The June 1 Board of Trustees meeting was the final meeting of Paul Johnson, MD’s presidency.
By Tom Lacock
Wyoming Medical Society
The Wyoming Medical Society’s (WMS) Board of Trustees met on June 1, at Jackson Lake Lodge in Grand Teton National Park and addressed a full agenda of business ranging from PA autonomy, to regulation of medical assistants and a new Wyoming Physician Leadership program.
In addition to being in charge of all PA’s working in the Cleveland Clinic’s health system, Josanne Pagel, PA-C, is also the President of the American Academy of PA’s (AAPA). She joined the board to discuss the Optimal Team Practice policy. The policy is an effort by the AAPA to help states develop legislation to meet the provider needs of their state. The policy would encourage states to make PA autonomy, something which is determined at the practice level instead of at the state level. The concern amongst PA’s, according to Pagel, is although they do not necessarily seek independence from physicians, there is concern that their profession is losing job opportunities to advanced practice nurses.
WMS Board member Bob Cummings, PA-C was on the national panel that helped to develop the Optimal Team Practice model. The hope is licensure won’t be tied to a supervising physician who is miles away or leaves the practice suddenly for various reasons. Pagel said Michigan has recently adopted similar rules and adds that the state could determine autonomy through ideas such as competency tests or years of service. She said she does not anticipate any new PA’s out of school trying to hang their own shingle.
Cummings has volunteered to bring some suggestions to the WMS Board and start discussions with a committee of WMS physicians to flesh out what Wyoming doctors would be willing to support.
A recent experience by a lawmaker from Laramie has led to discussion regarding the potential regulation of medical assistants. The Joint Labor, Health, and Social Services committee of the Wyoming Legislature has been asked to at least consider whether there needs to be regulation on the MA profession and that committee’s chair has asked the WMS for its take. Currently, the law simply states that a physician has the authority to delegate any responsibility that he/she deems appropriate to non-licensed medical personnel.
WMS Board of Trustees wondered whether there was data on actual issues with MA’s working in their current capacity to determine if there is an issue that needs addressed. If the Board of Medicine or Legislature sees an issue, the WMS is certainly welcome to continue the discussion.
At a Department of Health meeting the Director of the Wyoming Hospital Association, Eric Boley, said CRNAs are encouraging Governor Matt Mead to opt Wyoming out of requiring physician supervision of CRNAs in Wyoming hospitals.
WMS Trustee and Gillette anesthesiologist John Mansell, MD, briefed the Board of Trustees on the issue. He said Thus far 17 states have opted out of requiring physician supervision of CRNA’s in hospitals. Mansell said the Anesthesiologist Association is asking a surgeon or internist is available for a consultation. They are saying physicians should be part of a team to help outcome process for patients. He adds in 2013 the similar issue was raised and the WMS supported the Anesthesiologist Association. The Board of Trustees discussed the issue and took a vote on a position.
Physician Leadership Program
A Physician Leadership program is coming to Wyoming thanks to a grant from The Physicians Foundation. The program will allow a cohort of between 15-and-20 Wyoming physicians to take part in the program each year for a total of two years. In developing the program, The WMS will partner with Leadership Wyoming, The University of Wyoming School of Health and Sciences, WWAMI, and The Wyoming Hospital Association, whose members will join the program’s Advisory Council which will be made up predominantly of Wyoming physicians. The program will get underway in September of 2017 and involve both soft skill development, as well as panel discussions and other facility tours as a way to offer WMS physicians a larger view of healthcare in Wyoming.
Membership and Finance Update
Currently, WMS membership numbers are on the rise. As of June 1, there are 532 active members on the WMS rolls up from 493 a year ago. There are also 170 retired for 702 total. WMS finances also look good at this point with a forecast cash surplus for the year of around $4,000.
Health Information Exchange
An announcement was made by the Wyoming Department of Health last week that Medicity won a contract to provide the state’s health information exchange. Medicity will be at the Annual Meeting to present on the Exchange. However, at the next day’s CME a planned presentation on the HIE was tabled as a challenge to the bid was announced. WMS will have more on that as it develops.
Federal Legislation Opportunities
Hayley Miller traveled to Washington, DC last week to discuss healthcare reform with Senators John Barrasso, MD, and Mike Enzi through a grant from the AMA. Miller said the talking points that she will be brining include any bill focusing on access to affordable care, pre-existing conditions, and allowing children to remain on their parent’s insurance until age 26.
The National Board of Physicians and Surgeons (NBPAS) began lobbying the American Boards of Medical Specialties (ABMS) and more specifically the American Board of Internal Medicine (ABIM) to rescind MOC requirements but were met with great opposition. NBPAS have produced and published research analyzing the monopolistic dynamic at play, and effectively demonstrated the lack of evidence to support the ABIM’s contention that MOC is valuable. WMS has decided to support the NBPAS and its alternative continuing education board certification pathway by creating a statement of support for NBPAS and requesting hospitals and insurers in Wyoming recognize it to as an alternative to MOC.
Annual Meeting Update
The WMS Annual Scientific Meeting was held June 2-4 at Jackson Lake Lodge and featured 85 attendees, as well as strong sponsorships and demand for exhibit space by vendors. The Annual Meeting for 2018 is still in the planning process with the Board directing WMS staff to explore the concept of a January meeting in Jackson involving CME, a President’s Dinner, a Board of Trustees meeting, and discounted ski passes in Jackson.