Massachusetts Medical Society: Annual Letter from MMS President Henry Dorkin, MD, FAAP, to Society Members

Annual Letter from MMS President Henry Dorkin, MD, FAAP, to Society Members

Members of the Massachusetts Medical Society

Although Winston Churchill said that it is “always wise to look ahead,” I find that sometimes, a look back can often be a worthwhile endeavor. With the release of the Medical Society’s 2017 Annual Report – which I hope that you will peruse – I’m struck by what our esteemed organization has accomplished in the past year.

As physicians, we see what happens to our patients when they are unable to receive the care they need, at the time they need it. Throughout the last year, the medical community has fought hard to protect access to affordable health coverage and to meaningful care. The MMS joined in the fight to oppose ACA replacement legislation that would have made it harder for our patients, especially the most vulnerable, to get reliable health coverage and optimal therapy.

Your Medical Society made clear to state legislators that when it comes to health care costs, physicians are not the problem – we are part of the solution. We explained that cost-cutting measures that impose restrictive formularies or interfere with trusted patient/physician relationships are not in our patients’ best interests. We supported a new state law to not just protect, but to actually expand the ability of women to receive effective contraceptive services at no cost.  Our Society has taken every opportunity, with both legislators and third-party payers, to make the point that the more time the patient and the doctor have to discuss the symptoms and review proposed/response-to therapy, the less likely we are to order additional tests which can contribute to rising health care costs. Any increasing documentation and regulatory requirements which reduce time of the actual doctor-patient interaction have the potential to increase, not decrease, the cost of care, and diminish patient satisfaction.

Every physician matters. Each patient counts. That slogan became a rallying cry in our advocacy last year, and for our work in support of public health.

As the state’s preeminent physician organization, the Medical Society was a close and valued collaborator for the state’s Department of Public Health and its commissioner and MMS member, Dr. Monica Bharel. We hosted productive conversations about how understanding social determinants can be used to improve well-being and about how technology and information can tailor our approaches toward public health. We released educational materials to help physicians and patients have constructive discussions about firearm safety.

We follow closely the activities of the Board of Registration in Medicine, and bring to the attention of Society members issues which we feel will impact their practice. For example, recently the BORIM reduced the CME requirements to be documented upon license renewal. We appreciate any effort toward regulation simplification. At the same time, we are also confident that the physicians in our Society know that the burden of keeping current in the medical literature, so necessary to treat our patients in the most effective and current manner, is up to us. We all appreciate that it takes more than the minimum legal requirement for license renewal to provide the care we would want for ourselves and our families, as well as our patients. The addition of NEJM Journal Watch Online, to the NEJM subscription already enjoyed by Society members, is another attempt to aid in this continual education process.

Of course, our work to stem the tide of the opioid crisis moves forward unabated. Our Medical Society continues to support increased access to life-saving naloxone as well as access to the full range of treatment and recovery services, including medication-assisted treatment. We want physicians to have reliable information about pain management and opioid prescribing guidelines, and since we made our online CME on these topics available free of charge, more than 13,000 medical caregivers have completed more than 37,000 courses. This program is making a difference.

Still, our Medical Society did not stop there. In April, at the Annual Meeting, our House of Delegates voted to adopt a policy in support of a state-run pilot program to evaluate the feasibility of supervised injection facilities (SIFs) here in the Commonwealth. A research review conducted by our Opioids Task Force showed convincingly that the evidence supports use of SIFs to reduce overdose deaths and to facilitate patient entry into treatment and recovery programs.

I have publicly admitted to being a skeptic myself when I first heard of SIFs, but the data spoke for themselves. After all, we cannot help patients with substance use disorder if they are not alive, and SIFs in other countries have saved many lives.

Since the House of Delegates undertook this groundbreaking vote – making the MMS the first medical society in the country to promulgate a pilot project utilizing SIFs – support has grown across the Commonwealth and, indeed, across the country to consider this additional method of reducing opioid overdose mortality. In June, the AMA followed suit and endorsed the piloting of SIFs in the U.S., citing our Medical Society’s work as an impetus for this change.

When it comes to SIFs, without question, the Massachusetts Medical Society has helped lead the charge, and I couldn’t be prouder of the patient-focused approach that we have taken.

As we move into 2018, we will continue much of this work, focusing on the impact of health policies on the patients for whom we provide care. But we also won’t lose sight of the fact that without physicians, we can’t meet the needs of patients.

Because of that, we will continue our work to support physicians in all forms of endeavor, whether they are group-employed or in private practice, urban or rural, primary care or sub-specialty in nature, service oriented or academic/research inclined. Whatever a member of our Society chooses to do in medicine, we are there to support it. We are creating tools for young physicians to navigate the complex financial issues associated with beginning a career. We recognize not just that physician demoralization (aka burnout) is a problem, but also that the environment in which we labor impacts each of us in many different ways. We need a wide range of tools to help.

We will work with the Massachusetts Health and Hospital Association on our new Joint Task Force on Physician Burnout, with our cohort led by your President-Elect Dr. Alain Chaoui and Vice President Dr. Maryanne Bombaugh. We will continue our work with our partners in the Mass Collaborative to reduce administrative burdens in medical practice, targeting problems with both prior authorization and credentialing, to name but two specifics.

I also promise that we will continue to listen to you. Our governance process allows all of our members a voice; after all, our work on SIFs was inspired by a resolution introduced by a member of our medical student section. The House of Delegates considers both live and online testimony from all members, not just Delegates. We ask members to share their experiences through our social media platforms, and we share your stories in the pages of Vital Signs.

Ours is a strong medical community in the Commonwealth, and our MMS network reflects that. I thank you for your support throughout the eventful 2017 and look forward to an equally successful new year in 2018.

Of course, I haven’t been able to include all of our activities and accomplishments in this note. To see more, please take time to look over our new annual report, available here, and click through to enjoy the linked multimedia content. We have an exciting story to tell, and I’m pleased to share it with you all.

Henry L. Dorkin, MD, FAAP

President, Massachusetts Medical Society

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