How gender and bias in medicine affect physicians and patients

News and announcements

How gender and bias in medicine affect physicians and patients (Oct 19)

Bias in medicine is a two-sided coin, and those two sides are rarely considered together. This half-day CME program is changing that. Gender and Bias in Medicine — Effect on Physicians, Impact on Patients features keynote speaker Tamika Cross, MD, who was not acknowledged as a physician during an in-flight emergency and was prevented from rendering care. Dr. Cross’s experience crystallizes how bias against physicians has a direct effect on patient care, and helped shift the discussion toward awareness and advocacy. The keynote will be preceded by panel discussions, one focused on physicians, the other on patient care. The event will be held Friday, October 19, 12:30–5:15 p.m., at the MMS Headquarters, Waltham. For more information and to register, click the button below. 

Vital Signs: Women's Health and Policy issue

For more on bias in medicine, see the current issue of Vital Signs recognizing Women in Medicine Month:

• Inside the fight for women's reproductive health care: Q&A with the physician leader of PPLM
• Is the medical profession standing up to sexual harassment?
• Why do so many US women die from pregnancy-related causes?
• MMS acts against gagging physicians

The Prescription Drug Predicament: Improving Access and Fostering Innovation (Oct 25) 

The 15th Annual Public Health Leadership Forum from the MMS, a half-day CME program, will explore prescription drug costs and the implications for patients, doctors, and public health. The program will identify opportunities for balancing our reliance on pharmaceutical innovation against the price of prescription drugs as a barrier to access. Speakers include Monica Bharel, MD, MPH, commissioner of MDPH; Sandro Galea, MD, DrPH, dean of BU School of Public Health, who has emphasized prevention strategies to help contain the need for medications; Alysse Wurcel, MD, MS, of Tufts Medical Center, whose work with incarcerated people highlights the role of cost in treatment decisions of infectious disease; and Kenneth Kaitin, PhD, professor of medicine and director of the Tufts Center for the Study of Drug Development, on the difference between cost and price, and medication cost drivers. The event includes a panel discussion and networking opportunities. It will be held on October 25, 1:00 – 5:00 p.m., at the MMS Headquarters, Waltham. For more information and registration, click the button below.

2019 MMS Annual Awards: Call for nominations

Do you have a colleague who deserves to be nominated for their outstanding work or service to the community? Do you know a medical student or resident who is worthy of recognition for innovative IT solutions for medicine? The MMS recognizes excellence in multiple categories, including: medical service or public health; contributions to medical education, men’s health, women’s health or women’s physician leadership, or reducing health disparities; service to the MMS; and more. The MMS and its Committee on Recognition Awards are currently seeking nominations for the 2019 Annual Award Program; information and instructions.

Preparedness Month: Plan for emergencies and disasters 

Governor Charlie Baker has proclaimed September 2018 Emergency Preparedness Month to highlight the importance of emergency preparedness and to encourage planning for disasters and other types of emergencies. To help individuals and families prepare during Emergency Preparedness Month, the Massachusetts Emergency Management Agency (MEMA) is promoting four key preparedness messages:

• Be Informed and Receive Emergency Alerts
• Plan for Emergencies and Disasters
• Build an Emergency Kit
• Get Involved in community preparedness and resilience

MEMA will also stress the importance of considering the unique preparedness needs of children, pets, seniors and people with access and functional needs. See the MMS website for additional resources.  

National obesity report: Massachusetts adult obesity rises but prevention programs can work

A new report emphasizes the urgent need to increase evidence-based obesity prevention programs to prevent disease and potentially save billions in health care spending. Massachusetts is among six states that saw the adult obesity rate increase significantly between 2016 and 2017. The 15th annual State of Obesity: Better Policies for a Healthier America, by Trust for America’s Health and the Robert Wood Johnson Foundation, reports adult obesity rates of 30–35 percent in 22 states, and 25–30 percent in 19 states. Obesity levels are highest in Black and Latino, low-income, and rural communities where residents often have limited access to healthy options. Evidence-based programs, policies, and practices to reverse the obesity trend are known but need widespread implementation. The report offers 40 recommendations. Click the button below for the full report, including briefs on all 50 states.

Free financial wellness workshops for physicians
Coming up: another round of free financial workshops tailored to physicians. Use code MassMed and your ticket is free.

Physician Finance: Planning for Residents covers how to protect yourself from unique career risks including the potential of malpractice litigation, and build a solid financial foundation while paying down student debt. Brookline; Wed., Sept. 12, 6:30–8:00 p.m.  

Physician Finance: Planning for a Bright Future helps you prepare for retirement and protect your assets. You will also learn about estate planning basics, charitable giving, and college planning. Brookline; Thur. Sept. 20, 6:30–8:00 p.m.

The classes are provided by In Good Company, a collaboration between MassMutual and Baystate Financial, and are being promoted by the Physicians Insurance Agency of Massachusetts, an MMS subsidiary. Questions? Email piam@mms.org

What’s up in advocacy and policy

State health care report shows low cost growth

The Center for Health Information and Analysis released a report Wednesday evaluating the performance of the health care system in Massachusetts, indicating total health care costs totaled $61.1 billion last year, or $8,907 per capita. For the second year in a row, total health care costs met the state benchmark with the constrained growth increase of 1.6% in 2017. Yet again, physician spending was a driver of cost containment, coming in at 1.2% annual growth, whereas pharmacy and hospital outpatient spending remained the largest drivers of THCE growth. The Health Policy Commission will discuss this report in greater detail in the two-day Annual Cost Trends Hearings in October.

Inside the CARE Act: Peer-to-peer education for pain management and SUD treatment

VSTW is featuring week by week relevant sections of the CARE Act, the recent substance use disorder treatment bill passed by the legislature in July

The CARE Act  has established statewide programs for peer-to-peer clinical education and support programs on both pain management and the treatment of substance use disorder. These programs will allow clinicians to remotely contact peers with more experience with opioid and opioid antagonist prescribing, five days a week. These programs are subject to appropriations, and the MMS staff will closely follow that process and advocate for funding. The MMS is proud to have proposed these programs to the legislature, and we are confident that they will promote evidence-based prescribing practices that save lives. For more information about the CARE Act, click the button below.

Reminders: Stuff you should click on

Apply for a LGBTQ health disparities grant: Due Oct 5
The MMS is currently accepting grant proposals from medical students and residents/fellows whose curriculum development or research addresses health disparities in the LGBTQ community. Grant proposals are due October 5. Download the  Application and Guidelines; click the button below and scroll down.

Democratizing Healthcare: Conference (Oct 17)

The Society for Participatory Medicine is holding its annual conference on October 17 at the Seaport World Trade Center. Unlike other conferences, SPM2018 brings together patient, caregiver, doctor, nurse, healer, nutritionist, trainer, therapist, and others. The event will feature Participatory Medicine Heroes — people who’ve partnered with others to make change and understand the value of diversity — and enables you to join their ranks. For more information and registration, click the button below.

MMS grants for International Health Study (Sept 15)

Medical students and resident physician members of the MMS are eligible to apply for grants of up to $2,000 to defray the costs of studying abroad. The primary goal of these International Health Studies (IHS) grants, provided by the Massachusetts Medical Society and Alliance Charitable Foundation, is to encourage international education, particularly focusing on under-served populations. Preference will be given to projects providing health care-related work and/or training of staff, and to applicants planning careers serving underprivileged populations. Applications are due by September 15, 2018; more information.

Event: What’s your new purpose when retiring? (Oct 3)

After years of being a physician, how can you enjoy your retirement, without fear of losing your primary identity or purpose and coping with lifestyle changes and possible burnout and social isolation? What are community opportunities that welcome your extensive medical knowledge and expertise? Or perhaps you would like to consider non-medical options? Join us to learn, share and network at the free event on October 3, 2018 at the MMS Headquarters, Waltham. Spouses and partners are welcome, and is hosted by the Committee on Senior Physicians. Click the button below for more information and registration.

What is the physician's responsibility toward immigrants' and refugees' health care? (Oct 17)

Join us to learn about the physician’s moral, ethical, social and legal responsibilities when providing health care to immigrants and refugees. Also discover tools and resources available on the state and community levels as well as non-profit health care and law organizations. This free, unique event is on October 17, 2018 at the MMS Headquarters in Waltham. It is hosted by the MMS Committee on Senior Volunteer Physicians; for information and registration, click the button below.

2018-19 influenza recommendations
The Advisory Committee on Immunization Practices (ACIP) recently released its influenza vaccination recommendations for the 2018-19 flu season. Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Changes include a recommendation that LAIV4 may be administered to those for whom it is appropriate, and that persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine, including (IIV, RIV4, or LAIV4). Resources include:

• Influenza Recommendations for the 2018-19 flu season
• Summary of Recommendations, viewable either as an interactive  website or as a  4-page pdf document
• Current CDC influenza Vaccine Information Statement (VIS)
• Influenza VIS in other languages and additional tools
• Questions about flu vaccine recommendations? Call (617) 983 6800 and ask for an immunization epidemiologist
• Questions about state-supplied flu vaccine availability and ordering? Call (617) 983 6828

Educational programs and events

Live events

Conference on Universal Health Care (in person or live webinar)  
Wednesday, October 3  

The First Penile Transplant: The Surgeons and Patient Report
Thursday, October 11   

Gender and Bias in Medicine – Effect on Physicians, Impact on Patients
Friday, October 19   

The Prescription Drug Predicament: Improving Access and Fostering Innovation
15th Annual Public Health Leadership Forum
Friday, October 25

Featured online CME

Shared Decision Making: Essential Skills for Prostate, Lung, and Breast Cancer Screening (4 modules)

Quote of the week

"We, and our institutions, would be wise to improve the care offered to all victims of sexual harassment, including those holding the stethoscope .”
— Dr. Dara Kass, emergency medicine physician practicing in New York City, CEO of  FemInEM, on Les Moonves harassingn his doctor (Slate)

Tweet of the week

Esther Choo, MD, MPH
Emergency Doc — Researcher — Inappropriate Feminist
#ShareAStoryinOneTweet Check out #ThisWomanRocks! eqmedicine.com

What’s new in health care

Check out the most clicked-on stories from this week's MMS Media Watch. Sign up for daily Massachusetts media roundups by email. Some publications are fully accessible only to their subscribers.

Mass. diabetics making tough choices as insulin prices spike (Herald)

The rising cost of insulin is causing diabetics to ration supplies of the live-saving drug and forcing them to make choices about spending, says Andrew Silva, 23, of North Attleboro, a recent college graduate who has had Type I diabetes since he was 7. On three separate occasions since 2013, he has suffered initial stages of diabetic ketoacidosis. 

Hospitals vs. nurses' union in high-spending ballot fight (MassLive)

The Massachusetts Nurses Association has spent $4.7 million so far advocating on behalf of the November 2018 ballot question. Public fundraising reports from both sides show who the major players are in the fight, with the state's hospitals opposing the question and the Massachusetts Nurses Association supporting it. The report from the Committee to Ensure Safe Patient Care shows the Massachusetts Nurses Association spent $3.6 million to promote the ballot question this year, bringing its total spending since the campaign kicked off in the summer of 2017 to $4.7 million.

Addiction center at Boston Medical unveils new tool to help employers (WBUR)

The Grayken Center for Addiction at Boston Medical Center is launching an online resource library for employers to help their employees who are affected by the opioid epidemic. The library includes guidance about how to approach and support employees with an addiction, advice for coworkers or family members, and information about which drug and addiction treatments insurance plans should cover. Michael Botticelli, who runs the Grayken Center at Boston Medical, says fear of an employer's response is one key reason workers don't seek care. 

City of Boston sues drugmakers over opioid epidemic (Boston Business Journal)
The City of Boston filed a lawsuit Thursday against several pharmaceutical companies that make opioid drugs, joining dozens of other cities and towns in Massachusetts — as well as Attorney General Maura Healey — in seeking damages over the opioid crisis. The city, along with the Boston Public Health Commission and the Boston Housing Authority, filed a complaint in Suffolk County Superior Court against Connecticut-based Purdue Pharma LP; its predecessor company, Purdue Frederick Co.; Cephalon Inc., which is now part of Teva Pharmaceuticals Industries Ltd. (Nasdaq: TEVA); Johnson & Johnson (NYSE: JNJ); and its subsidiary, Janssen Pharmaceuticals Inc. 

BMC study: Most young opiate users not getting meds needed to recover (Herald)

"It's clear that the treatment infrastructure is really lacking across the country for young people," said Dr. Scott Hadland, a Grayken Center addiction specialist who led the study. He found that only a fourth of adults 18–22 received FDA-approved medication within three months of diagnosis. For teens under 18, that number was even lower, with just one in 21 people getting evidence-based medications methadone, buprenorphine or naltrexone. 

Boston archdiocese removes hospital chaplain after sex abuse allegation (Globe)

In a statement, the Boston Archdiocese identified the cleric as the Rev. Christian Ohazulume, an extern priest from Nnewi, Nigeria, who has served as a chaplain at Beth Israel Deaconess Medical Center since 2010. Jennifer Kritz, a spokeswoman for Beth Israel, said Ohazulume has been fired from his job at the hospital. "When the Archdiocese informed us about the allegation and its decision to revoke Rev. Ohazulume's ministry faculties, we immediately placed him on unpaid leave and terminated him shortly thereafter," Kritz said in a statement. "He is no longer employed by BIDMC." 

Flu season off to early start with 3 reported cases in Western Mass. (MassLive)

The 2018-2019 influenza season has arrived a few weeks early in the Pioneer Valley. This is the diagnosis of physician assistant Louise Cardellina of the American Family Care Urgent Care Center here. This week the center reported three cases of flu. "We confirmed a case on the second, another on the third and one on the fifth," Cardellina said. "Everyone was surprised. The reaction to the first was it's a bit of a fluke, the second, this is interesting and the third - fasten your seat belt."