It’s Thursday and time for your

NCMS Morning Rounds.

  June 18, 2020

The NC General Assembly is in session and the NCMS advocacy staff is closely tracking its work. Keep up-to-date on what could impact your practice and your patients at our Legislative blog. The blog is continually updated with behind-the-scenes, quick summaries as the proposed legislation makes its way through the various committees and floor votes. Go to the NCMS Legislative Blog.

Reflections on Attending George Floyd’s Service in Raeford

As a local public official and prominent community member, Karen Smith, MD, had a front-of-the-house seat for the private memorial service for George Floyd held in Raeford on June 6. Mr. Floyd’s horrific death at the hands of the Minneapolis police has prompted worldwide protests over racial injustice and prompted an outpouring of emotion at the services held in Raeford, near where he was born.

A longtime NCMS member, family physician in Raeford and medical director for the Hoke County Health Department, Dr. Smith was struck by the deep symbolism of Mr. Floyd’s service there.

Mr. Floyd’s relatives, dressed in white, sat on one side of the chapel while the attending dignitaries had been instructed to wear black and were seated on the other side. Mr. Floyd’s shining gold casket was wheeled down the center aisle.

“What a chariot,” Dr. Smith said. “White on one side; black on the other. What a dichotomy! Did these people know each other? How they live, work, what their issues are? Mr. Floyd’s casket in the middle was like a spark to open conversations. His death has opened up these conversations.”

For instance, Harvey Godwin, Jr., chairman of the Lumbee Tribe, addressed the historically co-existing Lumbee and African American communities, both with disproportionately higher vulnerable populations. At the service, he offered a proclamation from the tribe recognizing “that unity and solidarity between the Black and Lumbee communities is necessary to fight” against social and racial injustice. Read the Lumbee Tribe’s Unity Proclamation presented to Mr. Floyd’s family.

Also as part of the service, US Congressman G.K. Butterfield extended condolences to Mr. Floyd’s family “on behalf of the 55 men and women who are part of the Congressional Black Caucus. These leaders have pushed the US House to introduce the Justice in Policing Act.

Dr. Smith sees this time as a “magical moment.” Although racial injustice has a long history in this country, she views the events of the last several weeks as transformational. Like Cinderella being magically made over from rags into a princess, this country will not ever be able to fully return to what it was before thanks to the sad ‘spark’ of George Floyd’s death, she said.

“It’s an internal dream we all have,” Dr. Smith said. “We don’t want to go back.”

Dr. Smith urged everyone to “look at the mission statement of every organization you’re a part of. Look at every policy and procedure. If you see barriers to recognizing diversity – get rid of them.”

Key to a true transformation is being able to see individual human beings, Dr. Smith said.

Those who spoke at Mr. Floyd’s service “personified him as a gentle giant – a man, a brother, a father, a son,” she said. She recalled a recent personal encounter with a new patient. When Dr. Smith entered the exam room, the white patient was clearly taken aback by her race and initially seemed skeptical of her abilities. After conversing for a bit, the patient decided Dr. Smith seemed like “a happy person and could help her with her diabetes.”

“We have to start with what we have in common,” Dr. Smith said. “We have more similarities than differences.”

White Coat Wednesday and Staying Engaged in Advocacy

Yesterday several Kanof Institute for Physician Leadership (KIPL) class of 2020 Leadership College scholars participated in our NCMS virtual White Coat Wednesday – a way to stay engaged in advocating for your profession especially during these times of uncertainty.

NCMS Director for Legislative Relations Sue Ann Forrest, MPA, briefed Zachary Fleming, a medical student at the Campbell University School of Osteopathic Medicine and Marion McCrary, MD, FACP on the many bills currently under consideration by the General Assembly that the NCMS is tracking; answered their questions and gave tips and talking points for their virtual conversations with legislators.

Virtual White Coat Wednesdays offer you the opportunity to stay engaged in our advocacy efforts as legislators weigh important proposals around responding to the pandemic, Medicaid transformation and others that could impact your practice. Now that they are offered remotely, you have more flexibility in when you can participate. Learn more about how to get involved and sign up for a virtual White Coat Wednesday here.

Forrest also gave a 2-hour advocacy update to the LINC Scholar program at ECU’s Brody School of Medicine earlier in the week and several of the students also participated in White Coat Wednesday-type advocacy throughout the week. NCMS Immediate Past President Timothy Reeder, MD, MPH, FACEP is faculty for the LINC program.

Thank you to those who participated this week!

PAI Survey: High-Deductible Health Plans Are Barrier to Care

The results of a survey released last week by NCMS partner the Physicians Advocacy Institute (PAI) revealed that four out of five independent physicians in the United States (80 percent) say their patients refuse or delay medical care due to concerns about cost, and just as many (79 percent) say that high insurance deductibles are a leading cause. The findings come from a survey of more than 700 independent physicians nationwide administered by NORC at the University of Chicago for PAI.

Conducted prior to the COVID-19 pandemic, the survey offers insight into how high-deductible health plans (HDHP), which make patients financially responsible for thousands of dollars in health care costs, are leading physicians to change the way they care for patients.

Other key findings include:
• 55 percent of the independent physicians surveyed said patients’ cost concerns are causing them to alter their preferred approach to the timing of treatments provided
• 66 percent have changed their decision about whether to prescribe drugs;
• 61 percent changed the type of medical treatment provided; and
• 86 percent have changed which type of drugs they prescribe.
• Most say their office staff spends more than 300 hours per year educating patients about their insurance coverage. Yet three-out-of-four independent physicians (75 percent) say they don’t have most of the information they need to have cost of care conversations.

As COVID-19 transitioned from epidemic to pandemic, the Internal Revenue Service issued regulations to require insurers to suspend cost sharing, where patients shoulder all or a portion of the cost for medical services, under high-deductible and other types of insurance plans. No longer having to worry about affording COVID-19 related expenses, more patients received immediate or timely access to essential coronavirus testing and treatment.

Review the key findings of the survey here.

In the News

Missing Data Veils Coronavirus Damage to Minority Communities, Politico, 6-14-20

Learning Opportunity

Southern Regional AHEC is offering a livestream webinar on Saturday, July 25 from noon to 1:30 p.m. titled ‘A Critical Conversation: Listening and Learning Together.’

The persistent and pervasive injustices to black and brown people and other multicultural populations have long been documented over many generations. Persons of color continue to experience health disparities at an alarmingly disproportionate rate as evidenced by recent and historical acts of racism, violence, inequities and power paradigms. While many are sensitive to and saddened by these unfortunate realities, civil unrest across the nation has driven a call to action. The purpose of this activity is to facilitate a critical yet necessary conversation surrounding race relations, providing an open space for dialogue and bridging gaps at the public sector level, so that communities can listen and learn together. Learn more and register here.

If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!