|ACPM Headlines 9/21/15|
In this Issue
Policy and Practice
Research and Reports
1. PRESIDENT’S COLUMN: "WE ASKED. YOU RESPONDED. WE ARE LISTENING.”
In an organization as large and as diverse as ACPM, it is important leadership and staff take a step back take from time to time and make sure we are hearing the voices of all members when making decisions impacting the future of our organization.
This summer we distributed a survey to ask you if we were meeting your expectations. We asked you where ACPM should position itself in the future. We asked you about opening our membership to non-physicians. You answered these questions and more, and as promised we are sharing those results with you.
Almost a quarter (24%) of all members completed the Needs Assessment Survey—a good response rate for a physician survey. The results of the survey had many positive notes—over 90% of members feel their membership is valuable and would recommend ACPM to their colleagues (Please do!) and about 90% felt satisfied ACPM met their expectations relative to why they joined ACPM.
There also were some clear signs on areas on which you would like us to focus. Three of the top four issues cited by members were "promotion of preventive medicine”—to health professionals, medical schools, state and federal agencies, elected officials, and the public. Another four issues in the top seven concerned the offering of information—on preventive medicine trends, healthcare trends, CME/MOC, and "education I need in my career.” Position statements and practice guidelines, preparation of students and residents, and advocacy for the preventive medicine pipeline rounded out the top 10.
The report shows an organization with a generally satisfied membership, but one that sees potential for ACPM to take a greater role in expanding and supporting the profession and making sure the best evidence-based public health and preventive medicine is practiced in this country and beyond. The Board and I heard you, and you will be hearing in the coming months ways of how we are addressing these areas of concern.
The second survey distributed this summer was on the role of non-physicians in ACPM. As compared with the Needs Assessment Survey, there was a slightly lower response rate (17%), but like the first survey, there were pages of comments. It is clear this issue is one of great importance to many.
ACPM membership is quite divided on the question of allowing non-physicians to become members. Thirty-two percent of respondents indicated that it was not important or only slightly important to them that the organization remain physician-only; 49% indicated that it was important or extremely important that ACPM remain physician-only; and the remaining 19% were neutral on the issue. There was a concern that opening up membership to non-physicians could eventually change the nature of the organization, as we are a small specialty that could easily be overwhelmed by non-physicians. On the other side, many expressed concern that by closing ourselves off, we may be missing critical insights from non-physicians. Both sides have valid concerns and we will continue to have an open discussion that we hope will build to a consensus.
In one area the membership seemed to find some agreement, 70% of respondents felt the education and resources ACPM provides would be valuable to other members of their team-based work environments—even if they were not granted full membership. Although our conference is already open to non-physicians, we will explore how we can package our other products and services in a way that multidisciplinary teams can benefit from.
Obviously, these summaries only scratch the surface on the information we have been able to cull from these surveys. More detail can be found in the members-only section of the website at http://www.acpm.org/MemberNeedsAssessment (members-only).
I thank all of you who took the time to complete this survey and would like to especially thank the work of the following volunteers who helped craft both of the surveys:
2. HRSA ALLOCATES $5 MILLION TO PMR TRAINING PROGRAMS
The Health Resources and Services Administration (HRSA) has announced awards of roughly $5 million to 15 preventive medicine (PM) residency training programs. The newly funded programs bring the total number of HRSA-funded programs to 25, a high-water mark in the recent history of HRSA support of PM training programs. Since FY 2013, HRSA funding for PM training has increased from $3 million to more than $7 million.
Despite early efforts to zero-out HRSA funding for PM training programs in the FY 2016 Senate Labor, Health and Human Services and Education Appropriations bill, Sen. Tom Udall (D-NM) successfully worked with his colleagues on the Senate Appropriations Committee to protect HRSA funding for PM training programs from efforts to curtail federal spending. ACPM will continue to monitor the FY 2016 appropriations process and act to ensure sufficient funding is allocated to allow HRSA to maintain its current commitments to PM program grantees.
Surgeon General Dr. Vivek Murthy has launched a national Call to Action campaign on walking and creating walkable communities. The campaign promotes walking as an easy, effective and an affordable physical activity to improve overall health and reduce the risk of heart disease and diabetes. Fewer than half of all adults in the United States get the recommended amount of exercise to reduce the risk of chronic disease. Physical inactivity contributes to heart disease, lung disease, diabetes and cancer, which accounts for 86% of the nation’s health care costs.
The campaign also highlights the need for safe, walkable communities including accessible sidewalks and crosswalks for walkers and those who utilize a wheelchair. In a 2013 study by the Department of Transportation, three out of ten Americans reported not having any sidewalks in their neighborhoods. Additionally, in certain communities, perception of violence can be a barrier for people to walk and wheelchair roll safely. Click here for additional information including a video, the Surgeon General’s playlist for walking and other partner resources.
4. BOARD TAKES SEVERAL ACTIONS AT AUGUST TELECONFERENCE
The ACPM Board of Regents took a number of important actions during its August 20 teleconference. Among the strategic issues it addressed, the Board unanimously approved a draft membership recruitment, engagement, and retention plan prepared by the membership department and Membership Committee. The plan contains a variety of strategies aimed at growing ACPM’s membership among physicians, including reaching more physicians board-certified in Preventive Medicine, penetrating markets of primary care physicians who are practicing public health and preventive medicine, enhancing the value of ACPM membership, and retaining members who make career transitions and, hence, transitions across ACPM member categories. ACPM President Dan Blumenthal wrote a column for this edition of Headlines that shares with you the results of the recent membership surveys and how ACPM through this plan is addressing the needs identified in those surveys.
The Board also approved a conceptual framework for implementing its strategic initiative to promote population health and preventive medicine in health systems transformation, which includes a broad communications and branding strategy for preventive medicine and ACPM; adopted an ACPM position statement on Hepatitis C virus, which since has been submitted to the American Journal of Preventive Medicine; and voted to endorse the statement "Firearm-related Injury and Death in the United States: A Call to Action from 8 Health Professional Organizations and the American Bar Association,” which was published in the Annals of Internal Medicine.
ACPM member feedback on the actions of the Board and direction of the College are always encouraged. Please contact ACPM executive director Michael Barry at firstname.lastname@example.org or 202-466-2044 x106.
ACPM executive director, Mike Barry, CAE, associate executive director for policy, advocacy and external affairs, Paul Bonta, MA, and health policy resident, Bethany Strong, MD, met with the head of the Health Resources and Services Administration (HRSA) Division of Medicine and Dentistry, Candice Chen, MD, and program officer for the Preventive Medicine Residency grant program Irene Sandvold, DrPH, MPH, MSN, RN, to continue ACPM’s efforts to ensure a strong presence and promote preventive medicine among the agency’s leaders.
Dr. Chen is a pediatrician trained in public health and greatly values the role of preventive medicine in health care. The group discussed how preventive medicine must be front and center in the evolving health care system, and identified opportunities for HRSA and ACPM to work more closely together in furthering PM training in health care settings and collaborating on ACPM strategic initiatives.
ACPM Immediate Past President Halley Faust has resigned from the Board of Regents and President Dan Blumenthal has appointed ACPM Fellow Olugbenga ("Gbenga”) Obasanjo, MBBS PhD MPH MBA FACPM, to fill the vacancy.Dr. Obasanjo is District Health Director, District 4/LaGrange, Georgia Department of Health, and has served ACPM on the Membership Committee, the Preventive Medicine 2015 planning committee, and now as ACPM representative to the National Postgraduate Medical College of Nigeria’s certification exam. Dr. Obasanjo will complete the remaining 17+ months of Dr. Faust’s term in an at-large capacity, not as an Officer or part of the Executive Committee.
Welcome to the Board Dr. Obasanjo!
On September 17, ACPM hosted the 2015 National Specialty CEOs Summit of the American Association of Medical Society Executives (AAMSE) at its headquarters in Washington, DC. The full-day summit is exclusively for CEOs of national medical specialty societies, providing an educational and networking forum that caters to the unique needs of these professionals. ACPM has been a long-time member of AAMSE, which is committed to educating and supporting medical society professionals to advance the profession of medical society management, medical societies, and the physicians they serve. ACPM executive director Michael Barry served as chairman of this year’s meeting.
8. FROM THE USPSTF: DRAFT RECOMMENDATIONS FOR ASPIRIN TO PREVENT CVD & CANCER
The United States Preventive Services Task Force (USPSTF) has posted a draft recommendation statement and draft evidence summaries on aspirin to prevent cardiovascular disease(CVD) and cancer. The USPSTF concludes with moderate certainty that the net benefit of aspirin use to prevent CVD events and decrease colorectal cancer incidence in adults ages 50 to 59 years who are at increased risk for CVD but not bleeding is moderate. The statement is available for public comments until October 12, 2015.
The USPSTF concluded with moderate certainty that the net benefit of daily low-dose aspirin intake, for adults between the ages of 60-69, who are at an increased risk for CVD, but not bleeding, to prevent CVD and colorectal cancer is small and the decision should be made on an individual basis. Currently there is insufficient evidence to assess the harms and benefits of aspirin intake among adults younger than fifty and older than sixty-nine.
The Centers for Disease Control and Prevention (CDC) has announced the recipients of the new Prescription Drug Overdose: Prevention for States (PFS) grant program. The new program’s goal is to help states end the ongoing prescription drug overdose epidemic. The PFS program will make a significant investment in 16 states, giving them the resources and expertise they need to prevent overdose deaths. CDC plans to give these states annual awards between $750,000 and $1 million over the next four years to advance prevention on multiple fronts, tailoring interventions to fit the existing need within each state.
Also, the American Medical Association has launched a new, web-based resource: www.ama-assn.org/go/endopioidabuse designed to support effective pain management practices and evidence-based prescribing of opioids, promote appropriate referrals and access to care for patients with opioid use disorders, and take necessary steps needed to reduce opioid-related harm. Soon, AMA will begin a national ad campaign to increase physicians’ registration and use of prescription drug monitoring programs as well as promote enhanced education and training to ensure that physicians take the lead in becoming educated about evidence-based care and appropriate prescribing practices.
To increase vaccination rates within a targeted client population, the Community Preventive Services Task Force has recommended the implementation of health care system-based interventions in combination with two or more coordinated interventions. Additionally, the Task Force recommends utilizing multicomponent approaches that include one intervention to increase client demand for vaccinations such as client reminder and recall systems, clinic-based client education and manual outreach and tracking.
Efforts involve partnerships between community organizations, local government, and vaccination providers to implement and coordinate interventions to increase community demand with interventions to enhance access to vaccination services and/or interventions to reduce missed opportunities by vaccination providers.
The U.S. Food and Drug Administration (FDA) is warning that the type 2 diabetes medicines sitagliptin, saxagliptin, linagliptin, and alogliptin may cause joint pain that can be severe and disabling. FDA has added a new Warning and Precaution about this risk to the labels of all medicines in this drug class, called dipeptidyl peptidase-4 (DPP-4) inhibitors.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program.
12. CDC: U.S. SMOKING RATE FALLS TO 15%
A new survey shows that the smoking rate among adults continues to decline, as just over 15% of adults are current smokers. The rate has fallen gradually from 17% in 2014 and 18% in 2013. The rate of smoking among adults stalled between 2004 and 2009 at 20%. More men (17%) smoke when compared to women (13%) and more Blacks (18%) smoke when compared to Whites (17%) or Hispanics (10 percent).
Higher tobacco taxes, anti-smoking messages and smoke-free laws and bans are encouraging smokers to quit their addictive habit. But researchers note that there is still work to do. Only one state (North Dakota) has passed a comprehensive smoke-free law in the last five years and there are still twenty-two states that haven’t passed any limitations on where people can smoke. US Food and Drug Administration’s (FDA) efforts to regulate smoking products including cigars, hookahs and e-cigarettes could help reduce the smoking rate further. Researchers point out that 75% of smokers are dual users who smoke both e-cigarettes and traditional cigarettes at the same time, and further studies are need to assess the impact of e-cigarettes reducing the smoking rates of traditional cigarettes.
The data is collected from the National Health Interview Survey, an annual survey administered by the Centers for Disease Control and Prevention that collects information on a variety of public health issues.
The Journal of American Medical Association has published a new report that shows that close to half of all American adults have diabetes or prediabetes. Prediabetes is defined as higher than normal levels of blood sugar but not high enough to categorize as diabetic. In 2011-2012, 14% of adults had diagnosed or undiagnosed diabetes and 38% had diagnosed or undiagnosed prediabetes. The report was published with the help of data and trends from the US National Health and Nutrition Examination Surveys (NHANES).
Of the 14% of adults with diabetes, about 5% are undiagnosed; whereas of the 38% of adults with prediabetes, 36% are undiagnosed. Diabetes can only be treated when the diagnosis is known. The prevalence of diabetes is almost twice as high among Blacks (22%), Asians (21%), and Hispanics (22%) as among Whites (11%). Since the rate of obesity has stabilized since 2000, it has led to the stabilization of the prevalence of diabetes since 2010. Despite progress, sustained efforts are needed to identify people at risk for Type 2 diabetes and address pressing health issues including obesity.
According to a recent study, HIV testing among adults between the ages of 50-64 has declined to 3.7% after 2009, despite the Centers for Disease Control and Prevention (CDC) universal screening recommendations. In 2003, 5.5% of adults in that age group were screened for HIV. In 2006 HIV testing prevalence rate declined to 3.6%. Then in 2006, the CDC recommended that most doctors screen their patients for HIV regardless of whether they have symptoms. Following the recommendation, there was an immediate increase in the rate of testing to 4.5%.
According to initial research by CVS pharmacies on the first anniversary of its move to end tobacco sales in its stores, cigarette sales have declined during the past year in states with the most CVS pharmacies.
The results are based on a review of cigarette packs sold in 26 states, including 14 in which CVS pharmacies had at least a 15% market share. Those 14 states showed a 1% decrease in total cigarette sales compared to three "control group" states that had no CVS stores. The effect was smaller in states where CVS had a smaller presence. Over the period studied, the average smoker in the fourteen states purchased five fewer packs of cigarettes -- an estimated 95.2 million fewer cigarette packs -- over eight months.
16. MEMBERS IN THE NEWS: TRAVNICEK
ACPM Fellow Robert Travnicek, MD, MPH, FACPM, is prominently featured in NancyKay Wessman’s Katrina, Mississippi: Voices from Ground Zero, which chronicles the heroic efforts of first responders, including Dr. Travnicek, in the days leading up to Mississippi’s worst hurricane and its devastating aftermath. The new 10th anniversary commemorative book showcases heroes and their work from the epicenter of preparedness, response, rescue, recovery and rebuilding. Theirs are stories about human suffering and survival. Their work and successful first-ever employment of the unified command concept under the National Response Framework can instruct other first responders and the consumer public for preparedness and response, whether the emergency involves weather, wildfires, bioterrorism, emerging infectious diseases, or a plane crash or train wreck, for example. Amazon offers the book in soft cover and electronic editions.
Described as a 250-mile wide entity of "pure evil,” the storm claimed 1,836 lives and caused upwards of $115 billion in damage throughout Mississippi, Louisiana and Alabama. The focus of the book is on those who stepped up to confront the storm, prepare for it, survive it, and struggle to make the region whole afterward. Main players, including Dr. Travnciek, are listed in the beginning as champions of the storm. They include the federal, state and local emergency management teams, the local and state leaders, and volunteers. The book describes their fears, hopes and realities as they sought to help the region prepare and recover.