Patients and politics: What the AMA Code of Medical Ethics says

With the dawn of a midterm election year and major issues affecting the nation’s health system on the agenda, questions arise about the role physicians should play in discussing political topics with patients.

In a recent JAMA opinion essay, Harvard Medical School Professor Jerry Avorn, MD, argued that “a strong case can be made that rather than being a taboo subject, discussing transformational changes in health care coverage with patients could be seen as a core responsibility of all clinicians—physicians, nurses, pharmacists, therapists.”

Such communications are “necessary to ensure the capacity of health care professionals to continue to provide patients with the health care they seek from us,” he added. “The intimate connection between coverage and clinical care also offers a direct and unassailable way to communicate this information.”

The AMA Code of Medical Ethics has guidance for physicians on this sensitive issue.

My lede at AMA Wire. The whole shebang.

10 New Year’s resolutions for your health and your family’s

The waning months of 2017 probably began with gobbling a few unclaimed Halloween treats, might have continued with the Thanksgiving coma and may yet conclude with a headache on New Year’s Day. However you may have fared during the holiday season, the new year offers everyone another opportunity to make healthier choices for themselves and their loved ones.

The lede to my latest story in AMA Wire. The whole shebang.

Vantage Point

Often enough, I can fleetingly
Do as I am enjoined
And find in fatherhood a way
To see through bright new eyes
But look: The glimpse blurs
In the blink it takes
A preschooler’s toys to scatter
And I am re-educated in
Adulthood’s doleful knowledge

To be clear: I can feel
The fibrillating, unadulterated joy of
That sweet wave formed of flesh
Whose snapshots are finely focused
And shared with the adoring crowd
Yet I envision this fuzzy math that follows:
The inevitable findings that fathers are
Fallible, foolish, ultimately ephemeral

Here is a glancing truth, I suppose:
When cast from the correct vantage point
Nothing our vale of tears has to offer
Can sting more than the moment a sudsy drop
Of shampoo snakes its way down
The forehead, finding its collateral target
“Dry my eyes, please!” you beg
— So I do
Then you open them up to drink me in
And I do the same for you

– 30 –

When appearing in media, physicians carry special responsibility

Taking an active role in the mass media is one way that physicians can use their knowledge and expertise to help improve the nation’s health, but the roles of doctor and media personality sometimes come into conflict. The AMA House of Delegates has adopted new ethical guidance for physicians appearing in the media.

“Physicians have well-recognized responsibilities to use their knowledge and skills for the benefit of the community as a whole,” says the AMA Council on Ethical and Judicial Affairs report adopted at the 2017 AMA Interim Meeting in Honolulu, and “stepping into the media environment can serve as an extension of this public function.”

My lede. The whole shebang.

Opioids emergency declaration must be followed with smart action

President Donald Trump today directed the Department of Health and Human Services to declare the opioid epidemic a public health emergency. With the move, aimed at tackling the epidemic tied to hundreds of daily overdose deaths across the nation, the president also ordered other federal agency and department leaders to use any appropriate emergency authority they have to address the problem.

The president specifically announced a plan “to overcome a restrictive 1970s-era rule that prevents states from providing care at certain treatment facilities with more than 16 beds for those suffering from drug addiction.” He said several states had sought relief from this and other requirements and promised that “approvals to unlock treatment for people in need” would “come very fast, not like in the past.”

My lede. The whole shebang.

Individual market-stabilization bill earns physician support

A compromise, bipartisan Senate proposal that would extend cost-sharing reduction payments through 2019 and implement other changes aimed at stabilizing the individual health insurance marketplace under the Affordable Care Act should be passed by Congress.

That was the message put forth today by the AMA, which has long urged legislators to take action to address the instability that could be caused by the lack of funding for the CSR payments, which help reduce the out-of-pocket costs borne by low-income Americans.

My latest at AMA Wire. Read the whole shebang.

“Dreamers” bolster physician workforce, should be allowed to stay

To help alleviate the physician shortage and improve access to care, Congress should move quickly to enact legislation that would allow those granted Deferred Action for Childhood Arrivals status—often dubbed “dreamers”—to live and work legally in the U.S. An estimated 5,400 previously ineligible physicians could be introduced into the U.S. health system over the coming decades through a DACA-like legislative fix.

My latest at AMA Wire. Read the whole shebang.

Bridge

Sunlight shimmering on the river water
Leaves me squinty-eyed on a Chicago summer day
The only kind worth a damn in this dreary town
The ladies in their floral dresses
And the men in their short sleeves
Walk briskly toward their midday destinations
While the tourists carefully trace their steps
Speaking in foreign tongues and consulting
Their pocket computers

I take a spot near the Wabash Avenue Bridge
To sip my coffee and let the sun hug my skin
What a lovely day to feel so bereft
An architectural tour boat wades into view
And the guide tells about the building
Where I work, and I wonder whether to wave
It seems like the neighborly thing to be
One more welcoming sight, another
Connection across the skyline

“Yes, I see you down there,” I think, and thrust out my arm
To offer the gentlest, friendliest wave I can conjure
The nonchalant sort that doesn’t beg for notice
Or require any response
But up there go one, two, three hands
Threading the summer wind with their fingers
“Hello,” the hands say as the boat parts the waters
And their owners’ faces become the backs of heads
Yes, they saw me standing up here
With my back to the glass and steel

Genome editing and the AMA “Code of Medical Ethics”

An international team of researchers recently published, in the journal Nature, their study using genome editing to correct a heterozygous mutation in human preimplantation embryos using a technique called CRISPR-Cas9. This bench research, while far from bedside use, raises questions about the medical ethics of what could be considered “genetic engineering.” The AMA “Code of Medical Ethics” has guidance for physicians conducting research in this area.

My latest at AMA Wire. Read the whole shebang.

Senate should reject ACA repeal, replace bills

Ahead of a planned vote in the Senate on Tuesday, AMA Executive Vice President and CEO James L. Madara, MD, made it clear that neither of the bills senators may consider contain the necessary elements to earn the support of America’s physicians.

“We urge the Senate to reject efforts to repeal or replace the Affordable Care Act,” Dr. Madara wrote in a letter to Senate leaders, asking that they “work instead toward improvements that will increase access to affordable, quality health care coverage for all Americans.” He noted further that “recent revisions do not correct core elements that will lead to millions of Americans losing health insurance coverage with a resulting decline in both health status and outcomes.”

My latest at AMA Wire. Read the whole shebang.