VIRGINIA MEDICAL NEWSJULY 2015

You kept up with health care related legislation during the General

Assembly session with the Medical Society of Virginia’s (MSV) legislative updates and read about our big wins in our legislative wrap up, but now you’re wondering how all of these new laws impact your practice. The following is a primer on what to expect as these laws and regulations take effect.

TelemedicineThe new law clarifies that an e-mail, audio-only telephone conversation, fax or an online questionnaire do not qualify as telemedicine. Instead, you must use interactive audio or video to diagnose or treat a patient or when consulting with another health care provider on a patient’s diagnosis or treatment. Additionally, prescribing

schedule VI controlled substances via telemedicine must fulfill the following requirements:

• The patient-prescriber relationship must be established through face-to-face interactive, two-way, real-time communications or store-and-forward technology.

• The patient provides a medical history for the prescriber to review.

• The prescriber obtains an updated medical history at the time of prescribing.

• The prescriber makes a diagnosis at the time of prescribing.

• The encounter conforms to the in-person standard of care, including

July 1: Health care laws now in effect

IN THIS ISSUE

05 Save the date: 2016 White Coats on Call

06 CMS announces ICD-10 grace period

08Narrative medicine – A solution for physician burnout

10 President’s message: “Medical marriages”

16 Sync: Transforming Healthcare Leadership

continued on page 3

Prescription prior authorization reformAs of July 1, HB 1942 and SB 1262 will go into effect. Although they

impact prescribers, they do not require action on your part. Prescribers should know that health plans must respond within two business days for standard prescription prior authorization requests and 24 hours for urgent requests. Prescribers also can ask for a tracking number for their prior authorization request. If a request is denied, the health plan will need to offer a reason for the denial. Each health plan will have a page on its Web site devoted to prior authorization forms, drug formularies and lists of which medications require authorization. As MSV gathers these sites, they will be linked to on our prior authorization resource page.

when it requires use of diagnostic testing or performance of a physical examination, which may be carried out through the use of peripheral devices.

• The prescriber holds a Virginia medical license and is authorized to prescribe.

• If the patient is a member of a health plan or carrier, the prescriber is credentialed with them and the diagnosing and prescribing meets their qualifications for reimbursement.

• The prescriber, upon request, provides patient records in a timely manner in accordance with Virginia Code, as well as federal laws and regulations.

2 www.msv.org

MSV leadership

Medical Society of Virginia2924 Emerywood Parkway, Richmond, VA 23059

800 | 746-6768 • www.msv.org

Officers, Board Members and AMA Delegates

PresidentWilliam C. Reha,

M.D., M.B.A.

President ElectEdward G. Koch,

M.D.

Immediate Former PresidentSterling N. Ransone Jr.,

M.D., FAAFP

Secretary - TreasurerBhushan H. Pandya,

M.D.

Speaker of the HouseKurtis S. Elward,

M.D.

Vice SpeakerArthur J. Vayer Jr.,

M.D.

DirectorsJohn F. Butterworth IV, M.D. Sandy L. Chung, M.D. Sheela R. Damle Clifford L. Deal III, M.D., FACS Byrd S. Leavell, Jr., M.D.Stuart F. Mackler, M.D., FACS Ibe O. Mbanu, M.D., MBA, MPH

Larry G. Mitchell, M.D. Patricia Pletke, M.D.Pradeep K. Pradhan, M.D.William S. Prominski, M.D. Timothy L. Raines, M.D.T. Joey Tiwari, M.D. Alan L. Wagner, M.D., FACSJohn D. Ward, M.D.

George L. Weidig, M.D. Alan H. Wynn, M.D.

Associate DirectorsMichael S. Amster, M.D.Teresa W. Babineau, M.D. Joel T. Bundy, M.D. Trevar O. Chapmon, M.D.

Ehsan DowlatiJames R. Dudley, M.D. Jacqueline M. Fogarty, M.D. Michael S. Martin, M.D. S. Hughes Melton, M.D. Jonathan T. Schaaf Richard A. Szucs, M.D. Chi Young, M.D.

ChairCarol S. Shapiro, M.D., M.B.A.

Vice ChairRandolph J. Gould, M.D.

DelegatesClaudette E. Dalton, M.D. Edward G. Koch, M.D. Hazle S. Konerding, M.D. Mitchell B. Miller, M.D. Lawrence K. Monahan, M.D.

Alternate DelegatesDavid A. Ellington, M.D. Thomas W. Eppes Jr., M.D. Russell C. Libby, M.D. Bhushan H. Pandya, M.D. Sterling N. Ransone Jr., M.D.

William C. Reha, M.D., M.B.A. Cynthia C. Romero, M.D., FAAFP

AMA delegation

2 www.msv.org July 2015 3

Advocate for my profession

Health care laws - continued from page 1

The above stipulations do not apply to a prescriber providing on-call coverage per an agreement with another prescriber or that prescriber’s employer, a prescriber consulting with another prescriber regarding a patient’s care, or orders for prescribers for hospital out-patients or in-patients.

The Board of Medicine also released this guidance document (85-12 Telemedicine, adopted Feb. 19, 2015) earlier this year. It provides additional information on the provision of telemedicine.

Cannabidiol Oil and THC-A OilThe General Assembly also approved SB 1235/HB 1445 which authorizes Virginia physicians to issue a written certification for the use of cannabidiol oil or THC-A oil for the treatment of intractable epilepsy. Here is the link to the certification form that must be completed by the physician. The certification is not a prescription, but it provides the patient with documentation that can be provided to the courts if the patient is charged in connection with possession of the oil. The law does not legalize the sale or manufacture of cannabidiol or THC-A oil in Virginia.

continued on page 4

Prescription Monitoring Program (PMP) and prescription drug abuseDue to previously adopted legislation, all prescribers must be registered with the PMP upon application for or renewal of licensure beginning on July 1. The Department of Health Professions will automatically enroll any prescriber, so there is no action necessary on your part.

• If a prescriber prescribes a benzodiazepine or an opiate anticipated at the onset of treatment to last 90 days or more, the prescriber must check the PMP to see if the patient currently holds a prescription for a PMP covered substance.

• HB 1458/HB 1833/SB 1186 allow for a pharmacist to dispense Naloxone, an opioid antagonist, pursuant to an oral, written or standing order from a prescriber. It also allows properly trained law enforcement officers and firefighters to possess and administer Naloxone.

• Hospices who have a patient residing at home at the time of death must notify any pharmacy that has dispensed partial quantities of a schedule II controlled substance for a patient diagnosed with a terminal illness within 48 hours of death.

Physician assistants (PAs) and nurse practitioners (NPs) PAs and NPs are now permitted to be appointed to serve as local medical examiners. A PA must have a practice agreement and operate under the supervision of a physician medical examiner. For more information on the duties of a medical examiner, visit www.vdh.state.va.us/medExam/AboutMedExaminer.htm. If you have a desire to serve as a local medical examiner, contact the closest district office of the chief medical examiner and speak with an assistant chief medical examiner by visiting www.vdh.state.va.us/medExam/ContactUs.htm.

Nurse practitioners are now permitted to serve as expert witnesses within their scope of practice in court. The legislation clarifies that nurse practitioners are not permitted to testify for or against a physician in a malpractice suit regarding a physician’s standard of care or a defendant provider in a malpractice suit in regards to causation.

Safe sleepNurse midwives, midwives

and hospitals providing maternity care must provide patients, fathers of infants and any relevant family or caretakers information about safe sleep environments that is consistent with current information available from the American Academy of Pediatrics at www.healthychildren.org/English/ages-stages/baby/sleep/Pages/default.aspx.

Medical school scholarshipsSB 717 expanded eligibility of medical school scholarships from the Board of Health to include students from any accredited medical school in the United States, as long as they agree to practice in a medically underserved area of Virginia. Previously, these scholarships

Hospital patient observation statusHospitals must now notify patients, both verbally and in writing, when they are outpatients or in observation status. The notification must also say that they patient will be billed accordingly, regardless if they have stayed in the hospital overnight, been served meals, etc.

4 www.msv.org

were only open to students attending a Virginia medical school. You can find more information on this scholarship program here. The General Assembly has not funded these scholarships in recent years.

Right to tryA terminally ill Virginia patient who has exhausted all other approved treatments and is not a candidate for an ongoing clinical trial is able to gain access to experimental treatments with the following stipulations:

• The treatment has passed Phase 1 of FDA trials.

• Their physician determines the potential benefits outweigh the possible risks and recommends that the patient receive the treatment.

• The patient provides written informed consent.

A provider that recommends an experimental treatment cannot be found civilly liable and no cause of action will exist in court for claims of property, personal injury or death in relation to these treatments. Additionally, a provider cannot be found to have engaged in unprofessional conduct or have their licensure affected by recommending an experimental treatment.

The manufacturer of the investigational treatment can either charge the patient or provide the treatment for free, and health insurers are not obligated to cover the costs.

Health care laws - continued from page 3

Advocate for my profession

Certificate of public need (COPN)The Secretary of Health and Human Resources is leading a work group comprised of stakeholders including health care providers, health care consumers and representatives of the business community to review current COPN policy and any possible need for changes. The group will evaluate:

• The COPN review process, the criteria by which decisions are made and barriers to issuance of COPN

• The frequency of COPN approval or denial

• Fees charged for COPN review and the cost to the Commonwealth for processing requests

• The impact of the current process on establishment of new health care services

• The relationship between COPN and charity care and the impact of COPN on charity care

• The impact of COPN on graduate medical education and teaching hospitals

• The efficacy of regional health planning agencies, their role in the COPN process and barriers to their continued role in the process

• The frequency with which the State Medical Facilities Plan is updated and if it should be updated more frequently

The work group will develop recommendations for changes to the COPN process by Dec. 1, 2015,

including changes to be introduced in the 2016 General Assembly session

Provider assessmentAnother topic the General Assembly asked to be studied this year is a hospital provider assessment program that:

• Complies with applicable federal laws and regulations

• Is designed to operate in a way that is mutually beneficial to Virginia and affected health care organizations

• Addresses health system challenges in meeting the needs of the uninsured and preserving access to essential health care services

• Supports indigent care and graduate medical education costs in Virginia hospitals

• Advances reforms that are consistent with the goals of improved access, lower costs and better health for Virginians

• Takes into account the extent to which equity exists in both the assessment and funding distribution to affected health care organizations.

The study will be directed by the Secretary of Health and Human Resources and will be assisted by the Department of Medical Assistance Services, the Virginia Center for Healthcare Innovation, the Virginia Hospital and Healthcare Association, MSV and other affected stakeholders.

Studies

Visit www.msv.org/ 2015healthcarelaws for more information.i

4 www.msv.org July 2015 5

Advocate for my profession

The Medical Society of Virginia Political Action Committee (MSVPAC) is hosting a reception to thank its 2015 donors on

Fri., Oct. 23, in conjunction with the Medical Society of Virginia (MSV) Annual Meeting. During this reception, one especially notable contributor will be announced as the winner of the Clarence A. Holland Award.

The Holland Award is presented annually to a Virginia physician for outstanding contributions promoting the art and science of medicine and the advancement of public health through political service. The next winner will join the ranks of other recent Holland Award winners, including Cynthia C. Romero, M.D., FAAFP, Randolph J. Gould, M.D., FACS, Carol Shapiro, M.D., M.B.A., Karsten Konerding, M.D. and Hazle Konerding, M.D. Click here to view previous Holland Award winners.

Nominations for the Holland Award will be accepted at www.msv.org/hollandaward until Sept. 15. Nominees for the award must be MSV member physicians who have high personal integrity and

have been outstanding leaders in their fields. Nominees should embody one or more of the following award criteria:

• Has made an outstanding contribution to the community for citizenship and public service, beyond the call of duty, as a practicing physician.

• Has provided outstanding leadership in the field of political advocacy.

• Has promoted the art and science of medicine in or through government service.

MSVPAC will also present awards to its Advocacy in Action Award winner and to the district that raises the highest total amount for MSVPAC.

Please contact govtaffairs@msv.org with questions or to discuss these awards in further detail.

Help select the next Clarence A. Holland Award winner

Mark your calendar now to join us in January or February to meet with

your legislators for our White Coats on Call Days.

Why should I go?

• MSV will help schedule your appointments with your legislators (registration required).

• Breakfast and lunch to fuel your day.

• Special guests, including elected and administration officials, will offer their perspectives on the legislative issues affecting medicine.

• Great partnerships with local and specialty societies.

• The location: the Hilton Garden Inn-Downtown Richmond, conveniently located just blocks from the General Assembly building..

• Issue and bill briefing from the MSV lobbying team.

• The price: free to all participants.

Be on the lookout this fall for more information on how to register and make the most of your time in Richmond.

Save the date!

• Jan 19 – Physician Assistant Day 1

• Jan 20 – Leadership Day

• Jan 20 – Medical Students Day

• Jan 21 – Orthopaedic (VOS) and Plastic Surgeons (VSPS) Day

• Jan 26 – RAM Day 1

• Jan 26 – Eye Physicians and Surgeons (afternoon)

• Jan 27 – PA Day 2

• Jan 27 – Psychiatry Day

• Jan 28 – Pediatric Day

• Feb 2 – Radiology Day

• Feb 9 – All Call Day

• Feb 9 – RAM Day 2

Remember, if the scheduled day for your specialty or MSV district doesn’t work for you, you can join us on any other day!

Save the date: 2016 White Coats on Call days

6 www.msv.org

Earlier this month, the American Medical Association (AMA) and Centers for

Medicare and Medicaid Services (CMS) jointly announced an agreement on important elements of a “grace period” for the Oct. 1, 2015, implementation of the ICD-10 diagnosis code set.

CMS announced that:

• For a one year period starting Oct. 1, Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes. This policy will be followed by Medicare Administrative Contractors and Recovery Audit Contractors.

• To avoid potential problems with mid-year coding changes in CMS quality programs (PQRS, VBM and MU) for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in

• accurately calculating quality scores (i.e., for PQRS, VBM, or Meaningful Use). CMS will continue to monitor implementation and adjust the duration if needed.

• CMS will establish an ICD-10 Ombudsman to help receive and triage physician and provider problems that need to be resolved during the transition.

• CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.

The announcement demonstrates that CMS is responsive to physician concerns. MSV members sent over 1,000 messages to Virginia’s Senators and Congressmen, expressing concerns regarding the prospect of a smooth transition from ICD-9 to ICD-10 and advocating for a grace period. Additionally, MSV signed on to a joint letter with the AMA with the same message that went to House and Senate leadership and sent out a letter from MSV President Dr. William Reha, M.B.A. directly to CMS. Thank you to everyone who responded to the call and made their voice heard on this important issue – yet another example of the impact physicians can have when they are united for a cause!

What do you need to do?While this grace period announcement is an important development, Virginia physicians will still need to be prepared for the ICD-10 transition of Oct. 1. To help you prepare, MSV has created numerous resources to get your business staff and your fellow clinicians prepared for this change.

In-person training –

• ICD-10CM two-day boot camp A comprehensive two-day program designed to prepare individuals for ICD-10CM (Clinical Modification) diagnostic coding. Dates scheduled in Richmond, Marion, NOVA (Springfield), and NOVA (Manassas).

• One-Day Refresher Training Intensive one-day training for those who previously prepared for ICD-10CM. Dates scheduled in Richmond, Woodbridge, Charlottesville and Suffolk.

On-demand web-based training –Through an exclusive partnership with the American Health Information Management Association (AHIMA), MSV offers discounted web-based training in bite-sized installments for a variety of roles - physicians, nurse practitioners, physician assistants, other clinicians, out-patient and in-patient staff. Click here to learn more.

Audit your documentation practices – A review of claims coding and medical record documentation can be performed to determine whether the practice is following guidelines from the Centers for Medicare and Medicaid Services (CMS) and other payers for appropriate billing. This service is offered at-cost exclusively to MSV member groups. Contact practiceservices@msv.org for additional information.

Additional resources• www.msv.org/icd10• CMS and AMA news release• ICD-10 guidance

CMS announces ICD-10 grace period

Manage my practice

OCTOBER

6 www.msv.org July 2015 7

Manage my practice / Care for my patients

Physicians and life insurance companies work two sides of the same coin: understanding

what makes and takes life. Physicians endeavor to understand the impact of ailments and treatments to the individual; life insurance companies seek the same for the group.

Physicians, however, see both sides of this coin through their ownership of life insurance policies. Policies, like patients, need regular check-ups.

Why? There are five risks to consider.

1. Ensuring wealth is transferred to the desired beneficiaries. Often, the beneficiary on the policy issue date is not the desired or even feasible beneficiary on the date of death.

2. Monitoring variable-type life insurance. Such policies are economically sensitive so it’s important to monitor their actual vs. projected performance.

3. Checking the availability of lower cost options. Changes in actuarial tables and underwriting techniques may create opportunities to qualify.

4. Considering newly available riders. Example: using life insurance to manage the risk of long term care expenses later in life.

5. Reconciling tax and legal changes. Moving across state lines, law changes and changing needs demand a policy review.

6. While it’s important to buy the right life insurance policy to meet your needs, the goal is to end up with the right policy. Has the practice of medicine changed over decades? This is the duration of the typical life insurance policy. Changes affect policies, too. Entrusting the management of this significant asset to a financial professional is not dissimilar to entrusting the management of one’s health to a primary physician.

Every physician has a unique situation that requires a unique life insurance policy design. Most insurance policies contain exclusions, limitations, reductions of benefits, surrender charges, and terms for keeping them in force. 1752 Financial works with many life insurance companies to help identify the solutions that fit the needs our clients specify. For further information or answers to questions you may have, please contact Dustin Beekman at 877 | 226-9357 or dbeekman@msvia.com.

This article was submitted by Matt Brotherton of 1752 Financial.

By sharing your time and expertise, you can help empower your community.

When you become a physician volunteer, you not only help revive your passion for medicine, you also find personal and professional fulfillment. Not sure how to start? The Medical Society of Virginia Foundation (MSVF) has partnered with the Virginia Association of Free and Charitable Clinics (VAFC) to provide physicians a way to volunteer at free clinics and give back to their communities.

“Volunteering at the free clinic allows me to do what I went to medical school for—helping people, most of whom live with multiple chronic diseases with no other means for health care,” said John W. Knarr, M.D., MSV member and volunteer with the Free Clinic of Pulaski County. “Each patient I treat is grateful for the help they receive.”

Consider volunteering at least for a few hours a month to a local free or charitable clinic. VAFC represents 60

clinics, offering quality health care to around 72,000 economically disadvantaged individuals in Virginia. Clinics provide an array of services, from medical, dental, pharmaceutical and behavioral health care—so volunteers from all specialties and geographies are appreciated. More than 3,800 physicians and physicians assistants volunteered in 2014.

Learn more about volunteer opportunities at http://www.vafreeclinics.org/volunteer/physicians.

Five risks to life insurance policy maintenance

Chage lives— Physician volunteers needed

8 www.msv.org

Rita Charon, M.D., professor of internal

medicine at Columbia University and creator of narrative medicine, best demonstrated the importance of narrative

medicine in a paper where she referenced a hospital admission from Aug. 31, 1884, entitled, “Cancer of Lung, Haemoptysis”:

T.J.M., 24 New York Single ConductorPast History: Father died of pneumonia,

mother poisoned by mistake. Has had scarlet fever, intermittent. Denies syphilis. Drinks very little. Has had numerous hemorrhages, the first one seven years ago and the last two years ago, varying from a cup to a quart. Had night sweats.

Present Sickness: At 8:15 last night, while on his car, had a coughing spell immediately followed by a sweet taste in his mouth and bled from his mouth some 20 minutes. Took gallic acid which had good effect.

On Admission: Patient walked in bleeding profusely from the mouth. Pulse strong, at first rapid, later slowed down. Ord. Ergot, tannic acid solution.

Sept 1: Feels better this AM. Ord. ErgotSept 3: Very weak and short of breath,

still spits blood clots.Sept 4: Very much weaker. Infusion

Digitalis. Growing cyanotic, still raising blood.

Sept 5: Patient gradually sank at 8 am. No radial pulse. Temperature 105 and at 9:15, quietly died.

In this report, we get the very real sense that the physician was in close proximity to the patient until he died. When the physician used words like “much weaker” and “gradually sank” and “quietly died”, it showed that the physician was present and that there was a connection

between the physician and patient.Dr. Charon compared the report to

the description of a patient death by a medical student in 2000:

I saw one patient die. They had just announced a code overhead, and we ran, and my resident was doing chest compressions, and everything, and pushing the drugs, and all that, and then, at the end, they called—you know, the time of death, and it was over, and then everyone like, walked out of the room…[U]h, everyone walked out of the room, and the patient was just lying on the bed, naked. She had her head bent back, and the tube in her throat, and tape across her face, trying to hold it down, and her groin was all bloody from the multiple ABGs [arterial blood gas tests] we had done, or sent, and it just looked very horrible, and it was just very—everyone just left, like, they were like, okay, it’s over now, and just left.

This example shows us that the student seems to feel separate from the experience, referencing “they” and then describing the situation as a third party who just happened to be in the same room.

“Medicine is losing its humanity,” said Medical Society of Virginia (MSV) member Terri Babineau, M.D., assistant dean for student affairs at Eastern Virginia Medical School (EVMS). She is working to get more narrative medicine education taught in Virginia, starting with two narrative medicine workshops in EVMS and a class for undergraduates interested in pursuing medicine at William & Mary.

There is a need for more humanities in medical education and training, according to Dr. Babineau, because, as the health care profession gets deeper into technology and electronic health records (EHR), physicians are starting to lose important skills like close listening and reflection. Teaching more humanities can help prevent eventual

physician burnout because it encourages medical students to better understand their patients’ stories and therefore improve their ability to do things like medical interviewing, patient-centered care, self-awareness and reflective practice—having physicians understand their patients’ stories can also help them better understand their own role in their patients’ stories.

“Of course, if we don’t get the story right, we will burn out,” Dr. Babineau said. “All patients have a story, and as physicians, our stories interact—whether we acknowledge that or not. But it’s so important to get their stories right. For example, a victim of child abuse needs to be identified and treated differently. Our hope is that, with this curriculum, we will be able to show students how to see and understand their patients so they see them as real people—which will in turn decrease the chance they will burn out.”

MSV offers several resources to address physician burnout at www.msv.org/happy and will continue the conversation on this important topic at its Annual Meeting from Oct. 22 to 25 at the Westfields Marriott in Chantilly. There, Dr. Babineau will continue to explore physician burnout and demonstrate how narrative medicine can help physicians learn how to feel more physician professional satisfaction by learning how to be a better listener and make time for reflection.

“Narrative medicine teaches us mindfulness training; we’re teaching ways to save ourselves,” Dr. Babineau said. “We are seeing it become more of a requirement in medical school admissions now and recognize its importance in getting it out there in the frontline so we can teach undergrads and start early. We need physicians to be good thinkers who can get to the true story.”

Care for my patients

Narrative medicine – A solution for physician burnout

July 2015 9

The Medical Society of Virginia (MSV) is giving you another chance to show

off their talent in photography with its member photo contest. Please send us your photos at webmanager@msv.org or on MSV’s Facebook page at www.facebook.com/MedicalSocietyofVirginia by Aug. 30. We will post all photos to our Facebook wall and the photo that receives the most “likes” will be the winner.

Who is eligible? All MSV members.

What photos can be entered? Any fun, educational or artistic images. We will accept images of favorite landscape, animals, personal interests, locations or

abstract images, etc. Each participant may submit three photos. Photos that have been digitally altered will be disqualified.

How can I enter? Simply send the jpg files to webmanager@msv.org as attachments or visit www.facebook.com/MedicalSocietyofVirginia, click on the “Photo/Video” button and attach a photo. Once you are done, simply click on the “Post” button and all the information will be available on the MSV Facebook page. Include a brief caption of who the photograph was taken by and a description of what is in the photograph. The MSV photo contest will run through Aug. 30.

Prizes All winning photos will be featured in MSV’s Facebook page as well as in an upcoming issue of Virginia Medical News.

MSV news

The Medical Society of Virginia Foundation (MSVF) through a grant from the Physicians Institute for Excellence in

Medicine and in partnership with Sentara Northern Virginia Medical Center will host an educational seminar entitled Extended release (ER)/long acting (LA) opioid risk evaluation and mitigation strategies (REMS)—Achieving safe use while improving patient care in an attempt to tackle the growing opioid addiction problem.

This seminar will be held on:

Sat., Sept. 12, 20158:30 a.m. –11:30 a.m. Sentara Northern Virginia Medical Center Hylton Education CenterConference Rooms ABEF.

This is a free seminar and open to any interested participant.Led by Mary McMasters, MD, FASAM and Sarah Melton,

PharmD, BCPP, CGP, FASCP, this educational session offers (3) credits of continuing medical education (CME) for physicians and continuing education (CE) for nursing and dental participants. It covers the appropriate prescribing and safe use of ER/LA opioid analgesics as specified in the US Food & Drug Administration’s Risk Evaluation and Mitigation Strategy (REMS) blueprint and offers informational tools for patient assessment, risk evaluation, prescribing best practices, ongoing therapy management, patient and caregiver counseling methods and general and product-specific drug information concerning ER/LA opioid analgesics including identification of adverse effects.

Seating is limited and registration is required. Register at www.etsu.edu/com/cme/REMS2.aspx or contact Krista Cole at 423 | 439-8027. Other questions can be directed at the MSV Foundation office at 804 | 377-1053.

Care for my patients / MSV news

Safe prescribing of opioids seminar – Free CME!

12

34

56

78

9

Show your creative side

10 www.msv.org

Physician burnout has been a hot topic within the profession for a growing

number of years now, and it’s one that we have definitely taken care to address here at MSV with our Web resources at www.msv.org/happy and our educational sessions at our Annual Meeting. If you remember our last Annual Meeting in Williamsburg, many of you took time to share what makes you happy (which, in turn, also keeps you from burning out)—

many of you shared your family and/or your partner.

The term “medical marriage” is a growing one in popularity, meaning one or both parties in a relationship are practicing physicians. This term recognizes how relationships between physicians and their partners can face unique challenges because of issues like: the number of hours physicians work, the need to be in control, the neglect

that physicians can often place on themselves, fear in asking for help and the lack of boundaries between work and home.

Having the right partner by your side who will understand the challenges you go through every day in your profession makes a big difference in sustaining professional satisfaction in the profession for the long term. I can’t express enough how much it has helped me to have Melanie by my side to support me as I balance both my practice as well as my responsibilities as MSV President. It is not always easy as I am often guilty of letting my work life leak into my personal—but she has helped me by making sure I take care of myself and that I balance the fun along with the stresses that exist within the profession.

As physicians, we are important role models for our patients. If we practice healthy behaviors and exemplify work-life balance with the help of supportive partners, we can be better physicians.

We will continue our discussion on physician burnout at this year’s Annual Meeting, so I hope you will join us from Oct. 22 to 25 to continue the conversation. In order to help our patients, we need to be sure we take care of ourselves—and I can’t stress enough how much having the right person by your side plays such an important role.

President’s message: “Medical marriages”

MSV news

Regards,

William C. Reha, M.D., M.B.A.President, Medical Society of Virginia

10 www.msv.org July 2015 11

Oftentimes, from 6:30 a.m. to 8:30 p.m. or later, our Virginia delegation

to the American Medical Association (AMA) spends every second of their time at the AMA’s annual and interim meetings trying to influence national policy on health, medical, professional and governance matters. Although the Medical Society of Virginia (MSV) reports on what occurs during the AMA meetings, you may not be entirely aware of the time, effort and dedication that truly goes into serving on our Virginia delegation and how much they achieve on a national level.

As physicians, our Virginia delegates are familiar with the long hours on the go, and they get to talk about a topic extremely important to them: health care. Matters like electronic health records

(EHR), ICD-10, e-prescribing and student debts are among the many that come up in hundreds of resolutions that are discussed in detail. Much like MSV, the AMA holds its House of Delegates with this principal policy-making body transacting all business of the association and electing the general officers. Our Virginia delegation includes:

ChairCarol S. Shapiro, M.D., M.B.A.

Vice ChairRandolph J. Gould, M.D.

DelegatesClaudette E. Dalton, M.D. Edward G. Koch, M.D. Hazle S. Konerding, M.D.

Mitchell B. Miller, M.D. Lawrence K. Monahan, M.D.

Alternate DelegatesDavid A. Ellington, M.D. Thomas W. Eppes Jr., M.D. Russell C. Libby, M.D. Bhushan H. Pandya, M.D. Sterling N. Ransone Jr., M.D. William C. Reha, M.D., M.B.A. Cynthia C. Romero, M.D., FAAFP

These individuals devote two weeks each year to attend AMA’s two meetings—one week in Chicago in June for the Annual Meeting and one week in varying locations in November for the Interim Meeting—to focus on health care

MSV news

Inside our AMA delegation

continued on page 3

12 www.msv.org

issues that have national implications and represent Virginia physicians from all specialties. Our delegation is part of the entire AMA HOD, which is comprised of representatives from all fifty states, numerous specialty societies, and other constituents and includes more than 500 delegates in attendance at its meetings.

The AMA’s reference committees and resolution processes are very similar to MSV’s and which include reference committee reports, consent calendars, caucus meetings, etc. Our delegates rarely get a break as they spend each of their days reading hundreds and hundreds of pages of resolutions, preparing reports, conducting discussions, attending other specialty meetings, networking, presenting resolutions and making the cases for some of the country’s biggest health care issues. Oftentimes, many of their resolutions are brought forward as a result of ideas conceived through MSV.

On top of the usual work done by our delegates, several of them also serve on the AMA’s other groups, including—Percy Wootton, M.D. served as President and Robert Wah, M.D. is the Immediate Past President. Thomas Eppes, M.D. is Chair of the Integrated Physician Practice

Section; Bhushan Pandya, M.D. is Chair-Elect of the International Medical Graduate Governing Council; Lawrence Monahan, M.D. is our representative to the Organized Medical Staff Section; and Randolph Gould, M.D. is Chair of the Council on Legislation.

The AMA Annual Meeting provides growth and learning opportunities for our medical student section, which has had impressive attendance and leadership representation. This year, 21 Virginia students attend the AMA MSS meeting, with 14 as first time attendees. Our students successfully positioned themselves in leadership positions to maintain Virginia’s strength in the AMA with four Virginia students elected to serve on the Region 6 leadership board:

• Carl Rudebusch, Virginia Commonwealth University, Secretary/Treasurer

• Lee Ouyang, Eastern Virginia Medical School, Advocacy Chair

• Courtney Knill, Virginia Tech Carilion, Membership Chair

• Ambika Babbar, University of Virginia, Community Service Chair

“I’ve said it again and again, but it never ceases to amaze me how much the Virginia physician delegation truly supports and encourages all its student members year after year,” said Chris Li of Virginia Tech Carilion, who attended the meeting. “Their mentorship keeps the students motivated to continue their tradition of pursuing leadership and excellence in service and advocacy throughout the MSV and AMA.”

Physicians and students got to network and get to know one another on a more personal level during the meeting, as they enjoyed meals and meetings together. Carl Rudebusch of Virginia Commonwealth University (VCU) said he was so appreciative when former MSV President Russell C. Libby, M.D. took time with him to explain what sustainable growth rate (SGR) was and discuss his career goals.

“I would love to thank the MSV physicians for reaching out to the medical student section so extensively,” Carl said. “I am getting 1,000 times more out of my experience with organized medicine and growing more in my career than I ever could have without their help and support. I got to participate in the Virginia Delegation Meeting Caucus and learned a great deal about how the issues AMA is discussing affect Virginia specifically, and amazingly, the MSV leaders actually cared about input from the students! I feel so fortunate to have MSV as a resource now and in my future career as a physician.”

Please join us in thanking our physicians and medical students who take part in our Virginia delegation and help us have a seat at the table on a national level. This can be a daunting task but it is one that our delegation handles with skill as they fulfill the obligations of their two-year terms.

AMA delegation - continued from page 1

12 www.msv.org July 2015 13

2015 PHYSICIANS’ GALA

To purchase tickets call MSV Foundation804 | 377-1053

Presented by:

July 2015 15

2015 PHYSICIANS’ GALA

To purchase tickets call MSV Foundation804 | 377-1053

Presented by:

Help the Medical Society of Virginia Foundation (MSVF) honor exceptional

colleagues who have impact on the profession at our annual Salute to Service Awards. For more than 10 years, we’ve recognized individuals who provide extraordinary patient care in Virginia and abroad and represent our profession so well.

We know there are more deserving physicians out there to honor this year! Who do you know who “wows” you with their efforts in the international, patient safety and quality improvement, uninsured and underserved communities as well as outstanding volunteerism and leadership by a medical student? Share their stories and

help MSVF salute them. Nominate them!It’s easy. Simply complete the

online form by clicking here. MSVF staff is also available to help guide you through completing the form or answer any questions. For additional information, call 804 | 377-1053 or e-mail foundation@msv.org.

The Medical Society of Virginia (MSV) Annual Meeting is getting a facelift this year. We are building a robust and

engaging agenda for this year’s Annual Meeting at the Westfields Marriott in Chantilly from Oct. 22 to 25 so we invite you to attend this event, which will be unlike any event held by us before.

With a theme of (RE)member – (RE)charge. (RE)fresh. (RE)new., we will provide opportunities to help you feel renewed energy for your work as well as activities encouraged to promote work-life balance and professional satisfaction. We appreciate you and understand the things you face in your profession. Our event is geared to keep moving you forward so you can succeed.

Some new events include:

• A keynote speaker, Dr. Steve Bedwell, who will speak on problem solving and decision making, customized with clinical examples.

• A practice administration professionals panel discussion on risk management and other pertinent issues.

• Educational session planned in partnership with the Psychiatric Society of Virginia on integration of care.

• Burnout and physician satisfaction session led by Terri Babineau, M.D.

We also have many fun activities planned like a microbrewery tasting, yoga session with our very own medical student section vice chair Chris Li and karaoke in addition to the traditional agenda items. We’ll also continue to provide ample opportunity to network with colleagues and share the future of health care in the commonwealth—including open forum discussions and much more.

Everything you need to know about this year’s Annual Meeting is inside this edition of Virginia Medical News. We look forward to seeing you in October!

RE MEMBERMSV 2015 Annua l Meet ing

RE MEMBERMSV 2015 Annua l Meet ing

MSV news

Help us honor your exceptional colleagues

16 www.msv.org

The health care landscape is changing in ways that profoundly affect the strategic outlook and operations of health care

organizations. Now, more than ever, health care requires a stronger emphasis on interprofessional leadership.

The Medical Society of Virginia (MSV), Virginia Hospital & Healthcare Association (VHHA) and the Virginia Nurses Foundation (VNF) are responding to this need by partnering for the first time to create Sync - Transforming Healthcare Leadership, a learning institute to engage emerging leaders in collaborative leadership development.

The plan for Sync grew out of a series of statewide forums and interviews with health care leaders to consider ways in which their associations could contribute to the development of Virginia’s health care community and create collaborations and partnerships that benefit health care providers, patients and citizens of Virginia. Sync participants will benefit from the diverse membership and distinct leadership training expertise of each of the associations.

Sync will be available to teams of up to five emerging physician, nurse, pharmacist, social worker and other clinical

leaders who are endorsed by their organizations to participate in developing collaborative teamwork and leadership capabilities. These teams will learn to create synergy among themselves at the individual and organizational levels in order to best serve communities in health care, lead teams within the health care environment and enhance their leadership effectiveness.

Sync will also help participants build important core capabilities for successful collaborative teamwork, helping them understand their own role as well as those of other professions to appropriately assess health care needs, communicate in a responsive and responsible manner, apply relationship-building values to deliver care and apply principles of design thinking.

With this opportunity, participants will be expected to attend four in-person sessions between September 2015 to April 2016, engage in online discussions between sessions and complete capstone projects which they will present. Look out for more information about the program and how you can participate in upcoming publications.

Welcome new membersAbingdonMichel Bidros, MD

AnnandaleKatherine Alter Lewis, MD

ArlingtonJaclyn Park, PA-C

BedfordEugene W. Lowe, Jr., MD

FairfaxMaria Paraguya, MD

FishersvilleDavid Dean Krieger, DO David Paulk, PA-C, EdD

FredericksburgMichelle O’Connor, PA-C

HarrisonburgKristina Liskey, PA

Newport NewsJohn David Burrow, DO

RichmondMyrtle Harris, MD Stephen Paul Long, MDDaniel Musick, MD Laura Ruby Vinson, MD John J. Vollmer, PA-C, MHS

SpringfieldChristine Hollenbeck, PA-C

WoodbridgeNizar Hussain, MD

Joint Partnership of VHHA, VNA & MSV

SYNCTransforming Healthcare Leadership

16 www.msv.org July 2015 17

Member resourcesGet the most out of your involvement with MSV by taking advantage of our many valuable resources, publications, educational

opportunities, professional services and practice management tools. Most of these services are available to only MSV members so please join today to enjoy these exclusive benefits.

Free resources• Member helpline

800 | 746-6768, EXT 1060

• Member information center 800 | 746-6768, EXT. 1050 for questions regarding membership

• Regional staff

• JobBoard www.msv.org/jobboard

• Physician Directory www.msv.org/directory

• Health plan hassles www.msv.org/hasslefactor

Leadership• Committees and task forces

• House of Delegates and Board of Directors

• State leadership opportunities

Information• Grassroots action center

www.msv.org/grassrootstoolkit

• MSV Legislative Updates, MSV E-News, Virginia Medical News, Practice Services Updates www.msv.org/publications

• Issue backgrounders

• Knowledgebase www.msv.org/knowledgebase

Events• White Coats on Call lobby days

• Advocacy boot camps

• MSV Annual Meeting

• Medical student section events

Education• evolve™

• Free CME/Opioid education

Discounted• Coding webinars and classes

www.msv.org/classes

• Local consultation

• Discounted coding manuals

Additional services• Property & casualty insurance

• Life & health insurance

• DOC Rx Relief

Vendor partners• Total Merchant Services

• Digital Benefit Advisors

• 1752 Financial

Member resources

Who better to help you?

Each day thousands of physicians treat their patients with confidence in knowing that MSVIA is their insurance partner. Building on the Medical Society

of Virginia’s legacy of caring about Virginia physicians, our team stands ready to support you with unbiased guidance and exceptional service.

Request a quote at www.msvia.org/RequestQuote.

ANNIVERSARY