The Leg.Up

Ramifications

Are collaborative care models a done deal? That’s the premise of the lead article of the Summer issue of Ramifications. Also check out Dr. Walter Lawrence Jr., our editor, sorting out “Health care reform: Socialism, capitalism, and personal responsibility.” And much more! The Summer 2011 edition of Ramifications, a professional journal written by and for Academy members is available by clicking here.

The Spring 2011 edition of Ramifications is available by clicking here.

The Winter 2011 edition of Ramifications is available by clicking here.

Current News

 CAPITOL STEPS TO PERFORM FOR THE ACADEMY
APRIL 17, 2012

Laugh out loud with the Capitol Steps!  They put the MOCKin Democracy!

Please mark your calendars for Tuesday, April 17thand make plans to attend a performance by the Capitol Steps, a musical political satire group from Washington, D.C.  The event will be held at the University of Richmond's Modlin Center for the Arts --- reception at 7:00 p.m. followed by their performance at 8:00 p.m.  Please stay tuned for ticket information Unanimo

Taking Pulse of General Assembly

MSV President Hugh M. Bryan III writes that the society's legislative agenda has been favorably received in the General Assembly, including:

Unanimous passage by the Senate Education and Health Committee of the definition of surgery bill, SB 543, without one question or comment, with final approval in the Senate by a 40-0 margin Tuesday.

"The House has already passed the identical HB 266 with a 98-0 vote," Bryan writes. "Initial concerns from opponents of the bill were resolved through the efforts of the bill patron, Del. Chris Peace, R-Hanover, and his colleagues, Del. Roxann Robinson, R-Chesterfield, who is an optometrist, and Del. Scott Garrett, M.D., R-Lynchburg, a surgeon.

"Our bill to promote a team approach to patient-centered care, HB 346, has passed the House and is awaiting Senate action. This bill, which ensures that physicians remain the leader and manager of a health care team that includes nurse practitioners, builds upon the effective collaborative relationships physicians already have with their NPs, but does not give NPs independent practice. The MSV lobbying team expects this bill will be treated favorably in the Senate."

Next up, he writes, is Medicaid and fighting to restore $5 million in the next budget year to help free clinics and local health clinics. To read Bryan's full letter, click here.

In other legislative news:

MSV reports the General Assembly has spent significant time considering what, if anything, it should do about setting up a health benefit exchange (HBE) in Virginia as required under federal health reform. (More news on this below.)

An HBE would be a marketplace where individuals and small groups could compare health plan benefits and costs, as well as purchase insurance products. In the Senate, a subcommittee has spent significant time gathering public input on the five exchange bills before it.

The MSV supports the creation of an exchange in Virginia as a quasi-governmental entity, with physicians and patients represented on the exchange's governing board. The Senate subcommittee will again consider the HBE bills this week, while on the other side of the legislature, a House subcommittee voted to table all of the exchange bills before it. Click here for a recent column on the issue.

Former RAM President Del. John O'Bannon, MD, is championing a bill to establish an All Payer Claims Database (APCD) system. 

MSV has been actively involved in the drafting of the legislation, HB 343, to ensure that physicians' concerns about the system's infrastructure, data submission process, and costs are addressed.

To read more, click here.

Area Medical Specialists Volunteer to Serve the Indigent
Dr. Hazle Konerding's interview with NPR's John Ogle. 

RAM Doctors Blanket Legislature
 A persuasive group of politically-savvy RAM members marched up the hill to the General Assembly Tuesday for the first of two "White Coats On Call" events held with the Medical Society of Virginia.

After meeting privately with nearly 20 legislators or their aides, RAM leaders heard high praise from an old friend of the Academy. "You all are well organized and doing the right thing," said Del. John M. O'Bannon III, M.D., R-Henrico, one of three physicians in the House of Delegates, and former president of RAM.

Speaking of the General Assembly, O'Bannon, now in his 12^th year in the legislature, said, "It's good to keep our feet to the fire, and if we go off the reservation to let us know it." O'Bannon has introduced House Bill 346 that provides a "team-care concept" and allows physicians to supervise six nurse practitioners (an increase from four NPs).

RAM's articulate members put a human face on a number of bills pending in the legislature. They urged lawmakers not to cut the state's already paltry Medicaid reimbursement for physicians; to pass Dr. O'Bannon's bill to improve collaborative health care; and to create the first legal definition of surgery in the Code of Virginia, along with pressing other issues of interest to physicians.

A few snapshots from the meetings:

Dr. E. Claiborne Irby Jr. to Del. Kirk Cox, R-Colonial Heights: "We're just trying to come up with a definition of surgery," he said of House Bill 266. "The idea is not to take something away from people."

RAM President Dr. Richard A. Szucs to an aide for Sen. Stephen H. Martin, R-Amelia, on O'Bannon's bill for health care delivery teams: "We think this will help to fully utilize nurse practitioners and mid-level providers." He noted this was especially important with the current shortage of primary care physicians which is sure to be exacerbated by the surge in the number of new Medicaid patients in Virginia under the Affordable Care Act.

Dr. Hazle S. Konerding, chair of Access Now, delivered a mock check to Sen. Martin, explaining that it represented the more than $15 million in free care that physician volunteers and mid-level providers have donated since 2008.

Konerding said she's "extremely concerned" about a proposed cut of $5 million for Virginia health care safety net organizations in the second year of Gov. McDonnell's biennial budget. "The free clinics do a lot of good and simply can't absorb that cut," Konerding said.

Dr. Gigi deBlois, RAM's Immediate Past President, to an aide for Del. Manoli Loupassi, R-Richmond, on potential cuts of Medicaid reimbursements.: "Physicians can't maintain their practices with diminished physician reimbursement."

Del. O'Bannon, for his part, said of his time in the statehouse: "I will promise that any of you can do this. If you can do medicine, I promise you can do politics."

RAM thanks the following members who made the first White Coats Day a smashing success.

Owen Brodie, MD

Frank R. Cerniglia, Jr., MD

Eddie Clark

Clifford L. Deal, III, MD

Georgean G. deBlois, MD

Gerard Filicko, MHA, CMPE

Helen M. Foster, MD

David W. Gould, III, MD

Robert A. Halvorsen, MD

Zubair U. Hassan, MD

E. Claiborne Irby, Jr., MD

Vigneshwar Kasirajan, MD

Hazle S. Konerding, MD

Karsten F. Konerding, MD

Ritsu Kuno, MD

Anton J. Kuzel, MD

Walter Lawrence, Jr., MD

David W. MacMillan, MD

Mark H. Ryan, MD

Richard A. Szucs, MD

Bert Wilson

Patrick W. Woodward, MD

The next White Coats Day is Wednesday, Feb. 22. To sign up, email Lara Knowles at lknowles@ramdocs.org or call her at 643-6631.