As many of you may know in March, the Department of Health and Senior Services (DHHS) and Department of Mental Health (DMH) announced a new program, the Opioid Prescribing Intervention (OPI). The plan was to send letters to physicians if a prescription they wrote was flagged due to violating 1 of 12 quality indicators for prescribing opioids and benzodiazepines. In actuality, the program was not new. The state had previously been sending letters due to concerning prescriptions, but you were free to either never read them or just throw them away. What was new was that they required a response within 20 days of receiving the letter or they could refer you to the Board of Healing Arts (BHA) or the Bureau of Narcotics and Dangerous Drugs (BNDD).
Following the August primary, we know there will be 50+ new state representatives due to term limits and resignations. This upcoming, larger than normal, turnover in the legislature was overshadowed by the big blockbuster saga of the year – a new Governor in the absence of a gubernatorial election year. Eric Greitens resigned and Mike Parson was sworn in.
Christopher Sampson, MD, FACEP, and MOCEP’s Vice President, is the recipient of the 2018 ACEP National Faculty Teaching Award. Dr. Sampson is with the University of Missouri – Columbia School of Medicine and is an Associate Clinical Professor of Emergency Medicine, and Program Director for the Emergency Medicine Residency program.
Re-printed by permission of the Missouri Physicians Health Program, article published in the July, 2018 Physician Lifeline newsletter.
By Luther Philaya, MD
I am a physician in recovery and just celebrated my fifth-year anniversary on October 11, 2017.
The summer is coming to a close just as the political activity is starting back up again. Although, the political activity in Jefferson City really hasn’t slowed down much since the 2018 Legislative Session ended. We are gearing up to bring in a large number of new legislators with the upcoming elections, and we will need your help to educate them on emergency medicine. As Jorgen stated in the legislative update, before the session begins is the best time to introduce yourself and begin that relationship with the lawmakers. Also, don’t forget to get out and vote in November!
Emergency physicians regularly apply for hospital credentials to perform emergency procedures including emergency ultrasound. Theoretically, ultrasound training, credentialing and billing should be no different than other emergency procedures where training occurs in residency and an attestation letter from the residency is sufficient for local credentialing. When such training occurs outside of residency, “proctored pathways” often serve to assure competency. There is still a lack of understanding and awareness in the general medical community that emergency physicians routinely train in and perform point-of-care ultrasound.
Sam Shahid, MBBS, MPH
Practice Management Manager, ACEP
ACEP would like to provide you with very brief synopses of the latest articles in Annals of Emergency Medicine. Some of these have not appeared in print. These synopses are not meant to be thorough analyses of the articles, simply brief introductions. Before incorporating into your practice, you should read the entire articles and interpret them for your specific patient population.
It is with great pleasure and excitement that I have the privilege of writing to you all as the new President of the Missouri College of Emergency Physicians. It doesn’t seem like it was that long ago when I was a resident and was dragged to my first MOCEP meeting by a few of my attendings. While I didn’t fully appreciate it then, I can’t say how grateful I am to them for their continued mentorship, without which I wouldn’t be writing this today.
I’d also formally like to thank Dr. Jonathan Heidt, the outgoing MOCEP President, and the rest of the Board of Directors for their legislative efforts the past two years. There have been plenty of fights ranging from TCD CME requirements, to Medicaid, and most recently, Anthem. For those that weren’t aware, SB 982 passed both the House and Senate at the close of the legislative session and was signed by the Governor. The bill helps prevent an insurance company from denying a patient’s claim based on final diagnosis and requires out of network payments to be made directly to the physician without going through the patient. It also allows the Emergency Physician to determine what care is needed to screen and stabilize a patient. While we will have to fix a few unrelated amendments that were added at the last moment, the bill is a great accomplishment. For his efforts in what seems like daily meetings with legislators, Anthem executives, or the media, Dr. Heidt was just awarded the ACEP 911 Network Member of the Year Award.
However, what I really hope everyone takes away from this success is the power of what we can accomplish together. Anthem is a multibillion dollar corporation; we are an organization of approximately 600 physicians spread throughout the state. I’m sure they figured they’d get a little push back, maybe even a little negative press, on their way to implementing their new policy. I can’t imagine they ever dreamed of the headaches that we’d create for them through a barrage of media ads and interviews, notifying the state attorney general, effectively lobbying our United States Senators, and helping to create and guide legislation that was passed in less than a year. My whole point is that this would not have been possible without everyone’s support and effort.
I realize that not everyone has the time or desire to be on the Board of Directors or lead a committee. But what I am asking is for everyone to be as active as they can. This is the only way that we can continue to advocate for ourselves and our patients, because unfortunately, no one else is going to do this for us. While we were successful with Anthem, it is only a matter of time before another Anthem-like issue rears its head. The Board will continue to fight on your behalf, but to truly be successful, we need everyone’s continued support and help. The Board meetings are open to ALL members and the minutes are visible under the member’s only section on the website for anyone that is interested in getting more involved. We have multiple committees that ANY member can join. Most only meet via conference call a few times a year and require a minimal time commitment.
Additionally if you are interested in forming a new committee, please let us know. If you have ideas for projects or areas that need MOCEP’s attention, please let us know. We’ll do our best to make those things happen. And if nothing else, there is our PAC. If you can’t commit with time, I ask that you consider making a donation. It really is important and can be done through the MOCEP website.
We are a small group but can do great things if we work together.
Evan Schwarz, MD, FACEP, FACMT
We’d like to thank everyone that completed the survey MOCEP sent out earlier this year. The response rate was great and will really help focus the Board over the next year. As a reminder, three of the 6 questions discussed addiction. The other questions related to free standing EDs, and as legislation regarding them didn’t go anywhere, we think we can wait to see what occurs during the next legislative session. Here are the questions pertaining to addiction and the membership’s response.
- Should MOCEP support needle exchange programs? Yes-70%
- Should MOCEP support ED physicians providing MAT in the ED? Yes-67%
- Should MOCEP serve as a resource to those interested in beginning MAT in the EDs? Yes-77%
The 2018 MOCEP Annual General Membership Meeting was held April 26, in Springfield, MO. Douglas Char, MD, FACEP; John Owen, MD, FACEP; Robert Poirier, MD, MBA, FACEP; Christopher Sampson, MD, FACEP; and Evan Schwarz, MD, FACEP were re-elected to the Board of Directors. Melissa Kroll, MD, MPH, was newly elected to the board. Her experience includes: Continue Reading