Maine Medicine Weekly Update - 06/19/2017  (Plain Text Version)

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In this issue:
•  Professionalism Conference Draws Enthusiastic Crowd and Impressive Reviews
•  News and Views from the 2017 AMA Annual Meeting
•  AMA Launches Opioid Education Microsite
•  MMA Annual Benefit Golf Tournament Monday, July 10, 2017
•  HHS Update on WannaCry and New OCR Resources on Reporting After Cyberattacks
•  MMA Files Comments on Licensing Board Rules on Use of Controlled Substances for Treatment of Pain
•  FDA Requests Halt to OpanaŽ ER Sales
•  Is Your Staff Checking BP Correctly?
•  Weekly MMA Legislative Committee Conference Call Information
•  Legislative Highlights of the Week
•  Call Your State Representatives: L.D. 46 Eliminating Physician Exemption from Jury Duty Passed the Senate!
•  June 20 Webinar: Recognizing When Patients Have Concerns About the Cost of Their Health Care
•  National Medicare Education Program June 28
•  Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
•  Save the Date: MICIS Presentation on Opioid Prescribing in Auburn on Wednesday, July 19
•  16th Annual Downeast Ophthalmology Symposium - September 15-17
•  Patient Safety Academy - September 29
•  Maine Providers Standing Up for Healthcare Schedules Press Conference for this Friday in Lewiston
•  Register Now for the MMA and Maine Health Management Coalition 2017 Symposium on October 11
•  Family Medicine Physician - Pittsfield, ME
•  Primary Care Physician - Eastern Maine Medical Center
•  Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
•  Part-time Clinical & Part-time Research Position in Central Maine
•  Family Medicine Physician - Winthrop, ME
•  DO or MD Physician - Augusta, ME
•  Family Medicine Physician - Waterville, ME
•  Family Medicine Physician/Clinician Leader - Portland, ME
•  Family Medicine - Windham, ME
•  Family Nurse Practitioner/Physician Assistant Wanted
•  Physician - Lubec, ME
•  Nurse Practitioner - Swift River Family Medicine - Rumford, ME
•  Physician Assistant/Nurse Practitioner - Bridgton, ME
•  Hospitalist - Brunswick, Maine
•  Gastroenterologist - Brunswick, Maine
•  Ophthalmologist - Brunswick, Maine


Professionalism Conference Draws Enthusiastic Crowd and Impressive Reviews

Two outstanding keynote talks and panel presentations by the five leading clinical ethicists in Northern New England highlighted the Professionalism conference hosted by MMA, the Lown Institute and partnering professional associations on Saturday in Portsmouth, NH. Over 100 attendees provided very positive reviews of the day's events. Efforts will be made to continue the dialogue.

The day long conference had been in the works for well over a year and had been a joint effort among the Lown Institute and the Northern New England professional associations representing physicians, nurse practitioners and physician assistants. The speakers examined the current barriers to busy clinicians conducting themselves professionally and also the aspects of the current system leading to stress and burnout.

The morning keynote talk by Thomas Bodenheimer, M.D., MPH was entitled "Professionalism in the Age of Medical Conglomerates" and addressed the following topics:

  • Traditional physician professionalism: a contract between the medical profession and society
  • The medical profession breaks its contract with society
  • Medical conglomerates flourish
  • Impact on physicians
  • New views of professionalism


Dr. Bodenheimer discussed frankly the fragile bond between physicians and society and the loss of trust as the cost of health care has exploded and the quality of that care has been challenged by the IOM report and others. He also discussed the consolidation of the health insurance industry, hospitals and physician practices and the relationship of these events to physicians reporting the prevalence of burnout rising from 45 to 54% between 2011 and 2014. The burnout rate of the general working population in 2014 was 28%.  And he noted that burnout is associated with unnecessary testing and referrals, increased costs, lower quality and reduced patient experience of care. 
Dr. Bodenheimer attributed burnout to a lack of autonomy and control over work and noted that the content of the work does not match what physicians were trained for. EMRs were noted as an issue as well as the pressure to see more patients. And the average number of clinical items addressed in a 20 minute primary care visit has increased from 5.4 (1997) to 7.1 (2005). He also discussed how physicians spend their time and the general degradation of work under some models of modern management. He noted some bright spots around the country where preserving the division of labor occurred but was joined with conception and execution of work with teams.
Dr. Bodenheimer closed by talking about the Charter on Medical Professionalism (2002) and the Quadruple Aim.
The afternoon keynote speaker, Eric Campbell, PhD, Professor of Medicine at Harvard Medical School. Dr.Campbell is a sociologist with a special interest in physician conflicts of interest. His talk featured the current status of relationships between prescribers and industry.


Two panels of clinical ethicists responded to the morning keynote talk and also raised several additional topics. Attendees had ample time to ask questions and provide commentary and the  final reactor panel concluded that discussion of these issues was essential and should continue beyond the conference.  
One of the highlights of the conference was the performance of a one act play entitled, "Side Effects" written and performed by playwright and actor Michael Milligan. In the play, Milligan shares the struggles of a solo practicing physician through a fictionalized account of Dr. William MacQueen. As bureaucratic and financial pressures collide with his professional standards, Dr. MacQueen must reconcile the Art and Business of Medicine. The play was profound and Mr. Milligan received a standing ovation and many accolades from attendees.


MMA wishes to thank the Lown Institute and our collaborating medical, nursing and PA associations and organizations including Maine AllCare, the Maine Hospital Association and Quality Counts. We also wish to thank and acknowledge the following commercial sponsors:
Baystate Financial
CDI Quality Institute
Community Health Options
Dr. First
MedHelp Maine
NH Med Bank
Maine Medical Education Trust
Maine Independent Clinical Information Service (MICIS)
Norman Hanson and Detroy
Physicians Foundation
Spectrum HealthCare Partners