Editorials from the Executive Medical Director
As EMD of the College, I usually don’t take up controversial topics in this column. In fact, the College walks a fine line when we are approached to sign off on letters promoting a particular opinion on a health care issue. So why do I want to sound off on one of the most controversial issues facing our country, which no doubt will occupy our newsfeeds throughout the 2020 elections? Because this is an editorial column, where I can give my opinion. Before I start, let me say that this is my opinion alone and is NOT the opinion of the American College of Allergy, Asthma, and Immunology, its officers or its staff.
As you may know, the American Board of Allergy and Immunology is overseen by a parent organization, the American Board of Medical Specialties (ABMS). Presently there are 24 boards under this organization. Their mission is to serve the public and the medical profession by improving the quality of health care by setting professional standards for lifelong certification in partnership with member boards. Recently, the ABMS published a draft document to address the issues associated with Maintenance of Certification (MOC) for physicians in the U.S., Continuing Board Certification, Vision for the Future. You might be asking, “Was this document needed in the first place?”
It’s that time of year when we see all the stories flooding the news and social media about making our New Year’s resolutions. You know, the same ones we see every year - exercise more, lose weight, eat right, etc. We may try to keep these promises, but usually by Jan. 31 they are long forgotten.
Are there specific resolutions that we as allergists should ponder for 2019? I put together some that you could consider for the new year.
It seems like every day there is an article in the news about social media and especially Facebook. Issues related to Facebook include knowing more about you than you think, selling your data, affecting you mentally by making you feel you are not as cool as some of your friends and even leading to addiction to the site. And it’s hard to ignore the spread of misinformation and fake news as well as private information being hacked, which should disturb all of us. With all these fears about Facebook, why do so many of us still use it? I can think of a few great examples of the good that Facebook can do.
With the College’s Annual Scientific Meeting, Nov. 15-19 in Seattle, just around the corner, I thought I would give you a sneak peek of my talk, “The Path from Burnout to Wellness.” It’s part of a session with Mark O’Halloran, MD, FACAAI, who will update attendees on burnout with Gailen Marshall Jr., MD. PhD, FACAAI, and Megan Shepherd, MD, FACAAI acting as moderators and taking part in a panel discussion on the topic.
Why is it important to understand and reach the millennial allergist? In the near future, the largest percentage of physicians in the U.S. will be millennials, replacing the baby boomer generation. For allergy and the College to grow, understanding the needs of these allergists is paramount. In case you don’t know, the term millennial generally refers to the generation of people born between the early 1980s and the early 2000s. It’s the millennial allergists who grew up with personal computers, smartphones, tablets and social media. It is this group that is less likely to scream and curse at electronic medical records (EMRs), as they are more familiar with technology than any previous generation.
The physician-patient relationship has long been the cornerstone of the practice of medicine. I would imagine that most allergists would say that it is the connection they have with their patients, parents and caregivers that brings them the most joy in the practice of medicine. The American Medical Association (AMA) Code for Medical Ethics on the patient-physician relationship states, “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.
Just as we get some good news on the compounding issue from USP, our friends at the Centers for Medicare and Medicaid Services (CMS) may be causing the allergist misery in 2019. First some good news from CMS. Administrator, Seema Verma, announced the contraction of our office-based E&M codes from five to two. This would reduce the amount of documentation and paperwork for physicians and save 51 hours of clinic time per doctor per year. Let’s face it, that sounds terrific. The plan is to keep Level 1, which is primarily used for non-physician services, and Levels 2-5 would be incorporated into one code with one reimbursement rate.
The business of medicine is in flux. Practices are merging, getting bigger, moving into integrated health care delivery systems. With all these changes, is the way physicians are paid also changing? If we are moving away from a fee-for-service to a value-based health care system, should we not see changes in how we are compensated? Over the last eight years, the American Medical Association has analyzed its every other year Physician Practice Benchmark Survey results to assess how physicians are compensated. The latest data, from the 2016 survey, recently released in a paper written by Apoorva Rama, has some interesting insights for the allergist. Compare your compensation sources to the data below.
Are you laughing at the title of this article? Are you confused by it? I think you are looking at the future of medicine in the U.S. – the “Amazoning” or “Walmarting” of medicine. How can I say this is the future? I am sure that “mom and pop” grocery stores, clothing stores and hardware stores never thought they would be out of business 15 years ago. I’m afraid the same thing will happen with the “mom and pop” allergist as we move into the realm of disruptive innovation in health care.