WORD TO THE WISE Newsletter: June 2018 - Volume 18, No. 6

In this issue: President's corner: Resources for the new opioid prescribing law Welcome to Madison, PCMS summer intern Report from the PCMS/CMS CME dinner and regional forum Members on the move: We need your news! News from CMS: Update from CMS BOD rep Brad Roberts, MD; free leadership training with CME Upcoming events: Summer Social, PCMS board meeting, and local/state events In the News: Business guide for governor, suicide rates and prescription drug abuse News from the Pueblo Department of Public Health and Environment News from AMA: Progress in reducing opioid prescriptions Join our new members-only Facebook group!

PRESIDENT'S CORNER   Bill creating seven-day opioid prescription limit for acute pain signed into law May 21 On Monday, May 21, Gov. John Hickenlooper signed a bill into law (Senate Bill 18-022) that limits an initial opioid prescription for some patients, and, for those patients, requires physicians to conduct a screening on the Colorado Prescription Drug Monitoring Program database (PDMP) on the first refill to reduce the risk of drug-seeking behavior for nonclinical use or abuse. This law is effective immediately and you may need to change your practice habits immediately to stay within the bounds of this law. The Colorado Medical Society Office of General Counsel has developed a summary and initial FAQ of the new law to help you understand the new law and its requirements. Access this summary resource here.  From my perspective as an emergency room physician, the new law is not onerous. The opioid crisis is particularly apparent in the emergency room setting; however, this law will not have any impact on the way I currently practice and prescribe. I have audited my own prescribing and have found that I only prescribe a narcotic prescription to 9 percent of my patients and when I do it’s usually six tablets: 75 percent of the time I prescribe hydrocodone and 25 percent of the time I prescribe oxycodone. My prescriptions are enough for between one and three days of pain medication, not even close to the seven-day maximum. I check the PDMP as needed and I don’t “refill” narcotic scripts in the emergency room on a routine basis. If I receive a request for a second script from a patient seen by me or one of my colleagues I check the PDMP. There are exemptions to the law and I encourage you to explore the summary resource developed by CMS. Together we as physicians can help make a difference for our patients and communities. Sincerely, Tom Greidanus, MD PCMS President

Summer Social - Friday, June 15 Additionally, I strongly encourage you to attend PCMS's Summer Social at my home on Friday, June 15, starting at 6:30 p.m. We'll have great food and drinks. See more information below or RSVP here!

PCMS welcomes Madison Gutierrez as our summer intern PCMS is happy to welcome Madison Gutierrez, a freshman at Pueblo Community College, as our summer intern. She is a graduate of Pueblo County High School where she participated in the School of Engineering and Biomedical Sciences Program at County High and was a varsity cheerleader and soccer player. She will help our society with the newsletter, social media and other marketing materials. Welcome, Madison!

Thanks to those who were able to attend the PCMS/COPIC CME program and CMS Regional Forum If you missed our May 30 CME Program and Regional Forum, you missed a great educational meeting, discussion, ambiance and dinner buffet! CMS President M. Robert Yakely, MD and Chet Seward, CMS senior director of the Division of Health Care, spoke about the challenging year ahead of us legislatively and the benefits of working together and staying informed. Using diagrams and handouts explaining the core efforts by COMPAC, a segregated fund established by the CMS, the audience learned how during each election cycle trial lawyers outspend physicians by a 7 to 1 ratio. Consequently, Colorado’s stable liability system is threatened with attacks to expand the statutory damage cap outlined in the HCAA. CMS was able to, thankfully, turn back three vigorous attempts to directly expand the value of malpractice suits in the legislature!  The Regional Forum ended with President-elect Deb Parsons, MD, FACP, presenting attendees with information about CMS' board work plan and successful 2018 legislative session. Dr. Parsons also stressed the importance of understanding the new laws affecting Colorado prescribers and limits of opioid prescriptions. Click here to access the information. Guest speaker Josh Blum, MD, ended the meeting by sharing effective strategies for building relationships with people struggling with opioids and the benefits of utilizing effective pain management alternatives. Along with PCC's spacious, relaxed ballroom providing an easygoing atmosphere, PCMS members and their guests enjoyed a delicious dinner buffet at the event.

MEMBERS ON THE MOVE - Looking for submissions This section of the PCMS newsletter highlights members who are making a difference in our community or medical field. We encourage all members to send us a note about your professional or personal achievements, philanthropy, or those of a colleague that you think should be featured. Email cheryl.law@pueblocms.org .

NEWS FROM THE COLORADO MEDICAL SOCIETY

Update from Brad Roberts, MD, your PCMS representative on the CMS Board of Directors The CMS board of directors met May 18 for our most recent board meeting. During the meeting we reviewed the transition to the "21st Century Medical Society" that started in September 2015 when the former CMS House of Delegates enacted the most sweeping set of governance and communications reforms in the history of the Colorado Medical Society. The reforms were further developed in 2016 and fully implemented in 2017. The board is now reviewing each of the reforms to ensure effectiveness and make necessary course corrections. Important to connect the smaller CMS board of directors with the full membership is a new standing committee of the BOD. This committee will be responsible for interacting with members to formulate one-year operational plans that focus on our CMS mission – to champion health care issues that improve patient care, promote physician professional satisfaction and create healthier communities in Colorado. Click here to watch a two-minute presentation on the board’s action and what it means for you. Read the full May 18 board summary here.

UPCOMING EVENTS We strongly encourage all members and spouses to consider volunteering on a committee to plan a future PCMS event. Contact Cheryl at cheryl.law@pueblocms.org to volunteer or add your event to our upcoming event calendar.

Pueblo County Medical Society Events

Summer Social - Friday, June 15 Join PCMS for our members-only Summer Social, Friday, June 15, 2018, 6:30 - 8:30 p.m. at the home of PCMS Board President Tom Greidanus, MD: 535 Bewick Pl., Colorado Springs, CO, 80906. It's the perfect setting for meeting and mingling with colleagues in a relaxed atmosphere. Appetizers and drinks will be served. RSVP here!

Next PCMS Board Meeting - July 25 Attend the next PCMS board meeting on Wednesday, July 25, 5:30 - 7:30 p.m., Columbine Conference Room at Parkview Medical Center, 400 17th St., Pueblo, 81003. PCMS board meetings are open to members who wish to observe their leaders in action and become more involved in the society. Meetings will be productive and are invaluable to the organization! RSVP to cheryl.law@pueblocms.org.

Annual General Meeting and Awards Ceremony - Sept. 26; plus, volunteer for the awards committee Save the date for the PCMS Annual General Meeting and Awards Ceremony, Wednesday, Sept. 26, 2018, 5:30 - 8:30 p.m. Location to be determined. Dinner and drinks provided. Please join us! Also, we're looking for volunteers for the Awards Committee. Contact cheryl.law@pueblocms.org if you’re interested.

Physician Wellness Symposium - Oct. 13; plus, join the planning committee for our first meeting - June 13 Save the date for the Physician Wellness Symposium, Saturday, Oct. 13, 2018, 7 a.m. - 4 p.m. at the PMC West Annex Rosemount Room. We're looking for volunteers for the symposium planning committee; the first meeting will be held Wednesday, June 13, 2018, 12:15 - 1:15 p.m. at the Parkview Medical Center Thatcher Conference Room. Please join us!

Holiday Social - Nov. 16 Save the date for the event of the season, the PCMS Holiday Social, to be held Friday, Nov. 16, 2018, 6:30 - 8:30 p.m. Location: The Clink Lounge, 140 Central Main St #222, Pueblo, CO 81003. Appetizers and drinks will be served.

Local Events

Calling all southern Colorado golfers: 2018 FORE! EDUCATION GOLF TOURNAMENT - June 8 The 29th annual FORE! EDUCATION GOLF TOURNAMENT will take place on Friday, June 8 at the Pueblo Country Club. The tournament is a benefit for the Pueblo Community College Foundation and its efforts to support student scholarships and programs of academic excellence at Pueblo Community College. Registration is now open for this annual tournament that normally sells out quickly. Click here to download a 2018 Registration Brochure.

Buy tickets today for ZOOFARI - June 22 Make plans to attend Zoofari on June 22 from 4:30 p.m. - 9 p.m. to experience an evening with the most exotic residents of Pueblo. It is an exclusive event and a unique way to experience the Pueblo Zoo that cannot be missed! Start your adventure with a signature drink at check-in Meander to the new De Brazza's monkey exhibit Bid on great packages against your colleagues and friends Meet your new best friend Bandit (resident Amazon parrot) Sing and dance along with the Al Polivka band Listen for the calls of eagle owls as you call it a night Money raised at Zoofari supports the daily operation of the Pueblo Zoo you love. Zoofari funds daily animal food and veterinary care, our beautiful grounds, and education programs reaching thousands of kids every year. Learn more about the event here.

CMS/Other Events

PLSS: Building professional resilience - June 26 Grounded in current research from neuro-leadership and performance psychology, the next session in the CMS Physician Leadership Skills Series will explore the neuroscience and basic principles behind emotional intelligence, a framework for mental toughness and personal resilience based on performance psychology, the role of mindset and strategy in cultivating our resilience at any age, and tools to cultivate resilience in yourself and in your workforce. Make plans to join us Tuesday, June 26, 6-8 p.m. at the Colorado Medical Society offices, 7351 E. Lowry Blvd., Denver, CO 80230. Register now!

2018 CMS Annual Meeting - Sept. 14-15 Registration is now open for the 2018 Colorado Medical Society Annual Meeting, Sept. 14-15, 2018 at the Vail Marriott. Attendees will enjoy camaraderie, interactive workshops and lectures on the hottest topics in medicine, and great special events. Free child care is provided during conference events. Go to www.cms.org/events/annual-meeting for more information and to register.

IN THE NEWS

Access a business guide for Colorado’s next governor Colorado’s next governor has the opportunity to transform education in the state. To support voters and employers in making this important decision, Colorado Succeeds and the Common Sense Policy Roundtable -- in partnership with the Denver Business Journal and 18 industry partners -- have launched  A Business Guide for Colorado's Next Governor . This guide shows the  economic impact  if Colorado students obtained the levels of education needed for success in Colorado’s workforce, the impact of  Colorado’s skills gap on Colorado employers,  improvement strategies supported by Colorado voters and employers, and a  gubernatorial candidate survey on key education issues.

Drug abuse explained: Prescription and OTC drugs You as a physician likely know the brand and generic names for the most commonly abused prescription and over-the-counter drugs, but do you know the street names? Or how they are abused? Read this article for more.

Big rise in U.S. kids, teens attempting suicide In a troubling study, new research shows a doubling since 2008 in the number of kids and teens who’ve been hospitalized for attempted suicide or suicidal thoughts. Suicide is now the third leading cause of death among American adolescents, the authors noted. “We still know from other studies out there that less than half of young people with mental disorders seek treatment, and only a minority of teens with depression actually seek care,” said study author Dr. Gregory Plemmons. “In fact, the American Academy of Pediatrics issued guidelines this past February to encourage primary care doctors to begin depression screening.” Read more here.

Associated Press – Opioid treatment gap in Medicare: Methadone clinics Medicare doesn’t cover methadone, unless it’s prescribed for pain, but should it? One in three older Americans with Medicare drug coverage is prescribed opioid painkillers and methadone is the oldest and most effective of the three approved medications used to treat opioid addition. Congress is currently working on a bill to change this treatment gap. Read the article here.

NEWS FROM THE PUEBLO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Pueblo Department of Public Health and Environment uses HIE to investigate communicable disease patient information The Pueblo Department of Public Health and Environment (PDPHE) works to protect citizens of Pueblo from communicable diseases, such as rabies, pertussis, flu and tuberculosis. They track public health issues like outbreaks of illness, educate the community and local businesses, monitor food and water safety, run a clinic for women’s services and sexual health, and much more. The team of epidemiologists, registered nurses, care managers and investigators have to act quickly to follow up with patients who have been positively tested for a communicable disease. This could involve literally driving to the patient’s home to witness them taking important medications, to communicating with everyone the patient has been in contact with to see if they are presenting with symptoms, to simply getting the patient whatever they need to see the doctor and get treatment. PDPHE tracks numerous infectious diseases across the region through the Colorado Electronic Disease Reporting System (CEDRS), which is a confidential early-warning system that allows staff to follow disease trends and put critical control measures into place to protect the community. When a resident of Pueblo county tests positive for a communicable disease, the team at PDPHE look in the CORHIO web-based HIE portal  PatientCare 360®  to get information on what testing was done and what medications and treatments the provider put in the care plan. “They’re able to look up exactly what was done - if there was a confirmatory test, any specimens gathered, if medications were given,” says Lynn Procell, RN, MSN, Director of Community Health Division, Pueblo Department of Public Health and Environment. “If we learn that the patient has not followed through with treatment, we can reach out with more education or offer assistance getting them treated.” Read more here.

NEWS FROM THE AMERICAN MEDICAL ASSOCIATION AMA sees progress in declining opioid prescriptions The American Medical Association (AMA) issued a new report on May 31 documenting how physician leadership is advancing the fight against the opioid epidemic. Colorado Medical Society (CMS) physician surveys confirm a shared alarm of this public health crisis and ready acceptance for physicians to play a role in long-term solutions.  The AMA report found a 22 percent decrease in opioid prescribing nationwide, a 21 percent decrease in opioid prescribing in Colorado, and nationwide increases in the use of state prescription drug monitoring programs (PDMPs), the number of physicians trained and certified to treat patients with an opioid use disorder, and in access to naloxone.  Read more here.

Connect with PCMS on Facebook! PCMS now has a Facebook page with a members-only group. Click here to "like" the page then request access to join the group. The private group will be moderated by PCMS staff who appreciate receiving your suggestions -- and pretty much any information (e.g., recommendations for contractors, babysitters, questions, news, events) -- you would like us to consider sharing with group members. We look forward to connecting with you! Questions? Contact Cheryl at 719-281-6073 / cheryl.law@pueblocms.org .

MISSION:   Facilitate meaningful collaboration of medical professionals in Pueblo County.   VISION:   Create a medical society that serves as a venue for collaboration for the betterment of healthcare in Pueblo County. The Society’s efforts will improve the practice of medicine and life of medical professionals.

Board Officers: President: Thomas Greidanus, MD; President-Elect: Open position; Secretary: Ross Patrick, MD; Treasurer: Robert Tonsing, MD; Past-President: Alfredo Vargas, MD; CMS Representative: Brad Roberts, MD |  Directors: Teresa Braden, DO; Donald Luebke, MD; Julie Newburg, MD |  Executive Director: Cheryl Law, MA, MNM

This newsletter is intended for the members and interested persons of the Pueblo County Medical Society. If you have received this and wish to opt-out call 719-281-6073 or use the “unsubscribe” link below.

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