Blog

TedX comes to Youngstown, Ohio

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The first ever TedX event is going to be January 24, 2014 on the campus of Youngstown State University in Youngstown, Ohio. I am proud to be part of the sponsorship team for this event. Please check out the website for the event at this link.

Can't attend the event in person? That's ok. The event will be live streamed over the internet at this link. Because of work obligations, I will be unable to attend the event this year. But, I will definitely be watching the live stream. I hope to participate next year. I'm very happy TedX is coming to Youngstown!

Primary Care Advocacy in New Jersey

The Executive Vice President of the New Jersey Academy of Family Physicians, our pal Ray Saputelli (please follow him on twitter), was interviewed yesterday on a bill in the New Jersey state legislature for a program that would reimburse up to $200,000 for Primary Care and Family Medicine physicians' schooling, over four years, for those who stay in the state.

In the interview above from NJ TV Online, Saputelli states that New Jersey is one of the least attractive states for medical students to stay in because of issues like lack of physician payment/reimbursement. Here's a quote from the interview...

“I can’t tell you how many times I speak with medical students who are from New Jersey, who tell me that the situation here is just untenable to consider practicing primary care. When you look at what the environment is, both in terms of payment and lifestyle, in almost any other state in the nation, it’s very difficult”
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Our pal Ray put this on his Facebook page yesterday. Well done, my friend! We need everyone from the Family Medicine community and #FMRevolution out there on television, radio, print, the internet, and everywhere else telling the Family Medicine story!

Finally since this will probably be the last post before the holidays, I just wanted to wish everyone out there a Merry Christmas and Happy New Year! I've been 2014 strategic planning for the website and for my "social media brand," and I'm looking at some big plans next year. It's going to be very exciting. Hope you stay tuned to see what happens!

"Doc Fix" Debate 2013 Begins

It's only been a couple of days since the announcement of the bipartisan budget compromise. But, it's now the job of the Congress, like it typically does, to avoid the crisis of being in Washington DC for Christmas, by debating other financial issues. According to The Hill, today's items include a one-month farm bill extension, the National Defense Authorization Act, and a three month "Doc Fix."

"Doc Fix" is the euphemism used as a piece of legislation to avoid double digit cuts in Medicare payment to physicians. This topic has been written about on this website many times in the past. This time, I believe this will be around 25% congressionally mandated cuts to Medicare physicians. The graph below from politisane last year shows the proposed negative direction of medicare payments to the positively growing cost of inflation to keep a practice open.

Physician advocacy groups, like my own American Academy of Family Physicians, have been doing a lot of lobbying on Capitol Hill. They have been talking to legislators not only about avoiding the short term cut, but also coming up with a long term solution to fix the broken Medicare payment system (#fixSGR on twitter).

Current Congressional debate will be changing an approximate 25% cut in Medicare payment to a whopping 0.5% increase (that's zero point five percent) increase in Medicare payment - just through March 2014 - when we'll have to go through this political exercise again (possibly attached to the debt ceiling debate).

So, semi-political junkies like me will be viciously following sites like The Hill for the latest updates. But, all of us know what is going to happen. With the 2014 midterm elections just around the corner, neither political party is interested in any kind of long term solutions to things like the broken Medicare payment system.

Manufactured political crises, short term political deals, and pundits like me will continue to use phrases like "bandaid solution" and "kicking the can down the road."

Where will it end? Well, you're already seeing proactive people just getting out of this broken health care system with health care solutions like Direct Primary Care and concierge care. Is this the future? The one thing all of us can agree on is that our current path is unsustainable. If government doesn't solve the problem, grassroots medicine will...

Deeper Than Digital Connections

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I don't know about you, but I find some of the best times to write are at the airport waiting for a flight. It's a good time to reflect back before the realities of home start to hit you. 

This past weekend I was in Las Vegas at a Family Medicine educational course. At these events, I really try to focus on learning, and try not to socialize that much or draw attention to myself. However, at one of the lecture breaks, the two gentlemen above came up to me and said, "Hey, Mike! It's been a while, how are you doing?"

I haven't seen these guys (pictured above) for 2 years, but our connection is a leadership and advocacy meeting for our Family Medicine speciality. We've been peripherally "following" each other on social media platforms, but haven't talked in person for a long time. We only had limited time together, but it was like old times, and I have not laughed like that in a long time. 

I mean, it's not rocket science, and I know that I'm not the first person to say this. Digital connections are great, and networking is fabulous using social media. But, there really is nothing like In Real Life (or as my friend Meredith Gould says, In The Flesh) meet ups that go deeper than digital connections...

My Cancellation Letter on KevinMD

Thanks to KevinMD for sharing my post on their site entitled, "Doctor Quits AMA and State Medical Society." The original post on this site is entitled "My Cancellation Letter."

Welcome to those of you who are visiting from the KevinMD site. I invite you to take a look around here including My About Page, and My Media Links including local TV interviews. If you like what you see on the blog, I encourage you to subscribe to the blog here.

I also invite you to check out my other social media sites including My Podcast, twitter, you tube, facebook, linked-in, google plus, and others. Enjoy!

Welcome Twitchy Readers

Welcome to those of you who have clicked on over from the front page of the Twitchy US Politics page. I was alerted to this link by one of my friends on Facebook. I also noticed a huge update in visits to the website today. I guess that's the power of being picked up by a popular website. You can see by the pic below, how things have jumped up in the past few days

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Thanks so much to my friend Bunny Ellerin for posting the tweet below about my post entitled "My Cancellation Letter" talking about me non-renewing my membership with the American Medical Association and my state medical society.

Welcome to those new are new checking out the site! I encourage you to check out my other social media activity on twitter, you tube, Facebook, blog, and my podcast. Enjoy!

Dr. Regina Benjamin: Doomed Surgeon General

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This week in Washington, way beneath all the press about Obamacare, there have been articles panning the President's pick as the next Surgeon General of the United States. Wait a minute. What happened to the last Surgeon General?

Six months ago, Family Physician Dr. Regina Benjamin stepped down as the first Surgeon General under President Obama. Quick! Name one accomplishment under Dr. Benjamin. I can't either. What happened?

Dr Benjamin was a rising star in the medical community. In 1995, she was the first African-American woman to be elected to the American Medical Association Board of Trustees. She gained a lot of notoriety following Hurricane Katrina in 2005 as one of the only physicians treating patients in her community of Bayou La Batre. I remember seeing her speak in person in 2007 at an AAFP conference. She has a soft spoken presentation, but she tells a compelling story.

Following the 2008 Presidential election, there was a lot of buzz in the press about the possibility of Sanjay Gupta being nominated as Surgeon General. When that did not materialize, Dr Benjamin's nomination was announced. The Family Medicine community rejoiced. However, the press, who was clearly pulling for a Sanjay Gupta nomination, lashed out with headlines like "Is Regina Benjamin, Surgeon General Nominee, Overweight?"

In my opinion, this Surgeon General tenure was doomed from the start. Don't get me wrong, I'm a BIG fan of Dr Benjamin and her work. She's a nice person, but I think this was her downfall as well. Memorable Surgeon Generals include people like C Everett Coop and Joycelyn Elders. Why? Well, I thought they brought some controversy to the office, and to get attention in Washington DC, you need some controversy.

In Dr. Benjamin's TED talk below, she states that "One person can make a difference." When it comes to government and politics, I disagree with this. The other lesson learned from this doomed Surgeon General tenure is no one person can make an impact in the huge Washington bureaucracy. You need a great team around you and/or a huge amount of supporters within the Washington machine to get anything done there.

This lesson is important for the #FMRevolution activist community to know. Maybe we could have done a better job pushing back on the press when negative stories were sprouting up about Dr Benjamin. I believe this negative press removed most (if not all) her potential effectiveness as a Surgeon General.

One of these days, there will be another opportunity for a Family Physician to be Surgeon General of the United States. The Primary Care and Family Medicine community has to prepare for this by looking at our leadership development and advocacy pipelines. Not only do we need to groom tomorrow's leaders, but also we need to build the numbers of advocates in the public and private sectors to help the next Family Physician make a difference as Surgeon General of the United States.

The HPV Vaccine (Non) Controversy

"Why do we need Social Media in Medicine?" - This is the most common question I'm asked when I talk about social media. Well, THIS is the reason: Calling out hype and bad information.

On Wednesday, December 4, 2013, the main topic of the Katie Couric show will be the "HPV Vaccine Controversy." You'll see the video preview above. Here is what is on the show website:

The HPV vaccine is considered a life-saving cancer preventer. But is it a potentially deadly dose for girls? Meet a mom who claims her daughter died after getting the HPV vaccine, and hear all sides of the HPV cancer controversy.

Now, you know what's going on here, right? It's well documented in the entertainment press that the ratings for the Katie show have been awful and there's been talk about canceling her show. Her show is so "successful" that just last week, it was announced that she's taken a new job with Yahoo as a news anchor. I mean, they'll give anyone an internet show. Heck, I'm an internet news anchor LOL.

If you're in any kind of medical field, I hope you make your social media voice be heard on Wednesday. Even if you're not in medicine, but you get mad at people who spread hype and bad information, I hope you make your social media voice be heard on Wednesday.

Now, don't misunderstand, my heart goes out to this mom who is going to share her story on the Katie show. It is a tragedy that her daughter passed away. However, making the link to the HPV vaccine, seems like a stretch to me. This mom has every right to share her story. But, we as a medical community also have every right to share our story.

Here are some facts from the Public Library of Science post about HPV Vaccine:

In addition here are some links from our friends at the Centers for Disease Control:

How do you fight emotion and hype, with facts and science. I challenge anyone who reads this post to use your social media voice to share the truth about vaccines. For grassroots clinicians like me, I challenge you to especially talk about vaccines on Wednesday with your patients to defuse the hype that this show may generate. The truth and the science are on our side. We just have to get the word out to the public, and most importantly, to our patients....

My Cancellation Letter

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Everywhere in the news these days, you read of stories where physicians are being cancelled from insurance plans, and groups like the American Medical Association, and state based medical societies fighting to reverse these decisions. Does anyone think these actions will really make a difference? I certainly don't.

Since this is the start of December, this is the time of year where I look at certain expenses and wonder if they are worth continuing for next year. There are some elements which are essential, like my state medical license and DEA license (so I can prescribe certain medications). One cannot practice medicine without these.

What I struggle with every year is justifying the expense for continued membership in physician professional organizations like the American Medical Association, state based medical societies, and my speciality organization. 

It is no secret and it has been well documented that the American Medical Association has not had the membership numbers it once had, and less than 30 percent of American physicians are AMA members now. Every year, it has come down to this question for me: "Does this organization represent me and support my professional interests?" At one point that answer was "yes," but now, it's "no." I'm issuing my cancellation letter to the AMA and my state based medical society. With shrinking payment, increasing expenses, and not feeling like I have a voice there anymore, it is time to part ways.

I know there are some physicians out there saying, "What took you so long?" One could always hope that my Family Physician activist friends could help to turn the tide at the speciality driven AMA, but I don't have the dollars to wait any longer. My heart and soul and voice remains with my specialty organization (American Academy of Family Physicians), and I think that other physicians feel the same way in that their niche group or their specialty group brings their health policy message to the local, state, and federal levels for advocacy.

I went to medical school to be an independently owned, primary care physician, who sees patients in the hospital and in my office. Unfortunately, we are facing extinction in the face of the current trends of hospital owned, employed physicians, who are either hospital based or office based. Physician membership organizations are doing a lot of soul searching these days trying to figure out who there membership is these days. Fragmentation is not only in patient care. It is also in physician advocacy. My dollars and support will go to organizations who support me and hear my voice...

 

Addendum: Welcome to