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December 29,
2008 |
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IN THIS ISSUE
Editor's Column: Crisis Of Confidence
Dr. Smitherman For Surgeon General?
Surgeons Issue Health Reform Plan
WSUSOM Doc To Address Dementia On Latino TV
Henry Ford Hospital Honored For Increasing Organ
Donor Rates
Questions & Answers On Medical Marihuana From MDCH
Private House Parties Used To Debate Health Care
Reform
Post A Memory Of Kevin Kelly; Memorial Service
Jan. 14 |
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Editor's Column: Crisis Of Confidence
By JOSEPH WEISS, MD
The headlines on the effects of the crisis of financial confidence
go to Detroit automakers, but Michigan physicians should consider
what the present recession means to us. I am not talking about the
stopping of hospital construction, the firing of personnel in
hospitals or the freeze on hiring at BCBS. Nor am I considering what
the drop in stock market values may mean to our personal wealth.
What physicians in Southeastern Michigan will face is the
changed circumstances of our patients. First, we will need to
respond to new health plans that employers are negotiating because
of the economic downturn. With hardly an exception, employees who
are our patients, face higher deductibles and copays. The higher
copays include drugs that once cost $20-$40/prescription ( Tier 2
drugs) now costing the employee 20%-40% (reclassified as tier 3
drugs). We must prepare to answer patients who say that they need us
to substitute a drug they can afford.
Second, we must be ready to assist the patient, who between
losing a job, and or saddled with a mortgage beyond his means, or
experiencing a cut in income because of the fall of stock values,
can no longer make the co-pays or meet the deductible that the
health care plan calls for.
In the past, we dealt with the occasional patient who
suddenly couldn’t pay or the patient with no money who needed
expensive care. Now, we will see such circumstances on a scale that
will make the improvised solution impossible and the act of simply
forgoing a charge impractical.
Today, under the strain of the credit collapse it is not
possible for a management consultant to give physicians guidelines
on how to continue care for patients who can no longer pay for the
services they require. Likely, we will have to put aside the
formulas of our Excel spreadsheet and instead use a combination of
common sense, compassion, contacts with pharmaceutical
representatives, and camaraderie with hospital administration to
bring our patients through their hard times.
Meet with your office manager to plan how to triage and
render medical care. Consider that practicing medicine in the
present financial climate is like working in the time of cholera or
an anthrax epidemic.
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Dr. Smitherman For
Surgeon General?
According
to a report appearing in the Detroit News, US Rep. John Conyers is
urging President-elect Barack Obama to pick Dr. Herbert Smitherman
Jr., to be the next US surgeon general.
The News
reported that Conyers sent a letter pitching Dr. Smitherman to be
the nation's chief health educator. Dr. Smitherman, 48, is the
assistant dean of Community and Urban Health and an assistant
professor of the Department of Medicine for the Wayne State
University School of Medicine.
The Obama
transition team's press office didn't respond to a News request
about when the president-elect plans to nominate his choice for the
spot. Smitherman's chances for getting the nomination are unclear.
In a
statement, Smitherman called the job "a critical position,
especially on the eve of President-elect Obama's broad agenda for US
health care reform."
Smitherman
added, "My focus for the past 22 years here at Wayne State
University has been twofold: that of creatively improving coverage
and organizing delivery systems toward improved access to care for
vulnerable populations and increasing the health status of my
community. The U.S. surgeon general role would be an opportunity to
do this for my country."
Smitherman
told the News that Gov. Jennifer Granholm also recommended him for
the post.
“I was
called on Nov. 5 by Congressman Conyers, who asked me if he could
forward my name to the Obama-Biden transition team recommending me
for U.S. surgeon general,” confirmed Dr. Smitherman. “I indicated
that I was honored to be considered for such a recommendation by his
office.”
Rep.
Conyers followed up with a subsequent meeting with Dr. Smitherman,
and then submitted the recommendation in writing to the Obama team.
Rep.
Conyers wrote that his recommendation of Smitherman was inspired by
his “personal and professional commitment to serving (his)
community, state and nation.”
“Your
integrity, academic excellence, health policy leadership, as well as
your intellectual interests and career pursuits have supplemented
your commitment to finding solutions for providing health care
services to the uninsured and underinsured,” Rep. Conyers added in a
letter to Dr. Smitherman.
Dr.
Smitherman “is an informed and engaged advocate for affordable and
preventative health care services and has been involved in crafting
effective health policy in this state and sharing his experiences
nationwide,” Gov. Granholm wrote to the Obama transition team. He
has helped “lead the expansion of federally qualified health
centers, including Health Centers Detroit, which he leads as
president and CEO. He has also written a book (“Taking Care of the
Uninsured: A Path to Reform”) that articulates a successful
community health model for care of the uninsured and underinsured.”
Robert M.
Mentzer Jr., MD, dean of the School of Medicine and senior advisor
to the president on Medical Affairs, said such national recognition
spoke highly of Dr. Smitherman’s efforts and one of the school’s
stated missions of providing care to the community.
“Dr.
Smitherman not only exemplifies that part of our mission, he lives
it daily,” said Dean Mentzer. “His work in the community on behalf
of the School of Medicine shows that commitment and a focused effort
can truly make a difference in providing health care for underserved
populations. If he is appointed surgeon general, I can assure you
that goal will remain at the top of his priority list.”
Dr.
Smitherman, who this year received the School of Medicine’s
Trailblazer Award for substantial contributions, courage,
initiative, innovation, risk-taking and leadership, said that if he
is offered the position he will accept, but maintain his Wayne State
University appointment.
“It is a
critical position, especially on the eve of president-elect Obama’s
broad agenda for U.S. health care reform,” said Dr. Smitherman. “My
focus for the past 22 years here at Wayne State University has been
twofold: that of creatively improving coverage and organizing
delivery systems toward improved access to care for vulnerable
populations and increasing the health status of my community. The
U.S. Surgeon General role would be an opportunity to do this for my
country.”
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Surgeons Issue
Health Reform Plan
As
President-elect Barack Obama and the incoming 111th
Congress prepare for the many policy issues potentially complicating
the process of achieving effective health care reform, the American
College of Surgeons (ACS) has released a comprehensive policy
statement to help frame the debate. Specifically, the ACS calls on
policymakers to support a reform approach that improves access to
safe, high-quality, and affordable surgical care. A key objective of
the ACS effort is to address the crisis of access to quality
surgical care by emphasizing policies that will remedy the surgical
workforce shortage affecting the country.
The ACS’s
focus on and concern about patient access to safe and effective
surgical care and the looming surgeon shortage is supported by a
recent public opinion poll it conducted. Results of the survey
indicate that 86 percent of Americans feel a potential surgeon
shortage is an important issue to be addressed as part of any health
care reform process.
“Access to
surgical care is eroding in many communities across the country and
for some it is nonexistent,” said L. D. Britt, MD, MPH Brickhouse
Professor and Chair, department of surgery, Eastern Virginia Medical
School, Norfolk, VA, and Chair of the ACS Board of Regents. “The
availability of a highly trained surgeon can mean life or death to a
patient in need. Policymakers must address the root causes of this
workforce shortage because patient care must not suffer.”
Today, fewer
doctors coming out of medical school pursue surgical training,
raising concerns about the long-term impact of surgical workforce
availability due to the additional years required for surgical
training, according to the ACS
Those fears
are echoed by survey respondents, as most said they were concerned
that: there are 50 percent fewer general surgeons today than there
were 20 years ago (79 percent concerned); there are not enough
qualified surgeons to staff emergency trauma centers across the
country (89 percent); the number of medical students who become
general surgeons has decreased 30 percent over the last 10 years (81
percent); and three-quarters of U.S. hospitals say they don’t have
enough specialty surgeons to treat their patients (86 percent).
To ensure the
United States has a well-trained and available surgical workforce to
meet patient needs, the College encourages lawmakers to create
policies that:
·
Help eliminate disparities in surgical care by expanding the
National Health Service Corps to include surgeons. The College
believes that doing so will help increase public service and also
assist surgeons with medical school debt.
·
Support and help fund a national health workforce database to
identify areas with little or no access to surgical care.
·
Explore alternative methods for paying for health care to ensure the
presence of an adequate and robust surgical workforce over time by
working with the ACS to develop a demonstration program.
·
Reduce medical errors, improve safety, provide patients with higher
quality care, and potentially reduce the incidence of medical
liability cases
by partnering with the College and the surgical community to test
surgical and patient safety initiatives.
“It is our job
to ensure that all Americans have access to innovative,
high-quality, and affordable surgical care,” said Thomas R. Russell,
MD, FACS, ACS Executive Director. “Creating an environment in which
all patients–rural or urban, wealthy or poor--have access to the
surgical care they need must be an essential element of health care
reform. We look forward to working with policymakers, patient
advocates, and the surgical, medical, and health care communities to
make sure that when a surgeon is needed, the resources are there.”
In addition to
workforce and access issues, the College also lays out policy
recommendations to improve quality and safety and reduce overall
health care costs.
The College
takes a ”shared responsibility” approach in its policy statement and
recommends that all stakeholders work together to build a better
health care delivery system. In addition, the ACS outlines related
activities it is committed to undertaking to meet its policy
objectives. These commitments include providing better educational
and quality measurement resources and opportunities, promoting
health information technology (HIT) among the surgical community,
and developing better patient safety standards to help reduce
medical errors.
The American
College of Surgeon’s Statement on Health Care Policy Reform can be
found at
http://www.facs.org/ahp/hcreform08.pdf.
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WSUSOM Doc To
Address Dementia On Latino TV
A Wayne State
University School of Medicine assistant professor will be
interviewed about dementia and other health problems among the
Latino population by the nation’s largest private non-profit
Spanish-language network of non-commercial telecommunications
systems.
Hector Gonzalez,
Ph.D., will be interviewed for the Hispanic Information and
Telecommunications Network. With 12.7 million viewers, HITN claims
to be the largest distributed Spanish-language cable network in the
United States.
Dr. González, a
clinical neuropsychologist and an assistant professor in the
Department of Family Medicine and Public Health Sciences, has a
joint appointment in the Institute of Gerontology.
He will be
interviewed by telephone for the program “Diálago de Costa y Costa”
(Dialog Coast to Coast). Conducted in Spanish, the interview came
about, Dr. Gonzalez explained, because colleagues in the Hispanic
Community Health Study/Study of Latinos recommended him to HITN.
“It seems there
are very few Latinos with expertise on aging and dementia in the
country,” Dr. Gonzalez said. “Because of the unacceptable dearth of
Mexican-American clinicians and scholars, I got into this business
to serve my community's health needs. I feel it is both an honor and
an obligation to serve the community by providing the best
information available in ways that makes sense and have lasting
impact.”
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Henry Ford Hospital Honored For
Increasing Organ Donor Rates
The Medal of
Honor issued by the US Department of Health & Human Services honors
hospitals that convert at least 75 percent of eligible deaths into
organ donors. Each organ and tissue donor can save the lives of up
to eight people and enhance the lives of 50 people or more.
Henry Ford, one
of only two hospitals in Michigan that offer a full range of organ
transplantation, performs more than 250 transplants annually,
including kidney, liver, pancreas, heart, lung and bone marrow.
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Questions & Answers
On Medical Marihuana From MDCH
Q:Who will operate the Medical Marihuana Program?
A:
The Bureau of Health Professions (BHP) within the Michigan
Department of Community Health (MDCH) will run the Medical Marihuana
Program.
Q:
What is the Medical Marihuana Program?
A:
The program provides for the issuance of a registry identification
card for patients qualified to use marihuana for medical purposes
and for individuals qualified to serve as a caregiver on behalf of a
designated patient.
Q:
Who can apply for an identification card?
A:
A qualifying patient is a person who has been diagnosed by a
physician as having a debilitating medical condition. A primary
caregiver means a person who is at least 21 years old and who has
agreed to assist with a patient’s medical use of marihuana and who
has never been convicted of a felony involving illegal drugs. The
caregiver can assist no more than five patients.
Q:
What does Proposal 1 allow?
A:
Proposal 1 allows for patients with a debilitating medical condition
such as cancer, HIV, AIDS, or nail patella to utilize medical
marihuana after obtaining a registry identification card from MDCH.
In order to obtain a registry identification card, patients must
obtain a written certification from a physician verifying that they
have one of the qualifying debilitating medical conditions. Patients
in need of medical assistance in using the medical marihuana may
designate a primary caregiver. Registered patients or caregivers
will be allowed to grow limited amounts of marihuana for qualifying
patients in an enclosed, locked facility. MDCH cannot advise
registered patients on the growing process and does not have
information to give to patients. The law states the following:
A
qualifying patient who has been issued and possesses a registry
identification card shall not be subject to arrest, prosecution, or
penalty in any manner, or denied any right or privilege, including
but not limited to civil penalty or disciplinary action by a
business or occupational or professional licensing board or bureau,
for the medical use of marihuana in accordance with this act,
provided that the qualifying patient possesses an amount of
marihuana that does not exceed 2.5 ounces of usable marihuana, and,
if the qualifying patient has not specified that a primary caregiver
will be allowed under state law to cultivate marihuana for the
qualifying patient, 12 marihuana plants kept in an enclosed, locked
facility. Any incidental amount of seeds, stalks, and unusable roots
shall also be allowed under state law and shall not be included in
this amount.
2 (b)
A primary caregiver who has been issued and possesses a registry
identification card shall not be subject to arrest, prosecution, or
penalty in any manner, or denied any right or privilege, including
but not limited to civil penalty or disciplinary action by a
business or occupational or professional licensing board or bureau,
for assisting an qualifying patient to whom he or she is connected
through the department’s registration process with the medical use
of marihuana in accordance with this act, provided that the primary
caregiver possesses an amount of marihuana that does not exceed:
(1)
2.5 ounces of usable marihuana for each qualifying patient to whom
he or she is connected through the department’s registration
process; and (2) for each registered qualifying patient who has
specified that the primary caregiver will be allowed under state law
to cultivate marihuana for the qualifying patient, 12 marihuana
plants kept in an enclosed, locked facility; and (3) any incidental
amount of seeds, stalks, and unusable roots.
Q:
When can patients and caregivers begin to apply for the program?
A:
DCH must promulgate administrative rules by April 4, which is 120
days after the effective date of the act, which is Dec. 4. No one
can register for the program until after April 4.
Q:
Upon approval, when are identification cards issued?
A:
The department must verify applicant’s information or renewal
information within 15 days of receiving application. The
identification card must be issued within five days of approving
application or renewal.
Q:
How can I acquire marihuana for medicinal reasons?
A:
The new law does not provide a legal means of acquiring marihuana or
marihuana seeds. MDCH cannot provide advice on how to acquire
marihuana legally.
Q:
Who can grow medicinal marihuana?
A:
Only patients and caregivers who qualify in the Medical Marihuana
Program can grow marihuana.
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Private House
Parties Used To Debate Health Care Reform
The
New York Times
on Tuesday examined one of the more than 4,200 house parties to
discuss health care reform between Dec. 15 and Dec. 31 that were
requested by former Senate Majority Leader Tom Daschle (D-S.D.),
head of President-elect Barack Obama's health transition team and
nominee for
HHS secretary. The Times
highlighted one house party in Northern Virginia,
which had 12 participants.
The party's participants "quickly agreed on one point: they despise
health insurance companies," according to the
Times. In addition, they agreed that "health care was a
right; that insurance should cover 'everything,' not just some
services; and that coverage should be readily available from the
government, as well as from employers," according to the
Times. "The Obama
transition team did not ask people how a new health care system
should be financed, but several people" at the party "said that
individuals and businesses should have to pay a small health care
tax ... so that everyone could be covered," the
Times reports (Pear,
New York Times,
12/23).
Reprinted from
kaisernetwork.org. You can view the entire
Kaiser Daily Health Policy
Report, search the archives, and sign up for email
delivery at www.kaisernetwork.org/dailyreports/healthpolicy . The
Kaiser Daily Health Policy
Report is published for kaisernetwork.org, a free
service of The Henry J. Kaiser Family Foundation. © 2008 Advisory
Board Company and Kaiser Family Foundation. All rights reserved."
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Post A Memory Of
Kevin Kelly; Memorial Service Jan. 14
As a way for MSMS members and others to honor and remember former
MSMS Executive Director
Kevin A.
Kelly, MSMS has created a web page for users to post
their own comments and/or memories of Kevin. Click
here to post your own comment and read more about Kevin’s life.
A public memorial service has been scheduled for Wednesday, January
14, 2009, at 1 p.m., at
The
Peoples Church in East Lansing.
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