President’s Report to the House of Delegates

James S. Gessner, M.D., President
Massachusetts Medical Society
2017 Annual Meeting

Thank you, Mr. Speaker, and Good Morning to my colleagues, my fellow delegates, and invited guests.

It is a pleasure for me to speak to you today and provide a snapshot of our Medical Society’s activities and accomplishments over the last year. 

I am proud to say that they have been many and significant.

I hasten to point out that whatever our society has achieved during the past year is not the work of a single individual, nor can it be attributed to a single presidential year. 

The issues and challenges facing our Medical Society transcend a given presidential term.

And any success we may achieve is due to the groundwork laid by previous officer teams and the many dedicated members serving on numerous committees who volunteer to take on significant issues facing physicians and our patients.

Because of the dedication of our membership, our Medical Society is able to enhance its strength, its influence, and its reputation within the Commonwealth, with elected officials, legislators, regulators, the media, and the patient population on critical issues in medicine and health care.    

And that has certainly been the case in the last few years.  On many occasions during the last year, colleagues have told me how our medical society has become a compelling voice for health care in the Commonwealth.

As a result, we continue to fulfill our mission and our strategic direction to “advocate for the shared interests of patients and our profession.”

The key word here is ADVOCATE.  If there is one word that you take away from my remarks today, I hope it is “advocacy.”   

It is what our members tell us is the most important purpose of our society.  It is a theme I have tried to promote and elevate throughout my year as president, and it is an action that allows us to be a persuasive force in health care in Massachusetts and beyond. 

The Opioid Crisis

Nowhere, perhaps, has our advocacy been more active and resourceful than in combatting the opioid crisis affecting our state.   The effort began in earnest under Dr. Rick Peter’s tenure and increased under my immediate predecessor Dr. Dennis Dimitri.

Both are to be congratulated for their leadership on this effort.

It is not an exaggeration to say that over these last years the Massachusetts Medical Society has become THE leading health care organization in the state addressing the opioid crisis.   

We reached out to patients with public information campaigns, urging them to talk with their physicians and engage in safe storage and disposal of medications. 

Our greatest contribution, perhaps, lies in educating our fellow physicians and others in the medical community – an effort that continues to have impact today.

Under the Task Force on Opioid Therapy and Physician Communication, a group I was privileged to chair, our medical society was one of the first medical organizations in the nation to create prescribing guidelines – and share them with ALL prescribers.   

We established continuing medical education courses and offered them free, to ALL prescribers.   As of April 20, more than 9,900 individuals have taken more than 28,000 courses on opioids and pain management.    

Additionally, we were part of the Massachusetts Medical Education Working Group, a first-in-the-nation public/private partnership.

The collaboration between our society, the Commonwealth’s four medical schools, and the Massachusetts Department of Public Health resulted in the development of core competencies for the prevention and management of prescription drug misuse to be taught as part of the medical school curriculum. 

Also during the last year, we worked with the Department of Public Health in refining and promoting the use of the state’s prescription monitoring program. 

It is now much easier to use, connects with the systems in neighboring states, and has become a key tool in the battle against substance use disorder.

To reduce the diversion of drugs, we proposed legislation offering “partial-fill” prescriptions – a prime example of grassroots advocacy coming from one of our district medical society members. 

With the assistance of Senator Elizabeth Warren and Congresswoman Katherine Clark of our Congressional delegation, the “Reducing Unused Medications Act” became part of the Comprehensive Addiction and Recovery Act of 2016, signed into law by President Obama.  

We also collaborated with the Massachusetts Health and Hospital Association in developing tools for both prescribers and patients and met with former U.S. Surgeon General Vivek Murthy as he visited Massachusetts in his “Turn the Tide R - X” campaign.

While still engaged in prevention and education, we turned our focus to medication assisted treatment, drawing stakeholders together in a summit to encourage more attention to the critical need for treatment.  

It is an area that merits continued attention from our Medical Society.

Our actions and commitment to addressing the opioid crisis has had a startling and wonderful result: 

While just a few years ago, elected officials and the media were labeling physicians as being a major CAUSE of the opioid abuse problem, the perception has shifted:  We are now regarded as part of the SOLUTION.  

Our activity directed at the opioid crisis is perhaps the strongest and most visible illustration of our advocacy in public health.  

But there are others examples as well. 

Recreational Marijuana

The ballot question on recreational marijuana was a major area of interest and activity for our society last year.  

We joined the Campaign for a Safe and Healthy Massachusetts, a bipartisan effort of healthcare, business, education, public safety, and elected officials opposed to the legalization of recreational marijuana.

Our opposition was based on the public health and safety implications of the law, and while voters approved the ballot question, the alarms we rang about the impact of recreational marijuana resonated with public health officials and lawmakers. 

Our concerns and caveats about the use of recreational marijuana, particularly its potential effects on adolescents and young people, were clearly heard, and they are now evident in the deliberations of the legislature to amend the law to provide for public health protections, including education and treatment programs.

Gun Violence

Similarly, we raised awareness about another major public health issue - gun violence.

Gun violence is recognized as a public health crisis by the American Medical Association, the American Bar Association, and more than two dozen other medical societies and health organizations across the nation.

Our advocacy on this topic is in keeping with our society’s long-standing history – MORE THAN TWO DECADES LONG  -- of violence prevention policies and initiatives in many areas, including youth violence, bullying, domestic violence, and human trafficking.  

From our Public Health Forum on Firearm Violence last year, we created continuing medical education courses for physicians and other health care providers, to engage patients in discussions about gun safety.

We also supported Attorney General Maura Healey’s ban on “copycat” assault weapons and later collaborated with her office and law enforcement officials in developing materials for physicians and patients about gun safety. 

We were criticized in some quarters for doing so, and told by others to “stick to medicine” and stay out of the gun violence arena.  But we did not, and could not. 

Whether the issue is controversial or not, we recognize our leadership role in the arena of public health, as expressed in our mission statement: to act “for the health, benefit and welfare of the citizens of the Commonwealth."

Other major subjects came to the forefront during the last year as well, capturing our attention.  

End-of-Life Care

One of the issues becoming increasingly important is end-of-life care. 

A continuing medical education course on the subject is now required for licensure, and our patients and their families are seeking more information about hospice and palliative care and their options as end-of-life approaches. 

To state our commitment that health care for everyone in the Commonwealth reflects their values and preferences at all stages of life, our medical society became a member of the Coalition of Serious Illness Care, joining more than 75 Massachusetts-based public and private organizations in supporting and advocating for end-of-life discussions.      

It is becoming increasingly difficult, however, to separate those discussions from the topic of medical aid-in-dying.   We remember that in 2012, Medical Society efforts helped to narrowly defeat a ballot question on physician-assisted suicide.

Prompted by stories told by patients themselves, however, the movement for medical aid-in-dying has emerged once again, and is gaining acceptance among the public and some in medicine.

At this moment, a bill sits before the Massachusetts legislature containing many of the provisions expressed in the 2012 ballot question.

And physicians, once again, are squarely at the center of the debate on this topic.   Make no mistake:  our survey of membership on their attitudes toward medical aid-in-dying, now underway and to be completed in early fall, will go a long way to shaping the debate and influencing the outcome.

Our society also engaged in many other advocacy efforts.

Affordable Care Act, Determination of Need, MACRA, Health IT

We took a firm stand on maintaining the critical elements of the Affordable Care Act, which continues to come under attack by a new administration and congress, and joined the Coalition for Coverage and Care to state our case.

We also advocated to enhance regulations governing such areas as determination of need, new payment models like MACRA, and the requirements of health information technology.

And we began to focus on the ever-important topic of physician wellness, raising awareness and helping our members with webinars and a dedicated website.

Last, but certainly not least, I must take a moment to talk about leadership.  Transitions in leadership can often create unrest, confusion, and inertia.  But as you can see from the accomplishments of the last year, that was not the case at our medical society.

The arrival of our new executive vice president Lois Cornell on June 1 was the beginning of a smooth, seamless transition of MMS staff leadership. 

As she approaches her first anniversary with the medical society, I want to thank her for her leadership, support, and guidance over this past year. 

Finally, I want to thank you, the members of the House of Delegates, and the members of the many committees whose dedication and hard work made the achievements of the last year possible.

Mr. Speaker… that concludes my report.

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