NewsWatch October
2007
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| From Your WA/ACEP President, David Dabell MD FACEP | |
WA/ACEP
CHAPTER RECEPTION
Upholding
our chapter’s reputation for hosting fabulous events,
the ACEP reception held at the Seattle Space Needle on October 7th
was a success! Invited guests were ACEP councilors, board members and
staff who mingled with many of our local members at this event.
This reception was made possible through the generous contributions
the following ED physician groups, as well corporate support from Marina
Medical, Physicians Insurance, and Ultrasonix.
ACEP members can now receive an exceptional, low rate for dozens of new online CME opportunities each year, thanks to a partnership between ACEP and EMedHome.com.
A new Web site, http://www.acep-emedhome.com/, offers a range of educational content, including video lectures, audio podcasts, and articles that offer more than 100 hours of CME credit every year. The special annual fee for ACEP members is just $71.88. This members-only Web site contains many popular ACEP features, such as video and audio presentations from Scientific Assembly and Advanced Pediatric Emergency Medicine Assembly, plus a monthly Annals of Emergency Medicine-based CME opportunity.
For more information, visit http://www.acep-emedhome.com/.
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A
DANGEROUS GAP IN TRAUMA CARE
Trauma from injuries including accidents, falls and violence is the
leading cause of death for Americans under the age of 44, claiming more
than 140,000 lives and permanently disabling 80,000 people annually.
Only eight state trauma systems met nationally recommended preparedness
levels in a study by the federal government after the Sept. 11, 2001,
terrorist attacks. While some progress has been made, many states remain
woefully unprepared, trauma experts say.
Efforts are under way to develop a national trauma system to ensure
referral of severe injuries to qualified centers, but funding is tight.
The American College of Surgeons Web site has a list of verified trauma
centers and the level of care they provide (www.facs.org/trauma/verified.html).
At highest risk are those in rural areas, where nearly 60% of trauma
deaths occur even though such areas account for only 20% of the population.
But some big cities such as Washington and heavily populated states such
as California are still struggling to put all the pieces of a failsafe
trauma system together. Since 1990, the federal government has provided
only about $34.1 million to help develop statewide trauma systems. A
law passed in the spring authorized an additional $12 million for all
50 states. Some states have passed or are considering their own legislation
to create formal trauma systems.
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On Wednesday, October 3, President Bush vetoed, H.R. 976, legislation supported by ACEP, to reauthorize and expand the State Children's Health Insurance Program. The SCHIP legislation would reauthorize the program for five years, expand the program by $35 billion (to a total of $60 billion), and cover approximately 10 million children whose families are low-income, but not poor enough to qualify for Medicaid.
The House approved the bill on September 25, by a vote of 265 to 159, and the Senate approved the measure on September 27, by a vote of 67 to 29.
The House of Representatives will have to successfully override the veto before the bill would go back to the Senate. It takes two-thirds of the voting members to override a presidential veto, leaving the House 19 votes shy (based on the Sept. 26 vote), but the Senate does have enough support to override if it reaches that chamber.
The House is expected to attempt to override the veto on October 18, giving supporters of the measure two weeks to find the necessary support for the bill. If the veto override fails in the House, as we expect it to, it is unclear how the House will proceed.
SCHIP is currently operating under a temporary extension approved as
part of the Continuing Resolution enacted last week that allows federal
agencies and programs to maintain operations through November 16.
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H.R. 882 CO-SPONSOR UPDATE
Rep. Tammy Baldwin (D-WI), a member of the House Energy and Commerce
Health Subcommittee, is a new cosponsor of H.R. 882, the “Access
to Emergency Medical Services Act of 2007.” Currently, 14 members
of this subcommittee, which has jurisdiction over the bill, are co-sponsors.
For a complete list of co-sponsors, please go the ACEP
Website.
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The Centers for Medicare & Medicaid Services posted corrections to the hospital inpatient prospective payment system final rule for fiscal year 2008. An inadvertent technical error was made in the calculation of hospital-specific rates for sole community hospitals and Medicare dependent hospitals.
Even though CMS did not publish these hospital-specific rates in the FY08 IPPS final rule, these rates affect the calculation of budget neutrality factors for diagnosis-related group recalibration, the wage index, geographic reclassification and the rural floor.
CMS has recalculated these budget neutrality factors, as well as the standardized amounts and outlier threshold. The changes decreased the standardized amounts slightly and reduce the final FY 2008 outlier threshold by $175. CMS also corrected technical errors in the geographic classification or reclassification for several providers.
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The federal Medicare program is expected to announce that it will reduce by nearly half the $20 billion in cuts intended for inpatient care.
Hospital groups flooded Washington, D.C., legislators with calls and e-mails about the pending payment reductions. Last week, the House and Senate unanimously passed legislation sponsored by Rep. John Dingell, D-Mich., that will make the cuts feel more like a sting than a bite.
Instead
of a $20-billion reduction, hospitals will lose $2.5 billion in the
next two years and $7 billion in the five years after that
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The OIG has issued an advisory opinion that it will not prosecute a hospital for a highly structured paid-on-call system, but warned that lesser systems faced possible prosecution for violation of the anti-kickback laws. For a full discussion of the ruling and a full text PDF version of the ruling, please go to www.medlaw.com
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FDA
PROVIDING IMPORTANT SAFETY INFORMATION ON MEDICAL PRODUCTS
Physicians are urged to take advantage of the growing number of electronic
tools from the U.S. Food and Drug Administration (FDA) for accessing important
safety information on the medical products they use and prescribe. Health
care practitioners can now receive clinically useful safety information
on medical products from the FDA by subscribing to the FDA's MedWatch listserv
notification or RSS news feeds by bookmarking FDA's MedWatch Web site.
Visit http://www.fda.gov/medwatch to access these tools.
Recently, FDA launched the Drug Safety Newsletter, which provides information
about emerging drug safety issues, recently approved new drugs and other
important safety information. Visit http://www.fda.gov/cder/dsn/default.htm to access this newsletter.
In addition, updated prescription drug labels (package inserts) are available
free of charge to physicians through the National Library of Medicine's
DailyMed Web site. View http://dailymed.nlm.nih.gov/dailymed/about.cfm to access the National Library of Medicine's DailyMed Web site.
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GOVERNOR
CONTINUES TO WRITE OFF OTHER STATES’ APPROACHES TO HEALTH CARE
REFORMS
Governor Gregoire has made it clear in two recent public forums that she’s
not about to go down the pathway taken by some other states that have launched
- or have tried to launch - massive health care reform programs. First
at the September 20 Association of Washington Business Policy Summit and
then at the September 27 2007 Governor’s Life Sciences Summit, she
made these points:
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SIX-MONTH
REPRIEVE ON MEDICAID REQUIREMENTS RE TAMPER RESISTANT RX PADS
President Bush signed HR 3668, delaying the implementation of the Medicaid
tamper resistant Rx pad mandate for 6 months. The House and Senate had
passed separate measures earlier. The HR (House Resolution) version prevailed.
The original October 1 deadline for use of such Rx pads is now April 1,
2008.
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The House Ways and Means Committee approved, by a vote of 27 to 13, a mental health parity bill, H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act," sponsored by Reps. Patrick Kennedy (D-RI) and Jim Ramstad (R-MN). The bill faces one more mark-up in the Energy and Commerce Committee before it heads to the House floor.
The Senate unanimously approved their version of a mental health parity bill, S. 558, the "Mental Health Parity Act of 2007," sponsored by Sens. Pete Domenici (R-NM) and Ted Kennedy (D-MA). Both the Senate and House bills would require equal health insurance coverage for mental and physical illnesses when policies cover both.
The biggest difference between the bills is that S.558 allows health
plans to decide what mental health conditions to cover while H.R. 1424
requires plans to cover the conditions offered under the Federal Employees'
Health Benefits Program option with the highest average enrollment.
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DR.
BRUCE STEVENSON ADDED TO THE BOARD OF THE WASHINGTON PHYSICIANS HEALTH
PROGRAM (WPHP)
The Executive Committee has voted to add Dr. Stevenson, an emergency physician
at Swedish Medical Center in Issaquah, to the WPHP Board. The EC took the
action at its September 13 meeting. Dr. Stevenson rounds out of the board
of eight physicians and seven public members that directs the premier program
in the country for physicians with addiction and psychological issues.
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OPIOID
PRESCRIBING GUIDELINES: WHY WE NEED THEM, HOW WE DEVELOPED THEM
By Jeffery Thompson, MD, Olympia
Alarmed by studies showing an increase in accidental deaths associated
with the use of prescription opioids, the medical directors of seven
Washington state agencies joined forces two years ago to study the increase
and the underlying facts.
What We found Was Disturbing:
Click
Here to view Dr. Thompson’s entire opinion piece.
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Elizabeth L. Brown – Seattle
Fermin S. Godinez, DO – Kennewick
John P. Lemos – Seattle
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Eryn N. Alpert, MD – Seattle
Robert D. Kregenow, MD, MPH – Gig Harbor
Allister G. Stone, DO – Fircrest
Christofer A. Strode, MD – Lacey
Wenatchee
Emergency Physicians seeking a BC/BE emergency physician for full time
employment and partnership. We see 30k patients per year at a level
III trauma center. We offer superb recreational opportunities, excellent
physician and nursing staff, a growing community, and affordable housing.
Contact Tom Ettinger MD FACEP morsno@charter.com 509-679-9708,
Scott Stroming MD FACEP 509-679-3635, or one of our partners at Central
Washington Hospital 509-665-6163.
We are looking for a board certified/eligible emergency physician to join our
group of sixteen emergency physicians at Northwest Hospital in Seattle. We are
a congenial group who enjoys a very good relationship with the rest of the staff
and hospital administration. We offer excellent fee for service compensation
on a scenic hospital campus in north Seattle with a good patient mix (40,000
annual visits) and superb medical staff. If interested, please send CV to Dr.
Bill Johnston (billj@nwlink.com) or call
206-999-1772.
Cruise Ship Physicians wanted for 14-day (or longer) assignments with Holland
America Line. Take a break from the ED & enjoy a slower pace on a premium
passenger vessel, surrounded by the clear blue waters and beautiful scenery of
Alaska, the Caribbean and other itineraries worldwide. Known for setting the
industry standard in cruise ship medicine, Holland America Line has been recognized
by Conde Nast Traveler and Porthole magazines as having the “Best Medical
Facilities At Sea.” Travel to and from ship provided; family travel benefits
available. Competitive industry pay & malpractice coverage; limited clinic
hours, well-equipped medical facilities, RN and crew physician support staff,
officer privileges. Please contact Susan Suver at (206) 301-5279 or send CV to ssuver@hollandamerica.com
Mason General Hospital, Shelton, WA is recruiting for a full-time member of a
completely democratic ED group. We are looking for an 8th EM residency trained,
EM board certified or board prepared physician to join an existing group of 7
ED docs. Shelton sees approximately 20K visits/year of a good mix of medical,
blunt trauma and pediatric patients. We offer paid medical liability insurance,
very competitive hourly rate and immediate partner status. Please call Dean Gushee,
MD 360-427-6791 or email deangushee@gmail.com.
Tacoma Emergency
Care Physicians, a stable, democratic, two hospital group (60,000 pts./yr.)
of 18 board certified emergency physicians, is looking to hire another
excellent BC/BP emergency physician for a full-time position (12-14
eight hours shifts/month). We offer the chance to practice challenging,
high-acuity emergency medicine in a supportive environment with highly
competitive compensation and a quick transition to full shareholder
status. New ED at Tacoma General coming on line in 2008!
Please contact Rob Ripley at 206 290 2123 or rip-tecp@comcast.net
Are you considering a change of employment? If so, don't make a move until you give us a call. At any one time we have physician openings across, Washington, Oregon, Idaho, Montana and Wyoming. Northwest Emergency Physicians-TEAMHealth is the largest employer of emergency medicine physicians in the Northwest. Contact: Emily Simpson (800) 336-8614 x 2115 or email: emily_simpson@teamhealth.com or Lynn Benson at (800)336-8614 ex 2123/fax (253)838-6418 or lynn_benson@teamhealth.com
CRAssociates,
Inc. (CRA) is a national healthcare management company that is committed
to the delivery of high-quality health care services. We have a need
for full-time Emergency Medicine Physician to support the Naval Hospital
Bremerton. Requirements include:
· Board Certified as an Emergency Medicine Physician
· Min one year exp in last 3 years
CRA is proud to offer you a team environment, excellent compensation and benefits,
as well as company-paid professional liability insurance. Please send your
resume to Human Resources at one of the following: Fax: 866-550-1476 (Toll
Free) Email: ckm@crassoc.com CRA is proud
to be an equal opportunity employer.
Washington, Kitsap Peninsula: We staff two brand-new ED's seeing a total of
60,000 pts/annually and seek a full-time BC EM Physician to expand coverage.
Established, progressive, democratic group with excellent compensation and
benefit package. Mountain and Ocean recreation opportunities abound. One-hour
ferry ride to Seattle. See Website: www.harrisonmedical.org E-mail
CV to: Gail Donavan at gdonavan@harrisonmedical.org
Longview- Cascade Emergency Associates is looking for BC/BP emergency physicians.
Stable and growing practice in a Level III trauma center. Usually one of the
busiest practices in the state, with a census in 2005 of 49,500. Brand new
ED under construction. Wonderful family-oriented community located on the Columbia
River close to a myriad of recreational opportunities. Democratic scheduling
and compensation. Contact Dennis Ford, MD, FACEP, 136 Elk Ridge Dr., Longview,
WA, 98632 or dmford2@adelphia.net.
Immediate Full-Time Position for BC/BE EM Physician with Kennewick Emergency Physicians, a Democratic Group staffing a single hospital, 30,000 annual visits with moderate acquity on the banks of the Columbia River. Generous Competitive Package, Guarantee plus Incentive Compensation, Liability Insurance included, Relocation Expenses included, Full Partnership Tract in 18 months, 8-11hour shifts, Double coverage during peak hours, average 12-14 shifts/month with 3 weeks off/quarter built into schedule. Enjoy a peaceful lifestyle in this friendly community of approximately 200,000. Take advantage of hundreds of miles of waterways- fishing, water sports and beautiful sunsets- all near the mountains, over 300 days of sunshine annually, over 40 local wineries. Contact Louis K. Koussa DO, FACEP; 509-521-3396 or 509-627-1798 and email your CV to loukoussa@yahoo.com
WANTED: Emergency physicians for bipolar company. Quark (www.quarkexpeditions.com) leases Russian Icebreakers for 10 to 25 day voyages to the polar regions. We are in need of ED physicians willing to serve as ship’s doctor. On any ship, there at most 110 passengers and 50 crew members. No dressing up and no night life except the scenery and animals. Contact Dr. Dan Zak at zak38@aol.com. Please let your colleagues know about this as well.
Looking for FT & PT physicians in Central WA. (180 miles from Seattle). Enjoy this desert garden with the finest fruits and vegetables as well as the home to award-winning wineries! Washington State designated Level-4 Trauma Center with a 17K estimated annual patient volume. Efficient support staff with a great pace & good mix of patients. Medium to low acuity. Qualifications: Board Certified or Board Eligible IM, FP or EM. We offer an A-rated malpractice insurance program with no-tail obligation upon departure. This is an Independent Contractor facility with a competitive hourly rate and generous sign-on bonus! For more information, please contact John Torres, (800) 230-5160 ext. 3025, john_torres@emcare.com Visit our website at www.emcare.com
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