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Skorton Weighs In on DACA; CMS Releases New Payment Rules; Leadership Changes in Maryland, New Mexico; and Other Items of Interest

AAMC President and CEO David J. Skorton, MD, contributed an opinion piece to the Washington Post saying that a rescission of the Deferred Action for Childhood Arrivals program (DACA) would hurt American health care by "wasting the time, money and potential vested in these future doctors [with DACA status], while leaving future patients with fewer avenues to robust, reliable health care." The op-od was published just days before the Supreme Court begins hearing oral arguments in the case.
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CMS issued its 2020 final rules for the Medicare Physician Fee Schedule, including a streamlining of evaluation and management services (E/M) that was dropped from an earlier proposal. However, it doesn't completely collapse the five layers of E/M codes as a 2018 proposal advocated, reported Healthcare Dive.
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The AAMC issued a statement in response to CMS' changes to the Medicare Physician Fee Schedule. "The AAMC is pleased that CMS has finalized changes to how Medicare reimburses physicians for office or outpatient visits. These adjustments will allow providers to spend more time with patients and improve access to much-needed care for vulnerable patients and those with complex conditions, many of whom seek care from physicians affiliated with teaching hospitals and medical schools. We applaud CMS for listening to our concerns over past proposals and retaining separate payment rates for outpatient or office visits based on the complexity of a patient's condition, rather than implementing a blended payment rate in CY 2021. Separate payment rates will help to ensure that physicians are more adequately reimbursed for the resources needed to treat patients and supports physicians, including those affiliated with teaching hospitals and medical schools, who see a disproportionate share of more vulnerable patients," said AAMC Chief Health Care Officer Janis Orlowski, MD.
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CMS also released its final 2020 outpatient prospective payment system rule, which moves forward with site neutral payments and cuts to the 340B drug program, despite recent court cases blocking those proposals, reported Healthcare Finance. CMS said it is evaluating options to appeal.
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Mohan Suntha, MD, MBA, has been named president and CEO of the University of Maryland Medical System, effective Dec. 1. Dr. Suntha has served as president and CEO of the University of Maryland Medical Center, the system's flagship academic medical center in downtown Baltimore, since 2016 and previously was president and CEO for University of Maryland St. Joseph Medical Center.
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Paul B. Roth, MD, MS, chancellor for health sciences at the University of New Mexico (UNM) and dean of the UNM School of Medicine, announced his retirement this week. Dr. Roth has served for 26 years as the dean of the School of Medicine and 14 years as chancellor. In a statement, he said he plans to focus on mentoring medical school students. James Holloway, UNM provost and executive vice president for academic affairs, will chair a search committee for Dr. Roth's replacement. Dr. Roth will remain as chancellor until the search is complete.
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"Seventy-one institutions, including many of the most prestigious medical schools in the United States, are now investigating 180 individual cases involving potential theft of intellectual property," reported the New York Times in a piece that covered the government's response to academic espionage committed on behalf of the Chinese government. The article quoted AAMC Chief Scientific Officer Ross McKinney, MD, who highlighted the scope of the problem. "The effects this will have on long-term, trusting relationships are hard for us to face. We just are not used to systematic cheating," he said.
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U.S. District Judge Paul Engelmayer blocked the Department of Health and Human Services' "conscience rule" that would have let providers refuse to participate in abortions, sterilizations, or other types of care they disagree with based on religious or moral grounds, reported the Washington Post. The article noted that "while the rule sought to 'recognize and protect undeniably important rights,' the judge found the rulemaking process was 'shot through with glaring legal defects.'"
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HHS announced it will no longer enforce some nondiscrimination provisions stipulating that federal grants comply with rules that ban discrimination on the basis of sexual orientation and religion, reported the Wall Street Journal.
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The Pennsylvania Department of Health terminated Hahnemann University Hospital's license, but it's not clear what the revocation means for the proposed sale of Hahnemann's residency programs to Thomas Jefferson University Hospitals, Inc. for $55 million, reported the Philadelphia Inquirer.
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PBS Newshour explored how the arts could play a role in treating burnout among doctors and nurses. CFAS is holding a joint Twitter chat on medical humanities with the Medical Humanities Chat (@MedHumChat) on Nov. 11 from 8 to 9 p.m. ET (6-7 p.m. in Phoenix) during Learn Serve Lead 2019: The AAMC Annual Meeting. Participants should include #MedHumChat and #CFASChat in their tweets. All are welcome to log into Twitter and participate.
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Researchers from the University of Missouri - Kansas City and Abbott Laboratories discovered the first new HIV strain in 19 years, reported CNN.
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HHS is suing Gilead Sciences, a pharmaceutical company that sells HIV prevention drugs, including Truvada, charging it with earning billions from taxpayer-funded research without paying taxpayers back, reported the New York Times.
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A woman with a genetic mutation that protected her from dementia, even though her brain had developed a major neurological feature of Alzheimer's disease, might hold the key to unlocking treatments for the disease, reported the New York Times in an article that covered a study in Nature.
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Research at the West Virginia University Rockefeller Neuroscience Institute is exploring whether deep brain stimulation could help those who suffer from opioid addiction, reported the Washington Post.
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Nkeiruka Orajiaka, MD, an attending emergency medicine physician in Ohio, wrote an opinion piece in STAT on the dilemma she faces in prescribing opioids to children in pain. "Do I withhold an opioid and do no harm by preventing the unlikely but real possibility of addiction or side effect of respiratory depression? Or do I prescribe an opioid and do no harm by eliminating pain and its negative psychological effects, such as anxiety and possible PTSD from future medical care[?]"
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Researchers from the University of Pennsylvania took immune system cells from patients' blood and genetically altered them to enable the cells to recognize and fight cancer with minimal and manageable side effects, reported the Associated Press in an article that covered the first attempt in the United States to use CRISPR to fight cancer. The research was published on ClinicalTrials.gov.
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Diet-related illnesses such as obesity, Type 2 diabetes, high blood pressure, and heart disease are major drivers of both deaths and health care spending in the United States, but federal investment in nutrition research remains scant, said Politico.
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Tim Robinson, CEO of Nationwide Children's Hospital, wrote an op-ed in U.S. News & World Report highlighting how Nationwide Children's Hospital is tackling the social determinants of health affecting children in Ohio and how other hospitals and health systems could make progress. "When we started talking to others in our community, we learned many shared our vision, and that our investment could attract their investments. ... [P]ublic and private partners served to multiply our investment many times over; together, in the last 11 years, all of us have invested $30 million to build or rehabilitate more than 350 affordable homes for ownership," wrote Robinson.
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Modern Healthcare covered an announcement describing how more than a dozen of the country's largest hospital systems "will invest more than $700 million toward community-based initiatives aimed at addressing the economic and environmental drivers behind a widening disparity in health outcomes." The effort will focus on projects that address housing instability, food insecurity, and economic revitalization, among others. "The effort is part of a national campaign organized by the Healthcare Anchor Network, a collaborative of 45 hospitals and health systems launched in 2017 to help providers learn and share ways to implement strategies aimed at economic inclusion of communities."
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CNN described programs such as Michigan State University's Detroit Street Care, Wayne State University's Street Medicine Detroit, and the University of Michigan's Wolverine Street Medicine, which coordinate treatment of Detroit's homeless population and send medical students to treat homeless people wherever they are.
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Bloomberg Businessweek profiled Jeffrey Brenner, MD, a doctor-turned-executive at UnitedHealth Group Inc., who is drawing on his 25 years of experience caring for homeless people to get UnitedHealth to pay for housing and support services for roughly 60 formerly homeless Medicaid beneficiaries.
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Walmart is partnering with Doctor on Demand, a telehealth services company, to offer Walmart employees and their dependents primary care and behavioral health visits with a $4 copay in Colorado, Minnesota, and Wisconsin, reported Health Leaders.
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Geisinger Commonwealth School of Medicine will choose 40 incoming students to provide with full tuition coverage and a $2,000 monthly living stipend in exchange for the students' commitment to remain at Geisinger for four years after residency to serve in primary care roles, reported Business Insider.
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More than half of Medicare beneficiaries with serious illnesses reported that difficulty paying a medical bill and paying for prescription drugs was their most significant pain point, said Health Leaders in coverage of a study published in Health Affairs.
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The Washington Post explained how Senate disagreements over higher education funding bills jeopardize funding for minority-serving colleges and universities.
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CDC officials reported that millions of cases of heart disease and other illnesses could have resulted from abuse suffered early in life, reported the Associated Press. The article explored research indicating a strong association between traumatic events people experience in childhood and the diseases they develop later in adulthood.
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The American Medical Association posted an article describing five skills residency program directors expect in new residents. The piece interviewed CFAS Administrative Board member Steven Angus, MD, professor of medicine at University of Connecticut Health, who said internal medicine program directors believe residents should be able to gather a patient's history and perform a physical examination, provide an oral summary of a patient encounter, document a clinical encounter, participate as a member of an interprofessional team, and recognize when a patient requires urgent or emergent care.
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Stephen Parodi, MD, associate executive director at The Permanente Medical Group at Kaiser Permanente, wrote an op-ed in the New York Times on his harrowing experiences evacuating hospitals as wildfires rage across Northern California, claiming that medical evacuees are the new refugees of climate change. Dr. Parodi leads emergency management for 21 hospitals in Northern California.
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On a related note, Richard Horton, editor in chief of The Lancet, called on doctors and medical professionals to engage in nonviolent protests to address climate change, reported Scientific American.
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And an international group of 11,258 scientists from a range of disciplines signed on to an article in BioScience titled "World Scientists' Warning of a Climate Emergency," which calls for action on six broad policy goals to address climate change. The Washington Post covered the story.
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A tiny fraction of pregnant women suffers from hyperemesis gravidarum, an extreme form of morning sickness characterized by severe nausea, vomiting, and weight loss that puts the health of the mother and baby at risk, but many doctors either ignore it or don't know enough about it to believe their patients' discomfort is out of the ordinary, reported Slate.
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Even though hospitals are rationing and dose-cutting, a severe shortage of immune globulin injections used to treat epilepsy, cancer, and immune disorders is forcing providers to cancel patients' infusions, said the Washington Post.
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Lisa Rotenstein, MD, MBA, a resident at Brigham and Women's Hospital and a clinical fellow at Harvard Medical School, and Jessica Dudley, MD, chief medical officer of the Brigham and Women's Physicians Organization and vice president of care redesign at Brigham Health, wrote an article for Harvard Business Review on closing the gender pay gap in medicine by outlining three overarching approaches, including enhancing salary data, engaging allies in coaching and sponsorship, and facilitating equitable promotion.
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A pair of studies published in JAMA reported that approximately 28% of high school students and 11% of middle school students said they had used e-cigarettes within the past month, and even though e-cigarette-maker Juul Labs stopped selling fruit and dessert flavors, teens who use e-cigarettes still prefer Juul, and mint has become the new favorite flavor. The Associated Press covered the research.
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Proponents for Medicare for All might learn lessons from Vermont and Colorado's efforts to enact similar health care reforms, which floundered after the costs became too high to sell politically, reported the Wall Street Journal.
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Jonathan S. Lewin, MD, executive vice president for health affairs at Emory University, and president, CEO, and chairman of the Board of Emory Healthcare, received the National Medical Fellowships Pioneer Award, which recognizes those who advance diversity and inclusion in the health professions and lead efforts in the commitment to health equity for all.

David A. DiLoreto Jr., MD, PhD, was named chair of the University of Rochester Medical Center Department of Ophthalmology and director of the Flaum Eye Institute. He succeeds Steven Feldon, MD, MBA, who will transition to associate vice president and director of the Office of Biomedical Research Development. Dr. Feldon is a CFAS representative for the Association of University Professors of Ophthalmology and has been especially active in CFAS studying educational needs around surgical subspecialty training in academic medicine.
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Susan Anderson, MD, has been named the first dean of rural medicine at the University of South Dakota Sanford School of Medicine. This new position recognizes the importance of rural medicine in South Dakota, the school noted in a statement. Dr. Anderson will continue to serve in her role as chair of the Department of Family Medicine.
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Catherine B. Soehner, MLS, has been appointed associate dean for research and director of the Spencer S. Eccles Health Sciences Library at the University of Utah.
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Timothy S. Harlan, MD, FACP, will join the faculty of the George Washington University School of Medicine and Health Sciences and establish the GW Center for Culinary Medicine. Dr. Harlan serves as associate dean for clinical services at Tulane University School of Medicine, medical director of the Tulane University Medicine Group, and executive director of the Goldring Center for Culinary Medicine at Tulane.
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Kristen L. Carroll, MD, was awarded the Sherman S. Coleman, MD Presidential Endowed Chair in Pediatric Orthopaedics in the Department of Orthopaedics at the University of Utah. Dr. Carroll is a professor in the Department of Orthopaedic Surgery and chief of staff and a pediatric orthopedic surgeon at the Shriners Hospitals for Children.
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From the thriving CFAS News "Yuck" desk, comes the story of a Nebraska woman who found herself swatting away small flies around her head after she ran through a swarm along a California trail. Unfortunately for her (and as the Gizmodo article notes, potentially all of us), these weren't just any flies, but a particular species that lays its larvae onto the eyes of its hosts. Soon after - as was the case for the jogger - the host experiences eye irritation before small worms emerge. In this instance, four wrigglers were extracted from the woman's eyes over a period of weeks. The piece notes speculation that such parasitic infections could become more common in the United States. Time for goggles.
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And finally, in a shocking admission, NIH Director Francis Collins, MD, PhD, confessed he "don't know much biology!" Well, not really. Dr. Collins was profiled in Bethesda Magazine for his now-famous work fronting the Affordable Rock 'n' Roll Act, a band made up of NIH physicians, scientists, and researchers. The old Sam Cooke classic (everyone now: "Don't know much about history/don't know much biology/don't know much about a science book/don't know much about the French I took) happens to be one of their staples. "That's such a stupid song," Dr. Collins unsurprisingly says in the interview.
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Find more news items on AAMC's Research Clips page, and visit the CFAS Resources page for an archive of the previous four editions of CFAS News as well as our People of Academic Medicine page, which features a running list of academic promotions, appointments, and departures.

Your comments and news tips are always welcome. Please email them to Eric Weissman at eweissman@aamc.org.

Eric Weissman
Senior Director, Faculty and Academic Society Engagement
AAMC
eweissman@aamc.org
www.aamc.org/members/cfas

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