Posts tagged Council for Medical Specialty Societies

Update from the AMA 2011 Annual Meeting

by Chad D. Kollas, MD, FACP, FCLM, FAAHPM – AAHPM Delegate to the AMA

While in Chicago from June 18-20 to represent the Academy at the Annual Meeting of the American Medical Association House of Delegates, my colleague Dennis Pacl, MD FAAP FACP – AAHPM’s alternate delegate – and I took in a show one night…. We saw Steve Martin and Martin Short at the historic Chicago Theater in what was billed as “A Very Stupid Conversation.” Now, I know that some question the continuing relevance of the AMA, but I would assure all AAHPM members that our time spent at the AMA Annual Meeting was anything but stupid. In fact, I am pleased to say that this gathering of physicians representing state and specialty medical societies featured some very thoughtful conversations, many that impact the future of medicine and a number that are key to our field.

I was honored to have been elected in November to chair the AMA’s Pain and Palliative Medicine Specialty Section Council (PPMSSC). As representatives of nine diverse specialties, the PPMSSC reviews the reports and resolutions before the House with implications for the pain and palliative medicine communities and decide where to provide testimony and offer joint endorsement or opposition. One resolution, sponsored by the Iowa delegation, called for a national dialogue by interested parties on end-of-life (EOL) counseling. AAHPM testified in favor of the resolution and identified the Academy and PPMSSC as interested in serving as resources in the endeavor. The AMA House of Delegates adopted the resolution as new AMA policy, and we’ll provide timely updates on the effort. Another resolution, sponsored by the American Thoracic Society, led to a recommendation that the “AMA encourage the Centers for Medicare and Medicaid Services to designate voluntary discussions about end-of-life care as covered services in the 2012 Medicare Physician Fee Schedule.” These efforts – which harmonize with the Academy’s policy priorities – build upon an opinion by the AMA Council on Ethical and Judicial Affairs approved by the AMA House in November 2010, which encouraged physicians to participate in advance care planning.

The AMA House also passed a resolution that called for reform of the Patient Protection and Affordable Care Act (PPACA). Although the PPACA contained many directives consistent with AMA policy, such as expanding health insurance coverage for Americans, it also contained provisions considered undesirable or controversial. The AMA specifically called for repeal of the Independent Payment Advisory Board (IPAB), enactment of comprehensive medical liability reform, studying further the Medicare Cost/Quality index and expanding the use of health savings accounts (HSAs). Support for individual responsibility for health insurance to cover the uninsured was also reaffirmed read more.

The House also accepted a report from CEJA regarding ethics rules guiding industry support for continuing medical education (CME). A representative from the Accreditation Council for Continuing Medical Education (ACCME) testified that the new ethics rules were consistent with current ACCME standards. AAHPM already conforms to both the ACCME standards and the new AMA standards, and also signed on to the Council of Medical Specialty Societies’ Code for Interactions with Companies.

Finally, some issues of interest to palliative care physicians were referred for further study by the AMA. The Florida Delegation sponsored a resolution asking the AMA to study the issue of national or regional drug shortages, a problem that has profoundly affected palliative care specialists over the last several years. Additionally, AAHPM supported studying the content of patient navigators programs to enhance their consistency. The AAHPM Delegation to the AMA will make the findings of the reports available to Academy members when that information becomes available.

Beyond the annual meeting, our collaboration with members of the PPMSSC continues. This summer, we’ll develop comments on a resolution addressing the right of access to medication for pain relief that will be presented later this year at the World Medical Association meeting. In the meantime, if there are issues that you believe we should take to the “House of Medicine,” I welcome your thoughts. I also hope that if you’re not an AMA member, you will consider joining? (be sure to specify HPM as your specialty if you do) – AAHPM’s representation and participation is dependent on having a sufficient number of Academy members among the AMA’s ranks.

“What the heck is CMSS and why should I care?”

You may be asking yourself, “What the heck is CMSS and why should I care?” While I knew that this stands for Council of Medical Specialty Societies, I attended their recent annual meeting with less than a full appreciation of what this is and why it matters to us doing Hospice and Palliative Medicine. Afterwards, I have a much better understanding. Sitting through various presentations that included slides predicting not just political ‘fireworks’ in the coming year, but political ‘nuclear explosions.’

So what is CMSS? It is a place where the specialty societies that have ABMS primary Boards and an increasing number of subspecialty societies, like AAHPM, can come together and interface with each other, and with a number of other associated entities, like the Federation of State Medical Boards, the Association of American Medical Colleges, the National Board of Medical Examiners, the Accreditation Council for Continuing Medical Education, and others. The entities just named all provided speakers who educated the attendees on what is happening within their bailiwicks, as it relates to what we, the practicing physicians do.

Besides the aforementioned mention of how the November elections have obliterated many predictions of what to expect legislatively over the coming year, in depth discussion of the following was provided. CMSS, itself, has sponsored and promulgated the CMSS Code for Interactions with Companies, (what is known as ‘the Code’), providing guidance for how member societies can craft their members’ and leaders’ relations with industry, especially in light on the likelihood of passage of the “Sunshine Act,” which will require reporting of industry payments to physicians. AAHPM has already signed onto the Code, which is available online at http://cmss.org/codeforinteractions.aspx.

Physician workforce shortages were addressed by various entities, including AAMC, with discussions centering around deficiencies in how we select physicians, with current selection tools only accurately predicting how well students will do in the first half of medical school, rather than how well the future selectee will meet expected demands as practicing physicians. FSMB and ACCME discussed Maintenance of Licensure and Maintenance of Certification, and what to expect in the coming decade. ACGME duties hour limitations for residents were also discussed.

As the newest member of this august organization, AAHPM’s representatives were welcomed with open arms by the other member representatives, giving further indication that HPM is increasingly recognized as a crucial component of the entire continuum of medical practice. It was my privilege to represent the Academy, following up on the groundwork laid by Gail Cooney, our immediate past president. Other Academy representation included Steve Smith, our CEO, Laura Davis, director of marketing and membership, and Julie Bruno, director of education and training.

“Create an organization that’s so effective that you can’t afford not to belong.”

That’s the guiding principle of the Council for Medical Specialty Societies (CMSS) and AAHPM is their newest member! This month, Laura Davis, AAHPM Director of Marketing and Membership, and I represented AAHPM at the CMSS spring meeting in Washington DC.

What is CMSS and why did AAHPM leadership decide that it was important to participate? CMSS represents the needs of physician specialists and subspecialists in American health care. And, with complicated issues like the medical home and graduate medical education slots on the table, they represent an important voice. I liked their two overarching goals – (1) to create a culture of performance improvement and (2) to model professional and ethical medical practice. And they’re taking action. During the April meeting, CMSS approved a code for ethical interactions with health-care companies.

Michael Hash, Senior Advisor HHS Office of Health Reform and liaison to the White House Office of Health Reform, talked to the Council about the recent health reform legislations. He emphasized that Medicare and Medicaid will both focus on the subset of patients with multiple advanced chronic diseases. Hello?? Did someone say “Palliative Medicine?” On the GME issue, he did not expect any increase in the number of “slots”; instead, legislation is focusing on loans, loan forgiveness, and National Health Service programs. And last, he asked that physicians actively support Don Berwick’s nomination as director of CMSS – look for legislative action alerts!

Tom Nasca MD, CEO of ACGME spoke next about upcoming ACGME recommendations regarding resident duty hours. He strongly urged physicians to support the ACGME proposals, noting that, if the medical profession fails to act, someone else (i.e., the federal government) will do it for us.

Two panel discussions presented issues regarding the Patient Centered Medical Home (PCMU), the meaningful use (MU) of health information technology (HIT) – it’s Washington, loads of acronyms – and their intersection. I found a couple of useful take-home messages. First, current EMR (electronic medical records) are built to coordinate billing, not patient care. It’s SO true, but somehow I had missed that point before – I can be slow. Second, a new EMR needs to collect data on practice improvement, because performance measures are expected to be integral to proposed health care changes. And third, your EMR should support care coordination, the core principle of the PCMH model.

No one is quite sure what the PCMH model will look like, but it’s expected to follow NCQA guidelines. There’s talk of the “medical neighborhood” that includes specialists and subspecialists. And it’s likely that we’ll see non-physician providers (NPs and Pas) as PCMH practitioners soon. AAHPM needs to continue active discussion of how HPM physicians might fit into the PCMH model – Chad Collas and the Public Policy Committee are already at work.

Membership in CMSS is just another example of how AAHPM is working to meet members’ needs in a changing health care environment! Stay tuned for more. And leave your comments on these issues – we need to hear from you!!