November 15, 2022

NEED TO KNOW

Elections: Vermont Democrats Send the First Woman to Congress and Enshrine Abortion Rights

After a hard-fought election, Senator Becca Balint was elected to assume Congressman Welch's seat and will be the first openly gay woman to represent Vermont in the U.S. House. Peter Welch was elected as Senator and will take Senator Patrick Leahy's seat that he has held for over 45 years. Aside from overwhelmingly supporting the reelection of Gov. Phil Scott, Vermonters chose women to represent them in many statewide posts. Charity Clark will become the second female Attorney General after Suzanne Young was appointed this summer and Sarah Copeland-Hanzas will be Vermont's third female Secretary of State. The Vermont Democrats regained a veto-proof majority in both the Vermont House and Senate, with 23 Democratic Senators and 104 Democratic Representatives. In terms of Senate leadership, David Zuckerman will once again be Vermont's Lt. Governor and this past Sunday, Phil Baruth, D-Chittenden, was elected as the Senate President Pro Tem. Jill Krowinski, D-Burlington, will remain as the House Speaker and has the difficult job of determining the Vermont House Committee assignments after 41 of the 150 Representatives retired this past spring, including 9 Committee chairs. Both Prop 2, prohibiting slavery, and Prop 5, enshrining reproductive liberty, passed and will amend Vermont's constitution. Do you know your Representatives and Senators? Click here for the full Vermont 2022 election results.

Refugee Health Webinar Series: Watch Recordings and Review Presentations

VMS held a webinar series on Refugee health, where the goal was to provide information to health care professionals to better serve and support Vermont’s refugee communities. Content was framed with a health equity lens that promoted culturally and linguistically appropriate health care screenings, services, and supports.

To watch the recordings or view the presentations, click here.

Medicare CY2023 Physician Fee Schedule Rule Summary

As covered in the Rounds last week, the Centers for Medicare & Medicaid Services (CMS) recently released the 2023 Medicare Physician Payment Schedule final rule.  The CY 2023 Medicare conversion factor (CF) is $33.06, a decrease of $1.55 or 4.5% from the 2022 CF of $34.61. The decrease is largely a result of an expiring 3 percent increase funded by Congress through 2022. The additional approximate 1.6 percent decrease is the result of budget neutrality requirements that stem from revised E/M changes contained in the rule. The AMA and state and national medical societies are strongly advocating that Congress avert this payment cut, as well as implement an inflationary update for physicians.   VMS is particularly concerned that cuts to the Medicare conversion factor will also be mirrored in the Vermont Medicaid fee schedule.  Please reach out to Vermont’s Congressional Delegation to urge a fix to these pending cuts. The AMA has now prepared a summary of the Final Rule, along with an impact table reflecting the 3% cut on various specialties, which without Congressional action is scheduled to start January 1, 2023.  

Vermont Represented at American Medical Association House of Delegates

The American Medical Association House of Delegates is meeting this week, concluding business today.  Vermont has been represented by Interim-Delegate Catherine Schneider, MD, and Alternate-Delegate Simha Ravven, MD, both past presidents of VMS.  Top items of interest to Vermont and New England include efforts to expand the AMA’s position on a public option for health insurance, taking a position in favor of 12 weeks of paid family leave for physicians and trainees instead of 6 weeks, and expanding efforts to address gun violence.  Follow highlights from the meeting here.    


MISC.

CDC Webinar on New Opioid Prescribing Guidelines that Update and Replace '16 Version

As covered in the Rounds last week, the U.S. Centers for Disease Control and Prevention (CDC) on Nov. 4 issued the “CDC Clinical Practice Guideline for Prescribing Opioids for Pain—United States, 2022,” which “updates and replaces the CDC Guideline for Prescribing Opioids for Chronic Pain released in 2016.”  The New Guidelines were issued in response to considerable medical society and patient advocacy—and recognition of the widespread misapplication and harms resulting from its 2016 opioid prescribing guideline. In the update, the CDC removed the 2016 numeric thresholds for dose and quantity of opioid prescriptions from its recommendations, saying that “the recommendations are not intended to be implemented as absolute limits for policy or practice across populations by organizations, health care systems, or government entities.”   The CDC will hold a Zoom call on Nov. 17 from 2–3:00 p.m. Eastern, to discuss the updated 2022 guideline. Additional details, including access information for the call, are available on the CDC website

    Physicians Foundation Releases Survey Results on the State of Physician Practice

    The Physicians Foundation today released part three of its 2022 Survey of America’s Physicians, which assessed the state of the physician practice and strategies to improve it. 

    Some of the key findings of the survey include:

    • Capacity Issues Impact Physicians’ Ability to Deliver Patient Care
    • Mounting Challenges Are Affecting Primary Care
    • Physician-Informed Solutions
    You can read the full survey results here.

    Next VMS Public Health Update with the Commissioner of Health, Mark Levine, M.D. is November 17th at 12:30pm EST

    The next time we will speak with the Commissioner of Health will be November 17th where he will provide us with the most pressing information affecting the state and nation. You will have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting. Notes from the call with the Commissioner held last Thursday, Nov. 3rd can be found here. Commissioner Levine discussed new COVID-19 recombinants, RSV, influenza and other public health topics.

    You can join the zoom meetings here which take place on the 1st and 3rd Thursday of the month from 12:30pm to 1pm EST or add to your calendar by following this link and clicking download (you will then need to open the downloaded file and click save to add to your calendar).


     

    EVENTS

    Webinar: Rapid Treatment Access for Alcohol Use Disorder

    November 16th and November 18th, 11:30am to 1 pm EST


    Join the Vermont Department of Health for a webinar that will have topics including:

    • Walk through of Clinical Protocol including the Use of Medication to treat Alcohol Use Disorder and withdrawal management
    • Epidemiology of Alcohol Use Disorder, recognizing signs and symptoms
    • Organizing Systems of Care Within a Community

    For more information and to register for either the November 16th or 18th session, click here.


    CDC Clinical Practice Guideline for Prescribing Opioids for Pain

    November 17, 2pm to 3pm ET

    The Centers for Disease Control and Prevention (CDC) support the clinician-patient relationship in providing personalized pain management solutions. The 2022 CDC Clinical Practice Guideline provides 12 voluntary recommendations for managing acute, subacute, and chronic pain. The guideline is not applicable to pain management related to sickle cell disease, cancer-related pain treatment, palliative care, or end-of-life care.

    During this COCA Call, a subject matter expert will discuss CDC recommendations, implementation principles, and approaches to maximize benefits and minimize risks when starting, continuing, or discontinuing opioids for pain.

    Learn more and join here.

    The Power of Partnership: Collaborating with Physician Health Programs to Support Physician Wellbeing

    November 18, 12pm to 1pm EST


    Sponsored by the Coalition for Physician Wellbeing join speakers Chris Bundy, MD and Linda Bresnahan for their power of partnership webinar.


    Register here.

    Emergency Medicine Update

    January 22 - 25, 2023

    In-Person - Lodge at Spruce Peak, Stowe, VT

     

    This course will discuss a variety of timely, practical issues that are encountered in the emergency department on a daily basis. Lectures will be engaging, sometimes controversial, and present the audience with examples of both successes and failures in emergency medicine. At the end of this program, participants should be able to distinguish between advancement and change in the emergency department in a relaxed, family-oriented environment where learning does equal fun!


    All emergency medicine professionals are welcome.


    For more information about the speakers, sessions, accreditation and to register please visit: https://go.uvm.edu/stoweem23

    Hospital Medicine 2023

    January 29 - 31, 2023

    In-Person - Lodge at Spruce Peak, Stowe, VT


    This course will provide practical approaches to common problems in hospital medicine informed by experts and the latest evidence. Target audience: physicians, physician assistants, nurse practitioners, and nurses practicing Hospital Medicine. Also open to program administrators, resident physicians, and medical students with an interest in careers in Hospital Medicine. Topics will include: Curbing the Opioid Crisis, Pharmacy Pearls, Long COVID, Biliary Disease, End of Life Care in the Hospital. Optional workshop: POCUS

    For more information about the speakers, sessions, accreditation and to register please visit: https://go.uvm.edu/hm2023

    Eastern Winter Dermatology Conference

    February 2 - 5, 2023

    In-person - Stoweflake Mountain Resort & Spa, Stowe, VT


    The 34th Annual Eastern Winter Dermatology conference is designed to provide high-level continuing education for dermatologists and medical professionals specializing in dermatology, keeping them abreast of new and exciting findings in basic science, clinical dermatology and dermatologic therapy. Primary care physicians and medical professionals with a special interest in dermatology are also welcome to attend. Topics will include: Acne & rosacea update, innovations in connective tissue disease management, diagnosis of early CTCL, hidradenitis suppurativa, pediatric psoriasis issues, professional development - “how to say no,” erythema migrans pearls, management of high risk skin cancer, medical pearls from the literature and more!

    For more information about the speakers, sessions, accreditation and to register please visit: go.uvm.edu/winterderm23

    Eastern Winter Dermatology Conferen2023 Epilepsy & EEG in Clinical Practice

    February 10, 2023

    In-person - Main Street Landing, Burlington, VT

    Held in Burlington for the first time, the 2023 Epilepsy & EEG course will focus on providing a review of current medical and surgical clinical practices related to seizures and conjunction with adjunctive EEG testing and will address errors that may lead to incorrect diagnosis and treatment. An interactive and didactic format that includes multimedia presentations and allows for audience participation. Target audience: internists, family practice and general practice physicians, pediatricians, neurologists, physician assistants, nurses, allied health professionals and residents involved in the care of patients with seizures and epilepsy are encouraged to attend.

    Note: This is being held in conjunction with the EAEEG Annual Meeting. There is a discount for attending both events.

    For more information about the speakers, sessions, accreditation and to register please visit: https://go.uvm.edu/epilepsy23

    More conferences from UVM CMIE are expected this Spring to include these topics: Anesthesia, Cardiovascular/Vascular Disease, Geriatrics and Family Medicine. Sign-up to get updates via email for topics that are of interest here

    VTMD.ORG

    Vermont Medical Society

    134 Main Street

    Montpelier, VT 05602

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