|ACPM Headlines 12/17/12|
In this Issue
Policy and Practice
Research and Reports
1. USPSTF RELEASES DRAFT RECOMMENDATION ON YOUTH TOBACCO PREVENTION
The United States Preventive Services Task Force has released a draft statement recommending that clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents. The "Grade B” recommendation upgrades the Task Force’s 2003 "Grade I” recommendation.
This change comes from new evidence that individually-based interventions such as education or brief counseling in a primary care setting work to decrease the number of school-aged children and adolescents who begin smoking and the number of those who progress to become established smokers. The Task Force found no known harms and minimal potential harms. More specific recommendations regarding details of the interventions could not be systematically made as the interventions studied varied widely.
The final recommendation will be issued after a period of public comment, which ends on January 7th. Visit the USPSTF web site for the full recommendation statement and to submit a comment.
ACPM president Miriam Alexander, MD, MPH, FACPM sent a letter to members of the House and Senate promoting new policy by the American Medical Association (AMA) House of Delegates that calls on the AMA "to support budget allocations from the Prevention and Public Health Fund at no less than the levels adopted in the Affordable Care Act” and "actively oppose policies that aim to cut, divert, or use as an offset, dollars from the Prevention and Public Health Fund for purposes other than those stipulated in the Affordable Care Act.” The new policy, a result of an ACPM-sponsored resolution, is timely as negotiations in Congress continue to avert the nearly 30% payment reduction for physicians under the Medicare fee schedule.
In the letter, Dr. Alexander commended the 15 medical societies that cosponsored the resolution: "By supporting investments in population-level interventions, we not only will improve the public’s health but also ensure the sustainability of our health care system. If the current allocation and trajectory of health care spending—which emphasizes disease treatment—continues, we inevitably will find ourselves unable to cope with the growing economic and social burden of chronic diseases. Acute care facilities simply are not equipped to deal with the epidemic scale of chronic disease we are faced with today. For this reason, it is imperative that the House of Medicine work to ensure that dollars from the Prevention and Public Health Fund are not siphoned off to support programs that do not directly advance opportunities to prevent disease and promote health.”
View the letter from Dr. Alexander.
3. ACPM TO CONVENE PANEL TO PROMOTE ADOPTION OF LIFESTYLE MEDICINE IN PRACTICE
ACPM, in partnership with the Ardmore Institute of Health, has formed an expert steering committee to develop a framework, based on established physician competencies, which would facilitate and advance the adoption of lifestyle medicine into clinical practice. The panel, which will convene February 20, 2013 at ACPM’s Preventive Medicine 2013 conference in Scottsdale, AZ, is charged with identifying a pathway for helping physicians adopt lifestyle medicine as a standard of practice.
Panel members will contribute important stakeholder perspectives, such as clinical practice, academic medicine, public health, health promotion research, health plans and insurance providers, professional medical societies, and corporate employers. The panel’s efforts will focus on the physician competencies for prescribing lifestyle medicine previously published in JAMA (LianovL; JohnsonM. Physician competencies for prescribing lifestyle medicine. JAMA. 2010; 304(2):202-3). Liana Lianov, MD, MPH, FACPM, ACPM’s Public Health and General Preventive Medicine Regent, and chair of ACPM’s Lifestyle Medicine Task Force, has been tapped to lead the panel. Dr. Lianov also is President of the American College of Lifestyle Medicine (ACLM) and is working with ACLM as she forms the panel.
See the press release announcing this initiative.
4. ACPM ADOPTS POSITION STATEMENT ON TEXTING WHILE DRIVING
The ACPM Board of Regents unanimously approved a position statement on texting while driving written by ACPM Fellow Kevin Sherin, MD, MPH, FACPM and epidemiologists Daniel Leiva and Sarah Matthews. The statement takes the position that all state legislatures ban texting while driving and supports public awareness campaigns, educational requirements and programs, and additional research.
The full position statement is currently undergoing review by the American Journal of Preventive Medicine for publication in a future issue of the journal. Please contact Andrea Lowe, Policy and Practice Manager at firstname.lastname@example.org if you have questions regarding this position statement.
ACPM also congratulates Dr. Sherin for his appointment by ACPM President Miriam Alexander to chair ACPM’s Prevention Practice Committee, and recognizes Michael Compton, MD, MPH, FACPM, who has stepped down as committee chair, for his outstanding leadership of the committee.
The early-bird registration deadline for Preventive Medicine 2013 is rapidly approaching. Secure your registration at the discounted rate and save up to $150! Register before the December 30 early-bird registration deadline and be automatically entered to win two complimentary nights at the meeting hotel, Pointe Hilton Tapatio Cliffs Resort, in Scottsdale. These nights may be used during your stay at Preventive Medicine 2013 or at a later date within the next 12 months.
Visit the Preventive Medicine 2013 website for more information, and to view the program agenda.
ACPM has announced it will convene the first-ever ACPM Residency Fair. Hosted by ACPM’s Resident Physician Section (RPS), the Fair will be held Saturday, February 23, 2013, from 12-1:30 pm in conjunction with Preventive Medicine 2013in Scottsdale, AZ.
All residency program directors, medical students, and other physicians considering or interested in residency training in Preventive Medicine are encouraged to attend. This event will provide a wonderful opportunity for residency programs to network and share program information with prospective applicants and for prospective applicants to learn more about Preventive Medicine residency training and possible career paths for certified Preventive Medicine physicians.
Residency programs may participate in the Fair for only $145, which includes registration for two program representatives, one skirted, six-ft. table for materials display, and lunch. The Fair is free to non-PM residents and medical students, however, registration is required.
Registration is now open, but space is limited, so don’t miss this unique opportunity. Visit the PM 2013 website to register online today!
The Council of Medical Specialty Societies (CMSS) has announced its position recommending increased financial support for Graduate Medical Education (GME) and expansion of the number of GME trainee positions be based on the needs of the United States population for its physician workforce. CMSS believes that it is in the best interests of the public that GME in the United States be supported to meet the nation’s needs for its physician workforce.
The position statement was adopted by the CMSS Council during its recent Annual Meeting of the 39-member organization, which includes ACPM. CMSS hosted a conference on May 10, 2012 on the Financing of Graduate Medical Education in the United States. The proceedings from the conference form the background for the policy position and serve as a blueprint for the future of GME funding.
CMSS provides an independent forum for the discussion by medical specialty societies of issues of national interest and mutual concern. Today, CMSS represents thirty-nine societies with an aggregate membership of 700,000 US physicians.
8. COURT REFUSES GOVERNMENT’S APPEAL IN GRAPHIC WARNING LABELS CASE
The Federal U.S. Court of Appeals for the District of Columbia has denied a request by the government for a full-panel hearing on the Food and Drug Administration’s graphic tobacco warnings, upholding the decision by a three-member panel in August that the graphic labels violate the First Amendment rights of corporations.
The nine labels were created by the FDA as a means to implement the Family Smoking Prevention and Tobacco Control Act of 2009. They graphically illustrate the consequences of smoking, such as showing someone smoking through a tracheotomy via picture labels that cover half of the cigarette package. Their effectiveness, despite mounting evidence, is still unproven.
The law’s underlying provisions were upheld in March in the U.S. Court of Appeals for the 6th Circuit and were supposed to be implemented this October. However, enforcement of the law has been subsequently blocked in the District of Columbia court circuit by five tobacco companies arguing that they should not have to pay for labels that have no proven effect. The Department of Justice has 90 days to decide whether to appeal the case to the Supreme Court, which many anti-tobacco groups support, given the contradictory finding from the 6th Circuit that the law’s provisions are sound.
9. FDA APPROVES FIRST SEASONAL FLU VACCINE TO USE CELL CULTURE TECHNOLOGY
The Food and Drug Administration (FDA) has approved the first seasonal influenza vaccine licensed in the United States produced using cultured animal cells, instead of fertilized chicken eggs. The vaccine, Flucelvax, is approved to prevent seasonal influenza in people ages 18 years and older.
The manufacturing process for Flucelvax is similar to the egg-based production method, but the virus strains included in the vaccine are grown in animal cells of mammalian origin instead of in eggs. Cell culture technology has already been in use for several decades to produce other U.S. licensed vaccines. For more information, visit http://1.usa.gov/QX8O7p.
The Department of Health and Human Services (HHS) is seeking public comment for several proposed health insurance rules. The first rule is related to health insurance market reforms. These reforms were designed to prevent discrimination against people with pre-existing conditions and protect patients from exorbitant premium increases. In addition, this rule would amend the standards for data reporting and collection by health insurance companies and state governments. The second rule is related to essential health benefits, actuarial value, and accreditation standards of health plans that will be listed on health insurance exchanges. Public comments on both of these rules will be accepted until December 26th.
The final rule accepting public comment discusses employer or group health wellness program coverage. Specific amendments include increasing the maximum permissible reward for group health plans offering health-contingent wellness plans, wellness program design, and alternatives that could be offered to health plan members in order to avoid discrimination. Public comments on this rule will be accepted until January 25, 2013.
11. MANY INSURERS NOT COVERING RECOMMENDED TOBACCO CESSATION TREATMENTS
A recent study by Georgetown University researchers shows that many private insurance companies may not be adequately covering tobacco cessation interventions recommended by the United States Preventive Services Task Force. Recommended interventions include asking adults about tobacco use and provision of counseling and certain medications. This finding comes despite the Affordable Care Act’s provision for full coverage of preventive measures that receive a "Grade A” or "Grade B” by the Task Force.
The Georgetown study, sponsored by Campaign for Tobacco-Free Kids with Pfizer funding, assessed 39 different types of health insurance plans across 6 states. It found language that could leave patients confused about their coverage and/or discourage them from seeking cessation options, as well as cost-sharing requirements and gaps in coverage for recommended interventions, all of which violate the law under the ACA.
For more information, go to: http://bit.ly/Txq3co.
12. CDC VITAL SIGNS: HIV INFECTION, TESTING, AND RISK BEHAVIORS AMONG YOUTHS
The Centers for Disease Control and Prevention has released a new issue of Vital Signs featuring the MMWR report, Vital Signs:HIV Infection, Testing, and Risk Behaviors Among Youths—United States. The report found that a disproportionate number of new HIV infections occurs among youths, especially blacks/African Americans, Hispanics/Latinos, and men who have sex with men (MSM). The percentage of youths tested for HIV, however, was low, particularly among males. The report comes on the heels of the recent draft recommendation statement from the U.S. Preventive Services Task Force recommending that clinicians screen adolescents and adults ages 15 to 65 years for HIV infection.
13. AMERICANS LIVING LONGER, BUT ALSO UNNECESSARILY SICKER
Americans are living longer due to several medical advances, but unhealthy behavior and preventable illness threaten quality of life, according to United Health Foundation’s 2012 America’s Health Rankings®released earlier this month.
While premature, cardiovascular and cancer deaths have declined since 1990 by 18.0 percent, 34.6 percent and 7.6 percent, respectively, Americans are experiencing troubling levels of obesity (27.8 percent of the adult population), diabetes (9.5 percent of the adult population), high blood pressure (30.8 percent of the adult population) and sedentary behavior (26.2 percent of the adult population).
14. PCORI ANNOUNCES $96 MILLION FOR NEW COMPARATIVE EFFECTIVENESS RESEARCH
The Patient-Centered Outcomes Research Institute (PCORI), an institution authorized by Congress to support evidence-based research in comparative clinical effectiveness, recently announced $96 million in new funding for research that will ultimately assist patients and health care professionals with their health decision-making process. Funding opportunities are available through the PCORI website, and must align with the National Priorities for Research and Research Agenda.
In addition, PCORI is seeking health care stakeholders to review research applications, provide public comments on its work, suggest research questions, or participate in Engagement Workshops. If you are interested, please visit the website for more information.
The Centers for Disease Control and Prevention (CDC) and the Council of State and Territorial Epidemiologists (CSTE) have collaborated with the Associations of Schools of Public Health (ASPH) and the Health Resources and Services Administration (HRSA) to offer a fellowship opportunity in applied epidemiology for recent graduates. Fellows in this program will complete a two-year placement at a state health agency.
Interested applicants must have an MPH, MSPH, or MS in epidemiology or equivalent/advanced degree in a related field, and a desire to pursue a long-term career at the state- or local-level. Please visit the website for application instructions and additional information.
16. APTR-ODPHP ANNOUNCES HEALTH POLICY RESIDENCY ROTATION
The Association for Prevention Teaching and Research (APTR) has announced continuing field placements for Preventive Medicine and Primary Care residents based at the Office of Disease Prevention and Health Promotion (ODPHP) in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services (HHS).
This opportunity will allow residents to witness the process of federal health policy making and consider potential roles for physicians. Residents may become involved in any aspect of ODPHP activities, and may also participate in ODPHP’s policy advisory role by commenting on documents reviewed by the office. Residents will be encouraged to attend meetings and briefings with high-level policy makers and other prevention-related events which often occur in Washington, DC.
Two-month rotations are available from July 1, 2013 through June 30, 2014, contingent upon funding. A stipend of $3,100 per month will be paid directly to the residency program as well as a travel allowance of up to $250 per month to help defray commuting costs. Please note that this rotation must be completed on-site at ODPHP in Rockville, MD. The application cycle for the 2013-2014 rotations is ongoing with a final deadline of March 2013.
For additional information, or to apply online, please visit APTR’s website.