BULLETIN
AMERICAN ASSOCIATION OF PUBLIC HEALTH PHYSICIANS
“THE VOICE OF PUBLIC
HEALTH PHYSICIANS, GUARDIANS OF THE PUBLIC’S HEALTH”
Volume 46, Issue 1 Feburary 2000
BULLETIN Volume 46, Issue 1 Feburary 2000
Our March
meeting is always our most important.
This is the meeting where we determine dues, elect new officers and vote
on bylaws changes. This year we will be at Grady Hospital in Atlanta. If you can't come in person then come by
phone. As of press time, we did not have the phone number for the
telephone conference. If you are
interested in attending by phone, let us know so that we can contact you with
the correct phone number. Contact us by: email aaphp@iname.com, fax 630-604-3256 or voice mail
630-604-3256. Provide us with your Id
number «ID» and an email, fax number or phone number so that
we can contact you with up to date information on the tele-conference. For those who attend in person, the registration
fee is just $20.00 and includes lunch.
Residents can attend for free.
As usual this meeting is being held in conjunction with the 17th Annual National Preventive Medicine Meeting - March 23 - 26, 2000 in Atlanta, Georgia. Visit the Prevention 2000 Website for More Information www.prevention-meeting.org on the general meeting. DISCOUNTS FOR REGISTRATION SHOULD BE AVAILABLE TO AAPHP MEMBERS
We enter 2000 with 208 members, 76
of whom have already paid their year 2000 dues. To save money (and time) the
opportunity to pay dues is given with each mailing. Those members that do not pay their 2000 dues by December 31,
2000 are dropped from the membership roles.
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Conference on “Drinking Water and Disease: What Every Health Care Provider Should Know” |
| Annual membership meeting |
As much as I might try not to start my final letter as President of AAPHP with a cliché, it keeps popping into my mind. Time flies when you are having fun. And so it is as I look back on not one but two years as President of the American Association of Public Health Physicians, thinking both of what we have accomplished and what we have learned, and perhaps, more than anything, how much I have enjoyed it all.
The American Association of Public Health Physicians is unique among so many specialty societies and associations. Our philosophy and our agenda are not purely medical, nor purely public health. Rather, our paradigm is a hybrid of paradigms, the integration of ideas, practices and disciplines; it is the foundation, I am very sure, of what community health care will come to mean in this new century.
Consequently, as I have reviewed meeting minutes and e-mails from the past two years I find a variety of topics -- tobacco control, physician training, professional and organizational issues, among others -- that not only reflect the broad scope of prevention, but also the growth, and in some cases growing pains, of this Association. The tobacco control issue is a good example of both.
Because we as physicians are well aware of the health risks associated with tobacco, as public health advocates we must try to influence public policy that ultimately restricts the use of tobacco. But as a professional organization, we must also decide the best and most appropriate means of accomplishing those ends. In 1999 the AAPHP signed on as a petitioner in a tobacco settlement lawsuit in Pennsylvania but eventually withdrew from the suit. Although there was no financial cost associated with this activity, it did raise important questions and initiate necessary discussions about how our association should be governed, how decisions are made, and what resources can be brought to bear when advocating a particular policy. Indeed, answering these questions, sometimes repeatedly, is a necessary part of growing our organization and making it the best it can be.
But growth occurs in other ways as well, not the least of which is through the addition of new members. Recruitment of members continues to be a priority, and fortunately 1999 presented many opportunities to meet and network with potential members, as well as to raise awareness of AAPHP generally. And, as noted above, it is not just the scope of our philosophy, but also the quality of our organization that will be most useful in attracting new members.
Clearly, working on and through all of these issues takes time, and we as an association have put a great deal of both time and energy into them. Perhaps this is why it seems that the time has gone so fast, because we have all worked so hard at something we believe in very much. At the same time, it has not just been enjoyable, but to me, it has been fun. The kind of fun that results from a collective and stimulating process to find solutions, overcome barriers, and build something that is valuable and good.
As I wrote just last year, and I repeat again here, the AAPHP must continue in its advocacy of principles we know are right, and work toward the betterment of medicine, public health, and the communities we live in. Perhaps our biggest challenge lies not in building our organization, reducing tobacco use, or finding our niche in organized medicine, but in proving the value of medical public health in the communities where we live.
Our esteemed colleague Joel Nitzkin summarized this challenge so eloquently in one of his many e-mails this year, that I am compelled to share this thought and use his words as my way of passing the gavel (the italics are mine):
"We are dealing with the culture and beliefs of the potential employers, elected public officials and clinically-oriented physicians. All they tend to see is that a physician who does not see patients one-to-one in clinical environment, or has not "proven him (or her) self" in that environment is somehow not a real physician. They tend to see physicians as technicians who fix broken individual patients, not as trained professionals whose understanding of the human organism is essential at the community level, if programming at the community level is to optimize human health in a cost-effective way."
Finally I would like to commend Dr. Kim Buttery for his dedicated time and effort to provide us with a world class web page; and all of the officers and board members for their active participation this past year. THANK YOU.
It has been my pleasure and privilege to serve the American Association of Public Health Physicians for the past two years as President. I plan to continue to be actively involved. Thank you.
Our association web
page has been developed to be useful to our members. It provides new members (or old ones who have forgotten) about
organizational activities and news, as well as copies of by-laws and other
important information. Visitors to our
web pages should find the web links to public health and related organizations
particularly useful.
There is a discussion
web for members to use to post topics they believe might be interesting to
other members, the more controversial the
better. If you want the association bringing an
issue in front of the AMA,
or you want the
association to support a particular policy, why not try it
out on the discussion
web first, then see how much interest it draws from
other members.
Now that distance education is
becoming state of the art, we
will be adding
educational links to the web as we learn about them. For
example, the CDC’s
quarterly Ground Rounds, with CME credit, are now
available on the
net. Go to the useful web site button
and click on the
Public Health Grand
Rounds found in the education section.
In addition,
the CDC new focus on
emerging infectious diseases is available, with a
2-minute video introduction,
in the medical links section of the useful web
links. Please visit the site weekly and give us all
your feedback. This is
your site to develop
The AMA has provided us with 5 free copies of the EPEC Trainers Guide on CD-ROM. Each AMA member will also be getting one as they re-new their membership. The first four non AMA member to request a copy will be given one of the AAPHP allocation. (Additional CD-ROMS can be ordered for $95.00) IF you would like one let us know by email (AAPHP@AOL.com , Fax or Voice mail (630-604-3256). If you are one of the first 4 you will be asked to send a self- addressed stamped mailing pouch.
At our November 6 fall
conference in Chicago, in conjunction with the APHA meeting, we had a luncheon
speaker and four afternoon panelists, each of which addressed a current hot
topic in public health, with emphasis on the issue of evidence of efficacy of
both clinical and public health preventive interventions.
What follows are brief
summaries of each of the presentations, with names and contact numbers for
AAPHP members to contact, should they desire any additional detail.
Luncheon Presentation -- The Guide to Community Preventive Services
Speaker: Peter Briss, MD, – Development Coordinator
for the Guide and Guideline
Methodologist
The purpose of the
guide is to make evidence based recommendations available for planning and
implementation of community health interventions.
The upcoming Guide to Community Preventive Services (Guide) is being developed by the
independent Task Force on Community Preventive Services with the support of the
U.S. Department of health and Human Services.
Staff support for the Guide is
provided by the Centers for Disease Control and Prevention (CDC) in
Atlanta.
The Guide provides evidence-based
recommendations for population-based health promotion and disease prevention
interventions. The Guide complements a group of related federal policy initiatives
including Healthy People 2010 – which
provides health objectives for the nation; The
Guide to Clinical Preventive Services – which provides evidence based
recommendations for clinical prevention; and Putting Prevention into Practice which provides advice on
implementing effective interventions.
Taken together, these documents define prevention-related health policy
objectives and provide a roadmap for how these objectives can be reached.
The process of
developing the Community Guide began
in 1996, the first chapter on improving vaccine coverage in children,
adolescents, and adults was released in 1999, and the first volume is scheduled
for submission for publication in late 2000.
When considering the
efficacy of clinical interventions, the randomized controlled trial is widely
accepted as the “gold standard” study design. Although this design is useful
for some types of population-based research, it is not always feasible or
appropriate. Therefore, the Community Guide tends to strategically
combine evidence from a wide range of methodologically diverse studies and to
consider many aspects of evidence quality in addition to study design when
finding and evaluating evidence to support public health decision making. The methods used by the task force are
summarized in detail in the January supplement to the American Journal of
Preventive Medicine.
The intended audience
of the Community Guide includes
planners, funders and potential implementers of disease prevention and health
promotion interventions. The Community Guide is intended as an aide
to program planning – one which will encourage use of effective and efficient
interventions. It will also aid in the identification of gaps in knowledge that
could be closed by additional research.
For additional
information, you can check out the Guide on the web at http://web.health.gov/communityguide
, or contact Dr. Zaza (Chief, Guide Development Branch) or Dr. Briss
(Development Coordinator, Guide Development Branch) at (770) 488-8189, or by
e-mail at epogda@cdc.gov
.
Afternoon Panel
Presentation # 1 -- Evaluating the Nation's Diabetes Control Efforts
Speaker: Marc A. Safran, M.D., F.A.C.P.M., Senior Medical Officer, Division of
Diabetes Translation, Centers for
Disease Control and Prevention (CDC)
Diabetes affects nearly 16 million Americans. This presentation provided an
update on the evaluation efforts of the National Diabetes Control Program, a
program carried out by CDC and the health departments of 50 states, the
District of Columbia, and 8 other jurisdictions in the Atlantic and the Pacific
Basin. The progam focused on challenges entailed in evaluating public health
efforts aimed at chronic diseases such as diabetes, as well as some strategies
being used to overcome those challenges.
Dr. Safran encouraged public health physicians to work to
enhance evaluation efforts in the fields of diabetes control, chronic disease
prevention, and public health in general.
More information on diabetes and the National Diabetes Control Program is
available through the CDC diabetes website (http://www.cdc.gov/diabetes), the CDC's
diabetes phone line (1- 8 77 -CDC-DIAB), or via e-mail (diabetes@cdc.org.).
Additional information on evaluation of the national war on diabetes can be found in Safran MA and Vinicor F. The war against diabetes: how will we know if we are winning? Diabetes Care, 22 (3), 508-516, 1999. Individual reprints of that article can be ordered free of charge from CDC at the above phone number and e-mail address.
Speaker: Donna Grande,
MGA (Master of General Administration – a Marketing degree) is the new Deputy
Director of the Smokeless States Program for the American Medical Association.
Ms. Grande moved to Chicago from Tucson, AZ, where, for the past four years she
had been Executive Director for Full Court Press.
Full Court Press is a
comprehensive city-wide youth-tobacco-use control program implemented in
Tucson, Arizona in 1995. With a $3.2
million program grant from the Robert Wood Johnson Foundation (RWJ) and
separate $980,000 evaluation grant from RWJ, the Coalition for a Tobacco Free
Arizona and the University of Arizona implemented this five-year program to
reduce teen tobacco use, and fully document the results.
The goal was a 10%
reduction in teen tobacco use.
The five major
elements of this program were 1) Changing tobacco-related cues and messages; 2)
Enforcing and enhancing tobacco control policies; 3) Empowering teens; 4)
Developing partnerships with schools (but not school-based programs); and 5)
Promoting and developing youth cessation.
Planning and
implementation included a thorough review of the literature and development of
an extensive set of baseline data, with plans for mid-point and final outcome
surveys, and a review of strategic opportunities and options.
The program was teen
driven and teen run. Communications were tailored to groups of teens based on
race/ethnicity, education, music preferences, interests, economics and social
status. The “four horsemen of tobacco control” were defined as price,
advertising, access, and environmental tobacco smoke (ETS).
Preliminary results
suggest that benefits will be well in excess of the original goal as set.
This type of
comprehensive program focusing on youth can be and should be modeled in each
state with funding allocated to each state through the Master Settlement
Agreement. Funds specifically targeting
the tobacco industry cannot come from the MSA, however, exposing the tobacco
industry’s manipulative strategies to lure youth into a life of addiction
seemed to have a positive effect on teen attitudes and behavior.
Persons desiring
additional information about this program should contact Lynne Smith, the
current project director, at (520) 321-7989, or Hye-ryeon Lee, Principal
Investigator, at (520) 318-7100 or Lee@u.arizona.edu .
In concluding her
presentation, Ms Grande noted that AMA, in collaboration with the American
Cancer Society, The Robert Wood Johnson Foundation and a number of other
co-sponsoring agencies, is hosting The 11th World Conference on
Tobacco and Health, in Chicago, August 6-11, 2000. Persons interested in
presenting at the conference, or attending, should check out the conference web
site at http://www.WCTOH.org,
or contact Anne Jenkins, Conference Manager at AMA (312) 464-5159 or by E-mail at 11th WCTOH@ama-assn.org.
Persons wishing to
learn more about the AMA Tobacco-Free-States Initiative can contact Ms. Grande
at (312) 464-5540 or donna_grande@ama-assn.org .
Panel Presentation #
3 – Translation of HIV and STD Research Into Practice
Speaker: Ellen
Sogolow, PhD is a social psychologist and behavioral scientist. She heads up
the HIV/AIDS Preventive Research Synthesis and Technology Transfer Project at
CDC.
Translating research
into practice is a difficult and costly process – with costs running in the
range of $1million to $1.5million per intervention package.
The translation
process includes the gathering and review of pertinent research studies,
identification of the potential interventions and developing the guidelines by
which these findings can be translated into intervention programming.
Dr. Sogolow’s work
focuses on behavioral and social policy interventions.
For those wishing
additional information, Dr. Soglow can be reached at her CDC office at (404)
639-1937, or by E-mail at eds0@cdc.gov .
Speaker: Arvind Goyal,
MD, MPH, is a family practitioner with a preventive medicine consultation
practice in Rolling Meadows, Ill ( a small town not far from Chicago). For the
past four years, Dr. Goyal has represented AAPHP to the AMA CPT Advisory
Committee.
CPT stands for
“Current Procedural Terminology.” It is a classification and nomenclature
system for accurately identifying procedures and services performed by
physicians and other health care professionals for purposes of Medicare and other health insurance
reimbursement. CPT includes nearly
8,000 five-digit codes, each assigned to both a short and a long description of
a medical service or procedure. While not the only medical coding system, CPT
is the most commonly used, and the official system for Medicare and other
HCFA-sponsored programs.
CPT has been developed
and continues to be maintained by the American Medical Association (AMA). The
90-member CPT Advisory Committee meets once or twice a year to consider
suggested changes in the coding scheme – new procedures, different levels of
complexity, etc – and makes recommendations to the 16-member CPT Editorial
Panel that makes final decisions. The
process is such that it generally takes eighteen to twenty-four months for a
proposed change to be processed, then another year before it appears in print
in the official CPT Code Book.
The problem, from a
clinical preventive medicine perspective, is that preventive interventions,
especially counseling, are medically “simple,” but time intensive – thus, even
where recognized in the current code book, they are poorly reimbursed, if
reimbursed at all. Also, physicians
must be aware of what can be billed, and how this is most effectively
done. If preventive counseling is not
reimbursed, it will not be done on a widespread basis in healthcare delivery
settings.
On behalf of AAPHP,
Dr. Goyal has been urging replacement of the word “complexity” with the term
“time-intensive” for the evaluation and management (“E&M”) codes describing
preventive counseling, and developing a more extensive array or wider
definition of current codes, to create a situation in which counseling
procedures included in the Guide to Clinical Preventive Services can be
consistently and adequately reimbursed.
Members with
additional suggestions, or desiring additional information about CPT coding can
contact Dr. Goyal at (847) 255 0095, Dr. Elizabeth Safran at (770) 394-9008;
E-mail: esafran@bellsouth.net, or Dr. Joel L. Nitzkin at (504) 899-7893;
E-mail: jln@jln-md.com .
Proposed Bylaw Changes
A number of bylaws changes are proposed. These will be voted on at our March meeting. The current bylaws can be found on our web site - http://www.aaphp.org.
Proposed change 1- Article III Section C 1. Original - The Annual General Membership Meeting shall take place in conjunction with the annual "Prevention meeting".
Proposed Revision The Annual General membership meeting shall take place in conjunction with a public health meeting selected by the Board.
Reason - ACPM has notified members that it is pulling out of Prevention 2001. Therefore the status of the meeting is unknown at this time. This change will provide needed flexiblity to the Board.
Proposed change 2
Article VII Section E l.The Secretary, with the assistance of the Executive Manager, shall maintain all other Records of the Association.
Proposed Revision
The Secretary, with the assistance of the Executive Manager, shall maintain all other non-financial Records of the Association.
Proposed addition Article VII Section F Number 5
5.The Treasurer, with the assistance of the Executive Manager, shall maintain all financial Records of the Association.
Reason. The scretary does not maintain the financial records at this time. This change is needed to reconcile currrent practice.
Proposed Change3 Article II Section A- Current Mission:
1)Advocacy for public health issues and services
2)Advocacy intended to create an
environment in which physicians contemplating a career in public health can anticipate job opportunities rich with quality offerings, stability of employment and portability of retirement benefits.
3)Fostering communication, education and scholarship in public health.
Proposed Mission:
1)Promote the Public's Health
2)Represent Public Health Physicians
3)Educate the Nation on the Role and Importance of the Public Health Physicians Knowledge and Skills in practicing population medicine.
4)Foster Communication, Education and Scholarship in Public Health
Reason: At the Board retreat it was decided that a revised mission would be desirable.
Proposed change 4 Addition - Section VII A. 7
The President, with the approval of the Executive Committee, shall have the
power to reassign any or all duties and responsibilities of any officer,
committee chairperson or the Executive Manager, to any other individual, at
any time, and for any period of time deemed appropriate by the President.
Any and all such reassignments shall be considered interim, for the tenure
in office of that President.
Reason: Needed to spread the workload out between officers better.
Minutes Annual Meeting November
6, 1999
Attendance: Nina
Sisley MD MPH, Vrginia Dato MD MPH,Alfio Rausa MD
Richard Biek
MD MPH,Douglas Mack MD MPH,Joel Nitzkin MD DPA,John Poundstone MD MPH,David
Cundiff MD MPH,Arvind Goyal MD,Karen Scott MD MPH,Elizabeth Safran MD MPH,John
Muth MD,Franklyn Judson MD,Sherman Kahn MD,
Robert Travnicek MD, Stanley Reedy MD
Marc Safran MD, David Lieberman MD MPH, Jacqueline Christman MD MS, Hugh Fulmer MD,Gary Johnson MD MPH, Helga Rippen MD
The meeting was called to order at 9:12 AM by Dr. Mack.
The mintues of the previous meeting were approved as written. (Attachment A) Secretary's Report- Dr. Dato briefly provided the secretary's report which was published in the Oct. 99 Bulletin sent to the entire membership. (Attachment B)
Treasurer's Report-Dr. Poundstone gave the treasurer's report. Dr. Poundstone provided a cash flow report for 1/1/99 through 11/4/99 (Attachment C) which showed inflows of $7123.62 and outflows of 7483.40. Inflow was mostly from dues and outflow included expenses related to meeting expenses, our web page, publication expenses, our mailing address, and exhibits. Exhibits were used to increase membership. Dr. Mack will be hosting a booth at the correctional meeting that he is going to directly after this meeting. Dr. Poundstone was asked whether the web page was a continuing expense. He responded that it is and members were encouraged to visit the web site http://www.aaphp.org. Dr. Buttery is very open to suggestions. A question was asked about the $9000 owed to the AMA from when they administered our organization. The final result is that we will not be paying them any money, instead they are crediting the $42.00 per member which they had agreed to give us toward that sum. It was noted that the AMA has a special fee for retired physicians and that we should alert our members to that. Doug Mack was optimistic about our relationship with the AMA and in the future actually receiving the $42.00 per AMA members after our debt has been fully paid off. Dr. Poundstone mentioned that we are currently in a business market account but that he was exploring other options including CD's.
Report on Board Retreat-Dr. Mack reported on a board retreat held the previous evening. As a result of the retreat, the board plans to modify our mission slightly. The draft is as follows:
· Promote the Public's Health
· Represent Public Health Physicians
· Educate the Nation on the Role and Importance of the Public Health Physicians Knowledge and Skills in practicing population medicine.
· Foster Communication, Education and Scholarship in Public Health.
Any changes will be need to be approved by the general membership at our March Prevention 2000 meeting through changes in our bylaws. Volunteers are welcome to assist in the process. The current bylaws are on our web site. We also explored the decision making function of AAPHP at the retreat. There were concerns about making full use of the opportunities of electronic communication so that we can act on some very tight deadlines. We want to be highly participatory. We also decided to improve the logo and brochure and may contract some work out to the Pennsylvania Medical Society. Job market issues were also discussed at the retreat.
Next all members introduced themselves.
AMA Delegation Report - Due to unavoidable circumstances, Drs. Bradshaw and Weisbuch were unable to attend at the last minute. They did fax an extensive report (Attachment D) which included highlights of the June 1999 AMA meeting including reference committee highlights. In addition the delegation report was attached. AAPHP submitted resolution 428 which reaffirmed AMA support for tobacco control, asked for further lobby activities and for work with state and local specialty societies with a report at I-99. This was adopted as an extension of existing policy. In addition, we supported another resolution #414 which was also adopted, related to dealerting nuclear weapons. Drs. Weisbuch and Bradshaw also presented to the Interim council on Privacy and Confidentiality on September 26, 1999 in Chicago, Illinois. They spoke that privacy and confidentiality are fundamental to all specialties of medicine, especially in public health, that appropriate and timely reporting of health problems serves the patient, the provider and the community, that reporting public health information does not violate privacy and confidentiality for individual patients and that reporting public health problems is law. Dr Bradshaw is also involved in the Women Physicians Congress. AAPHP plans to nominate her for a leadership position.
The Young Physicians Report given by Dr. Liz Safran.
The young physicians group meet separately outside the room and reported that Jackie Christman is the new YPS Delegate to the AMA, and that we need to recruit an alternate delegate. Jackie will also represent ACPM (note: we were later informed by the AMA that one physician could not represent both groups).
CCRC (Committee for Community Responsive Care) given by Dr. Poundstone and Dr. Fulmer
CCRC received the endorsement of AAPHP in prior years. AAPHP is now on the board of CCRC. There has been a reorganization following the model of NCCHC. The initial meeting took place in Washington. John Poundstone was elected chair of the board. There are several national organizations including Clinicians for the Underserved, the National Association of Public Hspitals, and the national organizationsof AHEC. They are working on adding others. Financing is the main issue at this time. There will be an accreditation visit in February at which stable financing is needed. The new APEX instrument will be demonstrated in the Chelsea Health Department. Dr. Fulmer commented that training brings together the goals of the medicine-public health initiative. His program outlined six goals including the fact that the community is engaged right from the outset. The key thing for the program at this time is finding funding for January through June and major funding for next July.
The Job Market Initiative.
The report on the Job Market Initiative was given by Joel Nitzkin which was also published in the October 1999 bulletin. Dr. Nitzkin verbally reported on two sets of surveys which were in conjunction with Dr. Blumenfeld. Dr. Blumenfeld reviewed several years worth of journal advertisements. Only fraction of the advertisements which potentially required the expertise of a preventive medicine/public health physicians, stated that as a requirement. The second survey was a survey of registrants at Prevention 2000. The registrants did not perceive a problem with the job market. We have an open invitation to publish the results. In addition AAPHP submitted one grant application which did not get funded because it did not fall neatly into a niche. As we approach Prevention2000, we could have done some work if we had the administrative support. We have another opportunity for a follow up survey. However, we need something fairly substantive.
Tobacco Report -
Dr. Nitzkin provided the report on Tobacco control activities. AAPHP has had an influence well beyond our size. We have not supported denying peoples ability to sue the industry for tobacco damages. The tobacco industry has tremendous influence over very much that is done by government. In addition, it is now communicating to teens the wrong message. By depicting tobacco as forbidden fruit they may be encouraging smoking. Dr. Nitzkin also reported that the tobacco settlement has yet to reach finality. (note state specific finality was reached approximately one week later.) AAPHP has been involved in the State of PA. One of the most immediate concerns is that the tobacco companies have been getting the rules from the settlement put into state law. The gray market in tobacco is growing in an interesting way. These are cigarettes manufactured for international sale but which are sold instead here. Dr. Poundstone reported on some work that they are doing in his state so that a substantial proportion of money will go into tobacco control. At this time the meeting broke for lunch and the educational portion of the meeting.
After the break
AMA Resolutions
Helga Rippen asked for AAPHP support for a resolution that was going to be submitted by the young physician delegate of ACPM. That resolution supports a set of criteria needed to evaluate internet health information. The criteria were adopted by the Health Summit Working Group. (This criteria can be found at the following URL: http://hitiweb.mitretek.org/hswg. A motion was made to endorse the guidelines of the working group at the AMA December meeting. The motion was seconded and passed with two abstentions and all others in favor.
CPT
Dr. Goyal had made an excellent presentation to the group on work he did as part of the AMA advisory group. As part of that presentation, he suggested that we eliminated the word complexity from the CPT and add time and intensity. This would allow compensation for very time intensive activities to be covered. After some discussion it was determined that an action plan should be developed in this area. Dr. Liz Safran volunteered to chair this committee since it is a part of her current work. The group will 1. Ascertain what MD's can now do to bill for clinical preventive services, 2. What HCFA does and does not fund regarding clinical preventive services. 3. Consider CPT coding of community preventive services. 4. Develop an AAPHP action plan on all of the above and 5. Develop a grant application and ratify a source of funds for the action plan. Volunteers include Joel Nitzkin, Helga Rippen, Arvind Goyal, and David Cundiff.
Follow up of morning discussions.
1. It was decided that the mission changes would go directly to the bylaws committee.
Job Market Issues.
Are there certain functions that can best be done by a physician with public health training. We discussed possible goals for Prevention 2000. Suggestions included a presentation, white paper and a survey. The issue of the training of public health physicians was also raised. Hopkins did a survey and found that the training in residencies was spotty. The following action steps were discussed.
1. Develop a Prevention 2000 panel job market issues. Joel Nitzkin, Stan Reedy and Liz Safran volunteered for this activity.
2. Identify the roles and competencies of public health physicians. Ginny volunteered for this assignment.
3. AAPHP as a focal point for a white paper. (a previous effort was not successful). Al Rausa volunteered to attempt to identify sources for funding.
The meeting was adjourned at approximately 5 PM.
As always, Dr. Marc Safran deferred from discussion or voting on any issues that might have appeared to have been inappropriate for him to have discussed or voted on as a federal employee.
Physicians for Social Responsibility to Host Conference on
“Drinking Water and Disease: What Every Health Care Provider Should Know”
FRIDAY, MARCH 10, 2000
Physicians for Social Responsibility is hosting an intensive one-day educational conference entitled “Drinking Water and Disease: What Every Health Care Provider Should Know”. The conference, which is jointly sponsored by CDC and ATSDR, will be held in the Washington DC area on Friday, March 10, 2000. Continuing education credit is being requested through CDC.
This conference, intended primarily for physicians, nurses, and public health professionals, has the following objectives:
· Educating health professionals on important new Federal drinking water programs (including the new Consumer Confidence Reports) and their significance for health care providers and consumers;
· Increasing understanding among health professionals about the most common contaminants in drinking water, how they enter the water supply, and their health consequences;
· Improving physician skills in recognition and diagnosis of waterborne illness;
· Increasing understanding of the impacts of drinking water contamination on susceptible populations, and when to recommend alternative drinking water sources; and
· Providing essential tools for effective communication with patients and communities about drinking water and health.
Additional information and on-line registration are
available on PSR’s web site, http://www.psr.org, or you can call PSR at
202-898-0150. Early registration deadline is February 14, 2000.
PRESIDENT
Douglas A. Mack, MD, MPH
Grand Rapids, MI
(616) 336-3020
(616) 336-3884 Fax
E-mail: maupmack@iserv.net
VICE PRESIDENT
Mary Ellen Bradshaw, MD
Phoenix, AZ
(602) 528-3850
(602) 528-3840 Fax
E-mail: mebmd@aol.com
PRESIDENT ELECT
Dave Cundiff, MD, MPH
Olympia, WA
(360) 725-1500
(360) 664-4371 Fax
E-mail: cundidr@dshs.wa.gov
SECRETARY
Virginia M. Dato, MD, MPH
(412) 422-9351
(630) 604-3256 Fax
E-mail: vdato@aol.com
TREASURER
John Poundstone, MD, MPH
(606) 288-2486
(606) 288-2359 Fax