Feeling lucky? Mega Millions Jackpot Tops $800 Million
RALEIGH -- The Mega Millions will hold a drawing tonight for a jackpot of $810 million. If won at that amount, it’d be the fourth-largest lottery prize in history.
Fidelity Investments says you won’t win the jackpot. You just…won’t. The odds of winning are about 1-in-302 million, which means you’re far more likely to die from a meteorite strike or go to the ER because of a pogo stick injury than win the Mega Millions.
But let’s say you do win (because someone has to). Once you regain consciousness after fainting, you’ll be faced with a decision: Take the lump sum all at once, or spread the payout over decades in what’s called an “annuity.” Here’s how each would work.
- Lump sum: You’ll receive a payment of $470.1 million, after the 24% federal tax withholding takes a ~$113 million bite out of your total winnings. Plus, the 37% top marginal tax rate means you’ll fork over more of your prize to Uncle Sam come tax season.
- Annuity: You’ll receive an immediate payment followed by 29 annual installments over the next 30 years, with each cash infusion increasing by 5% to account for inflation.
So which should you take?
Most people who win the lottery choose the lump sum, and it’s not hard to see why: You can make more money. Thanks to the magic of compound interest, you can invest your lottery winnings right away, and even with a conservative rate of return, make far more over 30 years than you can with the smaller droplets of cash provided by the annuity. Neither you nor your family would ever have to think twice about paying extra for guac again.
That said, the lump sum may not be for everyone. Are you the type of person who invested in dogecoin right before Elon Musk hosted SNL? If so, the annuity could offer some self-imposed fiscal discipline to prevent you from blowing all your winnings—which definitely happens. The internet is littered with stories of lottery winners who squandered their fortune, or otherwise watched their lives fall apart after thinking they had made it. One small study in Florida found that lottery winners were more likely to declare bankruptcy in three to five years than the average American.
Bottom line: You’re not going to win the Mega Millions (because we are), so consider this a lighthearted economics thought experiment and nothing more.
Thank you to our NCMS PAC Investors
RALEIGH — The North Carolina Medical Society Political Action Committee (NCMS PAC) would like to thank some of our investors! We are incredibly grateful for the investment into your profession and patients.
Contact Hannah Rice ([email protected]) to learn more about how you can make a difference.
John J. Meier, IV, MD
Claudius D. B. Jarrett, MD
John R. Mangum, MD
Molly L. Fuller, MD
Banks Anderson, Jr., MD
Darlyne Menscer, MD
North Carolina Medical Society Alliance Celebrates Centennial
RALEIGH -- Next year the North Carolina Medical Society Alliance celebrates 100 years! The Alliance works to improve the health of all people in North Carolina.
In advance of the anniversary, NCMS Alliance is sharing some history and stories of it's history. Here is the first.
In the beginning
On April 18, 1923, during the 70th Annual Meeting of the North Carolina Medical Society in Asheville, Mrs. Presley McCain (Sadie Lou McCain-pictured), of Sanatorium, NC, presided over the first meeting of the Women’s Auxiliary of the Medical Society of the State of North Carolina. She was recruited to this mission in March of 1923 by Dr. John Wesley Long, then the president of the House of Delegates of the North Carolina Medical Society. He had witnessed the establishment of a Women’s Auxiliary at the American Medical Association in St. Louis, Missouri and knew that North Carolina needed such an organization. He felt that Mrs. McCain, whom he knew to be a proven leader with a network of supporters, could spearhead this effort. At this first meeting, the constitution and bylaws were adopted, and Mrs. McCain was elected president.
The first board of the Woman’s Auxiliary consisted of members from around the state. Fifty-three charter members recruited more members and, in 1928, started their first project—the funding of beds at four tuberculosis sanatoria in North Carolina.
Other highlights from our first decade include—
1924 The second annual meeting was held in Raleigh. Dues were set at one dollar per year.
1925 The social side of the Auxiliary was stressed, but members began to promote a role of service, especially related to child health.
1926 The Auxiliary emphasized efforts to establish more county units.
1927 By the fifth annual meeting, 10-12 county units had been established.
1928 The first health project was established. The Auxiliary voted to maintain a bed at the State Tuberculosis Sanatorium near Southern Pines. Doctor’s Day was celebrated for the first time.
1929 One hundred twenty-five people attended the Annual Meeting in Greensboro where the constitution was revised.
For more on the Alliance click here.
On Point: Room with a View - by James E. Hill, Jr., MEd, PA-C Emeritus, DFAAPA
I have been clinically retired as a practicing PA for several years now after a 42-year career as a PA, mostly in emergency medicine. During that time, a number of patient experiences have remained with me, mostly for the life lessons they taught me. There is one, though, which has haunted me for over 10 years, and I’ve finally decided to banish those demons by sharing the story.
In emergency medicine, the practice environment is a closed system. There are no windows and the doors lead to other areas of the ED or the hospital. In wintertime, while working a day shift, it was dark when I left for work and dark when I finished my shift to drive home. The florescent lights on the ceilings are our synthetic sunshine.
One winter’s shift I arrived to discover that the Spanish interpreter we usually used to help us with our Hispanic patients had called in sick, and there was not a backup interpreter available. My first patient was a 12-year-old Hispanic girl who was presenting with 2 weeks of nausea. She spoke English fluently, but her mother did not speak English. I had a dilemma since there were no staff in the ED who spoke Spanish that day.
I decided to speak to the 12 year old since she was intelligent and appeared mature for her age. I did ask her to share my questions with her mother, and her answers with her mother---English to Spanish to English. A history of present illness revealed no associated symptoms---just intermittent nausea throughout the day for 2 weeks. She also told me she had not started having menstrual periods yet and had no boyfriends.
Her physical examination was normal---no signs of dehydration, no icterus, no abdominal discomfort. The decision was then made to obtain some laboratory studies (blood and urine) as a screening assessment. Just before sending these to the lab for analysis, my “6th sense” told me to add a urine pregnancy test. All the labs came back normal except for one---a positive pregnancy test.
I returned to the room to speak to my patient about her lab results. She swore to me, quite adamantly, that the test had to be a mistake as she had no boyfriend and had never had sex. I was determined to uncover the truth, and we continued our discussion for over an hour---her denials and my persistent assertions that it was important to face the truth for her health. Ultimately, she started to cry, then told me that her stepfather had been sexually abusing her for several years, finally progressing to penetration in the past few months. She begged me not to tell her mother, saying that he was the only one who worked in the family and that she, her younger brother and her mother would have no place to live if he was arrested. I convinced her to tell her mother what she had told me. And, I told both of them I had to report this to the police and to the social worker as what the stepfather was doing was harmful to both of them, as well as a crime.
The mother had difficulty accepting the diagnosis and the facts behind the pregnancy. The police arrived as well as a social worker, and the stepfather was arrested in the waiting room. All I could think to say to the 12 year old girl that she would come to realize later this was the only way to heal and move toward a healthy life.
I then returned to seeing other patients after being tied up with one patient for over 2 hours. As is common in emergency medicine, her follow-up was lost to me. At the end of my shift, I drove home in darkness, thinking about this child and the terrible events bringing her to the emergency department, wondering what would happen to her and her pregnancy, wondering if she and her family would survive the betrayal of trust from her step-father and his path through the criminal justice system, wondering if she would grow wiser in the coming years. It was then I had an epiphany. The emergency department may have no windows, but it is truly a room with a view. It allows us to see people in their worst times, caused by events not of their choosing in most cases, and it allows us as PAs to be part of their lives for a sliver of time when dealing with the results of those events. I’m happy to settle for that.
Calling All Future Leaders in Healthcare!
If you are a student in a healthcare track, the Future Clinician Leaders College is a great opportunity for you! Offered by the NC Medical Society and the Kanof Institute for Physician Leadership Future Clinician Leaders College in partnership with the North Carolina NWAHEC, applications for the 2023 cohort are now open.
The program welcomes applications from students in North Carolina health profession training programs interested in a year-long state-wide interprofessional leadership development program. The program is open to medical, pharmacy, physician assistant, nursing, or other health professional students. The program is tuition-free.
Nominees will be evaluated by the Future Clinician Leaders College Program Committee based on the following criteria:
- a) Prior commitment to leadership in healthcare
- b) Strong potential for this program to impact the student’s future career development
- c) Commitment to attend all sessions
- d) Local support from institutional mentor
Click here for a full outline of requirements and program dates.
For more information click here.
For an application click here.
Henry Schein Medical is Here to Help!
Henry Schein Medical is the largest global supplier of medical/dental supplies offering standard next day shipping with an order fulfillment rate of 99%. Special pricing along with a dedicated service and support team is also extended for NCMS members not currently purchasing from Henry Schein Medical.
Henry Schein Medical provides quality products and solutions to help customers elevate patient care and run a better business. Henry Schein’s “pick, pack, and ship” distribution model ensures both physicians and patients have the products they need, when they need them most.
Henry Schein offers national brand, generic, and Henry Schein brand products that address your quality care initiatives—from prevention to diagnosis to treatment. Their expansive offerings include:
• Medical surgical supplies
• Medical equipment
• Laboratory supplies
• Pharmaceutical supplies
Henry Schein Medical forms strategic partnerships with suppliers to ensure that customers receive the best-in-class products and services available. Their suite of capabilities and innovative Solutions helps practices thrive clinically, operationally, and financially.
Henry Schein’s outstanding support and engagement during the pandemic along with the synergies we share, prompted the NCMS to establish a partnership agreement for the sole benefit of members.
Ready to learn more about Henry Schein Medical? Contact them today!
[email protected]
No waiting! Become a Destination Health Traveler!
The North Carolina Medical Society has re-launched its annual campaign! Destination Health is the new project everyone will be talking about and you can be part of it.
Become a Destination Health Traveler!
The Recurring Monthly Gift Campaign is key to securing resources to build better health in North Carolina. This fund will provide the financial means to invest in a host of innovative initiatives over the next decade. Knowing we can count on your monthly gifts lets us plan for a bright future.
Consider joining today. Your monthly gift of any size will grow over time and make an even bigger impact on health here in the state.
Can we count on you in 2022 and beyond?
Become a Destination Health Traveler now! Click here for all you need to know.
NCMS Board Member Dr. Claude Jarrett talks Healthcare Policy and Medicaid Expansion
RALEIGH -- North Carolina Medical Society Board Member Dr. Claude Jarrett took time to speak on a podcast with Connie Wilson about the recent legislative session. Jarret is an orthopedic surgeon practicing at Wilmington Health. In addition to his clinical practice, Dr. Jarrett also participates in grant funded research projects addressing rotator cuff injuries, shoulder arthritis, and upper extremity fractures.
In his conversation with Wilson he covers a broad range of topics with particular interest and insight into healthcare policy, Medicaid Expansion and Specialty Care.
Listen to his conversation by clicking here.
Somebody Could Have a Really Great Weekend Ahead of Them!
This Friday you could be a multi-millionaire! The Mega Millions jackpot has ballooned to $630 million after there were no winners to match Tuesday’s winning six numbers.
The numbers were 2, 31, 32, 37, 70 plus the gold Mega Ball 25, according to the lottery’s website.
The cash prize is estimated to be $360 million.
Strong ticket sales helped push Tuesday’s prize to its historical rank, which was about $317 million in cash, according to the lottery’s website.
There were four big winners Tuesday who drew the first five numbers, winning $1 million each. Fifty-two winners matched the first four numbers and the Mega Ball, the lottery said.
If you win please remember the North Carolina Medical Society when you start spreading that wealth around!
MEMBER SPOTLIGHT: Dr. Gabriel Cade
Meet some of your fellow NCMS members each month in our Member Spotlight! You can also take your turn in the spotlight. Look at the bottom of this story for more information.
1. What is a quote that has had a significant influence on your life, and why?
“Be Here Now.” The quotation is from a 1971 yogi spiritualist, but I first saw it in 9th grade when my math teacher wrote it in all caps on the board - an unintentionally meaningful attempt to gain the control of a rowdy class. I think it took me another decade (or two) to recognize the significance of this concept. Be present. Be in this moment. Be aware of the experience you are having. Be aware of the patient and their experience - be truly present for each need and concern. My intrinsically chaotic way of thinking and learning had led to many lucky wonderful adventures around the world and ultimately (inevitably) to emergency medicine, but I found this mantra necessary to get the most out of each experience. Even outside of the emergency department I see real value in this simple phrase. Put down my cell phone. Look at my wife. Look at my children. My job exposes me constantly to the frailty and flicker of the human condition and I sure don’t want to miss any of it.
2. Where are you from originally?
I was born about 200 feet from my current desk, in the lovely Blue Ridge Regional Hospital in Spruce Pine, NC, about an hour from Asheville. I had a fortunate childhood playing in the rivers and forest of the South Toe valley and I am doubly fortunate to continue doing so with my own children.
3. How did you decide to become a physician?
The dinner party answer is that I proposed to my wife when I was a two-time college dropout, rock climbing around the US, living in my car, occasionally getting work as a gear tester or travel writer. She and her family were understandably dubious. The reality is that it was inevitable - I was just waiting for dramatic timing. My parents, both medical workers themselves, raised me and my siblings with values of service and compassion. My father is a rural primary care physician, my mother is a retired nurse, and I saw the extraordinary relationship they had with our community. The practice of medicine can create opportunities to be very intimately present for another person - sometimes throughout the gentle meanders of a long life, and sometimes through the immediacy of an emergency or significant fear or suffering. My twin sister is a wonderful primary care Physician Assistant also working in rural Appalachia. My older brother is an immigration lawyer who works tirelessly to help children and families seeking asylum and support. We all believe in the value of this type of work and these relationships. Plus, I’m just not sure my wife wanted to live in my car.
4. What do you like about practicing in an underserved area?
It’s a unique and delightful experience to work side by side with my neighbors as we take care of our neighbors. There are many unique challenges practicing in a rural community. Access to resources - even basic non-medical resources - is very limited. Health literacy is low. Socioeconomic obstacles are significant. My family and I live in the same rural area where I work so we all experience some of these challenges ourselves. This helps reinforce the obvious truth that underserved doesn’t mean undeserved. My patients and our shared situation require that I be better at my job than when I worked at a level 1 trauma center. I have to read more and practice more and be more ready. This helps me be more present, to “be here now.” Luckily, I work with nurses and other local doctors who are really, really good at their jobs, and the more we work together in this intimate environment the better we all get together.
5. Is your practice using any tools to address social determinates of health for patients?
A few years ago I was able to participate in the Health Care Leadership and Management (HCLM) program through KIPL/NCMS. During this program we developed a questionnaire to integrate into triage to help identify SDOH in our patient population. Unfortunately, even as we work to identify more of these needs, we still struggle to provide the follow up resources necessary to make impactful change. There is no doubt that addressing these aspects of care enhances individual and community wellness and reduces reliance on primary and emergency care, but the infrastructure to support the need is greatly lacking.
6. What impact has the Covid-19 pandemic had on your practice?
Anyone involved in healthcare has been facing the dual pressures of dealing with COVID in their lives as well as caring for patients dealing with COVID. It has been really hard. The struggles with misinformation feel amplified in our rural community. The demand on our limited resources has been very heavy and our hospital lost some exceptional nurses to burnout and higher-paying travel jobs. It has further exposed some of the pre-existing failings of our healthcare system without (yet) making them better.
7. Do you have any hobbies or activities for self-care?
I have an amazing wife and two super rad little boys, and I don’t know what I would do to recharge without them. We live deep in the mountains and spend a lot of time tramping and playing outdoors. I also love to play soccer, read historical nonfiction adventure (age of exploration Lewis and Clark and Magellan type stuff), and, when everyone goes to bed, play video games.
8. You spent some time abroad in New Zealand, what were some of the differences in the manner healthcare is delivered in NZ v. US?
My truthful opinion is that the method of healthcare delivery in New Zealand is superior in almost all ways to that of the US system. Emergency department visits and any accident-related events are all free. Medications are affordable. Home health is much easier to arrange for management of diabetes, wounds, in-home antibiotics, physical and occupational therapy, and many other kinds of follow up. Nurses and physicians have compulsory “tea breaks” (with real tea) and generous paid leave, things I had never experienced before in almost 15 years in healthcare. The almost complete absence of medical litigation and metric-driven profit medicine fundamentally alter the approach to care. You don’t have to order every test and every scan on every patient every time. In the United States, the fear of missing something that first encounter, and the associated worry of being sued, complicate medical care and drive the cost of workups significantly. In New Zealand, if someone seemed well enough, we could send them home and just ask them to come back if they weren’t improving for a broader work up without any additional cost to the patient for a second visit. In 18 months of working there, I had less than half a dozen encounters with opiate dependent or opiate diverting patients, which is something I deal with almost daily in my US job. Physician salary is standardized across the country and based almost completely on your number of years out of training, so distribution of healthcare resources is much more uniform across all communities, and you don’t wonder if someone doing the same job is making more than you are - they also pay physicians about a third of what they can make in the US, but the emotionally supportive work environment makes it worth it. You do have to wait longer for elective type surgeries and procedures, but it turns out that you can! I believe in the potential of a centralized healthcare system, and with it a better approach to other social determinants of health.
If you would like to be featured in our Member Spotlight, please complete the form here.
CDC Sounds Alarm on Parechovirus
Last week, the CDC issued a health alert, warning pediatricians about the potentially dangerous pathogen Parechovirus.
Of the multiple reports of infection the agency received, most were for the PeV-A3 strain, commonly associated with severe disease.
Parechoviruses are common childhood pathogens similar to enteroviruses such as the poliovirus. The CDC encourages health care providers to test for Parechovirus when patients present certain symptoms. Symptoms most commonly seen in children 6 months to 5 years old include respiratory tract infection, fever and a rash. In infants younger than 3 months, symptoms may include fever, sepsis-like syndrome or neurologic illness, including seizures and meningitis.
Read more about Parechovirus here.
Do not try this at home!
A musician in South Africa is sharing one of the craziest videos on the internet right now. It shows a man trying to "fly" through a car. Honestly, there are so many questions! How did that car get up on bricks? Why would someone try this? What is the point?
Have you seen this yet? What do you think?
https://twitter.com/_Mashudu_M/status/1548576419172982784
Join Destination Health!
Did you know, our new recurring gift program Destination Health Traveler is the simplest and most effective way to support the North Carolina Medical Society Foundation’s efforts to improve access to quality health care for all North Carolinians?
Destination Health is the North Carolina Medical Society Foundation’s newly re-launched annual campaign to secure resources to build health in North Carolina. This fund will provide financial means to invest in a whole host of innovative initiatives over the next decade.
Join Destination Health Traveler and become a monthly donor today.
*P.S. If you are able to consider a gift of $100 a month, you will receive a special invitation to attend the annual 1849 Society dinner in 2023. The 1849 Society is the NCMS Foundation’s most prestigious giving club that recognizes donors who have given $10,000 or more cumulatively.
Music Under the Stars!
Wake County Medical Society (WCMS) invites you to a casual social event at the Booth Amphitheatre, this Saturday, July 16!
- What is the NC Symphony Summerfest?
- What is Booth Amphitheatre? A very central Wake County location and beautiful concert venue.
- Who is Sidecar Social Club? A very cool band appealing to several generations!
- Where is the WCMS hosting? Cocktails and hors d’oeuvres will be served in the Crescent Deck, adjacent to the VIP Café starting at 6:30pm. The concert starts at 8pm.
- What’s the weather forecast? Evening temps in the 70s!
- How do I buy tickets? See the promo code above, and buy your tickets for the Crescent Deck, or any location of your preference.
Have additional questions? Check out ncsymphony.org/wcms.
See you at Summerfest!
Do You TikTok? For One Doctor, 1.6 Million People are Learning and Having Fun
Do you know Dr. Glaucomflecken? That is the name that has hundreds of thousands of people flocking to hear Dr. Will Flanary on the popular app TikTok.
In his posts on Instagram, Twitter, and TikTok, Flanary mocks everyone, equally. He refers to ER docs as those who love adrenaline and bike helmets, considers Orthopedic doctors bros who are into the gym, and reserves specila fun for med students.
Is Your Business Suffering Because of Supply Chain Issues?
CMS is gathering feedback from providers, practices, hospitals, and stakeholders who are having issues with DME supply. The information you provide will be shared with CMS leadership for review.
Thank you very much for your help.
Please send your comments to Kristen Spaduzzi at [email protected] or 919.719.4169
Tailor Made: Tailored Care Management and Whole-Person Care
The NC Health Information Exchange Authority is hosting a Tele-town Hall on Tailored Care Management.
On August 17th at noon, you can learn about how Tailored Care Management can improve whole-person care. You will also learn how HIE can help you and your patients. To learn more and register, click here.
NC AHEC Offering Free Courses for Community Health Workers
RALEIGH -- The North Carolina Medical Society is excited to let you know that the NC AHEC Community Health Worker Program is offering FREE online courses.
THE NC AHEC Community Health Worker Program supports the development of a qualified and sustainable workforce that is well equipped to advance health equity. It is also partnering with Advanced Medical Homes as part of Medicaid Managed Care. It serves as an anchor partner of the NC CHW Initiative which is led by the NC Department of Health and Human Services Office of Rural Health. It also collaborates with the NC CHW Association, NC Division of Health Benefits, and other stakeholders to make sure training topics align with CHW Culture and priority learning needs.
Register NOW for 90-minute, self-guided courses. They are for community health workers, lay health workers, outreach workers, frontline public health workers, plus supervisors, colleagues and allies of the CHW workforce. CUEs and Contact Hours are offered. The courses are FREE to all, but registration is required.
Click here for more information and to register.
How YOU can help Climate Change
The Office of Climate Change and Health Equity (OCCHE) is launching a webinar series as part of the Health Care Climate Pledge, and you can learn more! Accelerating Healthcare Sector Action on Climate Change and Health Equity starts July 14th at noon and you don’t want to miss it! Learn how to take part and do more by clicking here.
Understanding Structural Barriers to Mental Health Care
More than 6 in 10 physicians (61%) report experiencing feelings of burnout, yet only 14% of physicians report seeking medical attention for their symptoms. Why? There are six key structural barriers that prevent physicians from seeking the mental health care services they may need. The NPSA Day resource Understanding Structural Barriers to Mental Health Care can help you learn more.
Leadership College Program - Now Accepting Applications for the Class of 2023!
The KIPL Leadership College Program is a nationally renowned, project-based curriculum designed to foster your leadership skills and build your network in the healthcare community so that you can lead and impact healthcare, in your workplace as well as in your community.
Based on the idea of health care as a system with equal access to all, Leadership College equips graduates to enhance their individual effectiveness to become more influential in motivating and inspiring other physicians and physician assistants to be leaders and drive transformation.
Enrollment is limited - Learn more about the program and apply today!
Appointment Opening for the Governor’s Advisory Council on Aging
The NCMS has the opportunity to appoint an NCMS Member to the Governor’s Advisory Council on Aging (GAC). The GAC consists of 33 members including 29 members appointed by the Governor, two members appointed by the President Pro Tempore of the Senate and two members appointed by the Speaker of the House of Representatives.
NCMS Application to State Boards and Commissions
Deadline to submit NCMS Application to State Boards and Commissions: August 31, 2022
*Preferred area of practice: Family Medicine - Geriatric Medicine
No Surprises for Your Patients With These Fact Sheets, the Latest on the No Surprises Act
The Centers for Medicare and Medicaid Services recently published four new fact sheets for practices to make available to patients. Here is what you need to know:
- Health Insurance Terms You Should Know
- How Do I Read My Medical Bill
- What's A Good Faith Estimate
- Health Care Notice & Consent Form
You can find these and more information from CMS about the No Surprises Act HERE.
Melanoma Monday: Survive the 4th with Beautiful Skin!
All summer NCMS is bringing you tips to enjoy the great Carolina outdoors. Melanoma Mondays run weekly until Autumn with information from your fellow NCMS members. Today it’s Dr. Sarah Cash from WNC Dermatology in Asheville with how to survive the 4th of July with beautiful skin. Enjoy!
Sarah Cash, MD
WNC Dermatology
Asheville, NC
Have fun and stay safe today!
- Seek shade! The sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow appears to be shorter than you are, look for a place of refuge in the shade.
- Use extra caution near water, snow, and sand. Those spots reflect and intensify the damaging rays of the sun, which can increase your chances of sunburn.
- Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Make sure that all skin not covered by clothing is protected. Broad-spectrum sunscreen provides protection from both UVA and UVB rays.
You can contact Dr. Cash with more questions by clicking here.
Not a NCMS Member yet? Click here to join!
Look for more advice next Monday and have a great 4th of July weekend!
On Point: Restricting abortion will not stop people from seeking abortion - by Dr. Amy Bryant
On Point submissions are individual member viewpoints and not North Carolina Medical Society policy.
I always ask my 3rd year medical students when they start Ob/Gyn: “What are you most excited about?” They invariably say “delivering a baby.” At the end of their rotation, they write essays about what has impacted them most. Someone, usually more than one, writes about how unexpectedly difficult pregnancy could actually be. They learn the truth that has become clear to me over almost 2 decades in Ob/Gyn: pregnancy is not always a joyous condition.
The Dobbs decision overturning Roe vs. Wade, which has protected the right to privacy between a patient and her doctor for almost half a century, turns the ability to make laws regarding abortion back to states. In North Carolina, the right to abortion exists for now, but could be rolled back if the state legislature decides to ban or restrict abortion. If this happens, there will be unintended consequences for women’s health. Pregnancy is not always a joyous condition, and in some cases can lead to severe morbidity and mortality, not to mention poorer outcomes for existing children, greater poverty, and less educational attainment (see turnaway_study_brief_web.pdf (ansirh.org)_
North Carolina has unacceptably high levels of maternal mortality, particularly among the most marginalized women populations. Racism and structural inequity are two of the drivers that deprive many Black, Indigenous and other people of color access to quality healthcare, including abortion, prenatal, and maternity care. These communities have higher rates of maternal and infant death and are more likely to be investigated, prosecuted, and punished for their pregnancy outcomes. The impacts of restricting abortion will fall hardest on people who already face discriminatory obstacles to health care—particularly Black, Indigenous, and other people of color, people with disabilities, people in rural areas, young people, undocumented people, and those having difficulty making financial ends meet.
Restricting abortion will not stop people from seeking abortion. Evidence of this has been seen around the world. When faced with obstacles to getting a safe abortion under the guidance of a trained physician, people will travel or seek other means of obtaining abortion. When a pregnant woman experiences a medical emergency, without consulting a medical expert, it may be impossible to tell whether they are experiencing an induced or spontaneous abortion, which could, under the new federal law, put a patient in jeopardy of criminal referral. Furthermore, physicians will need to make decisions not based on what is best for the patient, but on considerations of criminal liability. This is not an optimal way to practice medicine.
Every person and every pregnancy is different, and not every patient decides to continue a pregnancy. Our patients’ lives are complex, and full, and nuanced and beautiful. As physicians, we have the responsibility to care for our patients with dignity, respect and support, using shared decision making to come to the outcome that best serves each patient, who is the expert in her own preferences and values, without undue interference by outside parties.
Amy Bryant is North Carolina Ob/Gyn and a NC Ob/Gyn Society At-Large Member from Durham
Value-Based Contracting Survey
A team of physicians from Carolina Complete Health and the North Carolina Medical Society and researchers from the Center for Advanced Hindsight at Duke University are studying how providers feel about value-based contracts.
We'd like to invite you to participate in a 15-minute survey to assess your thoughts about and experiences with value-based contracting. Your participation is entirely voluntary.
In return for participation, you may opt to enter a drawing to win 1 of 20 charity prize packages with an approximate value of $40-$70. You may choose your prize from a list of 12 options supporting 10 different charities, such as UNICEF or the Red Cross. Entering the drawing requires sharing your email, but don’t worry – your email will be kept separate from your survey answers so that nothing you say can be linked back to you.
If you're interested, please click here to complete the survey. If you have any questions about the survey or your participation, email [email protected] to ask.
NCMGMA: Nominations for Practice of the Year
The North Carolina Medical Group Management Association (NCMGMA) is proud to partner with First Citizens Bank to present the 9th Annual Practice of the Year Award, to be presented on the evening of Thursday, September 15 during the Fall Conference dinner & awards.
This award recognizes a medical group practice that has made a significant contribution to their community, patients, and/or staff through volunteer work, indigent clinics, fundraisers, staff wellness programs, community clean-ups, community screenings and education (internal & external), etc.
The Award recipient will receive:
- An attractive award piece.
- A donation to be made in the practice's name to their charity of choice.
- Public recognition at the NCMGMA Fall Conference.
- Promotion through a press release to national trade and consumer media.
- Recognition in the NCMGMA Quarterly Newsletter and E-News Site, NCMGMA News.
To submit your nomination for the 2022 Practice of the Year Award, please access the printable form here and return it to the NCMGMA office at [email protected] by 5:00 PM on August 6, 2022.
Celebrate World Social Media Day
First there was mail, then the telegraph and telephone, then the fax was being used by everyone. Now it is all about social media and today is World Social Media Day!
World Social Media Day was launched by Mashable on June 30, 2010. It is to recognize social media’s impact on global communication. Almost everyone uses social media to connect with people all over the world in a simple and fast way. Here are some numbers from nationalday.com
WORLD SOCIAL MEDIA BY THE NUMBERS
3.5 billion – The number of people using social media worldwide.
68% – The proportion of U.S. adults who use Facebook.
3 hours – Time spent by your average person each day on social media or messaging
500 million – The number of people using Instagram Stories each day.
60 billion – WhatsApp and Facebook Messenger messages sent each day.
35 minutes – The average user spends on Facebook each day.
270 million – The estimated number of fake Facebook profiles.
707 – Number of followers the average Twitter user has.
300 hours – Video footage uploaded to YouTube every minute.
95 million – Photos uploaded to Instagram each day.
And here are some suggestions for today:
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Post, post, post!
Social media is only as good as the posts on it, so use this occasion to add your voice to the party! Post a selfie, a Tweet, or go live on Instagram or Facebook.
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Try new platforms
There are so many social media sites out there waiting for you to discover them. Before you know it, you could be making TikTok videos, sharing your greatest travel adventures on Instagram, or joining in fun trending topics on Twitter. Give some platforms a try and see if you like them.
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Take it offline
Social media can bring people together, but sometimes it's most special when your Internet friends become your IRL friends. In honor of Social Media Day, hang out with a friend you usually just talk to on social media out in the real world! Go on a walk, get a drink, or catch a flick. Just don't forget to take a pic to put on social media after!
AND FOLLOW NCMS!!!!
The North Carolina Medical Society posts daily with important updates, fun tips, and ways to make your day brighter and your business better. Like, comment, and share!!!!
Political Pulse June 28, 2022, reaction to Medicaid Expansion in NC
RALEIGH, NC -- The North Carolina Medical Society is leading the way to change! A standalone Medicaid expansion bill was introduced Tuesday. SB408 is supported by Speaker Tim Moore who called out NCMS for its continued support and aid in getting this important legislation passed.
NCMS supported the bill with testimony from CEO Chip Baggett. Also, Dr. Rachel Keever, Dr. Bryant Murphy, and Dr. Michael Utecht dropped everything and rushed to Raleigh in case the House Rules Committee had questions.
This Political Pulse is those three doctors discussing this important legislation.
Click here to contact your Senator and let them know you stand with NCMS and support Medicaid expansion.
Would Your Patients Benefit from a Y Medical Membership?
If you are a Triangle-area physician, the YMCA of the Triangle in partnership with Blue Cross and Blue Shield of North Carolina has evidence-based chronic disease prevention programs to support your patients through a YMCA Medical Membership program. You can refer a patient through the NCMS Foundation’s Our Community Health Initiative (OCHI) software platform directly to the YMCA of the Triangle for any of the six program offerings; diabetes prevention, weight management, high blood pressure, falls prevention, support for cancer survivors, or childhood and family weight management.
Medical Memberships are a bundled service that provide care coordination, a YMCA membership and the evidence-based program as prescribed due to your diagnosis.
Find out if a Medical Membership is right for your patients. Programs are starting soon! Your patients can find out more about cost and program enrollment here.
For additional questions please contact Medical Membership at [email protected] or at 919-582-9396
Behavioral Health Integration Immersion Program
The BHI Collaborative, a partnership between the AMA and seven other leading physician organizations, is launching a new, free initiative designed to provide enhanced technical assistance to physician practices.
Selected practices will participate (at no cost to them) in a 12-month curriculum designed and taught by industry experts on how to effectively implement behavioral health integration (BHI). Upon completion, practices will be able to:
• Identify the best approach for delivering integrated care (including telehealth) for their practice and patients
• Determine internal staffing needs (including preparation, training, or qualifications) along with outside partnerships
• Design a workflow(s) with processes and protocols that works best for their practice
• Bill/receive payment to sustain delivery of integrated care services
• Establish short- and long-term goals of success, including measurable improvement targets and indicators
Learn more and apply to see if your practice qualifies. Application process closes on Friday, August 5th.
Time for Action: NCMS Helping Move Standalone Medicaid Expansion Bill Forward
The North Carolina Medical Society is leading the way to change! A standalone Medicaid expansion bill was introduced on Tuesday. SB408 is supported by Speaker Tim Moore who called out NCMS for its continued support and aid in getting this important legislation passed.
NCMS supported the bill with testimony from CEO Chip Baggett. Also, Dr. Rachel Keever, Dr. Bryant Murphy, and Dr. Michael Utecht dropped everything and rushed to Raleigh in case the House Rules Committee had questions. Click here to hear their remarks on the legislation.
Now it is your turn. NCMS members need to advocate for this important legislation right now.
Click here to contact your Senator and let them know you stand with NCMS and support Medicaid expansion.
Summer is Here! Melanoma Mondays are here to keep your skin safe!
All summer NCMS will bring you tips to enjoy the great Carolina outdoors while staying safe from the sun's rays. Melanoma Mondays will run each week until Autumn with information from your fellow NCMS members. Today it's Dr. Matilda Nicholas from Duke Dermatology with ways to get the season started. Enjoy!
Have fun in the sun and be safe this summer! Here's how:
- Protect yourself from the sun! Use a sunscreen containing zinc oxide and reapply every two hours and more often if swimming or sweating. Apply a solid layer! A golf ball size amount of cream is about right for your body. Even sunscreen isn't enough for southern sun! Wear broad brimmed hats (4 inches ideally), sun protective clothing such as swim shirts and sun sleeves, and seek shade, especially during peak hours of sun between 10am and 4pm.
- Pay attention to your skin! If you see any new, growing, bleeding, or changing growths on your skin, or something that looks different from all of your other spots, see a dermatologist right away.
- Summer sun, salt water, and chlorine can dry out your skin. Be sure to shower after swimming and use lots of moisturizer to keep your skin healthy and comfortable.
You can contact Dr. Nicholas with more questions by clicking here.
Not a NCMS Member yet? Click here to join!
Look for more advice next Monday!
Member Spotlight: Q&A with Lisa Gangarosa, MD
Member Spotlight: Q&A with Lisa Gangarosa, MD
What are your hobbies or hobby?
Aerial dance, reading fiction
What is one item on your bucket list or that you want to do or place you want to travel in the future?
Back to Sicily
What is your all-time favorite book that you have read and want to recommend to others?
The Inspector Montalbano series by Andrea Camilleri.
What did you do during the COVID pandemic to practice self-care? If nothing, what would you like to learn more about to support self-care?
Initially frequent walks but when my aerial studios reopened I resumed my training.
Why are you a member of the North Carolina Medical Society?
I specifically like the advocacy efforts on behalf of physicians and our patients with the NC legislature.
Would you recommend NCMS membership to a peer?
Yes, definitely!
Are you ready for the Spotlight? Complete the form here.
NCMS Response to SCOTUS Roe v. Wade decision
Statement from North Carolina Medical Society CEO Chip Baggett on Supreme Court ruling overturning Roe V. Wade:
Today the United States Supreme Court voted to eliminate the constitutional right to an abortion, overruling the 1973 Roe v. Wade decision, leaving the question of abortion’s legality to the states. The North Carolina Medical Society position remains that an abortion is a personal health and medical decision to be made by a qualified doctor and patient.
The NCMS full position on abortion is available by clicking here:
NCDHHS Introduces Hope4Healers Helpline for Health Care Professionals
The Hope4Healers Helpline is a new initiative in partnership with the North Carolina Psychological Foundation. It provides mental health and resilience supports for health care professionals, emergency medical specialists, child care professionals, educators, disaster and first responders, other staff who work in health care and educational settings, and their families throughout the state who are experiencing stress from being on the front lies of the state’s COVID-19 response.
Hope4Healers is also available 24 hours per day, seven days a week for people to reach out for support from a licensed mental health professional.
If you need help call 919-226-2002 today.
On Point: CMS needs to include measures for social drivers of health
This op-ed was shared on April 29, 2022, on STAT
By , and
Yet even with an ongoing pandemic that has painfully brought these issues to the fore, no measures of social drivers of health exist in any federal quality and payment programs, and these factors are still not accounted for in CMS’s “risk adjustment” calculations — how healthy (or sick) a patient is and, therefore, how much their physician should be paid to care for them.
The Physicians Foundation, whose directors are appointed by 21 state and county medical societies, responded to CMS’s annual invitation for new Medicare measures by putting forward the first two SDOH measures ever proposed. These focus on the percentage of patients who are asked about food insecurity, housing instability, inadequate transportation, interpersonal safety, and difficulties paying for electricity and other utilities; and the percentage of patients who are positive for each of these needs. Even though CMS has declared it a priority to “develop and implement measures that reflect social and economic determinants,” these two measures are the only ones related to social drivers of health and are the only patient-level equity measures in this review cycle.
To truly move the needle to improve health outcomes for vulnerable Americans and give physicians the quality measures they want and need, CMS must act now to incorporate these two measures. Last week, CMS took a crucial first step by proposing these measures for the Hospital Inpatient Quality Reporting Program, which sets rules for Medicare payments to hospitals. Next, it will consider the same measures for the Merit-based Incentive Payment System.
Many stakeholders have emphasized the particular importance of the percentage of patients who screen positive for social needs. The rate itself should not be rewarded or penalized, recognizing that it would be influenced by the community in which a practice exists and its patient population. Yet this measure is essential to make visible and address factors that contribute to health disparities and support improvement activities. In addition, this measure would enable CMS to account for patient-level social drivers of health in risk adjustment, providing a more complete picture of the impact of these factors on health care costs, outcomes and disparities.
Both measures are essential to fulfill CMS’s commitment to health equity — articulated in its recently released health equity strategy pillar and its vision for the Centers for Medicare and Medicaid Innovation and its associated health equity initiatives, all of which cite the importance of routinely and in standard ways “collecting self-reported demographic and social-needs data.”
Over time, these measures of social drivers of health can and will be improved with the benefit of the input of physicians and patients across the country and the data generated by these measures. Yet we also recognize that, given the profound challenges that Covid-19 has wreaked on patients, physicians, and the U.S. health care system at large — and the commitment to equity and the reduction in health disparities that CMS and health care institutions across the country have declared — that time is of the essence in enacting these historic measures of social drivers of health.
Michael Darrouzet is the chief executive officer of the Texas Medical Association. Jennifer Lawrence Hanscom is the chief executive officer of the Washington State Medical Association. Chip Baggett is the chief executive officer of the North Carolina Medical Society. All are board members of The Physicians Foundation, a nonprofit seeking to advance the work of practicing physicians and help them facilitate the delivery of high-quality health care to patients.
On Point: Address rising violence in the ER - by Michael Utecht, MD
This op-ed was shared in several publications including the Raleigh News & Observer and the Charlotte Observer on January 27, 2022
Picture this: You’re a physician, nurse or other hospital staff member working a Friday night shift in a busy emergency department — where tensions often run high. Local law enforcement officers usher in a violent patient. He is placed in a room, evaluated and kept under guard for several hours.
Before it can be determined that the patient can be released back into police custody, he violently assaults a staff member, as well as the police officer guarding him. He grabs the officer’s weapon and threatens everyone around him. Shots ring out. Hospital police use deadly force to subdue the once patient, now assailant, and staff and patients flee.
This very scenario played out Jan. 14 in the Emergency Department at Duke University Medical Center. Violence in emergency departments and other hospital settings is growing at an alarming rate. Not just in large, urban centers but across the spectrum of healthcare facilities. VA hospitals, small rural hospitals and local community hospitals are not immune from such violence.
According to surveys by the American College of Emergency Physicians and the Emergency Nurses Association, almost half of emergency physicians report being physically assaulted at work, while about 70% of emergency nurses report being hit and kicked while on the job. Nearly 7 in 10 emergency physicians say their hospital reported the violent incident, yet only 3% of the hospital administrators pressed charges. So it is no surprise that 80% of emergency physicians say violence in the emergency department impacts patient care. To compound the problem, the COVID-19 pandemic has increased emergency department use by patients with behavioral health and substance abuse issues, pushing already resource-strained departments to the brink. Unfortunately, state and federal legislators have thus far done little to introduce legislation to prevent such violence. Often focused on “punishment” in the aftermath, no current legislation empowers hospitals to take the necessary measures to prevent violence in the first place. Simple measures such as requiring metal detectors at hospital main and emergency department entrances have proven to be effective as a first line of defense.
Sadly, some hospital administrators feel this promotes a negative image to their “clients,” although multiple studies have proven the contrary. Certainly metal detectors do not seem to deter anyone from attending a sporting event! Fortunately, groups like the American College of Emergency Physicians and Emergency Nurses Association continue to advocate for meaningful legislation to address violent crime in hospitals. Only time will tell if their efforts will put an end to the violence. But, quite frankly, time is running out. The frequency of violent attacks on nurses, physicians and patients in our nation’s emergency departments is unconscionable and unacceptable. For medical professionals, being assaulted must no longer be tolerated as “part of the job.” As one of the Duke Emergency Medicine residents said to me shortly after witnessing the events of that recent Friday night: “I never thought I was entering a profession where I could be killed!”
Michael Utecht is an emergency medicine physician in Durham and current president of the N.C. Medical Society.
NCMS Morning Rounds for Oct. 15, 2021
While the NC House and NC Senate have an agreed upon budget document, which has not been made public, negotiations are ongoing with Governor Roy Cooper to finalize a state spending plan. We hear there is an announcement planned for next week, so stay tuned and watch your NCMS Morning Rounds newsletter and next Friday's video for updates.
It's LEAD Health Care Conference time! We hope you enjoyed our NCMS PAC legislative forum last night! There is lots more to come today and tomorrow as our sessions address timely topics of importance to you, your practice and your patients.
NCMS Political Pulse for Oct. 8, 2021
The focus this week at the General Assembly was an energy bill moving through committee while budget negotiations continue between legislators and the Governor. We may see a final spending plan next week, so stay tuned.
Be sure to register for our 2021 Virtual LEAD Health Care Conference, which kicks off next Thursday, Oct. 14, with our NCMS PAC event featuring an all-star line up of legislator panelists to discuss the issues that impact your practice. Learn more and register here.
NCMS Political Pulse for October 1, 2021
Finally, we've reached the last step in the state budgeting process and hope to have a final product by mid-October. The NC House and Senate reached an agreement and are now negotiating with Governor Roy Cooper on a final state spending plan. We will continue to monitor this closely.
Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, discusses the latest legislative news including movement on SB85-- Allow Vision Service Plans, and gives you the list of exciting NCMS events coming up!
NCMS Political Pulse for Sept. 24, 2021
This week, NCMS Director of Legislative Relations Sue Ann Forrest, MPA, welcomes NC Sen. Jim Perry (R-Lenoir) to discuss SB257 -- Medication Cost Transparency Act, which regulates pharmacy benefit managers and recently was signed into law. Sen. Perry also offers a budget update and advice on how to make sure your voice is heard.
NCMS Political Pulse for September 10, 2021
It was a short and relatively uneventful week at the General Assembly this week as budget negotiations continue and we continue to advocate for our NCMS budget priorities. We expect to see a final budget document toward the end of September.
One item of note this week involves a letter to key legislators from Blue Cross and Blue Shield of NC voicing support for SB249/HB277 the SAVE Act. The NCMS opposes this legislation, which would grant independent practice to advance practice nurses. We have re-distributed our SAVE ACT Opposition Letter September 2021 describing our -- and many other specialty and county societies' -- opposition. Be sure to read your NCMS Morning Rounds on Monday for more information on this issue.
NCMS Political Pulse for Aug. 20, 2021
This week budget conferees were named. These individuals, who included committee chairs and democratic House members who had voted in favor of the House budget, will continue their negotiations over a state spending plan in the coming week. A side-by-side comparison of both the House and Senate budgets is available on our NCMS legislative blog.
While the budget process is underway, a number of other bills are still making their way through committees. These include:
- SB257 -- Medication Cost Transparency Act, which seeks to regulate pharmacy benefit managers.
- SB608 -- Dignity for Women Who are Incarcerated. We are working closely with the NC Obstetrical and Gynecological Society on this legislation.
- SB711 - NC Compassionate Care Act, more commonly referred to as the medical marijuana bill, which headed back to the Senate Judiciary Committee for discussion.
- SB228 -- Allow Employers to Offer EPO Benefits. The NCMS spoke against this legislation, which would allow narrow networks, in committee this week. Learn more by watching NCMS Director of Legislative Relations Sue Ann Forrest, MPA, in this week's video.
NCMS Political Pulse for Aug. 6, 2021
HB96--Allow Pharmacists to Administer Injectable Drugs, was heard in the Senate Rules Committee and received a unanimous favorable vote on the Senate floor before being sent back to the House for concurrence. While there were no amendments to the legislation, one requirement remains -- parental consent must be obtained when administering a vaccine with Emergency Use Authorization only to a minor. In other legislative news, the NC House released its budget. Funding for the ECU telepsychiatry program along with additional money for health departments -- both funding provisions we support -- were included. A vote on the House budget is anticipated next week. Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, gives you all the week's legislative highlights.
Please note you can always view the latest health care bill summaries and sign up for Action Alerts on our legislative blog: www.ncmedsoc.org/currentsession.
Political Pulse for July 23, 2021
While this week was supposed to be a lighter week at the General Assembly, several health related bills did move. HB96--Allow Pharmacists to Administer Injectable Drugs, was heard in the Senate Health Committee and referred to Senate Rules. The NCMS has been working with a variety of stakeholder groups to modify this bill and has been able to make several positive changes. Review the details of its progression here. Other bills moving this week include HB415 -- Update Chiropractic Laws and SB711 -- NC Compassionate Care Act, which seeks to legalize medical marijuana. Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA reviews the week's legislative highlights.
NCMS Political Pulse for July 16, 2021
This week, the NCMS along with several specialty societies met with legislators to discuss SB249/HB277 -- the SAVE Act, which would remove the current physician supervision requirements for nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists within the definition of “advanced practice registered nurse. NCMS Past President and chair of the NCMS' Medical Team Task Force Robert 'Charlie' Monteiro, MD, spoke at the meeting about the NCMS' opposition to this proposal and about the importance of training and education to patient safety. The NCMS and numerous medical specialty societies sent a letter outlining our opposition to the SAVE Act. Read the letter here. And watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, offers more detail on this meeting and other news from the General Assembly.
NCMS Political Pulse for July 2, 2021
The state's long awaited transformation to Medicaid managed care took place this week To aide in finding the resources and help you may need in this transition, the NCMS, working with our partners, has compiled necessary resources and a form to submit with any issues you encounter during this change. Access the page here. In other legislative action, several bills the NCMS supports including one regulating pharmacy benefits managers and one providing enhanced resources for school nutrition programs moved. Also, SB711- the NC Compassionate Care Act, which deals with medical marijuana unanimously passed the Senate Judiciary Committee this week. Watch as Sue Ann Forrest, MPA, NCMS Director of Legislative Relations, offers more information on the NCMS position on this and other important legislation.
Please note you can always view the latest health care bill summaries and sign up for Action Alerts on our legislative blog: www.ncmedsoc.org/currentsession.
NCMS Political Pulse for June 4, 2021
The budget process is underway -- sort of -- at the NC General Assembly. Neither the House nor Senate could agree on a spending amount, so each chamber's appropriations committees are meeting to discuss spending priorities. This will likely continue into next week and beyond as legislators work through a budget for the biennium. Some other legislative proposals did continue to move. Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, describes those bills. Keep up with all the daily activity at the NC General Assembly at the NCMS legislative blog here.