VERMONT MEDICAL SOCIETY 2004 ANNUAL REPORT James O’Brien, M.D. was sworn in as President at the October 2003 VMS Annual Meeting James O’Brien, M.D., VMS President and Paul Harrington, VMS EVP at an AMA Meeting Harvey Reich, M.D. in Washington, D.C. was sworn in as President at the October 2004 VMS Annual Meeting Left to right: Burlington Mayor Peter Clavelle and Gov. James Douglas Debate at on of the VMS sponsored debates in October 2004 VMS EXECUTIVE COMMITTEE CONTACTING THE VMS BY PHONE 802.223.7898 or 800.640.8767 HARVEY REICH, M.D. PRESIDENT 160 ALLEN STREET BY EMAIL [email protected] RUTLAND, VT 05701 747-3851 BY FAX 802.223.1201 [email protected] PETER DALE, M.D. BY MAIL PO Box 1457, PRESIDENT-ELECT Montpelier, Vermont 05601 195 HOSPITAL LOOP, SUITE 3 BERLIN, VT 05602 223-6196 [email protected] * V M S * S TAFF* DAVID JOHNSON, M.D. VICE PRESIDENT 18 MANSION STREET WINOOSKI, VT 05404 655-3000 JAMES.O’[email protected] JOHN MAZUZAN, M.D. PAUL HARRINGTON MADELEINE MONGAN JESSA BLOCK TREASURER EXEC. VICE PRES. VP FOR POLICY POLICY SPECIALIST 366 SOUTH COVE RD. [email protected] [email protected] [email protected] BURLINGTON, VT 05401 864-5039 [email protected] JAMES O’BRIEN, M.D. IMMEDIATE PAST PRESIDENT 18 MANSION STREET WINOOSKI, VT 05404 JOY IBEY STEVE LAROSE STEPHANIE WINTERS 655-3000 BUSINESS MANAGER COMMUNICATIONS DIR. OFFICE & MEMBERSHIP JAMES.O’[email protected] 2 [email protected] [email protected] [email protected] Dear Member of the Vermont Medical Society: our three groups can work together to improve substance abuse treatment in the three states. As a profession, we were faced with a number of challenges in 2004. Medical malpractice insurance premiums and the • The VMS partnered with several in-state groups to promote other costs of running a practice continued to escalate. public health and advocate for health reform. During the year we worked Meanwhile, reimbursement from payers remained flat, or in closely with the Vermont Association of Hospitals and Health Systems, the case of Medicaid, well below the cost of providing the Vermont Project for Quality in Health Care (VPQHC), the Coalition services. And lawmakers tried to expand regulation of our profession for a Tobacco Free Vermont, Vermont Action for Healthy Kids, the through several bills. Vermont Network Against Domestic Violence and Sexual Assault, and the Area Health Education Centers, to name a few. But despite of all this, the VMS was successful in a number of areas: • Thanks to the efforts of VMS members who provided • When the Vermont Senate voted to cut workers' compensation fee information about the hazards of exposure to second-hand smoke, four schedules, the VMS pointed out that physician reimbursement in communities in Chittenden County decided to ban smoking in bars and Vermont is already the second lowest in New England and New York, restaurants. Employees and patrons of these establishments are no and the eighth lowest in the nation. The VMS was successful in longer putting their health at risk when they walk in the door. VMS preventing reductions and we have a seat at the table in future members were very influential in convincing elected officials in negotiations over revisions to the workers' comp system. Burlington, South Burlington, Williston, and Winooski that protecting • A bill would have imposed fines and disciplinary action on people's health is paramount. physicians if patients were not satisfied in how their pain was being As successful as 2004 was, our work is not done. VMS members need to managed. In addition, all physicians would have been required to take 12 send a strong message to other communities across the state that still hours of CME in pain management. After input from the VMS, the CME allow smoking in bars and restaurants. We must not rest until smoking requirement was dropped and lawmakers agreed to study methods of in public spaces is eliminated statewide. I would like to thank the improving pain management. members who have been actively involved in this effort, and I urge all • The VMS worked tirelessly during the past year to educate members to join me in continuing to push for this change. lawmakers and the general public about the burden of medical malpractice premiums and their impact on patient care. VMS members Recently proposed provider payment cutbacks in the state Medicaid testified before several committees, and other members provided case program also threaten to jeopardize patient access to physician services. studies documenting how rising premiums are jeopardizing access to Your help will be needed in the months ahead to ensure that changes to physician services in Vermont communities. The VMS was able to secure Medicaid do not diminish the care that we can provide to this population. a $632,000 increase in Medicaid reimbursement for FY2005 to help offset As a VMS member, you can take pride that 2004 was a year filled with the higher cost of medical malpractice insurance. We also convinced accomplishments for the society. We have played a major role in shaping legislators to conduct an in-depth study of potential solutions to the health care policy in Vermont, we have protected physicians from medical malpractice crisis. proposals that would have been detrimental to the practice of medicine, Our successes in 2004 were not limited to the Statehouse and state and we have won changes that will protect the health of Vermonters for government. Our influence was felt both at the local and regional levels. years to come. • We continued to develop a strong relationship with the medical Sincerely, societies in Maine and New Hampshire. In fact, the directors of those 3 two societies joined VMS directors at a meeting in Stowe to discuss how James O'Brien, M.D., President 2003-2004 2004 VMS ANNUAL REPORT INDEX SECTION 1: WHO WE ARE & WHATWEDO Preventing Domestic Violence . .14 The Society in Brief . .Page 5 School Health Committee and Childhood Wellness . .14 Our Mission . .5 HIPAA . .14 Guide to Health Care Law . .15 SECTION 2: VMS ORGANIZATIONAL FRAMEWORK Authority . .Page 5 SECTION 5: 2004 MEMBER SERVICES Governance . .5 Insurance and Other Practice Related Programs . .Page 15 2004 Council Meetings . .5 VMS News Scan . .15 Committees . .6 Continuing Medical Education . .16 Issue Teams . .6 Tri-State Medical Society Services, Inc. .16 Physician Policy Council . .6 VMS Annual Meeting . .16 SECTION 3: 2004 ADVOCACY ACTIVITIES SECTION 6: PEER SUPPORT ACTIVITIES Vermont Practitioner Health Program . .Page 20 Federal Advocacy . .Page 7 VMS Educational and Research Foundation . .20 Federal Tort Reform . .7 Support for County and Specialty Society Chapters . .20 Reversing Medicare Payment Cuts . .8 Support for Other Events and Organizations . .21 Supporting Patient Safety . .8 State Advocacy . .8 SECTION 7: 2005 ADVOCACY PRIORITIES . .Page 22 Workers Compensation Medical Fee Schedule . .8 Improvement of Vermont's Health Care System . .22 Pain Management Study/AG Initiative on End of Life . .9 Ensuring Prompt and Adequate Medicaid Reimbursement . .22 Civil Monetary Penalties . .9 Enactment of State and National Medical Liability Reform . .23 Psychotropic Drugs for Children Bill . .9 Repeal of Medicare's Sustainable Growth Rate Reimbursement . Extension of PDL Exception . .10 Formula . .23 Increased Medicaid Payments . .10 Increased Physician Reimbursement Under Vermont's Workers' State-Based Tort Reform . .10 Compensation Medical Fee Schedule . .23 Fire-Safe Cigarettes . .11 Confronting the Opioid Challenge Facing Vermonters . .24 Banning Smoking in Bars . .11 Reducing the Secondary Effects of Cigarettes . .24 Funding for Tobacco Control Programs . .11 Reducing Childhood Obesity . .24 Childhood Wellness . .11 Improved End-of-Life Care . .24 Physician License Fees . .11 Domestic Violence as a Health Care Concern . .25 Respiratory Therapist Licenses . .12 SECTION 8: 2004 TREASURER'S REPORT . .Page 25 Optometry Scope of Practice . .12 SECTION 9: PAST PRESIDENTS & AWARD RECIPIENTS .Page 26 Naturopaths Insurance Mandate . .12 THE VMS COUNCIL . .Page 29 SECTION 4: 2004 EDUCATION & COMMUNICATIONS EFFORTS VMS Joins Coalition 21 . .Page 12 VMS AWARD RECIPIENTS . .Page 32 4 Chronic Care Initiative . .12 FREQUENTLY USED NUMBERS . .Page 34 ExCEL (Excellent End of Life Care) . .13 Substance Abuse and Opiate Dependency . .13 SECTION 1: WHO WE ARE & WHAT WE DO SECTION 2: VMS THE SOCIETY IN BRIEF ORGANIZATIONAL FRAMEWORK The Vermont Medical Society has been providing services to Vermont physicians for over 200 years. As a pro-active member organization, VMS AUTHORITY represents the interests of physicians and advocates on their behalf. The individual physician member is the base of all authority in the Vermont Medical Society. The Along with providing assistance, information and lobbying services on decisions of our members ultimately determine the legislative and regulatory matters, the Society also offers its members a nature, direction and goals of the Society’s activities. host of personal and professional services — including contract review, individualized technical assistance, a program to support our colleagues GOVERNANCE who are affected by the disease of substance abuse, development and Each member has an equal voice at the annual and special membership maintenance of Web sites, assistance with coding and compliance, and meetings that are the society’s definitive governing authority. In insurance programs for members and their employees. intervals between these meetings, the Council of the VMS conducts the TOTAL VMS