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ArMA Advocacy Success and More Community Opportunity

Posted By Michael F. Hamant, Thursday, April 26, 2018
Updated: Wednesday, April 25, 2018

Advocacy is a cornerstone of ArMA member benefits, and our leadership and staff work hard to keep members current on what is happening. I hope you have been able to follow the Legislative Updates included in our member newsletter, “Medicine This Week.” Although the Legislative Session is focusing more now on budget discussions, we are still tracking many bills as well as monitoring budget impacts related to health care. Let’s take a look at where we are now… 

 

In advance of the 2018 Arizona legislative session, the Arizona Medical Association (ArMA) Board of Directors approved 2018 Policy Priorities in December. They were: 

  • Protect, Cover, and Access to Health Services for our Most Vulnerable Populations 

  • Reversing the Opioid Epidemic 

  • Strengthen Public Health 

  • Administration Simplification for Physicians and Patients 

  • Support Efforts to Increase the Physician Pipeline 

  • Surprise Billing 

  • Scope of Practice 

 

Over the course of the legislative session, ArMA’s advocacy team and our Committee on Legislative & Government Affairs tracked, engaged, and advocated for physicians on over 150 bills. Your lobbying team, Pele Fischer, JD, ArMA VP of Policy & Political Affairs, and Steve Barclay, JD, our contract lobbyist, have worked tirelessly with ArMA physician leadership throughout the last four months, educating legislators, forming important alliances in the healthcare community, informing direct communications and grassroots with ArMA physician members, and engaging stakeholders in productive, diplomatic discussions. 

 

Another point of engagement for physicians at the Capitol is the Doctor of the Day program, a unique opportunity for physicians to volunteer at the Capitol during legislative session. ArMA wrapped up this program last week: we had 60 physicians and 10 medical students that participated in Doctor of the Day, with a great mix of specialties represented including IM/FM, anesthesiology, urology, radiology, ophthalmology, psychiatry, pediatrics, and surgery. There were 207 encounters with legislators and five medical calls attended for legislators and/or staff.  

 

The three biggest issues we faced so far this session were opioids, sunrise process changes, and physician credentialing.  

 

HB 2322, health insurers; provider credentialing, will bring badly-needed time limits and penalties, as well as transparency and disclosure requirements, to the way health insurers process physician credentialing and loading of their contracts for network participation. ArMA’s lobbying team worked closely with our allies at the Arizona Osteopathic Medical Association (AOMA), Arizona Hospital and Healthcare Association (AzHHA), and Health System Alliance of Arizona. Together we were able to find strength in numbers and garner strong support for successful passage of HB 2322. We had a great deal of support for this legislation from our members and in particular, from ArMA member organization, Arizona Associated Surgeons, and from our community partner Arizona Medical Group Management Association (AzMGMA)as they encountered deficiencies in the current system and brought awareness to the issuesThank you to everyone who took time to support the advocacy around this important bill. 

 

On SB 1034committee of reference; standing committee, we were able to reach a compromise in accordance with pre-established guiding principles to retain the patient safety protections inherent to the existing sunrise process and related scope of practice expansion applications.  

 

SB1001, the Arizona Opioid Epidemic Act, made significant changes to opioid prescribing and related pain management and addiction treatment in medicine. It went into effect on April 26, and Pele Fischer has authored an article outlining the items that need our immediate attention. I encourage you to review it today at The Arizona Pulse

 

Please continue to follow the progress in the weekly Legislative Updates portion of “Medicine This Week” and be sure to check out the comprehensive annual Legislative Report when it is released this summer. Share your thoughts in the comments below.

 

Our engagement in ArMA’s policy-building process ensures our focus and success at the Capitol. There are several ways right now that we as members can participate in the process. 

 

  • Contribute to ArMPAC – the Arizona Medical PAC identifies and supports medicine-friendly candidates, which in turn is helpful to our advocacy work at the Capitol. Contribute today!  

  • Sign up today to be an ArMA delegate at the June 2 Annual Meeting! 

  • Register now to attend the President’s Awards Banquet on June 2 for a unique networking opportunity with colleagues and health care community members. 

 

Sincerely, 

 

Michael Hamant, MD 

President, ArMA 

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Committed to Community & Well-being

Posted By Michael F. Hamant, Wednesday, April 25, 2018

I am pleased to announce the launch of the first digital magazine of the Arizona Medical Association (ArMA), The Arizona Pulse. I serve on the Advisory Council that strategized to establish the publication, and I am proud to serve as supervising editor for our first edition, dedicated to aspects of Physician Leadership.  

 

The inaugural edition of The Arizona Pulse features insights from physician leaders in Arizona, including Leigh Nuemayer, MD, MS, Interim Senior VP of Health Sciences at The University of Arizona (UA); Marc Leib, MD, JD, Chair of ArMA’s Committee on Legislative & Governmental Affairs; Ken Iserson, MD, MBA and Professor Emeritus at the UA Department of Emergency Medicine; and Dr. Woodrow Myers, Jr., CMO and Health Strategist at Blue Cross Blue Shield of Arizona. Dr. Paul DeChant, who spoke at our March 24 Physician Leadership Conference on Physician Engagement & Wellness, has contributed to our new publication, building on the conversation started at the conference.  

 

We have had interest and engagement from the physician community as we worked to establish this new publication for and by physicians, and I think you will be pleased with the results. The publication launches on Monday, April 2 – check The Arizona Pulse out at www.azpulse.org, and stay tuned for further updates.   

 

The 2018 ArMA Physician Leadership Conference held at Mayo Clinic in Scottsdale on March 24, “Physician Engagement & Wellness” was a success. We had about 80 attendees, and great audience engagement in a topic that hits close to home for all of us. Most of our attendees stayed for the networking lunch and had the opportunity to meet and connect with other members in similar practice settings and career stages.  

 

The conference featured speakers Suja Mathews, MD, Chair of Medicine at Cook County Health and Hospitals System, and Governor of the Illinois Northern Chapter of the American College of Physicians (ACP); Lois Krahn, MD, Professor of Psychiatry in the Mayo Clinic with joint appointments in the Section of Sleep Medicine, Division of Pulmonary Medicine, Department of Medicine, and the Department of Psychiatry and Psychology; and Paul DeChant, MD, MBA, Deputy Chief Health Officer with IBM Watson Health.  

 

Our speakers established a background of “how we got here” with the abysmal rates of physician satisfaction, and the cultural and psychological factors at play in the phenomenon of physician burnout. Dr. Paul DeChant walked us through how systems can use LEAN to address the drivers of physician burnout, and with panelists Marjorie Bessel, MD, VP and Chief Clinical Officer at Banner Health, and Kote Chundu, MD, MMM, President and CEO, District Medical Group, held a discussion with our attendees on what is happening currently in health systems to change the working environment to address and reduce burnout.   

 

Our take away is that a shift is taking place in the conversation about the physician burnout crisis. Focus is no longer on physicians solely being in charge of their own well-being, but on what systems need to do to make environmental changes to support well-being. 

 

want to applaud my colleague and ArMA’s immediate past president, Dr. Gretchen Alexander, on her dedication to planning an event that provided tools and continued a much-needed community conversation.  

 

I have said it before and will say it again - I have always found that organized medicine offers us a built-in professional support community. Let’s build on that together! 

 

In an era of medicine where physician well-being has become a foremost concern, organized medicine continues to be a natural fit for developing the community and capacity to counter physician isolation and help physicians develop tools and community to feel more empowered. I encourage you to take advantage of ArMA’s online community forums for various stages in professional careers and practice types. Sign in today at azmed.org (your username is your ArMA member ID and your pre-set password is Password1). Click on http://www.azmed.org/forums/Default.aspx to locate the practice forum community of interest to you.  

 

Sincerely, 

 

Michael Hamant, MD 

President, ArMA 

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Opioids and Physician Prescribing: Where are we and what's next?

Posted By Michael F. Hamant, Wednesday, February 28, 2018

As the largest organization in this state representing the interests of all physicians, the Arizona Medical Association (ArMA) takes very seriously its responsibility to advocate for physicians, public health, and the patients we serve. Over the past year, you have seen numerous communications from ArMA related to opioids – urging caution and prudence in prescribing matters, sharing guidelines and new state reporting requirements, and reporting on our advocacy as the state’s powers-that-be moved inexorably toward developing legislation to counter the opioid abuse epidemic.

The opioid crisis has reached epidemic proportions, is a complex, multi-faceted problem that requires a comprehensive, community approach. ArMA staff and members have provided leadership and guidance in meetings with legislators, stakeholders, and the medical community since efforts began to address it several years ago.

When the Governor dropped proposed opioid legislation, SB 1001, at the beginning of the Opioids Special Session last month, ArMA’s advocacy team had already spent months in talks with the Governor’s office. Throughout the special session, we worked hard to ensure that amendments to the bill during the process made essential improvements and added protections for patients and physicians. The bill passed with overwhelming bipartisan support and votes were unanimous in both chambers.

To be clear, the political will behind this bill was insurmountable.

Our role as physician advocates was to alleviate the burden that would inevitably fall upon physicians as prescribers. Several lawmakers shared our concerns about the bill, noting throughout the special session that the regulations risked placing burdensome requirements on physicians and encroaching on the doctor-patient relationship.

Now that this legislation has passed, ArMA intends to be your resource by:

1)      Providing important information on regulatory compliance

2)      Offering educational resources and FAQs to keep our members informed

3)      Serve as a repository for member feedback on unintended consequences that may result from this legislation

ArMA will continue to be an active stakeholder and will continue to work with the Governor’s office, legislators, Arizona Department of Health Service (ADHS), our state Medicaid program (AHCCCS), and the impacted regulatory boards to ensure the legislation is implemented in the best way possible and that necessary adjustments are made to protect physicians and their patients.

I want to assure my physician colleagues here at ArMA that YOU made a difference. Our advocacy team incorporated into their work all the information and concerns they heard from many member physicians about aspects of caring for opioid-naïve patients, addicted patients, and patients suffering from chronic pain.

There is much work to still be done. We want to help our physician members prepare for the legislation’s requirements when parts of it take effect April 26. Take a moment to share your thoughts in the comments below.

And in the face of more regulation, please remain encouraged. ArMA is your advocate, and it is comprised of you and your peers. Join us for community and collaboration at our Physician Leadership Conference on March 24. Register today.

Yours in solidarity,

Michael Hamant, MD

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Let's Bring Joy Back to Medicine

Posted By Michael F. Hamant, Wednesday, January 31, 2018
This month, the Medscape 2018 Physician Lifestyle Report was released, highlighting aspects of physician burnout and depression. The report had over 15,000 U.S. physicians from 29 specialties weigh in on their happiness at and outside of work, personality traits, and lifestyle.
 
An astonishing 42% of physician respondents reported feeling burned out.
 
We continue to see high rates of burnout with intensivists, neurologists, family medicine, and OB-GYN. OB-GYN and family medicine were also among the highest rates reporting both burnout and depression. Factors contributing to depression? “Job” was the highest cited contributor to those experiencing depression. Employment models seemed to make no difference – 42% of both employed and self-employed reported feeling burned out. 
 
The culprits
Not surprisingly, the highest marked contributor to burnout was charting and paperwork (selected by 56% of respondents). Other top contributors included spending too many hours at work, and lack of respect from administrators/employers, colleagues or staff.
 
The solutions
When asked what would reduce burnout, the top three suggestions were: increased compensation; a more manageable schedule; and decreased government regulations. While workplace programs are available to many physicians employed in larger institutions, office-based solo practices’ workplace programs had the highest rate of actual use.
 
What we are actually doing to cope offers its own insights. We are exercising, talking with close family/friends, sleeping – and sometimes isolating ourselves.

 

What about our colleagues who are not experiencing burnout? What are they doing? Well, they’re exercising, for one, and they cite the following important factors:
  • having autonomy or flexibility,
  • maintaining a sense of accomplishment or joy,
  • managing expectations and having a positive outlook,
  • liking their patients,
  • having support systems with relationships,
  • working in a good environment,
  • working part-time,
  • feeling they have work-life balance.
Before we all declare ourselves part-time physicians, I want to offer an alternative. Let’s bring joy back to medicine – let’s engage with each other and access a network of colleagues who understand the unique demands – and rewards – of practicing medicine.
 
ArMA’s 4th Annual Physician Leadership Conference on March 24, 2018 intends to explore more about the solutions to physician burnout and enhancing physician well-being. My colleague and ArMA’s immediate past president, Dr. Gretchen Alexander, is dedicated to planning an event that will provide tools and conversation to help our physician community see value and potential for well-being through leadership. Registration is now open – click here to learn more and sign up today!

 

I have been a member of ArMA for nearly two decades. As a small practice physician, I firmly believe that organized medicine continues to be a natural fit for developing the community and capacity to counter physician isolation and help physicians feel more empowered. 

 

On this premise, ArMA has established online community forums for various stages in professional careers and practice types.  Click here to sign in today and locate the practice forum community of interest to you! (In the right hand column of the Forums page, click on "sign in" using your username and password. Your default username is your ArMA member ID, and your pre-set password will be Password1). Please join us!

 

Share your thoughts in the comments below. How do you cope with burnout? What kinds of solutions can physicians and health care institutions pursue right now to ensure physician well-being?

Sincerely,

Michael Hamant, MD

ArMA President

 

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Important and Time Sensitive: The Legislature’s Special Session on Opioids

Posted By Michael F. Hamant, Friday, January 19, 2018

PLEASE PROVIDE YOUR INPUT.

As the largest organization in our state representing the interests of all physicians, the Arizona Medical Association (ArMA) has been an engaged participant in stakeholder meetings regarding the opioid abuse epidemic since our community began working on addressing it. This started with the initial opioid prescribing guidelines produced by Arizona Department of Health Services (ADHS) in 2014.

We have ensured that your voice was heard. In 2017 alone, between ArMA staff and leadership physicians, we attended weekly meetings of the stakeholder community. Throughout the process, we have repeatedly engaged our physician members as leaders, subject matter experts, clinicians, and patient advocates to help inform our Governor, legislators and regulatory entities as they have pursued various measures and strategies to decrease opioid prescribing, opioid abuse, and subsequent addictions to opiates of all forms.

And as physicians, we have self-regulated and made changes to our clinical decisions. We have decreased opioid prescribing since 2010, and since enhanced surveillance began in Arizona last June, opioid prescribing has continued to decline.

It’s not enough. Since last June 15, there have been 5,202 suspected opioid overdoses reported – 812 of which were fatal. About 40% of people who had a suspected overdose (between June 15 and December 31) had nine or more prescriptions for opioids filled during 2017. And 35% of people who had a suspected opioid overdose were prescribed opioids by 10 or more providers.

ArMA has solicited our member input all along as we have worked with stakeholders on their executive decisions, legislation, and regulatory measures. In the last five months alone, we have shared information and opportunities for feedback with you on the Prescription Monitoring Program requirements, emergency rule-making, the ADHS Opioid Action Plan, and the updated Opioid Prescribing Guidelines.

Next week will launch the start of a concurrent special session on opioids at the Arizona Legislature. We are preparing to review the proposed legislation, and once again, we need to hear from you. The legislation will likely include the proposals outlined in the Governor’s policy primer released today, for which we have provided a summary here

Your input is vital in representing the voice of medicine in Arizona!

We ask at this time that all our members take the time to review the proposals’ summary, and either reply via email to sharla@azmed.or or by posting in the comments feature below:

  • What proposed solutions have the potential to improve patient care and treatment?
  • What proposed solutions could have potential negative impact on patients?
  • What other solutions might be considered?
  • What other suggestions or considerations do you have?

The input provided throughout this process will inform the position we take on the final legislation once it is available. This weekend, we will hold a special emergency meeting of the ArMA Committee on Legislative & Governmental Affairs, where your comments and input will be a vital part of the review process for taking a position on this legislation.

Please submit your comments NOW.

Sincerely,

 

Michael Hamant, MD

President, ArMA

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2017 in the Rear-view; Looking Forward to 2018

Posted By Michael F. Hamant, Thursday, December 28, 2017
Updated: Thursday, December 28, 2017

As we are just days away from bidding 2017 farewell and welcoming 2018, now is an opportune time to reflect on the successes and challenges of our organization, the Arizona Medical Association (ArMA).

During the 2017 legislative session, ArMA worked closely with stakeholder and legislators on high profile legislation. We saw successes in working with legislators who were intent on addressing the issue of “surprise billing;” we were able to work through professional concerns with other members of the health care delivery team on scope of practice issues; we had the opportunity to make important changes that improve access to naloxone; and we supported public safety with legislation limiting teen driver use of mobile devices.

As always, even when the legislative session ends, ArMA’s advocacy work continued. Our advocacy team, led by Pele Fischer, JD, VP of Policy & Political Affairs, continued to work on behalf of physicians in our engagement as a key stakeholder clinician community in opioid abuse epidemic efforts. We worked closely and collaboratively with physician and community coalitions to oppose Affordable Care Act (ACA) repeal efforts that would have been detrimental to Arizona Medicaid (AHCCCS) and general patient access to care, as in the case of the BCRA and Graham-Cassidy legislation.  

I have been a member of ArMA for nearly two decades. As a small practice physician, I have always found that organized medicine offers us a built-in professional support community. In an era of medicine where physician well-being has become a foremost concern, organized medicine continues to be a natural fit for developing the community and capacity to counter physician isolation and help physicians feel more empowered. Under my direction, ArMA has established online community forums for various stages in professional careers and practice types. Sign in today (your username is your ArMA member ID and your pre-set password is Password1). Click on http://www.azmed.org/forums/Default.aspx to locate the practice forum community of interest to you. Please join us!

This year saw our organization undergo a monumental change with the retirement of Chic Older, our EVP of thirty plus years. The Executive Committee, Transition Committee and Board of Directors continue to work to ensure a seamless transition with our new EVP, Libby McDannell.

Libby has taken the initiative in reviewing our preparation for the New Year. Our Board of Directors met on Saturday, December 12 and made some important decisions that will move us forward in 2018. As we prepare for the launch of the 2018 Legislative Session, the Board voted to implement advocacy priorities. The advocacy priorities document was developed with a careful review of our Policy Compendium and will offer our advocacy team some additional guidance as we move into a busy session. This session will have a great deal of legislation focusing on opioid abuse; ArMA will be working hard to make sure physicians are part of practical and helpful solutions.

The Board of Directors also approved the decision to end our collaboration on the publication, Arizona Physician. Part of the decision was that ArMA will be looking to expand our online communications with a new online journal. We will continue to pursue other avenues of collaboration with our colleagues at Maricopa County Medical Society (MCMS) and Pima County Medical Society (PCMS). ArMA will produce our own publication again; we will provide updates on this opportunity to our members in the first quarter of 2018.

The first quarter of 2018 will also see us hold two of our key stakeholder events: the 2018 Legislative Reception, on February 5, offering a unique opportunity for physicians and legislators to meet; and our 4th Annual Physician Leadership Conference on March 24.

This year, we are pleased to have the partnership of Arizona Osteopathic Medical Association (AOMA) as well as MCMS and PCMS in hosting the Legislative Reception. Our cooperative work with AOMA continues on another front as well, the Joint Task Force on End of Life Care. The End of Life Care task force survey results will be available soon, and their work will help inform the development of education and resources around end of life care for Arizona physicians. I commend my colleagues on their work around this vital issue.

The 2018 Physician Leadership Conference on March 24 offers a focus on physician well-being; I applaud my colleague and ArMA’s immediate past president, Dr. Gretchen Alexander, on her dedication to planning an event that will provide tools and conversation to help our physician community see value and potential for well-being through leadership. Mark your calendars – registration will open in January for this event.

What do you think ArMA’s greatest accomplishments were this year? What would you consider our biggest priorities in 2018? Share your thoughts in the comments below.

I look forward to continuing our conversations in the New Year!

Sincerely,

Michael Hamant, MD

President, ArMA

Tags:  advocacy  community  leadership  legislative  organized medicine 

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ArMA Community and Giving

Posted By Michael F. Hamant, Thursday, November 30, 2017

The Thanksgiving holiday launches the beginning of the “spirit of giving” season. It is at this time of year when we are frequently reminded of the importance of community and supporting each other. This monthly communication with our membership is intended to keep you informed on the work of ArMA leadership and to foster a sense of community among our membership.

New Leadership

At ArMA, we are entering a new phase of leadership, and a new perspective on the ArMA member community. This week saw the arrival of ArMA’s new executive vice president, Libby McDannell, CAE. As Libby assesses our standing and works with ArMA physician leadership to update the strategic plan, she is committed to fostering a sense of community and engagement with our membership.

Community

To that end, we have implemented online community forums, based around physicians’ practice structure (small, large, employed, academic) and stages in their career (medical student, residents/fellows/early career, retired). These forums are intended to create space for physicians at all stages of their career to share ideas, discuss issues of concern – and to connect. Our use of these forums will inform how ArMA evolves the online community platform and opportunities for in-person engagement. Sign in today and click on http://www.azmed.org/forums/Default.aspx to locate the practice forum community of interest to you!

Advocacy

As our advocacy team gears up for the new Arizona legislative session, it is a reminder to take stock of how physicians can influence and educate our political system. Hand in hand with our advocacy is the function of ArMPAC, the only political action committee working for all physicians in Arizona. ArMPAC is the vehicle for moving the needle on electing medicine-friendly politicians. Contribute today and make a difference in the 2018 election cycle!

Doctor of the Day

This unique program allows a physician to serve at the Capitol each day during legislative session. The “on-call” capacity of the Doctor of the Day enhances both our visibility and our medical training. All our past participants of this program at the Capitol urge your future participation. Join Ingrid Garvey, AVP of Policy & Political Affairs, for a day filled with civics insights and opportunities to talk with your legislators. Download and submit the sign up form today.

Mark Your Calendar

The ArMA community has two upcoming events to keep in mind. The annual Legislative Reception, with its unique setting allowing physicians and legislators to meet in a relaxed environment, will be held Monday, January 22. Our 4th Annual Physician Leadership Conference will be held Saturday, March 24. This year’s focus is on physician wellness, a topic that should be near and dear to us all. Mark your calendars, save the date – give yourself the time to join your physician community in person and the opportunity to connect with each other.

 

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