WAFP November 2019 Newsletter

Organizational Health

Family Medicine Advocacy Day Registration is Open

Submit your Nomination for Family Physician of the Year and Family Medicine Educator of the Year

WAFP to Relaunch Key Contacts Program

More Resident and Medical Student Mixers Coming in 2020

Registration for Student & Resident Retreat Now Open

Seattle Resident Flores-Rodarte Appointed to AAFP Commission

Members in the News

Advocacy

Bree Collaborative Seeks Clinics to Participate in Behavioral Health Integration

State Agencies Lay Out Priorities in ‘Decision Packages’

Washington Health Alliance Chosen to Manage State’s APCD

Universal Health Care Work Group Holds First Meeting

Health of the Public

CDC Immunization Survey: WA Falls Short of Healthy People 2020 Goals

STD Rates Continue to Climb in Washington

CDC Issues Clinical Guidance for Vape-Related Lung Injury

Embracing Learners

In Spokane, Majority of Medical Students are Women

Leadership and Resources Critical to Successful RTT Programs

First Graduates of Rural Medical School Vary on Practice Locales

Practice Enhancement

WMC Raises Renewal Fees for Physicians, PAs

WHA Releases 2019 Report on Health Care Waste

Some FPs Denied Payment for Pneumococcal Vaccines

AAFP Adds Well-Being Index to Physician Health First Toolkit

 

Family Medicine Advocacy Day Registration is Open

WAFP members are now able to register for Family Medicine Advocacy Day (formerly known as the Policy Advocacy Leadership Institute, or PALI) on 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 of the Year and Family Medicine Educator of the Year

The WAFP is 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

The Family Medicine Educator of the Year Award was developed by the WAFP Foundation Board of Directors to recognize Academy members for excellence in teaching, development of innovative teaching models, or implementation of outstanding educational programs. One award is presented each year to a full-time, part-time, or volunteer faculty.

Nominations for FMEOY are due Jan. 31, 2020. Nominees will be evaluated based upon the following:

  • Recognition for exemplary teaching skills and outstanding progression of abilities over several years by medical students, residents or peers; or
  • Development and implementation of innovative curriculum, teaching model(s) or program(s) in a variety of educational spheres; and
  • Current membership in the WAFP/AAFP.

All candidates must be either a full-time or part-time family physician who holds a regular faculty appointment, and teach and practice exclusively in an academic setting. Volunteer family physicians who do not practice in an academic setting but engage in volunteer teaching activities are welcome as candidates.

Nominations must include a 2020 nomination form (available at http://bit.ly/2020-FMEOY); a copy of the nominee’s current curriculum vitae; and three to five letters of recommendation. At least two of the letters of recommendation must be submitted by 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.

WAFP members in good standing are eligible for the award; however, 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 (available at http://bit.ly/2020-FPOY); a current curriculum vitae; a head-and-shoulders photo of the nominee; and up to eight pages of supporting letters or documentation. Letters are welcome from colleagues or patients.

Nominations should be emailed to info@wafp.net.

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WAFP to Launch Key Contacts Program

To bolster its advocacy efforts, WAFP will launch its key contacts program. A key contact is a WAFP member who has, or is willing to build, a relationship with their elected officials in the Washington State Legislature. Earlier this year, more than 100 members volunteered to learn more about important issues and take the lead on communicating with their legislators.

Legislators benefit from the input of family physicians; very few of the 147 members of the legislature have ever worked in a health care service setting. Moreover, as a family physician, our members speak on behalf of their patients — many of whom are also likely constituents.

Those who have signed up at WAFP and King County Academy of Family Physicians events should expect to receive more information next week. If you’d like to be considered for our key contact program, please contact Brian Hunsicker, WAFP’s director of external affairs, at brian@wafp.net.

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More Resident and Medical Student Mixers Coming in 2020

WAFP will again host resident and medical student mixers in the coming year, with more frequency and in more locations.

In 2019, the Academy hosted mixers in Seattle, Spokane and Yakima, all in the summer or early fall. In 2020, the mixers will be held throughout the year, with plans to add events in Central Washington, Southwest Washington and the Skagit Valley.

For more information, contact Alyssa McEachran, WAFP’s director of pipeline and practice enhancement, at alyssa@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, as you will need to include it. 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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Jose Flores-Rodarte, MDSeattle Resident Flores-Rodarte Appointed to AAFP Commission

Jose Flores-Rodarte, MD, MPH, a second-year resident at the University of Washington Family Medicine Residency, has been appointed to the AAFP Commission on Quality and Practice. Flores-Rodarte was informed in an October letter from AAFP President Gary LeRoy, MD, FAAFP.

The Commission on Quality and Practice works on the AAFP’s numerous efforts in practice enhancement.

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Clint Hauxwell, MD, with drama students

Members in the News

  • Shawn Andrews, MD, was featured in a Grays Harbor Talk article on Summit Pacific Medical Center’s MAT clinic. Andrews is the medical director of the clinic. “The most rewarding part of working at the clinic is working with people on some of their toughest days and hearing that they feel safe, welcome, respected and want to come back for further visits,” Andrews said. “We get to see people get their lives back. See them get sober, integrate back into family relationships, housing, mental health services, jobs, deal with outstanding warrants and so much more.”
  • Clint Hauxwell, MD, was the subject of a feature in the Spokesman-Review. Hauxwell uses drama students from Spokane’s North Central High School to help demonstrate different ways to handle adolescent patient encounters. “It’s practicing interacting with patients,” Hauxwell told the newspaper. “… The first few weeks, we teach them how to do an exam. So this workshop emphasizes there are differences in the way we interact with little kids, the elderly, as well as adolescents.”
  • Leah Kobes, MD, talked to the Spokane Journal of Business about the challenges of being a parent while in medical school. Kobes gave birth during her fourth year, one of the 2.8 percent of medical students in the U.S. who report having a dependent. “I noticed a lot of my coworkers who were not parents would kind of dilly dally,” Kobes said. “I think [having a child] makes you want to work harder and go home faster.”
  • Angela Sparks, MD, FAAFP, was quoted in a Mic story on the dangers of mixing alcohol and caffeine. Adding caffeine to a night of drinking, she said, increases the risks of binge drinking. Since caffeine doesn’t change how drunk a person is, the best-case scenario is a really bad hangover, she said; the worst case is alcohol poisoning, a DUI charge, an ED visit or harming others.

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Bree Collaborative Seeks Clinics to Participate in Behavioral Health Integration

The Bree Collaborative is offering incentives to primary care clinics interested in participating in their Behavioral Health Integration Initiative. The program runs from January 2020 through June 2021.

In exchange for participation, the Bree Collaborative is offering customized, one-on-one technical assistance; a $500 incentive payment per assessment; participation in a peer learning collaborative; and monthly webinars.

The program seeks to improve clinic engagement, assessment, improvement and sustainability through a behavioral health integration lens.

To apply, fill out the survey at https://www.surveymonkey.com/r/BHII. To learn more, contact Bree Collaborative Director Ginny Weir at gweir@qualityhealth.org or implementation manager Amy Etzel at aetzel@qualityhealth.org.

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State Agencies Lay Out Priorities in ‘Decision Packages’

Ahead of the state legislature session, Washington’s state agencies have laid out their supplemental budget requests in a series of documents called decision packages.

The Department of Health, for instance, is requesting the legislature approve a variety of measures that maintain current service in some areas and expand service in others. DOH asks for: money to supplement the child profile health system; additional funding to support the state’s public health lab; funding to improve immunization rates; and funding to build a multi-agency system to better prevent suicides.

Among the funding requested by the Health Care Authority is money to implement a drug price transparency program and money to support an increase in the newborn screening fee for all Medicaid births.

To read more of the decision packages, use the Office of Financial Management’s website and select “2020 Supp” for the budget session. The agencies are listed numerically: HCA is no. 107 while DOH is no. 303.

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Washington Health Alliance Chosen to Manage State’s APCD

The Washington State Health Care Authority has selected the Washington Health Alliance to serve as the lead organization for the state’s all-payer claims database.

WHA will assume responsibility for the APCD beginning Jan. 1, 2020.

The APCD was created in 2014 and initially managed by Oregon Health and Science University. It collects health care claims data for reporting and analytics.

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Universal Health Care Work Group Holds First Meeting

Washington’s Universal Health Care Work Group, formed through legislation adopted in 2019, held its first meeting in early October. The meeting focused on potential topics of consideration as the group undertakes its work.

The work group features stakeholders from a variety of industries, including two WAFP members: Barbara Detering, MD, and Rich Kovar, MD, FAAFP, both of Seattle.

The group’s next meeting will be Monday, Dec. 9, at 1 p.m. on the Capitol Campus in Olympia.

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CDC Immunization Survey: WA Falls Short of Healthy People 2020 Goals

The Centers for Disease Control and Prevention has released its latest National Immunization Survey, and Washington stands near the rest of the country in several categories. However, those rates leave the state short of the goals established in the Healthy People 2020 initiative.

Healthy People 2020 aimed for 90 percent coverage, but the state missed that target in hepatitis B (86.7 percent), MMR (89.4 percent), polio (87.0 percent) and varicella (85.1 percent). Additionally, Washington’s rotavirus goal of 80 percent coverage was missed; 71.7 percent received the vaccine.

On the positive side, flu immunization rates of two or more doses are significantly higher than the national average (65.5 percent vs. 56.5 percent nationally).

Learn more on the CDC’s website.

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STD Rates Continue to Climb in Washington

Data from the Centers for Disease Control and Prevention shows rising rates of STDs both in Washington and in the U.S.

  • Chlamydia: From 2014 to 2018, Washington’s rate and total number of cases increased each year. In 2018, 34,449 cases of chlamydia were reported, though Washington’s rate per 100,000 people was substantially lower than the national average (465.2 compared to 539.9).
  • Gonorrhea: Washington’s caseload of gonorrhea nearly doubled from 2014 to 2018, going from 6,221 cases to 11,207. The rate per 100,000 people also increased each year, but like chlamydia, remains below the national average.
  • Syphilis: The total number of cases more than doubled in the five years of the published data. Washington’s rate of 10.8 cases per 100,000 matches the national average.

The CDC also included total case numbers and rates for 50 metropolitan statistical areas (MSA). The Seattle-Tacoma-Bellevue MSA was lower than the average MSA for all three STDs, as was the Portland-Vancouver-Hillsboro MSA.

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CDC Issues Clinical Guidance for Vape-Related Lung Injury

The Centers for Disease Control and Prevention has released guidance for clinicians for assessment, evaluation, management and follow-up of patients with symptoms of lung injury associated with vaping products.

“When evaluating patients with respiratory or gastrointestinal symptoms, health care providers should consider multiple causes, including the possibility of lung injury associated with use of e-cigarette, or vaping, products,” the CDC said in a statement. “The guidelines highlight the importance of asking patients about their use of using e-cigarette, or vaping, products in a non-judgmental way.”

At the request of Gov. Jay Inslee, the Washington State Board of Health recently banned the sale of flavored vapor products.

“This is a critical part of our response to the youth vaping epidemic and the outbreak of vaping associated lung injury in Washington and throughout the country,” said Secretary of Health John Wiesman, DrPH, MPH, who is also a member of the Board of Health. “While we don’t yet know the exact cause of the lung injury, we know these products are not safe and we must act quickly to protect young people.”

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In Spokane, Majority of Medical Students are Women

The Spokane Journal of Business reports that more women than men are enrolled in the city’s two medical schools.

At the Elson S. Floyd College of Medicine, the 2019-2020 first-year class is 54 percent women, compared to 60 percent women from the 2018-2019 first-year class. At the University of Washington’s medical school campus in Spokane, the two newest classes feature 60 and 63 percent women.

The Journal also noted that, nationally, the number of women applying to and attending medical school has increased each of the past seven years.

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Leadership and Resources Critical to Successful RTT Programs

Effective leadership — both institutionally and within residency programs — is the most important risk factor in the success of rural training track (RTT) programs, according to research published in the journal Family Medicine. Changes in leadership or burnout among staff could have outsized effects on an RTT, the study found.

Of the nine key themes identified by the study, the second, third and fourth most important broadly fall under resources: faculty and teaching resources (for example, the longevity and “embeddedness” of faculty in a community play a role in a program’s success), program support (in terms of importance to a host community and its patients, among others), and finances were other important risk factors.

Davis Patterson, PhD, a research assistant professor at the University of Washington’s Department of Family Medicine, was the study’s lead author.

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First Graduates of Rural Medical School Vary on Practice Locales

Kaiser Health News caught up with the first eight graduates of the University of Kansas School of Medicine-Salina, which opened in 2011. Of the eight, only three are currently practicing in provider shortage areas. Two others practice in small cities, while the remaining three practice in either Wichita or Topeka (the city’s largest and fifth-largest cities respectively).

For Claire Hinrichsen Groskurth, MD, the plan had always been to practice rurally, until she found her calling in OB-GYN and surgery. Another complicating factor: marrying a surgeon in training whose own career demanded training in a metro area.

But KHN notes “the spousal coin can flip both ways.” Sara Patry, MD, is an internist in Hutchinson, KS, to allow her husband to farm corn, sorghum, soybeans and wheat.

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WMC Raises Renewal Fees for Physicians, PAs

The Washington Medical Commission announced it would raise fees for physician and physician assistant license renewal. WMC notes that the causes of the fee increase include the high cost of disciplinary procedures, litigation, case management and credentialing.

These rules take effect Feb. 1, 2020.

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WHA Releases 2019 Report on Health Care Waste

The Washington Health Alliance released its third report on health care waste in Washington State. The report found that an estimated $703 million was spent on low-value care and nearly 850,000 Washingtonians received at least one low-value service during the four years the study covered.

From 2013 to 2017, however, there was a marked decrease in the provision of low-value services: a 10 percent reduction for commercially insured patients and a 24 percent reduction for Medicaid-insured patients.

The report highlights 47 common and overused treatments, tests, and procedures. and used the All-Payer Claims Database and Milliman MedInsight Health Waste calculator to produce its results.

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Some FPs Denied Payment for Pneumococcal Vaccines

AAFP reports that some family physicians have been denied payment for administering pneumococcal vaccines to Medicare patients.

If you’re among those physicians, the Centers for Medicare and Medicaid Services advises that you should resubmit those claims if the date of service falls within Medicare’s timely filing limits.

According to AAFP, the problem arose when some Medicare administrative contractors inserted lifetime limits and other modifications on the administration of the pneumococcal vaccine. CMS issued instructions in late September that would halt such modifications.

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AAFP Adds Well-Being Index to Physician Health First Toolkit

The AAFP has added a new tool created by the Mayo Clinic to assess physical well-being and added to the Physician Health First initiative.

The Physician Well-being Index replaces the Maslach Burnout Inventory as a way to focus more on professional satisfaction and fulfillment. The index takes about 11 minutes to complete, can be used once per month per physician, and allows physicians to instantly review and compare their scores with colleagues across the nation.

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