Plan to Join Your Colleagues at the Smyrna Opera House

Save the Date! for the MSD 2024 Interim Council Meeting to be held on Thursday, April 18th at the Smyrna Opera House, located at 7 W. South St., Smyrna, DE. The evening will begin at 6:00 p.m. with sign-in and a half-hour cocktail social, followed by the Interim Council business meeting beginning promptly at 6:30 p.m. As a member of MSD, this event affords you the opportunity to connect with your peers and meet new colleagues, all the while enjoying fine food and beverage at a historic Delaware location!

If you are interested in serving as a Council member, please contact Mary LaJudice, Senior Director of Corporate Services at (302) 224-5183 or email Mary.LaJudice@medsocdel.org.

Consider submitting a resolution. Resolutions are a vehicle to submit to Council your issues for change. Learn more about writing a resolution from the MSD Resolution Writing Guide or the brief training video developed. Resolution submission deadline is Friday, April 5th. Watch for more information about registration and plan to attend this year.

In Young Children and Pregnant People

Since approval of RSV vaccines and the monoclonal antibody nirsevimab, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have received reports of the Pfizer (Abrsyvo) or GSK (Arexvy) RSV vaccines being administered in error to young children. CDC and FDA have also received reports of the GSK RSV vaccine (Arexvy) being administered in error to pregnant people.

Nirsevimab (Beyfortus, Sanofi, and AstraZeneca) is only recommended for infants and some young children at increased risk for severe RSV disease. RSV vaccines (Pfizer Abrysvo, GSK Arexvy) are NOT approved for use in infants or young children. Pfizer (Abrysvo) is the only RSV vaccine recommended for pregnant people. The GSK RSV vaccine (Arexvy) is NOT approved for use during pregnancy.  

Most reports of administration errors in young children occurred in infants younger than 8 months. Administration errors for both young children and pregnant people occurred in outpatient settings, including doctor’s offices; administration errors of the GSK RSV vaccine (Arexvy) in pregnant people also occurred in pharmacies. Most of these administration error reports described no adverse event. When an adverse event was concurrently reported to VAERS, most reports were classified as nonserious. CDC, FDA, and other federal agencies continue to monitor the safety of RSV vaccines and reports of vaccine administration errors and will share information with the public as it becomes available. Read more on recommendations if incorrect RSV vaccine products are administered.

Provides Weekly Snapshot of Key Viral Respiratory Illness Findings

The amount of respiratory illness (fever plus cough or sore throat) causing people to seek healthcare is elevated or increasing across most areas of the country. CDC’s Respiratory Virus Data Channel provides a summary of the key viral respiratory illness findings for COVID-19, flu, and RSV. CDC continues to anticipate this fall and winter respiratory illness season will likely result in a similar number of hospitalizations as last season. Vaccination remains the best way to protect against serious outcomes of COVID-19, flu, and RSV (if eligible for RSV vaccine). Learn more.

CDC: Confirmed US Cases of Measles, Some from International Travelers

Between December 1, 2023 and January 23, 2024, the Centers for Disease Control and Prevention (CDC) was notified of 23 confirmed U.S. cases of measles, including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. Due to the recent cases, health care professionals should be on alert for patients who have: (1) febrile rash illness and symptoms consistent with measles (e.g., cough, coryza, or conjunctivitis), and (2) have recently traveled abroad, especially to countries with ongoing measles outbreaks. Infected people are contagious from 4 days before the rash starts through 4 days afterwards. Measles cases often originate from unvaccinated or under-vaccinated U.S. residents who travel internationally and then transmit the disease to people who are not vaccinated against measles. The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease. Read more on recommendations for health care professionals.

Encourages Physicians to Consider More Blood Testing for PFAS

Many studies of populations have examined possible relationships between levels of PFAS (Per-and polyfluoroalkyl substances) in blood and rates of harmful health effects, but research has not yet confirmed mechanisms for each health effect. The Agency for Toxic Substances and Disease Registry (ATSDR)’s 2021 Toxicological Profile for Perfluoroalkyls 

provides a comprehensive review of toxicological information for 12 different PFAS. ATSDR evaluated the available epidemiological data and found that the preponderance of the evidence suggested associations between exposure to individual PFAS and certain health effects. Some animal and human studies find positive associations between PFAS exposure and a much wider range of health effects. For example, they identify associations with serum uric acid concentrations, reproductive health, diabetes, kidney effects, asthma, and neurobehavioral outcomes.

Clinicians play an important role in helping patients identify and reduce exposures and in promoting standard age-appropriate preventive care measures for physical health, mental health, and wellness. No approved medical treatments are available to remove PFAS from the body. Based on information from both a patient’s PFAS exposure history and the patient’s health history, clinicians can collaborate with patients to develop individualized care plans. Systematic, community-wide blood testing can enable public health officials to investigate and respond to community-wide exposures. Results from these tests can assess the types and blood levels of PFAS in the community. (Blood PFAS is the accepted biomarker of exposure for PFAS studies, but some investigations have also included urine testing.) Clinicians can order PFAS blood levels through CLIA-certified commercial clinical laboratories. Results (current levels of PFAS in the blood) could reflect recent exposures or past exposures in the case of PFAS with long half-lives. Read more about deciding whether to order PFAS testing.

Apply to Become a Fellow - Deadline is Friday, March 15th

The AMA Center for Health Equity seeks applicants for the Medical Justice in Advocacy Fellowship program’s 2024-2025 cohort. Application deadline is March 15, 2024. The fellowship runs from September 2024 - November 2025.

The Medical Justice in Advocacy Fellowship is a collaborative educational initiative designed to enhance physicians’ advocacy leadership skills to improve health outcomes and advance health equity in the areas they serve or may serve. Using an anti-racist, equity-centered learning framework, the fellowship will provide a mentoring and training platform that will equip participants with the foundational skills, tools and knowledge to engage in institutional and political health advocacy. 

Started in 2021, in collaboration with the Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine (MSM), the fellowship mobilizes physicians to be part of the next generation of advocacy leaders, driving meaningful policy and structural changes that produce equity and justice in the communities they serve. The AMA-SHLI Medical Justice in Advocacy Fellowship is a unique, first of its kind post-doctoral fellowship open to all physicians and residents who have a demonstrated interest in health equity and health advocacy.

Join the third cohort of health equity-rooted physicians committed to closing the detrimental health gap impacting so many lives. Learn more and apply.

HHS Launches New Effort to Help Ensure Access to Emergency Health Care

The Department of Health and Human Services (HHS) announced that, together with the Centers for Medicare & Medicaid Services (CMS), it will launch a series of actions to educate the public about their rights to emergency medical care and to help support efforts of hospitals to meet their obligations under the Emergency Medical Treatment and Labor Act (EMTALA). As part of this comprehensive plan, the Department will:

• Publish new informational resources on CMS’s website to help individuals understand their rights under EMTALA and the process for submitting a complaint if they are denied emergency medical care;
• Partner with hospital and provider associations to disseminate training materials on providers’ obligations under EMTALA;
• Convene hospital and professional associations to discuss best practices and challenges in ensuring compliance with EMTALA; and
• Establish a dedicated team of HHS experts who will increase the Department’s capacity to support hospitals in complying with federal requirements under EMTALA.

The Department developed this comprehensive plan in response to a growing number of inquiries from patients and health care professionals to CMS about how they can ensure that federal obligations were being met. CMS remains committed to helping all individuals—including patients who are experiencing pregnancy loss and other pregnancy-related emergencies—have access to the emergency medical care required under federal law.

Gives Health Care Organizations a Roadmap of Essential, Enhanced Practices

The Department for Health and Human Services (HHS) has published voluntary cybersecurity performance goals tailored for health care organizations to enhance industrywide cybersecurity. The goals, released through HHS’ Administration for Strategic Preparedness and Response, are hosted on a new gateway website that the department has launched to centralize the cybersecurity resources it and other government groups have on offer. They are broken into two categories, “Essential Goals” and “Enhanced Goals,” that each reflect cybersecurity frameworks, best practices and strategies that have been developed by the health care industry.

CMS Call for Public Comment

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) to develop a measure of emergency care capacity and quality. This will be an electronic clinical quality measure (eCQM) determining emergency department (ED) care capacity and quality.  

CMS is inviting stakeholders and other interested members of the public to review and comment on the measure under development. The public comment period will close on February 16, 2024. This period provides an opportunity for the widest array of interested parties to provide input on the Equity of Emergency Care Capacity and Quality (ECCQ) eCQM and can prompt critical suggestions not previously considered by the measure developer. This email serves as the call for public comment on this measure. Read more. 

To Help in Developing More Comprehensive EM Programs

Effective July 1, 2024, a fully revised Emergency Management (EM) chapter, including new and revised EM standards, has been approved for all Joint Commission-accredited ambulatory care organizations and office-based surgery practices. The goal of the rewrite was to help health care organizations to develop more comprehensive EM programs and to better prepare for the health, safety, and security needs of their facilities, staff, patient populations, and communities during emergencies or disasters (such as the COVID-19 pandemic). Read more.

Rescheduled to March 5, 2 p.m.; Budget Proposal Slated for Jan 25, 1 p.m.

Given last week’s postponement, Governor Carney now will deliver his 2024 State of the State Address from the House of Representatives Chamber in Legislative Hall on Tuesday, March 5, at 2 p.m. The event will be livestreamed on de.gov/sots and on the Governor's YouTube channel. The Delaware General Assembly will convene in a Joint Session prior to the Governor's State of the State Address beginning at 1:45 p.m.

Focuses on Economy, Schools, Families & Workforce, and Environment

Governor Carney on Thursday presented his Fiscal Year 2025 Recommended Budget sending the General Assembly a plan that will strengthen Delaware’s economy, invest in public schools, support Delaware’s families and workforce, and protect our environment. This budget makes sustainable investments in the areas that matter most to Delawareans. Watch the presentation.

How State and Local Organizations Plan to Help

Lieutenant Governor Bethany Hall-Long and leaders from the Department of Health and Social Services (DHSS) along with partner community agencies led a community response briefing to provide the latest information regarding the state’s efforts to support individuals facing homelessness and housing instability related to substance use disorder. Organized by the DHSS Division of Substance Abuse and Mental Health (DSAMH), these quarterly briefings aim to inform the public about the State’s ongoing work to reduce overdoses and respond to the opioid epidemic. 

Report Reveals Delaware Must Focus on Protecting Tobacco Tax Structure

On Wednesday this week, the American Lung Association (ALA) released the 22nd annual “State of Tobacco Control” report, which finds that Delaware received 2 F grades, 2 A’s and one B grade for efforts to prevent and reduce tobacco use. This year’s report noted the need for Delaware policymakers to focus on protecting Delaware’s tobacco tax structure and defend any attempted rollbacks on specific products. The “State of Tobacco Control” report evaluates state and federal policies on actions taken to eliminate tobacco use and recommends proven-effective tobacco control laws and policies to save lives.

Breast Cancer Screening Event Scheduled for February

The Delaware Breast Cancer Coalition is holding a series of "Love Your Breasts" events, providing no-cost breast exams in the community. They are in need of health care professionals to provide clinical breast exams and write prescriptions for mammograms.

The program is designed to allow time for approximately three clients per hour to have a clinical breast/chest exam. Insured clients can have a mammography appointment scheduled by a patient navigator while at the event. Patient navigators will provide assistance with insurance needs, transportation, and interpretation for the appointment as needed.

Upcoming events are scheduled for:

• Saturday, February 24, 10:00 a.m.-2:00 p.m. - Route 9 Library, 3022 New Castle Ave., New Castle
• Saturday, March 9, 12:00-3:00 p.m. - Blades Elementary School, 900 S Arch St., Blades
• Saturday, April 13, 12:00-3:00 p.m. - West Seaford Elementary School, 511 Sussex Ave., Seaford

If you are interested in lending a hand, please contact Adriana Viveros-Sosa, Program Manager for Women's Health Screening at the Delaware Breast Cancer Coalition (aviveros-sosa@debreastcancer.org or 302/672-6435 ext. 1002).

Creating a Best Place to Work

Kaiser Permanente has been recognized for creating a workplace that supports and empowers people with disabilities. Several Permanente Medical Groups, the multispecialty physician groups that provide care to Kaiser Permanente members, are members of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians, and care teams with resources to help drive the future of medicine.

The integrated health care system received a 100% score on the most recent Disability Equality Index, the seventh year in a row in which Kaiser Permanente has done so. The index was created by Disability:IN, a global organization that promotes disability inclusion and equality in business, and the American Association of People with Disabilities, a national organization that advocates for full civil rights for more than 60 million Americans with disabilities. The index benchmarks companies based on culture, leadership, accessibility, employment practices, community engagement and supplier diversity.

The companies in the index incorporate practices such as:

• Offering flexible work options, having a written accommodations policy.
• Encouraging confidential self-identification as disabled.
• Having an active disability-focused employee or business resource group.
• Providing philanthropic support to an external disability organization or event.

Kaiser Permanente was also included in the organizations’ list of 2023 Best Places to Work for Disability Inclusion. Read more.

Understand Your Priorities for Your Next Job

When looking to join your first or next practice as a physician, take some time to consider what you want to focus on in your career. Answering those questions will help you identify employers who would support your career goals. When speaking with a potential employer, discuss issues such as physician support, workplace culture, organizational well-being, and EHR usability and satisfaction.

LEARN MORE:

Toolkit:

• What to Look for in Your First or Next Practice

AMA Resources:

• Career Development
• Evaluating a Prospective Employer

Podcast:

• What to Look for in Your Next Practice

AMA STEPS Forward^® offers a collection of engaging and interactive educational content designed to help put the joy back into medicine.

Attestation Demands Attention to Detail, Collaboration, and Commitment

Navigating attestation for the 2023 MIPS program is a critical task for physicians demonstrating compliance with the various category regulations. To help health care professionals navigate the complexities of attestation preparation with confidence, here’s what you should know.

Develop an Attestation Preparation Plan

Attestation preparation benefits from a well-structured timeline. Create a schedule outlining key milestones, deadlines, and tasks for a systematic approach.

• Double check provider eligibility for 2023 year-end
• Recap categories to be provided and HOW they will be reported
• Understand who will report each category
• Make sure you keep proof of the submission
• Submit on or before all vendor and federal deadlines, they usually vary greatly!

Tips for a Successful Attestation

• Conduct internal reviews to identify gaps and areas for improvement.
• Utilize technology to streamline data collection and reporting.
• Stay proactive with updates and adjust your attestation preparation plan accordingly. As of today, you must report your data by March 31, 2024, to be compliant with the CMS MIPS Quality Payment Program deadlines.
• Ensure thorough documentation by having all required documents organized, easily accessible, and ready for submission.
• Conduct a post-attestation evaluation to identify lessons learned and areas for improvement.

Looking for specific information about what has changed for this new 2024 performance year? Watch the Chirpy Bird MIPS 2024 Webinar on demand.

MGMA Survey

For medicine to meet the needs of an ever-changing population, employers must understand what motivates physicians to work for them early on and also how motivations change along the career path. Survey results from the Medical Group Management Association (MGMA) and recruiting firm Jackson Physician Search has found a potentially troubling trend: Early career physicians are staying less than two years at their first jobs.

Information on Recent Product Recalls

Recall of Robitussin Products

Haleon is voluntarily recalling eight lots of Robitussin Honey CF Max Day Adult and Robitussin Honey CF Max Nighttime Adult to the consumer level. The product is being recalled due to microbial contamination. In immunocompromised individuals, the use of the affected product could potentially result in severe or life-threatening adverse events such as fungemia or disseminated fungal infection. In non-immunocompromised consumers, the population most likely to use the product, life-threatening infections are not likely to occur. However, the occurrence of an infection that may necessitate medical intervention cannot be completely ruled out. To date, Haleon has not received any reports of adverse events related to this recall. Haleon is notifying its distributors and customers directly and has provided them with instructions for the return of all recalled products. Consumers are instructed to contact their physician if they experience any problems that may be related to using this product.

Imelyn Lahey, MD - Diamond State Primary Care, LLC

Alice Y. Wang, MD - Brandywine Urology Consultants

MSD members are afforded a seven-day review period from the date of this publication to comment regarding applicants for members. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any comments on the current pending members listed above or if you know of someone interested in joining MSD. You could be eligible for a membership referral discount on your dues!

William M. Kaplan, MD

It is with sadness that we share the news of the passing of MSD member, William M. Kaplan, MD, who passed away suddenly in Rehoboth Beach Friday, January 19. He was 76 years of age. Dr. Kaplan had a 34-year career practicing gastroenterology in the Bayhealth medical system in both Dover and Milford. He was the first practicing gastroenterologist in Kent and Sussex counties when he moved to Delaware in 1984. He retired in 2018. At Bayhealth he also served as chief of staff, a member of the medical executive committee and performance improvement committee member. Dr. Kaplan received his medical degree in 1974 from Hahnemann Medical School and attended George Washington University. He worked at the National Institutes of Health until he returned to Hahnemann Medical School and Hospital in 1976 for his internal medicine residency. He then completed his gastroenterology fellowship in 1980 at Temple University Hospital, where he became an assistant professor of medicine and director of GI endoscopy until 1984, at which time he started his medical practice in Delaware. Dr. Kaplan was board-certified in both internal medicine and gastroenterology. Dr. Kaplan had many interests and hobbies, including golfing, traveling, driving his cherished cars, and boating and fishing in Rehoboth and Delaware Bays. He was proud of adopting and spoiling the many homeless dogs and cats that he and his wife rescued. In lieu of flowers, contributions can be made in his honor to First State Animal Center and SPCA, 32 Shelter Circle, Camden, DE 19934. Burial will be private. Read obituary.

Ruth A. Oartel, MD

We also recognize the loss of MSD member Ruth Anne Oartel, M.D. who passed away on January 4, 2024. She was 94. Dr. Oartel earned a scholarship to begin her undergraduate studies at the University of Pittsburgh, then transferred to the University of Maryland, where she graduated in 1951. Notably, she completed medical school and her residency at George Washington University in Washington D.C., standing out as the only female in her class of 1954. Her medical career spanned almost 50 years, during which she served as a pediatrician in Claymont, Delaware. Dr. Oartel's commitment to children's welfare extended beyond her medical practice. She was a devoted Court Appointed Special Advocate for children in Delaware, ensuring the voices of the most vulnerable were heard. Dr. Oartel's devotion to her church and community prompted her to use her skill at needlepoint that carried over to the creation of beautiful kneelers for the parishioners at St. Peter's Church in Salisbury, Maryland to enjoy. Later in life, Ruth faced the challenge of losing her eyesight but met this with her characteristic grace and adaptability. She became involved with Blind Industries of Maryland, turning a personal challenge into another avenue for service and advocacy. A memorial service celebrating Ruth's life will be held at St. Peter's Episcopal Church, Salisbury, Maryland on Wednesday, February 7, 2024 at 2:00 pm, with visitation a half hour prior to the service. There will be a reception immediately following in the Church Parlor. A private interment is planned for the future. In lieu of flowers, contributions can be made in Ruth's honor to St. Peter's Episcopal Church Altar Guild or Blind Industries of Maryland. In a final act of service, Ruth has chosen to donate her body to the state of Maryland Anatomy Board for Research. Ruth's legacy as a healer, advocate, and beloved family member will continue to inspire and touch lives for generations to come. Read obituary.

Beebe Healthcare

ChristianaCare

January 26 - Delaware Academy of Dermatology Winter Meeting, Dermatology Tips for the General Dermatologist, 6:00-8:00 p.m., Harry's Savoy Grill, Wilmington. DAD member and non-member pricing applied. This activity has been approved for a maximum of 1 AMA PRA Category 1 credit.

February 2-4 - American Diabetes Association 2024 Clinical Update Conference, virtual and in-person at the Omni Orlando Resort at Champions Gate, Orlando, FL

February 11-13 - Medical Society Consortium on Climate and Health 7th Annual Meeting, presented virtually and in person in Arlington, VA on February 11-12, with in-person Congressional visits on February 13.

March 15 - 6th Biennial Perinatal Palliative Care Symposium: Aspects of Trauma in Perinatal Palliative Care, 8:00 a.m.- 4:00 p.m., John H. Ammon Education Center, ChristianaCare Newark Campus. This activity has been approved for a maximum of 5.5 AMA PRA Category 1 credit.

April 13 - SAVE THE DATE! Delaware Academy of Family Physicians Annual Meeting, Bayhealth SIM Center, Dover.

April 17 - SAVE THE DATE! 18th Annual Delaware Healthy Mother & Infant Consortium Summit, 9:00 a.m.-4:00 p.m., Chase Center on the Riverfront. Check DEThrives.com for updates.

The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section, we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.

• 2024 Adult Immunization Schedule (for ages 19 years or older) - www.cdc.gov/vaccines/schedules/hcp/imz/adult.html (includes new recommendations for RSV vaccine, Mpox vaccine, and pentavalent meningococcal vaccine)

• 2024 Child and Adolescent Immunization Schedule (for ages 18 years or younger) -https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html (includes new recommendations for RSV vaccine, RSV monoclonal antibody, Mpox vaccine, 20-valent pneumococcal conjugate vaccine, and pentavalent meningococcal vaccine)

• Information for Delaware Medical Professionals - https://publichealthalerts.delaware.gov/mpox/

• Updates to Clinical Testing Guidance Algorithms - CDC has updated several testing guidance pages for patients with acute respiratory illness (1) not being hospitalized, (2) being hospitalized, and (3) hospitalized and non-hospitalized patients when SARS-CoV-2 and influenza viruses are co-circulating. Clinicians can use these updated resources to inform clinical decision making. (12/8/2023)
• Ellume tests available for those who are blind or have low vision (free at-home COVID-19 tests) https://acl.gov/accessibletests
• Find COVID-19 Vaccines: https://www.vaccines.gov/
• No Cost COVID-19 Testing Locator can help uninsured people (or those adults without full vaccine insurance coverage) who are symptomatic or exposed find current community and pharmacy partners participating in the Increasing Community Access to Testing (ICATT) program.
• FDA At-Home OTC COVID-19 Diagnostic Tests provides a list of all FDA-authorized at-home over-the-counter (OTC) COVID-19 diagnostic tests
• Federal website for information on navigating COVID: COVID.gov
• CDC Isolation and Precautions for People with COVID-19
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker
• CDC will report regional-level test positivity data from the National Respiratory and Enteric Virus Surveillance System (NREVSS)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• (Delaware) General Questions: call 211 or email DPHCall@delaware.gov or Vaccine@delaware.gov for vaccine-specific questions.
• Latest information on Delaware's response (testing, treatment, vaccination): de.gov/coronavirus (Updated 2/2023)