News

March 16, 2023

President's Message: Dr. Jitendra Barmecha
Progress Note:

Congratulations to all the IM graduates who matched for residency training starting this summer!

On March 14, the epicenter of COVID-19 infection – NYC, marked the third anniversary of the first confirmed death from the coronavirus pandemic, and it was among 45,000 more COVID-19 related deaths to occur in the city. Additionally, since March 2020, New York City has seen 3.2 million confirmed cases, and 211,000 people hospitalized with COVID-19. Currently, however, COVID is trending down from a January spike in infections. According to the city’s health department, as of March 11, “an average of three New Yorkers died of the virus per day, 24 people were hospitalized and more than 470 new infections were detected”. In a recent poll from the pandemic action network, most Americans are concerned about pandemic threats and want increased government spending on future pandemic preparedness. 

Last week, the following NYS bills were signed (“Chaptered”) into law by Governor Hochul:

• Legal protections for abortion providers (Chapter 101 of the Laws of 2023)
• Notification of changes to the model contract with Medicaid managed care providers (Chapter 100 of the Laws of 2023)
• Coverage for, and notice to insureds of, colorectal cancer screenings (Chapter 78 of the Laws of 2023)
• Support of living organ donation (Chapter 66 of the Laws of 2023)
• Prescription price transparency (Chapter 63 of the Laws of 2023)

A summary of all the signed legislation can be accessed on HANYS 2023 State Legislative Activity Chart.

Your help is needed in urging the Federal Trade Commission (FTC) to amend their proposed rule on non-compete clauses in employment contracts. The proposal would ban non-compete clauses, but ACP is concerned that the protections for employees may not cover nonprofit health care organizations. ACP is asking members to let the FTC know their thoughts about the proposal, including why it’s important to include nonprofit health care organizations.  Visit ACP’s Legislative Action Center to send a message to your elected representative. The deadline to comment is March 20. 

ACP, along with other leading medical and public health care organizations across the United States are coming together to push for a comprehensive public health approach to advance firearm injury prevention efforts through education, advocacy, and community-centered approaches to address this epidemic. 

Applications are now being accepted for the NYACP Leadership Academy. This course is a six-part certificate program (via zoom), beginning in May 2023, and ending with an in-person final session on Friday, October 27th (the day prior to the NYACP Annual Meeting in Rochester, NY).

Next Monday, March 20, marks the official spring season – enjoy and stay warm!

Jitendra Barmecha, MD, MPH, FACP, SFHM
President

NYACP Welcomes Advocacy Intern Vincent Huang, MD 

My name is Vincent Huang, I am a second-year resident in the internal medicine program at Northwell. I applied for this internship because I wanted to learn more about how policies that impact our communities are created and understand the provider’s unique role throughout the whole process. I have learned that while legislators and government officials create policies, they still require assistance and input from experts. As providers, we are in a special position as we directly work with patients and the systems in place, and we recognize the limitations as well as the challenges present in providing care for our patients. Despite being able to provide this assistance, many of my resident colleagues and I have limited exposure to health care policy as well as advocacy due to our time constraints. As a result, it is difficult to learn more about creating, becoming involved, and advocating for the changes we are passionate about. In the next four weeks, I want to focus on learning how policies are created, working with representatives and stakeholders to further assist/reject a policy, and experiencing the provider’s role throughout the whole process. 

For this year’s topic,  I have chosen to focus on mental health mainly due to the experiences I have had in a medical school project, as well as my personal experiences working as a resident. During the fourth year of my medical school, at the height of the COVID pandemic, I had the privilege to assist with a project known as psychological first aid. The project consisted of reaching out and providing support to the vulnerable members of the ambulatory psychiatric population in dealing with the increased stresses of the pandemic. I would meet with patients from various backgrounds, but one thing that always stuck out to me was how difficult it was to have access to mental health resources and, oftentimes, the population that had the most difficulties would be the ones that are underrepresented. These same challenges would be echoed during my practices as a resident in both the hospital setting as well as the clinic setting. One of my more recent and memorable patient encounters involves an elderly black woman who was initially admitted to the hospital for suicidal ideation. When she was medically cleared to be discharged to our inpatient psychiatric unit, she no longer met inpatient psychiatric admission criteria as she no longer expressed suicidal ideation, per our psychiatric team. The main barrier for her discharge was setting her up with an outpatient psychiatrist given the reason for her admission. Despite multiple discussions and meetings with social workers and case managers, due to her insurance and financial limitations, there were no accepting providers for behavioral health. In addition, the psychiatric team did not have availability during that time to ensure a close follow-up for this high-risk patient. These experiences and many others have demonstrated the lack of access patients have to mental health resources, as well as the inequalities for access to these resources. In the next four weeks, I hope to further promote policies that increase access to behavioral health resources and reduce the inequalities among the different races and socioeconomic backgrounds in our diverse state. 

Summary on MSSNY Advocacy Day Collaboration 
Vincent Huang, MD, NYACP Advocacy Intern  

• The pandemic has exemplified physician burnout/moral injury due to the increased demands of our health care system. To ensure that our physician workforce can meet the continued demands, a major contributor to burnout includes excessive administrative burdens. Health insurance reform is necessary as health insurer-imposed barriers such as prior authorizations result in significant care delays and at times can lead to patients abandoning their treatments. Action is needed to remove these barriers that interfere with patient care as well as physician well-being. Currently, the Medical Society of the State of New York (MSSNY), NYACP, and other NYS Specialty Societies are advocating for proposals that reduce excessive health insurer interference in patient care by exempting physicians and other health care providers from health insurer-imposed prior authorization requirements in certain cases and streamlining the PA process.  
   
• New York has excessive liability cost and ranks amongst the top in total liability payout and per capita payments. Last year the New York State Legislature passed a bill that could significantly increase NY physician’s medical liability premiums by expanding damages awardable in wrongful death action. It is important to recognize that NY does not have laws that limit the award amounts, in contrast to other states with similar liability laws. A study has concluded that premiums could increase by nearly 40%. While well-meaning, paying more in liability would mean higher operating costs for private practices and may result in physicians leaving their practices and moving to other states. Given the strained health care system already, the closure of one of these clinics could prove detrimental to rural communities. To prevent these unintended consequences, support is needed for legislatures that reduce malpractice costs and non-meritorious claims rather than simply increasing malpractice insurance costs and ignoring the other factors. 
   
• In alignment with NYACP, MSSNY, the American College of Obstetricians and Gynecologists, and the New York State Society of Anesthesiologists all support preserving the physician-led care model and ensuring that professionals are practicing within their scope and level of education and training. The Governor’s budget contains several proposals that would expand healthcare services without applicable statutory collaboration or supervision requirements that could be delivered by non-physicians. To counteract these proposals, opposition is needed in the legislature that inappropriately permits independent practices by CRNAs, PAs, and NPs. Furthermore, in the context of scope of practice, there is also a need to promote opposition in granting psychologists prescribing privileges, as these professionals have not trained in the medical field.
   

If you agree with any of the topics discussed, please reach out to your local Assembly Member and/or Senator to discuss these priorities: NYACP Grassroots Action Center.

NYACP Advocacy Intern Experience
Nisha Khubchandani, MS4

As I near the end of my time in the  NYACP Advocacy Internship Program, I reflect on the many ways  the program met my expectations. My project focused on a data collection process to identify which adult patients at Albany Medical Center face barriers to accessing food. Through this project, I helped launch foundational steps to address a public health issue that resonates with me given my volunteer experiences. One of my expectations was to build working relationships with key stakeholders. In the past few weeks, I met with multiple stakeholders, including Senator Breslin and Assembly Member Colton, to discuss important topics such as geriatric care and food insecurity. This experience has been instrumental to honing my advocacy skills. 

Read More        

New ACP Paper Calls for Equal Access to Reproductive Health Care Services

A new position paper published in Annals of Internal Medicine, "Reproductive Health Policy in the United States: An ACP Policy Brief" details new recommendations to ensure patients receive equal access to reproductive health care without undue government interference. 

The recommendations are an update and expansion of ACP’s paper, "Women’s Health Policy in the United States," which was published in Annals in 2018.

White Paper: The Potential Impact of Negative Online Reviews on Medical Malpractice Litigation and the Important Role a Reputation Management Service Can Play
By: Kenneth R. Larywon, Esq., Thomas A. Mobilia, Esq., Barbara D. Goldberg, Esq. and Gregory A. Cascino, Esq. of Martin Clearwater & Bell LLP

Practitioners have few legal avenues available to directly address negative online reviews by patients. Such reviews are shielded from liability under most scenarios, and it is typically next to impossible to have a negative review taken down, unless it can be established that it was completely false. Moreover, a mid-level New York State Appellate Court recently held that a patient’s critical online comments about treatment by her plastic surgeon are in the “public interest.”1 Thus, under New York’s Anti-Strategic Lawsuits Against Public Participation (“SLAPP”) statute,2 the patient was able to seek attorney’s fees and damages resulting from the surgeon’s unsuccessful defamation action.

Read More

ACP App Library

The ACP App Library is a curated collection of the top-rated apps you can confidently recommend to your patients. ACP has collaborated with ORCHA, which conducts app assessments, to ensure they are safe, secure, and effective.

Support your patients' self-management of their health condition(s) with apps for:   

• Weight loss and diet
• Diabetes
• Hypertension and other cardiovascular conditions
• Asthma
• COPD

ACP members and their staff have free access to this resource. 

NYSDOH Webinars: Commissioner Medical Grand Rounds

Clinical Intervention and Community Engagement for Climate Change
Friday, March 24, 2023 / 12:00 pm - 2:00 pm 
More Info     Flyer

The Role of Hospitals in Preventing Gun Violence
Friday, March 31, 2023 / 12:00 pm - 2:00 pm
More Info     Flyer

I Raise the Rates Newsletter 

This edition of I Raise the Rates (IRtR), includes a variety of new resources from several public health partners, educational opportunities, and a selection of media articles related to immunizations.

ACP's 2023 Annual IM Meeting: NYACP and Joint Medical Schools Reception 

Are you going to ACP's Internal Medicine Meeting in San Diego in April? 

Connect with fellow NY members and celebrate the Chapter’s new Masters, Fellows and Award winners immediately following the Convocation Ceremony:

NYACP and Joint Medical Schools Reception 
Marriott Marquis San Diego Marina Hotel
Thursday, April 27, 2023
8:15 PM – 9:30 PM

RSVP with your name and number attending by April 14th to Lisa Noel at lnoel@nyacp.org.  Spouses and partners are welcome!  Please include them in your RSVP.

The reception is hosted by the New York Chapter ACP and co-sponsored by the following Medical Schools: Icahn School of Medicine at Mount Sinai; New York Presbyterian/Brooklyn Methodist Hospital -Weill Cornell Medical College; NYU Langone Medical Center; State University of New York Downstate Medical Center; State University of New York Upstate Medical University; New York Institute of Technology; Renaissance School of Medicine at Stony Brook, and SUNY at Buffalo - Dept. of Medicine. 
 

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