How to improve screening for social determinants of health

A recently published survey finds that about one in four hospitals and one in six physician practices screen their patients for social conditions that affect health, such as food access, housing stability, utility and transportation needs, and interpersonal violence.

Results of the cross-sectional survey of 2,300-plus physician practices and nearly 800 hospitals were published in JAMA Network Open, and they highlight barriers to discovering the factors outside the exam room or hospital wall that can affect health or interfere with patients’ engagement in their clinical care.

My latest at the AMA. The whole shebang.

$370,000 in AMA grants will help drive rigorous med ed innovations

Fifteen medical schools and institutions are getting grant funding from the AMA to advance innovative ideas that will transform education in areas such as curriculum, faculty development, coaching, systems approaches to learning, and competency-based medical education.

The grants were announced during the AMA Accelerating Change in Medical Education Consortium’s ChangeMedEd 2019 conference and total $370,000. The funding will help medical educators advance medical education changes that are feasible, scientifically rigorous, creative and adaptable to other institutions.

My latest for the AMA. The whole shebang.

Why it’s time to pull the plug on e-cigarette ads

The corporations that own CNN, CBS, TNT, TBS and other major broadcasting brands have announced that they will not air advertisements for e-cigarettes amid the ongoing investigation of vaping-related lung illnesses that have sickened hundreds of Americans and killed seven people.

But that does not go far enough, say the nation’s physicians.

“The use of e-cigarettes by young people is a growing public health epidemic that must be addressed. That’s why we’re calling on media organizations to help us promote public health and reject any advertisements that market e-cigarette products to youth,” said AMA President Patrice A. Harris, MD, MA.

“While we’re pleased to see some media companies denying e-cigarette product ads during the current lung illness outbreak, we also encourage them and others to extend bans on e-cigarette product ads beyond the outbreak to help stem the rising use of these products among youth,” Dr. Harris added.

My latest at the AMA. The whole shebang.

What doctors must know about the vaping crisis

New research shows that 40.5% of high-school seniors have tried nicotine vaping, adding urgency to President Trump’s announcement that the Food and Drug Administration (FDA) will take action to ban the e-cigarette flavorings that have proved so attractive to teens and young adults. Meanwhile, federal health agencies are encouraging physicians to report detailed information on cases of vaping-associated lung illnesses. Here’s what doctors need to know.

My lede. The whole shebang.

Title X gag rule: What’s on the line in upcoming oral arguments

The AMA will have its say in upcoming oral arguments in the 9th U.S. Circuit Court of Appeals in an effort to block a Trump administration rule that would gag physicians and decimate the Title X program. The new rule limits the medical advice physicians can give their Title X patients and compels physicians to act as government mouthpieces, violating the AMA “Code of Medical Ethics.”

The Title X family planning program ensures that every person has access to basic, preventive reproductive health care such as birth control, cancer screenings, and sexually transmitted-infection testing and treatment regardless of economic or insurance status. Roughly 4,000 clinics have served 4 million family-planning patients annually in the Title X program.

My lede. The whole shebang.

New immigration policy endangers patients needing life-saving care

A new policy implemented by U.S. Citizenship and Immigration Services (USCIS) bars its field offices from accepting or adjudicating requests for temporary deferral of deportation for immigrants with serious medical illnesses.

The AMA is strongly urging the USCIS to reverse the move. The agency has long used deferred action, which is a form of prosecutorial discretion, and in recent years the USCIS has allowed it for immigrants suffering serious medical conditions.

My latest for the AMA. The whole shebang.

Court blocks law that would force physicians to mislead patients

A federal district court in North Dakota has sided with the AMA and others and issued a preliminary injunction to block enforcement of a state law that would force physicians to violate the ”AMA Code of Medical Ethics” and act as mouthpieces for a politically motivated message that is misleading and could harm patients.

The provision would have forced North Dakota physicians to tell women “that it may be possible to reverse the effect of an abortion-inducing drug if she changes her mind, but time is of the essence, and information and assistance with reversing the effects of an abortion-inducing drug are available” in government-printed materials to be given to the patients.

“State legislatures should not be mandating unproven medical treatments, or requiring physicians to provide patients with misleading and inaccurate information,” says Chief Judge Daniel Hovland’s decision. “The provisions of [this law] violate a physician’s right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the 8th Circuit Court of Appeals, or other courts to date.”

The lawsuit was filed by the AMA in in the U.S. District Court for the District of North Dakota, in Bismarck, on behalf of the Red River Women’s Clinic, and the clinic’s medical director, AMA member Kathryn Eggleston, MD, as co-plaintiffs.

My lede. The whole shebang.

Also recently published at the AMA website:

New BRCA recommendations: What primary care doctors must know

The U.S. Preventive Services Task Force (USPSTF) has updated its recommendations on screening for the BRCA1 and BRCA2 genetic mutations that account for 15% of ovarian cancer cases and between 5% and 10% of breast cancer cases. Here is what primary care physicians should know about the new recommendations.

The USPSTF’s recommendation statement, published in JAMA along with the task force’s evidence report, represents a significant change to the group’s 2013 recommendations and broadens the pool of women for whom primary care physicians should conduct a risk assessment and potentially refer for genetic counseling and testing.

My latest for the AMA. The whole shebang.

Proposal would roll back LGBTQ protections. That’s an awful idea.

What’s the news: The AMA is strongly criticizing a proposed Department of Health and Human Services rule that would do away with Affordable Care Act (ACA) protections for LGBTQ people, women, immigrants, minorities and other patients.

“This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a sharply worded letter to HHS Secretary Alex Azar. “It legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.”

My latest for the AMA. The whole shebang.

E-prescribing controlled substances: Here’s why the clicks add up

Electronic prescribing has taken off, making it easier for physicians to get orders quickly and safely to the pharmacy of the patient’s choice. Yet while 70% of physicians e-prescribe, only 20% are able to electronically order controlled substances such as analgesic opioids.

And accessing the information in state prescription drug-monitoring program databases—a key tool to prevent opioid misuse or diversion—is another question altogether. It often means that physicians have to start a separate workflow with new windows, logins, and more clicks and keystrokes.

My latest for the AMA. The whole shebang.

Doctors battle state law that forces them to mislead patients

The AMA has filed a federal lawsuit challenging the constitutionality of North Dakota legal provisions forcing physicians to violate the AMA Code of Medical Ethics and act as mouthpieces for politically motivated messages that are misleading and could lead to patient harm.

North Dakota law already requires physicians or members of the doctor’s care team to tell women set to have an abortion that the procedure “will terminate the life of a whole, separate, unique, living human being.”

Now a provision set to take effect Aug. 1 would force them to also tell women “that it may be possible to reverse the effect of an abortion-inducing drug if she changes her mind, but time if of the essence, and information and assistance with reversing the effects of an abortion-inducing drug are available” in government-printed materials to be given to the patients.

Together, the two provisions “compel physicians and their agents to speak government-mandated messages that entail providing to their patients misleading or even patently false, nonmedical information with which they disagree,” says the complaint filed by the AMA and other plaintiffs.

My latest for the AMA. The whole shebang.

Men at Work

For blocks around, the black and yellow towers
Soar above the construction site
Approach to hear its cacophony
Of grinding, hammering, shouting
Men at work

Look up for a glimpse of their project
Come closer and the view ahead’s obscured
By tarpaulin-shielded, chain-link fencing
Come closer yet to find
Not all is opaque

See the upturned earth where the new building
Will have its foundation
The broken-up rock and concrete that
Will be carried away
See immense machines marching and
Men at work
In their hard hats and reflective gear
Work gloves and blue jeans

This morning’s kindergartners
Scattered the playground at summer camp
Letting the sand slip through their fingers
And the cool wind ruffle their t-shirts
Grinding down their temporary towers
Hammering away at invisible inventions
Yelling away, but with their reasons
Deeply engaged in the earnest business of
Children at play

Back at the work site
Look about to find
A bald-headed old man
In a beat-up windbreaker
Use the fence to steady himself
And discover a spot
Where two posts
Are imperfectly joined
To offer an unimpeded view of
Men at work
That leaves the old-timer
Shining the ecstatic beam of a
Little boy

— 30 —