WAFP March 2017 Newsletter
Health of the Public
Workforce and Education
Online Registration Now Open for 2017 Annual Scientific Assembly
Now is the time to reserve your spot for WAFP’s Annual Scientific Assembly on May 5 and 6 at Skamania Resort in Stevenson. Our online registration site is now live! Access it at http://bit.ly/WAFP2017ASA.
This year’s ASA features plenaries and workshops on a variety of topics, including physician burnout, suicide prevention, opioid prescription, HIV, transgender care and disruptive innovation in primary care. The full schedule is on the registration site, as well as the WAFP website. John Tomkowiak, MD, MOL, the founding dean of the Elson S. Floyd College of Medicine, will deliver the Mead Lecture on Friday, May 5.
The event also features the chance to network with 150-200 family medicine colleagues from around the state and WAFP’s Annual Banquet and Foundation Auction.
Exhibition and sponsorship opportunities are still available. Contact Brian Hunsicker at firstname.lastname@example.org for more information.
WAFP’s House of Delegates will also be held at Skamania Resort, on May 4. The five resolutions that will be discussed have been posted on the WAFP website.
Students, Residents Elect New Board Representatives
The resident and student chapters have voted for their leadership on the WAFP and WAFP Foundation boards. They have selected Mira Hattal and Theresa Myers as WAFP Student Co-Trustees, Laurie Bazán as the student representative on the WAFP Foundation board, and Lindsey Ruppel, DO, as the WAFP Resident Trustee.
Hattal, MS-3, is a student at the University of Washington School of Medicine. She has worked with the nonprofit WithinReach and served as the founder and co-lead of the UW Affordable Care Access, Education and Advocacy Project.
Myers, MS-3, is also at the University of Washington School of Medicine. Her previous work and volunteering took her to a wide variety of locales, from Oregon and Louisiana to Ecuador, Kenya and Myanmar.
Bazán, MS-2, is also at the University of Washington School of Medicine. She is a recipient of the UW School of Medicine Service Award and the Norman James and Ethel Jenisch Rose Endowed Scholarship; in 2010, she was named a Gates Millennium Scholar.
Ruppel is currently a resident at Spokane Family Medicine, having graduated from PNWU and the University of Idaho.
Free Buprenorphine Training for Southwest Washington: Limited Seats Remaining
On Friday, May 19, from 1 to 5 p.m., the WAFP Thurston-Mason-Lewis chapter, along with the Washington State Medical Society (Thurston-Mason County Medical Society) and Providence St. Peter Family Medicine, will offer regional providers a training to prescribe buprenorphine. The event is nearing capacity, so act soon to reserve your spot.
Prior to the live event, registrants must complete four hours of online modules. The eight total hours will qualify a physician for a waiver and begin prescribing buprenorphine right away. For NPs and PAs, the eight hours will count toward the 24 hours currently required to receive an application waiver from the special requirements of the Controlled Substances Act. Residents are welcome to take the waiver training but will not be able to apply for a waiver until they have a personal DEA number — assigned after the application waiver is accepted — and an unrestricted medical license.
Best known as Suboxone, this highly effective treatment for opioid use disorder blocks craving and withdrawal symptoms and allows patients to build a healthier life. If interested, contact Cindy Grande, MD (email@example.com) and/or Kari Lima, MD (firstname.lastname@example.org). Additional organizing committee members include Erin Kershisnik, MD; Sam Ritchie, MD; and Dan Stein, MD.
Celebrate an Outstanding Family Physician: Nominate Him or Her for Family Physician of the Year!
Each year, the WAFP honors a family physician who who exemplifies, in the tradition of family medicine, a compassionate commitment to improving the health and well-being of people and communities throughout Washington. If you know someone who embodies those principles, nominate that person for the 2017 Family Physician of the Year award!
The candidate must be a member in good standing with the WAFP, and any WAFP member is eligible to submit a nomination. 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.
The award will be presented during the WAFP Annual Meeting Banquet and Foundation Auction in May.
Family Medicine Advocacy Summit: Resident Scholarship Opportunity Extended
The AAFP’s Family Medicine Advocacy Summit (formerly known as the Family Medicine Congressional Conference) will take place May 22-23, 2017, in Washington, D.C. The early-bird registration fee ends April 7, so now is the time to sign up!
The WAFP Executive Committee has extended the deadline for resident applications to the Family Medicine Advocacy Summit. WAFP offers scholarships for residents to attend FMAS; the new deadline to send applications is April 3. This year’s FMAS will be held May 22-23 in Washington, D.C. More details are on the application form, which is available online.
On the first day of the summit, you’ll learn about family medicine’s legislative priorities and receive training on how to advocate on Capitol Hill. The second day is all about putting those skills to use by visiting your Washington congressional delegation to let them know about your patients and the challenges they face daily with the current delivery system and policies.
Local Chapter News
The King County Chapter will hold its next monthly board meeting on April 6 at 7 p.m. at Swedish Cherry Hill. The chapter will begin discussing incoming board nominations. For more information or to RSVP, email email@example.com.
If your chapter has upcoming meeting information, let us know! Email Brian Hunsicker at firstname.lastname@example.org with details, and we’ll be sure it shows up here.
Members in the News
Kimberly G. Harmon, MD, was mentioned in a Healio.com story about ECGs in young athletes. The subject of the story, Francesco Fedele, MD, a professor at Sapienza University of Rome, referenced Harmon’s research that found ECGs were effective at detecting cardiovascular disease.
Elizabeth Stuhlmiller, MD, wrote an opinion column for the Spokesman-Review about the benefits and challenges of rural medicine and how state legislators can improve access to health care.
A Yakima Herald story on the opioid crisis in that city focused on Shannon Boitano, a patient of WAFP member Ross Bethel, MD. Bethel is leading a study on opioids. The story also quoted Michael Parchman, MD, FAAFP, who is also investigating opioids at Group Health.
Bill Phillips, MD, MPH, FAAFP, received a Citation of Appreciation from the director of the Agency for Healthcare Research and Quality for completing a four-year term of service on the U.S. Preventive Services Task Force, 2013-2016.
As one of two AAFP Vaccine Science Fellows, John Merrill-Steskal, MD, recently visited the AAFP’s headquarters in Leawood, KS. A story from AAFP News details the past year for Merrill-Steskal and David Cope, MD, of Utah, as Vaccine Science Fellows.
AAFP Launches New Webpage for Members
The AAFP has announced its new Member Welcome Center, a one-stop shop for common AAFP membership management needs.
The page is divided into three areas:
- Get Started, which allows members to update their profiles, get answers to basic member questions and report CME.
- Get Involved, where members can connect with their chapters and peers, register for an event or learn about leadership opportunities.
- Get Informed, where members can stay up-to-date with what’s happening in family medicine, earn CME or make an impact on the specialty.
Call for Abstracts for Family Medicine Global Health Workshop
Abstracts are now being accepted for AAFP’s Family Medicine Global Health Workshop, to be held Oct. 5-7 at the JW Marriott in Houston.
Since CME credit will be available at the conference, presentations must needs-based topic areas, be supported by evidence, and support professional practice changes by attendees. The topics for this year’s workshop are:
- Clinical Topics in Global Family Medicine
- Global Expansion of Family Medicine
- Incorporating Global Health into Family Medicine Training and Practice
- Reflections in Global Health
- Research and Evaluation of Global Family Medicine
More information on each topic is available on the AAFP website.
Once an abstract is ready, fill out a conflict of interest form (nonmembers must create an account prior to filling out the form), get all relevant materials ready (each submission should include a title; a short abstract; learning objectives; knowledge, competency and/or performance gaps; contact information; names of the presenter(s) or author(s); and the conflict of interest form), and then submit through the AAFP’s Abstract Submission Tool.
Learn more about the FM Global Health Workshop on the AAFP’s website.
The focus in Olympia has turned to finances. Gov. Jay Inslee (D) released his proposal for the 2017-2019 state operating budget back in December, but the Senate released its proposal this week. The House will do the same next week.
Because of the McCleary decision, fully funded basic education is a key feature of all three proposals. The method of paying for it, however, is quite different: The Senate has for some time believed that complying with McCleary doesn’t require new sources of revenue. When its budget is released, the House is expected to take another approach.
The Senate budget also contains specific items on psychiatric hospitals, the prescription monitoring program and the Medicaid waiver, among other topics. Read up on those proposals in the latest of our weekly Legislative Updates (members only).
HCA Day at the Doctor’s Office: Be a Guide
Are you drowning in alphabet soup? MACRA, MIPS, ACA, ACO … There’s a new acronym coming our way: ACH – Accountable Communities of Health. Could this one be different, providing needed services for our patients without making new demands on our time? Maybe, if you and other WAFP members volunteer to be shadowed for a day, or even a few hours, by one of its planners. Staff members from the Washington State Health Care Authority, Department of Health and regional ACHs want to understand the realities of day-to-day clinic life so they can envision practical ways to smooth the path for our patients. If this opportunity intrigues you, please email Brian Hunsicker at Brian@WAFP.net.
Volk Legislation Won’t Become Law This Session
After passing the Washington State Senate, S.B. 5800 — which aims to counteract the Washington Supreme Court’s controversial Volk decision — the bill didn’t survive a House committee.
The WAFP advocated strongly for the bill’s passage and urged its members to do the same with their representatives. The bill had passed in the Senate with bipartisan support but was unable to make it through the House Judiciary Committee by the March 29 cutoff.
A week before the cutoff date, the House Judiciary Committee held its first hearing on the bill. There were numerous speakers in favor of the bill, including Jonathan Seib, WAFP’s advocacy consultants, and representatives from the Washington State Medical Association, the Washington State Hospital Association, Seattle Children’s Hospital, the Washington State Society for Clinical Social Work and the Washington Council for Behavioral Health.
While their testimony highlighted multiple problems with the Volk decision, witnesses returned to a central theme: How can a provider warn any potential victim, possibly in violation of HIPPA, when not doing so exposes them to liability?
“Before Volk, we knew what we needed to do. We knew who was involved and what to do about it,” Jeff Sconyers, representing Seattle Children’s Hospital, said. “Now we have to know who is a foreseeable victim. If it’s an angry teenager, maybe it’s the whole world. If it’s someone on the autism spectrum, maybe it’s someone who is standing in their way.
“My prediction is that lawyers who advise hospitals will advise their clients to refer each and every patient who displays anger management issues to a professional for evaluation, whether they pose a threat or not. Long-term, they’ll advise therapists to get out of this business” and choose something with less legal risk, like eating disorder treatment.
In time, he said, we could rely solely on Eastern State Hospital and Western State Hospital to provide any mental health treatment.
Another witness related a story in which she saw a man in a volatile relationship with his wife; both had attacked each other in the past. Having worked with him, they were able to control that anger before it led to action; however, if the patient had known of the providers’ duty to warn, it would’ve “derailed” his treatment, the witness said.
Another witness noted the impact the Volk decision is already having on the behavioral health workforce in the state. She said she had already heard from practitioners in Oregon and Idaho who were less likely to take cases from across the border in Washington.
The hearing included three witnesses in opposition to the bill, representing the Washington State Association of Justice, which represents the state’s trial lawyers, and a global litigation firm.
Their testimony centered on the paramount duty to preventing harm, though one said practitioners’ concerns about Volk are overblown.
“The idea that Volk changes the law for mental health providers is just not the case. There is no huge shift in law,” one of the lawyers said. “The standard of care isn’t burdensome, and in other states, this hasn’t led to a catastrophic flow of litigation.”
House Republicans Abandon Pursuit of AHCA
The American Health Care Act, crafted by House Republicans and President Donald Trump as a replacement for the Affordable Care Act never made it to a vote. In the hours before the vote was to begin, Republican leadership decided it didn’t have enough votes to pass.
“We’re going to be living with Obamacare for the foreseeable future,” Speaker Paul Ryan (R-WI) said.
In the days before the scheduled vote, the AAFP and numerous other groups came out against the AHCA. AAFP specifically cited the legislation’s potential to leave millions without health care coverage and make it more expensive for those with coverage.
“It is well-recognized that the two most influential indicators of health are continuous health care coverage and a usual source of care, typically through a continuous relationship with a primary care physician,” the AAFP wrote in a letter to Ryan and House Minority Leader Nancy Pelosi (D-CA). “Unfortunately, the AHCA fails both measures.”
Four of Washington’s congressional seats are represented by Republicans, and the WAFP urged members in those districts to contact their representatives.
Of those four, two (Congresswoman Cathy McMorris Rodgers and Congressman Dan Newhouse) continued to express support of the AHCA proposal; another, Congressman Dave Reichert, supported the AHCA in committee but was not sure he could support the proposal on the House floor, becoming known as a member of the “cold feet caucus.”
On the eve of the vote, Rep. Jaime Herrera Beutler declared her intention to vote no.
“While I appreciate this week’s effort by Speaker Ryan and his leadership team to better protect older Americans from health care cost increases, the difficulties this bill would create for millions of children were left unaddressed,” Herrera Beutler said in a statement. “I’m disappointed that it appears my amendment to strengthen the Medicaid safety net for the kids who depend on it for their health care will not be considered. Protecting vulnerable children is a core purpose of the Medicaid program and when the program fails to do so, it fails entirely. I will not vote to let those kids fall through the cracks. Southwest Washington residents also deserve a greater commitment to lowering health costs so that out-of-pocket expenses, premiums and taxes are taking up less of their monthly paychecks. Congress should more purposefully move ahead with free market reforms that increase competition between insurance providers and drive down premiums and deductibles.”
AAFP Among 12 Groups Form Medical Society Consortium on Climate and Health
Citing the increasingly harmful effects of climate change, the AAFP and several other like-minded groups have formed the Medical Society Consortium on Climate and Health. The new advocacy organization launched by releasing a new paper, “Medical Alert! Climate Change is Harming Our Health.”
The consortium will advocate federal and state officials to focus on energy efficiency and move toward clean, renewable energy sources.
“The danger of climate change is a danger to the health of every American,” said Mona Sarfaty, MD, MPH, the consortium’s director and also a family physician. “Americans are not aware that it is harming our health.”
The group is also looking for physicians who are willing to speak out about health and climate change with local media and elected officials. The group also offers posters, brochures and fact sheets to educate patients and the effect of climate change on health.
Other associations involved in the consortium are the American Congress of Obstetricians and Gynecologists; the American Academy of Allergy, Asthma & Immunology; the National Medical Association; the American Academy of Pediatrics; the American College of Physicians; the American College of Preventive Medicine; the American Medical Association; the American Podiatric Medical Association; the Infectious Diseases Society of America; the Society of General Internal Medicine; and the American Geriatrics Society.
Washington Mumps Outbreak Stands at 664 Cases
Spokane County and King County remain at the heart of Washington’s ongoing mumps outbreak, accounting for nearly four out of every mumps case in the current outbreak. As of late March, Spokane accounted for 283 cases and King had 240. No other county had more than 60.
And that didn’t count an outbreak on the University of Washington’s Seattle campus. The Seattle Times reported that the 20 cases were concentrated primarily in the school’s Greek system.
The Centers for Disease Control and Prevention noted that colleges are particularly susceptible to mumps transmission, given the close quarters found in a typical college dormitory. Indeed, the CDC reported that the previous three national mumps outbreaks were largely on college campuses.
Like Washington, Missouri, Arkansas, Oklahoma, Texas and New York have all reported 50 or more cases as of late February.
Influenza Season in Washington Nearly Finished
As of mid-March – the most recent update from the Washington State Department of Health – shows that influenza levels have dropped to levels not seen since October, before the height of flu season began.
So far, influenza has caused 254 deaths across the state; of those, 225 came in people 65 or older. Seven counties reported at least 10 deaths: King (70), Pierce (47), Snohomish (44), Clark (23), Spokane (15), Kitsap (13) and Thurston (10).
National-level data from the Centers for Disease Control and Prevention indicates declining levels as well. Through mid-March, four states in the Southeast, as well as Oklahoma and Maryland, still had high rates of influenza-like illnesses.
Deadly Fungal Infection Candida Auris Arrives in U.S.
New York and New Jersey have begun seeing cases of Candida auris, the first signs of the fungal infection reaching American shores. First documented in Japan in 2009, according to the Washington Post, the infection has since spread to Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Korea, Venezuela and the United Kingdom. The infection is a “serious global health threat,” according to the Centers for Disease Control and Prevention.
The Post notes that Candida auris wreaks havoc with bloodstream, can be passed from person to person in health care settings, and survives for months on the skin and for weeks on hospital equipment. And some strains – though not any seen in the U.S. – have been resistant to all three classes of anti-fungal drugs.
Though infections remain rare, those most at risk are those with long stays in the ICU or those using ventilators or central line catheters.
The CDC has developed a set of interim recommendations for health care facilities and labs.
Less Than 15 Percent of Baby Boomers Get Tested for Hepatitis C
Researchers at the American Cancer Society have found that a screening recommendation “did not increase [testing] substantially,” according to MedPage Today.
In 2013, only 12.3 percent of people born between 1945 and 1965 were tested for hepatitis C. That year, the U.S. Preventive Services Task Force declared that it too believed that all baby boomers should receive a one-time screening; the Centers for Disease Control and Prevention had come to that conclusion in 2012.
In the two years after that declaration, the prevalence of testing had increased to 13.8 percent — a statistically significant change but not a substantial one.
“These findings underscore the need for increased awareness for HCV testing among health care providers and baby boomers and other innovative strategies such as state-mandated HCV testing,” the researchers, Ahmedin Jemal, DVM, PhD, and Stacey Fedewa, PhD, wrote.
The study was first published online by the American Journal of Preventive Medicine.
Yellow Fever Spikes in Brazil; U.S. Officials Concerned
Jungle areas of southeast Brazil have seen a spike in humans contracting yellow fever. And given the spread of Zika to Puerto Rico, officials in the U.S. are concerned about yellow fever landing here.
“In an era of frequent international travel, any marked increase in domestic cases in Brazil raises the possibility of travel-related cases and local transmission in regions where yellow fever is not endemic. In light of the serious nature of this historically devastating disease, public health awareness and preparedness are critical, even for individual cases,” wrote Catharine Paules, MD, an infectious disease fellow at the National Institutes of Health, and Anthony Fauci, MD, director of the NIH’s National Institute of Allergy and Infectious Diseases, in the New England Journal of Medicine.
Though transmission to humans has been mostly incidental, Paules and Fauci note that transmissions that have occurred are near major urban areas where yellow fever vaccine is not routinely administered. Most of the cases have been documented in Minas Gerais, the second most populous state in Brazil; neighboring São Paulo — the most populous state or province in all of the Americas — has seen a handful of cases as well.
Study: Female Athletes More Prone to Recurrent Concussions
An analysis of 1,203 athletes from Columbia University found that females were more likely to be concussed than males, both overall and in gender-comparable sports.
“Concussion research has been heavily focused on male sports including football. In our study, both male and female athletes with a history of concussion were more likely to get another concussion, and female athletes particularly appeared to be more prone to recurrent concussion,” James M. Noble, MD, MS, of Columbia University Medical Center and the study’s senior author, told MedPage Today.
Noble and his team found 23.1 percent of females and 17 percent of males experienced at least one concussion during their careers. Symptoms following a concussion were similar in both genders, though amnesia was more prevalent in males and insomnia more prevalent in females.
Athletes of both genders who had previously suffered a concussion were three times more likely to have another, according to the study.
Colorectal Cancer Rates Rise — Some Sharply — in People in Their 20s and 30s
Research by the American Cancer Society has found that incidence of colorectal cancers, and rectal cancer in particular, have been on the rise for each generation born since 1950. The New York Times quoted the study’s lead author, Rebecca Siegel, MPH, as saying that her son — along with others born in 1990 — face double the risk of colon cancer and quadruple the risk of rectal cancer compared with someone born in 1950.
Young patients are also at risk for diagnosis in a later stage of the disease, since cancer is rarely a preliminary diagnosis in young people, according to the Times.
The ACS estimates that 13,500 new cases of colon and rectal cancers will be diagnosed this year in Americans under 50. Nearly 100,000 cases of colon cancer and 40,000 cases of rectal cancer will be diagnosed among all age groups this year.
The study was originally published in the Journal of the National Cancer Institute.
Key Dates Approaching for Student and Resident Scholarship and Leadership Opportunities
May 1 marks the deadline for a number of leadership opportunities and scholarships from the AAFP and WAFP for the National Conference of Family Medicine Residents and Students (NCFMRS).
For residents, the AAFP offers scholarships through its residents and returning students program as well as its minority scholarship program. For students, the WAFP offers scholarships to the event, as does the AAFP. Those aren’t the only scholarships available, however; the AAFP website has more.
During NCFMRS, the National Congress of Family Medicine Residents and National Congress of Student Members also meets. One delegate and one alternate delegate for each of the congresses may attend. Entrants must submit an application form, a one-page letter of interest, a C.V. (max two pages) and the Residency Program Recommendation form. Learn more about requirements and other expectation on the WAFP’s resident position page and WAFP’s student position page.
As an aside, the WAFP Executive Committee has extended the deadlines for resident applications to the Family Medicine Advocacy Summit. WAFP offers scholarships for residents to attend FMAS; the new deadline to send applications is April 3. This year’s FMAS will be held May 22-23 in Washington, D.C. More details are on the application form, which is available online.
Record Broken as 3,237 Match into Family Medicine Residency Programs
In setting a new record for family medicine placements, Match 2017 paired 132 more medical students and graduates with positions than in 2016. According to the AAFP, this marks the eighth straight year that the number of students entering family medicine has increased.
But that increase is not nearly enough to cover the coming shortage of primary care physicians.
“We’ve seen a slow and steady upward trend for eight years now, but slow is not good enough,” said AAFP President John Meigs, MD. “Slow is not going to cut it.”
At the University of Washington, 43 students matched into family medicine, including 19 who will remain in the state. PNWU was tabulating its match figures as of this writing.
Match results were announced March 17.
Interstate Medical Licensure Compact May Sue the FBI
The Interstate Medical Licensure Compact, which makes it easier for doctors to be licensed in multiple states, may sue the FBI, which has held up the compact’s progress in at least five states, according to Politico.
The FBI insists that states not share the information accessed from its criminal background check system. The background check is a component of a state’s approval to participate in the compact.
But given the FBI’s unwavering stance, the compact is in “significant jeopardy” of not being implemented effectively, Politico wrote. That could push the commission that runs the compact to file a lawsuit against the FBI. It is still weighing the decision.
The compact would allow greater health care access to rural and underserved areas and promote telemedicine. Washington is not yet a part of the compact, but there is a bill making its way through the Washington Senate that would change that. H.B. 1337 passed 94-3 in the House and has already been approved by the Senate Health Care Committee. It was then passed to the Rules Committee, where it awaits further action.
Medscape Examines Benefits, Drawbacks of Locum Tenens
Staff Care — a locum tenens staffing agency — released a survey in January that found increasing use of locum tenens doctors in health care facilities: Since 2002, doctors doing locum work had nearly doubled to 48,000. Based on that, Medscape took a deeper dive on what life is like in that line of work.
The pay is lucrative; in the Staff Care survey, respondents reported compensation ranging from several hundred dollars to $2,000 per day. But that wasn’t the only positive: A different survey in 2016 found that the ability to control one’s schedule and the experience of seeing different cases were also positives. Doctors in between jobs — or in between residency and a full-time job — also found these temporary assignments appealing.
What, then, are the downsides? According to the story, some believe that long term locum tenens work could be detrimental to a full-time career. Medscape cited another doctor who felt locums could be treated as outsiders and miss out on mentorship opportunities; they could also be assigned to manage a number of high-risk cases.
Report: Physician Shortage Could Reach 100,000 by 2030
A report prepared for the Association of American Medical Colleges found that American demographics will lead to a shortage of between 40,000 and 100,000 physicians by 2030. The shortage of primary care doctors alone could hit 43,100 by 2030.
The projected increase in the U.S. population — and disproportionate increase among Americans 65 and older, who utilize health care services at a much higher rate — explains the drastic shortage, even when the number of PAs and APRNs are factored in.
“There is going to be a significant workforce shortage under all of the likely projections. We see that, quite frankly, only getting worse as the population ages,” said Janis Orlowski, MD, AAMC chief health care officer.
And the report notes that the shortage could become even greater. If underserved populations had fewer barriers to care, demand for physicians could rise “substantially,” according to the report.
Family Physicians Likely to Fill Gaps in Palliative Care
A study by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care has found that a third of physicians surveyed said they provide palliative care.
The information was taken from nearly 11,000 diplomates of the American Board of Family Medicine who recertified in 2013, and the results of the study were published in the ABFM’s journal.
Those physicians who answered yes were most likely to be white males who have been in practice for 20 years or more. They are also most likely to be rural and live in the West.
“In rural areas, there is no one else to do palliative care, so for family physicians, it has to be part of their practice where they see their role as continuing from cradle to grave,” Claire Ankuda, MD, MPH, a co-author of the study, told AAFP News.
Physicians certified in hospice care and palliative medicine were excluded from the analysis to ensure the study’s focus remained on generalist family physicians.
Starting July 1, First-Year Residents Can Work 24-Hour Shifts
First-year residents will again be on the same schedule as other residents and fellows after the Accreditation Council for Graduate Medical Education announced revisions to its Common Program Requirements. As of July 1, they can again work 24-hour shifts, up from the current limit of 16 hours.
“The revised requirements return first-year residents to the same schedule as other residents and fellows, re-establishing the commitment to team-based care and seamless continuity of care while also ensuring professionalism, empathy, and the commitment of first-year residents to their patients,” the ACGME wrote in the memo.
The Washington Post fleshed out some of the other details: Residents cannot average more than 80 hours or work per week, must have one day off every seven days, and cannot work overnight in a hospital more than once in a three-day span.
ACHs to be Focus of Next Healthier Washington Webinar
The next Healthier Washington webinar will be April 5 from 1-2 p.m. and focus on accountable communities of health. Specifically, the webinar will examine the structure and roles of ACHs within Washington, how the state evaluates their progress, and other topics.
Panelists will include Dorothy Teeter, director of the Washington State Health Care Authority; Alison Carl White, executive director of Better Health Together; Elya Moore, PhD, director of the Olympic Community of Health; Erin Hertel, Community Health & Evaluation senior research associate/program manager; Marc Provence, MPH, director of the Office of Medicaid Transformation; and Chase Napier, community transformation manager.
Qualis to Host Webinar on Creating Community Linkages
Qualis will host a free webinar April 19, from noon to 1 p.m., to help practitioners understand strategies to identify and match patient needs with available community non-medical resources.
Hosted by Trudy Bearden, a senior consultant at Qualis Health, the webinar will help participants learn to identify patient barriers and needs; identify ways to apply team-based and coordinated care with the right community resources; and learn strategies on following up after referrals.
Study Finds CPC Practices Rank Slightly Higher in Patient Experience Ratings
Researchers from Mathematica Policy Research compared comprehensive primary care (CPC) practices to themselves and to comparison practices in an effort to determine whether a patient’s experience would be positively or negatively affected. They conclude that CPC practices improved from their first year to their second, and that in of three of six measures, CPC practices scored slightly higher than the comparison group.
Their results were published by the American Journal of Managed Care.
The CPC practices fared better than their counterparts in three areas: getting timely appointments, care and information; helping patients take care of their own health; and discussing medication decisions with patients.
The researchers write that, while the ratings for both groups were comparable, “both [face] substantial room for improvement.”