MMS Adopts Positions on Retail-Based Health Clinics, Primary Care, and Adverse Medical Events

Contact:
Richard P. Gulla
781-434-7101 
Pager: 877-820-9023
rgulla@mms.org

Waltham, Mass. – November 15, 2008 – The topics of retail-based health clinics, primary care, and adverse medical events led a list of resolutions adopted by physicians of the Massachusetts Medical Society (MMS) at its Interim Meeting on November 14-15 held in Waltham.  The Interim Meeting brings together hundreds of Massachusetts physicians from across the state to examine and consider specific resolutions on public health policy, health care delivery, and organizational administration by the Society’s House of Delegates, its policy-making body.

Retail-based health clinics: Reaffirming continuity of care as a “core value in primary care medicine” and acknowledging that store-based limited service clinics (SBLSC) may challenge the physician-patient relationship, delegates approved a lengthy resolution recognizing that a core mission of the MMS is to help physicians maintain the highest professional standards “in the face of emerging changes in the system of health care delivery, including potentially disruptive system changes such as the emergence of SBLSCs.”

Among the elements of the strongly-worded resolution were that (1) insurance plans that provide incentives to patients to receive care at such clinics rather than at a primary care practice (PCP) “may interfere with the patient/PCP relationship and continuity and quality of care,” and that (2) costs for services provided by the primary care physician in reviewing records resulting from care given at an SBLSC, or in further managing the patient’s condition by phone, e-mail, or office visit, “should be properly compensated by the patient, the insurer, or the SBLSC” and that no part of the cost should be borne by the primary care physician.

The resolution also stated that the Society should continue to monitor the work of the Department of Public Health (DPH) in overseeing and licensing limited service clinics for the foreseeable future, make recommendations to the DPH as concerns are identified, and urge the DPH to implement the advisory committee approved by the DPH’s Public Health Council in January of 2008 with MMS representation. 

Improvement of Recruitment and Retention of Primary Care Physicians/Stopping Early Retirement: With a critical shortage of primary care physicians in the state, MMS delegates voted to explore and consider establishing public/private partnerships for “student debt forgiveness” when doctors choose to practice primary care in the Commonwealth and to explore ways to help recruit and retain primary care physicians to the state. In a related resolution to address the shortage of physicians of all specialties, delegates tasked MMS to work with the state to create incentives to encourage more physicians to continue practicing in the state and to work with all health care stakeholders to encourage active development of re-entry options for physicians who have taken time out from practice.

Serious Preventable Adverse Medical Events and Patient Safety:  Stating a position to ensure that patient safety initiatives are implemented to eliminate serious preventable adverse medical events, delegates approved a multiple-part resolution urging Massachusetts physicians to “work diligently with all involved entities to investigate, report if required, and subsequently eliminate the occurrence of serious preventable adverse medical events.” The resolution also stated that the process for identifying such serious events as to which physicians will not be reimbursed should incorporate a case-by-case review and determination, and that the event should be evaluated by a root cause analysis through peer review process and that an independent third-party review should be available to physicians.

Ban on the Sale of Tobacco Products in Facilities that Provide Health Care:  Delegates approved a resolution stating that the MMS will “support government action to prevent the sale of tobacco in any health care facility icensed by the Commonwealth” or any site where a health care provider licensed under any section of Chapter 112 of the Massachusetts General Laws practices his or her profession.” The resolution also stated MMS support of government action to prohibit any individual or corporate entity from providing shared or leased space to a licensed health care facility in any site where tobacco products are sold or distributed.

Optimizing Care for Lesbian, Gay, Bisexual, and Transgender Patients: MMS physicians adopted the American Medical Association’s policy on the health care needs of the homosexual population and expanded the resolution to state that the MMS “believes that the physician’s nonjudgmental recognition of sexual orientation behavior and gender identity enhances the ability to render optimal patient care in health as well as in illness.” The MMS said it is committed to educating physicians on the current state of research in and knowledge of lesbian, gay, bisexual, and transgender (LGBT) patients; encouraging educational programs for LGBT patients to advise them about the disease for which they are at risk; and working with the LGBT community to offer physicians the opportunity to better understand the medical needs of homosexual, bisexual, and transgender patients.

Acceptance of Credentialing Screen Done by Joint Commission-Approved Entities: Physicians passed a resolution to have MMS work with the Massachusetts Hospital Association to develop ways to simplify the hospital credentialing process for physicians and to centralize hospital credentialing.

Among a number of other resolutions considered at the meeting were resolutions relating to hospital credentialing of physicians, e-prescribing, interoperability of medical devices, exchange of electronic health information, and various administrative items.

About the Massachusetts Medical Society The Massachusetts Medical Society, with more than 20,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 12 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information, visit www.massmed.org, www.nejm.org, or www.jwatch.org.

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