ANNUALMEETING

2018

INFORMATIONALREPORTS

MEMORANDUM September | 25 | 2018 TO: MSV House of Delegates FROM: Peter Kemp, M.D., Chair, MSVPAC RE: MSVPAC report Fundraising Update: We would like to thank those of you who have demonstrated their leadership by contributing to MSVPAC already this year. If you have not already done so this year, we hope you will join your colleagues in financially supporting MSVPAC for the benefits it brings to MSV’s advocacy and outreach to legislators. As of January 1, 2018, MSVPAC and AMPAC ended their collective fundraising agreement, meaning MSVPAC took over all control of its fundraising efforts. 2018 so far has been a year of realignment for the PAC, and we look forward to continuing to test and develop improved fundraising strategies. As of August 31, MSVPAC has raised approximately $58,912 against a budgeted goal of $231,800. MSVPAC Board Recruitment: Recruitment is urgently needed to fill vacant seats on the MSVPAC Board. There are currently vacancies in all districts. An application has been created and is available through our website here: https://www.msv.org/connections/political-action-committee/msvpac-board-application

Date September 24, 2018

To: MSV House of Delegates

From: Ryan Schlobach, MSV Medical Student Section Chair Eastern Virginia Medical School, M4 Re: Medical Student Section Annual Report, 2017-2018

On behalf of the Medical Student Section (MSS) of the Medical Society of Virginia (MSV), I would like to thank the House of Delegates for their continued support of the section and our chapters at Eastern Virginia Medical School (EVMS), Liberty College of Osteopathic Medicine (LUCOM), University of Virginia (UVA), Virginia Commonwealth University (VCU) Virginia College of Osteopathic Medicine (VCOM), and Virginia Tech Carilion (VTC). I am honored and proud to write to the House of Delegates on behalf of our MSS. The opportunity to take part in this organization has proven vital to our section’s efforts in developing essential skills to become strong advocates for our future patients and profession. It has always been a privilege to work alongside the students and staff of the MSV. As you will see below, we have accomplished much in the way of recruiting and engaging our student members, instilling the importance of organized medicine, and making Virginia’s students known on a national level.

Leadership MSV MSS Leadership On February 3, MSV medical student leaders met to elect the 2018 - 2019 academic year leadership for the MSV Medical Student Section. While students elected to section leadership positions did not assume their position until June 1, elections are held in the winter to allow for training and transition between officers.

Chair: Ryan Schlobach (EVMS) Vice Chair: Eugenie Quan (VCU) At-Large Officer: Bradley Mason (EVMS) Recruiting Committee Chair: Elizabeth Mannino (EVMS) Recruiting Committee Vice Chair: Lindsay Gould (EVMS) Recruiting Committee At-Large Officer: Christian Go (EVMS) Legislative Committee Chair: Krista Kennedy (UVA) Legislative Committee Co-Vice Chair: Ruth Stockton (EVMS) Legislative Committee Co-Vice Chair: Kayvon Mobarakeh (VCU) Legislative Committee Co-At-Large Officer: Daniel Akyeampong (UVA) Legislative Committee Co-At-Large Officer: Matthew Adsit (EVMS) Events Committee Chair: Daniel Phadke (UVA) Events Committee Vice Chair: Meeta Prakash (VTC)

Community Outreach Committee Chair: Emily Schutzenhofer (UVA) Community Outreach Committee Co-Vice Chair: Malek Bouzaher (VTC) Community Outreach Committee Co-Vice Chair: Joseph Hirst (EVMS) Community Outreach Committee At-Large Officer: Krishna Kinariwala (VCU) The student leaders also elected the representatives that they will submit to the MSV and MSVPAC Nominating Committees prior to the 2018 MSV Annual Meeting. These students will represent MSS on their respective boards. I would like to congratulate the newly selected leaders: MSV Board of Directors, MSS Associate Director: Michael Pierce (EVMS) MSVPAC Board of Directors, MSS Representative: Maxwell Wagner (EVMS)

AMA MSS Leadership Virginia’s students continue to have success in being selected for leadership positions among the AMA medical student section. The following medical students have been selected to serve in leadership roles:

Meeta Prakash (VTC M2) Secretary – MSS Region 6 Leadership Board Krishna Kinariwala (VCU M2) Legislative Chair – MSS Region 6 Leadership Board Omar Salman (VTC M4) Chair - MSS Committee on LGBTQI+ issues Meeta Prakash (VTC M2) MSS Committee for Global & Public Health Abby Winn (VTC M3) MSS Committee on Legislation and Advocacy Keri Godbe (VTC M2) MSS Committee on Membership, Engagement and Recruitment Grace Lee (VTC M2) MSS Committee on Bioethics and Humanities Ayesha Kar (VTC M2) MSS Committee on Medical Education Lisa Le (UVA M3) MSS Committee on Bioethics and Humanities Samantha Wickman (UVA M2) MSS Committee on Economics and Quality in Medicine

Chapter Leader Handbook As a leadership team, we spent the summer compiling a new chapter leadership handbook. This handbook was created with the intention of helping to ensure all student leaders are given the knowledge needed to prove successful in their individual leadership role and to grow MSV’s presence at their medical school.

Membership Recruitment 2017-2018 MSS Membership Recruiting The MSS’ annual membership recruiting drive concluded in November. Even with the increased dues rate for first year students to join MSV and AMA, through the hard work of our student leaders, we were able to recruit more than 50% of the collective first year student classes at EVMS, UVA, VCU and VTC; EVMS and VTC recruited greater than 70% of their first year classes.

Physician Membership Retention Campaign On February 4, student leaders will meet at MSV’s office and call MSV physician members who have yet to renew their memberships for 2019. We look forward to speaking with MSV physicians and sharing our passion for MSV with them to encourage their membership renewals. We appreciate the opportunity to help MSV and show our appreciation for all the organization has done for our MSS.

Recruitment Materials In following MSV’s segmented value proposition work, we created new recruitment materials for this year’s medical student membership drive. The materials have resonated with the first year classes and have been an aid to our recruitment efforts. I encourage you to go on MSV’s YouTube page to watch the recruitment video which was created. Our new flyer is included at the end of our report for your review.

Advocacy I am pleased to share our section’s engagement in MSV’s General Assembly advocacy efforts this session. Even with the constraints of the temporary Pocahontas building we had one of our most robust students lobbying years to date with 9 in person student lobbying days. Students from EVMS, VCU, UVA, VTC and VCOM spoke with dozens of legislators on the clinical educational components of medical education versus nurse practitioner education. In addition to our in-person efforts at the General Assembly in Richmond, we held a legislator phonathon event at EVMS. MSV student members called legislators expressing the need to continue state funded Graduate Medical Education to create new residency opportunities in Virginia. This was the first time we’d held such an event and it proved incredibly successful. With the combined student attendance at our Richmond lobbying days and EVMS chapter event we had 60 student members engage in MSV’s advocacy efforts. We are incredibly proud of our medical student advocates.

MSS Events and Community Outreach 2017 MSV Annual Meeting Serving as the pinnacle event for the Medical Student Section, the MSV Annual Meeting was a reflection of the increased focus on meaningful engagement for students at MSV events. The energy and excitement sparked at the Annual Meeting is still alive in the MSS. In preparation for the meeting, our section leadership prepared over twenty pages of background research on the proposed resolutions to ensure students in attendance understood the resolutions and their potential impact prior to voting as delegates. I would like to thank the Board for taking the time to speak to student attendees. The personal interaction between our student attendees and physician leaders is what sets MSV apart from other professional organizations.

VDH REVIVE! Partnership The Community Outreach Committee has been partnering with the VDH's REVIVE! program to start a program in which medical students train as trainers on identifying opioid overdoses and responding appropriately through Naloxone use. Seven students from three chapters have trained over the summer, and we will be hosting large trainings at each chapter this fall to prepare students to volunteer at Virginia Remote Area Medical events in the late fall as Naloxone and opioid overdose educators.

Looking Forward In the upcoming year, we will continue to focus on member recruitment, making MSV relevant and accessible to students across the Commonwealth throughout all four years of their medical education. We firmly believe that medical students are the future of MSV and by fostering their engagement within the organization at an early stage in their career; MSV can look forward to a bright future. It has been exceptional to watch the excitement for the MSS grow among students and physicians alike. I speak on behalf of my peers in saying that the conversations and interactions with MSV’s physicians have made our experiences with MSV both significant and effective. I am honored to be a part of an organization where the leadership has embraced our section, a sentiment that our students will engender in their roles as future physician leaders. In interacting with many of my counterparts across the country at national AMA MSS meetings, I have seen first-hand how fortunate we are to be members of the MSV. We have been given many opportunities and much support that is not always available in other states.

It is with sincere gratitude that I thank the Medical Society of Virginia for its continued support. The leadership of the organization as well as the continued staff guidance from Jenny Young remains essential to our continued success. The relationships we build in the MSS, both with one another and with the physicians in the MSV, are indispensable. They have proven to be an integral part of not only my medical school experience, but that of many of our members as well. Thank you, once again, for your support - it has allowed us to establish Virginia medical students as a robust and capable section, an envy at both state and national levels. Respectfully, Ryan Schlobach

The Medical Society of Virginia (MSV) is a professional association that serves as the voice for more than 30,000 physicians, residents, medical students, physician assistants and physician assistant students, representing all medical specialties in all regions of the Commonwealth.

MSV strives to advance high-quality health care and make Virginia the best place to receive care and practice medicine.

MSV fights to keep the practice of medicine in the hands of physicians and provides you with:

Leadership Opportunities

Professional Networking

Fulfilling Relationships

Career Advancement Leads

Access to resources on medicine, physician wellness, patient care topics, and the business of medicine

Health care is one of the most heavily regulated industries.

MSV makes sure that physician and medical student voices are heard to ensure important policy decisions are made that are physician-friendly and patient centered.

@MedSocietyVAwww.msv.org

That we can work together to make Virginia the best place to be a physician or a patient is powerful.”

Joe Pechacek, MD VTC SOM class of 2016 | Former Chair, MSV Medical Student Section

We are your champion so you can be your patient’s champion.

About MSV

Medical Student Section (MSS) You have a limited amount of time to make an impact in medical school. You are passionate about medicine, patient care and your personal success.

Join the organization that helps you become a leader and amplifies your voice to affect change for medical education, patient outcomes and the practice of medicine across Virginia.

MSV helps remind me during my stressful days of studying that I have chosen such an important career path that can potentially impact the entire country.

Ryan Schlobach EVMS M4 | Chair, MSV Medical Student Section

MSV values your voice and makes it count:In 2015, MSS gained MSV’s support of a statewide needle exchange program to help address the Commonwealth’s opioid epidemic and in 2017 supported and passed a bill in the General Assembly to create the Virginia needle exchange program

MSV raises your visibility and expands your network:MSV puts you in the same room with top physician leaders in Virginia - these physicians are eager to become a part of your network and will mentor you throughout your medical school career and beyond

MSV helps connect you with your future patients: MSS has partnered with the Virginia Department of Health’s REVIVE! Program to give members the opportunity to educate primary and secondary students in your community about opioid addiction

MSV empowers you to become a leader:With over 70 formal student leadership positions on the medical school and state levels, MSV coaches you to become a leader in your profession

MSV positions you one step ahead of your future colleagues:MSV keeps you in the know of pressing issues facing health care through bi-weekly emails that break down complex health care topics so they are easy to understand

MSV is your organization - and one to be proud of!

You have the power to create your own path. MSV will give you the tools to succeed.

Your physician career is more than medical school. MSV can help you define your identity as a physician and set you up to make a difference in the future of medicine.

Why wait? Join at www.msv.org/studentapplication

@MedSocietyVAwww.msv.org

MSS leaders with Sen. Tim Kaine

ORGANIZED MEDICAL STAFF SECTION REPORT

TO: The MSV House of Delegates’ Annual Meeting 2018

FROM: Lawrence K. (Larry) Monahan, M.D., F.A.C.P., Former MSV President; Virginia State

Chair for the Organized Medical Staff Section Assembly Meetings of the AMA;

And now Member-at-Large of the AMA-OMSS Governing Council

DATE: October, 2018

SUBJECT: Interim 2017 and Annual 2018 AMA Organized Medical Staff Section Assembly

Meetings (the 70th and 71

st meetings of this Assembly)

Since the 2017 meeting of the Medical Society of Virginia’s House of Delegates, your State OMSS Chair

continues to represent you at the Organized Medical Staff Section Assembly Meetings at the American Medical

Association, at the Interim Meeting (November 2017) and at the Annual Chicago Meeting (June 2018).

At these two meetings, OMSS delegates and officers from every state meet to discuss and shape policy on a

variety of medical staff issues: to increase knowledge in advocacy, leadership, and quality improvement; to

attend an array of educational programs with CME credit; and to connect with medical staff leaders from all

states and Puerto Rico. Through education, advocacy, sharing of best practices, and collaboration, OMSS

empowers physicians and their medical staffs to improve patient outcomes and the physician-patient experience.

At the subsequent meetings of the American Medical Association House of Delegates (over the following three

and a half to four days), many items which had originated with the OMSS were considered, and all of them

were favorably received and acted upon by the AMA House of Delegates (either through adoption, amendment

and then adoption, or referral to the Board of Trustees of the AMA with instructions for further refinement and

then adoption.)

The final actions and highlights of all of these activities can be found at the OMSS website at www.ama-

assn.org/go/omss (then choose the “post meeting” bullet under the Annual 2018 or Interim 2017 meeting

headings). The sessions were videotaped and may be viewed as a pod-cast or a download at the same website,

also for CME credit. A CD-ROM and a downloadable PowerPoint presentation are available, and contain all of

the PowerPoint slides presented at these events. MSV leaders are encouraged to use these resources to update

their medical staffs on this information and on the resources available from the OMSS Section.

Major items and issues discussed at the OMSS included: 1. Check to see that your hospital’s By-Laws are in compliance with the latest revisions to

the Medicare Conditions of Participation, which permit a multi-hospital health system to

have a unified, system-wide medical staff, rather than a separate medical staff at each

hospital, provided that the medical staff at each hospital votes to accept (or NOT to

accept!) a unified staff structure. Access the AMA Physician’s Guide to Medical Staff

Organization Bylaws (www.ama-assn.org/go/bylaws) for guidance, including how to

amend your medical staff bylaws to ensure compliance with CMS regulatory and

accreditation standards while protecting your own medical staff’s self-governance.

2. OMSS has a large and growing number of resources for medical staff leaders and other

medical staff members. (omss@ama-assn.org)

3. Physician and Medical Staff Wellness

4. Confronting inappropriate prescribing by pharmacists, vs physicians

5. Health Information Technology Principles

6. Study of discrimination by patients against physicians

7. Impact of High Capital Costs of Hospital HER’s on Medical Staffs

8. Establishing an Emeritus Category for OMSS members

9. Adopting AMA Principles of Medical Staff Rights and Responsibilities

10. Webinar: “Bringing Together Independent and Employed Medical Staff Members”

Continuing Medical Education Programs (CME) The OMSS hosted educational sessions providing many AMA PRA Category 1 Credits™:

1) Update on AMA’s 3 strategic focus areas: Professional satisfaction and practice

sustainability; accelerating change in medical education; and improving health outcomes.

2) Update on AMA’s advocacy efforts: Physicians’ voices in Washington DC

3) Block-chain technology

4) Employment Contracts

5) Addressing disruptive physician behavior

6) Cybersecurity

7) Telemedicine

New OMSS Resources—A number of OMSS resources are now available, including:

Annotated Model Co-Management Services Agreements

Physician Employment Online Resource Center

Physician Assistance Services

Model Medical Staff Code of Conduct

Annotated Model Physician-Hospital Employment Agreement

Physician’s Guide to Medical Staff Organization Bylaws—5th Edition; including

Staff unification/deunification

Drug testing (with and without random testing)

Board certification and recert as a membership/privileging requirement

**Principles of Integrated Leadership for Hospitals and Health Systems, which

were jointly developed by the AMA and the American Hospital Association

Visit the OMSS website to access these resources: www.ama-assn.org/go/omssresources.

2018 Interim Meeting – November 8-10 NEARBY AT THE GAYLORD in South Washington DC.

2019 Annual Meeting – next June 6-8, as customary, in Chicago

Further information about these meetings will be sent out in the coming weeks and posted to the OMSS

Meeting webpage: www.ama-assn.org/go/omssinterim or annual. (as the case may be)

These meetings are extremely important for all physicians who practice in physician groups of any size, (single

and multiple specialties); who practice in hospital medical staffs (under employed or independent practice

arrangements); and who practice in faculty medical positions. Once again, I call attention to each physician in the

MSV and to each medical staff in the Commonwealth of Virginia, of the importance of these meetings

themselves; and the importance of your becoming more knowledgeable in organized medical staff affairs. Each

medical staff or large physician practice in Virginia should be sending a representative to these meetings, where

there is no tuition for attending and where you do receive CME credit for the educational sessions. A PowerPoint

summary of each meeting is available, with a CD/ROM containing slides from each of the lectures; and each

session is video-taped and may be viewed as a pod cast or download at the same website listed above (and also for

CME credit). (An afterthought: In a contested election between 5 candidates for one available position as At-Large Member of the AMA-

OMSS Governing Council, your Virginia Representative is (I am) happy to have been elected on the first ballot!)

https://www.ama-omss/about/omss-meeting-documents is another good starting point for references!

AMA OMSS report for annual MSV HOD 10 2018

Board of Medicine

Report to the Medical Society of Virginia

September 25, 2018

1. The Board officers elected in June 2018 are:

President-Kevin O’Connor, MD of Paeonian Springs

Vice-President-Ray Tuck, DC of Blacksburg

Secretary-Treasurer-Lori Conklin, MD of Charlottesville

2. There have been 7 new Board members appointed since the 2017

Report to MSV. They are:

James Arnold, DPM of Winchester

Manjit Dhillon, MD of Chester

Blanton Marchese, citizen member of Chesterfield

Jacob Miller, DO of Virginia Beach

Karen Ransone, MD of Cobbs Creek

Brenda Stokes, MD of Lynchburg

Martha Wingfield, citizen member of Ashland

3. The Board now licenses 22 professions including;

Doctors of Medicine-37,626

Doctors of Osteopathy-3,491

Doctors of Podiatry-543

Doctors of Chiropractic-1,711

Interns & Residents-3,183

Licensed Acupuncturists-542

Athletic Trainers-1,686

Behavior Analysts-1,054

Assistant Behavior Analysts-156

Genetic Counselors-188

Licensed Midwives-84

Occupational Therapists-4,152

Occupational Therapy Assistants-1,590

Physician Assistants-3,998

Polysomnographic Technologists-492

Radiologic Technologists-4,424

Limited Radiologic Technologists-594

Radiologist Assistants-12

Respiratory Therapists-4,015

Surgical Assistants-250

Surgical Technologists-301

Nurse Practitioners licensed and regulated jointly with the

Board of Nursing-10,822

For a total of 81,031 healthcare professionals.

4. Since last year’s report, complaints against licensees of the Board

of Medicine have totaled approximately 1743.

5. Since last year’s report, 105 sanctions have been taken against

Board of Medicine licensees. Other actions to be noted are 8

dismissals of charges by an informal conference committee and 23

mandatory suspensions by the Director of the Department of

Health Professions. (Mandatory suspensions are Virginia’s

response to suspension or revocation by another jurisdiction or

conviction of a felony.)

6. In December 2018, the Board will notify by blast e-mail those

practitioners who will be required to obtain 2 hours of CAT I

opioid CME on pain management, proper prescribing, and the

diagnosis and management of addiction prior to their next biennial

renewal.

7. During 2018, the Board of Medicine refined the Emergency

Regulations for the Prescribing of Opioids and Buprenorphine,

which became Final Regulations on August 8, 2018. They have

had a significant impact on prescribing, with fewer doses of

opioids being written, for fewer days, as well as fewer refills.

8. A regulatory advisory panel (RAP) was convened last November

to formulate regulations on laser hair removal. Physicians,

physician assistants and nurse practitioners were part of the RAP,

as all three can perform laser hair removal independently and also

supervise individuals that are properly trained. The regulations are

at the Governor’s office.

9. The Virginia Board of Medicine studied the Interstate Medical

Licensure Compact over the last several years and decided not to

join at this time, but to promulgate regulations for Licensure by

Endorsement. The regulations became effective September 5,

2018. The Board should be able to begin accepting applications

for this expedited pathway by November 1, 2018, pending

approval of the application and the instructions by the October full

Board.

10. Former President of the Board, Barbara Allison-Bryan, MD, was

appointed as Deputy Director of the Department of Health

Professions by Governor Ralph Northam.

______________________ ______________________

Kevin O’Connor, MD William L. Harp, MD

President Executive Director

9960 Mayland Drive, Suite 300

Henrico, VA 23233

Date: September 6, 2018

To: MSV House of Delegates

From: Jeremy M. Welsh, VAPA President-Elect

Subj: PA Update

250 West Main Street, Suite 100

Charlottesville, VA 22902

434/977-3716 • Fax 434/979-2439

www.vapa.org • vapa@vapa.org

AAPA hosted the annual PA conference this year in New Orleans, Louisiana 19-23 May 2018. VAPA leadership was in attendance and had full representation at the HOD. There was extensive conversation surrounding Optimal Team Practice (OTP). The conversation focused around defining and moving forward with a clear and purposeful plan. A large number of states representatives and AAPA leadership talked about clarifying that OTP is not a push for independent practice for PAs. PAs are committed to team-based care in collaboration with physicians. Removal of restrictive and outdated state regulations and language is a primary focus. PAs are committed to practicing with physicians, while also reducing the administrative burdens.

VAPA hosted our 36th annual summer CME conference 22-27 July, 2018 in Virginia Beach. This year we sponsored 45 hours of combined CME lectures and workshops. The conference was a great success and we were able to host both new and returning speakers and are appreciative of Dr. Elward delivering the opening session to conference PAs.

I look forward to the upcoming year as I am stepping into the office as President-Elect. I anticipate an exciting year and am working closely with our committees to ensure Virginia’s PAs are heard and well represented. We continue to appreciate our work with MSV and our other colleagues and constituents to work towards patient-centered care and strengthening our commitment to team-based collaborative care.

Respectfully,

Jeremy M. Welsh, DHSc, JD, PA-C, DFAAPA

VAPA President-Elect