VIRGINIA MEDICAL NEWSMARCH 2015

Who is your champion for high quality care?

02 MSV legislative summit – Submit your ideas by April 15

02 Coming soon . . . MSVPAC school duel

03 Are you prepared to face 5 years without income?

04 President’s update – Celebrating Doctors’ Day

05 MSVF salutes those who serve our profession well

IN THIS ISSUE

Physicians are the leading authority on medical information and best practices in care delivery. Every day, physicians work to achieve their ultimate goal—to be the best resource for their patients and serve as the patient’s ally in advocating for optimal health and accessible health care.

The Medical Society of Virginia (MSV) celebrates physicians for being champions for their patients every year with its Doctors’ Day Facebook campaign, which commemorates the March 30 Doctors’ Day holiday that recognizes the contributions of physicians to the community. Nominate a physician who inspires you at www.facebook.com/MedicalSocietyofVirginia. Nominations are due by March 30, and the photo or story that gets the most number of “likes” will be featured in MSV’s Virginia Medical News.

Previous winners include Fred Arnold, M.D. and Carol Shapiro, M.D., M.B.A. This year could be your year to be recognized among other physician leaders who have made tremendous contributions to their communities and the profession.

Here’s how to submit your nomination: Simply visit www.facebook.com/MedicalSocietyofVirginia to share a story of a Virginia physician who embodies leadership to you.

Click on the empty “Post” box and start typing! If you would like to post a photo, please 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. If you do not have Facebook, you can e-mail webmanager@msv.org to share your photo and story.

This is your chance to recognize those in the medical profession who inspire you and who represent physician leadership. Please share stories and photos of physicians who make an impact and who you would like to thank for their many contributions.

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The staff of the Medical Society of Virginia (MSV) government affairs department is hitting the road after the close of the legislative session and coming to a town near you to give legislative briefings and a general overview of all the exciting legislation that was passed or defeated during the 2015 session.

If you are interested in having us in your office or at a local meeting, please contact Patti Seitz by e-mailing pseitz@msv.org or calling 804 | 377-1051. We will do our best to make it to as many group offices as our schedule permits.

Advocate for my profession

MSV legislative summit – Submit your ideas by April 15Over the last few years the Medical Society of Virginia (MSV) has celebrated many legislative successes, including its efforts to reform prescription prior authorization, preserve a stable and affordable medical liability insurance market, ensure patient safety through scope of practice protections and protect public health with smoke free restaurants. All of these ideas were developed through MSV’s annual process to seek member input on its legislative agenda—which begins at the MSV legislative summit.

This year’s summit will be held on May 1 from 2:30 p.m. to 5:00 p.m. at MSV headquarters in Richmond. Be sure to come learn about and discuss priorities for 2016.

It is easy to get involved. If you have an idea that you would like to have considered as part of MSV’s legislative agenda, you simply need to submit a proposal online at www.msv.org/legislativesummit. Proposals are due by April 15. All MSV members and local and specialty medical societies have the opportunity to submit proposals for potential inclusion in MSV’s 2016 legislative agenda.

After the summit, MSV’s legislative committee reviews the input and prioritizes issues for possible inclusion in the legislative agenda based on MSV policy, available resources and the current political landscape. The issues are then presented to MSV’s board of directors for consideration in developing and approving the final MSV legislative agenda.

For additional information on the legislative summit, please visit www.msv.org/legislativesummit.

Coming soon . . .

MSVPAC school duel Coming

to a town near you!

SDThe Medical Society of Virginia Political Action Committee (MVPAC) is pleased to announce the return of its medical school duel!

For those of you who missed it last year, here is how it works: Students from Eastern Virginia Medical School (EVMS), Virginia Commonwealth University (VCU) - (formerly Medical College of Virginia), University of Virginia (UVA) and Virginia Tech Carilion (VTC) form teams to plan events at their respective schools. They recruit other med students, residents, professors, alumni, physicians from the community and anyone willing to attend the event and/or make a contribution to MSVPAC.

During this competition, students learn the importance of investing in the political process and how it greatly impacts the medical community. Prizes for the winning school are given out at the MSV Annual meeting.

Host levels for the event are the same as MSVPAC normal giving levels: $2,400, $1,200, $600, $365 and $150. Tickets for physicians are $50 and tickets for students and residents are $15. Events will take place throughout the month of April.

Check out our Web site at http://msvpac.msv.org/ for the soon-to-be announced dates for each school. You can click here to make a contribution online right now. If you are interested in attending or helping out with the events, please contact Patti Seitz, MSVPAC fundraising manager, at 804 | 377-1051 or e-mail pseitz@msvpac.org.

March 2015 3

This article was submitted by the Virginia Office of the Managed Care Ombudsman.

Many people may not be aware, but the Office of the Managed Care Ombudsman is here to help. This office, which was established in 1999, is here to assist your patients in the appeal process with their Managed Care Health Insurance Plan (MCHIP) if the coverage is fully-insured and issued in Virginia.

As part of the State Corporation Commission’s Bureau of Insurance, the Managed Care Ombudsman can formally help your patients file appeals or provide the following services for patients whose health insurance is provided by MCHIP:• Assist in understanding their rights and how to resolve problems.• Answer inquiries from consumers, health care providers and

other individuals.• Provide information on MCHIPs, types of MCHIPs, mandated

benefits, utilization review procedures and available appeal options

• Assist in filing appeals, including utilization review appeals.• Ensure access to the office and receive timely responses.

Because the Managed Care Ombudsman office is part of state government, it does not have regulatory jurisdiction over self-insured plans, coverage provided by the federal government such as Medicare and TRICARE, nor can the office assist Medicaid recipients, or help individuals whose health insurance issued in another state. In accordance with the law that established the Ombudsman’s office, it can directly assist your patients but there is no provision to directly assist a physician. Subject to availability, the office is also able to provide speakers to address organizations on issues regarding health insurance.

Additional information on the office can be obtained via the SCC web page located at www.scc.virginia.gov. You can also contact the office at ombudsman@scc.virginia.gov or 877 | 310-6560.

Manage my practice

Helping patients appeal adverse decisions

1 in 8 professionals will be disabled at least 5 years during their working careers.*Have you thought about what your life would look like if you were unable to earn an income for 5 or

more years? How would you pay your bills, buy your groceries or provide for your family?Nobody wants to think about it, but an unexpected accident or illness could financially devastate you at

any time. This is why investing in the right disability income insurance policy is one of the smartest decisions you could ever make.

The Medical Society of Virginia Insurance Agency (MSVIA) is here for you when you need it most. MSVIA offers a discounted higher-limit disability program through Lloyd’s of London exclusively to MSV members to help you get the full income protection you need to have peace of mind.

Make your dues work for you“I knew that I did not have enough disability insurance to cover my family’s needs with my existing disability policy, but had found it difficult to obtain it at a more reasonable price until I called MSVIA. They offered one of the best disability policies with the oldest and most reputable insurer, Lloyd’s of London. Because of my MSV membership, I also received a significant discount. Nice to know our dues are working for us!” —Suzanne Everhart, D.O.

Enrollment for this coverage is open through May 31. Contact Dustin Beekman, MSVIA director of life and health, at dbeekman@msvia.org or 877 | 226-9357 ext. 1006 to find the right product for your needs.

*Council for Disability Awareness.

Are you prepared to face 5 years without income?

1 in 8 professionals

will be disabled at least 5 years

during their working careers.*

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Care for my patients / MSV news

Advanced care planning – Why it’s neededNational Health Care Decisions Day (NHDD) is coming up on April 16 so there has never been a better time to talk to your patients and educate them on how to communicate and document their health care decisions. This initiative was created to inspire and empower the public and providers about the importance of advanced care planning, encouraging patients to express their wishes regarding health care and for providers to respect those wishes. Click here to visit the NHDD Web site and get tools to help educate your patients on the importance of advance care planning.

Available resources • MSV advance directives knowledgebase – Several online resources on advance directives.• Virginia State Bar Web site – Get advance directive forms, which are documents that list an individual’s wishes regarding medical care

in writing.• Virginia Advance Health Care Directive Registry – Securely store critical planning documents like advance directives, health care power of

attorney and declaration of anatomical gift for access by authorized medical providers, emergency responders and family members.

“More than the application of science and technology, medicine is a special calling, and those who have chosen this vocation in order to serve their fellow man understand the tremendous responsibility it entails.”

On Oct. 30, 1990, then President George Bush wrote the above proclamation and signed S.J. RES.#366 into law, designating March 30 as the day to celebrate Doctors’ Day. Also in this proclamation, he recognized physicians for the hard work, stress and sacrifices they make to do the day-to-day work of healing.

Although the day began as a national holiday 25 years ago, research indicates that Doctors’ Day was actually first observed in the U.S. in 1933 in Winter, Georgia, when physician wife Eudora Almond set aside a day to honor physicians—since then, people celebrate by thanking their physicians and sending red carnations, which are commonly associated with the day. The March 30 date is significant because it is the anniversary of the first use of surgical anesthesia in 1842.

As you can see, we are part of longstanding and established profession. Despite our many obstacles like looming sustainable growth rate (SGR) cuts and endless governmental quality measures like meaningful use, PQRS, and value based modifier, our profession still endures and we continue to be the trusted voice in determining treatment for our patients. I’ve witnessed our victories firsthand this General Assembly session as we overcame obstacles that could have

interfered with our ability to provide care to our patients. We faced challenges with prescription prior authorization, workers’ compensation and chiropractors’ scope of practice, but we achieved success in our efforts because we worked together and stood up for our patients and our profession.

At the end of this month, I hope you will take some time to observe Doctors’ Day to continue to recognize our profession, our work, and the contributions we make every day to our communities. This Doctors’ Day, I hope you will also

take some time to remember some friends and colleagues who inspire you. MSV offers many great ways to recognize them in its Doctors’ Day campaign, which runs every March. Together, we celebrate physicians for being champions for their patients and recognize you for making a difference in the community. Nominate a friend or colleague who inspires you at www.facebook.com/MedicalSocietyofVirginia by March 30.

Finally, I wish you all a happy Doctors’ Day. I thank each and every one of you for your dedicated service to taking care of your patients and the community at large.

President’s update – Celebrating Doctors’ Day

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

March 2015 5

MSV news

Last year, the Medical Society of Virginia Foundation (MSVF) honored some phenomenal physicians and medical students with 2014 Salute to Service Awards, including:

1. Service to the Profession – The Honorable Ralph S. Northam, M.D. 2. Service to the Uninsured and Underserved – Janet Eddy, M.D. 3. Service to the International Community – Mary Susan Carlson, M.D. 4. Service by a Medical Student or Resident – Christopher J. Li 5. Service by a Medical Student or Resident – Tara G. Nagaraja 6. Service to the Commonwealth for Advancing Patient Safety and Quality Improvement – Joseph F. Territo, M.D.

Do you know individuals who can join the ranks of these accomplished individuals for their accomplishments as physician leaders and humanitarians? If so, please visit http://foundation.msv.org to recognize someone today or learn more about last year’s winners.

How can someone qualify for a Salute to Service Award? 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 the Medical Society of Virginia Foundation (MSVF) give them a salute by nominating them!

Winners will be recognized with a wonderful tribute at this year’s Physicians’ Gala during the Annual Meeting at the Westfields Marriott in Chantilly on Oct. 24. The awards are sponsored by The Doctors Company.

For additional information, call 804 | 377-1053 or e-mail foundation@msv.org.

MSVF salutes those who serve our profession well

Simply complete the online form at http://foundation.msv.org.

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It’s easy to nominate someone!

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MSV news

This article was contributed by Steven Lewis, M.D., a resident at EVMS Portsmouth Family Medicine. He also serves on the MSVF Board of Directors.

As a medical student, I remember reading an article or blog by a practicing emergency medicine physician who was discussing that medical school did not have to be so depressing, and how she suffered from burnout during training and was now a happy, practicing physician. There is a bright light at the end of the tunnel. A few years later, as a family medicine resident, I now read articles about how physicians are reporting more burnout and there doesn’t seem to be any sign of that improving. It is a slightly dimmer light now. But wait, I am a busy resident, who is very happy, and I am not burned out—yet.

Being a young physician, and one still in training, provides an extended glimpse to understand the stress, frustrations and the sometimes outright incomprehensibility of the upcoming future. I understand the stress caused by increasing patient loads, lack of control over schedule, navigating new and old regulations, increasing EHR requirements and overwhelming tasks on both EHRs and paper in a supposedly paperless system. Can we please stop prior authorizations? I also have been exposed to ways of addressing those stressors.

The 2015 Medscape physician lifestyle report shows that since 2012, overall burnout has increased, and the specialties with highest rates of burnout are critical care, emergency medicine, family medicine and internists. The least happy are the radiologists, and then the emergency medicine, family medicine and internists. Physician suicide rates are increasing. Medical student burnout has been associated with suicidal ideation. You would think younger physicians are more prepared to handle this given we are trained under current requirements with documentation and the avalanche of regulation; however, more than half of young physicians (<35 years old) reported burnout symptoms. But the young family medicine docs were less burned out than internists, so at least I have that. Overall, many of us are not very happy for a lot of reasons, but actions, new and old, can help.

Residency programs have made recent changes including monitoring stress levels, fatigue, sleep and of course regulating and monitoring work hours for residents. Studies do show that both monitoring satisfaction and stress levels as well as providing information and methods to decrease stress actually improve burnout rates. Some places even track how much time you spend on your EHR. Residencies and hospitals in general are using night float programs and nocturnists to improve satisfaction and decrease burnout in comparison to the every 2, 3 or 4 night, in-house call systems of old. Some hospitals provide their doctors with bonuses and incentives to decrease burnout, but making more money has not been correlated with less burnout. Practices often allow physicians to alter their hours to their preference, which markedly improved satisfaction and decreased burnout as physicians have more time to take part in other activities they enjoy. Distributing the documentation workload among the care team

(MDs, nurses, MAs, etc.) has improved burnout, especially with increasing charting requirements. The mindfulness revolution has provided an enlightened look at stress reduction and requires minimal training. And there is always that push to be physically active and have a strong support system, which both decrease burnout.

There are many minor solutions to start to address physician burnout, and there is no simple solution for this big problem. Though early in my career, I have chosen to commit to exercise, I attempt to practice mindfulness, but most importantly, I force myself to do the activities I enjoy. I spend time with my wife and family support system. I take time to be active with organizations like MSV and Virginia Academy of Family Physicians, which address my interest outside of day-to-day work. Having access to methods to decrease burnout and stress can improve burnout rates, and that provides ample opportunity for MSV and its members to make a potential impact by informing and supporting physicians. Whether its managing EHRs, meeting documentation criteria, billing, or searching for another job, MSV can be a source for decreasing some of the frustration, stress, and thus, burnout in Virginia’s physicians.

Reflections on burnout from the front line

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March 2015 7

MSV news

Reflections on burnout from the front line

MSV welcomes the following new members

AnnandaleEllen C. Vaughey, MD Srikrishna Vemana, MD

Chantilly Elizabeth Lauren Lavery, MD

FairfaxAhmed M. Hegab, MD

ManassasAshley Morgan Poe, MD

McLeanStuart Robert Stark, MD

MidlothianJohn R. Janes, Jr., MD Peter Jon Rosenbaum, MD

Richmond Ismat A. Asad, MD Arthur Clifford Ernst, MD Jennifer Lee Sheehan, MD

Roanoke Richard David Kauffman, DO Jeffrey M. Preuss, MD, FACEP

Salem Anthony Louis Dragovich, MD

Staunton Shashank Chhaganlal Parekh, MD Matthew Paul Shapiro, MD Thomas A. Zumsteg, MD

ViennaEdward Follett Morris, MD

Virginia BeachRobert C. Blackwood, MD Benford O. Nance, Jr., MD

WarrentonKevin Charles McCarthy, MD William L. Simpson, MD

Wytheville James Christopher Zwanch, DO

Medical students: Why our voices matterThis article was contributed by Daniel Young, a 4th year student at EVMS and chair of the MSV medical student section.

As a fourth year medical student at Eastern Virginia Medical School (EVMS), my journey toward becoming a physician is nearing a pivotal moment. As an aspiring radiologist, I’ve spent the last four months completing 46 residency interviews in 18 states. With final match lists submitted, my peers and I are anxiously awaiting our Match Day on March 20.

While I take this time to reflect upon my medical school career, I am thankful to have had my experiences with the Medical Society of Virginia (MSV) as an integral part of my medical education. While EVMS has done an extraordinary job teaching me the tools needed to succeed in my medical endeavors, MSV has provided me with the tools to become a physician leader and advocate for my patients and my profession.

I joined MSV quickly after beginning medical school in 2011. I began my leadership with MSV in my second year of medical school serving as the secretary-treasurer for the local EVMS MSV chapter. I then spent my third year as the secretary of the statewide MSV medical student section. I have been honored to serve as the chair of the MSV student section this past year. In my years of leadership, it has been exciting and at times invigorating to see the increased influence and impact that MSV has had on hundreds of aspiring physicians. I have seen the section grow tremendously and produce strong leaders active at both the state and national levels.

MSV’s student programming has not only provided students

the opportunity to create a network of passionate, forward-thinking medical students, it has taught us that the issues MSV is fighting are important, that our voices do matter and that we can make an impact. After having participated in MSV’s legislative summit, Annual Meeting and White Coats on Call, I have seen time and time

again how the legislative and advocacy process does create positive change for the profession and our patients. As medical students, we have been successful in stressing the importance of studying the needs for increased graduate medical education funding to provide additional residency opportunities in the commonwealth. At the conclusion of this year’s legislative session, a study was included in the budget to examine the issue. It is through these small victories that the beginnings of change occur.

MSV has shaped the physician that I will become. My decisions on my intended specialty and the residency match process have been formed based on the countless words of wisdom and advice I have been offered by many MSV physician members whom I’ve grown to view as mentors. While my future is solely in the hands of the match at this time, I do hope that I will be able to continue to call Virginia my home and MSV my medical society. I am pleased to know that regardless of where I end up, MSV will continue to be focused on fostering medical student engagement, growth and allowing those the same opportunities I have been offered.

New members

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