be held Jan. 22-23 on the Cherry Hill Campus of Swedish in Seattle. The two-day event is free to attend and offers free CME.

The summit is sponsored by Swedish, the Washington State Health Care Authority and the Washington Society of Addiction Medicine.

According to organizers, the event will offer discussion on how to improve nonjudgmental, trauma-responsive and patient-centered care for mothers, infants, families and communities affected by mental illness and substance use disorders.

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Bree Collaborative Releases Palliative Care, Shared Decision Making Recommendations

The Bree Collaborative has published recommendations surrounding palliative care and shared decision making. Among the recommendations for primary care providers:

Palliative Care

  • Explain diagnoses, prognosis and talk about setting expectations
  • Consider additional training in communication skills around palliative care
  • Ensure patients know how to contact your team with questions or urgent issues
  • Consider referral to specialty palliative care when necessary

Shared Decision Making

  • Undertake skills training, as shared decision making is a learned skillset that is supported by patient decision aids
  • Implement the skills learned and identify reminders or other methods to maintain these practices
  • Actively recommend and use high-quality decision aids with patients
  • Document use of shared decision making in the medical record

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State’s Health Systems Join Forces in Washington Health Care Climate Alliance

Eight health systems across the state comprise the founding members of the Washington Health Care Climate Alliance. The alliance aims to bring health care expertise to regulatory and legislative deliberations around energy, transportation, food, waste, infrastructure and community resilience.

CHI Franciscan, Kaiser Permanente, MultiCare, Providence St. Joseph Health, Seattle Children’s, Swedish Health Services, UW Medicine and Virginia Mason Medical Center are the founding members.

The alliance was formed in collaboration with Health Care Without Harm.

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RISE Program Aims to Increase Number of Native American Physicians

A collaborative effort including the Elson S. Floyd College of Medicine hopes to decrease health disparities and improve public health by getting more Native Americans into medical school.

The RISE project — Reimagine Indians into Medicine — is an expansion of the Wy’east Post-Baccalaureate Pathway developed at Oregon Health & Science University. Students in that 10-month program are citizens of federally recognized tribes and are provided a pathway to improve their academic skills and be successful in the medical school admissions process, according to WSU.

Upon successful completion of the program, students are conditionally accepted to ESFCOM, OHSU and the University of California Davis School of Medicine. The three schools, along with the Northwest Portland Area Indian Health Board, are behind the project.

According to WSU, if all 18 project students go on to study medicine, they would increase the total number of Natives enrolled in U.S. medical schools by nearly 40 percent.

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By 14 Votes, Pullman Voters Reject Bond Measure; Residency Planning Continues

Voters narrowly rejected a bond measure for Pullman Regional Hospital. The Spokesman-Review reports that while 59.7 percent of voters approved the measure, a 60 percent threshold was required — a difference of 14 votes.

The money was planned for a facility expansion and enhancement of the hospital’s EHR, as well as initial steps to apply for a family medicine residency program. Despite the setback, hospital officials say plans for the residency program continue to move forward.

“There’s a strong commitment to working towards the residency program,” Tricia Grantham, president of the hospital’s board of commissioners, told the Spokesman-Review. “The community needs to know this isn’t the new shiny object out there.”

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Well-Being Program in Residency Offers Hope for Combating Burnout

One year after introducing a well-being program, an internal medicine residency program in Indianapolis found improvements in 10 aspects of wellness. Though not statistically significant, the authors believe this represents a positive trend.

The success of the well-being program was significant enough, however, to garner continuing support from institutional leadership, the authors wrote.

“Physician burnout affects nearly half of U.S. physicians — including physicians in training,” lead author Laurel Fick, MD, told AAFP News. “By instilling personal well-being and self-care into residency training, we are hoping to prevent burnout before it happens to ensure a healthy and engaged physician workforce for the future.”

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UW to Host Perinatal Mental Health Webinar, In-Person Training in Richland

The University of Washington Department of Psychiatry and Behavioral Sciences will host an online and a live training session to help primary care providers treat mental health disorders during pregnancy and postpartum.

The webinar will be held Thursday, Jan. 9, beginning at noon. Registrations are now being accepted; there is no cost. Attendees will learn current information about perinatal depression and anxiety in Washington; best practices for screening; and how to integrate screening results into care plans.

On Thursday, Jan. 30 in Richland, a half-day training session will be held at the 2nd Columbia Conference Room at Kadlec Regional Medical Center (888 Swift Blvd. in Richland). Lunch begins at noon, with the training starting at 1 p.m. As with the webinar, registration is open and at no cost. Attendees will learn the process of differential diagnosis of common mental disorders in the perinatal period; risks of untreated mental disorders and psychotropic medication use during pregnancy and lactation; and informed consent discussions with pregnant and breastfeeding women regarding commonly used psychotropic medications.

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Bree Collaborative Announces Dates for Implementation Webinars

The Bree Collaborative will hold four implementation webinars in the first quarter of 2020:

  • Wednesday, Jan. 29, from noon to 1 p.m.: behavioral health integration
  • Wednesday, Feb. 26, from noon to 1 p.m.: suicide care pathway
  • Wednesday, March 25, from noon to 1 p.m.: addiction and dependence treatment
  • Wednesday, April 22, from noon to 1 p.m.: opioid use disorder treatment

The webinars will provide an overview, an implementation plan and checklist, and implementation success stories for each guideline.

Registration information is coming soon.

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54 Percent of HCA Payments are Value Based, Besting Goal

Of all payments among Public Employees Benefits Board and Medicaid managed programs in 2019, 54 percent were value-based payments. That exceeded the Washington State Health Care Authority’s goal of 50 percent.

When HCA included commercial plans and Medicaid, the VBP rate reached 58 percent.

By 2021, HCA hopes to achieve 90 percent VBP rate.

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Medicare Home Health Changes Take Effect on Jan. 1

When the calendar flips to 2020, Medicare will enact new changes for patients who receive home health services. Specifically, the home health unity of payment will change from the current 60 days to 30 days. The change is meant to ensure patients’ care needs are being actively monitored and met, according to AAFP News.

The changes won’t directly impact physician payment.

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