NCMS Morning Rounds 10-7-19

Happy PA Week!

Here is your NCMS Morning Rounds 

Oct. 7, 2019

We Appreciate Our Amazing Physician Assistants!

Thank you for all you do!

Legislators Discuss Issues at NCMS Legislative Breakfast

Four North Carolina state legislators shared their perspectives with NCMS members on health care, the state budget and the current hyper-partisan atmosphere over breakfast on Friday at the NCMS LEAD Health Care Conference in Raleigh.

On the panel moderated by NCMS Senior Vice President for Advocacy Chip Baggett, JD, were Sen. Don Davis (D-Greene), Rep. Josh Dobson (R-Avery), Rep. Darren Jackson (D-Wake) and Rep. Donna White (R-Johnson). Each legislator agreed that health care is a crucial issue in the state, and all have been key players in various ways in helping to develop and push health care legislation.

They each pushed for expanded access to insurance coverage – noting that proposals to do so are referred to by different terminology depending on your political persuasion.

Many in the audience applauded when Rep. Jackson called for ‘Medicaid expansion’ as a way to cover more individuals, address the opioid abuse epidemic and help struggling rural hospitals. Reps. Dobson and White made the case for a bill they have co-sponsored, HB655—NC Health Care for Working Families, which also increases the number of those with insurance coverage in the state. White pointed out that the legislation does offers exceptions to the bill’s work requirement, which has raised objections, for caregivers and those unable to work. Sen. Davis, the lone senator on the panel, spoke about getting the logjam over passing a budget and expanding coverage.

“I’d like to see us have an honest conversation [about access to care] no matter what we call it,” he said. “There is a pure economic part of this conversation we haven’t talked about. I’d love for the House to bring a bill over to the Senate.”

The panelists agreed that partisanship has gotten more pronounced in recent years, with Rep. Dobson calling it his “biggest frustration.”

“People are looking for simplistic solutions to complex problems,” he said as a reason for the deep partisan divide. “Division seems to be rewarded. It’s like entertainment. I don’t understand that.”

Panelists also highlighted the role NCMS members could play in influencing legislation.

“If this [expanded coverage] is something we want, we have to roll up our sleeves and come and advocate,” Sen. Davis told the group. “Not too many [General Assembly] members ignore their constituents. Never underestimate the power of grassroots advocacy. You can’t ignore the politics of your profession.”

NCMS Election Results Announced

At the NCMS’ Annual Business Meeting on Friday at the LEAD Health Care Conference, the results of the elections were announced. The following individuals were elected by vote of the NCMS membership:

• Dr. Philip Brown, Jr.
Board of Directors, Region 2 Representative
• Dr. Holly Biola
Board of Directors, At-Large Member
• Dr. Merritt Seshul
NC American Medical Association (AMA) Delegate
• Dr. Mary Ann Contogiannis
• Dr. John Fagg
NC American Medical Association (AMA) Alternate Delegate
• Dr. Dev Sangvai
Nominating and Leadership Development Committee (NLDC), Region 1
• Dr. Edward Ricciardelli
Nominating and Leadership Development Committee (NLDC), Region 2
• Dr. Ronald Laney, Jr.
• Dr. Vipul Shah
Nominating and Leadership Development Committee (NLDC), Region 3
• Dr. Docia Hickey
• James Hill, Jr., PA-C
• Dr. Janice Huff
Nominating and Leadership Development Committee (NLDC), Region 4
Dr. Frank Melvin
• Dr. Scott Paviol
Congratulations to all these individuals on their election to NCMS leadership roles.

NCMS Open Forum Generates Discussion of Timely Issues

At the conclusion of the NCMS Annual Business Meeting the Board of Directors opened the floor to members to bring up any issues and to discuss several topics including medically assisted suicide, legalization of medical marijuana and Medicaid expansion.
Issues raised by members included a policy on gun violence and changing the NCMS dues structure to allow Community Practitioner Program (CPP) participants to have a lower NCMS membership dues rate.

Incoming NCMS President Palmer Edwards, MD, DFAPA, then did an instant poll of those at the meeting to assess their opinion on:

Medicaid expansion in NC: Of those present and responding to the poll, 66 said yes to Medicaid expansion; 2 said no. Some discussion ensued on what the return on investment (ROI) to the state would be if Medicaid is expanded, with the majority believing there would be a positive ROI.

Physician-Assisted suicide: 37 in favor; 29 against. One commenter questioned why, if the NCMS supports palliative care, a separate policy on physician assisted suicide is even necessary. Another noted the moral and ethical complexities involved in this issue. The NCMS’ Ethical and Judicial Affairs Committee continues to grapple with these questions.

Legalizing medical marijuana: 45 approved of legalization; 18 said not to legalize it for medical use. The majority of those commenting on the results of the instant poll were incredulous at the results, giving examples of how legalizing the substance for medical use is simply a ‘Trojan horse’ to legalizing it for recreational use. Several gave examples from physician colleagues in Colorado, where it is already legal, saying it ends up in every teenager’s house. One physician who works at a public health clinic commented that marijuana is being used widely now and perhaps legalization would mean better regulation and tax revenues from its sale could be put to good use in the state.

The comments led former House of Delegates Speaker and past NCMS President John Fagg, MD, to remark that the question should be reconsidered based on the discussion, just as it would have been in the old House of Delegates procedures.

Dr. Edwards said that such polling and member surveys will continue as the NCMS’ new Policy Committee begins it work in the coming weeks.

Dr. Edwards Inaugurated as 166th NCMS President

Palmer Edwards, MD, DFAPA, a psychiatrist practicing in Winston-Salem, NC, was sworn in as the North Carolina Medical Society’s 166th president on Friday, Oct. 4, at the Society’s annual LEAD Health Care Conference.

An NCMS member since 1992 – nearly 30 years – Dr. Edwards has been involved in many important leadership roles during that time including serving on the NCMS Foundation’s Board of Trustees and being a member of the NCMS Board of Directors for the past 10 years. He is an alumnus of the Society’s Leadership College and has mentored future health care leaders through the program.

Medicine runs in his family. Dr. Edwards grew up in eastern North Carolina, the son of a physician. He saw firsthand the challenges and rewards of being a small town doctor. Later, a University of North Carolina/Duke University health policy course placed him in Washington, DC, working for the chair of the US House Public Health Committee. This experience helped him appreciate the nuances and complexities involved in developing sound public policy.

In his inaugural address, Dr. Edwards promised to continue to listen to NCMS members to help ensure they have the time, tools and resources to enable them to truly listen to their patients.

He is a graduate of the Wake Forest University School of Medicine, and completed both his adult psychiatry residency and child and adolescent psychiatry fellowship at Vanderbilt University.

Congratulations Dr. Edwards!

In the News

Flu Season Threatens to Complicate Diagnoses of Vaping-Related Illness, STAT, 9-27-19

Learning Opportunity

NCTracks has a listing of all provider trainings available for the month of October including help in the state’s transition to Medicaid managed care. View the listing and sign-up.



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