WAFP October 2019 Newsletter
Health of the Public
WAFP Board of Directors Opts for Further Study on HOD-ASA Timing
At its fall meeting, the WAFP Board of Directors heard of numerous potential ramifications of a proposed separation of the Academy’s marquee meetings, the House of Delegates and the Annual Scientific Assembly. As such, the Board commended the task force assembled to study the issue, recognizing the inclusive and intensive process they undertook. The Board further agreed to continued investigation into the optimum timing.
Among the concerns identified were the potential difficulties in winter travel over the Cascades; adverse effects on the events involving the WAFP Foundation, including its annual banquet and auction; and the challenge of avoiding conflicts that could cause the loss of a significant portion of attendees. The Board committed to a report to the House of Delegates on its progress on the issue.
The Academy has been looking at the issue since the 2018 House of Delegates, where a resolution was introduced to prevent WAFP from scheduling the ASA at the same time as Primary Care Update in Spokane.
Congress of Delegates Elects New AAFP Leadership
Ada Stewart, MD, FAAFP, was elected as AAFP’s president-elect at the 2019 Congress of Delegates meeting in Philadelphia.
Three new Board members were elected as well: Andrew Carroll, MD, FAAFP, of Chandler, AZ; Steven Furr, MD, FAAFP, of Jackson, AL; and Margot Savoy, MD, MPH, of Media, PA.
Additionally, the Board confirmed the selection of
- Brent Sugimoto, MD, MPH, FAAFP, of Oakland, CA, as new physician member;
- Kelly Thibert, DO, MPH, of Columbus, OH, as resident member; and
- Margaret Jean Miller, of Johnson City, TN, as medical student member.
AAFP’s Speaker of the Congress — Alan Schwartzstein, MD, FAAFP, of Oregon, WI — and Vice Speaker — Russell Kohl, MD, FAAFP, of Stillwell, KS — were re-elected to their positions. Gary LeRoy, MD, FAAFP, of Dayton, OH, assumed the role of AAFP president, and John Cullen, MD, FAAFP, of Valdez, AK, assumed the role of Board chair.
Congress of Delegates Considers Three WAFP Resolutions
WAFP brought three resolutions to the Congress of Delegates: two concerned abortion while the third asked for changes to a membership category for certain osteopathic physicians.
The Reference Committee on Health of the Public and Science considered WAFP’s abortion resolutions. The first asked AAFP to support clinicians who choose to provide abortion services. Testimony both in support and in opposition was heard; the reference committee opted to propose a substitute resolution, narrowing the scope to family physicians, as opposed to all clinicians. On the floor of the debate, the resolution was extracted by the New York State chapter, and considerable debate — on both the content of the substitute resolution and the parliamentary procedure to advance changes to the substitute — were heard. In the end, the Congress adopted the reference committee’s substitute language.
WAFP’s other abortion resolution, on assuring the availability of abortion services, was affirmed as current policy.
WAFP’s third resolution addressed allowing those members of the American College of Osteopathic Family Physicians without a state chapter to be granted membership within AAFP state chapters. With residencies moving toward single accreditation, those in support felt the AAFP should demonstrate inclusivity toward those osteopathic family physicians. Those opposed noted the AAFP’s linked memberships — meaning one cannot be a member of a constituent chapter without also being a member of the national academy — and a needed bylaws change to accommodate such a request. The Reference Committee on Organization and Finance recommended not adopting the resolution, and the Congress agreed.
Family Medicine Advocacy Day to Immediately Follow with Resident & Student Retreat in 2020
The 2020 WAFP Resident & Student Retreat will be held in Olympia on Jan. 25-26, 2020, coinciding with WAFP’s Family Medicine Advocacy Day — formerly known as the Policy & Advocacy Leadership Institute, or PALI — on Jan. 27.
A meeting of the WAFP Board of Directors will also happen during that weekend.
Exact times and locations will be revealed in the coming weeks.
Members in the News
- Mindy Fairbanks, DO, wrote a column for the Kitsap Sun on seasonal affective disorder. She provides readers with eight steps to boost their mental health as the cloudier days of fall approach in Western Washington. “Some of us are especially at risk for mental health problems, including anyone who feels isolated or excluded, people suffering from poverty or social injustice, and people who do not have adequate access to food, shelter or healthcare,” she wrote. “However, it is important for everyone to build resilience. It’s about growing our ability to enjoy more of life. Mental health is more than just the absence of a diagnosable mental illness.”
- Lisa Johnson, MD, wrote an op-ed in The Olympian opposing the planned liquified natural gas project in Tacoma. “Extracting fracked gas releases toxic air contaminants that exacerbate asthma and contribute to cancer, heart disease, and even premature death,” she wrote. “The fracked gas for this project would be sourced from British Columbia, where my fellow physicians see fracking’s impact on health up close: harm to pregnant mothers and preterm births, respiratory illness, and an increased incidence of cancer and neurological diseases.”
- Gene Moore, MD, CFAAFP, was feted by the American Board of Family Medicine for his continuous certification from 1970 — the first year certification was available for family physicians — through 2015. Along with a certificate, Moore received a letter from ABFM President and Chief Executive Officer Warren Newton, MD, MPH. “We wish you the very best in your retirement, and we deeply appreciate your professionalism, your continuing commitment to excellence, and your untiring efforts on behalf of our specialty,” Newton wrote.
- William R. Phillips, MD, MPH, FAAFP, has been honored with the 2019 Maurice Wood Award for Lifetime Contributions to Primary Care Research by the North American Primary Care Research Group. NAPCRG is the world’s premier family medicine research organization, and the Wood Award is its top honor. Phillips has also received a Fulbright Senior Scholar Award to study and teach in Dublin at the Royal College of Surgeons of Ireland in 2020. He will teach scientific writing and develop programs to improve patient-doctor shared decision making. He is Clinical Professor Emeritus of Family Medicine at the University of Washington.
- John Rambo, MD; Teresa Straub, DO; and Michael Watson, MD, FAAFP, were all quoted in a Kitsap Sun report on the groundbreaking for the building in Bremerton that will eventually hold the Northwest Family Medicine Residency Program. Watson is the program director while Rambo (R2) and Straub (R1) are residents. “As true family physicians we will take care of our patients from birth to death and all the way in between,” Watson said. “… This has to be at least three times as much space as in the current clinic.”
- David Ruiz, MD, FAAFP (above), was the subject of a feature in The Columbian for his long career serving patients in Vancouver. Ruiz recently received the Bravo Award from the Hispanic Metropolitan Chamber; the award honors the contributions of Latinos locally and nationally, according to the newspaper. He recalled that when he first began practicing, there was a dearth of Hispanic physicians in the area. “They were grateful to connect in their native language with someone who looked like them, una cara familiar, a familiar face,” he said. “It’s a lot easier to communicate with somebody who can speak the language, even try to speak the language.”
Now is A Great Time to Contact Your Legislator!
Just because the state legislature isn’t in session doesn’t mean that your legislators don’t want to hear from you.
Quite the opposite: Now is a great time to begin developing relationships with your elected officials.
Most likely, your legislators will be holding or attending numerous public events between now and the end of the year. The legislature’s website has a roster with links to every member of the body; signing up for newsletters and following your legislator on social media are great ways to learn about their policy focus areas and upcoming events.
As WAFP’s primary care investment initiative continues to move forward, the relationships you build today will become critical tomorrow.
If you’re interested in helping WAFP advocate for a health system more oriented to primary care, email WAFP’s director of external affairs, Brian Hunsicker, at email@example.com.
Inslee Takes Executive Action on Vaping
Through an executive order, Gov. Jay Inslee has taken steps to ban flavored vaping products throughout the state.
Announced in late September, the executive order initially asks the Washington State Department of Health to adopt emergency rules to ban all flavored vaping products, including flavored THC products. Inslee and his staff will also work with the legislature to draft a bill that would codify the ban on flavored vaping products, require disclosure of ingredients in vaping products and clarify DOH’s ability to act on urgent public health matters, even when the specific cause of harm is unknown.
“We aren’t waiting for Big Tobacco to tell us what is in their products,” Inslee said at a press conference announcing the directive. “We aren’t going to take health guidance from them, because we know that their goals are to make money and create new customers. That is what they are interested in. We are interested in ensuring that adults and young people have known and regulated ingredients in vaping products. Everyone deserves to know what is in the vaping liquid they are inhaling into their lungs.”
The seven lung illness cases in Washington are among the more than 800 reported nationally. Twelve patients have died since the illness outbreak began.
Sign On In Support of MAT Act
A group of health care and social service professionals have written a letter in support of the congressional Mainstreaming Addiction Treatment Act and are seeking additional signatories in support. The letter asks Washington’s congressional delegation to serve as cosponsors. So far, three have: Reps. Pramila Jayapal (D-Seattle), Denny Heck (D-Olympia) and Dan Newhouse (R-Yakima).
The bill would lower regulatory barriers to prescribing and using buprenorphine.
Nearly 140 physicians and allied health personnel have signed on so far. You can add your name here.
Opioid Conference to be Held Nov. 15-16
The Northwest Regional Primary Care Association, Sea Mar Community Health Centers and the Washington Association for Community Health have teamed up to offer a two-day conference entitled Responding to the Opioid Epidemic: Leveraging Care Integration in the Health Center Setting.
The conference will be held Nov. 15-16 in Seattle at the Renaissance Hotel.
Among the topics to be covered are the best practices for pain treatment, managing patients on chronic opioid therapy and treating opioid use disorder in the health center setting.
The conference has filed an application for CME credit with the AAFP.
DOH Releases Resource Guide for Hepatitis A
The Washington State Department of Health has put together a guide for immunization coordinators and partners to combat the state’s growing hepatitis A outbreak. Among the resources:
- DOH’s hepatitis A outbreak webpage, which includes the hepatitis A guideline, reporting form and numerous other resources for clinicians;
- The CDC’s guide to hepatitis A vaccine hesitancy; and
- An article published in the American Journal of Public Health on experiences and lessons learned from a recent hepatitis A outbreak.
The current outbreak has sickened 34 people across the state, including 23 in Spokane County.
Maternity Mortality Review Panel Seeks Members; Application Deadline is Oct. 15
The Washington State Department of Health is convening a Maternal Mortality Review Panel to conduct comprehensive reviews of maternal deaths to identify factors associated with those deaths and recommend system changes to improve health care services for women.
To apply, use DOH’s online form, which also lists selection criteria and expectations. The deadline to apply is Tuesday, Oct. 15.
Successful applicants will receive a letter signed by the secretary of health no later than Jan. 30, 2020.
DOH Awarded $4.4M for Opioid and Drug Overdose Surveillance and Prevention
The Centers for Disease Control and Prevention has awarded the Washington State Department of Health $4.4 million to surveil and prevent misuse of opioids and other drugs.
Previous grants were limited only to opioids.
DOH anticipates using the funding for enhancing educational efforts to pregnant women with substance use disorder; further collaborating with the Puyallup Tribal Health Authority; supporting 11 local health jurisdictions; staffing syringe service programs; and funding the Prescription Monitoring Program.
AHRQ Seeks Ambulatory Clinics for Program on Improving Antibiotic Use
The Agency for Healthcare Research and Quality is recruiting ambulatory adult and pediatric clinics in Washington to participate in the AHRQ Safety Program for Improving Antibiotic Use.
Continuing education credits, including ABFM maintenance of certification, will be offered at no charge for participants. Organizations will also receive clinical support to enhance antibiotic stewardship and other practice improvements.
The program is part of a collaboration between AHRQ, the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, and NORC at the University of Chicago.
Skagit Regional Health to Close Residency Program
The Skagit Regional Health program announced an intent to sunset its family medicine residency program over the next three years. The health system said the closure is because of the move toward a single accreditation system resulting from the merger between the American Osteopathic Association and the Accreditation Council for Graduate Medical Education. Connie Davis, MD, MHA, SRH’s chief medical officer, told GoSkagit.com that options were explored to keep the program running but none offered a long-term solution.
WAFP is monitoring the situation, along with other medical associations.
Skagit Regional Health will maintain its internal medicine residency, Davis said.
UW Study: FMIG Participation Associated with Higher Odds of Staying In Specialty
Four faculty members at the University of Washington Department of Family Medicine found that medical students’ participation in a family medicine interest group increased their odds of becoming a family physician.
The results of the study were published in the journal Family Medicine.
Sixty-eight percent of medical students who participated in an FMIG and listed family medicine as their top choice of specialty stuck with the specialty. Only eight percent of medical students became family doctors after not participating in an FMIG and not listing family medicine as their top choice of specialty.
The article was written by Amanda Kost, MD, MEd; Kimberly Kardonsky, MD; Jeanne Cawse-Lucas, MD; and Tomoko Sairenji, MD, MS.
CMS Agrees to Reimburse Residents at Critical-Access Hospitals
As of Oct. 1, training time for residents at critical-access hospitals will be eligible for Medicare reimbursement. The change came via updated rules from the Centers for Medicare and Medicaid Services; according to AAFP News, CMS will “update[e] Medicare’s hospital inpatient prospective payment systems to allow residents training in CAHs to be included in full-time equivalent counts for purposes of direct and indirect graduate medical education payments.”
AAFP had made the case to CMS in a June letter to the agency’s administrator, Seema Verma.
Study Identifies Institutional Barriers in Social Determinants of Health
A study from the National Academies has identified key elements of health systems when addressing social detriments of health. The study highlights institutional barriers to care, such as difficulty in sharing data across states and social services agencies; Medicaid coverage; lack of collaboration and benefit eligibility shared between agencies; and lack of funding to research potential policy changes.
The research further adds to the canon that social determinants of health, such as mental health, education and food security, contribute to the health of an individual. Moreover, a client’s overall health increases when they are treated historically with a diverse set of services to meet all their needs. Not only do patients have a better quality of life but agencies could see significant cost savings in the future. When a patient’s needs are addressed on all levels, their need for repeated services decreases.
New CMS Policies Aim to Reduce Administrative Burden
The Center for Medicare and Medicaid Services is focusing on driving administrative policy change to decrease administrative burden. Because CMS has an annual budget of $1 trillion, its policy impact can be felt throughout the health care system. CMS hopes these polices will target increasing savings for providers and suppliers.
Some of the changes include modifications to policy regarding portable X-rays, delegating progress notes to other practitioners, and allowing multiple hospital systems to have an integrative approach. CMS will also create an office to specifically devoted to reducing administrative burden on clinicians by reducing the amount of paperwork. CMS is going to continue to hold listening sessions to help inform policy reform to hopefully decrease administrative person and increase savings for providers.