June 21, 2004

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AHRQ Head Carolyn Clancy, M.D. Keynotes Hanley Leadership Luncheon
On Friday, June 18, Carolyn Clancy, M.D. spoke at the 2nd Annual Dan Hanley Leadership Luncheon, discussing the necessity of moving research findings more quickly into medical practice.
Dr. Clancy, Director of the federal Agency for Healthcare Research and Quality,  noted that it takes seventeen years for research findings to receive widespread acceptance and usage in practice.  In a presentation to nearly 100 healthcare leaders from around Maine, Dr. Clancy also noted the important role that former Maine Senator George Mitchell played in the formation of the agency, as well as the early efforts of Dr. Hanley and John Wennberg, M.D. in the area of geogragphic variations.  The Leadership Luncheon and the Forum preceding it were both held on the campus of Bowdoin College.

During the luncheon, Dr. Wennberg received the second annual Dan Hanley Leadership Award, recognizing his efforts over the past thirty years in the area of medical variations. Dr. Wennberg currently serves as the Peggy Y. Thompson Chair of the Center for the Evaluative Clinical Services at Dartmouth Medical School.  Dr. Wennberg has a long history with Maine starting in the mid-1970's when he worked with Dan Hanley, M.D., John Putnam and David Soule to establish a statewide hospital discharge data set.  Dr. Wennberg was among the first in the nation to develop population-based research of healthcare utilization, noting significant variations in physician practice patterns in Maine, Vermont and beyond.  This work led to three articles on small area varation published in l976 in the Journal of the Maine Medical Association under the guidance of its editor, Dr. Hanley.  This seminal work was the springboard for Dr. Hanley's formation of the Maine Medical Assessment Foundation, which existed for over 20 years but which was dissolved in 2002.

At the Leadership Forum preceding the luncheon, approximately forty healthcare leaders discussed the new obesity guideline issued by the U.S. Preventive Services Task Force.  In break-out sessions, the group addressed guideline adoption, reimbursement, awareness and clinical issues.  The purpose of the exercise was both to examine the guideline itself and to see how such guidelines can be disseminated and utilized.  MMA was represented at the Forum by President Maroulla Gleaton, M.D., President-elect Lawrence Mutty, M.D. and EVP Gordon Smith.  Of the 40 participants, 17 were physicians.

Opening up the morning program was a presentation by Robert Scalattar, M.D., MPH, Corporate Medical Director for Medical Policy at Anthem.  He provided a national perspective on leadership, collaboration and quality.

AMA Annual Meeting Concludes on Positive Note
The 2004 Annual Meeting of the American Medical Association concluded on Wednesday, June 14th.  On Tuesday evening, President-elect John Nelson, M.D., a practicing Ob-Gyn from Utah accepted the gavel from outgoing President Donald Palmisano, M.D., J.D.  and promised to work hard over the year to accomplish the AMA's priorities of liability reform, patient safety and Medicare payment reform.

Delegates considered hundreds of resolutions, but rejected even consideration of a proposal which would have declared the practice of not treating plaintiff lawyers and their families to be ethical.  The majority of delegates rejected even considering the proposal.

In addition to delegates David Simmons, M.D. and  Richard Evans, M.D., and alternates John Garofalo, M.D. and John Makin, M.D.,  specialty society delegates and alternates attending from Maine included Samuel Solish, M.D. (ophthalmology), Jo Linder, M.D. (emergency medicine), Joseph Rubin, M.D. (psychiatry), Francis Kittredge, M.D. (neurology) and John McGill, M.D. (plastic surgery).  Rounding out a very robust delegation from Maine was former AMA President Robert E. McAfee, M.D. , and MMA President Maroulla Gleaton, M.D.  Dr. Simmons serves as Vice-Chair of the New England delegation to the AMA.

VIsit http://www.ama-assn.org/ama/pub/article/1615-8642.html to read Reference Committee summaries from the meeting.  Visit http://www.ama-assn.org/ama/pub/article/3216-8628.html to view additional highlights of the meeting.

In addition to the ususal House of Delegates proceedings,  attendees were offered a variety of CME opportunities including presentations on treatment of pain and prevention of illegal diversion of narcotics, electronic medical records, and preventing and reducing obesity.  Accoding to the program, while public obesity is approaching 30% of the population, only 40% of physicians are confronting their obese patients regarding the impact of weight on their overall health.

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June 23, National TIME OUT Day for Surgery
The Joint Commission is partnering with the Association of Operating Room Nurses (AORN) in a media event that will call for a National Time Out Day on Wednesday, June 23.  The event highlights the implementation of the Joint Commission's Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery on July 1.

AORN, the nation's leading surgical nursing organization, has developed a Correct Site Surgery Tool Kit to assist provider organizations and practitioners in the implementation of the Universal Protocol.  Approximately 55,000 tool kits will be distributed across the country.  To obtain a tool kit, or for more information, click on tbarlow@aorn.org.  The Universal Protocol is available on the Joint Commission website at:  www.jcaho.org/accredited+organizations/patients+safety/universal+protocol/ws s_universal+protocol.htm.

The AMA and the Joint Commission Resources will host an audio conference to discuss practical approaches to implementing the protocol on Thursday, July 8, 2004 from noon to 1:30pm.  The conference will consist of 60 minutes of formal presentations and 30 minutes of questions and answers. Organizations may register and have more than one person on the call.  The cost is $199 per site.  To register, call Customer Service at 877-223-6866.

Presenters at the conference are John Carbonneau, M.D., FACS, a consultant to the Joint Commission, Michael Deren, M.D., a thoracic surgeon in solo practice in New London, Connecticut and Thomas Russell, M.D., FACS, Executive Director of the American College of Surgeons. [return to top]

Medical Liability Crisis Declared in Massachusetts
At the AMA Annual Meeintg last week, AMA President Donald J. Palmisano, M.D. declared a medical liability crisis in the Commonwealth of Massachusetts, bringing to 20 the number of states in crisis.

Dr. Palmisano said the decision to add Massachusetts to the list came after careful review, over several months, of methodologically sound research, news coverage and numerous documented examples of physicians in the state being forced to restrict their practices due to liability insurance pressures.

In addition to the AMA's own analysis, the Massachusetts Medical Society detailed the problems and provided a wealth of physician workforce surveys and other research on the liability climate, all of which pointed to a crisis, said Dr. Palmisano.  A public opinion poll released on June 7 by the University of Massachusetts showed that 73 percent of Massachusetts voters agree that the state is suffering from a medical liability crisis.

While Maine is not considered a crisis state at this time, two recent jury verdicts against physicians in the face of unanimous panel decisions in favor of the physician are alarming.  Widespread publicity of the verdicts will serve only to encourage plaintiff attorneys to ignore panel decisions and roll the dice.  MMA and its liability partners, including Medical Mutual Insurance Co. of Maine, will watch these trends carefully and be prepared to take aggressive action to preserve our stable liability insurance situation. [return to top]

Andrew MacLean named MMA Vice-President and General Counsel
At its meeting on June 9, the MMA Executive Committee promoted General Counsel and Director of Governmental Affairs Andrew B. MacLean to a new position of Vice President and General Counsel.  Mr. MacLean had served for five years in the previous position.

"Andrew has been an exceptional addition to the MMA staff and is was time to move him up to the functional level of a Deputy EVP", said Gordon Smith, Executive Vice-President.  "In his new capacity, Andy will still handle the duties of general counsel and head our lobbying team, but he will also take on more of the day-to-day management activities", Smith added.

MacLean is a native of the Bridgton, Maine area and is a graduate of Lake Region High School, Duke University and the University of Maine School of Law.  He served in the U.S. Marine Corps between his University education and law school.   Prior to his position at MMA, he served as assistant legislative counsel for former Governor John McKernan, practiced law privately in Augusta with the firm of Doyle and Nelson and worked in the legal department at Blue Cross and Blue Shield of Maine.  He and his wife Michele reside in Gardiner with their two children Hannah (10) and Cameron (2). [return to top]

Another Big Week for Dirigo Health
This week both the Dirigo Health Board of Directors and the Commission to Study Maine's Hospitals meet.   The Board will consider further the sole bid to offer the innovative DH product which was submitted by Anthem.  The Board will meet on Wednesday, June 23, from 2:00pm to 4:00pm in room 209 of the Augusta Armory on Western Ave., in Augusta.

The Commission to Study Maine's Hospitals will hold an all-day meeting, beginning at 9:00am on Monday, June 21.  The meeting will be held at the DHS Office at 442 Civic Center Drive, Augusta, in Conference Rooms 1A and 1B.  The morning portion of the meeting will feature a presentation by Nancy Kane, Professor of Management at the Harvard School of Public Health.

In a somewhat interesting development this past week,  State Representative Chris O'Neil of Saco, House Chair of the Insurance and Financial Committee of the Legislature, in a press release which received significant media exposure,  expressed considerable skepticism regarding the Dirigo Health plan stating that, "the cost of the Dirigo product will be no more competitive (and for non-subsidized enrollees, more expensive) than what the market has produced on its own, and the red tape for employees and their employers is bound to discourage robust enrollment."  Because of his Committee Chairmanship and further because he is a Democrat, Rep. O'Neill's comments took a number of observers by surprise.  The Bangor Daily News, in a lead editorial on Saturday (June 19) states that his warning is useful, but premature..The News has been an enthusiastic supporter of both the Governor and Dirigo Health. [return to top]

Thirteenth Annual Physician Survival Seminar in Bangor, Wednesday, June 23
Over one hundred Maine physicians and practice managers are registered for MMA's thirteenth annual Physician Survival Seminar being held this Wednesday, June 23 in Bangor.  The all-day program will be held at the Spectacular Events function hall. U.S. Attorney for the District of Maine, Paula Silsby is the keynote speaker and over a dozen other presentations are scheduled for the plenary session in the morning and breakout sessions in the afternoon.  The program is intended to provide medical practices with the kind of practical advice needed to be up to date on the many compliance issues facing a practice today, as well as presenting valuable information on such topics as Dirigo Health, MaineCare and quality improvement.

While a good crowd is expected, it is not too late to register.  Call Chandra Leister at MMA at 622-3374. [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association